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Sample records for evaluate treatment results

  1. Quantitative method for evaluation of aesthetic results after laser treatment for birthmarks.

    Science.gov (United States)

    Szychta, Pawel; Al-Nakib, Khalil; Anderson, Will; Stewart, Ken; Quaba, Awf

    2013-11-01

    Subjective assessment of results after laser treatment for birthmarks does not provide a validated method for clinicians. Previous reports concerning objective evaluation using L*a*b color coordinates were only partially successful due to difficulties in standardizing and comparing colors from pre- and posttreatment photographs. The study aimed to present a reliable and clinically applicable method of aesthetic result assessment after laser treatment for birthmarks. All 48 patients, included in the study, were treated for birthmarks on the face or neck using laser. Each pre- and posttreatment photograph was subjected to triple objective comparative assessment of color fading with use of a computer program, as well as to subjective evaluation by three core physicians and three laypeople. Objective analysis was based on an innovative method using combined L*a*b and hue saturation value color coordinates. Accuracy was higher between objective assessment with the computer program and subjective evaluation by core physicians than by laypeople. Repeatability of results was higher with the use of the computer program than among core physicians or among laypeople. In conclusion, our method may be considered for objective assessment of the results after laser treatment of vascular and pigmented birthmarks.

  2. An evaluation of culture results during treatment for tuberculosis as surrogate endpoints for treatment failure and relapse.

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    Patrick P J Phillips

    Full Text Available It is widely acknowledged that new regimens are urgently needed for the treatment of tuberculosis. The primary endpoint in the Phase III trials is a composite outcome of failure at the end of treatment or relapse after stopping treatment. Such trials are usually both long and expensive. Valid surrogate endpoints measured during or at the end of treatment could dramatically reduce both the time and cost of assessing the effectiveness of new regimens. The objective of this study was to evaluate sputum culture results on solid media during treatment as surrogate endpoints for poor outcome. Data were obtained from twelve randomised controlled trials conducted by the British Medical Research Council in the 1970s and 80s in East Africa and East Asia, consisting of 6974 participants and 49 different treatment regimens. The month two culture result was shown to be a poor surrogate in East Africa but a good surrogate in Hong Kong. In contrast, the month three culture was a good surrogate in trials conducted in East Africa but not in Hong Kong. As well as differences in location, ethnicity and probable strain of Mycobacteria tuberculosis, Hong Kong trials more often evaluated regimens with rifampicin throughout and intermittent regimens, and patients in East African trials more often presented with extensive cavitation and were slower to convert to culture negative during treatment. An endpoint that is a summary measure of the longitudinal profile of culture results over time or that is able to detect the presence of M. tuberculosis later in treatment is more likely to be a better endpoint for a phase II trial than a culture result at a single time point and may prove to be an acceptable surrogate. More data are needed before any endpoint can be used as a surrogate in a confirmatory phase III trial.

  3. Evaluation of the results from non-arthroplastic treatment (arthroscopy) for shoulder arthrosis☆

    Science.gov (United States)

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; da Silva, Luciana Andrade; do Val Sella, Guilherme; Garotti, José Eduardo Rosseto; Checchia, Sergio Luiz

    2015-01-01

    Objectives To evaluate the functional results from patients with arthrosis who underwent an arthroscopic procedure, in an attempt to correlate these results with the patients’ epidemiological profile, surgical technique used, possible complications and postoperative protocol. Methods Between 1998 and 2011, 31 patients (32 shoulders) with shoulder arthrosis underwent arthroscopic treatment performed by the Shoulder and Elbow Group of the Department of Orthopedics and Traumatology of Santa Casa de São Paulo. Primary or secondary cases of shoulder arthrosis under the age of 70 years, in which the rotator cuff was intact, were included. Furthermore, cases in which, despite an indication for an arthroplastic procedure, an attempt to perform an alternative procedure had been chosen, were also included. The following were evaluated: sex, age, dominance, comorbidities, length of time with complaint, associated lesions, etiology, previous treatment, operation performed, postoperative protocol and pre and postoperative active ranges of motion. The functional evaluation was conducted using the UCLA criteria, before and after the operation. The joint cartilage alterations were classified in accordance with Outerbridge and the arthrosis by means of Walch. Results There were statistically significant mean differences in the values for elevation, lateral rotation and medial rotation from before to after the operation (p < 0.001) and there was a tendency (p = 0.057) toward poor results with greater length of time with complaints before the surgery. The total gain in UCLA score did not have any statistically significant relationship with any of the other variables analyzed. Conclusion Arthroscopic treatment of glenohumeral arthrosis provided functional improvement of the glenohumeral joint, with significant gains in elevation and lateral and medial rotation, and improvements in function and pain. Greater length of time with complaints was a factor strongly suggestive of

  4. Evaluation of the results from non-arthroplastic treatment (arthroscopy for shoulder arthrosis

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    Alberto Naoki Miyazaki

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVES: To evaluate the functional results from patients with arthrosis who underwent an arthroscopic procedure, in an attempt to correlate these results with the patients' epidemiological profile, surgical technique used, possible complications and postoperative protocol. METHODS: Between 1998 and 2011, 31 patients (32 shoulders with shoulder arthrosis underwent arthroscopic treatment performed by the Shoulder and Elbow Group of the Department of Orthopedics and Traumatology of Santa Casa de São Paulo. Primary or secondary cases of shoulder arthrosis under the age of 70 years, in which the rotator cuff was intact, were included. Furthermore, cases in which, despite an indication for an arthroplastic procedure, an attempt to perform an alternative procedure had been chosen, were also included. The following were evaluated: sex, age, dominance, comorbidities, length of time with complaint, associated lesions, etiology, previous treatment, operation performed, postoperative protocol and pre and postoperative active ranges of motion. The functional evaluation was conducted using the UCLA criteria, before and after the operation. The joint cartilage alterations were classified in accordance with Outerbridge and the arthrosis by means of Walch. RESULTS: There were statistically significant mean differences in the values for elevation, lateral rotation and medial rotation from before to after the operation ( p< 0.001 and there was a tendency ( p= 0.057 toward poor results with greater length of time with complaints before the surgery. The total gain in UCLA score did not have any statistically significant relationship with any of the other variables analyzed. CONCLUSION: Arthroscopic treatment of glenohumeral arthrosis provided functional improvement of the glenohumeral joint, with significant gains in elevation and lateral and medial rotation, and improvements in function and pain. Greater length of time with complaints was a factor

  5. How you evaluate treatment results in low back pain patients depends on who the patient is

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein

    2008-01-01

    How you evaluate treatment results in low back pain patients depends on who the patient is Lauridsen, HH 1*, Hartvigsen, J1,2, Manniche, C1,3, Korsholm, L1,4, Grunnet-Nilsson, N1 1.    Clinical Locomotion Science, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark...... pain subscales of the SF36, the Low Back Pain Rating Scale (LBPRS) and a numerical rating scale for pain (0-10) were completed by 191 patients from the primary and secondary sectors of the Danish health care system. Clinical change was estimated using a 7-point transition question and a numeric rating...... of an evaluative instrument in back pain patients is complicated because of lack of head-to-head comparisons of clinimetric properties of the various instruments. In addition, little is known about instrument behaviour in clinical subgroups. The objective of this study was to concurrently compare responsiveness...

  6. Evaluation of bronchoscopic lung volume reduction coil treatment results in patients with severe emphysema.

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    Gulsen, Askin; Sever, Fidan; Girgin, Pelin; Tamci, Necdet Batuhan; Yilmaz, Hatice

    2017-09-01

    Bronchoscopic lung volume reduction coil (BLVR-C) implantation is an alternative therapeutic approach that can be applied together with medical treatment for patients with severe emphysema. BLVR-C is both easier and safer in terms of complications than volume reduction surgery. This study aimed to evaluate medium-term outcomes following BLVR-C treatment. Forty patients who underwent BLVR-C between September 2013 and March 2014 were reviewed retrospectively. We compared changes between the baseline and 6-month post-procedural results with respect to pulmonary function tests, a 6-min walk test (6MWT), chronic obstructive pulmonary disease (COPD) assessment test (CAT), St. George's Respiratory Questionnaire (SGRQ), and pulmonary artery pressure (PAP) and arterial blood gas analyses. Secondary outcomes included procedure-related and follow-up complications. An average of 9.5 (range: 5-11) coils were placed per lung in an average procedural duration of 20.8 ± 7.0 min (range: 9-45) min. Six months after BLVR-C treatment, significant improvements were observed in patients' pulmonary function tests and quality of life. Changes were observed in the forced exhalation volume in 1 s (+150 mL), residual volume (-14.5%), 6MWT (+48 m), SGRQ (-10.5) and CAT Score (-7.5). Changes in the PAP and partial pressure of carbon dioxide values were not significant, and pneumothorax did not occur. In a 6-month follow-up, 11 cases of COPD exacerbation (41.4%), 7 cases of pneumonia (16.9%) and 1 death (2%) occurred. Treatment in 1 case was postponed because of hypotension and bradycardia during the process. BLVR-C treatment appears to be effective over the medium-term and safe for patients with severe emphysema. © 2015 John Wiley & Sons Ltd.

  7. Evaluation of treatment results of patients with Dupuytren's contracture--our clinical experience.

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    Kobus, Kazimierz; Wójcicki, Piotr; Dydymski, Tomasz; Wegrzyn, Marek; Hamlawi, Fahed

    2007-01-01

    Dupuytren's contracture is a common condition leading to impairment of the function of the hand which affects from 2 to 12 % of the population, mainly males, and presents as progressive contracture of fingers caused by shortening of the palmar aponeurosis. The objective of the work was to present our own approach to managing Dupuytren's disease and evaluate treatment results in patients with hypertrophy of the palmar aponeurosis. Material and method 288 patients with Dupuytren's disease were treated at the Plastic Surgery Hospital in Polanica Zdroj over a period of 25 years (1977-2002). The present paper is a retrospective analysis of treatment results in 253 patients for whom complete medical documentation was available. All patients were operated in local anaesthesia in ischemia. A Bunnell flap skin incision was followed by a fasciectomy of the hypertrophied segment of the palmar aponeurosis. The skin wound was closed using V-Y plasty. Postoperative management involved hand elevation and early rehabilitation. Results Restoration of the full range of motion and total extension in the MP joint and the interphalangeal joints were achieved in 70% and 68% of patients, respectively. Of 145 patients who were professionally active, 132 were able to return to work. Finger amputation was necessary in 2 patients, one patient suffered from arthrodesis and two other developed skin necrosis which was removed with the wound closed by skin grafts. A follow-up examination 6 months after the operation revealed a recurrence in 8 patients and deterioration of hand dexterity with finger stiffness in 4. Conclusions A low complication rate and good treatment results are arguments in favour of the approach adopted at our hospital, i.e. surgery in local anaesthesia in ischemia with compressive bandaging, using a Bunnell flap skin incision followed by radical fasciectomy and V-Y plasty.

  8. Evaluation of the results from surgical treatment of the terrible triad of the elbow,

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    Alberto Naoki Miyazaki

    2014-06-01

    Full Text Available OBJECTIVE: to evaluate the results from surgical treatment of the terrible triad of the elbow (fracture of the radial head, fracture of the coronoid process and elbow dislocation and its complications.METHODS: between August 2002 and August 2010, 15 patients (15 elbows with the terrible triad were treated by the Shoulder and Elbow Group of the Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo. Nine (60% were male and six (40% were female; their ages ranged from 21 to 66 years, with a mean of 41 years. With the exception of one case that underwent arthroscopic surgery, all the patients underwent open surgery. The fracture of the coronoid process was fixed in 10 patients (66.7%. The fracture of the radial head was treated by means of internal osteosynthesis in 11 cases (73.3%; in three cases (20%, the radial head was resected; and in one case, only the fragment of the fracture was resected. The collateral ligaments, except for one case, were repaired whenever they were found to be injured; ten cases (66.7% of medial collateral injury and 15 (100% of lateral collateral injury were found. The mean length of the postoperative follow-up was 62 months, with a minimum of 12 months. The postoperative evaluation was done by means of the Bruce score.RESULTS: more than 80% of the patients recovered their functional ranges of motion but, according to the Bruce score, only 26% of the patients achieved results that were considered satisfactory.CONCLUSION: despite the unsatisfactory results, the functional ranges of motion and elbow function could be restored.

  9. Evaluation of postoperative results from videoarthroscopic treatment for recurrent shoulder dislocation using metal anchors

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    Éder Menegassi Martel

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To clinically and radiologically evaluate the results from videoarthroscopic treatment using metal anchors in patients with recurrent shoulder dislocation and its complications. METHODS: This was a retrospective study on 47 patients (47 shoulders operated by the shoulder group of the orthopedic hospital between February 2010 and February 2012. A questionnaire, interview and physical and radiographic examinations were used, with the classification of Samilson and Pietro. The mean postoperative follow-up was 33 months (range 12-47 months. The statistical analysis consisted of using Fisher's exact test through the IBM SPSS 22 statistical software. The significance level used was 5%. RESULTS: Recurrence was observed in nine cases. The patients were, on average, 26.5 years old at the first episode, and 19.1% were aged 20 years or under. Among these, 55.6% presented recurrence. In relation to age at the time of the surgical procedure, the average age was 27 years, and 12.8% were aged 20 years or under. Nineteen patients presented prominent anchors and, of these, 21% manifested arthrosis. CONCLUSION: There was a statistically identified correlation between the recurrence rate and age less than or equal to 20 years at the times of first dislocation and the surgical procedure. Further studies should be conducted in order to compare the use of absorbable anchors, which despite higher cost, may provide lower risk of developing glenohumeral arthrosis in some cases.

  10. [The results of the pharmacological treatment of attention deficit hyperactivity disorder: evaluation with neuropsychological methods].

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    Zavadenko, N N; Suvorinova, N Iu

    2014-01-01

    To investigate the dynamics of behavioral indicators, attention and memory in children with attention deficit hyperactivity disorder (ADHD) treated with noofen (capsules 250 mg). In an open study, 50 patients were randomized to 2 equal groups: patients of group 1 were treated with noofen (15-20 mg/kg (500-700 mg) per day perorally in 2-3 doses); the control group received low doses of multivitamins. Duration of treatment was one month. The results of neuropsychological testing revealed the improvement of cognitive functions, including the indicators of self-control, sustained, directed and divided attention, acoustic-verbal memory, to the end of treatment. The initial positive changes may be the basis for obtaining better clinical results during long-term treatment.

  11. Retrospective radiographic evaluation of treatment results of developmental dysplasia of the hip in walking-age children

    NARCIS (Netherlands)

    Heesakkers, N.A.M.; Witbreuk, M.M.E.H.; Besselaar, P.P.; van der Sluijs, J.A.

    2013-01-01

    We evaluated treatment results of 22 children (32 hips) with idiopathic hip dislocation after walking age in two Dutch academic hospitals. The Tönnis classification was used preoperatively. Outcome was measured using the Severin and Kalamchi classification. The mean age at treatment was 24 months

  12. Results from a Multi-Modal Program Evaluation of a Four Year Statewide Juvenile Sex Offender Treatment and Reentry Program

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    Underwood, Lee A.; Dailey, Frances L. L.; Merino, Carrie; Crump, Yolanda

    2015-01-01

    The results of the Program Evaluation show the OJJ Statewide Sex Offender Treatment program is exceptionally productive in meeting over 90% of its established performance markers. These markers included successful screening and assessment of risk and psychosocial needs, completion of initial and master treatment plans, establishment of sex…

  13. Examination of the properties of IMRT and VMAT beams and evaluation against pre-treatment quality assurance results.

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    Crowe, S B; Kairn, T; Middlebrook, N; Sutherland, B; Hill, B; Kenny, J; Langton, C M; Trapp, J V

    2015-03-21

    This study aimed to provide a detailed evaluation and comparison of a range of modulated beam evaluation metrics, in terms of their correlation with QA testing results and their variation between treatment sites, for a large number of treatments. Ten metrics including the modulation index (MI), fluence map complexity, modulation complexity score (MCS), mean aperture displacement (MAD) and small aperture score (SAS) were evaluated for 546 beams from 122 intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) treatment plans targeting the anus, rectum, endometrium, brain, head and neck and prostate. The calculated sets of metrics were evaluated in terms of their relationships to each other and their correlation with the results of electronic portal imaging based quality assurance (QA) evaluations of the treatment beams. Evaluation of the MI, MAD and SAS suggested that beams used in treatments of the anus, rectum, head and neck were more complex than the prostate and brain treatment beams. Seven of the ten beam complexity metrics were found to be strongly correlated with the results from QA testing of the IMRT beams (p beams with 100% specificity. However, few of the metrics are correlated with the results from QA testing of the VMAT beams, whether they were evaluated as whole 360° arcs or as 60° sub-arcs. Select evaluation of beam complexity metrics (at least MI, MCS and SAS) is therefore recommended, as an intermediate step in the IMRT QA chain. Such evaluation may also be useful as a means of periodically reviewing VMAT planning or optimiser performance.

  14. A 5-year Evaluation and Results of Treatment of Chronic Llocked Dislocations of the Shoulder Joint

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    Syawash Mirsaid Ghazi

    2008-11-01

    Full Text Available Background:Chronic neglected dislocation of the shoulder joint can be defined as a neglected dislocation for more than a 3 week period.However, it has been shown that the negligence could range from a 24 hour period to 6 months1. Depending on age,signs, symptoms,etiology and types of dislocation, conservative treatment or surgical intervention could be considered.Methods: In this study, 16 patients (13 were male and 3 were female were treated with chronic shoulder dislocations, 3 of which had bilateral dislocations. The age of this group ranged from 13-65 years with a mean age of 34 years. These patients were treated by closed or open reduction, either anterior, posterior or both approaches. Of 19 dislocations, 6 were anterior unilateral, 7 posterior unilateral, 1 anterior bilateral and 2 posterior bilateral dislocations. The mean period between dislocations and treatments was 3 months (from 4 weeks to 11 months,And the mean follow up period was 40 months (from 21 months to 5 years.Results: This study has shown that treatment varies according to pathology. In  this study the mean size of head defects was 35% and the extent of severity determined the approach. Findings at the last follow up were assessed according to Rowe and Zarins score and of the 19 shoulders assessed, 9 showed good and 10 showed excellent results. There was no recurrence of the dislocation in any patient.Conclusion:In some selected instances, open reduction of a chronic locked neglected shoulder dislocation of a 6 months period or more in young patients is recommended.This method is, however, contraindicated in elderly patients; in such cases a shoulder prosthesis is indicated.  

  15. Evaluation of remission of temporomandibular joints pain as a result of treatment of dysfunction using intraarticular injection.

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    Pihut, Małgorzata; Górecka, Małgorzata; Ceranowicz, Piotr

    2017-01-01

    The temporomandibular joint pain, which occurs in the course of temporomandibular joint dysfunction, is one of the main clinical problems in the treatment of joint disc displacement. The aim of the study was to evaluate changes in temporomandibular joints pain in treatment supporting disc displacement without reduction using intra-articular injection of hyaluronic acid and platelet-rich plasma. The study consisted of a group of 60 patients, aged 35-49, who reported for treatment, because of pain in the preauricural area. The functional examination stated disk dicplacement without reduction, along with the accompanying pain of temporomandibular joints. Patients were treated between January 2015 and February 2017. They were divided into two groups of 30 persons. The intraarticular injection of hyaluronic acid was administered in the I-test group, and the injection of platelet-rich plasma in the control group. This treatment was carried out parallel to the use of repositioning splits. Analysis of regression of symptoms other than intensity of pain during the treatment, evaluated in this study shows a decrease of individual symptoms, but the results of the regression of pain between two groups did not differ statistically significantly, because "p" is bigger than 0.05. The results of the research show the clinical benefits of application of hyaluronic acid and plate rich plasma in the treatment of temporomandibular joint dysfunction.

  16. How you evaluate treatment results in low back pain patients depends on who the patient is

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein

    2009-01-01

    ), the physical function and bodily pain subscales of the SF36, the Low Back Pain Rating Scale (LBPRS) and a numerical rating scale for pain (0-10) were completed by 191 patients from the primary and secondary sectors of the Danish health care system. Clinical change was estimated using a 7-point transition......Background The choice of an evaluative instrument in back pain patients is complicated because of lack of head-to-head comparisons of clinimetric properties of the various instruments. In addition, little is known about instrument behaviour in clinical subgroups. The objective of this study...... was to concurrently compare responsiveness and minimal clinically important differences (MCID) for commonly used pain scales and functional instruments in four subpopulations of LBP patients. Methods The Danish versions of the Oswestry Disability Index (ODI), the 23-item Roland Morris Disability Questionnaire (RMQ...

  17. Evaluation of the results of operative treatment of hip dysplasia in ...

    African Journals Online (AJOL)

    Methods: The study included 35 patients (42 hips), they had been treated by different combinations of open reduction, femoral (shortening, derotation and varus) and pelvic (Salter or Dega) osteotomy. The age at the time of the operation ranged from 18 to 96 months. Results: At the end of follow-up (a mean of 33.5 months), ...

  18. Delayed Presentation of Traumatic Diaphragmatic Hernia: The Evaluation of Surgical Treatment Results

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    Ali Sadrizadeh

    2015-06-01

    Full Text Available Introduction: Diaphragmatic hernia could be caused by congenital disorders, blunt trauma or penetrating injuries. The diagnosis of traumatic diaphragmatic hernia is normally neglected during the first presentation leading to late complications and considerably increased mortality and morbidity among the patients. Materials and Methods: In this retrospective, descriptive study, we reviewed the medical records of patients presented with traumatic diaphragmatic hernia who had undergone surgical operations between 1982-2015 in Ghaem Hospital and Omid Hospital affiliated to Mashhad University of Medical Sciences, Iran. The studied variables included age, gender, clinical symptoms, location of hernia, involved organs, type of imaging modalities, surgical techniques, length of hospital stay, mortality rate and surgical complications. Results: In this study, 38 patients were diagnosed with traumatic diaphragmatic hernia consisting of 28 men and 10 women. In total, 79% and 21% of the patients suffered from penetrating trauma and blunt trauma, respectively. In addition, left-sided, right-sided and bilateral hernias were present in 33%, 4% and 1% of the patients, respectively. The most frequently herniated organ was the stomach, and the most common clinical symptoms were abdominal pain (84% and dyspnea (53%. Initially, chest radiographs were performed on all the patients, and thoracotomy was performed to repair diaphragmatic tears in all the cases (100%. In this study, 3 patients had previously undergone Hartmann’s operation for gangrenous herniated colon, and devolvulation of gastric volvulus had also been performed on 3 patients. The main post-operative complications were reported to be pneumonia and respiratory insufficiency (2 cases, and the mean length of hospital stay was 6 days (5-8 days which was longer (1-2 months in patients with gangrenous bowel (3 patients. Furthermore, no mortality was reported during the course of hospitalization in these

  19. Evaluation of the results from arthroscopic surgical treatment of rotator cuff injuries in patients aged 65 years and over

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    Alberto Naoki Miyazaki

    2015-06-01

    Full Text Available OBJECTIVES: To evaluate the results from arthroscopic surgical treatment of rotator cuff injuries in patients aged 65 years and over.METHODS: Between 1998 and 2009, 168 patients underwent operations. Five cases were excluded. The remaining 163 patients were stratified according to their age group: 65-69 years (49.1%, 70-74 (26.4% and 75 years and over (24.5%. Their mean age was 71 years (range: 65-83. There were 63 male patients (38.7%. The mean length of time with pain, from the onset of symptoms to the surgery, was 23 months (range: 2 days to 240 months. Sixty-two patients (38% reported histories of trauma and 26 (16% reported that their pain worsened through exertion.RESULTS: From the UCLA criteria, 80.4% of the results were excellent, 16% good, 1.8% fair and 1.8% poor. Complications occurred in 11%. The final clinical result did not show any correlation with age progression, injury size or tendons affected. However, there was a significant association (p < 0.001 between the presence of trauma and larger injuries. The length of time between the onset of symptoms and the surgical procedure had a significant relationship (p < 0.027 with the postoperative results: the longer this time was, the worse the results were.CONCLUSION: Arthroscopic treatment of rotator cuff injuries in patients aged 65 years and over presented excellent and good results in 96.4% of the cases, according to the UCLA assessment, with a low complication rate. Advanced age did not show any influence on the postoperative clinical evolution, but the earlier the surgical treatment was instituted, the better the results were.

  20. Divertículo faringoesofagiano: avaliação dos resultados do tratamento Pharyngoesophageal diverticulum: evaluation of treatment results

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    Maria Aparecida Coelho de Arruda Henry

    2013-04-01

    Full Text Available OBJETIVO: Avaliar a evolução pós-operatória de pacientes com divertículo faringoesofagiano submetidos aos tratamentos cirúrgico e endoscópico. MÉTODOS: Foram analisados de maneira retrospectiva 36 pacientes com divertículo faringo-esofagiano atendidos no Hospital das Clínicas da Faculdade de Medicina de Botucatu - UNESP. Os pacientes foram distribuídos em dois grupos, na dependência do tratamento: grupo 1 (n=24 - diverticulectomia associada á miotomia do cricofaríngeo, através de cervicotomia esquerda; grupo 2 (n=12 - diverticulostomia endoscópica usando grampeador linear. RESULTADOS: A mortalidade operatória foi nula em ambos os grupos. Complicações precoces: grupo 1 - dois pacientes desenvolveram fistula cervical e outros dois, rouquidão; grupo 2 - sem complicações. Complicações tardias: grupo 1 - sem complicações: grupo 2: recidiva da disfagia em quatro pacientes (p=0,01. O seguimento médio foi 33 meses para o grupo 1 e 28 meses para o grupo 2. CONCLUSÃO: Os dois procedimentos foram eficazes na remissão da disfagia. O tratamento cirúrgico apresentou superioridade em relação ao endoscópico, com resolução da disfagia com um único procedimento. O tratamento endoscópico deve ser reservado para os mais idosos e portadores de comorbidades.OBJECTIVE: To evaluate the postoperative outcome of patients with pharyngoesophageal diverticulum submitted to surgical and endoscopic treatments. METHODS: We retrospectively analyzed 36 patients with pharyngo-esophageal diverticulum treated at the Hospital of the Medical School of Botucatu - UNESP. Patients were divided into two groups, depending on the treatment: group 1 (n = 24: diverticulectomy associated myotomy through a left cervicotomy; group 2 (n = 12: endoscopic diverticulostomy with linear stapler. RESULTS: Operative mortality was zero in both groups. Early complications: group 1- two patients developed cervical fistula and two, hoarseness; group 2 - none. Late

  1. Evaluation of remote results of treatment of children with long-bone fractures of the lower extremities

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    Aleksander A Patlatov

    2016-09-01

    Full Text Available Background. Evaluation of the effectiveness of treatment of long-bone fractures of the lower extremities should be comprehensive and include both subjective and objective indicators. In the developed countires, it is standard to assess the quality of life related to children’s health after trauma. According to the Russian literature, such assessment has not been studied. The aim of our study was to assess the quality of life in children, with long-bone fractures of the lower extremities, and to compare the results with data from the Lower Extremity Functional Scale (LEFS and assessment system according to N.B. Duysenov. Materials and methods. We examined 70 patients (age range, 8–18 years with long-bone fractures of the lower extremities. Forty patients had a history of tibia fracture, and 30 patients had a history of femoral fracture. We determined the severity of the fractures using pediatric comprehensive classification of long-bone fractures (PCCF. We assessed the quality of life of the children using the Pediatric Questionnaire for Quality of Life  (PedsQLTM 4.0. Results. Trauma had a significant impact on the quality of life in children. The children evaluated their quality of life after injury more objectively; on all scales, their scores had the highest correlation with LEFS and assessment system according to N.B Duysenov. In most cases, parents underestimated the mental and physical burden of their child’s condition after injury. The values for the “physical functioning” assessment in children with severe trauma was the lowest, and was not significantly different between parents and children. Parents who were aware of the severity of the injury gave their child more attention, which positively affected the child’s psychological and social functioning. Children with severe trauma had higher values on the emotional, social and role functioning scale, compared to children with minor  injuries. Conclusions. The results of

  2. Treatment Deployment Evaluation Tool

    Energy Technology Data Exchange (ETDEWEB)

    Rynearson, Michael Ardel; Plum, Martin Michael

    1999-08-01

    The U.S. Department of Energy (DOE) is responsible for the final disposition of legacy spent nuclear fuel (SNF). As a response, DOE's National Spent Nuclear Fuel Program (NSNFP) has been given the responsibility for the disposition of DOE -owned SNF. Many treatment technologies have been identified to treat some forms of SNF so that the resulting treated product is acceptable by the disposition site. One of these promising treatment processes is the electrometallurgical treatment (EMT) currently in development; a second is an Acid Wash Decladding process. The NSNFP has been tasked with identifying possible strategies for the deployment of these treatment processes in the event that the treatment path is deemed necessary. To support the siting studies of these strategies, economic evaluations are being performed to identify the least-cost deployment path. This model (tool) was developed to consider the full scope of costs, technical feasibility, process material disposition, and schedule attributes over the life of each deployment alternative. Using standard personal computer (PC) software, the model was developed as a comprehensive technology economic assessment tool using a Life-Cycle Cost (LCC) analysis methodology. Model development was planned as a systematic, iterative process of identifying and bounding the required activities to dispose of SNF. To support the evaluation process, activities are decomposed into lower level, easier to estimate activities. Sensitivity studies can then be performed on these activities, defining cost issues and testing results against the originally stated problem.

  3. Treatment Deployment Evaluation Tool

    Energy Technology Data Exchange (ETDEWEB)

    M. A. Rynearson; M. M. Plum

    1999-08-01

    The U.S. Department of Energy (DOE) is responsible for the final disposition of legacy spent nuclear fuel (SNF). As a response, DOE's National Spent Nuclear Fuel Program (NSNFP) has been given the responsibility for the disposition of DOE-owned SNF. Many treatment technologies have been identified to treat some forms of SNF so that the resulting treated product is acceptable by the disposition site. One of these promising treatment processes is the electrometallurgical treatment (EMT) currently in development; a second is an Acid Wash Decladding process. The NSNFP has been tasked with identifying possible strategies for the deployment of these treatment processes in the event that a treatment path is deemed necessary. To support the siting studies of these strategies, economic evaluations are being performed to identify the least-cost deployment path. This model (tool) was developed to consider the full scope of costs, technical feasibility, process material disposition, and schedule attributes over the life of each deployment alternative. Using standard personal computer (PC) software, the model was developed as a comprehensive technology economic assessment tool using a Life-Cycle Cost (LCC) analysis methodology. Model development was planned as a systematic, iterative process of identifying and bounding the required activities to dispose of SNF. To support the evaluation process, activities are decomposed into lower level, easier to estimate activities. Sensitivity studies can then be performed on these activities, defining cost issues and testing results against the originally stated problem.

  4. [Treatment of proximal humeral fractures by reverse shoulder arthroplasty: mid-term evaluation of functional results and Notching].

    Science.gov (United States)

    Hernández-Elena, J; de la Red-Gallego, M Á; Garcés-Zarzalejo, C; Pascual-Carra, M A; Pérez-Aguilar, M D; Rodríguez-López, T; Alfonso-Fernández, A; Pérez-Núñez, M I

    2015-01-01

    An analysis was made on relationship between Notching and functional and radiographic parameters after treatment of acute proximal humeral fractures with reverse total shoulder arthroplasty. A retrospective evaluation was performed on 37 patients with acute proximal humeral fracture treated by reversed shoulder arthroplasty. The mean follow-up was 24 months. Range of motion, intraoperative and postoperative complications were recorded. Nerot's classification was used to evaluate Notching. Patient satisfaction was evaluated with the Constant Score (CS). Statistical analysis was performed to evaluate the relationship between Notching and glenosphere position, or functional outcomes. Mean range of elevation, abduction, external and internal rotation were 106.22°, 104.46°, 46.08° and 40.27°, respectively. Mean CS was 63. Notching was present at 12 months in 29% of patients. Statistical analysis showed significance differences between age and CS, age and notching development, and tilt with notching. No statistical significance differences were found between elevation, abduction, internal and external rotation and CS either with scapular or glenosphere-neck angle. Reverse shoulder arthroplasty is a valuable option for acute humeral fractures in patients with osteoporosis and cuff-tear arthropathy. It leads to early pain relief and shoulder motion. Nevertheless, it is not exempt from complications, and long-term studies are needed to determine the importance of notching. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  5. Evaluation and Treatment Results of Ovarian Cysts in Childhood and Adolescence: A Multicenter, Retrospective Study of 100 Patients.

    Science.gov (United States)

    Aydin, Banu Kucukemre; Saka, Nurcin; Bas, Firdevs; Yilmaz, Yasin; Haliloglu, Belma; Guran, Tulay; Turan, Serap; Bereket, Abdullah; Yesiltepe Mutlu, Gul; Cizmecioglu, Filiz; Hatun, Sukru; Bezen, Digdem; Tutunculer, Filiz; Cebeci, Nurcan; Isguven, Pinar; Memioglu, Nihal; Ercan, Oya; Poyrazoglu, Sukran; Bundak, Rüveyde; Darendeliler, Feyza

    2017-08-01

    To investigate the characteristics of children with ovarian cysts and evaluate treatment strategies. Retrospective study. Eight pediatric endocrinology clinics, Turkey. A total of 100 children and adolescents with ovarian cysts. Patient data collected via retrospective chart review. Patients were stratified according to age into 4 groups (newborns, 1-12 months, 1-8 years, and 8-18 years). Special emphasis was given to torsion and tumor cases, concomitant diseases, treatment modalities, and problems during follow-up. Most newborns and infants were asymptomatic with the cysts being discovered incidentally; in girls ages 1-8, symptoms were common, including breast budding (47.1%, 16 of 34) and vaginal bleeding (29.4%, 10 of 34). Girls older than 8 years mostly presented with abdominal pain (31.6%, 12 of 38) and menstrual irregularity (21.1%, 8 of 38). Most of our patients were diagnosed with a simple ovarian cyst, but 9 patients were found to have ovarian tumors. Ovarian torsion was detected in 7 patients; 5 with large and 2 with small cysts (<20 mm). Two patients had central precocious puberty (CPP) at presentation and 5 patients developed CPP during follow-up. The surgical intervention rate was high (38%, 38 of 100), but was associated with earlier treatment year, and this association remained significant after adjusting for confounders (P = .035). Most girls have simple cysts, which have a favorable prognosis without intervention; however, there might be coexisting pathologies or complications such as tumors, torsion, and CPP; hence these patients should be evaluated accordingly and treated with a multidisciplinary approach. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  6. [The ND-Yag laser in the treatment of non-resectable esophageal neoplasms: evaluation and results].

    Science.gov (United States)

    Tenchini, P; Breda, B; Montresor, E; Abrescia, F; Iacono, C; Angelini, G P; Puchetti, V

    1985-08-01

    The Authors show a set of 9 cases of patients suffering from oesophagus flaky carcinoma, judged radically non-operable, and treated with endoscopic laser-therapy by N.D. Yag Laser. They illustrate the patients' main clinical data, method followed, complications observed and results obtained. What seems to emerge from the analysis of the data is: the effectiveness of laser-therapy in the control of disphagia, simplicity of the technique and its acceptability by the patient, as well as the rareness of complications. Three are the clinical parameters used for the checking of patients before and after the laser treatment: disphagia, odynophagia and thoracic ache. The intenseness of symptoms was classed from 0 up to 3. Before the treatment, six patients out of nine showed class 3 disphagia; after the treatment, two could assume fluids (class 2), two fed also on minced foods (class 1), and two fed normally; in the two cases with initial class 2 disphagia a normal feed could be adopted; in one case no initial disphagia was present. Odynophagia was initially present in one case only at class 3, in three cases at class 1, and in all the other cases it was absent (0). After the treatment, odynophagia disappeared totally, except in one class 1 case, which remained unchanged. The presence of thoracic ache before the treatment was class 1 in four cases, class 3 in one case, and absent in four cases. After the treatment, the class 3 ache turned into class 1: in one class 1 case it was not modified; in the remaining cases the ache, if present, disappeared. Some questions remain opened, concerning the effect on survival, even in relation to other palliative methods, to the duration of the palliation obtained and to the eventual associability of lasertherapy to radiotherapy.

  7. Evaluation of Toxicological Analysis Results and Treatment Applications in Cases Registered for Drug Addiction at Parole Branch office of Trabzon

    Directory of Open Access Journals (Sweden)

    Hülya Karadeniz

    2009-08-01

    Full Text Available Substance use, increased rapidly all over the world and our country become a very important social problem, to take legal measures were made compulsory parole is the conditional release of a prison inmate after serving part (if not all of his or her sentence, allowing the inmate to live in the community under supervision of the parole period. Parole and Aid Centers, which were put in effect by Ministry of Justice in the context of membership process of EU, set up as a social service on 20 July 2005 with a law which went into effect after being published in Official Gazette. At this study, 201 (47.2% cases, which contained drug addiction were examined out of 425 cases in total, which were registered to Branch Directorate of Trabzon Parole between the dates of 21 December 2005 and 30 June 2008. The cases were grouped in terms of age, gender, education level, occupation, drugs used, treatment, and toxicological analysis results. The rates of drug using for men are 98.5% (n = 198, and for women 1.5% (n=3. The ages of cases were ranked between 17 and 64, the average age was found as 32.47 ± 10.55 years. The frequency of drug use is most in the age group of 27-36 (39.8%, n=80. As a result, parole application, which is rather new in Turkey, has puts on the agenda with a chance of being addictive were recovered to the society by being followed and treated. The reluctance of guilty people returning to the prison again, the effect on individual of being considered important by system, and illuminating information which were given by educator, and treatment performance indicate positive effect on the guilty. Key words: Parole, drug, addiction

  8. Evaluation of polyphenols-rich natural compounds as treatments to prevent attacks by subterranean and drywood termites: preliminary results

    Directory of Open Access Journals (Sweden)

    Lara Maistrello

    2011-08-01

    Full Text Available In the view to find sustainable methods to prevent termite attacks to wooden objects and structural timbers, this study represents a preliminary step in the evaluation of some natural substances considered as effective by some African popular traditions. Dark shea cake, obtained from the kernels of Vitellaria paradoxa (Sapotaceae, is the phase just before the extraction of shea (= karitè butter. In some West African regions, by-products from this extraction are traditionally believed to protect houses from termites. To verify if this practice has scientific basis, shea cake was used in experiments with both subterranean and drywood termites, respectively Reticulitermes lucifugus (Rossi (Rhinotermitidae and Kalotermes flavicollis (Fabricius (Kalotermitidae. As shea nuts are extremely rich in polyphenols, the trials included a comparison with tannins from chestnut (Castanea sativa. Short-term experiments to evaluate repellency and feeding deterrence of the two compounds were performed. Results showed differences in the behavior of the two termites species and that shea cake is significantly more repellent than chestnut tannins, especially for K. flavicollis. No feeding deterrence activity was detected for either substance for either termite species. Further investigation is currently being performed to better clarify how these compounds affect termite biology.

  9. [Neonatal orthopedic treatment of patients with congenital cleft lip and palate. 2. Clinical considerations and evaluation of results].

    Science.gov (United States)

    Diolaiti, C; Giuliani, R

    1990-01-01

    The Authors, after dealing with the evolution of this kind of therapy, illustrate the multidisciplinary protocol for the treatment of patients with cleft lip and palate and in particular they explain the technique used for the neonatal orthopedic treatment by analyzing its methods and purposes.

  10. Serelaxin as a potential treatment for renal dysfunction in cirrhosis: Preclinical evaluation and results of a randomized phase 2 trial.

    Directory of Open Access Journals (Sweden)

    Victoria K Snowdon

    2017-02-01

    Full Text Available Chronic liver scarring from any cause leads to cirrhosis, portal hypertension, and a progressive decline in renal blood flow and renal function. Extreme renal vasoconstriction characterizes hepatorenal syndrome, a functional and potentially reversible form of acute kidney injury in patients with advanced cirrhosis, but current therapy with systemic vasoconstrictors is ineffective in a substantial proportion of patients and is limited by ischemic adverse events. Serelaxin (recombinant human relaxin-2 is a peptide molecule with anti-fibrotic and vasoprotective properties that binds to relaxin family peptide receptor-1 (RXFP1 and has been shown to increase renal perfusion in healthy human volunteers. We hypothesized that serelaxin could ameliorate renal vasoconstriction and renal dysfunction in patients with cirrhosis and portal hypertension.To establish preclinical proof of concept, we developed two independent rat models of cirrhosis that were characterized by progressive reduction in renal blood flow and glomerular filtration rate and showed evidence of renal endothelial dysfunction. We then set out to further explore and validate our hypothesis in a phase 2 randomized open-label parallel-group study in male and female patients with alcohol-related cirrhosis and portal hypertension. Forty patients were randomized 1:1 to treatment with serelaxin intravenous (i.v. infusion (for 60 min at 80 μg/kg/d and then 60 min at 30 μg/kg/d or terlipressin (single 2-mg i.v. bolus, and the regional hemodynamic effects were quantified by phase contrast magnetic resonance angiography at baseline and after 120 min. The primary endpoint was the change from baseline in total renal artery blood flow. Therapeutic targeting of renal vasoconstriction with serelaxin in the rat models increased kidney perfusion, oxygenation, and function through reduction in renal vascular resistance, reversal of endothelial dysfunction, and increased activation of the AKT

  11. RESULTS OF ACUTE LYMPHOBLASTIC LEUKEMIA TREATMENT WITH INTENSIVE CHEMOTHERAPY IN CHILDREN IN ST.-PETERSBURG: RETROSPECTIVE EVALUATION OF TWO VERSIONS OF COALL-92 PROTOCOL

    Directory of Open Access Journals (Sweden)

    E.G. Boichenko

    2011-01-01

    Full Text Available Regardless the success gained in treatment of acute lymphoblastic leukaemia, several problems still remain to be solved, such as: overcoming primary drug resistance and minimizing the amount of relapses as well as decreasing of chemotherapy toxicity without detriment to the final outcome of the treatment. Development of an optimal chemotherapeutical strategy still remains a hot issue. Objective: to evaluate an efficacy of two modifications of German protocol COALL-92 in treatment of ALL in children in St.-Petersburg. Methods: the retrospective analysis of results of treatment in patients under 18 years old with ALL was performed. The diagnosis was confirmed according to international criteria. The treatment was performed via protocols PECO-92 and COALL-St.-Petersburg-92. Results: 438 initial patients with ALL were treated in St.-Petersburg clinics during the period from 01.01.1993 to 01.01.2007. At the time of analysis the probability of event-free survival (pEFS was 60% in group of PECO-92 protocol and 70% — in COALL group (plog-rank = 0,048, probability of relapse-free survival (рRFS was 65 and 74% (plog-rank = 0,002, probability of overall survival was (pOS 78 and 70%, correspondingly (plog-rank = 0,079. Conclusion: inclusion of protocol treatment in practice of St.-Petersburg hospitals resulted in significant improvement of treatment results in children with ALL. The problem of both versions of COALL protocol is high rate of postremission mortality due to high toxicity of intensive stage if chemotherapy.Key words: children, acute lymphoblastic leukemia, intensive chemotherapy.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3: 33–42

  12. Predictive value of early 18F-FDG PET/CT studies for treatment response evaluation to ipilimumab in metastatic melanoma: preliminary results of an ongoing study.

    Science.gov (United States)

    Sachpekidis, Christos; Larribere, Lionel; Pan, Leyun; Haberkorn, Uwe; Dimitrakopoulou-Strauss, Antonia; Hassel, Jessica C

    2015-03-01

    Ipilimumab is a newly approved immunotherapeutic agent that has been shown to provide a survival benefit in patients with metastatic melanoma. (18)F-FDG PET/CT has demonstrated very satisfying results in detecting melanoma metastases in general. Using (18)F-FDG PET/CT we monitored patients with metastatic melanoma undergoing ipilimumab therapy during the course of treatment. The aim of our study was to evaluate the role of (18)F-FDG PET/CT performed after two cycles of ipilimumab in predicting the final response to therapy. In 22 patients suffering from unresectable metastatic melanoma, scheduled for ipilimumab treatment PET/CT scanning was performed before the start of treatment (baseline scan), after two cycles of treatment (early response) and at the end of treatment after four cycles (late response). Evaluation of the patient response to treatment on PET was based on the European Organization for Research and Treatment of Cancer 1999 criteria. Progression-free survival (PFS) and overall survival (OS) data are presented. After the end of treatment, 15 patients were characterized as having progressive metabolic disease (PMD) and five as having stable metabolic disease (SMD), and two patients showed a partial metabolic response (PMR). Early PET/CT performed after two ipilimumab cycles predicted treatment response in 13 of the 15 PMD patients, in five of the five SMD patients and in neither of the two PMR patients. Both patients with PMR showed pseudoprogression after the second cycle and were therefore wrongly classified. According to the patients' clinical outcome, patients with late PMD had a median PFS of 3.6 months (mean 5.6 months), while patients with late SMD had a median PFS of 9.8 months (mean 9.0 months). In comparison, patients with early PMD had a median PFS of 2.7 months (mean 5.5 months) and patients with early SMD had a median PFS of 6.3 months (mean 7.5 months). The difference in PFS between the two groups was statistically significant for

  13. Evaluating shoulder instability treatment

    NARCIS (Netherlands)

    van der Linde, J.A.

    2016-01-01

    Shoulder instability common occurs. When treated nonoperatively, the resulting societal costs based on health care utilization and productivity losses are significant. Shoulder function can be evaluated using patient reported outcome measurements (PROMs). For shoulder instability, these include the

  14. Enuresis: evaluation and treatment.

    Science.gov (United States)

    Traisman, Edward S

    2015-04-01

    Enuresis is a common pediatric problem that creates a lot of stress for both the child and his/her family. Unfortunately, many of these patients do not seek medical attention for evaluation and treatment. It is important in the care of the child with enuresis to understand the definitions of the disorder, routinely ask about bowel and bladder habits, clarify the nature of the wetting (daytime, nighttime, or both) in the child, and perform a thorough history and physical examination. Laboratory studies are often minimal. Treatment (behavioral or medicinal) is dependent on the type of enuresis present, and patient compliance. Successful management of enuresis has benefits to both the child and family. Copyright 2015, SLACK Incorporated.

  15. METODO, a prospective observational study to assess the efficacy and tolerability of methadone in heroin-addicted patients undergoing a methadone maintenance treatment: preliminary results at baseline evaluation.

    Science.gov (United States)

    D'Egidio, Pietro Fausto; Bignamini, Emanuele; De Vivo, Enrico; Leonardi, Claudio; Pieri, Maria Chiara; González-Saiz, Francisco; Lucchini, Alfio

    2013-12-01

    METODO (methadone efficacy therapy optimization dosage on-going) is a prospective observational study to assess the efficacy and tolerability of methadone in 500 heroin-addicted patients taking a methadone maintenance treatment, enrolled through 2010 to 2011 in five Italian sites, observed over 2 years. The Opiate Dosage Adequacy Scale has been used for the evaluation of the "adequacy" of the methadone dosage and to stratify patients in adequate and not adequate groups. The treatment efficacy has been evaluated in correlation to the dosage adequacy during the visits. Moreover, patients have been evaluated according to the retention rate and duration of retention in treatment and a series of questionnaires.

  16. Predictive value of early {sup 18}F-FDG PET/CT studies for treatment response evaluation to ipilimumab in metastatic melanoma: preliminary results of an ongoing study

    Energy Technology Data Exchange (ETDEWEB)

    Sachpekidis, Christos; Pan, Leyun; Dimitrakopoulou-Strauss, Antonia [German Cancer Research Center, Clinical Cooperation Unit Nuclear Medicine, Heidelberg (Germany); Larribere, Lionel [German Cancer Research Center, Clinical Cooperation Unit Dermato-Oncology, Heidelberg (Germany); Haberkorn, Uwe [German Cancer Research Center, Clinical Cooperation Unit Nuclear Medicine, Heidelberg (Germany); University of Heidelberg, Division of Nuclear Medicine, Heidelberg (Germany); Hassel, Jessica C. [University Hospital Heidelberg, Skin Cancer Center, Department of Dermatology, Heidelberg (Germany); National Center for Tumor Diseases Heidelberg, Heidelberg (Germany)

    2014-10-31

    Ipilimumab is a newly approved immunotherapeutic agent that has been shown to provide a survival benefit in patients with metastatic melanoma. {sup 18}F-FDG PET/CT has demonstrated very satisfying results in detecting melanoma metastases in general. Using {sup 18}F-FDG PET/CT we monitored patients with metastatic melanoma undergoing ipilimumab therapy during the course of treatment. The aim of our study was to evaluate the role of {sup 18}F-FDG PET/CT performed after two cycles of ipilimumab in predicting the final response to therapy. In 22 patients suffering from unresectable metastatic melanoma, scheduled for ipilimumab treatment PET/CT scanning was performed before the start of treatment (baseline scan), after two cycles of treatment (early response) and at the end of treatment after four cycles (late response). Evaluation of the patient response to treatment on PET was based on the European Organization for Research and Treatment of Cancer 1999 criteria. Progression-free survival (PFS) and overall survival (OS) data are presented. After the end of treatment, 15 patients were characterized as having progressive metabolic disease (PMD) and five as having stable metabolic disease (SMD), and two patients showed a partial metabolic response (PMR). Early PET/CT performed after two ipilimumab cycles predicted treatment response in 13 of the 15 PMD patients, in five of the five SMD patients and in neither of the two PMR patients. Both patients with PMR showed pseudoprogression after the second cycle and were therefore wrongly classified. According to the patients' clinical outcome, patients with late PMD had a median PFS of 3.6 months (mean 5.6 months), while patients with late SMD had a median PFS of 9.8 months (mean 9.0 months). In comparison, patients with early PMD had a median PFS of 2.7 months (mean 5.5 months) and patients with early SMD had a median PFS of 6.3 months (mean 7.5 months). The difference in PFS between the two groups was statistically

  17. Results Evaluation in Reduction Rhinoplasty

    Directory of Open Access Journals (Sweden)

    Arima, Lisandra Megumi

    2011-01-01

    Full Text Available Introduction: Final results evaluation after rhinoplasty is a not a topic widely studied from the patient's viewpoint. Objective:Evaluate the satisfaction of the patients submitted to reduction rhinoplasty, from the questionnaire Rhinoplasty Outcomes Evaluation (ROE. Method: Longitudinal study, retrospective cut type, of the preoperative and postoperative satisfaction. The sample was composed by 28 patients who were submitted to rhinoplasty and answered the ROE questionnaire. Three variables were obtained: satisfaction note that the patient had with his/her image before the surgery; note of satisfaction with the current appearance; the difference of the average satisfaction notes between postoperative and preoperative approaches. Results: The postoperative note was higher than the preoperative in all patients. We noticed a difference between the average of the postoperative and preoperative of 48.3 (p75 considered to be an excellent outcome (67.9%. Conclusions: The ROE questionnaire is a helpful tool to show the satisfaction of the patient submitted to reduction rhinoplasty. About 92% of the patients submitted to reduction rhinoplasty consider the postoperative result to be good or excellent.

  18. Avaliação dos resultados do tratamento artroscópico da epicondilite lateral Evaluation of the results of arthroscopic treatment of the lateral epicondylitis

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2010-01-01

    Full Text Available OBJETIVO: Avaliar os resultados dos pacientes com epicondilite lateral tratados cirurgicamente pela técnica artroscópica. MÉTODOS: Vinte pacientes foram operados pela técnica artroscópica. A idade variou de 19 a 54 anos (média de 41 anos e oito meses, sendo 12 (60% pacientes do sexo feminino e oito (40%, do masculino. O seguimento mínimo foi de 12 meses e o máximo, de 48 meses, sendo a média de 20 meses. Todos os casos eram refratários ao tratamento conservador (repouso e fisioterapia, com tempo de tratamento clínico prévio variando entre seis e 136 meses. Para a avaliação dos resultados utilizamos os critérios da Associação Médica Americana (AMA, modificados por Bruce. RESULTADOS: Obtivemos 13 (65% resultados excelentes e sete (13% regulares, com apenas uma complicação (distrofia simpático-reflexa. Este foi o único caso que referiu não estar satisfeito. CONCLUSÃO: O tratamento cirúrgico pela técnica artroscópica da epicondilite lateral do cotovelo representa uma boa opção para 65% dos casos.OBJECTIVE: To evaluate the results in patients with lateral epicondylitis surgically treated by the arthroscopy technique. METHODS: Twenty patients were submitted to surgery by the arthroscopic technique. Age ranged from 19 to 54 years (average 41 years and eight months. Twelve (60% of the patients were female and eight (40% male. The minimum follow-up period was 12 months and the maximum period, 48 months, with an average of 20 months. All the cases were refractory to conservative treatment (rest and physiotherapy, with previous clinical treatment times varying ranging from six to 136 months. For the evaluation of the results, we used the criteria of the American Medical Association (AMA, modified by Bruce. RESULTS: We obtained 13 (65% excellent results and seven (13% regular results, with just one complication (reflex sympathetic dystrophy. This was the only patient who reported dissatisfaction. CONCLUSION: Surgical treatment

  19. Results of Clubfoot Treatment with Kite Method

    Directory of Open Access Journals (Sweden)

    Arben Gjonej

    2014-10-01

    Full Text Available AIM: The goal of this study is to evaluate the success of clubfoot treatment by Kite method regarding the relaps rate and need for open surgical correction. Methods: We have studied clinical charts of 2008-2010 from statistic department of Service of Orthopaedic and Traumatology “ Prof Dr. Panajot Boga”. The statistical method used is the Fisher- Student test. Accepted error is less than 5% (p <0:05. Kite Method consists in conservative treatment with cast by gradual gentle manipulation. Intervention performed every 7-14 days. Treatment duration is approximately 6 months and at the end of the first 3 months of treatment, Achilles tenotomy was performed. Then we applied for 3 more months in plaster cast by changing it every 2-3 weeks.When treatment ends, family members were taught about exercises for foot and keeping Denis Brown shoes. In our country the ratio male: female was 1.7:1. Results: This study included 107 patients, of whom 68 were males and 39 females. Seventy four per cent of patients did not need surgery and others had need for surgical intervention. The success of the method used in our service proved to be 74%. Fourteen per cent of patients started treatment within 7 days of life and success has been 95%, 30% started treatment within 15 to 30 days, 14.9% have started treatment within the first 2-3 months after birth. While the rest of the treatment started 8-14 and 1-2 months after birth. Conclusion: Kite method had a low success rate in our serie of clubfoot patients, so we do not recommend any more the use of this method for conservative treatment of clubfoot.

  20. Evaluation of Long-Term Results of Surgical Treatment in Patients with Protrusions and Herniated Discs in Combination with Lumbar Instability

    Directory of Open Access Journals (Sweden)

    O.Ye. Pashkov

    2015-04-01

    Full Text Available The study of the data from 52 patients with lumbar instability and disc herniation was carried out. The short- and long-term results of surgical treatment, the nature and characteristics of their course in these periods were analyzed. The dependence of the incidence of recurrent pain radicular syndrome on the choice of method of surgical treatment is revealed.

  1. Evaluation of the results from surgical treatment of fractures of the lateral extremity of the clavicle, using the double ligature technique

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2015-04-01

    Full Text Available OBJECTIVE: To evaluate the incidence of consolidation in surgical treatment of fractures of the lateral extremity of the clavicle using the double subcoracoid ligature technique, with nonabsorbable No. 5 thread.METHODS: Between May 1993 and June 2013, the Shoulder and Elbow Group of our service surgically treated 116 patients (116 shoulders with fractures of the lateral extremity of the clavicle. Among these, we were able to reassess 65 cases. The surgical technique used consisted of double subcoracoid ligature with two nonabsorbable threads. In two patients classified as type III, we had to combine this technique with use of an interfragmentary screw for fixation of the intra-articular portion of the acromioclavicular joint.RESULTS: We achieved fracture consolidation in 90%. Fourteen cases (21% evolved with major complications: four cases of pseudarthrosis, five of adhesive capsulitis, two of delayed consolidation and three of loss of reduction. Two cases (3% evolved with minor complications of skin granuloma.CONCLUSION: The double ligature technique for fractures of the lateral extremity of the clavicle promotes the stabilization needed for consolidation to take place, without the need for synthesis using metal components. It avoids reoperation for the synthesis material to be removed. Moreover, it is a low-cost procedure with good reproducibility and preservation of the acromioclavicular joint.

  2. Evaluation of preventive maintenance treatments.

    Science.gov (United States)

    2012-04-01

    Scrub seals were placed in 2007 in Tallahatchie, Marshall, Carroll and Grenada Counties to evaluate their effectiveness and feasibility as preventive maintenance treatments. Condition data was collected and evaluated on the project sections.

  3. Gynecomastia: physiopathology, evaluation and treatment

    Directory of Open Access Journals (Sweden)

    Alfredo Carlos Simões Dornellas de Barros

    Full Text Available Gynecomastia (GM is characterized by enlargement of the male breast, caused by glandular proliferation and fat deposition. GM is common and occurs in adolescents, adults and in old age. The aim of this review is to discuss the pathophysiology, etiology, evaluation and therapy of GM. A hormonal imbalance between estrogens and androgens is the key hallmark of GM generation. The etiology of GM is attributable to physiological factors, endocrine tumors or dysfunctions, non-endocrine diseases, drug use or idiopathic causes. Clinical evaluation must address diagnostic confirmation, search for an etiological factor and classify GM into severity grades to guide the treatment. A proposal for tailored therapy is presented. Weight loss, reassurance, pharmacotherapy with tamoxifen and surgical correction are the therapeutic options. For long-standing GM, the best results are generally achieved through surgery, combining liposuction and mammary adenectomy.

  4. Aesthetic result after breast-conserving therapy is associated with quality of life several years after treatment. Swedish women evaluated with BCCT.core and BREAST-Q™.

    Science.gov (United States)

    Dahlbäck, Cecilia; Ullmark, Jenny Heiman; Rehn, Martin; Ringberg, Anita; Manjer, Jonas

    2017-08-01

    A gold standard for evaluation of aesthetic outcome after breast-conserving therapy (BCT) is still lacking. The BCCT.core software has been developed to assess aesthetic result in a standardised way. We aimed to study how the result of BCCT.core after BCT is associated with quality of life, measured with the BREAST-Q™, a validated questionnaire. Women eligible for BCT were consecutively recruited between February 1st 2008 and January 31st 2012 (n = 653). Photographs of 310 women, taken one year after BCT, were evaluated using the BCCT.core software. The postoperative BCT module of the BREAST-Q™ questionnaire was administered by mail and 348 questionnaires were returned (median 5.5 years after BCT). In all, 216 women had both BCCT.core results and completed BREAST-Q™ questionnaires available. The results from the BCCT.core evaluation were: excellent n = 49 (15.8%); good n = 178 (57.4%); fair n = 73 (23.5%); poor n = 10 (3.2%). The median BREAST-Q™ score for satisfaction with breasts was 66 [interquartile range (IQR) 57-80] and for psychosocial well-being 82 (IQR 61-100). Poor/fair results on BCCT.core were associated with Q-scores below median for both satisfaction with breasts [odds ratio (OR) 3.4 (confidence interval (CI) 1.7-6.8)] as well as for psychosocial well-being [OR 2.2 (CI 1.1-4.2)]. A statistically significant association between BCCT.core results one year after BCT and quality of life ratings using BREAST-Q™ several years later is shown in this study. This implies that the BCCT.core may be valuable in BCT follow-up and used as a standardised instrument in the evaluation of aesthetic results.

  5. [Evaluation of condylar fractures treatment].

    Science.gov (United States)

    Andrade Filho, Eduardo Fausto de; Martins, Dulce Maria Fonseca Soares; Sabino Neto, Miguel; Toledo J nior Cd, Carlos de Souza; Pereira, Max Domingues; Ferreira, Lydia Massako

    2003-01-01

    We analysed 40 patients with mandibular condylar process fractures, treated through the closed (intermaxilary fixation or conservatively) or open methods (wire internal fixation,titanium miniplates, bone reduction or articular exploration), from January 1993 to January 1999. We evaluated these patients clinically with pre-determined criteria through the temporomandibular articulation touching (ATM), by observing the mandibular symmetry, dental oclusion, deviation to the mouth opening and maximum interincisal opening, besides the questionnaire about the complaints at ATM, disfunction of the mastication system and satisfaction of the treatment. We found an index of good clinical results of, at least, 70% (in the maximum interincisal opening) in the patients submitted to IMF. In the conservative method, we found an index of, at least, 42.9% and in the patients submitted to wire open reduction, at least, 28.6% (in the ATM touching exam) without significant difference in the clinical exams; the pain index at ATM in the closed method was 3.7% and in the open one was 15.4%; mastication disfunction was 22.2% in the closed method and 15.4% in the open one; we only found 7.1% dissatisfied patients in the closed method. There was no significant difference in the method results. The closed method - with IMF and conservative - and the open reduction - with ORIF - brought good clinical results in an evaluation up to 6 months. We could also conclude that there is no difference in the complaint results after the open or closed treatment according to the patients' opinion.

  6. Utility of a tumor-mimic model for the evaluation of the accuracy of HIFU treatments. results of in vitro experiments in the liver.

    Science.gov (United States)

    N'Djin, William Apoutou; Melodelima, David; Parmentier, Hubert; Chesnais, Sabrina; Rivoire, Michel; Chapelon, Jean Yves

    2008-12-01

    Presented in this article is a tumor-mimic model that allows the evaluation, before clinical trials, of the targeting accuracy of a high intensity focused ultrasound (HIFU) device for the treatment of the liver. The tumor-mimic models are made by injecting a warm solution that polymerizes in hepatic tissue and forms a 1 cm discrete lesion that is detectable by ultrasound imaging and gross pathology. First, the acoustical characteristics of the tumor-mimics model were measured in order to determine if this model could be used as a target for the evaluation of the accuracy of HIFU treatments without modifying HIFU lesions in terms of size, shape and homogeneity. On average (n = 10), the attenuation was 0.39 +/- 0.05 dB.cm(-1) at 1 MHz, the ultrasound propagation velocity was 1523 +/- 1 m.s(-1) and the acoustic impedance was 1.84 +/- 0.00 MRayls. Next, the tumor-mimic models were used in vitro in order to verify, at a preclinical stage, that lesions created by HIFU devices guided by ultrasound imaging are properly positioned in tissues. The HIFU device used in this study is a 256-element phased-array toroid transducer working at a frequency of 3 MHz with an integrated ultrasound imaging probe working at a frequency of 7.5 MHz. An initial series of in vitro experiments has shown that there is no significant difference in the dimensions of the HIFU lesions created in the liver with or without tumor-mimic models (p = 0.3049 and p = 0.8796 for the diameter and depth, respectively). A second in vitro study showed that HIFU treatments performed on five tumor-mimics with safety margins of at least 1 mm were properly positioned. The margins obtained were on average 9.3 +/- 2.7 mm (min. 3.0 - max. 20.0 mm). This article presents in vitro evidence that these tumor-mimics are identifiable by ultrasound imaging, they do not modify the geometry of HIFU lesions and, thus, they constitute a viable model of tumor-mimics indicated for HIFU therapy.

  7. [Treatment results and complications after PFN osteosynthesis].

    Science.gov (United States)

    Hohendorff, B; Meyer, P; Menezes, D; Meier, L; Elke, R

    2005-11-01

    Intramedullary implants, such as the proximal femur nails (PFN), are inserted for the treatment of per-, inter- and subtrochanteric fractures. The initial experiences with these PFN, carried out by AO/ASIF in 1996, have been published. This study makes a systematic examination of the complications and clinical treatment results from 133 patients treated at our clinic from December 1997-2001 with 139 PFN in per-, inter- and subtrochanteric femur fractures. The mean age at the time of surgery was 78.4 years. All fractures were classified according to the AO system. The most frequent injuries were 31 A2.3 fractures (61.2%). All intraoperative image-converter images and all radiographs from the total period of treatment were evaluated retrospectively in accordance with 28 criteria. The degree of osteoporosis was estimated using the Singh classification. A total of 44 (31.7%) complications arose in 31 (23.3%) patients. On 11 occasions, hip screw cut-out was observed. Of these, two cases involved a Z-effect and one an inverted Z-effect. Two patients suffered a femoral neck fracture following removal of the hip screws. There were 38 (27.3%) reoperations required with 13 changes in procedure. In autumn 2002, clinical follow-up examinations were carried out on 65 (48.9%) patients who were assessed according to the Merle d'Aubigné score. A total of 51 (38.3%) patients had died at the time of follow-up. Normal ambulation was achieved by 33.8% of patients, while 64.6% were free of pain. The PFN is an appropriate implant in cases of per-, inter- and subtrochanteric femur fractures. Anatomical resetting and correct implant positioning are the keys to successful osteosynthesis. The risk of implant failure is highest in the case of multi-fragmentary per- and intertrochanteric fractures in which medial strengthening has been degraded in patients aged over 80 years. The clinical results in elderly patients are unsatisfactory.

  8. Wheezy bronchitis: results of treatment with ketotifen.

    Science.gov (United States)

    Cserháti, E F; Gegesi Kiss, A; Puskás, J; Kelemen, J; Mezel, G

    1986-01-01

    The authors consider that infants and young children with recurrent obstructive bronchitis require systematic follow-up care and treatment. To evaluate the severity of the disease, a rating scale was developed. Using this criteria, the severity of the disease in 132 infants and young children was evaluated. The patients were divided into a group of more severely ill and a group of less severely ill patients. The members of the more severely ill group were given long-term prophylactic treatment with ketotifen at a dose of 0.5 to 1.0 mg twice daily, in addition to standard symptomatic medication. Treatment with ketotifen afforded a decrease, although insignificant, in the number of coughing attacks, a significant decrease in the number of episodes of dyspnoea (p less than 0.025) and a significant decrease in the number of episodes of airway obstruction (p less than 0.0005). The authors conclude that patients with recurrent severe obstructive bronchitis should be given prophylactic treatment with ketotifen either during autumn and winter or throughout the year, depending on the severity of the symptoms.

  9. TUBERCULOSIS IN CHILDREN - TREATMENT EVALUATION AND RESULTS IN A 5 YEAR COHORT OF CHILDREN WITH TUBERCULOSIS IN TURIANI-HOSPITAL, TANZANIA

    NARCIS (Netherlands)

    VANDENHOMBERGH, J; GEBHARD, AC; VOORHOEVE, HWA

    Between January 1983 and January 1988, a total of 146 children started TB treatment in Turiani Hospital, Tanzania. During the treatment period 16 children died and another 16 have been transferred out. From the remaining 114, 84 could be traced and were visited at home. Out of this group, 85% were

  10. Evaluation of Radiographic Results Obtained by Using Modified Dual Pelvic Osteotomy (DPO Plate for the Treatment of Hip Dysplasia in Dogs

    Directory of Open Access Journals (Sweden)

    Murat KARABAĞLI

    2017-07-01

    Full Text Available Hip dysplasia is a developmental orthopedic joint disease that commonly effects many different dog breeds, which are generally observed bilaterally. Triple pelvic osteotomy (TPO is one of the most common techniques used to minimize the development of joint subluxation and hip dysplasia in young dogs. However, in the course of time, different ways to reduce the complications of TPO have been described and alternative techniques such as dual pelvic osteotomy (DPO have been developed. Materials of our study consisted of 12 dogs with hip dysplasia at 7-11 months age range. Six of these dogs were selected from the dogs for 7-9 months old while the other six were selected for dogs at the age of 10-11 months old. In operation, pubic osteotomy was performed initially and then modified DPO plates were placed in ilium following ilium osteotomy. In acute postoperative period, patients were evaluated for ischiadic nerve paralysis symptoms. Preoperative Norberg angle measurements were compared with Norberg angle measurements on ventrodorsal pelvis graphs taken at postoperative 2nd month. As a result, it was observed that DPO was effective in slowing the development of hip dysplasia in the older patient population than 4.5-9 months old. No signs of postoperative ischiadic paralysis or paresis were seen in the patients. No complications such as screw loosening and plate breakage like complications related to the modified DPO plate which we used were encountered.

  11. A multicenter, prospective, randomized trial evaluating the X STOP interspinous process decompression system for the treatment of neurogenic intermittent claudication: two-year follow-up results.

    Science.gov (United States)

    Zucherman, James F; Hsu, Ken Y; Hartjen, Charles A; Mehalic, Thomas F; Implicito, Dante A; Martin, Michael J; Johnson, Donald R; Skidmore, Grant A; Vessa, Paul P; Dwyer, James W; Puccio, Stephen T; Cauthen, Joseph C; Ozuna, Richard M

    2005-06-15

    A randomized, controlled, prospective multicenter trial comparing the outcomes of neurogenic intermittent claudication (NIC) patients treated with the interspinous process decompression system (X STOP) with patients treated nonoperatively. To determine the safety and efficacy of the X STOP interspinous implant. Patients suffering from NIC secondary to lumbar spinal stenosis have been limited to a choice between nonoperative therapies and decompressive surgical procedures, with or without fusion. The X STOP was developed to provide an alternative therapeutic treatment. METHODS.: 191 patients were treated, 100 in the X STOP group and 91 in the control group. The primary outcomes measure was the Zurich Claudication Questionnaire, a patient-completed, validated instrument for NIC. At every follow-up visit, X STOP patients had significantly better outcomes in each domain of the Zurich Claudication Questionnaire. At 2 years, the X STOP patients improved by 45.4% over the mean baseline Symptom Severity score compared with 7.4% in the control group; the mean improvement in the Physical Function domain was 44.3% in the X STOP group and -0.4% in the control group. In the X STOP group, 73.1% patients were satisfied with their treatment compared with 35.9% of control patients. The X STOP provides a conservative yet effective treatment for patients suffering from lumbar spinal stenosis. In the continuum of treatment options, the X STOP offers an attractive alternative to both conservative care and decompressive surgery.

  12. Evaluation of adherence to national treatment guidelines among ...

    African Journals Online (AJOL)

    -binomial regression was used to evaluate the association between treatment regimens, including DOT provision, and treatment outcome. Results. Of 1 339 TB cases in the parent evaluation, 598 (44.7%) were excluded from analysis owing to ...

  13. An Economic Evaluation of TENS in Addition to Usual Primary Care Management for the Treatment of Tennis Elbow: Results from the TATE Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Martyn Lewis

    Full Text Available The TATE trial was a multicentre pragmatic randomized controlled trial of supplementing primary care management (PCM-consisting of a GP consultation followed by information and advice on exercises-with transcutaneous electrical nerve stimulation (TENS, to reduce pain intensity in patients with tennis elbow. This paper reports the health economic evaluation.Adults with new diagnosis of tennis elbow were recruited from 38 general practices in the UK, and randomly allocated to PCM (n = 120 or PCM plus TENS (n = 121. Outcomes included reduction in pain intensity and quality-adjusted-life-years (QALYs based on the EQ5D and SF6D. Two economic perspectives were evaluated: (i healthcare-inclusive of NHS and private health costs for the tennis elbow; (ii societal-healthcare costs plus productivity losses through work absenteeism. Mean outcome and cost differences between the groups were evaluated using a multiple imputed dataset as the base case evaluation, with uncertainty represented in cost-effectiveness planes and through probabilistic cost-effectiveness acceptability curves. Incremental healthcare cost was £33 (95%CI -40, 106 and societal cost £65 (95%CI -307, 176 for PCM plus TENS. Mean differences in outcome were: 0.11 (95%CI -0.13, 0.35 for change in pain (0-10 pain scale; -0.015 (95%CI -0.058, 0.029 for QALYEQ5D; 0.007 (95%CI -0.022, 0.035 for QALYSF6D (higher score differences denote greater benefit for PCM plus TENS. The ICER (incremental cost effectiveness ratio for the main evaluation of mean difference in societal cost (£ relative to mean difference in pain outcome was -582 (95%CI -8666, 8113. However, incremental ICERs show differences in cost-effectiveness of additional TENS, according to the outcome being evaluated.Our findings do not provide evidence for or against the cost-effectiveness of TENS as an adjunct to primary care management of tennis elbow.

  14. Evaluation and treatment of infertility.

    Science.gov (United States)

    Lindsay, Tammy J; Vitrikas, Kristen R

    2015-03-01

    Infertility is defined as the inability to achieve pregnancy after one year of regular, unprotected intercourse. Evaluation may be initiated sooner in patients who have risk factors for infertility or if the female partner is older than 35 years. Causes of infertility include male factors, ovulatory dysfunction, uterine abnormalities, tubal obstruction, peritoneal factors, or cervical factors. A history and physical examination can help direct the evaluation. Men should undergo evaluation with a semen analysis. Abnormalities of sperm may be treated with gonadotropin therapy, intrauterine insemination, or in vitro fertilization. Ovulation should be documented by serum progesterone level measurement at cycle day 21. Evaluation of the uterus and fallopian tubes can be performed by hysterosalpingography in women with no risk of obstruction. For patients with a history of endometriosis, pelvic infections, or ectopic pregnancy, evaluation with hysteroscopy or laparoscopy is recommended. Women with anovulation may be treated in the primary care setting with clomiphene to induce ovulation. Treatment of tubal obstruction generally requires referral for subspecialty care. Unexplained infertility in women or men may be managed with another year of unprotected intercourse, or may proceed to assisted reproductive technologies, such as intrauterine insemination or in vitro fertilization.

  15. Anaplastic thyroid cancer: multimodal treatment results.

    Science.gov (United States)

    Aslan, Zaki Antonio Taissoun; Granados-García, Martín; Luna-Ortiz, Kuauhyama; Guerrero-Huerta, Francisco Javier; Gómez-Pedraza, Antonio; Namendys-Silva, Silvio A; Meneses-García, Abelardo; Ordoñez-Mosquera, Juliana María

    2014-01-01

    Anaplastic thyroid cancer is a rare and lethal disease. It accounts for 1-2% of thyroid malignancies, but specific mortality is higher than 90%. It is an aggressive locoregional disease with a high metastatic capacity. There is no agreement with regards to the best treatment. We analysed the results of treatment in a mestizo population treated in the National Cancer Institute (Mexico). We reviewed 1,581 files of thyroid carcinomas; of these, 29 (1.83%) had anaplastic thyroid carcinoma. Demographic variables, clinical manifestations, tumour characteristics, and treatments were analysed. The median age was 64.5 ± 13.2 years. Females were more affected (female/male ratio: 2.6:1); 21 cases occurred in women (72.4%), and eight in males (27.6%). The most common manifestations were neck enlargement (93.10%) and hoarseness (71.31%). The median tumour size was 8 cm (range: 4-20 cm). The percentage of cases which presented in clinical stage IVA was 10.3%, with 62.1% presenting in clinical stage IVb and 27.6% presenting in clinical stage VIc. Complete resection (R0) (p = 0.05), radiation doses of higher than 33.1 Gy (p = 0.04), and multimodal therapy were associated with better survival. Surgery plus radiotherapy with or without systemic treatment (p = 0.006). The median overall survival was 119 days (IC 95%, 36.3-201.6). Six-month, one-year and two-year survival was 37.9%, 21% and 13%, respectively. Complete surgical resection is associated with better survival but is very difficult to achieve due to aggressive biological behaviour. Multimodal therapy is associated with better survival and a better quality of life. There is a need for more effective systemic treatments as extensive surgical resections have little overall benefit in highly invasive and metastatic disease.

  16. Evaluation of Results from Sales Promotion Activities

    Directory of Open Access Journals (Sweden)

    Olimpia Ban

    2007-02-01

    Full Text Available An essential element of the sales promotion strategy and not only is the evaluation of the results obtained from the activities performed. Due to their nature and applicability, the evaluation of the sales promotion is much easier to be achieved, but it raises some problems. Using a hypothetical example, we have tried to develop a "classic" evaluation model of the specialty literature.

  17. Evaluation of late effects, esthetic results and quality of life after conservative treatment of breast cancer?; Evaluation des effets tardifs, du resultat esthetique et de la qualite de vie apres traitement conservateur du cancer du sein

    Energy Technology Data Exchange (ETDEWEB)

    Geffrelot, J.; Toudic-Emily, F.; Delozier, T.; Switsers, O.; Allouache, D.; Delcambre, C.; Segura, C.; Levy, C.; Dupont, M.; Joly, F. [Centre Francois-Baclesse, 14 - Caen (France)

    2009-10-15

    Purpose: to evaluate the delayed toxicity of two patterns of adjuvant radiotherapy including a breast irradiation, at the dose of 48 Gy in 20 seances and five weeks or 57.60 Gy in 24 seances and six weeks in case of majored factors of local recurrence risk. The secondary objective were the auto evaluation by the patient of the esthetic result and the influence of this last one on the quality of life. Conclusion: the delayed toxicity was dominated by the fibrosis low to moderated one, without any significant difference between the doses of 48 Gy and 57.60 Gy. The esthetic result evaluated by the patient, globally good, seemed however, damaged with the last pattern. A bad esthetic result, without affected the global quality of life was associated to more specific breast symptoms and damaged the perception of the body image. (N.C.)

  18. Long term results of childhood dysphonia treatment.

    Science.gov (United States)

    Mackiewicz-Nartowicz, Hanna; Sinkiewicz, Anna; Bielecka, Arleta; Owczarzak, Hanna; Mackiewicz-Milewska, Magdalena; Winiarski, Piotr

    2014-05-01

    The aim of this study was to assess the long term results of treatment and rehabilitation of childhood dysphonia. This study included a group of adolescents (n=29) aged from 15 to 20 who were treated due to pediatric hyperfunctional dysphonia and soft vocal fold nodules during their pre-mutational period (i.e. between 5 and 12 years of age). The pre-mutational therapy was comprised of proper breathing pattern training, voice exercises and psychological counseling. Laryngostroboscopic examination and perceptual analysis of voice were performed in each patient before treatment and one to four years after mutation was complete. The laryngostroboscopic findings, i.e. symmetry, amplitude, mucosal wave and vocal fold closure, were graded with NAPZ scale, and the GRBAS scale was used for the perceptual voice analysis. Complete regression of the childhood dysphonia was observed in all male patients (n=14). Voice disorders regressed completely also in 8 out of 15 girls, but symptoms of dysphonia documented on perceptual scale persisted in the remaining seven patients. Complex voice therapy implemented in adolescence should be considered as either the treatment or preventive measure of persistent voice strain, especially in girls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. An evaluation of Hanford water treatment practices

    Energy Technology Data Exchange (ETDEWEB)

    Touhill, C.J.

    1965-09-01

    An evaluation of Hanford reactor process water treatment practices was made in an effort to ascertain the reasons for variations in the effluent activity between reactors. Recommendations are made for improvements in unit processes as well as for the over-all treatment process based on field inspection of the water treatment plants. In addition, a research program is proposed to supplement the recommendations. The proposed research is designed to uncover methods of more efficient filtration as well as other procedures which might eventually lead to significant effluent activity reductions. The recommendations and research results will be applied toward process optimization.

  20. Building an evaluative culture for effective evaluation and results management

    OpenAIRE

    Mayne, John

    2008-01-01

    A weak evaluative culture undermines many attempts at building an effective evaluation and results management regime. This brief outlines practical actions that an organization can take to build and support an evaluative culture, where information on performance is deliberately sought in order to learn how to better manage and deliver programmes and services. Such an organization values empirical evidence on the results it is seeking to achieve.

  1. Factors influencing treatment results in pseudophakic endophthalmitis.

    Science.gov (United States)

    Koç, F; Sen, E; Demirbay, P; Taşkintuna, I; Teke, M Y; Ozdal, P; Ortaç, S; Oz, O; Tarkan, F; Firat, E

    2002-01-01

    To evaluate risk factors, therapeutic approaches and factors associated with the poor visual outcome in pseudophakic endophthalmitis. Data related to 28 cases with the diagnosis of endophthalmitis after cataract surgery and IOL implantation were gathered retrospectively. Preceding surgery was extracapsular cataract extraction (ECCE) in 18, phacoemulsification in 8 and scleral fixated intraocular lens implantation in two cases. Posterior capsule rupture and diabetes mellitus were considered to contribute to the development of endophthalmitis because of their high incidences (50% and 25%) in the study group. Microbiological studies from aqueous and vitreous humour were done in 85% of the cases and 58% were positive. S. Epidermidis was the most common organism, accounting for 50% of the isolates. All cases were given topical and systemic antibiotics. Inflammation was controlled by addition of subconjunctival antibiotics to this regimen in two, intravitreal antibiotic injection in 14, pars plana vitrectomy, total capsular and lens extraction and intravitreal antibiotic injection in three, lens exchange, intracapsular and intravitreal antibiotic injection in three cases. Six (21%) cases eventually needed evisceration. Visual acuity of 20/40 or better was achieved in 25%, and 20/100 or better in 64%. Treatment delay (p=0.039), capsular rupture complicating cataract surgery, especially with extracapsular cataract extraction (p=0.015), and initial visual acuity worse than hand motion (p=0.003) were strong predictors of poor visual outcome. The risk of endophthalmitis was not different forplanned ECCCE (0.26%) andphacoemulsification (0.27%) but the prognosis was better with the latter.

  2. Laser treatment of stretch marks: preliminary results

    Science.gov (United States)

    Longo, Leonardo; Piccinetti, A. L.; Monache, G. D.; Botta, G.; Mancini, S.

    2000-06-01

    The best treatment of these stretch mark is still unknown. Some authors proposed the treatment with flash-lamp-pumped dye laser 585 nm, with fluence over 8 J/cm2. Reviewing our experiences on no-surgical effects of lasers in the various phases of the wound healing, including the re- epithelization, we would like to apply the no-surgical laser therapy treating the stretch marks of breast, abdomen and lumbo-sacral region. The goal is to inhibit the fibrous tissue metabolism, encouraging the destruction of the collagen fibers with inflammatory mechanism, and increasing the reconstitution of the superficial dermis layers. We treated five cases of stretch marks in women 22-35 years old, since May 1999, with a cycle of applications of double lasers, 511 and 577 nm, with energy of 20 Joule for spot, respecting the maximum thermal relaxation times of the skin. We waited two weeks interval between the applications. Results obtained after five applications are very positive, and we are encouraged to continue this experimentation.

  3. Integrated thermal treatment system sudy: Phase 2, Results

    Energy Technology Data Exchange (ETDEWEB)

    Feizollahi, F.; Quapp, W.J.

    1995-08-01

    This report presents the second phase of a study on thermal treatment technologies. The study consists of a systematic assessment of nineteen thermal treatment alternatives for the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the MLLW. The alternatives considered in Phase 2 were innovative thermal treatments with nine types of primary processing units. Other variations in the study examined the effect of combustion gas, air pollution control system design, and stabilization technology for the treatment residues. The Phase 1 study, the results of which have been published as an interim report, examined ten initial thermal treatment alternatives. The Phase 2 systems were evaluated in essentially the same manner as the Phase 2 systems. The assumptions and methods were the same as for the Phase 1 study. The quantities, and physical and chemical compositions, of the input waste used in he Phase 2 systems differ from those in the Phase 1 systems, which were based on a preliminary waste input database developed at the onset of the Integrated Thermal Treatment System study. The inventory database used in the Phase 2 study incorporates the latest US Department of Energy information. All systems, both primary treatment systems and subsystem inputs, have now been evaluated using the same waste input (2,927 lb/hr).

  4. Scaling Research Results: Design and Evaluation | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Scaling Research Results: Design and Evaluation. Canada's International Development Research Centre (IDRC) supports research to seek scalable solutions to improve the lives of people in the developing world. While there is general understanding of the meaning of "scaling up/ within the domain of research for ...

  5. Results of surgical treatment of hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Adriano Miziara Gonzalez

    2004-12-01

    Full Text Available Objective: To perform a retrospective review of 14 patientssubmitted to surgical treatment of hepatocellular carcinoma atthe Universidade Federal de Sao Paulo – UNIFESP. Methods:Review of data obtained from 14 patients with hepatocellularcarcinoma submitted to surgical resection in the Discipline ofSurgical Gastroenterology, at the Universidade Federal de SaoPaulo - Escola Paulista de Medicina, from June 1992 to September1998. Results: Three patients (21.4% were female and 11 (78.6%were male. Ten patients (71.4% had disease-related symptoms;76.8% were classified as Child-Pugh A. Alpha-fetoprotein levelswere analyzed in 13 patients and were elevated in 65.1%. Allpatients had abdominal ultrasound and computerized tomographyscans compatible with hepatocellular carcinoma. Surgicalresections varied from segmetectomy to trisegmentectomy.Bleeding was the most common intraoperative complication andcaused one death. The most frequent postoperative complicationwas ascitis, followed by pleural effusion, encephalopathy and biliaryfistula. Tumor recurrence rate was 61.5% at one year and wasrelated to tumors larger than 5 cm, tumor invasion and absence ofa capsule, suggesting late diagnosis. Mean disease-free survivalrate was 17 months and mean survival rate was 21 months.Conclusion: The patients with hepatocellular carcinoma submittedto surgical resection had a high recurrence rate in a one-yearfollow-up, probably due to large tumor size, vascular invasion andabsence of a capsule. The importance of an early diagnosis isemphasized.

  6. [Evaluation of the impact of symptomatic gastroesophageal reflux disease on the result of surgical treatment with the use of endoscopic techniques and postoperative pharmacological treatment in patients with chronic sinusitis].

    Science.gov (United States)

    Nieckarz, Rafał; Szaleniec, Joanna; Hartwich, Patryk; Wróbel, Agnieszka; Hydzik-Sobocińska, Karolina; Muszyński, Piotr; Markiewicz, Beata; Turczynowski, Łukasz; Składzień, Jacek; Strek, Paweł

    2013-01-01

    It is estimated that in Europe 10% of adults suffer from chronic sinusitis. Chronic sinusitis can be caused by many different diseases that share chronic inflammation of the sinuses as a common symptom. Rhinitis can be caused by stomach acid coming up from the stomach into the esophagus, which successively can result in chronic sinusitis. The current gold standard for diagnosing GERD is--bothersome for the patient--24 h esophageal pH monitoring. This method can be unpleasant for the patients, which makes it less acceptable. Because of that the criteria for symptomatic GERD were made an alternative diagnostic way. We acknowledge that the presence of heartburn and stomach acid coming up from the stomach into the esophagus at least once a week can be diagnosed as symptomatic GERD. The aim of the study is the assessment of the frequency of symptomatic GERD in patients operated because of chronic sinusitis and impact of symptomatic GERD on the follow-up treatment up to 12 months after endoscopic nasal surgery. The authors analysed 144 patients operated at the JUCM Otolaryngological Clinic in Kraków between 2011 and 2013 because of sinusitis. The inclusion criteria were: diagnosed chronic sinusitis, indications for endoscopic sinus surgery, and a written consent for the research. Each patient was examined laryngologically and surveyed. Patients were divided into two groups: with and without symptomatic GERD. We analysed the symptoms in patients treated for sinusitis with or without GERD before, between 3 and 6 as well as in the 12th month after endonasal surgery. Moreover, we analysed the intensity of the global symptoms (expressed in the VAS scale) and separately for each of the 13 symptoms of chronic sinusitis (expressed on a scale 0 - 3). We established that 33 out of the 144 patients (22.9%) qualified for the first survey reported the symptoms of GERD. In the second survey, which was conducted between 3 and 6 month after ESS, 24 out of 119 (20%) people reported the

  7. Multistrain models predict sequential multidrug treatment strategies to result in less antimicrobial resistance than combination treatment

    DEFF Research Database (Denmark)

    Ahmad, Amais; Zachariasen, Camilla; Christiansen, Lasse Engbo

    2016-01-01

    Background: Combination treatment is increasingly used to fight infections caused by bacteria resistant to two or more antimicrobials. While multiple studies have evaluated treatment strategies to minimize the emergence of resistant strains for single antimicrobial treatment, fewer studies have...... considered combination treatments. The current study modeled bacterial growth in the intestine of pigs after intramuscular combination treatment (i.e. using two antibiotics simultaneously) and sequential treatments (i.e. alternating between two antibiotics) in order to identify the factors that favor...... generated by a mathematical model of the competitive growth of multiple strains of Escherichia coli.Results: Simulation studies showed that sequential use of tetracycline and ampicillin reduced the level of double resistance, when compared to the combination treatment. The effect of the cycling frequency...

  8. Diffusion-weighted magnetic resonance imaging using different b-value combinations for the evaluation of treatment results after volumetric MR-guided high-intensity focused ultrasound ablation of uterine fibroids

    Energy Technology Data Exchange (ETDEWEB)

    Ikink, Marlijne E.; Voogt, Marianne J.; Bosch, Maurice A.A.J. van den; Nijenhuis, Robbert J. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Keserci, Bilgin [Samsung Medical Center, High-intensity Focused Ultrasound (HIFU) Center, Seoul (Korea, Republic of); Philips Healthcare, Advanced Science and Development, Seoul (Korea, Republic of); Kim, Young-sun [Samsung Medical Center, High-intensity Focused Ultrasound (HIFU) Center, Seoul (Korea, Republic of); Samsung Medical Center, Sunkyunkwan University, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of); Vincken, Koen L.; Bartels, Lambertus W. [University Medical Center Utrecht, Department of Radiology and Image Sciences Institute, Utrecht (Netherlands)

    2014-09-15

    To assess the value of diffusion-weighted magnetic resonance imaging (DWI) and apparent diffusion coefficient (ADC) mapping using different b-value combinations for treatment evaluation after magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) of uterine fibroids. Fifty-six patients with 67 uterine fibroids were treated with volumetric MR-HIFU. Pre-treatment and post-treatment images were obtained using contrast-enhanced T1-weighted MRI (CE-T1WI) and DWI using b = 0, 200, 400, 600, 800 s/mm{sup 2}. ADC maps were generated using subsets of b-values to investigate the effects of tissue ablation on water diffusion and perfusion in fibroids treated with MR-HIFU. Four combinations of b-values were used: (1) all b-values; (2) b = 0, 200 s/mm{sup 2}; (3) b = 400, 600, 800 s/mm{sup 2}; and (4) b = 0, 800 s/mm{sup 2}. Using the lowest b-values (0 and 200 s/mm{sup 2}), the mean ADC value in the ablated tissue reduced significantly (p < 0.001) compared with baseline. Calculating the ADC value with the highest b-values (400, 600, 800 s/mm{sup 2}), the ADC increased significantly (p < 0.001) post-treatment. ADC maps calculated with the lowest b-values resulted in the best visual agreement of non-perfused fibroid tissue detected on CE images. Other b-value combinations and normal myometrium showed no difference in ADC after MR-HIFU treatment. A decrease in contrast agent uptake within the ablated region on CE-T1WI was correlated to a significantly decreased ADC when b = 0 and 200 s/mm{sup 2} were used. (orig.)

  9. [TRT: results after one year treatment].

    Science.gov (United States)

    Madeira, G; Montmirail, Ch; Decat, M; Gersdorff, M

    2007-01-01

    Tinnitus Retraining Therapy (TRT) (which aims to induce changes in the mechanisms responsible for transferring signals from the auditory system to the limbic and autonomic systems) is a method for treating Tinnitus and decreased sound tolerance. An individualised explanation of Jastreboff's neurophysiological model allows greater insight and motivation on the part of the patient. Previous studies have demonstrated that daytime TRT is effective. As sleep forms a significant component of the distress associated with Tinnitus however, we hypothesised that night-time TRT could represent a useful tool in the treatment of this disabling condition. 46 patients were studied (30 male, 16 female). Patients were selected from an ENT outpatient clinic. Patients with significant psychological disability were excluded. Patients were reviewed twice by their doctor and 5 times by a therapist over 12 months. Treatment consisted of 8 hours nighttime white noise stimulation, at progressively increasing intensity. Although several objective assessments of response were undertaken, patients' subjective testimonies were considered a more accurate signal of success. In total, 80% of patients had a satisfactory response after 1 year of treatment. 20% had no response. Patients were subcategorised according to Jastreboff's categories as follows: 1. Tinnitus (n = 6), 100% improved; 2. Tinnitus with hearing loss (n = 16); 62% improved; 3. Hyperacusis (with or without Tinnitus) (n = 16), 88.5% improved; 4. Hyperacusis (with or without Tinnitus, exacerbated by noise) (n = 8), 75% improved. Tinnitus is a symptom rather than an illness, and TRT gives patients greater control, allowing re-integration of normal perception. Night-time TRT is an effective treatment for Tinnitus and decreased sound tolerance. It has the potential advantage over day-time TRT of rapidly improving sleep and decreasing use of sedative hypnotics, a secondary effect noted in the personal testimonies of our cohort of

  10. Preliminary Results of the Louisiana Sex Offender Treatment Program

    Directory of Open Access Journals (Sweden)

    Lee A. Underwood

    2015-12-01

    Full Text Available The purpose of this study was to offer preliminary support for the Louisiana Sex Offender Treatment Program (LSOTP in addressing the needs of juvenile sex offenders. Research objectives were (1 to offer statistical evidence for reductions in anxiety, depression, cognitive distortion and negative attitudes towards women comparing a group of 21 adolescents, 12 of whom received services as usual and nine of whom participated in the LSOTP. A controlled experimental evaluation design was utilized. The juvenile sex offenders were randomly assigned to the experimental group for 12 weeks receiving treatment services and a control group receiving care “as usual” in a residential group care program. Participants in the experimental group experienced statistically significant decreases in cognitive distortions related specifically to rape and molestation.The results of this study offer preliminary support of the LSOTP as a best practices alternative to other treatment modalities.

  11. Clinical result of intra-arterial lymphocyte injection therapy for treatment of lymphedema and the evaluation of the efficacy of the therapy. Quantitative analysis by an injection of {sup 111}In-labeled lymphocytes and by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yoshizumi, Masanori; Kitagawa, Tetsuya; Hori, Takaki; Katoh, Itsuo; Harada, Masashi; Matsumoto, Takahiro; Nishitani, Hiromu [Tokushima Univ. (Japan). School of Medicine

    1995-11-01

    We have employed the intra-arterial lymphocytes injection therapy for treatment of lymphedema of the limbs with various causes. In the present study, we observed the clinical outcome of our therapy in 38 patients with lymphedema of the limbs. Results showed that the therapy was effective in 26 of 38 patients (68% of the total). Moreover, a marked efficacy was obtained in 13 of 38 patients (34% of the total). In the latest 5 patients, to evaluate the efficacy of our therapy, we examined the distribution of the {sup 111}In-oxine labeled lymphocytes injected into the proximal artery of the affected limb. The radioactivities of the affected limbs were apparently higher than that of the healthy limbs in effective cases. Moreover, MR imaging showed that the reduction of STIR ratio and T{sub 2} ratio well correlate with the results of clinical course. Thus, the efficacy of the lymphocyte injection therapy is able to be evaluated by radiolabeled lymphocytes and MR imaging. (author).

  12. Kenya's Radio Language Arts Project: evaluation results.

    Science.gov (United States)

    Oxford, R L

    1985-01-01

    The Kenya Radio Language Arts Project (RLAP), which has just been completed, documents the effectiveness of interactive radio-based educational instruction. Analyses in the areas of listening, reading, speaking, and writing show that children in radio classrooms consistently scored better than children in nonradio classrooms in every test. An evaluation of the project was conducted with the assistance of the Center for Applied Linguistics (CAL). Evaluation results came from a variety of sources, including language tests, observations, interviews, demographic and administrative records, and an attitude survey. A large proportion of the project's students were considerably transient. Only 22% of the total student population of 3908 were "normal progression" students -- that is, they advanced regularly through their education during the life of the project. Students who moved from the area, failed a standard (grade), dropped out, or were otherwise untrackable, comprised the remaining 78% of the total. 7 districts were included in the project. Tests were developed for listening and reading in Standards 1, 2, and 3 and in speaking and writing in Standards 2 and 3. The achievement tests were based on the official Kenya curriculum for those standards, so as to measure achievement against the curriculum. Nearly all the differences were highly significant statistically, with a probability of less than 1 in 1000 that the findings could have occurred by chance. Standard 1 radio students scored nearly 8 points higher than did their counterparts in the control group. Standard 2 and 3 radio students outperformed the control students by 4 points. The radio group consistently outperformed the control group in reading, writing, and speaking. Unstructured interviews and observations were conducted by the RLAP field staff. Overwhelmingly positive attitudes about the project prevailed among project teachers and headmasters. The data demonstrate that RLAP works. In fact, it works so

  13. Assessment Results of Patellar Fracture Treatment after Tension Band Wiring

    Directory of Open Access Journals (Sweden)

    S. Abdolhossein Mehdinasab

    2013-04-01

    Full Text Available Background: To assess the results of patellar fracture treatment by tension band wiring. Materials and Methods: This retrospective study was performed to evaluate clinical and radiological results of patellar fracture during past 6 years.Results: Twenty four patients were participated in follow-up. Union was occurred in the mean time of 2.67±0.61 months. Falling down and direct trauma were the most common cause of fracture. Most common complications were thigh muscle atrophy and pin irritation. Excellent and good results in 87.5% and fair results in 12.5% of the patients were seen.Conclusion: Fixation of patellar fractures with tension band wiring was associated with a high rate of union.

  14. Gynecomastia: physiopathology, evaluation and treatment

    OpenAIRE

    Barros,Alfredo Carlos Simões Dornellas de; Sampaio,Marcelo de Castro Moura

    2012-01-01

    Gynecomastia (GM) is characterized by enlargement of the male breast, caused by glandular proliferation and fat deposition. GM is common and occurs in adolescents, adults and in old age. The aim of this review is to discuss the pathophysiology, etiology, evaluation and therapy of GM. A hormonal imbalance between estrogens and androgens is the key hallmark of GM generation. The etiology of GM is attributable to physiological factors, endocrine tumors or dysfunctions, non-endocrine diseases, dr...

  15. AERMOD: MODEL FORMULATION AND EVALUATION RESULTS

    Science.gov (United States)

    AERMOD is an advanced plume model that incorporates updated treatments of the boundary layer theory, understanding of turbulence and dispersion, and includes handling of terrain interactions. This paper presents an overview of AERMOD's features relative to ISCST3. AERM...

  16. Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas: results of a site assessment conducted by the International epidemiologic Databases to Evaluate AIDS (IeDEA Collaboration

    Directory of Open Access Journals (Sweden)

    Stephany N Duda

    2014-12-01

    Full Text Available Introduction: HIV care and treatment programmes worldwide are transforming as they push to deliver universal access to essential prevention, care and treatment services to persons living with HIV and their communities. The characteristics and capacity of these HIV programmes affect patient outcomes and quality of care. Despite the importance of ensuring optimal outcomes, few studies have addressed the capacity of HIV programmes to deliver comprehensive care. We sought to describe such capacity in HIV programmes in seven regions worldwide. Methods: Staff from 128 sites in 41 countries participating in the International epidemiologic Databases to Evaluate AIDS completed a site survey from 2009 to 2010, including sites in the Asia-Pacific region (n=20, Latin America and the Caribbean (n=7, North America (n=7, Central Africa (n=12, East Africa (n=51, Southern Africa (n=16 and West Africa (n=15. We computed a measure of the comprehensiveness of care based on seven World Health Organization-recommended essential HIV services. Results: Most sites reported serving urban (61%; region range (rr: 33–100% and both adult and paediatric populations (77%; rr: 29–96%. Only 45% of HIV clinics that reported treating children had paediatricians on staff. As for the seven essential services, survey respondents reported that CD4+ cell count testing was available to all but one site, while tuberculosis (TB screening and community outreach services were available in 80 and 72%, respectively. The remaining four essential services – nutritional support (82%, combination antiretroviral therapy adherence support (88%, prevention of mother-to-child transmission (PMTCT (94% and other prevention and clinical management services (97% – were uniformly available. Approximately half (46% of sites reported offering all seven services. Newer sites and sites in settings with low rankings on the UN Human Development Index (HDI, especially those in the President's Emergency

  17. Evaluating Nanoparticle Breakthrough during Drinking Water Treatment

    Science.gov (United States)

    Chalew, Talia E. Abbott; Ajmani, Gaurav S.; Huang, Haiou

    2013-01-01

    Background: Use of engineered nanoparticles (NPs) in consumer products is resulting in NPs in drinking water sources. Subsequent NP breakthrough into treated drinking water is a potential exposure route and human health threat. Objectives: In this study we investigated the breakthrough of common NPs—silver (Ag), titanium dioxide (TiO2), and zinc oxide (ZnO)—into finished drinking water following conventional and advanced treatment. Methods: NPs were spiked into five experimental waters: groundwater, surface water, synthetic freshwater, synthetic freshwater containing natural organic matter, and tertiary wastewater effluent. Bench-scale coagulation/flocculation/sedimentation simulated conventional treatment, and microfiltration (MF) and ultrafiltration (UF) simulated advanced treatment. We monitored breakthrough of NPs into treated water by turbidity removal and inductively coupled plasma–mass spectrometry (ICP-MS). Results: Conventional treatment resulted in 2–20%, 3–8%, and 48–99% of Ag, TiO2, and ZnO NPs, respectively, or their dissolved ions remaining in finished water. Breakthrough following MF was 1–45% for Ag, 0–44% for TiO2, and 36–83% for ZnO. With UF, NP breakthrough was 0–2%, 0–4%, and 2–96% for Ag, TiO2, and ZnO, respectively. Variability was dependent on NP stability, with less breakthrough of aggregated NPs compared with stable NPs and dissolved NP ions. Conclusions: Although a majority of aggregated or stable NPs were removed by simulated conventional and advanced treatment, NP metals were detectable in finished water. As environmental NP concentrations increase, we need to consider NPs as emerging drinking water contaminants and determine appropriate drinking water treatment processes to fully remove NPs in order to reduce their potential harmful health outcomes. Citation: Abbott Chalew TE, Ajmani GS, Huang H, Schwab KJ. 2013. Evaluating nanoparticle breakthrough during drinking water treatment. Environ Health Perspect 121

  18. LONG-TERM RESULTS OF SURGICAL TREATMENT FOR ADRENOCORTICAL CANCER

    Directory of Open Access Journals (Sweden)

    T. A. Britvin

    2016-01-01

    Full Text Available Background: Adrenocortical cancer (ACC is a rare adrenal neoplasm with aggressive clinical course and poor prognosis, and with many unresolved problems of diagnostics, treatment and predictive factors. Aim: To identify the most significant clinical and morphological predictors of the outcome based on assessment of long-term results of surgical treatment of ACC patients. Materials and methods: This retrospective study included data on diagnosis and results of treatment of 73 ACC patients from 1999 to 2015. Results: Radical surgery was performed in 59 patients, and long-term results assessed in 52 of them (maximal duration of the follow-up was 12 years. The most favorable treatment results were seen in stages I and II of the disease, with a 5-year survival rate of 87%. The 5-year overall survival in patients with ACC stage III was significantly (p=0.042, multiple comparisons lower (48%. Two patients who had been operated with ACC stage IV (adrenalectomy with excision of a solid liver metastasis and atypical lung resection died of progressive tumor within 13 months after surgery. The survival rates in patients with stage III of the tumor were evaluated depending on the main clinical characteristics of the tumor. It was shown that the 5-year overall survival in non-functioning adrenocortical carcinomas was 59%, being significantly (p<0.05 better than that in patients with functionally active malignancies (22%. In the group of patients without metastases in the regional lymphatic nodes, the 5-year overall survival was 56%, whereas all patients with regional lymphatic metastases by the time of the surgery died from progression within 4 years after the intervention. There was an association between 5-year overall survival and the size of primary tumor, with significantly (p<0.05 lower numbers of 5-year overall survivors (29% among those with tumors of more than 10 cm in diameter, compared with 65% survival rate in those with tumors of less than 10

  19. Evaluating eating behavior treatments by FDA standards

    Directory of Open Access Journals (Sweden)

    A. Janet eTomiyama

    2014-01-01

    Full Text Available Behavioral treatments for obesity are not evaluated by the same criteria as pharmaceutical drugs, even though treatments such as low-calorie dieting are widely prescribed, require the patients’ time and investment, and may have risks. The Food and Drug Administration (FDA has a procedure for evaluating drugs, in which drugmakers must answer the following questions: (1 Is the treatment safe? (2 How dangerous is the condition the intervention is treating? (3 Is the treatment effective? (4 Is the treatment safe and effective for large numbers of people? We argue that using this framework to evaluate behavioral interventions could help identify unanswered research questions on their efficacy and effectiveness, and we use the example of low-calorie dieting to illustrate how FDA criteria might be applied in the context of behavioral medicine.

  20. Optimal Corrosion Control Treatment Evaluation Technical Recommendations

    Science.gov (United States)

    This document provides technical recommendations that both systems and primacy agencies can use to comply with LCR CCT requirements and effective evaluation and designation of optimal corrosion control treatment (OCCT).

  1. Economic evaluation of osteoarthritis treatment in Europe.

    Science.gov (United States)

    Gillette, Jennifer A; Tarricone, Rosanna

    2003-03-01

    Osteoarthritis is one of the leading causes of disability. Among the available treatments, NSAIDs are the most common. The present paper reviews economic studies conducted in the last five years on the treatment of osteoarthritis in Europe. The majority focus on NSAID therapy, mainly comparing COX2-specific inhibitors against COX non-specific inhibitors. The reviewed studies estimate healthcare costs only. The final results indicate that, owing to the lower incidence of adverse events, COX2-specific inhibitors should now dominate over traditional NSAIDs. However, the differences found in the methods used to measure costs suggest that results should be interpreted with caution. To estimate costs, authors used diverse values that were not always consistent with the studies' perspective. Furthermore, many did not report resource consumption patterns, making comparisons among the studies difficult, as economic results are influenced by the price/charging policies of different countries. Economic evaluations have the potential to affect health policy by assisting the ranking and prioritisation obligations of decision makers. In this context, it is important to meet strict methodological guidelines.

  2. Evaluating the Effectiveness Of Postfire Rehabilitation Treatments

    Science.gov (United States)

    Peter R. Robichaud; Jan L. Beyers; Daniel G. Neary

    2000-01-01

    Spending on postfire emergency watershed rehabilitation has increased during the past decade. A west-wide evaluation of USDA Forest Service burned area emergency rehabilitation (BAER) treatment effectiveness was undertaken as a joint project by USDA Forest Service Research and National Forest System staffs. This evaluation covers 470 fires and 321 BAER projects, from...

  3. Evaluation and treatment of musculoskeletal chest pain.

    Science.gov (United States)

    Ayloo, Amba; Cvengros, Teresa; Marella, Srimannarayana

    2013-12-01

    This article summarizes the evaluation and treatment of musculoskeletal causes of chest pain. Conditions such as costochondritis, rib pain caused by stress fractures, slipping rib syndrome, chest wall muscle injuries, fibromyalgia, and herpes zoster are discussed, with emphasis on evaluation and treatment of these and other disorders. Many of these conditions can be diagnosed by the primary care clinician in the office by history and physical examination. Treatment is also discussed, including description of manual therapy and exercises as needed for some of the conditions. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Upper cervical injuries: Clinical results using a new treatment algorithm

    Directory of Open Access Journals (Sweden)

    Andrei F Joaquim

    2015-01-01

    Full Text Available Introduction: Upper cervical injuries (UCI have a wide range of radiological and clinical presentation due to the unique complex bony, ligamentous and vascular anatomy. We recently proposed a rational approach in an attempt to unify prior classification system and guide treatment. In this paper, we evaluate the clinical results of our algorithm for UCI treatment. Materials and Methods: A prospective cohort series of patients with UCI was performed. The primary outcome was the AIS. Surgical treatment was proposed based on our protocol: Ligamentous injuries (abnormal misalignment, facet perched or locked, increase atlanto-dens interval were treated surgically. Bone fractures without ligamentous injuries were treated with a rigid cervical orthosis, with exception of fractures in the dens base with risk factors for non-union. Results: Twenty-three patients treated initially conservatively had some follow-up (mean of 171 days, range from 60 to 436 days. All of them were neurologically intact. None of the patients developed a new neurological deficit. Fifteen patients were initially surgically treated (mean of 140 days of follow-up, ranging from 60 to 270 days. In the surgical group, preoperatively, 11 (73.3% patients were AIS E, 2 (13.3% AIS C and 2 (13.3% AIS D. At the final follow-up, the American Spine Injury Association (ASIA score was: 13 (86.6% AIS E and 2 (13.3% AIS D. None of the patients had neurological worsening during the follow-up. Conclusions: This prospective cohort suggested that our UCI treatment algorithm can be safely used. Further prospective studies with longer follow-up are necessary to further establish its clinical validity and safety.

  5. Results of open wound technique in the treatment of post ...

    African Journals Online (AJOL)

    Background and method. Severe chronic osteomyelitis with variable outcomes is still common among children in developing nations. There has been no consensus on the optimal method of treatment. We therefore prospectively evaluated the rates of wound healing and recurrence following open wound treatment of ...

  6. Immediate results of treatment periprosthetic femoral fractures after hip replacement

    Directory of Open Access Journals (Sweden)

    V. V. Khominets

    2015-01-01

    Full Text Available Periprosthetic fractures are one of the most serious complications after hip replacement. Nineteen periprosthetic femoral fractures operated on during the period 2011-2015 were followed-up retrospectively. Periprosthetic fractures were classified according to the Vancouver classification. The functional results were evaluated using Harrison scale. Bone healing and implant stability were evaluated clinically, on plain radiographs and computed tomography. The periprosthetic fractures in all patients occurred in the postoperative period. Time from operation until fracture varied from 2 weeks to 11 years. A wedge-shaped cemented or cementless stems were implanted during the first surgery: Versys ET, Spotorno, CPT (Zimmer, США: cementless fixation was performed in 16 (84,2% patients, hybrid -in 2 (10,5% and cemented fixation - in 1 (5,3% patient. The fractures of greater trochanter were diagnosed in all patients with type A periprosthetic fractures. In type B1 periprosthetic fracture (8 patients open reduction, cerclage wiring and internal plate osteosynthesis were applied. Loosening stems in 3 patients with type B2 fractures were replaced with Wagner cementless revision component (Wagner SL Revision Stem. Angle-stable plate osteosynthesis and cerclage wiring were also performed. Closed reduction and internal minimal invasive plate osteosynthesis were performed in patients with type C periprosthetic fractures. Bone consolidation was achieved in 18 (94,7% patients, the average term was 14,3±5,2 weeks. The average Harris hip score in all patients 3 months after treatment was 64,9±16,7 points, and in 12 patients (63,2% after a year - 86,5±15,9. Femoral periprosthetic fractures require a specialized approach to choosing the treatment tactic depending on the fracture type and quality of bone tissue. It is necessary to evaluate the femoral component stability, especially in differential diagnosis of type B1 and B2 periprosthetic fractures. Computed

  7. Summary of comparative results integrated nonthermal treatment and integrated thermal treatment systems studies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-12-01

    In July 1994, the Idaho National Engineering Laboratory (INEL), under a contract from U.S. Department of Energy`s (DOE) Environment Management Office of Science and Technology (OST, EM-50) published a report entitled {open_quotes}Integrated Thermal Treatment System Study - Phase 1 Results{close_quotes} (EGG-MS-11211). This report was the culmination of over a year of analysis involving scientists and engineers within the DOE complex and from private industry. The purpose of that study was {open_quotes}to conduct a systematic engineering evaluation of a variety of mixed low level waste (MLLW) treatment system alternatives.{close_quotes} The study also {open_quotes}identified the research and development, demonstrations, and testing and evaluation needed to assure unit operability in the most promising alternative system.{close_quotes} This study evaluated ten primary thermal treatment technologies, organized into complete {open_quotes}cradle-to-grave{close_quotes} systems (including complete engineering flow sheets), to treat DOE MLLW and calculated mass balances and 20-year total life cycle costs (TLCC) for all systems. The waste input used was a representative heterogenous mixture of typical DOE MLLW. An additional study was conducted, and then, based on response to these studies, additional work was started to investigate and evaluate non-thermal treatment options on a footing comparable to the effort devoted to thermal options. This report attempts to present a summary overview of the thermal and non-thermal treatment technologies which were examined in detail in the process of the above mentioned reviews.

  8. Upper cervical injuries: Clinical results using a new treatment algorithm.

    Science.gov (United States)

    Joaquim, Andrei F; Ghizoni, Enrico; Tedeschi, Helder; Yacoub, Alexandre R D; Brodke, Darrel S; Vaccaro, Alexander R; Patel, Alpesh A

    2015-01-01

    Upper cervical injuries (UCI) have a wide range of radiological and clinical presentation due to the unique complex bony, ligamentous and vascular anatomy. We recently proposed a rational approach in an attempt to unify prior classification system and guide treatment. In this paper, we evaluate the clinical results of our algorithm for UCI treatment. A prospective cohort series of patients with UCI was performed. The primary outcome was the AIS. Surgical treatment was proposed based on our protocol: Ligamentous injuries (abnormal misalignment, facet perched or locked, increase atlanto-dens interval) were treated surgically. Bone fractures without ligamentous injuries were treated with a rigid cervical orthosis, with exception of fractures in the dens base with risk factors for non-union. Twenty-three patients treated initially conservatively had some follow-up (mean of 171 days, range from 60 to 436 days). All of them were neurologically intact. None of the patients developed a new neurological deficit. Fifteen patients were initially surgically treated (mean of 140 days of follow-up, ranging from 60 to 270 days). In the surgical group, preoperatively, 11 (73.3%) patients were AIS E, 2 (13.3%) AIS C and 2 (13.3%) AIS D. At the final follow-up, the American Spine Injury Association (ASIA) score was: 13 (86.6%) AIS E and 2 (13.3%) AIS D. None of the patients had neurological worsening during the follow-up. This prospective cohort suggested that our UCI treatment algorithm can be safely used. Further prospective studies with longer follow-up are necessary to further establish its clinical validity and safety.

  9. Treatment results of functional endoscopic sinus surgery in chronic sinusitis

    Directory of Open Access Journals (Sweden)

    Naraghi M

    2002-07-01

    Full Text Available Background: Endoscopic sinus surgery has been used for diagnosis and treatment of chronic inflammatory diseases of paranasal sinuses since recent years. Materials and Methods: In this study 104 patients with chronic sinusitis (with or without polyps which were managed with endoscopic sinus surgery (ESS were followed for 6 to 24 months after surgery (24 patients refused to continue follow up and the recovery rate of symptoms were evaluated. Results: The effectiveness of this therapy is statistically approved and the most important symptom which diminished was nasal obstruction (from 95 percent to 18.5 percent, the least important symptom which diminished was anosmia (from 57 percent to 21 percent. Conclusion: This study confirmed the efficacy of functional endoscopic sinus surgery in improvement of chronic sinusitis symptoms.

  10. Global Positioning System receiver evaluation results

    Energy Technology Data Exchange (ETDEWEB)

    Byrne, R.H.

    1993-09-01

    A Sandia project currently uses an outdated Magnavox 6400 Global Positioning System (GPS) receiver as the core of its navigation system. The goal of this study was to analyze the performance of the current GPS receiver compared to newer, less expensive models and to make recommendations on how to improve the performance of the overall navigation system. This paper discusses the test methodology used to experimentally analyze the performance of different GPS receivers, the test results, and recommendations on how an upgrade should proceed. Appendices contain detailed information regarding the raw data, test hardware, and test software.

  11. [Evaluation and results of ablative therapies in prostate cancer].

    Science.gov (United States)

    Renard-Penna, R; Sanchez-Salas, R; Barret, E; Cosset, J M; de Vergie, S; Sapetti, J; Ingels, A; Gangi, A; Lang, H; Cathelineau, X

    2017-11-01

    To perform a state of the art about methods of evaluation and present results in ablative therapies for localized prostate cancer. A review of the scientific literature was performed in Medline database (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using different associations of keywords. Publications obtained were selected based on methodology, language and relevance. After selection, 102 articles were analysed. Analyse the results of ablative therapies is presently difficult considering the heterogeneity of indications, techniques and follow-up. However, results from the most recent and homogeneous studies are encouraging. Oncologically, postoperative biopsies (the most important criteria) are negative (without any tumor cells in the treated area) in 75 to 95%. Functionally, urinary and sexual pre-operative status is spared (or recovered early) in more than 90% of the patients treated. More and more studies underline also the correlation between the results and the technique used considering the volume of the gland and, moreover, the "index lesion" localization. The post-treatment pathological evaluation by biopsies (targeted with MRI or, perhaps in a near future, with innovative ultrasonography) is the corner stone of oncological evaluation of ablative therapies. Ongoing trials will allow to standardize the follow-up and determine the best indication and the best techniques in order to optimize oncological and functional results for each patient treated. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. [Treatment results for different categories of vaginal intraepithelial neoplasia with electrocoagulation, 5-fluorouracil and combined treatment].

    Science.gov (United States)

    Veloz-Martínez, María Guadalupe; Quintana-Romero, Verónica; Contreras-Morales, María del Rosario Sandra; Jiménez-Vieyra, Carlos Ramón

    2015-10-01

    Vaginal intraepithelial neoplasia (VAIN) represents a variety of changes that initiate as an intraepithelial squamous lesion with the possibility of resulting in cancer. To compare the results of the treatment for the different categories of VAIN with electrocoagulation, 5-fluorouracil and combined treatment. Observational an analytical study. We stablished groups according to the category of VAIN evaluating and comparing remission, persistence, recurrence, or progression of the disease ac- cording to the received treatment, with a 1-year follow up. The results were compared by chi2 and Kruskal Wallis. The statistics analysis was done with the SPSS program version 20. One hundred thirty seven patients between 20 and 81 years of age (mean age: 52.49 years) were included. Seventy-four percent of the patients had a history of premalignant or malignant cervical lesions. Seventy-four patients had VAIN I, 34 patients had VAIN II, 22 patients had VAIN III and there were seven cases of vaginal carcinoma in situ. Fifty-eight patients were treated with electrocoagulation, 55 patients were treated with 5-FU, 16 patients had combined treatment, and eight patients received expectant management. Sixty three percent of patients had total remission of the lesion, 34% had persistence and 3% showed progression, and there were no cases of recurrence. Results were better in patients with VAIN I treated with 5-FU (bigger percentage of remission P .026), for the remaining categories of VAIN, no treatment showed superior results. The superior response occurs in patients with VAIN I treated with 5-FU. None of the treatments achieves a 100% remission. The VAIN frequency is high, patients with a history of malignant or premalignant cervical pathology should undergo a closer surveillance through cytocolposcopic control with respect to the remaining population.

  13. [Evaluation of the results of lumbar sympathectomy using hemodynamic variables].

    Science.gov (United States)

    Ley Pozo, J; Vega Gómez, M E; Ochoa Bizet, M; Cardona Alvarez, M; Romero Valdés, A; Fernández Boloña, A; Gutiérrez Jiménez, O

    1990-01-01

    In order to evaluate the results of the lumbar sympathectomy, we studied 49 patients in the National Institute of Angiology and Vascular Surgery during two years. The hemodynamic tests were performed the day before and one month after the surgical intervention; they included: skin thermometry, measurement of arterial blood flow and resistance in the foot and in the leg, and reactive hyperemia under photoplethysmographic control. Objectively, it could be seen only an increase in the distal skin temperature and an increase of skin blood flow after this treatment.

  14. Results of a Phase 2, Randomized,Vehicle-Controlled Study Evaluating the Efficacy,Tolerability, and Safety of Daily or Twice Daily SB204 for the Treatment of Acne Vulgaris.

    Science.gov (United States)

    Eichenfield, Lawrence F; Gold, Linda Stein; Nahm, Walter K; Cook-Bolden, Fran E; Pariser, David M

    2016-12-01

    This randomized, double-blind, placebo-controlled, Phase 2 study compared efficacy, tolerability, and safety of SB204 once or twice daily to vehicle in the treatment of acne vulgaris. Eligible subjects were to be between 12 and 40 years old, have facial acne vulgaris with 25 to 70 non-inflammatory lesions, 20 to 40 inflammatory lesions, no more than 2 nodules, and a baseline Investigator's Global Assessment (IGA) score of moderate or severe. The co-primary efficacy endpoints were the absolute change in inflammatory and non-inflammatory lesion counts and IGA success rate (baseline to week 12). Safety assessments included reported adverse events (AEs), physical examinations, and laboratory testing. Tolerability was evaluated by the investigators based on the occurrence and severity of erythema, scaling, dryness, pruritus, and burning/stinging. A total of 213 subjects were randomized: 27 subjects to vehicle once daily; 29 subjects to vehicle twice daily; 53 subjects to SB204 2% twice daily; 52 subjects to SB204 4% once daily; and 52 subjects to SB204 4% twice daily. When compared to vehicle, treatment with all 3 SB204 regimens significantly reduced the absolute inflammatory lesion count and SB204 4% once daily reduced the absolute non-inflammatory lesion count. Treatment with SB204 4% once daily demonstrated a significant reduction in percent inflammatory lesions by week 4. There were no significant differences in the IGA success rates between groups at the end of treatment. All treatment regimens of SB204 were found to be safe and well tolerated. When compared to vehicle, SB204 2% and SB204 4% significantly decreased the absolute inflammatory lesion count and SB204 4% once daily also significantly decreased the absolute non-inflammatory lesion count in subjects with acne vulgaris treated for 12 weeks. Treatment with SB204 2% and 4% was found to be safe and well tolerated. J Drugs Dermatol. 2016;15(12):1496-1502.

  15. [Operative treatment of flexor pollicis longus tendon with Krackow suture, functional results--preliminary results].

    Science.gov (United States)

    Bumbasirević, Marko Z; Andjelković, Sladjana; Lesić, Aleksandar R; Sudjić, Vojo S; Palibrk, Tomislav; Tulić, Goran Dz; Radenković, Dejan V; Bajec, Djordje D

    2010-01-01

    Surgical treatment of the injuried flexor tensons is the important part of hand surgery. Tendon adhesions, ruptures, joint contcatures-stifness are only one part of the problem one is faced during the tendon treatment. In spite of improvement in surgical technique and suture material, the end result of sutured flexor tendons still represent a serious problem. To present of operative treatment of flexor pollicis longus injury with Krakow suture technique. All patients are treated in the first 48 hours after the accident. The regional anesthesia was performed with use of turniquet. Beside spare debridement, the reconstruction of digital nerves was done. All patients started with active and pasive movements-excercises on the first postoperative day. Follow-up was from 6 to 24 months. In evaluation of functional recovery the grip strenght, pinch strenght, range of movements of interphalangeal and metacarpophalangeal joiht and DASH score were used. In the last two years there were 30 patients, 25 males (83.33%) and 5 females (16.66%). Mean age was 39.8 years, ranged from 17 to 65 years. According to mechanism of injury the patients were divided in two groups: one with sharp and other with wider zone of injury. Concomitant digital nerve lesions was noticed in 15 patients (50%). the Krackow sutrue allowed early rehabilitation, which prevent tendon adhesions, enabled faster and better functional recovery.

  16. Evaluation of NORM concentration in water treatment of Pocos de Caldas municipality, MG, Brazil: preliminary results; Avaliacao da presenca de NORM no tratamento de agua do municipio de Pocos de Caldas: resultados preliminares

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Adriano Mota; Villegas, Raul A.S.; Fukuma, Henrique Takuji, E-mail: htfukuma@cnen.gov.br, E-mail: adrianomotaferreira@gmail.com [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil)

    2014-07-01

    NORM is the acronym used to refer to naturally occurring radioactive materials. Besides being objects of study and monitoring such materials can be used as raw material or as by-products or waste of industrial activities. Oil and gas, mining and water treatment are examples of facilities that can handle NORM. In such cases, their concentration at significant levels from the perspective of environmental and occupational radiation protection may occur. This study aims to evaluate the presence of the natural radioactive {sup 238}U and {sup 232}Th series in the treatment of city water elements Pocos de Caldas - MG (water, materials and waste). The study can serve as an indication of the necessity of a more detailed review in the locally and in the country on this radiological issue. (author)

  17. Cosmetic results of conservative treatment for early breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo Kyoung; Shin, Seong Soo; Kim, Seong Deok; Ha, Sung Whan; Noh, Dong Young [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2001-03-01

    This study was performed to evaluate the cosmetic outcome of conservative treatment for early breast cancer and to analyze the factors influencing cosmetic outcome. From February 1992 through January 1997, 120 patients with early breast cancer were treated with conservative surgery and postoperative radiotherapy. The types of conservative surgery were quadrantectomy and axillary node dissection for 108 patients (90%) and lumpectomy or excisional biopsy for 10 patients (8.3%). Forty six patients (38%) received adjuvant chemotherapy (CMF or CAF). Cosmetic result evaluation was carried out between 16 and 74 months (median, 33 months) after surgery. The cosmetic results were classified into four categories, i.e., excellent, good, fair, and poor. The appearances of the patients' breasts were also analyzed for symmetry using the differences in distances from the stemal notch to right and left nipples. A logistic regression analysis was performed to identify independent variables influencing the cosmetic outcome. Cosmetic score was excellent or good in 76% (91/120), fair in 19% (23/120) and poor in 5% (6/ 120) of the patients. Univariate analysis showed that tumor size (T1 versus T2) (p=0.04), axillary node status (NO versus N1) (p=0.0002), extent of surgery (quadrantectomy versus lumpectomy or excisional biopsy) (p=0.02), axillary node irradiation (p=0.0005) and chemotherapy (p=0,0001) affected cosmetic score. Multivariate analysis revealed that extent of surgery (p=0.04) and chemotherapy (p=0.0002) were significant factors. For breast symmetry, univariate analysis confirmed exactly the same factors as above. Multivariate analysis revealed that tumor size (p=0.003) and lymph node status (p=0.007) affected breast symmetry. Conservative surgery and postoperative radiotherapy resulted in excellent or good cosmetic outcome in a large portion of the patients. Better cosmetic results were achieved generally in the group of patients with smaller tumor size, without

  18. Evaluation of the efficacy and safety of imidacloprid 10% plus moxidectin 2.5% spot-on in the treatment of generalized demodicosis in dogs: results of a European field study.

    Science.gov (United States)

    Heine, J; Krieger, K; Dumont, P; Hellmann, K

    2005-10-01

    Efficacy and safety of the test product imidacloprid 10%+moxidectin 2.5% spot on (Advocate, Advantage multi) in the treatment of canine generalized demodicosis were evaluated in a multi-centre, controlled, randomized, blinded field study in Albania, France, and Germany. The study was conducted according to a non-inferiority design to demonstrate that the efficacy of the test product is not inferior to that of a control product containing milbemycin oxime (Interceptor, tablets for oral application). Of the 72 dogs enrolled, all of which expressed clinical signs of generalized demodicosis, 63 completed the study. Of these, 30 dogs were treated 2-4 times, at 4-week intervals, with the test product at the recommended dose of at least 0.1 ml/kg body weight. Thirty-three dogs were treated daily for two to four periods of 4 weeks with the control product according to label instructions (0.5-1 or 1-2 mg/kg body weight). Presence of mites in deep skin scrapings and clinical improvement were assessed 3-6 times at each inspection at 4-week intervals. Treatment was discontinued in dogs negative for mites on two subsequent examinations 4 weeks apart or at the last examination on day 84. At the end of the trial, dogs in both groups showed a similar clinical improvement. No Demodex mites were detected in 26 of 30 dogs treated with imidacloprid/moxidectin and in 29 of 33 dogs treated with milbemycin oxime. Statistical evaluation confirmed that the efficacy of the test product in the treatment of generalized canine demodicosis was not inferior to that of milbemycin oxime.

  19. Treatment results of incomplete chemoradiotherapy in locally advanced cervical cancer

    Directory of Open Access Journals (Sweden)

    Gao Y

    2013-04-01

    Full Text Available Ying Gao,1,* Fei Gao,2,* Zi Liu,1 Li-ping Song1 1Department of Radiotherapy Oncology, First Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, People’s Republic of China; 2Second Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, People’s Republic of China *These authors contributed equally to this work Objective: Regimens that combine chemotherapy and radiotherapy increase toxicity and compromise a patient’s ability to adhere to the treatment plan. We evaluated the efficacy and safety of a partially completed chemoradiation regimen prescribed for locally advanced carcinoma of the cervix. Methods: Medical records of 156 patients with locally advanced cervical cancer stage IIB–IVA who received chemoradiation with cisplatin (40 mg/m2 and 5-fluorouracil (500 mg/m2 from October 2006 to October 2008 were collected. The treatment protocol called for two cycles of chemotherapy. External beam radiation therapy was administered using a 10-MeV electron beam. Local control, disease free survival, overall survival, and toxicities were evaluated. Results: With a median follow-up of 37.5 months, 89 patients (57% completed the planned protocol. Sixty seven patients (43% completed fewer than two cycles. The 3-year local control rate was significantly better in the patient group that completed the prescribed plan (92.1% compared to 80.6%; P = 0.033. No statistical significance was observed between the groups that completed or did not complete the two cycle protocol with regard to disease free survival (80.9% and 73.2%, respectively; P = 0.250, overall survival (84.3% and 79.1%; P = 0.405, and progression survival (3.4% and 3.0%; P = 0.892. Differences in acute hematologic toxicity and subcutaneous toxicity were observed between the two groups. Conclusions: Completion of two cycles of 5-fluorouracil and cisplatin with radiotherapy was effective, safe, and responsible for better local control

  20. Fragility fractures of the pelvis: treatment and preliminary results.

    Science.gov (United States)

    Arduini, M; Saturnino, L; Piperno, A; Iundusi, R; Tarantino, U

    2015-10-01

    With increasing life expectancy, fragility fractures of the pelvic ring (FFP) are becoming frequent. In elderly, osteoporosis leads to a decrease of bone strength and resistance to the ligament's traction; this represents the most important difference between FFP and fractures in young patients. Usually, these fractures are underestimated and treatment is often conservative. To evaluate clinical and surgical outcomes of surgically treated patients with FFP. We retrospectively enrolled 14 patients, in our Trauma Center, underwent surgery procedures for FFP between 2012 and 2014. All patients attended clinical and radiological investigation at 1, 3, and 6 months postoperatively and every year after surgery with a mean follow-up of 22 months. At 6-month follow-up, 11 patients resulted asymptomatic: able to maintain standing position and walk without crunches. Two patients were able to walk with one crunch. The patient with history of previous acetabular fracture walks with two crunches and is still waiting for total hip arthroplasty. The compromised health status and the diminished bone-healing capacity, in elderly, decrease chances for a good clinical outcome. In literature, many authors suggest that mortality rate in patients with FFP is similar to those with hip fracture. Diagnosis of FFP is very important: these fractures are highly disabling in elderly and can lead to displacement and instability. For these reasons, correct diagnosis and well-conduct preoperative plan are necessary to improve stability of fractures and support bone healing. After diagnosis, an anti-osteoporotic treatment is indicated to improve bone quality and bone healing. Our study shows encouraging results and demonstrates that minimally or less invasive osteosynthesis technique could lead to good outcome in these patients.

  1. Integrated thermal treatment system study -- Phase 2 results. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Feizollahi, F.; Quapp, W.J.

    1996-02-01

    This report presents the second phase of a study on thermal treatment technologies. The study consists of a systematic assessment of nineteen thermal treatment alternatives for the contact-handled mixed low-level waste (MLLW) currently stored in the US Department of Energy complex. The treatment alternatives consist of widely varying technologies for safely destroying the hazardous organic components, reducing the volume, and preparing for final disposal of the MLLW. The alternatives considered in Phase 2 were innovative thermal treatments with nine types of primary processing units. Other variations in the study examined the effect of combustion gas, air pollution control system design, and stabilization technology for the treatment residues. The Phase 1 study examined ten initial thermal treatment alternatives. The Phase 2 systems were evaluated in essentially the same manner as the Phase 1 systems. The alternatives evaluated were: rotary kiln, slagging kiln, plasma furnace, plasma gasification, molten salt oxidation, molten metal waste destruction, steam gasification, Joule-heated vitrification, thermal desorption and mediated electrochemical oxidation, and thermal desorption and supercritical water oxidation. The quantities, and physical and chemical compositions, of the input waste used in the Phase 2 systems differ from those in the Phase 1 systems, which were based on a preliminary waste input database developed at the onset of the Integrated Thermal Treatment System study. The inventory database used in the Phase 2 study incorporates the latest US Department of Energy information. All systems, both primary treatment systems and subsystem inputs, have now been evaluated using the same waste input (2,927 lb/hr). 28 refs., 88 figs., 41 tabs.

  2. Intratumoral Immunocytokine Treatment Results in Enhanced Antitumor Effects

    Science.gov (United States)

    Johnson, Erik E.; Lum, Hillary D.; Rakhmilevich, Alexander L.; Schmidt, Brian E.; Furlong, Meghan; Buhtoiarov, Ilia N.; Hank, Jacquelyn A.; Raubitschek, Andrew; Colcher, David; Reisfeld, Ralph A.; Gillies, Stephen D.; Sondel, Paul M.

    2008-01-01

    Immunocytokines (IC), consisting of tumor-specific monoclonal antibodies fused to the immunostimulatory cytokine interleukin 2 (IL2), exert significant antitumor effects in several murine tumor models. We investigated whether intratumoral (IT) administration of IC provided enhanced antitumor effects against subcutaneous tumors. Three unique ICs (huKS-IL2, hu14.18-IL2, and GcT84.66-IL2) were administered systemically or IT to evaluate their antitumor effects against tumors expressing the appropriate IC-targeted tumor antigens. The effect of IT injection of the primary tumor on a distant tumor was also evaluated. Here, we show that IT injection of IC resulted in enhanced antitumor effects against B16-KSA melanoma, NXS2 neuroblastoma, and human M21 melanoma xenografts when compared to intravenous (IV) IC injection. Resolution of both primary and distant subcutaneous tumors, and a tumor-specific memory response were demonstrated following IT treatment in immunocompetent mice bearing NXS2 tumors. The IT effect of huKS-IL2 IC was antigen-specific, enhanced compared to IL2 alone, and dose-dependent. Hu14.18-IL2 also showed greater IT effects than IL2 alone. The antitumor effect of IT IC did not always require T cells since IT IC induced antitumor effects against tumors in both SCID and nude mice. Localization studies using radiolabeled 111In-GcT84.66-IL2 IC confirmed that IT injection resulted in a higher concentration of IC at the tumor site than IV administration. In conclusion, we suggest that IT IC is more effective than IV administration against palpable tumors. Further testing is required to determine how to potentially incorporate IT administration of IC into an antitumor regimen that optimizes local and systemic anticancer therapy. PMID:18438664

  3. Treatment of otosclerosis with a superelastic nitinol piston: first results.

    Science.gov (United States)

    Bast, F; Weikert, S; Schrom, T

    2011-04-01

    Stapedotomy with implantation of an alloplastic prosthesis is a well-established therapy for the treatment of otosclerosis. Since the middle of 2008, a new Nitinol prosthesis with memory function and superelastic properties has been available which is expected to make fixation on the long process of the incus much easier. The advantage of this prosthesis is that heat-induced wire crimping is no longer necessary and damage to the incus caused by heat is avoided. Since May 2008, laser-assisted stapedotomy with implantation of a Nitinol prosthesis was performed in 21 patients suffering from otosclerosis. The prostheses used for all patients had a size of 4.5 mm × 0.4 mm. The patient collective consisted of 14 women and 7 men with a mean age of 53.4 years. Pre- and postoperatively, an ENT examination was carried out followed by an audiological evaluation of the hearing result. In addition, the properties of the prosthesis ("proper fitt", "handling", and "overall rating") were evaluated intraoperatively by means of a test protocol. The Nitinol prosthesis was implanted successfully in all 21 patients. The mean air-bone gap for the frequencies from 0.5 to 4 kHz was 9.83 dB postoperatively. Intraoperatively, the fit of the prosthesis was rated as "good to very good", the handling as "good" and the overall rating of the system was "good to very good". Our patient collective showed good postoperative hearing results. Due to simple intraoperative handling, especially placing the Nitinol prosthesis in position, the critical work step of crimping is no longer necessary.

  4. FUNCTIONAL RESULTS OF SURGICAL TREATMENT OF CERVICAL SPONDYLOTIC MYELOPATHY

    Directory of Open Access Journals (Sweden)

    MARVIN JESUALDO VARGAS UH

    Full Text Available ABSTRACT Objective: To analyze the functional outcome of surgical treatment of cervical spondylotic myelopathy. Methods: A retrospective study involving 34 patients with CSM, operated from January 2014 to June 2015. The neurological status was assessed using the Nurick and modified Japanese Orthopedic Association (mJOA scales preoperatively and at 12 months. Sex, age, time of evolution, affected cervical levels, surgical approach and T2-weighted magnetic resonance hyperintense signal were also evaluated. Results: A total of 14 men and 20 women participated. The mean age was 58.12 years. The average progression time was 12.38 months. The preoperative neurological state by mJOA was mild in 2 patients, moderate in 16 and severe in 16, with a mean of 11.44 points. The preoperative Nurick was grade II in 14 patients, grade III in 8, grade IV in 10 and grade V in 2. The T2-weighted hyperintense signal was documented in 18 patients (52.9%. The functional outcome according to the mJOA recovery rate was good in 15 patients (44.1% and poor in 19 (55.9%. The degree of Nurick recovery was good in 20 (58.8% and poor in 14 (41.2%. Conclusions: Decompressive surgery of the spinal cord has been shown to be effective in the treatment of cervical spondylotic myelopathy in well-selected patients. Although it is suggested that there are certain factors that correlate with functional outcome, we believe that more prospective randomized studies should be conducted to clarify this hypothesis.

  5. Evaluation of treatment effects by ranking

    DEFF Research Database (Denmark)

    Halekoh, U; Kristensen, K

    2008-01-01

    In crop experiments measurements are often made by a judge evaluating the crops' conditions after treatment. In the present paper an analysis is proposed for experiments where plots of crops treated differently are mutually ranked. In the experimental layout the crops are treated on consecutive...... plots usually placed side by side in one or more rows. In the proposed method a judge ranks several neighbouring plots, say three, by ranking them from best to worst. For the next observation the judge moves on by no more than two plots, such that up to two plots will be re-evaluated again...

  6. Influence of selected antithrombotic treatment on thromboelastometric results

    DEFF Research Database (Denmark)

    Holck, Mia Hammer; Christensen, Thomas Decker; Hvas, Anne-Mette

    2017-01-01

    treatment. The objective of the present study was to examine if the ROTEM(®) results are affected in patients receiving antithrombotic treatment. This prospective observational study included patients receiving either vitamin K-antagonists (VKA), aspirin (ASA) or ASA combined with an adenosine diphosphate...... glomerular filtration rate, and C-reactive protein were determined. The study included 231 patients receiving antithrombotic treatment and compared the results to ROTEM(®) previously collected data from 73 healthy subjects. The VKA (n = 73) patients had a consistently prolonged EXTEM clot initiation (p...

  7. [Late results of the treatment of eye burns].

    Science.gov (United States)

    Szweda, E; Stafiej, J; Cieślińska, I

    1992-04-01

    An analysis of patients treated in the Ophthalmic Department in Bydgoszcz for eye burns in the 10 years period from 1980 till 1990. Taken into account were the causes of burns, the treatment installed in the early period and in cases of late complications. All the patients were asked to call in for a control examination in order to compare the condition of the eyes at the date of discharge and in the long-lasting time. Among 118 eyes in 91 the visual acuity amounted 0.5-1.0, in the remaining 25 it was only hand movements--0.4. The main causes of low visual acuity were: corneal leucoma, secondary glaucoma, complicated cataract. The eye was enucleated in 2 patients because a painful ocular atrophy developed in the course of the pathological process. These were the cases of thermal burns combined with a mechanical injury. The obtained results were evaluated as sufficiently favourable and comparable to the data of other authors.

  8. Avaliação dos resultados do tratamento cirúrgico de pacientes portadoras de endometriose do septo retovaginal Evaluation of the results of surgical treatment of patients with endometriosis of the rectovaginal septum

    Directory of Open Access Journals (Sweden)

    Walid Makin Fahmy

    2005-10-01

    Full Text Available OBJETIVO: avaliar os resultados dos 14 primeiros casos de tratamento cirúrgico videolaparoscópico de pacientes com endometriose profunda do septo retovaginal no Setor de Endoscopia Ginecológica do Hospital do Servidor Público Estadual "Francisco Morato de Oliveira". MÉTODOS: foi realizada análise retrospectiva com dados retirados de prontuários, associada ao atendimento ambulatorial pós-operatório das 14 pacientes operadas entre fevereiro de 2002 e fevereiro de 2004, apresentando as seguintes características: a idade das pacientes variou de 33 a 44 anos, com média de 38,4; a paridade variou de 0 a 3, com média de 1,1; os principais sintomas pré-operatórios foram: dismenorréia em 14 (100%, dispareunia de profundidade em 12 (85,7%, dor pélvica acíclica em 10 (71,4%, dor à evacuação em duas (14,3%, enterorragia em duas (14,3% e infertilidade em duas (14,3%. A dosagem plasmática do CA-125 esteve entre 3,6 e 100,3 U/mL, com média de 52,9 U/mL. RESULTADOS: o exame anatomopatológico das lesões do septo retovaginal foi compatível com endometriose em nove (64,3% pacientes. Quanto à sintomatologia dolorosa, houve regressão total em sete (50% pacientes, melhora de mais de 80% em duas (14,3%, sem melhora em quatro (28,6% e piora em uma (7,1%. A incidência de complicações foi de 14,3%, sendo uma lesão de ureter associada a lesão no sigmóide e uma lesão retal diagnosticada no 8º dia de pós-operatório. CONCLUSÃO: pode-se concluir que a endometriose profunda do septo retovaginal pode ser tratada pela cirurgia laparoscópica, com baixa morbidade, e trazendo alívio dos sintomas para a maioria das pacientes.PURPOSE: to evaluate the results of 14 cases of laparoscopic surgical treatment of patients with deep endometriosis of the rectovaginal septum in the Sector of Gynecological Endoscopy of the 'Hospital do Servidor Público Estadual "Francisco Morato de Oliveira"'. METHODS: a retrospective analysis was accomplished with data

  9. Pathways to aggression in schizophrenia affect results of treatment.

    Science.gov (United States)

    Volavka, Jan; Citrome, Leslie

    2011-09-01

    Schizophrenia elevates the risk for aggressive behavior and violent crime, and different approaches have been used to manage this problem. The results of such treatments vary. One reason for this variation is that aggressive behavior in schizophrenia is heterogeneous in origin. This heterogeneity has usually not been accounted for in treatment trials nor is it adequately appreciated in routine clinical treatment planning. Here, we review pathways that may lead to the development of aggressive behavior in patients with schizophrenia and discuss their impact on treatment. Elements in these pathways include predisposing factors such as genotype and prenatal toxic effects, development of psychotic symptoms and neurocognitive impairments, substance abuse, nonadherence to treatment, childhood maltreatment, conduct disorder, comorbid antisocial personality disorder/psychopathy, and stressful experiences in adult life. Clinicians' knowledge of the patient's historical trajectory along these pathways may inform the choice of optimal treatment of aggressive behavior. Clozapine has superior antiaggressive activity in comparison with other antipsychotics and with all other pharmacological treatments. It is usually effective when aggressive behavior is related to psychotic symptoms. However, in many patients, aggression is at least partly based on other factors such as comorbid substance use disorder, comorbid antisocial personality disorder/psychopathy, or current stress. These conditions which are sometimes underdiagnosed in clinical practice must be addressed by appropriate adjunctive psychosocial approaches or other treatments. Treatment adherence has a crucial role in the prevention of aggressive behavior in schizophrenia patients.

  10. Infertility Evaluation and Treatment among Women in the United States

    Science.gov (United States)

    Kessler, Lawrence M.; Craig, Benjamin M.; Plosker, Shayne M.; Reed, Damon R.; Quinn, Gwendolyn P.

    2013-01-01

    Objective To examine the characteristics of women seeking infertility evaluation and treatment. Design Cross-sectional survey based on in-person interviews, followed by two-step hurdle analysis. Participants 4,558 married or cohabitating women ages 25–44 Setting U.S. household population of women based on the 2006–2010 National Survey of Family Growth Intervention None Main Outcome Measure(s) Likelihood of seeking preliminary infertility evaluation. Likelihood of seeking infertility treatment once evaluated. Treatment type provided. Results 623 women (13.7%) reported seeking infertility evaluation, of which 328 reported undergoing subsequent infertility treatment. Age at marriage, marital status, education, health insurance status, race/ethnicity, and religion were associated with the likelihood of seeking infertility evaluation. For example, the predicted probability that a non-White woman who married at 25 will seek evaluation was 12%. This probability increased to 34% for White women with a graduate degree who married at age 30. Among women who are evaluated, income, employment status, and ethnicity correlated strongly with the likelihood of seeking infertility treatment. Infertility drug therapy was the most frequent treatment used. Reproductive surgery and in vitro fertilization (IVF) were used the least. Conclusions The use of infertility services is not random and understanding the socio-demographic factors correlated with use may assist new couples with family planning. Roughly 50% of the women evaluated for infertility progressed to treatment, and only a small proportion were treated with more advanced assisted reproductive technologies (ARTs) such as IVF therapy. Future research aimed at improving access to effective healthcare treatments within the boundaries of affordability is warranted. PMID:23849845

  11. Radiobiologically based treatment plan evaluation for prostate seed implants

    Directory of Open Access Journals (Sweden)

    Sotirios Stathakis

    2011-07-01

    Full Text Available Purpose: Accurate prostate low dose-rate brachytherapy treatment plan evaluation is important for future care decisions. Presently, an evaluation is based on dosimetric quantifiers for the tumor and organs at risk. However, these do not account for effects of varying dose-rate, tumor repopulation and other biological effects. In this work, incorporation of the biological response is used to obtain more clinically relevant treatment plan evaluation.Material and methods: Eleven patients were evaluated. Each patient received a 145 Gy implant. Iodine-125 seeds were used and the treatment plans were created on the Prowess system. Based on CT images the post-implant plan was created. In the post-plan, the tumor, urethra, bladder and rectum were contoured. The biologically effective dose was used to determine the tumor control probability and the normal tissue complication probabilities for the urethra, bladder, rectum and surrounding tissue. Results: The average tumor control probability and complication probabilities for the urethra, bladder, rectum and surrounding tissue were 99%, 29%, 0%, 12% and 6%, respectively. These measures provide a simpler means for evaluation and since they include radiobiological factors, they provide more reliable estimation of the treatment outcome. Conclusions: The goal of this work was to create more clinically relevant prostate seed-implant evaluation by incorporating radiobiological measures. This resulted in a simpler descriptor of treatment plan quality and was consistent with patient outcomes.

  12. Improving treatment plan evaluation with automation

    Science.gov (United States)

    Covington, Elizabeth L.; Chen, Xiaoping; Younge, Kelly C.; Lee, Choonik; Matuszak, Martha M.; Kessler, Marc L.; Keranen, Wayne; Acosta, Eduardo; Dougherty, Ashley M.; Filpansick, Stephanie E.; Moran, Jean M.

    2017-01-01

    The goal of this work is to evaluate the effectiveness of Plan-Checker Tool (PCT) which was created to improve first-time plan quality, reduce patient delays, increase the efficiency of our electronic workflow, and standardize and automate the physics plan review in the treatment planning system (TPS). PCT uses an application programming interface to check and compare data from the TPS and treatment management system (TMS). PCT includes a comprehensive checklist of automated and manual checks that are documented when performed by the user as part of a plan readiness check for treatment. Prior to and during PCT development, errors identified during the physics review and causes of patient treatment start delays were tracked to prioritize which checks should be automated. Nineteen of 33checklist items were automated, with data extracted with PCT. There was a 60% reduction in the number of patient delays in the six months after PCT release. PCT was successfully implemented for use on all external beam treatment plans in our clinic. While the number of errors found during the physics check did not decrease, automation of checks increased visibility of errors during the physics check, which led to decreased patient delays. The methods used here can be applied to any TMS and TPS that allows queries of the database. PMID:27929478

  13. Land Treatment Research and Development Program, Synthesis of Research Results,

    Science.gov (United States)

    1983-08-01

    the impact of effluent application. Elgawhary, S.M., I.K. Iskandar and B.J. Blake (1979) Evaluation of nitrification inhibitors in cold regions lond...investigate the possibility that nitrapyrin could be useful. as a nitrification inhibitor in land treatment. Laboratory tests included soil incubation and soil...the U.S. Army Engineer Waterways Experiment Station, Vicksburg, Mississippi, the Agriculture Research Service, St. Paul, Minnesota, and many

  14. Planning, optimisation and evaluation of hyperthermia treatments.

    Science.gov (United States)

    Kok, H P; Kotte, A N T J; Crezee, J

    2017-09-01

    Hyperthermia treatment planning using dedicated simulations of power and temperature distributions is very useful to assist in hyperthermia applications. This paper describes an advanced treatment planning software package for a wide variety of applications. The in-house developed C++ software package Plan2Heat runs on a Linux operating system. Modules are available to perform electric field and temperature calculations for many heating techniques. The package also contains optimisation routines, post-treatment evaluation tools and a sophisticated thermal model enabling to account for 3D vasculature based on an angiogram or generated artificially using a vessel generation algorithm. The use of the software is illustrated by a simulation of a locoregional hyperthermia treatment for a pancreatic cancer patient and a spherical tumour model heated by interstitial hyperthermia, with detailed 3D vasculature included. The module-based set-up makes the software flexible and easy to use. The first example demonstrates that treatment planning can help to focus the heating to the tumour. After optimisation, the simulated absorbed power in the tumour increased with 50%. The second example demonstrates the impact of accurately modelling discrete vasculature. Blood at body core temperature entering the heated volume causes relatively cold tracks in the heated volume, where the temperature remains below 40 °C. A flexible software package for hyperthermia treatment planning has been developed, which can be very useful in many hyperthermia applications. The object-oriented structure of the source code allows relatively easy extension of the software package with additional tools when necessary for future applications.

  15. Radiobiologically based treatment plan evaluation for prostate seed implants.

    Science.gov (United States)

    Knaup, Courtney; Mavroidis, Panayiotis; Esquivel, Carlos; Baltas, Dimos; Stathakis, Sotirios; Swanson, Gregory; Papanikolaou, Nikos

    2011-06-01

    Accurate prostate low dose-rate brachytherapy treatment plan evaluation is important for future care decisions. Presently, an evaluation is based on dosimetric quantifiers for the tumor and organs at risk. However, these do not account for effects of varying dose-rate, tumor repopulation and other biological effects. In this work, incorporation of the biological response is used to obtain more clinically relevant treatment plan evaluation. Eleven patients were evaluated. Each patient received a 145 Gy implant. Iodine-125 seeds were used and the treatment plans were created on the Prowess system. Based on CT images the post-implant plan was created. In the post-plan, the tumor, urethra, bladder and rectum were contoured. The biologically effective dose was used to determine the tumor control probability and the normal tissue complication probabilities for the urethra, bladder, rectum and surrounding tissue. The average tumor control probability and complication probabilities for the urethra, bladder, rectum and surrounding tissue were 99%, 29%, 0%, 12% and 6%, respectively. These measures provide a simpler means for evaluation and since they include radiobiological factors, they provide more reliable estimation of the treatment outcome. The goal of this work was to create more clinically relevant prostate seed-implant evaluation by incorporating radiobiological measures. This resulted in a simpler descriptor of treatment plan quality and was consistent with patient outcomes.

  16. Evaluation of cervicovaginal smear results at postmenopausal period

    Directory of Open Access Journals (Sweden)

    Sefa Kelekci

    2016-02-01

    Full Text Available This study evaluates the statistical analysis of cervicovaginal smear results at postmenopausal period accompanied by literature. Cervicovaginal smear results of 894 postmenopausal women were evaluated retrospectively according to the 2001 Bethesda system (BS in Adana Numune Training and Research Hospital of Obstetrics and Gynecology Clinic from 2007–2010. The study found, normal results on 287 patients (32.1%, benign findings on 556 patients (62.2%, abnormal epithelial cell changes on 48 patients (5.36% and malignant changes on 3 patients (0.33%. The abnormal epithelial changes were observed to be atypical cells of undetermined significance (ASC-US for 22 patients (2.46%, low-grade squamous intraepithelial lesion (LSIL for 11 patients (1.23%, high-grade squamous intraepithelial lesion(HSIL for 7 patients (0.78%, findings that cannot exclude a high-grade squamous intraepithelial lesion (ASC-H for 6 patients (0.55% and atypical glandular cells-not otherwise specified (AGC-NOS for 2 patients (0.22%. Malignant results were 2 squamous cell carcinomas (SCC (0.22% and 1 adenocarcinoma (ACC (0.11%. Cervical cancer screening programs should be expanded and Pap smear screening should be applied to all postmenopausal women. The longer time span involved from premalignant lesions to cancer improves our chance for the diagnosis and treatment. As the incidence of invasive cancer increases in menopausal period, gynecological smear examination and regular check-up are crucial. A high rate of abnormalities of epithelial cells was detected in this study.

  17. Evaluation results of using sole Ilizarov fixator in Pilon fractures

    Directory of Open Access Journals (Sweden)

    Ahmad Reza Mirbolook

    2014-02-01

    Conclusion: According to the results obtained and comparing them with the results of other treatments ,one can claim that this treating approach is better than the others for pilon fractures,particularly for type 3c pilon fractures.

  18. Treatment modalities and evaluation models for periodontitis

    Science.gov (United States)

    Tariq, Mohammad; Iqbal, Zeenat; Ali, Javed; Baboota, Sanjula; Talegaonkar, Sushama; Ahmad, Zulfiqar; Sahni, Jasjeet K

    2012-01-01

    Periodontitis is the most common localized dental inflammatory disease related with several pathological conditions like inflammation of gums (gingivitis), degeneration of periodontal ligament, dental cementum and alveolar bone loss. In this perspective, the various preventive and treatment modalities, including oral hygiene, gingival irrigations, mechanical instrumentation, full mouth disinfection, host modulation and antimicrobial therapy, which are used either as adjunctive treatments or as stand-alone therapies in the non-surgical management of periodontal infections, have been discussed. Intra-pocket, sustained release systems have emerged as a novel paradigm for the future research. In this article, special consideration is given to different locally delivered anti-microbial and anti inflammatory medications which are either commercially available or are currently under consideration for Food and Drug Administration (FDA) approval. The various in vitro dissolution models and microbiological strain investigated to impersonate the infected and inflamed periodontal cavity and to predict the in vivo performance of treatment modalities have also been thrashed out. Animal models that have been employed to explore the pathology at the different stages of periodontitis and to evaluate its treatment modalities are enlightened in this proposed review. PMID:23373002

  19. Evaluating the effect of synchronized sea lice treatments in Chile.

    Science.gov (United States)

    Arriagada, G; Stryhn, H; Sanchez, J; Vanderstichel, R; Campistó, J L; Rees, E E; Ibarra, R; St-Hilaire, S

    2017-01-01

    The sea louse is considered an important ectoparasite that affects farmed salmonids around the world. Sea lice control relies heavily on pharmacological treatments in several salmon-producing countries, including Chile. Among options for drug administration, immersion treatments represent the majority of antiparasitic control strategies used in Chile. As a topical procedure, immersion treatments do not induce a long lasting effect; therefore, re-infestation from neighbouring farms may undermine their efficacy. Synchronization of treatments has been proposed as a strategy to improve immersion treatment performance, but it has not been evaluated so far. Using a repeated-measures linear mixed-effect model, we evaluated the impact of treatment synchronization of neighbouring farms (within 10km seaway distance) on the adult lice mean abundance from weeks 2 to 8 post-treatment on rainbow trout and Atlantic salmon farms in Chile, while controlling for external and internal sources of lice before the treatments, and also for environmental and fish-related variables. Results indicate that treatment synchronization was significantly associated with lower adult lice levels from weeks 5 to 7 after treatment. This relationship appeared to be linear, suggesting that higher levels of synchronization may result in lower adult sea lice levels during these weeks. These findings suggest that synchronization can improve the performance of immersion delousing treatments by keeping sea lice levels low for a longer period of time. Our results may be applicable to other regions of the world where immersion treatments are widely used. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  20. [Penile protheses multicentre practice evaluation, results after 282 procedures].

    Science.gov (United States)

    Menard, Johann; Tremeaux, Jack-Charles; Faix, Antoine; Staerman, Frédéric

    2007-04-01

    Multicentre practice evaluation in the field of penile prostheses based on the Club des Implanteurs de Prosthèses Péniennes (CIPP) database. 282 penile prostheses, including 276 inflatable prostheses (97.8%), were implanted in 254 patients between 1996 and 2005 in three centres (1 public and 2 private). Preoperative data (patient's age, aetiology and duration of erectile dysfunction, preliminary treatments) and intraoperative data (type of implant used, surgical approach) were recorded. Postoperative complications were studied and postoperative erectile function was evaluated by a self-administered questionnaire (IIEF). The mean follow-up was 27.7 months. Penile prostheses were implanted after an average of 39.2 months of erectile dysfunction in patients with a mean age of 58.6 years. The main aetiologies were arterial disease (35.3%), diabetes (22.8%) and radical prostatectomy (16.5%). The postoperative sepsis rate was 2.2% and the mechanical dysfunction rate was 7.5% at the beginning of the operators' experience. The rate of other complications requiring repeat surgery (erosion, migration, self-inflation) was 1.8% at the beginning of the operators' experience. The septic risk was increased (7.6%) in the presence of diabetes (p = 0.01). The postoperative overall satisfaction was 86.7% and the IIEF score increased from 20.5 +/- 11.8 preoperatively to 68.9 +/- 5.4 postoperatively. Penile prostheses achieve a high postoperative satisfaction score with a low complication rate. However, they are only indicated after failure of less invasive treatments and must be implanted by experienced operators. These results are comparable to those of large international single-centre series.

  1. Treatment results of CO2 laser vaporisation in a cohort of 35 patients with oral leukoplakia

    NARCIS (Netherlands)

    Brouns, E.R.E.A.; Baart, J.A.; Karagozoglu, K.H.; Aartman, I.H.A.; Bloemena, E.; van der Waal, I.

    2013-01-01

    Objectives The aim of the present study was to evaluate the treatment results of CO2 laser vaporisation in a well-defined cohort of patients with oral leukoplakia (OL). Material and methods The group consisted of 35 patients. Before treatment, a clinical photograph and an incisional biopsy were

  2. Review of evaluations of crushing results for the seedbed preparation

    Directory of Open Access Journals (Sweden)

    Siegfried Anisch

    2016-06-01

    Full Text Available For evaluating the work results of tillage operations today only inaccurate parameters are available which cannot be readily measured. Thus, evaluating and comparing the work results of machines and developing suitable sensors are difficult. At the Technical University of Dresden, till 1990, research projects for determining aggregate size composition of soil have been done. Based on this work, this study will show suggestions for measuring, displaying and evaluation of soil crushing results depending on tillage work conditions.

  3. Performance evaluation of effluent treatment plant for automobile industry

    Energy Technology Data Exchange (ETDEWEB)

    Ansari, Farid [Department of Applied Science and Humanities, PDM College of Engineering, Bahadurgarh (Haryana) (India); Pandey, Yashwant K. [School of Energy and Environmental Studies, Devi Ahilya Vishwavidyalaya, Indore (India); Kumar, P.; Pandey, Priyanka [Department of Environmental Science, Post Graduate College Ghazipur (IN

    2013-07-01

    The automobile industry’s wastewater not only contains high levels of suspended and total solids such as oil, grease, dyestuff, chromium, phosphate in washing products, and coloring, at various stages of manufacturing but also, a significant amount of dissolved organics, resulting in high BOD or COD loads. The study reveals the performance, evaluation and operational aspects of effluent treatment plant and its treatability, rather than the contamination status of the real property. The Results revealed that the treated effluent shows most of the parameters are within permissible limits of Central Pollution Control Board (CPCB), India and based on the site visits, discussion with operation peoples, evaluation of process design, treatment system, existing effluent discharge, results of sample analyzed and found that effluent treatment plant of automobile industry are under performance satisfactory.

  4. Results of laser treatment for sub-retinal neovascular membranes ...

    African Journals Online (AJOL)

    A retrospective study was carried out to determine the results of laser treatment for choroidal neovascular membranes in age-related macular degeneration in 92 patients in whom fluorescein angiography was performed for this condition over a 7-year period. Twenty-nine of these patients, treated with the argon laser, were ...

  5. Results of laser treatment for sub-retinal neovascular membranes

    African Journals Online (AJOL)

    1990-09-01

    Sep 1, 1990 ... A retrospective study was carried out to determine the results of laser treatment for choroidal neovascular membranes in age-related macular degeneration in 92 patients in whom fluorescein angiography was performed for this condition over a 7-year period. Twenty-nine of these patients, treated with the ...

  6. Results of treatment in children with anorectal malformations in ...

    African Journals Online (AJOL)

    Enrique

    Results of treatment in children with anorectal malformations in Calabar,. Nigeria. A. E. ARCHIBONG, F.W.A.C.S., PH.D., F.I.C.S.. I. M. IDIKA, M.B. B.S.. Paediatric Surgery Unit, Department of Surgery, University of Calabar, Calabar, Nigeria. Summary. Leading symptoms of anorectal malformation in the neonatal period are ...

  7. Floating knee: epidemiology and results of treatment | Abalo ...

    African Journals Online (AJOL)

    Introduction: Floating Knee is the term applied to ipsilateral fractures of the femur and tibia. Management of this complex injury has been variously described in the literature. This retrospective study was designed to present our experience with treatment of this injury, its complications and the functional results of these ...

  8. Evaluation of two methods in controlling dental treatment water contamination.

    Science.gov (United States)

    Bansal, Ritu; Puttaiah, Raghunath; Harris, Robert; Reddy, Anil

    2011-03-01

    Dental unit water systems are contaminated with biofilms that amplify bacterial counts in dental treatment water in excess of a million colony forming units per milliliter (cfu/ml). The Centers for Disease Control and Prevention and the American Dental Association have agreed that the maximum allowable contamination of dental treatment water not exceed 500 cfu/ml. This study was conducted to evaluate two protocols in controlling contamination of dental unit water systems and dental treatment water. Both methods used an antimicrobial self-dissolving chlorine dioxide (ClO₂) tablet at a high concentration (50 ppm) to shock the dental unit water system biofilms initially followed by periodic exposure. To treat dental treatment source water for patient care, 3 parts per million (ppm) ClO₂ in municipal/tap water was compared to use of a citrus botanical extract dissolved in municipal water. Heterotrophic microbial counts of effluent water and laser scanning confocal microscopy were performed to evaluate effects of the two treatments. Results from this study indicated that both treatments were effective in controlling biofilm contamination and reducing heterotrophic plate counts water system and effects of low-grade chemicals used on composite bonding to dentin and enamel is warranted before translation from efficacy studies to common clinical use. This study provides evidence-based information of using two methods of controlling dental treatment water contamination. The study was conducted in a clinical practice setting in an active dental clinic and the results are meaningful to a clinician who is interested in providing safe dental treatment water for patient care. Dental waterline biofilms, Dental treatment water contamination control, Chlorine dioxide, Emulsifiers, Heterotrophic plate counts, Laser scanning confocal microscopy. How to cite this article: Bansal R, Puttaiah R, Harris R, Reddy A. Evaluation of Two Methods in Controlling Dental Treatment Water

  9. Results of combined treatment of anaplastic thyroid carcinoma (ATC

    Directory of Open Access Journals (Sweden)

    Bournaud Claire

    2011-11-01

    Full Text Available Abstract Background Anaplastic thyroid carcinoma (ATC is among the most aggressive human malignancies. It is associated with a high rate of local recurrence and with poor prognosis. Methods We retrospectively reviewed 44 consecutive patients treated between 1996 and 2010 at Leon Berard Cancer Centre, Lyon, France. The combined treatment strategy derived from the one developed at the Institut Gustave Roussy included total thyroidectomy and cervical lymph-node dissection, when feasible, combined with 2 cycles of doxorubicin (60 mg/m2 and cisplatin (100 mg/m2 Q3W, hyperfractionated (1.2 Gy twice daily radiation to the neck and upper mediastinum (46-50 Gy, and then four cycles of doxorubicin-cisplatin. Results Thirty-five patients received the three-phase combined treatment. Complete response after treatment was achieved in 14/44 patients (31.8%. Eight patients had a partial response (18.2%. Twenty-two (50% had progressive disease. All patients with metastases at diagnosis died shortly afterwards. Thirteen patients are still alive. The median survival of the entire population was 8 months. Conclusion Despite the ultimately dismal prognosis of ATC, multimodality treatment significantly improves local control and appears to afford long-term survival in some patients. There is active ongoing research, and results obtained with new targeted systemic treatment appear encouraging.

  10. Methods for the Evaluation of Waste Treatment Processes

    Directory of Open Access Journals (Sweden)

    Hans-Joachim Gehrmann

    2017-01-01

    Full Text Available Decision makers for waste management are confronted with the problem of selecting the most economic, environmental, and socially acceptable waste treatment process. This paper elucidates evaluation methods for waste treatment processes for the comparison of ecological and economic aspects such as material flow analysis, statistical entropy analysis, energetic and exergetic assessment, cumulative energy demand, and life cycle assessment. The work is based on the VDI guideline 3925. A comparison of two thermal waste treatment plants with different process designs and energy recovery systems was performed with the described evaluation methods. The results are mainly influenced by the type of energy recovery, where the waste-to-energy plant providing district heat and process steam emerged to be beneficial in most aspects. Material recovery options from waste incineration were evaluated according to sustainability targets, such as saving of resources and environmental protection.

  11. Results of open tibial fracture treatment using external fixation

    Directory of Open Access Journals (Sweden)

    Golubović Ivan

    2016-01-01

    Full Text Available Introduction. Open lower leg fractures are the most common open fractures of the locomotor system and their treatment is associated with a number of complications. Objective. The aim of the paper was to present the results of the treatment of 68 patients with open lower leg fractures, as well as the complications that accompany the treatment of these fractures. Methods. In the analyzed group, there were 45 (66.18% men and 23 (33.82% women. The majority of patients - 33 (48.53% of them - were injured in motor vehicle accidents, whereas 24 (35.29% patients sustained injuries due to falls from heights. In two (2.94% patients the cause of open tibial fractures was gunshot injuries. In the analyzed group, there were 18 (26.47% type I open fractures, 21 (30.88% type II open fractures, 19 (27.94% type IIIA open fractures, seven (10.29% type IIIB open fractures, and three (4.41% type IIIC open fractures. Results. The tibial shaft fracture healed without serious complications in 50 (73.53% patients, whereas in 18 (26.47% patients we observed some complications. Nonunion was found in 10 (14.71% patients, osteitis in four (5.88, malunion in two (2.94% patients. Milder complications such as soft tissue pin tract infection developed in 13 (19.12% patients, infection of the open fracture wound soft tissue was observed in four (5.88% patients. Conclusion. Basic principles in the treatment of open lower leg fractures in this study are thorough primary open fracture wound treatment followed by the delayed wound closure, stable fracture fixation using unilateral external skeletal device, proper antibiotic treatment and tetanus prophylaxis. The results correlate with similar studies. [Projekat Ministarstva nauke Republike Srbije, br. III 41017: Virtual Human Osteoarticular System and its Application in Preclinical and Clinical Practice

  12. Results of surgical treatment of atypical endometrial hyperplasia

    Directory of Open Access Journals (Sweden)

    O. A. Gornykh

    2014-01-01

    Full Text Available The results of surgical treatment in 132 patients with atypical endometrial hyperplasia have been studied. Post-operative diagnosis was: en- dometrial cancer – in 19 %, atypical hyperplasia – in 35 %, simple and complex hyperplasia – in 33 %, only atrophic endometrial changes – in 13 % of patients. The tumor was within the endometrium in 5 patients, the superficial invasion of the myometrium (1–2 mm were in 8 patients, invasion to half of the myometrium – in 9 patients, invasion of more than half of the myometrium – in 3 patients. The questions of tactics of treatment of atypical endometrial hyperplasia is under discussion.

  13. Evaluation of the MiStent sustained sirolimus eluting biodegradable polymer coated stent for the treatment of coronary artery disease: does uniform sustained abluminal drug release result in earlier strut coverage and better safety profile?

    NARCIS (Netherlands)

    Tijssen, Ruben Y. G.; Kraak, Robin P.; Lu, Huangling; Mifek, Jeffrey G.; Carlyle, Wenda C.; Donohoe, Dennis J.; de Winter, Robbert J.; Koch, Karel T.; Wykrzykowska, Joanna J.

    2017-01-01

    Treatment of coronary artery disease has made strides over the last decades. Development of drug eluting stents (DES), coated with a polymer layer and an anti-proliferative drug to reduce neointimal hyperplasia, has reduced the incidence of in-stent-restenosis relative to treatment with bare metal

  14. Breast cancer treatment: evolving approaches but stable results.

    Science.gov (United States)

    Chism, S E; Brown, B S; Hoyle, B A

    1986-12-01

    This report describes the outcome of 530 women with breast cancer diagnosed from 1968 through 1983 and represents a demographic population rather than a referred selected one. The data represents the results of evolving breast cancer treatment approaches during the past 2 decades and is particularly useful as a measure of the total population denominator, free of selection factors that confound reports detailing a surgical, radiation, or chemotherapy experience. During the time interval reviewed, the standard treatment approach of the primary changed from radical mastectomy to biopsy and radiation therapy. Chemotherapy policy evolved from single agent treatment for relapse to multiple drug programs as adjuvant or for relapse. The major findings were: The 5-, 10-, and 15-year survival rates for the intervals 1972-75, 1976-79, and 1980-83 were slightly better than the earliest interval 1968-71, but with no statistically significant improvement. The frequency of favorable disease (Stages Tis, 1) increased from 16 to 31 percent during the interval but the mean age remained the same suggesting that patient education programs, availability of health insurance, or mammography may have lead to identifying patients with more favorable disease. Mastectomy has been replaced by breast conserving surgery and radiation as the most common treatment of the primary. Patients treated by surgery and biopsy/radiation had identical survival outcomes. It was not possible to detect improved survival that could be ascribed to the adoption of multiple agent chemotherapy but the magnitude of the effect is calculated to be on the order of 2% of the total patient population diagnosed. Death due to breast cancer decreases with time after diagnosis but is still 4% per year, 10 years after treatment. The findings suggest that progress has been made in detection, breast conservation, and palliation of symptoms in many subpopulations, but the end results for the total breast cancer population have

  15. Percutaneous Treatment of Splenic Cystic Echinococcosis: Results of 12 Cases

    Energy Technology Data Exchange (ETDEWEB)

    Akhan, Okan, E-mail: akhano@tr.net; Akkaya, Selçuk, E-mail: selcuk.akkaya85@gmail.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Dağoğlu, Merve Gülbiz, E-mail: drmgkartal@gmail.com [Istanbul University, Department of Radiology, Istanbul School of Medicine (Turkey); Akpınar, Burcu, E-mail: burcu-akpinar@yahoo.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Erbahçeci, Aysun, E-mail: aysunerbahceci@yahoo.com [Istanbul Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Department of Radiology (Turkey); Çiftçi, Türkmen, E-mail: turkmenciftci@yahoo.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey); Köroğlu, Mert, E-mail: mertkoroglu@hotmail.com [Antalya Education and Research Hospital, Department of Radiology (Turkey); Akıncı, Devrim, E-mail: akincid@hotmail.com [Hacettepe University, Department of Radiology, School of Medicine (Turkey)

    2016-03-15

    PurposeCystic echinococcosis (CE) in the spleen is a rare disease even in endemic regions. The aim of this study was to examine the efficacy of percutaneous treatment for splenic CE.Materials and MethodsTwelve patients (four men, eight women) with splenic CE were included in this study. For percutaneous treatment, CE1 and CE3A splenic hydatid cysts were treated with either the PAIR (puncture, aspiration, injection, respiration) technique or the catheterization technique.ResultsEight of the hydatid cysts were treated with the PAIR technique and four were treated with catheterization. The volume of all cysts decreased significantly during the follow-up period. No complication occurred in seven of 12 patients. Abscess developed in four patients. Two patients underwent splenectomy due to cavity infection developed after percutaneous treatment, while the spleen was preserved in 10 of 12 patients. Total hospital stay was between 1 and 18 days. Hospital stay was longer and the rate of infection was higher in the catheterization group. Follow-up period was 5–117 months (mean, 44.8 months), with no recurrence observed.ConclusionThe advantages of the percutaneous treatment are its minimal invasive nature, short hospitalization duration, and its ability to preserve splenic tissue and function. As the catheterization technique is associated with higher abscess risk, we suggest that the PAIR procedure should be the first percutaneous treatment option for splenic CE.

  16. Bleomycin treatment of brain tumors: an evaluation

    DEFF Research Database (Denmark)

    Linnert, Mette; Gehl, Julie

    2009-01-01

    Bleomycin has been used in the treatment of brain tumors for over 30 years. Currently, we are evaluating electrochemotherapy (the use of electric pulses to enhance uptake of bleomycin) for patients with secondary brain tumors. We, therefore, reviewed the literature with specific reference...... to the tolerability and toxicity of bleomycin. Using the keywords 'brain' and 'bleomycin', a database search without date restriction was performed and over 500 articles were found. Twenty-five articles were used for this study based on relevance determined by: (i) clinical studies, (ii) use of bleomycin, and (iii......) direct injection into brain tissue or cysts. There were two main indications for the use of bleomycin directly into the brain: (i) cystic tumors in the form of craniopharyngiomas and (ii) solid brain tumors such as glioblastomas and astrocytomas. The most frequent adverse effects reported were transient...

  17. Multi-month prescriptions, fast-track refills, and community ART groups: results from a process evaluation in Malawi on using differentiated models of care to achieve national HIV treatment goals.

    Science.gov (United States)

    Prust, Margaret L; Banda, Clement K; Nyirenda, Rose; Chimbwandira, Frank; Kalua, Thokozani; Jahn, Andreas; Eliya, Michael; Callahan, Katie; Ehrenkranz, Peter; Prescott, Marta R; McCarthy, Elizabeth A; Tagar, Elya; Gunda, Andrews

    2017-07-21

    In order to facilitate scale-up of antiretroviral therapy (ART) in Malawi, innovative and pragmatic models have been developed to optimize the efficiency of HIV service delivery. In particular, three models of differentiated care have emerged for stable patients: adjusted appointment spacing through multi-month scripting (MMS); fast-track drug refills (FTRs) on alternating visits; and community ART groups (CAGs) where group members rotate in collecting medications at the facility for all members. This study aimed to assess the extent to which ART patients in Malawi are differentiated based on clinical stability and describe the characteristics and costs associated with the models of differentiated care offered. A mixed methods process evaluation was conducted from 30 purposefully selected ART facilities. Cross-sectional data for this evaluation was collected between February and May 2016. The following forms of data collection are reported here: structured surveys with 136 health care workers; reviews of 75,364 patient clinical records; 714 observations of visit time and flow; and 30 questionnaires on facility characteristics. Among ART patients, 77.5% (95% confidence interval [CI] 74.1-80.6) were eligible for differentiated models of care based on criteria for clinical stability from national guidelines. Across all facilities, 69% of patients were receiving MMS. In facilities offering FTRs and CAGs, 67% and 6% of patients were enrolled in the models, respectively. However, eligibility criteria were used inconsistently: 72.9% (95% CI 66.3-78.6) of eligible patients and 42.3% (95% CI 33.1-52.0) ineligible patients received MMS. Results indicated that patient travel and time costs were reduced by 67%, and the unit costs of ART service delivery through the MMS, FTR and CAG models were similar, representing a reduction of approximately 10% in the annual unit cost of providing care to stable patients that receive no model. MMS is being implemented nationally and has

  18. Thyroid dysfunction during pregnancy and evaluation of its results

    Directory of Open Access Journals (Sweden)

    Fatih Taşkesen

    2011-06-01

    Full Text Available In this study, we aim to evaluate obstetric outcomes of the women with thyroid dysfunction than the normal pregnant women.Materials and methos: In our study, 633 women between the ages of 18 to 35 who admitted to Kovancılar State Hospital Obstetrics and Gynecology Clinic for pregnancy follow-up between January 2010 and January 2011 were evaluated. Serum thyroid - stimulating hormones (TSH, free tri-iyodotironin (T3, free thyroxine (T4 levels for all patients were studied. Antithyroidal peroxidase (anti-TPO and Anti-thyroglobulin (anti-Tg parameters were measured if they were necessary. The relationship between thyroid functions and complications such as eclampsia, preeclampsia, maternal anemia, postpartum hemorrhage, fetal anomalies, shoulder dystocia, neonatal hypoglycemia was examined.Results: Hypothyroidism was found 18 of cases and hyperthyroidism was found 4 of them. The mean age of patients in the study was 26.42 (± 8.42. The mean values were 1.86 ± 0.19 μIU/mL for TSH, 1.15 ± 0.29 ng/mL for free T4 and 2.90 ± 0.31 pg/mL for free T3 respectively. Hashimoto’s thyroiditis (9 cases, 50 % was the most frequent etiology for patients with hypothyroidism. Other etiologic factors for hypothyroidism were found to be for 4 cases as (22.2%, iatrogenic (previously undergone thyroidectomy and 5 cases as (37.8% a lack of iodine. Maternal anemia was observed in 5 (27.78% cases with hypothyroidism. Preeclampsia was observed 16.67% in patients with hypothyroidism.Conclusion: Observed thyroid dysfunction in pregnant women may cause serious maternal and fetal complications. For disorders of thyroid function during pregnancy, to provide the necessary treatment at the appropriate time is important to prevent complications of mother and fetus. J Clin Exp Invest 2011;2(2:196-201

  19. Results of treatment of Wilson's disease--own observations.

    Science.gov (United States)

    Jabłońska-Kaszewska, Irena; Drobińska-Jurowiecka, Anna; Dabrowska, Ewa; Trocha, Hanna

    2003-08-01

    Causative treatment of genetically determined Wilson's disease (WD) has been impossible so far, although gene therapy could be real in the future. Nowadays the principle of treatment is the elimination of the excess of easily mobilized copper, bound by chelating agents, the most important of which is d-penicillamine, through the kidneys. Blocking of the intestinal absorption of copper by administration of zinc preparations, which additionally induce hepatic metallothionein synthesis, is also possible. The aim of our study was to present own observations and results of treatment of Wilson's disease. During the last 16 years, we have observed 33 patients aged 13-60 (mean age 27 years) with various forms of WD. The studied group consisted of 11 females and 21 males, admitted to hospital or seen at the Specialistic Outpatient Department of Hepatology with various diagnoses. In addition to standard laboratory tests, the levels of ceruloplasmin, serum and urine copper, as well as the activity of some hepatic enzymes, proteins and HBV/HCV infection markers were determined. The patients were also examined by a neurologist and an ophthalmologist, with psychiatric consultation if necessary. Taking into account the overall clinical presentation, the patients were divided into the following groups according to the form of the disease: fulminant, acute, hepatic, hepatic with neurological and psychiatric symptoms, neuropsychiatric, asymptomatic. All the patients were initially treated with d-penicillamine. In most of them, no side effects were observed. The treatment was continued according to the levels of copper excreted with urine (for 10 years at the longest). After obtaining clinical improvement with reduced amount of copper excreted with 24-h urine, we tapered d-penicillamine doses or even discontinued the drug, introducing zinc preparations. In asymptomatic carriers, zinc preparations were used throughout the period of treatment. Early institution of chelation treatment

  20. The evaluation of treatment-resistant epilepsy.

    Science.gov (United States)

    Skjei, Karen L; Dlugos, Dennis J

    2011-09-01

    An estimated 10% to 40% of children with epilepsy have treatment-resistant epilepsy. Persistent seizures have negative psychosocial, behavioral, cognitive, and financial consequences and are associated with an increased mortality rate. Accurate syndromic and etiologic diagnoses are of vital importance because they may guide medical and/or surgical decision making. Revisitation of the history to confirm the diagnosis of epilepsy and the appropriateness of medication trials to date is vital. Routine imaging should include structural magnetic resonance imaging (MRI) with an established epilepsy protocol. In the setting of a normal previous MRI, repeat imaging may be indicated and may be supplemented with other imaging modalities. The admission for prolonged inpatient video-encephalographic monitoring may lead to a revision of a pre-existing diagnosis. Laboratory evaluations should include genetic, metabolic, and infectious/inflammatory studies when indicated. In this review, we discuss the implication of seizure semiology and syndrome classification when searching for an underlying diagnosis in treatment-resistant epilepsy, and will review both basic and more advanced procedures/studies that may aid diagnosis. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Ultrasonic Evaluation of Deeply Located Trabecular Bones - Preliminary Results

    Science.gov (United States)

    Cieślik, Lucyna; Litniewski, Jerzy

    The analysis of ultrasonic signals scattered by soft tissues have been successfully applied for their characterization. Similarly, the trabecular bone backscattered signal contains information about the properties of the bone structure. Therefore scattering-based ultrasonic technique potentially enables the assessment of microstructure characteristics of a bone. The femoral neck fracture often occurs in the course of osteoporosis and can lead to severe complications. Therefore assessment of femoral bone microstructure and condition is important and essential for the diagnosis and treatment monitoring. As far most of the trabecular bone investigations have been performed in vitro. The only in vivo measurements were carried out in transmission and mostly concerned estimation of the attenuation in heel bone. We have built the ultrasonic scanner that could be useful in acquiring the RF (Radio Frequency) echoes backscattered by the trabecular bone in vivo. Moreover, the bone scanner provides data not only from heel bone but from deeply located bones as well (e.g. femoral bone). It can be also used for easily accessible bones like heel bone or breastbone. In this case a gel-pad is applied to assure focusing of ultrasound in trabecular bone (approximately 10 mm beneath the cortical bone). This study presents preliminary results of the attenuating properties evaluation of trabecular bone from the ultrasonic echoes backscattered by heel bone and femoral neck.

  2. Evaluation of an 18-month commercial multidisciplinary obesity treatment programme.

    Science.gov (United States)

    Aller, E E J G; van Baak, M A

    2016-02-01

    The treatment of obesity is an often studied subject. Although reductions in weight and improvements in cardiometabolic risk factors are important aims of obesity treatment, improvements in quality of life and eating behaviour are also relevant outcomes. In this practice-based study, we evaluated an 18-month commercial multidisciplinary obesity treatment programme and report on treatment results for weight, cardiometabolic risk factors, eating behaviour and quality of life. From a local commercial obesity treatment centre, 426 subjects (65% female; 45.4 ± 12.2 years; body mass index 40.0 ± 6.6 kg m(-2)) were recruited. Measurements of body weight, height, body composition, waist circumference and blood pressure were scheduled at baseline and every 3 months, whereas fasting blood collections were scheduled at baseline and every 6 months. At the same time points, participants were asked to fill in questionnaires on dietary intake, eating behaviour and quality of life. After 18 months of treatment programme, average weight change [mean (95% confidence interval)] was -10.9 kg (-14.8 to -7.0; P treatment period. All collected data in this study provide evidence that a multidisciplinary treatment programme based on lifestyle modification results in significant weight loss and improvements in cardiometabolic risk factors, quality of life and eating behaviour. © 2015 World Obesity.

  3. Treatment with pharmacological agents in peripheral arterial disease patients does not result in biomechanical gait changes.

    Science.gov (United States)

    Huisinga, Jessie M; Pipinos, Iraklis I; Stergiou, Nicholas; Johanning, Jason M

    2010-08-01

    Pharmacological treatment has been used to alleviate the claudication symptoms and improve walking performance in peripheral arterial disease (PAD) patients. However, the effects of claudication treatments on gait mechanics have not been objectively identified with biomechanical techniques. For this study, 20 PAD patients were assigned to take either pentoxifylline (n=11) or cilostazol (n=9), the two FDA-approved pharmacological therapies used to treat intermittent claudication symptoms. All patients completed a gait evaluation protocol that involved the acquisition of kinematic and kinetic gait data before use of the medication and after 12 weeks of treatment. Results showed that treatment with either pentoxifylline or cilostazol resulted in limited overall improvement in gait parameters including joint angles and joint moments. Walking speed was unchanged, in either treatment group, as a result of the medication. These results suggest that to improve biomechanical walking parameters of PAD patients, clinicians cannot rely on drug therapies alone.

  4. Non-Formal Educator Use of Evaluation Results

    Science.gov (United States)

    Baughman, Sarah; Boyd, Heather H.; Franz, Nancy K.

    2012-01-01

    Increasing demands for accountability in educational programming have resulted in increasing calls for program evaluation in educational organizations. Many organizations include conducting program evaluations as part of the job responsibilities of program staff. Cooperative Extension is a complex organization offering non-formal educational…

  5. The ASCD Healthy School Communities Project: Formative Evaluation Results

    Science.gov (United States)

    Valois, Robert F.; Lewallen, Theresa C.; Slade, Sean; Tasco, Adriane N.

    2015-01-01

    Purpose: The purpose of this paper is to report the formative evaluation results from the Association for Supervision and Curriculum Development Healthy School Communities (HSC) pilot project. Design/methodology/approach: This study utilized 11 HSC pilot sites in the USA (eight sites) and Canada (three sites). The evaluation question was…

  6. [Trends and results of treatment of spinal fractures].

    Science.gov (United States)

    Plaue, R

    1988-01-01

    As long as simple and efficient operative techniques for stabilizing of injured segments of the vertebral column were missing naturally conservative methods dominated. The fixateur interne and the transpedicular spongiosa bone graft, however, provide operative techniques of high efficiency and technical simplicity, which make a revision of old indicational rules- operation versus conservative treatment - necessary. The example of a stable spine fracture points out that the calculated final result has to be clearly better if risk and effort of an operation should be advantageous for the patient. Both methods show a big difference concerning the space of time. Early functional treatment provides a short period of hospitalization as well as quick mobilization and rehabilitation, whereas operative management is more time consuming in every respect. Beside the operational stress, however, the time factor becomes the most important aspect for the patient. Therefore despite improved operative techniques the rate of stabile spine fractures in which operation is recommended and indicated will remain fairly limited. A different situation, however, we find in unstable fractures of the vertebral column. In this case conservative treatment mostly has no advantage except the avoided risk of an operation. Operative management is time-saving and provides better results. For that reason widening of indication for operative management especially in unstable fractures of spine seems favourable.

  7. Dosimetric evaluation in teletherapy for male breast cancer treatment

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Nilmara Almeida; Crispim, Verginia Reis, E-mail: nguimaraes@con.ufrj.br, E-mail: verginia@nuclear.ufrj.br [Coordenacao dos Cursos de Pos-Graduacao em Engenharia (COPPE/UFRJ), Rio de Janeiro, RJ (Brazil). Programa de Engenharia Nuclear

    2013-07-01

    The present study evaluated dose distribution in the male breast using thermoluminescent dosimeters (TLDs). The rate of male breast cancers has increased in recent years, due to the deficiency of preventive examinations (male mammography). Still, male breasts have smaller volumes than female breasts, thus, from the point of view of radiation protection, it is essential to monitor the doses received by the male breast, as well as those received by healthy and critical organs in order to evaluate radiotherapy performance and aid treatment planning. For this reason, the treatment of male breast cancer was simulated with the radiation by linear accelerator in Alderson Rando phantom and doses were measured with thermoluminescent dosimeters. The results of the treatment planning and measured were compared. (author)

  8. The results of surgical and nonsurgical treatment of mallet finger

    Directory of Open Access Journals (Sweden)

    Starčević Branislav

    2006-01-01

    Full Text Available Introduction: The injury of the hand tendon classified as mallet finger presents the loss of continuity of the united lateral band of the extensor apparatus above distal interphalangeal joint, which consequently leads to specific deformity of distal interphalangeal joint which is called mallet (hammer finger. Objective Our paper had several research Objectives: presentation of the existing Results of surgical and nonsurgical treatment of mallet finger deformities and comparison of our findings and other authors’ Results. Method: The study was retro-prospective, and analyzed 62 patients treated in the Clinical Center of Serbia in Belgrade (at the Institute of Orthopedic Surgery and Traumatology, and the Emergency Center in the period 1998 to 2003. The follow up of these patients lasted at least 8 months (from 8.3 months to 71.7 months. An average follow up was 28.7 months. The Objective parameters used in the study were as follows: sex, age, dominating hand, hand injury, finger injury, mode of treatment, complications, distal interphalangeal joint flexion and total movement of the distal interphalangeal joint. Collected data were analyzed by χ2-test and Student’s t-test. The confidence interval was p=0.05. Results: A total range of motion was 51.9±6.6 for nonsurgically treated patients, and 48.2±4.2 degrees for operated patients. Mean extension deficit of the distal interphalangeal joint was 6.5±3.3 for nonsurgical and 10.0±3.2 for operated patients. Conclusion: The Results confirmed that nonsurgical mode of treatment of mallet finger deformity was much more successful than surgical Method of treating the same deformity.

  9. [LAPTOP trial--results of an health economics evaluation].

    Science.gov (United States)

    Dippel, F-W

    2008-08-01

    Based on the LAPTOP trial, a cost and a benefit assessment were undertaken. The cost analysis was performed as a desk-top evaluation using the cost minimization method. The benefit assessment was done as a simulation using the diabetes mellitus model (DMM). In each analysis either cost or benefit of treating diabetes mellitus with oral antidiabetic drug(s) supported by insulin glargine were compared to those with conventional insulin treatment using premixed insulin twice daily. The cost benefit analysis demonstrated that treatment with insulin glargine plus oral antidiabetics was less expensive than the conventional insulin treatment with premixed insulin. Furthermore, avoidance of diabetic complications was better with insulin glargine plus oral antidiabetics than with premixed insulin alone.

  10. RESULTS OF SURGICAL TREATMENT IN THE CRANIOCERVICAL JUNCTION IN MUCOPOLYSACCHARIDOSIS

    Directory of Open Access Journals (Sweden)

    Luís Eduardo Carelli Teixeira da Silva

    2016-03-01

    Full Text Available ABSTRACT Objective: Evaluate the results after decompression and stabilization of craniocervical junction in patients with mucopolysaccharidosis (MPS. Method: Retrospective study of 10 patients with MPS through the analysis of medical records and additional tests. Result: All patients with mid-term and long-term follow-up achieved consolidation of the arthrodesis and 87.5% had neurological improvement of Nurick score. Conclusion: Early diagnosis and intervention in cases of stenosis and/or craniocervical instability of patients with MPS provide patients a good recovery of neurological function, despite the great technical difficulty and risk of complications.

  11. Evaluation and treatment of cryptorchidism: AUA guideline.

    Science.gov (United States)

    Kolon, Thomas F; Herndon, C D Anthony; Baker, Linda A; Baskin, Laurence S; Baxter, Cheryl G; Cheng, Earl Y; Diaz, Mireya; Lee, Peter A; Seashore, Carl J; Tasian, Gregory E; Barthold, Julia S

    2014-08-01

    Cryptorchidism is one of the most common pediatric disorders of the male endocrine glands and the most common genital disorder identified at birth. This guideline is intended to provide physicians and non-physician providers (primary care and specialists) with a consensus of principles and treatment plans for the management of cryptorchidism (typically isolated non-syndromic). A systematic review and meta-analysis of the published literature was conducted using controlled vocabulary supplemented with key words relating to the relevant concepts of cryptorchidism. The search strategy was developed and executed by reference librarians and methodologists to create an evidence report limited to English-language, published peer-reviewed literature. This review yielded 704 articles published from 1980 through 2013 that were used to form a majority of the guideline statements. Clinical Principles and Expert Opinions were used for guideline statements lacking sufficient evidence-based data. Guideline statements were created to inform clinicians on the proper methods of history-taking, physical exam, and evaluation of the boy with cryptorchidism, as well as the various hormonal and surgical treatment options. Imaging for cryptorchidism is not recommended prior to referral, which should occur by 6 months of age. Orchidopexy (orchiopexy is the preferred term) is the most successful therapy to relocate the testis into the scrotum, while hormonal therapy is not recommended. Successful scrotal repositioning of the testis may reduce but does not prevent the potential long-term issues of infertility and testis cancer. Appropriate counseling and follow-up of the patient is essential. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  12. [Results of individually adjusted radioiodine treatment of hyperthyroidism.].

    Science.gov (United States)

    Sigthorsson, G; Kjeld, M

    1995-01-01

    Radioiodine (131I) treatment was started in Iceland in 1960 and the same formula has been used from the beginning to calculate the doses of radioactivity aiming for 70 Gy irradiation of the gland. In the present investigation we studied 468 patients who were treated over a period of 19 years (1973-1991). About 90% of the patients had Graves' disease (GD), 9% toxic adenoma but less than 1% toxic multinodular goiter. Approximately 70% of the GD patients became hypothyroid (subclinical hypothyroidism included) within the first year after a single radioiodine treatment and about 80% were hypothyroid four years after treatment with no significant increase after that. By contrast, only one of 15 patients with toxic adenoma became hypothyroid after a single treatment. For both groups the recurrence rate of hyperthyroidism was approximately 20%. The formula used for dose calculation in this study for GD patients does not seem to be satisfactory. The smaller glands are getting to much irradiation and the larger glands to little as can be seen by the frequency of hypothyroidism in the smaller glands and recurrences (continuing hyperthyroidism) in the larger glands after one treatment (table V). In 1993 blood samples were obtained from a sample group (n=103) of once 131I treated GD patients and measurements were done for serum TSH, T4 and free T4. One third of the patients who were considered euthyroid, and therefore not taking T4, were found to be hypothyroid with elevated TSH and low FT4 and one third of those taking T4 seemed to be overtreated with elevated FT4 and decreased TSH levels. It is concluded that the results of the radioiodine treatment for GD are unsatisfactory and need to be changed, either by adjusting the present regimen so that radiation is decreased in the smaller glands but increased in the larger ones or alternatively, by increasing the radiation dose to all the glands rendering the majority of the patients quickly hypothyroid followed by replacement

  13. [Results of diabetic foot surgical treatment in gerontological patients].

    Science.gov (United States)

    Dibirov, M D; Kirtadze, D G; Dibirov, A A; Tereshchenko, S A; Ramazanova, Iu I

    2006-01-01

    The experience in surgical treatment of 1200 patients with an ischemic form of diabetic foot syndrome is analyzed. Surgical reconstruction of the major arteries was performed in 338 (28%) patients including reconstructive surgeries on the aorto-iliac-femoral segment--70 (21%), distal reconstructions--246 (73%), extra-anatomic reconstructions--22 (6%) patients. In distal reconstructions autovein in situ was used in 94, reversed autovein--in 82, and PTFE grafts--in 70 patients. Good results were achieved in 235 (69%), satisfactory--in 57 (17%) patients. Early thrombosis was revealed in 46 (14%) patients, femoral amputation was performed in 36 (10.6%) patients, 5 (1.4%) patients died.

  14. Our Treatment Results of Circumscribed and Diffuse Choroidal Hemangiomas

    Directory of Open Access Journals (Sweden)

    Esra Savku

    2013-08-01

    Full Text Available Purpose: To discuss our treatment results of choroidal hemangiomas. Material and Method: The records of 39 cases of choroidal hemangioma followed up at our clinic between July 1999–October 2012 were reviewed retrospectively. Asymptomatic cases were followed up. Symptomatic cases with subretinal fluid and impaired vision received treatment. Results: Mean age of the 39 patients was 44 (12-80 years. Thirty-five of 39 cases had circumscribed choroidal hemangioma, and 4 cases had diffuse choroidal hemangioma. Sturge-Weber syndrome was present in 3 cases with diffuse choroidal hemangioma. Cases with circumscribed choroidal hemangioma and minimal subretinal fluid were treated with TTT in 11 cases, PDT in 12 cases, and PDT+TTT in 1 case. Cases with circumscribed choroidal hemangioma and excessive subretinal fluid were treated with Ru-106 plaque radiotherapy in 1 case, Ru-106 plaque radiotherapy+TTT in 1 case, EBRT in 3 cases, and TTT+EBRT in 1 case. One painful blind eye with neovascular glaucoma and complicated cataract was enucleated. Cases with diffuse choroidal hemangioma and excessive subretinal fluid were treated with Ru-106 plaque radiotherapy+TTT in 1 case and EBRT in 1 case. Ahmed glaucoma valve implantation and FAKO emulsification were applied to a case with neovascular glaucoma and complicated cataract. Complete resorption of subretinal fluid was achieved in 23 (72% of treated 32 cases. When mean initial tumor thickness was 2.6 mm (0.5-6, mean final tumor thickness was 1.4 mm (0-6. When mean initial visual acuity (LogMAR was 1.5 (0-3, mean final visual acuity was 1.1 (0-3. No recurrence was observed. Discussion: The amount of the subretinal fluid determines the method of treatment in circumscribed choroidal hemangioma. While TTT and PDT are effective treatment modalities for minimal subretinal fluid, plaque radiotherapy and EBRT are applied in cases with excessive subretinal fluid. Combination therapies may be necessary according to the

  15. Evaluation and treatment of nonmonosymptomatic enuresis.

    Science.gov (United States)

    Roth, Elizabeth B; Austin, Paul F

    2014-10-01

    On the basis of some research evidence and consensus, up to one-third of patients with enuresis will have daytime urinary symptoms indicative of lower urinary tract (LUT) dysfunction. (8)(9) On the basis of international consensus, children with enuresis and LUT dysfunction are correctly identified as having nonmonosymptomatic enuresis (NMSE) (formerly termed diurnal enuresis). (1)(2) On the basis of some research evidence and consensus, an adequate voiding and elimination history is the primary tool in differentiating between MSE and NMSE. (2)(7)(8). On the basis of some research evidence and consensus, therapy for NMSE is based on addressing underlying LUT dysfunction, constipation, and comorbid behavioral conditions before addressing enuresis. (2)(8)(9)(12) On the basis of some research evidence and consensus, treatment of underlying BBD and comorbid conditions will often result in improvement or resolution of enuresis. (2)(8)(9)(12). On the basis of international consensus, if enuresis is still present and a concern after treatment of underlying LUT, specific medical or behavioral therapy for enuresis should be offered to the family.(2)(8).

  16. The development and use of algorithms for diagnosing and choosing treatment of ostomy complications: results of a prospective evaluation .

    Science.gov (United States)

    Kalashnikova, Irina; Achkasov, Sergey; Fadeeva, Svetlana; Vorobiev, Genadiy

    2011-01-01

    Stoma complications are classified and treated based on the etiology, pathology, location, and clinical presentation of the complication. Clinical assessments and descriptions of abdominal stomal topography differ among care providers, hampering interpretation and communication. Using existing literature and clinical experience at the State Scientific Centre of Coloproctology in Russia, algorithms were developed to facilitate a uniform approach to the diagnosis and choice of treatment of ostomy complications. The algorithms consist of a definite sequence of explicit step-by-step procedures, including visual inspection, digital exploration, and instrumental exploration, for determining whether complications should be categorized and treated as a stoma problem or peristomal skin disorder. The algorithm was subsequently used by nonexpert nurses for all consecutive patients who visited the clinic during a 2-year period. Of the 1,427 patients seen, 553 (38.8%) had 742 complications. Of those, 387 were stoma complications and 355 were classified as peristomal skin disorders (eg, contact dermatitis, hypergranulation of the skin, allergic dermatitis, folliculitis, psoriasis and herpes). Of the 553 patients with complications, the most frequent complications were found to be contact dermatitis (184 patients, 33.3%), parastomal hernia (97, 17.5%), and mucocutaneous separation (72, 13.0%); 176 patients were referred to surgery and 377 received conservative treatment. Although the algorithms remain to be validated, the authors believe that studying the manifestation and causes of complications will help in the selection of justified treatments, which will eventually reduce the number of complications and improve the quality of stoma care.

  17. Varfarin in the complex treatment of antiphospholipid syndrome: preliminary results

    Directory of Open Access Journals (Sweden)

    T M Reshetnyak

    2003-01-01

    Full Text Available Objective. To assess efficacy and tolerance of varfarin in prophylaxis and therapy of thrombotic complications in patients with antiphospholipid syndrome (APS. Methods. 20 pts with APS (5 male and 15 female received varfarin during a year. 8 of them had primary APS (PAPS and 12 -systemic lupus erythematosus with APS (SLE+APS. 2 other pts (I with SLE+APS and I with PAPS received varfarin during the last 4 years. Nobody from 9 pts with PAPS received corticosteroids (CS. In SLE+APS pts CS dose varied from 4 to 20 mg/day and was not increased during follow up. During the study prothrombine time (PT was examined with thromboplastin ( manufactured by Renam having international sensitivity index 1,2 and international normalization relation (INR. Depending on treatment scheme APS pts were divided into 3 groups. Group 1 included 8 pts with INR<2,0, Group 2-7 with INR >3,0, group 3 - 7 pts with INR<2,0 receiving as additional treatment thrombo ASS 100 mg/day and vasonit from 600 to 1200 mg/day. Results. Two pts with INR = 1,8 had thrombosis recurrence (due to leg thrombophlebitis. There were no recurrences in other groups. 2 from 22 pts had "large" bleedings. "Small" bleedings episodes were noted in 7 from 22 pts. Largely that were subcutaneous bleedings (in 4 pts no more than 5 cm of size. Two pts receiving varfarin with INR 1,8 and 2,4 had renal colic. Conclusion. Our preliminary results prove the necessity of inclusion of varfarin in the treatment of pts with APS and thrombosis but intensive anticoagulant effect is not always desired.

  18. Gap application results for adjacent electron beams treatment

    Energy Technology Data Exchange (ETDEWEB)

    Sampaio, Francisco G.A., E-mail: francisampaio@pg.ffclrp.usp.br [Departamento de Fisica - FFCLRP, Universidade de Sao Paulo - USP, Av. dos Bandeirantes 3900, CEP 14040-901, Ribeirao Preto, SP (Brazil); Del Lama, Lucas S., E-mail: lucasdellama@yahoo.com.br [Departamento de Fisica - FFCLRP, Universidade de Sao Paulo - USP, Av. dos Bandeirantes 3900, CEP 14040-901, Ribeirao Preto, SP (Brazil); Petchevist, Paulo C.D., E-mail: petchevist12@yahoo.com.br [Departamento de Fisica - FFCLRP, Universidade de Sao Paulo - USP, Av. dos Bandeirantes 3900, CEP 14040-901, Ribeirao Preto, SP (Brazil); Instituto de Radioterapia e Megavoltagem de Ribeirao Preto - IRMEV, Rua Sete de Setembro 1150, CEP 14010-180, Ribeirao Preto, SP (Brazil); Moreira, Marcos V., E-mail: marcos_vasques@yahoo.com.br [Departamento de Fisica - FFCLRP, Universidade de Sao Paulo - USP, Av. dos Bandeirantes 3900, CEP 14040-901, Ribeirao Preto, SP (Brazil); Instituto de Radioterapia e Megavoltagem de Ribeirao Preto - IRMEV, Rua Sete de Setembro 1150, CEP 14010-180, Ribeirao Preto, SP (Brazil); Almeida, Adelaide de, E-mail: dalmeida@ffclrp.usp.br [Departamento de Fisica - FFCLRP, Universidade de Sao Paulo - USP, Av. dos Bandeirantes 3900, CEP 14040-901, Ribeirao Preto, SP (Brazil)

    2011-12-15

    Nowadays, electron beams from high-energy linear accelerators (LINAC) are widely used in a variety of radiotherapy treatments being suitable especially for superficial tumors. Since this sort of ionizing radiation has stopping power higher than photons, deeper and healthier tissues can be preserved. On the other hand, when applying adjacent electron beams, 'hot' spots can be observed, due to penumbra and/or scattering, contributing to the increase of the absorbed dose in the target volume. In this sense, the objective of this work was to investigate the effects of parallel adjacent electron beams using the chemical dosimeter Fricke Xylenol Gel (FXG) and compare the experimental results with ones acquired using Monte Carlo simulation. Thus, 10 Multiplication-Sign 10, 15 Multiplication-Sign 15 and 20 Multiplication-Sign 20 cm{sup 2} fields were irradiated with 5, 8 and 10 MeV electron beams applying different gap widths. The experimental results and the simulations indicated overdose values up to 40% from the prescribed one for the specific tumor. This demonstrates that specific gaps are necessary in the case of treatments with parallel adjacent electron beams in order to prevent overdoses in the depth of interest.

  19. [Results of treatment papilloma of nasal cavity and paranasal sinuses].

    Science.gov (United States)

    Łukomski, Marek; Obrebka, Renata; Starska, Katarzyna; Pietruszewska, Wioletta; Durko, Marcin; Pajor, Anna; Gryczyński, Maciej; Józefowicz-Korczyńska, Magdalena

    2008-01-01

    Papilloma of the nose and paranasal sinuses is a benign tumor originated from nose mucosa. Especially inverted papilloma tumor has a significant recurrence and malignancy potential rate. The aim of the study was the analysis of clinical and treatment outcomes of patients with papilloma of the nose and paranasal sinuses. The retrospective analysis was curried out on 41 patients--16 with papiloma of the nasal vestibule and 25 with inverted papilloma the nose and paranasal sinuses surgically treated in I ENT Clinic Medical University in Lodz between 1998-2004 years. We analyzed patient's complains, clinical data and surgical follow-up results. The most frequent complains was increasing unilateral nasal obstruction and rhinorhea. Nasal vestibule papilloma were intranasal removed in all cases. In extended tumor nose and paranasal sinuses in 14 cases intranasal procedures, in 7 sublabial approached, in 4 lateral rhynothomy were performed. In 5 patient local recurrences was observed and in 3 neoplasmatic transformation. The choice of surgical management should be individual with respect to tumor localization and extension of neoplasmatic process. The treatment result depends of radical tumor resection.

  20. Treatment utilization and barriers to treatment: Results of a survey of dependent methamphetamine users

    Directory of Open Access Journals (Sweden)

    Lee Nicole K

    2011-02-01

    Full Text Available Abstract Background Australia has one of the highest rates of methamphetamine use in the world; however, treatment access for methamphetamine is comparatively low. This descriptive study aimed to identify patterns of treatment utilization and perceived barriers to accessing treatment among dependent methamphetamine users in the hope that such information will enable services to more appropriately respond to this group. Methods One hundred and twenty-six methamphetamine users who had a current or past history of methamphetamine dependence were interviewed about their experiences of, and perceived barriers to, treatment. Results Treatment utilization among methamphetamine users was reportedly low. One of the main reasons cited for not accessing treatment was that methamphetamine users did not perceive their drug use to be a problem (despite apparent levels of dependence. Self-detoxification with the use of other licit and illicit drugs was high among this group. Participants identified a lack of confidence in the ability of treatment services to address methamphetamine dependence and the 'opiate-centric' nature of treatment services as significant blocks to treatment entry. Suggestions for improvement by participants included operating specialist services for methamphetamine users, placing an emphasis on responsiveness and routinely involving case management services for this group. Discussion and Conclusions To improve service delivery, treatment services should reorient their services to better address the needs of methamphetamine users by making small changes such as specific opening times for methamphetamine users or using a dedicated space for methamphetamine treatment. Alternative options such as online treatments and specialist methamphetamine clinics should be considered for methamphetamine users.

  1. Connecticut Transit (CTTRANSIT) Fuel Cell Transit Bus: Preliminary Evaluation Results

    Energy Technology Data Exchange (ETDEWEB)

    Chandler, K.; Eudy, L.

    2008-10-01

    This report provides preliminary results from a National Renewable Energy Laboratory evaluation of a protoptye fuel cell transit bus operating at Connecticut Transit in Hartford. Included are descriptions of the planned fuel cell bus demonstration and equipment; early results and agency experience are also provided.

  2. [Hypoglossofacial anastomosis for facial palsy treatment: Indications and results].

    Science.gov (United States)

    Lamas, G; Gatignol, P; Barbut, J; Bernat, I; Tankéré, F

    2015-10-01

    Hypoglossofacial anastomosis is a classical surgical procedure for the treatment of facial paralysis when the trunk of the facial nerve cannot be repaired and its peripheral branches are normal. Between 2004 and 2015, 77 patients were able to benefit from an hypoglossofacial anastomosis. The etiology of the paralysis was mainly the surgery of vestibular schwannoma, tumors of the facial nerve and diseases of the brainstem. A specific and premature speech therapy remediation was realized for all patients in order to preserve the tongue function and to upgrade the facial motricity. Sixty-nine patients could be studied. The House Brackmann grading scale was used to appreciate the result. Thirty-one patients are grade III, 34 grade IV and in only one case the result is a grade V despite the anastomosis works. The main predictive factor for a good result is a small delay between the onset of the paralysis and the surgery for the rehabilitation. The specific physiotherapy upgrades the result with less side effects of the anastomosis. Hypoglossofacial anastomosis is a simple and reliable surgical procedure for rehabilitation of paralysed face. The quality of the result is linked with an early surgery and a specific physiotherapy. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  3. Treatment errors resulting from use of lasers and IPL by medical laypersons: results of a nationwide survey.

    Science.gov (United States)

    Hammes, Stefan; Karsai, Syrus; Metelmann, Hans-Robert; Pohl, Laura; Kaiser, Kathrine; Park, Bo-Hyun; Raulin, Christian

    2013-02-01

    The demand for hair and tattoo removal with laser and IPL technology (intense pulsed light technology) is continually increasing. Nowadays these treatments are often carried out by medical laypersons without medical supervision in franchise companies, wellness facilities, cosmetic institutes and hair or tattoo studios. This is the first survey is to document and discuss this issue and its effects on public health. Fifty patients affected by treatment errors caused by medical laypersons with laser and IPL applications were evaluated in this retrospective study. We used a standardized questionnaire with accompanying photographic documentation. Among the reports there were some missing or no longer traceable parameters, which is why 7 cases could not be evaluated. The following complications occurred, with possible multiple answers: 81.4% pigmentation changes, 25.6% scars, 14% textural changes and 4.6% incorrect information. The sources of error (multiple answers possible) were the following: 62.8% excessively high energy, 39.5% wrong device for the indication, 20.9% treatment of patients with darker skin or marked tanning, 7% no cooling, and 4.6% incorrect information. The causes of malpractice suggest insufficient training, inadequate diagnostic abilities, and promising unrealistic results. Direct supervision by a medical specialist, comprehensive experience in laser therapy, and compliance with quality guidelines are prerequisites for safe laser and IPL treatments. Legal measures to make such changes mandatory are urgently needed. © The Authors | Journal compilation © Blackwell Verlag GmbH, Berlin.

  4. 3D radiobiological evaluation of combined radiotherapy and hyperthermia treatments.

    Science.gov (United States)

    van Leeuwen, C M; Crezee, J; Oei, A L; Franken, N A P; Stalpers, L J A; Bel, A; Kok, H P

    2016-10-17

    Currently, clinical decisions regarding thermoradiotherapy treatments are based on clinical experience. Quantification of the radiosensitising effect of hyperthermia allows comparison of different treatment strategies, and can support clinical decision-making regarding the optimal treatment. The software presented here enables biological evaluation of thermoradiotherapy plans through calculation of equivalent 3D dose distributions. Our in-house developed software (X-Term) uses an extended version of the linear-quadratic model to calculate equivalent radiation dose, i.e. the radiation dose yielding the same effect as the thermoradiotherapy treatment. Separate sets of model parameters can be assigned to each delineated structure, allowing tissue specific modelling of hyperthermic radiosensitisation. After calculation, the equivalent radiation dose can be evaluated according to conventional radiotherapy planning criteria. The procedure is illustrated using two realistic examples. First, for a previously irradiated patient, normal tissue dose for a radiotherapy and thermoradiotherapy plan (with equal predicted tumour control) is compared. Second, tumour control probability (TCP) is assessed for two (otherwise identical) thermoradiotherapy schedules with different time intervals between radiotherapy and hyperthermia. The examples demonstrate that our software can be used for individualised treatment decisions (first example) and treatment optimisation (second example) in thermoradiotherapy. In the first example, clinically acceptable doses to the bowel were exceeded for the conventional plan, and a substantial reduction of this excess was predicted for the thermoradiotherapy plan. In the second example, the thermoradiotherapy schedule with long time interval was shown to result in a substantially lower TCP. Using biological modelling, our software can facilitate the evaluation of thermoradiotherapy plans and support individualised treatment decisions.

  5. Evaluation of antiretroviral therapy results in Blantyre, Malawi | van ...

    African Journals Online (AJOL)

    The most common side effect was peripheral neuropathy. Nevirapine plasma levels were remarkably high and associated with successful virological treatment results. Two simple adherence questions pertaining to the use of medication in the previous 8 days corresponded well with nevirapine levels. The most important ...

  6. Treatments Results and Prognostic Factors in Locally Advanced Hypopharyngeal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Mee-Sun; Chung, Woong-Ki; Ahn, Sung-Ja; Nam, Taek-Keun; Song, Ju-Young; Nah, Byung-Sik; Lim, Sang Cheol; Lee, Joon Kyoo [Chonnam National University Medical School, Gwangju (Korea, Republic of)

    2007-09-15

    The purpose of this study is to present the treatment results and to identify possible prognostic indicators in patients with locally advanced hypopharyngeal carcinoma. Materials and Methods: Between October 1985 to December 2000, 90 patients who had locally advanced stage IV hypopharyngeal carcinoma were studied retrospectively. Twelve patients were treated with radiotherapy alone, 65 patients were treated with a combination of chemotherapy and radiotherapy, and 13 patients were treated with surgery and postoperative radiotherapy with or without neoadjuvant chemotherapy. Total radiation dose ranged from 59.0 to 88.2 Gy (median 70 Gy) for radiotherapy alone. Most patients had ciplatin and 5-fluorouracil, and others had cisplatin and peplomycin or vincristin. Median follow-up period was 15 months. Kaplan-Meier method was used for survival rate and Cox proportional hazard model for multivariate analysis of prognostic factors. Results: Overall 3- and 5-year survival rates were 27% and 17%, respectively. The 2-year locoregional control rates were 33% for radiotherapy alone, 32% for combined chemotherapy and radiotherapy, and 81% for combined surgery and radiotherapy (p=0.006). The prognostic factors affecting overall survival were T stage, concurrent chemo radiation and treatment response. Overall 3- and 5-year laryngeal preservation rates in combined chemotherapy and radiotherapy were 26% and 22%, respectively. Of these, the 5-year laryngeal preservation rates were 52% for concurrent chemo radiation group (n=11), and 16% for neoadjuvant chemotherapy and radiotherapy (n=54, p=0.012). Conclusion: Surgery and postoperative radiotherapy showed better results than radiotherapy alone or with chemotherapy. Radiotherapy combined with concurrent chemotherapy is an effective modality to achieve organ preservation in locally advanced hypopharyngeal cancer. Further prospective randomized studies will be required.

  7. Treatment and results of chronic toxoplasmosis. Analysis of 33 cases.

    Science.gov (United States)

    Cengir, S D; Ortaç, F; Söylemez, F

    1992-01-01

    Women who grew up in Turkey, where undercooked meat is part of the usual diet, have an increased risk of toxoplasmosis. This study covers treatment and prognosis of 33 cases with chronic toxoplasmosis. The study group was selected among the patients with a history of repeated abortions, recurrent preterm labor, stillbirths and babies with congenital anomaly after all other causative reasons were ruled out. IgG and IgM antibody titers were detected by Sabin-Feldman's dye test and indirect fluorescence antibody test. 33 patients, who had negative IgM and IgG antibody titers above 1/64, were accepted as having chronic toxoplasmosis and were included in our study group. These patients were treated with our pyrimethamine treatment protocol (Dinçer Formula) for 36 days before their pregnancies. IgG antibody titers were repeated in the 8th and the 20th week of pregnancy. With the exception of 7 cases, 24 patients (72.7%) still had IgG antibody titers of more than 1/64 and were given the same treatment protocol in the 8th week of pregnancy. Very early abortions occurred in 2 cases. Of 24 patients, 8 had antibody titers still above 1/64 and were treated with spiramycine. While 28 cases (84.8%) had healthy and living infants, pregnancies of 3 cases are still continuing. No teratogenic effects of pyrimethamine on the fetuses were seen. As a result, we can say that a patient who presents with complaints of repeated abortions, recurrent preterm labor or stillbirth should be investigated for toxoplasmosis during pregnancy; even if the IgG antibody test is normal before pregnancy, she should be treated with the protocol mentioned above before pregnancy and in the 8th week of pregnancy when chronic toxoplasmosis is diagnosed.

  8. Results achieved in the treatment of patients with vestibular schwannoma.

    Science.gov (United States)

    Freigang, Bernd; Rudolf, Jan

    2004-01-01

    Personal experience gathered with the treatment of 264 vestibular schwannoma (VS) at the Magdeburg University ENT Hospital is analysed. ABR Audiometry is useful as a screening, even though it yielded false-negative values in 12.7% (n = 33) for intrameatal VS and 16.9% for all VS, despite accurate evaluation. Latency increases of Waves I, III and V and their intraaural comparison exhibited a statistically significant difference for the VS levels proposed by TOS. The mean of intrameatal VS too was found to have longer latencies compared with the normal-hearing ears of the patients. In the individual case, with threshold hearing normal, anamnestic findings as well as otoneurological evidence provide an early indication for enhanced MRI, CISS imaging, or individual 3D reconstruction of the pontocerebellar cisterna. Adopting intraoperative monitoring of the facial nerve and the cochlea as well as the Pars acustica by means of far-field and near-field electrodes, a good facial 'mobility' was achieved in 95.3%, and a useful audition (AAO-HNS Types A and B) in 60%. Monitoring is beneficial as it enhances the reliability and improves the subtle preparation during surgery. The power of hearing improved postoperatively within six months and remained at a good level over two years. From our perspective, otorhinolaryngologists are the right specialists to attend to VS.

  9. Biofeedback as complementary treatment in patients with epilepsy – an underestimated therapeutic option? Review, results, discussion

    Directory of Open Access Journals (Sweden)

    Uhlmann Carmen

    2016-12-01

    Full Text Available Background. Biofeedback methods represent side effect free complementary options in the treatment of epilepsy. In this paper we review the current status of these methods in terms of clinical study results and their evaluation by systematic review papers. Possible mechanisms of action in biofeedback methods are discussed.

  10. [Treatment and results of therapy in autoimmune hemolytic anemia].

    Science.gov (United States)

    Tasić, J; Macukanović, L; Pavlović, M; Koraćević, S; Govedarević, N; Kitić, Lj; Tijanić, I; Bakić, M

    1994-01-01

    Basic principles in the therapy of idiopathic autoimmune hemolytic anemia induced by warm antibody were glucocorticoides and splenectomy. Immunosupresive drugs, plasmaferesis and intravenous high doses gamma globulin therapy are also useful. In secundary autoimmune hemolytic anemia induced by warm antibody we treated basic illness. During the period of 1990-1992 we treated 21 patients with primary autoimmune hemolytic anemia and 6 patients with secondary /4 CLL and 2 Non-Hodgkin's lymphoma/. Complete remission we found as a normalisation of reticulocites and hemoglobin level respectively. Complete remission by corticoides we got in 14/21 patients, partial response in 2/21 respectively. Complete response by splenectomy we got in 2/3 splenoctomized patients (idiopathic type). For successful treatment secondary hemolytic anemias we treated primary diseases (CLL and malignant lymphoma) and we got in 4/6 patients complete remission. Our results were standard in both type of autoimmune hemolytic anaemias induced by warm antibody.

  11. Topical Peptide Treatments with Effective Anti-Aging Results

    Directory of Open Access Journals (Sweden)

    Silke Karin Schagen

    2017-05-01

    Full Text Available In the last two decades, many new peptides have been developed, and new knowledge on how peptides improve the skin has been uncovered. The spectrum of peptides in the field of cosmetics is continuously growing. This review summarizes some of the effective data on cosmeceutical peptides that work against intrinsic and extrinsic aging. Some peptides have been proven in their efficacy through clinical skin trials. Well-known and documented peptides like copper tripeptide are still under research to obtain more details on their effectiveness, and for the development of new treatments. Palmitoyl pentapeptide-4 and Carnosine are other well-researched cosmeceuticals. Additionally, there are many more peptides that are used in cosmetics. However, study results for some are sparse, or have not been published in scientific journals. This article summarizes topical peptides with proven efficacy in controlled in vivo studies.

  12. Outcome-driven Evaluation Metrics for Treatment Recommendation Systems.

    Science.gov (United States)

    Mei, Jing; Liu, Haifeng; Li, Xiang; Yu, Yiqin; Xie, Guotong

    2015-01-01

    Treatment recommendation systems aim to providing clinical decision supports, e.g. with integration of Computerized Physician Order Entry (CPOE). One of the most significant issue is the quality of recommendations which needs to be quantified, before getting the acceptance from physicians. In computer science, such evaluations are typically performed by applying appropriate metrics that provides a comparison of different systems. However, a big challenge for evaluating treatment recommendation systems is that ground truth is only partially observed. In this paper, we propose an outcome-driven evaluation methodology, and present five metrics (i.e. precision, recall, accuracy, relative risk and odds ratio) with highlight of their statistic meanings in clinical context. The experimental results are based on the comparison of two well-developed treatment recommendation systems (one is knowledge-driven and based on clinical practice guidelines, while the other is data-driven and based on patient similarity analysis), using our proposed evaluation metrics. As a conclusion, physicians are less prone to comply with clinical guidelines, but once following guideline recommendations, it is much more likely to get good outcomes than not following.

  13. Evaluation of Electrochemical Treatment of Chloride Contaminated Mortar Containing GGBS

    Directory of Open Access Journals (Sweden)

    Ki Hong Lee

    2017-01-01

    Full Text Available The present study concerns the influence of cementitious binder on electrochemical treatment of steel embedded in salt contaminated mortar. As binder, ordinary Portland cement (OPC and ground granulated blast furnace slag (GGBS were used and the current density of 250–750 mA/m2 was applied for 4 weeks to complete electrochemical chloride extraction. To evaluate the effect of electrochemical treatment the chloride profile and corrosion behaviour covering chloride concentration, galvanic current density, linear polarization resistance, open circuit potential, and mass loss were measured. An increase in the applied direct current density resulted in a decrease in the chloride concentration at the vicinity of steel, accompanying the mitigated corrosion damage. The performance of electrochemical treatment was more remarkable in mortar containing GGBS presumably due to binding mechanism. However, corrosion damage was more detrimental in GGBS rather than OPC at a given potential, while GGBS had superior corrosion resistance to a corrosive environment and treatment conditions. Therefore, the electrochemical treatment should be conducted prudently to evaluate the corrosion state of embedded steel depending on binder type.

  14. EVALUATION OF PARENTS’ DECISION-MAKING IN ONCOLOGIC PEDIATRIC TREATMENT

    Directory of Open Access Journals (Sweden)

    Lucas Bandinelli

    2017-01-01

    Full Text Available . Introduction: Decision-making when facing a pediatric cancer treatment deserves a spotlight due to the amount of decisions that parents must deal with during this process, which may often generate emotional stress, doubts, uncertainties and anxieties. Thus, assessing how the health team influences the decision of parents is an important factor to evaluate how much autonomy they have to be able to choose on the numerous possibilities resulting from the treatment. Objective: To evaluate parents’ decision-making process in oncologic pediatric treatments and to analyze the perception of coercion, the level of moral-psychological development and other difficulties. Method: 10 participants were selected by convenience to conduct individual semi-structured interviews, applying the Scale of Perception of Coercion in Assistance and the Moral-Psychological Development Scale. Results: Nine mothers and one father were interviewed (n = 10, with an average age of 33.1 years. Six categories were identified from the analysis of content originated from the central theme. There was no perception of coercion by parents and all have shown psychological and moral levels suitable for decision-making. Conclusion: It was observed that, in spite of emotional difficulties, parents have proved able to decide on issues related to the treatment of their children, having enough autonomy for decision-making.

  15. WP5 Evaluation: D54-D55 Evaluation Results V2 (V3)

    NARCIS (Netherlands)

    Van Rosmalen, Peter

    2011-01-01

    Van Rosmalen, P. (2010, 19 May). WP5 Evaluation: D54-D55 Evaluation Results V2 (V3). Presentation at idSpace Final Review, Heerlen, The Netherlands: Open University of the Netherlands. idSpace-project.

  16. Results of a Research Evaluating Quality of Computer Science Education

    Science.gov (United States)

    Záhorec, Ján; Hašková, Alena; Munk, Michal

    2012-01-01

    The paper presents the results of an international research on a comparative assessment of the current status of computer science education at the secondary level (ISCED 3A) in Slovakia, the Czech Republic, and Belgium. Evaluation was carried out based on 14 specific factors gauging the students' point of view. The authors present qualitative…

  17. Evaluating Treatment Outcome in an Interdisciplinary Pediatric Pain Service

    Directory of Open Access Journals (Sweden)

    Susan M Bennett

    2000-01-01

    Full Text Available OBJECTIVE: To provide descriptive data evaluating outcome and treatment satisfaction among former pediatric patients and their parents seen in an interdisciplinary treatment program for complex pain syndromes.

  18. Evaluation of the Treatment of Diabetic Retinopathy A Research Project

    Science.gov (United States)

    Kupfer, Carl

    1973-01-01

    Evaluated is the treatment of diabetic retinopathy (blindness due to ruptured vessels of the retina as a side effect of diabetes), and described is a research project comparing two types of photocoagulation treatment. (DB)

  19. Diagnosis and results of treatment of heart myxoma

    Directory of Open Access Journals (Sweden)

    Rafajlovski Sašo

    2011-01-01

    Full Text Available Background/Aim. Myxoma is the most common benign primary cardiac neoplasm, and usually originates from the left atrial septum. Early diagnosis of cardiac myxomas depends on a high index of a clinical suspicion. Surgical management must be done as soon as possible after diagnosis. The aim of this retrospective study was to present diagnostics and treatment outcome data of 61 patients with cardiac myxoma treated in the Military Medical Academy, Belgrade during a 49-years period. Methods. Intrahospital diagnosis was established in all the patients by the cardiologist. Diagnostic methods were various, in dependence on the examination period and suspected diagnosis. Results. Within a 49-years period (1961-2009 heart myxoma was diagnozed and treated in 61 patients in the Military Medical Academy, Belgrade. Most of the operated patients were females (38 or 62.3%. The operated patients were 19-68 years old. Average age of all the patients was 47.9%. The great majority of them (98.4% had atrial, and only one operated patient had ventricular myxoma. In 13 (21.3% of the patients heart myxoma was found out accidentally due to no previous cardiologic symptomatology. In most patients (27.44% symptomatology was presented as thromboembolic disease. Because of the suspected ventricular myxoma in one patient, the patient was operated on, but Hodgkin's lymphoma was found out which, according to the subsequent course of the disease, could be justifiably recognized as primary heart lymphoma. This study presented brief descriptions of the course of the disease in 4 patients with myxomas in each of the cardiac cavities. Conclusion. The only diagnostic difficulty in cardiac myxoma is due to its asymptomatic and oligosymptomatic presence within the longer period of time, namely, its growth period. Echocardiography should be the standard method of cardiologic examination of these patients, which could considerably contribute to early diagnosis and treatment of heart

  20. Real-World Clinical Characteristics and Treatment Patterns of Individuals Aged 80 and Older with Nonvalvular Atrial Fibrillation: Results from the ReAl-life Multicenter Survey Evaluating Stroke Study.

    Science.gov (United States)

    Biteker, Murat; Başaran, Özcan; Doğan, Volkan; Altun, İbrahim; Özpamuk Karadeniz, Fatma; Tekkesin, Ahmet İlker; Çakıllı, Yasin; Türkkan, Ceyhan; Hamidi, Mehmet; Demir, Vahit; Gürsoy, Mustafa Ozan; Tek Öztürk, Müjgan; Aksan, Gökhan; Seyis, Sabri; Ballı, Mehmet; Alıcı, Mehmet Hayri; Bozyel, Serdar

    2017-08-01

    To compare the clinical characteristics of and use of oral anticoagulant (OAC) therapy in individuals aged 80 and older with atrial fibrillation (AF) with those of individuals younger than 80 with AF in clinical practice. Observational study. The ReAl-life Multicenter Survey Evaluating Stroke prevention strategies in Turkey trial (NCT02344901), a national observational registry. Turkish adults with nonvalvular AF (NVAF). Age data were collected at the time of entry into the registry and the octogenarian subgroup included all patients aged ≥ 80 years. We compared background and management in octogenarian with non-octogenarian AF patients. Fifty-seven cardiology units enrolled 6,273 individuals in 3 months. Participants aged 80 and older (n = 1,170) were more likely to be female (60.7% vs 54.7%, P < .001) and had a higher prevalence of persistant or permanent AF, comorbidities, history of cerebral vascular accident, and major bleeding. As a consequence of having more comorbidities, Congestive heart failure; Hypertension; Aged 75 and older; Diabetes Mellitus; prior stroke, transient ischemic attack, or thromboembolism; Vascular disease; Aged 65 to 74; female Sex (CHA2 DS2 VASc) (4.32 ± 1.35 vs 3.04 ± 1.54, P < .001) and Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile international normalized ratio, Elderly, Drugs or alcohol (HAS-BLED) (2.14 ± 1.05 vs 1.54 ± 1.05, P < .001) scores were higher in those aged 80 and older. The mean time in therapeutic range of individuals who were taking warfarin was lower in those aged 80 and older (45.9 ± 27.9) than in those younger than 80 (54.7 ± 24.9%, P < .001). Anticoagulant therapy was prescribed for 74.8% of participants younger than 80% and 63% of those aged 80 and older (P < .001). Higher CHA2 DS2 VASc score and lower HAS-BLED score were independent predictors of OAC prescription in participants aged 80 and older. Nearly one-fifth of individuals with NVAF in this real

  1. "SABER": A new software tool for radiotherapy treatment plan evaluation.

    Science.gov (United States)

    Zhao, Bo; Joiner, Michael C; Orton, Colin G; Burmeister, Jay

    2010-11-01

    , both the calculation method and the application of DCF can change the ranking order of competing plans. The voxel-by-voxel TCP model makes it feasible to incorporate spatial variations of clonogen densities (n), radiosensitivities (SF2), and fractionation sensitivities (alpha/beta) as those data become available. The new software incorporates both spatial and biological information into the treatment planning process. The application of multiple methods for the incorporation of biological and spatial information has demonstrated that the order of application of biological models can change the order of plan ranking. Thus, the results of plan evaluation and optimization are dependent not only on the models used but also on the order in which they are applied. This software can help the planner choose more biologically optimal treatment plans and potentially predict treatment outcome more accurately.

  2. Clarifying Inconclusive Functional Analysis Results: Assessment and Treatment of Automatically Reinforced Aggression

    Science.gov (United States)

    Saini, Valdeep; Greer, Brian D.; Fisher, Wayne W.

    2016-01-01

    We conducted a series of studies in which multiple strategies were used to clarify the inconclusive results of one boy’s functional analysis of aggression. Specifically, we (a) evaluated individual response topographies to determine the composition of aggregated response rates, (b) conducted a separate functional analysis of aggression after high rates of disruption masked the consequences maintaining aggression during the initial functional analysis, (c) modified the experimental design used during the functional analysis of aggression to improve discrimination and decrease interaction effects between conditions, and (d) evaluated a treatment matched to the reinforcer hypothesized to maintain aggression. An effective yet practical intervention for aggression was developed based on the results of these analyses and from data collected during the matched-treatment evaluation. PMID:25891269

  3. Specialized treatment for Avoidant personality disorder (AvPD): Treatment rationales and preliminary results

    DEFF Research Database (Denmark)

    Simonsen, Sebastian

    and preliminary results from a specialized psychotherapy program developed for patients with AvPD treated at Stolpegaard Psychotherapy Centre, Capital Region of Denmark. Methods: Treatment consists of individual therapy based on Metacognitive Interpersonal Therapy (MIT) while group therapy is a modified form...

  4. SURGICAL TREATMENT OF SEVERE OBESITY IN TEENS: LATE RESULTS.

    Science.gov (United States)

    Ferraz, Álvaro Antônio Bandeira; de Siqueira, Luciana Teixeira; Noronha, Clarissa Guedes; de Holanda, Danilo Belem Rodrigues; de Araújo-Júnior, José Guido Corrêa; Muniz, Mariana Gomes

    2015-01-01

    In children is estimated that the prevalence of overweight and obesity has increased up to five times in developed countries and up to four in developing countries. In Brazil, the proportion of children and adolescents who are overweight also increased from approximately 4.1% to 13.9%. To evaluate the surgical results of severe obesity in adolescents. Retrospective descriptive study of 2737 patients with severe obesity that underwent Roux-en-Y gastric bypass selecting from the total 44 patients with mean age of 18.1 years, 14 males and 30 females, most (37) operated by laparotomy. There was follow-up of 20 patients (45.45%). All were followed preoperatively by a multidisciplinary team and had indication confirmed for surgical unanimous approval of all team members. Among the 20 adolescent, 14 were female. From five teenagers using anti-hypertension or hypoglycemic drugs before surgery, four (80%) had drug discontinuation and one (20%) reduced the dose in 50% postoperatively. The average weight loss was 45.4 kg after a mean follow up of 60 months. There were no deaths or severe postoperative complications. Among those who underwent postoperative follow-up with a multidisciplinary team, 18 were with BMI<30. Adolescents undergoing Roux-en-Y gastric bypass has good response in relation to weight loss and improvement of comorbidities. There was a low rate of complications and no deaths. All patients were satisfied with their personal results.

  5. The Immediate Results of Surgical Treatment of Bladder Cancer

    Directory of Open Access Journals (Sweden)

    Alexei L. Charyshkin

    2016-06-01

    Full Text Available The objective of this study was to evaluate the immediate results of the use of ureterointestinal anastomosis according to the Bricker technique at radical cystectomy (RC for bladder cancer (BC. Materials and Results: The study included 96 patients (11.5% women and 88.5% men with bladder cancer (BC, aged from 31 to 74 years (mean age 63.8±7.2, who underwent RC in the Lipetsk Regional Oncology Center, in the period from 2005 to 2014. Among the early postoperative complications, we identified dynamic ileus (16.7%, inflammatory complications of the surgical wound (12.5%, acute pyelonephritis (10.4%, and failure of ureterointestinal anastomosis (4.2%. The frequency of postoperative acute pyelonephritis corresponded to the findings of other authors. Two (2.1% patients died from early postoperative complications because of concomitant diseases (ischemic heart disease, myocardial infarction; thus, postoperative mortality in the early postoperative period was 4.2%. Chronic pyelonephritis with chronic renal failure detected in 15(15.6% patients after one year after surgery was the most frequent late postoperative complication. The stricture of ureterointestinal anastomosis in 9(9.4% patients has been eliminated through relaparotomy and resection of anastomosis. The development of urolithiasis in 12(12.5% patients after one year after surgery has required the implementation of contact lithotripsy and litholytic therapy.

  6. THE RESULTS OF TREATMENT OF BENIGN PROSTATIC OBSTRUCTION WITH FINASTERIDE

    Directory of Open Access Journals (Sweden)

    Bojan Tršinar

    2001-12-01

    Full Text Available Background. Finasteride is an inhibitor of 5 alpha-reductase. It prevents the conversion of testosterone intodihydrotestosterone, which results in gradual decrease in prostaticvolume. The objective of the study was to determine theimpact of finasteride on subjective and objective symptomaticimprovement in patients with benign prostatic obstruction(BPO.Patients and methods. This open prospective multicenter studyof 6-month duration included 370 men, mean age 63 years(range; 45–75 yrs, with clinical manifestations of BPO. Theenrolled patients received finasteride 5 mg/day. On the completionof therapy, the patients were assessed for symptomaticimprovement, urinary flow and prostatic volume, determinedby rectal examination and ultrasound. Total prostate-specificantigen levels in the serum were measured. At the end of thestudy, the patients were asked to evaluate the efficacy of finasteridetherapy and to report its possible adverse side-effects.Statistical analysis of the results was done using the Student ttest.Results. Of the 370 patients enrolled, 303 (82% completed the6-month study period. The rate of urinary symptoms declinedby an average of 55%, of which nocturia by 28% and difficultyin initiating the urinary stream by 74%. There was astatistically significant decrease in prostatic volume on rectalexamination (14%; p < 0.0001 and abdominal ultrasound(16%; p < 0.0037. The difference between both measurementswas statistically significant (p = 0.0037. Finasteride produceda statistically significant improvement in maximum urinaryflow rate and voiding time (p < 0.0001 and p = 0.0017,respectively. Untoward side-effects were experienced by 3.5%of the patients who had completed the 6-month period of finasteridetherapy. A the end of the study, 65% of the patientsreported notable improvement in micturition, and 76% statedthey would continue taking finasteride.Conclusion. Placing patients with urinary symptoms due toBPO on a 6-month course of

  7. Superficial urinary bladder tumors treatment results: A 10-year experience

    Directory of Open Access Journals (Sweden)

    Stanković Jablan

    2007-01-01

    Full Text Available Background/Aim. The most common urinary bladder tumors are superficial tumors. Due to their tension to relapse and progress towards deeper layers after surgical therapy, an adequate therapy significantly contributed to the improvement of the results of urinary bladder tumors treatment. Staging and gradus of the tumor, presence of the carcinoma in situ (CIS or relapses significantly influenced the choice of the therapy. The aim of this study was to ascertain the effectiveness of the intravesicelly applied BCG (Bacille Colmette - Guerin vaccine or chemiotherapy in the prevention of the relapses and further progression of superficial urinary bladder tumors. Methods. All of the diagnosed superficial tumors of bladder were removed by transurethral resection (TUR. After receiving the patohistological finding they were subjected to adjuvant therapy, immune BCG vaccine or chemiotherapy (epirubicin, doxorubicin, mitomycin-C. The third group did not accept adjuvant therapy, but had regularly scheduled cystoscopic controls. The appearance of relapses, progression of stage and grades of the tumor, as well as possible unwanted effects of adjuvant therapy were registered. Results. The applied immunotherapy (BCG influenced decreased tumor relapses (7% and statistically important difference between patients who had taken adjuvant chemotherapy (relapses 18.4% and those without this therapy was acknowledged. Grades of tumor did not show statistically significant difference on tumor relapse. A significantly longer period of time in the appearance of tumor relapse after BCG (29.33 months, had significant importance comparing to chemio (9.44 months or non-taken adjuvant therapy (9.84 months. Very small number of unwanted effects suggested an obligatory undertaking adjuvant therapy after TUR of superficial tumors. Conclusion. A significant decrease of relapses as well as avoidance of further progression of urinary bladder tumors, has introduced adjuvant therapy in

  8. [Intermittent thrombolytic treatment. Results during severe, chronic arterial diseases].

    Science.gov (United States)

    Fiessinger, J N; Aiach, M; Lagneau, P; Cormier, J M; Housset, E

    1975-04-20

    38 patients with severe chronic arteritis of the lower limbs were treated with streptokinase intermittently. All had been refused for surgical operation. One patient died, 4 others had early interruption of treatment. Eleven of the 38 patients had efficient thrombolysis confirmed by arteriography. The facts confirm the possibility of thrombolysis during chronic arterial disease. The fact that the aggravation was recent was favourable factor in prognosis. The eleven patients improved, had severe aggravation of symptomes for less than 2 months. Thus thrombolytic treatment has a place of choice in the treatment of severe arterial disease where surgery is impossible, or dangerous, owing to the uncertain state of the vascular bed below the lesion. Efficacious, it permits reconstructive surgery in cases where it had been at first refused. The use of intermittent treatment, apart from advantages of confort and cost, seems to increase the efficacy of treatment.

  9. [Surgical treatment of hepatocellular carcinoma. Long term results].

    Science.gov (United States)

    Figueras, Juan; Ramos, Emilio; Ibáñez, Luis; Valls, Carles; Serrano, Teresa; Rafecas, Antonio; Casanovas, Teresa; Fabregat, Juan; Xiol, Xavier; Torras, Jaume; Baliellas, Carmen; Jaurrieta, Eduardo; Casais, Luis

    2002-03-30

    Surgical treatment for hepatocellular carcinoma remains controversial due to a lack of prospective randomized studies. Between January 1990 and December 2000, 121 liver transplantations (group 1) and 52 hepatectomies (group 2) were performed for hepatocellular carcinoma. Each surgical treatment was carried out depending on patients' and tumor's characteristics. Patients from group 1 had a more advanced tumoral grade, with higher involvement of two lobes (19 vs 4%; p = 0.015) and higher number of nodules (1.9 DE [2] vs 1.2 [0.6]; p = 0.001); yet the mean tumor size was lower (3 cm [1.5] vs 4.2 [3.2]; p = 0.006). Operative mortality (4% vs 2%; p = 0.66) and 5- and 10-years survival (68% and 42% vs 63% and 45%; p = 0.23) were similar between both groups. Nevertheless, 5- and 10-years recurrence rates (10.6% and 10.6% vs 50% and 65.5%; p < 0.0001) were more favourable in group 1. Prognostic factors of recurrence included microscopic vascular invasion (RR = 12.12; CI, 2.02-75.52) and alpha-fetoprotein levels higher than 300 ng/mL (RR = 7.12; 95% CI, 1.08-47.02) in group 1, and the pT3-4 stage (RR = 3.86; 95% CI, 1.06-14.03) in group 2. Mean time on waiting lists for liver transplantation was 3.06 (2.66) months and it has increased significantly in last years, especially among blood group 0 patients. However, this fact has not been associated with a worsening of survival rates (p = 0.98). After a good patient selection, either liver transplantation or hepatectomy achieve excellent long term survival rates in patients with hepatocellular carcinoma, though the former allows a better control of the tumoral disease. The increase of mean time on waiting lists for liver transplantation during the last years has not led to a worsening of survival results.

  10. Psychological Evaluation Results in Patients Confronted with Sexual Abuse

    Directory of Open Access Journals (Sweden)

    Işık Karakaya

    2006-08-01

    Full Text Available Child and adolescent sexual abuse have lifelong consequences. Sexual development, emotional effects, depressed mood, anxiety, behavioral effects and alteration of personality are some possible consequences of sexual abuse. In this article we evaluated psychiatric symptoms according to DSM-IV diagnostic criteria in 21 sexually abused children and adolescents. Twelve girls and nine boys between 4 and 16 years of age were investigated. All the patients belonged to low socioeconomic strata. The most frequently diagnosed psychiatric disorders in these children were posttraumatic stress disorder, separation anxiety disorder, major depressive disorder and elimination disorder. Sexually abused children and adolescents present various psychiatric symptoms. So, understanding the consequences of sexual abuse on children and adolescents is significant in assessment, prevention, and treatment. Key words: Child, adolescent, sexual abuse, psychiatric effects

  11. Combining Results From Multiple Evaluations of the Same Measurand.

    Science.gov (United States)

    Kessel, Rüdiger; Kacker, Raghu N; Sommer, Klaus-Dieter

    2011-01-01

    According to the Guide to the Expression of Uncertainty in Measurement (GUM), a result of measurement consists of a measured value together with its associated standard uncertainty. The measured value and the standard uncertainty are interpreted as the expected value and the standard deviation of a state-of-knowledge probability distribution attributed to the measurand. We discuss the term metrological compatibility introduced by the International Vocabulary of Metrology, third edition (VIM3) for lack of significant differences between two or more results of measurement for the same measurand. Sometimes a combined result of measurement from multiple evaluations of the same measurand is needed. We propose an approach for determining a combined result which is metrologically compatible with the contributing results.

  12. Evidence-based evaluation of treatment strategy for multiple sclerosis

    Directory of Open Access Journals (Sweden)

    LI Meng-qiu

    2012-04-01

    Full Text Available Objective To formulate the best treatment plan for multiple sclerosis (MS patients by evaluating the therapeutic efficacy and side effect of various evidence-based programs. Methods Key words were defined as multiple sclerosis, immunomodulatory therapy and therapy, etc. We searched MEDLINE, Cochrane Library, Wanfang data bases for Scientific Journals in China and National Knowledge Infrastructure for Chinese Scientific Journals Database. Additionally, we applied manual searching and screened out conference paper and academic dissertation, etc, from various references. After that we obtained and evaluated by Jadad scales on systematic reviews, randomized controlled trials, controlled clinical trials and observational study cases about glucocorticoids, plasmapheresis, intravenous immunoglobulin, IFN-β, glatiramer acetate, mitoxantrone, natalizumab, fingolimod. Results After screening, all seventeen selected resources included systematic reviews 6 articles, randomized controlled trials 7 articles, controlled clinical trials 2 articles, observational study cases 2 articles, among which fifteen articles were proved to be high quality (according to Jadad scoring system, five score 4, six score 5, four score 7, two chapters were judged to be low quality scoring 3. Finally, we summerize that: 1 The first choice of treatment for acute relapses is glucocorticoids and we suggest that plasmapheresis or intravenous immunoglobulin may be tried as an alternative therapy in acute MS relapse, especially in case of contraindications to intravenous methylprednisolone. 2 Immunomodulatory or immunosuppressive treatment (IFN-β, glatiramer acetate, mitoxantrone, natalizumab can be an option to prevent new relapses and progression of disability. 3 Fingolimod is an oral treatment for multiple sclerosis to improve treatment adherence. Conclusion Using evidence-based medicine methods can provide us best clinical evidence on MS treatment.

  13. Travinfor Evaluation: Value Added Reseller (var) Study Phase 1 Results

    OpenAIRE

    Loukakos, D.; Hall, R.; Weissenberger, S.; Yim, Y. B.

    1996-01-01

    TravInfo is a Field Operational Test (FOT) in advanced traveler information systems (ATIS) for the San Francisco Bay Area sponsored by the Federal Highway Administration (FHWA). The project involves a public/private partnership which seeks to compile, integrate and broadly disseminate timely and accurate multi-modal traveler information through commercial products and services. This working paper is part of the Technology Element of the TravInfo evaluation. It presents the results of the "bef...

  14. Treatment results of a periprosthetic femoral fracture case series: treatment method for Vancouver type b2 fractures can be customized.

    Science.gov (United States)

    Niikura, Takahiro; Lee, Sang Yang; Sakai, Yoshitada; Nishida, Kotaro; Kuroda, Ryosuke; Kurosaka, Masahiro

    2014-06-01

    Currently, an algorithmic approach for deciding treatment options according to the Vancouver classification is widely used for treatment of periprosthetic femoral fractures after hip arthroplasty. However, this treatment algorithm based on the Vancouver classification lacks consideration of patient physiology and surgeon's experience (judgment), which are also important for deciding treatment options. The purpose of this study was to assess the treatment results and discuss the treatment options using a case series. Eighteen consecutive cases with periprosthetic femoral fractures after total hip arthroplasty and hemiarthroplasty were retrospectively reviewed. A locking compression plate system was used for osteosynthesis during the study period. The fracture type was determined by the Vancouver classification. The treatment algorithm based on the Vancouver classification was generally applied, but was modified in some cases according to the surgeon's judgment. The reasons for modification of the treatment algorithm were investigated. Mobility status, ambulatory status, and social status were assessed before the fracture and at the latest follow-up. Radiological results including bony union and stem stability were also evaluated. Thirteen cases were treated by osteosynthesis, two by revision arthroplasty and three by conservative treatment. Four cases of type B2 fractures with a loose stem, in which revision arthroplasty is recommended according to the Vancouver classification, were treated by other options. Of these, three were treated by osteosynthesis and one was treated conservatively. The reasons why the three cases were treated by osteosynthesis were technical difficulty associated with performance of revision arthroplasty owing to severe central migration of an Austin-Moore implant in one case and subsequent severe hip contracture and low activity in two cases. The reasons for the conservative treatment in the remaining case were low activity, low-grade pain

  15. Psychological care demand in clinical practice: treatment and results

    National Research Council Canada - National Science Library

    Labrador, Francisco Javier; Estupiñá, Francisco José; García Vera, María Paz

    2010-01-01

    With the aim of describing the usual clinical context as opposed to the academic or research context, the characteristics of patients and psychological treatments applied in a sample of 856 patients...

  16. Model for Quantitative Evaluation of Enzyme Replacement Treatment

    Directory of Open Access Journals (Sweden)

    Radeva B.

    2009-12-01

    Full Text Available Gaucher disease is the most frequent lysosomal disorder. Its enzyme replacement treatment was the new progress of modern biotechnology, successfully used in the last years. The evaluation of optimal dose of each patient is important due to health and economical reasons. The enzyme replacement is the most expensive treatment. It must be held continuously and without interruption. Since 2001, the enzyme replacement therapy with Cerezyme*Genzyme was formally introduced in Bulgaria, but after some time it was interrupted for 1-2 months. The dose of the patients was not optimal. The aim of our work is to find a mathematical model for quantitative evaluation of ERT of Gaucher disease. The model applies a kind of software called "Statistika 6" via the input of the individual data of 5-year-old children having the Gaucher disease treated with Cerezyme. The output results of the model gave possibilities for quantitative evaluation of the individual trends in the development of the disease of each child and its correlation. On the basis of this results, we might recommend suitable changes in ERT.

  17. Adolescent Substance Abuse Treatment: A Synthesis of Controlled Evaluations

    Science.gov (United States)

    Vaughn, Michael G.; Howard, Matthew O.

    2004-01-01

    Objective: A synthesis was conducted to assess outcome findings and methodological characteristics of controlled evaluations of adolescent substance abuse treatments. Method: Extensive computerized and manual bibliographic searches were employed to identify controlled evaluations of adolescent substance abuse treatment. Meta-analytic techniques…

  18. Evaluation of the results of coal jigging process

    Directory of Open Access Journals (Sweden)

    Surowiak Agnieszka

    2017-01-01

    Full Text Available Quality of applied hard coal fuel to combustion processes influence significantly on process efficiency and effects of its influence on surrounding environment. It is particularly important issue in time of Clean Coal Technologies (CTW. The paper presents the analysis of hard coal beneficiation in a jig for getting an optimal recovery of useful fraction in concentrate (combustible matter and not useful fraction (ash and sulfur. On the basis of industrial sampling of coal dust jig the density analysis of collected samples of concentrate and tailings was performed in laboratory conditions. In separated fractions of separation products the yields of products were calculated and the contents of ash and total sulfur were marked in them. On the basis of the results of density and chemical analyzes, separation products balance and appropriate calculations the Fuerstenau beneficiation curves were plotted which allowed to evaluate process and compare results of beneficiation of material containing various components. This is a different approach to evaluation of coal beneficiation effects, so far being used mainly for multi-component metals ores. Furthermore, the evaluation of separation preciseness on the basis of separation curves and factors was done and the statistical analysis of mutual correlations of analyzed parameters was done.

  19. [Update on current care guidelines: evaluation and treatment of menorrhagia].

    Science.gov (United States)

    2010-01-01

    Diagnosis of menorrhagia is based on an evaluation of the bleeding volume and its harm to the patient. The appropriate treatment of menorrhagia improves patients' quality of life. Medical treatment, including an intrauterine system (IUS), tranexamic acid, NSAIDs or contraceptive pills, should usually be tried before surgical treatment.

  20. Evaluation and Treatment of Lumbar Facet Cysts.

    Science.gov (United States)

    Boody, Barrett S; Savage, Jason W

    2016-12-01

    Lumbar facet cysts are a rare but increasingly common cause of symptomatic nerve root compression and can lead to radiculopathy, neurogenic claudication, and cauda equina syndrome. The cysts arise from the zygapophyseal joints of the lumbar spine and commonly demonstrate synovial herniation with mucinous degeneration of the facet joint capsule. Lumbar facet cysts are most common at the L4-L5 level and often are associated with spondylosis and degenerative spondylolisthesis. Advanced imaging studies have increased diagnosis of the cysts; however, optimal treatment of the cysts remains controversial. First-line treatment is nonsurgical management consisting of oral NSAIDs, physical therapy, bracing, epidural steroid injections, and/or cyst aspiration. Given the high rate of recurrence and the relatively low satisfaction with nonsurgical management, surgical options, including hemilaminectomy or laminotomy to excise the cyst and decompress the neural elements, are typically performed. Recent studies suggest that segmental fusion of the involved levels may decrease the risks of cyst recurrence and radiculopathy.

  1. Results of surgical treatment for juvenile myasthenia gravis.

    Science.gov (United States)

    Vázquez-Roque, F J; Hernández-Oliver, M O; Medrano Plana, Y; Castillo Vitlloch, A; Fuentes Herrera, L; Rivero-Valerón, D

    2017-04-01

    Radical or extended thymectomy is an effective treatment for myasthenia gravis in the adult population. There are few reports to demonstrate the effectiveness of this treatment in patients with juvenile myasthenia gravis. The main objective of this study was to show that extended transsternal thymectomy is a valid option for treating this disease in paediatric patients. Twenty-three patients with juvenile myasthenia gravis underwent this surgical treatment in the period between April 2003 and April 2014; mean age was 12.13 years and the sample was predominantly female. The main indication for surgery, in 22 patients, was the generalised form of the disease (Osserman stage II) together with no response to 6 months of medical treatment. The histological diagnosis was thymic hyperplasia in 22 patients and thymoma in one patient. There were no deaths and no major complications in the postoperative period. After a mean follow-up period of 58.87 months, 22 patients are taking no medication or need less medication to manage myasthenic symptoms. Extended (radical) transsternal thymectomy is a safe and effective surgical treatment for juvenile myasthenia gravis. Copyright © 2015 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. [Osteogenesis imperfecta: Treatment and results of a case series].

    Science.gov (United States)

    Escribano-Rey, R J; Duart-Clemente, J; Martínez de la Llana, O; Beguiristáin-Gúrpide, J L

    2014-01-01

    To describe our experience in the management of patients with osteogenesis imperfect (OI). We conducted a retrospective study of a series of cases affected with OI treated in the Clínica Univesidad de Navarra from 1980 to 2007, with a mean follow up of 17.3 years (7-27 years). We collected descriptive data of the sample, the fractures and the deformities, and the treatments given. The complications presented and the functional outcomes at the end of follow-up were also reviewed. The sample included ten patients. Approximately two-thirds (65%) of fractures were sustained in the lower limbs. One patient received medical treatment only. Three patients had combined medical and surgical treatment. Some type of surgical treatment was performed on 6 patients. The most common surgery was the Sofield-Millar performed on 37 occasions, with a third of them requiring revision surgery due to migration of the nails. There were 17 episodes of re-fracture. Complications such as non-union, iatrogenic fractures, and infections, were also observed. The functional outcome, according to the Hoffer-Bullock scale, at the end of follow-up was grade I/II in 7 patients. Despite the need for multiple interventions and complications presented during follow up, the appropriate treatment of patients with OI can provide acceptable functional outcomes. Copyright © 2012 SECOT. Published by Elsevier Espana. All rights reserved.

  3. Evaluation of medication treatment for Alzheimer's disease on clinical evidence

    Directory of Open Access Journals (Sweden)

    Meng-qiu LI

    2014-03-01

    Full Text Available Objective To formulate the best treatment plan for Alzheimer's disease patients by evaluating the therapeutic efficacy and side effect of various evidence-based programs. Methods Alzheimer's disease, donepezil, rivastigmine, galantamine, memantine, rosiglitazone, etc. were defined as retrieval words. PubMed, Cochrane Library, Wanfang Data and China National Knowledge Infrastructure (CNKI databases were used with applying of manual searching. Systematic reviews, randomized controlled trials (RCT, controlled clinical trials and case-observation studies were collected and evaluated by Jadad Scale. Results After screening, 33 selected resources included 14 systematic reviews, 14 randomized controlled trials, 4 controlled clinical trials and 1 case-observation study. According to Jadad Scale, total 28 articles were evaluated to be high quality (12 with score 4, 10 score 5, 6 score 7, and 5 were low quality with score 3. It was summarized as follows: 1 Alzheimer's disease is a progressive neurodegenerative disease for which no cure exists. To date, only symptomatic treatments with cholinesterase inhibitors (donepezil, rivastigmine, galantamine and an N-methyl-D-aspartate (NMDA receptor noncompetitive antagonist (memantine, are effective and well tolerated to counterbalance the neurotransmitter disturbance, but cannot limit or impact on disease progression. 2 Disease modifying drug is an potential agent, with persistent effect on slowing the progression of structural damage, and can be detected even after withdrawing the treatment. Many types of disease modifying drugs are undergoing clinical trials. Conclusions Using evidence-based medicine methods can provide best clinical evidence on Alzheimer's disease treatment. doi: 10.3969/j.issn.1672-6731.2014.03.009

  4. Acute and Chronic Urticaria: Evaluation and Treatment.

    Science.gov (United States)

    Schaefer, Paul

    2017-06-01

    Urticaria commonly presents with intensely pruritic wheals, sometimes with edema of the subcutaneous or interstitial tissue. It has a lifetime prevalence of about 20%. Although often self-limited and benign, it can cause significant discomfort, continue for months to years, and uncommonly represent a serious systemic disease or life-threatening allergic reaction. Urticaria is caused by immunoglobulin E- and non-immunoglobulin E-mediated release of histamine and other inflammatory mediators from mast cells and basophils. Diagnosis is made clinically; anaphylaxis must be ruled out. Chronic urticaria is idiopathic in 80% to 90% of cases. Only a limited nonspecific laboratory workup should be considered unless elements of the history or physical examination suggest specific underlying conditions. The mainstay of treatment is avoidance of triggers, if identified. The first-line pharmacotherapy is second-generation H1 antihistamines, which can be titrated to greater than standard doses. First-generation H1 antihistamines, H2 antihistamines, leukotriene receptor antagonists, high-potency antihistamines, and brief corticosteroid bursts may be used as adjunctive treatment. In refractory chronic urticaria, patients can be referred to subspecialists for additional treatments, such as omalizumab or cyclosporine. More than one-half of patients with chronic urticaria will have resolution or improvement of symptoms within a year.

  5. Surgical treatment of congenital mitral stenosis: medium-term results

    Directory of Open Access Journals (Sweden)

    Atik Fernando A.

    2003-01-01

    Full Text Available OBJECTIVE: For a cohort of patients with congenital mitral stenosis (CMS, to determine: patient outcomes, predictors of valve repairability and predictors of durability of valve repair. METHODS: From 1989 and 2002, 23 patients underwent surgical treatment of CMS, excluding those with common atrioventricular canal, and univentricular forms. The median age at operation was 15.5 months (range 2-204, and the median body weight was 11 Kg (range 4.5-51.6. Seventeen patients (73.9% had associated anomalies, including Shone's complex in nine (39.1% and pulmonary hypertension in 14 (60.9%. Mitral stenosis was severe in 14 patients (60.9% and moderate in the remaining (median trans-mitral gradient of 16 mmHg, range 8.5-32. Mitral valve repair was performed in 18 patients (78.3%, and valve replacement in five (21.7%. Repair techniques included papillary muscle splitting (n=10, excision of supravalvular ring (n=9 and commissurotomy (n=8. Twelve patients (52.2% required associated procedures. RESULTS: There were no early and late deaths at a mean follow-up of 58.5 ± 46.7 months (range 1-156. Mean hospital stay was 12.7 ± 8.2 days. There were no significant factors associated with unsuccessful valve repair. Actuarial freedom from reoperation at five years was 67.1% (CI 95%: 56.8% to 77.4%. The mitral valve repair group required reoperation in eight patients (44.4% (two early and six late, as opposed to one (20% in the replacement group. The presence of preoperative pulmonary hypertension was significantly related (p<0.005 to higher reoperation rates. All but two the followed patients are presently in functional class I and the echocardiography has shown less than 2+ mitral stenosis and/or regurgitation. CONCLUSION: Reoperations were the most important cause of morbidity at the medium-term follow-up of CMS. Preoperative pulmonary hypertension may predict the need for reoperation after mitral valve repair, which is the procedure of choice in CMS.

  6. Stem cells show promising results for lymphoedema treatment

    DEFF Research Database (Denmark)

    Toyserkani, Navid Mohamadpour; Quaade, Marlene Louise; Sheikh, Søren Paludan

    2015-01-01

    Abstract Lymphoedema is a debilitating condition, manifesting in excess lymphatic fluid and swelling of subcutaneous tissues. Lymphoedema is as of yet still an incurable condition and current treatment modalities are not satisfactory. The capacity of mesenchymal stem cells to promote angiogenesis......, secrete growth factors, regulate the inflammatory process, and differentiate into multiple cell types make them a potential ideal therapy for lymphoedema. Adipose tissue is the richest and most accessible source of mesenchymal stem cells and they can be harvested, isolated, and used for therapy...... in a single stage procedure as an autologous treatment. The aim of this paper was to review all studies using mesenchymal stem cells for lymphoedema treatment with a special focus on the potential use of adipose-derived stem cells. A systematic search was performed and five preclinical and two clinical...

  7. Evaluation of abiotic fate mechanisms in soil slurry bioreactor treatment

    Energy Technology Data Exchange (ETDEWEB)

    Glaser, J.A.; McCauley, P.T. [Environmental Protection Agency, Cincinnati, OH (United States); Dosani, M.A. [IT Corp., Cincinnati, OH (United States)] [and others

    1995-10-01

    Biological treatment of contaminated soil slurries may offer a viable technology for soil bioremediation. Slurry bioreactor treatment of soils, however, has not sufficiently progressed to be a durable, reliable, and cost-effective treatment option. Critical to the evaluation of slurry bioreactors is a better description of pollutant mass transfer during the treatment phase. Losses attributable to abiotic means are generally overlooked in field application of the technology. Discussions with EPA regional personnel and inspection of active soil slurry bioreactor operations have identified operational problems such as foaming which could result in possible abiotic loss. Field bioslurry operations have adopted various approaches to reduce foaming: (1) the addition of defoaming agents, (2) the reduction of rotational speed of the agitator, and (3) the reduction of gas flow through the bioreactor system. We have conducted two bench-scale slurry bioreactor treatability studies, at the U.S. EPA Testing & Evaluation Facility in Cincinnati, Ohio, which were designed to investigate some of the operating factors leading to foam formation and identify the most advantageous means to deal with foaming. The initial study has been previously presented as a general treatability study for treatment of creosote contamination in a soil. During this study, foaming became a major problem for operation. The foaming conditions were mitigated by use of defoamer and, in the more extreme cases, through reduction of the mixer rotational speed and gas flow. A subsequent study which was devoted specifically to investigating the causes and conditions of foaming using a different batch of soil from the same site as the earlier study showed little foaming at the very beginning of the study.

  8. Nonunion of Fractures of the Ulna and Radius Diaphyses: Clinical and Radiological Results of Surgical Treatment

    Directory of Open Access Journals (Sweden)

    Boussakri H

    2016-07-01

    Full Text Available Aseptic nonunion of the radius and ulna is a major complication of forearm fractures, accounting for 2% to 10% of all forearm fractures. The aim of our study is to evaluate the functional and radiological results of surgical treatment of diaphyseal aseptic nonunion of the radius and ulna, with autologous bone grafting, decortication and internal plate fixation. A series of 21 patients (26 nonunions was retrospectively reviewed, the average age was 35 years with a mean of 31,58 years (range 12-44 years . The fractures included isolated radius (n=6 and ulna (n=10, and both radius and ulna (n=5. The Grace and Eversmann score was used to evaluate our results. Fifteen had very good results, five good and one average. Consolidation of the two bones was attained in 6.2 months. Therefore, the functional prognosis of the upper limb imposes the need for an adequate treatment. This management strategy has enabled us to have satisfactory results. However, the best treatment of nonunion remains the preventive treatment with an optimal management and care of the forearm fractures.

  9. Process Evaluation Results from an Environmentally Focused Worksite Weight Management Study

    Science.gov (United States)

    DeJoy, David M.; Wilson, Mark G.; Padilla, Heather M.; Goetzel, Ron Z.; Parker, Kristin B.; Della, Lindsay J.; Roemer, Enid C.

    2012-01-01

    There is currently much interest in exploring environmental approaches to combat weight gain and obesity. This study presents process evaluation results from a workplace-based study that tested two levels of environmentally focused weight management interventions in a manufacturing setting. The moderate treatment featured a set of relatively…

  10. Physical activity across the curriculum: year one process evaluation results

    Directory of Open Access Journals (Sweden)

    Sullivan Debra K

    2008-07-01

    Full Text Available Abstract Background Physical Activity Across the Curriculum (PAAC is a 3-year elementary school-based intervention to determine if increased amounts of moderate intensity physical activity performed in the classroom will diminish gains in body mass index (BMI. It is a cluster-randomized, controlled trial, involving 4905 children (2505 intervention, 2400 control. Methods We collected both qualitative and quantitative process evaluation data from 24 schools (14 intervention and 10 control, which included tracking teacher training issues, challenges and barriers to effective implementation of PAAC lessons, initial and continual use of program specified activities, and potential competing factors, which might contaminate or lessen program effects. Results Overall teacher attendance at training sessions showed exceptional reach. Teachers incorporated active lessons on most days, resulting in significantly greater student physical activity levels compared to controls (p Conclusion In the first year of the PAAC intervention, process evaluation results were instrumental in identifying successes and challenges faced by teachers when trying to modify existing academic lessons to incorporate physical activity.

  11. Hand Robotics Rehabilitation: Feasibility and Preliminary Results of a Robotic Treatment in Patients with Hemiparesis

    Directory of Open Access Journals (Sweden)

    Patrizio Sale

    2012-01-01

    Full Text Available Background. No strongly clinical evidence about the use of hand robot-assisted therapy in stroke patients was demonstrated. This preliminary observer study was aimed at evaluating the efficacy of intensive robot-assisted therapy in hand function recovery, in the early phase after a stroke onset. Methods. Seven acute ischemic stroke patients at their first-ever stroke were enrolled. Treatment was performed using Amadeo robotic system (Tyromotion GmbH Graz, Austria. Each participant received, in addition to inpatients standard rehabilitative treatment, 20 sessions of robotic treatment for 4 consecutive weeks (5 days/week. Each session lasted for 40 minutes. The exercises were carried out as follows: passive modality (5 minutes, passive/plus modality (5 minutes, assisted therapy (10 minutes, and balloon (10 minutes. The following impairment and functional evaluations, Fugl-Meyer Scale (FM, Medical Research Council Scale for Muscle Strength (hand flexor and extensor muscles (MRC, Motricity Index (MI, and modified Ashworth Scale for wrist and hand muscles (AS, were performed at the beginning (T0, after 10 sessions (T1, and at the end of the treatment (T2. The strength hand flexion and extension performed by Robot were assessed at T0 and T2. The Barthel Index and COMP (performance and satisfaction subscale were assessed at T0 and T2. Results. Clinical improvements were found in all patients. No dropouts were recorded during the treatment and all subjects fulfilled the protocol. Evidence of a significant improvement was demonstrated by the Friedman test for the MRC (P<0.0123. Evidence of an improvement was demonstrated for AS, FM, and MI. Conclusions. This original rehabilitation treatment could contribute to increase the hand motor recovery in acute stroke patients. The simplicity of the treatment, the lack of side effects, and the first positive results in acute stroke patients support the recommendations to extend the clinical trial of this

  12. DEWATERING TREATMENT SCALE-UP TESTING RESULTS OF HANFORD TANK WASTES

    Energy Technology Data Exchange (ETDEWEB)

    TEDESCHI AR

    2008-01-23

    This report documents CH2M HILL Hanford Group Inc. (CH2M HILL) 2007 dryer testing results in Richland, WA at the AMEC Nuclear Ltd., GeoMelt Division (AMEC) Horn Rapids Test Site. It provides a discussion of scope and results to qualify the dryer system as a viable unit-operation in the continuing evaluation of the bulk vitrification process. A 10,000 liter (L) dryer/mixer was tested for supplemental treatment of Hanford tank low-activity wastes, drying and mixing a simulated non-radioactive salt solution with glass forming minerals. Testing validated the full scale equipment for producing dried product similar to smaller scale tests, and qualified the dryer system for a subsequent integrated dryer/vitrification test using the same simulant and glass formers. The dryer system is planned for installation at the Hanford tank farms to dry/mix radioactive waste for final treatment evaluation of the supplemental bulk vitrification process.

  13. Results of surgical treatment of quadriceps femoris/contracture in ...

    African Journals Online (AJOL)

    Gain in flexion ranged from minus forty degrees to positive 140 degrees. The average gain in flexion was 94.7 degrees. Five patients underwent a second procedure to improve flexion. Soft tissue complications developed in four cases. Conclusion: Quadriceps femoris/contracture responds well to surgical treatment with an ...

  14. Results of surgical treatment of quadriceps femoris/ contracture in ...

    African Journals Online (AJOL)

    knee was grouped as follows: two cases had dislocated knees, three had hyperextension contractures, thirteen (0-30 degrees) ... Conclusion: Quadriceps femoris/contracture responds well to surgical treatment with an expected gain in flexion of 94.7 .... physiotherapy and manipulation were ineffective except in mild and ...

  15. CONGENITAL ABSENCE OF THE VAGINA - RESULTS OF CONSERVATIVE TREATMENT

    NARCIS (Netherlands)

    LAPPOHN, RE

    Objective: To assess the efficacy of a combination of Frank's mold therapy with intercourse as a treatment for congenital vaginal aplasia. Study design: From 1973-1993, thirty-three patients with congenital aplasia of vagina and uterus were seen by one gynecologist. Patients with a partner were

  16. Tactical Automated Security System (TASS) operational concept field evaluation results

    Energy Technology Data Exchange (ETDEWEB)

    Lowe, D. [Electronic Systems Center, Hanscom AFB, MA (United States); Vinkels, G. [Horizons Technology, Inc., Billerica, MA (United States)

    1995-12-31

    The worldwide quick reaction deployment concept for the Tactical Automated Security System (TASS) was demonstrated to have great value in a base defense operational exercise. TASS equipment was deployed and used as part of the Foal Eagle 94 exercise at Kunsan AB, Korea. The TASS functions of detection, data communication, annunciation, assessment and portable power were evaluated using prototype equipment. The results of the TASS operation during the exercise was very impressive. The friendly forces quickly incorporated the TASS equipment into their defensive operations and were able to intercept and neutralize approximately 80% of the aggressor force penetration attempts at the defensive perimeter.

  17. Some quantitative evaluations on finite difference local and global results

    Directory of Open Access Journals (Sweden)

    Costamagna Eugenio

    2016-06-01

    Full Text Available Refined Schwarz-Christoffel (SC conformal transformations allow us to perform reliable quantitative evaluation of the accuracy of local computation of electric and magnetic fields with limited effort, which can be useful to complement well known comparisons of global results. In this paper some examples are presented for mesh point potentials obtained by means of finite difference (FD methods, but it is possible that similar considerations will be useful in the case of finite element methods (FEM or meshless computations too.

  18. Child sexual abuse: evaluation and treatment.

    Science.gov (United States)

    Crane, S

    1994-12-01

    Child sexual abuse and its disturbingly high prevalence have received increased attention during the past 2 decades, but the availability of adequate training and support services for this complex problem remain deficient. The identification of victims and early, effective intervention are necessary goals. This review provides a brief summary on the subject of child sexual abuse with an emphasis on recent progress in optimal evaluation.

  19. High energy thermotherapy in the treatment of benign prostatic hyperplasia: results of the European Benign Prostatic Hyperplasia Study Group

    NARCIS (Netherlands)

    de la Rosette, J. J.; de Wildt, M. J.; Höfner, K.; Carter, S. S.; Debruyne, F. M.; Tubaro, A.

    1996-01-01

    We documented the results of high energy transurethral microwave thermotherapy in the treatment of benign prostatic hyperplasia. We evaluated 116 patients following transurethral microwave thermotherapy according to symptom scores, transrectal ultrasound, free voiding and pressure-flow study

  20. Ways of Improving the Results of Treatment for Pulmonary Thromboembolism

    Directory of Open Access Journals (Sweden)

    M. I. Neimark

    2010-01-01

    Full Text Available Objective: to reveal the predictors of clinically significant deterioration of cardiac pump function resulting from alveolar opening maneuver (AOM (mobilization made early after extracorporeal circulation during standard cardiosurgery. Subjects and methods. Hemodynamic, clinical, and laboratory parameters were analyzed in 20 cardiosurgical patients who had undergone AOM in the early postperfusion period. The study inclusion criteria were a PaO2/FiO2 ratio of less than 350 mm Hg, a cardiac index (CI of more than 2.5 l/min/m2, a dosage of dopamine and/or dobutamine of not more than 10 ^g/kg/min, and standard AOM performance (Pmax, 30—35 cm H2O; end-expiratory pressure (PEEP, 13—15 cm H2O. Regression analysis was used to identify the predictors of a clinically significant reduction in CI (less than 2.5 l/min/m2. Results. Before and after AOM, CI was 3.1±0.1 and 2.9±0.1 l/min/m2, respectively (p>0.05; however, CI was less than 2.5 l/min/m2 (2.16±0.09 l/min/m2 in 25% of cases. After AOM, CI values were significantly related to those recorded prior to a respiratory procedure (p=0.039, total peripheral vascular resistance index (TPVRI (p=0.00039, and intrapulmonary blood shunt fraction (Qs/Qt (p=0.041. There were no relationships to other recorded and estimated hemodynamic parameters (p>0.1. – After AOM, CI values were unrelated (p>0.1 to the duration of extracorporeal circulation, the period of myocardial ischemia, and the used dosages of inotropic agents. The predictor of a clinically significant CI reduction after AOM was the only index TPVRI (p=0.00025 recorded before a respiratory procedure. Following AOM, the probability of a significant CI reduction substantially increased (the approximation coefficient R2=0.75 at TPVRI values of 2000 din^sec^cm-5^m2 or more. Conclusion. After AOM performed in the early period after extracorporeal circulation, CI values are related to the baseline level of CI, TPVRI, and Qs/Qt; however, after this

  1. Steel Containment Vessel Model Test: Results and Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Costello, J.F.; Hashimote, T.; Hessheimer, M.F.; Luk, V.K.

    1999-03-01

    A high pressure test of the steel containment vessel (SCV) model was conducted on December 11-12, 1996 at Sandia National Laboratories, Albuquerque, NM, USA. The test model is a mixed-scaled model (1:10 in geometry and 1:4 in shell thickness) of an improved Mark II boiling water reactor (BWR) containment. A concentric steel contact structure (CS), installed over the SCV model and separated at a nominally uniform distance from it, provided a simplified representation of a reactor shield building in the actual plant. The SCV model and contact structure were instrumented with strain gages and displacement transducers to record the deformation behavior of the SCV model during the high pressure test. This paper summarizes the conduct and the results of the high pressure test and discusses the posttest metallurgical evaluation results on specimens removed from the SCV model.

  2. Impedance cardiography – optimization and efficacy evaluation of antihypertensive treatment

    Directory of Open Access Journals (Sweden)

    Katarzyna Panasiuk-Kamińska

    2016-09-01

    Full Text Available Background . Hypertension is a civilization disease which currently affects about 10.5 m people in Poland. The number of patients with diagnosed, untreated hypertension amounts to 18%, and as many as 45% of patients are treated ineffectively whereas only 26% are treated effectively. Impedance cardiography (IC is an important tool both in diagnostics and the treatment of hypertensive patients, particularly in the case of antihypertensive treatment resistance. This method allows for the individualized treatment of each patient on the basis of hemodynamic parameters, monitoring of hypertensive patients in the outpatient care setting, and the assessment of cardiovascular risk factors. Objectives . The aim of the study was to evaluate the efficacy of hypotensive medications in patients with hypertension using impedance cardiography. Material and methods. The study involved 60 hypertensive patients, treated with antihypertensives, who failed to achieve the required blood pressure values. The modification of hypertension therapy was based on EBM (evidence-based medicine and on hemodynamic parameters obtained using impedance cardiography. Results . It was found that high blood pressure therapy based on impedance cardiography parameters has a significant influence on blood pressure reduction compared to EM B-based therapy: below 140/90: 66.8 vs. 55.1% and below 130/80: 23.5 vs. 18.9%. Conclusions . On the basis of this study it was confirmed that impedance cardiography allows for a significant reduction of hypertension and the selection of the most effective therapeutic strategy, providing for the optimization and efficacy of hypertension treatment.

  3. Evaluation of the screening test results before marriage

    Directory of Open Access Journals (Sweden)

    Süleyman Durmaz

    2011-09-01

    Full Text Available Objectives: Human immunodeficiency virus (HIV, Hepatitis B and Hepatitis C viruses and Treponema pallidum are parenterally and sexually transmitted infection agents. Screening test is made before marriage to pre-marital couples legally under the relevant legislation and legal procedures in our country; applicants are evaluated in terms of sexually transmitted diseases. The aim of this study is to evaluate pre-marital test results for HBsAg, anti-HCV, anti-HIV I/II and Treponema pallidum.Materials and methods: To make screening test before marriage, randomized 117 patients who were applied to Kızıltepe General Hospital of Infectious Diseases and Clinical Microbiology, were included in this study between January 2011 and March 2011. Of these patients, 64 were women (average age 24.7±5.7, and 55 were males (mean age 24.7±4.7. HBsAg, anti-HCV and anti-HIV I/II tests of the patients were studied by macro-ELISA device (ECIQ Vitros, Ortho Clinical Diagnostics, USA, screening of anti-Treponema pallidum IgG, IgA and IgM antibodies were studied by immunochromatographic rapid test (syphilis syphilis 3.0, Standard Diagnostics, inc. Korea.Results: Of the 119 patients, five patients (4.2% were positive for HBsAg (3 male and 2 female. Anti-HCV, anti-HIV I/II and anti-Treponema pallidum antibodies were negative in all patients.Conclusion: HBsAg test result which was obtained in present study has been found consistent with HBsAg positivity rate in our region. As a result of screening test that was done before marriage will continue to believe that the increased importance of the prevention of sexually transmitted diseases. J Clin Exp Invest 2011; 2 (3: 292-294.

  4. Bladder leiomyoma: Presentation, evaluation and treatment.

    Science.gov (United States)

    Khater, Nazih; Sakr, Ghazi

    2013-03-01

    Bladder leiomyomas are benign mesenchymal neoplasms and very rare urinary tumours that represent methods and surgical management, updated to 2012. We retrospectively reviewed articles published in the USA, Europe and Asia, from 1953 to date, using PubMed, Medscape, Medline and the several major journals. We report areas of controversies and well-established guidelines. We reviewed 36 articles that confirmed, with a high level of evidence-based medicine, that the male to female ratio is equal, the cause of bladder leiomyomas remains unknown, and their most common presentation is obstructive uropathy; endovesical tumours are the most common. Their radiological diagnosis can be made by ultrasonography, computed tomography or magnetic resonance imaging. Complete surgical resection is a very effective treatment, associated with almost no recurrence. In symptomatic patients a complete surgical resection can give a very good outcome, with almost no recurrence.

  5. Uniform presentation of process evaluation results facilitates the evaluation of complex interventions: development of a graph.

    Science.gov (United States)

    Bakker, Franka C; Persoon, Anke; Schoon, Yvonne; Olde Rikkert, Marcel G M

    2015-02-01

    Process evaluation is a highly essential element for the increasing number of studies regarding multi-component interventions. Yet, researchers are challenged to collect and present appropriate process outcomes in such way that it is easy and valuable to be used by other researchers and policy makers in interpreting and comparing intervention effects because of the absence of standards for conducting and publishing process evaluation. This article describes the development of a method to concisely summarize the results of process evaluations of complex multi-component interventions. Development of a graph with the aim to facilitate the reporting of process evaluation's results, based on a narrative review of the literature for process measures used in complex interventions for elderly people. Seventeen articles of process evaluations alongside effect studies of complex interventions were reviewed. From these articles, it was found that process evaluations should address whether the intervention (1) was implemented successfully; (2) was evaluated properly; and (3) can be continued in the future. A flow chart based on the essential components of an adequate process evaluation was developed. A simplified but highly informative figure reporting a summary of the results of the process evaluation is proposed and its use is explained by administering the figure to two studies including a process and effect evaluation of a complex intervention. A graphical approach - which includes the core results of process evaluation and can be used directly in reporting effectiveness studies - will help researchers and policy makers to interpret and compare effects of complex multi-component interventions. © 2014 John Wiley & Sons, Ltd.

  6. Burst fracture of the thoracolumbar spine: correlation between kyphosis and clinical result of the treatment

    Directory of Open Access Journals (Sweden)

    Rodrigo Arnold Tisot

    2015-06-01

    Full Text Available OBJECTIVE: To evaluate the correlation between kyphosis due to burst fractures of thoracic and lumbar spine and clinical outcome in patients undergoing conservative or surgical treatment.METHODS: A retrospective, cross-sectional study was conducted with 29 patients with thoracolumbar burst fractures treated by the Spine Group in a trauma reference hospital between the years 2002 and 2011. Patients were followed-up as outpatients for a minimum of 24 months. All cases were clinically evaluated by Oswestry and SF-36 quality of life questionnaires and the visual analogue scale (VAS of pain. They were also evaluated by X-ray examinations and CT scans of the lumbosacral spine at the time of hospitalization and subsequently as outpatients by Cobb method for measuring the degree of kyphosis.RESULTS: There was no statistically significant correlation between the degree of initial kyphosis and clinical outcome measured by VAS and by most of the SF-36 domains in both patients treated conservatively and the surgically treated. The Oswestry questionnaire showed benefits for patients who received conservative treatment (p=0.047 compared to those surgically treated (p=0.335. The analysis of difference between initial and final kyphosis and final kyphosis alone in relation to clinical outcome showed no statistical correlation in any of the scores used.CONCLUSION: The clinical outcome of treatment of the thoracic and lumbar burst fractures was not influenced by a greater or lesser degree of initial or residual kyphosis, regardless of the type of treatment.

  7. Treatment and follow up results of patients with monosymptomatic enuresis nocturna

    Directory of Open Access Journals (Sweden)

    Mehmet Sezai Oğraş

    2013-09-01

    Full Text Available Objective: To evaluate the treatment results of patientswith monosymptomatic enuresis nocturna.Methods: 97 patients with monosymptomatic enuresisnocturna were included. First, motivation and behavioraltreatment have been applied to the patients for 3 months.60-120 mcg desmopressin has been applied to 79 patientswho did not want to continue to the motivation andbehavioral treatment or who did not have benefit from motivationand behavioral treatment or whose disease haverelapsed. It is accepted as “full response” if the numberof wetting decreases 90-100%, “middle response” decreases50-90%, “failed response” decreases less than50%. Treatment and relapse rates were evaluated basedon the response to therapy at the time of controls.Results: Mean age of the patients was 7.75±1.96 (5-12years. 20 of 97 (21% patients who have taken motivationand behavioral treatment have been cured. Two (%10of these patients’ diseases have relapsed. Desmopressinhas been applied to79 patients who did not have benefitfrom motivation and behavioral treatment or whosediseases have relapsed. Full dryness has been providedin 36 (46% patients who have taken desmopressin andcame to the control visit. “Middle response” has been obtainedin 22 (28% patients. “Failed response” has beenobtained in 21 (26% patients. Relapse has been seen incase of quitting desmopressin in 35 (60% patients whohave benefit from desmopressin.Conclusion: Although, Desmopressin is the most preferredmethod in monosymptomatic enuresis nocturna,because of easy usage and fast response, relapse ratio ishigh following discontinuation of the drug.Key words: Monosymptomatic enuresis nocturna, desmopressin,treatment

  8. Fluorescence guided evaluation of photodynamic therapy as acne treatment

    Science.gov (United States)

    Ericson, Marica B.; Horfelt, Camilla; Cheng, Elaine; Larsson, Frida; Larko, Olle; Wennberg, Ann-Marie

    2005-08-01

    Photodynamic therapy (PDT) is an attractive alternative treatment for patients with acne because of its efficiency and few side effects. Propionibacterium acnes (P.acnes) are bacteria present in the skin, which produce endogenous porphyrins that act as photosensitisers. In addition, application of aminolaevulinic acid or its methyl ester (mALA) results in increased accumulation of porphyrins in the pilosebaceous units. This makes it possible to treat acne with PDT. This initial study investigates the possibility of fluorescence imaging as assessment tool in adjunct to PDT of patients with acne. Twenty-four patients with acne on the cheeks have been treated with PDT with and without mALA. Fluorescence images have been obtained before and after treatment. The clinical acne score was assessed as base line before PDT, and at every follow up visit. Additionally the amount of P.acnes was determined. The clinical evaluation showed a general improvement of acne, even though no difference between treatment with and without mALA was observed. By performing texture analysis and multivariate data analsysis on the fluorescence images, the extracted texture features were found to correlate with the corresponding clinical assessment (67%) and amount of P.acnes (72%). The analysis showed that features describing the highly fluorescent pores could be related to the clinical assessment. This result suggests that fluorescence imaging can be used as an objective assessment of acne, but further improvement of the technique is possible, for example by including colour images.

  9. [Indications and results of early functional vertebral fracture treatment].

    Science.gov (United States)

    Kempf, L; Plaue, R

    1985-01-01

    Early functional treatment was administered to 213 patients with stable compression fractures of thoracic and lumbar vertebrae between 1975 and 1982. Physiotherapy was carried out according to a uniform schedule. The patients were mobilized after an average of 6 days; hospitalization lasted 2 weeks on an average. Control examinations of 82 of these patients revealed only a slight union of compressed vertebral bodies (on an average, 7% of the initial height), which correlated with the primary compression and the patient's age. Remaining functional restriction of the spine and subjective complaints did not correlate significantly with the extent of vertebral compression.

  10. [Analysis on results of endodontic treatment and influencing factors].

    Science.gov (United States)

    Cheng, Yue; Peng, Bin; Shen, Ya; Bian, Zhuan; Fan, Ming-wen

    2006-09-01

    To assess the clinical outcome of root canal therapy (RCT) and the various factors that may influence the outcome of RCT. A total of 695 teeth from 357 patients were retrospectively studied three years after endodontic treatment. Pre- and intra-operative information was collected from the original patient records. The post-operative sign or symptom, periapical status and coronal restoration integrity were examined 3 years after obturation. Data were subjected to bivariate and multivariate analysis. The cure rate for 695 teeth was 75.1%, 96.0% of which was considered to be functional. The tooth group, pre-operative pulp and periapical status, quality of root filling and integrity of coronal restoration were revealed by means of bivariate analysis to exert a significant influence on treatment outcome. The logistic analysis indicated that the odds for cure in the teeth with pre-operative periapical radiolucency, underfilling and "open" coronal restoration were significantly lower by 2 folds, 3 folds and 1.6 folds than their counterparts, respectively. The pre-operative periapical status, quality of root filling and the integrity of coronal restoration are main predictors of outcome in RCT.

  11. [Treatment and results of therapy in chronic idiopathic thrombocytopenic purpura].

    Science.gov (United States)

    Tasić, J; Milenović, M; Drasković, S; Vukicević, T; Macukanović, L; Kitić, Lj; Bakić, M

    1994-01-01

    Basic principles in the therapy of chronic idiopathic thrombocytopenic purpura are glucocorticoides and splenectomy. Other measures: Intravenous high doses gamma globulin therapy, attenuated androgenes, immunosupresive drugs and plasmaferesis are less effective. During the period of 1989-1992 we treated 34 patients. From 34 patients, 23 were women and 11 were men. We treated patients primarily by prednisolon approximaly for 2 - 4 weeks. Rarely we use doses of 3 mg/kg per day for short periods of time (5 to 10 days) or "pulse therapy" of 500 mg per day. Those doses may be effective in elevating platelet count if the response is poor. If response occurs, high dosages of steroides should be tareped to determine the amount that will maintain the platelet count in the range of 30x10(9)/l to 50x10(9)/l (to minimaze the toxic sade effects of steroides). If steroides are ineffective, we perform splenectomy. From 34 treated patients by glucocorticoides, in 16 we got remission and in 11 partial response. We discussed in detailes relationship duration of treatment with glucocorticoides and level of platelets, and also correlation duration of treatment with prognosis. From 6 splenectomized patients 3 were successful. In two patients we applied intravenous gamma globulin therapy and attenuated androgen successfuly. In one patients therapy with gamma globulin, immunosupresive drugs, androgen and other measures was ineffective. In one patients without splenectomy we administrated successfuly gamma globulin therapy and androgen for peroid of two years.

  12. [To exactly evaluate the treatment effect of strabismus].

    Science.gov (United States)

    Xia, Qun

    2005-07-01

    To analyze the reason of the big difference of the healing rate of strabismus surgery reported in the literature in China. In the evaluation of the effect of the strabismus treatment, analyzer we should strictly master the evaluation criteria, especially the criteria for evaluating sentience state and movement. The criteria for evaluating the healing rate for the strabismus with high incidence should be refined, including consideration of the patient's satisfaction.

  13. Results of evaluation of tailing dumps dust intensity

    Directory of Open Access Journals (Sweden)

    Masloboev V. A.

    2016-03-01

    Full Text Available A set of most acceptable and well-known methods of dust intensity evaluation has been defined and tested (dependence of Westphal D. L. et al. and DEAD scheme based on the analysis of exiting approaches (deserts, tailing dumps, etc.. The description of the chosen methods has been given. The determination of dynamic velocity u* and velocity at the height of +10 m above the dusting surface u10 which are necessary to evaluate the dust intensity has been demonstrated. The method is based on two-dimensional numerical model of atmosphere aerodynamics in the area of "tailing dumps of ANOF-2 ‒ the town of Apatity". The study provides calculations of horizontal velocity at the height of +10 m above the dusting surface at the wind speed varying from 5 to 23 m/sec. The work also suggests the results of graphical data processing related to tailing grain size distribution from the surface of the firmly established surface of the tailing dumps of ANOF-2. Comparative analysis has been given and the peculiarities of interval (based on grains sizes dust intensity of the tailing dumps of ANOF-2 have been shown using the dependence of Westphal D. L. et al. and DEAD scheme within the wind speed range. The received values of dust intensity at the lower range limit are close to the "maximum specific dust off" value which is used by project specialists for documentation development

  14. Role and Evaluation of Interlaboratory Comparison Results in Laboratory Accreditation

    Science.gov (United States)

    Bode, P.

    2008-08-01

    Participation in interlaboratory comparisons provides laboratories an opportunity for independent assessment of their analytical performance, both in absolute way and in comparison with those by other techniques. However, such comparisons are hindered by differences in the way laboratories participate, e.g. at best measurement capability or under routine conditions. Neutron activation analysis laboratories, determining total mass fractions, often see themselves classified as `outliers' since the majority of other participants employ techniques with incomplete digestion methods. These considerations are discussed in relation to the way results from interlaboratory comparisons are evaluated by accreditation bodies following the requirements of Clause 5.9.1 of the ISO/IEC 17025:2005. The discussion and conclusions come largely forth from experiences in the author's own laboratory.

  15. Results of kyphoplasty in the minimally invasive treatment of vertebral metastasis

    Directory of Open Access Journals (Sweden)

    Carlos Fernando Pereira da Silva Herrero

    2014-09-01

    Full Text Available OBJECTIVE: To evaluate the clinical and radiological outcome of minimally invasive surgical treatment of vertebral metastases using the technique of kyphoplasty. METHODS: This was a prospective observational study of patients with the diagnosis of spinal metastasis who underwent minimally invasive surgical treatment by filling the vertebral body with balloon kyphoplasty technique. Clinical evaluation included patient age at surgery, diagnosis of the tumor, biopsy results, data of the surgical procedure performed, visual pain scale (VAS and complications related to surgery. Radiological evaluation involved the study of radiographic procedures in the anteroposterior and lateral incidences, with the analysis of vertebral body kyphosis and the occurrence of extravasation of cement. RESULTS: 22 patients with spinal metastases who were treated by balloon kyphoplasty, 8 (36% males and 14 (64% females were studied. The average age was 56.05 years and the mean follow-up was 8.5 months. The mean preoperative VAS was 8.73, 1.73 in the initial postoperative period, and 1.92 in the late postoperative period. CONCLUSION: Kyphoplasty proved to be a safe and effective technique for symptomatic treatment of vertebral metastases.

  16. SOFT TISSUE RECONSTRUCTION OF THE LOWER EXTREMITY: EVALUATION OF SURGICAL RESULTS IN 15 PATIENTS

    OpenAIRE

    Fatemi, M.J.; M Baghaei; M Soroush

    2003-01-01

    Introduction: There are general guidelines for reconstruction of complex wounds of the Lower extremity. The goal in treatment of these wounds is to preserve a limb that will be more functional than an amputation. Material & Methods: In this study, we evaluate our results in 15 patients with extensive wounds in lower extremities (April - 1998 to march - 2001). Results: The average age of the patients was 31.20 with an age range between 9 to 61 years. Majority of the patients were...

  17. CLINICAL RESULTS FROM THE TREATMENT OF CHRONIC SKIN WOUNDS WITH PLATELET RICH PLASMA (PRP

    Directory of Open Access Journals (Sweden)

    Pencho Kossev

    2015-12-01

    Full Text Available PURPOSE: To show platelet rich plasma (PRP application of chronic skin wounds and to evaluate the results from the treatment. MATERIAL AND METHODS: A total of 14 patients with problematic skin wounds had been treated at the clinic for a period of five years (from May 2009 to December 2014 with the following patient sex ratio: male patients - 5 and female patients - 9. Average age - 48,5 (30-76. Patients with Type 2 Diabetes - 4, with decubitus ulcers - 6, traumatic - 8, with infection - 5. Based on a scheme developed by us, all cases were treated by administering platelet-rich plasma, derived by PRGF Endoret system. Follow-up period was within 4 - 6 months (4,5 on average. RESULTS: The results have been evaluated based on the following functional scoring systems - Total wound score, Total anatomic score and Total score (20. The baseline values at the very beginning of the follow-up period were as follows: Total wound score - 12 p.; Total anatomic score - 10 p., Total score - 17 p. By the end of the treatment period the score was 0 p., which means excellent results, i.e. complete healing of the wounds. CONCLUSION: We believe that the application of PRP may become optimal therapy in the treatment of difficult to heal wounds around joints, bone, subject tendons, plantar surface of the foot, etc., as it opens new perspectives in the field of human tissue regeneration.

  18. Prophylactic treatment response in bipolar disorder: Results of a naturalistic observation study

    National Research Council Canada - National Science Library

    Garnham, Julie; Munro, Alana; Slaney, Claire; MacDougall, Marsha; Passmore, Michael; Duffy, Anne; O'Donovan, Claire; Teehan, Andrew; Alda, Martin

    2007-01-01

    The objective of this study was to evaluate effectiveness of commonly used prophylactic treatments for bipolar disorder in a naturalistic setting and to explore factors associated with treatment response...

  19. King County Metro Transit Hybrid Articulated Buses: Final Evaluation Results

    Energy Technology Data Exchange (ETDEWEB)

    Chandler, K.; Walkowicz, K.

    2006-12-01

    Final technical report compares and evaluates new diesel and diesel hybrid-electric articulated buses operated as part of the King County Metro Transit (KC Metro) fleet in Seattle, Washington. The evaluation lasted 12 months.

  20. SEE - Sight Effectiveness Enhancement. Results of the automotive evaluation

    DEFF Research Database (Denmark)

    Andersen, V.; Hansen, K.D.; Cathala, T.

    2006-01-01

    In the SEE project two parallel evaluations have been conducted, an experimental trial of the automotive and another of the aeronautical application. The evaluations have measured the efficiency and HMI (human-machine interaction) characteristics of theSEE prototype. This report covers the automo......In the SEE project two parallel evaluations have been conducted, an experimental trial of the automotive and another of the aeronautical application. The evaluations have measured the efficiency and HMI (human-machine interaction) characteristics of theSEE prototype. This report covers...... the automotive part of the evaluation. The evaluation of the automotive application was carried out in computer simulated environments and followed the general objectives of the evaluation described in ‘Definition of theEvaluation Plan’ . The field experiment discussed, however, was given up due to lack...

  1. EVALUATION OF VADOSE ZONE TREATMENT TECHNOLOGIES TO IMMOBILIZE TECHNETIUM-99

    Energy Technology Data Exchange (ETDEWEB)

    PETERSEN, S.W.

    2006-03-15

    The Hanford Site End State Vision document (DOE/RL-2003-59) states: ''There should be an aggressive plan to develop technology for remediation of the contamination that could get to the groundwater (particularly the technetium [{sup 99}Tc])''. In addition, there is strong support from the public and regulatory agencies for the above statement, with emphasis on investigation of treatment alternatives. In July 2004, PNNL completed a preliminary evaluation of remediation technologies with respect to their effectiveness and implementability for immobilization of {sup 99}Tc beneath the BC Cribs in the 200 West Area (Truex, 2004). As a result of this evaluation, PNNL recommended treatability testing of in situ soil desiccation, because it has the least uncertainty of those technologies evaluated in July 2004 (Treatability Test Outline, September 30, 2004). In 2005, DOE-RL and Fluor Hanford convened an independent technical panel to review alternative remediation technologies, including desiccation, at a three-day workshop in Richland, Washington. The panel was composed of experts in vadose-zone transport, infiltration control, hydrology, geochemistry, environmental engineering, and geology. Their backgrounds include employment in academia, government laboratories, industry, and consulting. Their review, presented in this document, is based upon written reports from Hanford, oral presentations from Hanford staff, and each panel members' years of experience in their particular field of expertise. The purpose of this report is to document the panel's evaluation of various treatment alternatives with potential for minimizing contaminant migration in the deep vadose zone at the Department of Energy Hanford Site. The panel was tasked with assessing the most viable and practical approach and making recommendations for testing. The evaluation of vadose-zone treatment alternatives was conducted to be broadly applicable at a variety of locations at

  2. Infertility evaluation and treatment among women in the United States.

    Science.gov (United States)

    Kessler, Lawrence M; Craig, Benjamin M; Plosker, Shayne M; Reed, Damon R; Quinn, Gwendolyn P

    2013-10-01

    To examine the characteristics of women seeking infertility evaluation and treatment. Cross-sectional survey based on in-person interviews, followed by two-step hurdle analysis. Not applicable. 4,558 married or cohabitating women ages 25 to 44 years. None. Likelihood of seeking a preliminary infertility evaluation and of seeking infertility treatment once evaluated, and the treatment type provided. Of 623 women (13.7%) who reported seeking an infertility evaluation, 328 reported undergoing subsequent infertility treatment. Age at marriage, marital status, education, health insurance status, race/ethnicity, and religion were associated with the likelihood of seeking infertility evaluation. For example, the predicted probability that a non-white woman who married at age 25 will seek evaluation was 12%. This probability increased to 34% for white women with a graduate degree who had married at age 30. Among women who were evaluated, income, employment status, and ethnicity correlated strongly with the likelihood of seeking infertility treatment. Infertility drug therapy was the most frequent treatment used, and reproductive surgery and in vitro fertilization (IVF) were used the least often. The use of infertility services is not random. Understanding the sociodemographic factors correlated with use may assist new couples with family planning. Roughly 50% of the women evaluated for infertility progressed to treatment, and only a small proportion were treated with more advanced assisted reproductive technologies such as in vitro fertilization. Future research aimed at improving access to effective health-care treatments within the boundaries of affordability is warranted. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Evaluation of patch test results in patients with contact dermatitis

    Directory of Open Access Journals (Sweden)

    Yavuz Yeşilova

    2011-12-01

    Full Text Available Objectives: Patch test is the most reliable method to diagnose allergic contact dermatitis and to find out the responsible contact allergen. The aim of this retrospective study was to evaluate the patch test results of patients with contact dermatitis in our region.Materials and methods: One Hundred fifty patients (84 female and 66 male with contact dermatitis were patch tested with European standard test series. The testing has been standardized by the international Contact Dermatitis Research Group (ICDRG.Results: A majority of the lesions (36% were localized on the hands. In 31 female (58,4% and 21 male (4,6% patients (a total of 72 patients there were positive allergic reactions to at least one chemical. Nickel sulphate (13,3%, potassium dichromate (11,3% and cobalt chloride (8,6% were the most often allergens reacted.Conclusion: Nickel sensitivity is more common. Comparing with healthy controls contact sensitization may be more prevalent in patients with contact dermatitis.

  4. Evaluating the Impact of Database Heterogeneity on Observational Study Results

    Science.gov (United States)

    Madigan, David; Ryan, Patrick B.; Schuemie, Martijn; Stang, Paul E.; Overhage, J. Marc; Hartzema, Abraham G.; Suchard, Marc A.; DuMouchel, William; Berlin, Jesse A.

    2013-01-01

    Clinical studies that use observational databases to evaluate the effects of medical products have become commonplace. Such studies begin by selecting a particular database, a decision that published papers invariably report but do not discuss. Studies of the same issue in different databases, however, can and do generate different results, sometimes with strikingly different clinical implications. In this paper, we systematically study heterogeneity among databases, holding other study methods constant, by exploring relative risk estimates for 53 drug-outcome pairs and 2 widely used study designs (cohort studies and self-controlled case series) across 10 observational databases. When holding the study design constant, our analysis shows that estimated relative risks range from a statistically significant decreased risk to a statistically significant increased risk in 11 of 53 (21%) of drug-outcome pairs that use a cohort design and 19 of 53 (36%) of drug-outcome pairs that use a self-controlled case series design. This exceeds the proportion of pairs that were consistent across databases in both direction and statistical significance, which was 9 of 53 (17%) for cohort studies and 5 of 53 (9%) for self-controlled case series. Our findings show that clinical studies that use observational databases can be sensitive to the choice of database. More attention is needed to consider how the choice of data source may be affecting results. PMID:23648805

  5. Treatment results of CO2 laser vaporisation in a cohort of 35 patients with oral leukoplakia.

    Science.gov (United States)

    Brouns, E R E A; Baart, J A; Karagozoglu, K H; Aartman, I H A; Bloemena, E; van der Waal, I

    2013-03-01

    The aim of the present study was to evaluate the treatment results of CO2 laser vaporisation in a well-defined cohort of patients with oral leukoplakia (OL). The group consisted of 35 patients. Before treatment, a clinical photograph and an incisional biopsy were performed in all cases. Also posttreatment results were documented with clinical photographs. The assessment of the treatment results was performed by an independent clinician who had not performed the treatment. The mean follow-up period was 61.9 months (range 12-179 months). In 14/35 patients, there was a recurrence between 1 and 43 months (mean 18.7 months), the annual recurrence rate being approximately 8%. In three of these patients, malignant transformation occurred at a later stage. In two other patients, a malignancy occurred without a prior recurrence. In altogether 5 of 35 patients, malignant transformation occurred in a mean period of 54 months, the annual malignant transformation rate being approximately 3%. The results in the present study are worse than those reported in the literature, perhaps owing to the use of different diagnostic criteria for OL, differences in the employed laser technique and assessment of possible recurrences by an independent clinician. © 2012 John Wiley & Sons A/S.

  6. Thinking Inside the Box: Simple Methods to Evaluate Complex Treatments

    Directory of Open Access Journals (Sweden)

    J. Michael Menke

    2011-10-01

    Full Text Available We risk ignoring cheaper and safer medical treatments because they cannot be patented, lack profit potential, require too much patient-contact time, or do not have scientific results. Novel medical treatments may be difficult to evaluate for a variety of reasons such as patient selection bias, the effect of the package of care, or the lack of identifying the active elements of treatment. Whole Systems Research (WSR is an approach designed to assess the performance of complete packages of clinical management. While the WSR method is compelling, there is no standard procedure for WSR, and its implementation may be intimidating. The truth is that WSR methodological tools are neither new nor complicated. There are two sequential steps, or boxes, that guide WSR methodology: establishing system predictability, followed by an audit of system element effectiveness. We describe the implementation of WSR with a particular attention to threats to validity (Shadish, Cook, & Campbell, 2002; Shadish & Heinsman, 1997. DOI: 10.2458/azu_jmmss.v2i1.12365

  7. Evaluation of treatments for myofascial pain syndrome and fibromyalgia.

    Science.gov (United States)

    Rudin, Nathan J

    2003-12-01

    Myofascial pain syndrome (MPS) and fibromyalgia (FM) are complex conditions and pose significant challenges to clinicians and patients. This chapter explores available treatments for MPS and FM in the context of pathophysiology, clinical evidence, and experimental support. This information may prove to be helpful in designing individualized treatment for patients with these complex syndromes. New treatments should be critically and carefully evaluated as they appear.

  8. PNF and manual therapy treatment results of patients with cervical spine osteoarthritis.

    Science.gov (United States)

    Maicki, Tomasz; Bilski, Jan; Szczygieł, Elżbieta; Trąbka, Rafał

    2017-09-22

    The aim of this study was to evaluate the effectiveness of PNF and manual therapy methods in the treatment of patients with cervical spine osteoarthritis, especially their efficacy in reducing pain and improving functionality in everyday life. Long-term results were also compared in order to determine which method of treatment is more effective. Eighty randomly selected females aged 45-65 were included in the study. They were randomly divided into two groups of 40 persons. One group received PNF treatment and the other received manual therapy (MAN.T). To evaluate functional capabilities, the Functional Rating Index was used. To evaluate changes in pain, a shortened version of the McGill Questionnaire was used. The PNF group achieved a greater reduction in pain than the MAN.T group. The PNF group showed a greater improvement in performing daily activities such as sleeping, personal care, travelling, work, recreation, lifting, walking and standing as well as decreased intensity and frequency of pain compared to the MAN.T group. The PNF method proved to be more effective in both short (after two weeks) and long (after three months) term.

  9. Evaluation of flat-Earth approximation results for geopotential missions.

    Science.gov (United States)

    Tapley, M. B.

    1997-04-01

    Simplified calculations can approximate the formal uncertainties in estimates of the spherical harmonic coefficients representing the Earth's gravitational potential. The calculations model the Earth locally as a plane, producing errors negligible for wavelengths shorter than the radius of the Earth. Information derived from observations of low altitude polar orbiting satellites is considered. With some constraints, the final model uncertainties derive from a priori gravitational field information, specific orbital elements, and parameters describing instrumentation characteristics. The author demonstrates how to refine the technique to accept inputs from the currently operational Navstar Global Positioning System (GPS) constellation and how to use information from partial tensor gravitational gradiometers. This approach is beneficial when evaluating prospective satellite geodesy missions because the covariance analyses for various mission scenarios can be made efficiently and expeditiously. The author demonstrates the utility of the flat Earth approach by comparing results with those of more elaborate and time consuming calculations performed for the European Space Agency ARISTOTELES proposed geopotential mapping mission, the NASA Gravity Probe B Relativity mission, and the NASA/Center National d'Etudes Spatiales Topographic Ocean Experiment Satellite (TOPEX)/Poseidon mission.

  10. BC Transit Fuel Cell Bus Project: Evaluation Results Report

    Energy Technology Data Exchange (ETDEWEB)

    Eudy, L. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Post, M. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2014-02-01

    This report evaluates a fuel cell electric bus demonstration led by British Columbia Transit (BC Transit) in Whistler, Canada. BC Transit is collaborating with the California Air Resources Board and the U.S. Department of Energy's National Renewable Energy Laboratory to evaluate the buses in revenue service. This evaluation report covers two years of revenue service data on the buses from April 2011 through March 2013.

  11. Laser surface treatment and the resultant hierarchical topography of Ti grade 2 for biomedical application

    Energy Technology Data Exchange (ETDEWEB)

    Kuczyńska, Donata, E-mail: donatakuczynska@gmail.com [Faculty of Materials Science and Engineering, Warsaw University of Technology, Warsaw (Poland); Kwaśniak, Piotr [Faculty of Materials Science and Engineering, Warsaw University of Technology, Warsaw (Poland); Marczak, Jan [Military University of Technology, Institute of Optoelectronics, Warsaw (Poland); Bonarski, Jan [Institute of Metallurgy and Materials Science, Polish Academy of Sciences, Cracow (Poland); Smolik, Jerzy [Institute for Sustainable Technology–National Research Institute, Radom (Poland); Garbacz, Halina [Faculty of Materials Science and Engineering, Warsaw University of Technology, Warsaw (Poland)

    2016-12-30

    Highlights: • Presented surface modification results in multimodal topography. • Laser treatment creates roughness in a range from nano- to micrometers. • Multimodal topography promote protein adsorption. • Hybrid surface treatment results in a texture favorable for osteogenic passes. - Abstract: Modern prosthesis often have a complex structure, where parts of an implant have different functional properties. This gradient of functional properties means that local surface modifications are required. Method presented in this study was develop to functionalize prefabricated elements with original roughness obtained by conventional treatments used to homogenize and clean surface of titanium implants. Demonstrated methodology results in multimodal, periodic grooved topography with roughness in a range from nano- to micrometers. The modified surfaces were characterized in terms of shape, roughness, wettability, surface energy and chemical composition. For this purpose, the following methods were used: scanning electron microscopy, optical profilometry, atomic force microscopy, contact angle measurements and X-ray photoelectron spectroscopy. Protein adsorption studies were conducted to determine the potential biomedical application of proposed method. In order to estimate the intensity and way of the protein adsorption process on different titanium surfaces, XPS studies and AFM measurements were performed. The systematic comparison of surface states and their osseointegration tendency will be useful to evaluate suitability of presented method as an single step treatment for local surface functionalization of currently produced implantable devices.

  12. Sexual dysfunction in infertile couples: evaluation and treatment of infertility.

    Science.gov (United States)

    Bayar, Ulku; Basaran, Mustafa; Atasoy, Nuray; Kokturk, Furuzan; Arikan, Ilker Inan; Barut, Aykut; Harma, Muge; Harma, Mehmet

    2014-02-01

    To evaluate the diagnostic and the predictive value of Arizona Sexual Experience Scale among primary infertile couples regarding sexual dysfunction. The cross-sectional and prospective pre, post study comprising primary infertile patients was carried out at Bulent Ecevit University Hospital, Zonguldak, Turkey. Fifty consecutive primary infertile couples not treated previously were investigated between 2003 and 2007 for the presence of sexual dysfunction by a psychiatrist. Arizona Sexual Experience Scale scoring was self-administered to determine sexual dysfunction among couples before treatment and also 3 months after the initiation of the treatment. Pretreatment mean values of the index parametres in both women and men were significantly increased after treatment. Statistically significant positive correlation was observed between pre- and post-treatment total scores in both women (r = 0.83; p treatment scores in women were were > 14 (Sensitivity: 57%; Specificity: 90%) and > 13 (Sensitivity: 83%; Specificity: 93%), respectively. Pre- and post-treatment scores in men were > 10 (Sensitivity: 65%; Specificity: 61%), > 11 (Sensitivity: 83%; Specificity: 62%), respectively. Binary logistic regression analyses revealed women's pre-treatment and post-treatment scores as a significant factor for prediction of sexual dysfunction independent of sociodemographic factors (p = 0.001 and p = 0.001, respectively). Evaluation and treatment of infertility is an important risk factor for sexual dyfunction. Pre- and posttreatment Arizona Sexual Experience Scale score could be used as a screening test for sexual dysfunction and might be used to decide pre/post-treatment consultation of couples with a specialist.

  13. Extracapsular approach for arthroscopic treatment of femoroacetabular impingement: clinical and radiographic results and complications

    Directory of Open Access Journals (Sweden)

    Bruno Dutra Roos

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVES: To evaluate the clinical and radiographic results and complications relating to patients undergoing arthroscopic treatment for femoroacetabular impingement by means of an extracapsular approach. METHODS: Between January 2011 and March 2012, 49 patients (50 hips underwent arthroscopic treatment for femoroacetabular impingement, performed by the hip surgery team of the Orthopedic Hospital of Passo Fundo, Rio Grande do Sul. Forty patients (41 hips fulfilled all the requirements for this study. The mean follow-up was 29.1 months. The patients were assessed clinically by means of the Harris Hip score, as modified by Byrd (MHHS, the Non-Arthritic Hip score (NAHS and the internal rotation of the hip. Their hips were also evaluated radiographically, with measurement of the CE angle, dimensions of the joint space, alpha angle, neck-head index, degree of arthrosis and presence of heterotopic ossification of the hip. RESULTS: Out of the 41 hips treated, 31 (75.6% presented good or excellent clinical results. There was a mean postoperative increase of 22.1 points for the MHHS, 21.5 for the NAHS and 16.4° for the internal rotation of the hip ( p< 0.001. Regarding the radiographic evaluation, correction to normal values was observed for the alpha angle and neck-head index, with a mean postoperative decrease of 32.9° and mean increase of 0.10, respectively ( p< 0.001. CONCLUSION: Arthroscopic treatment of femoroacetabular impingement by means of an extracapsular approach presented satisfactory clinical and radiographic results over a mean follow-up of 29.1 months, with few complications.

  14. Clinical evaluation of arthroscopic treatment of shoulder adhesive capsulitis

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the results of arthroscopic releases performed in patients with adhesive capsulitis refractory to conservative treatment. METHODS: This was a retrospective study, conducted between 1996 and 2012, which included 56 shoulders (52 patients that underwent surgery; 38 were female, and 28 had the dominant side affected. The mean age was 51 (29-73 years. The mean follow-up was 65 (12-168 months and the mean preoperative time was 8.9 (2-24 months. According to Zukermann's classification, 23 cases were considered primary and 33 secondary. With the patient in the lateral decubitus position, circumferential release of the joint capsule was performed: joint debridement; rotator interval opening; coracohumeral ligament release; anterior, posterior, inferior, and finally antero-inferior capsulotomy. A subscapularis tenotomy was performed when necessary. All patients underwent intense physical therapy in the immediate postoperative period. In 33 shoulders, an interscalene catheter was implanted for anesthetic infusion. Functional results were evaluated by the UCLA criteria. RESULTS: Improved range of motion was observed: mean increase of 45° of elevation, 41° of external rotation and eight vertebral levels of medial rotation. According to the UCLA score excellent results were obtained in 25 (45% patients; good, in 24 (45%; fair, in two (3%; and poor, in two (7%. Patients who had undergone inferior capsulotomy achieved better results. Only 8.8% of patients who used the anesthetic infusion catheter underwent postoperative manipulation. Seven patients had complications. CONCLUSION: There was improvement in pain and range of motion. Inferior capsulotomy leads to better results. The use of the interscalene infusion catheter reduces the number of re-approaches.

  15. Benchmarking Evaluation Results for Prototype Extravehicular Activity Gloves

    Science.gov (United States)

    Aitchison, Lindsay; McFarland, Shane

    2012-01-01

    subjects representing the design ]to hand anthropometry completed range of motion, grip/pinch strength, dexterity, and fit evaluations for each glove design in both the unpressurized and pressurized conditions. This paper provides a comparison of the test results along with a detailed description of hardware and test methodologies used.

  16. Periorbital hyperpigmentation: review of etiology, medical evaluation, and aesthetic treatment.

    Science.gov (United States)

    Roberts, Wendy E

    2014-04-01

    Periorbital hyperpigmentation (POH) is a common worldwide problem. It is challenging to treat, complex in pathogenesis, and lacking straightforward and repeatable therapeutic options. It may occur in the young and old, however the development of dark circles under the eyes in any age is of great aesthetic concern because it may depict the individual as sad, tired, stressed, and old. While "dark circles" are seen in all skin types, POH is often more commonly seen in skin of color patients worldwide. With a shifting US demographic characterized by growing number of aging patients as well as skin of color patients, we will encounter POH with greater frequency. As forecasted by the US Census, by 2030 1 in 5 Americans will be 65 plus years old and greater than 50% of the population will possess ethnic skin of color. The disparity in the medical community's understanding of POH versus popular demand for treatment is best illustrated when you have only 65 cited articles to date indexed on PubMed line compared to the 150,000,000 results on Google search engine. Most importantly POH may be a final common pathway of dermatitis, allergy, systemic disorders, sleep disturbances, or nutritional deficiences that lends itself to medical, surgical, and cosmeceutical treatments. A complete medical history with ROS and physical examination is encouraged prior to treating the aesthetic component. Sun protection is a cornerstone of therapy. Safety issues are of utmost concern when embarking upon treatments such as chemical peeling, filler injection, and laser therapy as not to worsen the pigmentation. Without intervention, POH usually progresses over time so early intervention and management is encouraged. The objective of this study was to review the current body of knowledge on POH, provide the clinician with a guide to the evaluation and treatment of POH, and to present diverse clinical cases of POH that have responded to different therapies including non-ablative fractional

  17. Early results after surgical treatment of left Ventricular Aneurysm

    Directory of Open Access Journals (Sweden)

    Wang Xisheng

    2012-11-01

    Full Text Available Abstract Background Left ventricular aneurysm (LVA is a serious complication of myocardial infarction and reduces the chances of survival. Controversy still exists regarding the optimal surgical technique for LVA repair. We analyze the efficacy of two techniques, linear vs. endoventricular circular patch plasty, for repair of LVA and the efficacy of surgical ventricular restoration (SVR on beating heart. Methods This study included 62 patients who underwent SVR from 1086 consecutive patients were subjected to coronary artery bypass grafting (CABG between 2000 and 2009. All selected patients were divided either into group liner or patch according to the choice of the repair technique depended on factors such as localization, size and dimension of the scar. The patients also were divided either into group beating heart or cardioplegia. The pre-, intra- and postoperative relevant data of all selected patients were analyzed. Results The mortality was not significantly different between linear and patch repair groups, also the actuarial survival rates within 24 months (p= 0.529. Postoperative echocardiographic findings showed significant improvements in left ventricular function in both groups. The beating heart technique reduced postoperative peak release by 27% for Cardiac troponin I (cTnI compared with the cardioplegia group (0.46 ± 0.06 ng/mL versus 0.63 ± 0.09 ng/mL, p= 0.004, and increased the perioperative survival by 9% (97.2% versus 88.5%, but the actuarial survival rates were not significantly different between the groups from 2 to 24 months (p= 0.151. Conclusions Both techniques (linear and patch achieved good results with respect to mortality, functional status and survival. The choice of surgical technique should be adapted in each patient. The beating heart technique may to some extent relieve myocardial injury in patients undergoing SVR.

  18. RESULTS OF POSTERIOR MYECTOMY FOR THE TREATMENT OF CHILDREN WITH CHRONIC CONSTIPATION.

    Science.gov (United States)

    Peyvasteh, Mehran; Askarpour, Shahnam; Talaiezadeh, Abdol-Hassan; Imani, Mohammad-Reza; Javaherizadeh, Hazhir

    2015-12-01

    The aim of this study was to evaluate the result of posterior myectomy in children with chronic constipation who underwent to this surgery. Forty eight children with chronic constipation who did not respond to diet, laxative, or enema were included. Children with abnormal barium enema showing transitional zone were excluded. Children with documented metabolic disease diabetes, and hypothyroidism were also excluded. All patients underwent posterior myectomy. Children were followed during 1 year after surgery regarding frequency of fecal evacuation, fecal consistency, straining during defecation, and diameter of feces. Data was analyzed using SPSS version 13.0 (Chicago, IL, USA). Of 48 cases that underwent surgery, 21 were male and 27 were female. Age range was 1.5 to 11 years old. Mean duration of constipation before surgery was 22.79±17.08 (range 6-48 months). Mean duration of medical treatment was 14.90±10.31 (range= 6-48 months). Fecal consistency, feces diameter, number of bowel movements and straining during defecation were compared before and after surgery. The results were statistically significant ( P constipation after surgery for 1 year. Ganglion cells were absent in 32 cases. Ganglion cells were present in seven children. Proximal ganglion cell was found in nine cases Treatment response was not different between cases according to status of ganglion cell in biopsy. Fecal consistency, feces diameter, number of bowel movements, and straining for defecation were improved after posterior myectomy. Another study with more sample is required for better evaluation of treatment.

  19. Evaluating tretinoin formulations in the treatment of acne.

    Science.gov (United States)

    Kircik, Leon H

    2014-04-01

    Topical tretinoin has been a standard treatment for acne vulgaris for more than 4 decades. While tretinoin has demonstrated proven efficacy in the treatment of acne lesions, it also is associated with the potential for skin irritation. Newer formulations have been designed to optimize both the drug concentration and the delivery vehicle with the aim to enable clinicians to provide increasingly effective acne treatment that minimizes irritation. These therapies include formulations with varying concentrations of tretinoin and vehicles that utilize a microsponge delivery system, hydrogels and micronized tretinoin, or propolymers. The purpose of this review is to evaluate different formulations and combinations of tretinoin in the treatment of acne vulgaris. While these advanced formulations were designed for controlled release of active ingredient, and have the potential to reduce cutaneous irritation relative to standard tretinoin cream and gel formulations, there is a need for comparative studies to evaluate the relative benefits of each of these advanced tretinoin formulations in optimizing acne treatment.

  20. High Intensity Focused Ultrasound (HIFU): a useful alternative choice in prostate cancer treatment. Preliminary results.

    Science.gov (United States)

    Maestroni, Umberto; Ziveri, Marcello; Azzolini, Nicola; Dinale, Francesco; Ziglioli, Francesco; Campaniello, Giovanna; Frattini, Antonio; Ferretti, Stefania

    2008-12-01

    High-Intensity Focused Ultrasound (HIFU) represents an alternative choice in mini-invasive treatment of prostate cancer. The technology of the device used to perform the treatment allows to exactly destroy a pre-selected area and to save all the tissues around it. We report our experience on the effectiveness and complications of this tecnique. From May 2006 to April 2007, 25 patients with prostate cancer were treated through Ablatherm (EDAP France) in spinal anesthesia. In the first six patients HIFU and TUR-P (Trans-Urethral Resection of Prostate) were performed in the same session and a suprapubic catheter was placed. In the other 14 patients HIFU was afterwards performed. In these patients a trans-urethral catheter was placed. All patients were divided into three groups: low risk (17 patients), intermediate risk (6 patients) and high risk (2 patients). The follow-up consisted in PSA evaluation after 1, 3, 6, 9, 12 months and in transrectal biopsy after six months. Complications related to the treatment, and symptomatological and sexual life tests were evaluated before and after the treatment. HIFU overall success rate was 84% (biochemical relapses in only 4 patients out of 25). Success rate was represented as follows: 94.2% in the low risk group, 83.4% in the intermediate risk group and 0% in the high risk group. No complications occurred during the treatment nor in the immediately post-operative time. We demonstrated that HIFU represents a useful alternative choice in mini-invasive therapy of prostate cancer. Particularly, results are remarkable in localized (low-intermediate risk) and low morbility prostate cancer. The role of this procedure in high risk patients needs to be further evaluated. Transrectal HIFU represents a mini-invasive therapeutic option that makes the treatment of prostate cancer possible in 84% of cases. Our results agree with the literature data and demonstrate that the success of the procedure depends on the correct indication of

  1. [Surgical treatment of thoraco-abdominal aneurysm. Indications and results].

    Science.gov (United States)

    Sandmann, W; Grabitz, K; Torsello, G; Kniemeyer, H W; Stühmeier, K; Mainzer, B

    1995-09-01

    Aortic replacement for thoraco-abdominal aneurysms remains a major challenge in vascular surgery. Related symptoms, maximal diameter > 6 cm, progression, aneurysm sac containing none or excentric thrombi and uncontrollable hypertension are factors in favour of surgery, if the general condition of the patient allows the operation. Patients with aneurysms eicosanoides to protect the kidneys and the spinal cord. If shunt or left-sided heart bypass can protect the spinal cord during clamping, is unknown, because the risk of paraplegia in the individual patient can be known only, if the function of the spinal cord is monitored. We have developed a spinal neuromonitoring system and found, that only one third of all TAAA-patients is at high risk to develop paraplegia during aortic clamping. The surgeon is guided by continuous recording of spinal evoked somatosensory potentials and can adapt the operative technique by early reimplantation and eventually subsequent separate reimplantation of segmental arteries supplying blood to the spinal cord, in order to reduce spinal ischemia time. Our results in 260 TAAA-patients are presented. In a high-risk population of patients with aneurysms type I-III (Crawford's classification) it was possible, to reduce the paraplegia rate from 7 to 3.5%, the risk of paraparesis from 15 to 6%, while the operative mortality was only reduced from 19 to 10%.

  2. Difficulties in evaluating abnormal lead screening results in children.

    Science.gov (United States)

    Block, B; Szekely, K; Escobar, M

    1996-01-01

    This report chronicles efforts to provide follow-up care for children with abnormal whole blood lead concentrations using the 1991 Centers for Disease Control and Prevention (CDC) guidelines in the Family Health Center at Shadyside Hospital in Pittsburgh. An automated surveillance module found all children with abnormal lead concentrations obtained between January 1994 and July 1995 and singled out children who were overdue for follow-up. Automated physician reminders and nursing case management were used to improve care and documentation. Longitudinal case summaries were used to evaluate care. All 99 children with a lead concentration of 10 micrograms/dL or greater had a documented follow-up plan. Twenty-nine children (47 percent) who had a lead concentration of 10 to 14 micrograms/dL, 23 (100 percent) who had a lead concentration of 15 to 19 micrograms/dL, and 8 (100 percent) who had a lead concentration of 20 micrograms/dL or greater had at least one follow-up lead concentration measurement by the end of the data collection in July 1995. Follow-up was incomplete in more than 70 percent of children. Nineteen children (19 percent) with initially abnormal lead concentrations had follow-up testing with persistently normal results. The yearly cost of follow-up was $15,888, with only 7 children requiring county health environmental intervention. The nurse-centered, computer-aided system improved follow-up care of children with abnormal lead concentrations, but most patients still did not receive mandated follow-up testing because of logistic obstacles. The effort and cost associated with CDC-mandated follow-up of children with lead concentrations between 10 and 19 micrograms/dL provides no apparent benefit and might detract from the care of children at higher risk.

  3. Antiresorptive Treatment for Spaceflight Induced Bone Atrophy - Preliminary Results

    Science.gov (United States)

    LeBlanc, Adrian; Matsumoto, toshio; Jones, Jeff; Shapiro, Jay; Lang, Thomas; Shackelford, Linda C.; Smith, Scott M.; Evans, Harlan J.; Spector, Elisabeth R.; Ploutz-Snyder, Robert; hide

    2011-01-01

    Detailed measurements from the Mir and ISS long duration missions have documented losses in bone mineral density (BMD) from critical skeletal sub-regions. The most important BMD losses are from the femoral hip, averaging about -1.6%/mo integral to -2.3%/mo trabecular. Importantly these studies have documented the wide range in individual BMD loss from -0.5 to -5%/mo. Associated elevated urinary Ca increases the risk of renal stone formation during flight, a serious impact to mission success. To date, countermeasures have not been satisfactory. The purpose of this study is to determine if the combined effect of anti-resorptive drugs plus the standard in-flight exercise regimen will have a measurable effect on preventing space flight induced bone loss (mass and strength) and reducing renal stone risk. To date, 4 crewmembers have completed the flight portion of the protocol in which crewmembers take a 70-mg alendronate tablet once a week before and during flight, starting 17 days before launch. Compared to previous ISS crewmembers (n=14) not taking alendronate, DXA measurements of the spine, femur neck and total hip were significantly improved from -0.8 +/- 0.5%/mo to 1.0 +/- 1.1%/mo, -1.1 +/- 0.5%/mo to -0.2 +/- 0.3%/mo, -1.1 +/- 0.5%/mo to 0.04 +/- 0.3%/mo respectively. QCT-determined trabecular BMD of the femur neck, trochanter and total hip were significantly improved from -2.7 +/- 1.9%/mo to -0.2 +/- 0.8%/mo, -2.2 +/- 0.9%/mo to -0.3 +/- 1.9%/mo and -2.3 +/- 1.0%/mo to -0.2 +/- 1.8%/mo respectively. Significance was calculated from a one-tailed t test. Resorption markers were unchanged, in contrast to measurements from previous ISS crewmembers that showed typical increases of 50-100% above baseline. Urinary Ca showed no increase compared to baseline levels, also distinct from the elevated levels of 50% or greater in previous crews. While these results are encouraging, the current n (4) is small, and the large SDs indicate that, while the means are improved, there

  4. Clinical evaluation of arthroscopic treatment of shoulder adhesive capsulitis.

    Science.gov (United States)

    Miyazaki, Alberto Naoki; Santos, Pedro Doneux; Silva, Luciana Andrade; Sella, Guilherme do Val; Carrenho, Leonardo; Checchia, Sergio Luiz

    2017-01-01

    To evaluate the results of arthroscopic releases performed in patients with adhesive capsulitis refractory to conservative treatment. This was a retrospective study, conducted between 1996 and 2012, which included 56 shoulders (52 patients) that underwent surgery; 38 were female, and 28 had the dominant side affected. The mean age was 51 (29-73) years. The mean follow-up was 65 (12-168) months and the mean preoperative time was 8.9 (2-24) months. According to Zukermann's classification, 23 cases were considered primary and 33 secondary. With the patient in the lateral decubitus position, circumferential release of the joint capsule was performed: joint debridement; rotator interval opening; coracohumeral ligament release; anterior, posterior, inferior, and finally antero-inferior capsulotomy. A subscapularis tenotomy was performed when necessary. All patients underwent intense physical therapy in the immediate postoperative period. In 33 shoulders, an interscalene catheter was implanted for anesthetic infusion. Functional results were evaluated by the UCLA criteria. Improved range of motion was observed: mean increase of 45° of elevation, 41° of external rotation and eight vertebral levels of medial rotation. According to the UCLA score excellent results were obtained in 25 (45%) patients; good, in 24 (45%); fair, in two (3%); and poor, in two (7%). Patients who had undergone inferior capsulotomy achieved better results. Only 8.8% of patients who used the anesthetic infusion catheter underwent postoperative manipulation. Seven patients had complications. There was improvement in pain and range of motion. Inferior capsulotomy leads to better results. The use of the interscalene infusion catheter reduces the number of re-approaches.

  5. Treatment plan complexity metrics for predicting IMRT pre-treatment quality assurance results.

    Science.gov (United States)

    Crowe, S B; Kairn, T; Kenny, J; Knight, R T; Hill, B; Langton, C M; Trapp, J V

    2014-09-01

    The planning of IMRT treatments requires a compromise between dose conformity (complexity) and deliverability. This study investigates established and novel treatment complexity metrics for 122 IMRT beams from prostate treatment plans. The Treatment and Dose Assessor software was used to extract the necessary data from exported treatment plan files and calculate the metrics. For most of the metrics, there was strong overlap between the calculated values for plans that passed and failed their quality assurance (QA) tests. However, statistically significant variation between plans that passed and failed QA measurements was found for the established modulation index and for a novel metric describing the proportion of small apertures in each beam. The 'small aperture score' provided threshold values which successfully distinguished deliverable treatment plans from plans that did not pass QA, with a low false negative rate.

  6. RESULTS OF POSTERIOR MYECTOMY FOR THE TREATMENT OF CHILDREN WITH CHRONIC CONSTIPATION

    Directory of Open Access Journals (Sweden)

    Mehran PEYVASTEH

    2015-12-01

    Full Text Available Background and Objectives - The aim of this study was to evaluate the result of posterior myectomy in children with chronic constipation who underwent to this surgery. Methods - Forty eight children with chronic constipation who did not respond to diet, laxative, or enema were included. Children with abnormal barium enema showing transitional zone were excluded. Children with documented metabolic disease diabetes, and hypothyroidism were also excluded. All patients underwent posterior myectomy. Children were followed during 1 year after surgery regarding frequency of fecal evacuation, fecal consistency, straining during defecation, and diameter of feces. Data was analyzed using SPSS version 13.0 (Chicago, IL, USA. Results - Of 48 cases that underwent surgery, 21 were male and 27 were female. Age range was 1.5 to 11 years old. Mean duration of constipation before surgery was 22.79±17.08 (range 6-48 months. Mean duration of medical treatment was 14.90±10.31 (range= 6-48 months. Fecal consistency, feces diameter, number of bowel movements and straining during defecation were compared before and after surgery. The results were statistically significant ( P <0.001. Of all cases, 52% continued treatment of constipation after surgery for 1 year. Ganglion cells were absent in 32 cases. Ganglion cells were present in seven children. Proximal ganglion cell was found in nine cases Treatment response was not different between cases according to status of ganglion cell in biopsy. Conclusion - Fecal consistency, feces diameter, number of bowel movements, and straining for defecation were improved after posterior myectomy. Another study with more sample is required for better evaluation of treatment.

  7. Responding to the treatment challenge of patients with severe BPD: results of three pilot studies of inpatient schema therapy.

    Science.gov (United States)

    Reiss, Neele; Lieb, Klaus; Arntz, Arnoud; Shaw, Ida A; Farrell, Joan

    2014-05-01

    Schema Therapy (ST), a psychotherapy model integrating cognitive, experiential and behavioural interventions, was initially developed and evaluated as an outpatient treatment for patients with severe and chronic disorders, among them Borderline Personality Disorder (BPD). Two randomized controlled trials have demonstrated the effectiveness of ST for BPD, delivered in an individual or group format, in the outpatient setting. However, the most severely impaired BPD patients are referred to inpatient treatment due to suicidality and severe self-harm. Specialized inpatient treatment programs are limited, with little evaluative research. The pilot studies are designed to be first steps in naturalistic clinical settings to evaluate the effects of an intensive inpatient ST treatment program. This report presents the results of three independent uncontrolled pilot studies with a total of 92 BPD patients. The programs combine individual and group modalities and are consistent theoretically with the ST model for BPD patients. RESULTS show that inpatient ST can significantly reduce symptoms of severe BPD and global severity of psychopathology with effect sizes ranging from Cohen's d = 2.84 to Cohen's d = .43. Differences in the effect sizes across the three pilot studies could be explained by length of treatment, number of group psychotherapists and their training. Although there are limitations to the presented pilot studies such as differences in the samples, treatment settings, variations in the treatment itself and the use of different measures, which may have influenced outcome, they are a starting point for describing and evaluating inpatient treatment for BPD in naturalistic settings.

  8. Evaluation Results From Prospective Drug Utilization Review: Medicaid Demonstrations

    OpenAIRE

    Kidder, David; Bae, Jay

    1999-01-01

    In 1992 HCFA awarded two cooperative agreements for demonstrations of prospective drug utilization review (PDUR). Iowa tested an on-line prospective drug utilization review (OPDUR) system. Washington tested payments to pharmacists for providing non-dispensing “cognitive services” (CS). In this article the authors report on an evaluation of these demonstrations and on three assessments of retrospective drug utilization review (RDUR) interventions. The evaluation failed to detect effects of eit...

  9. Assessment of root canal treatment outcomes performed by Turkish dental students: results after two years.

    Science.gov (United States)

    Ilgüy, Dilhan; Ilgüy, Mehmet; Fisekçioglu, Erdogan; Ersan, Nilüfer; Tanalp, Jale; Dölekoglu, Semanur

    2013-04-01

    The aim of this study was to evaluate radiographically the periapical status and technical standard of root canal therapies performed by a group of undergraduate dental students in Turkey two years following completion of the treatments. A random sample of 264 patients who received root canal treatment from undergraduate students at the Yeditepe University Faculty of Dentistry in 2009 were recalled after two years. The study sample consisted of 319 root-filled teeth in 158 dental patients (females=97, males=61) who presented to the student clinics during that time frame. For each root-filled tooth, two periapical radiographs were examined to identify the periapical status, one showing pre-treatment and the other showing post-treatment status. The quality of endodontic treatment was examined according to the distance between the end of root filling and radiographic apex and the density of the obturation according to presence of voids within the root filling material. This examination found that 54.2 percent of roots had fillings of acceptable length, while 37.3 percent were short, 7.8 percent were overfilled, and 0.6 percent was unfilled; 2.5 percent of the teeth were observed with broken root canal instruments. After two years, PAI scores of teeth with acceptable length of root canal filling (0-2 mm from the radiographic apex) were found to be lower than those of the overfilling and short filling cases (>2mm) (pendodontically treated teeth. The PAI scores of root fillings with inadequate density were significantly higher than adequate ones (pendodontic treatments performed by undergraduate students do not appear to be unqualified compared to those performed by general practitioners, more emphasis must be placed on the technical quality of endodontic treatment to obtain better results.

  10. To evaluate the results of endoscopic variceal band ligation (EVBL)

    African Journals Online (AJOL)

    hi-tech

    2004-04-04

    Apr 4, 2004 ... Villanueva, C. Ortiz, J. Minana, J. et al. Somatostatin treatment and risk stratification by continuous portal pressure monitoring during acute variceal bleeding. Gastroenterology. 2001; 121:ll0-117. 5. Nevens, F. and Rutgeerts, P. Variceal band ligation in the management of bleeding oesophageal varices: an ...

  11. Effects of unplanned treatment interruptions on HIV treatment failure - results from TAHOD.

    Science.gov (United States)

    Jiamsakul, Awachana; Kerr, Stephen J; Ng, Oon Tek; Lee, Man Po; Chaiwarith, Romanee; Yunihastuti, Evy; Van Nguyen, Kinh; Pham, Thuy Thanh; Kiertiburanakul, Sasisopin; Ditangco, Rossana; Saphonn, Vonthanak; Sim, Benedict L H; Merati, Tuti Parwati; Wong, Wingwai; Kantipong, Pacharee; Zhang, Fujie; Choi, Jun Yong; Pujari, Sanjay; Kamarulzaman, Adeeba; Oka, Shinichi; Mustafa, Mahiran; Ratanasuwan, Winai; Petersen, Boondarika; Law, Matthew; Kumarasamy, Nagalingeswaran

    2016-05-01

    Treatment interruptions (TIs) of combination antiretroviral therapy (cART) are known to lead to unfavourable treatment outcomes but do still occur in resource-limited settings. We investigated the effects of TI associated with adverse events (AEs) and non-AE-related reasons, including their durations, on treatment failure after cART resumption in HIV-infected individuals in Asia. Patients initiating cART between 2006 and 2013 were included. TI was defined as stopping cART for >1 day. Treatment failure was defined as confirmed virological, immunological or clinical failure. Time to treatment failure during cART was analysed using Cox regression, not including periods off treatment. Covariables with P 30 days were associated with failure (31-180 days HR = 2.66, 95%CI (1.70-4.16); 181-365 days HR = 6.22, 95%CI (3.26-11.86); and >365 days HR = 9.10, 95% CI (4.27-19.38), all P treatment failure. If TI is unavoidable, its duration should be minimised to reduce the risk of failure after treatment resumption. © 2016 John Wiley & Sons Ltd.

  12. EVALUATION OF SUGARCANE BAGASSE ACID HYDROLYZATE TREATMENTS FOR XYLITOL PRODUCTION

    Directory of Open Access Journals (Sweden)

    P.V. GURGEL

    1998-09-01

    Full Text Available Acid sugarcane bagasse hydrolyzate was submitted to pH shifts in order to remove toxic compounds from the medium. The hydrolyzate was treated with bases containing mono-, di- or tri-valent cations and H2SO4, and its performance as a fermentation medium was evaluated by the production of xylitol by Candida guilliermondii FTI 20037. The use of bases containing mono-valent cations was not an efficient method of detoxification, and the use of a tri-valent cation did not show any detectable improvement in detoxification. The treated hydrolyzate recovery (in volume is greatly affected by the utilized base. Treatment using Al(OH3 and NaOH showed the best hydrolyzate recovery (87.5%, while the others presented a recovery of about 45% of the original hydrolyzate volume. Considering the whole process, best results were achieved by treatment using Al(OH3 and NaOH which allowed 0.55 g of xylitol produced from each gram of xylose in the raw hydrolyzate.

  13. Long-term results of treatment of traumatic coxofemoral joint dislocation in dogs: 64 cases (1973-1992).

    Science.gov (United States)

    Evers, P; Johnston, G R; Wallace, L J; Lipowitz, A J; King, V L

    1997-01-01

    To determine long-term results of various treatments for traumatic coxofemoral joint dislocation in dogs. Retrospective case series. 64 dogs that underwent closed reduction and bandage stabilization, extracapsular suture stabilization, transacetabular pinning, toggle pinning, DeVita pinning, or femoral head and neck excision. Follow-up evaluations included owner evaluation (64 dogs), physical evaluation (23), and radiography (19). Follow-up time ranged from 8 to 156 months. Owner evaluation scores after closed reduction were significantly better than scores after DeVita pinning, extracapsular suture stabilization, and femoral head and neck excision. On physical examination, 6 of 23 dogs were lame on the side of the previous dislocation. Signs of pain and crepitation were evident during palpation of 12 and 8 of 25 joints, respectively. Thirteen of 21 joints had radiographic evidence of degenerative joint disease. There was a greater progression of degenerative joint disease in previously dislocated joints than in unaffected joints. There were not any significant differences between treatments in regard to results of physical and radiographic evaluation. Time between trauma and treatment and existence of concomitant injuries did not influence follow-up results, but there was a significant association between body weight and radiographic evaluation score. Concomitant injuries do not appear to justify a worse prognosis in dogs with traumatic coxofemoral joint dislocation, nor does a delay in treatment of > 3 days. Gait abnormalities and degenerative joint disease might develop in the long term. Proper body weight should be maintained regardless of treatment.

  14. Results of the treatment of syringomyelia associated with Chiari malformation: analysis of 60 cases

    Directory of Open Access Journals (Sweden)

    Arruda José Arnaldo Motta de

    2004-01-01

    Full Text Available We analyze the results of surgical treatment of 60 patients presenting syringomyelia (SM associated with Chiari malformation (CM who were operated in the period 1982-2000. For each case, analysis covered 15 signs and 16 symptoms included in a protocol that separated SM signs and symptoms from those of CM. A score system was established in parallel with the protocol to make the evaluation of treatment results easier. All cases were submitted to craniovertebral decompression by C1 and eventually C2 laminectomy and cerebellar tonsillectomy with duramater graft. To evaluate the results, statistical proportion difference tests and variance analyses were made to a reliability index of 95% (p=0.05. We conclude that the statistical improvement of CM signs and symptoms was very significant (p=0. Syringomyelia signs and symptoms also improved significantly, except for "upper limb hyporeflexia" , which did not improve. No statistical difference in the improvement of SM symptoms as compared to CM symptom was found. Syringomyelia signs improved statistically more than CM signs. In half of patients, the percent improvement of signs and symptoms ranged between 40% and 60%.

  15. Late life depression with cognitive impairment: Evaluation and treatment

    Directory of Open Access Journals (Sweden)

    Consuelo H Wilkins

    2008-09-01

    Full Text Available Consuelo H Wilkins1,2, Jose Mathews2, Yvette I Sheline21Department of Medicine (Division of Geriatrics and Nutritional Science; 2Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USAAbstract: Older adults with depression often present with signs and symptoms indicative of functional or cognitive impairment. These somatic symptoms make evaluating and treating depression in older adults more complex. Late life depression (LLD, depression in adults over the age of 65, is more frequently associated with cognitive changes. Cognitive impairment in LLD may be a result of the depressive disorder or an underlying dementing condition. Memory complaints are also common in older adults with depression. There is a wide range of cognitive impairment in LLD including decreased central processing speed, executive dysfunction, and impaired short-term memory. The etiology of cognitive impairment in LLD may include cerebrovascular disease, a significant risk factor for LLD, which likely interrupts key pathways between frontal white matter and subcortical structures important in mood regulation. Because depressive symptoms often coexist with dementia, it is important to determine the temporal relationship between depressive symptoms and cognitive change. If depressive symptoms pre-date the cognitive impairment and cognitive symptoms are mild and temporary, LLD is the likely etiology of the cognitive impairment. If cognitive changes appear prior to depressive symptoms and persist after LLD is successfully treated, an underlying dementia is more likely. Clinicians should be exclude common conditions such as thyroid disease which can contribute to depressive symptoms and cognitive impairment prior to treating LLD. Both antidepressants and psychotherapy can be effective in treating LLD. Subsequent evaluations following treatment should also reassess cognition.Keywords: late life depression, cognitive impairment, diagnosis, treatment

  16. Treatment of atrophic tibia non-unions according to 'diamond concept': Results of one- and two-step treatment.

    Science.gov (United States)

    Moghaddam, Arash; Zietzschmann, Severin; Bruckner, Thomas; Schmidmaier, Gerhard

    2015-10-01

    The successful treatment of atrophic tibia non-unions and tibia non-unions with large bone defects or infections is a major challenge in orthopedic and trauma surgery. This article evaluates the use of the 'diamond concept' using a one-step or two-step procedure according to 'Masquelet technique' in the treatment of atrophic tibia non-unions. Between February 2010 and March 2014, 102 patients with atrophic non-unions were treated according to the 'diamond concept' in our center. Ninety-nine were available for follow-up. Forty-nine received a one-step treatment (Group 1, G1) and 50 patients received a two-step treatment according to the 'Masquelet technique' (Group 2, G2). Clinical and radiological parameters were measured preoperatively as well as 4, 6, and 12 weeks and 6 and 12 months postoperatively. In order to evaluate the subjective health of patients, we used the SF-12 questionnaire. Data analysis was performed one year after treatment. The rate of consolidation in G1 was 84% and 80% in G2. The time to heal in G2 was 8.6 ± 2.9 months, which is significantly longer than in G1 being 6.9 ± 3.1 months. In comparison patients in G1/G2 had an average of 3.2/6.7 previous major surgeries. In G1, 4 of 8 patients who did not heal successfully showed positive intraoperative cultures. In G2, 26 patients (52%) initially presented with positive cultures. The results of the SF-12 questionnaire improved in both groups during the postoperative follow-up, but showed no significant differences between groups. In 29 patients a gentamycin-coated nail was used for reosteosynthesis. These patients showed by trend a lower rate of complications at a higher rate of consolidation. Our study showed that the 'diamond concept' is a suitable method for safely and effectively treating non-unions with large defects or infections. The use of an antibiotic-coated nail provides a therapeutic benefit. For large bone defects of infected non-unions the two-step procedure after Masquelet is an

  17. Evaluation of a physiotherapeutic treatment intervention in "Bell's" facial palsy.

    Science.gov (United States)

    Cederwall, Elisabet; Olsén, Monika Fagevik; Hanner, Per; Fogdestam, Ingemar

    2006-01-01

    The aim of this study was to evaluate a physiotherapeutic treatment intervention in Bell's palsy. A consecutive series of nine patients with Bell's palsy participated in the study. The subjects were enrolled 4-21 weeks after the onset of facial paralysis. The study had a single subject experimental design with a baseline period of 2-6 weeks and a treatment period of 26-42 weeks. The patients were evaluated using a facial grading score, a paresis index and a written questionnaire created for this study. Every patient was taught to perform an exercise program twice daily, including movements of the muscles surrounding the mouth, nose, eyes and forehead. All the patients improved in terms of symmetry at rest, movement and function. In conclusion, patients with remaining symptoms of Bell's palsy appear to experience positive effects from a specific training program. A larger study, however, is needed to fully evaluate the treatment.

  18. BC Transit Fuel Cell Bus Project Evaluation Results: Second Report

    Energy Technology Data Exchange (ETDEWEB)

    Eudy, L.; Post, M.

    2014-09-01

    Second report evaluating a fuel cell electric bus (FCEB) demonstration led by British Columbia Transit (BC Transit) in Whistler, Canada. BC Transit is collaborating with the California Air Resources Board and the U.S. Department of Energy's National Renewable Energy Laboratory to evaluate the buses in revenue service. NREL published its first report on the demonstration in February 2014. This report is an update to the previous report; it covers 3 full years of revenue service data on the buses from April 2011 through March 2014 and focuses on the final experiences and lessons learned.

  19. Results of evaluation of tailing dumps dust intensity

    OpenAIRE

    Masloboev V. A.; Baklanov A. A.; Amosov P. V.

    2016-01-01

    A set of most acceptable and well-known methods of dust intensity evaluation has been defined and tested (dependence of Westphal D. L. et al. and DEAD scheme) based on the analysis of exiting approaches (deserts, tailing dumps, etc.). The description of the chosen methods has been given. The determination of dynamic velocity u* and velocity at the height of +10 m above the dusting surface u10 which are necessary to evaluate the dust intensity has been demonstrated. The method is based on two-...

  20. Thyroid dysfunction during pregnancy and evaluation of its results

    OpenAIRE

    Bostancı, Mehmet Sühha; Taşkesen, Fatih

    2011-01-01

    S Objectives: In this study, we aim to evaluate obstetric outcomes of the women with thyroid dysfunction than the normal pregnant women. Materials and methods: In our study, 633 women between the ages of 18 to 35 who admitted to Kovancılar State Hospital Obstetrics and Gynecology Clinic for pregnancy follow-up between January 2010 and January 2011 were evaluated. Serum thyroid - stimulating hormones (TSH), free tri-iyodotironin (T3), free thyroxine (T4) levels for all patients were stud...

  1. Thyroid dysfunction during pregnancy and evaluation of its results

    OpenAIRE

    Fatih Taşkesen; Mehmet Sühha Bostancı

    2011-01-01

    In this study, we aim to evaluate obstetric outcomes of the women with thyroid dysfunction than the normal pregnant women.Materials and methos: In our study, 633 women between the ages of 18 to 35 who admitted to Kovancılar State Hospital Obstetrics and Gynecology Clinic for pregnancy follow-up between January 2010 and January 2011 were evaluated. Serum thyroid - stimulating hormones (TSH), free tri-iyodotironin (T3), free thyroxine (T4) levels for all patients were studied. Antithyroidal per...

  2. Retrospective evaluation of adverse drug reactions induced by antihypertensive treatment

    Science.gov (United States)

    Rende, Pierandrea; Paletta, Laura; Gallelli, Giuseppe; Raffaele, Gianluca; Natale, Vincenzo; Brissa, Nazareno; Costa, Cinzia; Gratteri, Santo; Giofrè, Chiara; Gallelli, Luca

    2013-01-01

    The use of cardiovascular drugs is related to the development of adverse drug reactions (ADRs) in about 24% of the patients in the Cardiovascular Care Unit. Here, we evaluated the ADRs in patients treated with antihypertensive drugs. The study was conducted in two phases: In the first phase, we performed a retrospective study on clinical records of Clinical Divisions (i.e., Internal Medicine Operative Unit and Geriatric Operative Unit) from January 1, 2012 to December 31, 2012. Moreover from January 1, 2013 to March 30, 2013 we performed a prospective study on the outpatients attending the Emergency Department (ED) of the Pugliese-Ciaccio Hospital of Catanzaro, by conducting patient interviews after their informed consent was obtained. The association between a drug and ADR was evaluated using the Naranjo scale. We recorded 72 ADRs in the Clinical Divisions and six in the ED, and these were more frequent in women. Using the Naranjo score, we showed a probable association in 92% of these reactions and a possible association in 8%. The most vulnerable age group involved in ADRs was that of the elderly patients. In conclusion, our results indicate that antihypertensive drugs may be able to induce the development of ADRs, particularly in elderly women receiving multiple drug treatment. Therefore, it is important to motivate the healthcare providers to understand their role and responsibility in the detection, management, documentation, and reporting of ADRs, as also all the essential activities for optimizing patient safety. PMID:24347982

  3. 10 CFR 709.15 - Processing counterintelligence evaluation results.

    Science.gov (United States)

    2010-01-01

    ... financial, credit, travel, and other relevant information to resolve any identified issues. Participation by Office of Intelligence and Counterintelligence personnel in any such evaluation is subject to Executive Order 12333, the DOE “Procedures for Intelligence Activities,” and other relevant laws, guidelines, and...

  4. Evaluation and treatment of hypernatremia: a practical guide for physicians.

    Science.gov (United States)

    Liamis, George; Filippatos, Theodosios D; Elisaf, Moses S

    2016-01-01

    Hypernatremia (serum sodium concentration >145 mEq/L) is a common electrolyte disorder with increased morbidity and mortality especially in the elderly and critically ill patients. The review presents the main pathogenetic mechanisms of hypernatremia, provides specific directions for the evaluation of patients with increased sodium levels and describes a detailed algorithm for the proper correction of hypernatremia. Furthermore, two representative cases of hypovolemic and hypervolemic hypernatremia are presented along with practical clues for their proper evaluation and treatment. Accurate diagnosis and appropriate treatment is crucial since undercorrection or overcorrection of hypernatremia are both associated with poor patients' prognosis.

  5. Evaluation of a commercial biologically based IMRT treatment planning system.

    Science.gov (United States)

    Semenenko, Vladimir A; Reitz, Bodo; Day, Ellen; Qi, X Sharon; Miften, Moyed; Li, X Allen

    2008-12-01

    A new inverse treatment planning system (TPS) for external beam radiation therapy with high energy photons is commercially available that utilizes both dose-volume-based cost functions and a selection of cost functions which are based on biological models. The purpose of this work is to evaluate quality of intensity-modulated radiation therapy (IMRT) plans resulting from the use of biological cost functions in comparison to plans designed using a traditional TPS employing dose-volume-based optimization. Treatment planning was performed independently at two institutions. For six cancer patients, including head and neck (one case from each institution), prostate, brain, liver, and rectal cases, segmental multileaf collimator IMRT plans were designed using biological cost functions and compared with clinically used dose-based plans for the same patients. Dose-volume histograms and dosimetric indices, such as minimum, maximum, and mean dose, were extracted and compared between the two types of treatment plans. Comparisons of the generalized equivalent uniform dose (EUD), a previously proposed plan quality index (fEUD), target conformity and heterogeneity indices, and the number of segments and monitor units were also performed. The most prominent feature of the biologically based plans was better sparing of organs at risk (OARs). When all plans from both institutions were combined, the biologically based plans resulted in smaller EUD values for 26 out of 33 OARs by an average of 5.6 Gy (range 0.24 to 15 Gy). Owing to more efficient beam segmentation and leaf sequencing tools implemented in the biologically based TPS compared to the dose-based TPS, an estimated treatment delivery time was shorter in most (five out of six) cases with some plans showing up to 50% reduction. The biologically based plans were generally characterized by a smaller conformity index, but greater heterogeneity index compared to the dose-based plans. Overall, compared to plans based on dose

  6. [Subconjunctival application of plasma platelet concentrate in the treatment of ocular burns. Preliminary results].

    Science.gov (United States)

    Márquez-de-Aracena, R; Montero-de-Espinosa, I; Muñoz, M; Pereira, G

    2007-08-01

    The efficiency of the subconjunctival application of autologous platelet concentrate in patients with ocular burns was assessed. This was carried out by analysing the effect of treatment in the eyes of 10 patients suffering from ocular burns as a result of work-related accidents. Two types of treatment were evaluated: the first group only received conventional topical medical treatment; and the second group, in addition, had subconjunctival injection of plasma platelet concentrate. The clinical condition of the patient and the period in which the disease prevented the patient from working were studied; monitoring was carried out until the burns had fully healed. Statistically significant differences were found between the group treated with subconjunctival autologous platelet concentrate and the group treated with conventional topical medications, with a shorter period of time in corneal and conjunctival healing, time on sick leave and time needed for full healing. Subconjunctival infiltration of autologous platelet concentrate should be considered as a straightforward, economical and possibly effective form of treatment for traumatic accidents (burns) of the ocular surface.

  7. Squamous cell carcinoma of the oropharynx--an analysis of treatment results in 289 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, L.V.; Grau, C.; Overgaard, J. [Aarhus Univ. Hospital (Denmark). Dept. of Experimental Clinical Oncology

    2001-01-01

    In this retrospective study the results of primary and salvage treatment of oropharyngeal carcinoma were evaluated. A total of 289 consecutive patients (103 females and 186 males) were included in the study. Most tumours originated in the tonsil area (58%) and comprised stages I 8%, II 19%, III 46% and IV 28%. The primary treatment was delivered with curative intent in 276 cases (96%). Of these, 266 received primary radiotherapy. The median radiation dose was 62 Gy, given as laterally opposed fields to the primary tumour and bilateral neck. Eight patients were treated with primary surgery and two with chemotherapy as part of a curatively intended treatment programme including radiotherapy. Six patients received palliative treatment, and seven were not treated at all. Out of 276 tumours treated with curative intent, 173 reappeared; 72% recurred in T position, 38% in N position, and 12% at distant metastatic sites, some in combination. Salvage surgery was possible in 52 patients, and 24 treatments were successful. Salvage radiotherapy or cryotherapy was used in 22 patients and 4 were controlled. For the entire group, the 5-year locoregional tumour control, disease-specific survival and overall survival rates were 38%, 44% and 31%, respectively. For patients treated with curative intent, clinical T- and N-stage, stage, tumour size, gender, age, and pretreatment haemoglobin were significant prognostic parameters in a univariate analysis. The Cox multivariate analysis showed that T-stage, N-stage and gender were independent prognostic factors. It is concluded that T-stage, N-stage and gender are significant independent prognostic factors. The primary control of the carcinoma in the T-position is crucial for overall success, but salvage surgery is found to have a favourable success rate in patients suitable for relapse treatment.

  8. Results of Treatment with 2-Chlorodeoxyadenosine (2-CDA in Multiple Reactivations or Refractory Langerhans Cell Histiocytosis

    Directory of Open Access Journals (Sweden)

    Ghasem Miri-Aliabad

    2014-01-01

    Full Text Available Background: Langerhans cell histiocytosis (LCH is the most common type of histiocytosis and characterized by abnormal proliferation and excess accumulation of inflammatory and langerhans cells at various tissue sites. Clinical manifestations are variable, ranging from spontaneously regressing single bone lesion to multisystem disease, life-threatening and refractory to treatment. Conventional chemotherapy has been shown to be effective in treatment of majority of patients with LCH. However, treatment of refractory disease or multiple reactivations is difficult. The aim of this study is to assess the efficacy of 2-CDA in relapsed or refractory LCH. Materials and methods: Four patients with relapsed or refractory LCH that were treated with 2-chlorodeoxyadenosin (2-CDA enrolled in this study. All patients had received at least one prior chemotherapy regimen. The dose and schedule of 2-CDA was 6 mg/m²/day for 5 days every 3-4 weeks. Results: Median age at the time of treatment with 2-CDA was 9.7 years. Three patients had multisystem disease and one had multifocal bone lesions. All patients had multifocal bone lesions. None of them had risk organ involvement. Mean course of treatment with 2-CDA was 9.5. Radiologic evaluations revealed complete resolution of bone lesions in two (50% patients. In one (25% patient lesions regressed (partial response and in another (25% the disease remained stable. Drug related side effects were minimal. At the present time all patients are alive. Conclusion: Our study demonstrates that 2-CDA as a single agent is efficacious in treatment of multiple reactivations or refractory LCH and well-tolerated in children.

  9. Psychological Evaluation Results in Patients Confronted with Sexual Abuse

    OpenAIRE

    Işık Karakaya; Ayşen Coşkun; Belma Ağaoğlu; Şahika Gülen Şişmanlar; Özlem Yıldız Öç; Nursu Çakın Memik; Ümit Biçer

    2006-01-01

    Child and adolescent sexual abuse have lifelong consequences. Sexual development, emotional effects, depressed mood, anxiety, behavioral effects and alteration of personality are some possible consequences of sexual abuse. In this article we evaluated psychiatric symptoms according to DSM-IV diagnostic criteria in 21 sexually abused children and adolescents. Twelve girls and nine boys between 4 and 16 years of age were investigated. All the patients belonged to low socioeconomic strata. The m...

  10. Long-term Results of Percutaneous Ethanol Injection for the Treatment of Hepatocellular Carcinoma in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Yon Mi; Choi, Don Gil; Lim, Hyo K. [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)] (and others)

    2006-09-15

    To evaluate the long-term follow-up results of percutaneous ethanol injection (PEI) for the treatment of hepatocellular carcinoma (HCC) in Korea. Sixty-eight nodular HCCs initially detected in 64 patients, were subjected to US-guided PEI as a first-line treatment. Long-term survival rates, local tumor progression rates, and complications were evaluated, as were the influences of tumor size and Child-Pugh class on these variables. No major complications occurred. The overall survival rates of the 64 patients at three and five years were 71% and 39%, and their cancer-free survival rates were 22% and 15%, respectively. The overall survival rate of patients with a small HCC ({<=} 2 cm) was significantly higher (p = 0.014) than that of patients with a medium-sized HCC ({<=} 2 cm). The overall survival rate of patients with Child- Pugh class A was significantly higher (p = 0.049) than that of patients with Child- Pugh class B. Of 59 cases with no residual tumor, local tumor progression was observed in ablation zones in 18, and this was not found to be significantly influenced by tumor size or Child-Pugh class. The results of our investigation of the long-term survival rates of PEI in HCC patients in Korea (a hepatitis B virus-endemic area) were consistent with those reported previously in hepatitis C endemic areas. Patients with a smaller tumor or a better liver function exhibited superior survival rates.

  11. Evaluating participatory research: Framework, methods and implementation results.

    Science.gov (United States)

    Smajgl, Alex; Ward, John

    2015-07-01

    This paper describes a structured participatory process and associated evaluation protocol developed to detect systems learning by decision makers involved in the management of natural resources. A series of facilitated participatory workshops were conducted to investigate learning when decision makers and influencers were confronted with the multiple, complex interactions arising from decisions concerned with the nexus of water, food and energy security. The participatory process and evaluation of learning were trialled in the Greater Mekong Subregion (GMS), where integrated scientific evidence was systematically presented to challenge existing beliefs concerned with the effectiveness of proposed policy actions and development investments. Consistent with theoretical propositions, individually held values, beliefs and attitudes were deployed as the primary factors (and psychometrics) that underpin and influence environmental management decision making. Observed and statistically significant changes in the three psychometrics expressed by decision makers in response to the facilitated presentation of scientific evidence during the participatory process, provided supportive evidence of systems learning and the evaluation protocol. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  12. Treatment outcome of mineral trioxide aggregate: repair of root perforations-long-term results.

    Science.gov (United States)

    Mente, Johannes; Leo, Meltem; Panagidis, Dimos; Saure, Daniel; Pfefferle, Thorsten

    2014-06-01

    This historical cohort study follows on a previously reported trial, with the aim of assessing the outcome for teeth with root perforations managed by the orthograde placement of mineral trioxide aggregate (MTA) and identifying potential outcome factors for such treatment with a larger sample size and longer follow-up periods than in the first phase of the project. The treatment outcomes of 64 root perforations repaired between 2000 and 2012 with MTA were investigated. The root perforations were located in different areas of the root. Calibrated examiners assessed clinical and radiographic outcomes by using standardized follow-up protocols 12-107 months after treatment (median, 27.5 months). Preoperative, intraoperative, and postoperative information was evaluated. The outcomes were dichotomized as healed or diseased. Of the 64 teeth examined (85% recall rate), 86% were healed. The univariate analyses (χ(2) tests) identified 2 potential prognostic factors, experience of the treatment providers (odds ratio, 2.14; 95% confidence interval, 0.39-11.74; P < .01) and placement of a post after treatment (odds ratio, 0.06; 95% confidence interval, 0.01-0.27; P < .01). In the multivariate stepwise logistic Cox regression, none of the potential prognostic factors displayed a significant effect on the outcome at the 5% level. MTA appears to have good long-term sealing ability for root perforations regardless of the location. The results of this historical cohort study confirm the results of the first phase of this project. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  13. HCV Treatment Initiation in Patients with Chronic Kidney Disease: Results from ERCHIVES

    Science.gov (United States)

    Butt, Adeel; Ren, Yanjie; Puenpatom, Amy; Arduino, Jean Marie; Kumar, Ritesh; Abou-Samra, Abdul-Badi

    2017-01-01

    Abstract Background Newer directing antiviral agents against HCV (DAAs) are safe and efficacious in persons with chronic kidney disease (CKD). Whether availability of these newer DAAs has resulted in more persons with CKD initiating HCV treatment remains unknown. Methods We identified HCV+ persons in ERCHIVES. We excluded HIV+ and HBsAg+ and those with missing HCV RNA and eGFR data. We determined the CKD stage according to National Kidney Foundation criteria. We determined the number of persons initiated on any of the approved DAA-regimen (defined as >14 days of DAA prescription). Logistic regression analyses was used to determine factors associated with treatment initiation. Results Among 76,513 evaluable persons, 21.1% initiated DAA treatment. Initiation rates differed significantly by CKD stage: 21.1% (15,136/68,469) for eGFR>90mL/minute/1.73m2 and CKD stage-2; 14.0% 9853/6,086) for CKD stage 3; and 7.6% (148/1,958) for CKD stage-4/5. Those with CKD stage-3 were 35% less likely and those with CKD stage-4/5 were 65% less likely to initiate treatment with a DAA compared with those with baseline eGFR>90mL/minute/1.73m2. Those with Body Mass Index (BMI)>30 were more likely to initiate treatment (OR 1.24, 95% CI 1.19,1.29). Treatment initiation was less likely in HCV genotype 2 or 3 and those with diabetes (OR 0.82, 95% CI 0.78,0.86), cardiovascular disease (OR 0.73, 95% CI 0.68,0.78), alcohol abuse or dependence (OR 0.75, 95% CI 0.72,0.78) or cirrhosis (OR 0.85, 95% CI 0.80,0.89) at baseline. Conclusion Persons with more advanced CKD are less likely to receive treatment for HCV. Strategies are needed to improve treatment rates in the HCV/CKD population. Disclosures A. Butt, Merck: Investigator, Grant recipient. A. Puenpatom, Merck: Employee, Salary. J. M. Arduino, Merck: Employee, Salary. R. Kumar, Merck: Employee, Salary

  14. Learning results and evaluation through levels given by the results in Religious Education

    Directory of Open Access Journals (Sweden)

    Emil Lazar

    2016-05-01

    Full Text Available Multilevel approach to religious education assessment entails rethinking the evaluative approach, starting from the systemic perspective on the evaluation object to religion, like regulatory reporting, to curriculum and who materialized from inductive perspective, in terms of subject assessment, the entire complexity of the student. The Assessment Tool that we proposed is an integrative one, an opportunity to see the process, be aware of the process by which it is evaluated and develop the ability to track what is happening in this process and intervene for the evaluator. It is about a formative assessment, as long as the proposed instrument "crosses the boundaries of various learning activities". As a school discipline, Religion is integrative one (contributing, complementing the student's general education and integrator (harmonizing the various skills of the student's academic in progress tracked throughout the student's education unit. Religious education provides and contributes to personal development of students and (self empowering their formation process, exceeding the borders of a single discipline and ensuring premises skills training trans-disciplinary on the basis of specific skills, necessary for personal development of the student. Finally, this idea of approaching religion as a subject from the perspective of education for values is very interesting and debated.

  15. Results of surgical treatment of massive localized lymphedema in severely obese patients

    Directory of Open Access Journals (Sweden)

    Wilson Cintra Júnior

    Full Text Available OBJECTIVE: to evaluate the importance of treatment of deformities caused by massive localized lymphedema (MLL in the severely obese. METHODS: in a period of seven years, nine patients with morbid obesity and a mean age of 33 years underwent surgical resection of massive localized lymphedema with primary synthesis. This is a retrospective study on the surgical technique, complication rates and improved quality of life. RESULTS: all patients reported significant improvement after surgery, with greater range of motion, ambulation with ease and more effective hygiene. Histological analysis demonstrated the existence of a chronic inflammatory process marked by lymphomonocitary infiltrate and severe tissue edema. We observed foci of necrosis, formation of microabscesses, points of suppuration and local fibrosis organization, and pachydermia. The lymphatic vessels and some blood capillaries were increased, depicting a framework of linfangiectasias. CONCLUSION: surgical treatment of MLL proved to be important for improving patients' quality of life, functionally rehabilitating them and optimizing multidisciplinary follow-up of morbid obesity, with satisfactory surgical results and acceptable complication rates, demonstrating the importance of treatment and awareness about the disease.

  16. Clinical results of endoscopic treatment without repair for partial thickness gluteal tears.

    Science.gov (United States)

    Coulomb, R; Essig, J; Mares, O; Asencio, G; Kouyoumdjian, P; May, O

    2016-05-01

    Various surgical treatments have been proposed for greater trochanteric pain syndrome (GTPS) related to gluteal tendinopathy with partial thickness tears. The clinical results of endoscopic debridement without repair of these gluteal tears are not well known. The objectives of this study were to determine if this procedure leads to: (1) reduction of pain, (2) functional improvement, (3) patient satisfaction (on scale of 0 to 10). Endoscopic treatment without tendon repair provides short-term pain relief in patients with GTPS due to partial thickness gluteal tears. Seventeen patients (16 women, 1 man) with GTPS due to partial thickness gluteal tears that was present for at least 6 months and was refractory to conservative treatment were included in the analysis. The average age at the time of the procedure was 53.5years (17-71). Pain was evaluated with a visual analogue scale (VAS). Functional outcomes were defined using the Harris Hip Score and the UCLA activity score. Satisfaction was evaluated using a VAS and Odom's criteria. The average follow-up was 37.6months (12-48). The average preoperative and follow-up values were respectively: (1) Pain: 7.2±1.1 (5-9) versus 3.3±1.9 (1-7) (P<0.001), (2) Harris score: 53.5±8.4 (36-68) versus 79.8±14.7 (45-96) (P<0.001). Seven patients (41.2%) were able to resume sports activities. The average satisfaction score for the surgery was 6.2±2.4 (0-9) at follow-up. Five patients had a poor outcome at the review: four still had pain and one had recurrence of the lateral snapping hip. Endoscopic treatment without repair of partial thickness gluteal tears is a treatment option with modest clinical results for GTPS patients refractory to conservative treatment. IV, retrospective study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. [Conservative treatment of acetabular fractures: epidemiology and medium-term clinical and radiological results].

    Science.gov (United States)

    Magala, M; Popelka, V; Božík, M; Heger, T; Zamborský, V; Šimko, P

    2015-01-01

    The vast majority of studies on fractures of the acetabulum are concerned with surgical treatment. All displaced fractures are presented as surgically treated. The purpose of this study was to evaluate the results of surgical and conservative treatment of patients with acetabular fractures in relation to the degree of fracture displacement. We analysed 140 fractures of the acetabulum treated in our institution by different methods between 2009 and 2013. In addition to the use of Letournel´s classification, we allocated each fracture to one of six groups: 1. Sixty displaced fractures treated surgically, 2. Twenty three fractures with a displacement of more than 6 mm, 3. Eighteen slightly displaced fractures (2-3 mm in the acetabular roof or 4-5 mm in other parts of the acetabulum), 4. Twenty non-displaced fractures, 5. Six pelvic fractures involving the acetabulum and 6. Thirteen fractures of old people, mostly displaced but not examined by CT. Groups 2 to 6 were treated conservatively. In all patients, demographic and epidemiologic factors were analysed in relation to the patient's group assignment. In 107 patients, hip function was assessed using the Matta clinical grading system at a minimum follow-up of 12 months (average 3.16 years). Radiological status, time of admission, start of weight-bearing after the accident, working ability, mortality and complications were also evaluated. Non-displaced fractures were often associated with serious injury or polytrauma in 20 patients; not all of them had excellent functional outcome. (mean score, 17.25). Excluding two patients who developed avascular necrosis, fourteen slightly displaced fractures had a fixal score of 16.92. Sixteen patients with displaced fractures were managed conservatively due to their poor medical condition and other circumstances. Their functional outcome (mean score, 15.25) was significantly worse than that of the patients with non-displaced fractures (p=0.02) and worse than the outcome in

  18. Evaluation of complications of root canal treatment performed by ...

    African Journals Online (AJOL)

    Mothanna K. AlRahabi

    2017-07-05

    Jul 5, 2017 ... This study evaluated the technical quality of root canal treatment (RCT) and detected iatrogenic errors in an undergraduate dental clinic at the College of Dentistry, Taibah. University, Saudi Arabia. Dental records of 280 patients who received RCT between 2013 and 2016 undertaken by dental students ...

  19. Evaluation of activated sludge treatment and settleability in ...

    African Journals Online (AJOL)

    Wastewater discharged from the edible oil industry contains a very concentrated amalgamation of organic and inorganic materials making it a problematic effluent to treat. The aim of this study was to evaluate the activated sludge treatment of edible oil effluent from a sunflower oil processing company in KwaZulu-Natal.

  20. Evaluation of activated sludge treatment and settleability in ...

    African Journals Online (AJOL)

    DRINIE

    2003-07-03

    Jul 3, 2003 ... Wastewater discharged from the edible oil industry contains a very concentrated amalgamation of organic and inorganic materials making it a problematic effluent to treat. The aim of this study was to evaluate the activated sludge treatment of edible oil effluent from a sunflower oil processing company in ...

  1. Multimodal Evaluation of Practice Interactions as Treatment for Social Isolation.

    Science.gov (United States)

    Royce, W. Stephen; Arkowitz, Hal

    1978-01-01

    Socially isolated college students volunteered for a program to increase social comfort and activity in friendship interactions. Results indicated no significant differences between the treatment groups or between the control groups. Treatment groups showed significant improvements in contrast to each control group on measures of social anxiety…

  2. Clinical Features, Presence of Human Herpesvirus-8 and Treatment Results in Classic Kaposi Sarcoma

    Directory of Open Access Journals (Sweden)

    Özlem Su

    2008-12-01

    Full Text Available Background and Design: Classic Kaposi sarcoma (KS occurs predominantly among the elderly, with Jews, Italians and Greeks. Classic KS has been seen relatively frequently in Turkey. Our aim was to evaluate the demographic, clinical features of Kaposi sarcoma and etiopathological role of human herpesvirus-8 (HHV-8. Treatment results of 18 classic Kaposi’s sarcoma were also concluded.Material and Method: Eighteen cases of classic Kaposi sarcoma diagnosed as clinically and histopathologically between January 2001 and August 2008 in our dermatology department were taken to this study. Demographic, clinical features and treatment results were reviewed retrospectively in all patients. HHV-8 was investigated in the lesional skin of 7 patients.Results: A male/female ratio of 2/1 was found. Mean age at diagnosis was 67.2 (37-94 years. Bilaterally lower extremities were involved in 15 patients (83.3%, the trunk was involved in 3 patients (16.6%. Plaques and nodules were the common type of lesions (66.6% and 55.5%. Nine patients had no symptoms (50%. Edema was the most common symptom (38.8%. A second primary malignancy was found in 2 patients (11.1%. HHV-8 was detected in 6 of the 7 patients(85.7%. Majority of the patients were treated with interferon alfa (subcutaneously and cryotherapy as a monotherapy or a combination therapy. Imiquimod was the second agent in combined treatment (27.7%. Conclusion: We suggest that interferon alfa and imiquimod can be used as first line therapy agents with their antiviral and immunmodulatuar features in the treatment of KKS. (Turkderm 2008; 42: 122-6

  3. Evaluation of the clinical usefulness of modulated Arc treatment

    CERN Document Server

    Lee, Young Kyu; Kim, Yeon Sil; Choi, Byung Ock; Nam, Sang Hee; Park, Hyeong Wook; Kim, Shin Wook; Shin, Hun Joo; Lee, Jae Choon; Kim, Ji Na; Park, Sung Kwang; Kim, Jin Young; Kang, Young-Nam

    2015-01-01

    The purpose of this study is to evaluate the clinical usefulness of modulated arc (mARC) treatment techniques. The mARC treatment plans of the non-small cell lung cancer (NSCLC) patients were performed in order to verify the clinical usefulness of mARC. A pre study was conducted to find the most competent plan condition of mARC treatment and the usefulness of mARC treatment plan was evaluated by comparing it with the other Arc treatment plans such as Tomotherapy and RapidArc. In the case of mARC, the optimal condition for the mARC plan was determined by comparing the dosimetric performance of the mARC plans with the use of various parameters. The various parameters includes the photon energies (6 MV, 10 MV), optimization point angle (6{\\deg}-10{\\deg} intervals), and total segment number (36-59 segment). The best dosimetric performance of mARC was observed at 10 MV photon energy and the point angle 6 degree, and 59 segments. The each treatment plans of three different techniques were compared with the followin...

  4. Our results of surgical treatment of supracondylar humeral fractures in children

    Directory of Open Access Journals (Sweden)

    Beşir Dikmen

    2014-03-01

    Full Text Available Objective: The second most common pediatric age fracture after the forearm fractures is distal humeral fractures. The aim of the current study is to retrospectively evaluate the results of the surgical treatment of pediatric supracondylar fractures in our clinic and compare it to the literature. Methods: During the period between 2006-2011 54 patients having supracondylar humeral fractures who were surgically treated with open reduction and crossed medial and lateral K wire fixation through posterior approach in our institution included in the study. The sex, etiology and type of the fracture, accompanying injuries, postoperative complications, radiologic parameters, cosmetic and functional results were evaluated. Results: 38 (70,4% male and 16 (29,6% female patients were evaluated with a mean age of 5.51 (range;1–11 years. The mean length of hospital stay was 2,29 days. The average follow up was 140 weeks. There was no iatrogenic vascular and nerve injuries. Pin tract infection and heterotopic ossification were observed only in one patient respectively. The functional results were excellent in 90,7%, good in 9,3% and cosmetic results were 90,7 excellent, 5,6% good, 1,9% satisfied, 1,9% bad according to the Flynn criteria. Conclusion: When taking into consideration the duration of hospital stay, the rate of neurovascular complication, the functional and cosmetic results it seems that treating the supracondylar humeral fractures using the posterior approach with crossed medial and lateral K-wire is a safe and effective method.

  5. MICROBIOLOGICAL EVALUATION OF WATER BUFFALO COLOSTRUM: FIRST RESULTS

    Directory of Open Access Journals (Sweden)

    P. Catellani

    2012-08-01

    Full Text Available Animal colostrum contains many substances with antibacterial activity such as lysozyme and lactoferrin which should inhibit the microbial growth. The aim of this research is to understand if colostrum can be considered a safe product, considering that Regulation (EC N° 1662/2006, which has modified the Regulation (EC N° 853/2004, introducing colostrum as human food. Microbiological tests, made on water buffalo colostrum, aiming to obtain the total microbial count (maximum concentration: 3,6•104 ufc/ml, the quantitative evaluation of total (maximum the highest concentration found: 2,3•103 ufc/ml and fecal coliforms (maximum concentration: 4,9•102 ufc/ml and the qualitative search of Salmonella spp. and Listeria monocytogenes, showed that there is not a microbial growth in colostrum, that it can be considered a safe food, from the microbial point of view

  6. Stereotactic radiosurgery for the treatment of brain metastases; results from a single institution experience.

    LENUS (Irish Health Repository)

    Burke, D

    2013-09-01

    Stereotactic radiosurgery is frequently used for the treatment of brain metastases. This study provides a retrospective evaluation of patients with secondary lesions of the brain treated with stereotactic radiosurgery (SRS) at our institution.

  7. Clinical outcome and radiographic results after operative treatment of Scheuermann's disease

    NARCIS (Netherlands)

    Poolman, R. W.; Been, H. D.; Ubags, L. H.

    2002-01-01

    The aim of this prospective study was to evaluate radiographic findings, patient satisfaction and clinical outcome, and to report complications and instrumentation failure after operative treatment of Scheuermann's disease using a combined anterior and posterior spondylodesis. The loss of sagittal

  8. Soil compaction: Evaluation of stress transmission and resulting soil structure

    DEFF Research Database (Denmark)

    Naveed, Muhammad; Schjønning, Per; Keller, Thomas

    Accurate estimation of stress transmission and resultant deformation in soil profiles is a prerequisite for the development of predictive models and decision support tools for preventing soil compaction. Numerous studies have been carried out on the effects of soil compaction, whilst relatively few...... and compaction-resulted soil structure at the same time. Stress transmission was quantified using both X-ray CT and Tactilus sensor mat, and soil-pore structure was quantified using X-ray CT. Our results imply that stress transmission through soil highly depends on the magnitude of applied load and aggregate...... studies have focused on the cause (mode of stress transmission in the soil). We have coupled both cause and effects together in the present study by carrying out partially confined compression tests on (1) wet aggregates, (2) air dry aggregates, and (3) intact soils to quantify stress transmission...

  9. Including a range of outcome targets offers a broader view of fibromyalgia treatment outcome: results from a retrospective review of multidisciplinary treatment.

    Science.gov (United States)

    Marcus, Dawn A; Bernstein, Cheryl D; Haq, Adeel; Breuer, Paula

    2014-06-01

    Fibromyalgia is associated with substantial functional disability. Current drug and non-drug treatments result in statistically significant but numerically small improvements in typical numeric measures of pain severity and fibromyalgia impact. The aim of the present study was to evaluate additional measures of pain severity and functional outcome that might be affected by fibromyalgia treatment. This retrospective review evaluated outcomes from 274 adults with fibromyalgia who participated in a six-week, multidisciplinary treatment programme. Pain and function were evaluated on the first and final treatment visit. Pain was evaluated using an 11-point numerical scale to determine clinically meaningful pain reduction (decrease ≥ 2 points) and from a pain drawing. Function was evaluated by measuring active range of motion (ROM), walking distance and speed, upper extremity exercise repetitions, and self-reports of daily activities. Numerical rating scores for pain decreased by 10-13% (p Fibromyalgia Impact Questionnaire (FIQ) scores decreased by 20% (p exercise repetitions doubled. Despite modest albeit statistically significant improvements in standard measures of pain severity and the FIQ, more substantial pain improvement was noted when utilizing alternative measures of pain and functional improvement. Alternative symptom assessment measures might be important outcome measures to include in drug and non-drug studies to better understand fibromyalgia treatment effectiveness. © 2013 John Wiley & Sons, Ltd.

  10. Methods for evaluation of medical care other than credentialing. Cost, experience, and results.

    Science.gov (United States)

    Ebert, P A

    1990-08-01

    Unfortunately, the majority of studies proposed to evaluate a physician's capabilities, such as effectiveness programs, outcome research, and hospital evaluation, do not focus directly on the individual practitioner. The certifying process, although imperfect, still offers the best method of evaluation. The other evaluation methods will need additional refinement to be able to individually analyze a specific physician's performance and determine whether he or she is truly providing the highest quality care. Physicians are being asked to document the effectiveness of their clinical decision making. On the surface this seems so simple, and in some areas where the outcome is either life or death or a specific yes or no type of answer, many have the capability to come forth with some realistic documentation. However, today's society is focused on health and the perfect outcome, and many nonlife-threatening therapies are evaluated by a patient's unrealistic expectation. Thus, the same result may be interpreted differently in one geographic area or by patients with different expectations. The biggest mistake would be to believe that outcome studies can be used to reduce cost. There may be some initial reduction or delays in treatment that suggest an immediate reduction of cost, the so-called sentinel effect, but no information or evidence indicates that these effects can be expanded without actually reducing needed health care services. In fact, the delays or obstruction to entering the health-care system experienced by many individuals often lead to more costly and less effective care with suboptimal results.

  11. Ultrasound-guided high-intensity focused ultrasound treatment for abdominal wall endometriosis: Preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Wang Yang [Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China); Wang Wei, E-mail: wangyang301301@yahoo.com.cn [Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China); Wang Longxia; Wang Junyan; Tang Jie [Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853 (China)

    2011-07-15

    Purpose: To evaluate the safety and therapeutic efficacy of ultrasound (US)-guided high-intensity focused ultrasound (HIFU) ablation for the treatment of abdominal wall endometriosis (AWE). Materials and methods: Twenty-one consecutive patients with AWE were treated as outpatients by US-guided HIFU ablation under conscious sedation. The median size of the AWE was 2.4 cm (range 1.0-5.3 cm). An acoustic power of 200-420 W was used, intermittent HIFU exposure of 1 s was applied. Treatment was considered complete when the entire nodule and its nearby 1 cm margin become hyperechoic on US. Pain relief after HIFU ablation was observed and the treated nodule received serial US examinations during follow-up. Results: All AWE was successfully ablated after one session of HIFU ablation, the ablation time lasted for 5-48 min (median 13 min), no major complications occurred. The cyclic pain disappeared in all patients during a mean follow-up of 18.7 months (range 3-31 months). The treated nodules gradually shank over time, 16 nodules became unnoticeable on US during follow-up. Conclusion: US-guided HIFU ablation appears to be safe and effective for the treatment of AWE.

  12. Results of surgical treatment versus chemoradiation therapy in oropharyngeal early tumors

    Directory of Open Access Journals (Sweden)

    Chedid, Helma Maria

    2009-03-01

    Full Text Available Introduction: The epidermoid carcinoma of the upper aerodigestive tract is diagnosed in approximately 40% of the cases of advanced clinical stages. Objective: To evaluate the disease-free interval in patients with clinical stages I and II epidermoid carcinoma who were submitted to surgery or chemoradiation. Method: Retrospective study of the records of 139 patients treated for oropharyngeal epidermoid carcinoma submitted to treatment with curative intent. Among those patients, 38 were classified with early tumors clinical stages I and II. Twenty-seven (71.1% underwent surgical treatment whereas eleven (28.9% were treated with chemoradiation. The mean age was 56.4 years; 31 cases (81.6% were in men and seven (18.4% were in women. Results: Among the eleven patients who were submitted to chemoradiation, 72.7% obtained locoregional control of the disease and their disease-free survival was of 42%. Among the 27 patients operated, 19 remained in Clinical Stages I and II in the histological report and six underwent postoperative radiation therapy. The disease-free interval for two years was of 70%. Conclusion: The patients submitted to the surgery had a better disease-free interval as compared to those submitted to chemoradiation treatment.

  13. Methadone maintenance treatment modalities in relation to incidence of HIV: results of the Amsterdam cohort study

    NARCIS (Netherlands)

    Langendam, M. W.; van Brussel, G. H.; Coutinho, R. A.; van Ameijden, E. J.

    1999-01-01

    To evaluate methadone maintenance treatment modalities, prescribed within the concept of harm reduction, in relation to incidence of HIV infection among drug users with a history of methadone treatment in Amsterdam, The Netherlands. Prospective observational cohort study among 582 HIV-negative drug

  14. Soil compaction: Evaluation of stress transmission and resulting soil structure

    Science.gov (United States)

    Naveed, Muhammad; Schjønning, Per; Keller, Thomas; Lamande, Mathieu

    2016-04-01

    Accurate estimation of stress transmission and resultant deformation in soil profiles is a prerequisite for the development of predictive models and decision support tools for preventing soil compaction. Numerous studies have been carried out on the effects of soil compaction, whilst relatively few studies have focused on the cause (mode of stress transmission in the soil). We have coupled both cause and effects together in the present study by carrying out partially confined compression tests on (1) wet aggregates, (2) air dry aggregates, and (3) intact soils to quantify stress transmission and compaction-resulted soil structure at the same time. Stress transmission was quantified using both X-ray CT and Tactilus sensor mat, and soil-pore structure was quantified using X-ray CT. Our results imply that stress transmission through soil highly depends on the magnitude of applied load and aggregate strength. As soon as the applied load is lower than the aggregate strength, the mode of stress transmission is discrete as stresses were mainly transmitted through chain of aggregates. With increasing applied load soil aggregates start deforming that transformed heterogeneous soil into homogenous, as a result stress transmission mode was shifted from discrete towards more like a continuum. Continuum-like stress transmission mode was better simulated with Boussinesq (1885) model based on theory of elasticity compared to discrete. The soil-pore structure was greatly affected by increasing applied stresses. Total porosity was reduced 5-16% and macroporosity 50-85% at 620 kPa applied stress for the intact soils. Similarly, significant changes in the morphological indices of the macropore space were also observed with increasing applied stresses.

  15. [Hearing screening at nursery schools: results of an evaluation study].

    Science.gov (United States)

    Weichbold, Viktor; Rohrer, Monika; Winkler, Cornelia; Welzl-Müller, Kunigunde

    2004-07-31

    This study aimed to evaluate the hearing screening of pre-school children at nursery schools in Tyrol, Austria. 47 nursery schools with a total of 2199 enrolled children participated in the study. At the screening, the children were presented a series of tones at frequencies 0.5 kHz (25dB), 1 kHz, 2 kHz, 3 kHz, and 4 kHz (20 dB each) from portable audiometers. The tones were presented over headphones for each ear separately and at irregular intervals. Failure to respond to any of the frequencies was considered failure of the screening. Parents were then advised in written form to have the child examined by an ENT-specialist. 1832 individuals were screened (coverage: 83% of nursery school children; corresponding to at least 63% of all Tyrolean children aged 3 to 5 years). Of these, 390 failed the test (referral rate: 21% of all screened). Examination through an ENT-specialist occurred with 217 children, and this confirmed the positive test in 139 children (hit rate: 64%). In most cases, a temporary conductive hearing loss due to external or middle ear problems (glue ear, tube dysfunction, cerumen, otitis media) was diagnosed. A sensorineural hearing loss was found in 4 children (in 3 of them bilateral). The need for therapy was recognized in 81 children (4% of all screened). Pre-school hearing screening identifies children with ear and hearing problems that need therapeutical intervention. Although the hearing problems are mostly of a temporary nature, some may require monitoring over some period. Also some children with permanent sensorineural hearing loss may be detected through this measure. Hearing screening is an efficient means of assessing ear and hearing problems in pre-school children. However, the follow-up rate needs to be improved for optimizing the efficacy.

  16. Outcome evaluation of staged treatment for bicondylar tibial plateau fractures.

    Science.gov (United States)

    Giordano, Vincenzo; do Amaral, Ney Pecegueiro; Koch, Hilton A; E Albuquerque, Rodrigo Pires; de Souza, Felipe Serrão; Dos Santos Neto, José Félix

    2017-10-01

    The universal accepted strategy for treating high-energy tibial plateau fractures remains a topic of ongoing debate. The challenge for the practicing orthopaedic trauma surgeon is to provide anatomical articular fracture reduction, with successfully managing the complex soft-tissue injury that is commonly present at patient admission. The primary aim of the actual study was to evaluate the results of a staged protocol for the treatment of high-energy bicondylar tibial plateau fractures. The secondary aim was to describe the technique used for the definitive fixation of this complex fracture pattern. Thirty patients with unstable high-energy closed bicondylar tibial plateau fractures (17 Schatzker V and 13 Schatzker VI) were managed. There were 24 men (80%) and six women (20%). All of them were skeletally mature with their age ranging from 19 to 67 years (mean of 33.1±3.4 years). Treatment involved a two-stage procedure with appropriate emergency care, preoperative planning, and definitive fixation. Initial treatment, named 'damage control on complex articular fracture elements', consisted on temporary bridging external fixation. Definitive treatment was delayed in a mean of 10 days (ranging from seven to 13 days) and was performed when the soft-tissue conditioning demonstrated either complete or almost complete remission of the inflammatory reaction due to the 'first hit'. Conventional implants were used in the 30 patients. All patients were evaluated clinically and radiographically. Twenty-six (86.7%) patients had a moderate level of activity, three (10%) patients had a very light level of activity, and one (3.3%) patient was unable to have any kind of work activity and is currently supported by the Brazilian Welfare. Using the visual analog scale mean pain score was 30 (ranging from 10 to 60); even the patient with the workers' compensation had no severe pain. All patients except three have no difficulty with stairs, giving way, locking, swelling, and squatting

  17. Evaluating EU Regional Policy: Many Empirical Specifications, One (Unpleasant) Result

    DEFF Research Database (Denmark)

    Breidenbach, Philipp; Mitze, Timo; Schmidt, Christoph

    Numerous studies have focused on the role of EU regional policy in fostering growth and convergence among European regions, why conducting another one? We argue that two facts are still lacking in the actual academic debate in order to get a sound empirical identification strategy and reliable...... results: First, one should take the theoretical underpinnings of regional growth models more serious, and second, a likewise careful account of the role of spatial dependence in the underlying data is needed. Though research has increasingly become aware of the latter point as important control factor...

  18. Acne Scarring—Pathogenesis, Evaluation, and Treatment Options

    Science.gov (United States)

    Connolly, Deirdre; Vu, Ha Linh; Mariwalla, Kavita

    2017-01-01

    Acne vulgaris is a ubiquitous problem affecting 80 percent of people ages 11 to 30 years, with many patients experiencing some degree of scarring. This review focuses on atrophic scars, the most common type of acne scar. We briefly address the cellular sequelae that lead to scar formation and the initial evaluation of patients with acne scars. We then discuss an algorithmic approach to the treatment of acne scarring based on the classification of scars into erythematous and atrophic types. Lastly, we discuss the future treatment of acne scars and ongoing clinical trials. PMID:29344322

  19. Lymph Node Failure Pattern and Treatment Results of Esophageal Cancer Patients Treated with Definitive Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sun Young; Kwon, Hyoung Cheol; Kim, Jung Soo [Chonbuk National University Hospital, Jeonju (Korea, Republic of); Lee, Heui Kwan [The Catholic University of Korea, Seoul (Korea, Republic of); Kim, Soo Geon [Jesushospital, Jeonju (Korea, Republic of)

    2008-06-15

    We evaluated the failure pattern of the celiac axis, gastric lymph node, and treatment outcome in the upper and mid-esophageal region of cancer patients treated by definitive radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, retrospectively. Materials and Methods: The study constituted the evaluation 108 patients with locally advanced esophageal cancer receiving radiotherapy or a combination of radiotherapy and chemotherapy at Chonbuk National University Hospital from January 1986 to December 2006. In total, 82 patients treated by planned radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, were analysed retrospectively. The study population consisted of 78 men and 2 women (mean age of 63.2 years). In addition, 51 patients received radiotherapy alone, whereas 31 patients received a combination of radiation therapy and chemotherapy. The primary cancer sites were located in the upper portion (17 patients), and mid portion (65 patients), respectively. Further, the patients were in various clinical stages including T1N0-1M0 (7 patients), T2N0-1M0 (18 patients), T3N0-1M0 (44 patients) and T4N0-1M0 (13 patients). The mean follow up period was 15 months. Results: The various treatment outcomes included complete response (48 patients), partial response (31 patients) and no response (3 patients). The failure patterns of the lymph node were comprised of the regional lymph node (23 patients) and the distance lymph node which included celiac axis and gastric lymph node (13 patients). However, metastasis was not observed in the regional and distant lymph node in 10 patients, whereas 36 patients were not evaluated. Furthermore, of the 13 patients who developed celiac axis and gastric lymph node metastases, 3 were in stage T1N0-1M0 and 10 were in stage T2-4N0-1M0. A complete response appeared in 12 patients, whereas a partial response appeared in 1 patient. The mean survival time of the

  20. SULFURIC ACID REMOVAL PROCESS EVALUATION: SHORT-TERM RESULTS

    Energy Technology Data Exchange (ETDEWEB)

    Gary M. Blythe; Richard McMillan

    2002-03-04

    results of the short-term tests; the long-term test results will be reported in a later document. The short-term test results showed that three of the four reagents tested, dolomite powder, commercial magnesium hydroxide slurry, and byproduct magnesium hydroxide slurry, were able to achieve 90% or greater removal of sulfuric acid compared to baseline levels. The molar ratio of alkali to flue gas sulfuric acid content (under baseline conditions) required to achieve 90% sulfuric acid removal was lowest for the byproduct magnesium hydroxide slurry. However, this result may be confounded because this was the only one of the three slurries tested with injection near the top of the furnace across from the pendant superheater platens. Injection at the higher level was demonstrated to be advantageous for this reagent over injection lower in the furnace, where the other slurries were tested.

  1. SULFURIC ACID REMOVAL PROCESS EVALUATION: SHORT-TERM RESULTS

    Energy Technology Data Exchange (ETDEWEB)

    Gary M. Blythe; Richard McMillan

    2002-02-04

    the results of the short-term tests; the long-term test results will be reported in a later document. The short-term test results showed that three of the four reagents tested, dolomite powder, commercial magnesium hydroxide slurry, and byproduct magnesium hydroxide slurry, were able to achieve 90% or greater removal of sulfuric acid compared to baseline levels. The molar ratio of alkali to flue gas sulfuric acid content (under baseline conditions) required to achieve 90% sulfuric acid removal was lowest for the byproduct magnesium hydroxide slurry. However, this result may be confounded because this was the only one of the three slurries tested with injection near the top of the furnace across from the pendant superheater platens. Injection at the higher level was demonstrated to be advantageous for this reagent over injection lower in the furnace, where the other slurries were tested.

  2. Preliminary results on scintigraphic evaluation of malignant external otitis

    Energy Technology Data Exchange (ETDEWEB)

    Malamitsi, J.; Maragoudakis, P. (Hippocrateion Hospital, Athens (Greece). Dept. of Nuclear Medicine); Papafragou, K.; Koukouliou, V. (Athens Univ. (Greece). Dept. of Medical Physics); Kalatzis, Y.; Adamopoulos, G.; Proukakis, C. (Hippocrateion Hospital, Athens (Greece). ORL Univ. Clinic)

    1993-06-01

    Malignant external otitis (MEO) is a potentially fatal otitis occurring in diabetic and immunosuppressed patients, which may cause cranial nerve palsies and massive thrombophlebitis of the brain. We studied five diabetic patients with the clinical diagnosis of external otitis who were suspected of having MEO and one diabetic patient presumed cured from MEO. All of them underwent methylene diphosphonate, nanocolloid and gallium single-photon emission tomography studies with quantitative analysis on the basis of regions of interest and count profile curves. This combined assessment helped us to diagnose and follow-up soft tissue and temporal bone infection, especially in the case of transsphenoidal extension of the disease, since conventional radiology and computed tomography were of no particular help. On the basis of these results, we consider scintigraphic demonstration of skull base infection as a fourth criterion of MEO given that the classical Chandler's triad (diabetes, granuloma, and Pseudomonas aeruginosa) is not always present. (orig.).

  3. Treatment results of combined platelet-rich plasma and fat injection in patients with velopharyngeal insufficiency

    Directory of Open Access Journals (Sweden)

    Hamid Reza Fathi

    2013-10-01

    Full Text Available Background: Velopharyngeal insufficiency causes hypernasal vocal quality and can also result in audible nasal air emission and difficulty in producing pressure consonants. The resulting speech is often socially unacceptable and can be difficult to understand. Platelet-rich plasma is an autologous derivative of whole blood. Today, the importance of clinical use of Platelet-rich plasma in the plastic surgery is considered. This study was designed to evaluate the effectiveness of combined Platelet-rich plasma and fat injection in the treatment of velopharyngeal insufficiency. Methods: In this prospective clinicaltrial study, of 15 patients including 9 males and 6 females and aged 15-20 years with mild/ moderate velopharyngeal insufficiency who were injected with 5 mL of combined Platelet-rich plasma (1 mL and fat (4 mL in the front volume in the posterior pharyngeal wall in the pre-vertebral fascia under sedation. Speech samples were recorded by nasoendoscopy before the injection, and at 6 weeks and 6 months after the injection. Assessment of pathologic speech was done by speech therapist. Results: Velar displacement showed significantly increased at 6 weeks after the injection (P=0.049. Velopharyngeal gap disappeared in 60% of patients at 6 weeks after the injection (P=0.019. Lateral pharyngeal wall movement showed significantly increased in 73.3% of the patients at 6 months after the injection (P=0.04. After the treatment, aerodynamic assessment showed significantly decreased in nasal air escape during phonation and repeat the words (P<0.05. Assessment speech therapist showed significantly improve quality of phonation in these patients (P<0.05. Conclusion: It seems that, combined Platelet-rich plasma and fat injection lead to improve voice resonance and reduce nasal air escape in all treated cases. It can be a promising alternative to major procedures, such as velopharyngoplasties, for the treatment of mild/ moderate velopharyngeal insufficiency.

  4. Evaluating Surface Flux Results from CERES-FLASHFlux

    Science.gov (United States)

    Wilber, A. C.; Stackhouse, P. W., Jr.; Kratz, D. P.; Gupta, S. K.; Sawaengphokhai, P.

    2016-12-01

    The Clouds and Earth's Radiant Energy System (CERES) mission provides TOA (Top-of-Atmosphere) and surface radiative flux products for each CERES footprint (Single Scanner Footprint) and also time integrated and spatially averaged (TISA) to provide 1ox1o fluxes at various temporal averages. The CERES TISA products are available to the public within 3-6 months of observation. The CERES Fast Longwave and SHortwave radiative Flux (FLASHFlux) data products were developed to provide a rapid release version of the CERES data products. FLASHFlux data products are made available to the research and applications communities within one week of the satellite observations. Over the last several years, the CERES team has contributed to a section on the variability of radiation budget at the Top-of-Atmosphere in the annual "State of the Climate Report" published in BAMS using CERES TISA and FLASHFlux data products. Recently, the FLASHFlux data were used to investigate the radiative impacts of the intense 2015-2016 El Nino event. In addition FLASHFlux date are routinely used by applied science in energy related and agricultural sectors. The current version of FLASHFlux is being upgraded to FLASHFlux Version4A to improve consistency with the climate quality Edition 4 CERES data products. This presentation will describe the planned changes including the change to the latest meteorological product from Global Modeling and Assimilation Office (GMAO), GEOS FP-IT (5.12.4). GEOS 5.12.4 is an assimilation that is consistent with MERRA-2. We present comparisons of global and regional changes in the TOA and surface radiative fluxes as a result of the upgrade for both longwave (LW) and shortwave (SW) surface fluxes. We also compare the data products against ground measurements using data from the Baseline Surface Radiation Network (BSRN) - including NOAA SURFRAD, Atmospheric Radiation Measurement (ARM) and Ocean buoy measurements from Woods Hole Oceanographic Institute (WHOI).

  5. Results of open wound technique in the treatment of post-sequestrectomy dead space.

    Science.gov (United States)

    Onuminya, J E; Onuminya, D S

    2008-02-01

    Severe chronic osteomyelitis with variable outcomes is still common among children in developing nations. There has been no consensus on the optimal method of treatment. We therefore prospectively evaluated the rates of wound healing and recurrence following open wound treatment of post-sequestrectomy dead spaces in 30 patients with haematogenous chronic osteomyelitis of the tibial shaft at the King Orthopaedic Clinic, Ekpoma, Edo State, Nigeria, between January 2001 and December 2005. Thirty similar patients whose post-sequestrectomy dead spaces were treated by closed wound technique formed the control group. Both groups were subjected to standard methods of perioperative management. Saucerisation, sequestrectomy and curettage were the cornerstones of surgical therapy. The wounds were primarily either left open (study group) or closed (control group). The rates of wound healing and recurrence were used to assess the outcome of treatment. The chi-square test was used for statistical analysis. The median age was 13 years, with a range of 6 - 60 years. Staphylococcus aureus was the organism most commonly associated with chronic osteomyelitis. Rates of wound healing and recurrence in the study group were significantly better than in the control group (p<0.05), even though it took a relatively longer period to achieve healing with the open method of treatment. The follow-up period ranged from 1 to 5 years, with a median of 2 years. We observed that the results of the open method of treating post-sequestrectomy dead spaces were good, and we advocate its use in resource-poor settings.

  6. Chronic antidepressant treatments resulted in altered expression of genes involved in inflammation in the rat hypothalamus.

    Science.gov (United States)

    Alboni, Silvia; Benatti, Cristina; Montanari, Claudia; Tascedda, Fabio; Brunello, Nicoletta

    2013-12-05

    To gain insight into the possible immune targets of antidepressant, we evaluated the expression of several inflammatory mediators in the hypothalamus of rats chronically (28 days) treated with the serotonin selective reuptake inhibitor fluoxetine (5mg/kg, i.p.) or the tricyclic compound imipramine (15 mg/kg, i.p.). We focused our attention on the hypothalamus as it plays a key role in determining many of the somatic symptoms experienced by depressed patients. This brain region, critical also for expression of motivated behaviours, participates in the control of the hypothalamic-pituitary-adrenal axis activity and in stress response as well as coordinates physiological functions such as sleep and food intake that have been found altered in a high percentage of depressed patients. Notably, hypothalamus is a key structure for brain cytokine expression and function as it integrates signals from the neuro, immune, endocrine systems. By means of quantitative Real Time PCR experiments we demonstrated that a chronic treatment with either fluoxetine or imipramine resulted in a reduction of IL-6 and IFN-γ mRNAs and increased IL-4 mRNA expression in the rat hypothalamus. Moreover, we demonstrated that hypothalamic expression of members of IL-18 system was differentially affected by chronic antidepressant treatments. Chronically administered fluoxetine decreased IL-8 and CX3CL1 hypothalamic expression, while a chronic treatment with imipramine decreased p11 mRNA. Our data suggest that a shift in the balance of the inflammation toward an anti-inflammatory state in the hypothalamus may represent a common mechanism of action of both the chronic treatments with fluoxetine and imipramine. © 2013 Published by Elsevier B.V.

  7. Evaluation of the results from partial arthroplasty for treating shoulder osteoarthrosis

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2013-04-01

    Full Text Available OBJECTIVE: In this study we aim at statistically evaluating the results of the surgical treatment of the osteoarthrosis of the shoulder (OAS with partial shoulder arthroplasty (PSA and at correlating them with the several variables involved. METHODS: In this study we evaluated 36 shoulders of 31 patients with OAS who underwent treatment with PSA in the Grupo de Ombro e Cotovelo (Group of Shoulders and Elbows of the Department of Traumatology and Orthopedics of the Faculdade de Ciências Médicas da Santa Casa de São Paulo - Pavillion Fernandinho Simonsen between January, 1989 and November, 2010. Patients who underwent PSA and who had a post-operative follow-up of at least 12 months were included in the study. RESULTS: After the surgery the range of elevation, external rotation, internal rotation and the UCLA scale improved (with average differences of 35º, 27º, 4ºand 17 points, respectively, with a significant level of 5% (p < 0.05. For the same level of significance, the relation between a satisfactory UCLA and two variables was found: patients with maximum age of 60 years old at the moment of the surgery and patients that underwent tenotomy of the long head of biceps. CONCLUSION: Patients under 60 who underwent surgery and patients who underwent tenotomy of the long head of biceps achieved better results.

  8. Placebo-free designs for evaluating new mental health treatments: the use of adaptive treatment strategies.

    Science.gov (United States)

    Dawson, Ree; Lavori, Philip W

    2004-11-15

    The dominant pre-marketing clinical trial in psychopharmacology is a non-equivalence design that randomizes patients to one of three treatments: an accepted standard, the innovation (new drug), or placebo, with the main efficacy comparison being innovation vs placebo. The reasons behind the choice of placebo control in new drug development include anticipated small effect size for active-controlled comparisons and the sufficiency of demonstrated treatment effect (new drug vs placebo) for regulatory approval. These reasons have led to great reliance on placebo control in drug evaluation studies, despite the ethical controversy over the use of placebo when there are known effective standard treatments. While the use of placebo controls has been widely debated, a less considered aspect of the usual placebo-controlled non-equivalence design is the disparity between the decisions that it supports and those that pervade clinical practice. We propose an alternative approach that randomizes one group of patients to an adaptive treatment strategy that exemplifies the adaptive nature of clinical decision-making in the treatment of ongoing mental health disorders. The basic idea is to compare the adaptive strategy, which uses a patient's outcomes to date to determine when to switch from an initial treatment (e.g. an accepted standard) to an alternative (e.g. the new) treatment, to fixed trials of either treatment option. We state the conditions under which the adaptive treatment RCT is attractive to implement and the requirements for doing so. 2004 John Wiley & Sons, Ltd.

  9. Triple endobuttton technique for the treatment of acute complete acromioclavicular joint dislocations: preliminary results.

    Science.gov (United States)

    Wei, Hai-Feng; Chen, Yun-Feng; Zeng, Bing-Fang; Zhang, Chang-Qing; Chai, Yi-Min; Wang, Hai-Ming; Lu, Ye

    2011-04-01

    Numerous procedures have been described for the operative management of acromioclavicular (AC) joint injuries. Some of these techniques, including hardware fixation and non-anatomical reconstructions, are associated with serious complications and high failure rates. Recently, AC joint reconstruction techniques have focused on anatomical restoration of the coracoclavicular ligaments to achieve optimal clinical outcomes. We used a triple endobutton technique to separately reconstruct the trapezoid and the coronoid portions of the coracoclavicular ligament. We evaluated the preliminary clinical and radiological results of this technique in patients with acute complete dislocation of the AC joint. All patients achieved a significant improvement in the pain and function of shoulder at a mean follow-up interval of 12 months (range, 8-14 months). Excellent reduction of the AC joint was maintained. The triple endobutton technique may be safe and effective for the treatment of acute complete AC joint dislocations.

  10. Cystic Dilation of Extrahepatic Bile Ducts in Adulthood: Diagnosis, Surgical Treatment and Long. Term Results

    Directory of Open Access Journals (Sweden)

    G. Belli

    1998-01-01

    Full Text Available To evaluate the long-term results of surgery for choledohal cyst in adulthood, a series of 13 patients over the age of 16 operated on for choledochal cyst during a period of six years and followed-up for a minimum of 3 years was analyzed. Patients with type I and IVa cysts underwent extrahepatic cyst resection and Roux-en-Y hepatico-jejunostomy. Choledochoceles (type III were managed endoscopically. No operative mortality or morbidity occurred. Type I and III cysts showed almost ideal follow-up with no sign of stricture on HIDA scan. One type IVa cyst patients developed recurrent cholangitis due to anastomotic stricture, managed percutaneously. Whenever possible, complete cyst resection and Roux-en-Y reconstruction is the treatment of choice for all extrahepatic biliary cysts. Intra- and extrahepatic dilatations are adequately treated by extrahepatic resection and careful endoscopic or radiologic surveillance. Small choledochoceles can be safely managed by endoscopic sphincterotomy.

  11. Effectiveness of Decongestive Lymphatic Therapy in Patients with Lymphedema Resulting from Breast Cancer Treatment Regardless of Previous Lymphedema Treatment.

    Science.gov (United States)

    Bozkurt, Mehtap; Palmer, Lynn J; Guo, Ying

    2017-03-01

    Decongestive lymphatic therapy (DLT) has gained wide acceptance as an effective treatment for patients with lymphedema resulting from breast cancer treatment. It is unclear whether DLT is effective for patients with lymphedema who have received lymphedema treatment previously. Our purpose was to compare the effectiveness of DLT in patients who had received lymphedema treatment previously with those who had never received treatment. We retrospectively reviewed the medical records of 98 patients who received outpatient lymphedema therapy for upper extremity lymphedema following surgery. Seventy-two eligible patients with a breast cancer diagnosis and complete medical records were divided into two groups: group 1; previously treated (PT) patients (n = 38, 53%) had previously received lymphedema treatment, while group 2 (no PT, n = 34, 47%) had never received lymphedema treatment. The primary outcome was the percent change in volume in the lymphedematous arm, measured by perometer, after DLT treatment. The two groups did not differ significantly in age, comorbidities, body mass index, and median time from surgery to current treatment, surgical procedure, previous radiation treatment, or history of cellulitis/lymphangitis. DLT significantly reduced arm volume in both groups (group 1, p lymphedema, regardless of previous lymphedema therapy. © 2016 Wiley Periodicals, Inc.

  12. CAP—advancing the evaluation of preclinical Alzheimer disease treatments

    Science.gov (United States)

    Reiman, Eric M.; Langbaum, Jessica B.; Tariot, Pierre N.; Lopera, Francisco; Bateman, Randall J.; Morris, John C.; Sperling, Reisa A.; Aisen, Paul S.; Roses, Allen D.; Welsh-Bohmer, Kathleen A.; Carrillo, Maria C.; Weninger, Stacie

    2016-01-01

    If we are to find treatments to postpone, reduce the risk of, or completely prevent the clinical onset of Alzheimer disease (AD), we need faster methods to evaluate promising preclinical AD treatments, new ways to work together in support of common goals, and a determination to expedite the initiation and performance of preclinical AD trials. In this article, we note some of the current challenges, opportunities and emerging strategies in preclinical AD treatment. We describe the Collaboration for Alzheimer’s Prevention (CAP)—a convening, harmonizing and consensus-building initiative to help stakeholders advance AD prevention research with rigour, care and maximal impact—and we demonstrate the impact of CAP on the goals and design of new preclinical AD trials. PMID:26416539

  13. [Detection, evaluation, and treatment of high blood cholesterol in adults].

    Science.gov (United States)

    2001-05-01

    This report is based on the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, which was recently issued by the National Institutes of Health of the United States of America. Also known as the Adult Treatment Panel (ATP) III, this new report updates two earlier such reports on high cholesterol. While continuing to concentrate on treating patients with coronary heart disease, the new report advocates more intensive treatment in order to reduce low-density lipoprotein (LDL) cholesterol in specific groups of individuals, pays special attention to primary prevention among patients with multiple risk factors, and recognizes as a secondary prevention concern a cluster of heart disease risk factors known as "the metabolic syndrome." Other issues that the ATP III report covers include therapeutic lifestyle changes to reduce LDL, LDL-lowering drug therapy, and the management of specific dyslipidemias.

  14. "Results Of Surgical Treatment Of Syndactyly, Imam Hospital - 1994 To 2003 "

    Directory of Open Access Journals (Sweden)

    Mortazavi

    2004-09-01

    Full Text Available Conclusion: Despite the long history of surgical treatment in syndactyly repair, this reconstructive operation has still special complexities. Materials and Methods: In order to evaluation of results of our surgical reconstructions, we studied 77 patients (40 boys and 37 girls with hand syndactyly (mean age at operation: 5.8±4.3 years in Imam Khomeini Hospital from 1994 to 2003. All of these patients had been operated by standard surgical methods. Post-operative complications and functional, sensational, and cosmetic results have been assessed by patient records and physical examination after an average follow-up of 4.6±2.1 years. Results: Syndactylies were simple in 71 patients (92.2%, complex in 2 (2.6%, and mixed in 4 (5.2%. In 45 patients (58.4%, surgical repair had been performed without graft. The overall results of operations were good in 81.8%, moderate in 13%, and poor in 5.2%. The most common complications were: web migration in 9.1%, scar contracture in 7.8%, infection in 5.2%, necrosis in 3.9%, and angular deformity in 2.6%. Conclusion: In this study we shown that the standard methods in our center for correction of syndactyly, at least in recent 10 years, have been efficient and with good results.

  15. Treatment outcome of mineral trioxide aggregate or calcium hydroxide direct pulp capping: long-term results.

    Science.gov (United States)

    Mente, Johannes; Hufnagel, Sarah; Leo, Meltem; Michel, Annemarie; Gehrig, Holger; Panagidis, Dimos; Saure, Daniel; Pfefferle, Thorsten

    2014-11-01

    This controlled, historic cohort study project continues a previously reported trial aiming to assess treatment outcome of direct pulp capping with mineral trioxide aggregate (MTA) versus calcium hydroxide (CH). Potential prognostic factors were re-evaluated on the basis of a larger sample size and longer follow-up periods. Clinical and radiographic outcomes of 229 teeth treated with direct pulp capping between 2001 and 2011 were investigated 24 up to 123 months post-treatment (median = 42 months). Pre-, intra-, and postoperative information was evaluated and statistically analyzed using a logistic regression model as well as generalized estimating equation logit models. Two hundred five patients (229 teeth) were available for follow-up (74% recall rate). The overall success rates were 80.5% (95% confidence interval [CI], 74.5-86.5) of teeth in the MTA group (137/170) and 59% (95% CI, 46.5-71.5) of teeth in the CH group (35/59). Multivariate analyses (generalized estimating equation logit model) indicated a significantly increased risk of failure for teeth that were directly pulp capped with CH compared with MTA (odds ratio = 2.67; 95% CI, 1.36-5.25; P = .001). Teeth that were permanently restored ≥ 2 days after direct pulp capping had a significantly worse prognosis irrespective of the pulp capping material chosen (odds ratio = 3.18; 95% CI, 1.61-6.3; P = .004). The results of this study indicate that MTA provides better long-term results after direct pulp capping compared with CH. Placing a permanent restoration immediately after direct pulp capping is recommended. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  16. The Results of the Treatment of Osteogenesis Imperfecta with Corkscrew Tipped Telescopic Nail

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    Hüseyin Günay

    2017-03-01

    Full Text Available Aim: We aimed to evaluate the clinical and radiological results of an intramedullary fixation system used in surgeries for fractures and deformities of osteogenesis imperfecta where we applied a new design corkscrew tipped intramedullary nailing. Materials and Methods: Twenty extremities of 14 osteogenesis cases, who underwent surgery and to whom corkscrew tipped intramedullary treatment was applied, were retrospectively scanned. Ambulation, discrepancies in the lenght of extremities, deformities and joint mobility range were all noted before the operation. Postoperative union rates, complications and our experience regarding the nail were also evaluated. Results: Six tibia and 14 femurs were operated using corkscrew tipped telescopic nails. Two bones were operated due to non-union, while seven bones underwent surgery due to acute fractures and 11 bones due to deformities. All the bones were seen to have achieved the aimed union. No major complications were observed. Infection was present in two cases. Conclusion: Corkscrew tipped telescopic nail is a safe and effective method of fixation in patients with osteogenesis imperfecta.

  17. Evaluation of Thompson's quadricepsplasty results in patients with knee stiffness resulted from femoral fracture

    Directory of Open Access Journals (Sweden)

    Hamid Mousavi

    2017-01-01

    Full Text Available Background: Posttraumatic and/or postsurgical knee stiffness is one of the orthopedic complications which is difficult to be treated and can affect individual's life negatively. The aim of this study is to investigate the results of quadricepsplasty in patients with knee stiffness resulted from femoral fracture. Materials and Methods: This is a cross-sectional study on all patients with femoral fracture which has caused knee flexion limitation referred to Kashani and Al-Zahra Hospitals in Isfahan from January 2010 to March 2013. The type and site of fracture, joint extension, and fracture fixation technique were recorded. Moreover, the range of motion (ROM before surgery, under general anesthesia, and 3- and 6-month postoperation were measured. Results: Among the patients, 13 had a simple fracture (48% and 14 had a segmental fracture (51.9%. Considering the fracture site, 11, 10, and 6 patients had femoral (40.74%, supracondylar (37.3%, and femoral supracondylar (22.2% fractures, respectively. The fracture fixation was performed by the plate, external, and Wagner fixation techniques for 24 (88.9%, 2 (7.4%, and 1 (3.7% patients, respectively. The mean ROM before operation, under general anesthesia, and 3- and 6-month postoperation were determined to be 33.15° ± 24.73°, 122.60° ± 10.22°, 99.63° ± 16.52°, and 100.74° ± 15.67°, respectively. The mean ROM value at various stages was not similar (P < 0.001. The mean changes in the ROM were 79.2° ± 24.6° and 62.1° ± 19.7° in the cases with simple and segmental fractures, respectively. The mean changes in the knee ROM were significantly higher in simple fractures in comparison with the segmental femoral fracture (P = 0.03. Conclusion: We found Thompson's quadricepsplasty may successfully increase the range of knee flexion in knee fracture and also regardless of quadriceps time.

  18. Is face-only photographic view enough for the aesthetic evaluation of breast cancer conservative treatment?

    DEFF Research Database (Denmark)

    Cardoso, Maria João; Magalhães, André; Almeida, Teresa

    2008-01-01

    The breast cancer conservative treatment. cosmetic results (BCCT.core) is a new software tool created for the automatic and objective evaluation of the aesthetic result of BCCT. It makes use of a face-only photographic view of each patient and might thus have been considered insufficient for an a...

  19. Evaluation of superficial dosimetry between treatment planning system and measurement for several breast cancer treatment techniques

    Energy Technology Data Exchange (ETDEWEB)

    Akino, Yuichi; Das, Indra J.; Bartlett, Gregory K.; Zhang Hualin; Thompson, Elizabeth; Zook, Jennifer E. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana 46202 (United States) and Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871 (Japan); Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana 46202 (United States)

    2013-01-15

    Purpose: Dosimetric accuracy in radiation treatment of breast cancer is critical for the evaluation of cosmetic outcomes and survival. It is often considered that treatment planning systems (TPS) may not be able to provide accurate dosimetry in the buildup region. This was investigated in various treatment techniques such as tangential wedges, field-in-field (FF), electronic compensator (eComp), and intensity-modulated radiotherapy (IMRT). Methods: Under Institutional Review Board (IRB) exemption, radiotherapy treatment plans of 111 cases were retrospectively analyzed. The distance between skin surface and 95% isodose line was measured. For measurements, Gafchromic EBT2 films were used on a humanoid unsliced phantom. Multiple layers of variable thickness of superflab bolus were placed on the breast phantom and CT scanned for planning. Treatment plans were generated using four techniques with two different grid sizes (1 Multiplication-Sign 1 and 2.5 Multiplication-Sign 2.5 mm{sup 2}) to provide optimum dose distribution. Films were placed at different depths and exposed with the selected techniques. A calibration curve for dose versus pixel values was also generated on the same day as the phantom measurement was conducted. The DICOM RT image, dose, and plan data were imported to the in-house software. On axial plane of CT slices, curves were drawn at the position where EBT2 films were placed, and the dose profiles on the lines were acquired. The calculated and measured dose profiles were separated by check points which were marked on the films before irradiation. The segments of calculated profiles were stretched to match their resolutions to that of film dosimetry. Results: On review of treatment plans, the distance between skin and 95% prescribed dose was up to 8 mm for plans of 27 patients. The film measurement revealed that the medial region of phantom surface received a mere 45%-50% of prescribed dose. For wedges, FF, and eComp techniques, region around the

  20. Anemia in the emergency department: evaluation and treatment.

    Science.gov (United States)

    Janz, Timothy G; Johnson, Roy L; Rubenstein, Scott D

    2013-11-01

    Anemia is a common worldwide problem that is associated with nonspecific complaints. The initial focus for the emergency evaluation of anemia is to determine whether the problem is acute or chronic. Acute anemia is most commonly associated with blood loss, and the patient is usually symptomatic. Chronic anemia is usually well tolerated and is often discovered coincidentally. Once diagnosed, the etiology of anemia can often be determined by applying a systematic approach to its evaluation. The severity of the anemia impacts clinical outcomes, particularly in critically ill patients; however, the specific threshold to transfuse is uncertain. Evaluation of the current literature and clinical guidelines does not settle this controversy, but it does help clarify that a restrictive transfusion strategy (ie, for patients with a hemoglobin anemias may have well-defined treatment options (eg, sickle cell disease), but empiric use of nutritional supplements to treat anemia of uncertain etiology is discouraged.

  1. The treatment of childhood acute lymphoblastic leukemia in Guatemala: Biologic features, treatment hurdles, and results.

    Science.gov (United States)

    Antillón, Federico G; Blanco, Jessica G; Valverde, Patricia D; Castellanos, Mauricio; Garrido, Claudia P; Girón, Veronica; Letona, Tomas R; Osorio, Emilia J; Borrayo, Dyna A; Mack, Ricardo A; Melgar, Mario A; Lorenzana, Rodolfo; Ribeiro, Raul C; Metzger, Monika; Conter, Valentino; Rossi, Emanuela; Valsecchi, Maria Grazia

    2017-02-01

    The National Pediatric Oncology Unit (UNOP) is the only pediatric hemato-oncology center in Guatemala. Patients ages 1 to 17 years with acute lymphoblastic leukemia (ALL) were treated according to modified ALL Intercontinental Berlin-Frankfurt-Münster (IC-BFM) 2002 protocol. Risk classification was based on age, white blood cell count, immunophenotype, genetics (when available), and early response to therapy. From July 2007 to June 2014, 787 patients were treated, including 160 who had standard-risk ALL, 450 who had intermediate-risk ALL, and 177 who had high-risk ALL. The induction death rate was 6.6%, and the remission rate was 92.9%. The rates of death and treatment abandonment during first complete remission were 4.8% and 2.5%, respectively. At a median observation time of 3.6 years, and with abandonment considered an event, the 5-year event-free survival and overall survival estimates ( ± standard error) were 56.2% ± 2.1% and 64.1% ± 2.1%, respectively, with a 5-year cumulative incidence of relapse of 28.9% ± 2.0%. Twenty-one of 281 patients (7.5%) investigated were positive for the ets variant 6/runt-related transcription factor 1 (ETV6/RUNX1) fusion. A well organized center in a low-middle-income country can overcome the disadvantages of malnutrition and reduce abandonment. Outcomes remain suboptimal because of late diagnosis, early death, and a high relapse rate, which may have a partly genetic basis. Earlier diagnosis, better management of complications, and better knowledge of ALL will improve outcomes. Cancer 2017;123:436-448. © 2016 American Cancer Society. © 2016 American Cancer Society.

  2. Clinical evaluation of desensitizing treatments for cervical dentin hypersensitivity

    Directory of Open Access Journals (Sweden)

    Ana Cecilia Corrêa Aranha

    2009-09-01

    Full Text Available The aim of this study was to compare different treatments for dentin hypersensitivity in a 6-month follow-up. One hundred and one teeth exhibiting non carious cervical lesions were selected. The assessment method used to quantify sensitivity was the cold air syringe, recorded by the visual analogue scale (VAS, prior to treatment (baseline, immediately after topical treatment, after 1 week, 1, 3 and 6 months. Teeth were randomly assigned to five groups (n = 20: G1: Gluma Desensitizer (GD; G2: Seal&Protect (SP; G3: Oxa-gel (OG; G4: Fluoride (F; G5: Low intensity laser-LILT (660 nm/3.8 J/cm²/15 mW. Analysis was based on the non-parametric Kruskal-Wallis test that demonstrated statistical differences immediately after the treatment (p = 0.0165. To observe the individual effects of each treatment, data was submitted to Friedman test. It was observed that GD and SP showed immediate effect after application. Reduction in the pain level throughout the six-month follow-up was also observed. In contrast, LILT presented a gradual reduction of hypersensitivity. OG and F showed effects as of the first and third month respectively. It can be concluded that, after the 6-month clinical evaluation, all therapies showed lower VAS sensitivity values compared with baseline, independently of their different modes of action.

  3. Results of Shipboard Approval Tests of Ballast Water Treatment Systems in Freshwater

    Science.gov (United States)

    2014-11-01

    effluent collected from treatment tanks 3P and 4P (all dilutions) and the algae exposed to the receiving water control, filtered water from Duluth...Results of Shipboard Approval Tests of Ballast Water Treatment Systems in Freshwater Distribution Statement A: Approved for public release...Title and Subtitle Results of Shipboard Approval Tests of Ballast Water Treatment Systems in Freshwater 5. Report Date November 2014 6

  4. Comparative results of three short brachytherapy schedules as exclusive treatment in postoperative endometrial carcinoma.

    Science.gov (United States)

    Rovirosa, Ángeles; Herreros, Antonio; Camacho, Cristina; Ascaso, Carlos; Sánchez, Joan; Cortés, Stepphania; Sabater, Sebastià; Solà, Jordi; Torné, Aureli; Arenas, Meritxell

    2017-08-08

    To compare vaginal control and treatment toxicity of three different high-dose-rate brachytherapy schedules as exclusive treatment in postoperative endometrial carcinoma. From 2003 to 2015, three different schedules were used as postoperative treatment for 146 patients (p) with intermediate-risk endometrial carcinoma. Group 1 (41 p): six fractions of 4-6 Gy, 3-4 fractions per week; Group 2 (59 p): four fractions of 5-6 Gy administered daily; Group 3 (46 p): 6 Gy × 3 fractions in three consecutive days. The dose was prescribed at 5 mm of applicator surface using an active treatment length of 2.5 cm. Toxicity scores were evaluated using the Radiation Therapy Oncology Group scores for bladder and rectum and the objective criteria of late effects of normal tissues-subjective, objective, management, analytic for vagina. Statistics used were group descriptions calculating their means, medians, and ranges. Bivariate analysis was evaluated using variance models and χ(2) tests. The mean followup was as follows: Group 1: 88 months, Group 2: 75 months, and 41 months in Group 3. No vaginal relapses were found. Late toxicity ≥ G2: rectum: 0 p in the three groups (0%). Bladder: Group 1: 1 p (2.4%), Group 2: 0%, and Group 3: 0%. Vagina: Group 1: 4 p (9.5%); Group 2: 9 p (15.3%); and Group 3:10 p (21.8%). There were no differences in late toxicity among the three groups of patients for rectum (p = 0.83), bladder (p = 0.58), and vagina (p = 0.67); the expected global risk of complications for rectum, bladder, and vagina is 0.8%, 0.8%, and 28.8%, respectively. Similar results in vaginal control and complications were achieved with the three schedules. The use of three fractions of 6 Gy administered daily is the best option for patient comfort and convenience and use of resources. Nonetheless, specific studies are needed to demonstrate the best cost-efficacy regime. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  5. Cephalometric evaluation of the anterior open bite treatment.

    Science.gov (United States)

    Chang, Y I; Moon, S C

    1999-01-01

    The present study was aimed at evaluating the treatment changes of anterior open bite malocclusion cases treated by means of the Multiloop Edgewise Arch Wire technique, which is considered one of the more effective treatment modalities for anterior open bite malocclusions. The open bite sample was composed of 16 young adults, 4 males and 12 females. The normal occlusion sample, as a controlled sample was composed of 58 young adults who had pleasing facial profiles and normal occlusions with no experience of orthodontic or prosthodontic treatment. The normal sample was subdivided by the cephalometric vertical facial relationships. Forty adults with cephalometric vertical facial relationships within the normal range of Korean standards were classified as Normal Occlusion Group 1. Eighteen adults with an increased vertical facial relationship but with normal occlusion, were classified as Normal Occlusion Group 2. Thirty-nine reference points were digitized on each film, and the computerized cephalometric analysis was obtained with 8 skeletal, 10 dentoalveolar, 17 teeth angulations, and 4 occlusal plane measurements. Treatment changes were determined by the paired t test, and the structural differences between the four groups were tabulated by the Student's t test. The treatment changes were observed mainly in the dentoalveolar region in the upper and the lower occlusal planes, accompanied by the uprighting of the posterior teeth to the occlusal plane through the distal tipping movement of the entire dentition. After the treatment, there was a tendency for the structural feature of the open bite group to approximate those of the normal occlusion group 2. This ascertains that the treatment changes of open bite malocclusion produced by means of the multiloop edgewise arch wire technique are similar to those found in the natural dentoalveolar compensatory mechanism.

  6. An evaluation of resurgence during treatment with functional communication training.

    Science.gov (United States)

    Volkert, Valerie M; Lerman, Dorothea C; Call, Nathan A; Trosclair-Lasserre, Nicole

    2009-01-01

    Extinction-induced resurgence is the recurrence of previously reinforced behavior when another behavior is placed on extinction (Lieving, Hagopian, Long, & O'Connor, 2004). This phenomenon may account for some instances of treatment relapse when problem behavior recovers during extinction-based treatments. The current study sought to determine whether resurgence of problem behavior would reliably occur with 5 participants who received treatment with FCT. Results showed that problem behavior reemerged for all but 1 participant when the communicative response was exposed to extinction or thin schedules of reinforcement. These findings suggest that resurgence may account for some instances of response recovery during treatment, and that the described procedure may be useful for the further study of resurgence and eventual prevention of this phenomenon.

  7. 42 CFR 483.372 - Medical treatment for injuries resulting from an emergency safety intervention.

    Science.gov (United States)

    2010-10-01

    ... emergency safety intervention. 483.372 Section 483.372 Public Health CENTERS FOR MEDICARE & MEDICAID... Age 21 § 483.372 Medical treatment for injuries resulting from an emergency safety intervention. (a... as a result of an emergency safety intervention. (b) The psychiatric residential treatment facility...

  8. Sucralfate in the treatment of reflux esophagitis in children. Preliminary results.

    Science.gov (United States)

    Argüelles-Martín, F; González-Fernández, F; Gentles, M G; Navarro-Merino, M

    1989-01-01

    In order to evaluate the use of sucralfate in the treatment of children with reflux esophagitis, we studied 66 children aged from 4 months to 12 years (mean 5.9 years, SD 3.5) diagnosed to have gastroesophageal reflux by means of esophageal isotopic examination and radiology. An endoscopic examination was carried out in all cases. None of the patients suffered from kidney disease or had taken antacids, cimetidine, sucralfate or antirheumatic drugs in the two weeks prior to the study. Patients were divided into three groups matched according to age, grade of esophagitis, sex, nutritional state and semiology and treated with sucralfate in tablets, cimetidine, or sucralfate in suspension; no dietetic or postural measures were used. On days 14, 28, 42 and 56, clinical control was carried out and endoscopy was done on day 28, this being repeated on day 56 if the course was not satisfactory. From the statistical analysis of the results we deduce that there are no differences between the three groups. Therefore sucralfate appears to be a useful drug for the treatment of children with esophagitis due to GER.

  9. Plant-wide (BSM2) evaluation of reject water treatment with a SHARON-Anammox process

    DEFF Research Database (Denmark)

    Volcke, Eveline; Gernaey, Krist; Vrecko, Darko

    2006-01-01

    treatment plant, reject water treatment with a combined SHARON-Anammox process seems a promising option. The simulation results indicate that significant improvements of the effluent quality of the main wastewater treatment plant can be realized. An economic evaluation of the different scenarios......In wastewater treatment plants (WWTPs) equipped with sludge digestion and dewatering systems, the reject water originating from these facilities contributes significantly to the nitrogen load of the activated sludge tanks, to which it is typically recycled. In this paper, the impact of reject water...... streams on the performance of a WWTP is assessed in a simulation study, using the Benchmark Simulation Model no. 2 (BSM2), that includes the processes describing sludge treatment and in this way allows for plant-wide evaluation. Comparison of performance of a WWTP without reject water with a WWTP where...

  10. Intravenous Vitamin C in the treatment of shingles: Results of a multicenter prospective cohort study

    Science.gov (United States)

    Schencking, Martin; Vollbracht, Claudia; Weiss, Gabriele; Lebert, Jennifer; Biller, Andreas; Goyvaerts, Birgit; Kraft, Karin

    2012-01-01

    Summary Background Vitamin C is an immune-relevant micronutrient, which is depleted in viral infections and this deficiency seems to play a critical role in the pathogenesis of herpes infections and in the development of postherpetic neuralgia. The objective of this observational multicenter study was to evaluate the utilization, safety and efficacy of intravenously administrated vitamin C in patients with shingles. Material/Methods Between April 2009 and December 2010 16 general practitioners recorded data of 67 participants with symptomatic herpes zoster who received vitamin C intravenously (Pascorbin® 7.5 g/50 ml) for approximately 2 weeks in addition to standard treatment. The assessment of pain (VAS) and the dermatologic symptoms of shingles such as hemorrhagic lesions and the number of efflorescences were investigated in a follow-up observation phase of up to 12 weeks. Results Mean declines of pain scores (VAS), number of affected dermatomes and efflorescences, and the presence of hemorrhagic vesicles between the baseline and follow-up assessments at 2 and 12 weeks were statistically significant. Overall, 6.4% of the participants experienced post-herpetic neuralgia. Common complaints such as general fatigue and impaired concentration also improved during the study. The effects and the tolerability of the treatment were evaluated positively by the physicians. The risk of developing PHN was reduced. Conclusions The data presented here provide evidence that concomitant use of intravenously administered ascorbic acid may have beneficial effects on herpes zoster-associated pain, dermatologic findings and accompanying common complaints. To confirm our findings, randomized, placebo-controlled clinical studies are necessary. PMID:22460093

  11. [Evaluation of dysphagia. Results after one year of incorporating videofluoroscopy into its study introduction].

    Science.gov (United States)

    García Romero, Ruth; Ros Arnal, Ignacio; Romea Montañés, María José; López Calahorra, José Antonio; Gutiérrez Alonso, Cristina; Izquierdo Hernández, Beatriz; Martín de Vicente, Carlos

    2017-11-09

    Dysphagia is very common in children with neurological disabilities. These patients usually suffer from respiratory and nutritional problems. The videofluoroscopic swallowing study (VFSS) is the most recommended test to evaluate dysphagia, as it shows the real situation during swallowing. To analyse the results obtained in our centre after one year of the implementation of VFSS, the clinical improvement after confirmation, and the prescription of an individualised treatment for the patients affected. VFSS performed in the previous were collected. The following variables were analysed: age, pathology, degree of neurological damage, oral and pharyngeal and/or oesophageal dysphagia and its severity, aspirations, prescribed treatment, and nutritional and respiratory improvement after diagnosis. A statistical analysis was performed using SPSS v21. A total of 61 VFSS were performed. Dysphagia was detected in more than 70%, being moderate-severe in 58%. Aspirations and/or penetrations were recorded in 59%, of which 50% were silent. Adapted diet was prescribed to 56%, and gastrostomy was performed on 13 (21%) patients. A statistical association was found between neurological disease and severity of dysphagia. The degree of motor impairment is related to the presence of aspirations. After VFSS evaluation and treatment adjustment, nutritional improvement was found in Z-score of weight (+0.3SD) and BMI (+0.4SD). There was respiratory improvement in 71% of patients with dysphagia being controlled in the Chest Diseases Department. After implementation of VFSS, a high percentage of patients were diagnosed and benefited from a correct diagnosis and treatment. VFSS is a fundamental diagnostic test that should be included in paediatric centres as a diagnostic method for children with suspected dysphagia. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  12. Long-term results after Boston brace treatment in adolescent idiopathic scoliosis

    Directory of Open Access Journals (Sweden)

    Steen Harald

    2009-08-01

    Full Text Available Abstract Background Few studies have evaluated long-term outcome after bracing using validated health related quality of life outcome measures. The aim of the present study was to evaluate the long-term outcome in adolescent idiopathic scoliosis (AIS 12 years or more after treatment with the Boston brace. Methods 109 (80% of 135 patients (7 men with AIS treated with the Boston brace at a mean of 19.2 (range 12–28 years previously responded to long-term follow-up examination. All patients (n = 109 answered a standardised questionnaire including demographics, work status, treatment, Global Back Disability Question, Oswestry Disability Index (ODI (100-worst possible, General Function Score (GFS (100 – worst possible, EuroQol (EQ-5D (1 – best possible, EQ-VAS (100 – best possible and Scoliosis Research Society -22 (SRS – 22 (5 – best possible. Clinical and radiological examination was obtained in 86 patients. Results The magnitude of the primary prebrace major curve was in average 33.4° (range 20 – 52. At weaning and at the last follow-up the corresponding values were 28.3° (9–56 and 34.2° (8 – 87, respectively. The mean age at follow-up was 35 (27 – 46 years. Work status was: full time (80%, on sick-leave (3%, on rehabilitation (4%, disability pension (4%, homemaker (7%, students (2%, 7% had changed their job because of back pain. 88% had had delivered a baby, 55% of them had pain in pregnancy. Global back status was excellent or good in 81%. The mean (standard deviation ODI was 6.4 (9.8, GFS 5.4 (10.5, EQ-5D 0.84 (0.2, SRS-22: pain 4.2 (0.8, mental health 4.2 (0.7, self-image 3.9 (0.7, function 4.1 (0.6, satisfaction with treatment 3.7 (1.0. 28% had taken physiotherapy for back pain the last year and 12% had visited a doctor. Conclusion Long-term results were satisfactory in most patients with AIS treated with the Boston brace.

  13. Active exercises utilizing a facilitating device in the treatment of lymphedema resulting from breast cancer therapy

    Directory of Open Access Journals (Sweden)

    de Fátima Guerreiro Godoy, Maria

    2010-01-01

    Full Text Available The aim of this study was to evaluate the reduction in volume of arm lymphedema secondary to breast cancer therapy utilizing an exercise facilitating device. Twenty-one women with arm lymphedema resulting from the surgical and radiotherapeutic treatment of breast cancer were randomly selected. Evaluation was made by water-displacement volumetry before and after each session. The patients were submitted to a series of active exercises using a facilitating device for four 12-minute sessions with intervals of 3 minutes between sessions in the sitting position with alignment of the spinal column. The lymphedematous arm was maintained under compression using a cotton-polyester sleeve. The active exercising device used was a mobile flexion bar fixed on a metal base at a height of 30 cm from the tabletop and at a distance of 10 cm from the patient’s body. The paired t-test was utilized for statistical analysis with an alpha error of 5% (p-value ≤0.05 being considered significant. The initial mean volume of the arms was 2,089.9 and the final volume was 2,023.0 mL with a mean loss of 66.9 mL (p-value <0.001. In conclusion, active exercises utilizing facilitating devices can contribute to a reduction in size of lymphedematous limbs.

  14. The effect of a geriatric evaluation on treatment decisions for older patients with colorectal cancer.

    Science.gov (United States)

    Verweij, N M; Souwer, E T D; Schiphorst, A H W; Maas, H A; Portielje, J E A; Pronk, A; van den Bos, F; Hamaker, M E

    2017-11-01

    Treating elderly colorectal cancer patients can be challenging. It is very important to carefully weigh the risks and benefits of potential treatments in individual patients. This treatment decision making can be guided by geriatric consultation. Our aim was to assess the effect of a geriatric evaluation on treatment decisions for older patients with colorectal cancer. Colorectal cancer patients who were referred for a geriatric consultation between 2013 and 2015 in three Dutch teaching hospitals were included in a prospective database. The outcome of geriatric assessment, non-oncological interventions and geriatricians' treatment recommendations were evaluated. The total number of included referrals was 168. The median age was 81 years (range 60-94). Most patients (71%) had colon cancer and 49% had tumour stage III disease. The reason for geriatric consultation was uncertainty regarding the optimal oncologic treatment in 139 patients (83%). Overall 93% of patients suffered from geriatric impairments; non-oncological interventions that followed after geriatric consultation was mostly aimed at malnutrition. The geriatrician recommended the 'more intensive treatment' option in 69% and the 'less intensive treatment' option in 31% of which 63% 'supportive care only'. Geriatric consultation can be useful in treatment decision making in elderly patients with colorectal cancer. It may lead to changes in the treatment plan for individual cases and may result in an additional optimisation of patient's health status prior to treatment.

  15. Treatment decisions and employment of breast cancer patients: Results of a population-based survey.

    Science.gov (United States)

    Jagsi, Reshma; Abrahamse, Paul H; Lee, Kamaria L; Wallner, Lauren P; Janz, Nancy K; Hamilton, Ann S; Ward, Kevin C; Morrow, Monica; Kurian, Allison W; Friese, Christopher R; Hawley, Sarah T; Katz, Steven J

    2017-12-15

    Many patients with breast cancer work for pay at the time of their diagnosis, and the treatment plan may threaten their livelihood. Understanding work experiences in a contemporary population-based sample is necessary to inform initiatives to reduce the burden of cancer care. Women who were 20 to 79 years old and had been diagnosed with stage 0 to II breast cancer, as reported to the Georgia and Los Angeles Surveillance, Epidemiology, and End Results registries in 2014-2015, were surveyed. Of the 3672 eligible women, 2502 responded (68%); 1006 who reported working before their diagnosis were analyzed. Multivariate models evaluated correlates of missing work for >1 month and stopping work altogether versus missing work for ≤1 month. In this diverse sample, most patients (62%) underwent lumpectomy; 16% underwent unilateral mastectomy (8% with reconstruction); and 23% underwent bilateral mastectomy (19% with reconstruction). One-third (33%) received chemotherapy. Most (84%) worked full-time before their diagnosis; however, only 50% had paid sick leave, 39% had disability benefits, and 38% had flexible work schedules. Surgical treatment was strongly correlated with missing >1 month of work (odds ratio [OR] for bilateral mastectomy with reconstruction vs lumpectomy, 7.8) and with stopping work altogether (OR for bilateral mastectomy with reconstruction vs lumpectomy, 3.1). Chemotherapy receipt (OR for missing >1 month, 1.3; OR for stopping work altogether, 3.9) and race (OR for missing >1 month for blacks vs whites, 2.0; OR for stopping work altogether for blacks vs whites, 1.7) also correlated. Those with paid sick leave were less likely to stop working (OR, 0.5), as were those with flexible schedules (OR, 0.3). Working patients who received more aggressive treatments were more likely to experience substantial employment disruptions. Cancer 2017;123:4791-9. © 2017 American Cancer Society. © 2017 American Cancer Society.

  16. Two-staged hybrid treatment of persistent atrial fibrillation: short-term single-centre results.

    Science.gov (United States)

    Kurfirst, Vojtěch; Mokraček, Aleš; Bulava, Alan; Čanadyova, Júlia; Haniš, Jiři; Pešl, Ladislav

    2014-04-01

    The treatment of persistent and long-standing persistent atrial fibrillation (AF) has unsatisfactory results using both medical therapy and/or catheter ablation, where incomplete ablation lines remain a significant problem. This study evaluates the feasibility, efficacy and safety of the sequential, two-staged hybrid treatment combining thoracoscopic surgical and transvenous catheter AF ablation. Thirty patients with persistent and long-standing persistent AF underwent surgical thoracoscopic radiofrequency (RF) ablation procedure using a predefined protocol (pulmonary veins isolation, box lesion, isthmus line lesion, dissection of the ligament of Marshall, left atrial appendage exclusion with an epicardial clip and ganglionated plexi ablation) followed by diagnostic catheterization and RF ablation 3 months later. In this session, electrical mapping of the left atrium was performed and any incomplete isolation lines were completed. Mitral and cavotricuspid isthmus ablation lines were performed during this session as well. The preoperative mean duration time of AF was 33 ± 27 months with 17% patients with persistent and 83% patients with long-standing persistent AF. The mean size of the left atrium was 48 ± 5 mm. The complete surgical ablation protocol was achieved in 97% of patients, with no death, and no early stroke or pacemaker implantation in the early postoperative period. In 63% of patients, the left atrial appendage was excluded with an epicardial clip. An endocardial touch-up for achievement of bidirectional block of pulmonary veins was necessary in 10 patients (33%) and on the box, (roof and floor) lesions in 20 patients (67%). Freedom from atrial fibrillation was 77% after surgical ablation and 93% after the completed hybrid procedure. The sequential, two-staged hybrid strategy (surgical thoracoscopic followed by catheter ablation) is feasible and safe with a high post-procedural success and seems to represent the optimal treatment with low risk load and

  17. Urogenital involvement in the Klippel-Trenaunay-Weber syndrome: treatment options and results

    Directory of Open Access Journals (Sweden)

    Fabio C. Vicentini

    2006-12-01

    Full Text Available OBJECTIVE: Klippel-Trenaunay-Weber syndrome (KTWS is a congenital condition characterized by vascular malformations of the capillary, venous and lymphatic systems associated to soft tissue and bone hypertrophy in the affected areas. This syndrome may involve bladder, kidney, urethra, ureter and genitals. We report the treatment of 7 KTWS patients with urogenital involvement. MATERIALS AND METHODS: From 1995 to 2005, 7 patients with KTWS were evaluated and the charts of these patients were reviewed. RESULTS: Patients’ median age was 19-years (range 4 to 46-years and only 1 was female. The clinical presentation included genital deformities in 3 cases, hematuria in 2 and urethrorragia in 2, one of which associated with cryptorchidism and phimosis. Three patients had an association of pelvic and genital malformations, including 2 patients with hematuria due to vesical lesions and 1 patient with left ureterohydronephrosis due to a pelvic mass. Two patients had urethral lesions. Treatment included endoscopic laser coagulation for 1 patient with recurrent hematuria and 1 patient with urethrorrhagia, pelvic radiotherapy for 1 patient with hematuria and circumcision in 2 patients with genital deformities. One patient required placement of a double-J catheter to relieve obstruction. Hematuria and urethrorragia were safely and effectively controlled with laser applications. Circumcision was also effective. The patient treated with radiotherapy developed a contracted bladder and required a continent urinary diversion. CONCLUSIONS: Urogenital involvement in patients with KTWS is not rare and must be suspected in the presence of hematuria or significant cutaneous deformity of the external genitalia. Surgical treatment may be warranted in selected cases.

  18. Surgical Treatment of Severe Traumatic Brain Injury in Switzerland: Results from a Multicenter Study.

    Science.gov (United States)

    Rossi-Mossuti, Frédéric; Fisch, Urs; Schoettker, Patrick; Gugliotta, Marinella; Morard, Marc; Schucht, Philippe; Schatlo, Bawarjan; Levivier, Marc; Walder, Bernhard; Fandino, Javier

    2016-01-01

    Since the introduction of modern surgical techniques and monitoring tools for the treatment of severe traumatic brain injury (TBI) in Switzerland, standardized nationwide operative procedures are still lacking. This study aimed to assess surgical management and monitoring strategies in patients admitted throughout Switzerland with severe TBI. Demographic, clinical, and radiologic data from a prospective national cohort study on severe brain-injured patients (Patient-relevant Endpoints after Brain Injury from Traumatic Accidents [PEBITA]) were collected during a 3-year period. This study evaluated patients admitted to 7 of the 11 trauma centers included in PEBITA. We retrospectively analyzed surgery-related computed tomography (CT) findings prior to and after treatment, intracranial pressure (ICP) monitoring, size and technical features of craniotomy, as well as surgical complications. ResULTS: This study included 353 of the 921 patients enrolled in PEBITA who underwent surgical treatment for severe TBI. At admission, acute subdural hematoma was the most frequent focal lesion diagnosed (n = 154 [44%]), followed by epidural hematoma (n = 96 [27%]) and intracerebral hematoma (n = 84 [24%]). A total of 198 patients (61%) presented with midline shift. Clinical deterioration in terms of Glasgow Coma Scale scores or intractable ICP values as an indication for surgical evacuation or decompression were documented in 20% and 6%, respectively. A total of 97 (27.5%) only received a catheter/probe for ICP monitoring. Surgical procedures to treat a focal lesion or decompress the cerebrum were performed in 256 patients (72.5%). Of the 290 surgical procedures (excluding ICP probe implantation), craniotomy (137 [47.2%]) or decompressive craniectomy (133 [45.9%]) were performed most frequently. The mean size of craniectomy in terms of maximal linear width on the CT axial slice was 8.4 ± 2.9 cm. Intraoperative ICP monitoring was reported in 61% of the interventions. Significant

  19. Results of surgical treatment of cervical cancer patients of childbearing age

    Directory of Open Access Journals (Sweden)

    V. S. Navruzova

    2015-01-01

    Full Text Available The world marked increase in the incidence of cervical cancer in young women, especially from 29 to 45 years old. Analysis showed that in patients with preserved ovarian function, not only the effectiveness of the treatment, but also the quality of life. It is associated with the acceleration, earlier puberty and the onset of sexual activity. In recent years more and more widely used radical surgery with preservation of the ovaries and the abduction of the radiation castration and preservation of reproductive function. In the National Cancer Research Centre of the Ministry of Health of the Republic of Uzbekistan analyzed the results of surgical treatment of 204 patients with cervical cancer younger. Age of patients from 23 to 45 years, that is, in the most hard-working, reproductive period. In our study patients met principally with exophytic – 82 (40.2 % and 68 (33.3 % еndophytic growth cervical tumors. Histological in 197 (96.6 % patients with squamous cervical cancer patients with 7 (3.4%. Adenocarcinoma of cervical cancer. Handard examination of the patient are further adapted to determine the level of sex hormones (estradiol, progesterone, determination of the tumor marter CA-125 levels of calcium and phosphate in the blood. 112 patients from the main group and the combined complex therapy surgical treatment with organ-component (conservation and ovarian transposition. The first group included 112 (55.1 % patients, who as part of combination therapy was performed and complex surgical treatment of ovarian transposition. The second group included 92 (44.9% patients who as part of combination therapy and complex surgery performed without ovarian transposition. Each group was divided into 3 subgroup included patients with stage process T1b–2aN0M0. Which performs the combined radiotherapy. The second subgroups included patients with stage process that runs systemic chemotherapy, surgery, combined radiotherapy. The third group included

  20. [Economic evaluation of antiviral treatment for chronic hepatitis B: a systematic review].

    Science.gov (United States)

    Solari, Lely; Hijar, Gisely; Zavala, Renzo; Ureta, Juan Manuel

    2010-03-01

    To revise the available evidence on the cost-effectiveness of antiviral regimens for treatment of chronic hepatitis B. We performed a systematic revision on MEDLINE, LILACS NICE and COCHRANE databases, searching for economic evaluations of antiviral regimens for treatment of chronic hepatitis B. We included original studies, systematic revisions and management guidelines including information on the cost-effectiveness of this treatment. We registered the characteristics and results of the retrieved documents. We obtained 29 original papers, 4 revision articles and 4 management guidelines. Most of these publications have been done in the last 5 years. There was conflict of interest in 73% of original articles, due to authors working for the pharmaceutical industry. 93% of articles that evaluate the cost-effectiveness of giving treatment for chronic hepatitis B against management of its complications find that it is indeed cost-effective to give antiviral treatment. 3/6 studies that evaluate lamivudine against other drugs find it as a dominant strategy, 3/5 find entecavir as the dominant strategy, 1/1 find tenofovir dominant, ¼ find conventional interferon as dominant and none of them find adefovir or pegylated interferon as dominant strategies. We consider that the available evidence suggests that to give antiviral treatment for chronic hepatitis B is a cost-effective intervention for many health systems, including ours. It has varying indexes of cost-effectiveness according to the evaluated regimens. Ideally , we should perform local economic evaluations in this issue.

  1. In Vivo Evaluation of Galla chinensis Solution in the Topical Treatment of Dermatophytosis

    Directory of Open Access Journals (Sweden)

    Kai Sun

    2017-01-01

    Full Text Available Aim. Dermatophytosis is one of the main fungal diseases in humans and animals all over the world. Galla chinensis, a traditional medicine, has various pharmacological effects. The goal of this study was to evaluate the treatment effect of Galla chinensis solution (GCS on dermatophytosis-infected dogs (Microsporum canis, Microsporum gypseum, and Trichophyton mentagrophytes, resp.. Methods. The treatment effects of GCS were evaluated by mycological cure rates and clinical score comprised of three indices, including inflammation, hair loss, and lesion scale. Results. The results showed that, in the three models of dermatophytosis, GCS significantly (P<0.05 improved skin lesions and fungal eradication. GCS (10% and 5% had higher efficacy compared to the positive control (Tujingpi Tincture. The fungal eradication efficacy exceeds 85% after treatment with GCS (10%, 5%, and 2.5% on day 14. Conclusion. The GCS has antidermatophytosis effect in dogs, which may be a candidate drug for the treatment of dermatophytosis.

  2. [Analysis of result and influence factors of operative treatment of acetabular fractures].

    Science.gov (United States)

    Zhi, Chunsheng; Li, Zhongqiang; Yang, Xiaosong; Fan, Shufeng

    2011-01-01

    To evaluate the results of operative treatment of acetabular fractures and to investigate its influence factors. The clinical data were analyzed retrospectively from 82 patients with acetabular fractures treated between September 2004 and June 2009. Of 82 patients, 65 were male and 17 were female, aged 26-72 years (mean, 38 years). Fractures were caused by traffic accident in 62 cases, by crush in 13 cases, and by falling from height in 7 cases. The time from injury to admission was 30 minutes to 12 days (median, 7.6 hours) in 70 cases, 12 cases were transferred because poor result after 34-67 days of conservative treatment. According to Judet classification, there were 24 cases of posterior wall fracture, 3 cases of posterior column fracture, 1 case of anterior wall fracture, 2 cases of anterior column fracture, 6 cases of transverse fracture, 16 cases of transverse and posterior wall fracture, 4 cases of posterior column and posterior wall fracture, 5 cases of T-type fracture, 3 cases of anterior and posterior hemitransverse fracture, and 18 cases of complete both-column fracture; 24 cases combined with dislocation of the hip. During operation, Kocher-Langenbeck approach was used in 49 cases, anterior ilioinguinal approach in 19 cases, and the combination of anterior and posterior approaches in 14 cases. Reconstructive plate (74 cases) and hollow lag screw (8 cases) internal fixation were used. The function of the hip was evaluated according to the modified Merled'Aubigne-Postel hip score system postoperatively. According to fracture type, age, lower extremity fracture before operation, quality of reduction, timing of surgery, hip dislocation and time of reduction, operative approach, deep vein thrombosis (DVT), and heterotopic ossification (HO), the patients were divided into the groups and the results were compared. Accordance with the Matta X-ray evaluation criteria, anatomic reduction was achieved in 21 cases, good reduction in 37 cases, fair reduction in 16

  3. Sacral nerve stimulation for the treatment of severe faecal incontinence: results after 10 years experience.

    Science.gov (United States)

    Ruiz Carmona, M Dolores; Martín Arévalo, José; Moro Valdezate, David; Plá Martí, Vicente; Checa Ayet, Félix

    2014-05-01

    The objective of this study is to report our experience with sacral nerve stimulation for the treatment of severe faecal incontinence after the first 10 years with this technique. Between 2001 and 2011, 49 patients with severe faecal incontinence underwent sacral nerve stimulation. Anorectal manometry, endoanal ultrasound and pudendal nerve latency were performed. Bowel habit diary, severity of faecal incontinence and quality of life scales were evaluated preoperatively and at the end of follow-up. Morbidity occurred in a third of patients, mostly minor. Four definitive devices were explanted. With a median follow-up of 37 months, severity of faecal incontinence, urge and incontinence episodes significantly improved at the end of follow-up. Patients' subgroup with major follow-up of 5 years significantly improved the severity of faecal incontinence but not the parameters of the bowel habit diary. Quality of life showed no significant improvement. Descriptive data in patients with sphincter defects did not show worse results than with sphincter integrity. Sacral nerve stimulation is a safe technique for severe faecal incontinence with good functional medium-term results. In the long term, severity of the faecal incontinence also improves but studies with larger sample are necessary to show if other clinical parameters and the quality of life support this information. Preliminary results in patients with sphincter defects suggest that this technique could be effective in this group but future studies will have to confirm these findings. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  4. An evaluation of treatment modalities in cervical intra-epithelial ...

    African Journals Online (AJOL)

    The scheme of management of cervical 'intraepithelial neoplasia presently utilized in the colposcopy service at Groote Schuur Hospital, Cape Town, is outlined, and the results of the treatment of 721 patients with the various modalities currently available are analysed. It is concluded that a radical approach (total ...

  5. [Evaluation and treatment of the critically ill cirrhotic patient].

    Science.gov (United States)

    Fernández, Javier; Aracil, Carles; Solà, Elsa; Soriano, Germán; Cinta Cardona, Maria; Coll, Susanna; Genescà, Joan; Hombrados, Manoli; Morillas, Rosa; Martín-Llahí, Marta; Pardo, Albert; Sánchez, Jordi; Vargas, Victor; Xiol, Xavier; Ginès, Pere

    2016-11-01

    Cirrhotic patients often develop severe complications requiring ICU admission. Grade III-IV hepatic encephalopathy, septic shock, acute-on-chronic liver failure and variceal bleeding are clinical decompensations that need a specific therapeutic approach in cirrhosis. The increased effectiveness of the treatments currently used in this setting and the spread of liver transplantation programs have substantially improved the prognosis of critically ill cirrhotic patients, which has facilitated their admission to critical care units. However, gastroenterologists and intensivists have limited knowledge of the pathogenesis, diagnosis and treatment of these complications and of the prognostic evaluation of critically ill cirrhotic patients. Cirrhotic patients present alterations in systemic and splanchnic hemodynamics, coagulation and immune dysfunction what further increase the complexity of the treatment, the risk of developing new complications and mortality in comparison with the general population. These differential characteristics have important diagnostic and therapeutic implications that must be known by general intensivists. In this context, the Catalan Society of Gastroenterology and Hepatology requested a group of experts to draft a position paper on the assessment and treatment of critically ill cirrhotic patients. This article describes the recommendations agreed upon at the consensus meetings and their main conclusions. Copyright © 2015 Elsevier España, S.L.U. y AEEH y AEG. All rights reserved.

  6. Evaluation of cell death after treatment with extracorporeal photopheresis.

    Science.gov (United States)

    Daniele, Nicola; Del Proposto, Gianpaolo; Cerrone, Paola; Sinopoli, Silvia; Sansone, Lucia; Gadaleta, Deborah Ilaria; Lanti, Alessandro; Ferraro, Angelo Salvatore; Spurio, Stefano; Scerpa, Maria Cristina; Zinno, Francesco; Adorno, Gaspare; Isacchi, Giancarlo

    2012-02-01

    The aim of our study is to assess the mortality of leukocytes during extracorporeal photopheresis. Sixty-three photopheresis performed on 13 patients affected by chronic GvHD were evaluated. Samples were analyzed using a FACSCalibur flow cytometer. Apoptosis and necrosis of limphomononuclear cells dramatically increased after the apheretic procedure. We found a further increase of apoptotic and necrotic limphomononuclear cells after treatment with 8-MOP and UVA (p≤0.05). Our data suggested that the immunomodulatory effects of extracorporeal photopheresis, triggered by circulating apoptotic or necrotic cells, could play an important role in the treatment of GvHD with this procedure. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. Evaluation and treatment of fever in intensive care unit patients.

    Science.gov (United States)

    Ferguson, Anne

    2007-01-01

    Fever is a common complaint in hospitalized patients, with estimates that more than 30% of ward patients and as much as 90% of critically ill patients will experience fever. Much of the treatment of fever, however, is based on tradition and the belief the fever is harmful to the patient rather than on scientific evidence. There is a need to determine via analysis of the literature the best evidence-based approach to the identification and treatment of fever with attention to appropriate measurement of body temperature, diagnostic evaluation, changing of indwelling catheters, administration of antipyretics, and alteration in antimicrobial therapy. The advanced practice nurse is uniquely capable of gathering this evidence and implementing a plan of care that meets the individual needs of the patient, family, nursing staff, and healthcare system.

  8. Evaluation of Chlorine Treatment Levels for Inactivation of Human Norovirus and MS2 Bacteriophage during Sewage Treatment.

    Science.gov (United States)

    Kingsley, David H; Fay, Johnna P; Calci, Kevin; Pouillot, Régis; Woods, Jacquelina; Chen, Haiqiang; Niemira, Brendan A; Van Doren, Jane M

    2017-12-01

    This study examined the inactivation of human norovirus (HuNoV) GI.1 and GII.4 by chlorine under conditions mimicking sewage treatment. Using a porcine gastric mucin-magnetic bead (PGM-MB) assay, no statistically significant loss in HuNoV binding (inactivation) was observed for secondary effluent treatments of ≤25 ppm total chlorine; for both strains, 50 and 100 ppm treatments resulted in ≤0.8-log 10 unit and ≥3.9-log 10 unit reductions, respectively. Treatments of 10, 25, 50, and 100 ppm chlorine inactivated 0.31, 1.35, >5, and >5 log 10 units, respectively, of the norovirus indicator MS2 bacteriophage. Evaluation of treatment time indicated that the vast majority of MS2 and HuNoV inactivation occurred in the first 5 min for 0.2-μm-filtered, prechlorinated secondary effluent. Free chlorine measurements of secondary effluent seeded with MS2 and HuNoV demonstrated substantial oxidative burdens. With 25, 50, and 100 ppm treatments, free chlorine levels after 5 min of exposure ranged from 0.21 to 0.58 ppm, from 0.28 to 16.7 ppm, and from 11.6 to 53 ppm, respectively. At chlorine treatment levels of >50 ppm, statistically significant differences were observed between reductions for PGM-MB-bound HuNoV (potentially infectious) particles and those for unbound (noninfectious) HuNoV particles or total norovirus particles. While results suggested that MS2 and HuNoV (measured as PGM-MB binding) behave similarly, although not identically, both have limited susceptibility to chlorine treatments of ≤25 ppm total chlorine. Since sewage treatment is performed at ≤25 ppm total chlorine, targeting free chlorine levels of 0.5 to 1.0 ppm, these results suggest that traditional chlorine-based sewage treatment does not inactivate HuNoV efficiently. IMPORTANCE HuNoV is ubiquitous in sewage. A receptor binding assay was used to assess inactivation of HuNoV by chlorine-based sewage treatment, given that the virus cannot be routinely propagated in vitro Results reported here

  9. Hypertension in African Americans: evaluation and treatment issues.

    Science.gov (United States)

    Kailani, S H; Wright, J T

    1991-01-01

    The evaluation and treatment of hypertension in the African-American patient with an elevated blood pressure presents a diagnostic challenge. We are less able to rely on young age and resistance to treatment as indications for more extensive evaluation of secondary causes of hypertension; thus, greater reliance on history, physical examination, and clinical judgment is required if we are to identify potentially treatable causes. The treatment of hypertension in the African-American patient also presents a therapeutic challenge. Thiazide diuretics remain the drugs of first choice for treating hypertension in the African-American hypertensive. The calcium channel blockers (CCBs) are attractive alternatives to thiazides in patients uncontrolled by or intolerant of thiazides or who have specific indications for these agents (eg, angina, severe diastolic dysfunction). Beta-blockers should not be denied to African-American hypertensives if indications for their use exist. Although beta-blockers may be less effective as monotherapy, 50% of African-American hypertensives can be so controlled. Resistance to beta-blockers may be eliminated by administering them with a diuretic. The angiotensin converting enzyme inhibitors (ACEIs), like CCBs, are well tolerated, but also lack long-term primary prevention data. As is the case with beta-blockers, ACEIs are less effective in African-American hypertensives when used as monotherapy. ACEIs have particular value in therapy for African-American hypertensives with concomitant congestive heart failure and may protect against progression of diabetic nephropathy. Finally, all hypertensives, especially African-American hypertensives, should have access to treatment prior to the development of end organ damage. The cost of early intervention is minimal compared with the economic consequences of neglect.

  10. Evaluation of Five Different Regimes For the Treatment of Vitiligo

    Directory of Open Access Journals (Sweden)

    J S Pasricha

    1989-01-01

    Full Text Available Response of vitiligo patients to five different regimes was evaluated taking only those patients who had either static or progressively increasing lesions. Selection of the regimen depended upon the clinical characteristics of the disease. Each regime was tried for at least 4 months and if a patient didnot improve with one regime, he was shifted to another regime. A patient was considered to have improved, if the lesions started regimenting or the previously progressive lesions stopped increasing further. Regime I consisted of 150 mg levamisol orally on two consecutive days per week, given to 13 cases, it resulted in improvement in 7 (53.80/o. Regime II consisted of levamisole in the same dose combined with once a day topical massage with 0.1% fluocinolone acetonide acetate cream; it led to improvement in 27 (81.8% of the 33 cases. Regime III consisted of 3 mg betamethasone orally on alternate days combined with levamisole and topical fluocinolone; given to 32 cases, it was successful in 28 (87.50/o. A combination of 2 mg betamethasone orally alternating with 20 mg 8-methoxypsoralen and sun exposure (regime IV caused improvement in 17 (85% of the 20 cases. An oral mini pulse consisting of 5 mg betamethasone orally twice a week combined with 50 mg cyclophosphimide daily orally (regime V was successful in 20 (90.9% of the 22 cases, the remaining two cases showed unprovement when the dose ofbetamethasonc .was increased from 5 mg to 7.5 mg twice a week. Thus ultimately each one of the 91 patients responded to one or the other regime. The side effects were minimal and insignificant.The degree of improvement at the time of analysis was 100% in 23.3% cases, 50-100% in 44.2′Yo cases and less than 50% in 32.5%, after 4-14 months of treatment. It is felt that the results may be better after a longer follow-up although all patients are not expected to get complete repigmentation.

  11. Evaluating Teachers More Strategically: Using Performance Results to Streamline Evaluation Systems. Issue Brief

    Science.gov (United States)

    White, Taylor

    2014-01-01

    Teacher evaluation systems introduced by states and school systems in the past several years have focused attention on improving the performance of public school teachers, but they have been cost- and time-intensive, placing a significant burden on states' and districts' resources. In Tennessee, for example, trained evaluators conducted nearly…

  12. Evaluation and treatment of unconsummated marriages among Orthodox Jewish couples.

    Science.gov (United States)

    Ribner, David S; Rosenbaum, Talli Y

    2005-01-01

    Orthodox Judaism expects new brides and grooms to engage in sexual intercourse on the first night of marriage or soon thereafter, despite stringent norms forbidding premarital physical contact. Any delay for more than several weeks in consummating a marriage is seen as problematic and worthy of rabbinic or professional attention. This article examines traditional Jewish sources for this emphasis on marital sexuality, defines the problem of unconsummated marriages, discusses issues pertinent to evaluation, and suggests appropriate treatment strategies. Our focus includes both the Orthodox and Ultra-Orthodox (Haredi) elements of the Jewish community.

  13. Antenatal Hydronephrosis: Differential Diagnosis, Evaluation, and Treatment Options

    Directory of Open Access Journals (Sweden)

    C.D. Anthony Herndon

    2006-01-01

    Full Text Available The diagnosis, evaluation and management of antenatal hydronephrosis has undergone a two stage paradigm shift since the advent of prenatal ultrasonography in the early 1980s. Initially the identification of a large number of asymptomatic infants appeared to afford the surgeon the opportunity for preemptive intervention. However, it has now become apparent that antenatal hydronephrosis (AH is far more difficult to interpret thanoriginally perceived. The initial enthusiasm for surgery has now been replaced by a much more conservative approach to ureteropelvic junction(UPJ obstruction, multi-cystic dysplastic kidney(MCDK, vesicoureteral reflux and the non-refluxing megaureter. This review will highlight the postnatal evaluation of AH and include an overview of the Society for Fetal Urology grading system for hydronephrosis. The differential diagnosis and treatment options for UPJ obstruction, vesicoureteral reflux, MCDK, duplication anomalies, megaureter, and posterior urethral valves will be discussed.

  14. Evaluation of intrauterine adhesion treatment by laser hysteroscopy

    Science.gov (United States)

    Mutrynowski, Andrzej; Zabielska, Renata

    1996-03-01

    Hysteroscopy, which is a kind of endoscopy, makes it possible to evaluate macroscopically the cervical canal, uterine cavity, and the uterine opening of the oviducts. Laser hysteroscopy is used for removing septa and intrauterine adhesions, polyps, small submucosus myomas, and for endometrium ablation in abnormal metrorrhagias. The paper aims at the initial evaluation of laser hysteroscopy in removing intrauterine adhesions in the cases of 41 infertile women. Among all infertile patients 16 women (39%) conceived. Among others 1 woman (2.5%) did not want to conceive and 19 had other causes of infertility. Thirteen (93%) out of 14 patients with hypomenorrhea before surgery reported improvement of the menstruation cycle after the treatment. Five patients (12%) had adhesions for the second time. The patients had the second laser hysteroscopy. The control diagnostic hysteroscopy showed no adhesions in those cases.

  15. Analysis of the results of treatment of patients with destructive forms of acute pancreatitis

    Directory of Open Access Journals (Sweden)

    N. V. Chubchenko

    2013-08-01

    Full Text Available In Ukraine the incidence of acute pancreatitis is 102 per 100 000 population. In recent years researches in the field of the methods of diagnostics of disease severity showed that one of the most promising is determination of the concentration of procalcitonin in blood. The experience of application hemodiafiltration was described In the literature. The purpose of the research: to analyze the results of treatment of patients with destructive forms of acute pancreatitis with the use of modern methods of diagnostics and treatment. Materials and methods. The study included 15 patients with destructive forms of acute pancreatitis. The severity of the patient's condition was evaluated by the scale APACHE II, the degree of multiple organ failure (MOF by the scale SOFA, the degree of endogenous intoxication by assess of the leukocyte index of intoxication (LII and concentration of procalcitonin. Results. Only 11 patients recovered, five had purulent-septic complications, which in one case led to a lethal outcome. Three patients admitted in the extremely pore condition of the disease with lethal outcome in connection with the development of shock and multiple organ failure. The highest values of procalcitonin corresponded to the maximum values of APACHE II and SOFA. Three patients received prolonged venous-venous hemodiafiltration and in two of them positive dynamics was got: decreased number of points by APACHE II ≤6,SOFA≤3, decreased LII ≤7 and concentration of procalcitonin, one became death. Conclusions. For the assessment of severity of disease it is necessary to determine the concentration of procalcitonin. In the complex intensive therapy the prolonged venous-venous hemodiafiltration use is justified.

  16. Evaluation of Five Treatment Plants for the Removal of Microcystins in Drinking Water

    Directory of Open Access Journals (Sweden)

    Manuel Álvarez Cortiñas

    2017-06-01

    Full Text Available In Galicia there are supplies that collect water from reservoirs showing growth of cyanobacteria that could produce toxins. The drinking water treatment plants (DWTPs of these supplies should provide adequate treatment and be subjected to maintenance. WHO guidelines make recommendations on the most suitable treatments for removing microcystins. The Department of Health developed a protocol of action against these events jointly with water basin authorities. 4 reservoirs and five treatment plants were identified for this study. The treatments of the plants, the maintenance carried out at the DWTPs and the results for sestonic and dissolved toxins analyzed by the Public Health Laboratory of Galicia in the reservoirs near the point of collection, before the treatment plants and after them, during the 2013-2014 biennium were evaluated.

  17. Avaliação dos resultados do tratamento cirúrgico da escoliose na atrofia muscular espinhal tipo 2 Evaluación de los resultados del tratamiento quirúrgico de la escoliosis en la atrofia muscular espinal tipo 2 Results evaluation of surgical treatment of scoliosis in spinal muscular atrophy type 2

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Munhoz da Rocha

    2011-01-01

    evaluaron el grado y el porcentaje de corrección de la deformidad y la oblicuidad pélvica después de la operación y la pérdida, además de las complicaciones y el impacto del tratamiento sobre la función respiratoria. RESULTADOS: El promedio de seguimiento fue 77,5 meses (6,4 años ± 58,9 meses (4,9 años, el ángulo de Cobb antes de la cirugía en promedio 76,1° ± 31,7° (35° a 144° y el postoperatorio fue 29,5° ± 23,2° (5° a 90°, con un promedio de corrección de 46,6° (61,29%. La oblicuidad pélvica promedio en el preoperatorio fue 15,1 ° ± 13,3° (variación de 0 ° a 37 ° y después de la operación 8,5° ± 9,9° (variación de 0° a 30°, con una corrección promedio de 6,5 ° (43,37%. Cinco pacientes presentaron complicaciones (41,6%. La Capacidad Ventilatoria Forzada (CVF preoperatoria promedio fue 62,9% ± 38,6% (variación de 23,3% a 89%, y 45,9% ± 25,0% (variación de 15% a 86,2% en la última evaluación. La disminución fue de 17% de la capacidad vital, con una reducción de 2,4% por año de seguimiento. CONCLUSIONES: El tratamiento quirúrgico de la escoliosis, en pacientes con AME, permite la corrección de la oblicuidad pélvica y restaurar el equilibrio sagital y coronal, liberando las manos para las actividades de la vida diaria. La función pulmonar se vio afectada positivamente por el tratamiento.OBJECTIVE: To evaluate the outcome of surgical treatment of scoliosis in patients with spinal muscular atrophy (SMA type 2. METHODS: A retrospective study with 12 patients with SMA type 2 who underwent arthrodesis and instrumentation for scoliosis correction with more than two years of follow-up. The degree and rate of correction of deformity and pelvic obliquity postoperatively and loss in the last evaluation were evaluated, in addition to the complications and the impact of treatment on respiratory function. RESULTS: Mean follow-up was 77.5 months (6.4 years ± 58.9 months (4.9 years, Cobb angle before surgery averaged 76.1° ± 31.7

  18. [Periprosthetic Femoral Fractures after Total Hip Replacement: Our Results and Treatment Complications].

    Science.gov (United States)

    Pavelka, T; Salášek, M; Weisová, D

    2017-01-01

    PURPOSE OF THE STUDY The study consists of a retroactive evaluation of results of surgical treatment in patients with periprosthetic femoral fracture after total hip replacement and a comparison with results reported in the literature. MATERIAL AND METHODS In the period from 2003 to 2013, a total of 83 patients with periprosthetic femoral fracture after total hip replacement were treated at our clinic, namely 69 women and 14 men. The mean age in the cohort was 74 years (range 47-87). The Vancouver classification was used to grade the fractures. The cohort included 31 patients with type B1 fracture, 25 patients with type B2 fracture, 8 patients with type B3 fracture, and 19 patients with type C fracture. Altogether 80 patients underwent a surgery, 3 patients with non-displaced type B1 fracture were treated conservatively. The mechanism of injury was a simple fall in 75 % of primary endoprostheses and in 56% of revision endoprostheses. The average time to fracture was 7.6 years in primary implant and 3.6 years in revision endoprosthesis. In fractures with a well-fixed stem (type B1 and C) plate osteosynthesis was used. In case of a comminution zone, osteosynthesis was followed by spongioplasty. In patients with a loose stem (type B2 and B3), the fracture was treated with a revision uncemented stem. In two cases a combination of a revision stem and a massive corticocancellous bone graft was used. The evaluation was performed using the Harris Hip Score and the minimum follow-up from the surgery was 3 years. RESULTS In the group of patients with type B1 fracture, 28 patients were treated surgically. An excellent result was achieved in 22 patients (84%), in 4 patients (16%) the result was very good. The remaining 2 patients failed to meet the requirement of the minimum follow-up of 3 years. In the group of patients with type B2 fractures, composed of 25 patients, the femoral component was replaced with a revision uncemented stem with cerclage wires or titanium tapes or

  19. Treatment of intracranial aneurysms by flow diverter devices: Long-term results from a single center

    Energy Technology Data Exchange (ETDEWEB)

    Briganti, Francesco, E-mail: frabriga@unina.it [Unit of Interventional Neuroradiology, Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Napoli, Manuela, E-mail: napoli.manuela@gmail.com [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Leone, Giuseppe, E-mail: g.leonemd@gmail.com [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Marseglia, Mariano, E-mail: mariano-marseglia@libero.it [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Mariniello, Giuseppe, E-mail: giuseppe.mariniello@unina.it [Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Caranci, Ferdinando, E-mail: ferdinando.caranci@unina.it [Department of Advanced Biomedical Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy); Tortora, Fabio, E-mail: fabiotor@libero.it [Chair of Neuroradiology, “Magrassi Lanzara” Clinical-Surgical Department, Second University of Naples, Viale Colli Aminei 21, 80131 Naples (Italy); Maiuri, Francesco, E-mail: frmaiuri@unina.it [Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, “Federico II” University, Via S.Pansini 5., 80131 Naples (Italy)

    2014-09-15

    Highlights: • We report the long-term results (2–4 years) with Flow Diverter Devices (FDD) from a single-center. • We recommend the use of FDD for large-neck aneurysms of the ICA syphon. • We think that more sophisticate FDD will reduce the incidence of technical adverse events. - Abstract: Objectives: Flow-Diverter Devices (FDD) are a new generation stents designed for the treatment of the intracranial aneurysms. This article reports the long-term results (2–4 years) of this treatment from a single-center. Methods: From November 2008 to January 2012, 35 patients (29 females and 6 males; mean age 53.9 y) with 39 intracranial aneurysms were treated by FDD. Five patients (14.3%) had ruptured aneurysms and 30 (85.7%) had no previous hemorrhage. The procedures were performed in 5 patients (14.3%) with SILK and in 30 (85.7%) with PED. In 3 patients FDDs were used as a second treatment after failure of previous coiling (2 cases) or stenting (one case). The 39 aneurysms were in supraclinoid ICA in 26 (66.7%), cavernous ICA in 2 (5.1%), PCoA in 4 (10.2%), MCA in 5 (12.9%), SCA in 1 (2.6%) and PICA in 1 (2.6%). The aneurysms were small (<10 mm) in 32 cases (82%), large (11–25 mm) in 6 (15.3%) and giant in 1 (2.6%). The occlusion rate according to the aneurysm location, size and neck and the complications were evaluated. Results: Peri-procedural complications included transient dysarthria (2 patients), vasospasm with acute intra-stent aggregation (one), microwire rupture (one) and failure of the stent opening (one). The follow-up was made between 24 and 62 months (mean 41 months); clinical examination and CTA were performed at 1, 3, 6 and 12 months after the procedure. The complete occlusion was confirmed by CTA and DSA. MRI with angiographic-studies was taken every year. Complete occlusion was obtained in 35 aneurysms (92.1%) and subtotal in 3 (7.9%). Complete occlusion occurred at 3 months in 24 cases (68.6%), within 3 and 6 months in 9 (25.7%). The rate and

  20. Surgical treatment of subcostal incisional hernia with polypropylene mesh - analysis of late results

    Directory of Open Access Journals (Sweden)

    Marco Antonio de Oliveira Peres

    Full Text Available OBJECTIVE: To evaluate the results of subcostal incisional hernia repair using polypropylene mesh, the technical aspects of musculo-aponeurotic reconstruction, routine fixation of supra-aponeurotic mesh and follow-up for five years.METHODS: We conducted a retrospective study that assessed 24 patients undergoing subcostal incisional hernia repair with use of polypropylene mesh; 15 patients (62.5% were female; ages ranged from 33 to 82, and 79.1% had comorbidities.RESULTS: Early complications: three cases (12.5% of wound infection, three cases (12.5% of seroma, one case (4.1% of hematoma; and one case (4.1% of wound dehiscence. Late complications occurred in one case (4.1% of hernia recurrence attributed to technical failure in the fixation of the mesh and in one case (4.1% of chronic pain. There were no cases of exposure or rejection of the mesh.CONCLUSION: The subcostal incisional hernia, though not very relevant, requires adequate surgical treatment. Its surgical correction involves rebuilding the muscle-aponeurotic defect, supra-aponeurotic fixation of polypropylene mesh, with less complexity and lower rates of complications and recurrences.

  1. Effect of Comorbidity on Treatment of Anxious Children and Adolescents: Results from a Large, Combined Sample

    Science.gov (United States)

    Rapee, Ronald M.; Lyneham, Heidi J.; Hudson, Jennifer L.; Kangas, Maria; Wuthrich, Viviana M.; Schniering, Carolyn A.

    2013-01-01

    Objective: The purpose of the present study was to evaluate the influence of comorbid disorders on the degree of change and the endpoint of cognitive-behavioral treatment in anxious young people. Method: Data on 750 children 6 to 18 years old were compiled from different samples within one clinic. All children had a primary anxiety disorder and…

  2. Efficacy and safety results of long-term growth hormone treatment of idiopathic short stature.

    Science.gov (United States)

    Kemp, Stephen F; Kuntze, Joyce; Attie, Kenneth M; Maneatis, Thomas; Butler, S; Frane, James; Lippe, Barbara

    2005-09-01

    Small clinical trials of GH treatment of idiopathic short stature (ISS) show variable efficacy. The study was an analysis of a large GH registry for efficacy and safety of GH treatment of ISS. There was also a comparison with a specific clinical trial. Up to 7 yr of GH treatment of ISS was evaluated for efficacy and safety in the National Cooperative Growth Study (NCGS). The NCGS study was conducted at Genentech, Inc. and included 47,226 patients. The ISS group included maximum stimulated GH 10 ng/ml or more and/or a report of ISS by investigator (n = 8018; all included for safety). Cohort 1 (n = 2520) was similar to the clinical trial, cohort 2 (n = 283) included subjects younger than 5 yr of age, and cohort 3 (n = 940) was pubertal at GH start. GH, approximately 0.30 mg/kg.wk, was given. These included growth velocities and height sd (HtSDS). Mean first-year growth velocities in cohorts 1, 2, and 3 increased 4.6, 3.9, and 4.4 cm/yr over pretreatment, respectively. Measures included: baseline mean HtSDS, -2.9, -3.2, and -2.8; mean HtSDS at 1 yr, -2.4, -2.3, and -2.3, respectively. Mean HtSDS after 7 yr in cohorts 1 (n = 303) and 2 (n = 85) and 5 yr in cohort 3 (n = 58) were: -1.2, -1.0, and -1.5, respectively. Cohort 3 shorter treatment time was due to advanced baseline age (mean 13.8 yr) and puberty. Mean HtSDS gain in cohort 1 was comparable with the clinical trial. No new safety signals specific to the NCGS ISS population were observed. ISS patients in the GH registry demonstrate a significant increase in HtSDS with the safety profile similar to GH-deficient patients. RESULTS were similar to the clinical trial.

  3. TU-A-BRD-01: Outcomes of Hypofractionated Treatments - Initial Results of the WGSBRT

    Energy Technology Data Exchange (ETDEWEB)

    Li, X [Medical College of Wisconsin, Milwaukee, WI (United States); Lee, P [UCLA, Los Angeles, CA (United States); Ohri, N [Albert Einstein College of Medicine, Bronx, NY (United States); Joiner, M [Wayne State University, Detroit, MI (United States); Kong, F [Georgia Regents University, Augusta, GA (Georgia); Jackson, A [Mem Sloan-Kettering Cancer Ctr, New York, NY (United States)

    2014-06-15

    Stereotactic Body Radiation Therapy (SBRT) has emerged in recent decades as a treatment paradigm that is becoming increasingly important in clinical practice. Clinical outcomes data are rapidly accumulating. Although published relations between outcomes and dose distributions are still sparse, the field has progressed to the point where evidence-based normal tissue dose-volume constraints, prescription strategies, and Tumor Control Probability (TCP) and Normal Tissue Complication Probability (NTCP) models can be developed. The Working Group on SBRT (WGSBRT), under the Biological Effects Subcommittee of AAPM, is a group of physicists and physicians working in the area of SBRT. It is currently performing critical literature reviews to extract and synthesize usable data and to develop guidelines and models to aid with safe and effective treatment. The group is investigating clinically relevant findings from SBRT in six anatomical regions: Cranial, Head and Neck, Thoracic, Abdominal, Pelvic, and Spinal. In this session of AAPM 2014, interim results are presented on TCP for lung and liver, NTCP for thoracic organs, and radiobiological foundations:• Lung TCP: Detailed modeling of TCP data from 118 published studies on early stage lung SBRT investigates dose response and hypothesized mechanisms to explain the improved outcomes of SBRT. This is presented from the perspective of a physicist, a physician, and a radiobiologist.• Liver TCP: For primary and metastatic liver tumors, individual patient data were extracted from published reports to examine the effects of biologically effective dose on local control.• Thoracic NTCP: Clinically significant SBRT toxicity of lung, rib / chest wall and other structures are evaluated and compared among published clinical data, in terms of risk, risk factors, and safe practice.• Improving the clinical utility of published toxicity reports from SBRT and Hypofractionated treatments. What do we want, and how do we get it? Methods

  4. Intravenous thrombolysis plus hypothermia for acute treatment of ischemic stroke (ICTuS-L): final results.

    Science.gov (United States)

    Hemmen, Thomas M; Raman, Rema; Guluma, Kama Z; Meyer, Brett C; Gomes, Joao A; Cruz-Flores, Salvador; Wijman, Christine A; Rapp, Karen S; Grotta, James C; Lyden, Patrick D

    2010-10-01

    Induced hypothermia is a promising neuroprotective therapy. We studied the feasibility and safety of hypothermia and thrombolysis after acute ischemic stroke. Intravenous Thrombolysis Plus Hypothermia for Acute Treatment of Ischemic Stroke (ICTuS-L) was a randomized, multicenter trial of hypothermia and intravenous tissue plasminogen activator in patients treated within 6 hours after ischemic stroke. Enrollment was stratified to the treatment time windows 0 to 3 and 3 to 6 hours. Patients presenting within 3 hours of symptom onset received standard dose intravenous alteplase and were randomized to undergo 24 hours of endovascular cooling to 33°C followed by 12 hours of controlled rewarming or normothermia treatment. Patients presenting between 3 and 6 hours were randomized twice: to receive tissue plasminogen activator or not and to receive hypothermia or not. Results- In total, 59 patients were enrolled. One patient was enrolled but not treated when pneumonia was discovered just before treatment. All 44 patients enrolled within 3 hours and 4 of 14 patients enrolled between 3 to 6 hours received tissue plasminogen activator. Overall, 28 patients randomized to receive hypothermia (HY) and 30 to normothermia (NT). Baseline demographics and risk factors were similar between groups. Mean age was 65.5±12.1 years and baseline National Institutes of Health Stroke Scale score was 14.0±5.0; 32 (55%) were male. Cooling was achieved in all patients except 2 in whom there were technical difficulties. The median time to target temperature after catheter placement was 67 minutes (Quartile 1 57.3 to Quartile 3 99.4). At 3 months, 18% of patients treated with hypothermia had a modified Rankin Scale score of 0 or 1 versus 24% in the normothermia groups (nonsignificant). Symptomatic intracranial hemorrhage occurred in 4 patients (68); all were treated with tissue plasminogen activator <3 hours (1 received hypothermia). Six patients in the hypothermia and 5 in the normothermia

  5. An interim assessment of the results of day-treatment in nursing homes

    NARCIS (Netherlands)

    Nies, H. L.G.R.

    1986-01-01

    Day-treatment has developed very rapidly in Dutch nursing homes. This development was due to several unproved positive expectations concerning the therapeutical results, the effects for relatives and caregivers at home and the substitutional effects of day-treatment. In this article these

  6. Late results of treatment of branchiogenic carcinoma; Odlegle wyniki leczenia chorych na raka torbieli bocznej szyi

    Energy Technology Data Exchange (ETDEWEB)

    Czech, I.; Jassem, J.; Lewandowski, D.; Kowalska, B. [Akademia Medyczna, Gdansk (Poland)

    1994-12-31

    Malignant transformation of branchiogenic cysts are very rare. In the least 32 years there have been 23 cases of intracystic carcinomas in our material. Clinical data and methods of treatment have been presented. Late results of treatment demonstrate that irrespective of the progress in management the prognosis is poor. (author)

  7. Results of Surgical Treatment of Chronic Patellar Tendinosis (Jumper's Knee): A Systematic Review of the Literature.

    Science.gov (United States)

    Brockmeyer, Matthias; Diehl, Nora; Schmitt, Cornelia; Kohn, Dieter M; Lorbach, Olaf

    2015-12-01

    To review the literature concerning surgical treatment options for chronic patellar tendinosis (jumper's knee), a common problem among athletes. When conservative treatment fails, surgical treatment is required. Systematic review of the literature concerning the results of current surgical treatment options for chronic patellar tendinosis. All articles of studies with an evidence level ≥IV from January 2000 until February 2015 presenting the surgical outcome after arthroscopic as well as open treatment of chronic patellar tendinosis were included. The literature research of the PubMed database was performed using the following key words: "patellar" and "tendinitis," "tendonitis," "tendinosis" or "tendinopathy"; "inferior patellar pole"; "jumper's knee"; "surgical treatment" and "open" or "arthroscopic patellar tenotomy." A systematic review of the literature was performed especially to point out the effectiveness of arthroscopic treatment of chronic patellar tendinosis. The results revealed good clinical results for arthroscopic as well as open treatment of chronic patellar tendinosis that is refractory to conservative treatment in athletes. An average success rate of 87% was found for the open treatment group and of 91% for the arthroscopic treatment group. However, after open surgery, the mean time of return to the preinjury level of activity is 8 to 12 months, with a certain number of patients/athletes who cannot return to the preinjury level of activity. Minimally invasive, arthroscopically assisted or all-arthroscopic procedures may lead to a significantly faster return to sporting activities and may, therefore, be the preferred method of surgical treatment. Level IV, systematic review of Level I-IV studies. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  8. Evaluation of long-term results of radical and organ-sparing operations on adrenal gland tumors

    Directory of Open Access Journals (Sweden)

    V. G. Chausova

    2014-01-01

    Full Text Available Long-term results have been estimated for laparoscopic adrenalectomy and laparoscopic partial adrenalectomy in the treatment of adrenal tumors. If preoperative data and intra-operating evaluation show no sign of malignancy, it is possible to perform organ-sparing surgery.

  9. Report of the evaluation by the Ad Hoc Review Committee on Advance Science Research. Result evaluation, interim evaluation, in-advance evaluation in fiscal year 2002

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-11-01

    The Research Evaluation Committee, which consisted of 13 members from outside of the Japan Atomic Energy Research Institute (JAERI), set up an Ad Hoc Review Committee on Advanced Science Research in accordance with the Fundamental Guideline for the Evaluation of Research and Development (R and D) at JAERI' and its subsidiary regulations in order to evaluate the accomplishments of the research completed in Fiscal Year 2001, the accomplishments of the research started in Fiscal Year 2000, and the adequacy of the programs of the research to be started in Fiscal Year 2003 at Advanced Science Research Center of JAERI. The Ad Hoc Review Committee consisted of eight specialists from outside of JAERI. The Ad Hoc Review Committee conducted its activities from May to July 2002. The evaluation was performed on the basis of the materials submitted in advance and of the oral presentations made at the Ad Hoc Review Committee meeting which was held on June 4, 2002, in line with the items, viewpoints, and criteria for the evaluation specified by the Research Evaluation Committee. The result of the evaluation by the Ad Hoc Review Committee was submitted to the Research Evaluation Committee, and was judged to be appropriate at its meeting held on August 5, 2002. This report describes the result of the evaluation by the Ad Hoc Review Committee on Advanced Science Research. (author)

  10. BIOPLAN: software for the biological evaluation of. Radiotherapy treatment plans.

    Science.gov (United States)

    Sanchez-Nieto, B; Nahum, A E

    2000-01-01

    Distributions of absorbed dose do not provide information on the biological response of tissues (either tumor or organs at risk [OAR]) to irradiation. BIOPLAN (BiOlogical evaluation of PLANs) has been conceived and developed as a PC-based user-friendly software that allows the user to evaluate a treatment plan from the (more objective) point of view of the biological response of the irradiated tissues, and at the same time, provides flexibility in the use of models and parameters. It requires information on dose-volume histograms (DVHs) and can accept a number of different formats (including DVH files from commercial treatment planning systems). BIOPLAN provides a variety of tools, such as tumor control probability (TCP) calculations (using the Poisson model), normal tissue complication probability (NTCP) calculations (using either the Lyman-Kutcher-Burman or the relative seriality models), the ATCP method, DVH subtraction, plots of NTCP/TCP as a function of prescription dose, tumor and OAR dose statistics, equivalent uniform dose (EUD), individualized dose prescription, and parametric sensitivity analysis of the TCP/NTCP models employed.

  11. Listening Visits: An Evaluation of the Effectiveness and Acceptability of a Home-based Depression Treatment

    Science.gov (United States)

    SEGRE, LISA SHARON; STASIK, SARA M.; O'HARA, MICHAEL W.; ARNDT, STEPHAN

    2011-01-01

    Purpose Maternal depression affects approximately one in five women, is under-treated, and compromises infant development. In the UK, public health nurses provide an empirically supported intervention (Listening Visits or LV), to depressed postpartum women. This study evaluates the effectiveness of LV when delivered by US home visitors. Method Nineteen women with depressive symptoms received LV. Pre, post, and follow-up assessments evaluated depression status, life satisfaction, and treatment acceptability. Results Listening Visits were associated with a statistically and clinically significant reduction in depression, improvement in life satisfaction, and were acceptable to women. Conclusions Listening Visits show considerable promise as an effective and acceptable depression treatment. PMID:21154029

  12. Evaluation of the functional results after rotator cuff arthroscopic repair with the suture bridge technique

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    Full Text Available ABSTRACT OBJECTIVE: To evaluate the results of arthroscopic treatment of large and extensive rotator cuff injuries (RCI that involved the supra and infraspinatus muscles using the suture bridge (SB technique. METHODS: Between July 2010 and November 2014, 37 patients with RCI who were treated with SB technique were evaluated. The study included all patients with a minimum follow-up of 12 months who underwent primary surgery of the shoulder. Twenty-four patients were male and 13 were female. The mean age was 60 years (45-75. The dominant side was affected in 32 cases. The most common cause of injury was trauma (18 cases. The mean preoperative motion was 123°, 58°, T11. Through magnetic resonance imaging, 36 fatty degenerations were classified according to Goutallier. Patients underwent rotator cuff repair with SB technique, which consists of using a medial row anchor with two Corkscrew(r fibertape(r or fiberwire(r at the articular margin, associated with lateral fixation without stitch using PushLocks(r or SwiveLocks(r. RESULTS: The mean age was 60 years and mean fatty degeneration was 2.6. The mean range of motion (following the AAOS in the postoperative evaluation was 148° of forward elevation, 55° in lateral rotation and medial rotation in T9. Using the criteria of the University of California at Los Angeles (UCLA, 35 (94% patients had excellent and good results; one (2.7%, fair; and one (2.7%, poor. CONCLUSION: Arthroscopic repair of a large and extensive RCI using SB technique had good and excellent results in 94% of the patients.

  13. Comparison of surgical blade and cryosurgery with liquid nitrogen techniques in treatment of physiologic gingival pigmentation: short term results.

    Science.gov (United States)

    Rahmati, Saeed; Darijani, Mansoore; Nourelahi, Maryam

    2014-12-01

    Melanin pigmentation of the gingiva is a crucial esthetic problem. A variety of methods have been used for gingival depigmentation. The purpose of this study was to compare the results of two treatment modalities: scalpel technique and cryotherapy with liquid nitrogen in treatment of gingival pigmentation. Twenty patients with chief complaint of gingival pigmentation participated in our study. 10 patients were treated with cryotherapy and remaining 10 participants were undergone the scalpel technique surgery. We evaluated acquiescence and comfort of the patients, degree of depigmentation, based on the area of pigmentation shown by gridlines option in Microsoft Paint software, and the presence or absence of gingival recession before and one month after treatment. Data was analyzed using Mann-Whitney and Chi-Square tests. A significance level of p≤ 0.05 was adopted. Mean value and standard deviation of depigmentation for group A and group B was 96.17±2.51 and 95±2.48, respectively. The difference was not statistically significant (p= 0.225). There was no association between the treatment modality and the gingival recession (p= 0.303) or the treatment modality and the patient satisfaction (p= 0.346). No significant difference was found between gingival recession measures before and after the operation in the two treatment modalities. Surgical blade and cryosurgery with liquid nitrogen had no significant difference in treatment of physiologic gingival pigmentation. Both Techniques are acceptable in the treatment of gingival pigmentation.

  14. Efficiency of Injection Therapy for Stress Incontinence: a Retrospective Evaluation of 8 Years Results

    Directory of Open Access Journals (Sweden)

    Kemal Ener

    2012-09-01

    Full Text Available Aim: To evaluate the long term affectivity of transurethral Calcium Hydroxylapatite (CaHA; Coaptite® injection therapy and the predictive importance of Body Mass Index (BMI, menopausal status and previous anti-incontinence surgery in selected female patients with stress urinary incontinence (SUI. Material and Method: Forty-five female patients with SUI, and having high risks for general anesthesia, received transurethal injection therapy, were evaluated retrospectively. First month, 12th month, and 8th year of post-injection period were evaluated in terms of International Consultatiton on Incontinence Questionnaire Short Form (ICIQ-SF, Quality of Life (QoL score, and pad test. Results: While the pad test of 1st and 12th months’ showed statistically significance, the pad test of last visit was found insignificant, when compared with pre-injection term. Through the evaluations of questionnaire forms similar to the pad test, it was observed that the post- injection scores showed statistically significance. However, unlike to the pad test, for each of both questionnaires, statistically significant differences were detected at the last examination’s scores, as well. When we examined the success of the transurethral injection treatment according to menopausal status, BMI, and previous anti-incontinence surgery, it was observed that QoL and ICIQ-SF score %variation, and 24 hr pad test values did not show any statistically significant differences at long term control, compared with the pre-injection term. Discussion: Transurethral injection is a cheap, easily performed and affective method for selected patients with SUI and BMI, previous anti-incontinence surgery, and menopausal status do not affect transurethral injection results at long term.

  15. The utility of the random controlled trial for evaluating sexual offender treatment: the gold standard or an inappropriate strategy?

    Science.gov (United States)

    Marshall, W L; Marshall, L E

    2007-06-01

    This paper examines the scientific, practical, and ethical issues surrounding the employment of the Random Controlled Trial (RCT) in the evaluation of sexual offender treatment. Consideration of these issues leads us to conclude that the RCT design is not suitable for determining the effectiveness of sexual offender treatment. We also examine the RCT study by Marques et al. (Sexual Abuse: A Journal of Research and Treatment and Evaluation 17:79-107, 2005) that is often held up as the model for the evaluation of sexual offender treatment. We found several problems with this study that, in our opinion, reduce its relevance for deciding whether treatment is effective with these clients. Finally, we examine two alternative strategies for evaluating treatment that may allow treatment providers to more readily examine, and report, the results of their programs.

  16. Early Childhood Mental Health Consultation: Results of a Statewide Random-Controlled Evaluation.

    Science.gov (United States)

    Gilliam, Walter S; Maupin, Angela N; Reyes, Chin R

    2016-09-01

    Despite recent federal recommendations calling for increased funding for early childhood mental health consultation (ECMHC) as a means to decrease preschool expulsions, no randomized-controlled evaluations of this form of intervention have been reported in the scientific literature. This study is the first attempt to isolate the effects of ECMHC for enhancing classroom quality, decreasing teacher-rated behavior problems, and decreasing the likelihood of expulsion in targeted children in early childhood classrooms. The sample consisted of 176 target children (3-4 years old) and 88 preschool classrooms and teachers randomly assigned to receive ECMHC through Connecticut's statewide Early Childhood Consultation Partnership (ECCP) or waitlist control treatment. Before randomization, teachers selected 2 target children in each classroom whose behaviors most prompted the request for ECCP. Evaluation measurements were collected before and after treatment, and child behavior and social skills and overall quality of the childcare environment were assessed. Hierarchical linear modeling was used to evaluate the effectiveness of ECCP and to account for the nested structure of the study design. Children who received ECCP had significantly lower ratings of hyperactivity, restlessness, externalizing behaviors, problem behaviors, and total problems compared with children in the control group even after controlling for gender and pretest scores. No effects were found on likelihood of expulsion and quality of childcare environment. ECCP resulted in significant decreases across several domains of teacher-rated externalizing and problem behaviors and is a viable and potentially cost-effective means for infusing mental health services into early childhood settings. Clinical and policy implications for ECMHC are discussed. Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  17. Pregabalin for the treatment of postoperative pain: results from three controlled trials using different surgical models

    Directory of Open Access Journals (Sweden)

    Singla NK

    2014-12-01

    Full Text Available Neil K Singla,1 Jacques E Chelly,2 David R Lionberger,3 Joseph Gimbel,4 Luis Sanin,5 Jonathan Sporn,5 Ruoyong Yang,5 Raymond Cheung,5 Lloyd Knapp,6 Bruce Parsons5 1Lotus Clinical Research, Pasadena, CA, USA; 2Division of Acute Interventional Perioperative Pain, Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA; 3Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX, USA; 4Arizona Research Center, Phoenix, AZ, USA; 5Pfizer Inc., New York, NY, USA; 6Pfizer Inc., New London, CT, USA Purpose: To evaluate the efficacy and safety of pregabalin (150 or 300 mg/d as an adjunctive therapy for the treatment of postoperative pain. Patients and methods: This study reports findings from three separate, multicenter, randomized, double-blind, placebo-controlled trials of adjunctive pregabalin for the treatment of postoperative pain. Patients underwent one of three categories of surgical procedures (one procedure per study: elective inguinal hernia repair (post-IHR; elective total knee arthroplasty (post-TKA; or total abdominal hysterectomy (posthysterectomy. The primary endpoint in each trial, mean worst pain over the past 24 hours, was assessed 24 hours post-IHR and posthysterectomy, and 48 hours post-TKA. Patients rated their pain on a scale from 0 to 10, with higher scores indicating greater pain severity. Results: In total, 425 (post-IHR, 307 (post-TKA, and 501 (posthysterectomy patients were randomized to treatment. There were no statistically significant differences between the pregabalin and placebo groups with respect to the primary endpoint in any of the three trials. The least squares mean difference in worst pain, between 300 mg/d pregabalin and placebo, was -0.7 (95% confidence interval [CI] =-1.4, -0.1; Hochberg adjusted P=0.067 post-IHR; -0.34 (95% CI =-1.07, 0.39; P=0.362 post-TKA; and -0.2 (95% CI =-0.66, 0.31; P=0.471 posthysterectomy. Conclusion: There were no significant differences

  18. Positive EtG findings in hair as a result of a cosmetic treatment.

    Science.gov (United States)

    Sporkert, Frank; Kharbouche, Hicham; Augsburger, Marc P; Klemm, Clementine; Baumgartner, Markus R

    2012-05-10

    In a case of a driving ability assessment, hair analysis for ethyl glucuronide (EtG) was requested by the authorities. The person concerned denied alcohol consumption and did not present any clinical sign of alcoholism. However, EtG was found in concentrations of up to 910pg/mg in hair from different sampling dates suggesting an excessive drinking behavior. The person declared to use a hair lotion on a regularly base. To evaluate a possible effect of the hair lotion, prospective blood and urine controls as well as hair sampling of scalp and pubic hair were performed. The traditional clinical biomarkers of ethanol consumption, CDT and GGT, were inconspicuous in three blood samples taken. EtG was not detected in all collected urine samples. The hair lotion was transmitted to our laboratory. The ethanol concentration in this lotion was determined with 35g/L. The EtG immunoassay gave a positive result indicating EtG, which could be confirmed by GC-MS/MS-NCI. In a follow-up experiment the lotion was applied to the hair of a volunteer over a period of six weeks. After this treatment, EtG could be measured in the hair at a concentration of 72pg/mg suggesting chronic and excessive alcohol consumption. Overnight incubation of EtG free hair in the lotion yielded an EtG concentration of 140pg/mg. In the present case, the positive EtG hair findings could be interpreted as the result of an EtG containing hair care product. To our knowledge, the existence of such a product has not yet been reported, and it is exceptionally unusual to find EtG in cosmetics. Therefore, external sources for hair contamination should always be taken into account when unusual cosmetic treatment is mentioned. In those cases, it is recommended to analyze the hair product for a possible contamination with EtG. The analysis of body hair can help to reveal problems occurring from cosmetic treatment of head hair. As a consequence, the assessment of drinking behavior should be based on more than one

  19. OPTIMIZATION OF RESULTS AND TREATMENT TIMING OF DEEP DERMAL BURNS IN CHILDREN

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    Константин Александрович Афоничев

    2014-06-01

    Full Text Available Untreated deep dermal burns in children are the cause of long-term treatment and severe cicatricial deformities, resulting in poor cosmetic results and greatly impairing functional outcome. The problem of optimizing the results and timing of treatment of deep burns in children in recent years has become particularly urgent. We observed 1853 children with III-A degree burns. Some of the children's burns healed spontaneously, which led to the development of scar deformities during the first six months after injury. Risk factors for their development, depending on the patient's age and location of the lesion, are pointed out. Other children underwent early tangential excision of eschar. The analysis of the treatment results showed that the use of early surgery in children with deep dermal burns can reduce treatment time, as well as significantly to improve the cosmetic and functional outcomes of trauma.

  20. Barriers to Mental Health Treatment: Results from the WHO World Mental Health (WMH) Surveys

    Science.gov (United States)

    Andrade, L. H.; Alonso, J.; Mneimneh, Z.; Wells, J. E.; Al-Hamzawi, A.; Borges, G.; Bromet, E.; Bruffaerts, R.; de Girolamo, G.; de Graaf, R.; Florescu, S.; Gureje, O.; Hinkov, H. R.; Hu, C.; Huang, Y.; Hwang, I.; Jin, R.; Karam, E. G.; Kovess-Masfety, V.; Levinson, D.; Matschinger, H.; O’Neill, S.; Posada-Villa, J.; Sagar, R.; Sampson, N. A.; Sasu, C.; Stein, D.; Takeshima, T.; Viana, M. C.; Xavier, M.; Kessler, R. C.

    2014-01-01

    Background To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders. Methods Data are from the WHO World Mental Health (WMH) Surveys. Representative household samples were interviewed face-to-face in 24 countries. Reasons to initiate and continue treatment were examined in a subsample (n= 63,678) and analyzed at different levels of clinical severity. Results Among those with a DSM-IV disorder in the past twelve months, low perceived need was the most common reason for not initiating treatment and more common among moderate and mild than severe cases. Women and younger people with disorders were more likely to recognize a need for treatment. Desire to handle the problem on one’s own was the most common barrier among respondents with a disorder who perceived a need for treatment (63.8%). Attitudinal barriers were much more important than structural barriers both to initiating and continuing treatment. However, attitudinal barriers dominated for mild-moderate cases and structural barriers for severe cases. Perceived ineffectiveness of treatment was the most commonly reported reason for treatment dropout (39.3%) followed by negative experiences with treatment providers (26.9% of respondents with severe disorders). Conclusions Low perceived need and attitudinal barriers are the major barriers to seeking and staying in treatment among individuals with common mental disorders worldwide. Apart from targeting structural barriers, mainly in countries with poor resources, increasing population mental health literacy is an important endeavor worldwide. PMID:23931656

  1. Evaluation of a treatment manual and workshops for disseminating, parent-child interaction therapy.

    Science.gov (United States)

    Herschell, Amy D; McNeil, Cheryl B; Urquiza, Anthony J; McGrath, Jean M; Zebell, Nancy M; Timmer, Susan G; Porter, Alissa

    2009-01-01

    This study's main purposes were to: (a) evaluate a treatment manual as a dissemination strategy, (b) compare two workshop formats for evidence-based treatment (EBT) training, and (c) provide preliminary data on therapist characteristics potentially associated with successful EBT adoption. Forty-two community-based clinicians were assigned to one of two training groups (didactic or experiential). Behavior observation and self-report data were collected at four time points. Results suggest that reading a treatment manual is useful, but not sufficient. Experiential and didactic training were equally effective in increasing knowledge, skill, and satisfaction; however, after a 2-day training, few participants demonstrated mastery of skills.

  2. Vismodegib for the treatment of basal cell carcinoma: results and implications of the ERIVANCE BCC trial.

    Science.gov (United States)

    Dessinioti, Clio; Plaka, Michaela; Stratigos, Alexander J

    2014-05-01

    The need for effective treatment of patients with locally advanced or metastatic basal cell carcinoma (BCC), in conjunction with major advances in the elucidation of the molecular basis of this tumor has led to the advent of new targeted therapies - namely, hedgehog inhibitors. The rationale for their use in patients with advanced BCC is based on their inhibitory effect on the hedgehog pathway, which is aberrantly activated in BCCs due to mutations of its primary components, PTCH1 and SMO genes. Vismodegib (GDC-0449) is an orally bioavailable hedgehog pathway inhibitor that selectively inhibits SMO. The ERIVANCE BCC study is a Phase II, international, multicenter clinical trial evaluating the efficacy and safety of vismodegib 150 mg once daily in patients with locally advanced or metastatic BCC. Vismodegib has been approved for the treatment of adult patients with metastatic BCC, or with locally advanced BCC that has recurred following surgery or who are not candidates for surgery or radiation therapy. This article will outline the rationale, design and available results from the ERIVANCE BCC study and discuss the clinical implications of vismodegib in the management of patients with BCC. Challenges regarding vismodegib use include the recurrence of BCC after drug discontinuation, the development of acquired resistance, the dramatic efficacy in patients with Gorlin syndrome, and class-related drug toxicity. Ongoing clinical trials aim to explore the role of vismodegib in the neoadjuvant setting prior to surgery, the potential use of alternate dosing regimens in order to limit chronic adverse events, as well as the identification of patients with BCC that are more likely to respond to this targeted therapy based on genotypic and/or phenotypic characteristics.

  3. [Comparative assessment of cryosurgical treatment results in allergic and non-allergic rhinitis].

    Science.gov (United States)

    Zielińska-Bliżniewska, Hanna; Repetowski, Marcin; Miłoński, Jarosław; Olszewski, Jurek

    2011-01-01

    The aim of the work was to assess the treatment efficiency in patients with allergic and non-allergic vasomotor rhinitis after cryoablation procedures. The study covered 60 patients, including 32 women and 28 men, aged 18-66. The patients were divided into two groups: I - 30 patients with chronic allergic rhinitis, II - 30 patients with non-allergic vasomotor rhinitis. The study methodology involved: an otorhinolaryngological interview with a questionnaire and an allergological interview, an objective otolaryngological and rhinomanometrical examination with Homoth apparatus, a subjective evaluation questionnaire for nasal blockage intensification (the scale ranging from 0 to 10), skin tests to aeorallergens and food allergens (Allergopharma Co.), nasal endoscopy with a straight rigid Eleps endoscope before the treatment and 3 months following it. The cryoablation of nasal conchas was performed under local infiltration anesthesia (1% Xylokaina solution) using the Cryo-S apparatus from CryoFlex Poland Company and a flat probe in a spatula shape (L-50) that was placed on the outer surfaces of the inferior nasal concha. The inferior nasal concha cryoablation resulted in a statistically significant improvement in the subjective assessment scale in group I by 82.6% and group II by 141.2%. In the endoscopic examination 3 months following the cryoablation a good nasal patency was achieved in 63.3% patients from group I and 76.7% patients from group II. The conducted studies show a better nasal passages patency in patients with non-allergic rhinitis than in those with allergic rhinitis. Cryoablation procedures on the inferior nasal conchas are not the primary therapy, but together with other methods they can immensely improve the life comfort of a rhinitis patient. Copyright © 2011 Polish Otolaryngology Society. Published by Elsevier Urban & Partner (Poland). All rights reserved.

  4. Boron neutron capture therapy (BNCT) for newly-diagnosed glioblastoma: comparison of clinical results obtained with BNCT and conventional treatment.

    Science.gov (United States)

    Kageji, Teruyoshi; Nagahiro, Shinji; Mizobuchi, Yoshifumi; Matsuzaki, Kazuhito; Nakagawa, Yoshinobu; Kumada, Hiroaki

    2014-01-01

    The purpose of this study was to evaluate the clinical outcome of boron neutron capture therapy (BNCT) and conventional treatment in patients with newly diagnosed glioblastoma. Since 1998 we treated 23 newly-diagosed GBM patients with BNCT without any additional chemotherapy. Their median survival time was 19.5 months; the 2-, 3-, and 5-year survival rates were 31.8%, 22.7%, and 9.1%, respectively. The clinical results of BNCT in patients with GBM are similar to those of recent conventional treatments based on radiotherapy with concomitant and adjuvant temozolomide.

  5. RESULTS OF THE TREATMENT OF DEGENERATIVE DYSTROPHIC SPINE LUMBAR DESEASE USING MECHANICAL DECOMPRESSOR

    Directory of Open Access Journals (Sweden)

    D. A. Mikhaylov

    2010-01-01

    Full Text Available The current problems of treatment of degenerative dystrophic spine disease are discussed. The authors have fulfilled a research in microinvasive surgery by mechanical decompressor. 55 persons, 25 of which are men and 30 are women with degenerative dystrophic spine diseases complicated by intervertebral disk hernia were observed. The results were estimated in 5 days and 3, 6, 12 months after the operation. Good results of the treatment in all the patients were received, pain syndrome was disappeared. The microdiscectomy using mechanical decompressor appeared to be useful in treatment of osteochondrosis of spine.

  6. Evaluation of the functional results after rotator cuff arthroscopic repair with the suture bridge technique.

    Science.gov (United States)

    Miyazaki, Alberto Naoki; Santos, Pedro Doneux; Sella, Guilherme do Val; Checchia, Caio Santos; Salata, Thiago Roncoletta; Checchia, Sergio Luiz

    2017-01-01

    To evaluate the results of arthroscopic treatment of large and extensive rotator cuff injuries (RCI) that involved the supra and infraspinatus muscles using the suture bridge (SB) technique. Between July 2010 and November 2014, 37 patients with RCI who were treated with SB technique were evaluated. The study included all patients with a minimum follow-up of 12 months who underwent primary surgery of the shoulder. Twenty-four patients were male and 13 were female. The mean age was 60 years (45-75). The dominant side was affected in 32 cases. The most common cause of injury was trauma (18 cases). The mean preoperative motion was 123°, 58°, T11. Through magnetic resonance imaging, 36 fatty degenerations were classified according to Goutallier. Patients underwent rotator cuff repair with SB technique, which consists of using a medial row anchor with two Corkscrew(®) fibertape(®) or fiberwire(®) at the articular margin, associated with lateral fixation without stitch using PushLocks(®) or SwiveLocks(®). The mean age was 60 years and mean fatty degeneration was 2.6. The mean range of motion (following the AAOS) in the postoperative evaluation was 148° of forward elevation, 55° in lateral rotation and medial rotation in T9. Using the criteria of the University of California at Los Angeles (UCLA), 35 (94%) patients had excellent and good results; one (2.7%), fair; and one (2.7%), poor. Arthroscopic repair of a large and extensive RCI using SB technique had good and excellent results in 94% of the patients.

  7. Results of tadalafil treatment in patients following an open nerve-sparing radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Erkan Hirik

    2016-03-01

    Full Text Available Purpose: To evaluate the effect of postoperatively administering a low daily dose of tadalafil on the erectile function of patients who underwent a nerve-sparing radical prostatectomy(NSRP due to localized prostate cancer (PCa. Materials and Methods: Of 138 patients, who underwent NSRP due to PCa between 2012 and 2014, 55 patients who had not had pre-operative erectile dysfunction (ED were included in the study. The mean age of the patients was 64 (54-72. On the 15th day after surgery, after ultrasound evaluation, all 55 patients started on a daily dose of 5 mg tadalafil that was continued for 2.5 months. The erectile function of patients was evaluated pre-operatively, post-operatively, and at the 3rd and 6th month after surgery using the International Index of Erectile Function (IIEF-5 test. None of the patients was treated with hormonal therapy or radiotherapy before or after surgery. Results: Three patients were excluded from the study due to the adverse effects of tadalafil and two patients elected to discontinue the treatment. Of the remaining 50 patients whose pre-operative erectile function had been found normal, at 3 months after surgery, 36 (72% had normal erectile function; of the remaining patients in the study six (12% presented with mild, two (4% with moderate, and six (12% with severe ED. Six months after surgery, 35 patients (70% had normal erectile function while seven (14% had mild, three (6% moderate and five (10% severe ED. There was no statistically significant difference between the results obtained at the 3rd and 6thmonth follow-up (p > 0.05. Three patients reported adverse effects with tadalafil including flushes in 2 (3.6% and a headache in 1 (1.8%. Conclusions: The administration of a 5 mg post-operative dose of tadalafil to patients that had undergone a bilateral NSRP was found to have a positive effect on the recovery and maintenance of erectile function. However, there is still a need to investigate a larger series of

  8. Early orthodontic treatment for Class II malocclusion reduces the chance of incisal trauma: Results of a Cochrane systematic review.

    Science.gov (United States)

    Thiruvenkatachari, Badri; Harrison, Jayne; Worthington, Helen; O'Brien, Kevin

    2015-07-01

    In this article, we summarize the most clinically relevant findings of our recently updated Cochrane systematic review into the treatment of Class II Division 1 malocclusion. A systematic review of the databases was performed to identify all randomized controlled trials evaluating early treatment with functional appliances to correct Class II Division 1 malocclusion. Three early treatment studies with data from 353 participants were included in this review. The results showed no significant difference for any outcomes, except new incidence of incisor trauma, which was significantly less for the early treatment group. The risk ratio analysis for new incisor trauma showed that providing early treatment reduced the risk of trauma by 33% and 41% in the functional and headgear groups, respectively. However, when the numbers needed to treat were calculated, early treatment with functional appliances prevents 1 incidence of incisal trauma for every 10 patients (95% CI, 5-174), and headgear treatment prevents 1 incidence of incisal trauma for every 6 patients (95% CI, 3-23). Orthodontic treatment for young children, followed by a later phase of treatment when the child is in early adolescence, appears to reduce the incidence of new incisal trauma significantly compared with treatment that is provided in 1 phase when the child is in early adolescence. However, these data should be interpreted with caution because of the high degree of uncertainty. There are no other advantages in providing 2-phase treatment compared with 1 phase in early adolescence. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  9. Initial presentation and late results of treatment of post-Chernobyl papillary thyroid carcinoma in children and adolescents of Belarus.

    Science.gov (United States)

    Fridman, Mikhail; Savva, Natallia; Krasko, Olga; Mankovskaya, Svetlana; Branovan, Daniel I; Schmid, Kurt W; Demidchik, Yuri

    2014-08-01

    The aim of this population-based study was to evaluate the clinical and pathological characteristics and outcome of papillary thyroid carcinoma (PTC) that have arisen in the Belarusian childhood population exposed to the radioactive fallout from the Chernobyl accident within a long-term period. The long-term treatment results were investigated in 1078 children and adolescents (Chernobyl radioiodine fallout was rather favorable. TT with RAI is recommended for minimizing loco-regional or distant relapses.

  10. Results of treatment of lymphoblastic lymphoma at the children cancer hospital Egypt – A single center experience

    Directory of Open Access Journals (Sweden)

    Hany Abdel Rahman Sayed

    2016-09-01

    Results of treatment of LBL on the St Jude’s total therapy XV study are comparable to most of the similar reported studies. Outcome of relapsing patients is extremely poor, hence there is a need to identify biologic or clinical prognostic factors including minimal residual tumor to better evaluate chemotherapy response. Steroid induced AVN, and cerebral vascular thrombosis were the main chemotherapeutic adverse events.

  11. Repetitive transcranial magnetic stimulation as an adjuvant method in the treatment of depression: Preliminary results

    Directory of Open Access Journals (Sweden)

    Jovičić Milica

    2014-01-01

    Full Text Available Introduction. Repetitive transcranial magnetic stimulation (rTMS is a method of brain stimulation which is increasingly used in both clinical practice and research. Up-to-date studies have pointed out a potential antidepressive effect of rTMS, but definitive superiority over placebo has not yet been confirmed. Objective. The aim of the study was to examine the effect of rTMS as an adjuvant treatment with antidepressants during 18 weeks of evaluation starting from the initial application of the protocol. Methods. Four patients with the diagnosis of moderate/severe major depression were included in the study. The protocol involved 2000 stimuli per day (rTMS frequency of 10 Hz, intensity of 120% motor threshold administered over the left dorsolateral prefrontal cortex (DLPFC for 15 days. Subjective and objective depressive symptoms were measured before the initiation of rTMS and repeatedly evaluated at week 3, 6, 12 and 18 from the beginning of the stimulation. Results. After completion of rTMS protocol two patients demonstrated a reduction of depressive symptoms that was sustained throughout the 15-week follow-up period. One patient showed a tendency of remission during the first 12 weeks of the study, but relapsed in week 18. One patient showed no significant symptom reduction at any point of follow-up. Conclusion. Preliminary findings suggest that rTMS has a good tolerability and can be efficient in accelerating the effect of antidepressants, particularly in individuals with shorter duration of depressive episodes and moderate symptom severity. [Projekat Ministarstva nauke Republike Srbije, br. III41029 i br. ON175090

  12. Use of hematological parameters in evaluation of treatment efficacy in cutaneous leishmaniasis

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    Bilal Sula

    2015-12-01

    Full Text Available Objective: In the present study we investigated the role of hematological parameters, including neutrophil/lymphocyte ratio and platelet/lymphocyte ratio, mean platelet volume and platelet distribution width in the evaluation of treatment efficacy in adult patients diagnosed with cutaneous leishmaniasis. Methods: The study group included 45 adult patients diagnosed with cutaneous leishmaniasis and treated as inpatients in the dermatology clinic between 2011 and 2014. A group of 45 healthy adults served as a control group. Results: Pre- and post-treatment white blood cell count, neutrophils, and lymphocytes were significantly reduced among the patient group relative to the control group. Platelet distribution width, red cell distribution width, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were significantly elevated among the patients compared to the healthy subjects. Pre-treatment white blood cell, lymphocyte and platelet counts were significantly elevated compared to post-treatment counts among the patient cohort. Treatment was associated with reduced eosinophil count, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio relative to pre-treatment status. Conclusion: Routine hematological testing results such as platelet/lymphocyte ratio, white blood cell count, neutrophil count, red cell distribution width, platelet distribution width, and mean platelet volume may be clinically significant markers of the inflammatory state useful in the evaluation of early treatment efficacy among patients with cutaneous leishmaniasis. J Microbiol Infect Dis 2015;5(4: 167-172

  13. Test results evaluation: Pilot evaluations Deliverable no D6.5. Final draft

    NARCIS (Netherlands)

    Hoedemaeker, D.M.; Dangelmaier, M.; Gelau, C.; Mattes, S.; Montanari, R.

    2003-01-01

    This deliverable describes the User Centred Design approach that has been adopted within the COMUNICAR project. In this design approach several iterative steps were taken to design and evaluate the multimedia Human Machine Interface that is able to manage all the information exchanges between the

  14. Treatment result of so-called keloid with electron beam irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Masatsugu; Narabayashi, Isamu; Tatsumi, Toshiaki; Sueyoshi, Kozo; Uesugi, Yasuo; Nakata, Yasunobu; Tajima, Sadao [Osaka Medical Coll., Takatsuki (Japan)

    1999-03-01

    Between September 1993 and February 1997, 28 sites of so-called keloid (14 true keloids and 14 hypertrophic scars) were treated with electron beam irradiation. Twenty-five of these sites were treated with surgical excision followed by radiotherapy, and the other 3 sites received radiotherapy only. Irradiation by 9 MeV electron beam was performed for all patients, with a total dose of 20 Gy (10 fractions for 2 weeks). The results were evaluated at 8-49 months (Ave. 28.4 months) after treatment. Three sites treated with radiation more than 60 days after excision were excluded from evaluation of treatment response. Twenty-two of 25 sites showed complete response (CR) or partial response (PR). The control rate of total sites was 88.0%. The control rate was 92.9% in true keloids and 81.8% in hypertrophic scars. All keloid sites in the face, neck, shoulder, back and arm exhibited CR. One site of keloid in the head showed no response (NR). In 10 sites in the thoracic lesion, 8 were PR (80.0%) and 2 were NR (20.0%). In 8 sites in the abdominal lesion, 6 were CR (75.0%), 2 were PR (25.0%). All 3 non-operative sites exhibited PR. The control rate of sites treated with radiation within 14 days after keloid excision was 80.0% and that in sites treated more than 15 days after excision was 100.0%. Seven sites (7/28=25.0%) developed acute reaction, which were demonstrated erythema in the irradiated field, but this reaction was transient. Five sites (5/28=17.9%) showed hyperpigmentation indicating late reaction. The development of malignant tumor in or around the irradiated field was not shown. Postoperative electron beam irradiation was effective for so-called keloid. These data suggest that 10-fraction irradiation controls low grade of hyperpigmentation development, even though patients received a comparatively high total dose of radiotherapy. (author)

  15. Patient-Based Long-Term Results of the Surgical Treatment of Congenital Talipes Equinovarus.

    Science.gov (United States)

    Symeonidis, Panagiotis; Christodoulou, Andreas; Mareti, Evaggelia; Eleftherochorinou, Areti; Gkourani, Syrmatenia; Mbeslikas, Theodoros; Kyrkos, John

    2016-06-01

    Long-term results of surgical treatment for congenital talipes equinovarus are documented in the literature but mainly in correlation with clinical and radiographic objective criteria. We present a retrospective study of 48 patients who underwent surgical correction (extended Cincinnati type "a la carte" approach) in our department with an average of 17 years' follow-up. Patients were interviewed and completed a validated disease specific instrument, which evaluates foot function as well as patients' satisfaction, the use of orthotics, shoe size, and the impact of this operation in their adult life. Parameters such as gender, age at first surgery, side affected, and the number of procedures were also studied. According to our findings, the greater the age at last surgery, the worse the outcome. Quality-of-life issues were expressed at a higher rate among women and by patients that underwent multiple surgeries. Unilateral correction has a correlation with the shoe size. Even if a "successful" surgical correction is achieved, residual symptoms may alter walking ability, self-image, and shoe wearing in adult life. It would be valuable to continue to follow these patients up over time. Therapeutic, Level IV: Case series. © 2015 The Author(s).

  16. Suspicion of macrolide allergy after treatment of infectious diseases including Helicobacter pylori: results of allergological testing.

    Science.gov (United States)

    Seitz, Cornelia S; Bröcker, Eva-B; Trautmann, Axel

    2011-01-01

    Macrolides are useful in a wide range of bacterial infections including upper and lower respiratory tract, skin, and sexually transmitted diseases and are used in Helicobacter pylori eradication regimen. Skin symptoms occurring during drug therapy are mostly attributed to the antibiotic, causing considerable limitations of future therapeutic options. The aim of this retrospective analysis was to demonstrate results of diagnostic testing in cases of clinically suspected immediate and delayed macrolide hypersensitivity. A total of 125 patients with a history of immediate or delayed hypersensitivity symptoms in temporal relation to treatment with a macrolide antibiotic were studied using standardised skin tests followed by oral challenges. Selected patients with severe symptoms were further evaluated with in vitro tests. Macrolide hypersensitivity was excluded in 109 patients (87.2%) by tolerated oral challenge tests. During 113 challenges in four patients an exanthema was provoked by the suspected macrolide. Only one patient developed a positive late skin test reaction. Out of the 28 Helicobacter pylori-treated patients, one patient with clarithromycin allergy was identified, whereas in eight cases amoxicillin allergy caused the exanthema. Laboratory tests using the suspected macrolides were constantly negative. History alone leads to an over-estimation of macrolide hypersensitivity. Moreover, skin and in vitro tests seem to be not very useful in identifying hypersensitive patients. Challenge tests appear to be necessary for definitely confirming or ruling out macrolide allergy. Copyright © 2010 SEICAP. Published by Elsevier Espana. All rights reserved.

  17. Periurethral constrictor: late results of the treatment of post prostatectomy urinary incontinence

    Directory of Open Access Journals (Sweden)

    Roberto S. Lima

    2011-08-01

    Full Text Available OBJECTIVES: We evaluated retrospectively, the long-term outcome of patients with post-prostatectomy urinary incontinence (PPUI after placement of the Periurethral Constrictor (PUC. MATERIALS AND METHODS: Fifty-six men with severe PPUI were studied, with a mean age of 68.5 years old. Fifty-one men had PPUI due to radical surgery having the device placed around the bulbous urethra, and five individuals with benign prostatic hypertrophy (BPH had placement around the bladder neck. The mean follow-up was 82.2 months. RESULTS: Twenty-two patients (39.28% became continent (0 to 1 pad a day and 34 (60.72% were incontinent. Complications were as follows: urethral erosion in 15 (26.78%; mechanical malfunction in 2 (3.5%; infection in 2 (3.5%; urinary fistula in 1 (1.7%; Urinary tract infection1 (1.7%. Twenty-three patients needed to have the device removed (41.07%. Success rate (continent me was 30.35%. CONCLUSION: In the present series the PUC was not effective for the treatment of severe PPUI in the long-term follow-up.

  18. The arthroscopic treatment of shoulder instability: bioabsorbable and standard metallic anchors produce equivalent clinical results.

    Science.gov (United States)

    Papalia, Rocco; Franceschi, Francesco; Diaz Balzani, Lorenzo; D'Adamio, Stefano; Denaro, Vincenzo; Maffulli, Nicola

    2014-09-01

    To investigate whether there are any differences in clinical outcomes and complications between absorbable and nonabsorbable suture anchors in the treatment of shoulder instability. We performed a comprehensive search of Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Embase, and the Cochrane Central Registry of Controlled Trials, from inception of the databases, using various combinations of keywords. Only studies focusing on clinical outcomes of patients who underwent arthroscopic shoulder stabilization with suture anchors were selected. Two authors (R.P. and L.D.B.) then evaluated the methodologic quality of each article using the Coleman Methodology Score. Ten articles were included. Four were prospective randomized studies, 2 were prospective cohort studies, and 4 were case series. The mean modified Coleman Methodology Score was 76.2. Given the overall good results reported after arthroscopic stabilization of the shoulder using different suture anchors, it is not possible to draw a definite and solid suggestion on which class of device is better advised for routine use. Thus the decision to use one of the anchor systems available may mostly depend on its cost-effectiveness, which should be the focus of future comprehensive research. Level IV, systematic review of Level I to IV studies. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  19. Operative Treatment and Soft Tissue Management of Open Distal Tibial Fractures - Pitfalls and Results.

    Science.gov (United States)

    Faschingbauer, Maximilian; Meiners, Jan; Schulz, Arndt Peter; Rudolf, Klaus-Dieter; Kienast, Benjamin

    2009-12-01

    Open tibial fractures usually result from high-energy trauma. Severe soft-tissue injuries are often combined with open fractures of the distal tibia. A consecutive series of 42 patients with open extraarticular distal tibial fractures (Gustilo I-IIIc) operated on between July 2006 and February 2009 were included in the study reported here. We performed open reduction and internal fixation for the Gustilo I cases. Soft tissue was closed directly after antibiotic beads had been temporarily applied. For the Gustilo II and III cases, our treatment protocol included soft-tissue debridement of all devitalized soft tissue and bone fragments, pulsatile jet irrigation, and external stabilization. Soft tissue was temporarily closed with Epigard_ after the application of antibiotic beads. A second-look operation was scheduled after 3-5 days. Gustilo II patients needed an average of 1.1 (0-3) revisions until wound closure, compared to the average of 2.1 revisions necessary for the Gustilo III patients. It took 5.6 (0-16) days to obtain definitive wound closure in the Gustilo II patients and 9.9 (3-28) days in the Gustilo III patients. Skin grafting was sufficient for definitive softtissue closure in ten cases, local flaps in eight cases, and free musculocutaneous flaps were needed in six cases. Gustilo II patients with primary wound closure remained hospitalized for 11 days, while patients with secondary wound closure stayed in hospital for an average of 20 days. Our early results concerning infection rate, number of reoperations, and time to bony consolidation can be compared with other studies. Functional results will have to be evaluated at clinical follow-up.

  20. Evaluation study of treatment outcome in Tuberculosis patients receiving DOTS under RNTCP

    Directory of Open Access Journals (Sweden)

    Mayank Jain

    2016-12-01

    Full Text Available Background: Tuberculosis is a global emergency and its control in community wholly depends on outcome of treatment taken by patient. India has 2nd position in total number of cases in World. Objective: To evaluate the factors which affect treatment outcome? Material & Methods: The study was a follow up study, for treatment outcome of tuberculosis patients receiving DOTS under RNTCP. Data were collected into SPSS version 16 and analyzed using appropriate statistical tests. Results: 241 patients were included in the study. Overall treatment success rate was 87.1%, default rate was 4.6%, failure rate was 2.1% and death rate was 6.2 %. Treatment success rate was 91.2% in category I and 70.2% in category II. Failure rate was 0.5% and 8.5%, default rate was 3.6% and 8.5%, death rate was 4.6% and 12 % for category I and category II respectively. In univariate analysis, variable education, occupation, socio-economic status, overcrowding, habit of tobacco consumption, presence of pre–existing illness and category of tuberculosis significantly affect the treatment outcome but on multiple logistic regression analysis education, occupation, habit of tobacco consumption and category of TB had significant effect on treatment outcome. Conclusion: Treatment success was 87.1% in present study conclude that DOTs is an effective form of tuberculosis treatment. Education, occupation, socio economic status and overcrowding have significant effect on treatment outcome.

  1. Are we underestimating the rates of incontinence after prostate cancer treatment? Results from NHANES.

    Science.gov (United States)

    Daugherty, Michael; Chelluri, Raju; Bratslavsky, Gennady; Byler, Timothy

    2017-10-01

    Local therapy for prostate cancer (PCa) includes radical prostatectomy (RP) and radiotherapy (XRT), both of which share a complication of urinary incontinence. Post-treatment incontinence has been reported to occur 6-69%, yet no truly patient-centered report has been compiled. We evaluated patient-reported incontinence rates and bother scores after treatment for prostate cancer. The NHANES database was queried for all men who reported a diagnosis and treatment of PCa from 2001 to 2010. A control arm of men without a diagnosis of PCa age 60-80 years was constructed for baseline incontinence rates. Incontinence was patient-reported and obtained through questionnaires. Three additional cohorts were created for patients treated with RP, XRT or combination RP and XRT. We identified 316 men treated for prostate cancer, of which 136 reported RP and 125 reported XRT, who were compared to 3534 controls. Men that underwent RP experience significant incontinence rates of 23% compared to 12% of those patients treated with XRT, whereas those patients with combined therapy had incontinence rates of 52% (p incontinence did not differ between treatment groups, but stress incontinence was significantly higher in surgical patients. These data from a nationwide sample of patient-reported urinary outcomes have limited interviewer bias and report significantly higher incontinence rates, which may impact prostate cancer discussions. This further underscores the importance of patient-reported outcomes in the evaluation of treatment success and counseling for patients with prostate cancer.

  2. Breast Cancer Patients’ Fear of Treatment: Results from the Multicenter Longitudinal Study BRENDA II

    Science.gov (United States)

    Singer, Susanne; Blettner, Maria; Kreienberg, Rolf; Janni, Wolfgang; Wöckel, Achim; Kühn, Thorsten; Felberbaum, Ricardo; Flock, Felix; Schwentner, Lukas

    2015-01-01

    Summary Background Fear of cancer treatment can become overwhelming. It is important to understand what patients are mainly afraid of and what factors are correlated with intense fear of treatment. Methods Patients with primary breast cancer (n = 761) completed questionnaires about fear of treatment before surgery (t1), and before (t2) and after (t3) adjuvant treatment. Psychological comorbidity was assessed using the Patient Health Questionnaire. Logistic regression identified predictors of intense fear of treatment. Results Patients were most afraid of chemotherapy (mean score 3.5), and fear remained high throughout follow-up; fear of radiotherapy and of surgery was lower and decreased over time (from 2.7 to 2.2, p < 0.0001; and from 2.6 to 2.2, p < 0.0001, respectively). Patients with psychological co-morbidity (odds ratios (OR) 1.7–3.0) and those who had heard reports of negative experiences with cancer treatments from others (OR 3.8–16.2) were more likely to have intense fear of all the treatments. Patients with a previous cancer less often expressed fear of surgery (OR 0.6, 95% confidence interval 0.4–1.0). Conclusion Fear of treatment, especially of chemotherapy, is prevalent in many patients with primary breast cancer. Patients with psychological co-morbidity and those who have heard reports of negative experiences with cancer treatment are at higher risk of experiencing intense fear. PMID:26195937

  3. Substance abuse treatment client experience in an employed population: results of a client survey

    Directory of Open Access Journals (Sweden)

    Merrick Elizabeth L

    2012-01-01

    Full Text Available Abstract Background Understanding client perspectives on treatment is increasingly recognized as key to improving care. Yet information on the perceptions and experiences of workers with private insurance coverage who receive help for substance use conditions is relatively sparse, particularly in managed behavioral health care organization (MBHO populations. Furthermore, the role of several factors including prior service use has not been fully explored. Methods Employees covered by a large MBHO who had received substance abuse services in the past year were surveyed (146 respondents completed the telephone survey and self-reported service use. Results The most common reasons for entering treatment were problems with health; home, family or friends; or work. Prior treatment users reported more reasons for entering treatment and more substance use-related work impairment. The majority of all respondents felt treatment helped a lot or some. One quarter reported getting less treatment than they felt they needed. Discussion and conclusions Study findings point to the need to tailor treatment for prior service users and to recognize the role of work in treatment entry and outcomes. Perceived access issues may be present even among insured clients already in treatment.

  4. Attachment based treatments for adolescents: the secure cycle as a framework for assessment, treatment and evaluation.

    Science.gov (United States)

    Kobak, Roger; Zajac, Kristyn; Herres, Joanna; Krauthamer Ewing, E Stephanie

    2015-01-01

    The emergence of attachment-based treatments (ABTs) for adolescents highlights the need to more clearly define and evaluate these treatments in the context of other attachment based treatments for young children and adults. We propose a general framework for defining and evaluating ABTs that describes the cyclical processes that are required to maintain a secure attachment bond. This secure cycle incorporates three components: (1) the child or adult's IWM of the caregiver; (2) emotionally attuned communication; and (3) the caregiver's IWM of the child or adult. We briefly review Bowlby, Ainsworth, and Main's contributions to defining the components of the secure cycle and discuss how this framework can be adapted for understanding the process of change in ABTs. For clinicians working with adolescents, our model can be used to identify how deviations from the secure cycle (attachment injuries, empathic failures and mistuned communication) contribute to family distress and psychopathology. The secure cycle also provides a way of describing the ABT elements that have been used to revise IWMs or improve emotionally attuned communication. For researchers, our model provides a guide for conceptualizing and measuring change in attachment constructs and how change in one component of the interpersonal cycle should generalize to other components.

  5. Promising results after endoscopic vacuum treatment of anastomotic leakage following resection of rectal cancer with ileostomy

    DEFF Research Database (Denmark)

    Nerup, Nikolaj; Johansen, John Lykkegaard; Alkhefagie, Ghalib Ali Abod

    2013-01-01

    , conservative irrigation regimes are reported to perdure for months and some even years and to be associated with a poor stoma closure rate. In the present paper, we evaluated endoscopic vacuum treatment of the perianastomotic abscess. MATERIAL AND METHODS: Patients who had LAR due to rectal cancer with total......-18) sessions. The median length of hospital stay was 25 (7-39) days. Mortality was zero, and the stoma closure rate was 12/13 (97%). CONCLUSION: Our data support the positive findings previously reported by other studies. Endoscopic vacuum treatment seems to be a safe approach for selected patients...

  6. A prospective evaluation of zirconia posterior fixed dental prostheses: three-year clinical results.

    Science.gov (United States)

    Peláez, Jesus; Cogolludo, Pablo G; Serrano, Benjamin; Lozano, Jose F L; Suárez, Maria J

    2012-06-01

    Although the favorable mechanical properties of zirconium oxide-based ceramics have increased the acceptance of fixed dental prostheses for use in the posterior regions of the mouth in recent years, there are few clinical studies documenting the longevity of these restorations. Furthermore, certain complications must be resolved before the material is used more extensively. The purpose of this randomized prospective study was to evaluate the clinical performance of zirconia (Lava) 3-unit posterior fixed dental prostheses. Twenty 3-unit fixed dental prostheses were placed in 17 participants to replace a second premolar or a first molar. Eleven were placed in the maxilla and 9 in the mandible. All abutment teeth were prepared with a chamfer finish line of 0.8 to 1 mm, and frameworks were prepared with the Lava system. Restorations were cemented with a resin cement. Two calibrated examiners independently evaluated the fixed dental prostheses 1 week (baseline) and 1, 2, and 3 years after placement with the California Dental Association quality evaluation system. The periodontal parameters: the gingival index, plaque index, margin index, and the probing depths of abutment teeth and contralateral teeth were assessed. Data were analyzed by using descriptive statistics and the Wilcoxon signed-rank test (α=.05). All fixed dental prostheses were rated satisfactory after 3 years, and no fracture of the framework was observed during the observation period. One fixed dental prostheses was lost because of a biological complication at the 3-year examination, and a small degree of chipping of the veneering ceramic was observed in 2 participants. No significant differences among the periodontal parameters of the test and control teeth were observed except for the margin index. The results of a 3-year evaluation suggest that posterior zirconia 3-unit fixed dental prostheses are a reliable treatment. Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry

  7. Evaluation and treatment of hypertensive crises in children

    Directory of Open Access Journals (Sweden)

    Stein DR

    2016-03-01

    Full Text Available Deborah R Stein, Michael A Ferguson Division of Nephrology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA Abstract: Hypertensive crises in children are medical emergencies that must be identified, evaluated, and treated promptly and appropriately to prevent end-organ injury and even death. Treatment in the acute setting typically includes continuous intravenous antihypertensive medications with monitoring in the intensive care unit setting. Medications commonly used to treat severe hypertension have been poorly studied in children. Dosing guidelines are available, although few pediatric-specific trials have been conducted to facilitate evidence-based therapy. Regardless of what medication is used, blood pressure should be lowered gradually to allow for accommodation of autoregulatory mechanisms and to prevent cerebral ischemia. Determining the underlying cause of the blood pressure elevation may be helpful in guiding therapy. Keywords: hypertensive crisis, hypertensive urgency, hypertensive emergency, antihypertensive medications

  8. Evaluation and treatment of hypertensive crises in children

    Science.gov (United States)

    Stein, Deborah R; Ferguson, Michael A

    2016-01-01

    Hypertensive crises in children are medical emergencies that must be identified, evaluated, and treated promptly and appropriately to prevent end-organ injury and even death. Treatment in the acute setting typically includes continuous intravenous antihypertensive medications with monitoring in the intensive care unit setting. Medications commonly used to treat severe hypertension have been poorly studied in children. Dosing guidelines are available, although few pediatric-specific trials have been conducted to facilitate evidence-based therapy. Regardless of what medication is used, blood pressure should be lowered gradually to allow for accommodation of autoregulatory mechanisms and to prevent cerebral ischemia. Determining the underlying cause of the blood pressure elevation may be helpful in guiding therapy. PMID:27051314

  9. Anal fistula: results of surgical treatment in a consecutive series of patients

    Directory of Open Access Journals (Sweden)

    Paulo Gonçalves de Oliveira

    2012-03-01

    Full Text Available OBJECTIVES: To evaluate the results of surgical treatment of patients with anal fistulas in a consecutive series of patients. METHODS: A retrospective analytical study of a consecutive series of cases prospectively collected. The sample comprised 210 patients who underwent surgery; demographic data, signs and symptoms, intraoperative classification of the fistulas and healing time were analyzed. RESULTS: The median age was 38 years and 69.0% of the patients were male. The most frequent symptom was perianal orifice with purulent drainage. The fistulas were classified as transsphincteric in 60.9% and the most used operative treatment was the marsupialization of fistulotomy, in 84.2% of cases. Complete healing occurred in all patients between 2 and 16 weeks. One hundred and seventy-eight patients, 84.8% of the patients who underwent surgery, were evaluated at least one year after surgery and recurrence occurred in 6.4% of cases. CONCLUSIONS: There was male prevalence (2.2/1, and most fistulas were transsphincteric. The marsupialization of fistulotomy was the most used operative treatment, and it presented acceptable low rates of morbidity and recurrence of 6.4%.OBJETIVOS: Avaliar os resultados do tratamento cirúrgico de pacientes portadores de fístulas anais em uma série consecutiva de pacientes. MÉTODOS: Estudo analítico, retrospectivo, de uma série consecutiva de casos que foram coletados de forma prospectiva. A casuística englobou 210 pacientes operados, tendo sido analisados os dados demográficos, os sinais e sintomas, a classificação transoperatória das fístulas e o tempo até a cicatrização completa. RESULTADOS: A mediana de idade foi de 38 anos e 69,0% dos pacientes eram homens. O sintoma mais frequente foi a drenagem de secreção purulenta por orifício perianal. As fístulas foram classificadas como transesfincterianas em 60,9%, e o tratamento operatório mais empregado foi a fistulotomia com marsupialização do trajeto

  10. [Subgroup analysis results of platelet inhibition trial in acute coronary syndrome patients (PLATO) who underwent intervention or medical treatment].

    Science.gov (United States)

    Aksakal, Enbiya

    2013-04-01

    Antiplatelet agents are among the most important drug classes in reducing mortality in patients with acute coronary syndromes (ACS). Ticagrelor is the first reversible and direct acting P2Y(12) receptor inhibitor with an earlier onset of action compared to clopidogrel. The PLATO study (Platelet Inhibition and Patient Outcomes) with ticagrelor was conducted with a design providing consistency with the current clinical practice, including all forms of ACS and a wide spectrum of treatment options in 18624 patients from 862 centers in 43 countries. Of these patients, 13408 underwent interventional procedures (ticagrelor/clopidogrel; 6732/6676) (PLATO-INVASIVE). As reported by the investigator, non-invasive treatment strategy was planned for 5216 patients (ticagrelor/clopidogrel; 2601/2615). However, 2040 patients in this group received interventional treatment during the follow-up (PLATO-NON-INVASIVE/MEDICAL TREATMENT). 1261 patients requiring surgical treatment underwent coronary artery bypass grafting (CABG) within 7 days after the discontinuation of study treatment (ticagrelor/clopidogrel; 632/629) (PLATO-CABG). The results of these three subgroups were consistent with the main PLATO study results, demonstrating that ticagrelor reduced the primary (cardiovascular death, myocardial Infarction and stroke) and secondary composite endpoints without increasing bleeding compared with clopidogrel. Ticagrelor fulfills an important unmet need regarding antiplatelet effectiveness in patients with ACS. This review evaluates the INVASIVE and MEDICAL subgroup studies of the PLATO study.

  11. Stereotactic intensity-modulated radiation therapy (IMRT) and inverse treatment planning for advanced pleural mesothelioma. Feasibility and initial results

    Energy Technology Data Exchange (ETDEWEB)

    Muenter, M.W.; Thilmann, C.; Hof, H.; Debus, J. [Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (dkfz), Heidelberg (Germany); Nill, S.; Hoess, A.; Partridge, M. [Dept. of Medical Physics, German Cancer Research Center (dkfz), Heidelberg (Germany); Haering, P. [Dept. of Central Dosimetry, German Cancer Research Center (dkfz), Heidelberg (Germany); Manegold, C. [Dept. of Medical Oncology/Internal Medicine, Thoraxklinik Heidelberg gGmbH, Heidelberg (Germany); Wannenmacher, M. [Dept. of Clinical Radiology, Univ. of Heidelberg, Heidelberg (Germany)

    2003-08-01

    Background and Purpose: Complex-shaped malignant pleural mesotheliomas (MPMs) with challenging volumes are extremely difficult to treat by conventional radiotherapy due to tolerance doses of the surrounding normal tissue. In a feasibility study, we evaluated if inversely planned stereotactic intensity-modulated radiation therapy (IMRT) could be applied in the treatment of MPM. Patients and Methods: Eight patients with unresectable lesions were treated after failure of chemotherapy. All patients were positioned using noninvasive patient fixation techniques which can be attached to the applied extracranial stereotactic system. Due to craniocaudal extension of the tumor, it was necessary to develop a special software attached to the inverse planning program KonRad, which can connect two inverse treatment plans and consider the applied dose of the first treatment plan in the area of the matchline of the second treatment plan. Results: Except for one patient, in whom radiotherapy was canceled due to abdominal metastasis, treatment could be completed in all patients and was well tolerated. Median survival after diagnosis was 20 months and after IMRT 6.5 months. Therefore, both the 1-year actuarial overall survival from the start of radiotherapy and the 2-year actuarial overall survival since diagnosis were 28%. IMRT did not result in clinically significant acute side effects. By using the described inverse planning software, over- or underdosage in the region of the field matchline could be prevented. Pure treatment time ranged between 10 and 21 min. Conclusion: This study showed that IMRT is feasible in advanced unresectable MPM. The presented possibilities of stereotactic IMRT in the treatment of MPM will justify the evaluation of IMRT in early-stage pleural mesothelioma combined with chemotherapy in a study protocol, in order to improve the outcome of these patients. Furthermore, dose escalation should be possible by using IMRT. (orig.)

  12. Upper Eyelid Blepharoplasty: Evaluation, Treatment, and Complication Minimization.

    Science.gov (United States)

    Yang, Patrick; Ko, Audrey C; Kikkawa, Don O; Korn, Bobby S

    2017-02-01

    Upper eyelid blepharoplasty is one of the most common procedures performed worldwide for both functional and cosmetic indications. There is a high rate of patient satisfaction; however, in this era of social media, patient expectations are higher than ever. Today's digitally savvy patients expect perfect outcomes with no complications and rapid recovery. To achieve optimal results, a careful preoperative evaluation and sound surgical technique is essential for minimizing complications. Here the authors review their approach to the management of the blepharoplasty patient.

  13. Results

    African Journals Online (AJOL)

    child.” (CIN, breastfeeding mother). “I am terribly stressed when I consider that the baby will be crying a lot and become difficult and this may force me to continue breastfeeding.” (FGD, breastfeeding mother). Women cited intense psychological stress when children were ill. This influenced them to re-evaluate their decision.

  14. The Evaluation of Minimal Erythema Dose For Narrowband UVB in Patients Receiving Isotretinoin Treatment

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    Tuba Çetiner

    2012-09-01

    Full Text Available Background and Design: Although photosensitivity is considered as one of the side effects of retinoids, there is no consensus on this issue. In this study, we aimed to evaluate the minimal erythema dose (MED for narrowband ultraviolet B in patients receiving isotretinoin treatmentMaterial and Method: Phototesting was done by narrowband ultraviolet B irradiation on fifty patients for whom isotretinoin treatment was planned. MED values were calculated before treatment (MED1 and during treatment after reaching half of the target dose (kgx120 mg (MED2, and it was evaluated whether there was statistically significant difference between the two MED values. In addition, the patients were assessed according to their skin phototypes in this respect. Results: When the mean values of MED1 and MED2 were compared in all patients who were treated with 0.5-0.7 mg/kg/day isotretinoin, the mean of MED2 values was found to be lower than the mean of MED1 values. Clinically, sunburn erythema was seen in only 3 (6% patients during the treatment. When the patients were evaluated according to their skin phototypes, significant difference between the means of MED 1 and MED 2 values was not determined. Conclusion: Although isotretinoin treatment does not cause clinically sunburn erythema, it was associated with decrease in MED values.

  15. Avaliação dos resultados do tratamento cirúrgico artroscópico da instabilidade anterior traumática do ombro com sutura da lesão na margem cruentizada da cavidade glenoidal Evaluation of the results from arthroscopic surgical treatment for traumatic anterior shoulder instability using suturing of the lesion at the opened margin of the glenoid cavity

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    Alberto Naoki Miyazaki

    2012-01-01

    Full Text Available OBJETIVO: Avaliar os resultados clínicos dos pacientes portadores de instabilidade anterior traumática do ombro tratados cirurgicamente por visualização artroscópica, utilizando âncoras bioabsorvíveis e com o uso da técnica de cruentização da margem anterior da cavidade glenoidal para a reparação da lesão de Bankart. MÉTODO: Entre março de 2006 e outubro de 2008 foram operados 27 ombros de 27 pacientes com diagnóstico de instabilidade anterior traumática do ombro, com média de idade de 28 anos e número de luxações prévias variando entre dois e 25 episódios. O sexo masculino predominou com 24 (89% pacientes. O tempo mínimo de seguimento foi de 24 meses, com uma média de 36 meses, e nenhum paciente tinha cirurgia prévia no ombro acometido ou lesão óssea significativa na margem glenoidal. A avaliação clínica pós-operatória foi realizada por meio da escala de Rowe. Para medirmos o grau de amplitude articular pré-operatória e pós-operatória, utilizamos o método descrito pela Academia Americana de Cirurgiões Ortopédicos (AAOS. RESULTADO: Pelos critérios de Rowe, 25 pacientes (93% obtiveram resultados excelentes e dois (7% resultados ruins, nenhum paciente apresentou resultado bom ou regular. Vinte e três pacientes estavam satisfeitos com o resultado obtido (85%, retornando às suas atividades sem limitações, e quatro pacientes (15% tinham algum grau de limitação. Houve recidiva da instabilidade em dois pacientes (7%. CONCLUSÃO: O tratamento da instabilidade traumática anterior do ombro por visualização artroscópica com a técnica de cruentização da margem articular anterior da cavidade glenoidal, para reparação da lesão de Bankart, proporcionou excelentes resultados em 93% dos pacientes operados.OBJECTIVE: To evaluate the clinical results from patients with traumatic anterior shoulder instability that was treated surgically through arthroscopic viewing, using bioabsorbable anchors and a technique

  16. Evaluation of a treatment programme for alcohol-related aggression.

    Science.gov (United States)

    McCulloch, Anna; McMurran, Mary

    2008-01-01

    The development of effective treatments for alcohol-related aggression and violence is important in binge drinking cultures, as in parts of the UK.Aim The aim was to evaluate the progress and experience of 10 participants in Control of Violence for Angry Impulsive Drinkers (COVAID) using a single case methodology. Participants completed 10 individual weekly sessions with trained facilitators following the COVAID manual. Change scores on psychometric questionnaires were examined by calculating clinical significance and reliability of change. Self-reports of alcohol consumption and aggression were examined. Follow-up data on convictions were collected. Participants were asked their opinions about COVAID. Scores on the Alcohol-Related Aggression Questionnaire (ARAQ) improved for nine participants; change was both clinically significant and reliable in five cases. Nine participants improved on the Controlled Drinking Self-Efficacy Scale (CDSES), with seven showing clinically significant improvement. Six participants reported a reduction in alcohol consumption from the first to the second half of the programme. At a mean of 29 weeks post-treatment, none of the participants had been reconvicted for a violent offence. Participants reported finding COVAID useful and interesting. Overall, our findings support the possibility that COVAID may assist in reducing alcohol-related violence and violent offending. Copyright (c) 2008 John Wiley & Sons, Ltd.

  17. Evaluation of treatments for separation anxiety in dogs.

    Science.gov (United States)

    Takeuchi, Y; Houpt, K A; Scarlett, J M

    2000-08-01

    To evaluate treatment outcome in dogs with separation anxiety and owner compliance with and perception of effectiveness of discharge instructions. Cohort study. 52 dogs with separation anxiety. Sex, age at which the owner obtained the dog, age at which separation anxiety was first noticed, age at behavioral examination, and discharge instructions were obtained from medical records of each dog. Between 6 and 64 months after the behavioral examination, owners were contacted by telephone and questioned about the outcome of treatment, their compliance with discharge instructions, and their perception of the effectiveness of each instruction. Thirty-two (62%) dogs had improved, whereas 20 were the same, were worse, or had been euthanatized or given away. Mixed-breed dogs were significantly less likely to improve than purebred dogs. Compliance varied according to discharge instruction. Significantly fewer dogs with owners that were given > 5 instructions improved or were cured, compared with those with owners given fewer instructions. Twenty-seven dogs were also treated with amitriptyline or other medication; 15 (56%) improved. Owners complied with instructions that involved little time such as omitting punishment and providing a chew toy at the time of departure. Owners were also willing to increase the dog's exercise but were not willing to uncouple the cues of departure from real departures or desensitize the dog to impending departure. Administration of psychoactive medication may be necessary to augment behavior modification techniques designed to reduce separation anxiety in dogs.

  18. Evaluation of the Drug Treatment and Persistence of Onychomycosis

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    Andrew W. Campbell

    2004-01-01

    Full Text Available Onychomycosis is a common nail disease responsible for approximately 50% of diseases of the nail. It occurs more in the elderly, though several cases have been reported among children. Several factors influence, such as climate, geography, and migration. The two dermatophytes most commonly implicated in onychomycosis are Trichophyton rubrum and T. mentagrophytes, accounting for more than 90% of onychomycoses. Nonetheless, several other toxigenic molds have been implicated. For convenience, onychomycosis is divided into four major clinical presentations: distal subungal, which is the most common form of the disease; proximal subungal, which is the most common form found in patients with human immunodeficiency virus infection; superficial; and total dystrophic onychomycosis. Epidemiology of onychomycosis in adults and children is evaluated and the most common clinical symptoms addressed. Although the risk factors are discussed, the multifactorial nature of onychomycosis makes this inexhaustible. The diagnosis and treatments are difficult and the choice of appropriate antifungal drugs complex and require the knowledge of the chemical structures of the metabolites of the molds that cause onychomycosis and their interaction with the antifungal drugs. This is true because most of the antifungal drugs are derived from mold/fungal metabolism. Treatment with griseofulvin and amphotericin is displaced by the use of newer drugs from azole compounds, pyrimidines, and allylamines derivatives. Amorolfine, itraconazole, and ciclopirox nail lacquer solution 8 have gained support globally, but the side effects, drug resistance, and persistence of the disease are still a serious concern to the patients, just as economics and quality of life. Hence, the search for safer and more efficacious drug treatments are continuing.

  19. The comparative analysis of results of surgical treatment of myasthenia in the remote periods of disease

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    L. Zaslavsky

    2016-01-01

    Full Text Available Based on long-term follow-up to perform comparative analysis of long-term results of surgical treatment of myasthenia. A retrospective analysis of long-term results of surgical treatment of 146 patients with myasthenia has been carried out. We used the modified Keynes classification to estimate the severity of myasthenia and to summarize the data relating to therapy volume and treatment results. In dependence on the type of thymus lesion patients were divided into two groups. Thymus hyperplasia was verified at — 106 (72.6 % patients, tumor lesion of the thymus gland (thymoma — at 40 (27.4 % ones. The results were estimated in the following periods after thymectomy: 1—2 years, 3—4 years, 5—6 years, 7 — 9 years, 10—14 years, and over 15 years. Short- and longterm results of surgical treatment of myasthenia for the patients without tumor lesions of the thymus gland were significantly better. Positive effects of surgical treatment of myasthenia in patients with hyperplasia are observed after 1 year of surgery (p = 0.0023, and the best results are observed after 5 — 6 year of the disease, then after 7 — 9 year one notes some deterioration of state (p = 0.026. In the myasthenia patients with thymoma one notes the similar trends in dynamics of state, but in general, the results are significantly (p = 0.042 badly than in the group of the patients with hyperplasia. Starting from the first year after operation treatment the patients with myasthenia with thymus hyperplasia have statistically significant (p = 0.048 decrease of average doses of glucocorticoids, and anticholinesterase drugs. The statistically best treatment results were noted for the patients operated at the first year of the disease. Positive result of surgical treatment of myasthenia is noted both in the short- and long-term period and at thymomas. In the group of patients with thymoma one has noted significantly badly results in comparison with group of hyperplasia. It is

  20. [Functional and aesthetic results of orthopaedic treatment of midshaft fractures of the clavicle. A 22 years follow-up study].

    Science.gov (United States)

    Sirvent-Díaz, E; Calmet-García, J; Capdevila-Baulenes, J

    2014-01-01

    To evaluate the functional results of the orthopaedic treatment of midshaft clavicle fractures with a minimum follow-up of 15 years. A retrospective study was conducted on 40 patients, mean age 35 years (18-64) with a non-surgically treated clavicle fracture. The mean follow-up was more than 22 years (15-32). The clinical evaluation was performed with the Disability of Arm, Shoulder and Hand score (DASH), Constant Shoulder Score test (CSS), EVA score, and a subjective assessment of the final result. Fractures were classified according to Neer's criteria. The radiological evaluation was performed with an anteroposterior and 45° cefalic anteroposterior oblique X-Ray. A mean DASH score 2.17 points (0-20.82), the mean CSS score was 98.2 (79-100), the mean EVA score was 0.42 (0-6), and 100% patients were satisfied, with good or excellent results. The control X-Ray showed 39 healed fractures (97.5%) with a mean shortening of 6.4mm (0-20). The presence of comminution and/or shortening of 15 mm or more had the worst functional and radiographic results. Despite this, non-surgical treatment showed excellent functional and radiographic results, and a high personal satisfaction. Copyright © 2012 SECOT. Published by Elsevier Espana. All rights reserved.

  1. Treatment intensity, age and outcome in medical ICU patients: results of a French administrative database.

    Science.gov (United States)

    Peigne, Vincent; Somme, Dominique; Guérot, Emmanuel; Lenain, Emilie; Chatellier, Gilles; Fagon, Jean-Yves; Saint-Jean, Olivier

    2016-12-01

    Intensive care unit (ICU) patients are aging, and older age has been associated with higher mortality in ICU. As previous studies have reported that older age was also associated with less intensive treatment, we investigated the relationship between age, treatment intensity and mortality in medical ICU patients. Data were extracted from the administrative database of 18 medical ICUs. Patients with a unique medical ICU stay and a Simplified Acute Physiology Score II (without age-related points) >15 were included. Treatment intensity was described with a novel indicator, which is a four-group classification based upon the most frequent ICU procedures. The relationship between age, treatment intensity and hospital mortality was analyzed with the estimation of standardized mortality ratio in the four groups of treatment intensity. A total of 23,578 patients, including 3203 patients aged ≥80 years, were analyzed. Hospital mortality increased from 13 % for the younger patients (age < 40 years) to 38 % for the older patients (age ≥ 80 years), while Simplified Acute Physiology Score II (without age-related points) increased only from 36 (age < 40 years) to 43 (age ≥ 80). Hospital mortality increased with age in the four groups of treatment intensity. Standardized mortality ratio increased with age among the patients with less intensive treatment but was not associated with age among the patients with the highest treatment intensity. Our results support the fact that the increase in mortality with age among ICU patients is not related to an increase in severity. Using a new tool to estimate ICU treatment intensity, our study suggests that mortality of ICU patients increases with age whatever the treatment intensity is. Further investigations are required to determinate whether this increase in mortality among older ICU patients is related to undertreatment or to a lower efficiency of organ support treatment.

  2. Interim results of the Ph-negative acute lymphoblastic leukemia treatment in adult patients (results of Russian research group of ALL treatment (RALL

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    E. N. Parovichnikova

    2015-01-01

    Full Text Available An interim analysis of long-term treatment results for 202 patients with acute lymphoblastic leukemia (ALL, aged 15–60 years, received therapy according protocol ALL-2009 was shown. The basic principle of ALL-2009 was non-aggressive, but continued cytostatic exposure, as well as the reproducibility in a regional hematology centers. Long-term treatment results of ALL-2009 are 2 times higher than the previously obtained in adult ALL patients within the Russian clinical multicenter studies of adult ALL. The 5‑year overall survival of patients younger than 30 years was 73.6 %, relapse-free survival (RFS – 71.5 %, compared with 52.7 % and 61.8 % in patients aged 30 years and older, respectively. In patients with B-precursor ALL with normal karyotype of blast cells significantly higher 5‑year RFS (82.1 % compared to patients with abnormal karyotype (58.8 % was registered. For T-ALL cytogenetic characteristics of blast cells had no prognostic significance. For patients with T-ALL important to perform autologous stem cell transplantation as a later consolidation, as this significantly reducerelapse rate (from 33 to 0 %.

  3. Results from a Community-Based Smoking Cessation Treatment Program for LGBT Smokers

    Science.gov (United States)

    Matthews, Alicia K.; Li, Chien-Ching; Kuhns, Lisa M.; Tasker, Timothy B.; Cesario, John A.

    2013-01-01

    Introduction. Little is known about lesbian, gay, bisexual, and transgender (LGBT) people's response to smoking cessation interventions. This descriptive study examined the benefits of a community-based, culturally tailored smoking cessation treatment program for LGBT smokers. Methods. A total of N = 198 LGBT individuals recruited from clinical practice and community outreach participated in group-based treatment. Sessions were based on the American Lung Association's “Freedom from Smoking Program” (ALA-FFS) and were tailored to LGBT smokers' needs. Seven-day smoking point prevalence abstinence served as the primary outcome. Results. Participants (M age = 40.5) were mostly White (70.4%) and male (60.5%) and had at least a college degree (58.4%). Forty-four percent scored in the moderate range on the Fagerström Test for Nicotine Dependence pretreatment, and 42.4% completed treatment (≥75% sessions). Higher educational attainment and use of nicotine replacement therapy (NRT) were associated with treatment completion. Self-reported quit rates were 32.3% at posttreatment assessment. Treatment attendance (OR = 2.45), use of NRT (OR = 4.24), and lower nicotine dependency (OR = 0.73) were positively associated with quitting smoking. Conclusions. Results suggest the benefits of offering LGBT smokers culturally tailored smoking cessation treatments. Future research could improve outcomes by encouraging treatment attendance and promoting NRT uptake. PMID:23840237

  4. Endovascular treatment of hepatocellular carcinoma with drug eluting microparticles (DC-Beads: CT evaluation of response to the treatment

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    Emanuele Boatta

    2013-01-01

    Full Text Available Background and Study Aims: Our aim was to assess the efficacy and tolerability of drug-eluting beads-transarterial chemoembolization (DEB-TACE in the treatment of hepatocellular carcinoma (HCC, evaluating the response to the treatment after 1, 6, 12, and 24 months with multidetector computed tomography (MDCT comparing European Association for the study of the Liver (EASL and modified Response Evaluation Criteria in Solid Tumors (mRECIST criteria. Materials and Methods: We enrolled 154 patients with uni- or multifocal HCC who underwent a DEB-TACE. A total of 278 HCC nodules were treated. CT follow-up was performed at 1, 6, 12, and 24 months after the procedure according to the EASL and RECIST criteria evaluating overall target and target nodule response. We also analyzed the shrinking of nodules in relation to response to treatment. Results: A total of 278 nodules of HCC underwent TACE by using DC-Beads: At 24, months complete response was similar for EASL and RECIST criteria (112 vs. 121 nodules with optimal accordance between methods and readers with k = 0.9. Partial Response resulted significantly different among the two methods within the first month, otherwise was similar after 24-month follow-up. Similar results in both methods were found for nodules classified as Stable Disease (P > 0.05. Progressive Disease results were similar in both the groups according to both the classification criteria without any significant difference (P > 0.05. Conclusion: Our study confirmed that EASL and mRECIST criteria are both effective methods for patient follow-up, however with some technical differences.

  5. Endovascular treatment of hepatocellular carcinoma with drug eluting microparticles (DC-Beads): CT evaluation of response to the treatment

    Science.gov (United States)

    Boatta, Emanuele; Corona, Mario; Cannavale, Alessandro; Fanelli, Fabrizio; Cirelli, Carlo; de Medici, Lorenzo

    2013-01-01

    Background and Study Aims: Our aim was to assess the efficacy and tolerability of drug-eluting beads-transarterial chemoembolization (DEB-TACE) in the treatment of hepatocellular carcinoma (HCC), evaluating the response to the treatment after 1, 6, 12, and 24 months with multidetector computed tomography (MDCT) comparing European Association for the study of the Liver (EASL) and modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria. Materials and Methods: We enrolled 154 patients with uni- or multifocal HCC who underwent a DEB-TACE. A total of 278 HCC nodules were treated. CT follow-up was performed at 1, 6, 12, and 24 months after the procedure according to the EASL and RECIST criteria evaluating overall target and target nodule response. We also analyzed the shrinking of nodules in relation to response to treatment. Results: A total of 278 nodules of HCC underwent TACE by using DC-Beads: At 24, months complete response was similar for EASL and RECIST criteria (112 vs. 121 nodules) with optimal accordance between methods and readers with k = 0.9. Partial Response resulted significantly different among the two methods within the first month, otherwise was similar after 24-month follow-up. Similar results in both methods were found for nodules classified as Stable Disease (P > 0.05). Progressive Disease results were similar in both the groups according to both the classification criteria without any significant difference (P > 0.05). Conclusion: Our study confirmed that EASL and mRECIST criteria are both effective methods for patient follow-up, however with some technical differences. PMID:24082476

  6. Intraprostatic Injection of Alcohol Gel for the Treatment of Benign Prostatic Hyperplasia: Preliminary Clinical Results

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    Benjamin T. Larson

    2006-01-01

    Full Text Available Benign prostatic hyperplasia (BPH is one of the most common diseases ailing older men. Office-based procedures offer the advantage of being more effective than medications, while limiting the adverse effects, cost, and recovery of surgery. This study presents preliminary data on a new procedure that utilizes intraprostatic alcohol gel injection to ablate prostatic tissue. The purpose of this study is to evaluate the feasibility of using this gel as a treatment for BPH.

  7. The Year of 2004 Treatment Results of Soldier Patients with Tuberculosis

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    Faruk Ciftci

    2008-02-01

    Full Text Available BACKGROUND: To present extensively the serial of soldier cases with tuberculosis (TB for the year of 2004 in the Turkish Armed Forces (TAF which is accepted as a risk group and to compare the results with other studies. METHODS: In this study, data was retrospectively analyzed for soldier patients diagnosed with tuberculosis (TB in our hospital by 2004. Our hospital is the greatest TB treatment center in TAF. Microscopical examination was done in all cases. The proper treatment was begun in all patients and they were followed during next 6-12 months. At the end of that period, treatment results were assessed. RESULTS: Two hundred thirty six cases with TB were found by the year of 2004. One hundred sixty of these cases (83,3% were pulmonary TB (PTB and 56 of them were (16,7% extra pulmonary TB (EPTB. It was discovered that 216 of our cases (91,5% were new and 20 of them were (8,5% previous cases. Twenty PTB patients had EPTB at the same time. Fifty two of total 56 EPTB cases (92,9% were pleural TB. Of 4 patients (7,1% had the other organs TB. Smear positive and smear negative cases numbers were 119 (%66,1, 61 (%33,9 respectively. In smear positive 119 cases, treatment outcomes were classified as follows: 95 cases (79.8% were cured, 9 patients (7,6% were treatment completion. Treatment success was managed in total 104 cases (87,4%. Three of smear positive patients (2,5% were treatment failure, 9 cases (7,6% were transfer out and 3 (2,5% was dead. CONCLUSION: Our cure results in smear positive patients are close to the rate of 85% targeted by WHO. In addition, we have fairly satisfied level in treatment success. [TAF Prev Med Bull 2008; 7(1.000: 7-14

  8. The Year of 2004 Treatment Results of Soldier Patients with Tuberculosis

    Directory of Open Access Journals (Sweden)

    Ali Kutlu

    2008-02-01

    Full Text Available BACKGROUND: To present extensively the serial of soldier cases with tuberculosis (TB for the year of 2004 in the Turkish Armed Forces (TAF which is accepted as a risk group and to compare the results with other studies. METHODS: In this study, data was retrospectively analyzed for soldier patients diagnosed with tuberculosis (TB in our hospital by 2004. Our hospital is the greatest TB treatment center in TAF. Microscopical examination was done in all cases. The proper treatment was begun in all patients and they were followed during next 6-12 months. At the end of that period, treatment results were assessed. RESULTS: Two hundred thirty six cases with TB were found by the year of 2004. One hundred sixty of these cases (83,3% were pulmonary TB (PTB and 56 of them were (16,7% extra pulmonary TB (EPTB. It was discovered that 216 of our cases (91,5% were new and 20 of them were (8,5% previous cases. Twenty PTB patients had EPTB at the same time. Fifty two of total 56 EPTB cases (92,9% were pleural TB. Of 4 patients (7,1% had the other organs TB. Smear positive and smear negative cases numbers were 119 (%66,1, 61 (%33,9 respectively. In smear positive 119 cases, treatment outcomes were classified as follows: 95 cases (79.8% were cured, 9 patients (7,6% were treatment completion. Treatment success was managed in total 104 cases (87,4%. Three of smear positive patients (2,5% were treatment failure, 9 cases (7,6% were transfer out and 3 (2,5% was dead. CONCLUSION: Our cure results in smear positive patients are close to the rate of 85% targeted by WHO. In addition, we have fairly satisfied level in treatment success. [TAF Prev Med Bull. 2008; 7(1: 7-14

  9. Multiple treatment comparisons in a series of anti-malarial trials with an ordinal primary outcome and repeated treatment evaluations

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    Youdom Solange

    2012-05-01

    Full Text Available Abstract Background Artemisinin-based combination therapies (ACT are widely used in African countries, including Cameroon. Between 2005 and 2007, five randomized studies comparing different treatment arms among artesunate-amodiaquine and other ACT were conducted in Cameroonian children aged two to 60 months who had uncomplicated Plasmodium falciparum malaria. In these studies, the categorical criterion proposed by the World Health Organization (WHO to assess the relative effectiveness of anti-malarial drugs was repeatedly evaluated on Days 14, 21 and 28 after treatment initiation. The aim of the present study was to compare the effects of different treatments on this repeated ordinal outcome, hence using the fully available information. Methods The quantitative synthesis was based on individual patient data. Due to the incomplete block design concerning treatment arms between different trials, a mixed treatment comparison (MTC meta-analysis approach was adopted. The repeated ordinal outcome was modelled through a latent variable, as a proportional odds mixed model with trial, period and treatment arms as covariates. The model was further complexified to account for the variance heterogeneity, and the individual log-residual variance was modelled as a linear mixed model, as well. The effects of individual covariates at inclusion, such as parasitaemia, fever, gender and weight, were also tested. Model parameters were estimated using a Bayesian approach via the WinBUGS software. After selecting the best model using Deviance Information Criterion (DIC, mixed treatment comparisons were based on the estimated treatment effects. Results Modeling the residual variance improved the model ability to adjust the data. The results showed that, compared to artesunate-amodiaquine (ASAQ, dihydroartemisinin-piperaquine (DHPP was significantly more efficacious. Artesunate-chlorproguanil-dapsone (ASCD was less efficacious than artesunate

  10. Treatment of Stress Urinary Incontinence in Neurological Patients With an Injectable Elastomer Prosthesis: Preliminary Results.

    Science.gov (United States)

    Renard, Julien; Citeri, Marco; Zanollo, Lucia; Guerrer, Chiara; Rizzato, Luigi; Frediani, Luca; Iselin, Christophe; Spinelli, Michele

    2017-03-24

    Many treatment options for stress urinary incontinence are difficult to apply to neurological patients. Urolastic is a new agent that is primarily indicated for women with mild stress urinary incontinence or men after prostate surgery. In this report, we present a series of 5 cases describing the first use of Urolastic to treat neurological patients. All patients were evaluated with a voiding diary and the use of auxiliary devices as the main indicators of continence. The median operative time was 30.8 minutes, and no complications were observed. Of the 5 patients, 4 reported improved incontinence: 2 switched from diapers to small pads, while the other 2 patients were able to discontinue urinary condom use. The only instance of treatment failure occurred in a patient with a low-compliance bladder. The advantages of this procedure appear to include a soft-cuff effect, reversibility, and minimal invasiveness. However, a future randomized study would be necessary to validate this treatment option.

  11. Evaluation and Treatment of Severe Obesity in Childhood

    Science.gov (United States)

    Wickham, Edmond P.; DeBoer, Mark D.

    2017-01-01

    Pediatric obesity is highly prevalent in developed countries globally (and worsening in developing countries) and threatens to shorten the lifespan of the current generation. At highest risk for weight-related comorbidities including Type 2 diabetes mellitus, non-alcoholic fatty liver disease and dyslipidemia is a sub-set of children with severe obesity, often defined as a body mass index (BMI) percentile ≥99th percentile for age and sex. The pathophysiology of severe obesity in childhood is complex, resulting from the dynamic interplay of a myriad of individual and societal factors including genetic predisposition and health behaviors contributing to energy imbalance. Approximately 4–6% of children have severe obesity, representing a common scenario encountered by providers, and intervention is critical to halt ongoing weight gain and, when possible, reverse the trend. Clinical approaches promoting behavioral weight loss may result in modest, albeit clinically significant, reductions in BMI; however, such changes are often difficult to maintain long-term. Data regarding the impact of targeted pharmacotherapy including agents such as orlistat are limited in the pediatric population and again only suggest modest results. However, increasing evidence suggest that surgical treatment, as an adjunct to ongoing lifestyle changes, may be a promising option in carefully-screened adolescents with severe obesity and weight-related comorbidities who are motivated to adhere to the long-term treatment needs. PMID:25567296

  12. Toxicity Evaluation of Through Fish Bioassay Raw Bulk Drug Industry Wastewater After Electrochemical Treatment

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    S Satyanarayan

    2011-10-01

    Full Text Available Considering the high pollution potential that the synthetic Bulk Drug industry Wastewater (BDW possesses due to the presence of variety of refractory organics, toxicity evaluation is of prime importance in assessing the efficiency of the applied wastewater treatment system and in establishing the discharge standards. Therefore, in this study the toxic effects of high strength bulk drug industry wastewater before and after electrochemical treatment on common fish Lebistes reticulatus-(peter were studied under laboratory conditions. Results indicated that wastewater being very strong in terms of color, COD and BOD is found to be very toxic to the studied fish. The LC50 values for raw wastewater and after electrochemical treatment with carbon and aluminium electrodes for 24, 48, 72 and 96 hours ranged between, 2.5-3.6%, 6.8-8.0%, 5.0-5.8% respectively. Carbon electrode showed marginally better removals for toxicity than aluminium electrode. It was evident from the studies that electrochemical treatment reduces toxicity in proportion to the removal efficiency shown by both the electrodes. The reduction in toxicity after treatment indicates the intermediates generated are not toxic than the parent compounds. Furthermore, as the electrochemical treatment did not result in achieving disposal standards it could be used only as a pre-treatment and the wastewater needs further secondary treatment before final disposal.

  13. Radiation injury of the rectum: Evaluation of surgical treatment

    Energy Technology Data Exchange (ETDEWEB)

    Anseline, P.F.; Lavery, I.C.; Fazio, V.W.; Jagelman, D.G.; Weakley, F.L.

    1981-12-01

    One hundred four patients, 80 women and 24 men, with radiation injury of the rectum following treatment for gynecologic and urologic malignancy were studied. In 50 patients, the rectal injury was treated surgically; 54 patients were treated conservatively. The age and sex distributions were the same in each group. In 63 patients, symptoms developed one month to one year after radiotherapy. The longest latent interval was 17 years. Of the 50 surgical patients, 23 had associated small bowel injury. The indications for surgery for the rectal injury were 1) proctitis unresponsive to conservative measures in 14 patients, 2) rectal stricture or fistula or both in 32, and 3) rectosigmoid perforation in four. Forty-one patients had external diversions. Eleven had intestinal continuity restored; six of the 11 had required the stoma for proctitis unresponsive to medical measures. Nineteen patients did not undergo colostomy closure, although symptoms were greatly improved. Diversion alone was insufficient treatment in the remaining 11 patients. Twenty-six patients died. The 12 deaths in the surgical group comprised four due to residual malignancy, four from post-operative complications, and four from unrelated causes. Of the 14 deaths in the nonsurgical group, 11 died of the primary malignancy and three of unrelated causes. Diversion is considered the safest form of treatment for rectovaginal fistulae, rectal strictures, and proctitis unresponsive to medical measures. Intestinal resection resulted in a sharp rise in the morbidity and mortality rates.

  14. Radiation injury of the rectum: evaluation of surgical treatment

    Energy Technology Data Exchange (ETDEWEB)

    Anseline, P.F.; Lavery, I.C.; Fazio, V.W.; Jagelman, D.G.; Weakley, F.L.

    1981-12-01

    One hundred four patients, 80 women and 24 men, with radiation injury of the rectum following treatment for gynecologic and urologic malignancy were studied. In 50 patients, the rectal injury was treated surgically; 54 patients were treated conservatively. The age and sex distributions were the same in each group. In 63 patients, symptoms developed one month to one year after radiotherapy. The longest latent interval was 17 years. Of the 50 surgical patients, 23 had associated small bowel injury. The indications for surgery for the rectal injury were 1) proctitis unresponsive to conservative measures in 14 patients, 2) rectal stricture or fistula or both in 32, and 3) rectosigmoid perforation in four. Forty-one patients had external diversions. Eleven had intestinal continuity restored; six of the 11 had required the stoma for proctitis unresponsive to medical measures. Nineteen patients did not undergo colostomy closure, although symptoms wer greatly improved. Diversion alone was insufficient treatment in the remaining 11 patients. Twenty-six patients died. The 12 deaths in the surgical group comprised four due to residual malignancy, four from postoperative complications, and four from unrelated causes. Of the 14 deaths in the nonsurgical group, 11 died of the primary malignancy and three of unrelated causes. Diversion is considered the safest form of treatment for rectovaginal fistulae, rectal strictures, and proctitis unresponsive to medical measures. Intestinal resection resulted in sharp rise in the morbidity and mortality rates.

  15. Sodium-bearing Waste Treatment Technology Evaluation Report

    Energy Technology Data Exchange (ETDEWEB)

    Charles M. Barnes; Arlin L. Olson; Dean D. Taylor

    2004-05-01

    Sodium-bearing waste (SBW) disposition is one of the U.S. Department of Energy (DOE) Idaho Operation Office’s (NE-ID) and State of Idaho’s top priorities at the Idaho National Engineering and Environmental Laboratory (INEEL). The INEEL has been working over the past several years to identify a treatment technology that meets NE-ID and regulatory treatment requirements, including consideration of stakeholder input. Many studies, including the High-Level Waste and Facilities Disposition Environmental Impact Statement (EIS), have resulted in the identification of five treatment alternatives that form a short list of perhaps the most appropriate technologies for the DOE to select from. The alternatives are (a) calcination with maximum achievable control technology (MACT) upgrade, (b) steam reforming, (c) cesium ion exchange (CsIX) with immobilization, (d) direct evaporation, and (e) vitrification. Each alternative has undergone some degree of applied technical development and preliminary process design over the past four years. This report presents a summary of the applied technology and process design activities performed through February 2004. The SBW issue and the five alternatives are described in Sections 2 and 3, respectively. Details of preliminary process design activities for three of the alternatives (steam reforming, CsIX, and direct evaporation) are presented in three appendices. A recent feasibility study provides the details for calcination. There have been no recent activities performed with regard to vitrification; that section summarizes and references previous work.

  16. Evaluation and treatment of constipation in infants and children.

    Science.gov (United States)

    Biggs, Wendy S; Dery, William H

    2006-02-01

    Constipation in children usually is functional and the result of stool retention. However, family physicians must be alert for red flags that may indicate the presence of an uncommon but serious organic cause of constipation, such as Hirschsprung's disease (congenital aganglionic megacolon), pseudo-obstruction, spinal cord abnormality, hypothyroidism, diabetes insipidus, cystic fibrosis, gluten enteropathy, or congenital anorectal malformation. Treatment of functional constipation involves disimpaction using oral or rectal medication. Polyethylene glycol is effective and well tolerated, but a number of alternatives are available. After disimpaction, a maintenance program may be required for months to years because relapse of functional constipation is common. Maintenance medications include mineral oil, lactulose, milk of magnesia, polyethylene glycol powder, and sorbitol. Education of the family and, when possible, the child is instrumental in improving functional constipation. Behavioral education improves response to treatment; biofeedback training does not. Because cow's milk may promote constipation in some children, a trial of withholding milk may be considered. Adding fiber to the diet may improve constipation. Despite treatment, only 50 to 70 percent of children with functional constipation demonstrate long-term improvement.

  17. Results of clubfoot treatment after manipulation and casting using the Ponseti method: experience in Harare, Zimbabwe.

    Science.gov (United States)

    Smythe, Tracey; Chandramohan, Daniel; Bruce, Jane; Kuper, Hannah; Lavy, Christopher; Foster, Allen

    2016-10-01

    The objective of this study was to evaluate the outcomes of the Ponseti manipulation and casting method for clubfoot in a tertiary hospital in Zimbabwe and explore predictors of these outcomes. A cohort study included children with idiopathic clubfoot managed from 2011 to 2013 at Parirenyatwa Hospital. Demographic data, clinical features and treatment outcomes were extracted from clinic records. The primary outcome measure was the final Pirani score (clubfoot severity measure) after manipulation and casting. Secondary outcomes included change in Pirani score (pre-treatment to end of casting), number of casts for correction, proportion receiving tenotomy and proportion lost to follow up. A total of 218 children (337 feet) were eligible for inclusion. The median age at treatment was 8 months; 173 children (268 feet) completed casting treatment within the study period. The mean length of time for corrective treatment was 10.2 weeks (9.5-10.9 weeks). Of the 45 children who did not complete treatment, 28 were under treatment and 17 were lost to follow up. A Pirani score of 1 or less was achieved in 85% of feet. Mean Pirani score at presentation was 3.80 (SD 1.15) and post-treatment 0.80 (SD 0.56, P-value <0.0001). Severity of deformity and being male were associated with a higher (worse) final Pirani score. Severity and age over two were associated with an increase in the number of casts required to correct deformity. This case series demonstrates that the majority (80%+) of children with clubfoot can achieve a good outcome with the Ponseti manipulation and casting method. © 2016 John Wiley & Sons Ltd.

  18. Learning the 'SMART' way... results from a pilot study evaluating an interprofessional acute care study day.

    Science.gov (United States)

    Lewis, Robin

    2011-01-01

    A significant number of patients requiring critical care are now being managed outside of critical care facilities. There is evidence that staff looking after these patients lack the necessary knowledge and skills to care for them safely, and that effective pre-registration education can play a significant role in addressing these shortfalls in nurses' knowledge and skills. A team from Sheffield Hallam University, in collaboration with the University of Sheffield, developed a pilot one day interprofessional acute illness programme which was called SMART® (Student Management of Acute illness - Recognition and Treatment). To evaluate the pilot programme, 16 student doctors and 72 student nurses were recruited. A pre- and post-course questionnaire based on the Featherstone et al. (2005) evaluation of ALERT was used to ascertain the students' general level of knowledge of the deteriorating patient, their experiences of and confidence in caring for an acutely unwell patient, and their level of comfort with interprofessional working. The results from the pilot study indicate that the students' levels of knowledge, their levels of confidence and their comfort with interprofessional working all rose after undertaking the programme. The pilot study has a number of implications for the future teaching and learning of acute care clinical skills, within a theoretically based curriculum. 2010 Elsevier Ltd. All rights reserved.

  19. A Method for Evaluating Treatment in Infants with Deformational Plagiocephaly

    DEFF Research Database (Denmark)

    Lanche, Stéphanie; Darvann, Tron Andre; Ólafsdottír, Hildur

    -surgical and involves parental education on infant repositioning to avoid pressure on the attened side, and, in many cases, orthotic molding helmet therapy. The purpose of this work was to develop a method for assessment of helmet therapy employing a statistical analysis of change in head asymmetry. The clinical......Deformational Plagiocephaly (DP) is a term describing head asymmetry and deformation commonly seen in infants. DP affects the back of the head and, to a lesser extent, the forehead. The deformity is thought to result from protracted external pressure to the skull in one position. Treatment is non...

  20. Perioperative Interstitial High-Dose-Rate Brachytherapy for the Treatment of Recurrent Keloids: Feasibility and Early Results

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Ping, E-mail: ping.jiang@uksh.de [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Baumann, René [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Dunst, Juergen [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Department of Radiation Oncology, University of Copenhagen, Copenhagen (Denmark); Geenen, Matthias [Department of Reconstructive Surgery, Lubinus Clinic Kiel, Kiel (Germany); Siebert, Frank-André [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Niehoff, Peter [Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany); Department of Radiation Oncology, Community Clinic Köln, Köln (Germany); Department of Radiation Oncology, University Witten/Herdecke, Witten (Germany); Bertolini, Julia; Druecke, Daniel [Department of Reconstructive Surgery, University Clinic Schleswig-Holstein, Campus Kiel, Kiel (Germany)

    2016-03-01

    Purpose: To prospectively evaluate high-dose-rate brachytherapy in the treatment of therapy-resistant keloids and report first results, with emphasis on feasibility and early treatment outcome. Methods and Materials: From 2009 to 2014, 24 patients with 32 recurrent keloids were treated with immediate perioperative high-dose-rate brachytherapy; 3 patients had been previously treated with adjuvant external beam radiation therapy and presented with recurrences in the pretreated areas. Two or more different treatment modalities had been tried in all patients and had failed to achieve remission. After (re-)excision of the keloids, a single brachytherapy tube was placed subcutaneously before closing the wound. The target volume covered the scar in total length. Brachytherapy was given in 3 fractions with a single dose of 6 Gy in 5 mm tissue depth. The first fraction was given within 6 hours after surgery, the other 2 fractions on the first postoperative day. Thus, a total dose of 18 Gy in 3 fractions was administered within 36 hours after the resection. Results: The treatment was feasible in all patients. No procedure-related complications (eg, secondary infections) occurred. Nineteen patients had keloid-related symptoms before treatment like pain and pruritus; disappearance of symptoms was noticed in all patients after treatment. After a median follow-up of 29.4 months (range, 7.9-72.4 months), 2 keloid recurrences and 2 mildly hypertrophied scars were observed. The local control rate was 94%. Pigmentary abnormalities were detected in 3 patients, and an additional 6 patients had a mild delay in the wound-healing process. Conclusions: The early results of this study prove the feasibility and the efficacy of brachytherapy for the prevention of keloids. The results also suggest that brachytherapy may be advantageous in the management of high-risk keloids or as salvage treatment for failure after external beam therapy.

  1. Magnetic resonance evaluation of nonsurgical treatment for internal derangement with closed lock of the temporomandibular joint

    Energy Technology Data Exchange (ETDEWEB)

    Chiba, Masatoshi; Kumagai, Masahiro; Takahashi, Tetsu; Teshima, Teiichi (Tohoku Univ., Sendai (Japan). School of Dentistry)

    1994-02-01

    This study used 1.5 Tesla magnetic resonance imaging (MRI) to evaluate the positional and morphological changes of the disc and condyle in patients with closed lock treated nonsurgically. A total of 20 joints (19 patients) which were successfully unlocked by nonsurgical treatment were studied. Nonsurgical treatment was gradually applied a follows: mandibular manipulation, anterior splint assisted manipulation, pumping manipulation, and stabilization splint therapy. The joints were evaluated by MRI in the closed-and open-mouth positions before and after treatment. Post-treatment MRI was also performed with the splint in place. Each imaging procedure was made in the same sagittal plane. After treatment, 19 patients experienced significant improvement in pain, range of motion, and mandibular dysfunction. Post-treatment MRI revealed that only one joint was normal. Six joints had anterior disc displacement with reduction (DWR), and 13 joints had anterior disc displacement without reduction (DNR). Evidence of disc repositioning with the splint in place was seen in 4 joints in the DWR group. Disc mobility increased with improved condylar translation in 19 joints. Disc deformity progressed in 10 joints of the DNR group. These results suggest that successful treatment for internal derangement with closed lock may require an increase in the mobility of the disc, regardless of disc position. (Author).

  2. Evaluation of regional metabolic abnormality and treatment effect in patients with narcolepsy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yu Kyeong; Yoon, In Young; Shin, Youn Kyung; Eo, Jae Sean; Won, Oh So; Lee, Won Woo; Kim, Sang Eun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2005-07-01

    The aim of the present study was to evaluated regional metabolic abnormalities in untreated narcoleptic patients and the changes in regional cerebral metabolism after treatment with modafinil. Eight drug free narcoleptic patients (mean age of 17{+-}1 yr) participated in this study. Two [{sup 18}F]fluorodeoxyglucose positron emission tomography (FDG-PET) scans before and after a 2-week titrated modafinil treatment (target dose = 100{approx}400 mg/day). The PET data were analyzed by using statistical parametric mapping methods to identify the regional cerebral abnormalities compared with those of healthy young controls. In addition, treatment effect was evaluated by comparison between before and after treatment scan. In narcolepsy patients, a significant reduction of regional metabolism was demonstrated in the brain stem, bilateral hypothalamus, posterior thalamus, hippocampus, parahippocampal gyrus, and adjacent perihinal area on pretreatment scans compared with those of healthy subjects. The decrease glucose metabolism was also found in the occipital cortex and cerebellum. The patients could control daytime sleepiness after treatment. Posttreatment scan showed a significant increase in regional metabolism in the left hippocampus. This study demonstrated the metabolic abnormalities and the effect of modafinil treatment in narcoleptic patients in the sleep associated regions. This results could be helpful to understand the pathophysiology of the narcolepsy