Time trends for alendronate prescription practices in women with chronic obstructive pulmonary disease and women exposed to systemic glucocorticoids

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Brask-Lindemann, Dorthe; Eiken, P; Eskildsen, P

2013-01-01

Summary Chronic obstructive pulmonary disease (COPD) and systemic glucocorticoid exposure are well-known risk factors of osteoporosis. We evaluated alendronate prescription practices related to COPD and exposure to systemic corticosteroids from 1996 to 2008 and showed an increasing targeting...... of alendronate treatment in patients with COPD and patients with systemic corticosteroid exposure. Introduction COPD and systemic glucocorticoid exposure are well-known risk factors of osteoporosis and fragility fracture, but osteoporosis is often underdiagnosed and undertreated in these patients. This study...... aims to evaluate alendronate prescription practices related to COPD and/or to exposure to systemic glucocorticoids among Danish women. Methods A total of 388,314 female subjects >50 years old, 64,719 of whom initiated treatment with alendronate, and 323,595 age- and gender-matched controls were...

Effects of short-term alendronate treatment on the three-dimensional microstructural, physical and mechanical properties of dog trabecular bone

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Hu, J; Ding, Ming; Søballe, K

2002-01-01

The bisphosphonate, alendronate, is well known for its potent inhibition of osteoclast-mediated bone resorption. It has been used clinically for the treatment of osteoporosis and has also recently been used to reduce osteolysis around prostheses in a canine revision model of implant loosening...... proximal humeri. These specimens were scanned using a high-resolution microcomputed tomography (micro-CT) system. From accurate data sets, three-dimensional microstructural properties were calculated and physical and mechanical properties were determined. Treatment with alendronate increased bone volume...

Glucocorticoid Steroid and Alendronate Treatment Alleviates Dystrophic Phenotype with Enhanced Functional Glycosylation of α-Dystroglycan in Mouse Model of Limb-Girdle Muscular Dystrophy with FKRPP448L Mutation.

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Wu, Bo; Shah, Sapana N; Lu, Peijuan; Richardson, Stephanie M; Bollinger, Lauren E; Blaeser, Anthony; Madden, Kyle L; Sun, Yubo; Luckie, Taylor M; Cox, Michael D; Sparks, Susan; Harper, Amy D; Lu, Qi Long

2016-06-01

Fukutin-related protein-muscular dystrophy is characterized by defects in glycosylation of α-dystroglycan with variable clinical phenotypes, most commonly as limb-girdle muscular dystrophy 2I. There is no effective therapy available. Glucocorticoid steroids have become the standard treatment for Duchenne and other muscular dystrophies with serious adverse effects, including excessive weight gain, immune suppression, and bone loss. Bisphosphonates have been used to treat Duchenne muscular dystrophy for prevention of osteoporosis. Herein, we evaluated prednisolone and alendronate for their therapeutic potential in the FKRPP448L-mutant mouse representing moderate limb-girdle muscular dystrophy 2I. Mice were treated with prednisolone, alendronate, and both in combination for up to 6 months. Prednisolone improved muscle pathology with significant reduction in muscle degeneration, but had no effect on serum creatine kinase levels and muscle strength. Alendronate treatment did not ameliorate muscle degeneration, but demonstrated a limited enhancement on muscle function test. Combined treatment of prednisolone and alendronate provided best improvement in muscle pathology with normalized fiber size distribution and significantly reduced serum creatine kinase levels, but had limited effect on muscle force generation. The use of alendronate significantly mitigated the bone loss. Prednisolone alone and in combination with alendronate enhance functionally glycosylated α-dystroglycan. These results, for the first time, demonstrate the efficacy and feasibility of this alliance treatment of the two drugs for fukutin-related protein-muscular dystrophy. Copyright © 2016 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

Prevention of aromatase inhibitor-induced bone loss with alendronate in postmenopausal women: The BATMAN Trial.

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Lomax, Anna J; Yee Yap, Saw; White, Karen; Beith, Jane; Abdi, Ehtesham; Broad, Adam; Sewak, Sanjeev; Lee, Chooi; Sambrook, Philip; Pocock, Nicholas; Henry, Margaret J; Yeow, Elaine G; Bell, Richard

2013-12-01

Postmenopausal women on aromatase inhibitors (AI) are at risk of aromatase inhibitor-associated bone loss (AIBL) and fractures. In 2005 Osteoporosis Australia proposed an algorithm for bisphosphonate intervention. Three hundred and three postmenopausal women with early breast cancer (EBC) were enrolled (osteoporotic, n=25; osteopaenic, n=146; normal bone mineral density (BMD), n=126). Weekly alendronate (70 mg) treatment efficacy as triggered by the algorithm in preventing bone loss was evaluated. All patients received anastrozole (1 mg daily), calcium and vitamin D. All osteoporotic patients received alendronate at baseline. Eleven out of the 146 (7.5%) osteopaenic patients commenced alendronate within 18 months of participation and eleven commenced after. One hundred and twenty four out of the 146 (84.9%) osteopaenic patients and all 126 with normal baseline BMD did not trigger the algorithm. At three years, lumbar spine mean BMD increased (15.6%, p<0.01) in the osteoporotic group. BMD in the osteopaenic group with early intervention significantly increased at three years (6.3%, p=0.02). No significant change was seen in the late intervention group. No change was observed in those with osteopaenia without alendronate. There was a significant drop in lumbar spine (-5.4%) and hip (-4.5%) mean BMD, in the normal BMD group, none of whom received alendronate. Fracture data will be presented. In postmenopausal women with endocrine-responsive EBC, BMD improved over time when a bisphosphonate is administered with anastrozole in osteoporotic patients using an osteoporosis schedule. Subjects with normal baseline BMD experienced the greatest BMD loss, although none became osteoporotic.

The Effect of Alendronate and Calcitonin Treatments on Bone Mineral Density and Quality of Life in Women With Postmenopausal Osteoporosis

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F. Taşçıoğlu

2002-06-01

Full Text Available The aim of this study was to compare the effect of alendronate and calcitonin treatments on bone mineral density (BMD and quality of life of women with postmenopausal osteoporosis. One hundred ninety-three patients were randomly assigned to two groups: 93 patients received daily doses of 10 mg alendronate and calcium 1000 mg, and 98 patients used intranasal salmon calcitonin (sCt at a dosage of 200 IU/day and they also received daily doses of 1000 mg calcium supplements. DXA was used for the measurement of BMD of the lumbar spine and proximal femur before and after the study period. SF-36 was used as a measure of health-related quality of life. At the end of the treatment, ALN produced significant increases in BMD at the lumbar spine (p< 0.001, femur neck (p<0.05, trochanteric region (p<0.001 and at the Ward triangle (p<0.05. In contrast, intranasal sCt treatment resulted in a significant bone loss in the femur neck (p<0.01 and Ward triangle (p<0.05, and only a significant increase in BMD of the lumbar spine was observed with calcitonin treatment(p< 0.05. Quality of life as assessed by SF-36 improved significantly in both groups(p<0.05. In conclusion, alendronate seemed to be more effective than calcitonin, increasing both spinal and femoral BMD, for the treatment of postmenopausal osteoporosis. Both treatments were found to be effective for the improvement of quality of life.

Adherence to alendronic or risedronic acid treatment, combined or not to calcium and vitamin D, and related determinants in Italian patients with osteoporosis

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Calabria S

2016-04-01

Full Text Available S Calabria,1 E Cinconze,2 M Rossini,3 E Rossi,2 AP Maggioni,1,4 A Pedrini,1 M De Rosa2 1CORE, Collaborative Outcome Research, Bologna, Italy; 2Health Care Systems Department, CINECA, Interuniversity Consortium, Bologna, Italy; 3Rheumatology Unit, University of Verona, Verona, Italy; 4ANMCO Research Center, Firenze, ItalyPurpose: Osteoporosis is a chronic disease and an important health and social burden due to its worldwide prevalence. Literature and clinical experience report incomplete adherence to the therapy. This retrospective observational study aimed at assessing the adherence to first-line antiosteoporosis drugs (AODs; reimbursed by the National Health System, according to the Italian Medicine Agency recommendation number 79, alendronate or risedronate, with or without calcium and/or vitamin D supplements, in a real, Italian clinical setting.Patients and methods: Analyses were carried out on data present in the ARNO Observatory, a population-based patient-centric Italian database. From a population of 5,808,832 inhabitants with available data, a cohort of 3.3 million of patients aged ≥40 years was selected. New users of first-line AODs as monotherapy (accrual period, 2007–2009 were followed up over 3 years to assess adherence at 6, 12, and 36 months to AODs and to supplements and related determinants.Results: Approximately 40,000 new users were identified: mostly women, aged on average (standard deviation 71±10 years. Alendronate was the most prescribed (38.2% of patients, followed by risedronate (34.9% and alendronate with colecalciferol as a fixed-dose combination (25.8%. Adherence at the 6-month follow-up was 54%, and this constantly and significantly decreased after 1 year to 46%, and after 3 years to 33% (P<0.01. Adherence to the fixed-dose combination was higher than to plain alendronate throughout the follow-up period. Similarly, adherence to supplements constantly decreased with the duration of treatment. Women and patients

Theoretical analysis of alendronate and risedronate effects on canine vertebral remodeling and microdamage

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Wang, Xiang; Erickson, Antonia M.; Allen, Matthew R.; Burr, David B.; Martin, R. Bruce; Hazelwood, Scott J.

2009-01-01

Bisphosphonates suppress bone remodeling activity, increase bone volume, and significantly reduce fracture risk in individuals with osteoporosis and other metabolic bone diseases. The objectives of the current study were to develop a mathematical model that simulates control and 1 year experimental results following bisphosphonate treatment (alendronate or risedronate) in the canine fourth lumbar vertebral body, validate the model by comparing simulation predictions to 3 year experimental res...

Whole body vibration exercise improves body balance and walking velocity in postmenopausal osteoporotic women treated with alendronate: Galileo and Alendronate Intervention Trail (GAIT).

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Iwamoto, J; Sato, Y; Takeda, T; Matsumoto, H

2012-09-01

A randomized controlled trial was conducted to determine the effect of 6 months of whole body vibration (WBV) exercise on physical function in postmenopausal osteoporotic women treated with alendronate. Fifty-two ambulatory postmenopausal women with osteoporosis (mean age: 74.2 years, range: 51-91 years) were randomly divided into two groups: an exercise group and a control group. A four-minute WBV exercise was performed two days per week only in the exercise group. No exercise was performed in the control group. All the women were treated with alendronate. After 6 months of the WBV exercise, the indices for flexibility, body balance, and walking velocity were significantly improved in the exercise group compared with the control group. The exercise was safe and well tolerated. The reductions in serum alkaline phosphatase and urinary cross-linked N-terminal telopeptides of type I collagen during the 6-month period were comparable between the two groups. The present study showed the benefit and safety of WBV exercise for improving physical function in postmenopausal osteoporotic women treated with alendronate.

Effect of topical alendronate on root resorption of dried replanted dog teeth.

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Levin, L; Bryson, E C; Caplan, D; Trope, M

2001-06-01

Alendronate (ALN) is a third generation bisphosphonate with demonstrated osteoclast inhibitory activity that may slow down the resorptive process after severe traumatic injuries. Eighty-two premolar roots of five mongrel dogs were endodontically treated and restored, extracted and treated as follows: 70 roots were bench dried for either 40 or 60 min. Thirty-eight of these roots were then soaked for 5 min in a 1 mM solution of ALN in Hanks' Balanced Salt Solution (HBSS) and replanted. Thirty-two roots were soaked for 5 min in HBSS and replanted. In the remaining 12 roots which were not exposed to the bench drying procedure, a 0.5 mM deep lingual mid-root cemental defect was made. Six of these roots were soaked in a 1 mM solution of ALN in HBSS for 5 min and replanted. The other six roots were soaked for 5 min in HBSS and replanted. Historical negative and positive controls were used from similarly treated teeth in our previous studies. After 4 months the dogs were killed and the roots prepared for histological evaluation. Five-microm-thick cross-sections of the root and surrounding tissue taken every 70 microm were evaluated for healing according to the criteria of Andreasen. In the 12 roots with cemental defects, healing with cementum of the damaged root surface was evaluated. In addition, residual root mass was also measured to determine the extent of root structure loss for each soaking method. Cemental healing took place in all 12 artificially damaged roots, indicating that these soaking media did not inhibit cementogenesis. The alendronate-soaked roots had statistically significantly more healing than the roots soaked in HBSS without alendronate. This improvement in healing was seen in all dogs except one and in all teeth except the first premolar. Soaking in alendronate also resulted in significantly less loss in root mass due to resorption compared to those teeth soaked in HBSS without alendronate.

EFFICACY AND SAFETY OF ALENDRONIC ACID IN PATIENTS WITH JUVENILE RHEUMATOID ARTHRITIS AND OSTEOPOROSIS

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A.O. Lisitsin

2010-01-01

Full Text Available Search for and practical application of new medications to treat of osteoporosis is one of the critical issues in pediatric rheumatology. The article reviews the efficacy and safety of alendronic acid in 64 subjects with juvenile rheumatoid arthritis and systemic osteoporosis. It is demonstrated that alendronate-based therapy in weekly 1 mg/kg doses over 12 months facilitated reliably increased bonedensity, decreased intensity of pain syndrome, and lowered C-terminal telopeptide serum concentration, which indicates improved bone metabolism processes.Key words: juvenile rheumatoid arthritis, osteoporosis, children, treatment, bisphosphonates, alendronic acid. (Pediatric Pharmacology. – 2010; 7(1:48-54

Systematic review and meta-analysis of the efficacy and safety of alendronate and zoledronate for the treatment of postmenopausal osteoporosis.

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Serrano, Ana Julissa; Begoña, Leire; Anitua, Eduardo; Cobos, Raquel; Orive, Gorka

2013-12-01

The aim of this meta-analysis was to evaluate the efficacy and safety of two bisphosphonates (alendronate and zoledronate) in the treatment of postmenopausal osteoporosis. The incidence of fractures was considered as primary endpoint. Only randomized trials with a follow-up period of 1 year or more were included in this systematic review and meta-analysis. We excluded studies that included patients with secondary osteoporosis especially in relation to therapy with corticosteroids or other drugs or diseases known to affect bone mineral density. Studies published as subgroup analysis, extension studies, economic evaluations, and comparisons with active control were excluded. The methodological quality of controlled clinical trials that met these inclusion criteria was evaluated. No studies were excluded from analysis due to lack of quality. The risk ratio of hip, vertebral and wrist fractures for alendronate were 0.61 [95% confidence interval (CI) 0.40-0.93], 0.54 (95% CI 0.44-0.66) and 0.65 (95% CI 0.33-1.25), respectively. Zoledronate risk ratio was 0.62 (95% CI 0.46-0.82) and 0.38 (95% CI 0.22-0.67) for hip and vertebral fractures, respectively.

A comparative study of zoledronic acid and once weekly Alendronate in the management of acute Charcot arthropathy of foot in patients with diabetes mellitus

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R Bharath

2013-01-01

Full Text Available Aim: The aim of this study was to assess and compare the response to two forms of treatment-immobilization with zoledronic acid injection and immobilization with oral weekly Alendronate, in patients with diabetes mellitus and acute Charcot arthropathy (CA of foot in terms of clinical and radiological parameters. Material and Methods: Patients attending the endocrinology and podiatry clinic with history of diabetes mellitus and Acute CA were taken for study. The patients were randomized into two treatment groups. Group Z-zoledronic acid injection along with total contact cast (TCC. Group A-Tab. Alendronate 70 mg. once a week till the complete clinical resolution of acute CA along with TCC. Forty-five patients were randomized and 40 of them completed the study. The primary end point was complete clinical resolution of acute CA-defined as temperature difference between normal and affected foot <1oF. Results: Among the 40 patients, 30 (75% had complete clinical resolution. The mean number of days taken for complete clinical resolution since the initiation of treatment (either Zoledronic acid or Alendronate was approximately 122 days. There was no significant difference in a number of days required for complete clinical resolution, between the two forms of therapy. There was more than 50% reduction in the visual score between the baseline and the final scan. The target to non-target ratio in the skeletal phase also showed an average of 40% reduction from the baseline to the final skeletal scintigraphy. Conclusion: Both Intravenous Zoledronic acid and oral alendronate had comparable efficacy with respect to the time taken for attaining complete clinical resolution of acute CA of foot. However, Alendronate therapy was cost effective among the two. 99m Tc MDP bone scan can be used as an adjuvant to the clinical parameters in assessing the response to therapy.

Radiodensitometric and DXA analyses for the measurement of bone mineral density after systemic alendronate therapy

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Lucisano, Marilia Pacifico; Nelson-Filho, Paulo; Silva, Raquel Assed Bezerra da; Silva, Lea Assed Bezerra da, E-mail: nelson@forp.usp.br [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Fac. de Odontologia. Dept. de Clinica Pediatrica, Preventiva e Odontologia Comunitaria; Morse, Leslie [Department of Physical Medicine and Rehabilitation, School of Medicine, Harvard Univ., Boston, MA (United States); Battaglino, Ricardo [Department of Skeletal Biology, Forsyth Institute, Cambridge, MA (United States); Watanabe, Plauto Christopher Aranha [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Fac. de Odontologia. Dept. de Morfologia, Estomacologia e Fisiologia

2013-05-15

Precise techniques for the measurement of maxillary bone mineral density (BMD) are useful for the early diagnosis of systemic diseases. The aim of this study was to compare in vivo the efficacy of dual energy x-ray absorptiometry (DXA) and radiographic densitometry for the measurement of BMD after systemic administration of sodium alendronate. Wistar rats were randomly allocated to a control group (n = 5), which received distilled water, and a sodium alendronate group (n = 8), which received two doses of chemically pure sodium alendronate (1 mg/kg) per week. After 8 weeks, the animals were euthanized, the tibias were removed, and the BMD of the proximal tibial metaphysis was analyzed radiographically and by DXA. The data were subjected to statistical analysis by the Kruskal-Wallis test at a significance level of 5%. Both of the techniques revealed that the alendronate-treated group had a significantly higher BMD (p < 0.05) than the control group after 8 weeks of treatment. Comparing the groups with and without alendronate therapy revealed increases of 14.9% and 29.6% in BMD, as detected radiographically and by DXA, respectively. In conclusion, both of the methods were able to detect an increase in BMD of the proximal tibial metaphysis after alendronate therapy. (author)

Radiodensitometric and DXA analyses for the measurement of bone mineral density after systemic alendronate therapy

International Nuclear Information System (INIS)

Lucisano, Marilia Pacifico; Nelson-Filho, Paulo; Silva, Raquel Assed Bezerra da; Silva, Lea Assed Bezerra da; Battaglino, Ricardo; Watanabe, Plauto Christopher Aranha

2013-01-01

Precise techniques for the measurement of maxillary bone mineral density (BMD) are useful for the early diagnosis of systemic diseases. The aim of this study was to compare in vivo the efficacy of dual energy x-ray absorptiometry (DXA) and radiographic densitometry for the measurement of BMD after systemic administration of sodium alendronate. Wistar rats were randomly allocated to a control group (n = 5), which received distilled water, and a sodium alendronate group (n = 8), which received two doses of chemically pure sodium alendronate (1 mg/kg) per week. After 8 weeks, the animals were euthanized, the tibias were removed, and the BMD of the proximal tibial metaphysis was analyzed radiographically and by DXA. The data were subjected to statistical analysis by the Kruskal-Wallis test at a significance level of 5%. Both of the techniques revealed that the alendronate-treated group had a significantly higher BMD (p < 0.05) than the control group after 8 weeks of treatment. Comparing the groups with and without alendronate therapy revealed increases of 14.9% and 29.6% in BMD, as detected radiographically and by DXA, respectively. In conclusion, both of the methods were able to detect an increase in BMD of the proximal tibial metaphysis after alendronate therapy. (author)

Effect of alendronate on early bone loss of renal transplant recipients.

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Abediazar, S; Nakhjavani, M R

2011-03-01

Renal transplant recipients (RTRs) are at risk of developing osteoporosis and osteopenia due to underlying renal osteodystrophy, hypophosphatemia, and immunosuppression. This process occurs more frequently in the first year after renal transplantation (RTX), resulting in eventual bone loss and fractures. The purpose of this study was to evaluate the effect of low-dose alendronate to prevent early bone loss after RTX. We prospectively studied 43 successful RTR including 22 men and 21-women with a mean overall age of 39.16±11.73 years, mean body mass index of 23.6±3.73, and mean dialysis duration of 25.73±17.67 months. We matched them based on age and sex: the alendronate-treated group received vitamin D (Vit D) during the study plus 30 mg alendronate weekly from 1 month after RTX. The control group only received Vit D. We measured serum calcium, phosphate, alkaline phosphatase, blood urea, creatinine, and intact parathyroid hormone (iPTH) at the pretransplant baseline and monthly thereafter as well as BMD of the lumbar spine, femur, and radius pretransplant baseline versus 3 and 6 months after RTX. At 6 month after RTX, the lumbar BMD in the alendronate group increased significantly from 0.819±0.11 to 0.863±0.14 (Pbone loss and increase BMD immediately after RTX. Copyright © 2011. Published by Elsevier Inc.

Alendronate inhalation ameliorates elastase-induced pulmonary emphysema in mice by induction of apoptosis of alveolar macrophages.

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Ueno, Manabu; Maeno, Toshitaka; Nishimura, Satoshi; Ogata, Fusa; Masubuchi, Hiroaki; Hara, Kenichiro; Yamaguchi, Kouichi; Aoki, Fumiaki; Suga, Tatsuo; Nagai, Ryozo; Kurabayashi, Masahiko

2015-03-10

Alveolar macrophages play a crucial role in the pathogenesis of emphysema, for which there is currently no effective treatment. Bisphosphonates are widely used to treat osteoclast-mediated bone diseases. Here we show that delivery of the nitrogen-containing bisphosphonate alendronate via aerosol inhalation ameliorates elastase-induced emphysema in mice. Inhaled, but not orally ingested, alendronate inhibits airspace enlargement after elastase instillation, and induces apoptosis of macrophages in bronchoalveolar fluid via caspase-3- and mevalonate-dependent pathways. Cytometric analysis indicates that the F4/80(+)CD11b(high)CD11c(mild) population characterizing inflammatory macrophages, and the F4/80(+)CD11b(mild)CD11c(high) population defining resident alveolar macrophages take up substantial amounts of the bisphosphonate imaging agent OsteoSense680 after aerosol inhalation. We further show that alendronate inhibits macrophage migratory and phagocytotic activities and blunts the inflammatory response of alveolar macrophages by inhibiting nuclear factor-κB signalling. Given that the alendronate inhalation effectively induces apoptosis in both recruited and resident alveolar macrophages, we suggest this strategy may have therapeutic potential for the treatment of emphysema.

Effect of alendronate on bone mineral density in adult patients with Laron syndrome (primary growth hormone insensitivity).

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Eshed, Varda; Benbassat, Carlos A; Laron, Zvi

2006-04-01

Severe short stature resulting from a deficiency in insulin-like growth factor-I (IGF-I) is a prominent feature of Laron syndrome (LS). Whether patients with LS are osteopenic or not, and whether they need treatment with bisphosphonates, remains uncertain. The aim of this study was to investigate the action of alendronate on the IGF-I-deficient bones of adult patients with LS and osteoporosis, as determined by dual X-ray absorptiometry . Seven patients (5 women and 2 men) of mean age 40.8+/-7.6 years and mean bone mass density (BMD) 0.843+/-0.06 g/cm2 (T score -2.9+/-0.5) at the lumbar spine and 0.734+/-0.11 g/cm2 (T score -2.2+/-0.9) at the femoral neck were treated with alendronate 70 mg once/weekly over a 12-month period. Treatment led to an increase of 5.3% in BMD (p=0.038) at the femoral neck. There was a similar trend at the lumbar spine, but the difference was not statistically significant (2.3%, p=0.34). Mean total alkaline phosphatase decreased by 14% from normal range at baseline (p=0.007). Urinary deoxypyridinoline levels, which were elevated at baseline (10+/-2.3 nM/mMcre), showed a nonsignificant change during treatment. Our study suggests that treatment with alendronate may have positive effects in patients with LS and low BMD on dual X-ray absorptiometry.

Effect of Low-Magnitude Whole-Body Vibration Combined with Alendronate in Ovariectomized Rats: A Random Controlled Osteoporosis Prevention Study

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Zhong, Zhao-Ming; Wu, Xiu-Hua; Huang, Zhi-Ping; Li, Wei; Ding, Ruo-Ting; Yu, Hui; Chen, Jian-Ting

2014-01-01

Background Alendronate (ALE) is a conventional drug used to treat osteoporosis. Low-magnitude whole-body vibration (WBV) exercise has been developed as a potential treatment for osteoporosis. The aim of this study was to investigate whether low-magnitude WBV could enhance the protective effect of ALE on bone properties in ovariectomized rats. Methods A total of 128 Sprague-Dawley rats were randomly divided into five groups (SHAM, OVX+VEH, OVX+WBV, OVX + ALE, OVX+WBV+ALE). The level of WBV applied was 0.3 g at 45–55 Hz for 20 min/day, 5 day/week and for 3 months. ALE was administered in dose of 1 mg/Kg once a week. Every four weeks eight rats from each group were sacrificed and their blood and both tibiae were harvested. The expression of osteocalcin and CTX in serum was measured by enzyme-linked immunosorbent assay (ELISA) and the tibiae were subjected to metaphyseal three-point bending and μCT analysis. Results Osteocalcin rose after ovariectomy and was not appreciably changed by either alendronate or WBV alone or in combination. Alendronate treatment significantly prevented an increase in CTX. WBV alone treatment did not alter this effect. Compared with the OVX+WBV group, nearly all tested indices such as the BV/TV, TV apparent, Tb.N, Tb.Th, and Conn.D were higher in the OVX+ALE group at week 12.Compared with the OVX+WBV group, certain tested indices such as BV/TV, TV apparent, Tb.N, and Con.D, were higher in the OVX+WBV+ALE group at week 12. At week 12, tibiae treated with WBV+ALE exhibited a significantly higher Fmax compared to the OVX+VEH group, and a significant difference was also found in energy absorption between the OVX+WBV+ALE and OVX+VEH groups. Conclusions Compared with the WBV, ALE was more effective at preventing bone loss and improved the trabecular architecture. However, WBV enhanced the effect of alendronate in ovariectomized rats by inducing further improvements in trabecular architecture. PMID:24796785

Estimating the Time to Benefit for Preventive Drugs with the Statistical Process Control Method: An Example with Alendronate.

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van de Glind, Esther M M; Willems, Hanna C; Eslami, Saeid; Abu-Hanna, Ameen; Lems, Willem F; Hooft, Lotty; de Rooij, Sophia E; Black, Dennis M; van Munster, Barbara C

2016-05-01

For physicians dealing with patients with a limited life expectancy, knowing the time to benefit (TTB) of preventive medication is essential to support treatment decisions. The aim of this study was to investigate the usefulness of statistical process control (SPC) for determining the TTB in relation to fracture risk with alendronate versus placebo in postmenopausal women. We performed a post hoc analysis of the Fracture Intervention Trial (FIT), a randomized, controlled trial that investigated the effect of alendronate versus placebo on fracture risk in postmenopausal women. We used SPC, a statistical method used for monitoring processes for quality control, to determine if and when the intervention group benefited significantly more than the control group. SPC discriminated between the normal variations over time in the numbers of fractures in both groups and the variations that were attributable to alendronate. The TTB was defined as the time point from which the cumulative difference in the number of clinical fractures remained greater than the upper control limit on the SPC chart. For the total group, the TTB was defined as 11 months. For patients aged ≥70 years, the TTB was 8 months [absolute risk reduction (ARR) = 1.4%]; for patients aged <70 years, it was 19 months (ARR = 0.7%). SPC is a clear and understandable graphical method to determine the TTB. Its main advantage is that there is no need to define a prespecified time point, as is the case in traditional survival analyses. Prescribing alendronate to patients who are aged ≥70 years is useful because the TTB shows that they will benefit after 8 months. Investigators should report the TTB to simplify clinical decision making.

Characteristics of patients who suffer major osteoporotic fractures despite adhering to alendronate treatment

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Abrahamsen, B; Rubin, K H; Eiken, Pia Agnete

2013-01-01

.03-1.06, for each drug). Dementia (HR 1.81, 95 % CI 1.18-2.78), prior fracture (one: HR 1.17, 95 % CI 1.02-1.34; multiple: HR 1.34, 95 % CI 1.08-1.67), and ulcer disease (HR 1.45, 95 % CI 1.04-2.03) also increased the risk. Diabetes did not influence fracture risk, nor did rheumatic disorders. The risk was lower...... and associations may not be causal, it may be prudent to include dementia, ulcer disease, and Parkinson's disease to capture the risk of fractures on treatment. Lower risk in patients treated with glucocorticoids and in men probably reflects a lower treatment threshold related to guidelines.......Antiresorptive treatment reduces the risk of fractures, but most patients remain at elevated risk. We used health registers to identify predictors of new major osteoporotic fractures in patients adhering to alendronate. Risk factors showed a different pattern than in the general population...

Efficacy of alendronate, a bisphosphonate, in the treatment of AVN of the hip. A prospective open-label study.

Science.gov (United States)

Agarwala, S; Jain, D; Joshi, V R; Sule, A

2005-03-01

To study the efficacy of alendronate, in the treatment of avascular necrosis (AVN) of the hip. Sixty patients with AVN of the hip (100 hips with AVN) were studied. The follow-up period ranged from 3 months to 5 yr. The most common cause of AVN was steroids. Parameters studied were walking time, standing time, pain and disability on a visual analogue scale (VAS), range of motion of the hip, X-ray and MRI of the hip. All patients were treated with alendronate 10 mg/day (or 70 mg/week) along with 500-1000 mg of daily calcium and vitamin D supplements, and were advised to avoid weight-bearing. NSAIDs and analgesics were permitted as needed and were recorded. Forty-one patients (71 AVN hips) with AVN have been followed up for a minimum of 1 yr, 24 patients (42 AVN hips) for 2 yr and 21 patients (37 AVN hips) for more than 2 yr (average 37 month). Fourteen patients have been followed up for less than 1 yr (3-9 months). Significant reduction in pain and disability scores (P 0.001). Radiologically, the hips either stabilized in the same grade or progressed by one grade. MRI showed a decrease in marrow oedema in most cases at the 1-yr follow-up. Six patients (10 hips) required surgery and there were two (three hips) dropouts. The drug was well tolerated and there was a reduction in NSAID requirement. Alendronate reduces pain, improves function and retards AVN progression. Early surgical intervention can be avoided in most patients.

Alendronate augments interleukin-1{beta} release from macrophages infected with periodontal pathogenic bacteria through activation of caspase-1

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Xue, Deng; Tamai, Riyoko [Division of Oral Bacteriology, Department of Oral Medical Science, Ohu University School of Dentistry, 31-1 Misumido, Tomitamachi, Koriyama, Fukushima 963-8611 (Japan); Endo, Yasuo [Department of Molecular Regulation, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575 (Japan); Kiyoura, Yusuke [Division of Oral Bacteriology, Department of Oral Medical Science, Ohu University School of Dentistry, 31-1 Misumido, Tomitamachi, Koriyama, Fukushima 963-8611 (Japan)

2009-02-15

Nitrogen-containing bisphosphonates (NBPs) are anti-bone-resorptive drugs with inflammatory side effects that include osteomyelitis and osteonecrosis of the jaw. Oral bacteria have been considered to be a trigger for these NBP-associated jaw bone diseases. The present study examined the effects of alendronate (a typical NBP) and clodronate (a non-NBP) on the production of proinflammatory cytokines by macrophages infected with Porphyromonas gingivalis and Tannerella forsythia, which are important pathogens of periodontal diseases. Pretreatment with alendronate augmented IL-1{beta}, but not TNF{alpha}, production by macrophages infected with P. gingivalis or T. forsythia. This augmentation of IL-1{beta} production was inhibited by clodronate. Furthermore, caspase-1, a promoter of IL-1{beta} production, was activated by treatment with alendronate, and caspase-1 inhibitor reduced the production of IL-1{beta} induced by alendronate and P. gingivalis. These results suggest that NBPs augment periodontal pathogenic bacteria-induced IL-1{beta} release via caspase-1 activation, and this phenomenon may contribute to the development of NBP-associated inflammatory side effects including jaw osteomyelitis. Co-treatment with clodronate may prevent and/or reduce these inflammatory effects induced by NBPs.

Alendronate augments interleukin-1β release from macrophages infected with periodontal pathogenic bacteria through activation of caspase-1

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Deng Xue; Tamai, Riyoko; Endo, Yasuo; Kiyoura, Yusuke

2009-01-01

Nitrogen-containing bisphosphonates (NBPs) are anti-bone-resorptive drugs with inflammatory side effects that include osteomyelitis and osteonecrosis of the jaw. Oral bacteria have been considered to be a trigger for these NBP-associated jaw bone diseases. The present study examined the effects of alendronate (a typical NBP) and clodronate (a non-NBP) on the production of proinflammatory cytokines by macrophages infected with Porphyromonas gingivalis and Tannerella forsythia, which are important pathogens of periodontal diseases. Pretreatment with alendronate augmented IL-1β, but not TNFα, production by macrophages infected with P. gingivalis or T. forsythia. This augmentation of IL-1β production was inhibited by clodronate. Furthermore, caspase-1, a promoter of IL-1β production, was activated by treatment with alendronate, and caspase-1 inhibitor reduced the production of IL-1β induced by alendronate and P. gingivalis. These results suggest that NBPs augment periodontal pathogenic bacteria-induced IL-1β release via caspase-1 activation, and this phenomenon may contribute to the development of NBP-associated inflammatory side effects including jaw osteomyelitis. Co-treatment with clodronate may prevent and/or reduce these inflammatory effects induced by NBPs

Alendronate treatment alters bone tissues at multiple structural levels in healthy canine cortical bone.

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Acevedo, Claire; Bale, Hrishikesh; Gludovatz, Bernd; Wat, Amy; Tang, Simon Y; Wang, Mingyue; Busse, Björn; Zimmermann, Elizabeth A; Schaible, Eric; Allen, Matthew R; Burr, David B; Ritchie, Robert O

2015-12-01

Bisphosphonates are widely used to treat osteoporosis, but have been associated with atypical femoral fractures (AFFs) in the long term, which raises a critical health problem for the aging population. Several clinical studies have suggested that the occurrence of AFFs may be related to the bisphosphonate-induced changes of bone turnover, but large discrepancies in the results of these studies indicate that the salient mechanisms responsible for any loss in fracture resistance are still unclear. Here the role of bisphosphonates is examined in terms of the potential deterioration in fracture resistance resulting from both intrinsic (plasticity) and extrinsic (shielding) toughening mechanisms, which operate over a wide range of length-scales. Specifically, we compare the mechanical properties of two groups of humeri from healthy beagles, one control group comprising eight females (oral doses of saline vehicle, 1 mL/kg/day, 3 years) and one treated group comprising nine females (oral doses of alendronate used to treat osteoporosis, 0.2mg/kg/day, 3 years). Our data demonstrate treatment-specific reorganization of bone tissue identified at multiple length-scales mainly through advanced synchrotron x-ray experiments. We confirm that bisphosphonate treatments can increase non-enzymatic collagen cross-linking at molecular scales, which critically restricts plasticity associated with fibrillar sliding, and hence intrinsic toughening, at nanoscales. We also observe changes in the intracortical architecture of treated bone at microscales, with partial filling of the Haversian canals and reduction of osteon number. We hypothesize that the reduced plasticity associated with BP treatments may induce an increase in microcrack accumulation and growth under cyclic daily loadings, and potentially increase the susceptibility of cortical bone to atypical (fatigue-like) fractures. Published by Elsevier Inc.

Injectable nanoparticle-loaded hydrogel system for local delivery of sodium alendronate

Czech Academy of Sciences Publication Activity Database

Posadowska, U.; Pařízek, Martin; Filová, Elena; Wlodarczyk-Biegun, M.; Kamperman, M.; Bačáková, Lucie; Pamula, E.

2015-01-01

Roč. 485, 1-2 (2015), s. 31-40 ISSN 0378-5173 R&D Projects: GA MZd(CZ) NT13297 Institutional support: RVO:67985823 Keywords : sodium alendronate * PLGA * nanoparticles Subject RIV: EI - Biotechnology ; Bionics Impact factor: 3.994, year: 2015

Alendronate Sodium as Enteric Coated Solid Lipid Nanoparticles; Preparation, Optimization, and In Vivo Evaluation to Enhance Its Oral Bioavailability.

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Khaled Mohamed Hosny

Full Text Available Treatment of osteoporosis with alendronate sodium has several challenges. The first challenge is the low bioavailability. The second main challenge is side effects, which include oesophageal ulceration. The aim of this research was to reformulate alendronate sodium as enteric coated solid lipid nanoparticles in order to enhance its bioavailability, and preventing the free alendronate sodium from coming into direct contact with the gastrointestinal mucosa, and thereby reducing the possibility of side effects. Enteric coated solid lipid nanoparticles were prepared according to the Box-Behnken design employing Design expert® software, and characterized for size, morphology, and entrapment efficiency. The optimized formula was coated with an Eudragit S100 and evaluated for drug release in acidic and basic media, stability studies and pharmacokinetic evaluations on rabbits. The results indicated that, using Derringer's desirability functional tool for optimization, the highest entrapment efficiency value of 74.3% and the smallest size value of 98 nm were predicted under optimum conditions with a desirability value of 0.917. The optimized nanoparticles released alendronate sodium only at an alkaline pH. The pharmacokinetic evaluation revealed that alendronate sodium bioavailability was enhanced by more than 7.4-fold in rabbits. In conclusion, enteric coated solid lipid nanoparticles is a promising formula for the delivery of alendronate sodium, eliminating its oesophageal side effects and enhancing its bioavailability.

Pharmacokinetic characteristics of formulated alendronate transdermal delivery systems in rats and humans.

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Choi, Ahyoung; Gang, Hyesil; Whang, Jiae; Gwak, Hyesun

2010-05-01

The objective of this study was to examine the absorption of alendronate from formulated transdermal delivery systems in rats and humans. When alendronate was applied to rats by transdermal delivery systems (7.2 mg) and oral administration (30 mg/kg), a statistically significant difference was found in the amount remaining to be excreted at time t (Ae(t)) and the amount remaining to be excreted at time 0 (Ae(infinity)) (p transdermal delivery systems. There was a linear relationship (r(2) = 0.9854) between the drug loading dose and Ae(infinity). The Ae(infinity) values from the transdermal delivery system containing 6% caprylic acid (53.8 mg as alendronate) and an oral product (Fosamax), 70 mg as alendronate) in humans were 127.0 +/- 34.2 microg and 237.2 +/- 56.3 microg, respectively. The dose-adjusted relative Ae(infinity) ratio of the transdermal delivery system to oral product was calculated to be 69.7%. The long half-life of alendronate in the transdermal delivery system (50.6 +/- 6.4 h), compared to that of the oral product (3.5 +/- 1.1 h) could allow less-frequent dosing. In conclusion, this study showed that a transdermal delivery system containing 6% caprylic acid in PG could be a favorable alternative for alendronate administration.

Effects of local alendronate sodium gel as an adjunct to scaling and root planing on smokers with chronic periodontitis: a pilot study

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Farin Kiany

2017-04-01

Full Text Available Background: Chemical treatments for the modulation of host response are applied along with mechanical modalities as adjunctive to periodontal treatment. The objective of this pilot study was to investigate the effects of locally-delivered alendronate sodium gel in adjunction to scaling and root planning on periodontal indices and bone formation within vertical defects of smokers with chronic periodontitis. Methods and Materials: In this study vertical defects (n=8 with depth>5 mm have been investigated. After performing the phase I of periodontal treatment, alendronate sodium gel (1% was applied into the periodontal pockets. The whole procedure was repeated after 4 weeks. Periodontal indices (plaque and bleeding, probing depth, gingival recession, and radiographic parameter (depth of bony defect were measured at the beginning and following 6 months. Results: Compared to pre-treatment, the probing depth, radiographic depth of bony defect and bleeding and plaque indices were significantly reduced by local application of alendronate sodium gel (P=0.026; P=0.012 and P=0.007 respectively. Gingival recession showed significant increase (P=0.011. Conclusion: Local alendronate sodium gel (1% plays an important role in the improvement process of periodontal indices and bone formation within vertical bony defects of smoker patients with chronic periodontitis.

Exercise prevented the lansoprazole-induced reduction of anti-osteoporotic efficacy of alendronate in androgen deficiency rats.

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Cegieła, Urszula; Pytlik, Maria; Folwarczna, Joanna; Miozga, Rafał; Piskorz, Szymon; Nowak, Dorota

2014-01-01

Clinical studies indicate that proton pump inhibitors (PPIs), used long-term in elderly patients, increase the risk of osteoporotic fractures, and decrease the anti-fracture efficacy of alendronate. The aim of the present study was to examine the effect of physical exercise on the anti-osteoporotic efficacy of alendronate administered concurrently with lansoprazole, a PPI, in male rats with androgen deficiency induced by orchidectomy. Male Wistar rats at 3 months of age were divided into: sham-operated control rats, orchidectomized (ORX) control rats, ORX rats receiving alendronate, ORX rats receiving alendronate and lansoprazole, ORX rats receiving alendronate and subjected to exercise, and ORX rats receiving alendronate and lansoprazole and subjected to exercise. The orchidectomy or sham-operation was performed 7-8 days before the start of drug administration. The rats were subjected to the exercise on the treadmill 1 hour/day for 7 weeks (6 days a week). Alendronate sodium (3 mg/kg p.o.) and lansoprazole (4 mg/kg p.o.) were administered once daily for 7 weeks (6 days a week). Mechanical properties of the tibial metaphysis and femoral neck were assessed. Bone turnover markers, histomorphometric parameters, bone mass and mass of bone mineral were also studied. Lansoprazole weakened the anti-osteoporotic efficacy of alendronate. The exercise increased the alendronate effect. Similar changes were observed in the rats treated with lansoprazole and alendronate, subjected to exercise; no deleterious effects of lansoprazole were observed. In conclusion, the exercise prevented the lansoprazole-induced reduction the anti-osteoporotic efficacy of alendronate in orchidectomized rats.

Combined Treatment of Alendronate and Low-Intensity Pulsed Ultrasound (LIPUS Increases Bone Mineral Density at the Cancellous Bone Osteotomy Site in Aged Rats: A Preliminary Study.

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H Aonuma

2011-12-01

Full Text Available Introduction: During fracture healing, alendronate encourages callus volume by inhibiting bone resorption, whereas low-intensity pulsed ultrasound (LIPUS enhances bone regeneration by promoting an anabolic response. Methods: In the present study, 9-month-old Sprague-Dawley rats, with a unilateral proximal tibial osteotomy, were treated with alendronate (daily, 1 g/kg plus sham-LIPUS (n = 14, saline plus LIPUS (20 min/day (n = 18, alendronate plus LIPUS (n = 16, or saline plus sham- LIPUS as a control (n = 13 for 4 weeks. The rats were then examined for changes in bone mineral density (BMD during metaphyseal bone repair. Results: The combined therapy signi cantly increased BMD at the osteotomy site at 4 weeks (p < 0.001 compared with the control, without affecting the contralateral, non-osteotomized tibia. Both alendronate and LIPUS alone also exerted a positive, albeit less, effect on BMD in the affected limb (p < 0.001 and p = 0.006, respectively. Conclusions: Alendronate and LIPUS cooperate to enhance BMD during metaphyseal bone healing. Keywords: LIPUS, bisphosphonate, bone mineral density.

Cytotoxicity evaluation of sodium alendronate on cultured human periodontal ligament fibroblasts.

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Correia, Vera de Fátima Padrão; Caldeira, Celso L; Marques, Márcia Martins

2006-12-01

External root resorption processes are usually associated with dental trauma, mainly avulsion and intrusion. In such cases endodontic therapy aims to prevent this process by using medications that can inhibit osteoclastic activity, such as bisphosphonates. However, these drugs must be biocompatible to the periapical tissues. The aim of this study was to analyze the cytotoxicity of a bisphosphonate (sodium alendronate) on human periodontal ligament fibroblasts (PDL cells). Cells were plated in a density of 1 x 10(3) cells per dish. The experimental groups were GI (control) no sodium alendronate, and GII, GIII, and GIV with sodium alendronate at the concentrations of 10(-5), 10(-6), and 10(-7) M, respectively. The experimental times were 1, 6, 12, and 24 h (short-term) for viability and 2, 4, 6, and 8 days (long-term) for cell survival. Data in triplicate were statistically analyzed. Cultures treated with the highest alendronate concentration (GII) showed cell viability percentages significantly lower (P < 0.01) than those of the other groups (GI, GIII, and GIV), at 12 and 24 h. Cell growth on GII and GIII groups was similar. GII presented smaller growth than the other groups (P < 0.05). We concluded that sodium alendronate, on direct contact with human periodontal ligament fibroblasts, is cytotoxic in concentrations higher than of 10(-6) M.

Treatment choices for fevers in children under-five years in a rural Ghanaian district

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Gyapong Margaret

2010-06-01

Full Text Available Abstract Background Health care demand studies help to examine the behaviour of individuals and households during illnesses. Few of existing health care demand studies examine the choice of treatment services for childhood illnesses. Besides, in their analyses, many of the existing studies compare alternative treatment options to a single option, usually self-medication. This study aims at examining the factors that influence the choices that caregivers of children under-five years make regarding treatment of fevers due to malaria and pneumonia in a rural setting. The study also examines how the choice of alternative treatment options compare with each other. Methods The study uses data from a 2006 household socio-economic survey and health and demographic surveillance covering caregivers of 529 children under-five years of age in the Dangme West District and applies a multinomial probit technique to model the choice of treatment services for fevers in under-fives in rural Ghana. Four health care options are considered: self-medication, over-the-counter providers, public providers and private providers. Results The findings indicate that longer travel, waiting and treatment times encourage people to use self-medication and over-the-counter providers compared to public and private providers. Caregivers with health insurance coverage also use care from public providers compared to over-the-counter or private providers. Caregivers with higher incomes use public and private providers over self-medication while higher treatment charges and longer times at public facilities encourage caregivers to resort to private providers. Besides, caregivers of female under-fives use self-care while caregivers of male under-fives use public providers instead of self-care, implying gender disparity in the choice of treatment. Conclusions The results of this study imply that efforts at curbing under-five mortality due to malaria and pneumonia need to take into

Personality disorder features as predictors of symptoms five years post-treatment.

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Jansson, Irene; Hesse, Morten; Fridell, Mats

2008-01-01

Personality disorders are associated with dysfunction in a variety of areas. Recent longitudinal research has shown that personality disorders are also predictive of problems later in life, as well as of poor response to treatment of depression and anxiety. This study assessed whether personality disorder features were associated with psychiatric symptoms in a cohort of women treated for substance abuse in Sweden. Patients were diagnosed with personality disorders using the Structured Clinical Interview for DSM-IV (SCID-II) personality questionnaire and SCID-II interview, and were then administered a self-report questionnaire designed to measure symptoms of psychiatric illness, the Symptoms Checklist-90 (SCL-90), during and five years after treatment. Concurrently, features of all personality disorders, except histrionic, were associated with SCL-90 score. At five-year follow-up, most personality disorders remained associated with SCL-90 score, with the exception of paranoid and schizoid personality disorder. After controlling for baseline score on the SCL-90, conduct disorder, borderline personality disorder, and narcissistic personality disorder remained significantly associated with symptoms at follow-up. After controlling for abstinence and baseline score, only borderline personality disorder features remained associated with SCL-90 score at follow-up. Patients with personality disorders should be monitored after treatment for psychiatric symptoms.

Influence of treatment with alendronate on the speed of sound, an ultrasound parameter, of the calcaneus in postmenopausal Japanese women with osteoporosis: a clinical practice-based observational study

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Iwamoto J

2012-06-01

Full Text Available Jun Iwamoto,1 Tetsuya Takada,2 Yoshihiro Sato,3 Hideo Matsumoto11Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, 2Department of Internal Medicine, Hiyoshi Medical Clinic, Kanagawa, 3Department of Neurology, Mitate Hospital, Fukuoka, JapanPurpose: The influence of alendronate (ALN treatment on the quantitative ultrasound parameters of the calcaneus remains to be established in Japanese patients. The aim of the present clinical practice-based observational study was to examine the influence of ALN treatment for 1 year on the speed of sound (SOS of the calcaneus and bone turnover markers in postmenopausal Japanese women with osteoporosis.Patients and methods: Forty-five postmenopausal Japanese women with osteoporosis who had received treatment with ALN for more than 1 year were enrolled in the study. The SOS and bone turnover markers were monitored over 1 year of ALN treatment.Results: The urinary levels of cross-linked N-terminal telopeptides of type I collagen and serum levels of alkaline phosphatase decreased significantly from the baseline values (–44.9% at 3 months and –22.2% at 12 months, respectively. The SOS increased modestly, but significantly, from the baseline value (0.6% at both 6 and 12 months. The percentage decrease in the urinary levels of cross-linked N-terminal telopeptides of type I collagen at 3 months was significantly correlated with the percentage increase in the SOS only at 6 months (correlation coefficient, 0.299.Conclusion: The present study confirmed that ALN treatment suppressed bone turnover, producing a clinically significant increase in the SOS of the calcaneus in postmenopausal Japanese women with osteoporosis.Keywords: postmenopausal osteoporosis, quantitative ultrasound (QUS, SOS, bone turnover, biochemical markers

A remarkable hematological and molecular response pattern in a patient with polycythemia vera during combination therapy with simvastatin and alendronate

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Anders Lindholm Sørensen

2016-01-01

Full Text Available We report a 57-year old man with polycythemia vera, who had a remarkable hematological and molecular response during treatment with simvastatin and alendronate. The patient was treated with this combination for 56 months, and during this period the patient has been in complete hematological remission. The JAK2-V617F allele burden has dropped from 64% to sustained values below 20%, and follow-up bone marrow biopsies have revealed no change in PV features, without any regular cytoreductive treatment.

Hydroxyapatite nanocrystals functionalized with alendronate as bioactive components for bone implant coatings to decrease osteoclastic activity

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Bosco, Ruggero; Iafisco, Michele; Tampieri, Anna; Jansen, John A.; Leeuwenburgh, Sander C. G.; van den Beucken, Jeroen J. J. P.

2015-02-01

The integration of bone implants within native bone tissue depends on periprosthetic bone quality, which is severely decreased in osteoporotic patients. In this work, we have synthesized bone-like hydroxyapatite nanocrystals (nHA) using an acid-base neutralization reaction and analysed their physicochemical properties. Subsequently, we have functionalized the nHA with alendronate (nHAALE), a well-known bisphosphonate drug used for the treatment of osteoporosis. An in vitro osteoclastogenesis test was carried out to evaluate the effect of nHAALE on the formation of osteoclast-like cells from monocytic precursor cells (i.e. RAW264.7 cell line) showing that nHAALE significantly promoted apoptosis of osteoclast-like cells. Subsequently, nHA and nHAALE were deposited on titanium disks using electrospray deposition (ESD), for which characterisation of the deposited coatings confirmed the presence of alendronate in nHAALE coatings with nanoscale thickness of about 700 nm. These results indicate that alendronate linked to hydroxyapatite nanocrystals has therapeutic potential and nHAALE can be considered as an appealing coating constituent material for orthopaedic and oral implants for application in osteoporotic patients.

Diagnostic PET Imaging of Mammary Microcalcifications Using 64Cu-DOTA-Alendronate in a Rat Model of Breast Cancer.

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Ahrens, Bradley J; Li, Lin; Ciminera, Alexandra K; Chea, Junie; Poku, Erasmus; Bading, James R; Weist, Michael R; Miller, Marcia M; Colcher, David M; Shively, John E

2017-09-01

The development of improved breast cancer screening methods is hindered by a lack of cancer-specific imaging agents and effective small-animal models to test them. The purpose of this study was to evaluate 64 Cu-DOTA-alendronate as a mammary microcalcification-targeting PET imaging agent, using an ideal rat model. Our long-term goal is to develop 64 Cu-DOTA-alendronate for the detection and noninvasive differentiation of malignant versus benign breast tumors with PET. Methods: DOTA-alendronate was synthesized, radiolabeled with 64 Cu, and administered to normal or tumor-bearing aged, female, retired breeder Sprague-Dawley rats for PET imaging. Mammary tissues were subsequently labeled and imaged with light, confocal, and electron microscopy to verify microcalcification targeting specificity of DOTA-alendronate and elucidate the histologic and ultrastructural characteristics of the microcalcifications in different mammary tumor types. Tumor uptake, biodistribution, and dosimetry studies were performed to evaluate the efficacy and safety of 64 Cu-DOTA-alendronate. Results: 64 Cu-DOTA-alendronate was radiolabeled with a 98% yield. PET imaging using aged, female, retired breeder rats showed specific binding of 64 Cu-DOTA-alendronate in mammary glands and mammary tumors. The highest uptake of 64 Cu-DOTA-alendronate was in malignant tumors and the lowest uptake in benign tumors and normal mammary tissue. Confocal analysis with carboxyfluorescein-alendronate confirmed the microcalcification binding specificity of alendronate derivatives. Biodistribution studies revealed tissue alendronate concentrations peaking within the first hour, then decreasing over the next 48 h. Our dosimetric analysis demonstrated a 64 Cu effective dose within the acceptable range for clinical PET imaging agents and the potential for translation into human patients. Conclusion: 64 Cu-DOTA-alendronate is a promising PET imaging agent for the sensitive and specific detection of mammary tumors as

The use of alendronate is associated with a decreased incidence of type 2 diabetes mellitus--a population-based cohort study in Taiwan.

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Ding-Cheng Chan

Full Text Available Bone remodeling has been linked to glucose metabolism in animal studies, but the results of human trials were inconclusive. Bisphosphonates may play a role in glucose metabolism through their impacts on bone remodeling enzymes. In this study, we aimed to examine the influence of alendronate usage on the incidence of type 2 diabetes mellitus (DM among osteoporotic patients.A retrospective cohort study was designed to include osteoporotic patients without DM from a population-based cohort containing 1,000,000 subjects. Patients treated with alendronate (exposed group, N=1,011 were compared with those who received no treatment (age and gender matched non-exposed group, N=3,033. Newly diagnosed DM was identified from medical records by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9CM code. The incidence of DM in both groups was calculated for comparison.The non-exposed group had a significantly higher incidence of DM (Odds ratio 1.21, 95% confidence interval 1.03~1.41 when compared with the exposed group. In subgroup analysis, the DM risk reduction in exposed group was only significant among those younger than 65 years and those without hypertension or dyslipidemia. Patients who were prescribed alendronate more than or equal to 3 times had demonstrated a significant reduction in DM risk.Our study showed alendronate might yield a protective effect for incident DM. This effect became insignificant in patients with older age, dyslipidemia or hypertension. The underlying mechanism needs further exploration with prospective data for confirmation of the observed findings.

Zoledronic acid and alendronate sodium and the implications in orthodontic movement.

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Franzoni, J S; Soares, F M P; Zaniboni, E; Vedovello Filho, M; Santamaria, M P; Dos Santos, G M T; Esquisatto, M A M; Felonato, M; Mendonca, F A S; Franzini, C M; Santamaria, M

2017-08-01

To evaluate orthodontic tooth movement (OTM) in rats treated with two types of bisphosphonates (BPs), alendronate sodium (A) and zoledronic acid (Z). In all, 15 male Wistar rats were randomly divided into three groups. Group OTM+A: orthodontic tooth movement and subcutaneous administration of alendronate sodium (2.5 mg/kg); Group OTM+Z: orthodontic tooth movement and subcutaneous administration of zoledronic acid (0.02 mg/kg), and Group OTM: orthodontic tooth movement and subcutaneous injection of saline. The BPs were administered once a day during 25 days before OTM started and during 10 days of OTM. The left upper first molar was moved with a stainless-steel closed coil spring which delivered an initial force of 0.4N. OTM was measured with a digital caliper comparing the moved and the contralateral side. The histomorphometric analysis counted the number of osteoclasts, inflammatory cells, blood vessels and fibroblasts (n/10 4  m 2 ) in periodontal ligament (PDL) of the distobuccal root. A reduction of 58.3% of OTM was found in Group OTM+A and 99.6% in Group OTM+Z, when compared with Group OTM. There was a significant decrease of osteoclasts and inflammatory cells in BP-treated groups. Blood vessels and fibroblastic cells decreased mainly in Group OTM+Z. Alendronate sodium and zoledronic acid have similar effects on the periodontal tissue during orthodontic treatment in rats. Especially, zoledronic acid can affect orthodontic tooth movement. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effect of heparin and alendronate coating on titanium surfaces on inhibition of osteoclast and enhancement of osteoblast function

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Moon, Ho-Jin; Yun, Young-Pil [Department of Maxillofacial Biomedical Engineering, School of Dentistry, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Han, Choong-Wan; Kim, Min Sung [Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Institute of Oral Biology, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Kim, Sung Eun; Bae, Min Soo [Department of Maxillofacial Biomedical Engineering, School of Dentistry, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Kim, Gyu-Tae; Choi, Yong-Suk; Hwang, Eui-Hwan [Department of Oral and Maxillofacial Radiology, School of Dentistry, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Institute of Oral Biology, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Lee, Joon Woo [Department of Technology Commercialization Information, Korea Institute of Science and Technology Information (KISTI), 66, Hoegi-ro, Dongdaemun-gu, Seoul 130-741 (Korea, Republic of); Lee, Jin-Moo; Lee, Chang-Hoon [Department of Oriental Gynecology, College of Oriental Medicine, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Kim, Duck-Su [Department of Conservative Dentistry, School of Dentistry, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Kwon, Il Keun, E-mail: kwoni@khu.ac.kr [Department of Maxillofacial Biomedical Engineering, School of Dentistry, Kyung Hee University, Seoul 130-701 (Korea, Republic of); Institute of Oral Biology, Kyung Hee University, Seoul 130-701 (Korea, Republic of)

2011-09-23

Highlights: {yields} We examine bone metabolism of engineered alendronate attached to Ti surfaces. {yields} Alendronate-immobilized Ti enhances activation of osteoblast differentiation. {yields} Alendronate-immobilized Ti inhibits osteoclast differentiation. {yields} Alendronate-immobilized Ti may be a bioactive implant with dual functions. -- Abstract: The failure of orthopedic and dental implants has been attributed mainly to loosening of the implant from host bone, which may be due to weak bonding of the implant material to bone tissue. Titanium (Ti) is used in the field of orthopedic and dental implants because of its excellent biocompatibility and outstanding mechanical properties. Therefore, in the field of materials science and tissue engineering, there has been extensive research to immobilize bioactive molecules on the surface of implant materials in order to provide the implants with improved adhesion to the host bone tissue. In this study, chemically active functional groups were introduced on the surface of Ti by a grafting reaction with heparin and then the Ti was functionalized by immobilizing alendronate onto the heparin-grafted surface. In the MC3T3-E1 cell osteogenic differentiation study, the alendronate-immobilized Ti substrates significantly enhanced alkaline phosphatase activity (ALP) and calcium content. Additionally, nuclear factor kappa B ligand (RANKL)-induced osteoclast differentiation of RAW264.7 cells was inhibited with the alendronate-immobilized Ti as confirmed by TRAP analysis. Real time PCR analysis showed that mRNA expressions of osteocalcin and osteopontin, which are markers for osteogenesis, were upregulated in MC3T3-E1 cells cultured on alendronate-immobilized Ti. The mRNA expressions of TRAP and Cathepsin K, markers for osteoclastogenesis, in RAW264.7 cells cultured on alendronate-immobilized Ti were down-regulated. Our study suggests that alendronate-immobilized Ti may be a bioactive implant with dual functions to enhance

Eleven years of experience with bisphosphonate plus alfacalcidol treatment in a man with osteogenesis imperfecta type I

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Iwamoto J

2012-12-01

Full Text Available Jun Iwamoto,1 Yoshihiro Sato,2 Mitsuyoshi Uzawa,3 Hideo Matsumoto11Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, 2Department of Neurology, Mitate Hospital, Fukuoka, 3Department of Orthopaedic Surgery, Keiyu Orthopaedic Hospital, Gunma, JapanAbstract: We report the 11-year follow-up of a man with osteogenesis imperfecta type I who was treated with bisphosphonates and alfacalcidol. A 36-year-old Japanese man with osteogenesis imperfecta type I who had frequently experienced painful fragility fractures consulted our clinic because of chronic back pain. The patient had multiple morphometric vertebral fractures and a low bone mineral density (BMD at the lumbar spine. The patient was treated with cyclical etidronate 200 mg, for 2 weeks every 3 months, plus alfacalcidol 1 µg daily, for 2 years; and alendronate 5 mg daily or 35 mg weekly, plus alfacalcidol 1 µg daily for 9 years. After 11 years of treatment, BMD at the lumbar spine increased by 6.4%, following a 20.3% reduction in serum alkaline phosphatase. Serum calcium, phosphorus, and intact parathyroid hormone levels remained within the normal ranges. Three clinical fractures occurred at two ribs and the metacarpus, and two morphometric vertebral fractures occurred at the thoracic spine during the 11-year treatment period, but the patient experienced no adverse effects. Thus, the present case report shows the long-term outcome and safety of bisphosphonate plus alfacalcidol treatment in a man with osteogenesis imperfecta type I.Keywords: etidronate, alendronate, fragility fracture, bone mineral density, osteogenesis imperfecta

Development of docetaxel and alendronate-loaded chitosan ...

African Journals Online (AJOL)

Development of docetaxel and alendronate-loaded chitosan-conjugated polylactide-co-glycolide nanoparticles: In vitro characterization in osteosarcoma cells. ... typical time-dependent cellular uptake and also displayed superior cytotoxicity in MG-63 cells compared with blank NPs, which were safe and biocompatible.

Differences in otosclerotic and normal human stapedial osteoblast properties are normalized by alendronate in vitro.

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Gronowicz, Gloria; Richardson, Yvonne L; Flynn, John; Kveton, John; Eisen, Marc; Leonard, Gerald; Aronow, Michael; Rodner, Craig; Parham, Kourosh

2014-10-01

Identify and compare phenotypic properties of osteoblasts from patients with otosclerosis (OSO), normal bones (HOB), and normal stapes (NSO) to determine a possible cause for OSO hypermineralization and assess any effects of the bisphosphonate, alendronate. OSO (n = 11), NSO (n = 4), and HOB (n = 13) cultures were assayed for proliferation, adhesion, mineralization, and gene expression with and without 10(-10)M-10(-8)M alendronate. Academic hospital. Cultures were matched for age, sex, and passage number. Cell attachment and proliferation + alendronate were determined by Coulter counting cells and assaying tritiated thymidine uptake, respectively. At 7, 14, and 21 days of culture + alendronate, calcium content and gene expression by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) were determined. OSO had significantly more cells adhere but less proliferation than NSO or HOB. Calcification was significantly increased in OSO compared to HOB and NSO. NSO and HOB had similar cell adhesion and proliferation rates. A dose-dependent effect of alendronate on OSO adhesion, proliferation, and mineralization was found, resulting in levels equal to NSO and HOB. All cultures expressed osteoblast-specific genes such as RUNX2, alkaline phosphatase, type I collagen, and osteocalcin. However, osteopontin was dramatically reduced, 9.4-fold at 14 days, in OSO compared to NSO. Receptor activator of nuclear factor κB ligand/osteoprotegerin (RANKL/OPG), important in bone resorption, was elevated in OSO with decreased levels of OPG levels. Alendronate had little effect on gene expression in HOB but in OSO increased osteopontin levels and decreased RANKL/OPG. OSO cultures displayed properties of hypermineralization due to decreased osteopontin (OPN) and also had increased RANKL/OPG, which were normalized by alendronate. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

Treatment-resistant, five-year long, postpartum-onset Capgras episode resolving after electroconvulsive therapy.

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Rapinesi, Chiara; Kotzalidis, Georgios D; Del Casale, Antonio; Ferri, Vittoria Rachele; Di Pietro, Simone; Scatena, Paola; Serata, Daniele; Danese, Emanuela; Sani, Gabriele; Koukopoulos, Alexia E; Angeletti, Gloria; Girardi, Paolo

2015-01-01

Postpartum psychosis, which rarely presents with Capgras syndrome (delusional misidentification), requires rapid symptom resolution. First-line drugs have important drawbacks, such as delayed onset of clinical response and secretion in breast milk. In this report, we report successful treatment of a treatment-resistant woman presenting with treatment-resistant Capgras syndrome, with onset during postpartum. A 36-year-old woman had presented with Capgras syndrome during postpartum. For more than five years, she believed her son and other family members were substituted by impostors. All adequately administrated treatments were unsuccessful. We suggested electroconvulsive therapy to overcome treatment resistance. After six electroconvulsive therapy sessions, delusions of doubles subsided and other symptoms improved. She was discharged two weeks later with a mood stabilizer and low-dose atypical antipychotic combination and is well at the one-and-a-half-year follow-up. Electroconvulsive therapy followed by a mood stabilizer-antipsychotic drug combination showed rapid, permanent, and effective control of long-standing Capgras syndrome in a young woman. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

[Five years of ROM in substance abuse treatment centres in the Netherlands].

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Oudejans, S C C; Schippers, G M; Spits, M E; Stollenga, M; van den Brink, W

2012-01-01

Three substance abuse treatment centres set up a benchmarking project for routine outcome management (ROM) of structured cognitive behavioral treatments for outpatients with a substance use disorder. To present the results of five years benchmarking. All patients were included at intake and the follow-up assessment was performed by a call-center nine months later. Twice a year aggregated data were fed back to management and treatment teams. Since 2005, clinical outcome data, including substance abuse data, have been collected for more than half of all 15.786 treated patients. At follow-up, nine months after intake, 23% was abstinent, 28% reported moderate substance use and 49% reported excessive substance use. The Dutch centres for the treatment of substance abuse were successful in setting up ROM projects to monitor and compare the development and the effects of outpatient addiction treatments. The clinical results are acceptable and correspond to the results of the American project called match. It is not yet clear whether the biannual feedback of aggregated outcomes to management and treatment teams has contributed to the creation of learning organisations, but it has provided transparency and has made it possible for teams to learn from the outcomes.

Determination of pKa values of alendronate sodium in aqueous solution by piecewise linear regression based on acid-base potentiometric titration.

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Ke, Jing; Dou, Hanfei; Zhang, Ximin; Uhagaze, Dushimabararezi Serge; Ding, Xiali; Dong, Yuming

2016-12-01

As a mono-sodium salt form of alendronic acid, alendronate sodium presents multi-level ionization for the dissociation of its four hydroxyl groups. The dissociation constants of alendronate sodium were determined in this work by studying the piecewise linear relationship between volume of titrant and pH value based on acid-base potentiometric titration reaction. The distribution curves of alendronate sodium were drawn according to the determined pKa values. There were 4 dissociation constants (pKa 1 =2.43, pKa 2 =7.55, pKa 3 =10.80, pKa 4 =11.99, respectively) of alendronate sodium, and 12 existing forms, of which 4 could be ignored, existing in different pH environments.

Inhibited osteoclastic bone resorption through alendronate treatment in rats reduces severe osteoarthritis progression.

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Siebelt, M; Waarsing, J H; Groen, H C; Müller, C; Koelewijn, S J; de Blois, E; Verhaar, J A N; de Jong, M; Weinans, H

2014-09-01

Osteoarthritis (OA) is a non-rheumatoid joint disease characterized by progressive degeneration of extra-cellular cartilage matrix (ECM), enhanced subchondral bone remodeling, osteophyte formation and synovial thickening. Alendronate (ALN) is a potent inhibitor of osteoclastic bone resorption and results in reduced bone remodeling. This study investigated the effects of pre-emptive use of ALN on OA related osteoclastic subchondral bone resorption in an in vivo rat model for severe OA. Using multi-modality imaging we measured effects of ALN treatment within cartilage and synovium. Severe osteoarthritis was induced in left rat knees using papain injections in combination with a moderate running protocol. Twenty rats were treated with subcutaneous ALN injections and compared to twenty untreated controls. Animals were longitudinally monitored for 12weeks with in vivo μCT to measure subchondral bone changes and SPECT/CT to determine synovial macrophage activation using a folate-based radiotracer. Articular cartilage was analyzed at 6 and 12weeks with ex vivo contrast enhanced μCT and histology to measure sulfated-glycosaminoglycan (sGAG) content and cartilage thickness. ALN treatment successfully inhibited subchondral bone remodeling. As a result we found less subchondral plate porosity and reduced osteophytosis. ALN treatment did not reduce subchondral sclerosis. However, after the OA induction phase, ALN treatment protected cartilage ECM from degradation and reduced synovial macrophage activation. Surprisingly, ALN treatment also improved sGAG content of tibia cartilage in healthy joints. Our data was consistent with the hypothesis that osteoclastic bone resorption might play an important role in OA and may be a driving force for progression of the disease. However, our study suggest that this effect might not solely be effects on osteoclastic activity, since ALN treatment also influenced macrophage functioning. Additionally, ALN treatment and physical activity

Effect of insulin combined alendronate sodium on bone mineral density and levels of serum BAP, TRAP-5b and BGP in aged patients with type 2 diabetes mellitus with osteoporosis

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Fang Wang

2016-06-01

Full Text Available Objective: To explore the effect of insulin combined alendronate sodium on bone mineral density and levels of serum BAP, TRAP-5b and BGP in aged patients with type 2 diabetes mellitus with osteoporosis. Methods: A total of 136 patients with type 2 diabetes mellitus with osteoporosis in January 2014 to January 2016 in our hospital for the treatment were selected, and randomly divided into 4 groups, each of 40 cases. Caltrate D was given as a basic treatment to all the patients, and the control group was given the treatment of insulin, and the metformin group was given the treatment of metformin, and the combination group was given the treatment of metformin combined alendronate, and the experiment group was given the treatment of insulin combined alendronate. BMD of the femoral neck and the serum levels of BAP, TRAP-5b and BGP were detected and recorded before the treatment and after one year’s treatment. Results: On index of bone mineral density, the control group and the metformin group showed no significant differences; the combination group was slightly improved, but showed no statistical significance; After the treatment, the bone mineral density of the experiment was significantly improved. On index of bone turnover, the levels of serum BAP and BGP all had been improved and the level of TRAP-5b all was reduced then before the treatment in the control group, the combination group and the experiment group, but only the experiment group showed significant differences; On index of bone turnover, the experiment group were better than other groups, the differences were statistical significant. Conclusions: It has greater clinical curative effect that insulin combined alendronate sodium in the treatment of aged patients with type 2 diabetes mellitus with osteoporosis, it can effectively balance the metabolism of bone, safe and reliable, and it is worthy of application.

The Effect of Alendronate on Various Graft Materials Used in Maxillary Sinus Augmentation: A Rabbit Study.

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Ayranci, Ferhat; Gungormus, Metin; Omezli, Mehmet Melih; Gundogdu, Betul

2015-12-01

Increasing sinus pneumatization and the accompanying alveolar bone resorption complicate dental implant placement. This problem can be overcome today by raising the maxillary sinus floor with graft materials. Bisphosphonates are commonly used to accelerate the recovery of the graft materials and to prevent resorption. The purpose of this study is to investigate whether systemic administration of a bisphosphonate (alendronate) would improve new bone formation and reduce fibrous tissue formation over a 6-week follow-up in rabbits treated with two different grafting materials for maxillary sinus floor augmentation. This experimental animal study was conducted at the Experimental Medical Application and Research Center at Erzurum/ Turkey. Twelve New Zealand rabbits, each weighing between 2.7 and 3.3 kg, were used. Twenty-four maxillary sinus floor elevation operations were performed, two on each animal (n = 24). Each elevation was repaired with either deproteinized bovine bone (xenograft) or autogenous bone graft obtained from the iliac crest. Both groups were divided into 2 subgroups: saline-treated and alendronate-treated. All groups underwent the same surgical procedures and evaluation, and were sacrificed at the 6th postoperative week. Sinuses augmented with deproteinized bovine bone (xenograft) and autogenous bone graft were examined histopathologically and histomorphometrically. At 6 weeks, the bone area was significantly larger in the Xenograft-Alendronate group (33.0% ± 5.0%) than in the Xenograft-Saline group (20.8% ± 4.9%) and the bone area was significantly larger in the Autogenous-Alendronate group (43.3% ± 3.8%) than in the Autogenous-Saline group (37.5% ± 6.6%) (P = 0.001). The histomorphometric and histopathological results consistently showed that alendronate stimulated bone formation and reduced fibrous tissue formation in maxillary sinus augmentation grafts, especially in the deproteinized bovine bone group (xenograft). Alendronate may be

In vitro disintegration studies of weekly generic alendronate sodium tablets (70 mg) available in the US.

Science.gov (United States)

Dansereau, Richard J; Crail, Debbie J; Perkins, Alan C

2009-02-01

Bisphosphonates as a class have the potential to cause upper gastrointestinal irritation. Although the generic alendronate sodium tablets are bioequivalent to the branded product, a potential concern is that the pharmaceutical attributes of the various generic formulations my affect the potential for local irritation and tolerability. The in vitro disintegration times were determined using the method described in the US Pharmacopeia 30 (USP 30). The disintegration of three generic alendronate sodium tablets 70 mg available in the United States was compared to that of the branded product. The mean disintegration times of the generic alendronate sodium tablets ranged from 9 to 10 s for the Barr lots to 108 s for the Watson lot. The disintegration time of the branded product (Fosamax) was 53 s. The three Barr lots and one Teva lot had rapid disintegration times which were similar to the disintegration standards (disintegrating tablets. Since there is no established disintegration time for alendronate sodium tablets there can be no assurance that the generic tablets are equivalent to the branded product in terms of esophageal exposure. However, the in vitro disintegration times have not been correlated with in vivo disintegration performance. Copies of generic alendronate sodium tablets are approved based on the results of single-dose bioavailability studies in healthy subjects and this is not considered adequate to establish similar disintegration characteristics.

A urine midmolecule osteocalcin assay shows higher discriminatory power than a serum midmolecule osteocalcin assay during short-term alendronate treatment of osteoporotic patients.

Science.gov (United States)

Srivastava, A K; Mohan, S; Singer, F R; Baylink, D J

2002-07-01

We isolated and characterized a peptide fragment corresponding to amino acid sequence 14-28 of human osteocalcin in urine from Paget's disease, and developed a polyclonal antibody reactive to this peptide in urine. We used this antibody to measure urinary fragments of osteocalcin and compared to efficacy of the urinary osteocalcin assay with a serum osteocalcin (sOC) assay (ELISA-Osteo, Cis-Bio International) to monitor the short-term changes in bone turnover in response to alendronate treatment. The synthetic peptide-based urinary osteocalcin (uOC) radioimmunoassay (RIA) showed an analytical sensitivity of 6.25 ng/mL, standard curve range of 3.12-400 ng/mL, and mean intra- (n = 20) and interassay (n = 30) coefficient of variation (CV) of sALP) (Alkphose-B, Metra Biosystems) in serum samples. The percent change data obtained between baseline and 30 days (n = 18) posttreatment suggested a rapid decline in uOC concentration (-27%, p sALP (-3.4%, p = 0.689), two specific markers of bone formation. As expected, due to the coupling of bone formation and bone resorption, the concentration of all markers showed a 30%-45% decline compared with baseline values after 90 days (n = 16) of treatment. Correlation of markers after a 30 day treatment with alendronate revealed a higher correlation (r = 0.61, p sALP (r = -0.14, p = 0.295) with uNTx. Similarly, correlation coefficients with r values between 0.48 and 0.55 (p < 0.05) were observed between uOC, sNTx, and sCTx, whereas no significant correlation was observed between sOC and sNTx or sCTx. These results provide indirect evidence that fragments measured by the urine assay probably originated from bone resorption, and suggest that the uOC assay could be used to assess short-term changes in bone metabolism with regard to osteocalcin.

Esophageal and gastric cancer incidence and mortality in alendronate users

DEFF Research Database (Denmark)

Abrahamsen, Bo; Pazianas, Michael; Eiken, Pia Agnete

2011-01-01

their esophageal or gastric location could be accurately distinguished. We conducted a register-based, open cohort study using national healthcare data for Denmark. Upper endoscopy frequency, cancer incidence and mortality was examined in 30,606 alendronate users (female, age 50 + ) and 122,424 matched controls......Recent studies have reached conflicting conclusions regarding the risk of esophageal cancer with oral bisphosphonates. Prior studies did not record the number of cancer deaths or endoscopy rates, which could be higher in bisphosphonate users and lead to more cancers being diagnosed at a stage when....... Primary outcomes were esophageal cancer incidence and death due to esophageal cancer. The analysis showed that alendronate users were more likely to have undergone recent upper endoscopy (4.1 vs 1.7%, p ...

Alendronate Can Improve Bone Alterations in Experimental Diabetes by Preventing Antiosteogenic, Antichondrogenic, and Proadipocytic Effects of AGEs on Bone Marrow Progenitor Cells

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Sara Rocío Chuguransky

2016-01-01

Full Text Available Bisphosphonates such as alendronate are antiosteoporotic drugs that inhibit the activity of bone-resorbing osteoclasts and secondarily promote osteoblastic function. Diabetes increases bone-matrix-associated advanced glycation end products (AGEs that impair bone marrow progenitor cell (BMPC osteogenic potential and decrease bone quality. Here we investigated the in vitro effect of alendronate and/or AGEs on the osteoblastogenic, adipogenic, and chondrogenic potential of BMPC isolated from nondiabetic untreated rats. We also evaluated the in vivo effect of alendronate (administered orally to rats with insulin-deficient Diabetes on long-bone microarchitecture and BMPC multilineage potential. In vitro, the osteogenesis (Runx2, alkaline phosphatase, type 1 collagen, and mineralization and chondrogenesis (glycosaminoglycan production of BMPC were both decreased by AGEs, while coincubation with alendronate prevented these effects. The adipogenesis of BMPC (PPARγ, intracellular triglycerides, and lipase was increased by AGEs, and this was prevented by coincubation with alendronate. In vivo, experimental Diabetes (a decreased femoral trabecular bone area, osteocyte density, and osteoclastic TRAP activity; (b increased bone marrow adiposity; and (c deregulated BMPC phenotypic potential (increasing adipogenesis and decreasing osteogenesis and chondrogenesis. Orally administered alendronate prevented all these Diabetes-induced effects on bone. Thus, alendronate could improve bone alterations in diabetic rats by preventing the antiosteogenic, antichondrogenic, and proadipocytic effects of AGEs on BMPC.

Risk of hip, subtrochanteric, and femoral shaft fractures among mid and long term users of alendronate

DEFF Research Database (Denmark)

Abrahamsen, Bo; Eiken, Pia; Prieto-Alhambra, Daniel

2016-01-01

OBJECTIVES: To determine the skeletal safety and efficacy of long term (≥10 years) alendronate use in patients with osteoporosis. DESIGN: Open register based cohort study containing two nested case control studies. SETTING: Nationwide study of population of Denmark. PARTICIPANTS: 61 990 men...... ratio (MPR, a proxy for compliance) >80%) compared with poor adherence (MPR

Effects of odanacatib on bone matrix mineralization in rhesus monkeys are similar to those of alendronate

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Barbara M. Misof

2016-12-01

Full Text Available Odanacatib (ODN is a selective and reversible inhibitor of cathepsin K which is an important enzyme for the degradation of collagen I. Aim of the present work was the head-to-head comparison between the effects of ODN and alendronate (ALN on bone mineralization density distribution (BMDD, based on quantitative backscattered electron imaging in relation to changes in histomorphometric mineralizing surface per bone surface (MS/BS in 12–22 years old ovariectomized rhesus monkeys. Trabecular and cortical BMDD derived parameters from vertebrae and proximal tibiae were compared among vehicle (VEH, n = 8, odanacatib low dose (ODN-L, n = 8, odanacatib high dose (ODN-H, n = 8, and alendronate (ALN, n = 6 treated animals. Additionally, data from an intact, non-treated group of animals are shown (INT, n = 8. In trabecular bone from the vertebra and metaphyseal tibia, the BMDD of the ODN and ALN treatment groups was shifted toward higher mineralization densities (p < 0.001 consistent with the significant reduction of MS/BS (p < 0.05 in ODN-H and ALN compared to VEH. Vertebral trabecular CaMean (average degree of mineralization was significantly higher in ODN-L (+6.5%, ODN-H (+6.1%, and ALN (+6.7%, all p < 0.001. Tibial osteonal cortical bone revealed also significantly increased CaMean for ODN-L (+1.4%, p < 0.05, ODN-H (+2.2%, p < 0.05, and ALN (+3.4%, p < 0.001 versus VEH, while primary cortical bone (devoid of secondary osteons did not show any significant differences between the study groups. The percentage of primary bone area in the tibial cross-sections (on average 45 ± 12% was also not significantly different between the study groups (p = 0.232. No significant differences in any BMDD parameters of all studied skeletal sites between ODN and ALN treatment were found. Correlation analysis revealed that MS/BS was highly predictive for trabecular BMDD in vertebral bone. The higher MS/BS, the lower was CaMean. Our findings are

Localized cortical thickening of the femoral diaphysis captured on an X-ray before alendronate therapy in two cases of atypical femoral fracture

Energy Technology Data Exchange (ETDEWEB)

Iizuka, Yoichi [Gunma University Graduate School of Medicine, Department of Orthopedic Surgery, Maebashi, Gunma (Japan); Shibukawa General Hospital, Department of Orthopedic Surgery, Shibukawa, Gunma (Japan); Takechi, Rumi [Gunma University Graduate School of Medicine, Department of Orthopedic Surgery, Maebashi, Gunma (Japan); Gunma Cardiovascular Center, Department of Orthopaedic Surgery, Maebashi, Gunma (Japan); Iizuka, Haku; Takagishi, Kenji [Gunma University Graduate School of Medicine, Department of Orthopedic Surgery, Maebashi, Gunma (Japan); Omodaka, Takuya [Gunma University Graduate School of Medicine, Department of Orthopedic Surgery, Maebashi, Gunma (Japan); Gunma Central Hospital, Department of Orthopedic Surgery, Maebashi, Gunma (Japan)

2016-10-15

We herein report two cases of atypical femoral fracture (AFF). X-ray examinations at the first visit of these two female patients showed a complete fracture of the femoral diaphysis diagnosed as an atypical femoral fracture (AFF). X-rays of these two cases also showed localized cortical thickening of the femoral diaphysis. Both patients had been taking alendronate for more than 3 years because of postmenopausal osteoporosis. We assumed that both of the fractures were associated with the long-term use of alendronate. However, we retrospectively identified localized cortical thickening of the femoral diaphysis on an X-ray taken before the alendronate therapy in both of these cases. Therefore, we suspected a pathogenesis of AFFs in which preexisting stress or an insufficient fracture unrelated to bisphosphonate (BP) therapy and subsequent suppression of bone turnover due to BP administration led to the occurrence of an AFF. The patient underwent surgery using intramedullary nails in both of these cases, followed by the administration of teriparatide, and they were able to walk without any support at the final follow-up examination. (orig.)

Process analytical technology to understand the disintegration behavior of alendronate sodium tablets.

Science.gov (United States)

Xu, Xiaoming; Gupta, Abhay; Sayeed, Vilayat A; Khan, Mansoor A

2013-05-01

Various adverse events including esophagus irritations have been reported with the use of alendronate tablets, likely attributed to the rapid tablet disintegration in the mouth or esophagus. Accordingly, the disintegration of six alendronate tablet drug products was studied using a newly developed testing device equipped with in-line sensors, in addition to the official compendial procedure for measuring the disintegration time. The in-line sensors were used to monitor the particle count and solution pH change to assess the onset and duration of disintegration. A relatively large variation was observed in the disintegration time of the tested drug products using the compendial method. The data collected using the in-line sensors suggested that all tested drug products exhibited almost instantaneous onset of disintegration, under 2 s, and a sharp drop in solution pH. The drop in pH was slower for tablets with slower disintegration. The in-house prepared alendronate test tablets also showed similar trends suggesting rapid solubilization of the drug contributed to the fast tablet disintegration. This research highlights the usefulness of the newly developed in-line analytical method in combination with the compendial method in providing a better understanding of the disintegration and the accompanying drug solubilization processes for fast disintegrating tablet drug products. Copyright © 2013 Wiley Periodicals, Inc.

Modulation of adhesion-dependent cAMP signaling by echistatin and alendronate

Science.gov (United States)

Fong, J. H.; Ingber, D. E.

1996-01-01

We measured intracellular cAMP levels in cells during attachment and spreading on different extracellular matrix (ECM) proteins. Increases in cAMP were observed within minutes when cells attached to fibronectin, vitronectin, and a synthetic RGD-containing fibronectin peptide (Petite 2000), but not when they adhered to another integrin alpha nu beta 3 ligand, echistatin. Because echistatin also inhibits bone resorption, we measured the effects of adding another osteoporosis inhibitor, alendronate, in this system. Alendronate inhibited the cAMP increase induced by ligands that primarily utilize integrin alpha nu beta 3 (vitronectin, Peptite 2000), but not by fibronectin which can also use integrin alpha 5 beta 1. These results show that cell adhesion to ECM can increase intracellular cAPM levels and raise the possibility that inhibitors of osteoporosis may act, in part, by preventing activation of this pathway by integrins.

Overcoming resistance to bisphosphonates through the administration of alfacalcidol: results of a 1-year, open follow-up study.

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Gaál, János; Bender, Tamás; Varga, József; Horváth, Irén; Kiss, Judit; Somogyi, Péter; Surányi, Péter

2009-11-01

This study intended to determine whether the replacement of vitamin D3 with alfacalcidol results in any bone mineral density (BMD) increase in 76 patients unresponsive to the combination of alendronate and conventional vitamin D3 treatment. In these patients the conventional vitamin D3 had been replaced with alfacalcidol (0.5 μg/day), and then the patients were followed up for a year. After treatment for 1 year, Wilcoxon test revealed a small but statistically significant (P d-pyr/creatinine ratio decreased significantly (P < 0.001). As suggested by our results, combination therapy with alendronate and alfacalcidol increases bone density and improves the biochemical markers of bone turnover, without any substantial increase in the incidence of adverse effects.

In vitro disintegration and dissolution studies of once-weekly copies of alendronate sodium tablets (70 mg) and in vivo implications.

Science.gov (United States)

Dansereau, Richard J; Crail, Debbie J; Perkins, Alan C

2008-04-01

The aim of this study was to evaluate the in vitro disintegration and dissolution of 26 alendronic acid tablets (70 mg) on the market in Canada, Germany, the Netherlands, and the United Kingdom compared to the branded product (Fosamax). The disintegration and dissolution times were determined using the methods described in the United States Pharmacopeia 30 (USP 30). The disintegration of four orally disintegrating tablets (non-bisphosphonates) and branded film-coated risedronate sodium tablets were included for comparison. The mean disintegration times of the alendronic acid tablets ranged from 14 s for Pharmachemie (Netherlands) to 342 s (5.7 min) for Betapharm (Germany). The mean disintegration time of the branded product tablets ranged from 43 to 78 s. Six of the 26 companies market alendronic acid tablets with very rapid disintegration times which are similar to those of orally disintegrating tablets (non-bisphosphonates). The alendronic acid tablets with very rapid mean disintegration times are as follows: Pharmachemie (Netherlands), 14 s; Novopharm (Canada), 13-24 s; GRY-Pharma (Germany), 21 s; Juta Pharma (Germany), 30 s; APS/Teva (United Kingdom), 26 and 37 s; and Teva (UK), 14-29 s. Since there is no established disintegration time for alendronic acid tablets there can be no assurance that the copy tablets are equivalent to the branded product in terms of esophageal drug exposure. However, the in vitro disintegration times have not been correlated with in vivo disintegration and performance. The dissolution of all the bisphosphonate tablets was rapid with greater than 80% dissolved in 15 min and all products conformed to the USP 30 specification. The dissolution of all alendronic acid tablets was rapid and complete and conformed to the established USP 30 specifications which should ensure adequate drug absorption from the copy products. However, copies of alendronic acid tablets are approved based on the results of single-dose bioavailability studies in

Production, quality control, biodistribution assessment and preliminary dose evaluation of {sup 166}Ho-alendronate as a bone marrow ablative agent

Energy Technology Data Exchange (ETDEWEB)

Fakhari, Ashraf [Tehran University of Medical Sciences (Iran, Islamic Republic of). Dept. of Radiopharmacy; Jalilian, Amir Reza; Yousefnia, Hassan; Zolghadri, Samaneh; Samani, Ali Bahrami; Akbari, Mahmoud Reza; Deha, Fariba Johari [Nuclear Science and Technology Research Institute (NSTRI), Tehran (Iran, Islamic Republic of); Shafiee-Ardestani, Mahdi; Khalaj, Ali [Tehran University of Medical Sciences (Iran, Islamic Republic of). Dept. of Medicinal Chemistry

2015-07-01

In this study, production, quality control and biodistribution studies of {sup 166}Ho-alendronate have been presented and followed by dosimetric evaluation for human based on biodistribution data in wild-type rats. {sup 166}Ho chloride was obtained by thermal neutron irradiation of natural {sup 165}Ho(NO{sub 3}){sub 3} samples. {sup 166}Ho-alendronate complex was prepared by adding the desired amount of alkaline alendronate solution (0.2 mL, 150 mg/mL) to 3-5 mCi of the {sup 166}HoCl{sub 3} solution. Radiochemical purity of the complex was monitored by instant thin layer chromatography (ITLC). {sup 166}Ho-alendronate complex was prepared in high radiochemical purity (> 99%, ITLC) and specific activity of 4.4 GBq/mmol. Stability studies of the complex in the final preparation and in the presence of human serum were performed up to 48 h. The major accumulation of the radio-complex was in the bone tissues followed by absorbed dose evaluation of each human organ by RADAR software used for modelling the radiation dose delivered. The final preparation was administered to wild-type rats and biodistribution of the complex was performed 2-48 h post injection showing major accumulation of the complex in the bone tissue. The highest absorbed dose for {sup 166}Ho-alendronate is observed in bone surface and red marrow with 2.670 and 1.880 mSv/MBq; respectively. These findings suggest that {sup 166}Ho-alendronate has considerable characteristics compared to {sup 166}Ho-DOTMP and can be a possible candidate for bone marrow ablation in patients with multiple myeloma.

Mutual augmentation of the induction of the histamine-forming enzyme, histidine decarboxylase, between alendronate and immuno-stimulants (IL-1, TNF, and LPS), and its prevention by clodronate

International Nuclear Information System (INIS)

Deng Xue; Yu Zhiqian; Funayama, Hiromi; Shoji, Noriaki; Sasano, Takashi; Iwakura, Yoichiro; Sugawara, Shunji; Endo, Yasuo

2006-01-01

Nitrogen-containing bisphosphonates (N-BPs), powerful anti-bone-resorptive drugs, have inflammatory side effects, while histamine is not only an inflammatory mediator, but also an immuno-modifier. In murine models, a single intraperitoneal injection of an N-BP induces various inflammatory reactions, including the induction of the histamine-forming enzyme histidine decarboxylase (HDC) in tissues important in immune responses (such as liver, lungs, spleen, and bone marrow). Lipopolysaccharide (LPS) and the proinflammatory cytokines IL-1 and TNF are also capable of inducing HDC. We reported previously that in mice (i) the inflammatory actions of N-BPs depend on IL-1 (ii) N-BP pretreatment augments both LPS-stimulated IL-1 production and HDC induction, and (iii) the co-administration of clodronate (a non-N-BP) with an N-BP inhibits the latter's inflammatory actions (including HDC induction). Here, we add the new findings that (a) pretreatment with alendronate (a typical N-BP) augments both IL-1- and TNF-induced HDC elevations, (b) LPS pretreatment augments the alendronate-induced HDC elevation, (c) co-administration of clodronate with alendronate abolishes these augmentations, (d) alendronate does not induce HDC in IL-1-deficient mice even if they are pretreated with LPS, and (e) alendronate increases IL-1β in all tissues tested, but not in the serum. These results suggest that (1) there are mutual augmentations between alendronate and immuno-stimulants (IL-1, TNF, and LPS) in HDC induction, (2) tissue IL-1β is important in alendronate-stimulated HDC induction, and (3) combination use of clodronate may have the potential to reduce the inflammatory effects of alendronate (we previously found that clodronate, conveniently, does not inhibit the anti-bone-resorptive activity of alendronate)

[Chest Injury and its Surgical Treatment in Polytrauma Patients. Five-Year Experience].

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Vodička, J; Doležal, J; Vejvodová, Š; Šafránek, J; Špidlen, V; Třeška, V

2016-01-01

PURPOSE OF THE STUDY Thoracic trauma, one of the most frequent injuries in patients with multiple traumata, is found in 50 to 80% of these patients and it is crucial for the patient's prognosis. It accounts for 25% of all death from polytraumatic injuries. The aim of this retrospective study was an analysis of the occurrence of chest injuries in polytrauma patients and their surgical treatment in the Trauma Centre or Department of Surgery of the University Hospital Pilsen in a five-year period. MATERIAL AND METHODS Patients with injuries meeting the definition of polytrauma and an Injury Severity Score (ISS) ≥16 were included. The demographic characteristics, mechanism of multiple trauma, ISS value and chest injury were recorded in each patient. The number of injured patients in each year of the study was noted. In the patients with chest injury, the type of injury and method of treatment were assessed. The therapy was further analysed including its timing. The number of deaths due to polytrauma involving chest injury, the cause of death and its time in relation to the patient's admission to the Trauma Centre were evaluated. RESULTS In the period 2010-14, 513 polytrauma patients were treated; of them 371 (72.3%) were men with an average age of 40.5 years. The most frequent cause of injury was a traffic accident (74%). The average ISS of the whole group was 35 points. Chest injury was diagnosed in 469 patients (91.4%) of whom only five (1.1%) had penetrating injury. Pulmonary contusion was most frequent (314 patients; 67%). A total of 212 patients with chest injury underwent surgery (45.2%); urgent surgery was performed in 143 (67.5%), acute surgery in 49 (23.1%) and delayed surgery in 63 (29.7%) patients. Chest drainage was the major surgical procedure used in the whole group. Of 61 patients who died, 52 had chest injury. In this subgroup the most frequent cause of death was decompensated traumatic shock (26 patients; 50%). In the whole group, 32 polytrauma

Estimating the Time to Benefit for Preventive Drugs with the Statistical Process Control Method: An Example with Alendronate

OpenAIRE

van de Glind, Esther M. M.; Willems, Hanna C.; Eslami, Saeid; Abu-Hanna, Ameen; Lems, Willem F.; Hooft, Lotty; de Rooij, Sophia E.; Black, Dennis M.; van Munster, Barbara C.

2016-01-01

Background For physicians dealing with patients with a limited life expectancy, knowing the time to benefit (TTB) of preventive medication is essential to support treatment decisions. Objective The aim of this study was to investigate the usefulness of statistical process control (SPC) for determining the TTB in relation to fracture risk with alendronate versus placebo in postmenopausal women. Methods We performed a post?hoc analysis of the Fracture Intervention Trial (FIT), a randomized, con...

Five-Year Risk of Interval-Invasive Second Breast Cancer

Science.gov (United States)

Buist, Diana S. M.; Houssami, Nehmat; Dowling, Emily C.; Halpern, Elkan F.; Gazelle, G. Scott; Lehman, Constance D.; Henderson, Louise M.; Hubbard, Rebecca A.

2015-01-01

Background: Earlier detection of second breast cancers after primary breast cancer (PBC) treatment improves survival, yet mammography is less accurate in women with prior breast cancer. The purpose of this study was to examine women presenting clinically with second breast cancers after negative surveillance mammography (interval cancers), and to estimate the five-year risk of interval-invasive second cancers for women with varying risk profiles. Methods: We evaluated a prospective cohort of 15 114 women with 47 717 surveillance mammograms diagnosed with stage 0-II unilateral PBC from 1996 through 2008 at facilities in the Breast Cancer Surveillance Consortium. We used discrete time survival models to estimate the association between odds of an interval-invasive second breast cancer and candidate predictors, including demographic, PBC, and imaging characteristics. All statistical tests were two-sided. Results: The cumulative incidence of second breast cancers after five years was 54.4 per 1000 women, with 325 surveillance-detected and 138 interval-invasive second breast cancers. The five-year risk of interval-invasive second cancer for women with referent category characteristics was 0.60%. For women with the most and least favorable profiles, the five-year risk ranged from 0.07% to 6.11%. Multivariable modeling identified grade II PBC (odds ratio [OR] = 1.95, 95% confidence interval [CI] = 1.15 to 3.31), treatment with lumpectomy without radiation (OR = 3.27, 95% CI = 1.91 to 5.62), interval PBC presentation (OR = 2.01, 95% CI 1.28 to 3.16), and heterogeneously dense breasts on mammography (OR = 1.54, 95% CI = 1.01 to 2.36) as independent predictors of interval-invasive second breast cancers. Conclusions: PBC diagnosis and treatment characteristics contribute to variation in subsequent-interval second breast cancer risk. Consideration of these factors may be useful in developing tailored post-treatment imaging surveillance plans. PMID:25904721

Use of Calcium and Alendronic Acid Preparations in Correction of Structural and Functional Disorders of Bone Tissue in Thyrotoxicosis

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O.B. Oliynyk

2012-02-01

Full Text Available Impact of calcium and alendronic acid preparations on disorders of structural and functional state of bone tissue in experimental animals at exogenic thyrotoxicosis was studied. It was defined that introduction of calcium preparations reduces bone mineral density loss in female rats with drug thyrotoxicosis, and combined use of calcium and alendronic acid prevents bone tissue loss regardless of thyrotoxicosis duration and presence of ovariectomy.

Effects of local alendronate sodium gel as an adjunct to scaling and root planing on smokers with chronic periodontitis: a pilot study

OpenAIRE

Farin Kiany; Hashem Montaseri; Sadaf Adibi; Masoud Golshah; Saba Golshah

2017-01-01

Background: Chemical treatments for the modulation of host response are applied along with mechanical modalities as adjunctive to periodontal treatment. The objective of this pilot study was to investigate the effects of locally-delivered alendronate sodium gel in adjunction to scaling and root planning on periodontal indices and bone formation within vertical defects of smokers with chronic periodontitis. Methods and Materials: In this study vertical defects (n=8) with depth>5 mm have be...

Prognostic factors and outcome of treatment in Perthes' disease: a prospective study of 368 patients with five-year follow-up.

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Wiig, O; Terjesen, T; Svenningsen, S

2008-10-01

This nationwide prospective study was designed to determine prognostic factors and evaluate the outcome of different treatments of Perthes' disease. A total of 28 hospitals in Norway were instructed to report all new cases of Perthes' disease over a period of five years and 425 patients were reported and followed for five years. Of these, 368 with unilateral disease were included in the present study. The hips were classified radiologically according to a modified two-group Catterall classification and the lateral pillar classification. A total of 358 patients (97%) attended the five-year follow-up, when a modified three-group Stulberg classification was used as a radiological outcome measure. For patients over six years of age at diagnosis and with more than 50% necrosis of the femoral head (152 patients), the surgeons at the different hospitals had chosen one of three methods of treatment: physiotherapy (55 patients), the Scottish Rite abduction orthosis (26), and proximal femoral varus osteotomy (71). Of these hips, 146 (96%) were available for the five-year follow-up. The strongest predictor of outcome was femoral head involvement of more or less than 50% (odds ratio (OR) = 7.76, 95% confidence interval (CI) 2.82 to 21.37), followed by age at diagnosis (OR = 0.98, 95% CI 0.92 to 0.99) and the lateral pillar classification (OR = 0.62, 95% CI 0.40 to 0.98). In children over six years at diagnosis with more than 50% of femoral head necrosis, proximal femoral varus osteotomy gave a significantly better outcome than orthosis (p = 0.001) or physiotherapy (p = 0.001). There was no significant difference between the physiotherapy and orthosis groups (p = 0.36), and we found no difference in outcome after any of the treatments in children under six years (p = 0.73). We recommend proximal femoral varus osteotomy in children aged six years and over at the time of diagnosis with hips having more than 50% femoral head necrosis. The abduction orthosis should be abandoned in

Does Alendronate reduce the risk of fracture in men? A meta-analysis incorporating prior knowledge of anti-fracture efficacy in women

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Papaioannou Alexandra

2005-07-01

Full Text Available Abstract Background Alendronate has been found to reduce the risk of fractures in postmenopausal women as demonstrated in multiple randomized controlled trials enrolling thousands of women. Yet there is a paucity of such randomized controlled trials in osteoporotic men. Our objective was to systematically review the anti-fracture efficacy of alendronate in men with low bone mass or with a history of prevalent fracture(s and incorporate prior knowledge of alendronate efficacy in women in the analysis. Methods We examined randomized controlled trials in men comparing the anti-fracture efficacy of alendronate to placebo or calcium or vitamin D, or any combination of these. Studies of men with secondary causes of osteoporosis other than hypogonadism were excluded. We searched the following electronic databases (without language restrictions for potentially relevant citations: Medline, Medline in Process (1966-May 24/2004, and Embase (1996–2004. We also contacted the manufacturer of the drug in search of other relevant trials. Two reviewers independently identified two trials (including 375 men, which met all inclusion criteria. Data were abstracted by one reviewer and checked by another. Results of the male trials were pooled using Bayesian random effects models, incorporating prior information of anti-fracture efficacy from meta-analyses of women. Results The odds ratios of incident fractures in men (with 95% credibility intervals with alendronate (10 mg daily were: vertebral fractures, 0.44 (0.23, 0.83 and non-vertebral fractures, 0.60 (0.29, 1.44. Conclusion In conclusion, alendronate decreases the risk of vertebral fractures in men at risk. There is currently insufficient evidence of a statistically significant reduction of non-vertebral fractures, but the paucity of trials in men limit the statistical power to detect such an effect.

Alendronate for fracture prevention in postmenopause.

Science.gov (United States)

Holder, Kathryn K; Kerley, Sara Shelton

2008-09-01

Osteoporosis is an abnormal reduction in bone mass and bone deterioration leading to increased fracture risk. Alendronate (Fosamax) belongs to the bisphosphonate class of drugs, which act to inhibit bone resorption by interfering with the activity of osteoclasts. To assess the effectiveness of alendronate in the primary and secondary prevention of osteoporotic fractures in postmenopausal women. The authors searched Central, Medline, and EMBASE for relevant randomized controlled trials published from 1966 to 2007. The authors undertook study selection and data abstraction in duplicate. The authors performed meta-analysis of fracture outcomes using relative risks, and a relative change greater than 15 percent was considered clinically important. The authors assessed study quality through reporting of allocation concealment, blinding, and withdrawals. Eleven trials representing 12,068 women were included in the review. Relative and absolute risk reductions for the 10-mg dose were as follows. For vertebral fractures, a 45 percent relative risk reduction was found (relative risk [RR] = 0.55; 95% confidence interval [CI], 0.45 to 0.67). This was significant for primary prevention, with a 45 percent relative risk reduction (RR = 0.55; 95% CI, 0.38 to 0.80) and 2 percent absolute risk reduction; and for secondary prevention, with 45 percent relative risk reduction (RR = 0.55; 95% CI, 0.43 to 0.69) and 6 percent absolute risk reduction. For nonvertebral fractures, a 16 percent relative risk reduction was found (RR = 0.84; 95% CI, 0.74 to 0.94). This was significant for secondary prevention, with a 23 percent relative risk reduction (RR = 0.77; 95% CI, 0.64 to 0.92) and a 2 percent absolute risk reduction, but not for primary prevention (RR = 0.89; 95% CI, 0.76 to 1.04). There was a 40 percent relative risk reduction in hip fractures (RR = 0.60; 95% CI, 0.40 to 0.92), but only secondary prevention was significant, with a 53 percent relative risk reduction (RR = 0.47; 95% CI

Treatment Outcome of Tuberculosis Patients under Directly Observed Treatment Short Course and Factors Affecting Outcome in Southern Ethiopia: A Five-Year Retrospective Study.

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Gebremedhin Gebrezgabiher

Full Text Available Tuberculosis (TB is one of the major public health and socio-economic issues in the 21st century globally. Assessment of TB treatment outcomes, and monitoring and evaluation of its risk factors in Directly Observed Treatment Short Course (DOTS are among the major indicators of the performance of a national TB control program. Hence, this institution-based retrospective study was conducted to determine the treatment outcome of TB patients and investigate factors associated with unsuccessful outcome at Dilla University Referral Hospital, southern Ethiopia. Five years (2008 to 2013 TB record of TB clinic of the hospital was reviewed. A total 1537 registered TB patients with complete information were included. Of these, 942 (61.3% were male, 1015 (66% were from rural areas, 544 (35.4% were smear positive pulmonary TB (PTB+, 816 (53.1% were smear negative pulmonary TB (PTB- and 177(11.5% were extra pulmonary TB (EPTB patients. Records of the 1537 TB patients showed that 181 (11.8% were cured, 1129(73.5% completed treatment, 171 (11.1% defaulted, 52 (3.4% died and 4 (0.3% had treatment failure. The overall mean treatment success rate of the TB patients was 85.2%. The treatment success rate of the TB patients increased from 80.5% in September 2008-August 2009 to 84.8% in September 2012-May 2013. Tuberculosis type, age, residence and year of treatment were significantly associated with unsuccessful treatment outcome. The risk of unsuccessful outcome was significantly higher among TB patients from rural areas (AOR = 1.63, 95% CI: 1.21-2.20 compared to their urban counterparts. Unsuccessful treatment outcome was also observed in PTB- patients (AOR = 1.77, 95% CI: 1.26-2.50 and EPTB (AOR = 2.07, 95% CI: 1.28-3.37 compared to the PTB+ patients. In conclusion, it appears that DOTS have improved treatment success in the hospital during five years. Regular follow-up of patients with poor treatment outcome and provision of health information on TB treatment to

Effect of an estrogen-deficient state and alendronate therapy on bone loss resulting from experimental periapical lesions in rats.

Science.gov (United States)

Xiong, Haofei; Peng, Bin; Wei, Lili; Zhang, Xiaolei; Wang, Li

2007-11-01

The aim of the research was to evaluate the impact of an estrogen-deficient state and alendronate (ALD) therapy on bone loss resulting from experimental periapical lesions in rats. Periapical lesions were induced on ovariectomized (OVX) and sham-ovariectomized (Sham) rats. After sample preparation, histologic and radiographic examination for periapical bone loss area and an enzyme histochemical test for tartrate-resistant acid phosphatase (TRAP) were performed. The results showed that OVX significantly increased bone loss resulting from periradicular lesions. After daily subcutaneous injection of ALD, the bone loss area and the number of TRAP-positive cells (osteoclasts) were reduced. These findings suggested that alendronate may protect against increased bone loss from experimental periapical lesions in estrogen-deficient rats. Given recent recognition of adverse effects of bisphosphonates, including an increased risk for osteonecrosis, the findings from this study should not be interpreted as a new indication for ALD treatment. However, they may offer insight into understanding and predicting outcomes in female postmenopausal patients already on ALD therapy for medical indications.

Assessing the benefits of five years of different approaches to treatment of urogenital schistosomiasis: A SCORE project in Northern Mozambique.

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Anna E Phillips

2017-12-01

Full Text Available In Mozambique, schistosomiasis is highly endemic across the whole country. The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE coordinates a five-year study that has been implemented in various African countries, including Mozambique. The overall goal of SCORE was to better understand how to best apply preventive chemotherapy with praziquantel (PZQ for schistosomiasis control by evaluating the impact of alternative treatment approaches.This was a cluster-randomised trial that compared the impact of different treatment strategies in study areas with prevalence among school children of ≥21% S. haematobium infection by urine dipstick. Each village was randomly allocated to one of six possible combinations of community-wide treatment (CWT, school-based treatment (SBT, and/or drug holidays over a period of four years, followed by final data collection in the fifth year. The most intense intervention arm involved four years of CWT, while the least intensive arm involved two years of SBT followed by two consecutive years of PZQ holiday. Each study arm included 25 villages randomly assigned to one of the six treatment arms. The primary outcome of interest was change in prevalence and intensity of S. haematobium among 100 children aged 9-to-12-years that were sampled each year in every village. In addition to children aged 9-to-12 years, 100 children aged 5-8 years in their first-year of school and 50 adults (aged 20-55 years were tested in the first and final fifth year of the study. Prevalence and intensity of S. haematobium infection was evaluated by two filtrations, each of 10mL, from a single urine specimen.In total, data was collected from 81,167 individuals across 149 villages in ten districts of Cabo Delgado province, Northern Mozambique. Overall PZQ treatment resulted in a significant reduction in the prevalence of S. haematobium infection from Year 1 to Year 5, where the average prevalence went from 60.5% to 38

Five-year risk of interval-invasive second breast cancer.

Science.gov (United States)

Lee, Janie M; Buist, Diana S M; Houssami, Nehmat; Dowling, Emily C; Halpern, Elkan F; Gazelle, G Scott; Lehman, Constance D; Henderson, Louise M; Hubbard, Rebecca A

2015-07-01

Earlier detection of second breast cancers after primary breast cancer (PBC) treatment improves survival, yet mammography is less accurate in women with prior breast cancer. The purpose of this study was to examine women presenting clinically with second breast cancers after negative surveillance mammography (interval cancers), and to estimate the five-year risk of interval-invasive second cancers for women with varying risk profiles. We evaluated a prospective cohort of 15 114 women with 47 717 surveillance mammograms diagnosed with stage 0-II unilateral PBC from 1996 through 2008 at facilities in the Breast Cancer Surveillance Consortium. We used discrete time survival models to estimate the association between odds of an interval-invasive second breast cancer and candidate predictors, including demographic, PBC, and imaging characteristics. All statistical tests were two-sided. The cumulative incidence of second breast cancers after five years was 54.4 per 1000 women, with 325 surveillance-detected and 138 interval-invasive second breast cancers. The five-year risk of interval-invasive second cancer for women with referent category characteristics was 0.60%. For women with the most and least favorable profiles, the five-year risk ranged from 0.07% to 6.11%. Multivariable modeling identified grade II PBC (odds ratio [OR] = 1.95, 95% confidence interval [CI] = 1.15 to 3.31), treatment with lumpectomy without radiation (OR = 3.27, 95% CI = 1.91 to 5.62), interval PBC presentation (OR = 2.01, 95% CI 1.28 to 3.16), and heterogeneously dense breasts on mammography (OR = 1.54, 95% CI = 1.01 to 2.36) as independent predictors of interval-invasive second breast cancers. PBC diagnosis and treatment characteristics contribute to variation in subsequent-interval second breast cancer risk. Consideration of these factors may be useful in developing tailored post-treatment imaging surveillance plans. © The Author 2015. Published by Oxford University Press. All rights reserved

Adolescent idiopathic scoliosis patients report increased pain at five years compared with two years after surgical treatment.

Science.gov (United States)

Upasani, Vidyadhar V; Caltoum, Christine; Petcharaporn, Maty; Bastrom, Tracey P; Pawelek, Jeff B; Betz, Randal R; Clements, David H; Lenke, Lawrence G; Lowe, Thomas G; Newton, Peter O

2008-05-01

A multicenter study of changes in Scoliosis Research Society (SRS) outcome measures after surgical treatment of adolescent idiopathic scoliosis (AIS). To evaluate changes in patient determined outcome measures between 2 and 5 years after AIS surgery. Current surgical procedures have been shown to improve subjective measures in patients with AIS. At 2-year follow-up, AIS patients reported significant improvement in all 4 preoperative domains of the SRS questionnaire. In addition, the major Cobb angle was shown to be negatively correlated with preoperative scores in the pain, general self-image, and general function domains. Five-year SRS scores have not been evaluated previously. A multicenter, prospectively generated database was used to obtain perioperative, radiographic, and SRS-24 outcomes data. The inclusion criteria were: a diagnosis of AIS, surgical treatment (anterior, posterior, or combined), a comprehensive set of radiographic measures, and completed preoperative, 2-year, and 5-year SRS questionnaires. Repeated measures analysis of variance was used to compare changes in patient responses for each of the 7 outcome domains. Univariate analysis of variance was used to compare the change in pain score at 5 years to the level of the lowest instrumented vertebrae and surgical approach. A correlation analysis was used to determine the association between changes in any of the radiographic variables and changes in SRS scores. The data were checked for normality and equal variances, and the level of significance was set at P < 0.01. Forty-nine patients (42 women, 7 men; 14.2 +/- 2.1 year old; 5.4 +/- 0.6 years follow-up) met the inclusion criteria for this study. Thirty-seven of 49 (76%) of these patients underwent an open or thoracoscopic anterior procedure. SRS-24 scores improved significantly in 3 of the 4 preoperative domains at the 2-year visit. At 5 years postop, a statistically significant decrease in the pain score (4.2 +/- 0.6 to 3.9 +/- 0.9, P = 0

Treatment of winery wastewater in a conventional municipal activated sludge process: five years of experience.

Science.gov (United States)

Bolzonella, D; Zanette, M; Battistoni, P; Cecchi, F

2007-01-01

A full-scale wastewater treatment plant where municipal and winery wastewaters were co-treated was studied for five years. The experimental results showed that suspended solids, COD, nitrogen and phosphorous were effectively removed both during the treatment of municipal wastewater and the cotreatment of municipal and winery wastewater. The sludge production increase from 4 tons to 5.5 tons per day during the harvesting and wine making period. In any case the specific sludge production was 0.2 kgMLVSS per kgCOD(removed) despite the organic loading increasing. About 70% of the COD was removed through respiration. Also the energy demand increased from 6,000 to 7,000 kWh per day. The estimated costs for the treatment of the winery wastewater was 0.2-0.3 Euros per m3 of treated wastewater. With reference to the process efficiency, the nitrogen removal was just 20%. The co-treatment of municipal and winery wastewater in conventional activated sludge processes can be a feasible solution for the treatment of these streams at relatively low costs.

Five years of specialised early intervention versus two years of specialised early intervention followed by three years of standard treatment for patients with a first episode psychosis

DEFF Research Database (Denmark)

Albert, Nikolai; Melau, Marianne; Jensen, Heidi

2017-01-01

assessment. Randomisation was centralised and computerised with concealed randomisation sequence carried out at an external site. SETTING: Participants were recruited from six OPUS teams in Denmark between 2009 and 2012. OPUS teams provide SEI treatment to all patients diagnosed with a schizophrenia spectrum...... of three core elements-modified assertive community treatment, family involvement, and social skill training-with a patient-case manager ratio of no more than 12:1. For participants randomised to five years of OPUS treatment, the treatment was largely unchanged. Participants randomised to the control group......, alogia, and affective blunting). Secondary outcomes were remission of both negative and psychotic symptoms, psychotic symptoms, suicidal ideation, substance abuse, compliance with medical treatment, adherence with treatment, client satisfaction, days in hospital care, and labour market affiliation...

Treated Hypertension has No Influence on the Efficacy of Alendronate in the Therapy of Postmenopausal Osteoporosis: A Non-Randomized, Non-Blind, Controlled Prospective Study

OpenAIRE

Matziolis, Doerte; Drewke, Monika; Matziolis, Georg; Perka, Carsten

2011-01-01

Changes in hormone metabolism during menopause are involved in the development of osteoporosis and arterial hypertension. A mutual influence of these two clinical pictures is evident on the basis of pathophysiological factors. In this study, we investigated whether a drug therapy of hypertension influences the efficacy of a bisphosphonate (alendronate) in the treatment of postmenopausal osteoporosis. For this purpose, 60 female patients were enrolled in the study, 30 of them on drug treatment...

Role of 1% alendronate gel as adjunct to mechanical therapy in the treatment of chronic periodontitis among smokers.

Science.gov (United States)

Sharma, Anuj; Raman, Achala; Pradeep, Avani Raju

2017-01-01

Alendronate (ALN) inhibits osteoclastic bone resorption and triggers osteostimulative properties both in vivo and in vitro, as shown by increase in matrix formation. This study aimed to explore the efficacy of 1% ALN gel as local drug delivery (LDD) in adjunct to scaling and root planing (SRP) for the treatment of chronic periodontitis among smokers. 75 intrabony defects were treated in 46 male smokers either with 1% ALN gel or placebo gel. ALN gel was prepared by adding ALN into carbopol-distilled water mixture. Clinical parameters [modified sulcus bleeding index, plaque index, probing depth (PD), and periodontal attachment level (PAL)] were recorded at baseline, at 2 months, and at 6 months, while radiographic parameters were recorded at baseline and at 6 months. Defect fill at baseline and at 6 months was calculated on standardized radiographs by using the image analysis software. Mean PD reduction and mean PAL gain were found to be greater in the ALN group than in the placebo group, both at 2 and 6 months. Furthermore, a significantly greater mean percentage of bone fill was found in the ALN group (41.05±11.40%) compared to the placebo group (2.5±0.93%). The results of this study showed 1% ALN stimulated a significant increase in PD reduction, PAL gain, and an improved bone fill compared to placebo gel in chronic periodontitis among smokers. Thus, 1% ALN, along with SRP, is effective in the treatment of chronic periodontitis in smokers.

Five-year Treatment Outcomes in the Ahmed Baerveldt Comparison Study

Science.gov (United States)

Budenz, Donald L.; Barton, Keith; Gedde, Steven J.; Feuer, William J.; Schiffman, Joyce; Costa, Vital P.; Godfrey, David G.; Buys, Yvonne M.

2014-01-01

Purpose To compare the five year outcomes of the Ahmed FP7 Glaucoma Valve (AGV) and the Baerveldt 101-350 Glaucoma Implant (BGI) for the treatment of refractory glaucoma. Design Multicenter randomized controlled clinical trial. Participants 276 patients, including 143 in the AGV group and 133 in the BGI group. Methods Patients 18 to 85 years of age with previous intraocular surgery or refractory glaucoma and intraocular pressure (IOP) of ≥ 18 mmHg in whom glaucoma drainage implant surgery was planned were randomized to implantation of either an AGV or BGI. Main Outcome Measures IOP, visual acuity, use of glaucoma medications, complications, and failure (IOP > 21 mmHg or not reduced by 20% from baseline, IOP ≤ 5 mmHg, reoperation for glaucoma, removal of implant, or loss of light perception). Results At 5 years, IOP (mean ± SD) was 14.7 ± 4.4 mmHg in the AGV group and 12.7 ± 4.5 mmHg in the BGI group (p = 0.012). The number of glaucoma medications in use at 5 years (mean ± SD) was 2.2 ± 1.4 in the AGV group and 1.8 ± 1.5 in the BGI group (p = 0.28). The cumulative probability of failure during 5 years of follow-up was 44.7% in the AGV group and 39.4% in the BGI group (p = 0.65). The number of subjects failing due to inadequately controlled IOP or reoperation for glaucoma was 46 in the AGV group (80% of AGV failures) and 25 in the BGI group (53% of BGI failures, p=0.003). Eleven AGV eyes (20% of AGV failures) experienced persistent hypotony, explantation of implant, or loss of light perception compared to 22 (47% of failures) in the BGI group. The 5-year cumulative reoperation rate for glaucoma was 20.8% in the AGV group compared to 8.6% in the BGI group (p=0.010). Change in logMAR Snellen visual acuity (mean ± SD) at 5 years was 0.42 ± 0.99 in the AGV group and 0.43 ± 0.84 in the BGI group (p=0.97). Conclusions Similar rates of surgical success were observed with both implants at 5 years. BGI implantation produced greater IOP reduction and a lower rate

Parapneumonic effusions in children: five years’ experience

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Atilla Cifci

2017-12-01

Full Text Available Aim: Most severe complication of respiratory tract infections that causing morbidity and mortality in children is parapneumonic effusion(PPE. PPE is a pleural exudate that is related with primary pneumonia. The early and appropriate antibiotic treatment is very important in follow-up of patients who are diagnosed as parapneumonic effusion and also the timing of interventional and surgical treatment is important to decrease morbidity and mortalitiy in whom clinical and laboratory findings are not cured enough. Materials and Methods: In this study, the clinical and laboratory findings of parapneumonic effusion one hundred patients applied to one center in five years time are discussed. Results: The mean age of patients were 52 months(1.5-156, 52 were male(52%.The 71% of patients were smaller than five years old. The mean duration of hospitalization of patients were 19.6 days(1-45 days. Most frequent spymptom in application was fever, most frequent sign were tachycardia and retractions, most frequent laboratory anormality was high white blood count. The most frequent microorganism in pleural fluid culture was S.aureus. Conclusion: The determination of pathogens causing parapneumonic effusions in our country is very important for starting most suitable treatment early and to decrease morbidity and mortality. [J Contemp Med 2017; 7(4.000: 340-347

The resistance of cortical bone tissue to failure under cyclic loading is reduced with alendronate.

Science.gov (United States)

Bajaj, Devendra; Geissler, Joseph R; Allen, Matthew R; Burr, David B; Fritton, J C

2014-07-01

Bisphosphonates are the most prescribed preventative treatment for osteoporosis. However, their long-term use has recently been associated with atypical fractures of cortical bone in patients who present with low-energy induced breaks of unclear pathophysiology. The effects of bisphosphonates on the mechanical properties of cortical bone have been exclusively studied under simple, monotonic, quasi-static loading. This study examined the cyclic fatigue properties of bisphosphonate-treated cortical bone at a level in which tissue damage initiates and is accumulated prior to frank fracture in low-energy situations. Physiologically relevant, dynamic, 4-point bending applied to beams (1.5 mm × 0.5 mm × 10 mm) machined from dog rib (n=12/group) demonstrated mechanical failure and micro-architectural features that were dependent on drug dose (3 groups: 0, 0.2, 1.0mg/kg/day; alendronate [ALN] for 3 years) with cortical bone tissue elastic modulus (initial cycles of loading) reduced by 21% (pbone remodeling, such as the size of osteons (-14%; ALN1.0: 10.5±1.8, VEH: 12.2±1.6, ×10(3) μm2; pbone tissue are altered by high-dose ALN treatment and contribute to reduced mechanical properties under cyclic loading conditions. Copyright © 2014 Elsevier Inc. All rights reserved.

A Retrospective Chart Review of Treatment Seeking Middle Aged Individuals at a Tertiary Care Substance Use Disorder Treatment Centre in North Part of India over Five Successive Years: Findings from Drug Abuse Monitoring System

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Yatan Pal Singh Balhara

2013-01-01

Full Text Available Adolescents and young adults continue to remain the main focus of attention with regards to substance use related problems. There has been a limited focus on illicit substance use among middle aged and elderly population. The current study explored the changing trends of substance use among treatment seeking middle aged individuals (aged 40–60 years at a tertiary level drug dependence treatment centre. The questionnaire used to gather information for the study is a 19-item structured questionnaire. It includes information on various sociodemographic variables, “current,” and “ever” use of substance. Information is also collected on variables related to high risk injecting drug use and HIV status of the individuals. There has been consistent increase in the population of treatment seekers over five years. Over the five-year period, the absolute percentage increase in treatment seeking population is approximately 21%. Polysubstance use was found to increase significantly over five-study years (PTrend = 0.007.

Does geographical variability influence five-year MACCE rates in the multicentre SYNTAX revascularisation trial?

Science.gov (United States)

Roy, Andrew K; Chevalier, Bernard; Lefèvre, Thierry; Louvard, Yves; Segurado, Ricardo; Sawaya, Fadi; Spaziano, Marco; Neylon, Antoinette; Serruys, Patrick A; Dawkins, Keith D; Kappetein, Arie Pieter; Mohr, Friedrich-Wilhelm; Colombo, Antonio; Feldman, Ted; Morice, Marie-Claude

2017-09-20

The use of multiple geographical sites for randomised cardiovascular trials may lead to important heterogeneity in treatment effects. This study aimed to determine whether treatment effects from different geographical recruitment regions impacted significantly on five-year MACCE rates in the SYNTAX trial. Five-year SYNTAX results (n=1,800) were analysed for geographical variability by site and country for the effect of treatment (CABG vs. PCI) on MACCE rates. Fixed, random, and linear mixed models were used to test clinical covariate effects, such as diabetes, lesion characteristics, and procedural factors. Comparing five-year MACCE rates, the pooled odds ratio (OR) between study sites was 0.58 (95% CI: 0.47-0.71), and countries 0.59 (95% CI: 0.45-0.73). By homogeneity testing, no individual site (X2=93.8, p=0.051) or country differences (X2=25.7, p=0.080) were observed. For random effects models, the intraclass correlation was minimal (ICC site=5.1%, ICC country=1.5%, p<0.001), indicating minimal geographical heterogeneity, with a hazard ratio of 0.70 (95% CI: 0.59-0.83). Baseline risk (smoking, diabetes, PAD) did not influence regional five-year MACCE outcomes (ICC 1.3%-5.2%), nor did revascularisation of the left main vs. three-vessel disease (p=0.241), across site or country subgroups. For CABG patients, the number of arterial (p=0.49) or venous (p=0.38) conduits used also made no difference. Geographic variability has no significant treatment effect on MACCE rates at five years. These findings highlight the generalisability of the five-year outcomes of the SYNTAX study.

Dose escalation with 3D conformal treatment: five year outcomes, treatment optimization, and future directions

International Nuclear Information System (INIS)

Hanks, Gerald E.; Hanlon, Alexandra L. M.S.; Schultheiss, Timothy E.; Pinover, Wayne H.; Movsas, Benjamin; Epstein, Barry E.; Hunt, Margie

1998-01-01

Purpose: To report the 5-year outcomes of dose escalation with 3D conformal treatment (3DCRT) of prostate cancer. Methods and Materials: Two hundred thirty-two consecutive patients were treated with 3DCRT alone between 6/89 and 10/92 with ICRU reporting point dose that increased from 63 to 79 Gy. The median follow-up was 60 months, and any patient free of clinical or biochemical evidence of disease was termed bNED. Biochemical failure was defined as prostate-specific antigen (PSA) rising on two consecutive recordings and exceeding 1.5 ng/ml. Morbidity was reported by the Radiation Therapy Oncology Group (RTOG) scale, the Late Effects Normal Tissue (LENT) scale, and a Fox Chase modification of the latter (FC-LENT). All patients were treated with a four-field technique with a 1 cm clinical target volume (CTV) to planning target volume (PTV) margin to the prostate or prostate boost; the CTV and gross tumor volume (GTV) were the same. Actuarial rates of outcome were calculated by Kaplan-Meier and cumulative incidence methods and compared using the log rank and Gray's test statistic, respectively. Cox regression models were used to establish prognostic factors predictive of the various measures of outcome. Five-year Kaplan-Meier bNED rates were utilized by dose group to estimate logit response models for bNED and late morbidity. Results: PSA 10 ng/ml based on 5-year bNED results. No dose response was observed for patients with pretreatment PSA 10 ng/ml strongly suggests that clinical trials employing radiation should investigate the use of 3DCRT and prostate doses of 76-80 Gy

[Efficacy of racecadotril vs. smectite, probiotics or zinc as an integral part of treatment of acute diarrhea in children under five years: A meta-analysis of multiple treatments].

Science.gov (United States)

Gutiérrez-Castrellón, Pedro; Ortíz-Hernández, Anna Alejandra; Llamosas-Gallardo, Beatriz; Acosta-Bastidas, Mario A; Jiménez-Gutiérrez, Carlos; Diaz-García, Luisa; Anzo-Osorio, Anahí; Estevez-Jiménez, Juliana; Jiménez-Escobar, Irma; Vidal-Vázquez, Rosa Patricia

2015-01-01

Despite major advances in treatment, acute diarrhea continues to be a public health problem in children under five years. There is no systematic approach to treatment and most evidence is assembled comparing active treatment vs. placebo. Systematic review of evidence on efficacy of adjuvants for treatment of acute diarrhea through a network meta-analysis. A systematic search of multiple databases searching clinical trials related to the use of racecadotril, smectite, Lactobacillus GG, Lactobacillus reuteri, Saccharomyces boulardii and zinc as adjuvants in acute diarrhea was done. The primary endpoint was duration of diarrhea. Information is displayed through network meta-analysis.The superiority of each coadjutant was analyzed by Sucra approach. Network meta-analysis showed race cadotril was better when compared with placebo and other adjuvants. Sucra analysis showed racecadotril as the first option followed by smectite and Lactobacillus reuteri. Considering a strategic decision making approach, network meta-analysis allows us to establish the therapeutic superiority of racecadotril as an adjunct for the comprehensive management of acute diarrhea in children aged less than five years.

A Randomised Controlled Treatment Trial of Two Forms of Family Therapy in Adolescent Anorexia Nervosa: A Five-Year Follow-Up

Science.gov (United States)

Eisler, Ivan; Simic, Mima; Russell, Gerald F. M.; Dare, Christopher

2007-01-01

Background: There is growing evidence that family therapy is an effective treatment for adolescent anorexia nervosa. This study aimed to ascertain the long-term impact of two forms of outpatient family intervention previously evaluated in a randomised controlled trial (RCT). Method: A five-year follow-up was conducted on a cohort of 40 patients…

Bisphosphonate-modified gold nanoparticles: a useful vehicle to study the treatment of osteonecrosis of the femoral head

Energy Technology Data Exchange (ETDEWEB)

Fanord, Fedena; Fairbairn, Korie; Bhethanabotla, Venkat; Gupta, Vinay K [Department of Chemical and Biomedical Engineering, University of South Florida, 4202 E. Fowler Avenue, ENB 118, Tampa, FL 33620 (United States); Kim, Harry [Shriners Hospitals for Children, 12502 USF Pine Drive, Tampa, FL 33612 (United States); Garces, Amanda, E-mail: vkgupta@usf.edu [Lisa Muma Weitz Microscopy and Cell Imaging, Department of Pathology and Cell Biology, University of South Florida, 12901 Bruce B Downs Boulevard, Tampa, FL 33612 (United States)

2011-01-21

Legg-Calve-Perthes disease (LCPD) is a juvenile form of osteonecrosis of the femoral head that presents in children aged 2-14 years. To date, there is no effective medical therapy for treating LCPD largely due to an inability to modulate the repair process, including the predominance of bone resorption. This investigation aims to evaluate the feasibility of using gold nanoparticles (GNPs) that are surface modified with a bisphosphonate compound for the treatment of osteonecrosis at the cellular level. Studies have found osteoclast-mediated resorption to be a process that contributes significantly to the pathogenesis of femoral head deformities arising from Perthes disease. Our in vitro model was designed to elucidate the effect of alendronate-(a bisphosphonate) modified GNPs, on osteoclastogenesis and osteoclast function. RAW 264.7 macrophage cells were cultured with recombinant mouse receptor activator of NF-{kappa}B ligand (RANKL), which stimulates osteoclastogenesis, and were then treated with alendronate-modified GNPs for 24, 48, and 72 h. Cell proliferation, osteoclast function, and osteoclast morphology were evaluated by trypan blue dye exclusion assay, tartrate-resistant acid phosphatase (TRAP) staining, and transmission electron microscopy (TEM) imaging. Comparative studies were performed with GNPs that were only stabilized with citrate ions and with alendronate alone. Neither osteoclastogenesis nor osteoclast function were adversely affected by the presence of the citrate-GNP. Alendronate-modified GNPs had an enhanced effect on inducing osteoclast apoptosis and impairing osteoclast function when compared to unbound alendronate populations.

Bisphosphonate-modified gold nanoparticles: a useful vehicle to study the treatment of osteonecrosis of the femoral head

International Nuclear Information System (INIS)

Fanord, Fedena; Fairbairn, Korie; Bhethanabotla, Venkat; Gupta, Vinay K; Kim, Harry; Garces, Amanda

2011-01-01

Legg-Calve-Perthes disease (LCPD) is a juvenile form of osteonecrosis of the femoral head that presents in children aged 2-14 years. To date, there is no effective medical therapy for treating LCPD largely due to an inability to modulate the repair process, including the predominance of bone resorption. This investigation aims to evaluate the feasibility of using gold nanoparticles (GNPs) that are surface modified with a bisphosphonate compound for the treatment of osteonecrosis at the cellular level. Studies have found osteoclast-mediated resorption to be a process that contributes significantly to the pathogenesis of femoral head deformities arising from Perthes disease. Our in vitro model was designed to elucidate the effect of alendronate-(a bisphosphonate) modified GNPs, on osteoclastogenesis and osteoclast function. RAW 264.7 macrophage cells were cultured with recombinant mouse receptor activator of NF-κB ligand (RANKL), which stimulates osteoclastogenesis, and were then treated with alendronate-modified GNPs for 24, 48, and 72 h. Cell proliferation, osteoclast function, and osteoclast morphology were evaluated by trypan blue dye exclusion assay, tartrate-resistant acid phosphatase (TRAP) staining, and transmission electron microscopy (TEM) imaging. Comparative studies were performed with GNPs that were only stabilized with citrate ions and with alendronate alone. Neither osteoclastogenesis nor osteoclast function were adversely affected by the presence of the citrate-GNP. Alendronate-modified GNPs had an enhanced effect on inducing osteoclast apoptosis and impairing osteoclast function when compared to unbound alendronate populations.

Effect of maternal Schistosoma mansoni infection and praziquantel treatment during pregnancy on Schistosoma mansoni infection and immune responsiveness among offspring at age five years.

Directory of Open Access Journals (Sweden)

Robert Tweyongyere

Full Text Available Offspring of Schistosoma mansoni-infected women in schistosomiasis-endemic areas may be sensitised in-utero. This may influence their immune responsiveness to schistosome infection and schistosomiasis-associated morbidity. Effects of praziquantel treatment of S. mansoni during pregnancy on risk of S. mansoni infection among offspring, and on their immune responsiveness when they become exposed to S. mansoni, are unknown. Here we examined effects of praziquantel treatment of S. mansoni during pregnancy on prevalence of S. mansoni and immune responsiveness among offspring at age five years.In a trial in Uganda (ISRCTN32849447, http://www.controlled-trials.com/ISRCTN32849447/elliott, offspring of women treated with praziquantel or placebo during pregnancy were examined for S. mansoni infection and for cytokine and antibody responses to SWA and SEA, as well as for T cell expression of FoxP3, at age five years.Of the 1343 children examined, 32 (2.4% had S. mansoni infection at age five years based on a single stool sample. Infection prevalence did not differ between children of treated or untreated mothers. Cytokine (IFNγ, IL-5, IL-10 and IL-13 and antibody (IgG1, Ig4 and IgE responses to SWA and SEA, and FoxP3 expression, were higher among infected than uninfected children. Praziquantel treatment of S. mansoni during pregnancy had no effect on immune responses, with the exception of IL-10 responses to SWA, which was higher in offspring of women that received praziquantel during pregnancy than those who did not.We found no evidence that maternal S. mansoni infection and its treatment during pregnancy influence prevalence and intensity of S. mansoni infection or effector immune response to S. mansoni infection among offspring at age five years, but the observed effects on IL-10 responses to SWA suggest that maternal S. mansoni and its treatment during pregnancy may affect immunoregulatory responsiveness in childhood schistosomiasis. This might have

3. barriers to prompt malaria treatment among under five children

African Journals Online (AJOL)

Esem

strategy need to be established. Therefore, this study aimed at determining barriers to prompt malaria treatment among this vulnerable age group in Mpika district. Objective: To determine the barriers to prompt malaria treatment among children under five years of age with malaria in Mpika district. Study design: This was an ...

Breast sarcoma surgical management: a five-year multicentric study

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Răzvan V. Scăunașu

2016-11-01

Full Text Available Background. Breast sarcomas are a heterogeneous group of breast neoplasms with a low incidence and a reserved prognosis. No treatment protocol has been yet established, a guideline similar to soft tissue sarcomas is used. Materials and Methods. Our study analyzed all the patients admitted with the diagnosis of malignant breast disease in two specialized centers on a five-year time frame. We compared long term results for the patients who underwent conservative treatment and mastectomy. Results. A total of 76 cases received surgical treatment with curative intent, 24 conservative procedures and 52 mastectomies. Incidence of local recurrence does not appear to be closely related to the type of surgical procedure. There were a number of five local recurrences for patients who received conservative treatment and 7 local recurrences where we used mastectomy. Kaplan-Meier analysis conducted shows no differences statistically significant (sig = 0.459 between the results of conservative treatment and mastectomy. Basically conservative surgery seems to get similar results, provided that R0 resection objective can be met. Conclusions. Treatment options are more limited for breast sarcomas than carcinomas, the role of surgery being more important to therapeutic success. The biological characteristic of the tumor including histological type and sub-type, play an important role in determining the results and the treatment should be tailored and adapted for each case.

The effect of five years versus two years of specialised assertive intervention for first episode psychosis - OPUS II: study protocol for a randomized controlled trial

DEFF Research Database (Denmark)

Melau, Marianne; Jeppesen, Pia; Thorup, Anne

2011-01-01

. Based on our sample size estimation, 400 patients treated in OPUS for two years will be randomized to further three years of OPUS treatment versus standard treatment. The specialized assertive OPUS treatment consists of three core elements: assertive community treatment, psycho-educational family...... treatment, and social skills training. Discussion It has been hypothesized that there is a critical period from onset up to five years, which represents a window of opportunity where a long-term course can be influenced. Extending the specialized assertive OPUS treatment up to five years may allow...... the beneficial effects to continue beyond the high-risk period, through consolidation of improved social and functional outcome. Trial registration Clinical Trial.gov NCT00914238...

Subtrochanteric and diaphyseal femur fractures in patients treated with alendronate: a register-based national cohort study

DEFF Research Database (Denmark)

Abrahamsen, Bo; Eiken, Pia; Eastell, Richard

2009-01-01

Alendronate (aln) is a potent bisphosphonate with a prolonged duration of action. Recent reports have found long-term aln use to be common in patients with subtrochanteric or proximal diaphyseal femur fracture, raising concerns that these fractures could be a consequence of excessive suppression...

40 CFR 68.42 - Five-year accident history.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Five-year accident history. 68.42... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Hazard Assessment § 68.42 Five-year accident history. (a) The owner or operator shall include in the five-year accident history all accidental releases from...

Stereotactic body radiotherapy for low-risk prostate cancer: five-year outcomes

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King Christopher R

2011-01-01

Full Text Available Abstract Purpose Hypofractionated, stereotactic body radiotherapy (SBRT is an emerging treatment approach for prostate cancer. We present the outcomes for low-risk prostate cancer patients with a median follow-up of 5 years after SBRT. Method and Materials Between Dec. 2003 and Dec. 2005, a pooled cohort of 41 consecutive patients from Stanford, CA and Naples, FL received SBRT with CyberKnife for clinically localized, low-risk prostate cancer. Prescribed dose was 35-36.25 Gy in five fractions. No patient received hormone therapy. Kaplan-Meier biochemical progression-free survival (defined using the Phoenix method and RTOG toxicity outcomes were assessed. Results At a median follow-up of 5 years, the biochemical progression-free survival was 93% (95% CI = 84.7% to 100%. Acute side effects resolved within 1-3 months of treatment completion. There were no grade 4 toxicities. No late grade 3 rectal toxicity occurred, and only one late grade 3 genitourinary toxicity occurred following repeated urologic instrumentation. Conclusion Five-year results of SBRT for localized prostate cancer demonstrate the efficacy and safety of shorter courses of high dose per fraction radiation delivered with SBRT technique. Ongoing clinical trials are underway to further explore this treatment approach.

Treatment outcomes of childhood tuberculosis in Addis Ababa: a five-year retrospective analysis

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Genene Tilahun

2016-07-01

Full Text Available Abstract Background Tuberculosis (TB kills one child every 5 min. Childhood TB is given low priority in most national health programmes particularly in TB-endemic areas. TB among children is an indicator of a recent transmission of the disease in the community. Treatment outcome results serve as a proxy of the quality of treatment provided by a health care system. In Ethiopia, data on treatment outcomes of childhood TB are limited. The aim of the study was to determine the treatment outcomes of childhood TB in a hospital setting in Addis Ababa. Methods The study was conducted during June to August 2014. The data of 491 children treated for TB in Zewditu Memorial Hospital during a 5 year (2009–2013 was analysed. TB was diagnosed using standard methods. Demographic and clinical data including type of TB, TB-HIV co-infection and treatment outcomes were collected from registry of the TB clinic. Treatment outcome definitions are used according to the World Health Organization. Results Of the 491 children, 272(55.4 % were females, 107(21.8 % were under 5 year old, 454(92.5 % of them were new cases. The types of TB were extra-pulmonary tuberculosis (EPTB 243(49.5 % and 248(50.5 % pulmonary tuberculosis (PTB. Of the PTB cases, 42(16.9 % were sputum smear positive. Of the 291 children tested for HIV, 82(28.2 % were positive. The overall treatment success rate was 420(85.5 % and the poor treatment outcome was 71(14.5 %. Of the children with poor treatment outcome, 9(1.8 % died, 3(0.6 % defaulted from treatment, 2(0.4 % were treatment failure and 55(11.2 % were transferred out. Males and females had similar treatment success rates of 85.8 % and 85.3 %, respectively. Infants under one year had significantly lower treatment success rate of 72.7 % compared to those above 1 years of age of 86.5 % (P < 0.001. Treatment success rate ranged from 78.0 to 92.6 % during the study period. Associated factors for treatment outcome were age above

The 2010 five-yearly review has started

CERN Multimedia

Association du personnel

2009-01-01

Every five years, the financial and social conditions of members of the personnel are examined according to the procedures defined in Annex A1 of the Staff Rules and Regulations (SR&R). This exercise is called the “five-yearly review” (5YR).

Development and characterization of a gastroretentive dosage form composed of chitosan and hydroxyethyl cellulose for alendronate

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Chen YC

2013-12-01

Full Text Available Ying-Chen Chen,1,* Hsiu-O Ho,1,* Chiao-Chi Chiu,1 Ming-Thau Sheu1,2 1School of Pharmacy, College of Pharmacy, Taipei Medical University, 2Clinical Research Center and Traditional Herbal Medicine Research Center, Taipei Medical University Hospital, Taipei, Taiwan*These authors contributed equally to this workAbstract: In this study, alendronate, the most commonly used biphosphonate for treating osteoporosis, was formulated as gastroretentive dosage form (GRDF tablets to enhance its oral bioavailability. GRDF tablets were characterized with the effects of different molecular weights (MWs of chitosan (CS and hydroxyethyl cellulose (HEC at various ratios on swelling, floating, and physical integrity. The CS component was formed using various acids: acetic, lactic, malic, succinic, and citric, and a high viscosity grade of HEC was selected. The results demonstrated that the swelling ratios of the formulations comprising high MW CS were lower than those of low or medium MW CS when salts were formed with any countering acids except for acetic acid. The decreasing ranking of the swelling rates was: CS-citrate > CS-malate > CS-lactate > CS-succinate > CS-acetate. A negative correlation was found between the pKa of the respective countering acid and the swelling rate. The swelling rate was promoted if an acidic salt of CS with a lower water content was incorporated, while it became slower when tablet hardness was higher or the compression force to form tablets was increased. Although HEC did not contribute to swelling or floating, it played a role in maintaining structural integrity. A prolonged dissolution profile of alendronate GRDF tablets developed in this study was observed.Keywords: gastroretentive dosage form, chitosan, hydrogel, hydroxyethyl cellulose, swelling, alendronate

Gender identity disorder in a five-year-old boy.

OpenAIRE

Herman, S. P.

1983-01-01

Markedly effeminate behavior in a young boy is a source of concern and confusion for parents, teachers, and the child. It also represents a therapeutic dilemma for the child psychiatrist. The case of a five-year-old boy with gender identity disorder of childhood is presented and the literature on hypotheses of etiology, treatment, and long-term follow-up is reviewed. The ethical and philosophical questions posed by such a case are discussed.

[Incidence of hip fractures due to osteoporosis in relation to the prescription of drugs for their prevention and treatment in Galicia, Spain].

Science.gov (United States)

Guerra-García, María Mercedes; Rodríguez-Fernández, José Benito; Puga-Sarmiento, Elías; Charle-Crespo, María Ángeles; Gomes-Carvalho, Claudia Sofía; Prejigueiro-Santás, Ana

2011-02-01

To analyse the evolution in the incidence of hip fractures in our autonomous community in relationship to the trend in the prescription of medicines for the prevention and/or treatment of osteoporotic hip fracture. Descriptive observational ecological study. Public health network in the whole autonomous community over five years, from 1st January 2004 to 31st December 2008. Patients over 44 years old admitted with osteoporotic hip fracture. Medicines dispensed at a pharmacy which are indicated for the prevention of osteoporotic hip fractures (alendronate, risedronate and strontium ranelate). Exclusion: Open fractures, hospital or private or prescriptions. Incidence (number of new cases of hip fractures occurring in a year), Incidence rate (incidence per 100,000 inhabitants), Dispersion rate (number of packets dispensed per year per 100,000 inhabitants) and Hazard ratio (HR, ratio between the rate of last year and first). Annual rates were calculated standardised by the direct method. We identified 12,137 hospital admissions for fractured hip (2,792 men and 9,345 women). Sub-capital fractures: Mean Incidence Rate (MIR)=86.14,95%CI[61.85-110.42]; HR=1.22, 95%CI[0.82-1.63] (men) and MIR=180.88,95%CI[124.74-237.02]; HR=1.08,95%CI[0.73-1.43] (women). Trochanteric fractures: MIR=56.30,95%CI[39.18-73.42], HR=1.04,95%CI[0.75-1.34] (men) and MIR=136.51,95%CI[90.23-182.78]; HR=1.12,95%CI[0.89-1.35] (women). Subtrochanteric fractures: MIR=8.92,95%CI[6.52-11.32]; HR=1.26,95%CI[0.05-2.46] (men) and MIR=22.91,95%CI[15.24-30.58]; HR=1.08,95%CI[0.57-1.58] (women). Total HR fractures=1.07, 95%CI[0.92-1.23] (men) and 0.99,95%CI[0.83-1.17] (women). Drug dispensing (2008-2004): HR alendronate=1.30; HR risedronate=1.92; HR strontium ranelate=10.38. Over five years the dispensing of drugs by the public health service has multiplied for the prevention and treatment of hip fractures while the incidence has remained unaltered. Copyright © 2010 Elsevier España, S.L. All rights reserved.

Validated spectrophotometric methods for determination of Alendronate sodium in tablets through nucleophilic aromatic substitution reactions

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Walash Mohamed I

2012-04-01

Full Text Available Abstract Background Alendronate (ALD is a member of the bisphosphonate family which is used for the treatment of osteoporosis, bone metastasis, Paget's disease, hypocalcaemia associated with malignancy and other conditions that feature bone fragility. ALD is a non-chromophoric compound so its determination by conventional spectrophotometric methods is not possible. So two derivatization reactions were proposed for determination of ALD through the reaction with 4-chloro-7-nitrobenzo-2-oxa-1,3-diazole (NBD-Cl and 2,4-dinitrofluorobenzene (DNFB as chromogenic derivatizing reagents. Results Three simple and sensitive spectrophotometric methods are described for the determination of ALD. Method I is based on the reaction of ALD with NBD-Cl. Method II involved heat-catalyzed derivatization of ALD with DNFB, while, Method III is based on micellar-catalyzed reaction of the studied drug with DNFB at room temperature. The reactions products were measured at 472, 378 and 374 nm, for methods I, II and III, respectively. Beer's law was obeyed over the concentration ranges of 1.0-20.0, 4.0-40.0 and 1.5-30.0 μg/mL with lower limits of detection of 0.09, 1.06 and 0.06 μg/mL for Methods I, II and III, respectively. The proposed methods were applied for quantitation of the studied drug in its pure form with mean percentage recoveries of 100.47 ± 1.12, 100.17 ± 1.21 and 99.23 ± 1.26 for Methods I, II and III, respectively. Moreover the proposed methods were successfully applied for determination of ALD in different tablets. Proposals of the reactions pathways have been postulated. Conclusion The proposed spectrophotometric methods provided sensitive, specific and inexpensive analytical procedures for determination of the non-chromophoric drug alendronate either per se or in its tablet dosage forms without interference from common excipients. Graphical abstract

Twenty-five-year atraumatic restorative treatment (ART) approach: a comprehensive overview

NARCIS (Netherlands)

Frencken, J.E.; Leal, S.C.; Navarro, M.F.

2012-01-01

BACKGROUND: The atraumatic restorative treatment (ART) approach was born 25 years ago in Tanzania. It has evolved into an essential caries management concept for improving quality and access to oral care globally. RESULTS: Meta-analyses and systematic reviews have indicated that the high

Environmental restoration and waste management five year plan, fiscal years 1994--1998

International Nuclear Information System (INIS)

1993-01-01

In March 1989, Secretary of Energy James D. Watkins outlined his vision for a changed Department of Energy (DOE) culture. This culture is one of envirorunental responsibility, increased knowledge and involvement in environmental management, a new openness to public input, and overall accountability to the Nation for its actions. Secretary Watkins also requested all the near-term activities necessary to bring DOEactivities into compliance with all applicable environmental requirements to be detailed in one plan. The Five-Year Plan was to be based on a ''bottom up'' approach to planning by using Activity Data Sheets to collect financial and technical information at the installation level. Over the past three years, the Five-Year Plan has evolved into the primary planning tool for the DOE Environmental Restoration and Waste Management Program, looking beyond the current three-year Federal budget horizon. The FY 1994--1998 Five-Year Plan demonstrates DOE's commitment to a culture based on the principles of openness, responsiveness, and accountability; reports on the progress made in carrying out DOE's environmental mission; identifies what must be accomplished during a five-year planning period; and describes strategies for achieving critical program objectives. This plan represents another step towards the implementation of the culture change Secretary Watkins envisioned. The Five-Year Plan is not exclusively focused on near-term activities. Italso expresses the DOE commitment to a 30-year goal for the cleanup of the 1989 inventory of inactive sites. The FY 1994--1998 Five-Year Plan reiterates the DOE commitment to meeting this and other important environmental goals

The 2015 five-yearly review

CERN Multimedia

Staff Association

2014-01-01

  This year CERN celebrates its 60th anniversary. On this occasion, throughout Europe — most recently on July 1st at the UNESCO headquarters in Paris — festivities are being organized to celebrate the Organization’s success as a flagship laboratory of high-energy physics. To ensure that CERN can remain a centre of excellence in the field of fundamental research, the Organization verifies every five years with the help of a five-yearly review procedure whether the financial and social conditions which it proposes to Staff Members allow it to recruit and retain Staff Members of the highest competence and integrity required for the execution of its mission from all its Member States. For Fellows these conditions should remain attractive compared with those in comparable research institutions, while for Associated members of personnel these conditions should allow it to host them in its research facilities taking into account the highest cost-of-living level in the local ...

Cost effectiveness of denosumab compared with oral bisphosphonates in the treatment of post-menopausal osteoporotic women in Belgium.

Science.gov (United States)

Hiligsmann, Mickaël; Reginster, Jean-Yves

2011-10-01

Denosumab has recently been shown to be well tolerated, to increase bone mineral density (BMD) and to significantly reduce the risk of hip, vertebral and non-vertebral fractures in the FREEDOM (Fracture REduction Evaluation of Denosumab in Osteoporosis every 6 Months) trial. It is becoming increasingly important to evaluate not only the therapeutic value of a new drug but also the cost effectiveness compared with the most relevant treatment alternatives. The objective of this study was to estimate the cost effectiveness of denosumab compared with oral bisphosphonates (branded and generic drugs) in the treatment of post-menopausal osteoporotic women in Belgium. Cost effectiveness of 3 years of treatment with denosumab was compared with branded risedronate and branded and generic alendronate using an updated version of a previously validated Markov microsimulation model. The model was populated with relevant cost, adherence and epidemiological data for Belgium from a payer perspective and the results were presented as costs per QALY gained (&U20AC;, year 2009 values). Analyses were performed in populations (aged ≥60 years) in which osteoporosis medications are currently reimbursed in many European countries, i.e. those with BMD T-score of -2.5 or less or prevalent vertebral fracture. Patients receiving denosumab were assumed to have a 46% lower risk of discontinuation than those receiving oral bisphosphonates, and the effect of denosumab after treatment cessation was assumed to decline linearly to zero over a maximum of 1 year. Denosumab was cost effective compared with all other therapies, assuming a willingness to pay of &U20AC;40 000 per QALY gained. In particular, denosumab was found to be cost effective compared with branded alendronate and risedronate at a threshold value of &U20AC;30 000 per QALY and denosumab was dominant (i.e. lower cost and greater effectiveness) compared with risedronate from the age of 70 years in women with a T-score of -2.5 or

Environmental restoration and waste management five-year plan, Fiscal years 1994--1998

International Nuclear Information System (INIS)

1993-01-01

In March 1989, Secretary of Energy James D. Watkins outlined his vision for a changed Department of Energy (DOE) culture. This culture is one of environmental responsibility, increased knowledge and involvement in environmental management, a new openness to public input, and overall accountability to the Nation for its actions. Over the past three years, the Five Year Plan has evolved into the primary planning tool for the DOE Environmental Restoration and Waste Management Program, looking beyond the current three-year Federal budget horizon. The FY 1994--1998 Five-Year Plan demonstrates DOE's commitment to a culture based on the principles of openness, responsiveness, and accountability; reports on the progress made in carrying out DOE's environmental mission; identifies what must be accomplished during a five-year planning period; and describes strategies for achieving critical program objectives. The Five-Year Plan is not exclusively focused on near-term activities. It also expresses the DOE commitment to a 30-year goal for the cleanup of the 1989 inventory of inactive sites. This goal was established in response to recommendations from the State and Tribal Government Working Group (STGWG) that DOE define a specific end point for completing necessary remediation and restoration activities. The FY 1994--1998 Five-Year Plan reiterates the DOE commitment to meeting this and other important environmental goals

Five-year-old historian.

Science.gov (United States)

Morrison, Wynne

2017-12-01

In this poem, the author describes a doctor talking with a five-year-old child who has been brought to the hospital after being in a car accident with his/her mother and brother. The child is not able to remember the mother's name, but the doctor continues to talk with the child. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Efficient Transdermal Delivery of Alendronate, a Nitrogen-Containing Bisphosphonate, Using Tip-Loaded Self-Dissolving Microneedle Arrays for the Treatment of Osteoporosis.

Science.gov (United States)

Katsumi, Hidemasa; Tanaka, Yutaro; Hitomi, Kaori; Liu, Shu; Quan, Ying-Shu; Kamiyama, Fumio; Sakane, Toshiyasu; Yamamoto, Akira

2017-08-17

To improve the transdermal bioavailability and safety of alendronate (ALN), a nitrogen-containing bisphosphonate, we developed self-dissolving microneedle arrays (MNs), in which ALN is loaded only at the tip portion of micron-scale needles by a dip-coating method (ALN(TIP)-MN). We observed micron-scale pores in rat skin just after application of ALN(TIP)-MN, indicating that transdermal pathways for ALN were created by MN. ALN was rapidly released from the tip of MNs as observed in an in vitro release study. The tip portions of MNs completely dissolved in the rat skin within 5 min after application in vivo. After application of ALN(TIP)-MN in mice, the plasma concentration of ALN rapidly increased, and the bioavailability of ALN was approximately 96%. In addition, the decrease in growth plate was effectively suppressed by this efficient delivery of ALN in a rat model of osteoporosis. Furthermore, no skin irritation was observed after application of ALN(TIP)-MN and subcutaneous injection of ALN, while mild skin irritation was induced by whole-ALN-loaded MN (ALN-MN)-in which ALN is contained in the whole of the micron-scale needles fabricated from hyaluronic acid-and intradermal injection of ALN. These findings indicate that ALN(TIP)-MN is a promising transdermal formulation for the treatment of osteoporosis without skin irritation.

Glaucoma-related adverse events in the first five years after unilateral cataract removal in the Infant Aphakia Treatment Study

Science.gov (United States)

Freedman, Sharon F.; Lynn, Michael J.; Beck, Allen D.; Bothun, Erick D.; Orge, Faruk H.; Lambert, Scott R.

2015-01-01

Importance Glaucoma-related adverse events constitute major sight-threatening complications of cataract removal in infancy, yet their relationship to aphakia versus primary intraocular lens (IOL) implantation remains unsettled. Objective To identify and characterize cases of glaucoma and glaucoma-related adverse events (glaucoma+glaucoma suspect) among children in the Infant Aphakia Treatment Study (IATS) by the age of five years. Design, Setting, and Participants A multicenter randomized controlled trial of 114 infants with unilateral congenital cataract who were between age 1–6 months at surgery. Interventions Participants were randomized at cataract surgery to either primary IOL, or no IOL implantation (contact lens [CL]). Standardized definitions of glaucoma and glaucoma suspect were created for IATS and applied for surveillance and diagnosis. Main Outcome Measures Development of glaucoma and glaucoma+glaucoma suspect in operated eyes up to age five years, plus intraocular pressure, visual acuity, and axial length at age five years. Results Product limit estimates of the risk of glaucoma and glaucoma+glaucoma suspect at 4.8 years after surgery were 17% (95%CI=11%–25%) and 31% (95%CI=24%–41%), respectively. The CL and IOL groups were not significantly different for either outcome: glaucoma (hazard ratio(HR)=0.8[95%CI=0.3–2.0],p=0.62); glaucoma+glaucoma suspect: (HR=1.3[95%CI=0.6–2.5],p=0.58). Younger (versus older) age at surgery conferred increased risk of glaucoma (26% versus 9%, respectively at 4.8 years after surgery (HR=3.2[95%CI=1.2–8.3]), and smaller (versus larger) corneal diameter showed increased risk for glaucoma+glaucoma suspect (HR=2.5[95%CI=1.3–5.0]). Age and corneal diameter were significantly positively correlated. Glaucoma was predominantly open angle (19/20 cases, 95%), most eyes received medication (19/20, 95%), and 8/20 (40%) eyes had surgery. Conclusions and Relevance These results suggest that glaucoma-related adverse events

Sustainable development: five structural milestones for the next five-year term

International Nuclear Information System (INIS)

Demailly, Damien; Treyer, Sebastien; Levai, David; Laurans, Yann; Rochette, Julien

2017-05-01

The energy transition, climate change, biodiversity, agriculture... the French President, the government and the new majority appointed by the 2017 elections will need to make some important decisions about sustainable development over the next five-year term. Their agenda will be marked in particular by five key events, not only in France, but also at the European and international levels. These five events will be opportunities to adapt the French economy to the major challenges of the 21. century, those of a regulated globalization, combining prosperity, social protection and environmental protection

FIVE-YEAR RESULTS OF ADJUVANT RADIOTHER

Science.gov (United States)

Osa, Etin-Osa O.; DeWyngaert, Keith; Roses, Daniel; Speyer, James; Guth, Amber; Axelrod, Deborah; Kerimian, Maria Fenton; Goldberg, Judith D.; Formenti, Silvia C.

2015-01-01

Purpose/Objective A technique of prone breast radiotherapy delivered by a regimen of accelerated intensity modulated radiation therapy (IMRT) with a concurrent boost to the tumor bed, was developed at our institution. We report the five year results of this approach. Methods and Materials Between 2003–2006, 404 patients with Stage I–II breast cancer were prospectively enrolled into two consecutive protocols, institutional trials 03–30 and 05–181, that used the same regimen of 40.5Gy/15 fractions delivered to the index breast over 3 weeks, with a concomitant daily boost to the tumor bed of 0.5Gy (total dose=48Gy). All patients were treated after segmental mastectomy, had negative margins, and nodal assessment. Patients were set up prone: only if lung or heart volumes were in the field was a supine set-up attempted, and chosen if found to better spare these organs. Results 92% of patients were treated prone, 8% supine. 72% had stage I, 28% stage II invasive breast cancer. In-field lung volume ranged from 0 –228.27cc, mean: 19.65cc. In-field heart volume for left breast cancer patients ranged from 0–21.24cc, mean: 1.59cc. There was no heart in the field for right breast cancer patients. At a median follow-up of five years, the five-year cumulative incidence of isolated ipsilateral breast tumor recurrence was 0.82% (95% CI: 0.65–1.04). The five-year cumulative incidence of regional recurrence was 0.53% (95% CI:0.41–0.69) and the five-year overall cumulative death rate was 1.28% (95% CI: 0.48–3.38). 82% (95% CI: 77–85) of patients judged their final cosmetic result as excellent/good. Conclusions Prone accelerated IMRT with a concomitant boost results in excellent local control, optimal sparing of heart and lung, with good cosmesis. RTOG 10–05, a phase III, multi-institutional, randomized trial is ongoing and is evaluating the equivalence of a similar dose and fractionation approach to standard six weeks radiotherapy with a sequential boost. PMID

Five-year workplace wellness intervention in the NHS.

Science.gov (United States)

Blake, Holly; Zhou, Dingyuan; Batt, Mark E

2013-09-01

Poor health and well-being has been observed among NHS staff and has become a key focus in current public health policy. The objective of this study was to deliver and evaluate a five-year employee wellness programme aimed at improving the health and well-being of employees in a large NHS workplace. A theory-driven multi-level ecological workplace wellness intervention was delivered including health campaigns, provision of facilities and health-promotion activities to encourage employees to make healthy lifestyle choices and sustained behaviour changes. An employee questionnaire survey was distributed at baseline (n = 1,452) and at five years (n = 1,134), including measures of physical activity, BMI, diet, self-efficacy, social support, perceived general health and mood, smoking behaviours, self-reported sickness absence, perceived work performance and job satisfaction. Samples were comparable at baseline and follow-up. At five years, significantly more respondents actively travelled (by walking or cycling both to work and for non-work trips) and more were active while at work. Significantly more respondents met current recommendations for physical activity at five years than at baseline. Fewer employers reported 'lack of time' as a barrier to being physically active following the intervention. Significantly lower sickness absence, greater job satisfaction and greater organisational commitment was reported at five years than at baseline. Improvements in health behaviours, reductions in sickness absence and improvements in job satisfaction and organisational commitment were observed following five years of a workplace wellness intervention for NHS employees. These findings suggest that health-promoting programmes should be embedded within NHS infrastructure.

40 CFR 68.168 - Five-year accident history.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Five-year accident history. 68.168 Section 68.168 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.168 Five-year accident history...

Therapies for treatment of osteoporosis in US women: cost-effectiveness and budget impact considerations.

Science.gov (United States)

Tosteson, Anna N A; Burge, Russel T; Marshall, Deborah A; Lindsay, Robert

2008-09-01

To evaluate the cost-effectiveness of osteoporosis treatments for women at high fracture risk and estimate the population-level impact of providing bisphosphonate therapy to all eligible high-risk US women. Fractures, healthcare costs, and quality-adjusted life-years (QALYs) were estimated over 10 years using a Markov model. No therapy, risedronate, alendronate, ibandronate, and teriperatide (PTH) were compared among 4 risk groups. Sensitivity analyses examined the robustness of model results for 65-year-old women with low bone density and previous vertebral fracture. Women treated with a bisphosphonate experienced fewer fractures and more QALYs compared with no therapy or PTH. Total costs were lowest for the untreated cohort, followed by risedronate, alendronate, ibandronate, and PTH in all risk groups except women aged 75 years with previous fracture. The incremental cost-effectiveness of risedronate compared with no therapy ranged from cost saving for the base case to $66,722 per QALY for women aged 65 years with no previous fracture. Ibandronate and PTH were dominated in all risk groups. (A dominated treatment has a higher cost and poorer outcome.) Treating all eligible women with a bisphosphonate would cost an estimated additional $5563 million (21% total increase) and would result in 390,049 fewer fractures (35% decrease). In the highest risk group, the additional cost of therapy was offset by other healthcare cost savings. Osteoporosis treatment of high-risk women is cost-effective, with bisphosphonates providing the most benefit at lowest cost. For highest risk women, costs are offset by savings from fracture prevention.

Patients' knowledge of Diabetes five years after the end of an educational program

Directory of Open Access Journals (Sweden)

Izabel Alves das Chagas

2013-10-01

Full Text Available We present a cross-sectional study that aims to describe the sociodemographic and clinical conditions of individuals with diabetes mellitus and to analyze their knowledge of treatment five years after the end of an educational program in which they took part. In 2010, 40 individuals who had participated in a diabetes educational program for 12 months in 2005 at a primary care service were interviewed. A form was used for data collection that included their knowledge of the notion, physiopathology, and treatment of the disease; exercise; nutrition; foot care; self-monitoring of capillary blood glucose at home; hypoglycemia; chronic complications; special situations; and family support. The results showed that the volunteers incorporated the information about the notion, physiopathology, and treatment of the disease; exercise; foot care; self-monitoring; care associated with hypoglycemia; chronic complications; and special situations. In contrast, nutrition and family support require further reinforcement. It is concluded that five years after the end of the educational program, the participants kept most of the information provided.

Tuberculosis treatment outcome and predictors in northern Ethiopian prisons: a five-year retrospective analysis.

Science.gov (United States)

Adane, Kelemework; Spigt, Mark; Dinant, Geert-Jan

2018-02-20

The prison situations are notorious for causing interruptions of tuberculosis (TB) treatment and occurrence of unfavorable outcomes. In Ethiopian prisons, though TB treatment programs exist, treatment outcome results and factors contributing to unsuccessful outcome are not well documented. In this study, we assessed the treatment outcome of TB cases and identified risk factors for unsuccessful outcome in northern Ethiopian prisons. A retrospective record review was conducted for all prisoners diagnosed with TB between September 2011 and August 2015. Outcome variables were defined following WHO guidelines. Out of the 496 patients, 11.5% were cured, 68% completed treatment, 2.5% were lost to follow-up, 1.6% were with a treatment failure, 1.4% died, and 15% were transferred out. All transferred out or released prisoners were not appropriately linked to health facilities and might be lost to treatment follow-up. The overall treatment success rate (TSR) of the 5 years was 94% among the patients who were not transferred out. The odds of unsuccessful outcome were 4.68 times greater among re-treatment cases compared to the newly treated cases. The year of treatment was also associated with variations in TSR; those treated during the earlier year were more likely to have unsuccessful outcome. Sputum non-conversion at the second-month check-up was strongly associated with unsuccessful outcome among the smear-positive cases. The mean TSR of the prisoners in the study prisons was quite satisfactory when gauged against the target level set by the End TB Strategy. However, the lack of appropriate linkage and tracking systems for those prisoners transferred or released before their treatment completion would have a negative implication for the national TB control program as such patients might interrupt their treatment and develop drug-resistant TB. Being in a re-treatment regimen and sputum non-conversion at the second-month check-up were significantly associated with

Suicide rates in five-year age-bands after the age of 60 years

DEFF Research Database (Denmark)

Shah, Ajit; Bhat, Ravi; Zarate-Escudero, Sofia

2016-01-01

-79 years) and the oldest old (80+ years) age groups. METHODS: Data on the number of suicides (International Classification of Diseases - ICD-10 codes, X60-84) in each of the eight five-year age-bands between the age-bands 60-64 years and 95-99 years in both gender for as many years as possible from 2000...... were ascertained from three sources: colleagues with access to national data, national statisics office websites and email contact with the national statistics offices. The population size for the corresponding years and age-bands was estimated for each country using data provided by the United Nations......BACKGROUND: There is paucity of studies examining suicide rates in narrow five-year age-bands after the age of 60 years. This study examined suicide rates in eight five-year age-bands between the age of 60 and 99 years because this will allow more precise comparison between the young old (60...

Alendronate functionalized mesoporous hydroxyapatite nanoparticles for drug delivery

Energy Technology Data Exchange (ETDEWEB)

Li, Dongdong, E-mail: lidongchem@sina.cn [State Key Laboratory of Inorganic Synthesis and Preparative Chemistry, College of Chemistry, Jilin University, Changchun 130012 (China); Zhu, Yuntao; Liang, Zhiqiang [State Key Laboratory of Inorganic Synthesis and Preparative Chemistry, College of Chemistry, Jilin University, Changchun 130012 (China)

2013-06-01

Highlights: ► The synthesized mesoporous hydroxyapatite has nanostructure and bioactivity. ► The materials have high surface area and amino group. ► The materials show higher drug loading and slower release rate than pure HAP. - Abstract: Mesoporous nanosized hydroxyapatite (HAP) functionalized by alendronate (ALN) was synthesized using cationic surfactant CTAB as template. The structural, morphological and textural properties were fully characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FT-IR) and N{sub 2} adsorption/desorption. Then the obtained materials were performed as drug delivery carriers using ibuprofen (IBU) as a model drug to investigate their drug storage/release properties in simulated body fluid (SBF). The materials showed relatively slower release rate compared with HAP due to the ionic interaction between -NH{sub 3}{sup +} on the matrix and -COO{sup −}belongs to IBU. The system provides a new concept for improving the drug loading or slowing down the release rate.

Alendronate functionalized mesoporous hydroxyapatite nanoparticles for drug delivery

International Nuclear Information System (INIS)

Li, Dongdong; Zhu, Yuntao; Liang, Zhiqiang

2013-01-01

Highlights: ► The synthesized mesoporous hydroxyapatite has nanostructure and bioactivity. ► The materials have high surface area and amino group. ► The materials show higher drug loading and slower release rate than pure HAP. - Abstract: Mesoporous nanosized hydroxyapatite (HAP) functionalized by alendronate (ALN) was synthesized using cationic surfactant CTAB as template. The structural, morphological and textural properties were fully characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FT-IR) and N 2 adsorption/desorption. Then the obtained materials were performed as drug delivery carriers using ibuprofen (IBU) as a model drug to investigate their drug storage/release properties in simulated body fluid (SBF). The materials showed relatively slower release rate compared with HAP due to the ionic interaction between -NH 3 + on the matrix and -COO − belongs to IBU. The system provides a new concept for improving the drug loading or slowing down the release rate

Evolution of Facial Aesthetic Treatment Over Five or More Years: A Retrospective Cross-sectional Analysis of Continuous OnabotulinumtoxinA Treatment.

Science.gov (United States)

Carruthers, Alastair; Sadick, Neil; Brandt, Frederic; Trindade de Almeida, Ada Regina; Fagien, Steve; Goodman, Greg J; Raspaldo, Herve; Smith, Kevin; Darmody, Sarah; Gallagher, Conor J; Street, James; Romagnano, Linda

2015-06-01

Little information exists on how facial aesthetic treatments are incorporated into aesthetic regimens. Assess the evolution of facial aesthetic treatments in patients receiving long-term continuous onabotulinumtoxinA treatment. This international retrospective chart review included patients with ≥5 years of continuous onabotulinumtoxinA treatments including ≥1 glabellar lines treatment/year. Charts were reviewed for facial areas treated, number of treatments, doses/treatment visit, concomitant aesthetic procedures, and onabotulinumtoxinA-related adverse events. Data were collected from 5,112 onabotulinumtoxinA treatment sessions for 194 patients over an average of 9.1 years. Dosing was relatively stable over time; however, interinjection intervals increased. Glabellar lines' treatment temporally preceded crow's feet lines and forehead lines' treatment. A majority of patients (85%) also received treatment with fillers. Cumulative increases in onabotulinumtoxinA treatments occurred over time and by facial area corresponding with increases in treatments with injectable fillers, energy-based devices, and prescription topical creams. The longer the patients were treated, the younger they perceived themselves to look. Rates of adverse events were low. OnabotulinumtoxinA treatment evolved over time, coinciding with growth of the facial aesthetics market. Additional treatment modalities were added as complements to onabotulinumtoxinA. Long-term continuous onabotulinumtoxinA injections are an important component of contemporary facial aesthetic treatment regimens.

TRIUMF: Five-year plan

International Nuclear Information System (INIS)

Anon.

1995-01-01

The Canadian government recently announced approval of a five-year-plan for TRIUMF, giving the Vancouver Laboratory assured funding until the year 2000. Besides continuation of the multidisciplinary cyclotron, this will allow construction of ISAC-1, a new on-line isotope separator. At the same time, TRIUMF will also be responsible for Canadian ''in-kind'' contributions to international science at CERN's LHC proton-proton collider (see page 1). The federal plan strengthens TRIUMF's role as a national facility, run by a consortium of universities across Canada. In addition, TRIUMF will have even stronger international links. The federal government has allocated a total of $166.6 million to TRIUMF over the next five years. In addition, the provincial British Columbia government, a long-time supporter of TRIUMF, has already agreed to provide approximately $10 million for conventional construction. The nature of the accelerator contributions to the LHC has not been finally decided, although two areas are under discussion - the upgrade of the accelerator chain, and construction of the two 'beam cleaning' insertions. The former would involve provision of various new systems (radiofrequency, magnets, power supplies, kickers, etc) for the Booster, PS and SPS synchrotrons; indeed activity is already underway in some areas, such as model studies for a new 40 MHz system for the PS. The acronym of the new facility, ISAC-1, is short for Isotope Separator & Accelerator. A prototype first stage already exists in TRIUMF. ISAC-1 will use the intense proton beam from the TRIUMF cyclotron to create powerful beams of exotic, short-lived, radioactive nuclei which will be accelerated in a new structure

The influence of alendronate on the healing of extraction sockets of ovariectomized rats assessed by in vivo micro-computed tomography.

Science.gov (United States)

Jee, Jeong-Hyun; Lee, Wan; Lee, Byung Do

2010-08-01

Many dental patients take bisphosphonates to reduce the risk of hip and vertebral fractures. In vivo micro-computed tomography (micro-CT) was used to examine the longitudinal inhibitory effect of alendronate on the healing of extraction sockets in ovariectomized rats. Twenty 5-week-old Sprague-Dawley rats were assigned randomly to 1 of 3 groups: sham-operated (n = 5), and 2 ovariectomized (OVX) groups: saline treated (0.1 mL/100 g/d, n = 7) and alendronate treated (1 mg/kg/d, n = 8). Before micro-CT scanning, the left maxillary first molars of the rats were extracted. In vivo micro-CT (spatial resolution 50 x 50 mum) of the jaw was performed at baseline and at 2-week intervals for 6 weeks. Alveolar-bone radiographic densities and dimensions were analyzed with repeated measures analysis of variance. The bony healing patterns of the extraction sockets were also evaluated in each group. The radiographic socket densities of the sham-treated and OVX-alendronate groups significantly increased during the first 4 weeks after extraction (P sockets in the OVX-saline group increased, but the increase was significantly lower than for the other groups at 4 weeks (P sockets in all groups 2 to 6 weeks after extraction. There was a significant loss of alveolar ridge height at the second week postextraction compared with baseline, and at the fourth week compared with the second week (P sockets in estrogen-deficient rats and helps resist the loss of alveolar bone adjacent to extraction sockets. Copyright 2010 Mosby, Inc. All rights reserved.

Columbine High: Five Years Later

Science.gov (United States)

Hurst, Marianne D.

2004-01-01

A few weeks before the fifth anniversary of the Columbine High School shootings on April 20, 1999, Principal Frank DeAngelis reflects on how his school has changed over the past five years. Much like the September 11, 2001 terrorist attacks against the United States, "Columbine" carries a chilling meaning that resonates across the…

Key Royale bridge five year evaluation.

Science.gov (United States)

2013-06-01

This report describes the design, construction, instrumentation, and five-year evaluation of the Key Royale Bridge substructure. The primary focus was the evaluation of the implementation of highly reactive supplementary cementitious materials (SCM) ...

Launching PPARC's five year strategy programme

CERN Document Server

2003-01-01

"Over one hundred delegates from Parliament, Whitehall and Industry attended a reception on Tuesday night (25 November) to mark the launch the Particle Physics and Astronomy Research Council's (PPARC) Five Year Plan" (1 page).

Development and characterization of a gastroretentive dosage form composed of chitosan and hydroxyethyl cellulose for alendronate.

Science.gov (United States)

Chen, Ying-Chen; Ho, Hsiu-O; Chiu, Chiao-Chi; Sheu, Ming-Thau

2014-01-01

In this study, alendronate, the most commonly used biphosphonate for treating osteoporosis, was formulated as gastroretentive dosage form (GRDF) tablets to enhance its oral bioavailability. GRDF tablets were characterized with the effects of different molecular weights (MWs) of chitosan (CS) and hydroxyethyl cellulose (HEC) at various ratios on swelling, floating, and physical integrity. The CS component was formed using various acids: acetic, lactic, malic, succinic, and citric, and a high viscosity grade of HEC was selected. The results demonstrated that the swelling ratios of the formulations comprising high MW CS were lower than those of low or medium MW CS when salts were formed with any countering acids except for acetic acid. The decreasing ranking of the swelling rates was: CS-citrate > CS-malate > CS-lactate > CS-succinate > CS-acetate. A negative correlation was found between the pKa of the respective countering acid and the swelling rate. The swelling rate was promoted if an acidic salt of CS with a lower water content was incorporated, while it became slower when tablet hardness was higher or the compression force to form tablets was increased. Although HEC did not contribute to swelling or floating, it played a role in maintaining structural integrity. A prolonged dissolution profile of alendronate GRDF tablets developed in this study was observed.

Radiotherapy and chemotherapy in the treatment of head and neck cancer: results after five years of a randomized study

Energy Technology Data Exchange (ETDEWEB)

Santarelli, M.; Raffetto, N.; Torcia, P.; Vitturini, A.; Tombolini, V.; Maurizi Enrici, R. [Istituto di radiologia Universita Roma ' ' La Sapienza' ' , Rome (Italy)

1999-11-01

Purpose: this study was undertaken to evaluate the efficacy of two regimens of chemoradiotherapy in the treatment of locally advanced head and neck cancer. Methods: from 1992 to 1997, 127 patients with locally advanced head and neck cancer (stage III-IV) were randomized. Sixty-six patients (group a), 42 male and 24 female, with a median age of 48 years (range 40-72) received during radiotherapy two courses (1.-6. week) of chemotherapy with carbo-platin (300 mg/m{sup 2} day 1) and etoposide (60 mg/m{sup 2} days 1 to 3). Sixty-one patients (group b), 40 male and 21 female, with a median age of 51 years (range 42-69) received two cycles of chemotherapy with 5 FU (750 mg/m{sup 2} days 1 to 5) and MIT C ( 10 mg/m{sup 2} day 1). The median dose of radiotherapy was 60 Gy (range 55-66 Gy) 180 cGy /d 5w. Results: the actuarial five-year survival rate(Kaplan-Meier) was 38 % for group a (CBDCA+etoposide+RT) and 25 % for group b (5FU+MIT C+RT). The difference was statistically significant (p = 0.036). Toxicity group a: mucositis G III in 41 patients and G IV in 16; dysphagia G III in 46 patients and IV in 5; leukopenia in 24 patients; 28 patients required nutritional therapy. Toxicity group b: mucositis G III in 38 patients and G IV in 17; dysphagia G III in 48 patients and G IV in 3; leukopenia in 23 patients; 25 patients needed nutritional therapy. Conclusions: the data of the actuarial survival five-year rate suggest that concomitant chemotherapy in group a (CBDCA+etoposide+RT) is better than the concomitant chemotherapy in group b (5FU+MIT C+RT). (author)

Radiotherapy and chemotherapy in the treatment of head and neck cancer: results after five years of a randomized study

International Nuclear Information System (INIS)

Santarelli, M.; Raffetto, N.; Torcia, P.; Vitturini, A.; Tombolini, V.; Maurizi Enrici, R.

1999-01-01

Purpose: this study was undertaken to evaluate the efficacy of two regimens of chemoradiotherapy in the treatment of locally advanced head and neck cancer. Methods: from 1992 to 1997, 127 patients with locally advanced head and neck cancer (stage III-IV) were randomized. Sixty-six patients (group a), 42 male and 24 female, with a median age of 48 years (range 40-72) received during radiotherapy two courses (1.-6. week) of chemotherapy with carbo-platin (300 mg/m 2 day 1) and etoposide (60 mg/m 2 days 1 to 3). Sixty-one patients (group b), 40 male and 21 female, with a median age of 51 years (range 42-69) received two cycles of chemotherapy with 5 FU (750 mg/m 2 days 1 to 5) and MIT C ( 10 mg/m 2 day 1). The median dose of radiotherapy was 60 Gy (range 55-66 Gy) 180 cGy /d 5w. Results: the actuarial five-year survival rate (Kaplan-Meier) was 38 % for group a (CBDCA+etoposide+RT) and 25 % for group b (5FU+MIT C+RT). The difference was statistically significant (p = 0.036). Toxicity group a: mucositis G III in 41 patients and G IV in 16; dysphagia G III in 46 patients and IV in 5; leukopenia in 24 patients; 28 patients required nutritional therapy. Toxicity group b: mucositis G III in 38 patients and G IV in 17; dysphagia G III in 48 patients and G IV in 3; leukopenia in 23 patients; 25 patients needed nutritional therapy. Conclusions: the data of the actuarial survival five-year rate suggest that concomitant chemotherapy in group a (CBDCA+etoposide+RT) is better than the concomitant chemotherapy in group b (5FU+MIT C+RT). (author)

Annex A1: cornerstone of the five-yearly review

CERN Multimedia

Staff Association

2016-01-01

As a reminder; the purpose of the five-yearly review is to review the financial and social conditions of all CERN personnel whether employed (MPE) or associated (MPA)! In December 2015, the CERN Council approved the package proposed by the Management. Early this year, and as final act of the 2015 five-yearly review, the CERN Council may decide, if necessary and appropriate, to review the procedures defined in Annex A1 and applicable to future five-yearly reviews. At the meeting of TREF (TRipartite Employment Forum)  in early March 2016 discussions will take place between all stakeholders (representatives of Member States, Management and the Staff Association) and Council will take a decision in June 2016, on the basis of the Management's recommendations. What does Annex A1 say and where can I find it? Annex A1 (Article S V 1.02) is a part of the Staff Rules and Regulations. This annex defines: The five-yearly review of the financial and social conditions of the staff, fellows and MPA; The a...

Suicide rates in five-year age-bands after the age of 60 years: the international landscape.

Science.gov (United States)

Shah, Ajit; Bhat, Ravi; Zarate-Escudero, Sofia; DeLeo, Diego; Erlangsen, Annette

2016-01-01

There is paucity of studies examining suicide rates in narrow five-year age-bands after the age of 60 years. This study examined suicide rates in eight five-year age-bands between the age of 60 and 99 years because this will allow more precise comparison between the young old (60-79 years) and the oldest old (80+ years) age groups. Data on the number of suicides (International Classification of Diseases - ICD-10 codes, X60-84) in each of the eight five-year age-bands between the age-bands 60-64 years and 95-99 years in both gender for as many years as possible from 2000 were ascertained from three sources: colleagues with access to national data, national statisics office websites and email contact with the national statistics offices. The population size for the corresponding years and age-bands was estimated for each country using data provided by the United Nations website. In men, suicide rates continued to increase for each of the seven five-year age-bands from 60-64 years to 90-94 years age-band, and then declined slightly for the 95-99 year age-band. In women, suicide rates continued to increase for each of the six five-year age-bands from 60-64 years to 85-89 years age-bands, and then declined slightly for the 90-94 years and 95-99 years age-bands. The overall global suicide rates for each of the eight five-year age-bands are sufficiently large for them to constitute a public health concern. This is especially important given the ongoing rise in the elderly population size and the paucity of data on risk and protective factors for suicide in the five-year age-bands after the age of 60 years.

Adherence to vaccination guidelines post splenectomy: A five year follow up study.

Science.gov (United States)

Boam, Tristan; Sellars, Peter; Isherwood, John; Hollobone, Chloe; Pollard, Cristina; Lloyd, David M; Dennison, Ashley R; Garcea, Giuseppe

Following a splenectomy patients are at increased risk of significant infections. In its most severe form, overwhelming post-splenectomy infection (OPSI) has a mortality rate of up to 80%. In this study we aim to establish the adherence to vaccination and antibiotic national guidelines in splenectomised patients. A retrospective study of 100 patients who underwent splenectomy (21 emergency, 79 elective), in two teaching hospitals was undertaken over a five-year period. Patients were followed up for five years. Hospital and GP records were reviewed for adherence to pre, intra and postoperative vaccination, thromboprophylaxis and antibiotic guidance. Eighty-six eligible patients (91.5%) received their Haemophilus influenzae B, meningococcal C and pneumococcus vaccinations peri-operatively. Eighty-one (86%) received post-operative antibiotics. Ninety-nine percent of patients received thromboprophylaxis treatment. Eighty-nine (95%) were treated with long-term antibiotic prophylaxis. Only 20 patients (23%) had an emergency supply of antibiotics. Ninety-five percent of patients were administered an annual influenza vaccination and 84% of eligible patients received a five-year pneumococcal booster vaccination. Improvement in the management of this patient cohort can be achieved by a multidisciplinary approach involving adherence to national guidelines, standardised trust protocols, patient information leaflets and advice detailing risk of infection, standardised GP letters and a splenectomy register to monitor and manage this vulnerable group of patients. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

阿仑膦酸钠对绝经后骨质疏松性骨痛的疗效分析%Effect analysis of alendronate on postmenopausal osteoporosis with bone ache

Institute of Scientific and Technical Information of China (English)

无

2001-01-01

@@ Background: Osteoporosis is a metabolic bone disease characterized by low bone component and regeneration of the microstructure of bone tissues, osteoporosis occurs in postmenopausal women for decreased estrogen level. Those women with osteoporosis often suffer from bone ache, such as pain at low back, back, knees and heels. In severe cases, there may be crookback or non- violent fracture. Objective: To discuss treatment effect of the Alendronate on 56 postmenopausal women with bone ache caused by osteoporosis. Unit: 210 Hospital of PLA.

Five-year analysis from the ESPRIT 10-year postmarketing surveillance registry of adalimumab treatment for moderate to severe psoriasis.

Science.gov (United States)

Menter, Alan; Thaçi, Diamant; Papp, Kim A; Wu, Jashin J; Bereswill, Mareike; Teixeira, Henrique D; Rubant, Simone; Williams, David A

2015-09-01

ESPRIT is an ongoing, 10-year, observational registry, evaluating long-term safety and effectiveness of adalimumab treatment in routine clinical practice for patients with moderate to severe, chronic plaque psoriasis. Initial 5-year results are reported. Two populations were analyzed: the "all-treated" population received 1 or more adalimumab doses in registry, continuing adalimumab treatment from a current prescription or previous study participation, and included the "new-prescription" population initiating adalimumab 4 weeks or earlier preregistry entry. Data were collected from September 26, 2008, through November 30, 2013, for all-treated (n = 6059), which included new-prescription (n = 2580, 42.6%); median registry exposure was 765 and 677 days, respectively. In all-treated, rate (events per 100 patient-years of total adalimumab exposure [E/100PY]) of serious treatment-emergent adverse events (inside or outside of the registry) was 4.3 E/100PY, serious infection 1.0 E/100PY, malignancies 0.9 E/100PY (nonmelanoma skin cancers 0.6 E/100PY; melanomas <0.1 E/100PY). Standardized mortality ratio was 0.30 (95% confidence interval 0.19-0.44). Physician Global Assessment clear or minimal (effectiveness parameter) was achieved by 57.0% at 12 months and 64.7% at 60 months of treatment. Observational data are subject to outcome-reporting bias. No new safety signals were observed with adalimumab treatment during this initial 5-year registry review. Observed number of deaths was below expected. As-observed effectiveness remained stable through 60 months. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

75 FR 34959 - Five-Year Review of Oil Pipeline Pricing Index

Science.gov (United States)

2010-06-21

...] Five-Year Review of Oil Pipeline Pricing Index June 15, 2010. AGENCY: Federal Energy Regulatory... comments on its five-year review of the oil pipeline pricing index established in Revisions to Oil Pipeline...-year review of the oil pricing index, the Commission adopted an index of PPI+1.3 for the five-year...

78 FR 26616 - Draft NOAA Five Year Research and Development Plan

Science.gov (United States)

2013-05-07

... DEPARTMENT OF COMMERCE Draft NOAA Five Year Research and Development Plan AGENCY: National Oceanic and Atmospheric Administration (NOAA), Department of Commerce (DOC). ACTION: Draft NOAA Five Year Research and Development Plan for Public Review. SUMMARY: NOAA's draft Five Year Research and Development...

Cumulative Alendronate Dose and the Long-Term Absolute Risk of Subtrochanteric and Diaphyseal Femur Fractures: A Register-Based National Cohort Analysis

DEFF Research Database (Denmark)

Abrahamsen, Bo; Eiken, Pia Agnete; Eastell, Richard

2010-01-01

are currently the subject of a U.S. Food and Drug Administration review. Objective: Our objective was to examine the risk of subtrochanteric/diaphyseal femur fractures in long term users of alendronate. Design: We conducted an age- and gender-matched cohort study using national healthcare data. Patients...

Treatment of Visceral Aneurysm Using Multilayer Stent: Two-Year Follow-Up Results in Five Consecutive Patients

Energy Technology Data Exchange (ETDEWEB)

Balderi, Alberto, E-mail: balders@libero.it; Antonietti, Alberto, E-mail: antonietti.a@ospedale.cuneo.it; Pedrazzini, Fulvio, E-mail: pedrazzini.f@ospedale.cuneo.it; Sortino, Davide, E-mail: davide.sortino@hotmail.it; Vinay, Claudia, E-mail: claudia.vinay@gmail.com; Grosso, Maurizio, E-mail: grosso.m@ospedale.cuneo.it [AO Santa Croce e Carle Hospital, Department of Radiology (Italy)

2013-10-15

Purpose: The present study was performed to analyze the midterm results (five consecutive patients, 2-year follow-up) of the endovascular management of visceral artery aneurysms using the Cardiatis Multilayer Flow Modulator (CMFM) (Cardiatis, Isnes, Belgium), a self-expandable stent. Materials and Methods: From August 2009 to January 2011, we implanted five CMFMs in five patients (all men; mean age 73 years) to treat two common hepatic artery aneurysms, one celiac trunk aneurysm, one splenic artery aneurysm, and one superior mesenteric artery aneurysm (diameter 25-81 mm). The primary end point was technical success. The secondary end point was stent patency, absence of aneurysm rupture or reperfusion, and shrinking of the sac at 6-, 12-, and 24-month follow-up using computed tomography angiography. Follow-up ranged from 24 to 48 months (mean 31.2). Results: Technical success was achieved in all patients. Complete exclusion of the aneurysm with sac shrinking was achieved in two patients. Two stents became occluded at 6- and 24-month follow-up, respectively; both patients were asymptomatic and were not retreated. One patient developed sac reperfusion due to incomplete aneurysm exclusion. Conclusion: Long-term results in a wider population are needed to validate the effectiveness of the CMFM.

Five-Yearly Review 2010 : Confirmation that our salaries are going downhill

CERN Multimedia

Staff Association

2010-01-01

A general review of our financial and social conditions takes place every five years: “the five-yearly review”, whose principles and procedures are described in Annex A1 of the Staff Rules and Regulations. The purpose of the five-yearly review is to ensure that the financial and social conditions offered by the Organization allow it to recruit and retain from all its Member States staff members of the highest competence and integrity required for the execution of its mission. The five-yearly review must include basic remuneration (the basic salaries of staff members, the stipends of fellows, and the subsistence allowances of associated members of the personnel) and may include any other financial or social conditions. Start of the 2010 five-yearly review and data collection As we wrote in Echo no. 80, CERN Council approved the document CERN/2862 for the 2010 five-yearly review (hereinafter 2010 5YR) at its meeting on 19th June 2009. This was the Management’s proposal which...

Development and characterization of a gastroretentive dosage form composed of chitosan and hydroxyethyl cellulose for alendronate

OpenAIRE

Chen YC; Ho HO; Chiu CC; Sheu MT

2013-01-01

Ying-Chen Chen,1,* Hsiu-O Ho,1,* Chiao-Chi Chiu,1 Ming-Thau Sheu1,2 1School of Pharmacy, College of Pharmacy, Taipei Medical University, 2Clinical Research Center and Traditional Herbal Medicine Research Center, Taipei Medical University Hospital, Taipei, Taiwan*These authors contributed equally to this workAbstract: In this study, alendronate, the most commonly used biphosphonate for treating osteoporosis, was formulated as gastroretentive dosage form (GRDF) tablets to enhance its oral bioav...

Outcome of the 2015 five-yearly review: decision time

CERN Multimedia

Staff Association

2015-01-01

To ensure that CERN remains a centre of excellence in the field of fundamental research, the Organization verifies every five years with the help of a Five-yearly review procedure whether the financial and social conditions which it proposes to its staff allow it to recruit and retain Staff Members of the highest competence and integrity required for the execution of its mission and coming from all Member States. For Fellows these conditions should remain attractive compared with those in comparable research institutions, while for Associated members of personnel the conditions should allow it to host them in its research facilities taking into account the highest cost-of-living level in the local region of the Organization. Annex A1 of the CERN Staff Rules prescribes the principles of how to manage this Five-Yearly process. Getting ready In order to prepare the 2015 Five-yearly review and to help define the topics which had to be decided by the CERN Council in June 2014, the Staff Association has organized ...

75 FR 80300 - Five-Year Review of Oil Pipeline Pricing Index

Science.gov (United States)

2010-12-22

...] Five-Year Review of Oil Pipeline Pricing Index Issued December 16, 2010. AGENCY: Federal Energy... five-year review of the oil pricing index, established in Order No. 561. After consideration of the... period commencing July 1, 2011. \\1\\ Five-Year Review of Oil Pipeline Pricing Index, 75 FR 34959 (June 21...

Significant achievements in '10th five-year plan' period and primary guidance in '11th five-year plan' period on uranium exploration

International Nuclear Information System (INIS)

Zhang Jindai; Li Youliang; Jian Xiaofei; Peng Xinjian; Jiang Deying

2007-01-01

During the '10th five-year-plane' period, uranium resource had attracted high attention and concentration from related organization of the CCPC and the central government because of the state's manifestation on the development goal for nuclear power, efforts on uranium research and exploration were intensified accordingly. In that five years, both uranium exploration, regional assessment and prognostication for the Mesozoic-Cenozoic basin in North China and research on uranium metallogeny theory and prospecting method had made fairly great progress and reached important fruits. Due to the improvement of prospecting theory and technology for ISL amenable sandstone hosted U-deposits, uranium exploration efficiency was great enhanced and had prompted the sustainable development for China's uranium exploration. This paper have briefly expounded the general deploy for the uranium geology research and exploration in the '11th five-year plan' period. (authors)

Studies on Five Senses Treatment

Science.gov (United States)

Sato, Sadaka; Miao, Tiejun; Oyama-Higa, Mayumi

2011-06-01

This study proposed a therapy from complementary and alternative medicine to treat mental disorder by through interactions of five senses between therapist and patient. In this method sounding a certain six voices play an important role in healing and recovery. First, we studied effects of speaking using scalp- EEG measurement. Chaos analysis of EEG showed a largely enhanced largest Lyapunov exponent (LLE) during the speaking. In addition, EEG power spectrum showed an increase over most frequencies. Second, we performed case studies on mental disorder using the therapy. Running power spectrum of EEG of patients indicated decreasing power at end of treatment, implying five senses therapy induced relaxed and lowered energy in central neural system. The results agreed with patient's reports that there were considerable decline in anxiety and improvements in mood.

Magnetic resonance imaging of osteosarcoma using a bis(alendronate)-based bone-targeted contrast agent.

Science.gov (United States)

Ge, Pingju; Sheng, Fugeng; Jin, Yiguang; Tong, Li; Du, Lina; Zhang, Lei; Tian, Ning; Li, Gongjie

2016-12-01

Magnetic resonance (MR) is currently used for diagnosis of osteosarcoma but not well even though contrast agents are administered. Here, we report a novel bone-targeted MR imaging contrast agent, Gd 2 -diethylenetriaminepentaacetate-bis(alendronate) (Gd 2 -DTPA-BA) for the diagnosis of osteosarcoma. It is the conjugate of a bone cell-seeking molecule (i.e., alendronate) and an MR imaging contrast agent (i.e., Gd-DTPA). Its physicochemical parameters were measured, including pK a , complex constant, and T 1 relaxivity. Its bone cell-seeking ability was evaluated by measuring its adsorption on hydroxyapatite. Hemolysis was investigated. MR imaging and biodistribution of Gd 2 -DTPA-BA and Gd-DTPA were studied on healthy and osteosarcoma-bearing nude mice. Gd 2 -DTPA-BA showed high adsorption on hydroxyapatite, the high MR relaxivity (r 1 ) of 7.613mM -1 s -1 (2.6 folds of Gd-DTPA), and no hemolysis. The MR contrast effect of Gd 2 -DTPA-BA was much higher than that of Gd-DTPA after intravenous injection to the mice. More importantly, the MR imaging of osteosarcoma was significantly improved by Gd 2 -DTPA-BA. The signal intensity of Gd 2 -DTPA-BA reached 120.3% at 50min, equal to three folds of Gd-DTPA. The bone targeting index (bone/blood) of Gd 2 -DTPA-BA in the osteosarcoma-bearing mice was very high to 130 at 180min. Furthermore, the contrast enhancement could also be found in the lung due to metastasis of osteosarcoma. Gd 2 -DTPA-BA plays a promising role in the diagnoses of osteosacomas, including the primary bone tumors and metastases. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Alendronate-Eluting Biphasic Calcium Phosphate (BCP Scaffolds Stimulate Osteogenic Differentiation

Directory of Open Access Journals (Sweden)

Sung Eun Kim

2015-01-01

Full Text Available Biphasic calcium phosphate (BCP scaffolds have been widely used in orthopedic and dental fields as osteoconductive bone substitutes. However, BCP scaffolds are not satisfactory for the stimulation of osteogenic differentiation and maturation. To enhance osteogenic differentiation, we prepared alendronate- (ALN- eluting BCP scaffolds. The coating of ALN on BCP scaffolds was confirmed by scanning electron microscopy (FE-SEM, energy-dispersive X-ray spectroscopy (EDS, and attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR. An in vitro release study showed that release of ALN from ALN-eluting BCP scaffolds was sustained for up to 28 days. In vitro results revealed that MG-63 cells grown on ALN-eluting BCP scaffolds exhibited increased ALP activity and calcium deposition and upregulated gene expression of Runx2, ALP, OCN, and OPN compared with the BCP scaffold alone. Therefore, this study suggests that ALN-eluting BCP scaffolds have the potential to effectively stimulate osteogenic differentiation.

Comparison of orally administered bisphosphonate drugs in reducing the risk of hip fracture in older adults: a population-based cohort study.

Science.gov (United States)

Cadarette, Suzanne M; Lévesque, Linda; Mamdani, Muhammad; Perreault, Sylvie; Juurlink, David N; Paterson, J Michael; Carney, Greg; Gunraj, Nadia; Hawker, Gillian A; Tadrous, Mina; Wong, Lindsay; Dormuth, Colin R

2013-09-01

Orally administered bisphosphonate drugs (i.e., alendronate, etidronate, risedronate) can reduce the risk of vertebral fracture. However, only alendronate and risedronate have proven efficacy in reducing the risk of hip fracture. We sought to examine the comparative effectiveness of orally administered bisphosphonate drugs in reducing hip fractures among older adults. We identified new users of orally administered bisphosphonate drugs in British Columbia and Ontario between 2001 and 2008. We used province- and sex-specific propensity score-matching strategies to maximize comparability between exposure groups. We used Cox proportional hazards models to compare time-to-hip fracture within 1 year of treatment between exposures by sex in each province. Our secondary analyses considered hip fracture rates within 2 and 3 years' follow-up. We used alendronate as the reference for all comparisons and pooled provincial estimates using random effects variance-weighted meta-analysis. We identified 321 755 patients who were eligible for inclusion in the study. We found little difference in fracture rates between men (pooled hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.74-1.14) or women (pooled HR 1.15, 95% CI 0.73-1.56) taking risedronate and those taking alendronate. We similarly identified little difference in fracture rates between women taking etidronate and those taking alendronate (pooled HR 1.00, 95% CI 0.82-1.18). However, we identified lower rates of hip fracture among men taking etidronate relative to alendronate (pooled HR 0.77, 95% CI 0.60-0.94). Results extended to 2 and 3 years' follow-up were similar. However, with 3 years' follow-up, rates of hip fracture were lower among women in British Columbia who had taken alendronate. We identified little overall difference between alendronate and risedronate in reducing the risk of hip fracture in men or women. Our finding that etidronate is associated with lower fracture risk among men is likely due to

Initiation of anti-osteoporotic therapy in patients with recent fractures: a nationwide analysis of prescription rates and persistence

DEFF Research Database (Denmark)

Roerholt, C; Eiken, P; Abrahamsen, Bo

2009-01-01

initiation within 1 year was highest after spine fracture: 39.6% of women began therapy in 2004 compared with 19.5% in 1997. In men, 16.5% began therapy in 2004 vs. 8.0% in 1997. Following hip fracture, 9.2% of women and 4.1% of men began therapy in 2004 vs. 3.4% and 0.7% in 1997, respectively. Median...... or weekly alendronate obtaining treatment durations equalling those of the licensing trials. INTRODUCTION: Reducing the societal fracture burden remains challenging due to failure to treat fragility fractures and non-compliance with treatment. METHODS: We used national registers to identify patients born...... persistence (years) was 2.8 for daily alendronate, 3.8 for weekly alendronate, 2.5 for etidronate and 4.7 for raloxifene. The risk of discontinuing or changing therapy increased with age. CONCLUSIONS: Prescription rates for anti-osteoporotic medication are very low, especially in hip fracture and in men...

The Chernobyl accident - five years later

International Nuclear Information System (INIS)

Mueck, K.

1991-06-01

At the fifth anniversary of the Chernobyl accident the initial situation at that time, the control of the consequences to Austria in the present light, as well as the knowledge gained from the accident and its consequences are described. A final estimate and appraisal of the total population dose by the accident alloted according to the individual exposure pathways and the dose reductions due to countermeasures by the authorities are given. The dose reduction in the following years is described. Five years later the external exposure was reduced to about 6 % of the values of the first year, the ingestion dose to about 5 % of the first-year-values. Finally, the current radiation situation is described and the dose contribution by foodstuff with elevated activity concentration is estimated. Also the consequences from the experience and knowledge obtained by the accident are described. (author)

State of logistics - a five-year review

CSIR Research Space (South Africa)

Ittmann, HW

2009-07-01

Full Text Available The state of logistics survey makes it possible to analyse and show trends over the past five years. This relates to quantitative and qualitative logistics issues that were not possible when this survey started in 2004. The paper will show...

Multidisciplinary therapy for the treatment of malocclusion in a patient with chronic periodontitis with a five-year follow-up: A case report.

Science.gov (United States)

Zhang, Dongmei; Lin, Li; Tang, Xiaoling; Li, Chen; Liu, Jingbo; Wang, Hongyang; Pan, Yaping

2017-10-01

Multidisciplinary therapy is essential in dental practice to achieve optimized outcomes. The present case report describes the application of periodontal surgery with a five-year follow-up in a patient with malocclusion and chronic periodontitis. In the presence of periodontal inflammation, orthodontic therapy may result in further periodontal breakdown due to plaque accumulation. In order to prevent this progression, scaling and root planning with a periodontal endoscope was applied, and continuous clinical monitoring and risk assessment was performed every 3 months using a Florida Probe. This combined treatment supports the long-term maintenance of periodontal conditions, functional occlusion and harmony of the facial profile.

Power generation in the 12-th five-year plan

International Nuclear Information System (INIS)

Troitskij, A.A.

1986-01-01

The state of electric power generation in the 11-th five-year plan is summed up. Perspectives of development of heat and electric power generation in the 12-th five-year plan are considered. Thermal power generation of NPPs in 1990 will increase by a factor of 8.4 as compared with 1975. The NPP development will be mainly realized on the basis of the WWER-1000 type reactors. It is planned to commission fast reactors of up to 800 MW

Medicinsk behandling af osteoporose hos mænd

DEFF Research Database (Denmark)

Eiken, Pia A; Vestergaard, Peter

2016-01-01

One in five men over the age of 50 years will suffer an osteoporotic fracture during their lifetime, and men who sustain fractures have an increased mortality risk compared to women. Three bisphosphonates (alendronate, risedronate and zolendronic acid), denosumab, strontium ranelate...

Medicinsk behandling af osteoporose hos mænd

DEFF Research Database (Denmark)

Eiken, Pia A; Vestergaard, Peter

2015-01-01

One in five men over the age of 50 years will suffer an osteoporotic fracture during their lifetime, and men who sustain fractures have an increased mortality risk compared to women. Three bisphosphonates (alendronate, risedronate and zolendronic acid), denosumab, strontium ranelate...

Magnetic resonance imaging in the evaluation of clinical treatment of otospongiosis: a pilot study.

Science.gov (United States)

de Oliveira Vicente, Andy; Chandrasekhar, Sujana S; Yamashita, Helio K; Cruz, Oswaldo Laercio M; Barros, Flavia A; Penido, Norma O

2015-06-01

To evaluate the applicability of magnetic resonance imaging (MRI) as a method for monitoring the activity of otospongiotic lesions before and after clinical treatment. Prospective, randomized, controlled, double-blind study. One single tertiary care institution in a large, cosmopolitan city. Twenty-six patients (n = 42 ears) with clinical, audiometric, and tomographic diagnosis of otosclerosis were enrolled. If computed tomography (CT) demonstrated active lesions, these patients underwent MRI to detect otospongiotic foci, seen as areas of gadolinium enhancement. Patients were divided into 3 groups and received treatment with placebo, sodium alendronate, or sodium fluoride for 6 months. After this period, clinical and audiometric evaluations and a second MRI were performed. Each MRI was evaluated by both a neuroradiologist and an otolaryngologist in a subjective (visual) and objective (using specific eFilm Workstation software) manner. Otospongiosis was most predominantly identified in the region anterior to the oval window, and this site was reliable for comparing pre- and posttreatment scans. The patients in the alendronate and sodium fluoride groups had MRI findings that suggested a decrease in activity of otospongiotic lesions, more relevant in the alendronate group. These findings were statistically significant for both subjective and objective MRI evaluations. MRI shows higher sensitivity than clinical or audiometric assessment for detecting reduction in activity of otospongiosis. The objective MRI evaluation based on software analysis was the most accurate method of monitoring clinical treatment response in otospongiosis. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

Development and validation of a Markov microsimulation model for the economic evaluation of treatments in osteoporosis.

Science.gov (United States)

Hiligsmann, Mickaël; Ethgen, Olivier; Bruyère, Olivier; Richy, Florent; Gathon, Henry-Jean; Reginster, Jean-Yves

2009-01-01

Markov models are increasingly used in economic evaluations of treatments for osteoporosis. Most of the existing evaluations are cohort-based Markov models missing comprehensive memory management and versatility. In this article, we describe and validate an original Markov microsimulation model to accurately assess the cost-effectiveness of prevention and treatment of osteoporosis. We developed a Markov microsimulation model with a lifetime horizon and a direct health-care cost perspective. The patient history was recorded and was used in calculations of transition probabilities, utilities, and costs. To test the internal consistency of the model, we carried out an example calculation for alendronate therapy. Then, external consistency was investigated by comparing absolute lifetime risk of fracture estimates with epidemiologic data. For women at age 70 years, with a twofold increase in the fracture risk of the average population, the costs per quality-adjusted life-year gained for alendronate therapy versus no treatment were estimated at €9105 and €15,325, respectively, under full and realistic adherence assumptions. All the sensitivity analyses in terms of model parameters and modeling assumptions were coherent with expected conclusions and absolute lifetime risk of fracture estimates were within the range of previous estimates, which confirmed both internal and external consistency of the model. Microsimulation models present some major advantages over cohort-based models, increasing the reliability of the results and being largely compatible with the existing state of the art, evidence-based literature. The developed model appears to be a valid model for use in economic evaluations in osteoporosis.

The Ahmed Versus Baerveldt Study: Five-Year Treatment Outcomes.

Science.gov (United States)

Christakis, Panos G; Kalenak, Jeffrey W; Tsai, James C; Zurakowski, David; Kammer, Jeffrey A; Harasymowycz, Paul J; Mura, Juan J; Cantor, Louis B; Ahmed, Iqbal I K

2016-10-01

To compare 2 frequently used aqueous shunts for the treatment of glaucoma. International, multicenter, randomized trial. Patients aged 18 years or older with uncontrolled glaucoma despite maximum tolerated medical therapy, many of whom had failed or were at high risk of failing trabeculectomy. Eligible patients were randomized to receive an Ahmed-FP7 valve implant (New World Medical, Inc, Rancho Cucamonga, CA) or a Baerveldt-350 implant (Abbott Medical Optics, Inc, Santa Ana, CA) using a standardized surgical technique. The primary outcome was failure, defined as intraocular pressure (IOP) outside the target range (5-18 mmHg) or reduced glaucoma surgery. Secondary outcomes measures included IOP, medication use, visual acuity, complications, and interventions. A total of 238 patients were randomized; 124 received the Ahmed-FP7 implant, and 114 received the Baerveldt-350 implant. Baseline characteristics were similar between groups. Mean preoperative IOP was 31.4±10.8 mmHg on 3.1±1.0 glaucoma medications. At 5 years, the cumulative failure rate was 53% in the Ahmed group and 40% in the Baerveldt group (P = 0.04). The main reason for failure in both groups was high IOP, and the cumulative de novo glaucoma reoperation rate was 18% in the Ahmed group and 11% in the Baerveldt group (P = 0.22). Hypotony resulted in failure in 5 patients (4%) in the Baerveldt group compared with none in the Ahmed group (P = 0.02). Mean IOP was 16.6±5.9 mmHg in the Ahmed group (47% reduction) and 13.6±5.0 mmHg in the Baerveldt group (57% reduction, P = 0.001). Mean medication use was 1.8±1.5 mmHg in the Ahmed group (44% reduction) and 1.2±1.3 mmHg in the Baerveldt group (61% reduction, P = 0.03). The 2 groups had similar complication rates (Ahmed 63%, Baerveldt 69%) and intervention rates (Ahmed 41%, Baerveldt 41%). Most complications were transient, and most interventions were slit-lamp procedures. Both implants were effective in reducing IOP and the need for glaucoma

A Multidisciplinary Approach to a Seven Year-Old Patient with Incontinentia Pigmenti: A Case Report and Five-Year Follow Up

Directory of Open Access Journals (Sweden)

Rezvan Rafatjou

2016-11-01

Full Text Available Incontinentia pigmenti is a rare inherited disorder involving abnormalities of the skin, hair, eyes, musculoskeletal system, central nervous system, and the teeth. Dental abnormalities are the most common manifestations of this disorder. The purpose of this case report was to present the clinical and radiological findings of a seven-year-old girl as well as the results of her five-year follow up. The patient showed faded linear pigmented macular lesions on the trunk and on upper and lower limbs. Dental examination was notable for conical and peg-shaped anterior teeth as well as delayed eruption of primary and permanent teeth. In addition to conservative treatments, prosthetic treatments such as interim removable partial dentures were indicated for the patient.Keywords: Incontinentia Pigmenti; Dental Prosthesis; Genetic Diseases, Inborn 

Ecological Responses to Five Years of Experimental Nitrogen Application in an Upland Jack-pine Stand

Science.gov (United States)

Melaschenko, N.; Berryman, S.; Straker, J.; Berg, K.; McDonough, A.; Watmough, S. A.

2016-12-01

A five-year experimental study was conducted to evaluate the response of an upland jack-pine (Pinus banksiana) forest to elevated levels of nitrogen (N) deposition in Northern Alberta. N deposition in the region is expected to increase with industrial expansion of oil sands activity, and there is regional interest to set N critical loads for sensitive ecosystems. In this study, N was applied as NH4NO3 above a jack-pine canopy via helicopter, annually for five years (2010-2015) at dosages equivalent to 5, 10, 15, 20 and 25 kg N ha-1 yr-1. Approximately 35% of the applied N was retained in the canopy while 65% reached understory vegetation dominated by lichens and mosses. We measured a significant increase in tissue N concentrations of common ground lichens (Cladonia mitis and C. stellaris) and ground moss (Pleurozium schreberi) as well as epiphytic lichens (Hypogymnia physodes and Evernia mesomorpha). On an annual basis, the applied N was primarily captured in the lichen and moss understory, dominated by C. mitis. In the highest treatments, N concentrations in C. mitis were 1.5-2.5 times greater than pre-treatment values. Peak N concentrations in the ground moss Pleurozium schreberi (1.4%) indicate that a threshold of N saturation was reached by year 3. We observed no changes in community composition of vascular and non-vascular plants, or changes in vascular plant tissue N. Chlorophyll levels in C. mitis increased with N treatment, but there was no indication of toxicity or changes to decomposition and growth. After five years of N application, only Peltigera polydactylon, a ground cyanolichen, appeared to be negatively impacted where the thalli showed necrosis at deposition loads >10kg N ha-1 yr-1. No changes to biomass or N ecosystem processes were observed. Based on these observations, we provide evidence that the first adverse ecological effects of N deposition in jack-pine stands occurred at deposition rates of 10 kg N ha-1 yr-1.

The Five-Year Resume: A Career Planning Exercise

Science.gov (United States)

Laker, Dennis R.; Laker, Ruth

2007-01-01

For most college students, lack of career planning wastes time and resources and may result in years of "career drift." Lack of planning can also lead to deception once students begin seeking career-related employment. Faced with a competitive job market, some students inflate and exaggerate their resumes. The five-year resume exercise helps…

Depression and anxiety in women with early breast cancer: five year observational cohort study

Science.gov (United States)

Burgess, Caroline; Cornelius, Victoria; Love, Sharon; Graham, Jill; Richards, Michael; Ramirez, Amanda

2005-01-01

Objective To examine the prevalence of, and risk factors for, depression and anxiety in women with early breast cancer in the five years after diagnosis. Design Observational cohort study. Setting NHS breast clinic, London. Participants 222 women with early breast cancer: 170 (77%) provided complete interview data up to either five years after diagnosis or recurrence. Main outcome measures Prevalence of clinically important depression and anxiety (structured psychiatric interview with standardised diagnostic criteria) and clinical and patient risk factors, including stressful life experiences (Bedford College life events and difficulties schedule). Results Nearly 50% of the women with early breast cancer had depression, anxiety, or both in the year after diagnosis, 25% in the second, third, and fourth years, and 15% in the fifth year. Point prevalence was 33% at diagnosis, falling to 15% after one year. 45% of those with recurrence experienced depression, anxiety, or both within three months of the diagnosis. Previous psychological treatment predicted depression, anxiety, or both in the period around diagnosis (one month before diagnosis to four months after diagnosis). Longer term depression and anxiety, were associated with previous psychological treatment, lack of an intimate confiding relationship, younger age, and severely stressful non-cancer life experiences. Clinical factors were not associated with depression and anxiety, at any time. Lack of intimate confiding support also predicted more protracted episodes of depression and anxiety. Conclusion Increased levels of depression, anxiety, or both in the first year after a diagnosis of early breast cancer highlight the need for dedicated service provision during this time. Psychological interventions for women with breast cancer who remain disease free should take account of the broader social context in which the cancer occurs, with a focus on improving social support. PMID:15695497

Preparation and biological studies of 68Ga-DOTA-alendronate

Directory of Open Access Journals (Sweden)

Ashraf Fakhari

2016-07-01

Full Text Available Objective(s: In line with previous research on the development of conjugated bisphosphonate ligands as new bone-avid agents, in this study, DOTA conjugated alendronate (DOTA-ALN was synthesized and evaluated after labeling with gallium-68 (68Ga.Methods: DOTA-ALN was synthesized and characterized, followed by 68Ga-DOTA-ALN preparation, using DOTA-ALN and 68GaCl3 (pH: 4-5 at 92-95°C for 10 min. Stability tests, hydroxyapatite assay, partition coefficient calculation,biodistribution studies, and imaging were performed on the developed agent in normal rats.Results: The complex was prepared with high radiochemical purity (>99% as depicted by radio thin-layer chromatography; specific activity: 310-320GBq/mmol after solid phase purification and was stabilized for up to 90 min with a logP value of -2.91. Maximum ligand binding (65% was observed in the presence of 50 mg of hydroxyapatite; a major portion of the activity was excreted through the kidneys. With the exception of excretory organs, gastrointestinal tract organs, including the liver, intestine, and colon, showed significant uptake; however, the bone uptake was low (

Five years retrospective cohort analysis of treatment outcomes of TB ...

African Journals Online (AJOL)

Background: Human immunodeficiency virus (HIV) associated tuberculosis (TB) remains a major global public health challenge, with an estimated 1.4 million patients worldwide. Co-infection with HIV leads to challenges in the diagnosis and treatment of patients. Objectives: The aim of this study was to assess treatment ...

Risk Factors for Malnutrition Among Under-Five-Year olds in an ...

African Journals Online (AJOL)

Objectives: To identify risk factors associated with the development of malnutrition in the under-five-year olds in a homogeneous inner city community. Design: A community-based, case-control study. Materials and Methods: One hundred and thirty eight children (subjects and controls) aged less than five years living in the ...

Five-year mortality after acute poisoning treated in ambulances, an emergency outpatient clinic and hospitals in Oslo.

Science.gov (United States)

Lund, Cathrine; Bjornaas, Mari A; Sandvik, Leiv; Ekeberg, Oivind; Jacobsen, Dag; Hovda, Knut E

2013-08-21

The long-term mortality after prehospital treatment for acute poisoning has not been studied previously. Thus, we aimed to estimate the five-year mortality and examine the causes of death and predictors of death for all acutely poisoned patients treated in ambulances, the emergency outpatient clinic, and hospitals in Oslo during 2003-2004. A prospective cohort study included all adults (≥16 years; n=2045, median age=35 years, male=58%) who were discharged after treatment for acute poisoning in ambulances, the emergency outpatient clinic, and the four hospitals in Oslo during one year. The patients were observed until the end of 2008. Standardized mortality rates (SMRs) were calculated and multivariate Cox regression analysis was applied. The study comprised 2045 patients; 686 treated in ambulances, 646 treated in the outpatient clinic, and 713 treated in hospitals. After five years, 285 (14%) patients had died (four within one week). The SMRs after ambulance, outpatient, and hospital treatment were 12 (CI 9-14), 10 (CI 8-12), and 6 (CI 5-7), respectively. The overall SMR was 9 (CI 8-10), while the SMR after opioid poisoning was 27 (CI 21-32). The most frequent cause of death was accidents (38%). In the regression analysis, opioids as the main toxic agents (HR 2.3, CI 1.6-3.0), older age (HR 1.6, CI 1.5-1.7), and male sex (HR 1.4, CI 1.1-1.9) predicted death, whereas the treatment level did not predict death. The patients had high mortality compared with the general population. Those treated in hospital had the lowest mortality. Opioids were the major predictor of death.

Bon courage! (Five-Yearly Review)

CERN Multimedia

Association du personnel

2006-01-01

With these words of encouragement the Director General ended his long presentation to the staff on 12 January. And he is not wrong there…we certainly will need courage, not only to complete the LHC and other CERN projects, but also, unfortunately, to defend our employment conditions. Indeed, Mr. Aymar very (too) quickly presented us with his conclusions on the Five-Yearly Review, in a resolutely positive manner. In short, we can say that, beneath a deceptive exterior, a serious attack on our employment conditions is in preparation! Salary levels, careers, family…we are talking about your future! Last June, a huge majority of you approved the Staff Association's demands for this Review.

Five-year follow-up of low-level laser therapy (LLLT) in patients with age-related macular degeneration (AMD)

Science.gov (United States)

Koev, K.; Avramov, L.; Borissova, E.

2018-03-01

The objective of this study was to examine long-term effects of low-level laser therapy (LLLT) in patients with age-related macular degeneration (AMD). The research was implemented for a period of five years. For LLLT, a He-Ne Laser with continuous emission at 633 nm (0.1 mW/cm2) was used in patients with AMD of all stages (dry to wet exudative forms were included). In total, 33 patients (16 men and 17 women – 66 eyes) with AMD of various stages and a mean age of 68.7 ± 4.2 years were included in the study. Progressive, exudative AMD was diagnosed in 8 eyes. 58 eyes had drusen or were depigmented. Laser radiation was applied transpupillary to the macula for six times for three minutes once in two days; 22 patients with AMD (44 eyes) were randomly selected to receive mock treatment (control group 10 men and 12 women with a mean age of 69.3 ± 4.8 years). The visual acuity was followed for a five-year period. The perimetry and Amsler test were used to screen central scotomas. The fluorescein angiography of AMD and the control groups was examined. The visual acuity remained unchanged in all patients in the control group. There was a statistically significant increase in the visual acuity (p<0.001, end of study versus baseline) for AMD patients for the period of five years after the treatment. The edema and hemorrhage in the patients with progressive, exudative AMD significantly decreased. No side effects were observed during the therapy. The prevalence of metamorphopsia, scotoma in AMD group was reduced. In conclusion, this study shows that LLLT may be a novel long-lasting therapeutic option for both forms of AMD. It is a highly-effective treatment that results in a long-term improvement of the visual acuity.

Medical nutrition therapy as a potential complementary treatment for psoriasis--five case reports.

Science.gov (United States)

Brown, Amy C; Hairfield, Michelle; Richards, Douglas G; McMillin, David L; Mein, Eric A; Nelson, Carl D

2004-09-01

This research evaluated five case studies of patients with psoriasis following a dietary regimen. There is no cure for psoriasis and the multiple treatments currently available only attempt to reduce the severity of symptoms. Treatments range from topical applications, systemic therapies, and phototherapy; while some are effective, many are associated with significant adverse effects. There is a need for effective, affordable therapies with fewer side effects that address the causes of the disorder. Evaluation consisted of a study group of five patients diagnosed with chronic plaque psoriasis (two men and three women, average age 52 years; range 40-68 years) attending a 10-day, live-in program during which a physician assessed psoriasis symptoms and bowel permeability. Subjects were then instructed on continuing the therapy protocol at home for six months. The dietary protocol, based on Edgar Cayce readings, included a diet of fresh fruits and vegetables, small amounts of protein from fish and fowl, fiber supplements, olive oil, and avoidance of red meat, processed foods, and refined carbohydrates. Saffron tea and slippery elm bark water were consumed daily. The five psoriasis cases, ranging from mild to severe at the study onset, improved on all measured outcomes over a six-month period when measured by the Psoriasis Area and Severity Index (PASI) (average pre- and post-test scores were 18.2 and 8.7, respectively), the Psoriasis Severity Scale (PSS) (average pre- and post-test scores were 14.6 and 5.4, respectively), and the lactulose/mannitol test of intestinal permeability (average pre- and post-test scores were 0.066 to 0.026, respectively). These results suggest a dietary regimen based on Edgar Cayce's readings may be an effective medical nutrition therapy for the complementary treatment of psoriasis; however, further research is warranted to confirm these results.

Radiation curing - twenty five years on

International Nuclear Information System (INIS)

Garnett, J.L.

1995-01-01

Progress in UV/EB curing during the past twenty five years is briefly reviewed. During this time developments in unique polymer chemistry, novel equipment design and the introduction of relevant educational programmes has enabled radiation curing to become an established technology with specific strengths in certain industries. Possible reasons for the emergence of the technology in these niche markets are discussed. Despite the worldwide recession, radiation curing is shown to be expanding at 5% per annum with the prospect of higher growth with improving economic conditions. (Author)

Five-Yearly Review: TREF avoids the worst!

CERN Multimedia

Staff Association

2006-01-01

In our last edition, we informed you about the Staff Council decision to reject the entire set of proposals for the five-yearly review, on the basis of the Director-General's revised proposals 2 and 10. We also indicated that a total failure could still be avoided at TREF on 4 and 5 October. To our relief, TREF avoided the worst!

Osteonecrosis of the jaw after dental implant placement. A case report

Directory of Open Access Journals (Sweden)

J.L. Calvo-Guirado

2014-03-01

Full Text Available Background: In the past few years, the occurrence of an oral lesion, called osteonecrosis of the jaw, has increasingly been reported in patients undergoing treatment with systemic bisphosphonates (BPs; however, few papers dealing with oral biphosphonates related osteonecrosis of the jaws (BRONJ can be found in the literature. The purpose of the present case was to report an occurrence of BRONJ after implant insertion. Case report: Ten years ago, eight dental implants were inserted in the jaw of a 65-year-old female. After 5 years of treatment with alendronic acid, a breakdown of the oral mucosa covering the implants occurred with a purulent discharge in the left side of the jaw; periapical radiolucency was present around both distal implants. An en-block resection of the alveolar bone including the two implants was performed. Thirthy-five hyperbaric sessions were taken and no signs of recurrence of the lesion were observed after a follow-up of 20 months. Before the new implant insertion, the patient had suspended the treatment with alendronic acid for 6 months. At the interface of one of the implants, a gap was observed between bone and implant. This bone was non vital, and many osteocyte lacunae were empty. Moreover, this bone appeared to be partially demineralized. Conclusion: There is certainly a temporal association between oral BPs use and development of BRONJ, but a correlation does not necessarily mean causation. In patients undergoing oraltreatment, clinicians must be aware of the increased risk of implant failure.

Vitamin K to prevent fractures in older women: systematic review and economic evaluation.

Science.gov (United States)

Stevenson, M; Lloyd-Jones, M; Papaioannou, D

2009-09-01

To determine the clinical and cost-effectiveness of vitamin K in preventing osteoporotic fractures in postmenopausal women. Searches were conducted in May 2007 in MEDLINE, MEDLINE In-Process, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, BIOSIS, CINAHL, DARE, NHS EED and HTA databases, AMED, NRR, Science Citation Index and Current Controlled Trials. The MEDLINE search was updated in March 2009. Selected studies were assessed and subjected to data extraction and quality assessment using standard methods. Where appropriate, meta-analysis was carried out. A mathematical model was constructed to estimate the cost-effectiveness of vitamin K1. The electronic literature searches identified 1078 potentially relevant articles. Of these, 14 articles relating to five trials that compared vitamin K with a relevant comparator in postmenopausal women with osteoporosis or osteopenia met the review inclusion criteria. The double-blind ECKO trial compared 5 mg of phylloquinone (vitamin K1) with placebo in Canadian women with osteopenia but without osteoporosis. Four open-label trials used 45 mg of menatetrenone (vitamin K2) in Japanese women with osteoporosis; the comparators were no treatment, etidronate or calcium. The methodological quality of the ECKO trial was good; however, all four menatetrenone trials were poorly reported and three were very small (n vitamin K were found and a mathematical model was thus constructed to estimate the cost-effectiveness of vitamin K1. Comparators were alendronate, risedronate and strontium ranelate. Vitamin K1 and alendronate were markedly more cost-effective than either risedronate or strontium ranelate. The base-case results favoured vitamin K1, but this relied on many assumptions, particularly on the efficacy of preventing hip and vertebral fractures. Calculation of the expected value of sampled information was conducted assuming a randomised controlled trial of 5 years' duration comparing alendronate

Five-Year NRHP Re-Evaluation of Historic Buildings Assessment

Energy Technology Data Exchange (ETDEWEB)

Ullrich, R A; Heidecker, K R

2011-09-12

The Lawrence Livermore National Laboratory (LLNL) 'Draft Programmatic Agreement among the Department of Energy and the California State Historic Preservation Officer Regarding Operation of Lawrence Livermore National Laboratory' requires a review and re-evaluation of the eligibility of laboratory properties for the National Register of Historic Places (NRHP) every five years. The original evaluation was published in 2005; this report serves as the first five-year re-evaluation. This re-evaluation includes consideration of changes within LLNL to management, to mission, and to the built environment. it also determines the status of those buildings, objects, and districts that were recommended as NRHP-eligible in the 2005 report. Buildings that were omitted from the earlier building list, those that have reached 50 years of age since the original assessment, and new buildings are also addressed in the re-evaluation.

Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer

International Nuclear Information System (INIS)

Fisher, B.; Bauer, M.; Margolese, R.

1985-01-01

In 1976 the authors began a randomized trial to evaluate breast conservation by a segmental mastectomy in the treatment of State I and II breast tumors less than or equal to 4 cm in size. The operation removes only sufficient tissue to ensure that margins of resected specimens are free of tumor. Women were randomly assigned to total mastectomy, segmental mastectomy alone, or segmental mastectomy followed by breast irradiation. All patients had auxillary dissections, and patients with positive nodes received chemotherapy. Life-tables estimates based on data from 1843 women indicated that treatment by segmental mastectomy, with or without breast irradiation, resulted in disease-free, distant-disease-free, and overall survival at five years that was no worse than that after total breast removal. In fact, disease-free survival after segmental mastectomy plus radiation was better than disease-free survival after total mastectomy, and overall survival after segmental mastectomy, with or without radiation, was better than overall survival after total mastectomy. A total of 92.3% of women treated with radiation remained free of breast tumor at five years, as compared with 72.1% of those receiving no radiation. Among patients with positive nodes 97.9% of women treated with radiation and 63.8% of those receiving no radiation remained tumor-free, although both groups received chemotherapy. They conclude that segmental mastectomy, followed by breast irradiation in all patients and adjuvant chemotherapy in women with positive nodes, is appropriate therapy for Stage I and II breast tumors less than or equal to 4 cm, provided that margins of resected specimens are free of tumor. 23 references, 4 figures, 6 tables

Guttate Psoriasis Following Streptococcal Vulvovaginitis in a Five-year-old Girl.

Science.gov (United States)

Hernandez, Melia; Simms-Cendan, Judith; Zendell, Kathleen

2015-10-01

Guttate psoriasis is frequently associated with a preceding pharyngeal or perianal streptococcal infection in children. Despite Group A beta-hemolytic streptococci (GABHS) being the most common cause of specific bacterial vulvovaginitis in prepubertal girls, there are no reports of streptococcal vulvovaginitis triggering guttate psoriasis. A five-year-old girl presented with guttate psoriasis following an episode of Streptococcal pyogenes vulvovaginitis. Following antibiotic treatment and bacterial eradication she developed vulvar psoriasis that resolved with high potency topical steroids. Identification of an antecedent streptoccocal infection can help predict the long term prognosis in children with guttate psoriasis. The vulvovaginal area should be considered as a source of GABHS infection in young girls with guttate psoriasis, and cultures should be considered if symptoms are present. Published by Elsevier Inc.

Collaboration on DIII-D Five Year Plan

International Nuclear Information System (INIS)

Allen, S

2003-01-01

with a single channel, the system has grown to 40 channels with three separate systems. We have continually developed new calibration techniques, with a goal of accuracy in the magnetic field pitch angle measurements of ∼0.1 degree. Measurements of the radial electric field E r have also been achieved. In the next five year period, GA plans on rotating one of the neutral beams so that it injects opposite to the sense of the plasma current (counter-injection). This enables two orthogonal MSE views of the neutral beam so that J(r) and E r can be obtained directly. In addition, the new views can be optimized so that increased spatial resolution will be obtained. Our plan is to install these new systems when the neutral beam is reoriented, and continue to provide high-resolution, ''state of the art'' current profile measurements for the DIII-D AT program. In the divertor physics area, our goal is the development of a model of the scrapeoff layer (SOL) and divertor plasmas which is benchmarked with data. We have identified the need for measurements of SOL flow and ion temperature. Working with GA, we are proposing a new edge Charge Exchange Recombination (CER) diagnostic. The understanding of SOL flow is important for understanding the tritium inventory problem in ITER. In addition, using plasma flow to ''entrain'' impurities in the divertor region (enabling a low density radiative divertor) is the current AT divertor heat flux control scenario. We are also augmenting our edge modeling capabilities with a coupled UEDGE (fluid code) with the BOUT (edge turbulence) code. Further work, funded through LLNL theory, is planned to develop a kinetic treatment of the edge. All of these efforts contribute to the understanding of the edge pedestal in the tokamak, an important AT and ITER topic. A secondary goal is the understanding of Edge Localized Modes (ELMs), which are also important in the ITER design, as the repetitive bursts of heat flux can cause increased erosion and damage

75 FR 75453 - Proposed Information Collection; Comment Request; Five-Year Records Retention Requirement for...

Science.gov (United States)

2010-12-03

... Request; Five-Year Records Retention Requirement for Export Transactions and Boycott Actions AGENCY... parties involved in export transactions and the U.S. party involved in a boycott action are required to... boycott documents and reports. The five-year record retention period corresponds with the five-year...

Five year survival analysis of an oxidised zirconium total knee arthroplasty.

Science.gov (United States)

Holland, Philip; Santini, Alasdair J A; Davidson, John S; Pope, Jill A

2013-12-01

Zirconium total knee arthroplasties theoretically have a low incidence of failure as they are low friction, hard wearing and hypoallergenic. We report the five year survival of 213 Profix zirconium total knee arthroplasties with a conforming all polyethylene tibial component. Data was collected prospectively and multiple strict end points were used. SF12 and WOMAC scores were recorded pre-operatively, at three months, at twelve months, at 3 years and at 5 years. Eight patients died and six were "lost to follow-up". The remaining 199 knees were followed up for five years. The mean WOMAC score improved from 56 to 35 and the mean SF12 physical component score improved from 28 to 34. The five year survival for failure due to implant related reasons was 99.5% (95% CI 97.4-100). This was due to one tibial component becoming loose aseptically in year zero. Our results demonstrate that the Profix zirconium total knee arthroplasty has a low medium term failure rate comparable to the best implants. Further research is needed to establish if the beneficial properties of zirconium improve long term implant survival. Copyright © 2012 Elsevier B.V. All rights reserved.

Abandoning presumptive antimalarial treatment for febrile children aged less than five years--a case of running before we can walk?

Directory of Open Access Journals (Sweden)

Mike English

2009-01-01

Full Text Available Current guidelines recommend that all fever episodes in African children be treated presumptively with antimalarial drugs. But declining malarial transmission in parts of sub-Saharan Africa, declining proportions of fevers due to malaria, and the availability of rapid diagnostic tests mean it may be time for this policy to change. This debate examines whether enough evidence exists to support abandoning presumptive treatment and whether African health systems have the capacity to support a shift toward laboratory-confirmed rather than presumptive diagnosis and treatment of malaria in children under five.

Civil partnerships five years on.

Science.gov (United States)

Ross, Helen; Gask, Karen; Berrington, Ann

2011-01-01

The Civil Partnership Act 2004, which came into force in December 2005 allowing same-sex couples in the UK to register their relationship for the first time, celebrated its fifth anniversary in December 2010. This article examines civil partnership in England and Wales, five years on from its introduction. The characteristics of those forming civil partnerships between 2005 and 2010 including age, sex and previous marital/civil partnership status are examined. These are then compared with the characteristics of those marrying over the same period. Further comparisons are also made between civil partnership dissolutions and divorce. The article presents estimates of the number of people currently in civil partnerships and children of civil partners. Finally the article examines attitudes towards same-sex and civil partner couples both in the UK and in other countries across Europe.

Parotid tumor statistics for the past five years

International Nuclear Information System (INIS)

Yamaguchi, Soichi; Sueno, Kohei; Yamaguchi, Takeshi; Asano, Yukimi; Shiba, Kazutaka; Sekiguchi, Nao; Masuda, Takeshi

2004-01-01

We reviewed the case of 40 patients with parotid tumor who underwent an operation in the past five years. The patients included 23 (57.5%) males and 17 (42.5%) females. The average age was 53.4 years old with a range of 19 to 71 years. Thirty eight (95.0%) had benign tumor, and 2 (5.0%) had malignant tumor. Tc scintigraphy was performed in 37 out of the 40 patients, and 9 patients showed positive results. Six patients had warthin's tumor, and 3 had pleomorphic adenoma. In other words, 66.7% were positive for warthin's tumor. Ga scintigraphy was performed in 31 out of the 40 patients. Nine were positive out of the 10 benign tumor that showed a positive result. None of the cases had permanent facial palsy as a postoperative complication. Transient facial palsy was exhibited by 13 patients (32.5%), but they all improved 2 weeks to 6 months. In addition, we experienced 1 case of salivary fistula. Pleomorphic adenoma was noted in 63.2%, and warthin's tumor in 23.7%. There was no gender difference for pleomorphic adenoma, but 8 out of the 9 patients with warthin's tumor were men. The average age was 47.0 for pleomorphic adenoma and 58.7 for warthin's tumor which was in accordance with conventional reports. The Tc scintigraphy positive rate of warthin's tumor was low, 66.7%, in comparison with that in conventional reports. In addition, 90% of the tumors that showed positive results in Ga scintigraphy were preoperatively positive tumors, indicating the diagnostic usefulness of this. Transient facial palsy was a complication in 32.5% of the patients, which was similar to the rate in the conventional report. We experienced 1 case salivary fistula, which did not improve with conservative treatment. We opened the wounded area, and drained it by pressing. (author)

Idaho supplementation studies : five year report : 1992-1996

International Nuclear Information System (INIS)

Walters, Jody P.; Idaho. Dept. of Fish and Game; United States. Bonneville Power Administration. Division of Fish and Wildlife.

1999-01-01

In 1991, the Idaho Supplementation Studies (ISS) project was implemented to address critical uncertainties associated with hatchery supplementation of chinook salmon Oncorhynchus tshawytscha populations in Idaho. The project was designed to address questions identified in the Supplementation Technical Work Group (STWG) Five-Year-Workplan (STWG 1988). Two goals of the project were identified: (1) assess the use of hatchery chinook salmon to increase natural populations in the Salmon and Clearwater river drainages, and (2) evaluate the genetic and ecological impacts of hatchery chinook salmon on naturally reproducing chinook salmon populations. Four objectives to achieve these goals were developed: (1) monitor and evaluate the effects of supplementation on presmolt and smolt numbers and spawning escapements of naturally produced fish; (2) monitor and evaluate changes in natural productivity and genetic composition of target and adjacent populations following supplementation; (3) determine which supplementation strategies (broodstock and release stage) provide the quickest and highest response in natural production without adverse effects on productivity; and (4) develop supplementation recommendations. This document reports on the first five years of the long-term portion of the ISS project. Small-scale studies addressing specific hypotheses of the mechanisms of supplementation effects (e.g., competition, dispersal, and behavior) have been completed. Baseline genetic data have also been collected. Because supplementation broodstock development was to occur during the first five years, little evaluation of supplementation is currently possible. Most supplementation adults did not start to return to study streams until 1997. The objectives of this report are to: (1) present baseline data on production and productivity indicators such as adult escapement, redd counts, parr densities, juvenile emigrant estimates, and juvenile survival to Lower Granite Dam (lower Snake

Twenty-Five Years of Gene Therapy for ADA-SCID: From Bubble Babies to an Approved Drug.

Science.gov (United States)

Ferrua, Francesca; Aiuti, Alessandro

2017-11-01

Twenty-five years have passed since first attempts of gene therapy (GT) in children affected by severe combined immunodeficiency (SCID) due to adenosine deaminase (ADA) defect, also known by the general public as bubble babies. ADA-SCID is fatal early in life if untreated. Unconditioned hematopoietic stem cell (HSC) transplant from matched sibling donor represents a curative treatment but is available for few patients. Enzyme replacement therapy can be life-saving, but its chronic use has many drawbacks. This review summarizes the history of ADA-SCID GT over the last 25 years, starting from first pioneering studies in the early 1990s using gamma-retroviral vectors, based on multiple infusions of genetically corrected autologous peripheral blood lymphocytes. HSC represented the ideal target for gene correction to guarantee production of engineered multi-lineage progeny, but it required a decade to achieve therapeutic benefit with this approach. Introduction of low-intensity conditioning represented a crucial step in achieving stable gene-corrected HSC engraftment and therapeutic levels of ADA-expressing cells. Recent clinical trials demonstrated that gamma-retroviral GT for ADA-SCID has a favorable safety profile and is effective in restoring normal purine metabolism and immune functions in patients >13 years after treatment. No abnormal clonal proliferation or leukemia development have been observed in >40 patients treated experimentally in five different centers worldwide. In 2016, the medicinal product Strimvelis™ received marketing approval in Europe for patients affected by ADA-SCID without a suitable human leukocyte antigen-matched related donor. Positive safety and efficacy results have been obtained in GT clinical trials using lentiviral vectors encoding ADA. The results obtained in last 25 years in ADA-SCID GT development fundamentally contributed to improve patients' prognosis, together with earlier diagnosis thanks to newborn screening. These advances

Five analogies between a King's Speech treatment and contemporary play therapies.

Science.gov (United States)

Terr, Lenore C

2012-01-01

Psychiatric patients frequently respond positively to play therapy, which may rely on psychoanalytic, Jungian, cognitive-behavioral, familial, school-based, or other theories. I wished to determine if there were unifying principles that tie together these various types of play treatments. The fact-based film, The King's Speech, vividly illustrates play utilized by Lionel Logue in his speech treatment (1926-1939) of the future King of England. In the film I found five analogies to the play therapy I employ in office practice. The play scenes in The King's Speech point to five unifying principles among contemporary play therapies: (1) the crucial nature of the relationship, (2) the centrality of having fun, (3) the occasional reliance on others, (4) the interjection of pithy talk, and (5) the usefulness of a little drama. No matter what theory a play therapist ascribes to, these five unifying principles should be kept in mind during treatment.

Retrospective Evaluation of the Five-Year and Ten-Year CSEP-Italy Earthquake Forecasts

OpenAIRE

Werner, M. J.; Zechar, J. D.; Marzocchi, W.; Wiemer, S.

2010-01-01

On 1 August 2009, the global Collaboratory for the Study of Earthquake Predictability (CSEP) launched a prospective and comparative earthquake predictability experiment in Italy. The goal of the CSEP-Italy experiment is to test earthquake occurrence hypotheses that have been formalized as probabilistic earthquake forecasts over temporal scales that range from days to years. In the first round of forecast submissions, members of the CSEP-Italy Working Group presented eighteen five-year and ten...

BAYESIAN ANALYSIS OF WHITE NOISE LEVELS IN THE FIVE-YEAR WMAP DATA

International Nuclear Information System (INIS)

Groeneboom, N. E.; Eriksen, H. K.; Gorski, K.; Huey, G.; Jewell, J.; Wandelt, B.

2009-01-01

We develop a new Bayesian method for estimating white noise levels in CMB sky maps, and apply this algorithm to the five-year Wilkinson Microwave Anisotropy Probe (WMAP) data. We assume that the amplitude of the noise rms is scaled by a constant value, α, relative to a pre-specified noise level. We then derive the corresponding conditional density, P(α | s, C l , d), which is subsequently integrated into a general CMB Gibbs sampler. We first verify our code by analyzing simulated data sets, and then apply the framework to the WMAP data. For the foreground-reduced five-year WMAP sky maps and the nominal noise levels initially provided in the five-year data release, we find that the posterior means typically range between α = 1.005 ± 0.001 and α = 1.010 ± 0.001 depending on differencing assembly, indicating that the noise level of these maps are biased low by 0.5%-1.0%. The same problem is not observed for the uncorrected WMAP sky maps. After the preprint version of this letter appeared on astro-ph., the WMAP team has corrected the values presented on their web page, noting that the initially provided values were in fact estimates from the three-year data release, not from the five-year estimates. However, internally in their five-year analysis the correct noise values were used, and no cosmological results are therefore compromised by this error. Thus, our method has already been demonstrated in practice to be both useful and accurate.

Twenty-five years of simulator training

International Nuclear Information System (INIS)

Anon.

2002-01-01

The first training simulator for nuclear power plant personnel in Germany was commissioned twenty-five years ago. The strategy of training by simulators was developed and pursued consistently and continuously in order to ensure sound training of nuclear power plant personnel. The present thirteen simulators cover a broad range of plants. A systematic training concept also helps to ensure a high level of competence and permanent qualification of plant personnel. The anniversary was marked by a festive event at which Erich K. Steiner read a paper on 'The Importance of Simulator Training', and Professor Dr. Adolf Birkhofer spoke about 'Nuclear Technology Education and Training'. (orig.)

Louisiana Airport System Plan Five-Year Capital Improvement Program.

Science.gov (United States)

1992-07-01

The Louisiana Airport System Plan (LASP) Five-Year-Capital Improvement Program (CIP) is a development plan for all commercial service, reliever, and general aviation airports in Louisiana. It is a detailed listing of potential projects based on the a...

General RMP Guidance - Chapter 3: Five-Year Accident History

Science.gov (United States)

This involves the reporting of significant accidental releases of one or more of the regulated toxic or flammable substances from a covered process in the five years prior to the submission of an initial or updated Risk Management Plan.

Prevalence of rotavirus among children under five years of age with ...

African Journals Online (AJOL)

2016-08-16

Aug 16, 2016 ... acute diarrhea in children under five years in Kaduna State, Nige- ria. Hence the need to introduce the vaccines into the childhood immunization program in the country. Keywords: Prevalence, Rotavirus,. Children, Kaduna State, Nigeria. Introduction. Diarrheal disease kills 1.8 million children under five.

One-year outcomes of a randomized controlled trial of housing first with ACT in five Canadian cities.

Science.gov (United States)

Aubry, Tim; Tsemberis, Sam; Adair, Carol E; Veldhuizen, Scott; Streiner, David; Latimer, Eric; Sareen, Jitender; Patterson, Michelle; McGarvey, Kathleen; Kopp, Brianna; Hume, Catharine; Goering, Paula

2015-05-01

Housing First is a groundbreaking approach to ending chronic homelessness among people with mental illness. This article presents one-year findings from a multisite randomized controlled trial (RCT) comparing Housing First with treatment as usual. The study was a nonblind, parallel-group RCT conducted in five Canadian cities. A sample of 950 high-need participants with severe mental illness, who were either absolutely homeless or precariously housed, was randomly assigned to Housing First (N=469) or treatment as usual (N=481). Housing First participants received a rent supplement, assistance to find housing, and assertive community treatment. Treatment-as-usual participants had access to all other existing programs. At one-year follow-up, 73% of Housing First participants and 31% of treatment-as-usual participants resided in stable housing (plife was significantly greater among Housing First participants compared with treatment-as-usual participants (pHousing First participants also showed greater improvements in community functioning compared with treatment-as-usual participants (p=.003, d=.25, CI=.09-.41). Compared with treatment as usual, Housing First produced greater improvements in housing stability, quality of life, and community functioning after one year of enrollment. The study provides support for adopting Housing First as an approach for ending chronic homelessness among persons with severe mental illness, even if they are actively symptomatic or using substances.

A model-based cost-effectiveness analysis of osteoporosis screening and treatment strategy for postmenopausal Japanese women.

Science.gov (United States)

Yoshimura, M; Moriwaki, K; Noto, S; Takiguchi, T

2017-02-01

Although an osteoporosis screening program has been implemented as a health promotion project in Japan, its cost-effectiveness has yet to be elucidated fully. We performed a cost-effectiveness analysis and found that osteoporosis screening and treatment would be cost-effective for Japanese women over 60 years. The purpose of this study was to estimate the cost-effectiveness of osteoporosis screening and drug therapy in the Japanese healthcare system for postmenopausal women with no history of fracture. A patient-level state transition model was developed to predict the outcomes of Japanese women with no previous fracture. Lifetime costs and quality-adjusted life years (QALYs) were estimated for women who receive osteoporosis screening and alendronate therapy for 5 years and those who do not receive the screening and treatments. The incremental cost-effectiveness ratio (ICER) of the screening option compared with the no screening option was estimated. Sensitivity analyses were performed to examine the influence of parameter uncertainty on the base case results. The ICERs of osteoporosis screening and treatments for Japanese women aged 50-54, 55-59, 60-64, 65-69, 70-74, and 75-79 years were estimated to be $89,242, $64,010, $40,596, $27,697, $17,027, and $9771 per QALY gained, respectively. Deterministic sensitivity analyses showed that several parameters such as the disutility due to vertebral fracture had a significant influence on the base case results. Applying a willingness to pay of $50,000 per QALY gained, the probability that the screening option became cost-effectiveness estimated to 50.9, 56.3, 59.1, and 64.7 % for women aged 60-64, 65-69, 70-74, and 75-79 years, respectively. Scenario analyses showed that the ICER for women aged 55-59 years with at least one clinical risk factor was below $50,000 per QALY. In conclusion, dual energy X-ray absorptiometry (DXA) screening and alendronate therapy for osteoporosis would be cost-effective for

Environmental restoration and waste management five-year plan, Fiscal years 1994--1998

International Nuclear Information System (INIS)

1993-01-01

The US Department of Energy (DOE) understands that cleaning up the Nation's nuclear-related sites and facilities affects many different segments of the public, ranging from communities near DOE facilities to engineers concerned with developing new technologies to clean up the environment. In an effort to make the Environmental Restoration and Waste Management Five-Year Plan for Fiscal Years (FY) 1994--1998 more responsive to your concerns, DOE invites your comments on the plan. Volume II contains 37 Installation Summaries that provide a synopsis of past, present and future activities of each major installation, and Progress Charts

Preparation and Biological Study of (68)Ga-DOTA-alendronate.

Science.gov (United States)

Fakhari, Ashraf; Jalilian, Amir R; Johari-Daha, Fariba; Shafiee-Ardestani, Mehdi; Khalaj, Ali

2016-01-01

In line with previous research on the development of conjugated bisphosphonate ligands as new bone-avid agents, in this study, DOTA-conjugated alendronate (DOTA-ALN) was synthesized and evaluated after labeling with gallium-68 ((68)Ga). DOTA-ALN was synthesized and characterized, followed by (68)Ga-DOTA-ALN preparation, using DOTA-ALN and (68)GaCl3 (pH: 4-5) at 92-95° C for 10 min. Stability tests, hydroxyapatite assay, partition coefficient calculation, biodistribution studies, and imaging were performed on the developed agent in normal rats. The complex was prepared with high radiochemical purity (>99% as depicted by radio thin-layer chromatography; specific activity: 310-320 GBq/mmol) after solid phase purification and was stabilized for up to 90 min with a log P value of -2.91. Maximum ligand binding (65%) was observed in the presence of 50 mg of hydroxyapatite; a major portion of the activity was excreted through the kidneys. With the exception of excretory organs, gastrointestinal tract organs, including the liver, intestine, and colon, showed significant uptake; however, the bone uptake was low (<1%) at 30 min after the injection. The data were also confirmed by sequential imaging at 30-90 min following the intravenous injection. The high solubility and anionic properties of the complex led to major renal excretion and low hydroxyapatite uptake; therefore, the complex failed to demonstrate bone imaging behaviors.

Effect of therapy on five- and ten-year survival of malignant melanoma patients

International Nuclear Information System (INIS)

Siffnerova; Bustova; Zikmund

1989-01-01

The results are reported of five-year and ten-year survival of malignant melanoma patients treated postoperatively by actinotherapy. In patients where lymph flow was not apparent, 2.5 Gy of daily doses of electron irradiation from a 6-8 MeV betatron were used centred on the scar. The total dose was 60 Gy. Where the lymph flow could be identified, cobalt or cesium sources were used to deliver a total dose of 50 Gy in 2.5 Gy daily. Both five-year and ten-year survival was significantly better than in patients treated with surgery only, without irradiation. 55% of the patients on combined management survived for more than 5 years, 86% of them without relapses. 41% patients survived for 10 years, of which 92% without relapse. In contrast, the corresponding figures for the patients treated with surgery only were 42% and 71% respectively for the five-year survival, and 26% and 70% respectively for the ten-year survival. (L.O.). 3 figs., 2 tabs

Therapeutic apheresis in the Republic of Macedonia - our five years experience (2000-2004).

Science.gov (United States)

Milovanceva-Popovska, M; Stojkovski, Lj; Grcevska, L; Dzikova, S; Ristovska, V; Gogovska, L; Polenakovic, M

2006-07-01

Membrane plasma exchange (PE) is a mode of extracorporeal blood purification. Since 1985 membrane PE has been in regular use at the Department of Nephrology, Medical Faculty of Skopje, R.Macedonia. In this paper we report on five years (2000-2004) of single centre plasma exchange activity. We performed 540 PE treatments (108 PE/per year) on 99 patients. The M/F ratio was 40/48. The patients underwent a median of 5.45 procedures (range, 1-16). The treated patients were from different Departments. Protocols for PE depend on the disease and its severity. PE were performed 2-4 times weekly using Gambro PF 2000 N filters with an adaptation of the Gambro AK10 dialysis machine or with the Gambro Prizma machine (2 cases). Blood access was achieved through femoral vein. Substitution was made with fresh frozen plasma and/or with 20% human albumin combined with Ringer's solution. An average amount of 2150 ml plasmafiltrate per treatment (respectively 30 to 40 ml plasmafiltrate/kg body weight) was eliminated. Most therapeutic procedures were performed on patients from the Department of Neurology. 63.6% of all patients were referred for Myasthenia gravis and the Guillian Barre syndrome. The total number of procedures per year has remained fairly stable, corresponding to a median of 5.4 treatments/100 000 inhabitants. We observed hypocalcaemia in 8% of the patients, urticarial reactions in 7.3%, pruritic reactions in 12%, and hypotension/headache in 6.8%. No major procedural complications were seen.

Sociohydrology: Where are we five years later?

Science.gov (United States)

Guneralp, I.; Weyand, S.; Guneralp, B.

2017-12-01

Studies exploring the nature of human-water systems and methodologies aiming to integrate social and biophysical cycles have existed long before the term `sociohydrology' was officially introduced in a 2012 article. Despite criticisms since this first publication, the term has promoted research towards a wholistic understanding of the dynamics of coupled human-water systems. The declaration of the 2013-2022 Scientific Decade as Panta Rhei - Everything Flows recognized the importance of interactions and feedbacks between hydrological and social systems: a call to broaden the horizons of sociohydrology. Five years have passed since the field began, and there is a need to analyze the growing body of literature and determine which steps to take next. This study will perform a meta-analysis of the literature pertaining to the field of sociohydrology from its coinage in 2012 until the present year. Our goal is to identify developing trends in the application of the sociohydrologic framework, study foci, criticisms, and the authors behind them. We have obtained 65 publications relating to `sociohydrology' or `socio-hydrology' and 34 additional publications identified solely by the "KeyWords PLUS" function on Web of Science. In addition to independent analyses, we will compare the two datasets for similarities and significant differences. Our interests include the areas of application - both geographically and in subject matter - and authorship diversity among others. These results will supplement the conversation on sociohydrology by discerning how the field has evolved over the past five years. The results will identify shortcomings in the scope of the current literature, potential prevailing biases, and criticisms of the field, in addition to unifying thought and novel application. It will finish by offering a direction for the research community to continue developing.

Effect of alendronate on post-traumatic osteoarthritis induced by anterior cruciate ligament rupture in mice.

Science.gov (United States)

Khorasani, Mohammad S; Diko, Sindi; Hsia, Allison W; Anderson, Matthew J; Genetos, Damian C; Haudenschild, Dominik R; Christiansen, Blaine A

2015-02-16

Previous studies in animal models of osteoarthritis suggest that alendronate (ALN) has antiresorptive and chondroprotective effects, and can reduce osteophyte formation. However, these studies used non-physiologic injury methods, and did not investigate early time points during which bone is rapidly remodeled prior to cartilage degeneration. The current study utilized a non-invasive model of knee injury in mice to investigate the effect of ALN treatment on subchondral bone changes, articular cartilage degeneration, and osteophyte formation following injury. Non-invasive knee injury via tibial compression overload or sham injury was performed on a total of 90 mice. Mice were treated with twice weekly subcutaneous injections of low-dose ALN (40 μg/kg/dose), high-dose ALN (1,000 μg/kg/dose), or vehicle, starting immediately after injury until sacrifice at 7, 14 or 56 days. Trabecular bone of the femoral epiphysis, subchondral cortical bone, and osteophyte volume were quantified using micro-computed tomography (μCT). Whole-joint histology was performed at all time points to analyze articular cartilage and joint degeneration. Blood was collected at sacrifice, and serum was analyzed for biomarkers of bone formation and resorption. μCT analysis revealed significant loss of trabecular bone from the femoral epiphysis 7 and 14 days post-injury, which was effectively prevented by high-dose ALN treatment. High-dose ALN treatment was also able to reduce subchondral bone thickening 56 days post-injury, and was able to partially preserve articular cartilage 14 days post-injury. However, ALN treatment was not able to reduce osteophyte formation at 56 days post-injury, nor was it able to prevent articular cartilage and joint degeneration at this time point. Analysis of serum biomarkers revealed an increase in bone resorption at 7 and 14 days post-injury, with no change in bone formation at any time points. High-dose ALN treatment was able to prevent early trabecular

The 2015 Five-yearly review: diversity in the spotlight

CERN Multimedia

Staff Association

2014-01-01

Introduction As mentioned in Echo 201, with the Council Decision of last June the CERN 2015 five-yearly review has formally begun. Following the procedure defined in Annex A1 of the Staff Rules and Regulations CERN will thus review its financial and social conditions that should enable it to recruit from all its Member States, and retain, staff of the highest competence and integrity necessary to perform its mission. In addition, these conditions should increase the attractiveness of CERN in all Member States and motivate staff of all ages and all occupations throughout their careers. Annex A1 stipulates that a five-yearly review must include basic salaries (stipends for Fellows and subsistence allowances for associated members of the personnel) and, optionally, may include any other financial or social conditions. For this optional part of the 2015 exercise, the CERN career structure and measures to improve diversity were chosen. Towards a better diversity policy The analysis of the 2013 Staff Associat...

Effect of different frequencies of preventive maintenance treatment on dental caries: five-year observations in general dentistry patients.

Science.gov (United States)

Rosén, Birgitta; Olavi, Göran; Birkhed, Dowen; Edvardsson, Stig; Egelberg, Jan

2004-10-01

A long-term study in adults at a public dental clinic in Sweden was initiated to evaluate the relative effectiveness of prophylactic treatments on the progression of dental caries and periodontal discase. With treatments scheduled every 3rd, 6th, 12th or 18th month, this report presents results on caries for the 3-month, 6-month and 18-month groups, and evaluates the impact of various caries-related risk factors. Caries increment over approximately 5 years was determined by adding clinical and radiographic findings of manifest primary and secondary caries during the study. Overall caries activity among all 105 participating individuals was low to moderate. No significant differences for caries on any of the various tooth surfaces or for total caries were observed among the three groups. Multiple regression analysis with 5-year caries increment as dependent variable showed that the following factors had a statistically significant association with caries increment: percentage filled surfaces at baseline examination, dietary score, plaque score, and number of mutans streptococci and lactobacilli in saliva. Non-significant factors included number of preventive treatments provided during the 5-year interval. The results of this long-term trial suggest that preventive treatments as often as every 3 6 months may not be justified in the case of patients with low to moderate caries activity.

Five years retrospective cohort analysis of treatment outcomes of TB ...

African Journals Online (AJOL)

Background: Human immunodeficiency virus (HIV) associated tuberculosis (TB) remains a major global public health chal- lenge, with an estimated 1.4 .... completed treatment and who is smear negative at the end of 6th or 7th month of treat- ..... the course of management of the dual disease entity. Conclusion. This study ...

Predictive value of developmental testing in the second year for cognitive development at five years of age

Directory of Open Access Journals (Sweden)

Alastair G Sutcliffe

2010-09-01

Full Text Available There is mixed evidence about the predictive validity of the Griffiths mental developmental scales. This study aimed to assess the predictive value of developmental assessments of children in their second year using the Griffiths mental development scales for neuro-developmental status at five years using the Wechsler preschool and primary scale of intelligence, revised (WPPSI-R. In a longitudinal study 253 children were assessed in their second year of life using the Griffiths scales and again at five years using the WPPSI-R. The scores were compared and the predictability of the WPPSI-R outcome on the basis of Griffiths scores was assessed. The WPPSI-R full scale IQ and the performance IQ at age five could be predicted moderately by the Griffiths general quotient (GQ and by the personal/social scale. The Griffiths GQ was not a significant predictor of verbal IQ at age 5. The Griffiths performance scale predicted subsequent WPPSI-R performance IQ, and marginally the Full Scale IQ. For the early identification of children at risk for language delay, the Griffiths scales may not be suitable. However, a shortened form would be useful to predict overall cognitive development from the second year to school entry, focussing on the personal-social and performance scales.

Prevalence of rotavirus diarrhoea among children under five years ...

African Journals Online (AJOL)

Rotavirus (RV) is a major etiological agent of acute infantile gastroenteritis and is associated with 20%-25% of diarrhoea cases in infants. Nigeria continues to be among the first five countries with greatest number of RV disease associated deaths per year. From September 2013-August 2014, 467 stool samples were ...

Goiania radiological accident: five years talking with the population

International Nuclear Information System (INIS)

Rozental, J.J.

1993-01-01

This article presents an overview five years after the Goiania radiological accident. It reviews from a number of important aspects the psychological impact and conflicting opinions, the public hearings and debates and, particularly describes the victims that still have difficulties to understand the accident and its consequences. (B.C.A.). 05 refs

Geospatial Health: the first five years

Directory of Open Access Journals (Sweden)

Jürg Utzinger

2011-11-01

Full Text Available Geospatial Health is an international, peer-reviewed scientific journal produced by the Global Network for Geospatial Health (GnosisGIS. This network was founded in 2000 and the inaugural issue of its official journal was published in November 2006 with the aim to cover all aspects of geographical information system (GIS applications, remote sensing and other spatial analytic tools focusing on human and veterinary health. The University of Naples Federico II is the publisher, producing two issues per year, both as hard copy and an open-access online version. The journal is referenced in major databases, including CABI, ISI Web of Knowledge and PubMed. In 2008, it was assigned its first impact factor (1.47, which has now reached 1.71. Geospatial Health is managed by an editor-in-chief and two associate editors, supported by five regional editors and a 23-member strong editorial board. This overview takes stock of the first five years of publishing: 133 contributions have been published so far, primarily original research (79.7%, followed by reviews (7.5%, announcements (6.0%, editorials and meeting reports (3.0% each and a preface in the first issue. A content analysis of all the original research articles and reviews reveals that three quarters of the publications focus on human health with the remainder dealing with veterinary health. Two thirds of the papers come from Africa, Asia and Europe with similar numbers of contributions from each continent. Studies of more than 35 different diseases, injuries and risk factors have been presented. Malaria and schistosomiasis were identified as the two most important diseases (11.2% each. Almost half the contributions were based on GIS, one third on spatial analysis, often using advanced Bayesian geostatistics (13.8%, and one quarter on remote sensing. The 120 original research articles, reviews and editorials were produced by 505 authors based at institutions and universities in 52 countries

Five-yearly Review: What now? Is this the end?

CERN Multimedia

Association du personnel

2006-01-01

The CERN Staff Association has made every effort over the past months to devise and propose numerous solutions in the framework of the current five-yearly review. The Staff Association has done this in close collaboration with the staff members, through several polls which have all resulted in a massive rejection of the Management's position.

47 CFR 22.947 - Five year build-out period.

Science.gov (United States)

2010-10-01

... authorized in the Gulf of Mexico Exclusive Zone, the licensee of the first cellular system authorized on each channel block in each cellular market is afforded a five year period, beginning on the date the initial authorization for the system is granted, during which it may expand the system within that market. (a) Exclusive...

Three-year follow-up of 3-year-old to 5-year-old children after participation in a multidisciplinary or a usual-care obesity treatment program

NARCIS (Netherlands)

Bocca, Gianni; Corpeleijn, Eva; van den Heuvel, Edwin R.; Stolk, Ronald P.; Sauer, Pieter J. J.

2014-01-01

Background & aims: Little is known on the long-term effects of obesity intervention programs in preschool-aged children. We compared the long-term effects of a multidisciplinary treatment program with a usual-care program in seventy-five 3- to 5-year-old overweight or obese children who had

Bioequivalence of generic alendronate sodium tablets (70 mg to Fosamax® tablets (70 mg in fasting, healthy volunteers: a randomized, open-label, three-way, reference-replicated crossover study

Directory of Open Access Journals (Sweden)

Zhang Y

2017-07-01

Full Text Available Yifan Zhang,1 Xiaoyan Chen,1 Yunbiao Tang,2 Youming Lu,1 Lixia Guo,1 Dafang Zhong1 1State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 2Department of Pharmacy, The General Hospital of Shenyang Military Region, Shenyang, People’s Republic of China Purpose: The aim of this study was to evaluate the bioequivalence of a generic product 70 mg alendronate sodium tablets with the reference product Fosamax® 70 mg tablet. Materials and methods: A single-center, open-label, randomized, three-period, three-sequence, reference-replicated crossover study was performed in 36 healthy Chinese male volunteers under fasting conditions. In each study period, the volunteers received a single oral dose of the generic or reference product (70 mg. Blood samples were collected at pre-dose and up to 8 h after administration. The bioequivalence of the generic product to the reference product was assessed using the US Food and Drug Administration (FDA and European Medicines Agency (EMA reference-scaled average bioequivalence (RSABE methods. Results: The average maximum concentrations (Cmax of alendronic acid were 64.78±43.76, 56.62±31.95, and 60.15±37.12 ng/mL after the single dose of the generic product and the first and second doses of the reference product, respectively. The areas under the plasma concentration–time curves from time 0 to the last timepoint (AUC0–t were 150.36±82.90, 148.15±85.97, and 167.11±110.87 h·ng/mL, respectively. Reference scaling was used because the within-subject standard deviations of the reference product (sWR for Cmax and AUC0–t were all higher than the cutoff value of 0.294. The 95% upper confidence bounds were -0.16 and -0.17 for Cmax and AUC0–t, respectively, and the point estimates for the generic/reference product ratio were 1.08 and 1.00, which satisfied the RSABE acceptance criteria of the FDA. The 90% CIs for Cmax and AUC0–t were 90.35%–129

Esophageal transit and in vivo disintegration of branded risedronate sodium tablets and two generic formulations of alendronic acid tablets: a single-center, single-blind, six-period crossover study in healthy female subjects.

Science.gov (United States)

Perkins, Alan C; Blackshaw, P Elaine; Hay, Peter D; Lawes, Simon C; Atherton, Clare T; Dansereau, Richard J; Wagner, Leigh K; Schnell, Dan J; Spiller, Robin C

2008-05-01

Delayed esophageal transit or disintegration of oral bisphosphonate tablets before they enter the stomach may be of concern with respect to iatrogenic complications among patients receiving longterm treatment. Different formulations of generic bisphosphonate tablets meeting regulatory requirements may have substantial differences in pharmaceutical attributes from the branded product that may result in different characteristics during esophageal transit. The primary objective of this study was to evaluate and compare esophageal transit times and in vivo disintegration of 3 bisphosphonate formulations, one branded and the others generic, that are commercially available in Canada and the United Kingdom. This was a single-center, randomized, singleblind, 6-period crossover study in healthy postmenopausal women aged >50 years. Each subject received a single oral dose of a branded risedronate sodium 35-mg tablet and 2 generic formulations of alendronic acid 70-mg tablets (Novopharm Limited, Toronto, Canada, and Teva UK Limited, Morley, United Kingdom) in both the erect and semisupine (45 degrees ) positions. Although the products are labeled to be taken in the erect position, the semisupine position was included to simulate dosing in bedridden patients. Subjects took tablets with 30 mL of water in the morning after an overnight fast. The tablets were radiolabeled with technetium-99m ion-exchange resins to enable visualization and measurement of esophageal transit time and disintegration using a gamma camera. Dynamic scintigraphic images were obtained for a total of 10 minutes: 2 images per second for the first 30 seconds and 1 image every 15 seconds for 9.5 minutes. This was a mechanistic study and tolerability was not assessed. The study was conducted in 20 healthy white female subjects with a mean age of 62 years (range, 51-77 years). The effect of body position was statistically significant (P = 0.043), with the estimated hazard ratio (HR) of 0.74 indicating longer

Chief Financial Officer FY 1997 status report and five-year plan

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-10-01

The Chief Financial Officers Act of 1990 (CFO Act) establishes the legal framework for improved Federal financial management. The Act requires the agency CFO to prepare, and annually revise, a plan to implement the Office of Management and Budget (OMB) Federal Financial Management Status Report and Five-Year Plan. This is the sixth Status Report and Five-Year Plan submission to OMB by the Department of Energy (DOE). Financial management at the Department operates in an environment of Government-wide efforts to improve financial management and implements legislation and administrative provisions which stress the need for change. This report sets forth the Department`s plans for financial management improvements in the coming years. It also highlights several new initiatives completed or currently underway that will significantly improve the overall effectiveness of financial management at the Department of Energy.

Transition to low carbon energy policies in China-from the Five-Year Plan perspective

International Nuclear Information System (INIS)

Yuan Xueliang; Zuo Jian

2011-01-01

Energy policy plays a critical role not only in the energy development, but also in the social and environmental aspects of a nation. Five-Year Plan for National Economic and Social Development is one of the most important government plans, which documents the national strategy during that period. This study presents a critical review of 12 Five-Year Plans that have been released by the Chinese central government in last 58 years. In particular, the recently released Twelfth Five-Year Plan is reviewed. The results clearly show a pattern of increasingly level of attention of Chinese government to energy efficiency improvement, air pollutant emission reduction, new and renewable energy development, carbon dioxide emission and climate change. - Highlights: → Critical review of the energy related contents in the 12 Five-Year Plans. → Energy policy of China is focusing on energy efficiency, new and renewable energy. → China is improving the capability of dealing with CO 2 emission and climate change. → China is on transition to low carbon energy policies for a sustainable development.

AMBULATORY CARE - SENSITIVE CONDITIONS IN CHILDREN UNDER FIVE YEARS

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Maria Aparecida Araújo Figueiredo

2013-05-01

Full Text Available Objective:analyzethe extent to which the incidence rate of primary care sensitivehospitalizations in children under five years is influenced by the percentage of coverage of theprimary care.Methods:This was a cross-sectional ecological study that combines coverage ofprimary careand theambulatorycare-sensitiveconditionsin 2000 and 2010. We used data from theHospital Information System (HIS and the Information System of Primary Care (SIAB.Results:The data revealed that the increased coverage providedprimary carereductionrateofhospitalization diseases studied. In 2000 the reduction was greater for gastroenteritis (51% inchildren under 01 years and 30% in children 01-04 years in 2010 for respiratory diseases (51% inchildren under 01years and 33% in children aged 01-04 years.Conclusion:we found an association between the coverage ofprimary careand admission rates, however seem to affect othervariables, suggesting the need for further studies.

Wood mouse and box turtle populations in an area treated annually with DDT for five years

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Stickel, L.F.

1951-01-01

A 117-acre area of dense woodland on the Patuxent Research Refuge received an aerial application of DDT in oil at the rate of 2 pounds per acre gnnually for five years. DDT reached ground level in a much smaller amount (thousandths to hundredths of a pound per acre). Treatment was made during the first week of June of each year from 1945 through 1949. Field studies of the wood mouse population in DDT and check areas showed no significant differences in the two areas before and after the 1949 DDT treatment. There was no significant difference between trapping samples taken in DDT and check areas in 1945 and those taken in 1949. Field studies of the box turtles in DDT and check areas in 1945 and 1949 showed no significant difference in population size. Growth of the four young turtles taken in the DDT area in both 1945 and 1949 appeared to be normal in comparison with growth of check area turtles.

Computing for magnetic fusion energy research: The next five years

International Nuclear Information System (INIS)

Mann, L.; Glasser, A.; Sauthoff, N.

1991-01-01

This report considers computing needs in magnetic fusion for the next five years. It is the result of two and a half years of effort by representatives of all aspects of the magnetic fusion community. The report also factors in the results of a survey that was distributed to the laboratories and universities that support fusion. There are four areas of computing support discussed: theory, experiment, engineering, and systems

A one-year observational study of all hospitalized acute poisonings in Oslo: complications, treatment and sequelae

Directory of Open Access Journals (Sweden)

Lund Cathrine

2012-07-01

Full Text Available Abstract Objectives Changes in poisoning trends may affect both complications and outcomes in patients with acute poisoning. This study reports the treatments given and the frequency of complications, also related to treatment, mortality and sequelae related to various toxic agents. Methods All acute poisonings in adults (≥16 years admitted to the five hospitals in Oslo were included consecutively during one year (2008 to 2009 in an observational cross-sectional multicenter study. A standardized form was completed by the treating physician, which covered the study aims. Results There were 1065 admissions in 912 patients. The median length of hospital stay was one day, and 49% were observed in an intensive care unit (ICU. Active treatment was given to 83%, and consisted of supportive therapy (70%, antidote(s (38%, activated charcoal (16% and gastric lavage (9%. The most commonly used antidotes were flumazenil (19%, naloxone (17% and N-acetylcysteine (11%. The rate of treatment-related complications was 2.4% (21/884. Neither flumazenil, naloxone, nor the combination, was associated with convulsions or other complications. Among those receiving N-acetylcysteine, 5% (6/120 developed allergic reactions, one of which mandated discontinuation of treatment. Nineteen percent presented in a coma. Complications developed in 30%, compared with 18% in a 2003 study, mainly respiratory depression (12%, prolonged QTc interval (6% and hypotension (5%. Eight patients died (0.8% and five (0.5% survived with permanent sequelae, mainly anoxic brain damage. Discussion Few patients stayed more than two days. The use of the ICU was liberal, considering that only one out of five presented in a coma. Antidotes were frequently given diagnostically. Although N-acetylcysteine induced allergic reactions, most were mild and treatment discontinuation was only necessary once. The frequency of complications had almost doubled in five years, although the poisoning pattern was

A one-year observational study of all hospitalized acute poisonings in Oslo: complications, treatment and sequelae

Science.gov (United States)

2012-01-01

Objectives Changes in poisoning trends may affect both complications and outcomes in patients with acute poisoning. This study reports the treatments given and the frequency of complications, also related to treatment, mortality and sequelae related to various toxic agents. Methods All acute poisonings in adults (≥16 years) admitted to the five hospitals in Oslo were included consecutively during one year (2008 to 2009) in an observational cross-sectional multicenter study. A standardized form was completed by the treating physician, which covered the study aims. Results There were 1065 admissions in 912 patients. The median length of hospital stay was one day, and 49% were observed in an intensive care unit (ICU). Active treatment was given to 83%, and consisted of supportive therapy (70%), antidote(s) (38%), activated charcoal (16%) and gastric lavage (9%). The most commonly used antidotes were flumazenil (19%), naloxone (17%) and N-acetylcysteine (11%). The rate of treatment-related complications was 2.4% (21/884). Neither flumazenil, naloxone, nor the combination, was associated with convulsions or other complications. Among those receiving N-acetylcysteine, 5% (6/120) developed allergic reactions, one of which mandated discontinuation of treatment. Nineteen percent presented in a coma. Complications developed in 30%, compared with 18% in a 2003 study, mainly respiratory depression (12%), prolonged QTc interval (6%) and hypotension (5%). Eight patients died (0.8%) and five (0.5%) survived with permanent sequelae, mainly anoxic brain damage. Discussion Few patients stayed more than two days. The use of the ICU was liberal, considering that only one out of five presented in a coma. Antidotes were frequently given diagnostically. Although N-acetylcysteine induced allergic reactions, most were mild and treatment discontinuation was only necessary once. The frequency of complications had almost doubled in five years, although the poisoning pattern was largely

Five-year workplace wellness intervention in the NHS

OpenAIRE

Blake, Holly; Zhou, Dingyuan; Batt, Mark E.

2013-01-01

aims:\\ud Poor health and well-being has been observed among NHS staff and has become a key focus in current public health policy. The objective of this study was to deliver and evaluate a five-year employee wellness programme aimed at improving the health and well-being of employees in a large NHS workplace.\\ud method:\\ud A theory-driven multi-level ecological workplace wellness intervention was delivered including health campaigns, provision of facilities and health-promotion activities to e...

Five-Year Wilkinson Microwave Anisotropy Probe Observations: Beam Maps and Window Functions

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Hill, R. S.; Weiland, J. L.; Odegard, N.; Wollack, E.; Hinshaw, G.; Larson, D.; Bennett, C. L.; Halpern, M.; Page, L.; Dunkley, J.; Gold, B.; Jarosik, N.; Kogut, A.; Limon, M.; Nolta, M. R.; Spergel, D. N.; Tucker, G. S.; Wright, E. L.

2009-02-01

Cosmology and other scientific results from the Wilkinson Microwave Anisotropy Probe (WMAP) mission require an accurate knowledge of the beam patterns in flight. While the degree of beam knowledge for the WMAP one-year and three-year results was unprecedented for a CMB experiment, we have significantly improved the beam determination as part of the five-year data release. Physical optics fits are done on both the A and the B sides for the first time. The cutoff scale of the fitted distortions on the primary mirror is reduced by a factor of ~2 from previous analyses. These changes enable an improvement in the hybridization of Jupiter data with beam models, which is optimized with respect to error in the main beam solid angle. An increase in main-beam solid angle of ~1% is found for the V2 and W1-W4 differencing assemblies. Although the five-year results are statistically consistent with previous ones, the errors in the five-year beam transfer functions are reduced by a factor of ~2 as compared to the three-year analysis. We present radiometry of the planet Jupiter as a test of the beam consistency and as a calibration standard; for an individual differencing assembly, errors in the measured disk temperature are ~0.5%. WMAP is the result of a partnership between Princeton University and NASA's Goddard Space Flight Center. Scientific guidance is provided by the WMAP Science Team.

Parents of children diagnosed with cancer: work situation and sick leave, a five-year post end-of-treatment or a child's death follow-up study.

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Wikman, Anna; Hovén, Emma; Cernvall, Martin; Ljungman, Gustaf; Ljungman, Lisa; von Essen, Louise

Cancer in a child is associated with a significant impact on parental employment. We assessed the proportions of parents of survivors and bereaved parents working and reporting sick leave five years after end of successful treatment (ST)/child's death (T7) compared with one year after end of ST/child's death (T6) and the association between partial post-traumatic stress disorder (PTSD) and work situation and sick leave at T7. Participants and procedure: The sample included 152 parents of survivors (77 mothers, 75 fathers) and 42 bereaved parents (22 mothers, 20 fathers) of children diagnosed with cancer in Sweden. The proportions of parents working or reporting sick leave did not differ among mothers and fathers of survivors (92% vs. 96% working, 20% vs. 18% on sick leave) or among bereaved mothers and fathers (91% vs. 90% working, 14% vs. 20% on sick leave) at T7. There was no change from T6 to T7 in the proportion of fathers working (fathers of survivors 91% vs. 96%, bereaved fathers 95% vs. 90%). Although more mothers of survivors (92% vs. 82%) and bereaved mothers (91% vs. 77%) worked at T7 than at T6, this increase was not significant. Fewer bereaved mothers reported sick leave at T7 than at T6 (14% vs. 59%, p leave at T7 than at T6 (fathers of survivors 18% vs. 8%, bereaved fathers 20% vs. 15%), this was not significant. Partial PTSD was not associated with parents' work situation or sick leave at T7. Results suggest little adverse effect on work situation and sick leave among parents of survivors and bereaved parents five years after end of ST/child's death from cancer. However, the pattern of change observed differed between parents, which could potentially indicate possible delayed consequences for fathers not captured in the present paper.

Preventing Dental Caries in Children from Birth Through Age Five Years

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Understanding Task Force Recommendations Preventing Dental Caries in Children from Birth Through Age Five Years The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement ...

Diffraction dissociation: thirty five years after

International Nuclear Information System (INIS)

Zotov, N.P.; Tsarev, V.A.

1988-01-01

Review of the basic results and stages of studying one of the most interesting phenomena in high energy physics-diffraction dissociation (DD) of hadrons is presented. The review contains complete information concerning the basic experimental results and the most ''set'' DD theoretical models. Though the discussion focuses primarily on considering a single nucleon DD, this still allows one to fully describe the basic features of the phenomenon under investigation. The last part of the review is devoted to the most notable results obtained during DD experimental investigation in the last five years, which have not been reflected in the earlier published reviews. Signs of excited system parton structure and pomeron are clearly found in the new experimental data. It is underlined that DD mechanism understanding is closely connected with the solution of the confinement problem in the strong interaction theory and requires further experimental and theoretical investigations

Twenty five years of fundamental theory

International Nuclear Information System (INIS)

Bell, J.S.

1980-01-01

In reviewing the last twenty five years in fundamental physics theory it is stated that there has been no revolution in this field. In the absence of gravitation, Lorentz invariance remains a requirement on fundamental laws. Einstein's theory of gravitation inspires increasing conviction on the astronomical scale. Quantum theory remains the framework for all serious effort in microphysics, and quantum electrodynamics remains the model of a fully articulated microphysical theory, completely successful in its domain. However,a number of ideas have appeared, of great theoretical interest and some phenomenological success, which may well contribute to the next decisive step. Recent work on the following topics is mentioned; gravitational radiation, singularites, black body radiation from black holes, gauge and hidden symmetry in quantum electrodynamics, the renormalization of electromagnetic and weak interaction theory, non-Abelian gauge theories, magnetic monopoles as the most striking example of solitons, and supersymmetry. (UK)

Development problems were common five years after positive screening for language disorders and, or, autism at 2.5 years of age.

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Miniscalco, Carmela; Fernell, Elisabeth; Thompson, Lucy; Sandberg, Eva; Kadesjö, Björn; Gillberg, Christopher

2018-04-10

This study identified whether children who had screened positive for either developmental language disorder (DLD) or autism spectrum disorder (ASD) at the age of 2.5 years had neurodevelopmental assessments five years later. Our study cohort were 288 children born from 1 July 2008 to 20 June 2009 who screened positive for DLD and, or, ASD at 2.5 years. Of these, 237 children were referred to, and assessed, at the Paediatric Speech and Language Pathology clinic (n = 176) or the Child Neuropsychiatry Clinic (n = 61) at the Queen Silvia Children's Hospital, Gothenburg, Sweden. Clinical registers covering all relevant outpatient clinics were reviewed five years later with regard to established diagnoses. When the 237 were followed up five years later, 96 (40%) had established neurodevelopmental disorders or problems, often beyond DLD and ASD. Co-existing problems were common in this cohort and multidisciplinary assessments were indicated. The other 60% did not appear in subsequent clinic records. It is likely that this 40% was a minimum rate and that more children will be referred for developmental problems later. Five years after they had been screened positive for DLD and, or autism at 2.5 years, 40% of our cohort had remaining or other developmental problems. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Socio-economic factors predisposing under five-year-old children to ...

African Journals Online (AJOL)

Background: Malnutrition is one of the leading causes of morbidity and mortality in children aged five years and below. Risk factors for severe protein energy malnutrition (PEM) have been identified as ignorance, family size, mothers and fathers education, poverty, residence, chronic infections, and congenital defects or ...

Colorectal cancer patients in a tertiary referral centre in Malaysia: a five year follow-up review.

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Rashid, Mohd Radzniwan A; Aziz, Aznida Firzah Abdul; Ahmad, Saharuddin; Shah, Shamsul Azhar; Sagap, Ismail

2009-01-01

Colorectal cancer (CRC) is one of the major malignancies in the world. In Malaysia, CRC is fast becoming the commonest cause of cancer death. Its etiology is complex, involving both environmental and genetic factors. This study looked at the profile and outcome of five-year follow-up of patients with CRC. Retrospective case review study done on CRC patients at University Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia. Patientsandapos; socio-demographic characteristics, modalities of treatment, cancer characteristics and outcome at 5-year follow up were extracted from the case records. A total of 107 case records of patients were analyzed. Peak age of CRC presentation was 40-69 years (71.1%). Male to female ratio was 1.2:1 with Chinese predominance (52.3%). Anaemia and its related symptoms including per rectal bleeding was the commonest clinical presentation. The median duration of clinical presentation was 13 weeks (IQR 21.8). More than two-thirds presented as non-emergency cases (69.2%). Most patients presented with Dukes C stage (40.2%). The overall 5-year survival rate was 40% with local recurrence rate of 19.6%. Metastasis after curative-intend treatment (surgery with adjuvant therapy) developed in 26% of patients. Lower recurrence (p = 0.016, OR = 0.205) and metastatic disease (p = 0.02, OR = 0.24) found among the Chinese patients. Almost half of the patients defaulted follow up care (43%), most often within the first year of treatment (22.4%) and the Chinese were the least likely to default (p= 0.04, OR = 0.45). Socio-demographic profile of CRC patients in UKMMC is comparable to Asia pacific region. Apparent delay in seeking treatment gives rise to poor overall survival and local recurrence rates.

RMP Guidance for Chemical Distributors - Chapter 3: Five-Year Accident History

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A five year accident history must be completed for each covered process, and all accidental release events meeting specified criteria must be reported in the Risk Management Plan (RMP) for that process.

Radiation therapy: A major factor in the five-year survival analysis of women with breast cancer in Lagos, Nigeria

International Nuclear Information System (INIS)

Makanjuola, Samira B.L.; Popoola, Abiodun O.; Oludara, Mobolaji A.

2014-01-01

Purpose: This retrospective study was carried out to examine five-year survival from breast cancer cases diagnosed between 2005 and May 2008 in Nigerian women. Material and methods: Two hundred and twenty-four patients were entered into the study. Five-year survival was evaluated using proportional hazard model proposed by Cox to assess variables such as age of diagnosis, menopausal status, and stage of the disease in the two treatment groups: surgery/chemotherapy or surgery/chemotherapy/radiotherapy. Results: Findings revealed that the different staging of disease and treatment are independent predictors of disease outcome whereas age of diagnosis and menopausal status although associated with low hazards, are not significant. TNM Stage I (Hazard Ratio = 0.153, 95% CI 0.45–0.51, P = 0.003), II (Hazard Ratio = 0.245, 95% CI 0.12–0.46, P = 0.0001), and III (Hazard Ratio = 0.449, 95% CI 0.31–0.46, P = 0.0001) showed significantly greater survival rates compared to TNM Stage IV for patients receiving surgery/chemotherapy. Similarly, for patients receiving surgery/chemotherapy/radiotherapy TNM Stage II (Hazard Ratio = 0.110, 95% CI 0.02–0.46, P = 0.003) and III (Hazard Ratio = 0.238, 95% CI 0.07–0.73, P = 0.012) also showed significantly greater survival rates compared to TNM Stage IV. Treatment had a significant impact on survival independent of stage, age, and menopausal status. Patients receiving surgery/chemotherapy/radiotherapy had a significant increase in survival outcome for TNM Stage (II, P = 0.045; III, P = 0.0001); age groups (40–49, P = 0.021; 50–59, P = 0.016; 60–69, P = 0.017; >70, P = 0.025); and menopausal status (premenopausal, P = 0.049; postmenopausal, P = 0.0001) compared to those receiving surgery/chemotherapy. Conclusion: The five-year breast cancer survival rate in Lagos, Nigeria 24.1% (54/224) is relatively poor compared to most countries in the world and needs to be improved. Poor survival rates are mainly attributed to late

Randomised clinical trial of five ear acupuncture points for the treatment of overweight people.

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Yeo, Sujung; Kim, Kang Sik; Lim, Sabina

2014-04-01

To evaluate the efficacy of the five ear acupuncture points (Shen-men, Spleen, Stomach, Hunger, Endocrine), generally used in Korean clinics for treating obesity, and compare them with the Hunger acupuncture point. A randomised controlled clinical trial was conducted in 91 Koreans (16 male and 75 female, body mass index (BMI)≥23), who had not received any other weight control treatment within the past 6 months. Subjects were divided randomly into treatment I, treatment II or sham control groups and received unilateral auricular acupuncture with indwelling needles replaced weekly for 8 weeks. Treatment I group received acupuncture at the five ear acupuncture points, treatment II group at the Hunger acupuncture point only and the sham control group received acupuncture at the five ear acupuncture points used in treatment I, but the needles were removed immediately after insertion. BMI, waist circumference, weight, body fat mass (BFM), percentage body fat and blood pressure were measured at baseline and at 4 and 8 weeks after treatment. For the 58 participants who provided data at 8 weeks, significant differences in BMI, weight and BFM were found between the treatment and control groups. Treatment groups I and II showed 6.1% and 5.7% reduction in BMI, respectively (pfive ear acupuncture points, generally used in Korean clinics, and the Hunger point alone treatment are both effective for treating overweight people.

A five-year follow-up study of Swedish adults with gender identity disorder.

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Johansson, Annika; Sundbom, Elisabet; Höjerback, Torvald; Bodlund, Owe

2010-12-01

This follow-up study evaluated the outcome of sex reassignment as viewed by both clinicians and patients, with an additional focus on the outcome based on sex and subgroups. Of a total of 60 patients approved for sex reassignment, 42 (25 male-to-female [MF] and 17 female-to-male [FM]) transsexuals completed a follow-up assessment after 5 or more years in the process or 2 or more years after completed sex reassignment surgery. Twenty-six (62%) patients had an early onset and 16 (38%) patients had a late onset; 29 (69%) patients had a homosexual sexual orientation and 13 (31%) patients had a non-homosexual sexual orientation (relative to biological sex). At index and follow-up, a semi-structured interview was conducted. At follow-up, 32 patients had completed sex reassignment surgery, five were still in process, and five-following their own decision-had abstained from genital surgery. No one regretted their reassignment. The clinicians rated the global outcome as favorable in 62% of the cases, compared to 95% according to the patients themselves, with no differences between the subgroups. Based on the follow-up interview, more than 90% were stable or improved as regards work situation, partner relations, and sex life, but 5-15% were dissatisfied with the hormonal treatment, results of surgery, total sex reassignment procedure, or their present general health. Most outcome measures were rated positive and substantially equal for MF and FM. Late-onset transsexuals differed from those with early onset in some respects: these were mainly MF (88 vs. 42%), older when applying for sex reassignment (42 vs. 28 years), and non-homosexually oriented (56 vs. 15%). In conclusion, almost all patients were satisfied with the sex reassignment; 86% were assessed by clinicians at follow-up as stable or improved in global functioning.

Risk Factors of Diarrhea in Children Under Five Years in Urban Slums

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Balakrishna Kalakheti

2016-12-01

Full Text Available Introduction: Diarrhea is a leading cause of mortality in children in developing countries and the condition is worse in slums. In order to provide effective preventive and management strategies, it is important to identify factors associated with the disease. This study was carried out to investigate the risk factors of diarrhea in  children under five years of age in urban slums. Methods: Parents of all children under five years from the urban slums of Tansen municipality, Palpa, Nepal were interviewed using a standardized pretested questionnaire and proforma. Parental variables, environmental factors, and presence of diarrhea in those children in past three months were collected by trained enumerators and the data were analyzed with statistical software SPSS-10. Results: A total of 450 under five years children were enrolled in the study. There were 216 (48% male and 234 (52% female children with F:M ratio of 1.08:1. Occurrence of diarrhea was lower if the children were breast-fed for more than six months, well-nourished, used fountain water for drinking, or used boiled or treated water. Similarly, diarrhea prevalence was lower if father had a regular job, daily income in the family was more than one US dollar, there was a toilet in the house, practice of hand washing was followed before feeding or preparing food, or there was no child suffering from diarrhea in the neighborhood. Conclusion: There are a few variables that are significantly related to diarrhea in children under five years of age. In order to decrease the diarrheal episodes in children in the slums of the developing countries, priority could be given in the improvement of those variables.

System of optimization computations of five year plans in the coal industry. [USSR

Energy Technology Data Exchange (ETDEWEB)

Goyzman, E I; Korenev, V G

1980-01-01

A system of optimization computations of five year plans is set forth which was developed over a number of years at the Central Scientific Research Institute of Economics and Scientific-Technical Information of the Coal Industry. Basic principles of design and methodological approaches are given which were used in development of the systemas well as levels of administration and information links between them. The report analyzes the characteristics of problems of planning which arise at different stages of formation of the five year plans and discusses possibilities of taking into account these characteristics in optimized models. Economic formulations of problems of optimization of five year plans are given as applied to two levels of administration: at the branch level and at the level of production associations. Economic-mathematical models of optimization of five year plans are developed for each of the levels and their characteristic features described. The primary methodological principles, on the basis of which optimization models were developed are examined. An economic-mathematical model with continuous variables was developed for the branch level of planning. Volumes of recovery according to a group of shafts in the stage of normal operation (stable group) of each production enterprise are adopted as model variables. A system of limitations which includes limitations on volumes and distinguishable resources is formulated. The minimum of operating expenses, minimum of capital investments and maximum of recovery volumes for the planned period can be used as the optimization criteria. An economic-mathematical model which uses integral variable was developed for the production association level.

The economic burden of pneumonia and meningitis among children less than five years old in Hanoi, Vietnam.

Science.gov (United States)

Le, Phuc; Griffiths, Ulla K; Anh, Dang D; Franzini, Luisa; Chan, Wenyaw; Pham, Ha; Swint, John M

2014-11-01

To estimate the average treatment costs of pneumonia and meningitis among children under five years of age in a tertiary hospital in Hanoi, Vietnam from societal, health sector and household perspectives. We used a cost-of-illness approach to identify cost categories to be included for different perspectives. A prospective survey was conducted among eligible patients to get detailed personal costing items. From the perspective of the health sector, the mean costs for treating a case of pneumonia and meningitis were USD 180 and USD 300, respectively. From the household's perspective, the average treatment costs were USD 272 for pneumonia and USD 534 for meningitis. When also including indirect costs, the average total treatment costs from the societal perspective were USD 318 for pneumonia and USD 727 for meningitis. The study contributed to limited evidence on the high treatment costs of pneumonia and meningitis to the Vietnamese society, which is useful for a cost-effectiveness analysis of Haemophilus influenzae type b vaccine or other relevant disease preventions. It also indicated a need to re-evaluate the health insurance policy for children under 6 years old, so that the unnecessarily high out-of-pocket costs of these diseases are reduced. © 2014 John Wiley & Sons Ltd.

Healing of extraction sockets and augmented alveolar defects following 1-year treatment with bisphosphonate.

Science.gov (United States)

Khojasteh, Arash; Behnia, Hossein; Morad, Golnaz; Dashti, Seyedeh Ghazaleh; Dehghan, Mohammad Mehdi; Shahab, Shahriyar; Abbas, Fatemeh Mashhadi

2013-01-01

To assess the effect of bisphosphonates on healing of extraction sockets and augmented alveolar defects, 12 adult female mongrel dogs were assigned to 2 experimental groups and a control group. The experimental groups received oral alendronate (ALN, 3.5 mg/kg/wk) or IV pamidronate (PAM, 1 mg/kg/wk) for 12 months. Animals were randomly tested for serum C-terminal telopeptide of collagen I (CTx). The right first and second premolars were extracted. After 8 weeks, extraction sites were evaluated for healing. Subsequently, 3-wall defects were created in ridges and filled with human mineralized cortical particulate bone. Two months post-augmentation, animals were sacrificed and mandibles were collected for cone-beam computed tomography (CBCT) and histomorphometric appraisal. The obtained data were compared using 1-way ANOVA test. CTx test results in both experimental groups were comparable (alveolar bone in the PAM group and the upper rim of the alveoli in the ALN group. Histologically, bone sequestra from the PAM group demonstrated empty osteocyte lacunae, while in the ALN group areas of necrotic bone along with evidence of active bone remodeling was distinguished. Eight weeks post-augmentation, the experimental groups showed no evidence of bone formation in the augmented area, while bone formation ratio was measured to be 18.32% in the control group. The mean amount of pixel intensity calculated from the CBCT images of the ALN, PAM, and control group was 113.69 ± 11.04, 124.94 ± 4.72, and 113.69 ± 6.63, respectively. Pixel intensity in PAM-treated group was significantly higher than both other groups. This study demonstrated that 1-year treatment with ALN/PAM was associated with impairment of post-extraction and post-augmentation bone healing in dogs.

Long-term outcomes five years after selective dorsal rhizotomy

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Lagergren Jan

2008-12-01

Full Text Available Abstract Background Selective dorsal rhizotomy (SDR is a well accepted neurosurgical procedure performed for the relief of spasticity interfering with motor function in children with spastic cerebral palsy (CP. The goal is to improve function, but long-term outcome studies are rare. The aims of this study were to evaluate long-term functional outcomes, safety and side effects during five postoperative years in all children with diplegia undergoing SDR combined with physiotherapy. Methods This study group consisted of 35 children, consecutively operated, with spastic diplegia, of which 26 were Gross Motor Function Classification System (GMFCS levels III–V. Mean age was 4.5 years (range 2.5–6.6. They were all assessed by the same multidisciplinary team at pre- and at 6, 12, 18 months, 3 and 5 years postoperatively. Clinical and demographic data, complications and number of rootlets cut were prospectively registered. Deep tendon reflexes and muscle tone were examined, the latter graded with the modified Ashworth scale. Passive range of motion (PROM was measured with a goniometer. Motor function was classified according to the GMFCS and measured with the Gross Motor Function Measure (GMFM-88 and derived into GMFM-66. Parent's opinions about the children's performance of skills and activities and the amount of caregiver assistance were measured with Pediatric Evaluation Disability Inventory (PEDI. Results The mean proportion of rootlets cut in S2-L2 was 40%. Muscle tone was immediately reduced in adductors, hamstrings and dorsiflexors (p Conclusion SDR is a safe and effective method for reducing spasticity permanently without major negative side effects. In combination with physiotherapy, in a group of carefully selected and systematically followed young children with spastic diplegia, it provides lasting functional benefits over a period of at least five years postoperatively.

Forty-five year follow-up after uninephrectomy.

Science.gov (United States)

Narkun-Burgess, D M; Nolan, C R; Norman, J E; Page, W F; Miller, P L; Meyer, T W

1993-05-01

This study examined the consequences of nephrectomy in United States Army personnel who lost a kidney due to trauma during World War II (WWII). Records of 62 servicemen who underwent nephrectomy at an average age of 25 years were obtained. Mortality was compared with that of WWII servicemen of the same age. Medical records of 28 deceased subjects were reviewed for evidence of kidney disease. Medical histories were obtained and blood pressure and kidney function were assessed in 28 living subjects. Two subjects could not be located, and four subjects declined to participate. Mortality at 45 years was not increased in nephrectomized subjects. Kidney disease present in six of 28 deceased subjects was attributable to causes other than prior nephrectomy. Glomerular sclerosis was not increased in 10 subjects who had autopsy examinations. The prevalence of hypertension was not increased in living subjects. Five of 28 living subjects had abnormal renal function manifested by proteinuria greater than 250 mg/day in four cases (range: 377 to 535 mg/day) and serum creatinine levels greater than 1.5 mg/dl in three cases (range: 1.7 to 1.9 mg/dl). Conditions other than nephrectomy could have contributed to impairment of renal function in each of these subjects. These findings suggest that uninephrectomy in young adults has few major adverse consequences over 45 years.

Family accommodation in obsessive-compulsive and anxiety disorders: a five-year update.

Science.gov (United States)

Lebowitz, Eli R; Panza, Kaitlyn E; Bloch, Michael H

2016-01-01

Family accommodation describes changes that individuals make to their behavior, to help their relative who is dealing with a psychiatric and/or psychological disorder(s), avoid or alleviate distress related to the disorder. Research on family accommodation has advanced rapidly. In this update we aim to provide a synthesis of findings from the past five years. A search of available, peer-reviewed, English language papers was conducted through PubMed and PsycINFO, cross referencing psychiatric disorders with accommodation and other family-related terms. The resulting 121 papers were individually reviewed and evaluated and the main findings were discussed. Family accommodation is common in obsessive-compulsive disorder (OCD) and in anxiety disorders, and manifests similarly across these disorders. Family accommodation is associated with more severe psychopathology and poorer clinical outcomes. Treatments have begun to focus on the reduction of family accommodation as a primary therapeutic goal and finally, neurobiological underpinnings of family accommodation are beginning to be investigated.

A one-year observational study of all hospitalized acute poisonings in Oslo: complications, treatment and sequelae

OpenAIRE

Lund Cathrine; Drottning Per; Stiksrud Birgitte; Vahabi Javad; Lyngra Marianne; Ekeberg Ivind; Jacobsen Dag; Hovda Knut

2012-01-01

Abstract Objectives Changes in poisoning trends may affect both complications and outcomes in patients with acute poisoning. This study reports the treatments given and the frequency of complications, also related to treatment, mortality and sequelae related to various toxic agents. Methods All acute poisonings in adults (≥16 years) admitted to the five hospitals in Oslo were included consecutively during one year (2008 to 2009) in an observational cross-sectional multicenter study. A standar...

Occurrence and persistence of organic emerging contaminants and priority pollutants in five sewage treatment plants of Spain: Two years pilot survey monitoring

International Nuclear Information System (INIS)

Bueno, M.J. Martínez; Gomez, M.J.; Herrera, S.; Hernando, M.D.; Agüera, A.

2012-01-01

This work summarized all results obtained during almost two-years of a monitoring programme carried out in five municipal sewage treatment plants (STPs) located in the north, centre and south-east of Spain. The study evaluated the occurrence and persistence of a group of 100 organic compounds belonging to several chemical groups (pharmaceuticals, personal care products, pesticides and metabolites). The average removal efficiencies of the STPs studied varied from 20% (erythromycin) to 99% (acetaminophen). In analysed samples, we identified a large number of compounds at mean range concentrations between 7–59,495 ng/L and 5–32,720 ng/L for influent and effluent samples, respectively. This study also identified 20 of the mostly detected and persistent compounds in wastewater effluent, of which hydrochlorothiazide, atenolol, gemfibrozil, galaxolide and three metabolites (fenofibric acid, 4-AAA and 4-FAA), presented the highest average contribution percentages, in relation to the total load of contaminants for the different STPs effluent studied. Highlights: ► The results summarize two-years of a monitoring programme. ► 100 organic compounds (priority substances and emerging contaminants) were analysed. ► The removal efficiency of 5 STPs of Spain was evaluated. ► The presence of target compounds in treated wastewater was also checked. ► The most frequently drugs detected were: antibiotics< anti-inflammatories<β-blockers. - Antibiotics and analgesics/anti-inflammatories were the most frequently drugs detected, following by some β-blockers, synthetic fragrances, lipid regulators and diuretics.

Five-year longitudinal assessment of the prognosis of apical microsurgery

DEFF Research Database (Denmark)

von Arx, Thomas; Jensen, Simon S; Hänni, Stefan

2012-01-01

Apical surgery is an important treatment option for teeth with post-treatment apical periodontitis. Knowledge of the long-term prognosis is necessary when weighing apical surgery against alternative treatments. This study assessed the 5-year outcome of apical surgery and its predictors in a cohor...

Five-year summary and evaluation of operations and performance of the Utica aquifer and North Lake Basin Wetlands restoration project in 2004-2009.

Energy Technology Data Exchange (ETDEWEB)

LaFreniere, L. M. (Environmental Science Division)

2011-09-13

This document reviews the performance of the groundwater (and wetlands) restoration program implemented by the Commodity Credit Corporation of the U.S. Department of Agriculture (CCC/USDA) at the former CCC/USDA grain storage facility in Utica, Nebraska, during the first five years (2004-2009) of this initiative. The report summarizes treatment system operational data and regulatory compliance monitoring results for the site during this period, together with the results of the targeted groundwater sampling and analysis for volatile organic compounds (VOCs) conducted in early 2010 (following completion of the fifth year of systems operation), to assess the initial five years of progress of the Utica remediation effort. On the basis of the 2003 groundwater sampling results, a remedial system employing 4 extraction wells (GWEX1-GWEX4), with groundwater treatment by spray irrigation and conventional air stripping, was implemented with the concurrence of the CCC/USDA and the agencies (Table 1.1). The principal components of the system are shown in Figure 1.3 and are briefly described in Section 1.2. Operation of well GWEX4 and the associated air stripper began on October 29, 2004, and routine operation of wells GWEX1-GWEX3 and the spray irrigation treatment units began on November 22, 2004.

Hyperfunctioning thyroid cancer: a five-year follow-up.

Science.gov (United States)

Azevedo, Monalisa Ferreira; Casulari, Luiz Augusto

2010-02-01

Differentiated thyroid cancer rarely occurs in association with hyperfunctioning nodules. We describe a case of a 47-year-old woman who developed symptoms of hyperthyroidism associated with a palpable thyroid nodule. Thyroid scintigraphy showed an autonomous nodule, and fine-needle aspiration biopsy was suggestive of papillary carcinoma. Laboratorial findings were consistent with the diagnosis of hyperthyroidism. The patient underwent thyroidectomy and a papillary carcinoma of 3.0 x 3.0 x 2.0 cm, follicular variant, was described by histological examination. The surrounding thyroid tissue was normal. Postoperatively, the patient received 100 mCi of (131)I, and whole body scans detected only residual uptake. No evidence of metastasis was detected during five years of follow-up. Hot thyroid nodules rarely harbor malignancies, and this case illustrated that, when a carcinoma occurs the prognosis seems to be very good with no evidence of metastatic dissemination during a long-term follow-up.

Infectious Diseases of Poverty, the first five years.

Science.gov (United States)

Wang, Wei; Chen, Jin; Sheng, Hui-Feng; Wang, Na-Na; Yang, Pin; Zhou, Xiao-Nong; Bergquist, Robert

2017-05-04

Although the focus in the area of health research may be shifting from infectious to non-communicable diseases, the infectious diseases of poverty remain a major burden of disease of global health concern. A global platform to communicate and share the research on these diseases is needed to facilitate the translation of knowledge into effective approaches and tools for their elimination. Based on the "One health, One world" mission, a new, open-access journal, Infectious Diseases of Poverty (IDP), was launched by BioMed Central in partnership with the National Institute of Parasitic Diseases (NIPD), Chinese Center for Disease Control and Prevention (China CDC) on October 25, 2012. Its aim is to identify and assess research and information gaps that hinder progress towards new interventions for a particular public health problem in the developing world. From the inaugural IDP issue of October 25, 2012, a total of 256 manuscripts have been published over the following five years. Apart from a small number of editorials, opinions, commentaries and letters to the editor, the predominant types of publications are research articles (69.5%) and scoping reviews (21.5%). A total of 1 081 contributing authors divided between 323 affiliations across 68 countries, territories and regions produced these 256 publications. The journal is indexed in major international biomedical databases, including Web of Science, PubMed, Scopus and Embase. In 2015, it was assigned its first impact factor (4.11), which is now 2.13. During the past five years, IDP has received manuscripts from 90 countries, territories and regions across six continents with an annual acceptance rate of all contributions maintained at less than 40%. Content analysis shows that neglected tropical diseases (NTDs), followed by the "Big Three" (HIV/AIDS, malaria and tuberculosis) and infectious diseases in general comprise 88% of all publications. In addition, a series of 10 thematic issues, covering 118 publications

Elderly victims of abuse: a five year document analysis

OpenAIRE

Garbin,Cléa Adas Saliba; Joaquim,Renata Colturato; Rovida,Tânia Adas Saliba; Garbin,Artênio José Isper

2016-01-01

Objective To verify the occurrence of maltreatment of the elderly and its characteristics (location, type, reason, involvement of alcohol/drugs, profile and family relationship of victims and perpetrators) from the police records of a specialized police station over a five year period. Method A cross-sectional, descriptive and documentary analytical study was performed. The police reports of a medium-sized municipality in the northwest of São Paulo were analyzed from 2008 to 2012. The sociod...

Twenty five years of clusters -- from Bochum to Strasbourg

International Nuclear Information System (INIS)

Betts, R.R.; Chicago Univ., IL

1994-01-01

Developments in the area of clustering aspects of nuclear structure and reactions over the past twenty-five years are reviewed. The viewpoint is that the nucleus is an assembly of clusters. The question is whether clusters actually exist in the nucleus. Although there is abundant evidence for this in light nuclei, the situation for more complex clusters in heavier nuclei is much worse. Differential cross sections for scattering of alpha particles and heavy ions are shown

Five-year longitudinal assessment of the prognosis of apical microsurgery.

Science.gov (United States)

von Arx, Thomas; Jensen, Simon S; Hänni, Stefan; Friedman, Shimon

2012-05-01

Apical surgery is an important treatment option for teeth with post-treatment apical periodontitis. Knowledge of the long-term prognosis is necessary when weighing apical surgery against alternative treatments. This study assessed the 5-year outcome of apical surgery and its predictors in a cohort for which the 1-year outcome was previously reported. Apical microsurgery procedures were uniformly performed using SuperEBA (Staident International, Staines, UK) or mineral trioxide aggregate (MTA) (ProRoot MTA; Dentsply Tulsa Dental Specialties, Tulsa, OK) root-end fillings or alternatively Retroplast capping (Retroplast Trading, Rorvig, Denmark). Subjects examined at 1 year (n = 191) were invited for the 5-year clinical and radiographic examination. Based on blinded, independent assessment by 3 calibrated examiners, the dichotomous outcome (healed or nonhealed) was determined and associated with patient-, tooth-, and treatment-related variables using logistic regression. At the 5-year follow-up, 9 of 191 teeth were unavailable, 12 of 191 teeth were extracted, and 170 of 191 teeth were examined (87.6% recall rate). A total of 129 of 170 teeth were healed (75.9%) compared with 83.8% at 1 year, and 85.3% were asymptomatic. Two significant outcome predictors were identified: the mesial-distal bone level at ≤ 3 mm versus >3 mm from the cementoenamel junction (78.2% vs 52.9% healed, respectively; odds ratio = 5.10; confidence interval, 1.67-16.21; P apical microsurgery was 8% poorer than assessed at 1 year. It also suggested that the prognosis was significantly impacted by the interproximal bone levels at the treated tooth and by the type of root-end filling material used. Copyright © 2012 American Association of Endodontists. All rights reserved.

Upper extremity lymphedema: presence and effect on functioning five years after breast cancer treatment.

Science.gov (United States)

Shigaki, Cheryl L; Madsen, Richard; Wanchai, Ausanee; Stewart, Bob R; Armer, Jane M

2013-11-01

Our goal was to explore the effects of lymphedema on long-term adjustment among breast cancer survivors, in terms of functioning in important life environments. Limb volume measurements and psychosocial survey data were collected from women shortly after undergoing surgical intervention for breast cancer and annually thereafter. A subset of these women were selected for the current study because they had preoperative limb volume measurement data, which is best suited to determine presence and severity of lymphedema. Our final sample of 61 women had both the arm measurements (preoperative and 5-year) and survey data (baseline and 5-year) needed for this study, which comprises a secondary cross-sectional analysis of longitudinal data. A correlational approach was used to explore associations among lymphedema (presence, severity, and whether the participant met the criteria for lymphedema at any assessment point since their treatment for breast cancer) and outcome variables (physical functioning, vocational functioning, social functioning, domestic functioning, and sexual functioning). Each of the three measures of lymphedema was significantly correlated with domestic functioning, but not with functioning in other common environments. Long-term breast cancer survivors are at risk for developing secondary conditions, such as lymphedema, to which they must learn to adjust and adapt. Lymphedema may increase risk for compromised functioning in everyday environments, a problem which lies at the heart of rehabilitation. Breast cancer survivorship, therefore, fits well within the scope of a rehabilitation framework. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Quality of life and salivary output in patients with head-and-neck cancer five years after radiotherapy

International Nuclear Information System (INIS)

Braam, Pètra M; Roesink, Judith M; Raaijmakers, Cornelis PJ; Busschers, Wim B; Terhaard, Chris HJ

2007-01-01

To describe long-term changes in time of quality of life (QOL) and the relation with parotid salivary output in patients with head-and-neck cancer treated with radiotherapy. Forty-four patients completed the EORTC-QLQ-C30(+3) and the EORTC-QLQ-H&N35 questionnaires before treatment, 6 weeks, 6 months, 12 months, and at least 3.5 years after treatment. At the same time points, stimulated bilateral parotid flow rates were measured. There was a deterioration of most QOL items after radiotherapy compared with baseline, with gradual improvement during 5 years follow-up. The specific xerostomia-related items showed improvement in time, but did not return to baseline. Global QOL did not alter significantly in time, although 41% of patients complained of moderate or severe xerostomia at 5 years follow-up. Five years after radiotherapy the mean cumulated parotid flow ratio returned to baseline but 20% of patients had a flow ratio <25%. The change in time of xerostomia was significantly related with the change in flow ratio (p = 0.01). Most of the xerostomia-related QOL scores improved in time after radiotherapy without altering the global QOL, which remained high. The recovery of the dry mouth feeling was significantly correlated with the recovery in parotid flow ratio

Five years of solar UV-radiation monitoring in Sweden

Energy Technology Data Exchange (ETDEWEB)

Josefsson, Weine

1996-10-01

A network of five stations measuring the solar UV-radiation has been operated for about five years. Data are presented as plotted time-series of monthly and yearly values for the sites. A general climatology can be deduced from these data. Daily and hourly maximum values are shown for each month as indicators of the potential extreme exposure levels. The large annual variation at high latitudes is easily seen in the data set. This illustrates the importance of the solar elevation on the level of the UV-irradiance. Influence of cloud variation and of larger changes in ozone is also detectable. A few examples of the daily variation also show the strong solar elevation dependence of the UV-irradiance. The quantity and unit of the UV-radiation in this presentation is CIE-weighted irradiance expressed as MED (minimum erythermal dose), where one MED equals 210 Jm{sup -2}. The values have been recomputed to refer to the international intercomparison of broad-band meters in Helsinki in 1995. In the following named WMO-STUK 1995 scale. As will be seen there are many sources of error and detailed studies are prevented by the large uncertainty connected with these data. Due to the short period of the record and the low accuracy no attempt to study trends is done. 6 refs, 27 figs, 4 tabs

e+e- physics at PETRA - the first five years

International Nuclear Information System (INIS)

Sau Lan Wu

1984-03-01

PETRA (Positron-Electron Tandem Ring Accelerator) is located at DESY in Hamburg, Germany, and is the highest energy electron-positron storage ring in the world. This report gives a global review of the experimental investigations carried out at PETRA for the first five years of its operation beginning in 1978 by the five Collaborations CELLO, JADE, MARK J, PLUTO and TASSO. The physics objectives in the original proposals have largely been fullfilled. The emphasis of this review, based mainly on journal publications before July 15, 1983 (the fifth anniversary of the first successful storage on an electron beam at PETRA), is on the physics results, ranging over strong, electromagnetic and weak interactions. The topics covered include quark and gluon physics, inclusive particle production, electroweak interference, two-photon physics, and search for new particles. Although cited for comparison, no attempt has been made for any systematic coverage of the corresponding results from PEP of SLAC. (orig.)

Esophageal adenocarcinoma five years after laparoscopic sleeve gastrectomy. A case report

Directory of Open Access Journals (Sweden)

Fernando Gabriel Wright

2017-01-01

Conclusion: We present a case of an esophageal adenocarcinoma five years after a laparoscopic sleeve gastrectomy for morbid obesity. There is need to better determine the relationship between sleeve gastrectomy and gastroesophageal reflux disease in order to prevent its related complications, such as esophageal adenocarcinoma.

A five-day inpatient EMDR treatment programme for PTSD: pilot study

NARCIS (Netherlands)

Zepeda Méndez, Mayaris; Nijdam, Mirjam J.; ter Heide, F. Jackie June; van der Aa, Niels; Olff, Miranda

2018-01-01

Conclusions: The majority of patients in our pilot study experienced symptom reduction consistent with reliable changes in this five-day inpatient treatment with EMDR and yoga. Randomized controlled trials - with longer follow up periods - are needed to properly determine efficacy and efficiency of

Five years of operating experience with Phenix

International Nuclear Information System (INIS)

Conte, F.

1980-01-01

The construction of Phenix began at the end of 1968; the unit first went critical on August 31 st, 1973, and it was first connected to the grid of Electricite de France on 31st December 1973. It started operating industrially on July 14th, 1974. The balance sheet after five years of operations is as follows: Gross thermal capacity: 590 MW; Grosss electric capacity: 264 MW; Gross capacity factor of the power station: 45%; Gross electrical power produced by 30th september 1979: more than six billion kWh. In 1976 and 1977 the operation of the plant was affected by modifications made to the intermediate heat exchangers following leaks discovered in October 1976. Since 1976 the plants has been working at full capacity and the availability rate during the period July 1978 - July 1979 was more than 80% [fr

Treatment of selective mutism: a 5-year follow-up study.

Science.gov (United States)

Oerbeck, Beate; Overgaard, Kristin Romvig; Stein, Murray B; Pripp, Are Hugo; Kristensen, Hanne

2018-01-22

Selective mutism (SM) has been defined as an anxiety disorder in the diagnostic and statistical manual of mental disorders (DSM-5). Cognitive behavioral therapy (CBT) is the recommended approach for SM, but prospective long-term outcome studies are lacking. Reports from the children themselves, and the use of more global quality of life measures, are also missing in the literature. We have developed a school-based CBT intervention previously found to increase speech in a pilot efficacy study and a randomized controlled treatment study. Continued progress was found in our 1-year follow-up studies, where older age and more severe SM had a significant negative effect upon outcome. In the present study, we provide 5-year outcome data for 30 of these 32 children with SM who completed the same CBT for mean 21 weeks (sd 5, range 8-24) at mean age 6 years (10 boys). Mean age at the 5-year follow-up was 11 years (range 8-14). Outcome measures were diagnostic status, the teacher- and parent-rated selective mutism questionnaires, and child rated quality of life and speaking behavior. At the 5-year follow-up, 21 children were in full remission, five were in partial remission and four fulfilled diagnostic criteria for SM. Seven children (23%) fulfilled criteria for social phobia, and separation anxiety disorder, specific phobia and/or enuresis nocturna were found in a total of five children (17%). Older age and severity at baseline and familial SM were significant negative predictors of outcome. Treatment gains were maintained on the teacher- and parent questionnaires. The children rated their overall quality of life as good. Although most of them talked outside of home, 50% still experienced it as somewhat challenging. These results point to the long-term effectiveness of CBT for SM, but also highlight the need to develop more effective interventions for the subset of children with persistent symptoms.Clinical trials registration NCT01002196.

Improving quality of care in substance abuse treatment using five key process improvement principles

Science.gov (United States)

Hoffman, Kim A.; Green, Carla A.; Ford, James H.; Wisdom, Jennifer P.; Gustafson, David H.; McCarty, Dennis

2012-01-01

Process and quality improvement techniques have been successfully applied in health care arenas, but efforts to institute these strategies in alcohol and drug treatment are underdeveloped. The Network for the Improvement of Addiction Treatment (NIATx) teaches participating substance abuse treatment agencies to use process improvement strategies to increase client access to, and retention in, treatment. NIATx recommends five principles to promote organizational change: 1) Understand and involve the customer; 2) Fix key problems; 3) Pick a powerful change leader; 4) Get ideas from outside the organization; and 5) Use rapid-cycle testing. Using case studies, supplemented with cross-agency analyses of interview data, this paper profiles participating NIATx treatment agencies that illustrate application of each principle. Results suggest that the most successful organizations integrate and apply most, if not all, of the five principles as they develop and test change strategies. PMID:22282129

Nutrition and public hygiene among children under five years of age ...

African Journals Online (AJOL)

Objective: To determine the relationship between sanitation and malnutrition among children below five years. Design: A random sampling followed by an experimental design on microbiological analysis of food and water samples. Setting: Mukuru slums of Makadara division in Nairobi City. Subjects: Eighty food and thirty ...

After Twenty-Five Years: A Twenty-Five Year Follow-up Study of Middlesex County Vocational and Technical High School Graduates of the Class of June 1953.

Science.gov (United States)

Rogers, William; Zanzalari, J. Henry

A twenty-five-year follow-up study was conducted to determine the occupational, educational, marital and armed forces experiences of the graduating class of 1953 from the Middlesex County Vocational and Technical high schools located in New Brunswick, Perth, Amboy, and Woodbridge, New Jersey. Data, in the form of questionnaire responses, were…

Capitation of public mental health services in Colorado: a five-year follow-up of system-level effects.

Science.gov (United States)

Bloom, Joan R; Wang, Huihui; Kang, Soo Hyang; Wallace, Neal T; Hyun, Jenny K; Hu, Teh-wei

2011-02-01

Capitated Medicaid mental health programs have reduced costs over the short term by lowering the utilization of high-cost inpatient services. This study examined the five-year effects of capitated financing in community mental health centers (CMHCs) by comparing not-for-profit with for-profit programs. Data were from the Medicaid billing system in Colorado for the precapitation year (1994) and a shadow billing system for the postcapitation years (1995-1999). In a panel design, a random-effect approach estimated the impact of two financing systems on service utilization and cost while adjusting for all the covariates. Consistent with predictions, in both the for-profit and the not-for-profit CMHCs, relative to the precapitation year, there were significant reductions in each postcapitation year in high-cost treatments (inpatient treatment) for all but one comparison (not-for-profit CMHCs in 1999). Also consistent with predictions, the for-profit programs realized significant reductions in cost per user for both outpatient services and total services. In the not-for-profit programs, there were no significant changes in cost per user for total services; a significant reduction in cost per user for outpatient services was found only in the first two years, 1995 and 1996). The evidence suggests that different strategies were used by the not-for-profit and for-profit programs to control expenditures and utilization and that the for-profit programs were more successful in reducing cost per user.

Higher morale is associated with lower risk of depressive disorders five years later among very old people.

Science.gov (United States)

Niklasson, Johan; Näsman, Marina; Nyqvist, Fredrica; Conradsson, Mia; Olofsson, Birgitta; Lövheim, Hugo; Gustafson, Yngve

The aim of this study was to investigate whether higher morale, i.e. future-oriented optimism, at baseline was associated with lower risk of depressive disorders five years later among very old people.Methods The Umeå85+/GErontological Regional Database, a population-based study with a longitudinal design, recruited participants in Sweden and Finland aged 85, 90 and ≥95 years. The sample in the present study included 647 individuals (89.1±4.4 years (Mean±SD), range 85-103). After five years, 216 were alive and agreed to a follow-up (92.6±3.4 years, range 90-104). The Philadelphia Geriatric Center Morale Scale (PGCMS) was used to assess morale. The depressive disorder diagnosis was determined according to DSM-IV based on medical records and interview data including assessment scales for depressive disorders. A number of sociodemographic, functional and health-related variables were analysed as possible confounders.Results For those with no depressive disorders at baseline, the only baseline variable significantly associated with depressive disorders five years later was the PGCMS score. A logistic regression model showed lower risk of depressive disorders five years later with higher baseline PGCMS scores (odds ratio 0.779 for one point increase in PGCMS, pfive years later).Conclusion Our results indicate that the higher the morale, the lower the risk of depressive disorders five years later among very old people. The PGCMS seems to identify those very old individuals at increased risk of depressive disorders five years later. Preventive measures could befocused on this group. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A Five-Year School Building and Future Sites Program 1966-1970.

Science.gov (United States)

1965

Five-year school building and site needs and related financial requirements are summarized for Milwaukee's schools. Educational policies concerning the school building program are stated, and consideration is given to factors affecting school board needs such as birth rate, public housing projects, urban renewal, highways, and expressways. School…

Influences of the Big Five personality traits on the treatment response and longitudinal course of depression in patients with acute coronary syndrome: A randomised controlled trial.

Science.gov (United States)

Kim, Seon-Young; Stewart, Robert; Bae, Kyung-Yeol; Kim, Sung-Wan; Shin, Il-Seon; Hong, Young Joon; Ahn, Youngkeun; Jeong, Myung Ho; Yoon, Jin-Sang; Kim, Jae-Min

2016-10-01

Influences of the Big Five personality traits on the treatment response and longitudinal course of depression in patients with acute coronary syndrome: A randomised controlled trial. This naturalistic observational study initially recruited 1152 ACS patients; 685 patients completed personality assessments at baseline, of whom 630 were followed-up one year later. Of the 294 patients with depression, 207 participated in a 24-week double blind trial of escitalopram or placebo. The remaining 87 patients who received medical treatment only and the 391 who had not depression were also followed in a one year naturalistic observational study. The Big five personality traits were assessed using the Big Five Inventory. The influences of personality on the Hamilton Depression Rating Scale score changes were analysed using a mixed-model repeated-measures analysis of covariance. A Cluster analysis identified two personality types: resilient and vulnerable. The vulnerable personality type was characterized by lower extraversion, agreeableness, and conscientiousness - but higher neuroticism - than the resilient type. This personality type was independently associated with a poorer outcome of depression in ACS patients during the 24-week treatment period and the one year longitudinal follow-up period compared to the resilient personality type, irrespective of treatment allocation. Recruitment from a single institution may limit generalisability. Personality traits were investigated 12-weeks after ACS; thus, the responses may have been influenced by the prior receipt of escitalopram. Personality types influences the treatment outcome and longitudinal course of depression in ACS patients independent of antidepressant treatment. Copyright © 2016 Elsevier B.V. All rights reserved.

Pneumonia in rural Malawians under five years old: Treatment outcomes and clinical predictors of death on admission

Directory of Open Access Journals (Sweden)

Prosper M. Lutala

2009-09-01

Method: The medical records of 466 consecutive patients admitted to the Mchinji District Hospital from January 2004 to January 2006 whose disease met the World Health Organization criteria for pneumonia were reviewed. Data were collected from forms that had been filled out and different treatment outcomes and determinants of death were analysed using logistic regression. Results: Of the 466 patients, 62.7% completed treatment, 15.9% had unknown outcomes, 12.9% died, 8.4% were lost to follow-up, 0.8% failed to improve with treatment, and 0.4% were transferred to other facilities. Independent predictors of death were: age less than 2 years, female sex, history of pneumonia, chest retractions, type of pneumonia, and central cyanosis. Conclusion: A high proportion of deaths and unknown outcomes occurred among participants. Young age, female sex, history of pneumonia, chest retractions and central cyanosis were associated with death. Mortality from pneumonia may be reduced by close monitoring of these risk factors and by improving health education programmes and communicating these findings to parents and health workers. Further investigations of local reasons for high rates of unknown/unreported outcomes are welcomed.

[Prevalence of overwight and obesity among children under five years in Peru 2007-2010].

Science.gov (United States)

Pajuelo-Ramírez, Jaime; Miranda-Cuadros, Marianella; Campos-Sánchez, Miguel; Sánchez-Abanto, José

2011-06-01

To estimate the prevalence of overweight and obesity in children under five in Peru in the years 2007-2010 and to describe according to geographical areas, poverty levels, maternal education, breastfeeding, child age, sex and birth weight. continuous (repeated cross-sectional) multistage, random sampling survey from the universe of children under five-years and pregnant women living in Peru, divided into five geographical areas. Out of 3,669 children, 50.3% were males (Lima N=680, Remaining Coast N=763, Urban Sierra N=719, Rural Sierra N=699, Jungle N=808) having their weight and height measured according to international standards. The national prevalence of overweight and obesity was 6.9%, with Metropolitan Lima (10.1%) as the highest and in the Jungle (2.6%) as the lowest. Age, sex, geographical area and birth weight were identified as risk factors through multiple logistic regression. overweight and obesity are higher in Lima, during the first year of age and when birth weight is more than 2.5 Kg.

Do retreatment tuberculosis patients need special treatment response follow-up beyond the standard regimen? Finding of five-year retrospective study in pastoralist setting.

Science.gov (United States)

Getnet, Fentabil; Sileshi, Henok; Seifu, Wubareg; Yirga, Selam; Alemu, Abere Shiferaw

2017-12-12

Treatment outcomes serve as proxy measures of the quality of tuberculosis treatment provided by the health care system, and it is essential to evaluate the effectiveness of Directly Observed Therapy-Short course program in controlling the disease, and reducing treatment failure, default and death. Hence, we evaluated tuberculosis treatment success rate, its trends and predictors of unsuccessful treatment outcome in Ethiopian Somali region where 85% of its population is pastoralist. A retrospective review of 5 years data (September 2009 to August 2014) was conducted to evaluate the treatment outcome of 1378 randomly selected tuberculosis patients treated in Kharamara, Dege-habour and Gode hospitals. We extracted data on socio-demographics, HIV Sero-status, tuberculosis type, treatment outcome and year using clinical chart abstraction sheet. Tuberculosis treatment outcomes were categorized into successful (cured and/or completed) and unsuccessful (died/failed/default) according to the national tuberculosis guideline. Data was entered using EpiData 3.1 and analyzed using SPSS 20. Chi-square (χ 2 ) test and logistic regression model were used to reveal the predictors of unsuccessful treatment outcome at P ≤ 0.05 significance level. The majority of participants was male (59.1%), pulmonary smear negative (49.2%) and new cases (90.6%). The median age was 26 years [IQR: 18-40] and HIV co-infection rate was 4.6%. The overall treatment success rate was 86.8% [95%CI: 84.9% - 88.5%]; however, 4.8%, 7.6% and 0.7% of patients died, defaulted and failed to cure respectively. It fluctuated across the years and ranged from 76.9% to 94% [p tuberculosis types and HIV status (P > 0.05). This study revealed that the overall tuberculosis treatment success rate has realized the global target for 2011-2015. However, it does not guarantee its continuity as adverse treatment outcomes might unpredictably occur anytime and anywhere. Therefore, continual effort to effectively

Five-year durability of stand-alone interspinous process decompression for lumbar spinal stenosis

Directory of Open Access Journals (Sweden)

Nunley PD

2017-09-01

Full Text Available Pierce D Nunley,1 Vikas V Patel,2 Douglas G Orndorff,3 William F Lavelle,4 Jon E Block,5 Fred H Geisler6 1Spine Institute of Louisiana, Shreveport, LA, 2The Spine Center, University of Colorado Hospital, Denver, CO, 3Spine Colorado, Mercy Regional Hospital, Durango, CO, 4Upstate Bone and Joint Center, East Syracuse, NY, 5Independent Consultant, San Francisco, CA, 6Independent Consultant, Chicago, IL, USA Background: Lumbar spinal stenosis is the most common indication for spine surgery in older adults. Interspinous process decompression (IPD using a stand-alone spacer that functions as an extension blocker offers a minimally invasive treatment option for intermittent neurogenic claudication associated with spinal stenosis.Methods: This study evaluated the 5-year clinical outcomes for IPD (Superion® from a randomized controlled US Food and Drug Administration (FDA noninferiority trial. Outcomes included Zurich Claudication Questionnaire (ZCQ symptom severity (ss, physical function (pf, and patient satisfaction (ps subdomains, leg and back pain visual analog scale (VAS, and Oswestry Disability Index (ODI.Results: At 5 years, 84% of patients (74 of 88 demonstrated clinical success on at least two of three ZCQ domains. Individual ZCQ domain success rates were 75% (66 of 88, 81% (71 of 88, and 90% (79 of 88 for ZCQss, ZCQpf, and ZCQps, respectively. Leg and back pain success rates were 80% (68 of 85 and 65% (55 of 85, respectively, and the success rate for ODI was 65% (57 of 88. Percentage improvements over baseline were 42%, 39%, 75%, 66%, and 58% for ZCQss, ZCQpf, leg and back pain VAS, and ODI, respectively (all P<0.001. Within-group effect sizes were classified as very large for four of five clinical outcomes (ie, >1.0; all P<0.0001. Seventy-five percent of IPD patients were free from reoperation, revision, or supplemental fixation at their index level at 5 years.Conclusion: After 5 years of follow-up, IPD with a stand-alone spacer provides

Prevalence of rotavirus among children under five years of age with ...

African Journals Online (AJOL)

Rotavirus (RV) is a major etiological agent of acute infantile gastroenteritis and is associated with 20%-25% of diarrhea cases in infants. Nigeria continues to be among the first five countries with greatest number of RV disease associated deaths per year. The objective was to determine some demographic factors that might ...

Public comments and responses to the 1993 Hanford cleanup five-year plan

International Nuclear Information System (INIS)

1993-08-01

In March 1993, the US Department of Energy, Richland Operations Office (DOE-RL) published its annual Site-Specific Five-Year Plan. The Site-Specific Plan is published to inform the public about the background, status, and plans for Environmental Restoration (ER) and Waste Management (WM) activities at the Hanford site. It is the only document that seeks to bring all ER and WM elements together in one document. The Site-Specific Plan is a companion document to the National Five-Year Plan that deals with all the sites within the DOE complex on a summary level. This Response to Comments document does not try to address every question or concern raised during the public comment period. Some questions were outside the scope of the Five-Year Plan, some we could not decipher, others were variations of the same question. The initial round of public meetings was held in Portland, Oregon, and Seattle, Pasco, and Olympia, Washington. At the request of the Oregon Department of Energy (ODOE) and the Washington State Department of Ecology (Ecology), a second round of meetings was held in Portland and Olympia. Both agencies felt that the first two meetings were held with too little advance notice, and before the Plan could be distributed. Once the public meetings were over and the comment period closed, we then compiled the public comments, largely from audio tapes of the meetings. Individual functions within Hanford were asked to consider and respond to the comments

Does life satisfaction predict five-year mortality in community-living older adults?

Science.gov (United States)

St John, Philip D; Mackenzie, Corey; Menec, Verena

2015-01-01

Depression and depressive symptoms predict death, but it is less clear if more general measures of life satisfaction (LS) predict death. Our objectives were to determine: (1) if LS predicts mortality over a five-year period in community-living older adults; and (2) which aspects of LS predict death. 1751 adults over the age of 65 who were living in the community were sampled from a representative population sampling frame in 1991/1992 and followed five years later. Age, gender, and education were self-reported. An index of multimorbidity and the Older American Resource Survey measured health and functional status, and the Terrible-Delightful Scale assessed overall LS as well as satisfaction with: health, finances, family, friends, housing, recreation, self-esteem, religion, and transportation. Cox proportional hazards models examined the influence of LS on time to death. 417 participants died during the five-year study period. Overall LS and all aspects of LS except finances, religion, and self-esteem predicted death in unadjusted analyses. In fully adjusted analyses, LS with health, housing, and recreation predicted death. Other aspects of LS did not predict death after accounting for functional status and multimorbidity. LS predicted death, but certain aspects of LS are more strongly associated with death. The effect of LS is complex and may be mediated or confounded by health and functional status. It is important to consider different domains of LS when considering the impact of this important emotional indicator on mortality among older adults.

Five-yearly review: where do we stand now?

CERN Multimedia

Staff Association

2016-01-01

A reminder The first issue of Echo in 2016 announced a year of changes with many challenges for the Staff Association and the staff it represents. Indeed, following the decision of the Council in December 2015 to approve all components of the five-yearly review, many changes were to be implemented in 2016. This is the case of the new career structure, the definition of benchmark jobs (BMJ), the redesign of the advancement and promotions process, etc. Looking back at 2015 and the various statements In December 2015, the CERN Council emphasized: the substantial effort made by the Staff Association and the Management, taking into account the difficult economic situation faced by some Member States, led to the creation of a package of measures as balanced as possible. It is clear however: that there was no alignment of CERN basic salaries with the comparison salaries; that in the new career system, staff will have their advancement prospects, and consequently the level of their pension, reduced with respect to ...

Tc-99m Radiolabeled Alendronate Sodium Microemulsion: Characterization and Permeability Studies Across Caco-2 Cells.

Science.gov (United States)

Elitez, Yetkin; Ekinci, Meliha; Ilem-Ozdemir, Derya; Gundogdu, Evren; Asikoglu, Makbule

2018-01-01

Alendronate sodium (ALD) is used orally but it is poorly absorbed from the gastrointestinal (GI) tract. For this reason, microemulsion system was chosen to evaluate ALD from the GI tract after oral delivery. This study was aimed to prepare water-in-oil (w/o) microemulsion formulation of ALD and evaluate the permeability of ALD microemulsion from Caco-2 cell lines with radioactive and nonradioactive studies. The ALD microemulsion was developed by using pseudo-ternary phase diagram and composed of Soybean oil, Colliphor EL, Tween 80, Transcutol and distilled water. The prepared ALD microemulsion was characterized by physical appearance, droplet size, viscosity, pH, electrical conductivity and refractive index. The stability of the formulation was investigated for 6 months at 25±2°C/60±5% of relative humidity (RH) as well as at 40±2°C/75±5% RH. After that 1 mg of ALD was radiolabeled with 99mTc and added to microemulsion. The permeability studies were performed with both 99mTc-ALD microemulsion and ALD microemulsion. The experimental results suggested that ALD microemulsion presented adequate stability with droplet size varying from 37.8±0.9 to 39.9±1.2 nm during incubation time. In addition, ALD microemulsion was radiolabeled with high labeling efficiency (>95%). In a non-radioactive study, ALD permeability was found to be 45 µg.mL-1 and microemulsion has high permeability percentage when compared to another study. The novel w/o microemulsion formulation has been developed for oral delivery of ALD. Based on the results, permeability of ALD could be significantly improved by the microemulsion formulation. In addition, 99mTc-ALD microemulsion in capsule can be used for bone disease treatment and diagnosis. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Results on safety research for five years (from fiscal year 1996 to 2000). A field of power reactors

International Nuclear Information System (INIS)

2001-10-01

This safety research carried out by the Japan Nuclear Cycle Development Institute (JNC) for five years ranged from 1996 to 2000 fiscal year, was performed according to the safety research basic plan (from 1996 to 2000 fiscal year) established on March, 1996 (revised again on May, 2000). This report was arranged on a field on power reactors (all subjects on fields of advanced conversion reactor and a subject on power reactor in a field of seismic resistant and probability theoretical safety evaluation) by combining its research results for five years ranged from 1996 to 2000 fiscal year with general outlines on the safety research basic plan. Here were shown outlines on the safety research basic plan, aims and subjects on safety research at a field of power reactors, a list of survey sheets on safety research result, and survey sheets on safety research results. The survey sheets containing research field, title, organization, researcher name, researching period, names of cooperative organization, using facilities, research outline, research results, established contents, application, and research trends, are ranged to 5 items on advanced conversion reactor, 29 items on high breeder reactor, 1 item on seismic resistance, and 5 items on probability theoretical safety evaluation. (G.K.)

Decommissioning of AECL Whiteshell Laboratories: progress from first five years of legacy funding

International Nuclear Information System (INIS)

Swartz, R.S.; Bilinsky, D.M.; Harding, J.W.; Ridgway, W.R.

2011-01-01

In 2006, the Government of Canada adopted a new long-term strategy to deal with the nuclear legacy liabilities and initiated a five-year start-up phase. The objective is to safely and cost-effectively reduce these liabilities, and associated risks, based on sound waste management and environmental principles in the best interests of Canadians. AECL's Whiteshell Laboratories is part of the long-term strategy and decommissioning activities are underway. Several redundant non-nuclear buildings have been removed/decommissioned, and redundant nuclear facilities (hot cell facilities, radiochemical laboratories) are being decontaminated and prepared for demolition. This paper describes the progress in the first five-year funding period (2006 April to 2011 March). (author)

[Association between the use of blood components and the five-year mortality after liver transplant].

Science.gov (United States)

de Morais, Bruno Salomé; Sanches, Marcelo Dias; Ribeiro, Daniel Dias; Lima, Agnaldo Soares; de Abreu Ferrari, Teresa Cristina; Duarte, Malvina Maria de Freitas; Cançado, Guilherme Henrique Gomes Moreira

2011-01-01

Liver transplant (LT) surgery is associated with significant bleeding in 20% of cases, and several authors have demonstrated the risks related to blood components. The objective of the present study was to evaluate the impact of using blood components during hospitalization in five-year survival of patients undergoing LT. One hundred and thirteen patients were evaluated retrospectively. Several variables, including the use of blood components intraoperatively and throughout hospitalization, were categorized and evaluated by univariate analysis using Fisher's test. A level of significance of 5% was adopted. Results with p renal dysfunction, and longer stay in hospital and ICU are associated with greater five-year mortality after LT (p transplantation (p < 0.01). This study emphasizes the relationship between the use of blood components during hospitalization and increased mortality in five years after LT. 2011 Elsevier Editora Ltda. All rights reserved.

Children under Five and Digital Technologies: Implications for Early Years Pedagogy

Science.gov (United States)

Palaiologou, Ioanna

2016-01-01

This project aimed to investigate the types of digital technologies children under the age of five are using at home and assess the possible implications for early years pedagogy. The research, carried out between 2010 and 2012, was based in four European countries: England, Greece, Malta and Luxemburg. A mixed methods approach was employed to…

An appraisal of retained placentae in Ibadan: a five year review ...

African Journals Online (AJOL)

During the study period, 4980 deliveries took place at the University College Hospital, Ibadan and 106 cases of retained placenta were managed making the incidence 2.13 per cent of all births. Results: During the five year period, there were 106 patients with retained placenta; of these, 90 (84.9%) case notes were ...

Use of insecticide-treated mosquito nets for children under five years ...

African Journals Online (AJOL)

2011-06-13

Jun 13, 2011 ... Background: Insecticide-treated nets (ITNs) have proven to be one of the most effective means of reducing malaria morbidity and mortality in children and pregnant women. This study is carried out to determine the practice and determinants of ITN use for children under five years among care givers in an ...

Electricity supply alternatives : the next five years

International Nuclear Information System (INIS)

Oliver, W.J.

1998-01-01

Characteristics of the energy market for New England and the state of New York were summarized. It was predicted that in the next five years, virtually all proposals for electricity generation for New England and New York will be gas-fired combined cycle projects which are designed to meet new generation requirements and displace older steam units. The status of nuclear plants will influence project economics. It has been estimated that New England will need about 6,000-7,000 MW by 2004. This need is driven by the current deficiencies and increased shortfalls due to load growth and economic retirements of 2,000-4,000 MW. Market assumptions for new entrants, merchant plant economics, gas requirements in New England, pipeline capacity and power generation, and the challenges facing the natural gas industry were reviewed. A list of proposed combined cycle natural gas merchant power plants and their generating capacity was also provided. 1 tab., 5 figs

Retrospective evaluation of the five-year and ten-year CSEP-Italy earthquake forecasts

Directory of Open Access Journals (Sweden)

Stefan Wiemer

2010-11-01

Full Text Available On August 1, 2009, the global Collaboratory for the Study of Earthquake Predictability (CSEP launched a prospective and comparative earthquake predictability experiment in Italy. The goal of this CSEP-Italy experiment is to test earthquake occurrence hypotheses that have been formalized as probabilistic earthquake forecasts over temporal scales that range from days to years. In the first round of forecast submissions, members of the CSEP-Italy Working Group presented 18 five-year and ten-year earthquake forecasts to the European CSEP Testing Center at ETH Zurich. We have considered here the twelve time-independent earthquake forecasts among this set, and evaluated them with respect to past seismicity data from two Italian earthquake catalogs. We present the results of the tests that measure the consistencies of the forecasts according to past observations. As well as being an evaluation of the time-independent forecasts submitted, this exercise provides insight into a number of important issues in predictability experiments with regard to the specification of the forecasts, the performance of the tests, and the trade-off between robustness of results and experiment duration. We conclude with suggestions for the design of future earthquake predictability experiments.

Five years of operating the TRIGA Mainz reactor

International Nuclear Information System (INIS)

Benedict, Georg

1970-01-01

Considerable obstacles had to be surmounted before TRIGA MAINZ, first TRIGA reactor built in Germany, reached initial criticality in 1965. Subsequent five years' operation did not raise any major problems. The facility has proven quite reliable and particularly well suited for the purposes of the nuclear chemistry research program pursued at Mainz University. Extensive use is made of the pulse mode of operation. As a result, fuel elements are obviously somewhat overstressed, even though most pulses performed are of the 1.50 dollar size. Maximum licensed steady state power of 100 kW till now has met the requirements of most experiments. However, efforts are in progress to improve irradiation conditions by increasing the reactor power to 300 kW. (author)

A Five-Year Review of Tag Rugby Hand Injuries.

Science.gov (United States)

Joyce, C W; Woods, J F C; Murphy, S; Bollard, S; Kelly, J L; Carroll, S M; O'Shaughnessy, M

2016-10-01

Tag rugby is one of the fastest growing sports in Ireland. It is a soft-contact team game that is loosely based on the rugby league format except players try to remove Velcro tags from their opponents' shorts rather than engage in a typical rugby tackle. The purpose of this study was to examine all tag rugby associated hand injuries over a five-year period in three large tertiary referral hospitals in Ireland. Using the patient corresponding system, 228 patients with hand injury related tag rugby injuries were observed from 2010 to 2015. There were 138 males and 90 females in the study and over 40% of patients required surgery. Most of the patients were young professionals with an average age of 30. Twenty-five patients worked in the financial services whilst there were 23 teachers. Fractures accounted for 124 of the 228 injuries and mallet injuries accounted for 53. Eighty percent of all injuries occurred during the tackle. The mean number of days missed from work was 9.1±13.8 days. These injuries resulted in an average of seven hospital appointments per patient. Considering it is a soft-contact sport, it is surprising the number of hand injuries that we have observed. Although safety measures have been introduced to decrease the number of hand injuries in recent years, there is a need for further improvements. Better player education about seeking prompt medical attention once an injury occurs, coupled with longer shorts worn by players may improve measures for the sport. Copyright © 2016. Published by Elsevier Ltd.

Lenin nuclear reactor research institute in the tenth five-year plan

International Nuclear Information System (INIS)

Tsykanov, V.A.; Kulov, E.V.

1980-01-01

Main tasks and research results of Lenin Nuclear Reactor Reseach Institute in the 10-th Five-Year Plan are considered. Main research achievements are noted in nuclear power, radiation material testing, accumulation of transuranium elements and investigation of their physicochemical properties at VK-50, BOR-60, SM-2, RBT-6 and MIR reactor plants and in material testing laboratories

Caries in five-year-old children and associations with family-related factors.

Science.gov (United States)

Mattila, M L; Rautava, P; Sillanpää, M; Paunio, P

2000-03-01

It is generally understood that the teeth of pre-school-aged children are healthy, but the improvement in the dmft index has halted in the industrialized countries. Those few children who have caries have more of it than before. Little is known of the family-related factors which are associated with this polarization of caries. A representative population-based sample consisted of 1443 mothers expecting their first child. The children were followed at well-baby clinics and public dental health clinics for over five years. The objective was to study the prevalence of dental caries and its predictors in five-year-old children and to assess children's own dental health habits and the meaning of family-related factors in dental health. The findings were based on questionnaire data from parents and on clinical dental examinations of the five-year-old children as completed by 101 public health dentists. In firstborn five-year-old children, dental health was found to be good in 72%, fair in 20%, and poor in 8% of the cases. The final multivariate analysis illustrated that the dmft index > 0 was independently associated with the mother's irregular toothbrushing (OR 2.2; 95% CI 1.4-3.5), annual occurrence of several carious teeth in the father (OR 2.6; 95% CI 1.9-3.6), daily sugar consumption at the age of 18 months (OR 2.4; 95% CI 1.4-4.1), occurrence of child's headaches (OR 3.7; 95% CI 1.5-8.8), parents' cohabitation (OR 3.3; 95% CI 1.5-7.6), rural domicile (OR 2.4; 95% CI 1.2-4.5), and mother's young age (OR 5.0; 95% CI 1.3-19.8). The findings indicated that attention should be paid not only to the child's dental health care but also to that of the whole family. Parents should be supported in their upbringing efforts and encouraged to improve their children's dental health habits. In everyday life, parents function as role models for their children, and therefore, parents' own dental hygiene habits are very meaningful.

SNL Five-Year Facilities & Infrastructure Plan FY2015-2019

Energy Technology Data Exchange (ETDEWEB)

Cipriani, Ralph J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2014-12-01

Sandia’s development vision is to provide an agile, flexible, safer, more secure, and efficient enterprise that leverages the scientific and technical capabilities of the workforce and supports national security requirements in multiple areas. Sandia’s Five-Year Facilities & Infrastructure Planning program represents a tool to budget and prioritize immediate and short-term actions from indirect funding sources in light of the bigger picture of proposed investments from direct-funded, Work for Others and other funding sources. As a complementary F&I investment program, Sandia’s indirect investment program supports incremental achievement of the development vision within a constrained resource environment.

Vitamin E diffused highly cross-linked polyethylene in total hip arthroplasty at five years

DEFF Research Database (Denmark)

Nebergall, Audrey K; Greene, M. E.; Laursen, M B

2017-01-01

Aims: The objective of this five-year prospective, blinded, randomised controlled trial (RCT) was to compare femoral head penetration into a Vitamin E diffused highly cross-linked polyethylene (HXLPE) liner with penetration into a medium cross-linked polyethylene control liner using......, ArComXL. This is the longest-term RCT comparing the wear performance and clinical outcome of Vitamin E diffused HXLPE with a previous generation of medium cross-linked polyethylene....... radiostereometric analysis. Patients and Methods: Patients scheduled for total hip arthroplasty (THA) were randomised to receive either the study E1 (32 patients) or the control ArComXL polyethylene (35 patients). The median age (range) of the overall cohort was 66 years (40 to 76). Results: The five-year median...

A Study Of Universal Immunization Coverage During Last Five Years In Resettlement Colonies Of Delhi

Directory of Open Access Journals (Sweden)

Salhotra V S

1999-01-01

Full Text Available Research Question: Is there any difference in immunization coverage in resettlement colonies of Delhi during past five years? Objectives: 1. To study the immunization coverage levels of children over a period of five years. 2. To observe changes in the coverage levels of different years, if any. Study design: Cross-sectional study. Setting: Khichripur, Kalyanpuri, Kalyanpuri, Trilokpuri and Himmatpuri- four resettlement colonies of trans-Yamuna area of Delhi. Participants: 1500 children belonging to five age-groups i.e. birth-1 yr., 1-2 yrs., 2-3 yrs, and 4-5 yrs. Methods: Verification of child’s immunization from immunization card and interview of mother if immunization car was not available. Study period: May1997 to March1998 Results: Immunization with individual vaccines and immunization status of the children peaked in 1995-96 but started falling thereafter due to fall in ICE activities.

Rural Transformation and Planning Tactics in the 13th Five-Year Plan Period

Institute of Scientific and Technical Information of China (English)

Luo; Xiaolong; Xu; Xiao; Li; Min

2016-01-01

Rural development has long been the focus of China’s central and local governments. Since the late 2000 s, rural areas have presented new transformation features and development trends. To stimulate rural transformation and development in the 13 th Five-Year Plan period, this paper reviews major ideas on rural development in related disciplines. This study also summarizes main rural transformation features, including the aging population, hollow villages, changes in the allocation of land resource, semi-urbanization, and regional differences in rural development. Finally, it also provides suggestions for planning tactics in the 13 th Five-Year Plan period, such as making differentiated rural development strategies, exploring new methods to stimulate rural stock land planning and use, and enforcing relevant policy and management reforms.

Rural Transformation and Planning Tactics in the 13th Five-Year Plan Period

Institute of Scientific and Technical Information of China (English)

Luo Xiaolong; Xu Xiao; Li Min

2016-01-01

Rural development has long been the focus of China's central and local governments.Since the late 2000s,rural areas have presented new transformation features and development trends.To stimulate rural transformation and development in the 13th Five-Year Plan period,this paPer reviews major ideas on rural development in related disciplines.This study also summarizes main rural transformation features,including the aging population,hollow villages,changes in the allocation of land resource,semi-urbanization,and regional differences in rural development.Finally,it also provides suggestions for planning tactics in the 13th Five-Year Plan period,such as making differentiated rural development strategies,exploring new methods to stimulate rural stock land planning and use,and enforcing relevant policy and management reforms.

Five years program execution outcome; Bilan d'execution du plan quinquenal

Energy Technology Data Exchange (ETDEWEB)

NONE

1983-07-01

This document presents realized activities during five years program in mine field and petroleum (1979-1983). It involves mining and petroleum researches and mining productions. [French] Le document presente les activites realisees dans le domaine des mines et du petrole pendant les 5 annees du plan quinquenal (1979-1983). Il s'agit des recherches minieres et petrolieres et des productions minieres.

[Orthodontic treatment of patients medicated with bisphosphonates-a clinical case report].

Science.gov (United States)

Krieger, Elena; d'Hoedt, Bernd; Scheller, Herbert; Jacobs, Collin; Walter, Christian; Wehrbein, Heinrich

2013-01-01

Bisphosphonates (BP) are an established medication, e.g., for the prevention/therapy of osteoporosis. The effects of the changed bone metabolism for orthodontic treatments are unknown. A 66-year-old woman underwent a total oral rehabilitation. The therapy included (1) tooth extractions, (2) periodontal treatment, (3) insertion of dental implants, (4) provisional implant restorations, (5) orthodontic treatment, and (6) definite implant restorations. The orthodontic tooth movements were in- and retrusion of the upper frontal teeth, intrusion of the lower front teeth, using the dental implants as skeletal anchorage. After implant insertion and one month before beginning the orthodontic treatment, osteoporosis was diagnosed in this patient and, without notification to our facility, BP treatment was initiated by her general practitioner (alendronate oral, 70 mg/week), with an overall duration of intake of 7 months. After 13 months, the orthodontic treatment was successfully accomplished; however enlarged periodontal gaps, sclerotic bone areas, and mild apical root resorptions of the upper frontal teeth were found in this patient. Currently, there are no recommendations for orthodontic patients undergoing BP therapy. Orthodontic tooth movement in this low-risk patient with a short duration of intake and a low-dose BP medication was possible. Because of the reduced bone metabolism and the higher amount of side effects, the treatment should be performed with extremely light forces and frequent monitoring.

Career Decision Status as a Predictor of Resignation Behavior Five Years Later

Science.gov (United States)

Earl, Joanne K.; Minbashian, Amirali; Sukijjakhamin, Aun; Bright, Jim E. H.

2011-01-01

This paper extends earlier research exploring the relationship between career decision status and work outcomes by examining resignation behavior in a group of new graduates five years after initial appointment. On appointment various measures were collected including career decision status variables. Earlier research identified a significant…

Double cervix in a five-year-old white Fulami cow | Ajala | African ...

African Journals Online (AJOL)

A case report of true double cervix in a five-year-old white Fulani cow is presented. The condition is known to cause infertility which might be the reason why the cow was brought to the slaughterhouse at this critical age. Keywords: Double cervix, cow ...

Five years of opening the electricity market in Germany: an assessment

International Nuclear Information System (INIS)

Feder, A.

2004-01-01

In 1998, the German federal government decided to transpose in national law the principle of competition in the sector of electricity. To set up an electricity market, the new law has more or less dismantled the former system of the juxtaposed monopolies of approximately nine hundred local energy firms. The author tries to answer the following questions: How were the new market's legal and institutional modalities determined? What political choices underlie them? What benefits will consumers draw from this liberalization? What assessment has Germany made about these past five years ? What are the hopes and fears for coming years? (author)

Still the One: Reflections on Sixty-Five Years of Resilience and Relevance

Science.gov (United States)

Adcock, Donald; Ballard, Susan

2015-01-01

2016 marks an important milestone for the American Association of School Librarians (AASL). Despite the ever-changing and always-challenging economic, political, and societal landscape, for nearly sixty-five years the association has grown and prospered within the structure of the American Library Association (ALA) and remains "the only…

Key projects to be enforced during the 11th Five-year Plan

Institute of Scientific and Technical Information of China (English)

无

2009-01-01

@@ Addressing major S&T issues of strategic importance to China's socioeconomic growth, national security and development sustainability, the key projects of CAS during the period of the 11th Five-year Plan (2006-2010) are large-scale research initiatives with an expectation to give rise to S&T breakthroughs.

Five-year change in morale is associated with negative life events in very old age.

Science.gov (United States)

Näsman, Marina; Niklasson, Johan; Saarela, Jan; Nygård, Mikael; Olofsson, Birgitta; Conradsson, Mia; Lövheim, Hugo; Gustafson, Yngve; Nyqvist, Fredrica

2017-10-27

The objectives were to study changes in morale in individuals 85 years and older, and to assess the effect of negative life events on morale over a five-year follow-up period. The present study is based on longitudinal data from the Umeå85+/GERDA-study, including individuals 85 years and older at baseline (n = 204). Morale was measured with the Philadelphia Geriatric Center Morale Scale (PGCMS). Negative life events were assessed using an index including 13 negative life events occurring during the follow-up period. Linear regression was used for the multivariate analyses. The majority of the sample (69.1%) had no significant changes in morale during the five-year follow-up. However, the accumulation of negative life events was significantly associated with a greater decrease in PGCMS. A higher baseline PGCMS score did not attenuate the adverse effect negative life events had on morale. Morale seemed to be mainly stable in a five-year follow-up of very old people. It seems, nonetheless, that individuals are affected by negative life events, regardless of level of morale. Preventing negative life events and supporting individuals who experience multiple negative life events could have important implications for the care of very old people.

Risk factors for malnutrition in under-five children: one year after the Yogyakarta earthquake

Directory of Open Access Journals (Sweden)

Neti Nurani

2011-12-01

Full Text Available Background Malnutrition in children under the age of five remains a major health problem, since half of mortality cases in this age group involve malnutrition. The 2006 earthquake caused destruction of physical, biological and socio-economic environments, potentially leading to malnutrition in Yogyakarta children. Objective To identify the prevalence and risk factors of malnutrition in Yogyakarta children under five years of age, one year after the 2006 earthquake. Methods We conducted a cross-sectional study among children aged 0 to 60 months in the Bambanglipuro Subdistrict, Bantul Regency, Yogyakarta from September to October 2007. Nutritional status was determined using weight for height Z-scores, according to the WHO 2006 Child Growth Standards. Results Out of 666 subjects, we found severe malnutrition, undernutrition, normal weight, and overweight status in 1.7%, 4.8%, 88.6% and 4.8%, respectively. By multivariate analysis, risk factors for malnutrition were not having been weighed during the previous three months (OR 0.35; 95% CI 0.1 to 0.8 and having acute respiratory infection in the previous two weeks (OR 1.99; 95% CI 1.1 to 3.8 Conclusion One year following the 2006 earthquake, acute respiratory infection in the previous two weeks and unmonitored growth in the previous three months were risk factors for malnutrition in children under five years.

Results on safety research for five years (from fiscal year 1996 to 2000). A field of nuclear fuel cycle

International Nuclear Information System (INIS)

2001-10-01

This safety research carried out by the Japan Nuclear Cycle Development Institute (JNC) for five years ranged from fiscal year 1996 to 2000, was performed according to the safety research basic plan (from fiscal year 1996 to 2000) established on March, 1996 (revised again on May, 2000). This report was arranged on a field on nuclear fuel cycle (all subjects on fields of nuclear fuel facility, environmental radioactivity and radioactive wastes and a subject on nuclear fuel cycle in a field of seismic resistant and probabilistic safety assessment) by combining its research results for five years ranged from 1996 to 2000 fiscal year with general outlines on the safety research basic plan. Here were shown outlines on the safety research basic plan, aims and subjects on safety research at a field of nuclear fuel cycle, a list of survey sheets on safety research result, and survey sheets on safety research results. The survey sheets containing research field, title, organization, researcher name, researching period, names of cooperative organization, using facilities, research outline, research results, established contents, application, and research trends, are ranged to 21 items on nuclear fuel facility, 1 item on seismic resistance, 2 items on probabilistic safety assessment, 8 items on environmental radioactivity, and 20 items on radioactive wastes. (G.K.)

CO2 emissions and economic development: China's 12th five-year plan

International Nuclear Information System (INIS)

Meng Ming; Niu Dongxiao; Shang Wei

2012-01-01

For the period of the 12th Five-Year Plan (2011–2015), the Chinese government has decided to reconsider and adjust its policies on economic development because of the pressures of CO 2 emissions and fossil energy consumption. The current paper adopts the logarithmic Stochastic Impacts by Regression on Population, Affluence, and Technology (STIRPAT) model to simulate the relationship between CO 2 emissions and other economic development factors in China. Three groups of outliers are found using samples from 1989 to 2008 and the Partial Least Square (PLS) regularity test method. The outlier analysis reveals three important areas for CO 2 reduction: (a) decreasing the share of coal to the total energy consumption and replacing it with non-fossil energies; (b) controlling vehicles used in the cities as well as (c) adjusting industrial structure. Furthermore, based on the social and economic realities of China, the current paper designs six feasible development scenarios for the period covered by the 12th Five-Year Plan and predicts the values of each factor in each scenario. The values can test the implementation of China's CO 2 control development concept. The experiences obtained by outlier analysis can be of significant reference value for realizing the predicted scenarios. - Highlights: ► Using STIRPAT to analyze China's CO 2 emissions and economic development factors. ► Using the PLS outlier test method, three groups of outliers are found. ► Outlier analysis reveals three important areas on reducing CO 2 emissions. ► We design six feasible scenarios for the period covered by the 12th Five-Year Plan. ► We predict the values of each factor in each scenario.

The Scope of Numeracy after Five Years

Directory of Open Access Journals (Sweden)

H.L. Vacher

2013-01-01

Full Text Available The purpose of this editorial is to provide an efficient way for readers and potential authors to see (a what type of papers are published in this journal and (b what subjects are appropriate. The editorial consists mainly of about a dozen pages of tables including live links to the papers’ access/abstract pages to facilitate easy browsing. In the first table, the 85 papers that have been published in the journal’s first five years are classified into: review papers; research papers; case studies; essays; book reviews; columns; and editorials about the journal. In the second table, the papers are inventoried into overlapping sets on: assessment; QL and writing; the construct of QL; focused QL courses and curricula; QL across the curriculum; QL centers; algebra and calculus education; statistics education; intersections with science and engineering; intersections with social sciences; financial numeracy; health numeracy; math anxiety; and cognition. Browsing these links confirms what we said in the first editorial: the scope of Numeracy is huge.

Relationship Between Mothers’ Role and Knowledge in Recurrence Prevention of Food Allergy for Children Under Five Years-Old

Directory of Open Access Journals (Sweden)

Fitria Rinawarti

2017-04-01

Full Text Available There are 30-40% of people with allergies world wide in 2011, this is based on data from the Center for Disease Control and Prevention (CDC more than tripled from 1993 to 2006. Parents play an important role in overcoming the recurrence of allergies in children in order of recurrence allergies and more severe recurrence. The goal of the study is to analyze association mothers’s role and knowledge in recurrence prevention of food allergy in children under five years-old. The study is an analytic observational research with cross sectional design. Method of sampling usedis simple random sampling. The samples were 39 mothers who have children under five years-old with food allergy in Rumah Sakit Islam Jemursari Surabaya. Analysis used chi-square test with α = 0.05 significance level.The results revealed the knowledge of mothers’ with allergy recurrance is 15 person (38,5% have a good knowledge in prevention of food allergy in children under five years-old, while mothers’s role in recurrence prevention of food allergy in children under five years-old is 26 person (66,7% have a role unfavorable. The statistical test by using chi-square revealed there were association between mothers’role (ρ=0,030 and mother’s of knowledge (ρ=0,00001in recurrence prevention of food allergy for children under five years-old.The conclusions of the results this study is mothers’s role with unfavorable to have children under five years-old with an allergy recurrence of severe allergy, while mothers with good knowledge to have children under five years-old with an allergy reccurrance of mild allergy. Keywords: recurrence allergies, mother’s role, mother’s knowledge

Alendronate-Loaded Modified Drug Delivery Lipid Particles Intended for Improved Oral and Topical Administration

Directory of Open Access Journals (Sweden)

Lacramioara Ochiuz

2016-06-01

Full Text Available The present paper focuses on solid lipid particles (SLPs, described in the literature as the most effective lipid drug delivery systems that have been introduced in the last decades, as they actually combine the advantages of polymeric particles, hydrophilic/lipophilic emulsions and liposomes. In the current study, we present our most recent advances in the preparation of alendronate (AL-loaded SLPs prepared by hot homogenization and ultrasonication using various ratios of a self-emulsifying lipidic mixture of Compritol 888, Gelucire 44/14, and Cremophor A 25. The prepared AL-loaded SLPs were investigated for their physicochemical, morphological and structural characteristics by dynamic light scattering, differential scanning calorimetry, thermogravimetric and powder X-ray diffraction analysis, infrared spectroscopy, optical and scanning electron microscopy. Entrapment efficacy and actual drug content were assessed by a validated HPLC method. In vitro dissolution tests performed in simulated gastro-intestinal fluids and phosphate buffer solution pH 7.4 revealed a prolonged release of AL of 70 h. Additionally, release kinetics analysis showed that both in simulated gastrointestinal fluids and in phosphate buffer solution, AL is released from SLPs based on equal ratios of lipid excipients following zero-order kinetics, which characterizes prolonged-release drug systems.

A five year study of the attitudes, perceptions, and philosophies of five secondary science education teachers prepared in the constructivist teaching methodology advanced at the University of Iowa

Science.gov (United States)

Hollenbeck, James Edward

1999-11-01

The present study researched the attitudes, Perceptions, and philosophies of five secondary education science teachers prepared in the constructivist teaching methodology advanced at the University of Iowa. This study is a continuation of a three-year study---the Salish I Project supported by the US Department of Education. The teachers studied are five 1993 University of Iowa Science Education Center graduates who have taught for five years. The main objective of the present study was finding answers to four questions aiming at further understanding of the impact and importance of the preservice education in I the constructivist teaching methodology of new teachers, and the changes they experience in the first five years of teaching. The instruments used in the study are various as they cover a wide range of different categories of beliefs I in terms of teaching, learning, teacher performance and view of school. The following trends came out on reviewing all of the data: in the first year of teaching three of the five teachers studied taught as constructivist teachers. in the third year of teaching, the classroom practices of the teachers converged more closely to their beliefs and preservice preparation. In the fifth year, all five teachers were ranked as constructivist in their teaching methodology in the classroom. Using the Wilcoxson test, significant, positive relationships were revealed between the teacher's philosophy of teaching and learning, with their actual practice. Teacher's philosophy and teaching practice were compared with selected standards set forth by the National Science Education Standards and were found to be in close alignment in their fifth year of teaching. Teachers prepared in the constructivist methodology are concerned about their subject content and value student input and reflection. The teachers reported using student-initiated ideas, alternative assessment strategies and being receptive to alternatives. Other important factors

Assessment of China's renewable energy contribution during the 12th Five Year Plan

International Nuclear Information System (INIS)

Hong, Lixuan; Zhou, Nan; Fridley, David; Raczkowski, Chris

2013-01-01

In recent years, China has been ambitious in investing and developing renewable energy technologies, aiming to enhance its energy security, mitigate its energy-related CO 2 emissions and develop renewable energy industry. The 12th Five Year Plan (2011–2015) has set clear targets on installed capacities of different renewable energy technologies. This study aimed to assess the possible contribution of 12th Five Year Plan for China's future energy system and identify factors that might influence its impacts. First, current status of renewable energy development in China has been reviewed. Then several energy scenarios have been developed in an hourly simulation using an energy system analysis tool EnergyPLAN. It was identified that existing grid bottleneck would greatly reduce the potential contribution of renewable installations in terms of share of renewable electricity generation, share of non-fossil fuels in primary energy and system CO 2 emissions. In contrast, improving technical performance of renewable energy technologies and sectoral energy efficiency plays an important role in increasing the share of renewables and promoting China’s energy system transition. Finally, some policy suggestions were drawn to facilitate a better implementation of the renewable energy plan. - Highlights: • China's renewable energy contribution during the 12th Five Year Plan was assessed. • Non-fossil fuel targets in primary energy for 2015 and 2020 could be easily achieved. • Grid bottlenecks severely decrease the share of RES-E in electricity generation through the 12th Five Year Period. • Improved technical performance of renewable technologies and sectoral energy efficiency are extremely important for achieving higher RES-E share. • Several policy suggestions were drawn

Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs.

Science.gov (United States)

Cummings, Steven R; Karpf, David B; Harris, Fran; Genant, Harry K; Ensrud, Kristine; LaCroix, Andrea Z; Black, Dennis M

2002-03-01

To estimate how much the improvement in bone mass accounts for the reduction in risk of vertebral fracture that has been observed in randomized trials of antiresorptive treatments for osteoporosis. After a systematic search, we conducted a meta-analysis of 12 trials to describe the relation between improvement in spine bone mineral density and reduction in risk of vertebral fracture in postmenopausal women. We also used logistic models to estimate the proportion of the reduction in risk of vertebral fracture observed with alendronate in the Fracture Intervention Trial that was due to improvement in bone mineral density. Across the 12 trials, a 1% improvement in spine bone mineral density was associated with a 0.03 decrease (95% confidence interval [CI]: 0.02 to 0.05) in the relative risk (RR) of vertebral fracture. The reductions in risk were greater than predicted from improvement in bone mineral density; for example, the model estimated that treatments predicted to reduce fracture risk by 20% (RR = 0.80), based on improvement in bone mineral density, actually reduce the risk of fracture by about 45% (RR = 0.55). In the Fracture Intervention Trial, improvement in spine bone mineral density explained 16% (95% CI: 11% to 27%) of the reduction in the risk of vertebral fracture with alendronate. Improvement in spine bone mineral density during treatment with antiresorptive drugs accounts for a predictable but small part of the observed reduction in the risk of vertebral fracture.

Im. A. F. Zasyad'ko coal mine during the eleventh five year plan

Energy Technology Data Exchange (ETDEWEB)

Zvyagil' skii, E.L.

1985-08-01

The achievements of this mine are chronicled, which began production in December 1958, throughout the eleventh five year plan, showing how the annual targets for coal output, roadway drivage, savings in energy and materials, output per manshift and cost price of coal were met and improved upon in each of the five years. The factors which made possible these achievements in productivity and efficiency are described and include: use of modern equipment and systems, increased mechanization, on-site education and training, improved discipline, reduced absenteeism, incentive schemes and, above all, the full involvement of the coal mine in the program of socialist competition. The social infrastructure supporting the coal mine and its workforce is also described.

Virtual Knowledge Center Five Year Vision

International Nuclear Information System (INIS)

KENNY, N.E.

2003-01-01

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

Endovascular Treatment of Chronic Mesenteric Ischemia: Report of Five Cases

International Nuclear Information System (INIS)

Nyman, Ulf; Ivancev, Krasnodar; Lindh, Mats; Uher, Petr

1998-01-01

Purpose: To evaluate the midterm results of percutaneous transluminal angioplasty (PTA) and stent placement in stenotic and occluded mesenteric arteries in five consecutive patients with chronic mesenteric ischemia. Methods: Five patients with 70%-100% obliterations of all mesenteric vessels resulting in chronic mesenteric ischemia (n= 4) and as a prophylactic measure prior to abdominal aortic aneurysm repair (n= 1) underwent PTA of celiac and/or superior mesenteric artery (SMA) stenoses (n= 2), primary stenting of ostial celiac occlusions (n= 2), and secondary stenting of a SMA occlusion (n= 1; recoil after initial PTA). All patients underwent duplex ultrasonography (US) (n= 3) and/or angiography (n= 5) during a median follow-up of 21 months (range 8-42 months). Results: Clinical success was obtained in all five patients. Asymptomatic significant late restenoses (n3) were successfully treated with repeat PTA (n= 2) and stenting of an SMA occlusion (n= 1; celiac stent restenosis). Recurrent pain in one patient was interpreted as secondary to postsurgical abdominal adhesions. Two puncture-site complications occurred requiring local surgical treatment. Conclusions: Endovascular techniques may be attempted prior to surgery in cases of stenotic or short occlusive lesions in patients with chronic mesenteric ischemia. Surgery may still be preferred in patients with long occlusions and a low operative risk

Five-Year Outcomes of High-Dose Single-Fraction Spinal Stereotactic Radiosurgery

International Nuclear Information System (INIS)

Moussazadeh, Nelson; Lis, Eric; Katsoulakis, Evangelia; Kahn, Sweena; Svoboda, Marek; DiStefano, Natalie M.; McLaughlin, Lily; Bilsky, Mark H.; Yamada, Yoshiya; Laufer, Ilya

2015-01-01

Purpose: To characterize local tumor control and toxicity risk in very long-term survivors (>5 years) after high-dose spinal image guided, intensity modulated radiation therapy delivered as single-dose stereotactic radiosurgery (SRS). Previously published spinal SRS outcome analyses have included a heterogeneous population of cancer patients, mostly with short survival. This is the first study reporting the long-term tumor control and toxicity profiles after high-dose single-fraction spinal SRS. Methods and Materials: The study population included all patients treated from June 2004 to July 2009 with single-fraction spinal SRS (dose 24 Gy) who had survived at least 5 years after treatment. The endpoints examined included disease progression, surgical or radiation retreatment, in-field fracture development, and radiation-associated toxicity, scored using the Radiation Therapy Oncology Group radiation morbidity scoring criteria and the Common Terminology Criteria for Adverse Events, version 4.0. Local control and fracture development were assessed using Kaplan-Meier analysis. Results: Of 278 patients, 31 (11.1%), with 36 segments treated for spinal tumors, survived at least 5 years after treatment and were followed up radiographically and clinically for a median of 6.1 years (maximum 102 months). The histopathologic findings for the 5-year survivors included radiation-resistant metastases in 58%, radiation-sensitive metastases in 22%, and primary bone tumors in 19%. In this selected cohort, 3 treatment failures occurred at a median of 48.6 months, including 2 recurrences in the radiation field and 1 patient with demonstrated progression at the treatment margins. Ten lesions (27.8%) were associated with acute grade 1 cutaneous or gastrointestinal toxicity. Delayed toxicity ≥3 months after treatment included 8 cases (22.2%) of mild neuropathy, 2 (5.6%) of gastrointestinal discomfort, 8 (22.2%) of dermatitides, and 3 (8.3%) of myalgias/myositis. Thirteen

Five-Year Outcomes of High-Dose Single-Fraction Spinal Stereotactic Radiosurgery

Energy Technology Data Exchange (ETDEWEB)

Moussazadeh, Nelson [Division of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York (United States); Lis, Eric [Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Katsoulakis, Evangelia [Department of Radiation Oncology, New York Methodist Hospital, Brooklyn, New York (United States); Kahn, Sweena; Svoboda, Marek; DiStefano, Natalie M.; McLaughlin, Lily [Division of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Bilsky, Mark H. [Division of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York (United States); Yamada, Yoshiya [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Laufer, Ilya, E-mail: lauferi@mskcc.org [Division of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York (United States)

2015-10-01

Purpose: To characterize local tumor control and toxicity risk in very long-term survivors (>5 years) after high-dose spinal image guided, intensity modulated radiation therapy delivered as single-dose stereotactic radiosurgery (SRS). Previously published spinal SRS outcome analyses have included a heterogeneous population of cancer patients, mostly with short survival. This is the first study reporting the long-term tumor control and toxicity profiles after high-dose single-fraction spinal SRS. Methods and Materials: The study population included all patients treated from June 2004 to July 2009 with single-fraction spinal SRS (dose 24 Gy) who had survived at least 5 years after treatment. The endpoints examined included disease progression, surgical or radiation retreatment, in-field fracture development, and radiation-associated toxicity, scored using the Radiation Therapy Oncology Group radiation morbidity scoring criteria and the Common Terminology Criteria for Adverse Events, version 4.0. Local control and fracture development were assessed using Kaplan-Meier analysis. Results: Of 278 patients, 31 (11.1%), with 36 segments treated for spinal tumors, survived at least 5 years after treatment and were followed up radiographically and clinically for a median of 6.1 years (maximum 102 months). The histopathologic findings for the 5-year survivors included radiation-resistant metastases in 58%, radiation-sensitive metastases in 22%, and primary bone tumors in 19%. In this selected cohort, 3 treatment failures occurred at a median of 48.6 months, including 2 recurrences in the radiation field and 1 patient with demonstrated progression at the treatment margins. Ten lesions (27.8%) were associated with acute grade 1 cutaneous or gastrointestinal toxicity. Delayed toxicity ≥3 months after treatment included 8 cases (22.2%) of mild neuropathy, 2 (5.6%) of gastrointestinal discomfort, 8 (22.2%) of dermatitides, and 3 (8.3%) of myalgias/myositis. Thirteen

New developments in Indian space policies and programmes—The next five years

Science.gov (United States)

Sridhara Murthi, K. R.; Bhaskaranarayana, A.; Madhusudana, H. N.

2010-02-01

Over past four decades Indian space programme has systematically acquired capabilities in space technologies and implemented its programmes with a high level of focus on societal applications. It is developed into a multi-dimensional programme where its strategy is directed towards diverse stake holders and actors such as government, users and beneficiaries including general public, industrial suppliers as well as customers, academia and other space agencies/international organisations. Over the next five years, the Indian space programme has charted an ambitious set of policies and programmes that aim to enhance impacts on society. The major task is to enlarge and diversify the services delivered to a large section of population affected by income, connectivity and digital divides. While efficacy of application of space based systems have been proven in several fields such as tele-education, water resources management, improving productivity of land and out reaching quality health services and others, the crux of the problem is to evolve sustainable and scalable delivery mechanisms on a very large scale and extending over large geographical areas. Essentially the problem shifts from being predominately a technology problem to one of a composite of economic, cultural and social problems. Tackling such problems would need renewal of policies relating to commercial as well as public service systems. Major programmatic initiatives are planned in the next five years involving new and upgraded technologies to expand services from space to fill the gaps and to improve economic efficiency. Thrust is also given to science and exploration mission beyond Chandrayaan-1 and some initial steps for the participation in human space flight. This paper discusses the policy and strategy perspectives of the programmes planned by Indian Space Research Organisation over next five years.

A five year study on the susceptibility of isolates from various parts of ...

African Journals Online (AJOL)

tests. The various isolates for the five-year period were Staphylococcus aureus 1000, Klebsiella pneumoniae 340, Proteus mirabilis 38 Escherichia coli 295, Pseudomonas aeroginosa 240, Alcaligenes faecalis 200, Enterobacter aerogenes 175, Acinetobacter baumannii 150, Proteus vulgaris 110, Providencia stuartii 101, ...

Southern Stalemate: Five Years without Public Education in Prince Edward County, Virginia

Science.gov (United States)

Bonastia, Christopher

2012-01-01

In 1959, Virginia's Prince Edward County closed its public schools rather than obey a court order to desegregate. For five years, black children were left to fend for themselves while the courts decided if the county could continue to deny its citizens public education. Investigating this remarkable and nearly forgotten story of local, state, and…

Mathematical descriptions of a one- and five-year old child for use in dosimetry calculations

Energy Technology Data Exchange (ETDEWEB)

Hwang, J.M.L.; Shoup, R.L.; Warner, G.G.; Poston, J.W.

1976-03-01

Mathematical representations for estimating the absorbed radiation dose from external and internal radiation sources of a one-year old and a five-year old human have been designed. The phantoms used consist of head, trunk and leg regions with a skeletal system and twenty-two internal organs, each. The mathematical descriptions of these phantoms have been coded into Fortran computer language for use with a Monte-Carlo photon transport code. This computer code was used to calculate absorbed fractions of energy deposited in different targets organs from a radionuclide deposited uniformly in a source organ. Absorbed dose calculations were performed for two /sup 99m/Tc-labeled pharmaceuticals. Photon absorbed fraction estimates for the pediatric phantoms from Monte-Carlo calculations were combined with biological data to estimate dose distributions in one-year old and five-year old children. (CH)

Mathematical descriptions of a one- and five-year old child for use in dosimetry calculations

International Nuclear Information System (INIS)

Hwang, J.M.L.; Shoup, R.L.; Warner, G.G.; Poston, J.W.

1976-03-01

Mathematical representations for estimating the absorbed radiation dose from external and internal radiation sources of a one-year old and a five-year old human have been designed. The phantoms used consist of head, trunk and leg regions with a skeletal system and twenty-two internal organs, each. The mathematical descriptions of these phantoms have been coded into Fortran computer language for use with a Monte-Carlo photon transport code. This computer code was used to calculate absorbed fractions of energy deposited in different targets organs from a radionuclide deposited uniformly in a source organ. Absorbed dose calculations were performed for two /sup 99m/Tc-labeled pharmaceuticals. Photon absorbed fraction estimates for the pediatric phantoms from Monte-Carlo calculations were combined with biological data to estimate dose distributions in one-year old and five-year old children

Progress in 11th Five Year and the geneal idea for 12th Five Year of uranium exploration and geological science and technology

International Nuclear Information System (INIS)

Zhang Jindai; Jian Xiaofei; Li Youliang; Du Jiannong; Guo Qinggen; Zhang Qiuying

2011-01-01

Since the 11th-Five Year, uranium exploration in China has retrieved obviously and some new resources have been identified. More detailed uranium exploration has been carried out in about 1 000 000 km 2 , exploration in large uranium resource bases, old orefields and focusing prospect areas has achieved important progress, several middle-large and extral-large deposits have been discovered, and one super-large deposit was submitted for the first time in China. In the science and technology of uranium exploration, the capability and platform of research has been reinforced, a number of key projects have been carried out such as national uranium potential evaluation, study of 'four types of uranium deposit', research for the enlargement of uranium resource bases, research of application foundation of uranium geology, research on exploratin techniques and method and technological standard. All these projects have obtained fruitful result and significantly raised the creative level in uranium science and technology. In the coming 12th Five Year, uranium exploration will follow the strategy of 'foundation research first with focus on resource base,systematical exploration and integral evaluation second' under the guideline of 'domestic foothold and oversea development' and set up large uranium resource bases, four major geological preosecting programs will be commence in the exploration for large uranium resource base, national uranium survey, regional evaluation of potential uranium resource and science and technology innovation of uranium geology, Ideas of 'Great uranium exploration system' should be set up to widely unite the localized prospecting teams and cooperate with the geologic research organization such as domestic and foreign university and college so as to make corespondent contribution to raise the supporting capability of uranium resources in China. (authors)

Five years after Fukushima, it's time to seize new nuclear opportunities

Energy Technology Data Exchange (ETDEWEB)

Shephers, John [nuclear24, Redditch (United Kingdom)

2016-05-15

In March of this year, we marked a painful chapter in the history of the world's civil nuclear energy industry as we reflected on the earthquake and tsunami that struck Japan five years ago - leading to the nuclear accident at Fukushima-Daiichi. In moving on, the nuclear industry needs to absorb the lessons learned from Fukushima and there are now clear signals for going on with nuclear.

Does television viewing predict dietary intake five years later in high school students and young adults?

Directory of Open Access Journals (Sweden)

Neumark-Sztainer Dianne

2009-01-01

Full Text Available Abstract Background Prior research has found that television viewing is associated with poor diet quality, though little is known about its long-term impact on diet, particularly during adolescence. This study examined the associations between television viewing behavior with dietary intake five years later. Methods Survey data, which included television viewing time and food frequency questionnaires, were analyzed for 564 middle school students (younger cohort and 1366 high school students (older cohort who had complete data available at Time 1 (1998–1999 and five years later at Time 2 (mean age at Time 2, 17.2 ± 0.6 and 20.5 ± 0.8 years, respectively. Regression models examined longitudinal associations between Time 1 television viewing behavior and Time 2 dietary intake adjusting for sociodemographic characteristics, Time 1 dietary intake, and Time 2 total daily energy intake. Results Respondents were categorized as limited television users (2 hours/daily, moderately high television viewers (2–5 hours/daily, and heavy television viewers (≥5 hours/daily. Among the younger cohort, Time 1 heavy television viewers reported lower fruit intake and higher sugar-sweetened beverage consumption than the other two groups. Among the older cohort, watching five or more hours of television per day at Time 1, predicted lower intakes of fruits, vegetables, whole grain and calcium-rich foods, and higher intakes of trans fat, fried foods, fast food menu items, snack products, and sugar-sweetened beverages (products commonly advertised on television five years later. Conclusion Television viewing in middle and high school predicted poorer dietary intake five years later. Adolescents are primary targets of advertising for fast food restaurants, snack foods, and sugar-sweetened beverages, which may influence their food choices. Television viewing, especially during high school, may have long-term effects on eating choices and contribute to poor eating

Five-year change in physical activity is associated with changes in cardiovascular disease risk factors: the Inter99 study

DEFF Research Database (Denmark)

Aadahl, Mette; von Huth Smith, L; Pisinger, Charlotte

2009-01-01

OBJECTIVE: To evaluate whether five-year changes in self-reported physical activity level were associated with changes in waist circumference, weight, serum lipids and blood pressure. METHODS: In the Inter99 study (1999-2006) in Copenhagen, Denmark, 4039 men and women (30-60 years) answered quest....... Change in physical activity level induced a significant change in HDL concentration in men only. Women's use of hormone replacement therapy may partly explain this gender difference.......OBJECTIVE: To evaluate whether five-year changes in self-reported physical activity level were associated with changes in waist circumference, weight, serum lipids and blood pressure. METHODS: In the Inter99 study (1999-2006) in Copenhagen, Denmark, 4039 men and women (30-60 years) answered...... questions on lifestyle and provided blood samples and anthropometric measures at baseline and after five years. Multiple regression analyses were performed with five-year value of each cardiovascular biomarker as outcome and change in physical activity level as explanatory variable. RESULTS: Approximately...

CLIMEX project: Report on the third year of treatment. May 1996 - December 1996

Energy Technology Data Exchange (ETDEWEB)

Jenkins, A. [ed.

1997-10-10

CLIMEX (Climate change experiment) is an international, cooperative whole-ecosystem research project studying the response of entire forested catchments to increased CO{sub 2} and temperature. The project is located at Risdalsheia in the southernmost Norway and involves five catchments and employs multiple treatments and controls. These whole-catchment manipulation experiments are designed to allow quantification of the links between terrestrial and aquatic ecosystems and provide direct experimental evidence of the effect of climatic change on natural forests, terrestrial ecosystems and water resources. This report describes results from the third year of treatment, which was 1996. Significant responses in vegetation, soils and waters were measured. 41 refs., 35 figs., 11 tabs.

Effect of antiresorptive drugs in the alveolar bone healing. A histometric and immunohistochemical study in ovariectomized rats.

Science.gov (United States)

Ramalho-Ferreira, Gabriel; Faverani, Leonardo Perez; Momesso, Gustavo Antonio Correa; Luvizuto, Eloá Rodrigues; de Oliveira Puttini, Igor; Okamoto, Roberta

2017-06-01

The aim of this study is to evaluate the alendronate and raloxifene influence in the alveolar healing process of osteoporotic rats. Sixty-four female rats were divided in four groups: sham rats (SHAM), ovariectomized rats and no medical treatment (OVX NT), ovariectomized rats and submitted to alendronate treatment (OVX ALE), and ovariectomized and submitted to raloxifene treatment (OVX RAL). The histomorphometrical and immunohistochemical analysis was performed. The quantitative data were analyzed through Kruskal-Wallis and Dunn tests (α = 0.05). In the longest period, SHAM and OVX RAL groups showed the better bone formation responses (P alveolar healing process in osteoporotic rats, but not enough to achieve the histometrical and protein expression values that were observed in the SHAM group. Alendronate is largely used as a potent antiresorptive agent. Otherwise, considering the undesirable effects in relation to the alveolar healing, other antiosteoporosis medications should be studied. Raloxifene seems to be a good candidate once its action mechanism involves the activation of osteoblasts.

A five-year follow-up of two different 131I treatment methods for Graves' disease and the factors affecting the outcome

International Nuclear Information System (INIS)

Yoshimoto, Midori; Iino, Shiro; Yoshimura, Hiroshi; Ishikawa, Naofumi; Momotani, Naoko; Hamada, Noboru; Ito, Kunihiko.

1994-01-01

We employed two different methods of 131 I treatment for Graves' disease in 285 patients and compared the results between the two. (We also analyzed the factors affecting the treatment outcome.) A single dose of 131 I adjusted to the patients' thyroid weight was administered to 180 patients in group 1, while a relatively lower dose of 131 I (approximately 30 Gy) was given repeatedly to 105 patients in group 2. A 5-year follow-up showed that in group 1, 34% of the patients were euthyroid, 11% hypothyroid, 11% subclinical hypothyroid and 44% still remained hyperthyroid. In group 2, 43% of the patients were euthyroid, 5% hypothyroid, 35% subclinical hypothyroid and 17% hyperthyroid. The factors affecting the outcome of the treatment in group 1 patients were their thyroid weight, the duration of the disease and TRAb levels. No significant correlation was observed between the efficacy of 131 I treatment and the patients' sex, age, 24 hr 131 I-uptake, effective half life of administered 131 I or titers of antithyorid antibodies. We conclude that the repeated low dose administration of 131 I provides the best outcome in a 5-year follow-up. However, we suggest that an adjusted dose of 131 I in relation to the patients' thyroid weight should be employed to obtain a faster therapeutic response. (author)

Economic aspects of complicated osteoporosis: The cost of treatment in the first year after fracture

OpenAIRE

O. V. Dobrovolskaya; N. V. Toroptsova; O. M. Lesnyak

2016-01-01

Objective: to estimate the cost of treatment in patients with complicated osteoporosis (OP) in the first year after fracture under the conditions of the Moscow municipal healthcare system.Patients and methods. The investigation enrolled 196 women (mean age, 65.8±9.1 years) who had sustained fractures at five major osteoporotic sites (proximal hip (PH), distal forearm (DF), surgical humeral neck, vertebral column, and medial and/or lateral ankle). A unified questionnaire that included data on ...

THE FIVE YEAR FERMI/GBM MAGNETAR BURST CATALOG

Energy Technology Data Exchange (ETDEWEB)

Collazzi, A. C. [SciTec, Inc., 100 Wall Street, Princeton, NJ 08540 (United States); Kouveliotou, C.; Horst, A. J. van der; Younes, G. A. [Department of Physics, The George Washington University, 725 21st Street NW, Washington, DC 20052 (United States); Kaneko, Y.; Göğüş, E. [Sabancı University, Orhanlı-Tuzla, İstanbul 34956 (Turkey); Lin, L. [François Arago Centre, APC, 10 rue Alice Domon et Léonie Duquet, F-75205 Paris (France); Granot, J. [Department of Natural Sciences, The Open University of Israel, 1 University Road, P.O. Box 808, Raanana 43537 (Israel); Finger, M. H. [Universities Space Research Association, NSSTC, 320 Sparkman Drive, Huntsville, AL 35805 (United States); Chaplin, V. L. [School of Medicine, Vanderbilt University, 1161 21st Avenue S, Nashville, TN 37232 (United States); Huppenkothen, D. [Center for Data Science, New York University, 726 Broadway, 7th Floor, New York, NY 10003 (United States); Watts, A. L. [Anton Pannekoek Institute, University of Amsterdam, Postbus 94249, 1090 GE Amsterdam (Netherlands); Kienlin, A. von [Max-Planck-Institut für extraterrestrische Physik, Giessenbachstrasse 1, D-85748 Garching (Germany); Baring, M. G. [Department of Physics and Astronomy, Rice University, MS-108, P.O. Box 1892, Houston, TX 77251 (United States); Gruber, D. [Planetarium Südtirol, Gummer 5, I-39053 Karneid (Italy); Bhat, P. N. [CSPAR, University of Alabama in Huntsville, 320 Sparkman Drive, Huntsville, AL 35899 (United States); Gibby, M. H., E-mail: acollazzi@scitec.com [Jacobs Technology, Inc., Huntsville, AL (United States); and others

2015-05-15

Since launch in 2008, the Fermi Gamma-ray Burst Monitor (GBM) has detected many hundreds of bursts from magnetar sources. While the vast majority of these bursts have been attributed to several known magnetars, there is also a small sample of magnetar-like bursts of unknown origin. Here, we present the Fermi/GBM magnetar catalog, providing the results of the temporal and spectral analyses of 440 magnetar bursts with high temporal and spectral resolution. This catalog covers the first five years of GBM magnetar observations, from 2008 July to 2013 June. We provide durations, spectral parameters for various models, fluences, and peak fluxes for all the bursts, as well as a detailed temporal analysis for SGR J1550–5418 bursts. Finally, we suggest that some of the bursts of unknown origin are associated with the newly discovered magnetar 3XMM J185246.6+0033.7.

Progression of MDS-UPDRS Scores Over Five Years in De Novo Parkinson Disease from the Parkinson's Progression Markers Initiative Cohort.

Science.gov (United States)

Holden, Samantha K; Finseth, Taylor; Sillau, Stefan H; Berman, Brian D

2018-01-01

The Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UDPRS) is a commonly used tool to measure Parkinson disease (PD) progression. Longitudinal changes in MDS-UPDRS scores in de novo PD have not been established. Determine progression rates of MDS-UPDRS scores in de novo PD. 362 participants from the Parkinson's Progression Markers Initiative, a multicenter longitudinal cohort study of de novo PD, were included. Longitudinal progression of MDS-UPDRS total and subscale scores were modeled using mixed model regression. MDS-UPDRS scores increased in a linear fashion over five years in de novo PD. MDS-UPDRS total score increased an estimated 4.0 points/year, Part I 0.25 points/year, Part II 1.0 points/year, and Part III 2.4 points/year. The expected average progression of MDS-UPDRS scores in de novo PD from this study can assist in clinical monitoring and provide comparative data for detection of disease modification in treatment trials.

Ten Years Back, Five Years Forward: The Data Seal of Approval

Directory of Open Access Journals (Sweden)

Ingrid Dillo

2015-02-01

Full Text Available If we want to share data, the long-term storage of those data in a trustworthy digital archive is an essential condition. Trust is the basis of storing and sharing data. That trust must be present in the various stakeholders involved. Certification of digital archives can make an important contribution to the confidence of these stakeholders in the digital archives.Ten years ago DANS was assigned the task of developing a Seal of Approval for digital data to ensure that archived data can still be found, understood and used in the future. In 2009 this Data Seal of Approval (DSA was transferred to an international body, the DSA Board, which has managed and further developed the guidelines and the peer review process ever since.The objectives of the DSA are to safeguard data, ensure high quality and guide reliable management of data for the future without requiring implementation of new standards, regulations or heavy investments. The DSA contains 16 guidelines for applying and verifying quality aspects concerning the creation, storage, use and reuse of digital data.Based on feedback from data archives that applied for a DSA and different case studies we have gained some insight into the benefits of DSA. Still, the impact of having the Seal is not easy to measure. Seal holders usually refer to qualitative benefits in the form of increased awareness of the value of their repositories to their communities, funders and publishers.Ten years down the line we can safely state that the Data Seal of Approval has proven its added value. If we try to look five years into the future, what can we expect? There are different developments: a growing interest in DSA among European research infrastructures, the collaboration between DSA and the ISCU World Data System under the umbrella of the RDA (Research Data Alliance and the European Commission is showing a growing interest in certification services.The success of DSA also provides the challenge to further

The U.S.-Singapore Free Trade Agreement: Effects After Five Years

Science.gov (United States)

2010-03-26

U.S. service providers in Singapore under the FTA , Citibank has been able to expand its operations there (it has 50% of the credit card market...failing to comply with a collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE 26 MAR 2010 2. REPORT...U.S.-Singapore Free Trade Agreement: Effects After Five Years Congressional Research Service Summary The U.S.-Singapore Free Trade Agreement ( FTA

Attempted suicide in Denmark. IV. A five-year follow-up

DEFF Research Database (Denmark)

Nielsen, B; Wang, A G; Brille-Brahe, U

1990-01-01

contact with the psychiatric ward. Predictors for future suicide were chronic somatic disease, depression, abuse of medicine, and chronic alcohol abuse. The authors emphasize the need for a thorough medical evaluation of patients attempting suicide, to be able to identify and eventually treat......From October 1, 1980 to April 20, 1981, 207 patients were admitted to the Department of Psychiatry, Odense University Hospital, after attempting suicide. Information on physical, mental and social conditions was collected. The patients were then followed for 5 years, to register subsequent suicidal...... behaviour and to try to identify relevant factors for evaluation of future suicide risk. During the follow-up period 11.6% of the attempters committed suicide, the majority within the first year after the index attempt. Seventy-five percent of the suicides were committed less than 6 months after the last...

Myeloproliferative neoplasms in five multiple sclerosis patients

DEFF Research Database (Denmark)

Thorsteinsdottir, Sigrun; Bjerrum, Ole Weis

2013-01-01

The concurrence of myeloproliferative neoplasms (MPNs) and multiple sclerosis (MS) is unusual. We report five patients from a localized geographic area in Denmark with both MS and MPN; all the patients were diagnosed with MPNs in the years 2007-2012. We describe the patients' history and treatment...

Five-year all-cause mortality rates across five categories of substantiated elder abuse occurring in the community.

Science.gov (United States)

Burnett, Jason; Jackson, Shelly L; Sinha, Arup K; Aschenbrenner, Andrew R; Murphy, Kathleen Pace; Xia, Rui; Diamond, Pamela M

2016-01-01

Elder abuse increases the likelihood of early mortality, but little is known regarding which types of abuse may be resulting in the greatest mortality risk. This study included N = 1,670 cases of substantiated elder abuse and estimated the 5-year all-cause mortality for five types of elder abuse (caregiver neglect, physical abuse, emotional abuse, financial exploitation, and polyvictimization). Statistically significant differences in 5-year mortality risks were found between abuse types and across gender. Caregiver neglect and financial exploitation had the lowest survival rates, underscoring the value of considering the long-term consequences associated with different forms of abuse. Likewise, mortality differences between genders and abuse types indicate the need to consider this interaction in elder abuse case investigations and responses. Further mortality studies are needed in this population to better understand these patterns and implications for public health and clinical management of community-dwelling elder abuse victims.

Five cases of neurocysticercosis diagnosed in Sydney.

Science.gov (United States)

Walker, J; Chen, S; Packham, D; McIntyre, P

1991-12-01

Cysticercosis, once rare in Australia, is now more frequently diagnosed. This change reflects the countries of origin of new immigrants and the destinations of Australians travelling. Five cases of neurocysticercosis diagnosed at Westmead Hospital in Sydney are described. Two involved Australians, a father and son who had visited eastern and southeastern Asia 10 years before presentation. The other three included immigrants from Chile and India and a visitor from Timor. Ages ranged from 5 to 57 years. Three individuals presented after focal seizures involving the upper limb, one had a long standing history of neurological dysfunction and one suffered from persistent headaches. In all cases computed tomographic scanning (CT) or magnetic resonance imaging (MRI) revealed cystic brain lesions and three of the five were seropositive as well. Four were treated with praziquantel and in one the lesions regressed significantly following treatment. However, the lesion in one case had decreased in size prior to treatment and that in the untreated individual also became smaller.

Public health in Kosovo after five difficult years of independence

Directory of Open Access Journals (Sweden)

Naim Jerliu

2015-12-01

administration. Regarding the health status, five years after independence, compared with other European countries, post-war transitional Kosovo is still characterized by higher mortality rates including traditional public health problems pertinent to infant mortality and maternal deaths. In parallel, however, Kosovo is undergoing a rapid process of epidemiological transition characterized by an aging trend which is inevitably coupled with high cardiovascular and cancer mortality and morbidity along with an excess mortality in external causes of death and injuries among the adult population. Adoption of the new Health Law in December 2012 by the Kosovo Assembly aims the transition from centralized health care system established under emergency conditions of the post-war period towards a contemporary modern health care system with a clear purchaser-provider split based on a high transparency and accountability of the health care providers and their contractors. The health care reform, leading eventually to significant changes within the health sector in Kosovo, consists of two main pillars: (i structural and functional reorganization of the health care system through establishment of Kosovo Health Service (an autonomous and non-for-profit public enterprise at central level of the health care sector, and; (ii establishment for the first time of the public health insurance system with a Health Insurance Fund as its main body. Nevertheless, five years after declaration of independence, Kosovo, the newest state in Europe consisting of the youngest population, is currently facing a particularly difficult socioeconomic and political transition and is additionally struggling and mainstreaming all energies and efforts in order to get full international recognition.

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.

Five years' experience of the new SAPs: overview and way forward

International Nuclear Information System (INIS)

Pape, R.P.

1998-01-01

This paper gives an overview of the five years' experience gained in applying the new safety assessment principles (SAPs). Beginning with a brief history of SAPs, it goes on to discuss their structure and their relevance to safety matters. It develops some of the more basic issues which users have to bear in mind and also considers how SAPs are used by NII. Finally, there is a look forward to future developments in SAPs usage and application. (author)

The First Five Years of the Alpha Magnetic Spectrometer on the International Space Station

CERN Multimedia

CERN. Geneva

2016-01-01

In the five years since its installation on the International Space Station, it has collected more than 90 billion cosmic rays. Some of the unexpected results and their possible interpretations will be presented.

Weight Loss Five Years After Behavioral Treatment.

Science.gov (United States)

Levitz, Leonard S.; And Others

The behaviorally-based weight control program conducted by Levitz and Jordan at the University of Pennsylvania and the Institute for Behavioral Education is tailored to patient needs and includes stimulus control, cognitive restructuring, and nutrition education. The success of patients in maintaining the clinically meaningful weight losses…

3D printed alendronate-releasing poly(caprolactone) porous scaffolds enhance osteogenic differentiation and bone formation in rat tibial defects.

Science.gov (United States)

Kim, Sung Eun; Yun, Young-Pil; Shim, Kyu-Sik; Kim, Hak-Jun; Park, Kyeongsoon; Song, Hae-Ryong

2016-09-29

The aim of this study was to evaluate the in vitro osteogenic effects and in vivo new bone formation of three-dimensional (3D) printed alendronate (Aln)-releasing poly(caprolactone) (PCL) (Aln/PCL) scaffolds in rat tibial defect models. 3D printed Aln/PCL scaffolds were fabricated via layer-by-layer deposition. The fabricated Aln/PCL scaffolds had high porosity and an interconnected pore structure and showed sustained Aln release. In vitro studies showed that MG-63 cells seeded on the Aln/PCL scaffolds displayed increased alkaline phosphatase (ALP) activity and calcium content in a dose-dependent manner when compared with cell cultures in PCL scaffolds. In addition, in vivo animal studies and histologic evaluation showed that Aln/PCL scaffolds implanted in a rat tibial defect model markedly increased new bone formation and mineralized bone tissues in a dose-dependent manner compared to PCL-only scaffolds. Our results show that 3D printed Aln/PCL scaffolds are promising templates for bone tissue engineering applications.

Irritable bowel syndrome and functional abdominal pain in five-year-old children are related to lifestyle.

Science.gov (United States)

Uusijärvi, Agneta; Alm, Johan; Lindblad, Frank; Olén, Ola

2016-08-01

Abdominal pain of functional origin is very common in childhood, and environmental factors are thought to be of aetiologic importance. The anthroposophic lifestyle has dietary and lifestyle characteristics that may influence child health, and this study aimed to assess the effect of such lifestyles on abdominal pain of functional origin. A prospective Swedish lifestyle cohort (n = 470) was followed from birth to five years of age. Family lifestyles were characterised through questionnaires. Abdominal pain was defined as irritable bowel syndrome or functional abdominal pain according to the Rome III criteria and measured with parental questionnaires and interviews at the age of five. The prevalence of abdominal pain was 15%. Children were more likely to have abdominal pain at five years of age if their family had a partly anthroposophic lifestyle, with an adjusted odds ratio (OR) of 2.61 (95% CI 1.15-5.93), or an anthroposophic lifestyle, with an adjusted OR of 2.34 (95% CI 0.96-5.70). A family lifestyle with anthroposophic characteristics was associated with an increased risk of abdominal pain in five-year-old children. The mechanisms for this increase were unclear, but we speculate that there may have been different prerequisites for coping with stressors. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

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

DEFF Research Database (Denmark)

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

2008-01-01

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

Inflammatory eye reactions in patients treated with bisphosphonates and other osteoporosis medications - cohort analysis using a national prescription database

DEFF Research Database (Denmark)

Pazianas, Michael; Clark, Emma M; Eiken, Pia Agnete

2013-01-01

Ocular inflammatory reactions have been described in patients on bisphosphonate treatment. We estimated the incidence rate of ocular inflammation at 3 and 12 months in patients treated for osteoporosis using a register based cohort linked to prescription data (hospitals and private practice.......4%) of patients on osteoporosis therapy filled one or more prescriptions for TES. TES treatment rates (per 1000 patient years) in the first year of osteoporosis treatment were 44 (95% confidence interval (CI) 42-46) for alendronate, 40 (95% CI 38-43) for etidronate, 45 (95% CI 35-57) for risedronate, 32 (95% CI...

Psychological stress and health in undergraduate dental students: fifth year outcomes compared with first year baseline results from five European dental schools

NARCIS (Netherlands)

Gorter, R.C.; Freeman, R.; Hammen, S.; Murtomaa, H.; Blinkhorn, A.; Humphris, G.

2008-01-01

Objective: To compare the levels of a series of health-related indicators from a cohort of fifth year dental students from five European schools with their first year scores, and to investigate the relationship between these follow-up measures. Methods: Burnout was measured using the Maslach Burnout

FORMakademisk – Fem års jubileum - Five years anniversary

Directory of Open Access Journals (Sweden)

Janne Beate Reitan

2013-01-01

Full Text Available When we first published FORMakademisk five years ago, we stated in the very first editorial on page 1 in Volume 1, Issue 1 that:The aim of the journal is to provide a venue for research in design and design education, and thereby develop an interest and working community of scholars in the field. The editorial team perceives design as a generic term that includes creative and performing activities in the great span of the artefacts ‘from the spoon to the city’. The editorial team relates to design education as a field that includes the dissemination of design in society and the teaching of design at all levels general education, vocational preparation, professional education and research education—from kindergarten to doctorate.Since then we have published two issues every year, nine all together, with more than 50 articles. The editorial team saw that future contributors to FORMakademisk would mainly be recruited from researchers within the design disciplines, and their research interests would have their roots in creative and artistic design practice. At the same time, FORMakademisk has invited scientists from established academic disciplines, when their interest has been directed towards design issues.

[Email in a dedicated headache clinic: experience gained over a five-year period].

Science.gov (United States)

Pedraza, M Isabel; Herrero-Velázquez, Sonia; López-Mesonero, Luis; Ruiz-Piñero, Marina; Posadas, Javier; Guerrero-Peral, Ángel L

2015-06-16

The use of email can facilitate communication between the different levels of an organisation. Our primary care physicians have had an email service in the dedicated headache clinic (DHC) since November 2009, and our aim is therefore to analyse the use of email over that five-year period. Data concerning the emails sent up until October 2014 were collected prospectively. The questions were classified as need for referral to the DHC (group 1), progress made by the cases seen in the DHC (group 2), training in headaches (group 3) or the treatment of the headaches suffered by primary care physicians themselves as patients (group 4). A total of 274 email messages were analysed. Monthly consultations have increased (from 1.5 per month during the first year to 7.5 per month during the fifth). Findings showed that 10.2% of the email messages came from rural health centres and 89.8% were sent from urban health centres. Replies were sent within 2 ± 2.8 days (range: 0-24 days). Altogether 130 consultations were classified as belonging to group 1 (47.4%), in which referral through the normal channel was recommended in 60 cases (46.2%), via the preferential channel in 47 (36.2%) and non-referral was suggested in 23 cases (17.6%). Group 2 included 125 emails (45.7%) and in 80 cases there was no need to make a new appointment or to bring forward the existing one (64%). Thirteen visits (4.7%) were classified into group 3 and six (2.2%) in group 4. Our primary care physicians are using the email of the DHC on an increasingly more frequent basis. Its use makes it possible to detect patients whose appointment -whether the first or a follow-up- needs to be brought forward, as well as allowing issues to be solved without the need for referral. It is effective for the treatment of physicians who themselves have headaches and as a tool for continuing education.

Twenty-five years of post-Bretton Woods experience: some lessons

Directory of Open Access Journals (Sweden)

H. ASKARI

1999-03-01

Full Text Available In 1971 many academic economists were predicting that the Bretton Woods system of fixed parities would collapse. Some, most notably Milton Friedman, became excited about the possibility of a floating system because the benefits of international capital mobility can only be achieved through the flexibility in the exchange rate. These economists argued that a floating exchange rate system can ensure positive results more than the fixed parities system. Twenty-five years later, however, there is still no consensus on the matter. The author reviews the post-Bretton Woods experience to highlight some policies and approaches that might be helpful for the future.

Impressions That Last: Particularly Negative and Positive Experiences Reported by Parents Five Years after the End of a Child's Successful Cancer Treatment or Death.

Directory of Open Access Journals (Sweden)

Lisa Ljungman

Full Text Available To describe the experience of parenting a child diagnosed with cancer by examining particularly negative and positive experiences reported by parents of childhood cancer survivors and parents of children lost to cancer.168 parents (88 mothers, 80 fathers participated. Data were collected five years after the end of successful treatment or the child's death. The parents' experiences were identified by open-ended semi-structured questions about particularly negative and positive experiences of the child's cancer. An inductive approach was used in which the manifest verbal content of the answers was analysed using content analysis.The analysis revealed eight categories of negative experience (child late effects; distressing events; healthcare; impaired relationships; long-term psychological consequences; own reactions; surrounding institutions; the fact that the child got cancer and seven categories of positive experience (healthcare; improved relationships; long-term consequences for the child; personal development; support systems; treatment outcome; unexpected joy. The categories were related to past events or to the present situation. The findings indicate variations in experiences between parents of survivors and bereaved parents, and between fathers and mothers, as some experiences were only reported by parents of survivors and some experiences were only reported by mothers.The results highlight the importance of past and present events to parents, and accordingly the long-lasting impact of paediatric cancer on parents. The results also point to the wide range of negative as well as positive experiences involved in parenting a child diagnosed with cancer, and provide a comprehensive understanding of the overall experience for parents of children with cancer. Specifically, the findings give guidance to healthcare providers by illustrating the need to provide healthcare personnel with continuous training in communication skills, offering

Search for relativistic magnetic monopoles with five years of the ANTARES detector data

NARCIS (Netherlands)

Albert, A.; André, M.; Anghinolfi, M.; Anton, G.; Ardid, M.; Aubert, J.-J.; Avgitas, T.; Baret, B.; Barrios-Martí, J.; Basa, S.; Bertin, V.; Biagi, S.; Bormuth, R.; Bourret, S.; Bouwhuis, M.C.; Bruijn, R.; Brunner, J.; Busto, J.; Capone, A.; Caramete, L.; Carr, J.; Celli, S.; Chiarusi, T.; Circella, M.; Coelho, J.A.; Coleiro, A.; Coniglione, R.; Costantini, H.; Coyle, P.; Creusot, A.; Deschamps, A.; De Bonis, G.; Distefano, C.; Di Palma, I.; Domi, A.; Donzaud, C.; Dornic, D.; Drouhin, D.; Eberl, T.; El Bojaddaini, I.; Elsässer, D.; Enzenhöfer, A.; Felis, I.; Fusco, L.A.; Galatà, S.; Gay, P.; Giordano, V.; Glotin, H.; Grégoire, T.; Gracia-Ruiz, R.; Graf, K.; Hallmann, S.; van Haren, H.; Heijboer, A.J.; Hello, Y.; Hernandez-Rey, J.J.; Hößl, J.; Hofestädt, J.; Hugon, C.; Illuminati, G.; James, C.W.; de Jong, M.; Jongen, M.; Kadler, M.; Kalekin, O.; Katz, U.; Kießling, D.; Kouchner, A.; Kreter, M.; Kreykenbohm, I.; Kulikovskiy, V.; Lachaud, C.; Lahmann, R.; Lefevre, D.; Leonora, E.; Lotze, M.; Loucatos, S.; Marcelin, M.; Margiotta, A.; Marinelli, A.; Martinez-Mora, J.A.; Mele, R.; Melis, K.; Michael, T.; Migliozzi, P.; Moussa, A.; Navas, S.; Nezri, E.; Organokov, M.; Pavalas, G.E.; Pellegrino, C.; Perrina, C.; Piattelli, P.; Popa, V.; Pradier, T.; Quinn, L.; Racca, C.; Riccobene, G.; Sánchez-Losa, A.; Saldaña, M.; Salvadori, I.; Samtleben, D.F.E.; Sanguineti, M.; Sapienza, P.; Schüssler, F.; Sieger, C.; Spurio, M.; Stolarczyk, Th.; Taiuti, M.; Tayalati, Y.; Trovato, A.; Turpin, D.; Tönnis, C.; Vallage, B.; Van Elewyck, V.; Versari, F.; Vivolo, D.; Vizzoca, A.; Wilms, J.; Zornoza, J.D.; Zúñiga, J.

2017-01-01

A search for magnetic monopoles using five years of data recorded with the ANTARES neutrino telescope from January 2008 to December 2012 with a total live time of 1121 days is presented. The analysis is carried out in the range β > 0.6 of magnetic monopole velocities using a strategy based on

[Epidemiologic behavior of malignant digestive tract tumors over a five year period in Veracruz, Mexico].

Science.gov (United States)

Roesch-Dietlen, F; Jiménez-García, V A; Remes-Troche, J M; Rubio-Arce, J F; López-Salinas, A; Ruiz-Juárez, I; Grube-Pagola, P; Silva-Cañetas, C F

2012-01-01

Tumors of the digestive system are considered to be a public health problem because of their elevated mortality rate. In Mexico, gastric cancer and colon cancer rank fourth and fifth, respectively, following tracheal, bronchial, and lung cancer, and there has been an increase in their frequency in the last few years. However, there are no specific studies that have evaluated their epidemiologic behavior in Veracruz. To determine the frequency of digestive system cancer in five health institutions in the city of Veracruz and to describe its epidemiologic behavior over a five-year period. Annual statistics from the following hospitals were reviewed: the Instituto Mexicano del Seguro Social, the Secretaría de Salud, the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Petróleos Mexicanos, and the Secretaría de la Defensa Nacional within the time frame of January 2005 to December 2009. Diagnoses based on histopathology were recorded, along with patient age and sex. A total of 1803 cases of digestive tract cancers were detected: 52% were men and 48% were women. A yearly increase in the number of cases was observed with colon cancer being in first place, followed by stomach cancer and rectal cancer. The increase in digestive system cancer cases over the last five years in Veracruz underlines the need to evaluate the implementation of screening programs for the at-risk population and to study the different etiologic factors involved in its manifestation.

Five-year activity (1981-1985) on the project ionizing and nonionizing radiation protection investigations

International Nuclear Information System (INIS)

Zaricj, M.

1987-01-01

The brief review of the work conducted during five year's period on the project is given. Some organization and financial questions are touched. In spite of the permanent difficulties, it may be concluded that past period was successful. (author) 3 refs

Five years database of landslides and floods affecting Swiss transportation networks

Science.gov (United States)

Voumard, Jérémie; Derron, Marc-Henri; Jaboyedoff, Michel

2017-04-01

Switzerland is a country threatened by a lot of natural hazards. Many events occur in built environment, affecting infrastructures, buildings or transportation networks and producing occasionally expensive damages. This is the reason why large landslides are generally well studied and monitored in Switzerland to reduce the financial and human risks. However, we have noticed a lack of data on small events which have impacted roads and railways these last years. This is why we have collect all the reported natural hazard events which have affected the Swiss transportation networks since 2012 in a database. More than 800 roads and railways closures have been recorded in five years from 2012 to 2016. These event are classified into six classes: earth flow, debris flow, rockfall, flood, avalanche and others. Data come from Swiss online press articles sorted by Google Alerts. The search is based on more than thirty keywords, in three languages (Italian, French, German). After verifying that the article relates indeed an event which has affected a road or a railways track, it is studied in details. We get finally information on about sixty attributes by event about event date, event type, event localisation, meteorological conditions as well as impacts and damages on the track and human damages. From this database, many trends over the five years of data collection can be outlined: in particular, the spatial and temporal distributions of the events, as well as their consequences in term of traffic (closure duration, deviation, etc.). Even if the database is imperfect (by the way it was built and because of the short time period considered), it highlights the not negligible impact of small natural hazard events on roads and railways in Switzerland at a national level. This database helps to better understand and quantify this events, to better integrate them in risk assessment.

[Acute Dystonia due to Aripiprazole Use in Two Children with Autism Spectrum Disorder in the First Five Years of Life].

Science.gov (United States)

Küçükköse, Mustafa; Kabukçu Başay, Bürge

2017-01-01

Autism spectrum disorders (ASD) are neuropsychiatric disorders characterized by impairment in social interactions, in verbal and non-verbal communication, and restricted and stereotyped patterns of interest and behavior within the first 3 years of life. Pharmacologic interventions may be needed for the treatment of temper tantrums, aggression, hyperactivity, and stereotypes in children with ASD. The approval of aripiprazole by the United States Food and Drug Administration (USFDA) for the treatment of temper tantrums in children and adolescents with ASD has gained increased interest for the use in these patients. Aripiprazole is a partial agonist for the dopamine D2, serotonin 5-HT1A receptors, and an antagonist for 5HT2A receptors. Because aripiprazole is a partial agonist, it has been is speculated that aripiprazole has a protective effect for extrapyramidal side effects, movement disorders, and metabolic problems. But the increased use in children and adolescents is associated with an increase in the number of case reports related with such problems. Nevertheless, our review of the literature uncovered limited data regarding the association between acute dystonia and aripiprazole use in ASD children under five years of age is. In this paper, we present two cases of autistic spectrum disorder children with ages under 5 years that developed acute dystonia taking aripiprazole.

Doctors and baldness: a five thousand year old challenge.

Science.gov (United States)

Campo, Daniele; D'Acunzo, Valeria

2016-02-01

The history of trichology follows a thread that continually intersects with that of the history of medicine in general. Even Hippocrates believed that the approach to baldness should be of a medical nature. This confrontation between doctors and hair loss, which has lasted for five thousand years, begins with the invocations of the head physicians in the Egyptian era and ends with the recent institution of postgraduate Master's degrees at Faculties of Medicine and Surgery. The biggest names in medicine concerned themselves with trichology beginning with Hippocrates, who dealt with the topic in his most famous work: the Aphorisms. Even the most celebrated doctors of the Roman era, such as Galen and Pliny the Elder, did not disdain considering hair loss, leaving important scientific contributions before passing on the baton to their distinguished colleagues of the Byzantine Empire. The narrative then flows through the most prestigious institutions of the Middle Ages, such as the Salerno School of Medicine and the Siena Accademia del Fisiocritici where, at the end of the 1600s, the distinguished anatomical describer Marcello Malpighi also taught trichology, and left his contribution to "Hair Science" with a fine description of the hair follicle in the pages of his Opera Posthuma. At the turn of the late Middle Ages and the early modern era, barbers formed the primordial nucleus of surgery and at the same time became the ones to concern themselves with hair loss. In the 1800s, several doctors published the first texts dealing with the anatomy and physiology of the hair and taking into account the principal forms of alopecia, but at the therapeutic level did not yet propose anything scientifically valid. Until a few decades ago trichology still lent itself to various commercial speculations. It was not until the twentieth century that the pathogenetic mechanisms of baldness were clarified in a scientific manner. With this knowledge, the pharmaceutical industry has been

Football as a treatment for hypertension in untrained 30-55-year-old men: a prospective randomized study

DEFF Research Database (Denmark)

Andersen, Lars Juel; Randers, Morten Bredsgaard; Westh, K.

2010-01-01

The present study investigated whether football has favorable effects in the treatment of mild-to-moderate arterial hypertension in untrained middle-aged men. Twenty-five untrained males aged 31-54 year with mild-to-moderate hypertension were randomized to a football training group (FTG, two 1-h.......p.m.), whereas no change was observed for DAG. After 3 months, FTG had higher (Pattractive non-pharmacological supplement...... to the treatment of mild-to-moderate arterial hypertension in untrained middle-aged men....

Nutritional profile in children under five years of Afro-descendant communities in Paraguay

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Susana Sánchez-Bernal

2015-12-01

Full Text Available Background: In Paraguay, little is known about the Afro-descendant population. It is important to know about their nutritional status, mainly in childhood, to guide appropriate action. Objective: To determine the nutritional profile of children under five years from the African descendants’ communities in Paraguay and its associated factors. Material and methods: A cross-sectional and observational design with analytical component was developed. It involved healthy male and female children under five years old, with at least one African descendant as immediate family. Dietary habits and nutritional status (WHO criteria were assessed. WHO Anthro and SPSS 16.0 software were used. Results: 150 children were included. The median of age was 26.9 months (1.2-59.9 m, and 50.7% were males. The median maternal age was 28.3 years (16-49 years. Children with Exclusive Breast Feeding (EBF, n=119 had a mean duration of 3.5±1.8 months (1-7m. 26.9% were exclusively breastfed during six months. The starting of complementary feeding was on average 5.2 months. The underweight prevalence (UW, zP/E 0.05. Children with UW had a lower average of age of onset of complementary feeding (1.7 vs 4.9 months, p˂0.0001 compare with their pairs without malnutrition. Conclusion: Chronic malnutrition was the most prevalent chronic disease affecting over 1 in 10 children. Early initiation of complementary feeding could be a risk factor for malnutrition.

Age specific aetiological agents of diarrhoea in hospitalized children aged less than five years in Dar es Salaam, Tanzania

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Myrmel Helge

2011-02-01

Full Text Available Abstract Background This study aimed to determine the age-specific aetiologic agents of diarrhoea in children aged less than five years. The study also assessed the efficacy of the empiric treatment of childhood diarrhoea using Integrated Management of Childhood Illness (IMCI guidelines. Methods This study included 280 children aged less than 5 years, admitted with diarrhoea to any of the four major hospitals in Dar es Salaam. Bacterial pathogens were identified using conventional methods. Enzyme Linked Immunosorbent Assay (ELISA and agglutination assay were used to detect viruses and intestinal protozoa, respectively. Antimicrobial susceptibility was determined using Kirby-Bauer disk diffusion method. Results At least one of the searched pathogens was detected in 67.1% of the cases, and mixed infections were detected in 20.7% of cases. Overall, bacteria and viruses contributed equally accounting for 33.2% and 32.2% of all the cases, respectively, while parasites were detected in 19.2% patients. Diarrhoeagenic Escherichia coli (DEC was the most common enteric pathogen, isolated in 22.9% of patients, followed by Cryptosporidium parvum (18.9%, rotavirus (18.1% and norovirus (13.7%. The main cause of diarrhoea in children aged 0 to 6 months were bacteria, predominantly DEC, while viruses predominated in the 7-12 months age group. Vibrio cholerae was isolated mostly in children above two years. Shigella spp, V. cholerae and DEC showed moderate to high rates of resistance to erythromycin, ampicillin, chloramphenicol and tetracycline (56.2-100%. V. cholerae showed full susceptibility to co-trimoxazole (100%, while DEC and Shigella showed high rate of resistance to co-trimoxazole; 90.6% and 93.3% respectively. None of the bacterial pathogens isolated showed resistance to ciprofloxacin which is not recommended for use in children. Cefotaxime resistance was found only in 4.7% of the DEC. Conclusion During the dry season, acute watery diarrhoea is the

The randomized shortened dental arch study: tooth loss over five years.

Science.gov (United States)

Walter, M H; Hannak, W; Kern, M; Mundt, T; Gernet, W; Weber, A; Wöstmann, B; Stark, H; Werner, D; Hartmann, S; Range, U; Jahn, F; Passia, N; Pospiech, P; Mitov, G; Brückner, J; Wolfart, S; Busche, E; Luthardt, R G; Heydecke, G; Marré, B

2013-04-01

The study was designed to provide clinical outcome data for two treatments of the shortened dental arch (SDA). In a multicenter randomized controlled clinical trial, patients with complete molar loss in one jaw were provided with either a partial removable dental prosthesis (PRDP) retained with precision attachments or treated according to the SDA concept preserving or restoring a premolar occlusion. No implants were placed. The primary outcome was tooth loss. Of 152 treated patients, 132 patients reached the 5-year examination. Over 5 years, 38 patients experienced tooth loss. For the primary outcome tooth loss, the Kaplan-Meier survival rates at 5 years were 0.74 (95% CI 0.64, 0.84) in the PRDP group and 0.74 (95% CI 0.63, 0.85) in the SDA group. For tooth loss in the study jaw, the survival rates at 5 years were 0.88 (95% CI 0.80, 0.95) in the PRDP group and 0.84 (95% CI 0.74, 0.93) in the SDA group. The differences were not significant. No Cox regression models of appropriate fit explaining tooth loss on the patient level could be found. The overall treatment goals of a sustainable oral rehabilitation and the avoidance of further tooth loss over longer periods were not reliably achievable. The influence of the type of prosthetic treatment on tooth loss might have been overestimated. Regarding our results, the patient's view will gain even more importance in the clinical decision between removable and fixed restorations in SDAs.

Five-year follow-up of knee joint cartilage thickness changes after acute anterior cruciate ligament rupture

DEFF Research Database (Denmark)

Eckstein, F; Wirth, W; Lohmander, Stefan

2015-01-01

Objective: Anterior cruciate ligament (ACL) rupture involves increased risk of osteoarthritis. We explored cartilage thickness changes over five years after ACL rupture. Methods: 121 young active adults (26% women, age 18-35 years) with acute traumatic ACL rupture were studied (the KANON-trial). ...

Dgroup: DG00783 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available DG00783 Chemical ... DGroup Alendronic acid ... D07119 ... Alendronic acid (INN) D00939 ... Alendron...ate sodium (USAN); Alendronate sodium hydrate (JP17) ... Other ... DG01600 ... Bisphosphonate ATC code: M05BA04 Bisphosphonates FDPS [HSA:2224] [KO:K00787] ...

ANALYSIS ON THE EVOLUTION OF INSURANCE SYSTEMS IN ROMANIA - THE PAST FIVE YEARS

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AURELIA PĂTRAȘCU

2016-08-01

Full Text Available The aim of this paper is to analyze the evolution of insurance systems in Romania in the past five years. Unlike other European countries, it can be seen that Romania does not have a well-established insurance tradition. Insurance companies are constantly adapting to the realities of the financial situation and the market structure in Romania.

An Explanation on the Tenth-Five-Year Plan of China’s Auto Industry

Institute of Scientific and Technical Information of China (English)

2002-01-01

<正> The Tenth-Five-Year-Plan of the auto industry recently issued has made an analysis on the market demand, development environment and situation that the auto industry will face and advanced the idea for solving contractions and problems, taking the restructuring as motif. Compared with the previous medium-and-long-term programs, the plan is more macroscopic, strategical,

Fukushima five years after, a return to the abnormal

International Nuclear Information System (INIS)

Boilley, David

2016-02-01

After a synthetic presentation of the study which discusses how different issues have been and are still addressed in Fukushima (evacuated populations, protection against radiations, food contamination, future of evacuated lands, reluctance of inhabitants to come back), this report outlines that radioactive releases are still going on (discussion of source terms, continuing leakages, impact on sea, practices resulting in significant releases of radioactive dusts, a still threatening Fukushima plant). The author then addresses issues related to radioactive contamination and evacuation (evacuation sequence, number of displaced persons, situation after 5 years), discusses the reviewing of levels of protection after a nuclear accident (principles of radiation protection, evacuation policy, protection values and operational values, limits for food contamination). He proposes an assessment of food contamination five years after the accident (initial mistakes in food control, extended food controls, internal exposure of consumers, threats on some activities due to production restrictions), and comments the restoration of contaminated territories (restoring policy, limited effects of decontamination, production of a large quantity of wastes which are not well maintained nor secure). He finally comments the issue of population come-back (government decisions, reluctance of inhabitants, depopulation and ageing of contaminated areas, case of human right violation, suffering of elderly people)

The external quality assessment scheme: Five years experience as a participating laboratory

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Chaudhary Rajendra

2010-01-01

Full Text Available Background and Aim : Quality assurance in blood banking includes active participation in the external quality program. Such a program offers valuable benefits to patient care, their safety, and an overall quality of laboratory practices. In the year 2002, we participated in the External Quality Assessment Scheme (EQAS under the World Health Organization (WHO, Bureau of Laboratory Quality Standards, Thailand. Materials and Methods: In the current study we evaluated our EQAS test result of the past five years, from 2003 to 2007. Test results of all blood samples such as ABO grouping, D typing, antibody screening, antibody identification, and transfusion transmitted infection (TTI testing were analyzed and documented. Results: Discordant results in one or more instances were observed with antibody identification, weak D testing, and tests for anti-HIV1/2 and HBsAg. Twice we failed to detect the ′anti-Mia′ antibody in the issued sample and that could be attributed to the absence of the corresponding antigen in the used cell panel. HBsAg was missed due to its critically low titer in the serum and the comparatively low sensitivity of our Enzyme-Linked Immunosorbent Assay (ELISA test kit. Conclusion: All these failures in the last five years have helped us to significantly improve our transfusion service in terms of performance evaluation, patient care and safety issues, and the overall quality of laboratory practices. We therefore recommend all laboratories and hospitals to participate in the EQAS program, which will definitely help them to improve from what they learn.

RECURRENCE RATE OF HELICOBACTER PYLORI IN PATIENTS WITH PEPTIC ULCER FIVE YEARS OR MORE AFTER SUCCESSFUL ERADICATION.

Science.gov (United States)

Fernandes, Yuri Costa Farago; Bonatto, Gabriel da Rocha; Bonatto, Mauro Willeman

2016-01-01

Infection with Helicobacter pylori is highly prevalent worldwide, especially in developing countries. Its presence in the gastroduodenal mucosa is related with development of peptic ulcer and other illnesses. The eradication of H. pylori improves mucosal histology in patients with peptic ulcers. This study was aimed to verify if H. pylori recurrence occurs five years or more after confirmed eradication in patients with peptic ulcer. Moreover, we sought to determine the recurrence rate. Retrospective and longitudinal, this study was based on a sample of 201 patients from western Paraná, Brazil. The patients were diagnosed with peptic ulcer disease, in the period of 1990-2000, and followed for five years or more after successful H. pylori eradication. Patients with early recurrence - prior to five years after eradication - were excluded from the sample. During an average follow-up of 8 years, 180 patients (89.55%) remained negative, and 21 (10.45%) became positive for H. pylori infection. New ulcers appeared in two-thirds of the patients with H. pylori recurrence. The recurrence of H. pylori in patients with peptic ulcer can occur in the long-term - even if the infection had been successfully eradicated and the patients had remained free of recurrence in the first years of follow-up.

Treatment and violent behavior in persons with first episode psychosis during a 10-year prospective follow-up study

DEFF Research Database (Denmark)

Langeveld, Johannes; Bjørkly, Stål; Auestad, Bjørn

2014-01-01

BACKGROUND: First episode psychosis (FEP) patients have an increased risk for violence and criminal activity prior to initial treatment. However, little is known about the prevalence of criminality and acts of violence many years after implementation of treatment for a first episode psychosis. AIM......: To assess the prevalence of criminal and violent behaviors during a 10-year follow-up period after the debut of a first psychosis episode, and to identify early predictors and concomitant risk factors of violent behavior. METHOD: A prospective design was used with comprehensive assessments of criminal...... follow-up period, 20% of subjects had been apprehended or incarcerated. At 10-year follow-up, 15% of subjects had exposed others to threats or violence during the year before assessment. Illegal drug use at baseline and five-year follow-up, and a longer duration of psychotic symptoms were found...

Wound Healing Society (WHS) venous ulcer treatment guidelines: what's new in five years?

Science.gov (United States)

Tang, Jennifer C; Marston, William A; Kirsner, Robert S

2012-01-01

Since the establishment of the guidelines for the treatment of venous ulcers by the Wound Healing Society in 2006, there has been an abundance of new literature, both in accord and discord with the guidelines. The goal of this update is to highlight new findings since the publication of these guidelines to assist practitioner and patient in appropriate health care decisions, as well as to drive future research endeavors. © 2012 by the Wound Healing Society.

Perceived weight status may contribute to education inequalities in five-year weight change among mid-aged women.

Science.gov (United States)

Siu, Jessica; Giskes, Katrina; Shaw, Jonathan; Turrell, Gavin

2011-06-01

To examine education differences in five-year weight change among mid-aged adults, and to ascertain if this may be due to socioeconomic differences in perceived weight status or weight control behaviours (WCBs). Data were used from the Australian Diabetes, Obesity and Lifestyle Study. Mid-aged men and women with measured weights at both baseline (1999-2000) and follow-up (2004-2005) were included. Percent weight change over the five-year interval was calculated and perceived weight status, WCBs and highest attained education were collected at baseline. Low-educated men and women were more likely to be obese at baseline compared to their high-educated counterparts. Women with a certificate-level education had a greater five-year weight gain than those with a bachelor degree or higher. Perceived weight status or WCBs did not differ by education among men and women, however participants that perceived themselves as very overweight had less weight gain than those perceiving themselves as underweight or normal weight. WCBs were not associated with five-year weight change. The higher prevalence of overweight/obesity among low-educated women may be a consequence of greater weight gain in mid-adulthood. Education inequalities in overweight/obesity among men and women made be due (in part) to overweight or obese individuals in low-educated groups not perceiving themselves as having a weight problem. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

Five-year experience with burns from glass fireplace doors in the pediatric population.

Science.gov (United States)

Baryza, Mary Jo; Hinson, Michelle; Conway, Jennifer; Ryan, Colleen M

2013-01-01

Burns from contact with glass doors of gas fireplaces have been previously reported. The purpose of this study is to examine the incidence and severity of this injury in our population. Patients were identified for inclusion in the retrospective chart review study using the National Trauma Registry of the American College of Surgeons (NTRACS) and our local outpatient database. Criteria for inclusion were burn injuries sustained from contact with fireplace glass doors treated at our pediatric burn center from 2007 through 2011. Fifty children met these criteria, including two children whose burns were caused by electric fireplace glass doors. BSA burned was 1.5 ± 1.5% (mean ± SD), range 0.5 to 10%. Age was 27.2 ± 27.3 months, range 8 months to 13 years. Forty-five children (90%) had hand burns; of these, 18 children had bilateral hand involvement. Facial burns were found in three children (6%), and eight children (16%) had other areas burned. One patient developed cellulitis. Two patients required surgery. Six children (12%) required hospitalization; mean length of stay was 5.8 ± 5 days, range 1 to 5 days. Although the number of inpatient admissions was relatively few, 329 outpatient visits and 309 rehabilitation visits were required for treatment of these children. Nineteen patients (38%) required splints and six patients (12%) required scar treatment with pressure garments. Burns from contact with fireplace glass doors are a recurring problem. Toddlers are most at risk. Directed preventive strategies including parent education, safety warnings, and design modifications such as temperature sensors and barrier screens could be potentially helpful in reducing the incidence of this injury.

Branch Development of Five-Year-Old Betula alnoides Plantations in Response to Planting Density

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Chun-Sheng Wang

2018-01-01

Full Text Available Branch development in the lower part of stem is critical to both early stem growth and wood quality of the most valuable section of tree, and its regulation through planting density has always been greatly concerned. Here the effect of planting density on branch development was examined in a five-year-old plantation of Betula alnoides with six planting densities (625, 833, 1111, 1250, 1667, and 2500 stems per hectare (sph in Guangdong Province, South China. Branch quantity (number, proportion, and density, morphology (diameter, length, and angle, position (height and orientation, and branch status (dead or alive were investigated for 54 dominant or co-dominant trees under six treatments of planting density after the growth of each tree was measured. Factors influencing branch development were also explored by mixed modelling. The results showed that the mean tree heights of 1250 and 1667 sph treatments were higher than those of other planting density treatments. The quantity of live branches decreased with increasing planting density. However, planting density had no significant effect on the number of all branches, and there existed no remarkable difference in branch number and proportion among four orientations. As for branch morphology, only the largest branch diameter had a significantly negative correlation with planting density. In addition, high planting density significantly increased the height of the largest branch within the crown. Mixed effects models indicated that branch diameter, length, and angle were closely correlated with each other, and they were all in positively significant correlation to the branch height at the stem section below six meters. It was concluded that properly increasing planting density will promote natural pruning, improve early branch control, and be beneficial for wood production from the most valuable section of the stem.

Five years' experience of classical swine fever polymerase chain reaction ring trials in France.

Science.gov (United States)

Po, F; Le Dimna, M; Le Potier, M F

2011-12-01

Since 2004, the French National Reference Laboratory for classical swine fever (CSF) has conducted an annual proficiency test (PT) to evaluate the ability of local veterinary laboratories to perform real-time polymerase chain reaction (PCR) for CSF virus. The results of five years of testing (2004-2008) are described here. The PT was conducted under blind conditions on 20 samples. The same batch of samples was used for all five years. The number of laboratories that analysed the samples increased from four in 2004 to 13 in 2008. The results of the PT showed the following: cross-contamination between samples and deficiencies in RNA preparation can occur even in experienced laboratories; sample homogeneity should be checked carefully before selection; samples stored at-80 degrees C for several years remain stable; and poor shipment conditions do not damage the samples with regard to detection of CSF virus genome. These results will enable redesign of the panel to improve the overall quality of the PT, which will encourage laboratories to check and improve their PCR procedures and expertise. This is an excellent way to determine laboratory performance.

Five Years of Cyclotron Radioisotope Production Experiences at the First PET-CT in Venezuela

International Nuclear Information System (INIS)

Colmenter, L.; Coelho, D.; Esteves, L. M.; Ruiz, N.; Morales, L.; Lugo, I.; Sajo-Bohus, L.; Liendo, J. A.; Greaves, E. D.; Barros, H.; Castillo, J.

2007-01-01

Five years operation of a compact cyclotron installed at PET-CT facility in Caracas, Venezuela is given. Production rate of 18 F labeled FDG, operation and radiation monitoring experience are included. We conclude that 18 FDG CT-PET is the most effective technique for patient diagnosis

A National Study of the Prevalence of Autism among Five-Year-Old Children in Iran

Science.gov (United States)

Samadi, Sayyed Ali; Mahmoodizadeh, Ameneh; McConkey, Roy

2012-01-01

In Iran, more than 1.3 million five-year olds have been screened for autism over three academic years, with the Social Communication Questionnaire (SCQ). The Autism Diagnostic Interview-Revised (ADI-R) is used to confirm a diagnosis of typical autism. The resulting prevalence of 6.26 per 10,000 for typical autism is in line with rates for certain…

The first permanent molar: spontaneous eruption after a five-year failure.

Science.gov (United States)

Mistry, Vinay N; Barker, Christopher S; James Spencer, R

2017-09-01

It is rare for a first permanent molar (FPM) to temporarily exhibit clinical features of failure of eruption, followed by regeneration of full eruptive capacity 5 years later. Indeterminate failure of eruption (IFE) is a diagnosis of exclusion where the distinction between primary failure of eruption (PFE) and mechanical failure of eruption (MFE) is unclear, including patients too young to specify. An 11-year-old girl attended the orthodontic clinic at Mid Yorkshire Hospitals NHS Trust regarding an unerupted lower right FPM. Her medical and dental trauma history was unremarkable. She presented with a Class II division 2 malocclusion in the mixed dentition, with all other FPMs fully erupted. This report documents that an unerupted FPM in an 11-year-old patient may still have the eruptive potential to become functional within the dentition. The period spent monitoring the FPM's outcome prior to surgical intervention has avoided an operation under general anaesthetic and potentially unnecessary orthodontic treatment, as the tooth subsequently erupted without treatment. © 2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Assessment of Peer-Led Team Learning in Calculus I: A Five-Year Study

Science.gov (United States)

Merkel, John Conrad; Brania, Abdelkrim

2015-01-01

This five-year study of the peer-led team learning (PLTL) paradigm examined its implementation in a Calculus I course at an all-male HBCU institution. For this study we set up a strong control group and measured the effect of PLTL in the teaching and learning of Calculus I through two points of measure: retention and success rates and learning…

Determinants of delay in malaria treatment-seeking behaviour for under-five children in south-west Ethiopia: a case control study

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Deribew Amare

2010-11-01

Full Text Available Abstract Background Prompt diagnosis and timely treatment of malaria within 24 hours after onset of first symptoms can reduce illness progression to severe stages and therefore, decrease mortality. The reason why mothers/caretakers delay in malaria diagnosis and treatment for under-five children is not well studied in Ethiopia. The objective of this study was to assess determinants of malaria treatment delay in under-five children in three districts of south-west Ethiopia. Methods A case control study was conducted from March 15 to April 20, 2010. Cases were under-five children who had clinical malaria and sought treatment after 24 hours of developing sign and symptom, and controls were under-five children who had clinical malaria and sought treatment within 24 hours of developing sign and symptom of malaria. Data were collected by trained enumerators using structured questionnaire. Data were entered in to Epi Info version 6.04 and analyzed using SPSS version 16.0. To identify determinants, multiple logistic regression was done. Results A total of 155 mothers of cases and 155 mothers of controls were interviewed. Mothers of children who were in a monogamous marriage (OR = 3.41, 95% CI: 1.39, 8.34, who complained about the side effects of anti-malarial drugs (OR = 4.96, 95% CI: 1.21, 20.36, who had no history of child death (OR = 3.50, 95% CI: 1.82, 6.42 and who complained about the higher cost of transportation to reach the health institutions (OR = 2.01, 95% CI: 1.17, 3.45 were more likely to be late for the treatment of malaria in under-five children. Conclusion Effective malaria control programmes should address reducing delayed presentation of children for treatment. Efforts to reduce delay should address transport cost, decentralization of services and increasing awareness of the community on early diagnosis and treatment.

Five-year follow-up of cognitive impairment in older adults with bipolar disorder.

Science.gov (United States)

Schouws, Sigfried N T M; Comijs, Hannie C; Dols, Annemieke; Beekman, Aartjan T F; Stek, Max L

2016-03-01

To date, cognitive impairment has been thought to be an integral part of bipolar disorder. In clinical staging models, cognitive impairment is one of the hallmarks to define the clinical stage and it plays an important role in identifying the risk factors for progression to later stages of the illness. It is important to examine neurocognitive performance over longer periods to test the hypothesis of neuroprogression of bipolar disorder. A comprehensive neuropsychological test battery was applied at baseline and five years later to 56 euthymic older outpatients with bipolar disorder (mean age = 68.35 years, range: 60-90 years) and to a demographically matched sample of 44 healthy subjects. A group-by-time repeated measures multivariate analysis of variance was performed to measure changes over time for the two groups. The impact of baseline illness characteristics on the intra-individual change in neurocognitive performance within the bipolar disorder group was studied by using logistic regression analysis. At baseline and at follow-up, patients with bipolar disorder performed worse on all neurocognitive measures compared to the matched healthy subjects. However, there was no significant group-by-time interaction between the patients with bipolar disorder and the comparison group. Although older patients with bipolar disorder had worse cognitive function than healthy subjects, they did not have greater cognitive decline over a five-year period. The change in acquired cognitive impairment of patients with bipolar disorder might parallel the cognitive development as seen in normal aging. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Long term (five-year survival following radical surgical treatment plus adjuvant chemotherapy (FAM in advanced gastric cancer: a controlled study

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Bresciani Cláudio

2000-01-01

Full Text Available Several drugs and their associations are being used for adjuvant or complementary chemotherapy with the aim of improving results of gastric cancer treatment. The objective of this study was to verify the impact of these drugs on nutrition and on survival rate after radical treatment of 53 patients with gastric cancer in stage III of the TNM classification. A control group including 28 patients who had only undergone radical resection was compared to a group of 25 patients who underwent the same operative technique followed by adjuvant polychemotherapy with FAM (5-fluorouracil, Adriamycin, and mitomycin C. In this latter group, chemotherapy toxicity in relation to hepatic, renal, cardiologic, neurological, hematologic, gastrointestinal, and dermatological functions was also studied. There was no significant difference on admission between both groups in relation to gender, race, macroscopic tumoral type of tumor according to the Borrmann classification, location of the tumor in the stomach, length of the gastric resection, or response to cutaneous tests on delayed sensitivity. Chemotherapy was started on average, 2.3 months following surgical treatment. Clinical and laboratory follow-up of all patients continued for 5 years. The following conclusions were reached: 1 The nutritional status and incidence of gastrointestinal manifestation were similar in both groups; 2 There was no occurrence of cardiac, renal, neurological, or hepatic toxicity or death due to the chemotherapeutic method per se; 3 Dermatological alterations and hematological toxicity occurred exclusively in patients who underwent polychemotherapy; 4 There was no significant difference between the rate and site of tumoral recurrence, the disease-free interval, or the survival rate of both study groups; 5 Therefore, we concluded, after a 5-year follow-up, chemotherapy with the FAM regimen did not increase the survival rate.

[A case of transverse colon cancer without a recurrence lesion after five years from resection of hepatic metastasis].

Science.gov (United States)

Ami, Katsunori; Nakamura, Masahiro; Takasaki, Jun; Watayou, Yoshihisa; Amagasa, Hidetoshi; Ganno, Hideaki; Kurokawa, Toshiaki; Fukuda, Akira; Nagahama, Takeshi; Ando, Masayuki; Tei, Shikofumi; Okada, Youichi; Arai, Kuniyoshi

2011-11-01

The treatment of hepatic metastasis of colon cancer was in progress by new biochemical agents. Generally, a resection was the first alternative treatment against hepatic metastasis of colon cancer, but new antitumor agents were more effective than conventional antitumor agents. Disappearance of metastasis for colon cancer treated with only antitumor agents was commenced to report. We were experienced a case of transverse colon cancer without a recurrence lesion after five years from the resection of hepatic metastasis. A case was a 77-year-old man. He was operated against transverse colon cancer in February 2003. Pathological stage was ss, n0, Stage II. In April 2004, serum CEA was increased. CT examination was not detected a hepatic metastasis but ultrasound examination and MRI detected the metastasis at S7 lesion in the liver. In July 2004, he was admitted to S-1 and PSK until October 2004. In December 2004, the lesion of hepatic metastasis was reduced and serum CEA was decreased. But in September 2005, the metastatic lesion was re-grown. A resection for hepatic metastasis was executed in November 2005. After the resection for hepatic metastasis, he was admitted to UFT/ UZEL from January 2006 to October 2006. Present time( June 2011), the lesion of recurrence was not detected by several examinations (CT, MRI, Ultrasound etc).

Risk of atrial fibrillation among bisphosphonate users: a multicenter, population-based, Italian study.

Science.gov (United States)

Herrera, L; Leal, I; Lapi, F; Schuemie, M; Arcoraci, V; Cipriani, F; Sessa, E; Vaccheri, A; Piccinni, C; Staniscia, T; Vestri, A; Di Bari, M; Corrao, G; Zambon, A; Gregori, D; Carle, F; Sturkenboom, M; Mazzaglia, G; Trifiro, G

2015-05-01

Bisphosphonate treatment is used to prevent bone fractures. A controversial association of bisphosphonate use and risk of atrial fibrillation has been reported. In our study, current alendronate users were associated with a higher risk of atrial fibrillation as compared with those who had stopped bisphosphonate (BP) therapy for more than 1 year. Bisphosphonates are widely used to prevent bone fractures. Controversial findings regarding the association between bisphosphonate use and the risk of atrial fibrillation (AF) have been reported. The aim of this study was to evaluate the risk of AF in association with BP exposure. We performed a nested case-control study using the databases of drug-dispensing and hospital discharge diagnoses from five Italian regions. The data cover a period ranging from July 1, 2003 to December 31, 2006. The study population comprised new users of bisphosphonates aged 55 years and older. Patients were followed from the first BP prescription until an occurrence of an AF diagnosis (index date, i.e., ID), cancer, death, or the end of the study period, whichever came first. For the risk estimation, any AF case was matched by age and sex to up to 10 controls from the same source population. A conditional logistic regression was performed to obtain the odds ratio with 95% confidence intervals (CI). The BP exposure was classified into current (reference point. A subgroup analysis by individual BP was then carried out. In comparison with distant past users of BP, current users of BP showed an almost twofold increased risk of AF: odds ratio (OR) = 1.78 and 95% CI = 1.46-2.16. Specifically, alendronate users were mostly associated with AF as compared with distant past use of BP (OR, 1.97; 95% CI, 1.59-2.43). In our nested case-control study, current users of BP are associated with a higher risk of atrial fibrillation as compared with those who had stopped BP treatment for more than 1 year.

Anti-HBs in immunized children with cuban hepatitis B vaccine and impact of booster dose after five years

International Nuclear Information System (INIS)

Dahifar, H.; Mousavi, F.; Ghorbani, A.

2008-01-01

Hepatitis B virus infection and associated diseases are a major public health problem. This study was planned to find out the persistence of antibody against hepatitis B surface antigen in Iranian vaccinated children after five years. Anti-HBs titers in a group of healthy good - responder children who were vaccinated with Cuban hepatitis B vaccine in infancy were measured after five years. Children with antibody titers <100 mlU/ml were revaccinated and retested after four weeks. Mean anti-HBs titers in 68 children (29 females, 39 males) were 482.1 mlU/ml at six months after the third dose of primary vaccination and 153 mlU/ml at five years later. Total mean anti-HBs titers in 36 (52.9%) children out of 68 (17 females, 19 males) were 38.3 mlU/ml and 4(5.8%) of 68 children (two of each sexes) had no detectable antibody after five years. Total mean anti-HBs titers in these hypo- responder and non- responder were 774.3 mlU/ml and 625.5 mlU/ml respectively after booster dose. In a group of children, who were immunized with Cuban hepatitis B vaccine from birth, anti-HBS titers fell at 6.5 years of age and almost half of children became hypo responder or no responder and their anti-HBs titers developed secondary rise after booster vaccination. All children showed immunologic memory to a booster dose. (author)

Letter to the Editor: Re: A Five-year Survey of Cesarean Delivery at a ...

African Journals Online (AJOL)

Letter to the Editor: Re: A Five-year Survey of Cesarean Delivery at a Nigerian Tertiary Hospital. VO Ajuzieogu, AO Amucheazi. Abstract. Letter to the editor - no abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Article Metrics. Metrics Loading .

Five-year survival in 309 patients with colorectal liver metastases treated with radiofrequency ablation

International Nuclear Information System (INIS)

Gillams, A.R.; Lees, W.R.

2009-01-01

There is little published long-term survival data for patients with colorectal liver metastases treated with radiofrequency ablation (RFA). We present a multivariate analysis of 5-year survival in 309 patients (198 male, aged 64 (24-92)) treated at 617 sessions. Our standard protocol used internally cooled electrodes introduced percutaneously under combined US and CT guidance/monitoring. The number and size of liver metastases, the presence and location of extrahepatic disease, primary resection, clinical, chemotherapy and follow-up data were recorded. Data analysis was performed using SPSS v.10. On multivariate analysis, significant survival factors were the presence of extrahepatic disease (p < 0.001) and liver tumour volume (p = 0.001). For 123 patients with five or less metastases of 5 cm or less maximum diameter and no extrahepatic disease median survival was 46 and 36 months from liver metastasis diagnosis and ablation, respectively; corresponding 3- and 5-year survival rates were 63%, 34% and 49%, 24%. Sixty-nine patients had three or less tumours of below 3.5 cm in diameter and their 5-year survival from ablation was 33%. There were 23/617(3.7%) local complications requiring intervention. Five-year survival of 24-33% post ablation in selected patients is superior to any published chemotherapy data and approaches the results of liver resection. (orig.)

Error identification in a high-volume clinical chemistry laboratory: Five-year experience.

Science.gov (United States)

Jafri, Lena; Khan, Aysha Habib; Ghani, Farooq; Shakeel, Shahid; Raheem, Ahmed; Siddiqui, Imran

2015-07-01

Quality indicators for assessing the performance of a laboratory require a systematic and continuous approach in collecting and analyzing data. The aim of this study was to determine the frequency of errors utilizing the quality indicators in a clinical chemistry laboratory and to convert errors to the Sigma scale. Five-year quality indicator data of a clinical chemistry laboratory was evaluated to describe the frequency of errors. An 'error' was defined as a defect during the entire testing process from the time requisition was raised and phlebotomy was done until the result dispatch. An indicator with a Sigma value of 4 was considered good but a process for which the Sigma value was 5 (i.e. 99.977% error-free) was considered well controlled. In the five-year period, a total of 6,792,020 specimens were received in the laboratory. Among a total of 17,631,834 analyses, 15.5% were from within hospital. Total error rate was 0.45% and of all the quality indicators used in this study the average Sigma level was 5.2. Three indicators - visible hemolysis, failure of proficiency testing and delay in stat tests - were below 5 on the Sigma scale and highlight the need to rigorously monitor these processes. Using Six Sigma metrics quality in a clinical laboratory can be monitored more effectively and it can set benchmarks for improving efficiency.

Nearly 30 Years of Treatment for Recurrent Granulosa Cell Tumor of the Ovary: A Case Report and Review of the Literature

Directory of Open Access Journals (Sweden)

Deanna Teoh

2010-01-01

Full Text Available A 30-year-old woman was diagnosed with a stage IA granulosa cell tumor (GCT of the ovary in 1979. Following removal of the adnexal mass and complete surgical staging, she remained disease-free for 12 years. In 1991 she underwent a resection of a retroperitoneal mass, confirmed to be a recurrent GCT. Despite adjuvant radiation treatment at the time of recurrence, the patient presented five years later with abdominal pain, and was found to have a second recurrence. Over the next 10 years the patient had multiple recurrences and progressive disease despite surgical resection, cytotoxic, hormonal and targeted chemotherapy treatments. In conclusion, there is no standard management for recurrent GCT of the ovary. We review this patient’s treatment in the context of the current literature.

Application of an incident taxonomy for radiation therapy: Analysis of five years of data from three integrated cancer centres.

Science.gov (United States)

Greenham, Stuart; Manley, Stephen; Turnbull, Kirsty; Hoffmann, Matthew; Fonseca, Amara; Westhuyzen, Justin; Last, Andrew; Aherne, Noel J; Shakespeare, Thomas P

2018-01-01

To develop and apply a clinical incident taxonomy for radiation therapy. Capturing clinical incident information that focuses on near-miss events is critical for achieving higher levels of safety and reliability. A clinical incident taxonomy for radiation therapy was established; coding categories were prescription, consent, simulation, voluming, dosimetry, treatment, bolus, shielding, imaging, quality assurance and coordination of care. The taxonomy was applied to all clinical incidents occurring at three integrated cancer centres for the years 2011-2015. Incidents were managed locally, audited and feedback disseminated to all centres. Across the five years the total incident rate (per 100 courses) was 8.54; the radiotherapy-specific coded rate was 6.71. The rate of true adverse events (unintended treatment and potential patient harm) was 1.06. Adverse events, where no harm was identified, occurred at a rate of 2.76 per 100 courses. Despite workload increases, overall and actual rates both exhibited downward trends over the 5-year period. The taxonomy captured previously unidentified quality assurance failures; centre-specific issues that contributed to variations in incident trends were also identified. The application of a taxonomy developed for radiation therapy enhances incident investigation and facilitates strategic interventions. The practice appears to be effective in our institution and contributes to the safety culture. The ratio of near miss to actual incidents could serve as a possible measure of incident reporting culture and could be incorporated into large scale incident reporting systems.

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

Directory of Open Access Journals (Sweden)

Phirum Lay

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

Proposed Treatment Protocol for Frostbite: A Retrospective Analysis of 17 Cases Based on a 3-Year Single-Institution Experience

Directory of Open Access Journals (Sweden)

Eun-Kyung Woo

2013-09-01

Full Text Available BackgroundThis paper discusses the treatment protocol for patients with frostbite.MethodsWe performed a retrospective analysis of a series of 17 patients with second- and higher-degree frostbite who had been treated at our medical institution between 2010 and 2012.ResultsOur clinical series of patients (n=17 included 13 men and four women, whose mean age was 42.4±11.6 years (range, 22-67 years. The sites of injury include the foot in six patients (35.3%, the hand in six patients (35.3% and the facial region in five patients (29.4%. Seven patients with second-degree frostbite were completely cured with only conservative treatment during a mean period of 12.7±3.3 days (range, 8-16 days. Of the five patients with third-degree frostbite, two underwent skin grafting following debridement, and the remaining three achieved a complete cure with conservative treatment during a mean period of 35±4.3 days (range, 29-39 days. Five patients with fourth-degree frostbite were treated with surgical procedures including amputation.ConclusionsWith the appropriate conservative management in the early stage of onset, surgeons should decide on surgery after waiting for a sufficient period of time until the demarcation of the wound. Continuous management of patients is also needed to achieve functional recovery after a complete cure has been achieved. This should also be accompanied by patient education for the avoidance of re-exposure to cold environments.

Five-year follow-up using a prostate stent as fiducial in image-guided radiotherapy of prostate cancer.

Science.gov (United States)

Carl, Jesper; Sander, Lotte

2015-06-01

To report results from the five-year follow-up on a previously reported study using image-guided radiotherapy (IGRT) of localized or locally advanced prostate cancer (PC) and a removable prostate stent as fiducial. Patients with local or locally advanced PC were treated using five-field 3D conformal radiotherapy (3DRT). The clinical target volumes (CTV) were treated to 78 Gy in 39 fractions using daily on-line image guidance (IG). Late genito-urinary (GU) and gastro-intestinal (GI) toxicities were scored using the radiotherapy oncology group (RTOG) score and the common toxicity score of adverse events (CTC) score. Urinary symptoms were also scored using the international prostate symptom score (IPSS). Median observation time was 5.4 year. Sixty-two of the 90 patients from the original study cohort were eligible for toxicity assessment. Overall survival, cancer-specific survival and biochemical freedom from failure were 85%, 96% and 80%, respectively at five years after radiotherapy. Late toxicity GU and GI RTOG scores≥2 were 5% and 0%. Comparing pre- and post-radiotherapy IPSS scores indicate that development in urinary symptoms after radiotherapy may be complex. Prostate image-guided radiotherapy using a prostate stent demonstrated survival data comparable with recently published data. GU and GI toxicities at five-year follow-up were low and comparable to the lowest toxicity rates reported. These findings support that the precision of the prostate stent technique is at least as good as other techniques. IPSS revealed a complex development in urinary symptoms after radiotherapy.

Type distribution of lymphomas in Lebanon: five-year single institution experience.

Science.gov (United States)

Sader-Ghorra, Claude; Rassy, Marc; Naderi, Samah; Kourie, Hampig Raphael; Kattan, Joseph

2014-01-01

Lymphomas represent the fifth most frequent cancer in Lebanon. However, little is known concerning epidemiologic characteristics and distribution of lymphoid neoplasms according to the 2008 WHO classification. We conducted a retrospective study of lymphoma cases diagnosed from 2008 till 2012 at Hotel-Dieu de France University Hospital. A total of 502 new cases of lymphoma were diagnosed at our institution during a five year period: 119 cases (24%) were Hodgkin lymphomas (HL) and 383 cases (76%) were non-Hodgkin lymphomas (NHL). HLs were equally distributed in both sexes with a mean age at diagnosis of 30 years. Among NHL, 87% (332 cases) were B cell lymphomas, 9% (34 cases) were T cell lymphomas and 4%(17 cases) were classified as precursor lymphoid neoplasms. Among B cell lymphomas, 44% (147 cases) were diffuse large B cell lymphomas (DLBCL), 20% (65 cases) follicular lymphomas and 8% (27 cases) mantle cell lymphomas. DLBCL were equally distributed in both sexes with a mean age of 58 years. Follicular lymphomas were characterized by a male predominance (57%) and a mean age of 60 years. Mantle cell lymphomas showed a pronounced male predominance (85%) with a mean age of 60 years in men and 70 years in women. Some 72% of patients having T cell lymphomas were men, with a mean age of 57 years in men and 45 years in women, while 65% of patients having precursor lymphoid neoplasms were women with a mean age of 22 years in women and 30 years in men. The lymphoma subtype distribution in Lebanon is unique when compared to other countries from around the world. In fact, Hodgkin and follicular lymphomas are more frequent than in most Far Eastern, European and American countries, while T-cell lymphomas and DLBCL are less frequent.

Vertigo/dizziness in pediatric emergency department: Five years' experience.

Science.gov (United States)

Raucci, Umberto; Vanacore, Nicola; Paolino, Maria Chiara; Silenzi, Romina; Mariani, Rosanna; Urbano, Antonella; Reale, Antonino; Villa, Maria Pia; Parisi, Pasquale

2016-05-01

Vertigo/Dizziness in childhood is not a rare cause of visits to the emergency department (ED). We analyzed a selected group with vertigo/dizziness to identify signs and symptoms that may help to guide the diagnostic approach and management. A total of 616 children admitted for vertigo to the ED over a five-year period were retrospectively reviewed. Their medical history, clinical characteristics, laboratory and neuroimaging tests, final diagnoses and management were analyzed. Migraine and syncope were the most frequent causes. Two patients were affected by life-threatening cardiac syncope, while structural life-threatening central nervous system diseases were found in 15 patients, none of whom presented with vertigo as an isolated clinical finding. Most cases of vertigo/dizziness in childhood that consist mainly of migraine and syncope are of benign origin. The prompt identification of neurological or cardiological signs or symptoms associated with vertigo in children is mandatory to rule out life-threatening conditions. © International Headache Society 2015.

The incidence of mobility restrictions among elderly people in two Nordic localities. A five-year follow-up

DEFF Research Database (Denmark)

Sakari-Rantala, Ritva; Avlund, Kirsten; Frändin, Kerstin

2002-01-01

The aim of this study was to investigate the incidence of limitations in self-reported mobility as well as the decline in measured walking speed and stair-mounting ability over five years among men and women aged 75 at baseline in two Nordic localities. Another purpose was to analyze the relation......The aim of this study was to investigate the incidence of limitations in self-reported mobility as well as the decline in measured walking speed and stair-mounting ability over five years among men and women aged 75 at baseline in two Nordic localities. Another purpose was to analyze...

Psycho-social activity factors associated with self-rated health among community-dwelling elderly people A five-year longitudinal study.

Science.gov (United States)

Yamauchi, Kanako; Saito, Isao; Kato, Tadahiro; Tanigawa, Takeshi; Kobayashi, Toshio

2015-01-01

This longitudinal study examined psychological and social activity factors related to poor self-rated health (SRH) in community-dwelling elderly people. The general health of 7,413 elderly individuals aged 65 years and over in Toon City, Ehime Prefecture, Japan was surveyed. We followed 4,372 participants, over a five-year period, after excluding those who were aged 85 years and over, had a disability, had moved away, or had died. The data from 3,358 respondents (response rate: 76.8%) were analyzed. We divided the patients into two groups based on their SRH responses: healthy, including those who answered "excellent" or "good," and unhealthy, including those who answered "not good" or "poor." We examined changes in SRH for both groups between the first survey and the survey conducted after five years. Among the healthy subjects at the first survey, we analyzed the relationship between SRH, after five years, and psycho-social activity factors using a logistic regression analysis. These factors included physical and social competence, life satisfaction, and tendency towards dementia and/or depression. SRH of both men and women significantly declined over five years. The percentage of men and women, who maintained SRH as healthy, after the 5-year follow-up period, was approximately 60% in those aged 65-74 years and 40% in those aged 75-84 years. In those aged 65-74 years, the odds ratio (OR) for a SRH of unhealthy (after five years), associated with Life Satisfaction Index-K (LSI-K) scores (at the first survey), was significantly lower at 0.85 (95% confidence interval [CI]: 0.77-0.93) for men and 0.79 (95% CI: 0.72-0.87) for women. The OR of tendency toward depression was significantly higher at 1.68 (95% CI: 1.11-2.56) for women only. In those aged 75-84 years, the OR for a SRH of unhealthy (after five years), associated with LSI-K scores (at the first survey), was significantly lower at 0.87 (95% CI: 0.77-1.00) for men and 0.89 (95% CI: 0.80-0.99) for women. The OR

Clinical anatomy e-cases: a five-year follow-up of learning analytics.

Science.gov (United States)

Perumal, Vivek; Butson, Russell; Blyth, Phil; Daniel, Ben

2017-01-27

This article explores the development and user experiences of a supplementary e-learning resource (clinical anatomy e-cases) for medical students, across a five-year teaching period. A series of online supplementary e-learning resources (the clinical anatomy e-cases) were developed and introduced to the regional and clinical anatomy module of the medicine course. Usage analytics were collected online from a cohort of third-year medical students and analysed to gain a better understanding of how students utilised these resources. Key results showed that the students used the supplementary learning resource during and outside regular teaching hours that includes a significant access during holidays. Analysis also suggested that the resources were frequently accessed during examination periods and during subsequent clinical study years (fourth or fifth years of medicine course). Increasing interest and positive feedback from students has led to the development of a further series of e-cases. Tailor-made e-learning resources promote clinical anatomy learning outside classroom hours and make supplementary learning a 24/7 task.

Conducting five-year plan and tri-party agreement community outreach activities at the U. S. Department Of Energy Richland Field Office

International Nuclear Information System (INIS)

Peterson, James M.; Brown, Madeleine C.

1992-01-01

For cleanup to succeed, the public must be informed and involved. Both the Tri-Party Agreement and the Five-Year Plan require significant public interactions. The Tri-Party Agreement has a community relations plan, and the Five-Year Plan has a rigorous community outreach agenda. Both recognize that the public must get every reasonable opportunity to learn about and to voice opinions about DOE's cleanup activities. Beginning this year, our Five-Year Plan public participation action plan will fold in all DOE Environmental Restoration and Waste Management outreach activities at Hanford. This supports the need we recognize to coordinate public involvement activities sitewide. (author)

The hydrogen sulfide donor, Lawesson's reagent, prevents alendronate-induced gastric damage in rats

International Nuclear Information System (INIS)

Nicolau, L.A.D.; Silva, R.O.; Damasceno, S.R.B.; Carvalho, N.S.; Costa, N.R.D.; Aragão, K.S.; Barbosa, A.L.R.; Soares, P.M.G.; Souza, M.H.L.P.; Medeiros, J.V.R.

2013-01-01

Our objective was to investigate the protective effect of Lawesson's reagent, an H 2 S donor, against alendronate (ALD)-induced gastric damage in rats. Rats were pretreated with saline or Lawesson's reagent (3, 9, or 27 µmol/kg, po) once daily for 4 days. After 30 min, gastric damage was induced by ALD (30 mg/kg) administration by gavage. On the last day of treatment, the animals were killed 4 h after ALD administration. Gastric lesions were measured using a computer planimetry program, and gastric corpus pieces were assayed for malondialdehyde (MDA), glutathione (GSH), proinflammatory cytokines [tumor necrosis factor (TNF)-α and interleukin (IL)-1β], and myeloperoxidase (MPO). Other groups were pretreated with glibenclamide (5 mg/kg, ip) or with glibenclamide (5 mg/kg, ip)+diazoxide (3 mg/kg, ip). After 1 h, 27 µmol/kg Lawesson's reagent was administered. After 30 min, 30 mg/kg ALD was administered. ALD caused gastric damage (63.35±9.8 mm 2 ); increased levels of TNF-α, IL-1β, and MDA (2311±302.3 pg/mL, 901.9±106.2 pg/mL, 121.1±4.3 nmol/g, respectively); increased MPO activity (26.1±3.8 U/mg); and reduced GSH levels (180.3±21.9 µg/g). ALD also increased cystathionine-γ-lyase immunoreactivity in the gastric mucosa. Pretreatment with Lawesson's reagent (27 µmol/kg) attenuated ALD-mediated gastric damage (15.77±5.3 mm 2 ); reduced TNF-α, IL-1β, and MDA formation (1502±150.2 pg/mL, 632.3±43.4 pg/mL, 78.4±7.6 nmol/g, respectively); lowered MPO activity (11.7±2.8 U/mg); and increased the level of GSH in the gastric tissue (397.9±40.2 µg/g). Glibenclamide alone reversed the gastric protective effect of Lawesson's reagent. However, glibenclamide plus diazoxide did not alter the effects of Lawesson's reagent. Our results suggest that Lawesson's reagent plays a protective role against ALD-induced gastric damage through mechanisms that depend at least in part on activation of ATP-sensitive potassium (K ATP ) channels

μCT-based, in vivo dynamic bone histomorphometry allows 3D evaluation of the early responses of bone resorption and formation to PTH and alendronate combination therapy.

Science.gov (United States)

de Bakker, Chantal M J; Altman, Allison R; Tseng, Wei-Ju; Tribble, Mary Beth; Li, Connie; Chandra, Abhishek; Qin, Ling; Liu, X Sherry

2015-04-01

Current osteoporosis treatments improve bone mass by increasing net bone formation: anti-resorptive drugs such as bisphosphonates block osteoclast activity, while anabolic agents such as parathyroid hormone (PTH) increase bone remodeling, with a greater effect on formation. Although these drugs are widely used, their role in modulating formation and resorption is not fully understood, due in part to technical limitations in the ability to longitudinally assess bone remodeling. Importantly, it is not known whether or not PTH-induced bone formation is independent of resorption, resulting in controversy over the effectiveness of combination therapies that use both PTH and an anti-resorptive. In this study, we developed a μCT-based, in vivo dynamic bone histomorphometry technique for rat tibiae, and applied this method to longitudinally track changes in bone resorption and formation as a result of treatment with alendronate (ALN), PTH, or combination therapy of both PTH and ALN (PTH+ALN). Correlations between our μCT-based measures of bone formation and measures of bone formation based on calcein-labeled histology (r=0.72-0.83) confirm the accuracy of this method. Bone remodeling parameters measured through μCT-based in vivo dynamic bone histomorphometry indicate an increased rate of bone formation in rats treated with PTH and PTH+ALN, together with a decrease in bone resorption measures in rats treated with ALN and PTH+ALN. These results were further supported by traditional histology-based measurements, suggesting that PTH was able to induce bone formation while bone resorption was suppressed. Copyright © 2014 Elsevier Inc. All rights reserved.

Outcome of mucormycosis after treatment: report of five cases

Directory of Open Access Journals (Sweden)

F. Bellazreg

2015-07-01

Full Text Available Mucormycoses are serious infections caused by filamentous fungi of the order Mucorales. They occur most often in immunocompromised patients. We report five cases of mucormycosis in patients hospitalized in the Infectious Diseases Department in Sousse – Tunisia between 2000 and 2013. They were 4 males and one female, mean age 60 years. Three patients were diabetic and one patient had acute leukemia. The locations of mucormycosis were rhinocerebral, rhino-orbital, auricular, pulmonary and cutaneous. The Mucorales isolated were Rhizopus arrhizus in 3 cases and Lichteimia in 2 cases. All patients were treated with amphotericin B and 2 patients had, in addition, surgical debridement. Two patients died and 2 kept peripheral facial paralysis.

A five year prospective investigation of anterior pituitary function after traumatic brain injury: is hypopituitarism long-term after head trauma associated with autoimmunity?

Science.gov (United States)

Tanriverdi, Fatih; De Bellis, Annamaria; Ulutabanca, Halil; Bizzarro, Antonio; Sinisi, Antonio A; Bellastella, Giuseppe; Amoresano Paglionico, Vanda; Dalla Mora, Liliana; Selcuklu, Ahmed; Unluhizarci, Kursad; Casanueva, Felipe F; Kelestimur, Fahrettin

2013-08-15

Traumatic brain injury (TBI) has been recently recognized as a common cause of pituitary dysfunction. However, there are not sufficient numbers of prospective studies to understand the natural history of TBI induced hypopituitarism. The aim was to report the results of five years' prospective follow-up of anterior pituitary function in patients with mild, moderate and severe TBI. Moreover, we have prospectively investigated the associations between TBI induced hypopituitarism and presence of anti-hypothalamus antibodies (AHA) and anti-pituitary antibodies (APA). Twenty five patients (20 men, five women) were included who were prospectively evaluated 12 months and five years after TBI, and 17 of them also had a third-year evaluation. Growth hormone (GH) deficiency is the most common pituitary hormone deficit at one, three, and five years after TBI. Although most of the pituitary hormone deficiencies improve over time, there were substantial percentages of pituitary hormone deficiencies at the fifth year (28% GH, 4% adrenocorticotropic hormone [ACTH], and 4% gonadotropin deficiencies). Pituitary dysfunction was significantly higher in strongly AHA- and APA-positive (titers ≥1/16) patients at the fifth year. In patients with mild and moderate TBI, ACTH and GH deficiencies may improve over time in a considerable number of patients but, although rarely, may also worsen over the five-year period. However in severe TBI, ACTH and GH status of the patients at the first year evaluation persisted at the fifth year. Therefore, screening pituitary function after TBI for five years is important, especially in patients with mild TBI. Moreover, close strong associations between the presence of high titers of APA and/or AHA and hypopituitarism at the fifth year were shown for the first time.

Comparison of Environmental Attitudes and Experiences of Five-Year-Old Children Receiving Preschool Education in the Village and City Centre

Science.gov (United States)

Durkan, Nazmi; Güngör, Hande; Fetihi, Leyla; Erol, Ahmet; Gülay Ogelman, Hülya

2016-01-01

The purpose of the study is to compare environmental attitudes and experiences of five-year-old children receiving preschool education in the village and city centre. The first group comprised 54 five-year-old children who received preschool education and attended kindergartens of two primary schools in the Karateke and Kocabas villages of Honaz…

Idiopathic Non-histaminergic Angioedema: Successful Treatment with Omalizumab in Five Patients.

Science.gov (United States)

Faisant, Charles; Du Thanh, Aurélie; Mansard, Catherine; Deroux, Alban; Boccon-Gibod, Isabelle; Bouillet, Laurence

2017-01-01

Idiopathic non-histaminergic acquired angioedema (InH-AAE) is a rare disease characterized by AE resistant to antihistamines and a chronic course. We report five new cases of InH-AAE (two women and three men) with a rapid and dramatic response to the anti-immunoglobulin-E antibody omalizumab. In our literature review, we found 13 other relevant cases with a good response to this treatment. Overall, in 6 out of 18 patients, the doses of omalizumab required to prevent recurrences of attacks were higher than the licensed dose for chronic urticaria. No significant adverse effects have been reported.

Real-Life and RCT Participants

DEFF Research Database (Denmark)

Reyes, Carlen; Pottegård, Anton; Schwarz, Peter

2016-01-01

We aimed to characterize incident users of alendronate from Denmark and Spain, and investigate their eligibility for participation in the pivotal Fracture Intervention Trial (FIT). This is an international cross-sectional study, where the data were obtained from the SIDIAP database (Sistema d...... of alendronate who were not eligible to participate in FIT. 14,316 and 21,221 subjects initiated alendronate in 2006-2007 (SIDIAP) and 2005-2006 (DHR), respectively. SIDIAP and DHR alendronate user cohorts had 2347 (16.4 %) and 5275 (24.9 %) subjects aged >80 years old, reported 9 (0.1 %) and 91 (0.......4 %) diagnoses of myocardial infarction, 423 (3 %) and 368 (1.7 %) of erosive gastro-intestinal disease, 200 (1.4 %) and 1109 (5.2 %) of dyspepsia, and 349 (2.4 %) and 149 (0.7 %) of metabolic bone disease, all of which were exclusion criteria in FIT. Men [3818 (26.7 %) in SIDIAP and 3885 (18.3 %) in DHR...

Chemoembolization With Doxorubicin-Eluting Beads for Unresectable Hepatocellular Carcinoma: Five-Year Survival Analysis

Energy Technology Data Exchange (ETDEWEB)

Malagari, Katerina, E-mail: kmalag@otonet.gr [University of Athens, Second Department of Radiology (Greece); Pomoni, Mary [University of Athens, Imaging and Research Unit (Greece); Moschouris, Hippocrates, E-mail: hipmosch@gmail.com [Tzanion Hospital, Department of Radiology (Greece); Bouma, Evanthia [University of Athens, Imaging and Research Unit (Greece); Koskinas, John [Ippokration Hospital, University of Athens, Department of Internal Medicine and Hepatology (Greece); Stefaniotou, Aspasia [University of Athens, Imaging and Research Unit (Greece); Marinis, Athanasios [Tzanion Hospital, Department of Surgery (Greece); Kelekis, Alexios; Alexopoulou, Efthymia [University of Athens, Second Department of Radiology (Greece); Chatziioannou, Achilles [University of Athens, First Department of Radiology (Greece); Chatzimichael, Katerina [University of Athens, Second Department of Radiology (Greece); Dourakis, Spyridon [Ippokration Hospital, University of Athens, Department of Internal Medicine and Hepatology (Greece); Kelekis, Nikolaos [University of Athens, Second Department of Radiology (Greece); Rizos, Spyros [Tzanion Hospital, Department of Surgery (Greece); Kelekis, Dimitrios [University of Athens, Imaging and Research Unit (Greece)

2012-10-15

Purpose: The purpose of this study was to report on the 5-year survival of hepatocellular carcinoma (HCC) patients treated with DC Bead loaded with doxorubicin (DEB-DOX) in a scheduled scheme in up to three treatments and thereafter on demand. Materials and Methods: 173 HCC patients not suitable for curable treatments were prospectively enrolled (mean age 70.4 {+-} 7.4 years). Child-Pugh (Child) class was A/B (102/71 [59/41 %]), Okuda stage was 0/1/2 (91/61/19 [53.2/35.7/11.1 %]), and mean lesion diameter was 7.6 {+-} 2.1 cm. Lesion morphology was one dominant {<=}5 cm (22 %), one dominant >5 cm (41.6 %), multifocal {<=}5 (26 %), and multifocal >5 (10.4 %). Results: Overall survival at 1, 2, 3, 4, and 5 years was 93.6, 83.8, 62, 41.04, and 22.5 %, with higher rates achieved in Child class A compared with Child class B patients (95, 88.2, 61.7, 45, and 29.4 % vs. 91.5, 75, 50.7, 35.2, and 12.8 %). Mean overall survival was 43.8 months (range 1.2-64.8). Cumulative survival was better for Child class A compared with Child class B patients (p = 0.029). For patients with dominant lesions {<=}5 cm 1-, 2-, 3-, 4-, and 5-year survival rates were 100, 95.2, 71.4, 66.6, and 47.6 % for Child class A and 94.1, 88.2, 58.8, 41.2, 29.4, and 23.5 % for Child class B patients. Regarding DEB-DOX treatment, multivariate analysis identified number of lesions (p = 0.033), lesion vascularity (p < 0.0001), initially achieved complete response (p < 0.0001), and objective response (p = 0.046) as significant and independent determinants of 5-year survival. Conclusion: DEB-DOX results, with high rates of 5-year survival for patients, not amenable to curative treatments. Number of lesions, lesion vascularity, and local response were significant independent determinants of 5-year survival.

Chemoembolization With Doxorubicin-Eluting Beads for Unresectable Hepatocellular Carcinoma: Five-Year Survival Analysis

International Nuclear Information System (INIS)

Malagari, Katerina; Pomoni, Mary; Moschouris, Hippocrates; Bouma, Evanthia; Koskinas, John; Stefaniotou, Aspasia; Marinis, Athanasios; Kelekis, Alexios; Alexopoulou, Efthymia; Chatziioannou, Achilles; Chatzimichael, Katerina; Dourakis, Spyridon; Kelekis, Nikolaos; Rizos, Spyros; Kelekis, Dimitrios

2012-01-01

Purpose: The purpose of this study was to report on the 5-year survival of hepatocellular carcinoma (HCC) patients treated with DC Bead loaded with doxorubicin (DEB-DOX) in a scheduled scheme in up to three treatments and thereafter on demand. Materials and Methods: 173 HCC patients not suitable for curable treatments were prospectively enrolled (mean age 70.4 ± 7.4 years). Child-Pugh (Child) class was A/B (102/71 [59/41 %]), Okuda stage was 0/1/2 (91/61/19 [53.2/35.7/11.1 %]), and mean lesion diameter was 7.6 ± 2.1 cm. Lesion morphology was one dominant ≤5 cm (22 %), one dominant >5 cm (41.6 %), multifocal ≤5 (26 %), and multifocal >5 (10.4 %). Results: Overall survival at 1, 2, 3, 4, and 5 years was 93.6, 83.8, 62, 41.04, and 22.5 %, with higher rates achieved in Child class A compared with Child class B patients (95, 88.2, 61.7, 45, and 29.4 % vs. 91.5, 75, 50.7, 35.2, and 12.8 %). Mean overall survival was 43.8 months (range 1.2–64.8). Cumulative survival was better for Child class A compared with Child class B patients (p = 0.029). For patients with dominant lesions ≤5 cm 1-, 2-, 3-, 4-, and 5-year survival rates were 100, 95.2, 71.4, 66.6, and 47.6 % for Child class A and 94.1, 88.2, 58.8, 41.2, 29.4, and 23.5 % for Child class B patients. Regarding DEB-DOX treatment, multivariate analysis identified number of lesions (p = 0.033), lesion vascularity (p < 0.0001), initially achieved complete response (p < 0.0001), and objective response (p = 0.046) as significant and independent determinants of 5-year survival. Conclusion: DEB-DOX results, with high rates of 5-year survival for patients, not amenable to curative treatments. Number of lesions, lesion vascularity, and local response were significant independent determinants of 5-year survival.

North Dakota University System Five-Year Plan. Daring to Be Great: The NDUS Edge

Science.gov (United States)

North Dakota University System, 2017

2017-01-01

This report presents the 2017-19 edition of the State Board of Higher Education's strategic narrative. Contents include: (1) North Dakota University System (NDUS) colleges and locations; (2) Board Chair Neset's report; (3) Five-year goals; (4) Deliver degrees that are the best value in the nation; (5) Provide programs people want; (6) Equip…

Multileaf collimator-based linear accelerator radiosurgery: five-year efficiency analysis.

Science.gov (United States)

Lawson, Joshua D; Fox, Tim; Waller, Anthony F; Davis, Lawrence; Crocker, Ian

2009-03-01

In 1989, Emory University initiated a linear accelerator (linac) radiosurgery program using circular collimators. In 2001, the program converted to a multileaf collimator. Since then, the treatment parameters of each patient have been stored in the record-and-verify system. Three major changes have occurred in the radiosurgery program in the past 6 years: in 2002, treatment was changed from static conformal beams to dynamic conformal arc (DCA) therapy, and all patients were imaged before treatment. Beginning in 2005, a linac was used, with the opportunity to treat at higher dose rates (600-1,000 monitor units/min). The aim of this study was to analyze the time required to deliver radiosurgery and the factors affecting treatment delivery. Benchmark data are provided for centers contemplating initiating linac radiosurgery programs. Custom software was developed to mine the record-and-verify system database and automatically perform a chart review on patients who underwent stereotactic radiosurgery from March 2001 to October 2006. The software extracted 510 patients who underwent stereotactic radiosurgery, and the following information was recorded for each patient: treatment technique, treatment time (from initiation of imaging, if done, to completion of therapy), number of isocenters, number of fields, total monitor units, and dose rate. Of the 510 patients, 395 were treated with DCA therapy and 115 with static conformal beams. The average number of isocenters treated was 1.06 (range, 1-4). The average times to deliver treatment were 24.1 minutes for patients who underwent DCA therapy and 19.3 minutes for those treated with static conformal beams, reflecting the lack of imaging in the latter patients. Eighty percent of patients were treated in question the need for a dedicated radiosurgery unit for even busy treatment centers.

Anisotropies in the cosmic neutrino background after Wilkinson Microwave Anisotropy Probe five-year data

International Nuclear Information System (INIS)

De Bernardis, Francesco; Pagano, Luca; Melchiorri, Alessandro; Serra, Paolo; Cooray, Asantha

2008-01-01

We search for the presence of cosmological neutrino background (CNB) anisotropies in recent Wilkinson Microwave Anisotropy Probe (WMAP) five-year data using their signature imprinted on modifications to the cosmic microwave background (CMB) anisotropy power spectrum. By parameterizing the neutrino background anisotropies with the speed viscosity parameter c vis , we find that the WMAP five-year data alone provide only a weak indication for CNB anisotropies with c vis 2 >0.06 at the 95% confidence level. When we combine CMB anisotropy data with measurements of galaxy clustering, the SN-Ia Hubble diagram, and other cosmological information, the detection increases to c vis 2 >0.16 at the same 95% confidence level. Future data from Planck, combined with a weak lensing survey such as the one expected with DUNE from space, will be able to measure the CNB anisotropy parameter at about 10% accuracy. We discuss the degeneracy between neutrino background anisotropies and other cosmological parameters such as the number of effective neutrinos species and the dark energy equation of state

78 FR 13380 - Silicomanganese From India, Kazakhstan, and Venezuela; Scheduling of Full Five-Year Reviews...

Science.gov (United States)

2013-02-27

... From India, Kazakhstan, and Venezuela; Scheduling of Full Five-Year Reviews Concerning the Antidumping Duty Orders on Silicomanganese From India, Kazakhstan, and Venezuela AGENCY: United States..., Kazakhstan, and Venezuela would be likely to lead to continuation or recurrence of material injury within a...

Five-year trajectories of social networks and social support in older adults with major depression.

Science.gov (United States)

Voils, Corrine I; Allaire, Jason C; Olsen, Maren K; Steffens, David C; Hoyle, Rick H; Bosworth, Hayden B

2007-12-01

Research with nondepressed adults suggests that social networks and social support are stable over the life course until very late age. This may not hold true for older adults with depression. We examined baseline status and trajectories of social networks and social support at the group and individual levels over five years. The sample consisted of 339 initially depressed adults aged 59 or older (M = 69 years) enrolled in a naturalistic study of depression. Measures of social ties, including social network size, frequency of interaction, instrumental support, and subjective support, were administered at baseline and yearly for five years. Latent growth curve models were estimated for each aspect of social ties. On average, social network size and frequency of interaction were low at baseline and remained stable over time, whereas subjective and instrumental support were high at baseline yet increased over time. There was significant variation in the direction and rate of change over time, which was not predicted by demographic or clinical factors. Because increasing social networks may be ineffective and may not be possible for a portion of people who already receive maximal support, interventions to increase social support may only work for a portion of older depressed adults.

Epidemiology and treatment outcome of surgically treated mandibular condyle fractures. A five years retrospective study.

Science.gov (United States)

Zrounba, Hugues; Lutz, Jean-Christophe; Zink, Simone; Wilk, Astrid

2014-09-01

Surgical management of mandibular condyle fractures is still controversial. Although it provides better outcome than closed treatment questions still remain about the surgical approach and the osteosynthesis devices to be used. Between 2005 and 2010, we managed 168 mandibular condyle fractures with open treatment. Two surgical approaches were used in this study, a pre-auricular and a high submandibular approach (one or the other or as a combined approach). Internal fixation was performed using TCP(®) plates (Medartis, Basel, Switzerland) or with two lag screws (15 and 17 mm). Delta plates were used in 15 cases (8.9%). We report the epidemiology of these fractures and the outcomes of the surgical treatment. We assessed the complications related to the surgical procedure and those related to the osteosynthesis material. The facial nerve related complication rate was very low and the osteosynthesis materials used proved to be strong enough to realize a stable fixation. The two approaches used in this study appeared to be safe with good aesthetic results. Most of the surgical procedure failures occurred in high subcondylar fractures especially when bilateral. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

A 5-year prospective observational study of the outcomes of international treatment guidelines for Crohn's disease.

LENUS (Irish Health Repository)

Cullen, Garret

2012-02-01

BACKGROUND & AIMS: Therapeutic strategies for patients with Crohn\\'s disease are based on American and European guidelines. High rates of corticosteroid dependency and low remission rates are identified as weaknesses of this therapy and as justification for early introduction of biologic agents (top-down treatment) in moderate\\/severe Crohn\\'s disease. We reviewed outcomes and corticosteroid-dependency rates of patients with moderate-to-severe disease who were treated according to the international guidelines. METHODS: Consecutive patients (102) newly diagnosed with Crohn\\'s disease in 2000-2002 were identified from a prospectively maintained database. Severity of disease was scored using the Harvey-Bradshaw Index (HBI). Disease was classified by Montreal classification. Five-year follow-up data were recorded. RESULTS: Seventy-two patients had moderate\\/severe disease at diagnosis (HBI >8). Fifty-four (75%) had nonstricturing, nonpenetrating disease (B1). Sixty-four (89%) received corticosteroids, and 44 (61%) received immunomodulators. Twenty-one patients (29%) received infliximab. Thirty-nine patients (54%) required resection surgery. At a median of 5 years, 66 of 72 (92%) patients with moderate\\/severe disease were in remission (median HBI, 1). Twenty-five patients (35%) required neither surgery nor biologic therapy. CONCLUSIONS: When international treatment guidelines are strictly followed, Crohn\\'s disease patients can achieve high rates of remission and low rates of morbidity at 5 years. Indiscriminate use of biologic agents therefore is not appropriate for all patients with moderate-to-severe disease.

[State of the quality of drinking water in households in children under five years in Peru, 2007-2010].

Science.gov (United States)

Miranda, Marianella; Aramburú, Adolfo; Junco, Jorge; Campos, Miguel

2010-01-01

To evaluate the proportion of children under five with access to quality water and its behavior according to geographical location, water supply and poverty status. Continuous survey (repeated cross), with multistage random sampling, being the universe children under five years living in Peru. We evaluated the presence of free chlorine in drinking water samples in the dwellings of 3570 children (Metropolitan Lima 666, Rest of Coast 755, Urban Sierra 703, Rural Sierra 667, and Jungle 779). We evaluated the presence of total coliforms and E. coli in water samples of 2310 households (445 Metropolitan Lima, Rest of Coast 510, Urban Sierra 479, Rural Sierra Selva 393 and 483). The national proportion of children under five years living in households with adequate free chlorine in drinking water reaches 19.5% of the total, while water free of coliforms and E. coli is 38.3%. There is a marked difference in results by area of residence (the most affected areas were rural Sierra and Jungle), public network at home inside the dwelling and income quintiles. Children under five years living in households belonging to the rural areas and extreme poverty, have a great disadvantage to access quality water consumption. This situation represents a serious problem for the control of diarrheal diseases and children malnutrition.

Frontal recurrence of medulloblastoma five years after excision and craniospinal irradiation

Directory of Open Access Journals (Sweden)

Roka Y

2009-07-01

Full Text Available Medulloblastomas were originally classified under gliomas of the cerebellum until Bailey and Cushing in 1925 named these tumors as medulloblastoma. At present these tumors are classified under primitive neuroectodermal tumor. Surgical excision followed by craniospinal irradiation is the treatment of choice. A 13-year-old-girl operated for posterior fossa medulloblastoma 5 years ago presented with history of headache and vomiting on and off for 4 days in late August 2008. The MRI showed left frontal tumor which on excision was reported as medulloblastoma. Even after optimal treatment reports of recurrence abound in literature. The most common location is in the posterior fossa, followed by spinal, supratentorial, and uncommonly, systemic metastases. We conclude that medulloblastomas are highly aggressive tumor with high local recurrences if the initial excision is incomplete and that recurrence in the supratentorial area although uncommon is still a possibility. This mandates regular follow up of these children till adulthood to catch early recurrences and metastatic disease.

Development trends of remote sensing technology for uranium exploration in 12th Five Year

International Nuclear Information System (INIS)

Zhang Jielin

2011-01-01

This paper introduced the research status,application requirements, technique questions and development trends of remote sensing technology for uranium exploration in the 12th five year, and discussed the applicant prospects and potential of applied basic research innovation, thermal infrared hyperspectral and microwave remote sensing, 4D geological mapping and stereo exploration model in the uranium exploration. (authors)

Five Years of Humanitarian Missions in São Tomé and Príncipe

Directory of Open Access Journals (Sweden)

Cristina Caroça

2016-01-01

We have witnessed a considerable improvement on the children to whom we have adapted prosthetics. Some of them return to school, have friends and became more social. As the result of this work, we conclude that all Humanitarian Missions must be adapted to each country’s needs as we have done over the past five years.

AEC sets five year nuclear safety research program

International Nuclear Information System (INIS)

Anon.

1976-01-01

The research by the government for the establishment of means of judging the adequacy of safety measures incorporated in nuclear facilities, including setting safety standards and collecting documents of general criteria, and the research by the industry on safety measures and the promotion of safety-related technique are stated in the five year program for 1976-80 reported by subcommittees, Atomic Energy Commission (AEC). Four considerations on the research items incorporated in the program are 1) technical programs relating to the safety of nuclear facilities and the necessary criteria, 2) priority of the relevant items decided according to their impact on circumstances, urgency, the defence-indepth concept and so on, 3) consideration of all relevant data and documents collected, and research subjects necessary to quantify safety measurement, and 4) consideration of technological actualization, the capability of each research body, the budget and the time schedule. In addition, seven major themes decided on the basis of these points are 1) reactivity-initiated accident, 2) LOCA, 3) fuel behavior, 4) structural safety, 5) radioactive release, 6) statistical method of safety evaluation, and 7) seismic characteristics. The committee has deliberated the appropriate division of researches between the government and the industry. A set of tables showing the nuclear safety research plan for 1976-80 are attached. (Iwakiri, K.)

U.S. Department of Energy clean cities five-year strategic plan.

Energy Technology Data Exchange (ETDEWEB)

Cambridge Concord Associates

2011-02-15

Clean Cities is a government-industry partnership sponsored by the U.S. Department of Energy's (DOE) Vehicle Technologies Program, which is part of the Office of Energy Efficiency and Renewable Energy. Working with its network of about 100 local coalitions and more than 6,500 stakeholders across the country, Clean Cities delivers on its mission to reduce petroleum consumption in on-road transportation. In its work to reduce petroleum use, Clean Cities focuses on a portfolio of technologies that includes electric drive, propane, natural gas, renewable natural gas/biomethane, ethanol/E85, biodiesel/B20 and higher-level blends, fuel economy, and idle reduction. Over the past 17 years, Clean Cities coalitions have displaced more than 2.4 billion gallons of petroleum; they are on track to displace 2.5 billion gallons of gasoline per year by 2020. This Clean Cities Strategic Plan lays out an aggressive five-year agenda to help DOE Clean Cities and its network of coalitions and stakeholders accelerate the deployment of alternative fuel and advanced technology vehicles, while also expanding the supporting infrastructure to reduce petroleum use. Today, Clean Cities has a far larger opportunity to make an impact than at any time in its history because of its unprecedented $300 million allocation for community-based deployment projects from the American Recovery and Reinvestment Act (ARRA) (see box below). Moreover, the Clean Cities annual budget has risen to $25 million for FY2010 and $35 million has been requested for FY2011. Designed as a living document, this strategic plan is grounded in the understanding that priorities will change annually as evolving technical, political, economic, business, and social considerations are woven into project decisions and funding allocations. The plan does not intend to lock Clean Cities into pathways that cannot change. Instead, with technology deployment at its core, the plan serves as a guide for decision-making at both the

Five-year follow-up of Community Pediatrics Training Initiative.

Science.gov (United States)

Minkovitz, Cynthia S; Goldshore, Matt; Solomon, Barry S; Guyer, Bernard; Grason, Holly

2014-07-01

To compare community involvement of pediatricians exposed to enhanced residency training as part of the Dyson Community Pediatrics Training Initiative (CPTI) with involvement reported by a national sample of pediatricians. A cross-sectional analyses compared 2008-2010 mailed surveys of CPTI graduates 5 years after residency graduation with comparably aged respondents in a 2010 mailed national American Academy of Pediatrics survey of US pediatricians (CPTI: n = 234, response = 56.0%; national sample: n = 243; response = 59.9%). Respondents reported demographic characteristics, practice characteristics (setting, time spent in general pediatrics), involvement in community child health activities in past 12 months, use of ≥1 strategies to influence community child health (eg, educate legislators), and being moderately/very versus not at all/minimally skilled in 6 such activities (eg, identify community needs). χ(2) statistics assessed differences between groups; logistic regression modeled the independent association of CPTI with community involvement adjusting for personal and practice characteristics and perspectives regarding involvement. Compared with the national sample, more CPTI graduates reported involvement in community pediatrics (43.6% vs 31.1%, P .05). Differences in involvement remained in adjusted analyses with greater involvement by CPTI graduates (adjusted odds ratio 2.4, 95% confidence interval 1.5-3.7). Five years after residency, compared with their peers, more CPTI graduates report having skills and greater community pediatrics involvement. Enhanced residency training in community pediatrics may lead to a more engaged pediatrician workforce. Copyright © 2014 by the American Academy of Pediatrics.

'THE FIVE ACCURSED YEARS'

DEFF Research Database (Denmark)

Bryld, Claus

2007-01-01

The subject for this paper is the question of how the Second World War has been perceived and used since that war - in Denmark, and especially in recent years, but also with a comparative view to Norway and Sweden. In addition to an outline of the development of public history regarding the war...

Drug: D10841 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available D10841 Mixture ... Drug Alendronic acid - colecalciferol mixt; Adrovance (TN) (Alendron...ate sodium [DR:D00939] | Alendronic acid [DR:D07119]), Cholecalciferol [DR:D00188] ... ATC code: M05BB03 ... Osteoporosis, postmenopausal ... PubChem: 319902641 ...

Body mass index, Mini Nutritional Assessment, and their association with five-year mortality in very old people.

Science.gov (United States)

Burman, M; Säätelä, S; Carlsson, M; Olofsson, B; Gustafson, Y; Hörnsten, C

2015-04-01

to investigate the prevalence of malnutrition and the association between Body Mass Index (BMI), Mini Nutritional Assessment (MNA) and five-year mortality in a representative population of very old (>85 years) people. A prospective cohort study. A population-based study of very old people in northern Sweden and western Finland, living in institutional care or in the community. Out of 1195 potential participants, 832 were included (mean age 90.2±4.6 years). Nutritional status was assessed using BMI and MNA and the association of those two variables with five-year mortality was analyzed. The mean BMI value for the whole population was 25.1±4.5 kg/m2, with no difference between genders (P=0.938). The mean MNA score was 22.5±4.6 for the whole sample, and it was lower for women than for men (Ppeople, and BMI might be misleading and could underestimate the prevalence of malnutrition, especially in women.

The 1989 patterns of care study for prostate cancer: five-year outcomes

International Nuclear Information System (INIS)

Chuba, Paul J.; Moughan, Jennifer; Forman, Jeffrey D.; Owen, Jean; Hanks, Gerald

2001-01-01

Purpose: Five-year results from the 1989 patterns of care study (PCS) for prostate cancer are now ready for analysis. The PCS was initiated to determine national averages for treatments and examine outcomes prospectively; the 1989 prostate study is the first to have collected pre- and post-treatment serum PSA data. Methods and Materials: Six hundred patients treated with radiotherapy with curative intent for prostate cancer at 71 separate institutions in the year 1989 made up the study population. Three hundred ninety-one cases were fully analyzable. Pretreatment patient and tumor characteristics were as follows: of the 391 analyzable, 255 had pretreatment PSA values obtained, and 245 had a Gleason's sum (GS) reported. Three hundred fifty-eight were Caucasian, 24 African-American, and 3 Hispanic (also 6 unknown). One hundred three patients had PSA 20. Ninety-seven patients were from Radiation Therapy Oncology Group (RTOG), Community Cancer Centers (CCC), or teaching institutions; 141 patients were from other hospital-based, nonteaching institutions; and 153 were from freestanding radiation oncology facilities. Seventy-one patients were T1, 203 T2, and 100 T3/4. Twenty-four out of 391 patients also received neoadjuvant hormone therapy. Survival curves were constructed using Kaplan-Meier methods, and differences between groups were tested for significance using the log-rank test. For cumulative incidence curves, Gray's test was used to investigate failure distributions between groups. The variables entering Cox model for multivariate analysis included age, race, T stage, pretreatment PSA, and GS. A patient was considered a PSA failure if the treating radiation oncologist reported it as such. Results: With a median follow-up of 5.7 years, the 5-year biochemical no evidence of disease (bNED) and overall survival were 56% and 79% respectively for Stage T1, 52% and 81% for T2, and 36% and 63% for Stages T3 and T4 combined. As expected, higher pretreatment PSA, GS, and T

Centre-based day care for children younger than five years of age in high-income countries.

Science.gov (United States)

van Urk, Felix C; Brown, Taylor W; Waller, Rebecca; Mayo-Wilson, Evan

2014-09-23

A large proportion of children younger than five years of age in high-income countries experience significant non-parental care. Centre-based day care services may influence the development of children and the economic situation of parents. To assess the effects of centre-based day care without additional interventions (e.g. psychological or medical services, parent training) on the development and well-being of children and families in high-income countries (as defined by the World Bank 2011). In April 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE, PsycINFO, the Education Resources Information Center (ERIC) and eight other databases. We also searched two trials registers and the reference lists of relevant studies. We included randomised and quasi-randomised controlled trials of centre-based day care for children younger than five years of age. We excluded studies that involved co-interventions not directed toward children (e.g. parent programmes, home visits, teacher training). We included the following outcomes: child cognitive development (primary outcome), child psychosocial development, maternal and family outcomes and child long-term outcomes. Two review authors independently assessed the risk of bias and extracted data from the single included study. We contacted investigators to obtain missing information. We included in the review one trial, involving 120 families and 143 children. Risk of bias was high because of contamination between groups, as 63% of control group participants accessed day care services separate from those offered within the intervention. No evidence suggested that centre-based day care, rather than no treatment (care at home), improved or worsened children's cognitive ability (Griffiths Mental Development Scale, standardised mean difference (SMD) 0.34, 95% confidence interval (CI) -0.01 to 0.69, 127 participants, 1 study, very low-quality evidence) or psychosocial development (parental report of abnormal development, risk ratio (RR

Perceptions of five-year competitive categories: model of how relative age influences competitiveness in masters sport.

Science.gov (United States)

Medic, Nikola; Young, Bradley W; Grove, J Robert

2013-01-01

The purpose of this study was to examine the contrasting perceptions of masters swimmers related to the first and fifth constituent years of a 5-year age category. Swimmers aged between 35 and 93 years (154 male, 184 female) were surveyed at the 2008 FINA World Masters Championships. Exploratory factor analysis indicated the existence of the following five factors considered important for preparation, attendance, and success at masters competitions: awareness of advantages, expectancy, motivation, training, and physiological capacity. One sample t-tests showed that masters swimmers are conscious of advantages that 5-year age categories afford to relatively-younger cohorts (i.e., those who are in the first year of any age category). They also perceive that, in the first compared to the fifth year of an age category, they have greater physiological capacity, engage in more training, have higher expectations to perform well, and are more motivated (all ps competitions than relatively older masters athletes. Key PointsThere are at least five psycho-social and physical factors (i.e., awareness of advantages, expectancy, motivation, training, and physiological capacity) that may explain why relatively younger masters athletes are more likely to perform better and to participate more in masters competitions than relatively older masters athletes.Masters athletes are conscious of the advantage that 5-year age categories afford to relatively younger cohorts of athletes.Differential perceptions associated with the 5-year age categories might compromise masters athletes' continuity of sport competitiveness and underlying training.

Understanding the Educational Experiences of Science Teachers in a Five-Year Teacher Education Program: A Phenomenological Study

Science.gov (United States)

Srivastava, Nitin

This qualitative study provides an overview of educational experiences of six in-service and three pre-service secondary science teachers in the Benedum Collaborative Five-Year Teacher Education Program at a land-grant university. The researcher interviewed secondary science teachers on the experiences they found meaningful in various program components that influenced their teacher identity, beliefs about science pedagogy, and their sense of preparedness for teaching. Document analysis of teachers' journals and lesson plans supplemented the qualitative data in addition to the researcher's role and knowledge as an outsider (non-Benedum graduate) and insider (facilitator and instructor in the technology integration based classes for one year) of the Benedum Collaborative Five-Year Teacher Education Program. Findings also supported the Holmes (1986) and Goodlad (1990) views for extended field experiences and "collaborative culture" in teacher education for well-prepared teachers.

Five years of monitoring bird strike potential at a mountain-top wind turbine, Yukon Territory

Energy Technology Data Exchange (ETDEWEB)

Mossop, D.H. [Yukon College, Whitehorse, YT (Canada)

1997-12-31

A five-year study was conducted to determine if birds were at risk of collision with an experimental wind turbine on a 1,500 metre mountain near the major Shakwak migration corridor used by many thousands of birds. More than 100 ground searches at the turbine site and about 80 hours of migration watch were conducted. In five years, six birds hit the control tower, none hit the turbine tower. All strikes were in winter and none of the birds killed were in migration. Waterfowl were found to navigate in the valley centre about 1,000 feet below the turbine. Small birds were rarely found at the altitude where the turbine was located. Raptors were the most common birds found near the site, but they were able to avoid the tower. It was concluded that birds using the migration corridor near Whitehorse were not at great risk of collision with towers above 1,200 metre altitude. 7 refs., 3 tabs., 6 figs.

Consultant-based otolaryngology emergency service: a five-year experience.

Science.gov (United States)

Barnes, M L; Hussain, S S M

2011-12-01

To present our experience of running a consultant-based otolaryngology emergency care service for more than five years. In 2003, we developed a system of consultant-based emergency service: consultants spent a week on-call providing a dedicated emergency service, with routine commitments cancelled. Our new system had advantages over traditional working practices in terms of consultant involvement, trainee education, continuity and efficiency. It also reduced disruption to elective commitments for both consultants and registrars. This system was fundamental to the successful review of all urgent (and in future elective) cases within target periods. Only 31 per cent of new referrals to the consultant emergency clinics required a further appointment. Good teamwork and flexibility in working arrangements have been essential to the success of this service. Given that health service changes have reduced junior trainee working hours and numbers, and that patients increasingly expect to be treated by trained doctors, our new consultant-based emergency service has merit. Although implementation in other units may differ, we recommend this new service, for the above reasons.

The covered distance for twenty five years of the Manche waste storage 1969 - 1994

International Nuclear Information System (INIS)

Gourden, J.M.

2001-01-01

The twenty five years of the Manche plant,are narrated with the difficulties of the beginning, the problems coming from leaks or runoff that have led to improvement in the knowledge of radioactive waste behaviour and the solutions that have been brought. It is from the building of the plant until the radioactive waste management that is related in this book. (N.C.)