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  1. Late somatic sequelae after treatment of childhood cancer in Slovenia

    Directory of Open Access Journals (Sweden)

    Erman Nuša

    2012-05-01

    Full Text Available Abstract Background This is a long-term follow-up clinical study of adolescents and adults, survivors of childhood cancer. We evaluate and analyze the late somatic sequelae of childhood cancer treatment. Many such studies are susceptible to a strong selection bias, i.e., they employ a limited non-systematic sample of patients, based on a clinical hospital that provided the cancer treatment or performed the follow-up. To address the issue of selection bias, we perform here an analysis of late sequelae on a systematic database of the entire population of the children treated for cancer in Slovenia. Due to the specifics of cancer treatment procedures in Slovenia, they have all been treated and followed-up in the same clinic. Methods The data are based on the centralized registry of cancer patients in Slovenia and present a controlled and homogeneous collection. Late sequelae are evaluated following a modified CTCAE, i.e., the National Cancer Institute’s Common Terminology Criteria for Adverse Events version 3.0. We use survival analysis method to estimate the incidence of and risk for late sequelae, where the time variable is measured in years from the diagnosis date, while we follow the event of incidence of late sequelae scored other than none. Survival analysis is performed using KaplanMeier estimator and Cox regression model. Results The incidence of mild, moderate, or severe late sequelae of childhood cancer treatment significantly decreased from 75% in the group of patients diagnosed before 1975 to 55% for those diagnosed after 1995. The Cox regression analysis of the risk factors for the incidence of late sequelae identifies three significant factors: treatment modalities, age at diagnosis, and primary diagnosis. Conclusions The change of treatment modalities in terms of replacement of surgery and radiotherapy with chemotherapy is the main reason for the decrease of the incidence and the risk for late sequelae of childhood cancer treatment

  2. Late neuro endocrinological sequelae of radiation therapy

    International Nuclear Information System (INIS)

    Bieri, S.; Bernier, J.; Sklar, C.; Constine, L.

    1997-01-01

    When the hypothalamic-pituitary axis (HPA) is included in the treatment field in children and adults, a variety of neuroendocrine disturbances are more common than has been appreciated in the past. Clinical damage to the pituitary and thyroid glands usually occurs months to years after treatment, and is preceded by a long subclinical phase. Primary brain tumors represent the largest group of malignant solid tumors in children. The survival rates of 50 reported in the literature are achieved at the expense of late occurring effects. Radiation-induced abnormalities are generally dose-dependent. Growth hormone deficiency and premature sexual development can occur at doses as low as 18 Gy in conventional fractionation, and is the most common neuroendocrine problem in children. In patients treated with > 40 Gy on the HPA, deficiency of gonadotropins, thyroid stimulation hormone, and adrenocorticotropin (> 50 Gy), hyperprolactinemia can be seen, especially among young women. Most neuroendocrine disturbances that develop as a result of HPA can be treated efficiently, provided that an early detection of these endocrine dysfunctions abnormalities is done. (authors)

  3. Late sequelae in children treated for brain tumors and leukemia

    International Nuclear Information System (INIS)

    Jereb, B.; Petric-Grabnar, G.; Zadravec-Zaletel, L.; Korenjak, R.; Krzisnik, C.; Anzic, J.; Stare, J.

    1994-01-01

    Forty-two survivors treated at an age of 2-16 years for brain tumors or leukemia were, 4-21 years after treatment, subjected to an extensive follow-up investigation, including physical examination and interview; 35 of them also had endocrinological and 33 psychological evaluation. Hormonal deficiencies were found in about two-thirds of patients and were most common in those treated for brain tumors. The great majority had verbal intelligence quotient (VIQ) within normal range. Also, the performance intelligence quotients (PIQ) were normal in most patients. However, the results suggested that the primary intellectual capacity in children treated for cancer was not being fully utilized, their PIQ being on the average higher than their VIQ; this tendency was especially pronounced in the leukemia patients. (orig.)

  4. Late sequelae in children treated for brain tumors and leukemia

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    Jereb, B. (Institute of Oncology, Ljubljana (Slovenia)); Petric-Grabnar, G. (Institute of Oncology, Ljubljana (Slovenia)); Zadravec-Zaletel, L. (Institute of Oncology, Ljubljana (Slovenia)); Korenjak, R. (Clinical Center, Psychiatric Outpatient Dept., Ljubljana (Slovenia)); Krzisnik, C. (Clinical Center, Dept. of Pediatrics, Ljubljana (Slovenia)); Anzic, J. (Clinical Center, Dept. of Pediatrics, Ljubljana (Slovenia)); Stare, J. (Institute of Biomedical Informatics, Medical Faculty, Ljubljana (Slovenia))

    1994-01-01

    Forty-two survivors treated at an age of 2-16 years for brain tumors or leukemia were, 4-21 years after treatment, subjected to an extensive follow-up investigation, including physical examination and interview; 35 of them also had endocrinological and 33 psychological evaluation. Hormonal deficiencies were found in about two-thirds of patients and were most common in those treated for brain tumors. The great majority had verbal intelligence quotient (VIQ) within normal range. Also, the performance intelligence quotients (PIQ) were normal in most patients. However, the results suggested that the primary intellectual capacity in children treated for cancer was not being fully utilized, their PIQ being on the average higher than their VIQ; this tendency was especially pronounced in the leukemia patients. (orig.).

  5. Late sequelae in children treated for brain tumors and leukemia.

    Science.gov (United States)

    Jereb, B; Korenjak, R; Krzisnik, C; Petric-Grabnar, G; Zadravec-Zaletel, L; Anzic, J; Stare, J

    1994-01-01

    Forty-two survivors treated at an age of 2-16 years for brain tumors or leukemia were, 4-21 years after treatment, subjected to an extensive follow-up investigation, including physical examination and interview; 35 of them also had endocrinological and 33 psychological evaluation. Hormonal deficiencies were found in about two-thirds of patients and were most common in those treated for brain tumors. The great majority had verbal intelligence quotient (VIQ) within normal range. Also, the performance intelligence quotients (PIQ) were normal in most patients. However, the results suggested that the primary intellectual capacity in children treated for cancer was not being fully utilized, their PIQ being on the average higher than their VIQ; this tendency was especially pronounced in the leukemia patients.

  6. Late sequelae of whiplash injury with dissection of cervical arteries.

    Science.gov (United States)

    Hauser, Vital; Zangger, Peter; Winter, Yaroslav; Oertel, Wolfgang; Kesselring, Jürg

    2010-01-01

    The objective of our study was to estimate the incidence of posttraumatic dissections of cervical arteries in patients with whiplash injury acquired in a car accident. We performed a retrospective analysis of medical records of 500 patients with whiplash injury acquired in car accidents between 1996 and 2005 and searched for dissections of cervical arteries occurring within 12 months after injury. Eight cases of cervical arterial dissection occurred within 12 months following whiplash injury. In 7 cases (87.5%), the dissection was complicated by brain infarction. The incidence of posttraumatic dissections after whiplash injuries was much higher than the overall incidence of cervical arterial dissections in the general population (1.6 vs. 0.0041%). The risk of cerebrovascular events was still increased 4-12 months after whiplash injury (0.6 vs. 0.003075% in the general population). There is an increased risk of posttraumatic dissection and cerebrovascular events within 12 months after whiplash injury. Car accident is an important risk factor for arterial dissections. The victims of car accidents should be screened for arterial dissections. The results of this study should be more thoroughly investigated in a prospective trial of car accident victims as a risk factor for arterial dissections. Copyright © 2010 S. Karger AG, Basel.

  7. Late rectal sequelae following definitive radiation therapy for carcinoma of the uterine cervix: a dosimetric analysis

    International Nuclear Information System (INIS)

    Roeske, John C.; Mundt, Arno J.; Halpern, Howard; Sweeney, Patrick; Sutton, Harold; Powers, Claire; Rotmensch, Jacob; Waggoner, Steve; Weichselbaum, Ralph R.

    1997-01-01

    Purpose: This study attempted to correlate patient, treatment, and dosimetric factors with the risk of late rectal sequelae in patients treated with radiation therapy (RT) for cervical carcinoma. Methods and Materials: A total of 183 patients with cervical carcinoma (67 Stage I, 93 Stage II, and 23 Stage III) treated with definitive RT with a minimum of 2 years follow-up were evaluated. Treatment consisted of external beam pelvic RT (EBRT) followed by intracavitary RT (ICRT) consisting of one or two insertions. Complications were scored and analyzed as a function of 25 patient and treatment factors. Conventional total rectal doses were obtained by adding together the EBRT and ICRT rectal doses. To account for differences in dose rate between the ICRT and EBRT, and variations in EBRT fractionation schemes, biologically equivalent rectal doses (BED) were calculated using a linear quadratic model. In addition, the influence of the varying proportions of EBRT and ICRT rectal doses were evaluated. Results: Twenty-eight patients (15.3%) developed late rectal sequelae (13 Grade 1, 3 Grade 2, and 12 Grade 3). Diabetes (p = 0.03), Point A dose (p = 0.04), and conventional EBRT dose (p = 0.03) were the most significant factors on multivariate analysis. Logistic regression analysis demonstrated a low risk (<10%) of late rectal sequelae below conventional and biological rectal doses of 75 Gy and 135 BED, respectively. The percentage of rectal dose delivered by the EBRT significantly influenced the dose-response relationship. A defined threshold percentage above which rectal sequelae were more common was identified over the range of doses evaluated. This threshold was 87% at a total rectal dose of 60 Gy and decreased to 60% at 80 Gy. Conclusion: Diabetes, Point A, and EBRT doses are the most significant factors associated with the risk of late rectal sequelae in patients treated with RT for cervical carcinoma. The percentage of rectal dose delivered by the EBRT significantly

  8. Late sequelae and cosmetic outcome after radiotherapy in breast conserving therapy

    International Nuclear Information System (INIS)

    Dore, M.; Hennequin, C.

    2012-01-01

    Radiotherapy after breast-conserving therapy for early breast cancer is reported to adversely affect the cosmetic outcome. The incidence of radiation-induced fibro-atrophy is around 10% at 5 years. A better knowledge of its pathophysiology has revealed the essential role of activated fibroblasts and reactive oxygen species, mediated by TGF beta 1, allowing the development of antioxidant in the management of the established radiation-induced fibro-atrophy. Cosmetic sequelae are evaluated with standardized scales, such as the LENT-SOMA and must be monitored during at least 5 years. The main factors determining the occurrence of sequelae are a large breast volume, dose heterogeneity and the use of tumour bed boost after whole-breast radiation therapy. Intensity modulated radiotherapy and partial breast irradiation position themselves as a good alternatives to reduce the incidence of late skin side effects. The use of predictive tests of intrinsic radiosensitivity might fit into the therapeutic strategy. (authors)

  9. Treatment of late sequelae after radiotherapy for head and neck cancer.

    Science.gov (United States)

    Strojan, Primož; Hutcheson, Katherine A; Eisbruch, Avraham; Beitler, Jonathan J; Langendijk, Johannes A; Lee, Anne W M; Corry, June; Mendenhall, William M; Smee, Robert; Rinaldo, Alessandra; Ferlito, Alfio

    2017-09-01

    Radiotherapy (RT) is used to treat approximately 80% of patients with cancer of the head and neck. Despite enormous advances in RT planning and delivery, a significant number of patients will experience radiation-associated toxicities, especially those treated with concurrent systemic agents. Many effective management options are available for acute RT-associated toxicities, but treatment options are much more limited and of variable benefit among patients who develop late sequelae after RT. The adverse impact of developing late tissue damage in irradiated patients may range from bothersome symptoms that negatively affect their quality of life to severe life-threatening complications. In the region of the head and neck, among the most problematic late effects are impaired function of the salivary glands and swallowing apparatus. Other tissues and structures in the region may be at risk, depending mainly on the location of the irradiated tumor relative to the mandible and hearing apparatus. Here, we review the available evidence on the use of different therapeutic strategies to alleviate common late sequelae of RT in head and neck cancer patients, with a focus on the critical assessment of the treatment options for xerostomia, dysphagia, mandibular osteoradionecrosis, trismus, and hearing loss. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Therapy and prophylaxis of acute and late radiation-induced sequelae of the esophagus

    International Nuclear Information System (INIS)

    Zimmermann, F.B.; Geinitz, H.; Feldmann, H.J.

    1998-01-01

    Background: Radiation-induced esophagitis is a frequent acute side effect in curative and palliative radiotherapy of thoracal and cervical tumors. Late reactions are rare but might be severe. Methods: A resarch for reports on prophylactic and supportive therapies of radiation-induced esophagitis was performed (Medline, Cancerlit, and others). Results: Nutrition must be ensured and symptomatic relief of sequelae is important, especially in the case of dysphagia. The latter can be improved by topic or systemic analgetics. If esophageal spasm occurs, calcium antagonists might help. In case of gastro-esophageal reflux proton pump inhibitors should be used. There is no effective prophylactic measure for radiation esophagitis. Late side effects with clinical relevance are rare in conventional radiotherapy. Chronic ulcera, fistula or stenosis may develop. Before any treatment, a tumor infiltration of the esophagus should be excluded by biopsy. This can lead more often to late complications than radiation therapy itself. Nutrition should be ensured by endoscopic dilation, stent-implantation, or endoscopic percutaneous gastrostomy. Local injection of steroids might be used to avoid an early restenosis. Conclusions: An intensive symptomatic therapy of acute esophagitis is reasonable. Effective prophylaxis do not exist. Late radiation induced sequelae is rare. Therefore, a tumor recurrence should be excluded in cases of dysphagia. Securing nutrition by PEG, stent, or port is well in the fore. (orig.) [de

  11. MRI in late sequelae of Perthes' disease: imaging findings and symptomatology in ten hips

    International Nuclear Information System (INIS)

    Lahdes-Vasama, T.T.; Lamminen, A.E.; Marttinen, E.J.; Merikanto, J.E.O.

    1996-01-01

    Five painful (group A) and five symptomless (group B) hips in nine patients with late sequelae of Perthes' disease were studied with plain radiography and magnetic resonance imaging (MRI) in order to correlate MRI findings with symptomatology. The unaffected hips were also studied. In group A hips, poor congruence of the articular cartilage surfaces was present in three of five cases, whereas good congruence was found in all group B hips. In one spherical but painful hip (group A), MRI revealed a protuberance in the anterolateral cartilage of the femoral head. The joint cartilage in group A and B hips was, on average, 0.5 and 1.5 mm thicker, respectively, than the cartilage in the unaffected hips. The lateral joint capsule was, on average, 3.0 mm thicker in group A hips than in the unaffected hips (P < 0.05), which possibly reflects reactive changes due to chronic irritation in the painful hips. The mean joint capsule thickness differed by only 0.5 mm between the unaffected and group B hips. Mean anterior acetabular coverage by MRI was 97 % in group A and 98 % in group B, while in the unaffected hips mean anterior coverage was 102 %. In an aspherical painful hip, MRI revealed a juxta-articular cyst not visible by radiography. A symptomless intra-articular fragment, due to osteochondritis dissecans, was well visualized with MRI. MRI is recommended for evaluation of pain in hips with late sequelae of Perthes' disease. It may show abnormalities in bony structures, as well as in joint capsule and cartilage. (orig.). With 5 figs., 1 tab

  12. Therapy and prophylaxis of acute and late radiation-induced sequelae of the esophagus

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    Zimmermann, F.B.; Geinitz, H.; Feldmann, H.J. [Klinik und Poliklinik fuer Strahlentherapie und Radiologische Onkologie, Klinikum rechts der Isar, Muenchen (Germany)

    1998-11-01

    Background: Radiation-induced esophagitis is a frequent acute side effect in curative and palliative radiotherapy of thoracal and cervical tumors. Late reactions are rare but might be severe. Methods: A resarch for reports on prophylactic and supportive therapies of radiation-induced esophagitis was performed (Medline, Cancerlit, and others). Results: Nutrition must be ensured and symptomatic relief of sequelae is important, especially in the case of dysphagia. The latter can be improved by topic or systemic analgetics. If esophageal spasm occurs, calcium antagonists might help. In case of gastro-esophageal reflux proton pump inhibitors should be used. There is no effective prophylactic measure for radiation esophagitis. Late side effects with clinical relevance are rare in conventional radiotherapy. Chronic ulcera, fistula or stenosis may develop. Before any treatment, a tumor infiltration of the esophagus should be excluded by biopsy. This can lead more often to late complications than radiation therapy itself. Nutrition should be ensured by endoscopic dilation, stent-implantation, or endoscopic percutaneous gastrostomy. Local injection of steroids might be used to avoid an early restenosis. Conclusions: An intensive symptomatic therapy of acute esophagitis is reasonable. Effective prophylaxis do not exist. Late radiation induced sequelae is rare. Therefore, a tumor recurrenc e should be excluded in cases of dysphagia. Securing nutrition by PEG, stent, or port is well in the fore. (orig.) [Deutsch] Hintergrund: Die radiogene Oesophagitis ist eine haeufige akute Nebenwirkung bei kurativen wie palliativen Bestrahlungen thorakaler und zervikaler Tumoren. Spaete Gewebereaktionen sind selten, koennen aber schwerwiegend sein. Methode: Es wurde eine Literaturrecherche nach prophylaktischen und supportiven Therapien der radiogen verursachten Oesophagitis durchgefuehrt (Medline, Cancerlit und andere). Ergebnisse: Therapeutisch stehen die Sicherung der Ernaehrung und die

  13. The course of functional status and muscle strength in patients with late-onset sequelae of poliomyelitis: A systematic review

    NARCIS (Netherlands)

    Stolwijk-Swüste, Janneke M.; Beelen, Anita; Lankhorst, Gustaaf J.; Nollet, Frans

    2005-01-01

    Stolwijk-SwUste JM, Beelen A, Lankhorst GJ, Nollet F, for the CARPA Study Group. The course of functional status and muscle strength in patients with late-onset sequelae of poliomyelitis: a systematic review. Arch Phys Med Rehabil 2005;86:1693-701. Objectives: To review systematically studies of

  14. Late sequelae of retained foreign bodies after world war II missile injuries.

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    Surov, Alexey; Thermann, Florian; Behrmann, Curd; Spielmann, Rolf-Peter; Kornhuber, Malte

    2012-09-01

    A number of people injured during the second world war harbour foreign bodies such as grenade splinters or bullets in some part of the body. Most of these metal fragments remain clinically silent. Some of them, however, may cause delayed complications. The purpose of this study was to determine the characteristics of delayed complications associated with foreign bodies after world war II injuries. 159 patients with retained foreign bodies after world war II injuries were retrospectively identified radiologically in our data bases in the time interval from 1997 to 2009. Diverse delayed complications secondary to the metal objects were diagnosed in 3 cases (2%): one patient with grenade splinter migration into the choledochal duct, one case with pseudotumoural tissue reaction, and one patient with late osteomyelitis. The time from injury to clinical presentation varied from 56 to 61 years. PubMed and Medline were screened for additional cases with delayed sequelae after foreign body acquisition during the 2nd world war. A 30 year search period from 1980 up to date was selected. 15 cases were identified here. Our study demonstrates that health consequences of the 2nd world war extend into the present time, and therefore physicians should be aware of the presence of hidden foreign bodies and their different possible late reactions. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  15. Late psychological sequelae of abortion: questions from a primary care perspective.

    Science.gov (United States)

    Butler, C

    1996-10-01

    Research strongly supports the view that pregnancy termination is seldom associated with adverse psychological sequelae in the short to medium term, but experience shows that there is a small group of women who experience long and intense suffering. This is a report of the cases of two women who presented with psychological problems associated with a termination 19 and 5 years earlier.

  16. A randomized controlled trial of coenzyme Q10 for fatigue in the late-onset sequelae of poliomyelitis.

    Science.gov (United States)

    Peel, Margaret M; Cooke, Marie; Lewis-Peel, Helen J; Lea, Rodney A; Moyle, Wendy

    2015-12-01

    To determine if coenzyme Q(10) alleviates fatigue in the late-onset sequelae of poliomyelitis. Parallel-group, randomized, placebo-controlled trial. Coenzyme Q(10) has been shown to boost muscle energy metabolism in post-polio subjects but it does not promote muscle strength, endurance or function in polio survivors with post-poliomyelitis syndrome. However, the collective increased energy metabolism might contribute to a reduction in post-polio fatigue. Polio survivors from the Australian post-polio networks in Queensland and New South Wales who attribute a moderate to high level of fatigue to their diagnosed late-onset sequelae of poliomyelitis. Those with fatigue-associated comorbidities of diabetes, anaemia, hypothyroidism and fibromyalgia were excluded. Participants were assigned (1:1), with stratification of those who use energy-saving mobility aids, to receive 100 mg coenzyme Q(10) or matching placebo daily for 60 days. Participants and investigators were blinded to group allocation. Fatigue was assessed by the Multidimensional Assessment of Fatigue as the primary outcome and the Fatigue Severity Scale as secondary outcome. Of 103 participants, 54 were assigned to receive coenzyme Q(10) and 49 to receive the placebo. The difference in the mean score reductions between the two groups was not statistically significant for either fatigue measure. Oral supplementation with coenzyme Q(10) was safe and well-tolerated. A daily dose of 100 mg coenzyme Q(10) for 60 days does not alleviate the fatigue of the late-onset sequelae of poliomyelitis. The registration number for the clinical trial is ACTRN 12612000552886. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Late neurologic and cognitive sequelae of inflicted traumatic brain injury in infancy.

    Science.gov (United States)

    Barlow, Karen M; Thomson, Elaine; Johnson, David; Minns, Robert A

    2005-08-01

    There is limited information regarding the long-term outcome of inflicted traumatic brain injury (TBI), including shaken infant syndrome. The purpose of this study was to describe the long-term neurologic, behavioral, and cognitive sequelae seen in this population. A cross-sectional and prospective longitudinal study was conducted of 25 children with inflicted TBI in Scotland between 1980 and 1999. After consent was obtained, neurologic and cognitive examinations were performed on all participants and sequentially in the prospective cohort. Two global outcome measures were used: Glasgow Outcome Score (GOS) and Seshia's outcome score. Cognitive outcome was assessed using the Bayley Scales of Infant Development, British Ability Scales, and the Vineland Adaptive Behavior Scales. The mean length of follow-up was 59 months. A total of 68% of survivors were abnormal on follow-up, 36% had severe difficulties and were totally dependant, 16% had moderate difficulties, and 16% had mild difficulties on follow-up. A wide range of neurologic sequelae were seen, including motor deficits (60%), visual deficits (48%), epilepsy (20%), speech and language abnormalities (64%), and behavioral problems (52%). There was a wide range of cognitive abilities: the mean psychomotor index, 69.9 (SD: +/-25.73); and mean mental development index, 74.53 (SD: +/-28.55). Adaptive functioning showed a wide range of difficulties across all domains: communication domain (mean: 76.1; SD: +/-25.4), Daily living skills domain (mean: 76.9; SD: +/-24.3), and socialization domain (mean: 79.1; SD: +/-23.1). Outcome was found to correlate with the Pediatric Trauma Score and the Glasgow Coma Score but did not correlate with age at injury or mechanism of injury. Inflicted TBI has a very poor prognosis and correlates with severity of injury. Extended follow-up is necessary so as not to underestimate problems such as specific learning difficulties and attentional and memory problems that may become apparent only

  18. Nerve conduction velocity in human limbs with late sequelae after local cold injury.

    Science.gov (United States)

    Arvesen, A; Wilson, J; Rosén, L

    1996-06-01

    Cold-induced neuropathy may play a dominant role in the long-term sequelae with cold sensitivity after local cold injuries (LCIs). Somatosensory functions were assessed and nerve conduction velocity (NCV) and motor distal delay (MDD) were measured in the limbs of 31 Norwegian former soldiers with persistent cold intolerance 3-4 years after the primary LCI. NCV measurements were performed in 24 lower and 16 upper extremities. NCV was related to degree of overall subjective complaints quantified by means of a visual analogue scale (VAS). Motor (MNCV) and sensory conduction velocity (SNCV) in the lower extremities and SNCV in the hands were significantly decreased compared with controls. MDD was pathologically increased in the feet. NCV of the forearms ranged from normal to significant reduction. The more pronounced effect on the lower extremities may be caused by deeper cooling of the calves compared with forearms for several reasons. No significant associations were found between VAS and NCV except for the right median nerve. NCV measurements may provide objective findings in cold-injured patients and in those with few or no conspicuous clinical signs.

  19. Late sequelae and complications in exclusive high voltage radiotherapy for carcinoma of the cervix uteri

    International Nuclear Information System (INIS)

    Rousseau, J.; Fenton, J.; Mathieu, G.; Dulac, G.; Picco, C.

    1976-01-01

    524 cases of uterine cervix (except stade IV cases) completely treated at the foundation Curie with exclusive radiotherapy from 1962 to 1968 are studied. The irradiation techniques, as well as the doses given to the tumor and to the critical organs are stated. The various sequelae and complications are described, according to the class and severity. The rectal troubles are frequent (55% of all the troubles) in 40% of the patients; though rarely, they can be severe (6% of the cases). They appear relatively early. The bladder troubles rank second (37% of all the troubles) in 20% of the patients; never severe and without any renal effect, they are more delayed than the former. The skin and soft tissues troubles are only a few (5%) for 5% of the patients. They are mostly mild and moderate. One skin necrosis was noted due for a large part to the very poor general conditions of the patient. The bone troubles are always classified here as marked or severe; they are rare (2,6%) in 2,3% of the patients. Their treatment is satisfactory. One single case of bilateral femur neck fracture gave a permanent infirmity. The genital troubles noted in 21% of the patients are mostly vaginal adhesion in women over 60 years of age [fr

  20. Late sequelae and complications in exclusive high voltage radiotherapy for carcinoma of the cervix uteri

    Energy Technology Data Exchange (ETDEWEB)

    Rousseau, J; Fenton, J; Mathieu, G; Dulac, G; Picco, C [Institut du Radium, 75 - Paris (France)

    1976-05-01

    524 cases of uterine cervix (except stade IV cases) completely treated at the foundation Curie with exclusive radiotherapy from 1962 to 1968 are studied. The irradiation techniques, as well as the doses given to the tumor and to the critical organs are stated. The various sequelae and complications are described, according to the class and severity. The rectal troubles are frequent (55% of all the troubles) in 40% of the patients; though rarely, they can be severe (6% of the cases). They appear relatively early. The bladder troubles rank second (37% of all the troubles) in 20% of the patients; never severe and without any renal effect, they are more delayed than the former. The skin and soft tissues troubles are only a few (5%) for 5% of the patients. They are mostly mild and moderate. One skin necrosis was noted due for a large part to the very poor general conditions of the patient. The bone troubles are always classified here as marked or severe; they are rare (2,6%) in 2,3% of the patients. Their treatment is satisfactory. One single case of bilateral femur neck fracture gave a permanent infirmity. The genital troubles noted in 21% of the patients are mostly vaginal adhesion in women over 60 years of age.

  1. Late cardiac, thyroid, and pulmonary sequelae of mantle radiotherapy for Hodgkin's disease

    International Nuclear Information System (INIS)

    Morgan, G.W.; Freeman, A.P.; McLean, R.G.; Jarvie, B.H.; Giles, R.W.

    1985-01-01

    Cardiac, thyroid and pulmonary function were evaluated in 25 patients aged 35 years or under, treated for Hodgkin's disease by mantle radiotherapy 5-16 years previously. No patient had symptoms of heart disease. Although thallium myocardial perfusion scintigraphy was normal in all patients, abnormalities of myocardial function were detected in 6 (24%) patients using gated equilibrium rest and exercise radionuclide ventriculography. Resting left ventricular ejection fraction (LVEF) was abnormal in 1 patient, and in 3 patients there was an abnormal LVEF response to exercise. All 6 patients had right ventricular dilatation. Apical hypokinesia was present in 4 of these patients. A small asymptomatic pericardial effusion was detected by M-Mode echocardiography in only 2 (8%) patients. Twenty-three (92%) patients had evidence of abnormal thyroid function. Two (8%) patients had become clinically hypothyroid. Serum TSH was elevated in 13 (52%) patients and TRH stimulation test was abnormal in a further 10 (40%) patients in whom TSH was normal. Pulmonary function studies showed a moderate decrease in diffusing capacity (72% of predicted) and a minor reduction in lung volume. Although a high incidence of cardiac, thyroid and pulmonary abnormalities was detected, only the 2 patients who had become hypothyroid were symptomatic. Modification of the irradiation technique may reduce the incidence of cardiac abnormalities, but is unlikely to alter significantly the thyroid or pulmonary sequelae

  2. Neuroimaging assessment of early and late neurobiological sequelae of traumatic brain injury: implications for CTE

    Directory of Open Access Journals (Sweden)

    Mark eSundman

    2015-09-01

    Full Text Available Traumatic brain injury (TBI has been increasingly accepted as a major external risk factor for neurodegenerative morbidity and mortality. Recent evidence indicates that the resultant chronic neurobiological sequelae following head trauma may, at least in part, contribute to a pathologically distinct disease known as Chronic Traumatic Encephalopathy (CTE. The clinical manifestation of CTE is variable, but the symptoms of this progressive disease include impaired memory and cognition, affective disorders (i.e., impulsivity, aggression, depression, suicidality, etc., and diminished motor control. Notably, mounting evidence suggests that the pathology contributing to CTE may be caused by repetitive exposure to subconcussive hits to the head, even in those with no history of a clinically evident head injury. Given the millions of athletes and military personnel with potential exposure to repetitive subconcussive insults and TBI, CTE represents an important public health issue. However, the incidence rates and pathological mechanisms are still largely unknown, primarily due to the fact that there is no in vivo diagnostic tool. The primary objective of this manuscript is to address this limitation and discuss potential neuroimaging modalities that may be capable of diagnosing CTE in vivo through the detection of tau and other known pathological features. Additionally, we will discuss the challenges of TBI research, outline the known pathology of CTE (with an emphasis on Tau, review current neuroimaging modalities to assess the potential routes for in vivo diagnosis, and discuss the future directions of CTE research.

  3. SF36 physical functioning scale and 2-minute walk test advocated as core qualifiers to evaluate physical functioning in patients with late-onset sequelae of poliomyelitis

    NARCIS (Netherlands)

    Stolwijk-Swüste, Janneke M.; Beelen, Anita; Lankhorst, Gustaaf J.; Nollet, Frans; Stolwijk-Swüste, J. M.; Lankhorst, G. J.; Dekker, J.; van Dijk, G. M.; van den Ende, C. H. M.; Post, B.; de Haan, R. J.; Speelman, H.

    2008-01-01

    OBJECTIVE: To select a questionnaire and walking capacity test based on comparison of clinimetric properties and mutual association to be used as "core" qualifiers for physical functioning in patients with late-onset sequelae of poliomyelitis. DESIGN: Repeated-measures at 3-week intervals. SUBJECTS:

  4. Sf36 physical functioning scale and 2-minute walk test advocated as core qualifiers to evaluate physical functioning in patients with late-onset sequelae of poliomyelitis.

    NARCIS (Netherlands)

    Stolwijk-Swuste, J.M.; Beelen, J.A.J.M.; Lankhorst, G.J.; Nollet, F.

    2008-01-01

    Objective: To select a questionnaire and walking capacity test based on comparison of clinimetric properties and mutual association to be used as "core" qualifiers for physical functioning in patients with late-onset sequelae of poliomyelitis. Design: Repeated-measures at 3-week intervals. Subjects:

  5. Boxing-acute complications and late sequelae: from concussion to dementia.

    Science.gov (United States)

    Förstl, Hans; Haass, Christian; Hemmer, Bernhard; Meyer, Bernhard; Halle, Martin

    2010-11-01

    Boxing has received increased public attention and acceptance in recent years. However, this development has not been accompanied by a critical discussion of the early and late health complications. We selectively review recent studies on the acute, subacute, and chronic neuropsychiatric consequences of boxing. Cerebral concussions ("knock-outs") are the most relevant acute consequence of boxing. The number of reported cases of death in the ring seems to have mildly decreased. Subacute neuropsychological deficits appear to last longer than subjective symptoms. The associated molecular changes demonstrate neuronal and glial injury correlated with the number and severity of blows to the head (altered total tau, beta-amyloid, neurofilament light protein, glial fibrillary acidic protein, and neuron-specific enolase). The risk of a punch-drunk syndrome (boxer's dementia, dementia pugilistica) as a late effect of chronic traumatic brain injury is associated with the duration of a boxer's career and with his earlier stamina. There are similarities (e.g. increased risk with ApoE4-polymorphism, beta-amyloid pathology) and differences (more tau pathology in boxers) compared with Alzheimer's disease. Protective gear has led to a remarkable reduction of risks in amateur boxing. Similar measures can also be used in professional boxing, but may decrease the thrill, which does appeal to many supporters.

  6. Clinical manifestation of late sequelae and patient disability after breast cancer treatment

    International Nuclear Information System (INIS)

    Radenkov, Kh.

    1976-01-01

    Based on medical records from 453 breast cancer patients undergoing complex treatment with follow-up periods of 1 to 12 years at the Shumen Area Oncologic Dispensary, evidence of late effects of therapy was studied in terms of resulting disability. Pre- and post-operative radiotherapy was found to enhance, in a dose-dependent fashion, upper extremity lymphatic stasis following mastectomy. The impact of radiotherapy was further manifested in bone changes, painfulness of shoulder-joint mitions, leukopenia, pneumosclerosis, and a number of neurologic and mental signs. The following invalidity groups were delineated: first group, any III or IV stage patient within the 5-year post-treatment period irrespective of how radical the treatment; second group, any II or I stage patient experiencing severe complication(s); and third group, any I stage patient with only slight physical defects and no concomitant conditions or other complications. (A.B.)

  7. Clinical manifestation of late sequelae and patient disability after breast cancer treatment

    Energy Technology Data Exchange (ETDEWEB)

    Radenkov, K [Okryzhen Onkologichen Djspanser, Shumen (Bulgaria)

    1976-01-01

    Based on medical records from 453 breast cancer patients undergoing complex treatment with follow-up periods of 1 to 12 years at the Shumen Area Oncologic Dispensary, evidence of late effects of therapy was studied in terms of resulting disability. Pre- and post-operative radiotherapy was found to enhance, in a dose-dependent fashion, upper extremity lymphatic stasis following mastectomy. The impact of radiotherapy was further manifested in bone changes, painfulness of shoulder-joint mitions, leukopenia, pneumosclerosis, and a number of neurologic and mental signs. The following invalidity groups were delineated: first group, any III or IV stage patient within the 5-year post-treatment period irrespective of how radical the treatment; second group, any II or I stage patient experiencing severe complication(s); and third group, any I stage patient with only slight physical defects and no concomitant conditions or other complications.

  8. Late neuro endocrinological sequelae of radiation therapy; Effets tardifs de la radiotherapie sur la sphere neuroendocrine

    Energy Technology Data Exchange (ETDEWEB)

    Bieri, S.; Bernier, J. [Ospedale San Giovanni (Switzerland); Sklar, C. [Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Constine, L. [Rochester Univ., NY (United States)

    1997-12-01

    When the hypothalamic-pituitary axis (HPA) is included in the treatment field in children and adults, a variety of neuroendocrine disturbances are more common than has been appreciated in the past. Clinical damage to the pituitary and thyroid glands usually occurs months to years after treatment, and is preceded by a long subclinical phase. Primary brain tumors represent the largest group of malignant solid tumors in children. The survival rates of 50 reported in the literature are achieved at the expense of late occurring effects. Radiation-induced abnormalities are generally dose-dependent. Growth hormone deficiency and premature sexual development can occur at doses as low as 18 Gy in conventional fractionation, and is the most common neuroendocrine problem in children. In patients treated with > 40 Gy on the HPA, deficiency of gonadotropins, thyroid stimulation hormone, and adrenocorticotropin (> 50 Gy), hyperprolactinemia can be seen, especially among young women. Most neuroendocrine disturbances that develop as a result of HPA can be treated efficiently, provided that an early detection of these endocrine dysfunctions abnormalities is done. (authors)

  9. Side effects and late sequelae of combined irradiation- and chemotherapy of the neurocranium in children with acute lymphoblastic leukaemia

    International Nuclear Information System (INIS)

    Zippel, R.M.

    1978-01-01

    Therapeutical procedures are not only judged according to their efficacy, but also with respect to their affection to the patient. For acute side effects as headaches, nausea, tiredness and fever, which occurred in several children, cranial irradiation and intrathecal MTX injections have to be considered as responsible factors. These accompanying symptoms, for example also alopecia, have to be tolerated with respect to the successful course of phase II, i.e. the prevention of a leukaemic meningo-encephalitis. The somnolence syndrome can be observed also after cerebral irradiation with a different indication; in several patients the occurrence of this syndrome has to be expected. Up to the present no secondary damages caused by this syndrome have been observed. Severe neurologic disorders only rarely appear within the course of the ALL; nevertheless it is necessary to determine at the earliest possible date also more subtle disturbances in the neurologic and psychic development of the children by neurologic examinations, regular ECG registrations, and psychologic tests. A delineation of late damages of ZNS therapy is only possible on the basis of the cerebral post-mortem findings. Since the dose of the brain irradiations of phase II are within the limits of the generally accepted tolerance range, a late necrosis induced by irradiation, has not to be expected. Single cases of leukoencephalopathies are ascribed to the ALL therapy. Growth retardations - which in the most cases are reversible - are found in children treated with ALL therapy; as possibly damaging agent also neurocranial irradiation might be considered as responsible. Regular control examinations of the length show a possibly occuring growth reduction, which should be accessible by hormone therapy if necessary. (orig./MG) [de

  10. Late sequelae of a non-optimal neonatal neurological condition in ERPs at the age of 11-13 years.

    Science.gov (United States)

    De Sonneville, L M; Visser, S L; Njiokiktjien, C

    1989-06-01

    In a longitudinal study a selective attention task was administered to 11-13-year-old children. During this task (employing a combined filter and selective-set paradigm), event-related brain potentials were recorded to study timing and morphology of early and late selection processes. Task performance was prospectively and retrospectively related to neurological optimality at birth and to flash-evoked potential correlates that were registered at the age of five. The results provided evidence that even after 13 years neonatal neurological suboptimality was reflected in task performance, both in reaction time and in electrophysiological data. Task load interacted with group classification according to optimality to the disadvantage of suboptimals. This implied that load demands differentiated between groups. The event-related brain potentials revealed the existence of a negative shift associated with memory load (search-related negativity) at Fz and Cz, and a positive deflection at Pz (P3b) associated with target detection. Cortical activity, expressed in terms of these deflections, appeared to be less pronounced for the suboptimal group.

  11. The influence of internal irradiation on the endocrine system and the importance of its functional state for the development of late sequelae

    International Nuclear Information System (INIS)

    Dedov, V.I.; Norets, T.A.

    1981-01-01

    The problem of choosing and proving criteria for the estimation of their biological effect at the level of organism results from the necessity to clarify the danger of incorporation of low doses of radioactive compounds. Therefore the importance of changes in the functional state of the endocrine system for the development of late sequelae following internal irradiation was investigated. Male and female rats were injected once with 1.22x10 4 Bq/g body weight 75 Se-selenomethionine. In the blood plasma the content of thyroxine, corticosterone, testosterone, and estradiol was determined. Moreover, the conditions of adaptation and reparation processes as well as of the reproductive function were checked. A long time afterwards the male rats showed a suppression of the functions of the endocrine system which led to a suppression of the adaptive and repairing processes and of the reproductive function, to a decrease in body weight and dynamic activity. In female animals such phenomena did never occur; that is probably connected to the weakly pronounced changes in the hormonal state. The results allow to propose the hormonal state as a criterion for evaluation of the biological effect of internal irradiation. (author)

  12. Late bone and soft tissue sequelae of childhood radiotherapy. Relevance of treatment age and radiation dose in 146 children treated between 1970 and 1997

    Energy Technology Data Exchange (ETDEWEB)

    Doerr, W. [Technical Univ. of Dresden (Germany). Dept. of Radiotherapy and Radiation Oncology; Medical University / AKH Vienna (Austria). Dept. of Radiation Oncology; Kallfels, S. [Technical Univ. of Dresden (Germany). Dept. of Radiotherapy and Radiation Oncology; Kinder- und Jugendmedizin, Chemnitz [Germany; Herrmann, T. [Technical Univ. of Dresden (Germany). Dept. of Radiotherapy and Radiation Oncology

    2013-07-15

    Purpose: The present retrospective study was initiated to characterize the effect of oncological treatments in children and adolescents on bone and soft tissues, and to assess their dependence on radiation dose and age at exposure. Patients and methods: The study included 146 patients treated between 1970 and 1997. All patients received external beam radiotherapy to the trunk or extremities, but no cranial irradiation. Median age at treatment was 8.8 years. Patients were screened at 18 years (median time interval since treatment 9.2 years, range 0.9-17.7 years) for pathological changes in the skeletal system and soft tissues (scoliosis, kyphosis, bony hypoplasia, soft tissue defects, asymmetries), which were classified as minor/moderate (grade 1) or substantial (grade 2). Results: Pathological findings were recorded in 75/146 patients (51 %). These were scored as minor in 44 (59 %) and substantial in 31 patients (41 %). Most pathological changes occurred in children treated under the age of 6 years. At 6 years and older, only doses > 35 Gy caused an effect, and no substantial changes were seen for treatment ages exceeding 12 years. Significant effects of radiation dose and age at exposure were observed for kyphoscoliosis (with vertebral body dose gradients < 35 Gy), hypoplasia and soft tissue defects and asymmetrical growth. Conclusion: Tolerance doses of 20 Gy need to be respected for growing bone, particularly in children treated under the age of 6 years. The late treatment sequelae analysed in the present study are largely avoided with the use of current therapeutic protocols. However, the systematic evaluation, documentation and continuous analysis of adverse events in paediatric oncology remains essential, as does the evaluation of novel radio(chemo)therapeutic approaches. (orig.)

  13. German register for detection of late sequelae after radiotherapy for children and adolescents (RiSK): present status and first results

    International Nuclear Information System (INIS)

    Boelling, T.; Schuck, A.; Willich, N.; Pape, H.; Ruebe, C.; Meyer, F.M.; Martini, C.; Timmermann, B.; Asadpour, B.; Kortmann, R.D.; Beck, J.D.; Langer, T.; Paulides, M.

    2007-01-01

    Undoubtedly, radiotherapy is an important treatment strategy for many malignancies in paediatric oncology. However, sufficient data about late side effects do not exist. There is a lack of information about radiation dose-effect relationships in view of late side effects in childhood and adolescence. Late effects after radiotherapy in childhood and adolescence have mainly been characterized retrospectively with small patient numbers. Many of these analyses are limited due to little information about organ dose levels and older radiation techniques in some cases. Therefore the German Group of Paediatric Radiation Oncology (APRO) established the ''Register for the evaluation of late side effects after radiation in childhood and adolescence (RiSK)''. Aim of this prospective multicentric register study is to evaluate irradiation dose effect relationships of organs and part of organs with respect to late effects. The feasibility of RiSK has already been shown and first results have recently been published. The characterization of late effects after cancer therapy in childhood is of rising interest. In Germany, several study groups like the ''Late Effects Surveillance System'' (LESS) or the working group ''Quality of life'' examine different aspects of late effects. In the United States of America, the ''Childhood Cancer Survivor Study'' has been established to characterize retrospectively the health status of 5-year-survivors of childhood cancer. In these studies, more than 12,000 patients were evaluated by questionnaires regarding their health status. For radiotherapy, this study is not able to give detailed information about late side effects due to rare data about radiation doses and organ dose levels. To our knowledge, ''RiSK'' is the only multicentric study that evaluates radiation associated side effects prospectively with detailed information about organ dose levels. (orig.)

  14. German register for detection of late sequelae after radiotherapy for children and adolescents (RiSK): present status and first results

    Energy Technology Data Exchange (ETDEWEB)

    Boelling, T.; Schuck, A.; Willich, N. [Dept. of Radiotherapy of the Univ. Hospital Muenster (Germany); Pape, H. [Dept. of Radiotherapy of the Univ. Hospital Duesseldorf (Germany); Ruebe, C. [Dept. of Radiotherapy of the Univ. Saarland, Homburg/Saar (Germany); Meyer, F.M. [Dept. of Radiotherapy of the Clinic of Augsburg (Germany); Martini, C. [Dept. of Radiotherapy of the Univ. Hospitals Freiburg (Germany); Timmermann, B. [Paul Scherrer Inst., Villigen (Switzerland); Asadpour, B. [Dept. of Radiotherapy of the Univ. Hospital Aachen (Germany); Kortmann, R.D. [Dept. of Radiotherapy of the Univ. Hospital Leipzig (Germany); Beck, J.D.; Langer, T.; Paulides, M. [LESS Center, Univ. Children' s Hospital Erlangen (Germany)

    2007-12-15

    Undoubtedly, radiotherapy is an important treatment strategy for many malignancies in paediatric oncology. However, sufficient data about late side effects do not exist. There is a lack of information about radiation dose-effect relationships in view of late side effects in childhood and adolescence. Late effects after radiotherapy in childhood and adolescence have mainly been characterized retrospectively with small patient numbers. Many of these analyses are limited due to little information about organ dose levels and older radiation techniques in some cases. Therefore the German Group of Paediatric Radiation Oncology (APRO) established the 'Register for the evaluation of late side effects after radiation in childhood and adolescence (RiSK)'. Aim of this prospective multicentric register study is to evaluate irradiation dose effect relationships of organs and part of organs with respect to late effects. The feasibility of RiSK has already been shown and first results have recently been published. The characterization of late effects after cancer therapy in childhood is of rising interest. In Germany, several study groups like the 'Late Effects Surveillance System' (LESS) or the working group 'Quality of life' examine different aspects of late effects. In the United States of America, the 'Childhood Cancer Survivor Study' has been established to characterize retrospectively the health status of 5-year-survivors of childhood cancer. In these studies, more than 12,000 patients were evaluated by questionnaires regarding their health status. For radiotherapy, this study is not able to give detailed information about late side effects due to rare data about radiation doses and organ dose levels. To our knowledge, 'RiSK' is the only multicentric study that evaluates radiation associated side effects prospectively with detailed information about organ dose levels. (orig.)

  15. Neurological sequelae of bacterial meningitis

    NARCIS (Netherlands)

    Lucas, Marjolein J.; Brouwer, Matthijs C.; van de Beek, Diederik

    2016-01-01

    We reported on occurrence and impact of neurological sequelae after bacterial meningitis. We reviewed occurrence of neurological sequelae in children and adults after pneumococcal and meningococcal meningitis. Most frequently reported sequelae are focal neurological deficits, hearing loss, cognitive

  16. [Late sequelae of central nervous system prophylaxis in children with acute lymphoblastic leukemia: high doses of intravenous methotrexate versus radiotherapy of the central nervous system--review of literature].

    Science.gov (United States)

    Zając-Spychała, Olga; Wachowiak, Jacek

    2012-01-01

    Acute lymphoblastic leukemia is the most common malignancy in children. All current therapy regimens used in the treatment of childhood acute lymphoblastic leukemia include prophylaxis of the central nervous system. Initially it was thought that the best way of central nervous system prophylaxis is radiotherapy. But despite its effectiveness this method, may cause late sequelae and complications. In the programme currently used in Poland to treat acute lymphoblastic leukemia, prophylactic radiotherapy has been reduced by 50% (12 Gy) and is used only in patients stratified into the high risk group and in patients diagnosed as T-cell ALL (T-ALL). Complementary to radiotherapy, intrathecal methotrexate is given alone or in combination with cytarabine and hydrocortisone is given, as well as systemic chemotherapy with intravenous methotrexate is administered in high or medium doses (depending on risk groups and leukemia immunophenotype). Recent studies have shown that high dose irradiation of the central nervous system impairs cognitive development causing memory loss, visuomotor coordination impairment, attention disorders and reduction in the intelligence quotient. It has been proved that the degree of cognitive impairment depends on the radiation dose directed to the medial temporal lobe structures, particularly in the hippocampus and the surrounding cortex. Also, methotrexate used intravenously in high doses, interferes with the metabolism of folic acid which is necessary for normal development and the optimal functioning of neurons in the central nervous system. It has been proved that patients who have been treated with high doses of methotrexate are characterized by reduced memory skills and a lower intelligence quotient. The literature data concerning long term neuroanatomical abnormalities and neuropsychological deficits are ambiguous, and there is still no data concerning current methods of central nervous system prophylaxis with low doses of irradiation in

  17. Accidental radioisotope burns - Management of late sequelae

    Directory of Open Access Journals (Sweden)

    Varghese Bipin

    2010-10-01

    Full Text Available Accidental radioisotope burns are rare. The major components of radiation injury are burns, interstitial pneumonitis, acute bone marrow suppression, acute renal failure and adult respiratory distress syndrome. Radiation burns, though localized in distribution, have systemic effects, and can be extremely difficult to heal, even after multiple surgeries. In a 25 year old male who sustained such trauma by accidental industrial exposure to Iridium192 the early presentation involved recurrent haematemesis, pancytopenia and bone marrow suppression. After three weeks he developed burns in contact areas in the left hand, left side of the chest, abdomen and right inguinal region. All except the inguinal wound healed spontaneously but the former became a non-healing ulcer. Pancytopenia and bone marrow depression followed. He was treated with morphine and NSAIDs, epidural buprinorphine and bupivicaine for pain relief, steroids, antibiotics followed by wound excision and reconstruction with tensor fascia lata(TFL flap. Patient had breakdown of abdominal scar later and it was excised with 0.5 cm margins up to the underlying muscle and the wound was covered by a latissimis dorsi flap. Further scar break down and recurrent ulcers occurred at different sites including left wrist, left thumb and right heel in the next two years which needed multiple surgical interventions.

  18. "A Fair Chance for the Girls": Discourse on Women's Health and Higher Education in Late Nineteenth Century America

    Science.gov (United States)

    Tsang, Tiffany Lee

    2015-01-01

    Histories of education in America often discuss how concerns over women's health influenced public opinion on women's participation in higher education in the late nineteenth century. However, these histories almost exclusively focus on literature produced by the medical community--literature claiming that rigorous academic study was detrimental…

  19. Late-time tails of wave propagation in higher dimensional spacetimes

    International Nuclear Information System (INIS)

    Cardoso, Vitor; Yoshida, Shijun; Dias, Oscar J.C.; Lemos, Jose P.S.

    2003-01-01

    We study the late-time tails appearing in the propagation of massless fields (scalar, electromagnetic, and gravitational) in the vicinities of a D-dimensional Schwarzschild black hole. We find that at late times the fields always exhibit a power-law falloff, but the power law is highly sensitive to the dimensionality of the spacetime. Accordingly, for odd D>3 we find that the field behaves as t -(2l+D-2) at late times, where l is the angular index determining the angular dependence of the field. This behavior is entirely due to D being odd; it does not depend on the presence of a black hole in the spacetime. Indeed this tail is already present in the flat space Green's function. On the other hand, for even D>4 the field decays as t -(2l+3D-8) , and this time there is no contribution from the flat background. This power law is entirely due to the presence of the black hole. The D=4 case is special and exhibits, as is well known, t -(2l+3) behavior. In the extra dimensional scenario for our Universe, our results are strictly correct if the extra dimensions are infinite, but also give a good description of the late-time behavior of any field if the large extra dimensions are large enough

  20. Psychiatric sequelae of induced abortion.

    Science.gov (United States)

    Gibbons, M

    1984-03-01

    An attempt is made to identify and document the problems of comparative evaluation of the more recent studies of psychiatric morbidity after abortion and to determine the current consensus so that when the results of the joint RCGP/RCOG study of the sequelae of induced abortion become available they can be viewed in a more informed context. The legalization of abortion has provided more opportunities for studies of subsequent morbidity. New laws have contributed to the changing attitudes of society, and the increasing acceptability of the operation has probably influenced the occurrence of psychiatric sequelae. The complexity of measuring psychiatric sequelae is evident from the many terms used to describe symptomatology and behavioral patterns and from the number of assessment techniques involved. Numerous techniques have been used to quantify psychiatric sequelae. Several authors conclude that few psychiatric problems follow an induced abortion, but many studies were deficient in methodology, material, or length of follow-up. A British study in 1975 reported a favorable outcome for a "representative sample" of 50 National Health Service patients: 68% of these patients had an absence of or only mild feelings of guilt, loss, or self reproach and considered abortion as the best solution to their problem. The 32% who had an adverse outcome reported moderate to severe feelings of guilt, regret, loss, and self reproach, and there was evidence of mental illness. In most of these cases the adverse outcome was related to the patient's environment since the abortion. A follow-up study of 126 women, which compared the overall reaction to therapeutic abortion between women with a history of previous mild psychiatric illness and those without reported that a significantly different emotional reaction could not be demonstrated between the 2 groups. In a survey among women seeking an abortion 271 who were referred for a psychiatric opinion regarding terminations of pregnancy

  1. Psychological sequelae of induced abortion.

    Science.gov (United States)

    Romans-Clarkson, S E

    1989-12-01

    This article reviews the scientific literature on the psychological sequelae of induced abortion. The methodology and results of studies carried out over the last twenty-two years are examined critically. The unanimous consensus is that abortion does not cause deleterious psychological effects. Women most likely to show subsequent problems are those who were pressured into the operation against their own wishes, either by relatives or because their pregnancy had medical or foetal contraindications. Legislation which restricts abortion causes problems for women with unwanted pregnancies and their doctors. It is also unjust, as it adversely most affects lower socio-economic class women.

  2. Late Effects of Polio: An Overview

    Science.gov (United States)

    ... Polio Wellness Retreats For Health Professionals The Late Effects of Polio: An Overview FRENCH | GERMAN | PORTUGUESE POLIOMYELITIS ( ... largest and most inclusive category is called Late Effects of Polio or Polio Sequelae and is defined ...

  3. Sinus of Valsalva Pseudoaneurysm as a Sequela to Infective Endocarditis.

    Science.gov (United States)

    Lee, Chin C; Siegel, Robert J

    2016-02-01

    Pseudoaneurysm is an uncommon sequela of infective endocarditis. We treated a 44-year-old man who had an active case of group B streptococcal infective endocarditis of the aortic valve despite no evidence of valvular dysfunction or vegetation on his initial transesophageal echocardiogram. After completing 6 weeks of intravenous antibiotic therapy, the patient developed a sinus of Valsalva pseudoaneurysm and severe aortic regurgitation caused by partial detachment of the left coronary cusp. We used a pericardial patch to close the pseudoaneurysm and repair the coronary cusp. This case shows the importance of routine clinical follow-up evaluation in infective endocarditis, even after completion of antibiotic therapy. Late sequelae associated with infective endocarditis or its therapy include recurrent infection, heart failure caused by valvular dysfunction (albeit delayed), and antibiotic toxicity such as aminoglycoside-induced nephropathy and vestibular toxicity.

  4. Residual neurologic sequelae after childhood cerebral malaria

    NARCIS (Netherlands)

    van Hensbroek, M. B.; Palmer, A.; Jaffar, S.; Schneider, G.; Kwiatkowski, D.

    1997-01-01

    Cerebral malaria is an important cause of pediatric hospital admissions in the tropics. It commonly leads to neurologic sequelae, but the risk factors for this remain unclear and the long-term outcome unknown. The purpose of this study was to identify the common forms of neurologic sequelae that

  5. Psychiatric sequelae of traumatic brain injury: Retrospective ...

    African Journals Online (AJOL)

    Objective: Traumatic brain injury (TBI) is a public health problem and is associated with many complications. However little is known about the psychiatric sequelae of TBI in Nigeria. This study described the pattern and determinants of psychiatric sequelae among subjects with TBI. Materials and Methods: The study is a ...

  6. Late Holocene higher sea level and its radiocarbon dates in Okierabu-jima, Ryukyus

    International Nuclear Information System (INIS)

    Koba, Motoharu; Omoto, Kunio; Takahashi, Tatsuo.

    1980-01-01

    Okierabu-jima of the Ryukyu Islands, which is a poly-terraced Pleistocene raised coral reef island, doesn't have a Holocene raised coral reef, but coastal erosional features showing higher sea levels in Holocene. The authors obtained some data indicating the period of one of the Holocene higher sea levels. All radiocarbon dates concerning Okierabu-jima's Holocene sea-level changes are plotted on the date-height coordinates. The paleo sea level between 5000 and 2000 y. B. P. lies above the broken line drawn from 6 m below to 2.18 m above the present sea level. The period of the highest sea level in Holocene seems to be about 3000 to 2000 y. B. P. in this island. Its height is presumably 2.4 m a. s. l. derived on an average from heights of stacks and coastal benches in the almost all coasts of the island (Koba, 1974). Beach rocks were already formed at the landward extremity of the reef flat corresponding to the almost present sea level about 1300 y. B. P. (author)

  7. Evidence of a higher late-Holocene treeline along the Continental Divide in central Colorado

    Science.gov (United States)

    Carrara, Paul E.; McGeehin, John

    2015-01-01

    Using a combination of 23 radiocarbon ages and annual ring counts from 18 Rocky Mountain bristlecone pine (Pinus aristata) remnants above the local present-day limits, a period of higher treeline has been determined for two sites near the Continental Divide in central Colorado. The highest remnants were found about 30 m above live bristlecone pines of similar size. The majority of the remnants, consisting of standing snags, large logs, and smaller remains, are highly eroded, such that the innermost annual rings of all but one are missing. The radiocarbon ages obtained from the oldest wood recovered from each remnant indicate that the majority were established above the present-day limit of bristlecone pine from prior to 2700 cal. yr BP to no later than about 1200 cal. yr BP. These radiocarbon ages combined with the annual ring count from the corresponding remnant indicate that the majority of the sampled remnants grew above the present-day limit of bristlecone pine from sometime before 2700 cal. yr BP to about 800 cal. yr BP. Evidence of recent climatic warming is demonstrated at one of the sites by young bristlecone pine saplings growing next to the highest remnants; the saplings were established after AD 1965 and represent the highest advance of treeline in at least 1200 years.

  8. Late prematurity: a systematic review

    Directory of Open Access Journals (Sweden)

    Luís Carlos Machado Júnior

    2014-06-01

    Full Text Available Objective: this study aimed to review the literature regarding late preterm births (34 weeks to 36 weeks and 6 days of gestation in its several aspects. Sources: the MEDLINE, LILACS, and Cochrane Library databases were searched, and the references of the articles retrieved were also used, with no limit of time. Data synthesis: numerous studies showed a recent increase in late preterm births. In all series, late preterm comprised the majority of preterm births. Studies including millions of births showed a strong association between late preterm birth and neonatal mortality. A higher mortality in childhood and among young adults was also observed. Many studies found an association with several neonatal complications, and also with long-term disorders and sequelae: breastfeeding problems, cerebral palsy, asthma in childhood, poor school performance, schizophrenia, and young adult diabetes. Some authors propose strategies to reduce late preterm birth, or to improve neonatal outcome: use of antenatal corticosteroids, changes in some of the guidelines for early delivery in high-risk pregnancies, and changes in neonatal care for this group. Conclusions: numerous studies show greater mortality and morbidity in late preterm infants compared with term infants, in addition to long-term disorders. More recent studies evaluated strategies to improve the outcomes of these neonates. Further studies on these strategies are needed.

  9. Imaging of the late sequelae of spinal cord injuries

    International Nuclear Information System (INIS)

    Bodley, R.

    1994-01-01

    With an increasing ability to diagnose and treat the neurological complications, surveillance of the state of the spinal cord has now assumed great importance. Magnetic resonance imaging (MRI), or computerized tomography (CT) with myelography if MRI is contra-indicated is the method of choice and can demonstrate the pathology with great clarity. In most patients, midline sagittal T1W images are sufficient for screening purposes and for monitoring the success of treatment. Operative, imaging and postmortem studies have shown that the two main changes that occur are: (a) atrophic and (b) cystic - the microcystic and myxoid gel changes of myelomalacia, focal cysts and the larger, more expansive, syringomyelia. As yet, there is no standardization of terminology to describe the various pathological and radiological states. This is critical as only one condition, syringomyelia, is currently amenable to definitive surgery and without conformity, comparisons of incidence in different populations and assessment of the results of surgery are impossible. The published small studies of predominantly symptomatic patients at varying stages of chronicity give differing incidences of changes. Preliminary results of a surveillance MRI study of the spinal cord changes in 153 patients who had had a spinal cord injury over 20 years previously are presented. Altrophy was present in 62%, myelomalacia in 54%, syringomyelia in 22%, focal cysts in 9% and disruption in 7%. (orig./VHE) [de

  10. Clinical and radiographic sequelae to primary teeth affected by dental trauma: a 9-year retrospective study

    Directory of Open Access Journals (Sweden)

    Vanessa Polina Pereira Costa

    Full Text Available Abstract This retrospective study aimed at determining the predicted risks of clinical and radiographic complications in primary teeth following traumatic dental injuries, according to injury type, severity and child’s age. Data were collected from records of children treated at a Dental Trauma Center in Brazil for nine years. Records of 576 children were included; clinical sequelae were assessed in 774 teeth, and radiographic sequelae, in 566 teeth. A total of 408 teeth (52.7% had clinical sequelae and 185 teeth (32.7%, radiographic sequelae. The type of injury with the highest number of clinical sequelae was the crown-root fracture (86.4%. Clinical sequelae increased with injury severity (p < 0.001, whereas radiographic sequelae did not (0.236. The predicted risk of color change was 29.0% (95%CI 19–41 for teeth with enamel fracture, and 26.0% (95%CI 14–40 for teeth with enamel dentin fracture as well as enamel dentin pulp fracture. Risk of periapical radiolucency was higher for teeth with enameldentinpulp fracture (61.1% 95%CI 35–82 and those with subluxation (15.8% 95%CI 10–22. Risk of premature loss was 27.3% (95%CI 13–45 for teeth with extrusive luxation, and 10.2% (95%CI 5–17 for those with intrusive luxation. The assessment of predicted risks of sequelae showed that teeth with hard tissue trauma tended to present color change, periapical radiolucency and premature loss, whereas teeth with supporting tissue trauma showed color change, abnormal position, premature loss and periapical radiolucency as the most common sequelae. Knowledge about the predicted risks of complications may help clinicians establish appropriate treatment plans.

  11. Role of Individual, Family, and Peers in Sexual Initiation Among Late Adolescents Attending Institutions of Higher Learning in Malaysia.

    Science.gov (United States)

    Abdul Samad, Shazimah; Hairi, Noran Naqiah; Ismail, Maslinor

    2016-05-01

    This cross-sectional study aimed to determine the prevalence and the factors associated with sexual initiation among the late adolescents in 6 institutions of higher learning in Malaysia. A total of 1572 students completed self-administered questionnaires between April and September 2013. Hierarchical multivariate logistic regression analyses stratified by gender were employed to identify the correlates of sexual initiation. The analyses were further adjusted by sampling weights. The overall prevalence of sexual initiation was 9.8% (95% confidence interval [CI] = 8.3-11.6), 18.1% (95% CI = 15.1-21.5) among males, and 4.1% (95% CI = 2.9-5.9) among females. The risk factors identified in this study supported the influence of the individual, family, and peer factors in the social-ecological model on adolescents' behaviors. The findings suggest the need for risk-reduction strategies aimed at the individual, family, and peer levels as well as the importance of gender-specific focus in assuring better outcomes. © 2016 APJPH.

  12. Endocrine sequelae after radiotherapy in childhood and adolescence

    International Nuclear Information System (INIS)

    Couto-Silva, Ana Claudia; Adan, Luis Fernando; Brauner, Raja

    2005-01-01

    Radiotherapy may result in endocrine abnormalities, osteoporosis, obesity and neurological sequelae in patients treated for cancer. In the hypothalamo-pituitary area, GH deficiency is the most frequent complication. The frequency, delay of appearance and severity of GH deficiency depend most on the dose delivered during cranial irradiation but variables as age at treatment and fractionation schedule may play an important role as well. Other hypothalamo-pituitary dysfunctions are also dose-dependent. Low dose cranial irradiation may induce precocious or early puberty, while high doses are related to gonadotropin deficiency. Endocrine complications due to extracranial irradiation such as gonadal or thyroid abnormalities are described. In spite of normal GH secretion, linear growth may be impaired by bone lesions secondary to craniospinal or total body irradiation. Results on final height have been optimized by better indicators of GH therapy associated with adequate treatment of early or precocious puberty. The purpose of this review is to explore the late endocrine sequelae of radiotherapy. (author)

  13. Endocrine sequelae after radiotherapy in childhood and adolescence; Sequelas endocrinas da radioterapia no tratamento do cancer na infancia e adolescencia

    Energy Technology Data Exchange (ETDEWEB)

    Couto-Silva, Ana Claudia; Adan, Luis Fernando [Universidade Federal da Bahia, Salvador, BA (Brazil); Brauner, Raja [Paris-5 Univ. (France)

    2005-10-15

    Radiotherapy may result in endocrine abnormalities, osteoporosis, obesity and neurological sequelae in patients treated for cancer. In the hypothalamo-pituitary area, GH deficiency is the most frequent complication. The frequency, delay of appearance and severity of GH deficiency depend most on the dose delivered during cranial irradiation but variables as age at treatment and fractionation schedule may play an important role as well. Other hypothalamo-pituitary dysfunctions are also dose-dependent. Low dose cranial irradiation may induce precocious or early puberty, while high doses are related to gonadotropin deficiency. Endocrine complications due to extracranial irradiation such as gonadal or thyroid abnormalities are described. In spite of normal GH secretion, linear growth may be impaired by bone lesions secondary to craniospinal or total body irradiation. Results on final height have been optimized by better indicators of GH therapy associated with adequate treatment of early or precocious puberty. The purpose of this review is to explore the late endocrine sequelae of radiotherapy. (author)

  14. Classification system for acute and chronic radiation treatment sequelae

    International Nuclear Information System (INIS)

    Seegenschmiedt, M.H.; Sauer, R.

    1993-01-01

    A classification system in German language is proposed for scoring of acute and chronic treatment sequelae after radiotherapy. It includes all important organs and organ systems. The proposed grading corresponds to the four-scale-system of the WHO and UICC. The system is also compatible to the RTOG and EORTC acute and late radiation morbidity scoring criteria. This facilitates the data transfer for retrospective and prospective analysis of monomodal and multimodal radiotherapy treatment regimes. We recommend to use this scoring system in all German speaking countries for multicentric prospective studies. It is possible, that organ-specific sophistications of the toxicity grading will be developed in the future. These additions should conform with (inter)national standards and apply the same four-scale grading of this classification system. (orig.) [de

  15. Sequelae og død efter pneumokokmeningitis

    DEFF Research Database (Denmark)

    Korsholm, Jakob; Kristensen, Rasmus Nygård; Heslop, Anders

    2009-01-01

    to an annual incidence of 11.7/mill. The mean age was 36.6 years (range: four days - 80 years) and the mean duration from debut of acute otitis media (AOM) to admission was three days. Twenty three percent had received antibiotics prior to admission. The most common symptoms were fever and affected...... and sequelae. Affected consciousness was a significant prognostic factor. The mortality rate was four times higher among adults than among children. Mastoidectomy was performed in 56% of adults without any significant influence on the outcome. Based on the presented results it appears relevant to treat cases...

  16. Concurrent chemoradiotherapy was associated with a higher severe late toxicity rate in nasopharyngeal carcinoma patients compared with radiotherapy alone: a meta-analysis based on randomized controlled trials

    International Nuclear Information System (INIS)

    Du, Cheng-run; Ying, Hong-mei; Kong, Fang-fang; Zhai, Rui-ping; Hu, Chao-su

    2015-01-01

    To investigate the incidence and risk of severe late toxicity with concurrent chemoradiotherapy (CCRT) in nasopharyngeal carcinoma patients. Eligible studies included prospective randomized controlled trials (RCTs) evaluating CCRT versus radiotherapy alone in patients with nasopharyngeal carcinoma and in which data on severe late toxicities were available. Random effects or fixed effect models were applied to obtain the summary incidence, relative risks (RRs) and 95% confidence intervals (CIs). Five RCTs with 1102 patients with NPC were included in this analysis. The summary incidence of overall severe late toxicities in patients receiving CCRT was 30.7% (95% CI, 18–47.2%) and the incidence of radiotherapy alone group was 21.7% (95% CI, 13.3–33.4%). The use of concurrent chemotherapy was associated with an increased risk of severe late toxicities, with a RR of 1.349 (95% CI, 1.108–1.643; P = 0.005). As for specific late toxicity, CCRT significantly increased the risk of ear deafness/otitis (RR = 1.567; 95% CI, 1.192–2.052), but other late toxicities were not significantly different. Patients receiving concurrent chemotherapy regimens with 3-week high-dose cisplatin (HC) have a higher risk of ear deafness/otitis (RR = 1.672; 95% CI, 1.174–2.382; P = 0.026). However, there was no significant increase in the RR of severe ear complication with the addition of non-3-week high-dose cisplatin (nonHC) regimens (RR = 1.433; 95% CI, 0.946–2.171; P = 0.095). With the present evidence, the addition of concurrent chemotherapy seems to increase the risk of severe late toxicities in patients with NPC, especially when using HC regimen for the occurrence of severe ototoxicity

  17. Evaluation of some oral postradiotherapy sequelae in patients treated for head and neck tumors

    International Nuclear Information System (INIS)

    Rubira, Cassia Maria Fischer; Devides, Nadia Juliana; Ubeda, Liliane Torsani; Lauris, Jose Roberto; Rubira-Bullen, Izabel Regina Fischer; Damante, Jose Humberto

    2007-01-01

    The aim of this study was to evaluate the oral sequelae of radiotherapy in patients treated between 1999 and 2003 for head and neck tumors. One-hundred patients (24 women, 76 men) ranging in age from 30 to 83 years (mean 59.2 years) were examined. Time since radiotherapy ranged from 1 to 72 months (mean 28 months). The total mean radiation dose received by the patients was 5,955 cGy. The evaluation protocol included anamnesis, intraoral and extraoral examination, measurement of stimulated salivary flow and salivary pH. Symptoms reported by the patients included dry mouth (68%), dysphagia (38%), and dysgeusia (30%). In 64% of the patients, the mean stimulated salivary flow rate was less than 0.7 ml/min. The mean salivary pH was 6.97 (± 0.714). Stimulated salivary flow increased with increasing postradiotherapy time (p < 0.05). The prevalence of mucositis was associated with higher radiation doses (p < 0.05), and the prevalence of atrophic candidiasis was related to a longer post-treatment period (p < 0.05). Two cases of recurrence of the primary tumor were detected during the study. The main effect of radiotherapy in the head and neck region was a reduction of the salivary flow rate, even though our study demonstrated that there was a modest late improvement of the salivary flow. (author)

  18. Shoulder arthroplasty for sequelae of poliomyelitis.

    Science.gov (United States)

    Werthel, Jean-David; Schoch, Bradley; Sperling, John W; Cofield, Robert; Elhassan, Bassem T

    2016-05-01

    Polio infection can often lead to orthopedic complications such as arthritis, osteoporosis, muscle weakness, skeletal deformation, and chronic instability of the joints. The purpose of this study was to assess the outcomes and associated complications of arthroplasty in shoulders with sequelae of poliomyelitis. Seven patients (average age, 70 years) were treated between 1976 and 2013 with shoulder arthroplasty for the sequelae of polio. One patient underwent reverse shoulder arthroplasty, 2 had a hemiarthroplasty, and 4 had total shoulder arthroplasty. Average follow-up was 87 months. Outcome measures included pain, range of motion, and postoperative modified Neer ratings. Overall pain scores improved from 5 to 1.6 points (on a 5-point scale) after shoulder arthroplasty. Six shoulders had no or mild pain at latest follow-up, and 6 shoulders rated the result as much better or better. Mean shoulder elevation improved from 72° to 129°, and external rotation improved from 11° to 56°. Average strength in elevation decreased from 3.9 to 3.4 postoperatively, and external rotation strength decreased from 3.9 to 3.3. This, however, did not reach significance. Evidence of muscle imbalance with radiographic instability was found in 4 shoulders that demonstrated superior subluxation, anterior subluxation, or both. This remained asymptomatic. No shoulder required revision or reoperation. Shoulder arthroplasty provides significant pain relief and improved motion in patients with sequelae of poliomyelitis. Muscle weakness may be responsible for postoperative instability, and careful selection of the patient with good upper extremity muscles must be made. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  19. Post-infectious sequelae of travelers' diarrhea.

    Science.gov (United States)

    Connor, Bradley A; Riddle, Mark S

    2013-01-01

    Travelers' diarrhea (TD) has generally been considered a self-limited disorder which resolves more quickly with expeditious and appropriate antibiotic therapy given bacteria are the most frequently identified cause. However, epidemiological, clinical, and basic science evidence identifying a number of chronic health conditions related to these infections has recently emerged which challenges this current paradigm. These include serious and potentially disabling enteric and extra-intestinal long-term complications. Among these are rheumatologic, neurologic, gastrointestinal, renal, and endocrine disorders. This review aims to examine and summarize the current literature pertaining to three of these post-infectious disorders: reactive arthritis, Guillain-Barré syndrome, and post-infectious irritable bowel syndrome and the relationship of these conditions to diarrhea associated with travel as well as to diarrhea associated with gastroenteritis which may not be specifically travel related but relevant by shared microbial pathogens. It is hoped this review will allow clinicians who see travelers to be aware of these post-infectious sequelae thus adding to our body of knowledge in travel medicine. Data for this article were identified by searches of PubMed and MEDLINE, and references from relevant articles using search terms "travelers' diarrhea" "reactive arthritis" "Guillain-Barré syndrome" "Post-Infectious Irritable Bowel Syndrome." Abstracts were included when related to previously published work. A review of the published literature reveals that potential consequences of travelers' diarrhea may extend beyond the acute illness and these post-infectious complications may be more common than currently recognized. In addition since TD is such a common occurrence it would be helpful to be able to identify those who might be at greater risk of post-infectious sequelae in order to target more aggressive prophylactic or therapeutic approaches to such individuals. It is

  20. [Fat grafting in facial burns sequelae].

    Science.gov (United States)

    Viard, R; Bouguila, J; Voulliaume, D; Comparin, J-P; Dionyssopoulos, A; Foyatier, J-L

    2012-06-01

    Fat graft is now part of the armamentarium in face plastic surgery. It is successfully used in burn scars. The aim of our study is the discussion of the value of this technique in optimizing cosmetic result of burns face sequelae. Fifteen adult patients (10 females and five males) with scars resulting from severe burns 2 to 9 years previously were selected. The patients were treated by injection of adipose tissue harvested from abdominal subcutaneous fat and processed according to Coleman's technique. Two to three injections were administered at the dermohypodermal junction. Ages, sexes, aetiology of burn, facial burn sequelae, recipient sites, quantity of fat injected, aesthetic results are discussed. Patient age ranged from 21 to 55 years (average: 38). The mean follow-up of the study was 66 months (23-118). Patients received 7.5 (5-11) facial restorative surgeries before fat graft. Patients underwent two sessions of fat transfer, 33cc average per session. We did not report any complications. The clinical appearance, discussed by three surgeons and subjective patient feelings, after a 6-month follow-up period, suggests considerable improvement in the mimic features, skin texture, and thickness. The result is good in 86% of cases and acceptable in the other cases. Burns sequelae offer local conditions which justify special cannula can cross fibrosis and explaining the value of multiplying the sessions. Indications for lipostructure include four distinct nosological situations, sometimes combined. Lipostructure can restore a missing relief, filling a localized depression, reshape a lack of face volume or smooth a scarring skin. Fat graft seems to complete and improve the results of the standard surgical approach in burned face. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  1. Late prematurity: a systematic review

    Directory of Open Access Journals (Sweden)

    Luís Carlos Machado, Júnior

    2014-05-01

    Full Text Available Objective: this study aimed to review the literature regarding late preterm births (34 weeks to 36 weeks and 6 days of gestation in its several aspects. Sources: the MEDLINE, LILACS, and Cochrane Library databases were searched, and the references of the articles retrieved were also used, with no limit of time. Data synthesis: numerous studies showed a recent increase in late preterm births. In all series, late preterm comprised the majority of preterm births. Studies including millions of births showed a strong association between late preterm birth and neonatal mortality. A higher mortality in childhood and among young adults was also observed. Many studies found an association with several neonatal complications, and also with long-term disorders and sequelae: breastfeeding problems, cerebral palsy, asthma in childhood, poor school performance, schizophrenia, and young adult diabetes. Some authors propose strategies to reduce late preterm birth, or to improve neonatal outcome: use of antenatal corticosteroids, changes in some of the guidelines for early delivery in high-risk pregnancies, and changes in neonatal care for this group. Conclusions: numerous studies show greater mortality and morbidity in late preterm infants compared with term infants, in addition to long-term disorders. More recent studies evaluated strategies to improve the outcomes of these neonates. Further studies on these strategies are needed. Resumo: Objetivo: revisar a literatura sobre prematuridade tardia (nascimentos de 34 semanas a 36 semanas e seis dias em seus vários aspectos. Fonte dos dados: buscas nas bases MEDLINE, LILACS e Biblioteca Cochrane, sem limite de tempo, e nas referências bibliográficas dos artigos encontrados. Síntese dos dados: muitos estudos mostram aumento na taxa de prematuridade tardia nos últimos anos. Em todas as séries, os prematuros tardios correspondem à maioria dos nascimentos prematuros. Estudos envolvendo análises de milhões de

  2. Long-term sequelae after chemotherapy and radiotherapy for childhood acute lymphoblastic leukemia

    International Nuclear Information System (INIS)

    Reiter, G.E.P.

    1994-12-01

    Background: Effective forms of treatment for acute lymphoblastic leukemia (ALL) in childhood now result in survival rates of more than 70%. With improving cure rates increasing interest has been focused on adverse late effects caused by chemotherapy and cranial irradiation. Methods: We investigated 40 survivors, 22 males and 18 females with an average age of 15.8 years (6.6 to 28.1), all treated at the Children's Hospital of Innsbruck, Austria, after a follow-up of 9.2 years (4.6 - 20) on average in continuous complete remission. Our evaluation included cardiac status, growth, endocrinological function and a wide variety of other clinical and laboratory investigations. To identify cardiac dysfunction due to anthracyclines we performed Dobutamine-Stress-Echocardiography (DSE) using a graded dosage regimen (1.0, 2.5 and 5.0 μg/kg/min). We compared the DSE data with those obtained from 17 age-matched control subjects. Results: Conventional echocardiography revealed only 4 patients (11.4%) with abnormalities of left ventricular contractility (measured as left ventricular shortening fraction). In contrast DSE detected a 3-fold higher percentage of patients with cardiac dysfunction. There was no correlation between total cumulative anthracycline dose, age at time of diagnosis and length of follow-up with incidence of abnormalities. Primary hypothyroidism in 4 patients (10%) and a permanent linear growth retardation in 5 patients (12%, all of which had been irradiated) were the only endocrinological problems detected. No survivor showed hemato-immunological disturbances. Remarkably, transfusion- associated sequelae, liver or kidney dysfunction were not found. Conclusion: The high incidence of late cardiac effects requires continued monitoring of patients after ALL treatment. In this respect, DSE revealed to be a sensitive method. (author)

  3. The relationship between higher social trust and lower late HIV diagnosis and mortality differs by race/ethnicity: results from a state-level analysis.

    Science.gov (United States)

    Ransome, Yusuf; Batson, Ashley; Galea, Sandro; Kawachi, Ichiro; Nash, Denis; Mayer, Kenneth H

    2017-04-06

    Black men who have sex with men (MSM) continue to suffer a disproportionate burden of new HIV diagnoses and mortality. To better understand some of the reasons for these profound disparities, we examined whether the association between social trust and late HIV diagnosis and mortality differed by race/ethnicity, and investigated potential indirect effects of any observed differences. We performed generalized structural equation modelling to assess main and interaction associations between trust among one's neighbours in 2009 (i.e. social trust) and race/ethnicity (Black, White, and Hispanic) predicting late HIV diagnosis (a CD4 count ≤200 cell/µL within three months of a new HIV diagnosis) rates and all-cause mortality rates of persons ever diagnosed late with HIV, across 47 American states for the years 2009-2013. We examined potential indirect effects of state-level HIV testing between social trust and late HIV diagnosis. Social trust data were from the Gallup Healthways Survey, HIV data from the Centers for Disease Control and Prevention, and HIV testing from the Behavioral Risk Factor Surveillance System. Covariates included state-level structural, healthcare, and socio-demographic factors including income inequality, healthcare access, and population density. We stratified analysis by transmission group (male-to-male, heterosexual, and injection drug use (IDU)). States with higher levels of social trust had lower late HIV diagnosis rates: Adjusted Rate Ratio [aRR] were consistent across risk groups (0.57; 95%CI 0.53-0.62, male-to-male), (aRR 0.58; 95%CI 0.54-0.62, heterosexual) and (aRR 0.64; 95%CI 0.60-0.69, IDU). Those associations differed by race/ethnicity (all p < 0.001). The associations were most protective for Blacks followed by Hispanics, and least protective for Whites. HIV testing mediated between 18 and 32% of the association between social trust and late HIV diagnosis across transmission group but for Blacks relative to Whites only. Social

  4. Mangrove associated lignite beds of Malvan, Konkan: Evidence for higher sea-level during the Late Tertiary (Neogene) along the west coast of India

    Energy Technology Data Exchange (ETDEWEB)

    Kumaran, K.P.N.; Shindikar, M.; Limaye, R.B. [Agharkar Research Inst., Pune (India)

    2004-01-25

    Fossil pneumatophores (breathing roots) of Avicennia are recovered and reported from the lignite beds exposed in Kolamb well-section near Malvan, Konkan area of western Maharashtra. The accrued palynoflora is dominated by mangroves (Avicennia, Aegialitis, Excoecaria, Rhizophora and Sonneratia). The spores of mangrove fern (Acrostichum aureum) an estuarine fungus Cirrenalia indicate that these lignites are autochthonous and deposited in a near-shore environment. Presence of foraminiferal linings (= microforaminifera), dinoflagellate cysts, a few calcareous nannofossils and scolecodonts is an irrefutable proof of marine and brackish water influence during the deposition of lignites under intertidal/tidal swampy condition (mangrove influenced) with fair input from freshwater swamps and hinterland. Freshwater-related forms, viz. Ceratopteris thalictroides, Nymphaeaceae, Ctenolophonaceae and hinterland taxa (Cullenia/Durio) of Bombacaceae along with abundance of microthyriaceous fungi in the palynoflora imply a warm humid tropical climate with high precipitation during the depositional period. The presence of Ctenolophon englerianus (= Ctenolophonidites costatus) in Kolamb lignites suggests the Late Neogene (Late Miocene-Early Pliocene) age. The occurrence of pneumatophores and associated lignite deposits about 37 m above the present mean sea-level, and much inland, clearly indicates the higher sea-level strand during Late Neogene along the west coast of India.

  5. Changes in higher mental functions in persons with late sequels of exposure to small ionizing radiation doses

    International Nuclear Information System (INIS)

    Turuspekova, S.

    2002-01-01

    This is a report on the results of studies on the state of higher mental function in individuals with a previous history of exposure to small doses ionizing radiations. The disorders observed are assigned under several groups as follows: dyspraxia, gnostic, visual-spatial agnosia, mnestic, mental processes impairment, neurodynamic. Mnestic and acoustic-gnostical disturbances, and those of the mental processes are rather markedly expressed. Mnestic derangements play a major role in the general pattern of cognitive disorders, being characterized by both modal-specific, and modal-nonspecific features. The topical principle of the classification proposed enables to distinguish the syndrome of middle nonspecific brain structures involvement and the cortical syndromes among the higher mental function disorders, invariably encountered in combination and not isolated. The aforementioned points to the diffuse nature of the neuropsychological disorders, with involvement in the process of both nonspecific and specific structures, characterized by predomination of the frontal and temporal brain cortex sections. Impairment of the higher mental functions in young persons of active age with a past history of exposure to small doses ionizing radiations, necessitate to work out effective measures precluding occurrence and intensification of the cognitive defect. (author)

  6. Neurological sequelae in survivors of cerebral malaria | Oluwayemi ...

    African Journals Online (AJOL)

    Introduction: Cerebral malaria is a common cause of neurological sequelae and death in childhood. Information on persistent neurological sequelae post hospital discharge and their predisposing factors are scarce. Methods: This is a prospective study describing persisting neurological impairments post discharge among ...

  7. Urological sequelae following radiotherapy of gynecological tumors

    International Nuclear Information System (INIS)

    Burgkhardt, M.; Jacob, J.; Burgkhardt, C.

    1983-01-01

    After radiotherapy of malign tumors of the female genitals early and late radiation effects, resp. of the urogenital system may arise. Reversible as well as irreversible radiation injuries appear and very often develop fistulae of different kinds

  8. Neurologic sequelae associated with foscarnet therapy.

    Science.gov (United States)

    Lor, E; Liu, Y Q

    1994-09-01

    To report three cases of possible foscarnet-induced neurologic sequelae. We report two cases of seizures and one case of hand cramping and finger paresthesia after starting foscarnet therapy with no evidence of predisposing risk factors, such as serum laboratory abnormalities, renal dysfunction, or known central nervous system (CNS) involvement. All three patients had stable laboratory values during therapy and when the neurologic adverse effects occurred. All patients were receiving appropriate dosages of foscarnet. The incidence of seizures in AIDS patients was reviewed. A history of CNS lesions, infections, and/or AIDS per se may increase the risk of a neurologic adverse effect while receiving foscarnet therapy. Acute ionized hypocalcemia may cause these neurologic adverse effects. Ionized hypocalcemia is transitory, is related to the rate of foscarnet infusion, and may not be reflected as a change in total serum calcium concentration. Foscarnet probably contributed to the neurologic adverse effects reported here. Foscarnet may need to be administered at a slower rate than is recommended by the manufacturer. Electrolytes must be monitored closely; however, a neurologic adverse effect may not be foreseen.

  9. [Interventions for mental health sequelae of accidents].

    Science.gov (United States)

    Angenendt, J

    2014-06-01

    Emergency psychology and psychotraumatology deal with the psychological sequelae of traumatic experiences, i.e., the prevention and early intervention of posttraumatic mental health disorders. Accidents are the most prevalent traumatic events in the general population that may result in a range of severe trauma and adjustment disorders. Accidents happen suddenly, unexpectedly, and can gravely threaten health, personal integrity, and life. The prevalence of intermittent and chronic psychiatric disorders in the aftermath of severe accidents varies between 5 and 30 %. Victims suffer from unknown and frightening posttraumatic symptoms, often irreversible handicaps as a consequence of their injuries, impairments in everyday functioning, and negative impact on the quality of life. The direct and indirect burden for society is high. Comprehensive secondary prevention, starting with early detection and early intervention of post-accident disorders, is not well established in clinical care. In case of severe accidental injuries, emergency and medical treatment has absolute priority. But all too often, severe mental health problems remain undetected in later treatment phases and therefore cannot be addressed adequately. In primary care, knowledge of specific psychodiagnostic and treatment options is still insufficient. Prejudices, denial, and fear of stigmatization in traumatized victims as well as practical constraints (availability, waiting time) in the referral to special evidence-based interventions limit the access to adequate and effective support. This overview presents the objectives, concepts, and therapeutic tools of a stepped-care model for psychological symptoms after accidental trauma, with reference to clinical guidelines.

  10. Severe neurological sequelae and behaviour problems after cerebral malaria in Ugandan children

    Directory of Open Access Journals (Sweden)

    Tugumisirize Joshua

    2010-04-01

    Full Text Available Abstract Background Cerebral malaria is the most severe neurological complication of falciparum malaria and a leading cause of death and neuro-disability in sub-Saharan Africa. This study aimed to describe functional deficits and behaviour problems in children who survived cerebral malaria with severe neurological sequelae and identify patterns of brain injury. Findings Records of children attending a specialist child neurology clinic in Uganda with severe neurological sequelae following cerebral malaria between January 2007 and December 2008 were examined to describe deficits in gross motor function, speech, vision and hearing, behaviour problems or epilepsy. Deficits were classified according to the time of development and whether their distribution suggested a focal or generalized injury. Any resolution during the observation period was also documented. Thirty children with probable exposure to cerebral malaria attended the clinic. Referral information was inadequate to exclude other diagnoses in 7 children and these were excluded. In the remaining 23 patients, the commonest severe deficits were spastic motor weakness (14, loss of speech (14, hearing deficit (9, behaviour problems (11, epilepsy (12, blindness (12 and severe cognitive impairment (9. Behaviour problems included hyperactivity, impulsiveness and inattentiveness as in attention deficit hyperactivity disorder (ADHD and conduct disorders with aggressive, self injurious or destructive behaviour. Two patterns were observed; a immediate onset deficits present on discharge and b late onset deficits. Some deficits e.g. blindness, resolved within 6 months while others e.g. speech, showed little improvement over the 6-months follow-up. Conclusions In addition to previously described neurological and cognitive sequelae, severe behaviour problems may follow cerebral malaria in children. The observed differences in patterns of sequelae may be due to different pathogenic mechanisms, brain

  11. Late effects of ionizing radiations on head and neck region tissues

    International Nuclear Information System (INIS)

    Mazeron, J.J.; Griamrd, L.

    1997-01-01

    Numerous structures are includes in the irradiated volume of patients presenting with head and neck cancer: skin, mucosa, bone, teeth, cartilage, muscles, salivary glands, etc. Curative intent treatment of such tumours requires aggressive approach which can lead to severe sequelae. These sequelae are in most cases dose-dependent and volume-dependent. However, an appropriate technique might decrease the severity of such sequelae. Details of these late changes are presented, including their pathophysiology, clinical syndromes, potential treatment, and prevention. (authors)

  12. Thyroiditis: Symptoms to sequelae - An Indian experience

    International Nuclear Information System (INIS)

    Sneha, S.; Krishna, B.A.; Madhavi, C.; Sangeeta, T.; Rijju, G.

    2002-01-01

    Introduction: Thyroiditis presents with symptoms varying from thyrotoxicosis to hypothyroidism. In fairly a large number of patients the symptoms are very subtle and hence clinical diagnosis is difficult to make without laboratory assistance. In view of this we undertook a study to assess the patterns of clinical presentation and the behavioral pattern of patients with thyroiditis. Materials and Methods: Totally 43 patients were included in the study with clinical suspicion of thyroiditis. 31 patients presented with symptoms of thyrotoxicosis while 6 patients presented with hypothyroid symptoms. Six patients presented with history of acute upper respiratory tract infection with tender thyromegaly and euthyroid status. These patients were subjected to thyroid scan (43 patients), sonography (6 patients), thyroid antibody levels estimation (43 patients), FNAC evaluation (3 patients) and T3, T4, TSH estimation (43 patients). The patients were followed up for a period of 6 months to 2 years. Clinical evaluation and T3, T4 and TSH evaluation was performed. Result: 19 of the 31 patients (61.29%) who presented with thyrotoxicosis progressed to hypothyroid state both clinically and biochemically. 11 of the 31 patients (35.48%) reverted to euthyroid status. One patient continued to maintain thyrotoxic state at the end of 2 years and was treated with antithyroid measures. In the hypothyroid group of six patients, four patients continued to maintain hypothyroid state while two patients reverted to euthyroid status during follow up. In the euthyroid group of six patients four patients developed hypothyroid status and the other two patients remained euthyroid. The 99m- Tco4 scan demonstrated poor and patchy uptake in all the patients. Conclusion: Our study demonstrated that majority of the patients (72.09%) of thyroiditis present with thyrotoxic symptoms. The sequelae of hypothyroidism was seen in 61.29% of patients in this group. We observed an interesting finding of patients

  13. Sequelae of Endoscopic Inguinal Hernia Repair : Incidence, evaluation and management

    NARCIS (Netherlands)

    Burgmans, J.P.J.

    2015-01-01

    The endoscopic preperitoneal technique (TEP) is an appealing inguinal hernia repair technique, theoretically superior to other approaches. In practice some problems remain unsolved. Real incidences of chronic postoperative inguinal pain (CPIP) and other important sequelae of endoscopic hernia repair

  14. Early neurologic complications and long-term sequelae of childhood bacterial meningitis in a limited-resource country (Kosovo).

    Science.gov (United States)

    Namani, Sadie A; Koci, Bulëza M; Milenković, Zvonko; Koci, Remzie; Qehaja-Buçaj, Emine; Ajazaj, Lindita; Mehmeti, Murat; Ismaili-Jaha, Vlora

    2013-02-01

    Since neurologic complications of childhood bacterial meningitis are encountered frequently despite antibiotic treatments, the purpose of this study was to analyze early neurologic complications and long-term sequelae of bacterial meningitis in children in a limited-resource country (Kosovo) This study uses a retrospective chart review of children treated for bacterial meningitis in two study periods: 277 treated during years 1997-2002 and 77 children treated during years 2009-2010. Of the 277 vs 77 children treated for bacterial meningitis, 60 (22%) vs 33 (43%) patients developed early neurologic complications, while there were 15 (5.4%) vs 2 (2.6%) deaths. The most frequent early neurologic complications were the following: subdural effusions (13 vs 29%), recurrent seizures (11 vs 8%), and hydrocephalus (3 vs 3%). The relative risk (95% confidence interval) for neurologic complications was the highest in infants (3.56 (2.17-5.92) vs 2.69 (1.62-4.59)) and in cases caused by Haemophilus influenzae 1.94 (1.09-3.18) vs Streptococcus pneumoniae 2.57(1.26-4.47). Long-term sequelae were observed in 10 vs 12% of children, predominantly in infants. The most frequent long-term sequelae were late seizures 9 vs 1%, neuropsychological impairment 1 vs 5%, and deafness 1 vs 3%. In both study periods, the most frequent early neurologic complications of childhood bacterial meningitis were subdural effusions. Long-term sequelae were observed in 10% of children, with late seizures, neuropsychological impairment, and deafness being the most common one. Age prior to 12 months was risk factor for both early neurologic complications and long-term sequelae of bacterial meningitis in children.

  15. Lack of pupil reflex and loss of consciousness predict 30-day neurological sequelae in patients with carbon monoxide poisoning.

    Directory of Open Access Journals (Sweden)

    Jian-Fang Zou

    Full Text Available Predicting the neurological sequelae of carbon monoxide poisoning (COP has not been well studied. We investigated the independent predictors of neurological sequelae in patients with COP and combined these predictors to predict the prognosis.This study was conducted at four hospitals in Shandong Province, China. Data were retrospectively collected from 258 patients with COP between November 1990 and October 2011. Thirty-day neurological sequelae were the primary endpoints.A lack of pupil reflex and a loss of consciousness appear to be independent predictors for neurological sequelae in patients with COP. The presence of either one had a sensitivity of 77.0% (95% confidence interval [CI]: 69.3-83.2, a specificity of 47.1% (95% CI: 38.3-56.0, positive predictive value (PPV of 62.9% (95% CI: 55.2-70.1, and a negative predictive value (NPV of 63.6% (95% CI: 52.6-73.4. With both predictors present, the sensitivity was 11.5% (95% CI: 6.9 to 18.3, the specificity was 99.2 (95% CI: 94.7-100.0, the PPV was 94.1% (95% CI: 69.2-99.7, and the NPV was 49.0% (95% CI: 42.5-55.5.The risk for neurological sequelae apparently increased with the number of independent predictors. In patients with both predictors, the risk for neurological sequelae was 94.1%. Almost all (99.2% patients with neither predictor had no neurological sequelae. This finding may help physicians make decisions about and dispositions for patients with COP. For patients with a higher risk, earlier treatment and more appropriate utilization of health care services, including hyperbaric oxygen, should be considered.

  16. Early symptomatic and late seizures in Kosovar children with bacterial meningitis.

    Science.gov (United States)

    Namani, Sadie A; Kuchar, Ernest; Koci, Remzie; Mehmeti, Murat; Dedushi, Kreshnike

    2011-11-01

    Despite the dramatic decrease of mortality rate among children with bacterial meningitis in recent decades, some patients are left with neurologic sequelae. The purpose of this study was to analyze the occurrence of seizures as predictors for meningitis-related deaths or neurological sequelae including late seizures. This study uses a retrospective chart review of 277 children (aged 0-16 years, median 2 years, 162 boys) treated for bacterial meningitis in University Clinical Centre in Prishtina (Kosovo). Of the 277 children treated for bacterial meningitis, 60 children (22%) manifested seizures prior to admission, 57 children (21%) had seizures after admission, and late seizures were diagnosed in 24 children (9%). The risk for adverse outcome was significantly higher in patients who had seizures prior to admission (52/60) and in patients who manifested seizures later than 24 h (41/41; RR 8.17 and 6.78 respectively, p < 0.0001). All children who manifested late seizures were diagnosed with meningitis-related acute neurologic complications: subdural effusion (18), hydrocephalus (6), intracranial bleeding (1), and subdural empyema (2). Of the 60 children who presented seizures prior to admission, only 11 manifested late seizures. Seizures prior to admission were predictors of high risk of adverse outcome in bacterial meningitis in children. The risk of secondary epilepsy (9%) occurred only in children with evident structural neurologic complications during the acute phase of bacterial meningitis.

  17. Evaluation of some oral postradiotherapy sequelae in patients treated for head and neck tumors; Avaliacao de algumas sequelas bucais pos-radioterapia em pacientes tratados de neoplasias de cabeca e pescoco

    Energy Technology Data Exchange (ETDEWEB)

    Rubira, Cassia Maria Fischer; Devides, Nadia Juliana; Ubeda, Liliane Torsani; Lauris, Jose Roberto; Rubira-Bullen, Izabel Regina Fischer; Damante, Jose Humberto [University of Sao Paulo, Bauru, SP (Brazil). School of Dentistry. Stomatology Dept.; Bortolucci Junior, Antonio Geraldo [Amaral Carvalho Hospital, Jau, SP (Brazil)]. E-mail: damante@fob.usp.br

    2007-07-01

    The aim of this study was to evaluate the oral sequelae of radiotherapy in patients treated between 1999 and 2003 for head and neck tumors. One-hundred patients (24 women, 76 men) ranging in age from 30 to 83 years (mean 59.2 years) were examined. Time since radiotherapy ranged from 1 to 72 months (mean 28 months). The total mean radiation dose received by the patients was 5,955 cGy. The evaluation protocol included anamnesis, intraoral and extraoral examination, measurement of stimulated salivary flow and salivary pH. Symptoms reported by the patients included dry mouth (68%), dysphagia (38%), and dysgeusia (30%). In 64% of the patients, the mean stimulated salivary flow rate was less than 0.7 ml/min. The mean salivary pH was 6.97 ({+-} 0.714). Stimulated salivary flow increased with increasing postradiotherapy time (p < 0.05). The prevalence of mucositis was associated with higher radiation doses (p < 0.05), and the prevalence of atrophic candidiasis was related to a longer post-treatment period (p < 0.05). Two cases of recurrence of the primary tumor were detected during the study. The main effect of radiotherapy in the head and neck region was a reduction of the salivary flow rate, even though our study demonstrated that there was a modest late improvement of the salivary flow. (author)

  18. Predictors of Grade 3 or Higher Late Bowel Toxicity in Patients Undergoing Pelvic Radiation for Cervical Cancer: Results From a Prospective Study

    Energy Technology Data Exchange (ETDEWEB)

    Chopra, Supriya, E-mail: schopra@actrec.gov.in [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra (India); Dora, Tapas [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra (India); Chinnachamy, Anand N. [Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Parel, Mumbai, Maharashtra (India); Thomas, Biji [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra (India); Kannan, Sadhna [Epidemiology and Clinical Trials Unit, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra (India); Engineer, Reena; Mahantshetty, Umesh [Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Parel, Mumbai, Maharashtra (India); Phurailatpam, Reena; Paul, Siji N. [Department of Radiation Oncology, Advanced Centre for Treatment Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai, Maharashtra (India); Shrivastava, Shyam Kishore [Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Parel, Mumbai, Maharashtra (India)

    2014-03-01

    Purpose: The present study investigates relationship between dose–volume parameters and severe bowel toxicity after postoperative radiation treatment (PORT) for cervical cancer. Methods and Materials: From June 2010 to December 2012, a total of 71 patients undergoing PORT were included. Small bowel (SB) and large bowel (LB) loops were contoured 2 cm above the target volume. The volume of SB and LB that received 15 Gy, 30 Gy, and 40 Gy was calculated (V15 SB, V15 LB, V30 SB, V30 LB, V40 SB, V 40 LB). On follow-up, bowel toxicity was scored using Common Terminology Criteria for Adverse Events (CTCAE), version 3.0. A reciever operating characteristic (ROC) curve identified volume thresholds that predicted for grade 3 or higher toxicity with highest specificity. All data was dichotomized across these identified cut-off values. Univariate and multivariate analysis was performed using SPSS, version 15. Results: The median patient age was 47 years (range, 35-65 years). Of the 71 patients, 46 received image-guided intensity modulated radiation therapy, and 25 received conformal radiation (50 Gy in 25 fractions for 5 weeks). Overall, 63 of 71 patients received concurrent chemotherapy. On a median follow-up of 18 months (range, 8-29 months), grade 2 or higher bowel toxicity was seen in 22 of 71 patients (30.9%) and grade 3 or higher bowel toxicity was seen in 9 patients (12.6%). On univariate analysis, V15 SB <275 cc (P=.01), V30 SB <190 cc (P=.02), V40 SB <150 cc (P=.01), and V15 LB <250 cc (P=.03), and V40 LB <90 cc (P=.04) predicted for absence of grade 3 or higher toxicity. No other patient- or treatment-related factors were statistically significant. On multivariate analysis, only V15 SB (P=.002) and V15 LB (P=.03) were statistically significant. Conclusions: V 15 Gy SB and LB are independent predictors of late grade 3 or higher toxicity. Restricting V15 SB and V15 LB to <275 cc and <250 cc can reduce grade 3 or higher toxicity to less than 5%.

  19. Computed tomography for sequelae of brain contusions

    International Nuclear Information System (INIS)

    Aminov, M.

    1995-01-01

    Follow-up clinical and computed tomographic (CT) studies were performed in 140 patients with focal brain contusions at the acute stage of brain injury (BI). A total of 133 victims were followed up and the time course of CT changes were examined in the intervening and late BI periods. Despite the favourable natural history of acute BI, mild, moderate, and severe posttraumatic changes were shown to appear as cicatricial-adhesive and atrophic processes, intracerebral cysts, porencephalies, which result in posttraumatic epilepsy, hydrocephalus and others. The magnitude of diffuse changes rather than focal changes in the area of the prior medullary lesion was found to play the leading role in the victims disability [ru

  20. An application of semiquantitative analysis of pulmonary scintigraphy to pulmonary tuberculosis sequelae

    International Nuclear Information System (INIS)

    Uchida, Kou; Miyasaka, Takashi; Nakayama, Hiroyuki; Suganuma, Yasuaki; Sim, Jae-Joon; Takahashi, Hideki; Takano, Masaaki; Kawata, Kanemitsu.

    1996-01-01

    We performed ventilation-perfusion scintigraphy in 13 patients with pulmonary tuberculosis sequelae and 21 with chronic obstructive pulmonary disease. We used 99m Tc-MAA for perfusion scintigram and 133 Xe gas for ventilation scintigram. We added the radioactivities during the rebreathing phase of the ventilation scintigram to make a computerized image of the lung volume. Regions of interest (ROIs) were derived from radioactivities on each image. ROIs included each whole lung on lung volume (L) image and areas where radioactivity was greater than 70% of the highest radioactivity on perfusion (P70) image. We counted the area of ROIs on L and P70, and used the ratio of perfusion to lung volume (P70/L) as a parameter of pulmonary perfusion. P70/L in patients with pulmonary tuberculosis sequelae was significantly higher than that in those with COPD. This suggested that the area of high pulmonary perfusion is larger in the patients with pulmonary tuberculosis sequelae as compared with those with COPD. (author)

  1. Late effects of thoracic irradiation in children

    Energy Technology Data Exchange (ETDEWEB)

    Boelling, T.; Koenemann, S.; Ernst, I.; Willich, N. [Dept. of Radiotherapy, Univ. Hospital of Muenster (Germany)

    2008-06-15

    Purpose: to summarize the literature regarding the late effects of radiotherapy to the thorax in childhood and adolescence with special emphasis on cardiac and pulmonary impairment. Material und methods: the literature was critically reviewed using the PubMed {sup registered} database with the key words 'late effects', 'late sequelae', 'child', 'childhood', 'adolescence', 'radiation', 'radiotherapy', 'thorax', 'lung', 'heart', and 'pulmonary'. Results: 17 publications dealing with radiation-induced pulmonary and cardiac late sequelae in children could be identified and were analyzed in detail. 29 further publications with additional information were also included in the analysis. Pulmonary function impairment after mediastinal irradiation arose in one third of all pediatric patients, even when treatment was performed with normofractionated lower doses (15-25 Gy). Whole lung irradiation was regularly followed by pulmonary function impairment with differing rates in several reports. However, clinically symptomatic function impairment like dyspnea was less frequent. Irradiation of up to 25 Gy (single doses {<=} 2 Gy) to the heart showed little or no cardiac toxicity in analyses of irradiated children (median follow-up 1.3-14.3 years). Doses of > 25 Gy (single doses {<=} 2-3.3 Gy) led to several cardiac dysfunctions. However, new data from adults with longer follow-up may indicate threshold doses as low as 1 Gy. Impairment of skeletal growth, breast hypoplasia, and secondary malignancy were further potential late sequelae. Conclusion: several retrospective reports described radiation-associated late sequelae in children. However, there is still a lack of sufficient data regarding the characterization of dose-volume effects. (orig.)

  2. Calf restoration with asymmetric fat injection in polio sequelae.

    Science.gov (United States)

    Yazar, Memet; Kurt Yazar, Sevgi; Kozanoğlu, Erol

    2016-09-01

    Many things cause leg asymmetry and sequelae seen after poliomyelitis infections are still a cause of leg deformities. In this study, lipofilling and liposuction combinations are performed on patients with poliomyelitis sequelae. Volume deficiency is not the only leg problem with polio sequelae, leg length is also a problem. For this reason, the length deficiency must be addressed in order to achieve the desired symmetry. The aim of this study is correcting limb asymmetry by a method addressing both limb length deficiency by heel raise and volume deficiency by injection of fat based on corrected limb length. From 2011 through 2013, 10 female patients who had unilateral leg atrophy as a result of paediatric polio infections were included in our study. All of the patients were treated with liposuction and lipofilling combinations. During planning, a ridge was placed under the affected leg in order to equalize the lengths of both legs. The fat injection sites on the affected leg were marked to mimic the unaffected leg. All the patients stated that they were satisfied with the results. Transient hypoesthesia was seen in only one patient, but this was spontaneously resolved six months later. The study results indicate that the asymmetric fat injection procedure can be a good technique to use with patients who have polio sequelae, both with short legs and volume deformities. 4. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  3. Chronic otitis media sequelae in skeletal material from medieval Denmark

    DEFF Research Database (Denmark)

    Qvist, M; Grøntved, A M

    2001-01-01

    OBJECTIVES: Chronic otitis media sequelae (COMS) have been identified in archaeological skeletal materials from various ages. COMS reflecting episodes of upper respiratory tract infection may be used as a paleopathological indicator of general health. Estimation of the frequency of COMS may...

  4. Perceived threat predicts the neural sequelae of combat stress

    NARCIS (Netherlands)

    van Wingen, G. A.; Geuze, E.; Vermetten, E.; Fernández, G.

    2011-01-01

    Exposure to severe stressors increases the risk for psychiatric disorders in vulnerable individuals, but can lead to positive outcomes for others. However, it remains unknown how severe stress affects neural functioning in humans and what factors mediate individual differences in the neural sequelae

  5. Perceived threat predicts the neural sequelae of combat stress.

    NARCIS (Netherlands)

    Wingen, G.A. van; Geuze, E.; Vermetten, E.; Fernandez, G.S.E.

    2011-01-01

    Exposure to severe stressors increases the risk for psychiatric disorders in vulnerable individuals, but can lead to positive outcomes for others. However, it remains unknown how severe stress affects neural functioning in humans and what factors mediate individual differences in the neural sequelae

  6. Long-term psychological sequelae of augmentation mammoplasty ...

    African Journals Online (AJOL)

    A request for elective surgery for augmentation mammoplasty (AM) is often associated with underlying psychopathology and high expectations of a positive psychological outcome. This study was designed to ascertain the long-term psychological sequelae of AM in a group of patients who were reassessed 3 years or more ...

  7. Sequelae of closed craniocerebral trauma and the efficacy of piracetam in its treatment in adolescents.

    Science.gov (United States)

    Zavadenko, N N; Guzilova, L S

    2009-05-01

    The efficacy of piracetam in treating the sequelae of moderate and severe closed craniocerebral trauma (CCT) in adolescents was evaluated in studies of 42 patients aged 12-18 years who had suffered CCT 1.5-5 years prior to the study. Adolescents of the experimental group (20 individuals) received piracetam (Nootropil) at doses of 40-50 mg/kg (daily daily 1600-2400 mg) for one month; patients of group 2 (22 individuals) served as controls. Piracetam was found to have positive therapeutic effects on impairments to higher mental (memory, attention, executive) and motor (coordination) functions and on measures of the speeds of cognitive and motor operations.

  8. A Case Report of Sequela of Operation of Talus Osteonecrosis

    Directory of Open Access Journals (Sweden)

    Choi Sung-Hun

    2006-02-01

    Full Text Available Objective : The clinic study or report about Oriental Medical treatment about osteonecrosis is very insufficient. Therefore, we report a case about a sequela of operation of talus osteonecrosis treated by Oriental Medical treatments. Methods : The patient was managed by bee venom and Carthami Flos Herbal-Acupuncture, Sa-am and body acupucture, oxibustion, physical theraphy and herbal medicine. We evaluated the patient through Visual Analogue Scale(VAS. Results : After 25 days of treatment, the patient showed that clinical symptoms was decreased and VAS changed from 10 to 2. Conclusion : In this case, Oriental Medical treatments for a sequela of operation of talus osteonecrosis was effective. But further studies are required to confirm the effect of these methods

  9. Otitis Media and Its Sequelae in Kenyan Schoolchildren.

    Science.gov (United States)

    Simões, Eric A F; Kiio, Francis; Carosone-Link, Phyllis J; Ndegwa, Serah N; Ayugi, John; Macharia, Isaac M

    2016-12-01

    The goal of this study was to obtain representative Kenyan data on the point prevalence of acute otitis media (AOM) and its sequelae (otitis media with effusion [OME] and chronic suppurative otitis media [CSOM]), a major cause of preventable hearing loss in children in developing countries. In Africa, there are limited studies on the prevalence of AOM and its sequelae in children. Study subjects were children aged 2 to 15 years and were enrolled from randomly selected preprimary and primary schools. After parental or guardian consent, subjects had a questionnaire administered, otoscopy and tympanometry were done, and audiometry was performed on those with ear problems detected on these examinations. A total of 9825 (75%) children was from rural schools. The prevalence of CSOM was 15 of 1000, OME was 15 of 1000, and AOM was 7 of 1000 children. Rural Rift Valley schoolchildren had the highest prevalence of CSOM (24 of 1000) compared with other regions (12 of 1000; P < .0001). Ear discharge occurred before 3.5 years in 50% of 901 children with ear discharge. A history of ear discharge was associated with abnormal tympanograms (odds ratio [OR], 11.9-19.2) and mild-to-severe hearing loss (OR, 21.6-38.6), even in children without ear disease (OR, 10.7-24.4). The burden of AOM sequelae in Kenyan preschool and schoolchildren is significant, and it occurs mostly in the first 4 years of life. By preventing early recurrent AOM, pneumococcal vaccination might partly avert nonreversible sequelae. © The Author 2015. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  10. Congenital cytomegalovirus infection: treatment, sequelae and follow-up.

    Science.gov (United States)

    Lombardi, Giuseppina; Garofoli, Francesca; Stronati, Mauro

    2010-10-01

    Cytomegalovirus (CMV) is the most common cause of congenital infection affecting about 1% of all the live births worldwide. Its prevalence in the developed world seems to be slightly lower, ranging between 0.6 and 0.7%. Symptoms can be detected at birth in 10-15% of the congenitally infected of which 50-90% will develop sequelae, the most frequent being sensorineural hearing loss (SNHL), visual defect, psychomotor impairment, mental retardation, cerebral palsy and seizures. Eighty-five to 90% of the infected newborns are asymptomatic but 10-15% of them are equally at risk for sensorineural sequelae, like 20-30% of all the infected children. Therefore it is important a time prolonged and closer follow-up of infected children that we propose should be until 6 years of age. This should lead to an early intervention, better management and eventually even control the long-term sequelae. Infants born with symptomatic congenital infection have a worse prognosis than those with no evidence of clinical disease, and ganciclovir (GCV) intravenous 6 mg/kg every 12 h for 6 weeks is the most used therapy for symptomatic newborns. Valganciclovir (V-GCV) syrup is a pro-drug of GCV and presents high oral bioavailability. To date, it is possible to administer this drug at home, and the tolerability profile may allow for wider indications and longer treatments.

  11. Treatment of late sequelae after radiotherapy for head and neck cancer

    NARCIS (Netherlands)

    Strojan, Primož; Hutcheson, Katherine A; Eisbruch, Avraham; Beitler, Jonathan J; Langendijk, Johannes A; Lee, Anne W M; Corry, June; Mendenhall, William M; Smee, Robert; Rinaldo, Alessandra; Ferlito, Alfio

    Radiotherapy (RT) is used to treat approximately 80% of patients with cancer of the head and neck. Despite enormous advances in RT planning and delivery, a significant number of patients will experience radiation-associated toxicities, especially those treated with concurrent systemic agents. Many

  12. LATE NEUROLOGICAL, COGNITIVE AND BEHAVIORAL SEQUELAE OF PRENATAL EXPOSURE TO COUMARINS - A PILOT-STUDY

    NARCIS (Netherlands)

    OLTHOF, E; DEVRIES, TW; TOUWEN, BCL; SMRKOVSKY, M; GEVENBOERE, LM; HEIJMANS, HSA; VANDERVEER, E

    Neurological, cognitive and behavioural development were assessed in a group of 21, 8- to 10-year old children whose mothers took coumarins during pregnancy. Findings were compared with those in a group of 17 control children. The study was performed to test whether it is feasible to carry out a

  13. Calcified subdural haematomas associated with arrested hydrocephalus - late sequelae of shunt operation in infancy

    Energy Technology Data Exchange (ETDEWEB)

    Barmeir, E.P.; Stern, D.; Harel, S.; Holtzman M.; Krije, T.J.

    1985-08-01

    Calcified chronic subdural haematoms (SDH) and features of arrested (compensated) hydrocephalus were demonstrated by skull radiography and cranial computed tomography (CT) in two children who had no neurological deficit. Ventricular surgical drainage had been performed 8 and 11 years prior to admission and the haematomas remained subsequently undetected. The following presentation will serve to illustrate the characteristic radiological features of this entity, the issue of management, and includes a review of the literature.

  14. Geometrical Sparing Factors for the Rectum and Bladder in the Prediction of Grade 2 and Higher Complications After High-Dose-Rate Brachytherapy for Cervical Cancer

    International Nuclear Information System (INIS)

    Chen, S.-W.; Liang, J.-A.; Hung, Y.-C.; Yeh, L.-S.; Chang, W.-C.; Yang, S.-N.; Lin, F.-J.

    2009-01-01

    Purpose: This study aimed to assess the predictive values of geometrical sparing factors for the rectum and bladder in high-dose-rate intracavitary brachytherapy (HDRICB) for Grade 2 and higher late sequelae in patients with cervical cancer. Methods: A total of 392 patients were enrolled in this study. They were treated with external beam radiotherapy to the pelvis, after which HDRICB was performed using Ir-192 remote after-loading at 1-week intervals for three or four sessions. The geometrical sparing factor (GSF) was defined as the average of the ratios between the reference doses and the Point A dose. Results: A total of 46 patients (11.7%) had Grade 2 or higher late rectal complications (36 Grade 2, 9 Grade 3, and 1 Grade 4). In all, 32 patients (8.2%) had Grade 2 or higher late bladder complications (14 Grade 2, 16 Grade 3, and 2 Grade 4). Multivariate analysis demonstrated a high risk of rectal sequelae in patients who developed bladder complications (p = 0.0004, hazard ratio 3.54) and had a rectal GSF greater than 0.7 (p = 0.01, hazard ratio 1.99). The high risk factors for bladder complications were development of rectal complications (p = 0.0004, hazard ratio 3.74), concurrent chemotherapy (p = 0.0001, relative risk 3.94), and a bladder GSF greater than 0.9 (p = 0.01, hazard ratio, 2.53). Conclusion: This study demonstrates the predictive value of GSFs in HDRICB for cervical cancer. Patients with rectal GSFs greater than 0.7 or bladder GSFs greater than 0.9 are at risk for Grade 2 and higher late sequelae.

  15. Geometrical sparing factors for the rectum and bladder in the prediction of grade 2 and higher complications after high-dose-rate brachytherapy for cervical cancer.

    Science.gov (United States)

    Chen, Shang-Wen; Liang, Ji-An; Hung, Yao-Ching; Yeh, Lian-Shung; Chang, Wei-Chun; Yang, Shih-Neng; Lin, Fang-Jen

    2009-12-01

    This study aimed to assess the predictive values of geometrical sparing factors for the rectum and bladder in high-dose-rate intracavitary brachytherapy (HDRICB) for Grade 2 and higher late sequelae in patients with cervical cancer. A total of 392 patients were enrolled in this study. They were treated with external beam radiotherapy to the pelvis, after which HDRICB was performed using Ir-192 remote after-loading at 1-week intervals for three or four sessions. The geometrical sparing factor (GSF) was defined as the average of the ratios between the reference doses and the Point A dose. A total of 46 patients (11.7%) had Grade 2 or higher late rectal complications (36 Grade 2, 9 Grade 3, and 1 Grade 4). In all, 32 patients (8.2%) had Grade 2 or higher late bladder complications (14 Grade 2, 16 Grade 3, and 2 Grade 4). Multivariate analysis demonstrated a high risk of rectal sequelae in patients who developed bladder complications (p = 0.0004, hazard ratio 3.54) and had a rectal GSF greater than 0.7 (p = 0.01, hazard ratio 1.99). The high risk factors for bladder complications were development of rectal complications (p = 0.0004, hazard ratio 3.74), concurrent chemotherapy (p = 0.0001, relative risk 3.94), and a bladder GSF greater than 0.9 (p = 0.01, hazard ratio, 2.53). This study demonstrates the predictive value of GSFs in HDRICB for cervical cancer. Patients with rectal GSFs greater than 0.7 or bladder GSFs greater than 0.9 are at risk for Grade 2 and higher late sequelae.

  16. High Cytomegalovirus (CMV) DNAemia Predicts CMV Sequelae in Asymptomatic Congenitally Infected Newborns Born to Women With Primary Infection During Pregnancy.

    Science.gov (United States)

    Forner, Gabriella; Abate, Davide; Mengoli, Carlo; Palù, Giorgio; Gussetti, Nadia

    2015-07-01

    We investigated the kinetics of cytomegalovirus (CMV) clearance in blood and urine and the relationship between the viral load in blood at birth and the development of late-onset sequelae in asymptomatic congenital CMV infection. Thirty-three newborns with congenital asymptomatic CMV infection born to women with primary CMV infection during pregnancy were enrolled. CMV infection was monitored by polymerase chain reaction analysis of blood and urine. The follow-up examination was concluded at 6 years of age. Ten infants developed postnatal sequelae, whereas twenty-three infants remained asymptomatic. Fifty percent of babies cleared CMV in blood and urine within 3 and 36 months, respectively. Logistic multivariate regression revealed that the risk of neonatal clinical disease crossed the level of 50% with a DNAemia at birth of ≥ 12,000 copies/mL (P = .0002). The risk of hearing deficit crossed the level of 50% with a DNAemia at birth of ≥ 17,000 copies/mL (P = .0001). No significant difference was found between the kinetics of CMV clearance in asymptomatic children as compared to babies with late-onset disease. Asymptomatic newborns with a CMV DNAemia at birth of ≥ 12,000 copies/mL were more likely to experience CMV-related sequelae. The risk of hearing deficit increased with a viral load in blood of ≥ 17,000 copies/mL. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  17. Vitiligo iridis and glaucoma: a rare sequelae of small pox.

    Science.gov (United States)

    Kavitha, S; Patel, S R; Mohini, P; Venkatesh, R; Sengupta, S

    2015-10-01

    Vitiligo iridis refers to focal areas of iris atrophy as sequelae of small pox infection. We report a series of patients with unilateral vitiligo iridis, some of whom presented with secondary open-angle glaucoma. Three patients with vitiligo iridis underwent a comprehensive ophthalmic examination including intraocular pressure (IOP) measurement, slit lamp biomicroscopy, gonioscopy, and fundus evaluation. Patients' facial features were also documented and photographed. All patients were in their sixth decade. Two out the three had elevated IOP (52 mm Hg and 36 mm Hg) in the same eye as vitiligo iridis, at initial presentation. Gonioscopy showed patchy iris hyperpigmentation and fundus evaluation showed glaucomatous optic disc changes in the involved eye. One patient responded favourably to topical antiglaucoma medications, whereas the other was taken up for combined phacoemulsification-trabeculectomy with good results. The third patient had normal IOP in the involved eye. All three patients gave a history of small pox in childhood and had pitted facial scars typical of previous small pox infection. Vitiligo iridis may be associated with the secondary glaucoma as a long-term sequelae of small pox. It may be prudent to periodically follow-up such patients for development of raised IOP in the future.

  18. March critical care journal club: sequelae of critical care

    Directory of Open Access Journals (Sweden)

    Raschke RA

    2014-04-01

    Full Text Available No abstract available. Article truncated at 150 words. We focused on the topic of long-term sequelae of acute respiratory failure requiring mechanical ventilation. Our discussion panel included the fellows, many of our faculty including Drs. Robbins, Mathew, Singarajah, Thomas, Rinne, Garcia-Orr, and Nair, and invited guests from Palliative Care Medicine: Dr. Carleton, and Julie Lehn (from the VAMC and BGSMC respectively. The long term clinical outcomes of two groups of patients were examined. The first group was comprised of survivors of acute respiratory distress syndrome (ARDS requiring mechanical ventilation of any duration. Although the short-term mortality of ARDS has improved, previously unrecognized long-term sequelae have become a focus of research. Studies have now shown that significant depression, cognitive deficits similar in magnitude to those of mild Alzheimer’s, and post-traumatic stress disorder (PTSD each occur in approximately 25-30% of these patients (1-4. PTSD continues in about a quarter of patients even out to eight years after discharge (2. Functional ...

  19. International comparisons of preterm birth: higher rates of late preterm birth are associated with lower rates of stillbirth and neonatal death.

    Science.gov (United States)

    Lisonkova, S; Sabr, Y; Butler, B; Joseph, K S

    2012-12-01

    To examine international rates of preterm birth and potential associations with stillbirths and neonatal deaths at late preterm and term gestation. Ecological study. Canada, USA and 26 countries in Europe. All deliveries in 2004. Information on preterm birth (Statistics Canada, the EURO-PERISTAT project and the National Center for Health Statistics. Pearson correlation coefficients and random-intercept Poisson regression were used to examine the association between preterm birth rates and gestational age-specific stillbirth and neonatal death rates. Rate ratios with 95% confidence intervals were estimated after adjustment for maternal age, parity and multiple births. Stillbirths and neonatal deaths ≥ 32 and ≥ 37 weeks of gestation. International rates of preterm birth (births. Preterm birth rates at 32-36 weeks were inversely associated with stillbirths at ≥ 32 weeks (adjusted rate ratio 0.94, 95% CI 0.92-0.96) and ≥ 37 weeks (adjusted rate ratio 0.88, 95% CI 0.85-0.91) of gestation and inversely associated with neonatal deaths at ≥ 32 weeks (adjusted rate ratio 0.88, 95% CI 0.85-0.91) and ≥ 37 weeks (adjusted rate ratio 0.82, 95% CI 0.78-0.86) of gestation. Countries with high rates of preterm birth at 32-36 weeks of gestation have lower stillbirth and neonatal death rates at and beyond 32 weeks of gestation. Contemporary rates of preterm birth are indicators of both perinatal health and obstetric care services. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

  20. Radiotherapy for pituitary adenoma: long-term outcome and sequelae

    International Nuclear Information System (INIS)

    McCord, Mark W.; Buatti, John M.; Fennell, Eileen M.; Mendenhall, William M.; Marcus, Robert B.; Rhoton, Albert L.; Grant, Maria B.; Friedman, William A.

    1997-01-01

    Purpose: To review outcome and treatment sequelae in patients treated with external beam radiotherapy for pituitary adenomas. Methods and Materials: One hundred forty-one patients with pituitary adenomas received radiotherapy at the University of Florida and had 2-year minimum potential follow-up. One hundred twenty-one had newly diagnosed adenomas, and 20 had recurrent tumors. Newly diagnosed tumors were treated with surgery and radiotherapy (n = 98) or radiotherapy alone (n = 23). Patients with recurrent tumors received salvage treatment with surgery and radiotherapy (n = 10) or radiotherapy alone (n = 10). The impact of age, sex, presenting symptoms, tumor extent, surgery type, degree of resection, hormonal activity, primary or salvage therapy, and radiotherapy dose on tumor control was analyzed. Tumor control is defined by the absence of radiographic progression and stable or decreased hormone level (in hormonally active tumors) after treatment. Effect of therapy on vision, hormonal function, neurocognitive function, life satisfaction, and affective symptoms were examined. A Likert categorical scale survey was used for assessment of neurocognitive, life satisfaction, and affective symptom status. Survey results from the radiotherapy patients were compared with a control group treated with transsphenoidal surgery alone. Multivariate analysis used the forward step-wise sequence of chi squares for the log rank test. Results: At 10 years, tumor control for the surgery and radiotherapy group (S + RT) was 95% and not statistically different (p = 0.58) than for patients treated with radiotherapy alone (RT) (90%). Patients with prolactin- and ACTH-secreting tumors had significantly worse tumor control, as did patients treated for recurrent tumors. Multivariate analysis for tumor control revealed that only young age was predictive of worse outcome (p = 0.0354). Visual function was either unaffected or improved in most patients, although four patients developed visual

  1. Radiotherapy for pituitary adenoma: long-term outcome and sequelae

    International Nuclear Information System (INIS)

    McCord, Mark W.; Buatti, John M.; Fennel, Eileen M.; Mendenhall, William M.; Marcus, Robert B.; Friedman, William A.; Rhoton, Albert L.

    1996-01-01

    Purpose/Objective: To review outcome and treatment sequelae in patients treated with external-beam radiotherapy for pituitary adenomas. Materials and Methods: One hundred forty-one patients with pituitary adenomas received radiotherapy and had 2-year minimum follow-up. One hundred twenty-one patients had newly diagnosed adenomas and 20 patients had recurrent tumors. Newly diagnosed tumors were treated with surgery and radiotherapy (S + RT; n=98) or radiotherapy alone (RT; n=23). Patients with recurrent tumors received salvage treatment with S+RT (n=10) or RT (n=10). The impact of age, sex, presenting symptoms, tumor extent, surgery type, degree of resection, hormonal activity, primary or salvage therapy, and radiotherapy dose on local control and cause-specific survival was analyzed. Effect of therapy on vision, hormonal function, life satisfaction, neurocognitive function, and affective symptoms was examined. A Likert scale survey was used for assessment of life satisfaction, neurocognitive status, and affective symptoms after therapy. Survey results from the RT patients were compared to a control group treated with transsphenoidal surgery alone (S). Survival analysis employed the Kaplan-Meier method. Multivariate analysis used the forward step-wise sequence of chi-squares for the log-rank test. Results: At 10 years, local control for the S+RT group (S + RT) was 95% and not statistically different (p=.58) than for patients in the RT group (90%). Cause-specific survival rates were also similar (p=.88) between the S+RT (97%) and RT (99%) groups. Patients with prolactin- and ACTH-secreting tumors had significantly worse local control, as did patients treated for recurrent tumors. Cause-specific survival was not decreased in any patient group. Multivariate analysis for local control and cause-specific survival revealed only young age to be predictive of worse outcome (p=.0354 and p=.0355 respectively). Visual function was either unaffected or improved in most patients

  2. Urinary complications and sequelae of the cervix carcinoma treatment

    International Nuclear Information System (INIS)

    Cleophax, J.P.; Durand, J.C.; Pilleron, J.P.; Mathieu, F.; Fenton, J.; Mathieu, G.; Rousseau, J.

    1980-01-01

    The authors describe the sequelae and urinary complications of: - radiotherapy only in 524 patients, stage I to III treated between 1960 and 1974; - 721 operations performed between 1968 and 1974, according to the protocol of treatment as used in the Fondation Curie. This reveals: - for irradiated patients, no iatrogenic damage to the upper urinary tract, whilst bladder complications were often present. No major complication was found in this group; - for operated patients, the surgical act was without harmful consequence in the 672 cases when the operation was foreseen in the initial protocol (0.6% of chief complications). On the other hand, surgery performed for persistent tumour or recurrence after exclusive radiotherapy showed 8% of chief complications. In this group they analyse the factors that might influence ureterohydronephroses, especially the extent of node dissection and associated external irradiation [fr

  3. Management of the Sequelae of Severe Congenital Abdominal Wall Defects

    Directory of Open Access Journals (Sweden)

    Sara Fuentes

    2016-05-01

    Full Text Available BackgroundThe survival rate of newborns with severe congenital abdominal wall defects has increased. After successfully addressing life-threatening complications, it is necessary to focus on the cosmetic and functional outcomes of the abdominal wall.MethodsWe performed a chart review of five cases treated in our institution.ResultsFive patients, ranging from seven to 18 years of age, underwent the following surgical approaches: simple approximation of the rectus abdominis fascia, the rectus abdominis sheath turnover flap, the placement of submuscular tissue expanders, mesh repair, or a combination of these techniques depending on the characteristics of each individual case.ConclusionsPatients with severe congenital abdominal wall defects require individualized surgical treatment to address both the aesthetic and functional issues related to the sequelae of their defects.

  4. Complex sequelae of psychological trauma among Kosovar civilian war victims.

    Science.gov (United States)

    Morina, Nexhmedin; Ford, Julian D

    2008-09-01

    The impact of war trauma on civilians may include, but also extend beyond, post-traumatic stress disorder (PTSD) to include complex sequelae such as those described by the syndrome of Disorders of Extreme Stress Not Otherwise Specified (DESNOS). In the present study, 102 civilian war victims were interviewed in Kosovo, assessing traumatic life events, PTSD, DESNOS, and depression. Full DESNOS rarely occurred (2% prevalence), however, clinically significant DESNOS symptoms of somatization, altered relationships, and altered systems of meaning were reported by between 24-42% of respondents. Although DESNOS symptoms were correlated with PTSD symptoms, DESNOS symptoms were associated with poorer overall psychological functioning, self-evaluations, satisfaction with life, and social support independent of the effects of PTSD. The findings suggest that DESNOS warrants attention in addition to PTSD in the assessment and treatment of civilians who have been exposed to war and genocide.

  5. Cranial radiation in childhood acute lymphocytic leukemia. Neuropsychologic sequelae

    International Nuclear Information System (INIS)

    Whitt, J.K.; Wells, R.J.; Lauria, M.M.; Wilhelm, C.L.; McMillan, C.W.

    1984-01-01

    A battery of neuropsychologic tests was administered ''blindly'' to 18 children with acute lymphocytic leukemia (ALL) who had been randomly assigned to treatment regimens with or without cranial radiation. These children were all in complete continuous remission for more than 3 1/2 years and were no longer receiving therapy. The results indicated no substantial differences between groups as a function of radiation therapy. However, decreased neuropsychologic performance was found when the entire sample was compared with population norms. These data do not support the hypothesis that cranial radiation therapy is responsible for the neuropsychologic sequelae seen in these survivors of ALL. Post hoc multiple regression analysis indicated that parental education levels accounted for more of the neuropsychologic variability seen in these children than other factors such as age at diagnosis, type of therapy, or sex of child

  6. Restless legs syndrome in patients with sequelae of poliomyelitis.

    Science.gov (United States)

    Kumru, Hatice; Portell, Enric; Barrio, Manuela; Santamaria, Joan

    2014-10-01

    No studies have examined the association between RLS and the sequelae of poliomyelitis (PM). We studied the frequency and severity of RLS in a group of consecutive patients with the sequelae of poliomyelitis (PM) and the effect of treatment with dopaminergic drugs. A diagnosis of RLS was made according to the criteria of the International RLS Study Group, and severity was assessed by the RLS rating scale. Information on sex, age, age at onset, site affected by PM, disease duration of PM, and history of post-polio syndrome (pPS) was obtained in a cohort of 52 PM patients. The mean age was 55.9 ± 6.5 years; 39 patients had post-polio syndrome (75%). RLS was diagnosed in 21 (40.4%) patients. Sixteen of the 21 patients (76.2%) with RLS had pPS, which was similar to the non-RLS group (74.2% patients with pPS). RLS symptoms were very severe in 5 patients, severe in 13, moderate in 2 and mild in 1. Nineteen of the 21 patients with RLS had symptoms predominantly in the more affected lower limb (90% of patients). Sixteen patients received dopaminergic agonist treatment with a significant reduction in their scores on the RLS severity scale from 28.3 ± 4.7 to 6.9 ± 7.3 (p < 0.001). RLS occurs frequently in patients with PM, both in those with and without pPS, and responds well to treatment with dopaminergic drugs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. [Perspectives of cell therapy in sequelae from cerebrovascular accidents].

    Science.gov (United States)

    Otero, Laura; Zurita, Mercedes; Bonilla, Celia; Aguayo, Concepción; Rico, Miguel Angel; Vaquero, Jesús

    2012-09-01

    Spontaneous intracerebral hemorrhage (ICH) is associated with mortality between 40 and 50% of cases. Among the survivors, only 10% are independent after one month, there is no effective treatment of sequelae, except for the limited possibilities providing for rehabilitation. We review the current experience with intracerebral transplantation of mesenchymal stem cells (MSCs) obtained from bone marrow as a potential treatment of neurological sequelae occurring after experimental ICH. We describe the model of ICH by intracerebral administration of collagenaseIV at basal ganglia level in Wistar rats. Neurological deficits caused by ICH can be quantified through a variety of functional assessment test (NMSS, Rota-rod, VTB-test). 5×10allogeneic MSCs in 10μl of saline were administered intracerebrally in 10 animals, 2 months after ICH. In another 10 animals (controls) the same volume of saline was administered. Changes in the functional deficits were assessed during the next 6 months in both experimental groups. The results suggested therapeutic efficacy of MSCs transplantation and showed that transplanted stem cells can survive in the injured brain, transforming into neurons and glial cells. This form of cell therapy induces reactivation of endogenous neurogenesis at the subventricular zone (SVZ) and achieves antiapoptotic protective effect in the injured brain. Cell therapy represents an important field of research with potential clinical application to treatment of neurological sequels, currently considered irreversible. Neurosurgeons should become involved in the development of these new techniques that are likely to shape the future of this specialty. Copyright © 2011 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  8. Findings of universal cystoscopy at incontinence surgery and their sequelae

    Science.gov (United States)

    Zyczynski, Halina M.; Sirls, Larry T.; Greer, W. Jerod; Rahn, David D.; Casiano, Elizabeth; Norton, Peggy; Kim, Hae-Young; Brubaker, Linda

    2014-01-01

    OBJECTIVE The purpose of this study was to report the frequency of abnormal cystoscopy at incontinence surgery and to identify risk factors and sequelae of injury. STUDY DESIGN Findings of cystoscopy were collected prospectively in 3 multicenter surgical trials. Clinical, demographic, and procedure characteristics and surgeon experience were analyzed for association with iatrogenic injury and noninjury abnormalities. Impact of abnormalities on continence outcomes and adverse events during 12 months after the procedure were assessed. RESULTS Abnormal findings in the bladder or urethra were identified in 95 of 1830 women (5.2%). Most injuries (75.8%) were iatrogenic. Lower urinary tract (LUT) injury was most common at retropubic urethropexy and retropubic midurethral sling procedures (MUS; 6.4% each), followed by autologous pubovaginal sling procedures (1.7%) and transobturator MUS (0.4%). Increasing age (56.9 vs 51.9 years; P = .04), vaginal deliveries (3.2 vs 2.6; P = .04), and blood loss (393 vs 218 mL; P=.01) were associated with LUT injury during retropubic urethropexy; however, only age (62.9 vs 51.4 years; P = .02) and smoking history (P = .04) were associated for pubovaginal sling procedures. No factors correlated with increased risk of injury at retropubic and transobturator MUS. Notably, previous incontinence surgery, concomitant procedures, anesthesia type, and trainee participation did not increase LUT injury frequency. Although discharge with an indwelling catheter was more common after trocar perforation compared with the noninjury group (55.6% vs 18.5%; P urinary tract infections, or urge urinary incontinence. CONCLUSION Universal cystoscopy at incontinence surgery detects abnormalities in 1 in 20 women. Urinary trocar perforations that are addressed intraoperatively have no long-term adverse sequelae. PMID:24380742

  9. Pediatric malignancies and radiation therapy: What are the chronic treatment sequelae?

    International Nuclear Information System (INIS)

    Constine, Louis S.; Shelton, Dabney

    1997-01-01

    Most pediatric malignancies have proved to be vulnerable targets to cytotoxic therapy. The bleak outlook that historically accompanied these diseases has changed into an optimism for cure; 65% of affected children now survive. These gains are a direct consequence of the development of effective chemotherapeutic agents, radiotherapeutic and surgical techniques, and strategies to maximize their complementary actions in obtaining both local and systemic tumor control. In concert with the advances in tumor eradication has come an increased flexibility for devising approaches which reduce associated morbidities, including second malignancies. Children are particularly vulnerable for developing debilitating normal tissue effects, and are particularly complicated because in children a mosaic of different tissues are developing at different rates and in different temporal sequences. Understanding these biologic principles in the setting of progress in radiotherapeutic technique is critical to accomplishing the goal of appropriate and safe treatment delivery. Second malignancies result from the collision of cytotoxic therapy and the genetic constitution of the child. Since death is a frequent outcome, their importance is heightened. The objective of this course is to provide an understanding of organ-specific chronic effects of cancer therapy, and to offer a systematic guide to their evaluation and management. Since one of every 1000 young adults is now a childhood cancer survivor, the late sequelae of therapy, including second malignancies, become increasingly relevant for the radiation oncologist to appreciate, manage, and consider when formulating therapy

  10. Pediatric malignancies and radiation therapy: what are the chronic treatment sequelae?

    International Nuclear Information System (INIS)

    Shelton, Dabney; Constine, Louis S.

    1995-01-01

    Most pediatric malignancies have proved to be vulnerable targets to cytotoxic therapy. The bleak outlook that historically accompanied these diseases has changed into an optimism for cure; 65% of affected children now survive. These gains are a direct consequence of the development of effective chemotherapeutic agents, radiotherapeutic and surgical techniques, and strategies to maximize their complementary actions in obtaining both local and systemic tumor control. In concert with the advances in tumor eradication has come an increased flexibility for devising approaches which reduce associated morbidities, including second malignancies. Children are particularly vulnerable for developing debilitating normal tissue effects, and are particularly complicated because in children a mosaic of different tissues are developing at different rates and in different temporal sequences. Understanding these biologic principles in the setting of progress in radiotherapeutic technique is critical to accomplishing the goal of appropriate and safe treatment delivery. Second malignancies result from the collision of cytotoxic therapy and the genetic constitution of the child. Since death is a frequent outcome, their importance is heightened. The objective of this course is to provide an understanding of organ-specific chronic effects of cancer therapy, and to offer a systematic guide to their evaluation and management. Since one of every 1000 young adults is now a childhood cancer survivor, the late sequelae of therapy, including second malignancies, become increasingly relevant for the radiation oncologist to appreciate, manage, and consider when formulating therapy

  11. Human Albumin Improves Long-Term Behavioral Sequelae After Subarachnoid Hemorrhage Through Neurovascular Remodeling.

    Science.gov (United States)

    Xie, Yi; Liu, Wenhua; Zhang, Xiaohao; Wang, Liumin; Xu, Lili; Xiong, Yunyun; Yang, Lian; Sang, Hongfei; Ye, Ruidong; Liu, Xinfeng

    2015-10-01

    Subarachnoid hemorrhage results in significant long-lasting neurologic sequelae. Here, we investigated whether human albumin improves long-term outcomes in experimental subarachnoid hemorrhage and whether neurovascular remodeling is involved in the protection of albumin. Laboratory investigation. Hospital research laboratory. Male Sprague-Dawley rats. Rats underwent subarachnoid hemorrhage by endovascular perforation. Albumin of either 0.63 or 1.25 g/kg was injected IV immediately after the surgery. Modified Garcia test, beam-walking test, novel object recognition, and Morris water maze were employed to determine the behavioral deficits. The effects of albumin on early neurovascular dysfunction and chronic synaptic plasticity were also studied. Both doses of albumin significantly improved the sensorimotor scores (F = 31.277; p = 0.001) and cognitive performance (F = 7.982; p = 0.001 in novel object recognition test; and F = 3.431; p = 0.026 in the latency analysis of Morris water maze test) for at least 40 days after subarachnoid hemorrhage. There were remarkable microvasculature hypoperfusion, intracranial pressure rise, early vasoconstriction, neural apoptosis, and degeneration in subarachnoid hemorrhage rats, with albumin significantly attenuating such neurovascular dysfunction. Furthermore, albumin markedly prevented blood-brain barrier disruption, as indicated by less blood-brain barrier leakage, preserved blood-brain barrier-related proteins, and dampened gelatinase activities. The expressions of key synaptic elements were up-regulated with albumin supplementation in both acute and chronic phases. Accordingly, a higher dendritic spine density was observed in the prefrontal and hippocampal areas of albumin-treated subarachnoid hemorrhage animals. Albumin at low-to-moderate doses markedly improves long-term neurobehavioral sequelae after subarachnoid hemorrhage, which may involve an integrated process of neurovascular remodeling.

  12. Laypersons' expectation of the sequelae of whiplash injury. A cross-cultural comparative study between Canada and Lithuania.

    Science.gov (United States)

    Ferrari, Robert; Obelieniene, Diana; Russell, Anthony; Darlington, Paul; Gervais, Roger; Green, Paul

    2002-11-01

    The objective of the present study is to compare the frequency and nature of expected 'whiplash' symptoms in Lithuania (a country where the late whiplash syndrome is rare or unknown) with that in Canada. A symptom checklist was administered to 2 subject groups selected from local companies in Kaunas, Lithuania, and Edmonton, Canada, respectively. Subjects were asked to imagine having suffered a neck sprain (whiplash injury) with no loss of consciousness in a motor vehicle accident, and to check which, of a variety of symptoms, they would expect might arise from the injury. For symptoms they anticipated, they were asked to select the period of time they expected those symptoms to persist. In both the Lithuanian and Edmontonian groups, the pattern of symptoms anticipated closely resembled the acute symptoms commonly reported by accident victims with acute neck sprain, but while up to 50% of Edmontonians also anticipated symptoms to last months or years, very few Lithuanian subjects selected any symptoms as likely to persist. In Lithuania, despite the documented occurrence of neck sprain symptoms in some 50% of individuals following motor vehicle accidents, there is a very low rate of expectation of any sequelae from this injury. What current or previous aspects of society that underlie this remain uncertain. This lack of expectation of chronicity in Lithuania may, in part, determine the low prevalence of the late whiplash syndrome there. Further studies of symptom expectation as an etiologic factor in the late whiplash syndrome are needed.

  13. Skeletal sequelae of radiation therapy for malignant childhood tumors

    International Nuclear Information System (INIS)

    Butler, M.S.; Robertson, W.W. Jr.; Rate, W.; D'Angio, G.J.; Drummond, D.S.

    1990-01-01

    One hundred forty-three patients who received radiation therapy for childhood tumors, and survived to the age of skeletal maturity, were studied by retrospective review of oncology records and roentgenograms. Diagnoses for the patients were the following: Hodgkin's lymphoma (44), Wilms's tumor (30), acute lymphocytic leukemia (26), non-Hodgkin's lymphoma (18), Ewing's sarcoma (nine), rhabdomyosarcoma (six), neuroblastoma (six), and others (four). Age at the follow-up examination averaged 18 years (range, 14-28 years). Average length of follow-up study was 9.9 years (range, two to 18 years). Asymmetry of the chest and ribs was seen in 51 (36%) of these children. Fifty (35%) had scoliosis; 14 had kyphosis. In two children, the scoliosis was treated with a brace, while one developed significant kyphosing scoliosis after laminectomy and had spinal fusion. Twenty-three (16%) patients complained of significant pain at the radiation sites. Twelve of the patients developed leg-length inequality; eight of those were symptomatic. Three patients developed second primary tumors. Currently, the incidence of significant skeletal sequelae is lower and the manifestations are less severe than reported in the years from 1940 to 1970. The reduction in skeletal complications may be attributed to shielding of growth centers, symmetric field selection, decreased total radiation doses, and sequence changes in chemotherapy

  14. The emotional sequelae of whistleblowing: findings from a qualitative study.

    Science.gov (United States)

    Peters, Kath; Luck, Lauretta; Hutchinson, Marie; Wilkes, Lesley; Andrew, Sharon; Jackson, Debra

    2011-10-01

    To highlight and illuminate the emotional sequelae of whistleblowing from whistleblowers and subjects of whistleblowing complaints. Whistleblowing has the potential to have a negative impact on individuals' physical and emotional well-being. However, few empirical studies have been conducted using qualitative methods to provide an in-depth exploration of the emotional consequences for those involved in whistleblowing incidents. Qualitative narrative inquiry design. Purposive sampling was used to recruit participants who had been involved in whistleblowing incidents. During interviews participants' accounts were digitally recorded and then transcribed verbatim. Data were then analysed by two researchers until consensus was reached. Findings revealed that participants' emotional health was considerably compromised as a result of the whistleblowing incident. Analysis of the data revealed the following dominant themes: 'I felt sad and depressed': overwhelming and persistent distress; 'I was having panic attacks and hyperventilating': acute anxiety; and, 'I had all this playing on my mind': nightmares, flashbacks and intrusive thoughts. While it has been previously acknowledged that whistleblowing has the potential to have a negative impact on all aspects of an individual's life, this study notably highlights the intensity of emotional symptoms suffered by participants as well as the extended duration of time these symptoms were apparent. As professionals, nurses, as well as organisations, have a responsibility to identify those who may be suffering the emotional trauma of whistleblowing and ensure they have access to appropriate resources. © 2011 Blackwell Publishing Ltd.

  15. Prospective study of neuropsychological sequelae in children with brain tumors

    International Nuclear Information System (INIS)

    Bordeaux, J.D.; Dowell, R.E. Jr.; Copeland, D.R.; Fletcher, J.M.; Francis, D.J.; van Eys, J.

    1988-01-01

    Surgery and radiotherapy are the primary modalities of treatment for pediatric brain tumors. Despite the widespread use of these treatments, little is known of their acute effects (within one year posttreatment) on neuropsychological functions. An understanding of acute treatment effects may provide valuable feedback to neurosurgeons and a baseline against which delayed sequelae may be evaluated. This study compares pre- and posttherapy neuropsychological test performance of pediatric brain tumor patients categorized into two groups on the basis of treatment modalities: surgery (n = 7) and radiotherapy (n = 7). Treatment groups were composed of children aged 56 to 196 months at the time of evaluation with heterogeneous tumor diagnoses and locations. Comparisons of pretherapy findings with normative values using confidence intervals indicated that both groups performed within the average range on most measures. Outstanding deficits at baseline were observed on tests of fine-motor, psychomotor, and timed language skills, and are likely to be attributable to tumor-related effects. Comparisons of pre- versus posttherapy neuropsychological test findings indicated no significant interval changes for either group. Results suggest that surgery and radiotherapy are not associated with acute effects on neuropsychological functions

  16. Survival without sequelae after prolonged cardiopulmonary resuscitation after electric shock.

    Science.gov (United States)

    Motawea, Mohamad; Al-Kenany, Al-Sayed; Hosny, Mostafa; Aglan, Omar; Samy, Mohamad; Al-Abd, Mohamed

    2016-03-01

    "Electrical shock is the physiological reaction or injury caused by electric current passing through the human body. It occurs upon contact of a human body part with any source of electricity that causes a sufficient current through the skin, muscles, or hair causing undesirable effects ranging from simple burns to death." Ventricular fibrillation is believed to be the most common cause of death after electrical shock. "The ideal duration of cardiac resuscitation is unknown. Typically prolonged cardiopulmonary resuscitation is associated with poor neurologic outcomes and reduced long term survival. No consensus statement has been made and traditionally efforts are usually terminated after 15-30 minutes." The case under discussion seems worthy of the somewhat detailed description given. It is for a young man who survived after 65 minutes after electrical shock (ES) after prolonged high-quality cardiopulmonary resuscitation (CPR), multiple defibrillations, and artificial ventilation without any sequelae. Early start of adequate chest compressions and close adherence to advanced cardiac life support protocols played a vital role in successful CPR.

  17. Delirium in the Critically Ill Child: Assessment and Sequelae.

    Science.gov (United States)

    Paterson, Rebecca S; Kenardy, Justin A; De Young, Alexandra C; Dow, Belinda L; Long, Debbie A

    2017-01-01

    Delirium is a common and serious neuropsychiatric complication in critically ill patients of all ages. In the context of critical illness, delirium may emerge as a result of a cascade of underlying pathophysiologic mechanisms and signals organ failure of the brain. Awareness of the clinical importance of delirium in adults is growing as emerging research demonstrates that delirium represents a serious medical problem with significant sequelae. However, our understanding of delirium in children lags significantly behind the adult literature. In particular, our knowledge of how to assess delirium is complicated by challenges in recognizing symptoms of delirium in pediatric patients especially in critical and intensive care settings, and our understanding of its impact on acute and long-term functioning remains in its infancy. This paper focuses on (a) the challenges associated with assessing delirium in critically ill children, (b) the current literature on the outcomes of delirium including morbidity following discharge from PICU, and care-giver well-being, and (c) the importance of assessment in determining impact of delirium on outcome. Current evidence suggests that delirium is a diagnostic challenge for clinicians and may play a detrimental role in a child's recovery after discharge from the pediatric intensive care unit (PICU). Recommendations are proposed for how our knowledge and assessment of delirium in children could be improved.

  18. Late complications following cryotherapy of lattice degeneration.

    Science.gov (United States)

    Benson, W E; Morse, P H; Nantawan, P

    1977-10-01

    We observed 341 patients who had received cryotherapy for lattice degeneration in order to identify possible late complications. Sequelae such as retinal tears posterior to an operculum or flap tears within treated areas showed that treatment did not necessarily prevent subsequent vitreous traction. Moreover, the newly created flap tears may extend beyond the treated area and can cause retinal detachment. Even scleral buckling did not necesserily prevent further traction. Therefore, we concluded that when cryotherapy is used to treat lattice degeneration, an adequate margin of surrounding retina should be treated and the treatment should extend to the ora serrata.

  19. Late Budgets

    DEFF Research Database (Denmark)

    Andersen, Asger Lau; Lassen, David Dreyer; Nielsen, Lasse Holbøll Westh

    are negative rather than positive; and when there is divided government. We test the hypotheses of the model using a unique data set of late budgets for US state governments, based on dates of budget approval collected from news reports and a survey of state budget o¢ cers for the period 1988...

  20. Value of lifestyle intervention to prevent diabetes and sequelae.

    Science.gov (United States)

    Dall, Timothy M; Storm, Michael V; Semilla, April P; Wintfeld, Neil; O'Grady, Michael; Narayan, K M Venkat

    2015-03-01

    The Community Preventive Services Task Force recommends combined diet and physical activity promotion programs for people at increased risk of type 2 diabetes, as evidence continues to show that intensive lifestyle interventions are effective for overweight individuals with prediabetes. To illustrate the potential clinical and economic benefits of treating prediabetes with lifestyle intervention to prevent or delay onset of type 2 diabetes and sequelae. This 2014 analysis used a Markov model to simulate disease onset, medical expenditures, economic outcomes, mortality, and quality of life for a nationally representative sample with prediabetes from the 2003-2010 National Health and Nutrition Examination Survey. Modeled scenarios used 10-year follow-up results from the lifestyle arm of the Diabetes Prevention Program and Outcomes Study versus simulated natural history of disease. Over 10 years, estimated average cumulative gross economic benefits of treating patients who met diabetes screening criteria recommended by the ADA ($26,800) or USPSTF ($24,700) exceeded average benefits from treating the entire prediabetes population ($17,800). Estimated cumulative, gross medical savings for these three populations averaged $10,400, $11,200, and $6,300, respectively. Published estimates suggest that opportunistic screening for prediabetes is inexpensive, and lifestyle intervention similar to the Diabetes Prevention Program can be achieved for ≤$2,300 over 10 years. Lifestyle intervention among people with prediabetes produces long-term societal benefits that exceed anticipated intervention costs, especially among prediabetes patients that meet the ADA and USPSTF screening guidelines. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Involuntary movements and coma as the prognostic marker for acute encephalopathy with biphasic seizures and late reduced diffusion.

    Science.gov (United States)

    Lee, Sooyoung; Sanefuji, Masafumi; Torio, Michiko; Kaku, Noriyuki; Ichimiya, Yuko; Mizuguchi, Soichi; Baba, Haruhisa; Sakai, Yasunari; Ishizaki, Yoshito; Torisu, Hiroyuki; Kira, Ryutaro; Hara, Toshiro; Ohga, Shouichi

    2016-11-15

    Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) occurs in children associated with infection. It is characterized by a prolonged febrile seizure in the first phase, and a cluster of seizures, deterioration of consciousness and the white matter lesions with reduced diffusion in the second phase. The patients often have severe neurological sequelae, but the prognostic indicators remain unknown. The present study aimed to clarify the characteristics of AESD patients who subsequently exhibited severe neurological sequelae. We retrospectively analyzed the clinical and laboratory findings along with the brain imaging in patients who had severe (n=8) and non-severe neurodevelopmental outcomes (n=12). Severe group more frequently showed coma (p=0.014) or involuntary movements including dystonia and oral dyskinesia (p=0.018) before the second phase than non-severe group. Severe group exhibited higher levels of serum alanine aminotransferase than non-severe group (p=0.001). Quantitatively assessed MRI in the second phase revealed that severe group had more extensive lesions than non-severe group, in the anterior (p=0.015) and posterior parts (p=0.011) of the cerebrum and basal ganglia (p=0.020). Early appearing involuntary movements or coma might account for the extension of acute brain lesions and the poor neurological outcomes in AESD patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  2. Late Raphael

    OpenAIRE

    Henry, Tom F. K.; Joannides, Paul; González Mozo, Ana; Martín, Bruno

    2012-01-01

    Exhibition catalogue (co-authored with P. Joannides) in English, Spanish and French by the Museo del Prado and the Musée du Louvre, 2012. English edition, publisher: Museo Nacional del Prado (ISBN 978-84-8480-237-2). 382 pages, of which 300 were co-authored with P. Joannides. This publication was the catalogue of the major exhibtion of Raphael's late work which was at the Prado and the Louvre in 2012-13. The exhibition was seen by more than 650,000 visitors, and was widely reviewed in the int...

  3. Chlamydia sequelae cost estimates used in current economic evaluations: does one-size-fit-all?

    Science.gov (United States)

    Ong, Koh Jun; Soldan, Kate; Jit, Mark; Dunbar, J Kevin; Woodhall, Sarah C

    2017-02-01

    Current evidence suggests that chlamydia screening programmes can be cost-effective, conditional on assumptions within mathematical models. We explored differences in cost estimates used in published economic evaluations of chlamydia screening from seven countries (four papers each from UK and the Netherlands, two each from Sweden and Australia, and one each from Ireland, Canada and Denmark). From these studies, we extracted management cost estimates for seven major chlamydia sequelae. In order to compare the influence of different sequelae considered in each paper and their corresponding management costs on the total cost per case of untreated chlamydia, we applied reported unit sequelae management costs considered in each paper to a set of untreated infection to sequela progression probabilities. All costs were adjusted to 2013/2014 Great British Pound (GBP) values. Sequelae management costs ranged from £171 to £3635 (pelvic inflammatory disease); £953 to £3615 (ectopic pregnancy); £546 to £6752 (tubal factor infertility); £159 to £3341 (chronic pelvic pain); £22 to £1008 (epididymitis); £11 to £1459 (neonatal conjunctivitis) and £433 to £3992 (neonatal pneumonia). Total cost of sequelae per case of untreated chlamydia ranged from £37 to £412. There was substantial variation in cost per case of chlamydia sequelae used in published chlamydia screening economic evaluations, which likely arose from different assumptions about disease management pathways and the country perspectives taken. In light of this, when interpreting these studies, the reader should be satisfied that the cost estimates used sufficiently reflect the perspective taken and current disease management for their respective context. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Post-infectious bronchiolitis obliterans: clinical, radiological and pulmonary function sequelae

    International Nuclear Information System (INIS)

    Chang, A.B.; Masel, J.P.; Masters, B.

    1998-01-01

    Background. There are few data on clinical, chest radiograph (CXR) or pulmonary function sequelae in children with post-infectious bronchiolitis obliterans (BO) (pulmonary crepitations, abnormalities on CXR, CT, nuclear medicine scans, or bronchography, with a history of past pulmonary infection and in the absence of other underlying pathology). Objective. To analyse the methodology of diagnosis, long-term clinical imaging and pulmonary function sequelae of post-infectious BO in children. Materials and methods. Imaging (CXRs, CT and nuclear lung scans) and clinical histories of 19 children were analysed. Results. Clinical follow-up (mean 6.8 years), revealed a high incidence of continuing problems (asthma and bronchiectasis). Fixed airway obstruction was the most common pulmonary function sequela. The sequelae on follow-up (mean 5.8 years) CXR were classified into five patterns which are illustrated: unilateral hyperlucency of an enlarged lung/part of lung; complete collapse of the affected lobe; unilateral hyperlucency of a small or normal-sized lung; bilateral hyperlucent lungs and a mixed pattern of persistent collapse, hyperlucency and peribronchial thickening. Conclusion. Long-term observations in children with post-infectious BO should be undertaken to detect bronchiectasis and obstructive airway disease. Sequelae evident on CXR, other than those previously described, can be found. Bronchography and/or lung biopsy are not usually required for the diagnosis of post-infectious BO. (orig.)

  5. [Analysis of sequelae of the latissimus dorsi flap removal. Report of 44 cases reviewed and tested].

    Science.gov (United States)

    Legré, R; Boghossian, V; Servant, J M; Magalon, G; Bureau, H

    1990-01-01

    Since Tanzini, the latissimus dorsi muscle flap has been widely used in plastic surgery. Based on the experience of two plastic surgery units, we decided to try to define the sequelae of this operation. In order to simplify our analysis we only considered free flaps. Out study is based on 42 patients (26 pure muscular flaps and 16 musculo-cutaneous flaps). The sequelae were analysed in terms of aesthetic and functional criteria. The aesthetic sequelae appeared to be minima in the case of pure muscular flaps, but more severe in the case of musculo-cutaneous flaps. Functional sequelae in the shoulder were observed on muscle testing in 30% of cases, although there were no repercussions on sport or work activities. Analysis of spinal posture demonstrated a modification in the frontal plane in 40% of cases although this could not be clearly attributed to the donor site. On the basis of this study, we can conclude that the latissimus dorsi flap retains an important place in the therapeutic arsenal of plastic surgery due to its reliability and its minor cicatricial and functional sequelae at the donor site.

  6. Otitis Media and Children with Hearing Impairments: A Sequela.

    Science.gov (United States)

    Beattie, R. G. John L.

    1991-01-01

    This review of research on otitis media in children with existing hearing impairments concludes that the incidence of otitis media is probably higher than in the general population. The possible reasons for higher incidence, effects of otitis media on children with known losses, and the role of the classroom teacher are discussed. (Author/DB)

  7. [Self-concept level in children with burns sequelae: A comparative study].

    Science.gov (United States)

    Castillo C, Carmen; Santander M, Dolores; Solís F, Fresia

    2015-01-01

    Self-concept is the set of ideas and attitudes that a person has about him/herself. To evaluate whether there are differences in the level of self-concept in children 8-12 years old with and without burns sequelae. To identify predictive variables of self-concept in children with sequelae. A comparative cross-sectional study of self-concept in 109 children with burns sequelae, from 8 to 12 years old, with 109 children without burns sequelae, and of the same age and socioeconomic status. The Piers-Harris self-concept scale is used, which provides a general measurement of self-concept and behavioural, intellectual and school status, appearance, and physical attributes, anxiety, popularity, happiness and satisfaction dimensions. There were no significant differences in the level of general self-concept or their dimensions (P>.05). In the group with burns sequelae, the protective factor was the variable number of sequels was associated with the dimensions of anxiety, popularity, happiness-satisfaction and general self-concept. The location variable emerged as a risk factor for the behavioural dimension. The absence of differences in self-concept between children with burns sequelae and children without them is similar to that reported in the literature. The finding in the risk and protective factors encourages to further research, and perhaps incorporating pre-morbidity and family background. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Tool for objective quantification of pulmonary sequelae in monitoring of patients with tuberculosis; Ferramenta para quantificacao objetiva de sequelas pulmonares no acompanhamento de pacientes com tuberculose

    Energy Technology Data Exchange (ETDEWEB)

    Giacomini, Guilherme; Alvarez, Matheus; Pina, Diana R. de; Bacchim Neto, Fernando A.; Pereira, Paulo C.M.; Ribeiro, Sergio M.; Miranda, Jose Ricardo de A., E-mail: guigiacomini92@aluno.ibb.unesp.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucaru, SP (Brazil)

    2014-07-01

    Tuberculosis (TB), caused by Mycobacterium tuberculosis, is an ancient infectious disease that remains a global health problem. Chest radiography is the method commonly employed in assessing the evolution of TB. However, lung damage quantification methods are usually performed on a computerized tomography (CT). This objective quantification is important in the radiological monitoring of the patient by assessing the progression and treatment of TB. However, precise quantification is not feasible by the number of CT examinations necessary due to the high dose subjected to the patient and high cost to the institution. The purpose of this work is to develop a tool to quantify pulmonary sequelae caused by TB through chest X-rays. Aiming the proposed objective, a computational algorithm was developed, creating a three-dimensional representation of the lungs, with regions of dilated sequelae inside. It also made the quantification of pulmonary sequelae of these patients through CT scans performed in upcoming dates, minimizing the differences in disease progression. The measurements from the two methods were compared with results suggest that the effectiveness and applicability of the developed tool, allowing lower doses radiological monitoring of the patient during treatment.

  9. Bony fusion of the maxilla and mandible as a sequelae of noma: A rare case report

    Energy Technology Data Exchange (ETDEWEB)

    Bagewadi, Shivanand B.; Awasthi, Ujjwala Rastogi; Mody, Bharat M.; Suma, Gundareddy N.; Garg, Shruti [Dept. of Medicine and Radiology, ITS Center for Dental Studies and Research, Ghaziabad, Uttar Pradesh (Korea, Republic of)

    2015-09-15

    Noma is a gangrenous disease of the orofacial region that leads to severe facial tissue destruction and is a significant cause of death among children. With the advent of modern antibiotics and improved nutrition, children with noma may survive into adulthood, but must face the challenge of undergoing repair of the sequelae of noma. This report describes a case of bony fusion of the maxilla and mandible in a 28-year-old female patient, which was a sequelae of a childhood case of noma.

  10. Magnetic resonance imaging of sequelae of central pontine myelinolysis in chronic alcohol abusers

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, Akira; Kudo, Sho [Department of Radiology, Saga Medical School, 5-1-1 Nabeshima, 849-8501, Saga (Japan); Yuzuriha, Takefumi; Murakami, Masaru; Endoh, Koichi; Hiejima, Shigeto; Koga, Hiroshi [Center for Emotional and Behavional Disorders, Hizen National Hospital, 160 Mitsu, Higashisefuri, Kanzaki, 842-0192, Saga (Japan)

    2003-12-01

    Central pontine myelinolysis (CPM) is one of the serious neurological complications of alcoholism. This study evaluated magnetic resonance images of sequelae of CPM. Approximately 600 alcoholic patients were examined by a 1.0-T magnetic resonance imaging device, and 11 patients were retrospectively found to have a central pontine lesion, a presumed sequela of CPM. The lesions had various shapes and most were cavitary. In 3 of the 11 patients bilateral symmetrical oval lesions were faintly visible in the middle cerebellar peduncles. These middle cerebellar peduncular lesions were diagnosed as having Wallerian degeneration of the pontocerebellar tract secondary to CPM. (orig.)

  11. Emotional Sequelae of Elective Abortion: The Role of Guilt and Shame.

    Science.gov (United States)

    Whitney, Donna Krupkin

    2017-06-01

    Although estimates vary, many women experience long-term emotional, spiritual, psychological and interpersonal difficulties following abortion, including complicated grief, depression, post-traumatic stress disorder (PTSD) and relationship disturbances. Developmental, drive, object-relations and narcissism models for perinatal loss also illuminate the dynamics of post-abortion syndromes. Guilt and shame play important roles in generating and concealing post-abortion sequelae. Pastoral care and healthcare providers can increase their awareness of post-abortion sequelae and provide effective care for women experiencing these syndromes.

  12. Radio-induced neuropathology: from early effects to late sequelae. Rat behavioural and metabolic studies after sublethal total body irradiation

    International Nuclear Information System (INIS)

    Martigne, A.P.

    2010-05-01

    The radioresistance dogma of Central Nervous System (CNS) is now obsolete. Recent progress in neuroscience allow us to reconsider the radiation-induced cognitive dysfunctions observed after radiation therapy or after a nuclear accident, and to devise appropriate diagnostic and therapeutic means. We have developed a Rat model to study the effects of total body irradiation at a sublethal dose (4.5 Gy). This leads to impaired learning and memory of a task being acquired during the first month - which is prevented by administration of a radioprotector (amifostine) - while it does not appear to affect retrograde memory. Early, an apoptotic wave occurs in the sub-ventricular zone, 5 to 9 hours after exposure, while neuro-genesis is suppressed. Two days after irradiation, the metabolic study conducted by NMR HRMAS (High Resolution Magic Angle Spinning) suggests the presence of cerebral oedema and the study of brain lipids in liquid NMR confirms the membrane damages (elevated cholesterol and phospholipids). The lipid profile is then normalized while a gliosis appears. Finally, 1 month post-irradiation, the elevation of GABA, an inhibitory neurotransmitter, in 2 separate brain structures, occurs simultaneously with a taurine decrease in the hippocampus that lasts 6 months. Our integrated model allows validating bio-markers measurable in vivo NMR spectroscopy - the next experimental stage - and testing new radiation-protective agents. (author)

  13. The free radical scavenger, edaravone, ameliorates delayed neuropsychological sequelae after acute carbon monoxide poisoning in rabbits.

    Science.gov (United States)

    Qingsong, Wang; Yeming, Guan; Xuechun, Liu; Hongjuan, Liu; Jing, Wang

    2013-01-01

    The mechanism underlying delayed neuropsychological sequelae (DNS) after acute carbon monoxide (CO) poisoning is unclear. There are no effective treatments for DNS. As part of a new generation of antioxidants, edaravone has been reported to improve clinical outcomes in patients exhibiting ischemic strokes. There has been little data about edaravone in relationship to DNS prevention and treatment. We hypothesized that edaravone could ameliorate DNS: Here we test that hypothesis in rabbits Rabbits were randomly divided into sham control,DNS group, saline group and edaravone group. DNS model was made by intraperitoneal injection of CO. Normal saline or edaravone (1 mg/kg, twice daily, a total of one course for 14 days) was infused through the ear vein from Day 15 since the DNS model was established. Serum superoxide dismutase (SOD) activity and malondialdehyde (MDA) were measured in each group. Magnetic resonance spectroscopy (MRS) was used to examine regions of the brain for various compounds. The apoptotic index and neuronal density in the hippocampal CA1 area were also investigated. SOD activity decreased significantly and MDA content increased substantially in the DNS group and saline group when compared with the sham control (p edaravone group, serum SOD activity significantly increased and MDA levels significantly decreased when compared with DNS and saline group (p edaravone group (p edaravone group was significantly lower than that of the DNS and saline groups (p edaravone group was significantly higher than that of the DNS and saline group in the hippocampal CA1 area (p edaravone could ameliorate DNS after acute carbon monoxide poisoning in rabbits. These results suggest free radicals could be involved in the underlying mechanisms of DNS. Furthermore, brain MRS shows promise as a tool for early diagnosis for DNS.

  14. Distribution of cytomegalovirus gN variants and associated clinical sequelae in infants.

    Science.gov (United States)

    Paradowska, Edyta; Jabłońska, Agnieszka; Studzińska, Mirosława; Suski, Patrycja; Kasztelewicz, Beata; Zawilińska, Barbara; Wiśniewska-Ligier, Małgorzata; Dzierżanowska-Fangrat, Katarzyna; Woźniakowska-Gęsicka, Teresa; Czech-Kowalska, Justyna; Lipka, Bożena; Kornacka, Maria; Pawlik, Dorota; Tomasik, Tomasz; Kosz-Vnenchak, Magdalena; Leśnikowski, Zbigniew J

    2013-09-01

    Human cytomegalovirus (HCMV) is the most widespread cause of congenital infection. The effects of various viral strains and viral loads on the infection outcome have been under debate. To determine the distribution of gN variants in HCMV strains isolated from children with congenital or postnatal infection and to establish the relationship between the viral genotype, the viral load, and the sequelae. The study population included congenitally HCMV-infected newborns and children with postnatal or unproven congenital HCMV infection. The genotyping was performed by RFLP analysis of PCR-amplified fragments, and the viral load was measured by quantitative real-time PCR. Our results demonstrated that the HCMV genotypes gN3b, gN4b, and gN4c were prevalent in the patients examined. There were no differences in the distributions of gN genotypes in the congenitally and postnatally infected children. Multiple HCMV strains were detected in both groups of children. A significant association between the HCMV gN4 genotype and the incidence of neurological disorders was observed (p=0.045). Our results suggest that the detection of the gN2 or the gN4 genotype may be indicative of serious manifestations in children. In contrast, the gN3b and the gN1 genotypes represent less pathogenic HCMV strains. The HCMV load in urine was significantly higher in children with congenital infection compared with children with postnatal infection. No correlation was found between the viral load and the genotype. Our results suggest that the gN genotype may be a virological marker of symptomatic HCMV infection in newborns. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. Analysis of neurological sequelae from radiosurgery of arteriovenous malformations: how location affects outcome

    International Nuclear Information System (INIS)

    Flickinger, John C.; Kondziolka, Douglas; Maitz, Ann H.; Lunsford, L. Dade

    1998-01-01

    Purpose/Objective: To elucidate how the risks of developing temporary and permanent neurological sequelae from radiosurgery for arteriovenous malformations (AVM) are related to AVM location, the addition of stereotactic magnetic resonance (MR) imaging to angiographic targeting, and prior hemorrhage or neurological deficits. Materials and Methods: We evaluated follow-up imaging and clinical data in 332 AVM patients who received gamma knife radiosurgery at the University of Pittsburgh between 1987 and 1994. All patients had regular clinical or imaging follow-up for a minimum of 2 years (range: 24-96 months, median = 45 months). There were 83 patients with MR-assisted planning, 187 with prior hemorrhages, and 143 with prior neurological deficits. Results: Symptomatic postradiosurgery sequelae (any neurological problem including headache) developed in 30 (9%) of 332 patients. Symptoms resolved in 58% of patients within 27 months with a significantly greater proportion (p = 0.006) resolving in patients with Dmin 0.3), including the addition of MR targeting, average radiation dose in 20 cc, prior hemorrhage, or neurological deficit. We used these results to construct a risk prediction model for symptomatic postradiosurgery sequelae. The risk of radiation necrosis was significantly correlated with PIE score (p < 0.048), but not with 12-Gy volume. Conclusion: The risks of developing complications from AVM radiosurgery can be predicted according to location with the PIE score, in conjunction with the 12-Gy treatment volume. Further study of factors affecting persistence of these sequelae (progression to radiation necrosis) is needed

  16. Long-term functional sequelae of sacrococcygeal teratoma : a national study in the Netherlands

    NARCIS (Netherlands)

    Derikx, Joep P. M.; De Backer, Antoine; van de Schoot, Leon; Aronson, Daniel C.; de Langen, Zacharias J.; van den Hoonaard, Thelma L.; Bax, Nicolaas M. A.; van der Staak, Frans; van Heurn, L. W. Ernest

    Background: Long-term functional sequelac after resection of sacrococcygeal teratoma (SCT) are relatively common. This study determines the incidence of these sequelae associated clinical variables and its impact on quality of life (QoL). Patients and methods: Patients with SCT treated from 1980 to

  17. To explore the community rehabilitation assessment scales for patients with stroke sequelae

    Directory of Open Access Journals (Sweden)

    Ling Tian

    2015-01-01

    Full Text Available Objective: To choose the scales that can comprehensively assess the function of patients with stroke sequelae for the grassroots medical staff. Methods: The commonly used scales were selected. The patients with stroke sequelae were assessed by the MOS item short from health survey(SF-36, Modified Barthel Index(MBI, Brain Injury Community Rehabilitation Outcome Scales(BICRO-39,WHO Disability Assessment Scale II(WHO-DAS II and Anxiety and Depression Self-rating Scales(SAS and SDS. The assessment datum was conducted by Pearson correlation coefficient. Results: The data of MBI have significant correlation among the datum of WHO-DASII, SF-36 and BICRO 39 scales(P<0.05. The datum of MBI doesn’t have correlation among the datum of the SAS and SDS (P>0.05. Conclusions: Community doctors can choose MBI which can effectively assess the activities of daily living for the community patients with stroke sequelae. MBI also can reflect the functional levels of community patients with stroke sequelae.

  18. Endocrine Disorders in Childhood: A Selective Survey of Intellectual and Educational Sequelae.

    Science.gov (United States)

    Sandberg, David E.; Barrick, Christopher

    1995-01-01

    Examines intellectual and educational sequelae of selected endocrine systems and the psychosocial impact of their medical conditions. Many conditions are named including: Growth Hormone Deficiency, Turner Syndrome, Precocious Puberty, Klinefelters Syndrome, Congenital Hypothyroidism, and Insulin-Dependent Diabetes Mellitus. Gives psychoeducational…

  19. Evaluation of chemotherapeutic sequelae and quality of life in survivors of malignant sacrococcygeal teratoma

    NARCIS (Netherlands)

    Kremer, Marijke E B; Derikx, Joep P M; Kremer, Leontien C M; van Baren, Robertine; Heij, Hugo A.; Wijnen, Marc H W A; Wijnen, René M H; van der Zee, David C.; van Heurn, L. W Ernest

    2016-01-01

    Purpose: The impact of chemotherapeutic sequelae on long-term quality of life (QoL) for survivors of malignant sacrococcygeal teratoma (SCT) is unknown. The incidence of chemotherapeutic toxicity in patients treated for malignant SCT and possible effects on the QoL were analyzed. Methods:

  20. Psychological Sequelae of Childhood Sexual Abuse: Abuse-Related Characteristics, Coping Strategies, and Attributional Style

    Science.gov (United States)

    Steel, Jennifer; Sanna, Lawrence; Hammond, Barbara; Whipple, James; Cross, Herbert

    2004-01-01

    Objective: The aim of this study was to test a model predicting the contribution of abuse-related characteristics and mediating variables such as coping and attributional style in the development of psychological sequelae in adults reporting a history of child sexual abuse (CSA). Methodology: Two hundred and eighty-five males and females from…

  1. The isolated burned palm in children : Epidemiology and long-term sequelae

    NARCIS (Netherlands)

    Barret, JP; Desai, MH; Herndon, DN

    The isolated burn of the palm is a typical injury in young children. Positioning and splinting in small hands is difficult, and long-term sequelae of these injuries are not uncommon. The objective of the present study was to assess the outcome of palm burns and to identify the risk factors for

  2. The Genetic Precursors and the Advantageous and Disadvantageous Sequelae of Inhibited Temperament: An Evolutionary Perspective

    Science.gov (United States)

    Davies, Patrick T.; Cicchetti, Dante; Hentges, Rochelle F.; Sturge-Apple, Melissa L.

    2013-01-01

    Guided by evolutionary game theory (Korte, Koolhaas, Wingfield, & McEwen, 2005), this study aimed to identify the genetic precursors and the psychosocial sequelae of inhibited temperament in a sociodemographically disadvantaged and racially diverse sample (N = 201) of 2-year-old children who experienced elevated levels of domestic violence.…

  3. PROTOCOL FOR THE PREVENTION AND TREATMENT OF ORAL SEQUELAE RESULTING FROM HEAD AND NECK RADIATION-THERAPY

    NARCIS (Netherlands)

    JANSMA, J; VISSINK, A; SPIJKERVET, FKL; ROODENBURG, JLN; PANDERS, AK; VERMEY, A; SZABO, BG; SGRAVENMADE, EJ

    1992-01-01

    In addition to the desired antitumor effects, head and neck radiation therapy induces damage in normal tissues that may result in oral sequelae such as mucositis, hyposalivation, radiation caries, taste loss, trismus, soft-tissue necrosis, and osteoradionecrosis. These sequelae may be dose-limiting

  4. Dressing-related trauma: clinical sequelae and resource utilization in a UK setting

    Directory of Open Access Journals (Sweden)

    Charlesworth B

    2014-04-01

    Full Text Available Bruce Charlesworth,1 Claire Pilling,1 Paul Chadwick,2 Martyn Butcher31Adelphi Values, Macclesfield, 2Salford Royal Foundation Trust, Salford, 3Northern Devon Healthcare Trust, Devon, UKBackground: Dressings are the mainstay of wound care management; however, adherence of the dressing to the wound or periwound skin is common and can lead to dressing-related pain and trauma. Dressing-related trauma is recognized as a clinical and economic burden to patients and health care providers. This study was conducted to garner expert opinion on clinical sequelae and resource use associated with dressing-related trauma in a UK setting.Methods: This was an exploratory study with two phases: qualitative pilot interviews with six wound care specialists to explore dressing-related trauma concepts, sequelae, and resource utilization; and online quantitative research with 30 wound care specialists to validate and quantify the concepts, sequelae, and resource utilization explored in the first phase of the study. Data were collected on mean health care professional time, material costs, pharmaceutical costs, and inpatient management per sequela occurrence until resolution. Data were analyzed to give total costs per sequela and concept occurrence.Results: The results demonstrate that dressing-related trauma is a clinically relevant concept. The main types of dressing-related trauma concepts included skin reactions, adherence to the wound, skin stripping, maceration, drying, and plugging of the wound. These were the foundation for a number of clinical sequelae, including wound enlargement, increased exudate, bleeding, infection, pain, itching/excoriation, edema, dermatitis, inflammation, and anxiety. Mean total costs range from £56 to £175 for the complete onward management of each occurrence of the six main concepts.Conclusion: These results provide insight into the hidden costs of dressing-related trauma in a UK setting. This research successfully conceptualized

  5. Prevalência de sequelas auditivas pós meningite piogênica em crianças Prevalence of auditory sequelae after pyogenic meningitis in children

    Directory of Open Access Journals (Sweden)

    Luzia Poliana Anjos da Silva

    2009-01-01

    Full Text Available OBJETIVO: Analisar a prevalência de déficit auditivo e caracterizar as principais sequelas auditivas e neurológicas pós-meningite, correlacionando o tipo de antibiótico utilizado durante o período de internação e a frequência de surdez, além do tipo de meningite mais prevalente como causa de déficit auditivo. MÉTODOS: Trata-se de um estudo de coorte transversal. Foram enviadas 289 cartas para os responsáveis pelas crianças que apresentaram meningite piogênica entre 28 dias e 24 meses, admitidas no Hospital Couto Maia (HC Maia entre janeiro de 2002 a dezembro de 2003. A amostra foi constituída por 55 crianças que sobreviveram com ou sem sequelas evidentes, que compareceram para as avaliações audiológica e neurológica. Foi realizada avaliação audiológica completa, incluindo a bateria subjetiva e objetiva de avaliação, com utilização de instrumentos validados para investigação da audição da criança. RESULTADOS: A faixa etária, no momento da avaliação audiológica, variou de dois a cinco anos. A deficiência auditiva foi encontrada em 29% da amostra, sendo a maioria do tipo neurossensorial, bilateral e de grau profundo. As principais sequelas neurológicas encontradas foram epilepsia, hemiparesia, hidrocefalia, disfasia e hiperatividade. CONCLUSÃO: Os resultados destacam a necessidade de monitoramento audiológico e acompanhamento neurológico nas crianças com história prévia de meningite piogênica, especialmente aquelas infectadas em idade precoce, buscando, desta forma, detectar as possíveis alterações auditivas e intervir o mais precocemente possível, por meio de intervenção especializada, protetização e reabilitação da linguagem oral.PURPOSE: To analyze the prevalence of hearing impairment and to characterize the main auditory and neurological sequelae after meningitis, correlating the type of antibiotic used during the hospitali66zation period and the frequency of deafness, as well as the most

  6. Quantification of late complications after radiation therapy

    International Nuclear Information System (INIS)

    Jung, Horst; Beck-Bornholdt, Hans-Peter; Svoboda, Vladimir; Alberti, Winfried; Herrmann, Thomas

    2001-01-01

    ; Type 3, curves composed of two components, a fast initial decline followed by an exponential decrease. For each kind of kinetics, provided that the dose distribution is not too heterogeneous, the incidence of late effects appears to occur at exponential or approximately exponential kinetics, even many years after treatment. This implies that a random process might be involved in the occurrence of late radiation sequelae. Conclusions: There might be a lifelong risk of developing late complications, of which patients and clinicians should be aware. It appears worthwhile to try to identify, in follow-up examinations of patients after radiation therapy, what kind of processes might be involved in triggering subclinical residual injury to develop into a clinically manifest late effect

  7. Exploring Late Globalization

    DEFF Research Database (Denmark)

    Turcan, Romeo V.

    2016-01-01

    literature on late globalization from sociocultural and economic perspectives. It illustrates in a vignette the character and features of late globalization observable in the withdrawal from foreign locations or deinternationalization of universities, as late globalizing entitis. The paper discusses...

  8. A Review of Double Common Bile Duct and Its Sequelae.

    Science.gov (United States)

    Kolli, Sindhura; Etienne, Denzil; Reddy, Madhavi; Shahzad, Ghulamullah

    2018-02-01

    A double or accessory common bile duct (ACBD) is a rare congenital anomaly. We report the case of a 60-year-old American Asian male, who was found to have a double or duplicated common bile duct after being admitted for evaluation of a pancreatic mass. A duplicated bile duct has the same mucosa histologically as a single bile duct. However, the opening of a duplicated bile duct lacks a sphincter allowing retrograde flow of gut contents which results in a higher probability of intraductal calculus formation. On rare occasions, it can predispose to liver abscesses, pancreatitis, pancreatic cancer, gallbladder cancer, gastric cancer, and ampullary cancer depending on the location of the opening of the ACBD. We present an integrative review of the limited cases of ACBD with correlation to the current case and discussion regarding the aspects of diagnosis and management.

  9. Late haemorrhagic disease of the newborn.

    Science.gov (United States)

    Zengin, Emine; Sarper, Nazan; Türker, Gülcan; Corapçioğlu, Funda; Etuş, Volkan

    2006-09-01

    Late haemorrhagic disease of the newborn (HDN) can occur owing to a lack of vitamin K prophylaxis, as a manifestation of an underlying disorder or idiopatically from the 8th day to 12 weeks after birth. Eight infants admitted to Kocaeli University Hospital with nine episodes of late HDN between January 2002 and April 2005 were evaluated retrospectively from hospital records. The median age at presentation was 46 (26-111) days. All the infants were born at full-term to healthy mothers and were exclusively breast-fed. All had an uneventful perinatal history, except one who had meconium aspiration. Four patients had received no vitamin K prophylaxis and another three had uncertain histories. At presentation, six had intracranial bleeding and the remainder had bleeding either from the venepuncture site or the gastro-intestinal tract. The presenting signs and symptoms were irritability, vomiting, bulging or full fontanelle, convulsions and diminished or absent neonatal reflexes. Galactosaemia was detected in a 2-month-old infant with prolonged jaundice. There was no surgery-related mortality or complications but one survived for only 2 days on ventilatory support following surgery. Only one of the six survivors had severe neurological sequelae. Late HDN frequently presents with intracranial haemorrhage, leading to high morbidity and mortality. HDN can be the manifestation of an underlying metabolic disorder. Vitamin K prophylaxis of the newborn should be routine in developing countries.

  10. Neuropsychological sequelae of work-stress-related exhaustion.

    Science.gov (United States)

    Österberg, Kai; Skogsliden, Sofia; Karlson, Björn

    2014-01-01

    The aim was to assess long-term cognitive performance after substantial recovery from work-stress-related exhaustion, in relation to subjective cognitive complaints and return to active work. In total, 54 patients previously diagnosed with work-stress-related exhaustion participated in a neuropsychological examination ∼2 years after initial sick leave. Most participants were substantially recovered at follow-up, with only 13% still meeting the criteria for exhaustion disorder suggested by the Swedish National Board of Health and Welfare. When participants' scores on 14 neuropsychological tests were compared to a matched group of 50 controls, the former patient group showed lower performance mainly on attention tests of the reaction time type, but also slightly lower scores on visuo-spatial constructional ability. However, the former patient group performed better than controls on two memory tests and, in part, on a test of simultaneous capacity. Self-ratings of everyday cognitive problems remained significantly higher in the former patient group than among controls, but the extent of self-rated cognitive problems was generally unrelated to performance on the neuropsychological tests. No relationship between performance on these tests and the extent of work resumption was observed. In summary, persons with previous work-stress-related exhaustion showed persistent signs of a minor attention deficit, despite considerable general recovery and return to work.

  11. Ocular sequelae of congenital toxoplasmosis in Brazil compared with Europe.

    Directory of Open Access Journals (Sweden)

    Ruth E Gilbert

    2008-08-01

    Full Text Available Toxoplasmic retinochoroiditis appears to be more severe in Brazil, where it is a leading cause of blindness, than in Europe, but direct comparisons are lacking. Evidence is accumulating that more virulent genotypes of Toxoplasma gondii predominate in South America.We compared prospective cohorts of children with congenital toxoplasmosis identified by universal neonatal screening in Brazil and neonatal or prenatal screening in Europe between 1992 and 2003, using the same protocol in both continents.Three hundred and eleven (311 children had congenital toxoplasmosis: 30 in Brazil and 281 in Europe, where 71 were identified by neonatal screening. Median follow up was 4.1 years in Europe and 3.7 years in Brazil. Relatively more children had retinochoroiditis during the first year in Brazil than in Europe (15/30; 50% versus 29/281; 10% and the risk of lesions by 4 years of age was much higher: the hazard ratio for Brazil versus Europe was 5.36 (95%CI: 3.17, 9.08. Children in Brazil had larger lesions, which were more likely to be multiple and to affect the posterior pole (p<0.0001. In Brazil, visual impairment (<6/12 Snellen was predicted for most affected eyes (87%, 27/31, but not in Europe (29%; 20/69, p<0.0001. The size of newly detected lesions decreased with age (p = 0.0007.T. gondii causes more severe ocular disease in congenitally infected children in Brazil compared with Europe. The marked differences in the frequency, size and multiplicity of retinochoroidal lesions may be due to infection with more virulent genotypes of the parasite that predominate in Brazil but are rarely found in Europe.

  12. Ocular sequelae of congenital toxoplasmosis in Brazil compared with Europe.

    Science.gov (United States)

    Gilbert, Ruth E; Freeman, Katherine; Lago, Eleonor G; Bahia-Oliveira, Lilian M G; Tan, Hooi Kuan; Wallon, Martine; Buffolano, Wilma; Stanford, Miles R; Petersen, Eskild

    2008-08-13

    Toxoplasmic retinochoroiditis appears to be more severe in Brazil, where it is a leading cause of blindness, than in Europe, but direct comparisons are lacking. Evidence is accumulating that more virulent genotypes of Toxoplasma gondii predominate in South America. We compared prospective cohorts of children with congenital toxoplasmosis identified by universal neonatal screening in Brazil and neonatal or prenatal screening in Europe between 1992 and 2003, using the same protocol in both continents. Three hundred and eleven (311) children had congenital toxoplasmosis: 30 in Brazil and 281 in Europe, where 71 were identified by neonatal screening. Median follow up was 4.1 years in Europe and 3.7 years in Brazil. Relatively more children had retinochoroiditis during the first year in Brazil than in Europe (15/30; 50% versus 29/281; 10%) and the risk of lesions by 4 years of age was much higher: the hazard ratio for Brazil versus Europe was 5.36 (95%CI: 3.17, 9.08). Children in Brazil had larger lesions, which were more likely to be multiple and to affect the posterior pole (p<0.0001). In Brazil, visual impairment (<6/12 Snellen) was predicted for most affected eyes (87%, 27/31), but not in Europe (29%; 20/69, p<0.0001). The size of newly detected lesions decreased with age (p = 0.0007). T. gondii causes more severe ocular disease in congenitally infected children in Brazil compared with Europe. The marked differences in the frequency, size and multiplicity of retinochoroidal lesions may be due to infection with more virulent genotypes of the parasite that predominate in Brazil but are rarely found in Europe.

  13. Stroke with neuropsychiatric sequelae after cannabis use in a man: a case report

    Directory of Open Access Journals (Sweden)

    Giroud Maurice

    2011-06-01

    Full Text Available Abstract Introduction The outcome of cerebral ischemic stroke associated with cannabis use is usually favorable. Here we report the first case of cannabis-related stroke followed by neuropsychiatric sequelae. Case presentation A 24-year-old Caucasian man was discovered in a deeply comatose non-reactive state after cannabis use. A magnetic resonance imaging scan of his brain showed bilateral multiple ischemic infarcts. The patient remained deeply comatose for four days, after which time he developed other behavioral impairments and recurrent seizures. Conclusion Stroke related to cannabis use can be followed by severe neuropsychiatric sequelae. Concomitant alcohol intoxication is essential neither to the occurrence of this neurologic event nor to its severity.

  14. Chernobyl disaster sequelae in recent immigrants to the United States from the former Soviet Union (FSU).

    Science.gov (United States)

    Foster, RoseMarie Perez; Goldstein, Marjorie F

    2007-04-01

    Long-term mental health sequelae of the 1986 Chernobyl disaster have been documented for exposed populations who remained in the former Soviet Union (FSU) (Havenaar et al., 1997), and in a cohort migrated to Israel (Cwikel et al., 1997). This paper reports on Chernobyl disaster sequelae in émigrés (n = 321) to the United States. Demographic characteristics, migration factors, and self-reported physical health were considered. Both geographical proximity to the 1986 disaster, and perception of radiation risk stood as long-term indicators of current psychological distress. Proximity was related to poor self-perceived physical health, as well as current symptoms of depression (pChernobyl-related trauma distress (p<.001) on standardized measures. Environmental contamination as a reason for migration was also associated with greater mental health symptomatology.

  15. Analysis of neurological sequelae from radiosurgery of arteriovenous malformations: how location effects outcome

    International Nuclear Information System (INIS)

    Flickinger, John C.; Kondziolka, Douglas; Maitz, Ann H.; Lunsford, L. Dade

    1997-01-01

    Purpose/Objective: To elucidate how the risks of developing temporary and permanent neurological sequelae from radiosurgery for arteriovenous malformations (AVM) relate to AVM location, the addition of stereotactic magnetic resonance (MR) imaging to angiographic targeting, and prior hemorrhage or neurological deficits. Materials and Methods: We evaluated follow-up imaging and clinical data in 332 AVM patients who received gamma knife radiosurgery at the University of Pittsburgh between 1987 and 1994. All patients had regular clinical or imaging follow up for a minimum of two years (range: 24-96 mo., median=45 mo.). 83 patients had MR. planning, and 187 previously bled. Results: Symptomatic post-radiosurgery sequelae (any neurological problem including headache) developed in 30/332 patients (9.0%). Symptoms resolved in 58% of patients within 24 mo. with a significantly greater proportion (p=0.006) resolving in patients with Dmin <20 vs. ≥20 Gy (89 vs. 36%). The 7 yr. actuarial rate for developing persistent symptomatic sequelae was 3.8%. We first evaluated the relative risks for different locations to construct a post-radiosurgery injury expression (PIE) score for AVM location (see Table 1). Multivariate logistic regression analysis of symptomatic post-radiosurgery injury identified independent significant correlations with PIE location score (p=0.0007) and 12 Gy volume (p=0.008) but none of the other factors tested (p≥0.3) including the addition of MR targeting, average radiation dose in 20 cc, prior bleed or neurological deficit. We used these results to construct risk prediction models for any symptomatic post-radiosurgery sequelae and for symptomatic necrosis. Conclusion: The risks of complications from AVM radiosurgery can be predicted according to location with the PIE score and by the 12 Gy treatment volume (Table 2)

  16. Sequelae of Foodborne Illness Caused by 5 Pathogens, Australia, Circa 2010

    OpenAIRE

    Ford, Laura; Kirk, Martyn; Glass, Kathryn; Hall, Gillian

    2014-01-01

    In Australia circa 2010, 4.1 million (90% credible interval [CrI] 2.3–6.4 million) episodes of foodborne gastroenteritis occurred, many of which might have resulted in sequelae. We estimated the number of illnesses, hospitalizations, and deaths from Guillain-Barré syndrome, hemolytic uremic syndrome, irritable bowel syndrome, and reactive arthritis that were associated with contaminated food in Australia. Data from published studies, hospital records, and mortality reports were combined with ...

  17. Combined tibial lengthening and ankle arthrodesis for patients with certain type of sequelae of poliomyelitis.

    Science.gov (United States)

    Wu, Chi-Chuan

    2017-01-01

    Following far advancement of modern medicine and technology, functional disability in a certain type of sequelae of poliomyelitis may be effectively improved. Eight consecutive adult patients with unilateral sequelae of poliomyelitis were treated. These patients had shortened lower extremity of an average of 4.8 cm (range, 4.0-5.5 cm) in the lesion side. Muscle power of the ipsilateral knee was nearly intact (grade 4 or 5) but the ankle extension was completely flaccid. The tibia was osteotomized and lengthened with external fixation. Consequently, all external fixators were converted to plates supplemented with autogenous corticocancellous bone graft and bone graft substitute. Ankle arthrodesis was performed concomitantly. Seven patients were followed up for an average of 3.7 years (range, 2.2-5.4 years). All seven lengthened sites healed with an average union time of 3.9 months (range, 3.5-4.5 months) after plating. One ankle infection occurred. Gait function significantly improved by modified Mazur scoring evaluation ( p = 0.02). At the latest follow-up, all patients had a minimal or unnoticed limp in level walking. The described combined techniques may be an excellent alternate for treating selected patients with sequelae of poliomyelitis. The procedure is not complex but the efficiency is extremely prominent.

  18. Sequelae and survivorship in patients treated with (131)I-MIBG therapy.

    Science.gov (United States)

    Sze, W C C; Grossman, A B; Goddard, I; Amendra, D; Shieh, S C C; Plowman, P N; Drake, W M; Akker, S A; Druce, M R

    2013-08-06

    (131)I-meta-iodobenzylguanidine ((131)I-MIBG) has been in therapeutic use since 1980s. Newer treatment modalities are emerging for neuroendocrine tumours (NETs) and chromaffin cell tumours (CCTs), but many of these do not yet have adequate long-term follow-up to determine their longer term efficacy and sequelae. Fifty-eight patients with metastatic NETs and CCTs who had received (131)I-MIBG therapy between 2000 and 2011 were analysed. Survival and any long-term haematological or renal sequelae were investigated. In the NET group, the overall median survival and median survival following the diagnosis of metastatic disease was 124 months. The median survival following the commencement of (131)I-MIBG was 66 months. For the CCT group, median survival had not been reached. The 5-year survival from diagnosis and following the diagnosis of metastatic disease was 67% and 67.5% for NETs and CCTs, respectively. The 5-year survival following the commencement of (131)I-MIBG therapy was 68%. Thirty-two patients had long-term haematological sequelae: 5 of these 32 patients developed haematological malignancies. Two patients developed a mild deterioration in renal function. Long follow up of (131)I-MIBG therapy reveals a noteable rate of bone marrow toxicities and malignancy and long term review of all patients receiving radionuclide therapies is recommended.

  19. Acupuncture for sequelae of Bell's palsy: a randomized controlled trial protocol

    Science.gov (United States)

    2011-01-01

    Objective Incomplete recovery from facial palsy has a long-term impact on the quality of life, and medical options for the sequelae of Bell's palsy are limited. Invasive treatments and physiotherapy have been employed to relieve symptoms, but there is limited clinical evidence for their effectiveness. Acupuncture is widely used on Bell's palsy patients in East Asia, but there is insufficient evidence for its effectiveness on Bell's palsy sequelae. The objective is to evaluate the efficacy and safety of acupuncture in patients with sequelae of Bell's palsy. Method/Design This study consists of a randomized controlled trial with two parallel arms: an acupuncture group and a waitlist group. The acupuncture group will receive acupuncture treatment three times per week for a total of 24 sessions over 8 weeks. Participants in the waitlist group will not receive any acupuncture treatments during this 8 week period, but they will participate in the evaluations of symptoms at the start of the study, at 5 weeks and at 8 weeks after randomization, at which point the same treatment as the acupuncture group will be provided. The primary outcome will be analyzed by the change in the Facial Disability Index (FDI) from baseline to week eight. The secondary outcome measures will include FDI from baseline to week five, House-Brackmann Grade, lip mobility, and stiffness scales. Trial registration Current Controlled-Trials ISRCTN43104115; registration date: 06 July 2010; the date of the first patient's randomization: 04 August 2010 PMID:21388554

  20. Acupuncture for sequelae of Bell's palsy: a randomized controlled trial protocol.

    Science.gov (United States)

    Kwon, Hyo-Jung; Kim, Jong-In; Lee, Myeong Soo; Choi, Jun-Yong; Kang, Sungkeel; Chung, Jie-Yoon; Kim, Young-Jin; Lee, Seung-Hoon; Lee, Sanghoon; Nam, Dongwoo; Kim, Yong-Suk; Lee, Jae-Dong; Choi, Do-Young

    2011-03-09

    Incomplete recovery from facial palsy has a long-term impact on the quality of life, and medical options for the sequelae of Bell's palsy are limited. Invasive treatments and physiotherapy have been employed to relieve symptoms, but there is limited clinical evidence for their effectiveness. Acupuncture is widely used on Bell's palsy patients in East Asia, but there is insufficient evidence for its effectiveness on Bell's palsy sequelae. The objective is to evaluate the efficacy and safety of acupuncture in patients with sequelae of Bell's palsy. This study consists of a randomized controlled trial with two parallel arms: an acupuncture group and a waitlist group. The acupuncture group will receive acupuncture treatment three times per week for a total of 24 sessions over 8 weeks. Participants in the waitlist group will not receive any acupuncture treatments during this 8 week period, but they will participate in the evaluations of symptoms at the start of the study, at 5 weeks and at 8 weeks after randomization, at which point the same treatment as the acupuncture group will be provided. The primary outcome will be analyzed by the change in the Facial Disability Index (FDI) from baseline to week eight. The secondary outcome measures will include FDI from baseline to week five, House-Brackmann Grade, lip mobility, and stiffness scales.

  1. Elevated levels of circulating thyroid hormone do not cause the medical sequelae of hyperthyroidism.

    Science.gov (United States)

    Kelly, Tammas; Denmark, Lawrence; Lieberman, Daniel Z

    2016-11-03

    Clinicians have been reluctant to use high dose thyroid (HDT) to treat affective disorders because high circulating levels of thyroid hormone have traditionally been equated with hyperthyroidism, and understood as the cause of the medical sequelae of hyperthyroidism, such as osteoporosis and cardiac abnormalities. This conclusion is not supported by (HDT) research. A literature review of research related to the morbidity and mortality of HDT treatment was performed. There exists a large body of research involving the use of HDT treatment to prevent the recurrence of differentiated thyroid cancer and to treat affective disorders. A review of this literature finds a lack of support for HDT as a cause of osteoporosis, nor is there support for an increase in morbidity or mortality associated with HDT. This finding contrasts with the well-established morbidity and mortality associated with Graves' disease, thyroiditis, and other endogenous forms of hyperthyroidism. The lack of evidence that exogenous HDT causes osteoporosis, cardiac abnormalities or increases mortality compared with the significant morbidity and mortality of hyperthyroidism requires an alternative cause for the medical sequelae of hyperthyroidism. One possibility is an autoimmune mechanism. High circulating levels of thyroid hormone is not the cause of the sequela of hyperthyroidism. The reluctance to using high dose thyroid is unwarranted. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Sequelae of foodborne illness caused by 5 pathogens, Australia, circa 2010.

    Science.gov (United States)

    Ford, Laura; Kirk, Martyn; Glass, Kathryn; Hall, Gillian

    2014-11-01

    In Australia circa 2010, 4.1 million (90% credible interval [CrI] 2.3-6.4 million) episodes of foodborne gastroenteritis occurred, many of which might have resulted in sequelae. We estimated the number of illnesses, hospitalizations, and deaths from Guillain-Barré syndrome, hemolytic uremic syndrome, irritable bowel syndrome, and reactive arthritis that were associated with contaminated food in Australia. Data from published studies, hospital records, and mortality reports were combined with multipliers to adjust for different transmission routes. We used Monte Carlo simulation to estimate median estimates and 90% CrIs. In Australia, circa 2010, we estimated that 35,840 (90% CrI 25,000-54,000) illnesses, 1,080 (90% CrI 700-1,600) hospitalizations, and 10 (90% CrI 5-14) deaths occurred from foodborne gastroenteritis-associated sequelae. Campylobacter spp. infection was responsible for 80% of incident cases. Reducing the incidence of campylobacteriosis and other foodborne diseases would minimize the health effects of sequelae.

  3. Acupuncture for sequelae of Bell's palsy: a randomized controlled trial protocol

    Directory of Open Access Journals (Sweden)

    Kim Yong-Suk

    2011-03-01

    Full Text Available Abstract Objective Incomplete recovery from facial palsy has a long-term impact on the quality of life, and medical options for the sequelae of Bell's palsy are limited. Invasive treatments and physiotherapy have been employed to relieve symptoms, but there is limited clinical evidence for their effectiveness. Acupuncture is widely used on Bell's palsy patients in East Asia, but there is insufficient evidence for its effectiveness on Bell's palsy sequelae. The objective is to evaluate the efficacy and safety of acupuncture in patients with sequelae of Bell's palsy. Method/Design This study consists of a randomized controlled trial with two parallel arms: an acupuncture group and a waitlist group. The acupuncture group will receive acupuncture treatment three times per week for a total of 24 sessions over 8 weeks. Participants in the waitlist group will not receive any acupuncture treatments during this 8 week period, but they will participate in the evaluations of symptoms at the start of the study, at 5 weeks and at 8 weeks after randomization, at which point the same treatment as the acupuncture group will be provided. The primary outcome will be analyzed by the change in the Facial Disability Index (FDI from baseline to week eight. The secondary outcome measures will include FDI from baseline to week five, House-Brackmann Grade, lip mobility, and stiffness scales. Trial registration Current Controlled-Trials ISRCTN43104115; registration date: 06 July 2010; the date of the first patient's randomization: 04 August 2010

  4. Neurosensory sequelae assessed by thermal and vibrotactile perception thresholds after local cold injury.

    Science.gov (United States)

    Carlsson, Daniel; Burström, Lage; Lilliesköld, Victoria Heldestad; Nilsson, Tohr; Nordh, Erik; Wahlström, Jens

    2014-01-01

    Local freezing cold injuries are common in the north and sequelae to cold injury can persist many years. Quantitative sensory testing (QST) can be used to assess neurosensory symptoms but has previously not been used on cold injury patients. To evaluate neurosensory sequelae after local freezing cold injury by thermal and vibrotactile perception thresholds and by symptom descriptions. Fifteen patients with a local freezing cold injury in the hands or feet, acquired during military training, were studied with QST by assessment of vibrotactile (VPT), warmth (WPT) and cold (CPT) perception thresholds 4 months post-injury. In addition, a follow-up questionnaire, focusing on neurovascular symptoms, was completed 4 months and 4 years post-injury. QST demonstrated abnormal findings in one or both affected hands for VPT in 6 patients, for WPT in 4 patients and for CPT in 1 patient. In the feet, QST was abnormal for VPT in one or both affected feet in 8 patients, for WPT in 6 patients and for CPT in 4 patients. Freezing cold injury related symptoms, e.g. pain/discomfort when exposed to cold, cold sensation and white fingers were common at 4 months and persisted 4 years after the initial injury. Neurosensory sequelae after local freezing cold injury, in terms of abnormal thermal and/or vibration perception thresholds, may last at least 4 months after the initial injury. Symptoms such as pain/discomfort at cold exposure, cold sensations and white fingers may persist at least 4 years after the initial injury.

  5. Tool for objective quantification of pulmonary sequelae in monitoring of patients with tuberculosis

    International Nuclear Information System (INIS)

    Giacomini, Guilherme; Alvarez, Matheus; Pina, Diana R. de; Bacchim Neto, Fernando A.; Pereira, Paulo C.M.; Ribeiro, Sergio M.; Miranda, Jose Ricardo de A.

    2014-01-01

    Tuberculosis (TB), caused by Mycobacterium tuberculosis, is an ancient infectious disease that remains a global health problem. Chest radiography is the method commonly employed in assessing the evolution of TB. However, lung damage quantification methods are usually performed on a computerized tomography (CT). This objective quantification is important in the radiological monitoring of the patient by assessing the progression and treatment of TB. However, precise quantification is not feasible by the number of CT examinations necessary due to the high dose subjected to the patient and high cost to the institution. The purpose of this work is to develop a tool to quantify pulmonary sequelae caused by TB through chest X-rays. Aiming the proposed objective, a computational algorithm was developed, creating a three-dimensional representation of the lungs, with regions of dilated sequelae inside. It also made the quantification of pulmonary sequelae of these patients through CT scans performed in upcoming dates, minimizing the differences in disease progression. The measurements from the two methods were compared with results suggest that the effectiveness and applicability of the developed tool, allowing lower doses radiological monitoring of the patient during treatment

  6. Sequelas bucais da radioterapia de cabeça e pescoço Oral sequelae of head and neck radiotherapy

    Directory of Open Access Journals (Sweden)

    Daniel Antunes Freitas

    2011-12-01

    Full Text Available TEMA: cirurgia, radioterapia e quimioterapia são as modalidades terapêuticas usadas no tratamento de câncer bucal. Podem ser usadas isoladas ou conjuntamente. Radiação ionizante causa lesões nos tecidos normais localizados no campo de radiação. Isto se torna particularmente evidente nas regiões de cabeça, uma área complexa composta de várias estruturas diferentes que respondem diferentemente à radiação. As seqüelas orais resultantes podem causar problemas substanciais durante e depois da terapia de radiação e são os maiores fatores de determinação na qualidade de vida dos pacientes. Dentre as complicações da radioterapia estão a xerostomia, osteorradionecrose, mucosite e candidose. OBJETIVO: apresentar aos profissionais de saúde uma reflexão sobre as questões pertinentes às sequelas bucais da radioterapia de cabeça e pescoço. CONCLUSÃO: o acompanhamento odontológico sistemático pode minimizar os efeitos da radiação sobre os tecidos da cavidade bucal.BACKGROUND: surgery, radiotherapy and chemotherapy are therapeutic modalities used in the treatment of oral cancer. They can be used separately or in combination. Ionizing irradiation causes damage to normal tissues located at the radiation field. This becomes particularly evident in the head and neck region, a complex area composed of several dissimilar structures that respond differently to radiation. The resulting oral sequelae may cause substantial problems during and after radiation therapy and are major factors in determining the patient's quality of life. Xerostomia, osteoradionecrosis, mucositis and candidosis are some of radiotherapy's complications. PURPOSE: introduce health professionals to reflect on issues relevant to oral sequelae of head and neck radiotherapy. CONCLUSION: regular dental follow-up may reduce the effects of radiation in the tissues of the oral cavity.

  7. Late induced abortion.

    Science.gov (United States)

    Savage, W

    1990-09-01

    In the UK in 1988, 13.3% of abortions were performed at 13 weeks' gestation or later. Reasons for this delay, in addition to the diagnosis through amniocentesis of a fetal abnormality, include late recognition of pregnancy, a change of mind about completing the pregnancy, a failure of primary care physicians to entertain the diagnosis of pregnancy, travel or financial problems, and referral difficulties and scheduling delays. Women with little education and very young women are most likely to present for late abortions. From 13-16 weeks, dilatation and evacuation is the safest method of pregnancy termination. The procedure can be made easier through preparation of the cervix with a prostaglandin pessary or Foley catheter. After 16 weeks, an instillation method is recommended; prostaglandin administration can be intro- or extra-amniotic. Complication rates at 13-19 weeks are 14.5/1000 for vaginal methods of abortion and 7.2/1000 for prostaglandin methods. The risk of complications is 3 times higher for women who have 2nd-trimester abortions through the National Health Service. Although it is not realistic to expect that late abortions ever can be eliminated, improved sex education and contraceptive reliability as well as reforms in the National Health Service could reduce the number substantially. To reduce delay, it is suggested that the National Health Service set up satellite day care units and 1-2 central units in each region to deal quickly with midtrimester abortions. Delays would be further reduced by legislation to allow abortion on request in at least the 1st trimester of pregnancy.

  8. Childhood physical maltreatment with physical injuries is associated with higher adult psychopathology symptoms.

    Science.gov (United States)

    Lamela, Diogo; Figueiredo, Bárbara

    2018-05-29

    Previous research has neglected the distinction between childhood physical maltreatment (CPM) behaviors and the physical sequelae resulting from CPM. Prior empirical work has combined CPM behaviors (e.g., beat, hit with a belt) and CPM physical sequelae (e.g., bruises, fractures) into a single conceptual category to predict adverse psychological consequences in adults. This is preventing the examination whether specific subgroups of CPM exposure may report a higher risk of psychopathology symptoms in adulthood. The aim of this study was to examine whether distinct experiences of CPM histories (no physical maltreatment, physical maltreatment only, and physical maltreatment with physical sequelae) would be differentially associated with specific psychopathology dimensions in adulthood. symptoms METHOD: Data were drawn from the Portuguese National Representative Study of Psychosocial Context of Child Abuse and Neglect (N = 941). Participants completed the Childhood History Questionnaire and the Brief Symptom Inventory. Three groups were created based on participants' experience of CPM assessed by the Childhood History Questionnaire. Participants who reported that suffered physical sequelae of the CPM exhibited significantly higher symptoms in all psychopathology dimensions than participants with no history of CPM and participants that were exposed to physical maltreatment without sequelae. These findings suggest that clinicians should discriminate CPM behavior from CPM physical sequelae in order to increase effectiveness of mental health treatment with adults with history of CPM. Our findings are discussed in light of the evolutionary-developmental frameworks of adaptative development and cumulative risk hypothesis. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  9. Severe late anemia of hemolytic disease of the newborn

    Science.gov (United States)

    Mitchell, Simon; James, Andrew

    1999-01-01

    Late anemia is a well-recognized complication of Rhesus hemolytic disease of the newborn (HDN). The incidence of Rhesus HDN is declining, with a tendency for more severely affected pregnancies to be managed in specialist centres. Consequently, many paediatric departments may see relatively few affected infants with comparatively mild disease, and the risk of late anemia in such cases may not always be appreciated. Two cases of infants born with evidence of Rhesus isoimmunization noted at birth and encountering no immediate problems other than mild hyperbilirubinemia are described. After an uneventful early neonatal course, both infants were discharged without follow-up and presented in the second to third weeks of life with severe, life-threatening anemia, leading to neurological sequelae in one case. The importance of close surveillance, including hemoglobin measurements, in all infants with Rhesus hemolytic disease, irrespective of initial severity, is reiterated. PMID:20212966

  10. Late changes in barium sulfate aspiration: HRCT features

    International Nuclear Information System (INIS)

    Voloudaki, A.; Ergazakis, N.; Gourtsoyiannis, N.

    2003-01-01

    Aspiration of barium sulfate occurs accidentally. Lung reaction is usually mild in the early phase due to inert character of the substance and long-term reactions or late toxicities are not expected. Little if any fibrotic response is speculated. We present a case with barium aspiration, studied by high-resolution computed tomography (HRCT) 1 year after the event, as late pulmonary sequelae studied by CT have not been described yet, to the best of our knowledge. The HRCT revealed thickened interlobular septa, subpleural lines, subpleural cysts, and centrilobular micronodules along with barium particles in a subpleural distribution. Those findings indicated that barium is capable of producing mild though silent clinically fibrosis. (orig.)

  11. Long-term sequelae of perinatal asphyxia in the aging rat

    DEFF Research Database (Denmark)

    Weitzdoerfer, R; Gerstl, N; Hoeger, H

    2002-01-01

    Information on the consequences of perinatal asphyxia (PA) on brain morphology and function in the aging rat is missing although several groups have hypothesized that PA may be responsible for neurological and psychiatric deficits in the adult. We therefore decided to study the effects of PA...... the platform of the MWM was moved to a new location, were observed in asphyxiated rats. We showed that deteriorated cognitive functions accompanied by aberrant expression of hippocampal SERT and impaired relearning are long-term sequelae of perinatal asphyxia, a finding that may form the basis...

  12. Neurocognitive sequelae of cerebral malaria in adults: a pilot study in Benguela Central Hospital, Angola.

    Science.gov (United States)

    Peixoto, Bruno; Kalei, Isabel

    2013-07-01

    To characterize the neurocognitive sequelae of cerebral malaria (CM) in an adult sample of the city of Benguela, Angola. A neuropsychological assessment was carried out in 22 subjects with prior history of CM ranging from 6 to 12 months after the infection. The obtained results were compared to a control group with no previous history of cerebral malaria. The study was conducted in Benguela Central Hospital, Angola in 2011. CM group obtained lower results on the two last trials of a verbal learning task and on an abstract reasoning test. CM is associated to a slower verbal learning rate and to difficulties in the ability to discriminate and perceive relations between new elements.

  13. Acesso e expansão do ensino superior noturno em goiás: perspectivas de democratização / Access and expansion of higher education in late goiás: prospects for democracy

    Directory of Open Access Journals (Sweden)

    Jandernaide Resende Lemos

    2009-01-01

    Full Text Available O presente texto analisa a evolução da oferta de educação superior, no turno noturno, em Goiás, tendo por base as reformas implementadas, sobretudo a partir da década de 1990. Busca-se compreender, em especial, como vem se estruturando a oferta de educação superior em Goiás e sua relação com as políticas públicas de educação superior no Brasil. O propósito básico é verificar se a expansão das matrículas dos cursos noturnos nas Instituições de Ensino Superior(IES, públicas e privadas, vem contribuindo com uma efetiva democratização do acesso a esse nível de ensino.Abstract This paper analyzes the evolution of the supply of higher education, on the night shift, in Goias, based on the reforms implemented, particularly since the 1990s. We seek to understand, inparticular, as has been structuring the provision of higher education in São Paulo and their relationship with the public policies of higher education in Brazil. The basic purpose is to ensure that the expansion of enrollment in night courses at Higher Education Institutions (HEIs, public and private, has contributed to an effective democratization of access to that level of education.

  14. Intraoperative Hemorrhage and Postoperative Sequelae after Intraoral Vertical Ramus Osteotomy to Treat Mandibular Prognathism

    Science.gov (United States)

    Chen, Chun-Ming; Lai, Steven; Chen, Ker-Kong; Lee, Huey-Er

    2015-01-01

    Objective. To investigate the factors affecting intraoperative hemorrhage and postoperative sequelae after orthognathic surgery. Materials and Methods. Eighty patients with mandibular prognathism underwent surgical mandibular setback with intraoral vertical ramus osteotomy (IVRO). The correlation between the blood loss volume and postoperative VAS with the gender, age, and operating time was assessed using the t-test and Spearman rank correlation coefficient. The correlation between the magnitude of mandibular setback with the presence of TMJ clicking symptoms and lip sensation was also assessed. Results. The mean operating time and blood loss volume for men and women were 249.52 min and 229.39 min, and 104.03 mL and 86.12 mL, respectively. The mean VAS in men and women was 3.21 and 2.93, and 1.79 and 1.32 on the first and second postoperative days. There is no gender difference in the operating time, blood loss, VAS, TMJ symptoms, and lip numbness. The magnitude of mandibular setback was not correlated with immediate and long-term postoperative lip numbness. Conclusion. There are no gender differences in the intraoperative hemorrhage and postoperative sequelae (pain, lip numbness, and TMJ symptoms). In addition, neither symptom was significantly correlated with the amount of mandibular setback. PMID:26543855

  15. [Maxillary advancement osteotomy with sequelae cleft lip and palate: Dilemma between occlusion and aesthetic profile].

    Science.gov (United States)

    Vigneron, A; Morand, B; Lafontaine, V; Lesne, V; Lesne, C; Bettega, G

    2015-11-01

    Maxillary hypoplasia is a common sequela of cleft lip and palate. Its surgical treatment consists in a maxillary advancement by distraction or by conventional orthognathic surgery but morphological results are unpredictable. Our goal in this study was to see if the esthetical results (on the lip and the nose) of maxillary advancement were correlated to the preservation of lateral incisor space of the cleft side. This retrospective study included 38 patients operated between 2002 and 2013. Unilateral clefts were studied independently from bilateral clefts. Profile aesthetics was evaluated independently and subjectively by two surgeons and scored on an 8-point scale. The result was classified as "good" if the score was superior or equal to 6. The score was correlated to the following parameters: amount of maxillary advancement, upper incisor axis, preservation of the missing lateral incisor space. In the "good result" group, the space of the lateral incisor was less often preserved. The nasolabial angle was more open and the upper central incisor axis more vertical. These results were more pronounced in bilateral clefts, but also found in unilateral clefts. Under reservation of the subjective evaluation and of the small number of patients, it seemed that lateral incisor space closure improved the profile of patients treated by maxillary advancement for cleft lip and palate sequelae. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. Animal Models of Virus-Induced Neurobehavioral Sequelae: Recent Advances, Methodological Issues, and Future Prospects

    Directory of Open Access Journals (Sweden)

    Marco Bortolato

    2010-01-01

    Full Text Available Converging lines of clinical and epidemiological evidence suggest that viral infections in early developmental stages may be a causal factor in neuropsychiatric disorders such as schizophrenia, bipolar disorder, and autism-spectrum disorders. This etiological link, however, remains controversial in view of the lack of consistent and reproducible associations between viruses and mental illness. Animal models of virus-induced neurobehavioral disturbances afford powerful tools to test etiological hypotheses and explore pathophysiological mechanisms. Prenatal or neonatal inoculations of neurotropic agents (such as herpes-, influenza-, and retroviruses in rodents result in a broad spectrum of long-term alterations reminiscent of psychiatric abnormalities. Nevertheless, the complexity of these sequelae often poses methodological and interpretational challenges and thwarts their characterization. The recent conceptual advancements in psychiatric nosology and behavioral science may help determine new heuristic criteria to enhance the translational value of these models. A particularly critical issue is the identification of intermediate phenotypes, defined as quantifiable factors representing single neurochemical, neuropsychological, or neuroanatomical aspects of a diagnostic category. In this paper, we examine how the employment of these novel concepts may lead to new methodological refinements in the study of virus-induced neurobehavioral sequelae through animal models.

  17. [On the contribution of magnets in sequelae of facial paralysis. Preliminary clinical study].

    Science.gov (United States)

    Fombeur, J P; Koubbi, G; Chevalier, A M; Mousset, C

    1988-01-01

    This trial was designed to evaluate the efficacy of EPOREC 1 500 magnets as an adjuvant to rehabilitation following peripheral facial paralysis. Magnetotherapy is used in many other specialties, and in particular in rheumatology. The properties of repulsion between identical poles were used to decrease the effect of sequelae in the form of contractures on the facial muscles. There were two groups of 20 patients: one group with physiotherapy only and the other with standard rehabilitation together with the use of magnets. These 40 patients had facial paralysis of various origins (trauma, excision of acoustic neuroma, Bell's palsy etc). Obviously all patients had an intact nerve. It was at the time of the development of contractures that magnets could be used in terms of evaluation of their efficacy of action on syncinesiae, contractures and spasticity. Magnets were worn at night for a mean period of six months and results were assessed in terms of disappearance of eye-mouth syncinesiae, and in terms of normality of facial tone. Improvement and total recovery without sequelae were obtained far more frequently in the group which wore magnets, encouraging us to continue along these lines.

  18. Periapical lesions are not always a sequelae of pulpal necrosis: a retrospective study of 1521 biopsies.

    Science.gov (United States)

    Kontogiannis, T G; Tosios, K I; Kerezoudis, N P; Krithinakis, S; Christopoulos, P; Sklavounou, A

    2015-01-01

    To record the incidence of lesions that were not the sequelae of pulpal necrosis (non-SPN) amongst 1521 biopsies of periapical lesions submitted with a clinical diagnosis of a sequelae of pulpal necrosis (SPN). A retrospective study of 1521 biopsy request forms of specimens submitted for histopathological examination with a clinical diagnosis 'periapical inflammation', 'periapical abscess', 'periapical granuloma' or 'periapical cyst' during an arbitrarily selected 14-year period was undertaken. Gender and age of the patient, site and maximum diameter of the lesion, symptoms, inclusion of the final diagnosis in the differential diagnosis and specialty of the clinician submitting the biopsy material were recorded in each case. The final diagnosis for each case was extracted from the pathology report, and two groups were formed, SPN and non-SPN lesions. Differences between the respective features of SPN and non-SPN cases were analysed with Yate's chi-square test and t-test (significance level P cysts, lateral periodontal cysts, central ossifying fibromas as well as malignancies (metastatic carcinomas and Langerhans cell histiocytosis). Non-SPN lesions appeared in the periapical region mimicking a SPN, although rarely. Most of them were developmental cysts, in particular OKCs, but odontogenic tumours, such as ameloblastoma, or malignant lesions were also diagnosed. Histological examination of tissue harvested from periapical lesions should be performed, in particular when those lesions are large. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  19. Intraoperative Hemorrhage and Postoperative Sequelae after Intraoral Vertical Ramus Osteotomy to Treat Mandibular Prognathism

    Directory of Open Access Journals (Sweden)

    Chun-Ming Chen

    2015-01-01

    Full Text Available Objective. To investigate the factors affecting intraoperative hemorrhage and postoperative sequelae after orthognathic surgery. Materials and Methods. Eighty patients with mandibular prognathism underwent surgical mandibular setback with intraoral vertical ramus osteotomy (IVRO. The correlation between the blood loss volume and postoperative VAS with the gender, age, and operating time was assessed using the t-test and Spearman rank correlation coefficient. The correlation between the magnitude of mandibular setback with the presence of TMJ clicking symptoms and lip sensation was also assessed. Results. The mean operating time and blood loss volume for men and women were 249.52 min and 229.39 min, and 104.03 mL and 86.12 mL, respectively. The mean VAS in men and women was 3.21 and 2.93, and 1.79 and 1.32 on the first and second postoperative days. There is no gender difference in the operating time, blood loss, VAS, TMJ symptoms, and lip numbness. The magnitude of mandibular setback was not correlated with immediate and long-term postoperative lip numbness. Conclusion. There are no gender differences in the intraoperative hemorrhage and postoperative sequelae (pain, lip numbness, and TMJ symptoms. In addition, neither symptom was significantly correlated with the amount of mandibular setback.

  20. Tumor histology and location predict deep nuclei toxicity: Implications for late effects from focal brain irradiation.

    Science.gov (United States)

    Plaga, Alexis; Shields, Lisa B E; Sun, David A; Vitaz, Todd W; Spalding, Aaron C

    2012-01-01

    Normal tissue toxicity resulting from both disease and treatment is an adverse side effect in the management of patients with central nervous system malignancies. We tested the hypothesis that despite these improvements, certain tumors place patients at risk for neurocognitive, neuroendocrine, and neurosensory late effects. Defining patient groups at risk for these effects could allow for development of preventive strategies. Fifty patients with primary brain tumors underwent radiation planning with magnetic resonance imaging scan and computed tomography datasets. Organs at risk (OAR) responsible for neurocognitive, neuroendocrine, and neurosensory function were defined. Inverse-planned intensity-modulated radiation therapy was optimized with priority given to target coverage while penalties were assigned to exceeding normal tissue tolerances. Tumor laterality, location, and histology were compared with OAR doses, and analysis of variance was performed to determine the significance of any observed correlation. The ipsilateral hippocampus exceeded dose limits in frontal (74%), temporal (94%), and parietal (100%) lobe tumor locations. The contralateral hippocampus was at risk in the following tumor locations: frontal (53%), temporal (83%), or parietal (50%) lobe. Patients with high-grade glioma were at risk for ipsilateral (88%) and contralateral (73%) hippocampal damage (P <0.05 compared with other histologies). The pituitary gland and hypothalamus exceeded dose tolerances in patients with pituitary tumors (both 100%) and high-grade gliomas (50% and 75%, P <0.05 compared with other histologies), respectively. Despite application of modern radiation therapy, certain tumor locations and histologies continue to place patients at risk for morbidity. Patients with high-grade gliomas or tumors located in the frontal, temporal, or parietal lobes are at risk for neurocognitive decline, likely because of larger target volumes and higher radiation doses. Data from this study

  1. Tumor histology and location predict deep nuclei toxicity: Implications for late effects from focal brain irradiation

    International Nuclear Information System (INIS)

    Plaga, Alexis; Shields, Lisa B.E.; Sun, David A.; Vitaz, Todd W.; Spalding, Aaron C.

    2012-01-01

    Normal tissue toxicity resulting from both disease and treatment is an adverse side effect in the management of patients with central nervous system malignancies. We tested the hypothesis that despite these improvements, certain tumors place patients at risk for neurocognitive, neuroendocrine, and neurosensory late effects. Defining patient groups at risk for these effects could allow for development of preventive strategies. Fifty patients with primary brain tumors underwent radiation planning with magnetic resonance imaging scan and computed tomography datasets. Organs at risk (OAR) responsible for neurocognitive, neuroendocrine, and neurosensory function were defined. Inverse-planned intensity-modulated radiation therapy was optimized with priority given to target coverage while penalties were assigned to exceeding normal tissue tolerances. Tumor laterality, location, and histology were compared with OAR doses, and analysis of variance was performed to determine the significance of any observed correlation. The ipsilateral hippocampus exceeded dose limits in frontal (74%), temporal (94%), and parietal (100%) lobe tumor locations. The contralateral hippocampus was at risk in the following tumor locations: frontal (53%), temporal (83%), or parietal (50%) lobe. Patients with high-grade glioma were at risk for ipsilateral (88%) and contralateral (73%) hippocampal damage (P <0.05 compared with other histologies). The pituitary gland and hypothalamus exceeded dose tolerances in patients with pituitary tumors (both 100%) and high-grade gliomas (50% and 75%, P <0.05 compared with other histologies), respectively. Despite application of modern radiation therapy, certain tumor locations and histologies continue to place patients at risk for morbidity. Patients with high-grade gliomas or tumors located in the frontal, temporal, or parietal lobes are at risk for neurocognitive decline, likely because of larger target volumes and higher radiation doses. Data from this study

  2. Tumor histology and location predict deep nuclei toxicity: Implications for late effects from focal brain irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Plaga, Alexis; Shields, Lisa B.E. [Norton Neuroscience Institute, Louisville, KY (United States); Sun, David A.; Vitaz, Todd W. [Norton Neuroscience Institute, Louisville, KY (United States); Brain Tumor Center, Norton Healthcare, Louisville, KY (United States); Spalding, Aaron C., E-mail: acspalding1@gmail.com [Brain Tumor Center, Norton Healthcare, Louisville, KY (United States); Norton Cancer Institute, Radiation Center, Kosair Children' s Hospital, Louisville, KY (United States)

    2012-10-01

    Normal tissue toxicity resulting from both disease and treatment is an adverse side effect in the management of patients with central nervous system malignancies. We tested the hypothesis that despite these improvements, certain tumors place patients at risk for neurocognitive, neuroendocrine, and neurosensory late effects. Defining patient groups at risk for these effects could allow for development of preventive strategies. Fifty patients with primary brain tumors underwent radiation planning with magnetic resonance imaging scan and computed tomography datasets. Organs at risk (OAR) responsible for neurocognitive, neuroendocrine, and neurosensory function were defined. Inverse-planned intensity-modulated radiation therapy was optimized with priority given to target coverage while penalties were assigned to exceeding normal tissue tolerances. Tumor laterality, location, and histology were compared with OAR doses, and analysis of variance was performed to determine the significance of any observed correlation. The ipsilateral hippocampus exceeded dose limits in frontal (74%), temporal (94%), and parietal (100%) lobe tumor locations. The contralateral hippocampus was at risk in the following tumor locations: frontal (53%), temporal (83%), or parietal (50%) lobe. Patients with high-grade glioma were at risk for ipsilateral (88%) and contralateral (73%) hippocampal damage (P <0.05 compared with other histologies). The pituitary gland and hypothalamus exceeded dose tolerances in patients with pituitary tumors (both 100%) and high-grade gliomas (50% and 75%, P <0.05 compared with other histologies), respectively. Despite application of modern radiation therapy, certain tumor locations and histologies continue to place patients at risk for morbidity. Patients with high-grade gliomas or tumors located in the frontal, temporal, or parietal lobes are at risk for neurocognitive decline, likely because of larger target volumes and higher radiation doses. Data from this study

  3. The risk of sequelae due to pneumococcal meningitis in high-income countries: a systematic review and meta-analysis.

    Science.gov (United States)

    Jit, Mark

    2010-07-01

    To determine the risk of various kinds of sequelae in survivors of meningitis due to Streptococcus pneumoniae, as well as the influence of co-factors such as study design, study population and treatment on this risk. MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from 1 September 1991 to 18 June 2009 for original articles on pneumococcal meningitis sequelae. Prevalence of sequelae was pooled using random effects meta-analysis. Studies were appraised for the influence of referral bias, external validity of study populations, testing procedure and publication bias. Data were extracted from 63 studies involving 3408 pneumococcal meningitis survivors. The pooled prevalence of any reported sequelae from 48 studies was 31.7% (95% confidence interval 27.2-36.3%) using a random effects model (Cochran-Q = 277, p < 0.01). Differences in studies due to design, study population and treatment were not significant. The pooled prevalence of hearing loss, seizures, hydrocephalus, spasticity/paresis, cranial nerve palsies and visual impairment was 20.9% (17.1-24.7%), 6.5% (3.3-9.7%), 6.8% (3.3-10.2%), 8.7% (6.4-11.0%), 12.2% (5.3-19.1%) and 2.4% (0-5.7%) respectively. The burden of sequelae due to pneumococcal meningitis remains high in the reviewed studies.

  4. Megalophallus as a sequela of priapism in sickle cell anemia: use of blood oxygen level-dependent magnetic resonance imaging.

    Science.gov (United States)

    Kassim, A A; Umans, H; Nagel, R L; Fabry, M E

    2000-09-01

    Priapism is a common complication of sickle cell anemia. We report a little known sequela of priapism: painless megalophallus, with significant penile enlargement. The patient had had an intense episode of priapism 9 years previously and his penis remained enlarged. Blood oxygen level-dependent magnetic resonance imaging revealed enlarged, hypoxic corpora cavernosa. Megalophallus probably resulted from permanent loss of elasticity of the tunica albuginea due to severe engorgement during the episode of priapism. This sequela needs to be recognized by physicians because no intervention is necessary and sexual function seems to remain intact.

  5. Acute and late effects of 16- and 50-MeV/sub d → Be/ neutrons on the oral mucosa of Rhesus monkeys

    International Nuclear Information System (INIS)

    Jardine, J.H.; Hussey, D.H.; Boyd, D.D.; Raulston, G.L.; Davidson, T.J.

    1975-01-01

    Twenty-five rhesus monkeys were randomly assigned to one of five mouth irradiation treatment schedules: control group, no irradiation; 60 Co γ five times weekly; 60 Co twice weekly; 16-MeV/sub d→Be/ neutrons twice weekly. Although the acute reactions of the oral mucosa were similar in the four irradiated groups, the late sequelae were more severe in the animals irradiated twice weekly with 60 Co γ or neutrons. All of the animals irradiated with 60 Co γ twice weekly or with 16 MeV/sub d→Be/ neutrons exhibited oromucosal necrosis, whereas none of those irradiated five times weekly with 60 Co γ did. The difference in the effect of photon fractionation on early and late radiation sequelae may be related to different patterns of redistribution of surviving cells through the division cycle in tissues responsible for early and late damage. (auth)

  6. Personality in Late Midlife

    DEFF Research Database (Denmark)

    Mortensen, Erik Lykke; Flensborg-Madsen, Trine; Molbo, Drude

    2014-01-01

    To analyze associations in late midlife between sex, age, education and social class, and the Big Five personality traits; to analyze associations between personality traits and cognitive ability in late midlife; and to evaluate how these associations are influenced by demographic factors....

  7. Neuropsychological sequelae of central nervous system prophylaxis in survivors of childhood acute lymphoblastic leukemia

    International Nuclear Information System (INIS)

    Said, J.A.; Waters, B.G.; Cousens, P.; Stevens, M.M.

    1989-01-01

    We assessed neuropsychologically 106 children with acute lymphoblastic leukemia (ALL) who had all received cranial irradiation for the prevention of central nervous system (CNS) leukemia 1-13 years previously. Children were assessed for adverse late effects of their therapy, using age-appropriate Wechsler measures of overall intellectual ability and supplementary tests. Forty-five siblings near in age to the patients were tested as controls. The patients who had had the most intensive central nervous system (CNS) prophylaxis were found to have a WISC-R Full Scale IQ 17 points lower than the sibling control group. Performance IQ was more affected than verbal IQ. The patients were more easily distracted and less able to concentrate. The severity of the aftereffects was related to younger age at the time of CNS prophylaxis and to a higher dose of cranial irradiation but not to time since CNS prophylaxis. CNS prophylaxis using a combination of cranial irradiation and intrathecal methotrexate has lowered the incidence of CNS relapse in childhood ALL but is associated with considerable long-term morbidity in survivors

  8. NEUROLOGICAL SEQUELAE FOLLOWING ANAESTHETIC RECOVERY AFTER BILATERAL TOTAL KNEE REPLACEMENT – TWO CASE REPORTS

    Directory of Open Access Journals (Sweden)

    Harpreet

    2016-03-01

    Full Text Available BACKGROUND Thromboembolism is a common and serious complication of joint replacement surgery. Cognitive decline occurs in 5-29% of patients, undergoing major orthopaedic surgery. Many studies show that systemic embolism may occur in the absence of venous-arterial shunts leading to cognitive dysfunction and neurological sequelae. METHODS We present two cases of neurological consequences occurring post bilateral TKR. Cases were successfully done under Combined Spinal Epidural Anaesthesia. Steroids were not used intraoperatively. RESULTS Both cases had neurological complications following completion of surgery. First case had posterior circulation TIA while the other had a right upper motor neuron facial palsy. CONCLUSION We suspect both as cases of cerebral fat microembolism in the absence of any venous-arterial shunt.

  9. Pain, sensory disturbances and psychological distress are common sequelae after treatment of ductal carcinoma in situ

    DEFF Research Database (Denmark)

    Mertz, Birgitte Goldschmidt; Duriaud, Helle Molter; Kroman, Niels

    2017-01-01

    Sequelae such as pain, sensory disturbances and psychological distress are well known after treatment for invasive breast cancer (IBC). Patients treated for ductal carcinoma in situ (DCIS) receive a similar treatment as low-risk IBC. The aim of this cross-sectional study was to describe prevalence......: 1.1–7.0, p = 0.02) and anxiety and depression (measured by HADStotal >15 OR of 3.1 (95% CI: 1.5–6.3, p = 0.003)) were significantly associated with moderate to severe pain. Approximately one-third of the patients reported sensory disturbances such as pins and needles (32%), numbness (37......%) and painful itch (30%) and 94 women (20%) reported anxiety ≥8, 26 (6%) depression and 51 (11%) reported distress. Conclusions: This cross-sectional study showed that women treated for DCIS suffered from pain, sensory disturbances and psychological impairment and had unmet rehabilitation needs. Further...

  10. Clinical-radiological evaluation of sequelae of stereotactic radiosurgery for intracranial arteriovenous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Levy, R.P.; Fabrikant, J.I.; Frankel, K.A.; Phillips, M.H.; Steinberg, G.K.; Marks, M.P.; DeLaPaz, R.L.; Chuang, F.Y.S.

    1989-12-01

    Stereotactic heavy-charged-particle Bragg peak radiosurgery has been used to treat 322 patients with surgically-inaccessible intracranial vascular malformations. (The clinical results of this method for the treatment of angiographically demonstrable arteriovenous malformations (AVMs) and angiographically occult vascular malformations (AOVMs) of the brain are described in separate reports of this symposium). The great majority of patients have had an uneventful post-treatment course with satisfactory health outcomes. However, several categories of delayed sequelae of stereotactic radiosurgery have been identified, involving the vascular structures essential for the integrity of the brain tissue and the brain parenchyma directly. These categories reflect both reaction to injury and to alterations in regional hemodynamic status, and include vasogenic edema, occlusion of functional vasculature, radiation necrosis, and local or remote effects on cerebral arterial aneurysms. 10 refs., 7 figs., 1 tab.

  11. Spontaneous bronchoesophageal fistula in an adult – A possible delayed sequela of pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Surendra Patel

    2015-01-01

    Full Text Available Spontaneous bronchoesophageal fistula in the adult is a rare clinical entity. Most bronchoesophageal fistulae are due to malignancy, prolonged endotracheal intubation or trauma. Granulomatous infections like tuberculosis, HIV and mediastinitis are rare causes of acquired bronchoesophageal fistula. We report a case of a 50 year old man, treated for pulmonary tuberculosis 15 years ago, who developed a spontaneous bronchoesophageal fistula between the mid-esophagus and right main stem bronchus, having no history of malignancy or trauma. Surgical closure of the fistula was done and post operative recovery was uneventful. In this case, the bronchoesophageal fistula probably developed as a delayed sequela of pulmonary tuberculosis as the patient had no active signs of pulmonary tuberculosis clinically or histopathologically.

  12. Clinical-radiological evaluation of sequelae of stereotactic radiosurgery for intracranial arteriovenous malformations

    International Nuclear Information System (INIS)

    Levy, R.P.; Fabrikant, J.I.; Frankel, K.A.; Phillips, M.H.; Steinberg, G.K.; Marks, M.P.; DeLaPaz, R.L.; Chuang, F.Y.S.

    1989-12-01

    Stereotactic heavy-charged-particle Bragg peak radiosurgery has been used to treat 322 patients with surgically-inaccessible intracranial vascular malformations. (The clinical results of this method for the treatment of angiographically demonstrable arteriovenous malformations (AVMs) and angiographically occult vascular malformations (AOVMs) of the brain are described in separate reports of this symposium). The great majority of patients have had an uneventful post-treatment course with satisfactory health outcomes. However, several categories of delayed sequelae of stereotactic radiosurgery have been identified, involving the vascular structures essential for the integrity of the brain tissue and the brain parenchyma directly. These categories reflect both reaction to injury and to alterations in regional hemodynamic status, and include vasogenic edema, occlusion of functional vasculature, radiation necrosis, and local or remote effects on cerebral arterial aneurysms. 10 refs., 7 figs., 1 tab

  13. Aesthetic skin branding: a novel form of body art with adverse clinical sequela.

    Science.gov (United States)

    Karamanoukian, Raffy; Ukatu, Chidi; Lee, Edward; Hyman, Josh; Sundine, Michael; Kobayashi, Mark; Evans, Gregory R D

    2006-01-01

    Branding is a form of body art wherein third-degree burns are inflicted on the skin to produce permanent scars. This method of scarification is a common practice among many indigenous cultures and has become exceedingly common in western societies. As with other forms of body art, branding is not a manifestation of a psychiatric disorder but, rather, a method of self-expression. The process can be performed through the use of electrocautery, laser, chemicals, freezing, and hot metal. Complications arising from the procedure include acute infection, transmission of blood-borne pathogens, allergic reactions, and sequelae arising from third-degree burns. In addition, skin branding has been shown to be associated with substance abuse and high-risk behaviors among adolescents. The purpose of this article is to present the following case report and review to familiarize clinicians with this dangerous method of body art.

  14. Long-term sequelae after lung abscess in children - Two tertiary centers' experience.

    Science.gov (United States)

    Wojsyk-Banaszak, I; Krenke, K; Jończyk-Potoczna, K; Ksepko, K; Wielebska, A; Mikoś, M; Bręborowicz, A

    2018-05-01

    The aim of the study was to describe the epidemiology and clinical characteristic of children hospitalized with pneumonia complicated by lung abscess, as well as to evaluate the long-term sequelae of the disease. A retrospective review of medical records of all patients treated for pulmonary abscess in two tertiary centers was undertaken. Pulmonary function tests and lung ultrasound were performed at a follow-up. During the study period, 5151 children with pneumonia were admitted, and 49 (0.95%) cases were complicated with lung abscess. In 38 (77.5%) patients, lung abscess was treated solely with antibiotics, and in nine cases (16.3%) surgically. In 21 (51.21%) children complete radiological regression was documented. The mean time for radiological abnormalities regression was 84.14 ± 51.57 days, regardless of the treatment mode. Fifteen patients were followed up at 61.6 ± 28.3 months after discharge. Lung ultrasound revealed minor residual abnormalities: pleural thickening, subpleural consolidations and line B artefacts in 11 (73.3%) children. Pulmonary function tests results were abnormal in eight (53.3%) patients, the most frequent abnormality being hyperinflation. We did not find a restrictive disorder in any of the children. There were no deaths in our study. Lung abscess is a rare but severe complication of pneumonia in children. Most children recover uneventfully with no significant long-term pulmonary sequelae. Copyright © 2018 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  15. Safety and feasibility of the robotic platform in the management of surgical sequelae of chronic pancreatitis.

    Science.gov (United States)

    Hamad, Ahmad; Zenati, Mazen S; Nguyen, Trang K; Hogg, Melissa E; Zeh, Herbert J; Zureikat, Amer H

    2018-02-01

    The application of minimally invasive surgery to chronic pancreatitis (CP) procedures is uncommon. Our objective was to report the safety and feasibility of the robotic approach in the treatment of surgical sequelae of CP, and provide insights into the technique, tricks, and pitfalls associated with the application of robotics to this challenging disease entity. A retrospective review of a prospectively maintained database of patients undergoing robotic-assisted resections and/or drainage procedures for CP at the University of Pittsburgh between May 2009 and January 2017 was performed. A video of a robotic Frey procedure is also shown. Of 812 robotic pancreatic resections and reconstructions 39 were for CP indications. These included 11 total pancreatectomies [with and without auto islet transplantation], 8 Puestow procedures, 4 Frey procedures, 6 pancreaticoduodenectomies, and 10 distal pancreatectomies. Median age was 49, and 41% of the patients were female. The most common etiology for CP was idiopathic pancreatitis (n = 16, 46%). Median operative time was 324 min with a median estimated blood loss of 250 ml. None of the patients required conversion to laparotomy. A Clavien III-IV complication rate was experienced by 5 (13%) patients, including one reoperation. Excluding the eleven patients who underwent TP, rate of clinically relevant postoperative pancreatic fistula was 7% (Grade B = 2, Grade C = 0). No 30 or 90 day mortalities were recorded. The median length of hospital stay was 7 days. Use of the robotic platform is safe and feasible when tackling complex pancreatic resections for sequelae of chronic pancreatitis.

  16. Association between unintentional injury during pregnancy and excess risk of preterm birth and its neonatal sequelae.

    Science.gov (United States)

    Liu, Shiliang; Basso, Olga; Kramer, Michael S

    2015-11-01

    The sequelae of preterm births may differ, depending on whether birth follows an acute event or a chronic condition. In a population-based cohort study of 2,711,645 Canadian hospital deliveries from 2003 to 2012, 3,059 women experienced unintentional injury during pregnancy. We assessed the impact of the acute event on pregnancy outcome and on neonatal complications, such as nontraumatic intracranial hemorrhage, respiratory distress syndrome, intubation, and death. We adjusted for maternal age, parity, pregnancy conditions, and (for neonates) gestational age in logistic regression analyses. Injury was significantly associated with fetal mortality and early preterm delivery. For preterm infants born to injured women during the hospitalization for injury versus those born to noninjured women, the adjusted odds ratios were 2.25 (95% confidence interval (CI): 1.23, 4.17) for neonatal death, 2.44 (95% CI: 1.76, 3.37) for respiratory distress, 2.20 (95% CI: 1.26, 3.84) for nontraumatic intracranial hemorrhage, and 2.17 (95% CI: 1.60, 2.96) for intubation, despite more favorable fetal growth in those born to noninjured women (adjusted birth-weight-for-gestational-age z score: 0.154 vs. 0.024, P = 0.041; small-for-gestational-age rate: 4.5% vs. 9.5%, P = 0.001). Our findings suggest that adaptation to the suboptimal intrauterine environment underlying chronic causes of preterm birth may protect preterm infants from adverse sequelae. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Clinical Research on the Comprehensive Curative Effect of Acupuncture and Traditional Chinese Medicine for Pelvic Inflammatory Sequelae.

    Science.gov (United States)

    Mao, Penyuan; Liu, Shujie; Xue, Jianguo; Wu, Yuejun; Wang, Changqing

    2018-05-08

    BACKGROUND This randomized, controlled trial was designed to assess whether acupuncture plus an oral administration of Chinese herbal medicine provides greater relief of symptoms than oral administration of Chinese herbal medicine alone for treatment of pelvic inflammatory sequelae. MATERIAL AND METHODS Sixty-two patients ages 22 to 45 years with pelvic inflammatory sequelae were randomly assigned into one of 2 groups: an herbal group (n=30) and an herbal with acupuncture group (n=32). Both groups were treated for 3 courses of 3 months each. RESULTS Significant improvement of clinical symptoms and signs of pelvic inflammatory sequelae occurred in both treatment groups. The total effective rate for the herbal group was 83.33%, and for the herbal with acupuncture group it was 100% ([i]P[/i]=0.354 for difference between groups). During treatment, 5 patients had adverse reactions of nausea, loss of appetite, and diarrhea. After adjustment of the herb prescription, all adverse reactions disappeared. CONCLUSIONS Our results highlight the benefit of oral administration of Chinese herbal medicine along with acupuncture; this had a greater clinical curative effect rate than oral administration of Chinese herbal medicine alone when treating pelvic inflammatory sequelae.

  18. The costs of human Campylobacter infections and sequelae in the Netherlands: A DALY and cost-of-illness approach

    NARCIS (Netherlands)

    Mangen, M.J.J.; Havelaar, A.H.; Bernsen, R.A.J.A.M.; Koningsveld, van G.A.; Wit, de G.A.

    2007-01-01

    Campylobacter infections and sequelae pose an important public health problem for the Netherlands. With the help of a second order stochastic simulation model (using @Risk), confidence intervals (CI) for the associated disease burden (summing up morbidity and mortality) and the associated

  19. Impact of age and co-morbidity on the functioning of patients with sequelae of poliomyelitis: a cross-sectional study

    NARCIS (Netherlands)

    Stolwijk-Swuste, Janneke M.; Beelen, Anita; Lankhorst, Gustaaf J.; Nollet, Frans

    2007-01-01

    OBJECTIVE: To investigate the impact of age and co-morbidity on the functional independence and perceived physical functioning of patients with sequelae of poliomyelitis. DESIGN: Cross sectional study. SUBJECTS: A convenience sample of 168 patients with sequelae of poliomyelitis, aged 45-85 years,

  20. Late-Stage Caregiving

    Science.gov (United States)

    ... Caregiving Middle-Stage Caregiving Late-Stage Caregiving Behaviors Aggression & Anger Anxiety & Agitation Depression Hallucinations Memory Loss & Confusion Repetition Sleep Issues & Sundowning Suspicion & Delusions Wandering Abuse Start Here What You Need to Know Online ...

  1. Endocrine and metabolic sequelae of tumours with a focus on craniopharyngioma

    NARCIS (Netherlands)

    M. Wijnen (Mark)

    2018-01-01

    textabstractDuring the past decades, cancer survival increased substantially in both children and adults. Consequently, long-term complications of cancer and its treatment became increasingly important. Studies on late effects of cancer treatment focused predominantly on survivors of

  2. Late effects of treatment of cancer in infancy

    International Nuclear Information System (INIS)

    Pastore, G.; Antonelli, R.; Fine, W.; Li, F.P.; Sallan, S.E.

    1982-01-01

    Eighty-six children were diagnosed with cancer in infancy, followed for at lest 5 years, and assessed for late effects of disease and therapy. One child subsequently died from respiratory failure and 3 died from second primary cancers. Another patient survived second primary cancers of the skin. The high frequency of new cancers (4 observed, 0.09 expected) was attributable to host susceptibility factors and treatment effects. Kyphoscoliosis was diagnosed in 44 patients, 40 of whom had received radiotherapy to the spine. Other patients had neurologic deficits, pulmonary fibrosis, hypoplastic breasts, bowel adhesions, thyroid nodules, musculoskeletal defects, and liver fibrosis associated with tumor therapy. Sequelae of cancer were more common after treatment in infancy than in later childhood. Improved treatments and knowledge of natural history can reduce adverse effects of therapy

  3. Higher Education

    African Journals Online (AJOL)

    Kunle Amuwo: Higher Education Transformation: A Paradigm Shilt in South Africa? ... ty of such skills, especially at the middle management levels within the higher ... istics and virtues of differentiation and diversity. .... may be forced to close shop for lack of capacity to attract ..... necessarily lead to racial and gender equity,.

  4. Sequelas pleurais dos derrames tuberculosos: em busca de parâmetros preditivos

    Directory of Open Access Journals (Sweden)

    A.M.S. Chibante

    2003-01-01

    Full Text Available RESUMO: A tuberculose é uma enfermidade bastante comum relacionada com situações socioeconómicas mais desfavoráveis e frequentemente associada a derrame pleural. Vários autores focalizam as sequelas pleurais como consequências que em determinados casos podem interferir na função respiratória desencadeando insuficiência ventilatória. Alguns estudiosos têm procurado definir parâmetros bioquímicos de modo a detectar futuros espessamentos pleurais e prevenir, através de maior vigilância, possível incapacidade pulmonar. Este estudo baseia-se na análise radiográfica do tórax após término do tratamento e procura correlacionar possíveis achados pleurais com dados bioquímicos do líquido na fase inicial, volume dos derrames e tempo de sintomas.REV PORT PNEUMOL IX (1: 9-18 ABSTRACT: Tuberculosis is a very common disease usualy related to bad social-economic conditions and sometimes with associated pleural effusion. Pleural sequelae are referred by some authors as a consequence that may interfere with lung function provoking respiratory failure in some critical situations. Some experts try to find clinical and biochemical parameters in order to detect possibilities that could predict future pleural thickening and necessity of closer vigilance to avoid lung function disability.This study is based on the post-treatment roentgenological pleural findings and their correlation with the initial pleural fluid biochemical data, the volume of the effusions and time of patients complains.REV PORT PNEUMOL IX (1: 9-18 Palavras-chave: espessamento pleural, derrame pleural tuberculoso, inflamação pleural, Key-words: pleural fluid, pleural tuberculosis, pleural thikening

  5. Correlation of chest computed tomography findings with dyspnea and lung functions in post-tubercular sequelae

    Directory of Open Access Journals (Sweden)

    Ananya Panda

    2016-01-01

    Full Text Available Aims: To study the correlation between dyspnea, radiological findings, and pulmonary function tests (PFTs in patients with sequelae of pulmonary tuberculosis (TB. Materials and Methods: Clinical history, chest computed tomography (CT, and PFT of patients with post-TB sequelae were recorded. Dyspnea was graded according to the Modified Medical Research Council (mMRC scale. CT scans were analyzed for fibrosis, cavitation, bronchiectasis, consolidation, nodules, and aspergilloma. Semi-quantitative analysis was done for these abnormalities. Scores were added to obtain a total morphological score (TMS. The lungs were also divided into three zones and scores added to obtain the total lung score (TLS. Spirometry was done for forced vital capacity (FVC, forced expiratory volume in 1 s (FEV1, and FEV1/FVC. Results: Dyspnea was present in 58/101 patients. A total of 22/58 patients had mMRC Grade 1, and 17/58 patients had Grades 2 and 3 dyspnea each. There was a significant difference in median fibrosis, bronchiectasis, nodules (P < 0.01 scores, TMS, and TLS (P < 0.0001 between dyspnea and nondyspnea groups. Significant correlations were obtained between grades of dyspnea and fibrosis (r = 0.34, P = 0.006, bronchiectasis (r = 0.35, P = 0.004, nodule (r = 0.24, P = 0.016 scores, TMS (r = 0.398, P = 0.000, and TLS (r = 0.35, P = 0.0003. PFTs were impaired in 78/101 (77.2% patients. Restrictive defect was most common in 39.6% followed by mixed in 34.7%. There was a negative but statistically insignificant trend between PFT and fibrosis, bronchiectasis, nodule scores, TMS, and TLS. However, there were significant differences in median fibrosis, cavitation, and bronchiectasis scores in patients with normal, mild to moderate, and severe respiratory defects. No difference was seen in TMS and TLS according to the severity of the respiratory defect. Conclusion: Both fibrosis and bronchiectasis correlated with dyspnea and with PFT. However, this correlation was not

  6. Effect of clopidogrel premedication in off-pump cardiac surgery: are we forfeiting the benefits of reduced hemorrhagic sequelae?

    Science.gov (United States)

    Kapetanakis, Emmanouil I; Medlam, Diego A; Petro, Kathleen R; Haile, Elizabeth; Hill, Peter C; Dullum, Mercedes K C; Bafi, Ammar S; Boyce, Steven W; Corso, Paul J

    2006-04-04

    Premedication with clopidogrel has reduced thrombotic complications after percutaneous coronary revascularization procedures. However, because of the enhanced and irreversible platelet inhibition by clopidogrel, patients requiring surgical revascularization have a higher risk of bleeding complications and transfusion requirements. A principal benefit of surgical coronary revascularization without cardiopulmonary bypass is its lower hemorrhagic sequelae. The purpose of this study was to evaluate the effect of preoperative clopidogrel administration in the incidence of hemostatic reexploration, blood product transfusion rates, morbidity, and mortality in patients undergoing off-pump coronary artery bypass graft surgery using a large patient sample and a risk-adjusted approach. Two hundred eighty-one patients (17.9%) did and 1291 (82.1%) did not receive clopidogrel before their surgery, for a total of 1572 patients undergoing isolated off-pump coronary artery bypass graft surgery between January 2000 and June 2002. Risk-adjusted logistic regression analyses and a matched pair analyses by propensity scores were used to assess the association between clopidogrel administration and reoperation as a result of bleeding, intraoperative and postoperative blood transfusions received, and the need for multiple transfusions. Hemorrhage-related preoperative risk factors identified in the literature and those found significant in a univariate model were used. The clopidogrel group had a higher likelihood of hemostatic reoperations (odds ratio [OR], 5.1; 95% confidence interval [CI], 2.47 to 10.47; P<0.01) and an increased need in overall packed red blood cell (OR, 2.6; 95% CI, 1.94 to 3.60; P<0.01), multiple unit (OR, 1.6; 95% CI, 1.07 to 2.48; P=0.02), and platelet (OR, 2.5; 95% CI, 1.77 to 3.66; P<0.01) transfusions. Surgical outcomes and operative mortality (1.4% versus 1.4%; P=1.00) were not statistically different. Clopidogrel administration in the cardiology suite increases

  7. Clinical Factors Predicting Late Severe Urinary Toxicity After Postoperative Radiotherapy for Prostate Carcinoma: A Single-Institute Analysis of 742 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Cozzarini, Cesare, E-mail: cozzarini.cesare@hsr.it [Department of Radiotherapy, San Raffaele Scientific Institute, Milan (Italy); Fiorino, Claudio [Department of Medical Physics, San Raffaele Scientific Institute, Milan (Italy); Da Pozzo, Luigi Filippo [Department of Urology, San Raffaele Scientific Institute, Milan (Italy); Alongi, Filippo; Berardi, Genoveffa; Bolognesi, Angelo [Department of Radiotherapy, San Raffaele Scientific Institute, Milan (Italy); Briganti, Alberto [Department of Urology, San Raffaele Scientific Institute, Milan (Italy); Broggi, Sara [Department of Medical Physics, San Raffaele Scientific Institute, Milan (Italy); Deli, Aniko [Department of Radiotherapy, San Raffaele Scientific Institute, Milan (Italy); Guazzoni, Giorgio [Department of Urology, San Raffaele Scientific Institute, Milan (Italy); Perna, Lucia [Department of Medical Physics, San Raffaele Scientific Institute, Milan (Italy); Pasetti, Marcella; Salvadori, Giovannella [Department of Radiotherapy, San Raffaele Scientific Institute, Milan (Italy); Montorsi, Francesco; Rigatti, Patrizio [Department of Urology, San Raffaele Scientific Institute, Milan (Italy); Di Muzio, Nadia [Department of Radiotherapy, San Raffaele Scientific Institute, Milan (Italy)

    2012-01-01

    Purpose: To investigate the clinical factors independently predictive of long-term severe urinary sequelae after postprostatectomy radiotherapy. Patients and Methods: Between 1993 and 2005, 742 consecutive patients underwent postoperative radiotherapy with either adjuvant (n = 556; median radiation dose, 70.2 Gy) or salvage (n = 186; median radiation dose, 72 Gy) intent. Results: After a median follow-up of 99 months, the 8-year risk of Grade 2 or greater and Grade 3 late urinary toxicity was almost identical (23.9% vs. 23.7% and 12% vs. 10%) in the adjuvant and salvage cohorts, respectively. On univariate analysis, acute toxicity was significantly predictive of late Grade 2 or greater sequelae in both subgroups (p <.0001 in both cases), and hypertension (p = .02) and whole-pelvis radiotherapy (p = .02) correlated significantly in the adjuvant cohort only. The variables predictive of late Grade 3 sequelae were acute Grade 2 or greater toxicity in both groups and whole-pelvis radiotherapy (8-year risk of Grade 3 events, 21% vs. 11%, p = .007), hypertension (8-year risk, 18% vs. 10%, p = .005), age {<=} 62 years at RT (8-year risk, 16% vs. 11%, p = .04) in the adjuvant subset, and radiation dose >72 Gy (8-year risk, 19% vs. 6%, p = .007) and age >71 years (8-year risk, 16% vs. 6%, p = .006) in the salvage subgroup. Multivariate analysis confirmed the independent predictive role of all the covariates indicated as statistically significant on univariate analysis. Conclusions: The risk of late Grade 2 or greater and Grade 3 urinary toxicity was almost identical, regardless of the RT intent. In the salvage cohort, older age and greater radiation doses resulted in a worse toxicity profile, and younger, hypertensive patients experienced a greater rate of severe late sequelae in the adjuvant setting. The causes of this latter correlation and apparently different etiopathogenesis of chronic damage in the two subgroups were unclear and deserve additional investigation.

  8. The treatment of late radiation effects with hyperbaric oxygenation (HBO)

    International Nuclear Information System (INIS)

    Plafki, C.; Carl, U.M.; Glag, M.; Hartmann, K.A.

    1998-01-01

    Background: Late radiation injuries may impose a negative influence on the quality of life in the affected patients. In several entities, standardized treatment protocols are lacking. Hyperbaric oxygenation (HBO) has been shown to have beneficial effects in the treatment of late radiation sequelae. Material and methods: The basic principles of HBO are reviewed as well as clinical issues. Current study protocols are presented. Results: During HBO-therapy the patient breathes pure oxygen at pressures above 100 kPa. The oxygen solubility within the fluid phase of the blood is largely increased. Biological effects include an increased oxygen diffusibility, improved collagen synthesis and neoangiogenesis as well as an enhancement of antimicrobial defenses. By decreasing the capillary filtration pressure a reduction of edema becomes possible. HBO has been shown to prevent complications following surgery in irradiated tissues. Its efficacy as an adjunct in the treatment of osteonecroses in radiation patients could be demonstrated. In addition, the loss of osseointegrated implants in the maxillofacial bones of these patients could be significantly reduced. Further indications include soft tissue necroses, hemorrhagic cystitis and proctitis in tumor patients that have been treated by radiotherapy as part of a multimodality approach. Conclusions: HBO in the treatment of late radiation effects is still subject of investigation, but remarkable results have been reported. Optimized treatment protocols need to be determined in various entities. The rate of side effects is acceptable low. (orig.) [de

  9. Higher Education

    Science.gov (United States)

    & Development (LDRD) National Security Education Center (NSEC) Office of Science Programs Richard P Databases National Security Education Center (NSEC) Center for Nonlinear Studies Engineering Institute Scholarships STEM Education Programs Teachers (K-12) Students (K-12) Higher Education Regional Education

  10. Factors associated with long-term functional outcomes and psychological sequelae in Guillain-Barre syndrome.

    Science.gov (United States)

    Khan, F; Pallant, J F; Ng, L; Bhasker, A

    2010-12-01

    To examine factors impacting long-term health-related outcomes in survivors of Guillain-Barre syndrome (GBS). Seventy-six consecutive patients with definite GBS admitted to the Royal Melbourne Hospital (1996-2009) were reviewed in the neurorehabilitation clinics. They underwent a structured interview designed to assess the impact of GBS on their current activity and restriction in participation using validated questionnaires: Functional Independence Measure (FIM), Perceived Impact of Problem Profile (PIPP) and Depression Anxiety Stress Scale (DASS). Their sociodemographic and disease severity data were obtained from the medical record. The 76 patients [60% male, mean age 56 years, median time since GBS 6 years (range 1-14 years)] showed good functional recovery (median motor FIM score 90). However, 16% reported moderate to extreme impact on their ability to participate in work, family, and social activities; and 22% substantial impact on mood, confidence and ability to live independently. More reported moderate to extreme depression (18%), anxiety (22%) and stress (17%) compared with the normative Australian population (13%). Factors associated with poorer current level of functioning and wellbeing included: females, older patients (57+ years), acute hospital stay (>11 days), those treated in intensive care and those discharged to rehabilitation. No associations were found between the Medical Research Council (MRC) Motor Scale Rating scores at admission, nor time since GBS diagnosis (≤6 vs. >6 years) on outcomes used. GBS is complex and requires long-term management of psychological sequelae impacting activity and participation.

  11. Pseudotumors after primary abdominal lipectomy as a new sequela in patients with abdominal apron.

    Science.gov (United States)

    Dragu, Adrian; Bach, Alexander D; Polykandriotis, Elias; Kneser, Ulrich; Horch, Raymund E

    2009-11-01

    Malnutrition and overweight is a common problem in modern societies. Primary abdominal lipectomy is a standard surgical tool in patients with these problems. However, unknown secondary problems result from recent advances in obesity surgery. Plication of the anterior musculoaponeurotic wall is a widely and commonly used operative technique during abdominoplasty. Many different plication techniques have been published. So far no common standard and long-term effectiveness is proven. In addition, there is no sufficient literature dealing with the postoperative risks of plication of the musculoaponeurotic wall. Four patients with development of pseudotumors were reviewed. All four patients received 12 months in advance a primary abdominal lipectomy including a vertical plication of the musculoaponeurotic wall. All four patients were females with mean age of 61 years and mean body mass index (BMI) of 37 kg/m(2). All four patients had developed a pseudotumor of the abdomen as a long-term complication more than 12 months after primary abdominal lipectomy including a vertical plication of the anterior rectus sheath. One should be aware of the potential long-term risk of secondary postoperative hematoma formation, with or without partial necrosis of the anterior rectus sheath after vertical plication of the anterior musculoaponeurotic wall. Viewed clinically and radiologically, such sequelas may appear as pseudotumor like masses and require immediate revision.

  12. Tomographic Aspects of Advanced Active Pulmonary Tuberculosis and Evaluation of Sequelae following Treatment

    Directory of Open Access Journals (Sweden)

    Rafael Barcelos Capone

    2017-01-01

    Full Text Available Objectives. To evaluate tomographic changes in pulmonary tuberculosis (TB, degree of agreement among three radiologists regarding tomographic diagnoses, and sequelae following treatment. Methods. Cross-sectional and descriptive study of 74 TB patients confirmed by sputum culture and chest computed tomography before (CT1 and 6 months after (CT2 drug therapy. Results were performed by three radiologists blinded to clinical and laboratory results. Results. Main findings in CT1 included nodules indicating the presence of a tree-in-bud pattern in 93% of cases, ill-defined nodules in 84% of cases, consolidation in 77% of cases, architectural distortion in 71% of cases, cavitary lesions in 62% of cases, and ground glass opacities in 37% of cases. Airway involvement, characterized by increased thickness and dilatation of the bronchial walls, occurred in 93% of cases. Pleural involvement occurred in 54%. There was an agreement on active TB among the three radiologists in 85% of cases. The results in CT2 indicated the presence of architectural distortion in 91% of cases and cylindrical bronchiectasis in 86%. Conclusions. The study established a tomographic pattern for diagnosis of active TB characterized by the presence of airway nodules, consolidation, architectural distortion, and cavitary lesions, and an almost complete degree of agreement (Kappa was observed among the radiologists (0.85. CT after treatment assists in defining the cure.

  13. A short-term longitudinal study of correlates and sequelae of attachment security in autism

    Science.gov (United States)

    Rozga, Agata; Hesse, Erik; Main, Mary; Duschinsky, Robbie; Beckwith, Leila; Sigman, Marian

    2018-01-01

    ABSTRACT In this short-term longitudinal study, 30 preschool-aged children with autism were first observed in Ainsworth’s Strange Situation Procedure and, separately, interacting with the primary caregiver in the home. One year later, each child completed both a developmental assessment and an observational assessment of empathic responding. Behaviors typical for children with autism were distinguished from behaviors suggestive of relationally based attachment disorganization. Forty-five percent of the children were classified as securely attached. The secure group demonstrated language skills superior to those of the insecurely attached group, concurrently and during the follow-up. Compared to parents of children who were insecurely attached, parents of securely attached children were rated as more sensitive. Compared to both organized insecure and disorganized children, secure children were rated as more responsive to an examiner’s apparent distress during the follow-up relative to their ratings at intake, whereas empathy ratings of children with insecure classifications did not increase. Importantly, attachment security was associated with empathy above and beyond the contribution of children’s language level. These results indicate that the sequelae of attachment security in autism may be similar to those documented for typically developing children. PMID:28959921

  14. Late onset endophthalmitis

    Directory of Open Access Journals (Sweden)

    Abdulaziz AlHadlaq

    2016-04-01

    Full Text Available We report an extremely rare presentation of late-onset endophthalmitis in a young adult patient with an unexposed Ahmed tube implant. The implant was inserted 11 years prior to presentation. There was no history of trauma or any obvious exposure on clinical examination and the tube plate was filled with purulent material. After aqueous and vitreous tap, the patient underwent intracameral, intravitreal subconjunctival antibiotic injections and was started on systemic antibiotics with good response. Endophthalmitis associated with tube drainage device can present as late as 11 years and even without an unexposed tube.

  15. Lateness to School Remediation Game

    Science.gov (United States)

    Ugwuegbulam, Charles N.; Ibrahim, Haj. Naheed

    2015-01-01

    Primary and secondary school in Nigeria encourage punctuality to school yet a good number of the learners came late to school. This is especially true in the case of day students. Learners who come late to school are usually punished in one way or the other yet the lateness to school phenomenon still persist. Lateness to school behaviour affects…

  16. Poor neurological sequelae of herpes simplex virus encephalitis in an infant despite adequate antiviral and adjunct corticosteroid therapy

    Directory of Open Access Journals (Sweden)

    Ratna B Basak

    2011-01-01

    Full Text Available A 2-month-old infant presented to our emergency department with fever, altered consciousness, and focal seizures of acute onset. He had vesicular skin lesions over the right preauricular region. CT brain showed a large hypodense lesion involving the left temporo-parietal region, left basal ganglia and left thalamus. MRI brain revealed bilateral multifocal corticomedullary lesions suggestive of encephalitis. CSF-PCR was positive for herpes simplex virus (HSV type I. He was treated with standard dose intravenous acyclovir for 15 days along with a trial of pulse methylprednisolone, but was readmitted within a week with features of an early relapse. The infant survived but developed significant neurological sequelae. Although treatment of HSV is available, the neurological outcome is guarded even with adequate antiviral therapy. Adjunct corticosteroid therapy did not appear to attenuate the neurological sequelae.

  17. External Qi therapy to treat symptoms of Agent Orange Sequelae in Korean combat veterans of the Vietnam War.

    Science.gov (United States)

    Lee, Myeong Soo; Woo, Won-Hong; Lim, Hyun-Ja; Hong, Sung-Soo; Kim, Hye-Jung; Moon, Sun-Rock

    2004-01-01

    We investigated the efficacy of Qi therapy as a non-pharmacological treatment for various symptoms presented by Korean combat veterans of the Vietnam War with Agent Orange Sequelae. Nine subjects volunteered to receive 30 minutes of Qi therapy, twice per day for 7 days. There was marked improvement in 89% of the patients with impaired physical activity, 86% of those with psychological disorder, 78% of those with heavy drug use, and 67% of those with fatigue, indigestion and high blood glucose levels. This data suggests that Qi therapy combined with conventional treatment has positive effects in reducing and managing the pain, psychosomatic disorders, and substance abuse in patients with Agent Orange Sequelae. We cannot completely discount the possible influence of the placebo effect, and more objective, clinical measures are needed to study the long-term effects of Qi therapy.

  18. Current and future strategies in radiotherapy of childhood low-grade glioma of the brain. Part II. Treatment-related late toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Kortmann, R.D.; Timmermann, B.; Plasswilm, L.; Paulsen, F.; Jeremic, B.; Kay, S.; Bamberg, M. [Dept. of Radiooncology, Univ. of Tuebingen (Germany); Taylor, R.E. [Radiotherapy Dept., Cookridge Hospital, Leeds (United Kingdom); Scarzello, G. [Dept. of Radiotherapy, Padua General Hospital (Italy); Gnekow, A.K. [Children' s Hospital Augsburg (Germany); Dieckmann, K. [Dept. of Radiooncology, General Hospital Vienna (Austria)

    2003-09-01

    Material and Methods: Studies on the use of radiation therapy in children with low-grade glioma were systematically reviewed for data on radiotherapy-induced side effects on brain parenchyma, endocrine dysfunction, growth retardation, neurocognitive dysfunction, vasculopathy, and secondary neoplasms. Results: Data on late effects are scarce and heterogeneous. Past reports included only retrospective series from the 1930s to present days, a time during which treatment policies and radiation techniques widely varied and considerably changed in recent years. Often, considerable uncertainty existed regarding pretreatment health status and radiotherapy-related factors (e.g., total dose, dose per fraction, treatment fields). In spite of these shortcomings and often conflicting observations, it appears that especially younger children and children with neurofibromatosis (NF) are at risk of endocrinopathies in terms of growth retardation and developmental abnormalities, as well as neurocognitive dysfunction expressed as problems in the psychosocial environment such as in education and occupation. However, both observations may be attributed to the higher proportion of NF in the very young who frequently develop large tumors spreading along the entire supratentorial midline. The risk of radiation-induced disturbances in visual function is low (no case reported). Young children with NF appear to have an increased risk of vasculopathies. 33 cases of moyamoya disease were found (preferably in the very young), 18 of whom were NF-positive. Other cerebrovascular accidents (24 cases, of whom 14 were NF-positive) and secondary neoplasms (15 cases, of whom only five occurred in field - four were high-grade astrocytomas) are a rare condition. The latter cannot be distinguished from late relapses with malignant transformation. Modern treatment techniques appear to reduce the risk of radiation-induced late effects. Conclusions: More studies and clear definitions of clinical endpoints

  19. Current and future strategies in radiotherapy of childhood low-grade glioma of the brain. Part II. Treatment-related late toxicity

    International Nuclear Information System (INIS)

    Kortmann, R.D.; Timmermann, B.; Plasswilm, L.; Paulsen, F.; Jeremic, B.; Kay, S.; Bamberg, M.; Taylor, R.E.; Scarzello, G.; Gnekow, A.K.; Dieckmann, K.

    2003-01-01

    Material and Methods: Studies on the use of radiation therapy in children with low-grade glioma were systematically reviewed for data on radiotherapy-induced side effects on brain parenchyma, endocrine dysfunction, growth retardation, neurocognitive dysfunction, vasculopathy, and secondary neoplasms. Results: Data on late effects are scarce and heterogeneous. Past reports included only retrospective series from the 1930s to present days, a time during which treatment policies and radiation techniques widely varied and considerably changed in recent years. Often, considerable uncertainty existed regarding pretreatment health status and radiotherapy-related factors (e.g., total dose, dose per fraction, treatment fields). In spite of these shortcomings and often conflicting observations, it appears that especially younger children and children with neurofibromatosis (NF) are at risk of endocrinopathies in terms of growth retardation and developmental abnormalities, as well as neurocognitive dysfunction expressed as problems in the psychosocial environment such as in education and occupation. However, both observations may be attributed to the higher proportion of NF in the very young who frequently develop large tumors spreading along the entire supratentorial midline. The risk of radiation-induced disturbances in visual function is low (no case reported). Young children with NF appear to have an increased risk of vasculopathies. 33 cases of moyamoya disease were found (preferably in the very young), 18 of whom were NF-positive. Other cerebrovascular accidents (24 cases, of whom 14 were NF-positive) and secondary neoplasms (15 cases, of whom only five occurred in field - four were high-grade astrocytomas) are a rare condition. The latter cannot be distinguished from late relapses with malignant transformation. Modern treatment techniques appear to reduce the risk of radiation-induced late effects. Conclusions: More studies and clear definitions of clinical endpoints

  20. Higher Education.

    Science.gov (United States)

    Hendrickson, Robert M.

    This chapter reports 1982 cases involving aspects of higher education. Interesting cases noted dealt with the federal government's authority to regulate state employees' retirement and raised the questions of whether Title IX covers employment, whether financial aid makes a college a program under Title IX, and whether sex segregated mortality…

  1. 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...

  2. Late effecten van kankerbehandeling

    NARCIS (Netherlands)

    Langeveld, Nelia E.

    2004-01-01

    In dit artikel wordt ingegaan op de lange termijn effecten van kanker op de kinderleeftijd. Vervolgens wordt een kort overzicht gegeven van de belangrijkste late gevolgen die kunnen optreden na een oncologische behandeling met radio- en/of chemotherapie toegepast in de kinderleeftijd. Er wordt kort

  3. Late-modern hipsters

    DEFF Research Database (Denmark)

    Andersen, Bjørn Schiermer

    2014-01-01

    The article deals with the cultural significance of a new figure in late-modern Western culture: the hipster. The current hipster culture, so I argue, can be used as a magnifying glass that makes impending changes to our conception of culture and of cultural development visible. It ushers...

  4. Big Java late objects

    CERN Document Server

    Horstmann, Cay S

    2012-01-01

    Big Java: Late Objects is a comprehensive introduction to Java and computer programming, which focuses on the principles of programming, software engineering, and effective learning. It is designed for a two-semester first course in programming for computer science students.

  5. Late Embryogenesis Abundant Proteins

    NARCIS (Netherlands)

    Shih, M.D.; Hoekstra, F.A.; Hsing, Y.I.C.

    2008-01-01

    During the late maturation stage of seed development, water content decreases greatly. One of the most striking characteristics of mature orthodox seeds is their ability to withstand severe desiccation. Mechanisms of plant drought/desiccation tolerance have been studied by numerous groups, and a

  6. [Cleft lip, alveolar and palate sequelae. Proposal of new alveolar score by the Alveolar Cleft Score (ACS) classification].

    Science.gov (United States)

    Molé, C; Simon, E

    2015-06-01

    The management of cleft lip, alveolar and palate sequelae remains problematic today. To optimize it, we tried to establish a new clinical index for diagnostic and prognostic purposes. Seven tissue indicators, that we consider to be important in the management of alveolar sequelae, are listed by assigning them individual scores. The final score, obtained by adding together the individual scores, can take a low, high or maximum value. We propose a new classification (ACS: Alveolar Cleft Score) that guides the therapeutic team to a prognosis approach, in terms of the recommended surgical and prosthetic reconstruction, the type of medical care required, and the preventive and supportive therapy to establish. Current studies are often only based on a standard radiological evaluation of the alveolar bone height at the cleft site. However, the gingival, the osseous and the cellular areas bordering the alveolar cleft sequelae induce many clinical parameters, which should be reflected in the morphological diagnosis, to better direct the surgical indications and the future prosthetic requirements, and to best maintain successful long term aesthetic and functional results. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  7. Disability Studies in Higher Education

    Science.gov (United States)

    Taylor, Steven J.

    2011-01-01

    As a topic of study, disability is not new at institutions of higher education. Psychological and intellectual disabilities have been of interest in psychiatry and psychology at least since the late 1800s and early 1900s. The post-World War II era, in particular, witnessed the rapid expansion of academic programs in special education, vocational…

  8. Hidradenitis suppurativa/acne inversa: bilocated epithelial hyperplasia with very different sequelae.

    Science.gov (United States)

    von Laffert, M; Stadie, V; Wohlrab, J; Marsch, W C

    2011-02-01

    of the interfollicular epidermis with subepidermal inflammatory infiltrate might be interpreted as an inflammation-driven process basically identical to that which is evident at the terminal follicle. However, it does not lead to harmful and progressive sequelae like those (rupture, sinus tracts) seen at the terminal follicles. © 2010 The Authors. BJD © 2010 British Association of Dermatologists.

  9. Trend data for administration of medications in patients with acute cerebrovascular accidents and its sequelae

    Directory of Open Access Journals (Sweden)

    Levytska Oksana

    2017-06-01

    Full Text Available The trends in drug utilization in patients with acute cerebrovascular accidents (ACVA and its sequelae were investigated in the Neurological Department of Lviv Regional Hospital, Ukraine, in 2007 and 2015. From the 10 anatomical groups of the Anatomical Therapeutic Chemical (ATC classification system, in 2007, 181 medications were prescribed for treatment of ACVA and concomitant diseases, compared to 198 medications in 2015. The medications of Group C (Cardiovascular system were of the maximal proportion in both analyzed periods (28.1% in 2007 and 29.8% in 2015. Moreover, the largest proportion of the prescribed medications of the 3rd level groups of the ATC classification system were of group В01А - “Antithrombotic agents” (7.2% in 2007 and 6.6% in 2015. Furthermore, three medications (Magnesium sulfate, L-lysini aescinas and Potassium chloride were prescribed for 50% and more patients in both analyzed periods, while the prescriptions of other medications were characterized by high variability. АТС/DDD analysis also revealed the tendency toward an increase in prescription and drug utilization of the main medication groups, and that these were used for nonspecific and specific therapy for ACVA, as well as for secondary prevention (antihypertensives, anticoagulants, antiplatelet agents and statins. Totally, the drug utilization of these medication groups was 38.5% in 2007 and 58.0%, respectively, in 2015, compared to the overall number of DDDs. The results of our study suggest the existence of a positive tendency in prescriptions, and of compliance with the current principles of treatment, in patients with ACVA, in Ukraine.

  10. Prenatal treatment for serious neurological sequelae of congenital toxoplasmosis: an observational prospective cohort study.

    Science.gov (United States)

    Cortina-Borja, Mario; Tan, Hooi Kuan; Wallon, Martine; Paul, Malgorzata; Prusa, Andrea; Buffolano, Wilma; Malm, Gunilla; Salt, Alison; Freeman, Katherine; Petersen, Eskild; Gilbert, Ruth E

    2010-10-12

    The effectiveness of prenatal treatment to prevent serious neurological sequelae (SNSD) of congenital toxoplasmosis is not known. Congenital toxoplasmosis was prospectively identified by universal prenatal or neonatal screening in 14 European centres and children were followed for a median of 4 years. We evaluated determinants of postnatal death or SNSD defined by one or more of functional neurological abnormalities, severe bilateral visual impairment, or pregnancy termination for confirmed congenital toxoplasmosis. Two-thirds of the cohort received prenatal treatment (189/293; 65%). 23/293 (8%) fetuses developed SNSD of which nine were pregnancy terminations. Prenatal treatment reduced the risk of SNSD. The odds ratio for prenatal treatment, adjusted for gestational age at maternal seroconversion, was 0.24 (95% Bayesian credible intervals 0.07-0.71). This effect was robust to most sensitivity analyses. The number of infected fetuses needed to be treated to prevent one case of SNSD was three (95% Bayesian credible intervals 2-15) after maternal seroconversion at 10 weeks, and 18 (9-75) at 30 weeks of gestation. Pyrimethamine-sulphonamide treatment did not reduce SNSD compared with spiramycin alone (adjusted odds ratio 0.78, 0.21-2.95). The proportion of live-born infants with intracranial lesions detected postnatally who developed SNSD was 31.0% (17.0%-38.1%). The finding that prenatal treatment reduced the risk of SNSD in infected fetuses should be interpreted with caution because of the low number of SNSD cases and uncertainty about the timing of maternal seroconversion. As these are observational data, policy decisions about screening require further evidence from a randomized trial of prenatal screening and from cost-effectiveness analyses that take into account the incidence and prevalence of maternal infection. Please see later in the article for the Editors' Summary.

  11. Prenatal treatment for serious neurological sequelae of congenital toxoplasmosis: an observational prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Mario Cortina-Borja

    2010-10-01

    Full Text Available The effectiveness of prenatal treatment to prevent serious neurological sequelae (SNSD of congenital toxoplasmosis is not known.Congenital toxoplasmosis was prospectively identified by universal prenatal or neonatal screening in 14 European centres and children were followed for a median of 4 years. We evaluated determinants of postnatal death or SNSD defined by one or more of functional neurological abnormalities, severe bilateral visual impairment, or pregnancy termination for confirmed congenital toxoplasmosis. Two-thirds of the cohort received prenatal treatment (189/293; 65%. 23/293 (8% fetuses developed SNSD of which nine were pregnancy terminations. Prenatal treatment reduced the risk of SNSD. The odds ratio for prenatal treatment, adjusted for gestational age at maternal seroconversion, was 0.24 (95% Bayesian credible intervals 0.07-0.71. This effect was robust to most sensitivity analyses. The number of infected fetuses needed to be treated to prevent one case of SNSD was three (95% Bayesian credible intervals 2-15 after maternal seroconversion at 10 weeks, and 18 (9-75 at 30 weeks of gestation. Pyrimethamine-sulphonamide treatment did not reduce SNSD compared with spiramycin alone (adjusted odds ratio 0.78, 0.21-2.95. The proportion of live-born infants with intracranial lesions detected postnatally who developed SNSD was 31.0% (17.0%-38.1%.The finding that prenatal treatment reduced the risk of SNSD in infected fetuses should be interpreted with caution because of the low number of SNSD cases and uncertainty about the timing of maternal seroconversion. As these are observational data, policy decisions about screening require further evidence from a randomized trial of prenatal screening and from cost-effectiveness analyses that take into account the incidence and prevalence of maternal infection. Please see later in the article for the Editors' Summary.

  12. Childhood central nervous system leukemia: historical perspectives, current therapy, and acute neurological sequelae

    Energy Technology Data Exchange (ETDEWEB)

    Laningham, Fred H. [St. Jude Children' s Research Hospital, Division of Diagnostic Imaging, Department of Radiological Sciences, Memphis, TN (United States); University of Tennessee Health Sciences Center, Memphis, TN (United States); Kun, Larry E. [St. Jude Children' s Research Hospital, Division of Radiation Oncology, Department of Radiological Sciences, Memphis, TN (United States); University of Tennessee Health Sciences Center, Memphis, TN (United States); Reddick, Wilburn E.; Ogg, Robert J. [St. Jude Children' s Research Hospital, Division of Translational Imaging Research, Department of Radiological Sciences, Memphis, TN (United States); Morris, E.B. [St. Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States); Pui, Ching-Hon [St. Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States); University of Tennessee Health Sciences Center, Memphis, TN (United States)

    2007-11-15

    During the past three decades, improvements in the treatment of childhood leukemia have resulted in high cure rates, particularly for acute lymphoblastic leukemia (ALL). Unfortunately, successful therapy has come with a price, as significant morbidity can result from neurological affects which harm the brain and spinal cord. The expectation and hope is that chemotherapy, as a primary means of CNS therapy, will result in acceptable disease control with less CNS morbidity than has been observed with combinations of chemotherapy and radiotherapy over the past several decades. In this review we discuss the poignant, historical aspects of CNS leukemia therapy, outline current methods of systemic and CNS leukemia therapy, and present imaging findings we have encountered in childhood leukemia patients with a variety of acute neurological conditions. A major objective of our research is to understand the neuroimaging correlates of acute and chronic effects of cancer and therapy. Specific features related to CNS leukemia and associated short-term toxicities, both disease- and therapy-related, are emphasized in this review with the specific neuroimaging findings. Specific CNS findings are similarly important when treating acute myelogenous leukemia (AML), and details of leukemic involvement and toxicities are also presented in this entity. Despite contemporary treatment approaches which favor the use of chemotherapy (including intrathecal therapy) over radiotherapy in the treatment of CNS leukemia, children still occasionally experience morbid neurotoxicity. Standard neuroimaging is sufficient to identify a variety of neurotoxic sequelae in children, and often suggest specific etiologies. Specific neuroimaging findings frequently indicate a need to alter antileukemia therapy. It is important to appreciate that intrathecal and high doses of systemic chemotherapy are not innocuous and are associated with acute, specific, recognizable, and often serious neurological

  13. Immunobiotic Lactobacillus administered post-exposure averts the lethal sequelae of respiratory virus infection.

    Science.gov (United States)

    Percopo, Caroline M; Rice, Tyler A; Brenner, Todd A; Dyer, Kimberly D; Luo, Janice L; Kanakabandi, Kishore; Sturdevant, Daniel E; Porcella, Stephen F; Domachowske, Joseph B; Keicher, Jesse D; Rosenberg, Helene F

    2015-09-01

    We reported previously that priming of the respiratory tract with immunobiotic Lactobacillus prior to virus challenge protects mice against subsequent lethal infection with pneumonia virus of mice (PVM). We present here the results of gene microarray which document differential expression of proinflammatory mediators in response to PVM infection alone and those suppressed in response to Lactobacillus plantarum. We also demonstrate for the first time that intranasal inoculation with live or heat-inactivated L. plantarum or Lactobacillus reuteri promotes full survival from PVM infection when administered within 24h after virus challenge. Survival in response to L. plantarum administered after virus challenge is associated with suppression of proinflammatory cytokines, limited virus recovery, and diminished neutrophil recruitment to lung tissue and airways. Utilizing this post-virus challenge protocol, we found that protective responses elicited by L. plantarum at the respiratory tract were distinct from those at the gastrointestinal mucosa, as mice devoid of the anti-inflammatory cytokine, interleukin (IL)-10, exhibit survival and inflammatory responses that are indistinguishable from those of their wild-type counterparts. Finally, although L. plantarum interacts specifically with pattern recognition receptors TLR2 and NOD2, the respective gene-deleted mice were fully protected against lethal PVM infection by L. plantarum, as are mice devoid of type I interferon receptors. Taken together, L. plantarum is a versatile and flexible agent that is capable of averting the lethal sequelae of severe respiratory infection both prior to and post-virus challenge via complex and potentially redundant mechanisms. Published by Elsevier B.V.

  14. Childhood central nervous system leukemia: historical perspectives, current therapy, and acute neurological sequelae

    International Nuclear Information System (INIS)

    Laningham, Fred H.; Kun, Larry E.; Reddick, Wilburn E.; Ogg, Robert J.; Morris, E.B.; Pui, Ching-Hon

    2007-01-01

    During the past three decades, improvements in the treatment of childhood leukemia have resulted in high cure rates, particularly for acute lymphoblastic leukemia (ALL). Unfortunately, successful therapy has come with a price, as significant morbidity can result from neurological affects which harm the brain and spinal cord. The expectation and hope is that chemotherapy, as a primary means of CNS therapy, will result in acceptable disease control with less CNS morbidity than has been observed with combinations of chemotherapy and radiotherapy over the past several decades. In this review we discuss the poignant, historical aspects of CNS leukemia therapy, outline current methods of systemic and CNS leukemia therapy, and present imaging findings we have encountered in childhood leukemia patients with a variety of acute neurological conditions. A major objective of our research is to understand the neuroimaging correlates of acute and chronic effects of cancer and therapy. Specific features related to CNS leukemia and associated short-term toxicities, both disease- and therapy-related, are emphasized in this review with the specific neuroimaging findings. Specific CNS findings are similarly important when treating acute myelogenous leukemia (AML), and details of leukemic involvement and toxicities are also presented in this entity. Despite contemporary treatment approaches which favor the use of chemotherapy (including intrathecal therapy) over radiotherapy in the treatment of CNS leukemia, children still occasionally experience morbid neurotoxicity. Standard neuroimaging is sufficient to identify a variety of neurotoxic sequelae in children, and often suggest specific etiologies. Specific neuroimaging findings frequently indicate a need to alter antileukemia therapy. It is important to appreciate that intrathecal and high doses of systemic chemotherapy are not innocuous and are associated with acute, specific, recognizable, and often serious neurological

  15. Late renal function after upper abdominal irradiation

    International Nuclear Information System (INIS)

    Morris, Monica M.; Willett, Christopher G.

    1997-01-01

    Purpose: This study assesses the late renal function and complications following upper abdominal irradiation. Methods and Materials: Eighty-six adult patients were identified who were treated with curative intent to the upper abdomen, received greater than 50% unilateral kidney irradiation to doses of at least 26 Gy, and survived for 1 year or more. Following treatment, the clinical course, blood pressure, addition of anti-hypertensive medications, serum creatinine and creatinine clearance were determined. Creatinine clearance was calculated by the formula: creatinine clearance equals [(140 - age) x (weight in kilograms)] / (72 x serum creatinine), which has a close correlation to creatinine clearances measured by 24 hour urine measurement. The percent change in creatinine clearance from pre-treatment values was analyzed. Mean follow-up was 6.7 years. Seventeen patients were followed for 11 or more years. Results: Of the 16 patients with pre-radiotherapy hypertension, eight required an increase in the number of medications for control and eight required no change in medication. Twenty-one patients developed hypertension in follow-up, 15 of whom required no medication. One patient developed malignant hypertension on the basis of renal artery stenosis. Acute or chronic renal failure was not observed in any patient. The serum creatinine for all 86 patients prior to irradiation was below 2 mg/100 ml; in follow-up it rose to between 2-3 mg/100 ml in five patients. On univariate analysis, older patient age, female sex, pre-existing hypertension and initially abnormal renal function (creatinine clearance <90mg/ml) were significantly correlated with later poor creatinine clearance (<50 mg/ml). Conclusions: After significant unilateral kidney irradiation, patients demonstrated a laboratory trend to increased creatinine and decreased creatinine clearance. With long-term follow-up, these physiologic changes did not appear to translate into a clinically relevant alteration in

  16. Hypothyroidism in late-onset Pompe disease

    Directory of Open Access Journals (Sweden)

    Joseph Schneider

    2016-09-01

    Conclusions: Hypothyroidism was found at a higher prevalence in patients with late-onset Pompe disease compared to the general adult population at UMMC. Studies in larger populations of patients with Pompe disease would be needed to confirm an association of Pompe disease and hypothyroidism. Challenges include finding an adequate sample size, due the rarity of Pompe disease.

  17. Late onset polio sequelae : Disabilities and handicaps in a population-based cohort of the 1956 poliomyelitis outbreak in The Netherlands

    NARCIS (Netherlands)

    Ivanyi, Barbara; Nollet, E; Redekop, WK; De Haan, R; Wohlgemuht, M; van Wijngaarden, JK; de Visser, Marianne

    Objective: To investigate the prevalence of new neuromuscular symptoms, disabilities, and handicaps in a group of polio survivors. Design: A self-constructed health questionnaire about neuromuscular complaints and disability and handicap levels during the stable period after recovery from polio and

  18. Late onset polio sequelae: disabilities and handicaps in a population-based cohort of the 1956 poliomyelitis outbreak in The Netherlands

    NARCIS (Netherlands)

    Ivanyi, B.; Nollet, F.; Redekop, W. K.; de Haan, R.; Wohlgemuht, M.; van Wijngaarden, J. K.; de Visser, M.

    1999-01-01

    OBJECTIVE: To investigate the prevalence of new neuromuscular symptoms, disabilities, and handicaps in a group of polio survivors. DESIGN: A self-constructed health questionnaire about neuromuscular complaints and disability and handicap levels during the stable period after recovery from polio and

  19. Medicinal plants used in the traditional management of diabetes and its sequelae in Central America: A review.

    Science.gov (United States)

    Giovannini, Peter; Howes, Melanie-Jayne R; Edwards, Sarah E

    2016-05-26

    Globally 387 million people currently have diabetes and it is projected that this condition will be the 7th leading cause of death worldwide by 2030. As of 2012, its total prevalence in Central America (8.5%) was greater than the prevalence in most Latin American countries and the population of this region widely use herbal medicine. The aim of this study is to review the medicinal plants used to treat diabetes and its sequelae in seven Central American countries: Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua and Panama. We conducted a literature review and extracted from primary sources the plant use reports in traditional remedies that matched one of the following disease categories: diabetes mellitus, kidney disease, urinary problems, skin diseases and infections, cardiovascular disease, sexual dysfunctions, visual loss, and nerve damage. Use reports were entered in a database and data were analysed in terms of the highest number of use reports for diabetes management and for the different sequelae. We also examined the scientific evidence that might support the local uses of the most reported species. Out of 535 identified species used to manage diabetes and its sequelae, 104 species are used to manage diabetes and we found in vitro and in vivo preclinical experimental evidence of hypoglycaemic effect for 16 of the 20 species reported by at least two sources. However, only seven of these species are reported in more than 3 studies: Momordica charantia L., Neurolaena lobata (L.) R. Br. ex Cass., Tecoma stans (L.) Juss. ex Kunth, Persea americana Mill., Psidium guajava L., Anacardium occidentale L. and Hamelia patens Jacq. Several of the species that are used to manage diabetes in Central America are also used to treat conditions that may arise as its consequence such as kidney disease, urinary problems and skin conditions. This review provides an overview of the medicinal plants used to manage diabetes and its sequelae in Central America and of

  20. Late-Onset Asthma

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli

    2017-01-01

    Late-onset asthma is common, associated with poor outcome, underdiagnosed and undertreated, possibly due to the modifying effect of ageing on disease expression. Although the diagnostic work-up in elderly individuals suspected of having asthma follows the same steps as in younger individuals (case......, to objectively confirm asthma. If necessary, a trial of oral or inhaled corticosteroid might be necessary. Asthma can be diagnosed when increased airflow variability is identified in a symptomatic patient, and if the patient does not have a history of exposure, primarily smoking, known to cause chronic...... obstructive pulmonary disease, the diagnosis is asthma even if the patient does not have fully reversible airflow obstruction. Pharmacological therapy in patients with late-onset asthma follows international guidelines, including treatment with the lowest effective dose of inhaled corticosteroid to minimize...

  1. Late Babylonian Astrology

    Science.gov (United States)

    Steele, John M.

    The last five centuries BC saw the development of several new forms of astrology in Babylonia. Key to these new astrological techniques was the invention of the zodiac in about 400 BC. These new forms of astrology include personal horoscopes, astral medicine, and the exploitation of geometrical relationships between the position of heavenly bodies. Several Late Babylonian astrological doctrines were later adopted within Greek astrology.

  2. Late Palaeozoic plants.

    Science.gov (United States)

    Feng, Zhuo

    2017-09-11

    Land plants are one of the major constituents of terrestrial ecosystems on Earth, and play an irreplaceable role in human activities today. If we are to understand the extant plants, it is imperative that we have some understanding of the fossil plants from the deep geological past, particularly those that occurred during their early evolutionary history, in the late Palaeozoic. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Late somatic effects

    International Nuclear Information System (INIS)

    Gilbert, E.S.

    1989-01-01

    Late effects are by definition effects that occur at least one year, and in most cases decades, after the time of exposure. The late effects considered in this chapter are limited to latent cancer incidence and mortality, and benign thyroid disease. A model is provided for estimating risks of late effects resulting from the radiation exposure likely to be received in the event of a nuclear power plant accident. It is assumed that exposure to high-LET radiation would be negligible in such an accident, and thus only risks from low-LET exposure are evaluated. Separate estimates are provided for risks of leukemia, bone cancer, lung cancer, gastrointestinal cancers, thyroid cancer, skin cancer, and the residual group of all other cancers; estimates of leukemia and other cancers due to in utero exposure are also provided. Risks are expressed in absolute terms as the number of cancer deaths (or cases) per million persons exposed to a particular dose. Because the time of death is also important in assessing the impact of an accident, and because the quality of life after the occurrence of cancer will often be reduced, the number of years of life lost and the number of years of life lived after the occurrence of cancer are also estimated

  4. Late-onset social anxiety disorder following traumatic brain injury.

    Science.gov (United States)

    Chaves, Cristiano; Trzesniak, Clarissa; Derenusson, Guilherme Nogueira; Araújo, David; Wichert-Ana, Lauro; Machado-de-Sousa, João Paulo; Carlotti, Carlos Gilberto; Nardi, Antonio E; Zuardi, Antônio W; de S Crippa, José Alexandre; Hallak, Jaime E C

    2012-01-01

    Neuropsychiatric sequelae are the predominant long-term disability after traumatic brain injury (TBI). This study reports a case of late-onset social anxiety disorder (SAD) following TBI. A patient that was spontaneous and extroverted up to 18-years-old started to exhibit significant social anxiety symptoms. These symptoms became progressively worse and he sought treatment at age 21. He had a previous history of traumatic brain injury (TBI) at age 17. Neuroimaging investigations (CT, SPECT and MRI) showed a bony protuberance on the left frontal bone, with mass effect on the left frontal lobe. He had no neurological signs or symptoms. The patient underwent neurosurgery with gross total resection of the lesion and the pathological examination was compatible with intradiploic haematoma. Psychiatric symptoms may be the only findings in the initial manifestation of slowly growing extra-axial space-occupying lesions that compress the frontal lobe from the outside. Focal neurological symptoms may occur only when the lesion becomes large. This case report underscores the need for careful exclusion of general medical conditions and TBI history in cases of late-onset SAD and may also contribute to the elucidation of the neurobiology of this disorder.

  5. Coping – Late Side Effects

    Science.gov (United States)

    Cancer treatment can cause late side effects that may not show up for months or years after treatment. These late effects may include heart and lung problems, bone loss, eye and hearing changes, lymphedema, and other problems

  6. Factors of late radiosensitivity of normal tissues; Facteurs de radiosensibilite tardive des tissus sains

    Energy Technology Data Exchange (ETDEWEB)

    Azria, A. [CRLC Val d' Aurelle-Paul-Lamarque, departement de radiotherapie, 34 - Montpellier (France); Pointreau, Y. [CHRU Bretonneau, 37 - Tours (France); Toledano, A. [Clinique Hartman, 92 - Neuilly-sur-Seine (France); Ozsahin, M. [CHU Vaudois, Lausanne (Switzerland)

    2010-07-15

    The impact of curative radiotherapy depends mainly on the total dose delivered homogeneously in the targeted volume. Nevertheless, the dose delivered to the surrounding healthy tissues may reduce the therapeutic ratio of many radiation treatments. Two different side effects (acute and late) can occur during and after radiotherapy. Of particular interest are the radiation-induced sequelae due to their irreversibility and the potential impact on daily quality of life. In a same population treated in one centre with the same technique, it appears that individual radiosensitivity clearly exists. In the hypothesis that genetic is involved in this area of research, lymphocytes seem to be the tissue of choice due to easy accessibility. Recently, low percentage of CD4 and CD8 lymphocyte apoptosis were shown to be correlated with high grade of sequelae. In addition, recent data suggest that patients with severe radiation-induced late side effects possess four or more single nucleotide polymorphisms (SNP) in candidate genes (ATM, SOD2, TGFB1, XRCC1, and XRCC3) and low radiation-induced CD8 lymphocyte apoptosis in vitro. On-going studies are being analyzing the entire genome using a Genome-wide association study (GWAS) analysis. (authors)

  7. 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

  8. "Imagine your neighbor mows the lawn": a pilot study of psychological sequelae due to awake craniotomy: clinical article.

    Science.gov (United States)

    Milian, Monika; Luerding, Ralf; Ploppa, Annette; Decker, Karlheinz; Psaras, Tsambika; Tatagiba, Marcos; Gharabaghi, Alireza; Feigl, Guenther C

    2013-06-01

    Although it has been reported that awake neurosurgical procedures are well tolerated, the long-term occurrence of general psychological sequelae has not yet been investigated. This study assessed the frequency and effects of psychological symptoms after an awake craniotomy on health-related quality of life (HRQOL). Sixteen patients undergoing an awake surgery were surveyed with a self-developed questionnaire, the Posttraumatic Stress Disorder Inventory For Awake Surgery Patients, which adopts the core components of the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) posttraumatic stress disorder (PTSD) criteria. The mean time between surgery and data collection was 97.3 ± 93.2 weeks. Health-related quality of life was assessed with the 36-Item Short Form Health Survey. Forty-four percent of the patients stated that they had experienced either repetitive distressing recollections or dreams related to the awake surgery, 18.8% stated persistent avoidance of stimuli associated with the awake surgery, and symptoms of increased arousal occurred in 62.5%. Two patients presented with postoperative psychological sequelae resembling PTSD symptoms. Younger age at surgery and female sex were risk factors for symptoms of increased arousal. The experience of intense anxiety during awake surgery appears to favor the development of postsurgical PTSD symptoms, while recurrent distressing recollections particularly affect HRQOL negatively. In many cases awake craniotomy is necessary to preserve language and motor function. However, in some cases awake craniotomy can lead to postoperative psychological sequelae resembling PTSD symptoms. Therefore, possible long-term effects of an awake surgery should be considered and discussed with the patient when planning this type of surgery.

  9. 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

  10. Experiences of appearance-related teasing and bullying in skin diseases and their psychological sequelae: results of a qualitative study.

    Science.gov (United States)

    Magin, Parker; Adams, Jon; Heading, Gaynor; Pond, Dimity; Smith, Wayne

    2008-09-01

    Acne, psoriasis and atopic eczema are common diseases and have been consistently associated with adverse psychological sequelae including stigmatization. Being teased on the basis of appearance has been associated with psychiatric morbidity in children and adolescents. The objective of this qualitative study was to explore the experiences of teasing and bullying in patients with acne, psoriasis and eczema, and the role of appearance-related teasing and bullying as mediators of psychological morbidity in these patients. Data collection consisted of 62 in-depth semi-structured interviews with patients with acne, psoriasis or atopic eczema recruited from both specialist dermatology and general practices. Data analysis was cumulative and concurrent throughout the data collection period reflecting a grounded theory approach. Analysis followed the analytic induction method, allowing themes to emerge from the data. Teasing, taunting or bullying was a considerable problem for a significant minority of acne, psoriasis and atopic eczema participants. Themes that emerged were the universally negative nature of the teasing, the use of teasing as an instrument of social exclusion, and as a means of establishing or enforcing power relationships, teasing related to contagion and fear, the emotional and psychological sequelae of teasing and the theme of 'insensate' teasing. For those who had suffered teasing or bullying, this was causally linked in respondents' accounts with psychological sequelae, especially self-consciousness and effects on self-image and self-esteem. Experiences of teasing and bullying were found to have principally occurred during the adolescence of participants and the perpetrators were other adolescents, but there were findings of respondents with psoriasis also having been subjected to ridicule or derogatory remarks by health professionals. Teasing, taunting and bullying may represent an underappreciated source of psychological morbidity in children and

  11. Late Washing efficiency

    International Nuclear Information System (INIS)

    Morrissey, M.F.

    1992-01-01

    Interim Waste Technology has demonstrated the Late Washing concept on the Experimental Laboratory Filter (ELF) at TNX. In two tests, washing reduced the [NO 2 - ] from 0.08 M to approximately 0.01 M on slurries with 2 year equivalent radiation exposures and 9.5 wt. % solids. For both washes, the [NO 2 - ] decreased at rates near theoretical for a constant volume stirred vessel, indicating approximately l00% washing efficiency. Permeate flux was greater than 0.05 gpm/ft 2 for both washes at a transmembrane pressure of 50 psi and flow velocity of 9 ft/sec

  12. Late-onset hypogonadism

    Directory of Open Access Journals (Sweden)

    Piotr Dudek

    2017-06-01

    Full Text Available In Poland, the number of men over the age of 50 years exceeds 6 million. It is estimated that about 2-6% of this population develops symptoms of late-onset hypogonadism (LOH. In men, testosterone deficiency increases slightly with age. LOH is a clinically and biochemically defined disease of older men with serum testosterone level below the reference parameters of younger healthy men and with symptoms of testosterone deficiency, manifested by pronounced disturbances of quality of life and harmful effects on multiple organ systems. Testosterone replacement therapy may give several benefits regarding body composition, metabolic control, and psychological and sexual parameters.

  13. Early and late motherhood

    DEFF Research Database (Denmark)

    Christoffersen, Mogens; Lausten, Mette

    2009-01-01

    The study investigates parental child rearing methods, structural factors relating to the family during adolescence geographic segregation, individual resource deficits and social background of first time late live births among 32 to 37 years old women and compare to teenagers before becoming...... economic and social gradient for first-time teenage mothers. Teenagers who had experienced family separation or who were formerly in out-of-home care in particular had an increased risk of early childbearing. Results showed that teenage mothers were in every respect in a more disadvantaged position than...

  14. Late effects of post-high-dose-rate brachytherapy for oropharyngeal carcinoma: are they severer than post-low-dose-rate?

    International Nuclear Information System (INIS)

    Nose, T.; Koizumi, M.; Nishiyama, K.; Peiffert, D.; Lapeyre, M.; Hoffstetter, S.

    2004-01-01

    Background: late effects by high-dose-rate (HDR) brachytherapy have been believed severer than low-dose-rate (LDR) provided tumor control was constant. Local control of oropharyngeal carcinoma with HDR at Osaka Medical Center was comparable to LDR series from Centre Alexis Vautrin (82%, 79.5%, respectively). To assess the feasibility of HDR brachytherapy, the late effects were compared. Patients and methods: the data of 29 HDR and 24 LDR patients (median follow-up of 27 and 29.5 months, respectively; p = 0.89) were collected. The HDR schedule was 21 Gy/3.5 fractions/2 days following 46 Gy/23 fractions external beam, while 25 Gy/3 days following 50 Gy/25 fractions external beam was for LDR. Late changes were evaluated using RTOG/EORTC late morbidity scoring scheme. For subclinical late changes, mucosa chapter of Dische score was modified for brachytherapy. Scores were discussed through photos and were agreed on by authors. Late sequelae were estimated, by reviewing charts, concerning frequency, severity, and duration of mucosal damages (erosion and ulcer). Results: Late changes were of no difference (p = 0.12 for EORTC/RTOG, and p = 0.45, 0.47, 1.00, 0.12, 0.16, 0.95, 0.27, 0.21 for erythema, ulceration, edema, thinning, pallor, telangiectasia, mobility impairment of tongue/faucial pillars, respectively, of the modified Dische score). Late sequelae showed no differences (p = 0.90, 0.12, 0.40 for frequency, severity, duration, respectively, of mucosal damages). Conclusion: the late effects by HDR were not severer than by LDR. HDR oropharyngeal brachytherapy is as safe as LDR. (orig.)

  15. Psychological sequelae of the station nightclub fire: Comparing survivors with and without physical injuries using a mixed-methods analysis.

    Directory of Open Access Journals (Sweden)

    Nhi-Ha T Trinh

    Full Text Available Surveying survivors from a large fire provides an opportunity to explore the impact of emotional trauma on psychological outcomes.This is a cross-sectional survey of survivors of The Station Fire. Primary outcomes were post-traumatic stress (Impact of Event Scale - Revised and depressive (Beck Depression Inventory symptoms. Linear regression was used to examine differences in symptom profiles between those with and without physical injuries. The free-response section of the survey was analyzed qualitatively to compare psychological sequelae of survivors with and without physical injuries.104 participants completed the study survey; 47% experienced a burn injury. There was a 42% to 72% response rate range. The mean age of respondents was 32 years, 62% were male, and 47% experienced a physical injury. No significant relationships were found between physical injury and depressive or post-traumatic stress symptom profiles. In the qualitative analysis, the emotional trauma that survivors experienced was a major, common theme regardless of physical injury. Survivors without physical injuries were more likely to experience survivor guilt, helplessness, self-blame, and bitterness. Despite the post-fire challenges described, most survivors wrote about themes of recovery and renewal.All survivors of this large fire experienced significant psychological sequelae. These findings reinforce the importance of mental health care for all survivors and suggest a need to understand factors influencing positive outcomes.

  16. The school inclusion and use of assistive technology with myelomeningocele sequelae students: a view of the teachers

    Directory of Open Access Journals (Sweden)

    Caroline Penteado Assis

    2011-06-01

    Full Text Available Myelomeningocele is a congenital malformation that affects the fetus during pregnancy. It can causes numerous consequences for the development of the child and consequently in their schooling process. So, there are several challenges that can be experienced by these children in their inclusion at school. The use of assistive technology in the school context has been implanted with goal to high from the functional abilities of these students. In Brazil are conducted a lot of studies to know the reality of children with myelomeningocele. Therefore, the goal of this study was to investigate, from the teacher ́s perspective of regular and multifunctional class, as was the process of schooling for students with myelomeningocele sequelae and resource utilization of assistive technology in the school context. The participants of this research were seven teachers and four students with myelomeningocele sequels enclosed in regular scholl.The researcher confectioned the instruments used in interviews. Data were analyzed using content of interview analysis. The results reveal that there are present challenges for inclusion of students with myelomeningocele sequelae and that teachers did not use assistive technology resources at school. It is considered that for the real practice of educational inclusion of these students the knowledge about meningomyelocele and various technologies that can be used in the school context must be published.

  17. Acute and delayed deferoxamine treatment attenuates long-term sequelae after germinal matrix hemorrhage in neonatal rats.

    Science.gov (United States)

    Klebe, Damon; Krafft, Paul R; Hoffmann, Clotilde; Lekic, Tim; Flores, Jerry J; Rolland, William; Zhang, John H

    2014-08-01

    This study investigated if acute and delayed deferoxamine treatment attenuates long-term sequelae after germinal matrix hemorrhage (GMH). Bacterial collagenase (0.3 U) was infused intraparenchymally into the right hemispheric ganglionic eminence in P7 rat pups to induce GMH. GMH animals received either deferoxamine or vehicle twice a day for 7 consecutive days. Deferoxamine administration was initiated at either 1 hour or 72 hours post-GMH. Long-term neurocognitive deficits and motor coordination were assessed using Morris water maze, rotarod, and foot fault tests between day 21 to 28 post-GMH. At 28 days post-GMH, brain morphology was assessed and extracellular matrix protein (fibronectin and vitronectin) expression was determined. Acute and delayed deferoxamine treatment improved long-term motor and cognitive function at 21 to 28 days post-GMH. Attenuated neurofunction was paralleled with improved overall brain morphology at 28 days post-GMH, reducing white matter loss, basal ganglia loss, posthemorrhagic ventricular dilation, and cortical loss. GMH resulted in significantly increased expression of fibronectin and vitronectin, which was reversed by acute and delayed deferoxamine treatment. Acute and delayed deferoxamine administration ameliorated long-term sequelae after GMH. © 2014 American Heart Association, Inc.

  18. Late-Modern Symbolism

    DEFF Research Database (Denmark)

    Andersen, Bjørn Schiermer

    2015-01-01

    Through analysis of key texts, I seek to demonstrate the explanative potential of Durkheim’s sociology of religion in the present context. I critically readdress the idea, found in his early work, that modernity is characterized by a rupture with pre-modern forms of solidarity. First, I investigate...... the ways in which Durkheim sets up a stark distinction between the pre-modern and the modern in his early work, and how this distinction is further cemented by his orthodox critique of the modern economy and its negative effects on social life. Second, I show how another timeless and positive understanding...... of “mechanical” solidarity is to be found behind the “symbolist” template crystalizing in Durkheim’s late work. Third, I develop this template for a modern context by critically addressing and removing other obstacles and prejudices on Durkheim’s part....

  19. Late somatic effects

    International Nuclear Information System (INIS)

    Gilbert, E.

    1985-01-01

    A model is provided for estimating risks of late effects resulting from low-LET radiation exposure likely to be received in the event of a nuclear power plant accident. Separate estimates are provided for risks of leukemia, cancers of the bones, lungs, gastrointestinal tract, thyroid, skin, and the residual group of all other cancers; estimates of leukemia and other cancers due to in utero exposure are also provided. Risks are expressed in absolute terms as the number of cancer deaths (or cases) per million persons exposed to a particular dose. In addition, the number of years of life lost and the number of years of life lived after the occurrence of cancer are also estimated. The model used in the earlier Reactor Safety Study has been modified to reflect additional epidemiological data and these changes are described in detail. 37 references, 1 figure, 13 tables

  20. Epilepsy surgery for epileptic encephalopathy as a sequela of herpes simplex encephalitis: case report.

    Science.gov (United States)

    Taskin, Birce Dilge; Tanji, Kurenai; Feldstein, Neil A; McSwiggan-Hardin, Maureen; Akman, Cigdem I

    2017-07-01

    Herpes simplex virus (HSV) encephalitis can manifest with different clinical presentations, including acute monophasic illness and biphasic chronic granulomatous HSV encephalitis. Chronic encephalitis is much less common, and very rare late relapses are associated with intractable epilepsy and progressive neurological deficits with or without evidence of HSV in the cerebrospinal fluid. The authors report on an 8-year-old girl with a history of treated HSV-1 encephalitis when she was 13 months of age and focal epilepsy when she was 2 years old. Although free of clinical seizures, when she was 5, she experienced behavioral and academic dysfunction, which was later attributed to electrographic focal seizures and worsening electroencephalography (EEG) findings with electrical status epilepticus during slow-wave sleep (ESES). Following a right temporal lobectomy, chronic granulomatous encephalitis was diagnosed. The patient's clinical course improved with the resolution of seizures and EEG abnormalities.

  1. Influence of adjuvant irradiation on the development of late arm lymphedema and impaired shoulder mobility after mastectomy for carcinoma of the breast

    International Nuclear Information System (INIS)

    Ryttov, N.; Holm, N.V.; Qvist, N.; Blichert-Toft, M.; Odense Univ. Hospital

    1988-01-01

    The influence of postoperative radiation therapy on development of late arm lymphedema and shoulder joint disability following mastectomy was evaluated from a series of 57 women with operable carcinoma of the breast. The patients were divided into three groups. Common for all three groups was mastectomy and partial axillary dissection. In addition one group received postoperative irradiation plus systemic therapy and another group systemic therapy alone. The incidence of late arm lymphedema/impaired shoulder mobility was 11%/4% in the group of patients undergoing surgery alone, 46%/38% in the group of patients receiving adjuvant irradiation and 6%/12% in the group of patients receiving adjuvant systemic therapy. It is concluded that adjuvant irradiation to the axilla in patients with metastatic lymph nodes highly increases the risk of late physical sequelae following modified radical mastectomy. Adjuvant systemic therapy can be administered to high risk patients without increasing the risk of late arm lymphedema and shoulder disability. (orig.)

  2. Late Carboniferous to Late Permian carbon isotope stratigraphy

    DEFF Research Database (Denmark)

    Buggisch, Werner; Krainer, Karl; Schaffhauser, Maria

    2015-01-01

    An integrated study of the litho-, bio-, and isotope stratigraphy of carbonates in the Southern Alps was undertaken in order to better constrain δ13C variations during the Late Carboniferous to Late Permian. The presented high resolution isotope curves are based on 1299 δ13Ccarb and 396 δ13Corg...

  3. Late complications after radiotherapy for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Jung, H. [University Hospital Hamburg-Eppendorf (Germany). Inst. of Biophysics and Radiobiology; University Hospital Hamburg-Eppendorf (Germany). Lab. of Radiobiology and Experimental Radiooncology; Beck-Bornholdt, H.P. [University Hospital Hamburg-Eppendorf (Germany). Inst. of Biophysics and Radiobiology; Svoboda, V. [University Hospital Hamburg-Eppendorf (Germany). Inst. of Biophysics and Radiobiology; Portsmouth Oncology Centre, Saint Mary' s Hospital (United Kingdom). Dept. of Radiotherapy; Alberti, W. [University Hospital Hamburg-Eppendorf (Germany). Dept. of Radiotherapy and Radiooncology; Herrmann, T. [Technical Univ. Dresden (Germany). Dept. of Radiotherapy and Radiooncology

    2012-11-15

    Background: The aim of the present study was to analyze in detail the time course of the incidence of radiation-induced late effects. For this purpose, unpublished data of patients treated by radiation therapy in Hamburg in the late 1980s were analyzed. Relatively large volumes were exposed to comparatively high doses, thus leading to a high rate of treatment-related side effects. Patients and methods: A total of 180 consecutive patients received radiotherapy for prostate cancer. The median age was 66 years (range 41-88 years). The median of the maximum dose was 77.5 Gy (range 56.3-95 Gy) and overall treatment time was 51 days (range 28-128 days). Endpoints analyzed were late complications of grade 3 or higher, overall and disease-free survival, local tumor control, and distant metastases. Data analysis was actuarial and the log-rank test was used to compare the various subgroups. Results After 2 years, 80.5 {+-} 3.2% of the patients were without any complications of grade 3 or higher, and after 5 years a constant level of 70.3 {+-} 4.0% was approached. When multiple lesions occurred per patient, the later events were disregarded. A total of 66 complications occurred in 42 patients. The percentage of patients being free from late complications, plotted as a function of time after start of radiation therapy, was adequately described by an exponential function and a constant fraction. Complications approached a constant level of 70.3% at a rate of 5.3% per month. This means that patients who will develop a complication do so at exponential kinetics and at a relatively high rate, whereas about 70% of the patients will never experience a late effect even over long observation periods. After subdividing the maximum dose into three equal dose groups of 55 patients each (< 73.3 Gy, 73.3-80 Gy, > 80 Gy), the constant fraction decreased from 85.7 to 72.8% and 52.2%, whereas the incidence rate was 4.3%, 7.7%, and 5.6% per month and, thus, almost independent of radiation dose

  4. Intervenção fisioterapêutica nas sequelas de drenagem linfática manual iatrogênica: relato de caso Physical therapy in sequelae of iatrogenic manual lymphatic drainage: a case report

    Directory of Open Access Journals (Sweden)

    Rogério Eduardo Tacani

    2011-06-01

    Full Text Available Atualmente, a drenagem linfática manual (DLM é um dos recursos de grande destaque no tratamento de edemas, linfedemas e condições inestéticas, porém, na prática clínica têm-se observado sua aplicação de forma iatrogênica. Os objetivos deste relato de caso foram apontar as sequelas da aplicação iatrogênica da DLM, em uma jovem caucasiana, e verificar os efeitos da intervenção fisioterapêutica no tratamento dessas. Voluntária de 27 anos, apresentava-se com uma equimose importante na região lateral da coxa esquerda (28 x 9,5 cm, telangiectasias, microvaricosidades e petéquias em ambas as coxas e pernas, dor de forte intensidade e edema, após ter se submetido a um procedimento manual iatrogênico com finalidade estética há dois dias. As condutas fisioterapêuticas adotadas foram: Ultrassom 3 MHz, pulsado (2 ms on, 8 ms off, 0,4 W/cm² SATP na região da equimose e DLM (Método Leduc durante 20 minutos, na coxa esquerda. Foram realizadas nove sessões até a alta no 16º dia pós-lesão, observando-se apenas a redução gradativa da dor e da equimose. Verificou-se a efetividade da intervenção fisioterapêutica em apenas algumas das sequelas provocadas pela iatrogenia, sem desconsiderar que a remissão espontânea dos sinais e sintomas também pode ter contribuído para tal. Destaca-se a importância de conscientizar os fisioterapeutas que atuam com este procedimento para que o aplique de forma adequada, evitando tais iatrogenias.Recently, the manual lymphatic drainage (MLD is an important resource in the treatment of edemas, lymphedemas, and other unaesthetic conditions. However, problems caused by the incorrect application of this therapy have been observed in the clinical practice. The aims of this case report were to describe sequelae resulting from the negligent application of MLD on a young patient, and to determine the effects of physical therapy on the treatment of sequelae. A 27-year-old Caucasian woman presented

  5. Polycystic ovarian syndrome (PCOS), related symptoms/sequelae, and breast cancer risk in a population-based case-control study

    Science.gov (United States)

    Kim, Jayeon; Mersereau, Jennifer E.; Khankari, Nikhil; Bradshaw, Patrick T.; McCullough, Lauren E.; Cleveland, Rebecca; Shantakumar, Sumitra; Teitelbuam, Susan L.; Neugut, Alfred I.; Senie, Ruby T.; Gammon, Marilie D.

    2016-01-01

    Purpose Despite the overlap between the clinical symptoms/sequelae of polycystic ovarian syndrome (PCOS) and many known reproductive risk factors for breast cancer, the relationship between PCOS and breast cancer remains unclear, possibly because of the complex heterogeneity and challenges in diagnosing PCOS over time. We hypothesized that PCOS, specific PCOS-related symptoms/sequelae, or clusters of PCOS-related symptoms/sequelae, may be differentially associated with pre- vs. postmenopausal breast cancer risk. Materials and Methods Cases were 1,508 women newly diagnosed with a first primary in situ or invasive breast, and the 1,556 population-based controls were frequency-matched by age. Results History of physician-diagnosed PCOS was reported by 2.2% (n=67), among whom oral contraceptive (OC) use, irregular menstruation, and infertility due to ovulatory dysfunction were common. Using unconditional logistic regression, adjusted odds ratios (95% confidence intervals) for PCOS were increased for premenopausal [2.74 (1.13, 6.63)], but not post-menopausal breast cancer [0.87 (0.44, 1.71)]. We used cluster analysis to investigate whether risk among all women varied by PCOS-related symptoms/sequelae, such as reproductive irregularities, OC use, and components of insulin resistance. In the cluster analysis, odds ratios were elevated among premenopausal women who had a history of OC use and no ovulatory dysfunction [1.39 (1.03, 1.88)], compared to those with fewer number of PCOS-related symptoms/sequelae. Conclusion PCOS, and associated PCOS-related symptoms/sequelae including OC use, may play a role in the development of premenopausal breast cancer. Our findings require confirmation in studies with a larger number of premenopausal women with systematically applied diagnostic criteria for PCOS. PMID:26797454

  6. Polycystic ovarian syndrome (PCOS), related symptoms/sequelae, and breast cancer risk in a population-based case-control study.

    Science.gov (United States)

    Kim, Jayeon; Mersereau, Jennifer E; Khankari, Nikhil; Bradshaw, Patrick T; McCullough, Lauren E; Cleveland, Rebecca; Shantakumar, Sumitra; Teitelbuam, Susan L; Neugut, Alfred I; Senie, Ruby T; Gammon, Marilie D

    2016-03-01

    Despite the overlap between the clinical symptoms/sequelae of polycystic ovarian syndrome (PCOS) and many known reproductive risk factors for breast cancer, the relationship between PCOS and breast cancer remains unclear, possibly because of the complex heterogeneity and challenges in diagnosing PCOS over time. We hypothesized that PCOS, specific PCOS-related symptoms/sequelae, or clusters of PCOS-related symptoms/sequelae may be differentially associated with pre- versus postmenopausal breast cancer risk. Cases were 1,508 women newly diagnosed with a first primary in situ or invasive breast, and the 1,556 population-based controls were frequency-matched by age. History of physician-diagnosed PCOS was reported by 2.2 % (n = 67), among whom oral contraceptive (OC) use, irregular menstruation, and infertility due to ovulatory dysfunction were common. Using unconditional logistic regression, adjusted odds ratios (95 % CI) for PCOS were increased for premenopausal [2.74 (1.13, 6.63)], but not postmenopausal breast cancer [0.87 (0.44, 1.71)]. We used cluster analysis to investigate whether risk among all women varied by PCOS-related symptoms/sequelae, such as reproductive irregularities, OC use, and components of insulin resistance. In the cluster analysis, odds ratios were elevated among premenopausal women who had a history of OC use and no ovulatory dysfunction [1.39 (1.03, 1.88)], compared to those with fewer number of PCOS-related symptoms/sequelae. PCOS and associated PCOS-related symptoms/sequelae including OC use may play a role in the development of premenopausal breast cancer. Our findings require confirmation in studies with a larger number of premenopausal women with systematically applied diagnostic criteria for PCOS.

  7. Early- versus Late-Onset Systemic Sclerosis

    Science.gov (United States)

    Alba, Marco A.; Velasco, César; Simeón, Carmen Pilar; Fonollosa, Vicent; Trapiella, Luis; Egurbide, María Victoria; Sáez, Luis; Castillo, María Jesús; Callejas, José Luis; Camps, María Teresa; Tolosa, Carles; Ríos, Juan José; Freire, Mayka; Vargas, José Antonio; Espinosa, Gerard

    2014-01-01

    Abstract Peak age at onset of systemic sclerosis (SSc) is between 20 and 50 years, although SSc is also described in both young and elderly patients. We conducted the present study to determine if age at disease onset modulates the clinical characteristics and outcome of SSc patients. The Spanish Scleroderma Study Group recruited 1037 patients with a mean follow-up of 5.2 ± 6.8 years. Based on the mean ± 1 standard deviation (SD) of age at disease onset (45 ± 15 yr) of the whole series, patients were classified into 3 groups: age ≤30 years (early onset), age between 31 and 59 years (standard onset), and age ≥60 years (late onset). We compared initial and cumulative manifestations, immunologic features, and death rates. The early-onset group included 195 patients; standard-onset group, 651; and late-onset, 191 patients. The early-onset group had a higher prevalence of esophageal involvement (72% in early-onset compared with 67% in standard-onset and 56% in late-onset; p = 0.004), and myositis (11%, 7.2%, and 2.9%, respectively; p = 0.009), but a lower prevalence of centromere antibodies (33%, 46%, and 47%, respectively; p = 0.007). In contrast, late-onset SSc was characterized by a lower prevalence of digital ulcers (54%, 41%, and 34%, respectively; p < 0.001) but higher rates of heart conduction system abnormalities (9%, 13%, and 21%, respectively; p = 0.004). Pulmonary hypertension was found in 25% of elderly patients and in 12% of the youngest patients (p = 0.010). After correction for the population effects of age and sex, standardized mortality ratio was shown to be higher in younger patients. The results of the present study confirm that age at disease onset is associated with differences in clinical presentation and outcome in SSc patients. PMID:24646463

  8. The late administration of surfactant

    African Journals Online (AJOL)

    HMD and 4 as having congenital pneumonia. Overall there was a significant and sustained improvement ... 3 infants weighing> 2 400 g with congenital pneumonia responded to a single delayed dose of SRT. Late SRT is ..... pneumonia and meconium aspiration syndrome.' It does not appear that late SRT compromised the ...

  9. Mondini dysplasia--late complications.

    Science.gov (United States)

    Mitchell, D P; Rubin, A M

    1985-08-01

    Mondini's deformity is the second most common malformation seen in congenital genetic deafness. It is characterized by bony and membranous abnormalities of the inner ear, with a wide range of morphological and functional abnormalities. The importance of the Mondini malformation is that the patient is at an increased risk of developing meningitis or bilateral total hearing loss (or both) at an early age. Six cases are presented which illustrate the various sequelae of the Mondini malformation including meningitis, vertigo, and auditory deterioration. Decompression of the endolymphatic sac was undertaken in three patients. Emphasis is placed on the danger of head trauma, even minor, in these patients. The necessity of early diagnosis with adequate patient counseling is stressed.

  10. Management of mental health disorders and central nervous system sequelae in HIV-positive children and adolescents

    Directory of Open Access Journals (Sweden)

    R Nassen

    2014-09-01

    Full Text Available HIV-positive children and adolescents are at increased risk of both central nervous system (CNS sequelae and mental disorders owing to a number of factors, including the impact of HIV infection on the brain, social determinants of health (e.g. poverty and orphanhood and psychosocial stressors related to living with HIV. Every effort should be made to identify perinatally HIV-infected children and initiate them on antiretroviral therapy early in life. HIV clinicians should ideally screen for mental health and neurocognitive problems, as part of the routine monitoring of children attending antiretroviral clinics. This guideline is intended as a reference tool for HIV clinicians to support the early identification, screening and management of mental health disorders and/or CNS impairment in children and adolescents. This guideline covers mental disorders (section 1 and HIV-associated neurocognitive disorders (section 2 among children and adolescents.

  11. Frequency, imaging findings, risk factors, and long-term sequelae of distal clavicular osteolysis in young patients

    International Nuclear Information System (INIS)

    Roedl, Johannes B.; Nevalainen, Mika; Gonzalez, Felix M.; Morrison, William B.; Zoga, Adam C.; Dodson, Christopher C.

    2015-01-01

    Atraumatic distal clavicular osteolysis (DCO) has been described in adult male weightlifters. Our purpose was to investigate the frequency, magnetic resonance imaging (MRI) characteristics, risk factors, and long-term sequelae of DCO in young patients. Individuals with atraumatic DCO were identified in a retrospective review of 1,432 consecutive MRI shoulder reports in patients between 13 and 19 years of age. MRI findings of DCO, association with athletic activity, short-term clinical outcome after 3-6 months, and long-term clinical and MRI outcome after 2 years were analyzed. A pre-MRI questionnaire assessed the patients' athletic history including overhead activity and weightlifting. At a mean age of 15.9 years, 6.5 % (93/1432) of patients had atraumatic DCO, and 24 % were females. The combination of an overhead sport (basketball, volleyball, tennis, swimming) and supplemental weight training was a risk factor for DCO (odds ratio = 38, p = 0.01). Ninety-three percent of patients responded to conservative therapy. On follow-up imaging, 71 % of DCO patients had acromioclavicular (AC) joint osteoarthritis (vs. 35 % in controls, p = 0.006); 79 % had flattening of the distal clavicle and interval widening of the AC joint to a mean of 5.0 mm (compared to 2.4 mm in controls, p < 0.001). Severity of DCO edema was associated with pain (p < 0.02) at initial presentation and with AC joint osteoarthritis (p = 0.004) on follow-up. In athletic teenagers, the combination of weightlifting and overhead activity is a risk factor for atraumatic DCO, and females are affected in 24 %. Long-term sequelae include widening of the AC joint and AC joint osteoarthritis. (orig.)

  12. Frequency, imaging findings, risk factors, and long-term sequelae of distal clavicular osteolysis in young patients

    Energy Technology Data Exchange (ETDEWEB)

    Roedl, Johannes B.; Nevalainen, Mika; Gonzalez, Felix M.; Morrison, William B.; Zoga, Adam C. [Thomas Jefferson University Hospital, Thomas Jefferson University, Division of Musculoskeletal Imaging and Interventions, Department of Radiology, Philadelphia, PA (United States); Dodson, Christopher C. [Thomas Jefferson University Hospital, Rothman Institute, Sidney Kimmel Medical College at Thomas Jefferson University, Division of Sports Medicine, Department of Orthopedic Surgery, Philadelphia, PA (United States)

    2015-05-01

    Atraumatic distal clavicular osteolysis (DCO) has been described in adult male weightlifters. Our purpose was to investigate the frequency, magnetic resonance imaging (MRI) characteristics, risk factors, and long-term sequelae of DCO in young patients. Individuals with atraumatic DCO were identified in a retrospective review of 1,432 consecutive MRI shoulder reports in patients between 13 and 19 years of age. MRI findings of DCO, association with athletic activity, short-term clinical outcome after 3-6 months, and long-term clinical and MRI outcome after 2 years were analyzed. A pre-MRI questionnaire assessed the patients' athletic history including overhead activity and weightlifting. At a mean age of 15.9 years, 6.5 % (93/1432) of patients had atraumatic DCO, and 24 % were females. The combination of an overhead sport (basketball, volleyball, tennis, swimming) and supplemental weight training was a risk factor for DCO (odds ratio = 38, p = 0.01). Ninety-three percent of patients responded to conservative therapy. On follow-up imaging, 71 % of DCO patients had acromioclavicular (AC) joint osteoarthritis (vs. 35 % in controls, p = 0.006); 79 % had flattening of the distal clavicle and interval widening of the AC joint to a mean of 5.0 mm (compared to 2.4 mm in controls, p < 0.001). Severity of DCO edema was associated with pain (p < 0.02) at initial presentation and with AC joint osteoarthritis (p = 0.004) on follow-up. In athletic teenagers, the combination of weightlifting and overhead activity is a risk factor for atraumatic DCO, and females are affected in 24 %. Long-term sequelae include widening of the AC joint and AC joint osteoarthritis. (orig.)

  13. Pathophysiology and Natural History of Anorectal Sequelae Following Radiation Therapy for Carcinoma of the Prostate

    International Nuclear Information System (INIS)

    Yeoh, Eric K.; Holloway, Richard H.; Fraser, Robert J.; Botten, Rochelle J.; Di Matteo, Addolorata C.; Butters, Julie

    2012-01-01

    Purpose: To characterize the prevalence, pathophysiology, and natural history of chronic radiation proctitis 5 years following radiation therapy (RT) for localized carcinoma of the prostate. Methods and Materials: Studies were performed in 34 patients (median age 68 years; range 54-79) previously randomly assigned to either 64 Gy in 32 fractions over 6.4 weeks or 55 Gy in 20 fractions over 4 weeks RT schedule using 2- and later 3-dimensional treatment technique for localized prostate carcinoma. Each patient underwent evaluations of (1) gastrointestinal (GI) symptoms (Modified Late Effects in Normal Tissues Subjective, Objective, Management and Analytic scales including effect on activities of daily living [ADLs]); (2) anorectal motor and sensory function (manometry and graded balloon distension); and (3) anal sphincteric morphology (endoanal ultrasound) before RT, at 1 month, and annually for 5 years after its completion. Results: Total GI symptom scores increased after RT and remained above baseline levels at 5 years and were associated with reductions in (1) basal anal pressures, (2) responses to squeeze and increased intra-abdominal pressure, (3) rectal compliance and (4) rectal volumes of sensory perception. Anal sphincter morphology was unchanged. At 5 years, 44% and 21% of patients reported urgency of defecation and rectal bleeding, respectively, and 48% impairment of ADLs. GI symptom scores and parameters of anorectal function and anal sphincter morphology did not differ between the 2 RT schedules or treatment techniques. Conclusions: Five years after RT for prostate carcinoma, anorectal symptoms continue to have a significant impact on ADLs of almost 50% of patients. These symptoms are associated with anorectal dysfunction independent of the RT schedules or treatment techniques reported here.

  14. Pathophysiology and Natural History of Anorectal Sequelae Following Radiation Therapy for Carcinoma of the Prostate

    Energy Technology Data Exchange (ETDEWEB)

    Yeoh, Eric K., E-mail: eric.yeoh@health.sa.gov.au [Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide (Australia); Discipline of Medicine, University of Adelaide, Adelaide (Australia); Holloway, Richard H. [Discipline of Medicine, University of Adelaide, Adelaide (Australia); Department of Gastroenterology, Royal Adelaide Hospital, Adelaide (Australia); Fraser, Robert J. [Discipline of Medicine, University of Adelaide, Adelaide (Australia); Gastrointestinal Investigation Unit, Repatriation General Hospital, Adelaide (Australia); Botten, Rochelle J.; Di Matteo, Addolorata C.; Butters, Julie [Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide (Australia)

    2012-12-01

    Purpose: To characterize the prevalence, pathophysiology, and natural history of chronic radiation proctitis 5 years following radiation therapy (RT) for localized carcinoma of the prostate. Methods and Materials: Studies were performed in 34 patients (median age 68 years; range 54-79) previously randomly assigned to either 64 Gy in 32 fractions over 6.4 weeks or 55 Gy in 20 fractions over 4 weeks RT schedule using 2- and later 3-dimensional treatment technique for localized prostate carcinoma. Each patient underwent evaluations of (1) gastrointestinal (GI) symptoms (Modified Late Effects in Normal Tissues Subjective, Objective, Management and Analytic scales including effect on activities of daily living [ADLs]); (2) anorectal motor and sensory function (manometry and graded balloon distension); and (3) anal sphincteric morphology (endoanal ultrasound) before RT, at 1 month, and annually for 5 years after its completion. Results: Total GI symptom scores increased after RT and remained above baseline levels at 5 years and were associated with reductions in (1) basal anal pressures, (2) responses to squeeze and increased intra-abdominal pressure, (3) rectal compliance and (4) rectal volumes of sensory perception. Anal sphincter morphology was unchanged. At 5 years, 44% and 21% of patients reported urgency of defecation and rectal bleeding, respectively, and 48% impairment of ADLs. GI symptom scores and parameters of anorectal function and anal sphincter morphology did not differ between the 2 RT schedules or treatment techniques. Conclusions: Five years after RT for prostate carcinoma, anorectal symptoms continue to have a significant impact on ADLs of almost 50% of patients. These symptoms are associated with anorectal dysfunction independent of the RT schedules or treatment techniques reported here.

  15. Radiobiological considerations of late effects arising from radiotherapy

    International Nuclear Information System (INIS)

    Kogelnik, H.D.; Kaercher, K.H.

    1977-01-01

    A variety of clinical and experimental data are reviewed to investigate the different factors leading to appearance of late complications. Higher individual doses per fraction are related to an increase in the incidence and severity of late effects and massive dose techniques result in catastrophic late complications. There is no apparent relation between the severity of initial skin reactions and late effects, indicating that matching of acute radiation reactions on skin or mucous membranes cannot be extrapolated to late damage in connective tissues and organs. The probability of late tissue injury increases with the volume of tissue irradiated. Several phenomena, e.g. parenchymal cell depletion, vascular injury and fibrocyte dysfunction, are likely to operate together as well as separately in the pathogenesis of late effects. The late complications of radiotherapy develop in cells with a slow proliferation, and this is consistent with the hypothesis that parenchymal cell killing may be the basis for the injury. The response of cells with a slow proliferation to a course of fractionated irradiation differs from that of rapidly proliferative cells in three biological processes: repair of potentially lethal damage, redistribution and regeneration. (author)

  16. Chronic pain and other sequelae in long-term breast cancer survivors: Nationwide survey in Denmark

    DEFF Research Database (Denmark)

    Peuckmann, V.; Ekholm, O.; Rasmussen, N.K.

    2008-01-01

    %, chronic pain 29%, arm/shoulder swelling 25%, phantom sensations 19%, and allodynia 15%. Chronic pain related to breast cancer was significantly associated with poorer HRQOL and higher medicine consumption, and, in multiple logistic regression analysis, with age (education, being single...... (divorced, widowed, separated), radiotherapy, and time since operation

  17. Comparison of the clinical efficacy of methylprednisolone with ibuprofen and ibuprofen alone on the postoperative sequelae of surgical removal of impacted third molar

    Directory of Open Access Journals (Sweden)

    Navneet Kaur

    2014-01-01

    Full Text Available Purpose: The aim of the study was to compare the clinical efficacy of methylprednisolone with ibuprofen to ibuprofen alone on the postoperative sequelae of surgical removal of impacted third molars. Materials and Methods: The present study was conducted on the 35 patients requiring surgical extraction of bilateral impacted third molars attending the Outpatient Department of Oral and Maxillofacial Surgery, Guru Nanak Dev Dental College and Research Institute. The impacted teeth were removed in two sessions at least 3 weeks apart. The selected patients were randomly put on regimen 1 or regimen II at either the first or second surgery in accordance with randomization plan. The measurements and recordings for pain, swelling, and interincisal distance (mouth opening, were made on 1 st , 3 rd , and 7 th day postoperatively on the scales designed for the purpose. The data recorded was compiled and put to statistical analysis. Results: It was observed from the present study that postoperative sequelae, that is, pain, swelling, and trismus was significantly less in the regimen I group than regimen II group on the 1 st and 3 rd postoperative day. Conclusion: The results of this study substantiate the fact that a single class of drugs (nonsteroidal anti-inflammatory drug (NSAID is less effective in controlling postoperative inflammatory sequelae than the combination of ibuprofen (NSAID and methylprednisolone (corticosteroid following the third molar surgery. Therefore, this pharmaceutical combination should be considered for attenuation of postoperative sequelae in healthy patients undergoing surgical removal of impacted mandibular third molar.

  18. Early and late toxicity of involved-field radiation therapy in conjunction with high-dose chemotherapy and stem cell rescue

    International Nuclear Information System (INIS)

    Lubich, L.; Mundt, A.; Sibley, G.; Hallahan, D.; Nautiyal, J.; Weichselbaum, R.

    1995-01-01

    Purpose: Recent reports have demonstrated a benefit to involved-field radiation therapy (IFRT) in patients with relapsed/metastatic disease undergoing high-dose chemotherapy (HDCT) and stem cell rescue (SCR). We evaluate here the early and late toxicity of this approach. Methods: Eighty-five patients with either metastatic breast cancer (MBC) (31) or relapsed/refractory Hodgkin's disease (HD) (54) underwent HDCT/SCR. HDCT in the MBC patients consisted of cytoxan, thiotepa +/- carmustine and VP-16, cytoxan, BCNU +/- thiotepa in the HD patients. Thirty-four patients (40%) received IFRT either prior to (14) or following (20) HDCT to sites of disease involvement. A total of 18 patients received chest wall/mediastinal (CWMED) RT. Median followup for the MBC and HD patients were 21.3 months and 41 months, respectively. Results: Acute sequelae were similar in the 2 groups. Only one patient (5%) treated with IFRT (HD with 5 nodal sites) required a break from therapy due to low blood counts. Seven patients (0 MBC, 7 HD) (8.2%) suffered a toxic death (TD). No difference in was seen in the rate of TD in the patients as a whole ((1(14)) vs. (6(71))) (p =0.87) nor in the HD patients alone ((1(7)) vs. (6(47))) (p =0.91) with the use of IFRT prior to HDCT. Eleven patients (12.9%) developed late toxicity: 3 myelodysplasia/acute leukemia (MAL), 2 persistent low blood counts (requiring transfusions), 4 pulmonary toxicity (PT) and 2 hypothyroidism. All 4 cases of PT occurred in the HD group of which 3 received CWMED RT. The Table below shows the 5-yr actuarial risk of PT with and without CWMED RT as well as the 5-yr actuarial risk of MAL and any hematologic sequelae with and without RT. Multivariate analysis in the HD patients demonstrated that CWMED RT was the most significant factor for PT (p =0.09). All 3 cases of MAL and the 2 cases of persistent low blood counts occurred in the HD group. The use of IFRT did not increase the incidence of MAL or of any hematologic sequelae

  19. 7 CFR 920.112 - Late payments.

    Science.gov (United States)

    2010-01-01

    ... Miscellaneous Provisions § 920.112 Late payments. Pursuant to § 920.41(a), interest will be charged at a 1.5 percent monthly simple interest rate. Assessments for kiwifruit shall be deemed late if not received... late charge will be assessed when payment becomes 30 days late. Interest and late payment charges shall...

  20. FACEBOOK COMMUNICATION IN HIGHER EDUCATION

    Directory of Open Access Journals (Sweden)

    Emanuela Maria AVRAM

    2014-11-01

    Full Text Available The social networks have been growing steadily in recent years. Facebook, one of the most popular social networks, is a modern means of communication and socialization that has taken lately more ground in higher education becoming an important academic tool in the communication process. Many universities have their own Facebook page, being used by both students and teachers, and creating Facebook groups increasingly facilitates communication with students. Thus, this paper aims to identify the importance that Facebook holds in the academic communication process and highlights the implications it has in higher education. The results reveal that this type of communication has gained more ground in academia creating real social communities, and students use it more and more for collaboration in various activities involved in the higher education system, but also for socializing and information.

  1. Vaginal bleeding in late pregnancy

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000627.htm Vaginal bleeding in late pregnancy To use the sharing ... JavaScript. One out of 10 women will have vaginal bleeding during their 3rd trimester. At times, it ...

  2. Torture and its sequel--a comparison between victims from six countries.

    Science.gov (United States)

    Moisander, Pia A; Edston, Erik

    2003-11-26

    The aim of the study was to compare torture victims from six different nations and analyse differences and similarities. From the files of the Centre for Trauma Victims in Stockholm (KTC), 160 patients were selected: 53 patients from Bangladesh, 21 from Iran, 16 from Peru, 24 from Syria, 25 from Turkey, and 21 from Uganda. The data was classified into: (i) information about social conditions and circumstances pertaining to alleged torture, (ii) type of trauma and torture methods, and (iii) acute and late sequel to torture. Descriptive and non-parametric statistics were used in the analyses. There was a strong male dominance in all but the Ugandan group where 43% were women. The majority in all but the Turkish group had college exams and/or university studies. Over 84% were members of a political organisation except in the Iranian and Syrian groups, where more than 40% had no political affiliation. The majority in all groups had travelled to Sweden alone to apply for asylum, but most refugees from Turkey, Iran, and Syria had close relatives already living in Sweden. The stories of circumstances and torture methods were similar within each group but differed a great deal between groups. Typically, in Bangladesh, Peru, and Turkey, the periods under arrest were short: from a few hours to 3 days. In Iran, Uganda, and Syria, the time in custody varied from several months to several years. A prison sentence preceded by trial was common only in Iran. Many patients, especially from Bangladesh and Turkey, had been arrested several times. Sensory deprivation by isolation and blindfolding was common in all countries except Uganda and Peru. Beating with fists, sticks, truncheons, etc. were reported in 100% in every group. In Bangladesh, police batons (lathi) were used more commonly than in any other group. Whipping with electric cords occurred frequently only in Iran and Syria. Rape was most often reported among the Ugandans. Genital torture was frequently alleged by patients

  3. The Contemporary Incidence and Sequelae of Rhabdomyolysis Following Extirpative Renal Surgery: A Population Based Analysis.

    Science.gov (United States)

    Gelpi-Hammerschmidt, Francisco; Tinay, Ilker; Allard, Christopher B; Su, Li-Ming; Preston, Mark A; Trinh, Quoc-Dien; Kibel, Adam S; Wang, Ye; Chung, Benjamin I; Chang, Steven L

    2016-02-01

    We evaluate the contemporary incidence and consequences of postoperative rhabdomyolysis after extirpative renal surgery. We conducted a population based, retrospective cohort study of patients who underwent extirpative renal surgery with a diagnosis of a renal mass or renal cell carcinoma in the United States between 2004 and 2013. Regression analysis was performed to evaluate 90-day mortality (Clavien grade V), nonfatal major complications (Clavien grade III-IV), hospital readmission rates, direct costs and length of stay. The final weighted cohort included 310,880 open, 174,283 laparoscopic and 69,880 robotic extirpative renal surgery cases during the 10-year study period, with 745 (0.001%) experiencing postoperative rhabdomyolysis. The presence of postoperative rhabdomyolysis led to a significantly higher incidence of 90-day nonfatal major complications (34.7% vs 7.3%, p rhabdomyolysis (incidence risk ratio 1.83, 95% CI 1.56-2.15, p rhabdomyolysis (vs laparoscopic approach, OR 2.43, p rhabdomyolysis (p rhabdomyolysis developing. Our study confirms that postoperative rhabdomyolysis is an uncommon complication among patients undergoing extirpative renal surgery, but has a potentially detrimental impact on surgical morbidity, mortality and costs. Male gender, comorbidities, obesity, prolonged surgery (more than 5 hours) and a robotic approach appear to place patients at higher risk for postoperative rhabdomyolysis. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  4. The distinctive sequelae of children's coping with interparental conflict: Testing the reformulated emotional security theory.

    Science.gov (United States)

    Davies, Patrick T; Martin, Meredith J; Sturge-Apple, Melissa L; Ripple, Michael T; Cicchetti, Dante

    2016-10-01

    Two studies tested hypotheses about the distinctive psychological consequences of children's patterns of responding to interparental conflict. In Study 1, 174 preschool children (M = 4.0 years) and their mothers participated in a cross-sectional design. In Study 2, 243 preschool children (M = 4.6 years) and their parents participated in 2 annual measurement occasions. Across both studies, multiple informants assessed children's psychological functioning. Guided by the reformulated version of emotional security theory, behavioral observations of children's coping with interparental conflict assessed their tendencies to exhibit 4 patterns based on their function in defusing threat: secure (i.e., efficiently address direct instances of threat), mobilizing (i.e., react to potential threat and social opportunities), dominant (i.e., directly defeat threat), and demobilizing (i.e., reduce salience as a target of hostility). As hypothesized, each profile predicted unique patterns of adjustment. Greater security was associated with lower levels of internalizing and externalizing symptoms and greater social competence, whereas higher dominance was associated with externalizing problems and extraversion. In contrast, mobilizing patterns of reactivity predicted more problems with self-regulation, internalizing symptoms, externalizing difficulties, but also greater extraversion. Finally, higher levels of demobilizing reactivity were linked with greater internalizing problems and lower extraversion but also better self-regulation. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  5. Late effects from hadron therapy

    Energy Technology Data Exchange (ETDEWEB)

    Blakely, Eleanor A.; Chang, Polly Y.

    2004-06-01

    Successful cancer patient survival and local tumor control from hadron radiotherapy warrant a discussion of potential secondary late effects from the radiation. The study of late-appearing clinical effects from particle beams of protons, carbon, or heavier ions is a relatively new field with few data. However, new clinical information is available from pioneer hadron radiotherapy programs in the USA, Japan, Germany and Switzerland. This paper will review available data on late tissue effects from particle radiation exposures, and discuss its importance to the future of hadron therapy. Potential late radiation effects are associated with irradiated normal tissue volumes at risk that in many cases can be reduced with hadron therapy. However, normal tissues present within hadron treatment volumes can demonstrate enhanced responses compared to conventional modes of therapy. Late endpoints of concern include induction of secondary cancers, cataract, fibrosis, neurodegeneration, vascular damage, and immunological, endocrine and hereditary effects. Low-dose tissue effects at tumor margins need further study, and there is need for more acute molecular studies underlying late effects of hadron therapy.

  6. Sports injuries: population based representative data on incidence, diagnosis, sequelae, and high risk groups.

    Science.gov (United States)

    Schneider, S; Seither, B; Tönges, S; Schmitt, H

    2006-04-01

    To generate national representative data on the incidence, diagnosis, severity, and nature of medically treated sports injuries and to identify high risk groups. The first national health survey for the Federal Republic of Germany, conducted in the format of a standardised, written, cross sectional survey in the period October 1997 to March 1999, gathered data on the incidence of accident and injury and information on social demographics, injury related disability/time off work, and injury location/setting. The net sample comprised 7124 people aged 18-79. 3.1% of adult Germans said they sustained a sports injury during the previous year, corresponding to an annual injury rate of 5.6% among those engaging in regular recreational physical activity and ranking sports injuries as the second most common type of accident. About 62% of all sports injuries result in time taken off work. The period of occupational disability is 14 days or less in around two thirds of these cases. The occupational disability rate after occupational and traffic accidents is much higher by comparison. Dislocations, distortions, and/or torn ligaments make up 60% of all sports injuries, followed by fractures (18%), contusions, surface wounds, or open wounds (12%). Three out of four sports injury casualties are male. The incidence declines noticeably in higher age groups. Future injury prevention measures should focus on the high risk group of young male recreational athletes. The data indicate that the fear of damage to health and injury, believed to be significant internal psychological barriers to participation in sports, is largely unwarranted for the female population and/or older age groups. Sporting injuries are a marginal phenomenon among the female population and mobile seniors actively engaged in sports.

  7. Avaliação espirométrica de doentes com sequela de tuberculose submetidos à lobectomia

    Directory of Open Access Journals (Sweden)

    Elias Amorim

    Full Text Available OBJETIVO: Avaliar a espirometria no pré e pós-operatório de doentes com sequela de tuberculose, submetidos à lobectomia. MÉTODOS: Foram selecionados 20 doentes, com idade entre 15 e 56 anos, de ambos os sexos, com história pregressa de tratamento de tuberculose, apresentando infecção de repetição ou hemoptises. Foram submetidos à lobectomia pulmonar. O tempo de tratamento da tuberculose foi seis meses e o aparecimento dos sintomas entre um e 32 anos. Foram avaliadas a capacidade vital (CV, a capacidade vital forçada (CVF, o volume expiratório forçado (VEF1, o VEF1/CVF, o fluxo expiratório forçado (FEF e o pico de fluxo expiratório (PFE após o primeiro, terceiro e sexto meses em relação ao pré-operatório. O nível de significância (á aplicado em todos os testes foi 5%, ou seja, considerou-se significativo quando p<0,05. RESULTADOS: As Médias encontradas foram as seguintes: Capacidade Vital (CV Pré-operatória-2,83 ; 1º PO 2,12; 3º PO 2,31; 6º PO 2,43. Capacidade Vital Forçada (CVF Pré-operatória- 2,97; 1º PO 2,21; 3º PO 2,35; 6º PO 2,53. Volume Expiratório no 1º Segundo (VEF1 Pré-operatório 2,23; 1º PO 1,75; 3º PO 1,81; 6º PO 1,97. Houve diminuição acentuada das funções respiratórias no primeiro mês de pós-operatório, porém houve melhora dos parâmetros a partir do terceiro mês, com progressivo aumento até o sexto mês de pós-operatório. CONCLUSÃO: Não houve recuperação dos parâmetros espirométricos, comparados aos do pré operatório, após seis meses de pós-operatório nos pacientes com sequela de tuberculose submetidos à lobectomia.

  8. Hypothyroidism in late-onset Pompe disease.

    Science.gov (United States)

    Schneider, Joseph; Burmeister, Lynn A; Rudser, Kyle; Whitley, Chester B; Jarnes Utz, Jeanine

    2016-09-01

    In Pompe disease, a deficiency of acid α-glucosidase enzyme activity leads to pathologic accumulation of glycogen in tissues. Phenotype heterogeneity in Pompe includes an infantile form and late-onset forms (juvenile- and adult-onset forms). Symptoms common to all phenotypes include progressive muscle weakness and worsening respiratory function. Patients with late-onset forms of Pompe disease commonly complain of chronic fatigue and generalized muscle weakness prior to being diagnosed with Pompe disease, and this may lead to consideration of hypothyroidism in the differential diagnosis. This study aimed to evaluate the prevalence of hypothyroidism in the adult-onset form of Pompe disease. Electronic chart review was performed at the Advanced Therapies Clinic at the University of Minnesota Medical Center (UMMC) to identify patients with late-onset Pompe disease. The identified charts were reviewed for a co-diagnosis of hypothyroidism. A query was made to the clinical data repository at UMMC searching diagnosis ICD9 code 244.9 (hypothyroidism not otherwise specified) and/or presence of levothyroxine from 2011 to 2014 in patients 18 years of age and older. The clinical data repository found a prevalence of hypothyroidism of 3.15% (56,072 of 1,782,720 patients) in the adult patient population at UMMC. Ten adult patients with Pompe disease were identified, five with the diagnosis of hypothyroidism (50%, 95% CI: 23.7, 76.3, p Hypothyroidism was found at a higher prevalence in patients with late-onset Pompe disease compared to the general adult population at UMMC. Studies in larger populations of patients with Pompe disease would be needed to confirm an association of Pompe disease and hypothyroidism. Challenges include finding an adequate sample size, due the rarity of Pompe disease.

  9. Trends in the incidence of diabetes, its clinical sequelae, and associated costs in pregnancy

    Science.gov (United States)

    Jovanovič, Lois; Liang, Yuanjie; Weng, Wayne; Hamilton, Marianthe; Chen, Lisa; Wintfeld, Neil

    2015-01-01

    Background Increasing diabetes prevalence affects a substantial number of pregnant women in the United States. Our aims were to evaluate health outcomes, medical costs, risks and types of complications associated with diabetes in pregnancy for mothers and newborns. Methods In this retrospective claims analysis, patients were identified from the Truven Health MarketScan® database (2004–2011 inclusive). Participants were aged 18–45 years, with ascertainable diabetes status [Yes/No], date of birth event >2005 and continuous health plan enrolment ≥21 months before and 3 months after the birth. Results In total, 839 792 pregnancies were identified, and 66 041 (7.86%) were associated with diabetes mellitus [type 1 (T1DM), 0.13%; type 2 (T2DM), 1.21%; gestational (GDM), 6.29%; and GDM progressing to T2DM (patients without prior diabetes who had a T2DM diagnosis after the birth event), 0.23%]. Relative risk (RR) of stillbirth (2.51), miscarriage (1.28) and Caesarean section (C-section) (1.77) was significantly greater with T2DM versus non-diabetes. Risk of C-section was also significantly greater for other diabetes types [RR 1.92 (T1DM); 1.37 (GDM); 1.63 (GDM progressing to T2DM)]. Risk of overall major congenital (RR ≥ 1.17), major congenital circulatory (RR ≥ 1.19) or major congenital heart (RR ≥ 1.18) complications was greater in newborns of mothers with diabetes versus without. Mothers with T2DM had significantly higher risk (RR ≥ 1.36) of anaemia, depression, hypertension, infection, migraine, or cardiac, obstetrical or respiratory complications than non-diabetes patients. Mean medical costs were higher with all diabetes types, particularly T1DM ($27 531), than non-diabetes ($14 355). Conclusions Complications and costs of healthcare were greater with diabetes, highlighting the need to optimize diabetes management in pregnancy. © 2015 The Authors. Diabetes/Metabolism Research and Reviews published by John Wiley & Sons, Ltd. PMID

  10. [Severe late-onset group B streptococcal infection. A case report].

    Science.gov (United States)

    Haase, Roland; Nagel, Frank; Hirsch, Wolfgang; Sitka, Uwe

    2003-01-01

    Group B Streptococcus (GBS) is a well-known cause of neonatal pneumonia, sepsis and meningitis. Peripartal antibiotic prophylaxis for early-onset GBS infection is in routine use since the beginning of the last decade, but strategies for effective prevention of late-onset GBS infections are still lacking. Few hours after discharge from a non-local maternity ward a 3-week-old boy was admitted to our hospital because of GBS meningitis with necrotizing encephalomalacia. Maternal mastitis, not a disease of the baby, had led to the first admission. Case history and negative maternal swabs and cultures for GBS led to the hypothesis of nosocomial infection. Screening and risk based peripartal antibiotic prophylaxis, better monitoring and improved therapeutic modalities have reduced the incidence and mortality of early-onset GBS infections, but peripartal prophylaxis failed to influence late-onset GBS infections. Up to 40 % of infants with late-onset meningitis develop neurological sequelae. Maternal vaccination with multivalent conjugate vaccines against GBS is a new strategy which may lead to passive protection of the infant. Further studies to examine the efficacy of vaccines are in progress.

  11. The acute myxedema after hyperthyroidism treated by radioactive iodine and its sequelae

    Directory of Open Access Journals (Sweden)

    Ivković Staša

    2013-01-01

    Full Text Available This is a case report of a female patient who developed, after radioactive iodine therapy for Grave's hyperthyroidism, a severe clinically manifested hypothyroidism, which was accompanied by predominantly sensory neuropathy of dominant axonal type. Besides symptoms and neurophysiological signs of polyneuropathy, the patient, in spite of seemingly adequate levothyroxine monotherapy for hypothyroidism during the last 2 years, still manifested persistent hypothyroid symptoms by CNS, higher serum concentrations of total and LDL cholesterol and clinical signs of the increased peripheral vascular resistance. Non-physiological serum FT3 and FT4 ratio was maintained, together with serum TSH and FT4 concentrations, which suggested lower sensitivity of thyroid-hypophyseal negative feedback. The introduced combined LT4/LT3 substitution therapy resulted in quick subsidence of CNS-related hypothyroid symptoms, significant reduction of serum concentrations of total and LDL cholesterol, FT3/FT4 ratio normalization, at least in the first hours of drug administration, and disappearance of clinical signs of the increased peripheral vascular resistance. The extent of polyneuropathic difficulties was reduced to the level of not disturbing the sleep. Time and control ENG will show the final effects of combined T4/FT3 therapy on the peripheral nerve injuries. In the first 6 months, no adverse effects of this therapy were recorded.

  12. Precursor or sequela: pathological disorders in people with Internet addiction disorder.

    Directory of Open Access Journals (Sweden)

    Guangheng Dong

    Full Text Available BACKGROUND: This study aimed to evaluate the roles of pathological disorders in Internet addiction disorder and identify the pathological problems in IAD, as well as explore the mental status of Internet addicts prior to addiction, including the pathological traits that may trigger Internet addiction disorder. METHODS AND FINDINGS: 59 students were measured by Symptom CheckList-90 before and after they became addicted to the Internet. A comparison of collected data from Symptom Checklist-90 before Internet addiction and the data collected after Internet addiction illustrated the roles of pathological disorders among people with Internet addiction disorder. The obsessive-compulsive dimension was found abnormal before they became addicted to the Internet. After their addiction, significantly higher scores were observed for dimensions on depression, anxiety, hostility, interpersonal sensitivity, and psychoticism, suggesting that these were outcomes of Internet addiction disorder. Dimensions on somatisation, paranoid ideation, and phobic anxiety did not change during the study period, signifying that these dimensions are not related to Internet addiction disorder. CONCLUSIONS: We can not find a solid pathological predictor for Internet addiction disorder. Internet addiction disorder may bring some pathological problems to the addicts in some ways.

  13. Laypersons' expectation of the sequelae of whiplash injury: a cross-cultural comparative study between Canada and Greece.

    Science.gov (United States)

    Ferrari, Robert; Constantoyannis, Constantine; Papadakis, Nikolas

    2003-03-01

    The objective of the present study is to compare the frequency and nature of expected 'whiplash' symptoms in Greece [a country where the chronic whiplash syndrome is rare or unknown] with that in Canada. A symptom checklist was administered to 2 subject groups selected from local companies in Patras Greece, and Edmonton, Canada, respectively. Subjects were asked to imagine having suffered a neck sprain [whiplash injury] with no loss of consciousness in a motor vehicle collision, and to check which, of a variety of symptoms, they would expect might arise from the injury. For symptoms they anticipated, they were asked to select the period of time they expected those symptoms to persist. In both the Greek and Edmontonian groups, the pattern of symptoms anticipated closely resembled the acute symptoms commonly reported by accident victims with acute neck sprain, but while up to 50% of Edmontonians also anticipated symptoms to last months or years, very few Greek subjects selected any symptoms as likely to persist. In Greece, despite the documented occurrence of neck sprain symptoms in individuals following motor vehicle collisions, there is a very low rate of expectation of any sequelae from this injury. What current or previous aspects of society that underlie this remain uncertain. This lack of expectation of chronicity in Greece may, in part, determine the low prevalence of the chronic whiplash syndrome there. Further studies of symptom expectation as an etiologic factor in the chronic whiplash syndrome are needed.

  14. Psychiatric Sequelae of Former "Comfort Women," Survivors of the Japanese Military Sexual Slavery during World War II.

    Science.gov (United States)

    Lee, Jeewon; Kwak, Young-Sook; Kim, Yoon-Jung; Kim, Eun-Ji; Park, E Jin; Shin, Yunmi; Lee, Bun-Hee; Lee, So Hee; Jung, Hee Yeon; Lee, Inseon; Hwang, Jung Im; Kim, Dongsik; Lee, Soyoung Irene

    2018-04-01

    "Comfort women" refers to young women and girls who were forced into sexual slavery by the Imperial Japanese military during World War II. They were abducted from their homes in countries under Imperial Japanese rule, mostly from Korea, and the rest from China, Philippines, Malaysia, Taiwan, Indonesia, the Netherlands, etc. "Comfort women" endured extreme trauma involving rape, sexual torture, physical abuse, starvation, threats of death, and witnessed many others being tortured and killed. This article reviews all the studies that have investigated the psychiatric or psychosocial sequelae of the survivors of the Japanese military sexual slavery. Most importantly, a recent study which conducted a psychiatric evaluation on the former "comfort women" currently alive in South Korea is introduced. The participants' unmarried rate was relatively high and their total fertility rate was relatively low. Majority of the participants reported having no education and being the low economic status. They showed high current and lifetime prevalence of posttraumatic disorder, major depressive disorder, somatic symptom disorder, social anxiety disorder, panic disorder, and alcohol use disorder. Participants showed high suicidality and majority of the participants still reported being ashamed of being former "comfort women" after all these years. This article high-lights the fact that the trauma has affected the mental health and social functioning of former "comfort women" throughout their lives, and even to the present day.

  15. Retention of contrast media in the history of radiology. Sequelae of the former use of thorotrast and new challenges

    International Nuclear Information System (INIS)

    Kaick, G. van; Delorme, S.

    2016-01-01

    Detection of gadolinium deposits in patients who have repeatedly been administered intravenous gadolinium chelates have given rise to concern regarding the long-term safety of magnetic resonance imaging (MRI) contrast media. Nevertheless, negative long-term clinical effects have not yet been observed. In some publications parallels have been drawn to the sequelae of thorotrast that was formerly used for arterial angiography. In this article the history of thorotrast use is briefly described and in particular why, despite warnings, this substance was used frequently and worldwide. A brief summary of the results of the German Thorotrast Study revealed that high excess rates were only observed for primary malignant liver tumors after a 15-year or longer latency period and to a lesser degree of leukemias, as well as for severe local complications due to paravascular injections, particularly in the neck region. Based on this historical review, we will venture to take stock of the outcome from the ''success story'' of this contrast agent. (orig.) [de

  16. What Therapies are Favored in the Treatment of the Psychological Sequelae of Trauma in Human Trafficking Victims?

    Science.gov (United States)

    Salami, Temilola; Gordon, Mollie; Coverdale, John; Nguyen, Phuong T

    2018-03-01

    Human trafficking is a major public health concern that brings about deleterious psychological consequences and sequelae. Although a number of risk and protective factors for the health consequences of human trafficking victims have been identified, there is a dearth of information in the area of treatment. Specifically, we found no articles comparing the different components of prevailing trauma treatment strategies, and the potential usefulness of these strategies in the treatment of human trafficking victims. To this end, we compared and contrasted the different therapeutic treatments typically implemented with victims of trauma (including domestic violence victims and torture victims), and discussed how the different components of these treatments may or may not be helpful for human trafficking victims. We assessed the impact of these treatments on the psychological consequences of trauma and, in particular on posttraumatic stress disorder. We also assessed the potential usefulness of these treatments with co-occurring problems such as substance use, psychosis, dissociation, and other mood and anxiety disorders. On the basis of the prevailing research, we highlighted cognitive therapies as being preferred in addressing the needs of human trafficking victims. Mental health providers who work with human trafficking victims should become aware of and practiced in the use of cognitive therapeutic approaches in treating this population. Efficacy and effectiveness studies are needed to validate our recommendations.

  17. Developmental sequelae and neurophysiologic substrates of sensory seeking in infant siblings of children with autism spectrum disorder

    Directory of Open Access Journals (Sweden)

    Cara R. Damiano-Goodwin

    2018-01-01

    Full Text Available It has been proposed that early differences in sensory responsiveness arise from atypical neural function and produce cascading effects on development across domains. This longitudinal study prospectively followed infants at heightened risk for autism spectrum disorder (ASD based on their status as younger siblings of children diagnosed with ASD (Sibs-ASD and infants at relatively lower risk for ASD (siblings of typically developing children; Sibs-TD to examine the developmental sequelae and possible neurophysiological substrates of a specific sensory response pattern: unusually intense interest in nonsocial sensory stimuli or “sensory seeking.” At 18 months, sensory seeking and social orienting were measured with the Sensory Processing Assessment, and a potential neural signature for sensory seeking (i.e., frontal alpha asymmetry was measured via resting state electroencephalography. At 36 months, infants’ social symptomatology was assessed in a comprehensive diagnostic evaluation. Sibs-ASD showed elevated sensory seeking relative to Sibs-TD, and increased sensory seeking was concurrently associated with reduced social orienting across groups and resting frontal asymmetry in Sibs-ASD. Sensory seeking also predicted later social symptomatology. Findings suggest that sensory seeking may produce cascading effects on social development in infants at risk for ASD and that atypical frontal asymmetry may underlie this atypical pattern of sensory responsiveness. Keywords: Sensory, Autism, Infant siblings, Longitudinal, Frontal asymmetry, EEG

  18. Cranial MRI findings in pediatric patients with bilateral spastic paralysis. Comparison with neonatal cranial echography and correlation with neurological sequelae

    International Nuclear Information System (INIS)

    Yamashita, Yushiro; Horikawa, Mizuho; Matsuishi, Toyojiro; Utsunomiya, Hidetsuna; Okudera, Toshio; Fukuda, Seiichi; Hashimoto, Takeo; Nakamura, Yasuhiro.

    1994-01-01

    Fourteen patients with bilateral spastic paralysis (an average age of 2 years and 5 months) were examined using magnetic resonance imaging (MRI). Common MRI findings were an enlarged cerebral ventricle, irregular wall, abnormal signal area in the vicinity of the cerebral ventricle, decrease in the content of white matter, and thickening of the callosum. These findings seemed to reflect pathological lesions in periventricular leukomalacia (PVL). Of 3 patients who had been diagnosed as having cystic PVL on neonatal ultrasonography, 2 had cystic lesions in the corresponding areas on MRI. In the other patient with cystic PVL, membrane-like wall between the cyst and the enlarged cerebral ventricle was different from that seen definitely in porencephalie on spin density images. In patients in whom PVL was missed on neonatal ultrasonography, MRI demonstrated PVL. There was correlation between MRI findings and neurological sequelae: the severity of exercise function tended to correlate with the degree of decreased white matter; however, there was no correlation between spread of abnormal signal areas and the severity of exercise function. (N.K.)

  19. Cranial MRI findings in pediatric patients with bilateral spastic paralysis. Comparison with neonatal cranial echography and correlation with neurological sequelae

    Energy Technology Data Exchange (ETDEWEB)

    Yamashita, Yushiro; Horikawa, Mizuho; Matsuishi, Toyojiro (Kurume Univ., Fukuoka (Japan). School of Medicine); Utsunomiya, Hidetsuna; Okudera, Toshio; Fukuda, Seiichi; Hashimoto, Takeo; Nakamura, Yasuhiro

    1994-08-01

    Fourteen patients with bilateral spastic paralysis (an average age of 2 years and 5 months) were examined using magnetic resonance imaging (MRI). Common MRI findings were an enlarged cerebral ventricle, irregular wall, abnormal signal area in the vicinity of the cerebral ventricle, decrease in the content of white matter, and thickening of the callosum. These findings seemed to reflect pathological lesions in periventricular leukomalacia (PVL). Of 3 patients who had been diagnosed as having cystic PVL on neonatal ultrasonography, 2 had cystic lesions in the corresponding areas on MRI. In the other patient with cystic PVL, membrane-like wall between the cyst and the enlarged cerebral ventricle was different from that seen definitely in porencephalie on spin density images. In patients in whom PVL was missed on neonatal ultrasonography, MRI demonstrated PVL. There was correlation between MRI findings and neurological sequelae: the severity of exercise function tended to correlate with the degree of decreased white matter; however, there was no correlation between spread of abnormal signal areas and the severity of exercise function. (N.K.).

  20. Late Adverse Events after Enhanced and Unenhanced MRI and CT

    DEFF Research Database (Denmark)

    Azzouz, Manal; Rømsing, Janne; Thomsen, Henrik S.

    2014-01-01

    Prospective evaluation of frequency of late and very late adverse events in patients undergoing enhanced or unenhanced magnetic resonance imaging (MRI) or computed tomography (CT). The imaging procedure was performed according to the protocols of the department. All patients were contacted three...... of LAEs was significantly higher in the enhanced MRI (38%) and CT (27%) groups than unenhanced MRI (20%) and CT (16%) groups. The frequency of nausea, dizziness, abdominal pain and diarrhoea was significantly higher in the enhanced MRI group than in the MRI control group, while taste sensation...

  1. Chylous Ascites in a Patient with HIV/AIDS: A Late Complication of Mycobacterium avium Complex-Immune Reconstitution Inflammatory Syndrome

    Directory of Open Access Journals (Sweden)

    Imam H. Shaik

    2014-01-01

    Full Text Available Chylous ascites is very rare in HIV/AIDS and its association with Mycobacterium avium complex-immune reconstitution inflammatory syndrome (MAC-IRIS has been rarely reported. Here, we report a case of a young African-American male who developed chylous ascites as a late sequela to immune reconstitution inflammatory syndrome while on treatment for MAC. Antiretroviral drug-naive patients who start HAART in close proximity to the diagnosis of an opportunistic infection and have a rapid decline in HIV RNA level should be monitored for development of IRIS. Although the long term prognosis is poor, early diagnosis and treatment help to improve quality of life.

  2. Higher curvature supergravity and cosmology

    Energy Technology Data Exchange (ETDEWEB)

    Ferrara, Sergio [Th-Ph Department, CERN, Geneva (Switzerland); U.C.L.A., Los Angeles, CA (United States); INFN - LNF, Frascati (Italy); Sagnotti, Augusto [Scuola Normale Superiore, Pisa (Italy); INFN, Pisa (Italy)

    2016-04-15

    In this contribution we describe dual higher-derivative formulations of some cosmological models based on supergravity. Work in this direction started with the R + R{sup 2} Starobinsky model, whose supersymmetric extension was derived in the late 80's and was recently revived in view of new CMB data. Models dual to higher-derivative theories are subject to more restrictions than their bosonic counterparts or standard supergravity. The three sections are devoted to a brief description of R + R{sup 2} supergravity, to a scale invariant R{sup 2} supergravity and to theories with a nilpotent curvature, whose duals describe non-linear realizations (in the form of a Volkov-Akulov constrained superfield) coupled to supergravity. (copyright 2015 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  3. Computed tomography of late-onset epilepsy

    International Nuclear Information System (INIS)

    Kim, Young Sik; Im, Jae Yung; Joo, Yang Goo; Park, Sam Kyoon

    1982-01-01

    Epilepsy can be divided into idiopathic epilepsy and symptomatic epilepsy according to the existence of underlying organic brain disease. It has been said that the incidence of the symptomatic epilepsy caused by underlying organic brain disease is higher in late-onset epilepsy after the age of 20 than in childhood-onset epilepsy. CT is very sensitive and non-invasive method for detection of organic brain disease. 168 cases of late-onset epilepsy after the age of of 20 were studied by CT in recent 2 years were analyzed. The results were as follows: 1. The 3rd decade was the most frequent age group, and the ratio of male to female was 2.5 : 1. 2. Structural abnormality on brain CT was demonstrated in 51.8% of the patient. 3. The older onset of age was, the higher the ratio of abnormal CT findings, except 5th decade which showed less CT abnormality than 4th decade. 4. The most frequent history related to epilepsy was trauma. 63.1% of patients had no relevant history: and they showed CT findings of brain tumor, atrophy and infraction in decreasing order of frequency. 5. Abnormal CT findings was demonstrated in 49.2% of normal neurologic examination and in 46.4% of normal EEG study. 6. The most frequent lesion of abnormal CT scan in late-onset epilepsy was 30 cases (18.4%) of brain atrophy. The next frequent lesion was 18 cases (10.7%) of brain tumor. Infarction, parasites and calcification were other frequent lesions

  4. Recent casualties of late globalization

    DEFF Research Database (Denmark)

    Turcan, Romeo V.

    2016-01-01

    In this essay I will expand my thoughts on universities as ‘late globalizers’ and the impact ‘being late’ has on university internationalization or globalization activities. In my earlier essay I viewed universities as ‘late globalizers’ and briefly introduced the impact of being ‘late’, e.g., wi.......g., withdrawal or de-internationalization of universities due to incompatibility between university autonomy and the context in the target country or universities unwillingness to compromise on their freedom and autonomy....

  5. Refining a measure of brain injury sequelae to predict postacute rehabilitation outcome: rating scale analysis of the Mayo-Portland Adaptability Inventory.

    Science.gov (United States)

    Malec, J F; Moessner, A M; Kragness, M; Lezak, M D

    2000-02-01

    Evaluate the psychometric properties of the Mayo-Portland Adaptability Inventory (MPAI). Rating scale (Rasch) analysis of MPAI and principal component analysis of residuals; the predictive validity of the MPAI measures and raw scores was assessed in a sample from a day rehabilitation program. Outpatient brain injury rehabilitation. 305 persons with brain injury. A 22-item scale reflecting severity of sequelae of brain injury that contained a mix of indicators of impairment, activity, and participation was identified. Scores and measures for MPAI scales were strongly correlated and their predictive validities were comparable. Impairment, activity, and participation define a single dimension of brain injury sequelae. The MPAI shows promise as a measure of this construct.

  6. Culture Negative Listeria monocytogenes Meningitis Resulting in Hydrocephalus and Severe Neurological Sequelae in a Previously Healthy Immunocompetent Man with Penicillin Allergy

    DEFF Research Database (Denmark)

    Gaini, Shahin; Karlsen, Gunn Hege; Nandy, Anirban

    2015-01-01

    A previously healthy 74-year-old Caucasian man with penicillin allergy was admitted with evolving headache, confusion, fever, and neck stiffness. Treatment for bacterial meningitis with dexamethasone and monotherapy ceftriaxone was started. The cerebrospinal fluid showed negative microscopy...... the catheter. The patient had severe neurological sequelae. This case report emphasises the importance of covering empirically for Listeria monocytogenes in all patients with penicillin allergy with suspected bacterial meningitis. The case also shows that it is possible to have significant infection...

  7. Gratkorn - A new late Middle Miocene vertebrate fauna from Styria (Late Sarmatian, Austria)

    Science.gov (United States)

    Gross, M.; Böhme, M.; Prieto, J.

    2009-04-01

    Integrated stratigraphic approaches provide precise correlations of global standard stages with regional Paratethys stages. Nevertheless, higher resolution stratigraphic matching of terrestrial deposits remains challenging due to the lack of a practical continental biostratigraphy. The mostly used tool for biostratigraphic correlation of non-marine deposits in the Old World is still the concept of Neogene Mammal-zones (MN-zones). However, at higher biostratigraphic resolution (reptiles (scincids, lacertids, gekkonids, anguids, varanids, colubrids, testudinids, emydids), birds (coliiformes), rodents and lagomorphs (cricetids, glirids, eomyids, sciurids, castorids), insectivores and chiropterans (erinaceids, soricids, talpids), and large mammals (suids, tragulids, moschids, cervids, ?palaeomerycids, equids, chalicotheriids, rhinos, proboscidians, carnivors). Litho- and biostratigraphy (terrestrial gastropods) as well as magnetostratigraphic data and the sequence stratigraphic and geodynamic frame indicate an age of 12-12.2 Ma (early Late Sarmatian s.str., chron 5An.1n) for the locality. Therefore, Gratkorn is one of richest and most complete fauna of the late Middle Miocene of Central Europe and will be confidentially one of the key faunas for a high-resolution continental biostratigraphy and the comprehension of the faunal succession and interchanges near the Middle/Late Miocene transition. Acknowledgements This is a preliminary overview of the Gratkorn vertebrate fauna. Several taxa are still under investigation. We are especially grateful to Gudrun Daxner-Höck, Ursula Göhlich (both Natural History Museum Vienna) and Getrud Rössner (University of Munich) for their comments to the rodents, ruminants, proboscidians and bird remains. References Böhme, M., Ilg, A., Winklhofer, M. 2008. Late Miocene "washhouse" climate in Europe.- Earth and Planetary Science Letters, 275: 393-401. Gross, M., 2008. A limnic ostracod fauna from the surroundings of the Central

  8. Late onset globoid cell leukodystrophy.

    OpenAIRE

    Grewal, R P; Petronas, N; Barton, N W

    1991-01-01

    A 29 year old male with onset of globoid cell leukodystrophy at age 14 is described. This is the first case of enzymatically confirmed globoid cell leukodystrophy with onset of symptoms after the age of ten. This patient is unique because of the late onset and slow progression and extends the clinical spectrum of globoid cell leukodystrophy.

  9. Late onset globoid cell leukodystrophy.

    Science.gov (United States)

    Grewal, R P; Petronas, N; Barton, N W

    1991-11-01

    A 29 year old male with onset of globoid cell leukodystrophy at age 14 is described. This is the first case of enzymatically confirmed globoid cell leukodystrophy with onset of symptoms after the age of ten. This patient is unique because of the late onset and slow progression and extends the clinical spectrum of globoid cell leukodystrophy.

  10. Early and Late Retirement Exits

    Science.gov (United States)

    Brougham, Ruby R.; Walsh, David A.

    2009-01-01

    The current study proposes that personal need fulfillment (relatedness, generativity, identity, growth, and finances) predicts early and late retirement intentions. The personal needs of 160 full-time older employees were measured by personal goals, job satisfactions, job characteristics, and intrinsic motivation. Results suggest that the personal…

  11. Late onset startle induced tics

    NARCIS (Netherlands)

    Tijssen, MAJ; Brown, P; Morris, HR; Lees, A

    1999-01-01

    Three cases of late onset Gilles de la Tourette's syndrome are presented. The motor ties were mainly induced by an unexpected startling stimulus, but the startle reflex was not exaggerated. The ties developed after physical trauma or a period of undue emotional stress. Reflex ties may occur in

  12. Late onset startle induced tics

    NARCIS (Netherlands)

    Tijssen, M. A.; Brown, P.; Morris, H. R.; Lees, A.

    1999-01-01

    Three cases of late onset Gilles de la Tourette's syndrome are presented. The motor tics were mainly induced by an unexpected startling stimulus, but the startle reflex was not exaggerated. The tics developed after physical trauma or a period of undue emotional stress. Reflex tics may occur in

  13. Long-term outcomes following laparoscopic adjustable gastric banding: postoperative psychological sequelae predict outcome at 5-year follow-up.

    Science.gov (United States)

    Scholtz, Samantha; Bidlake, Louise; Morgan, John; Fiennes, Alberic; El-Etar, Ashraf; Lacey, John Hubert; McCluskey, Sara

    2007-09-01

    NICE guidelines state that patients with psychological contra-indications should not be considered for bariatric surgery, including Laparoscopic Adjustable Gastric Banding (LAGB) surgery as treatment of morbid obesity, although no consistent correlation between psychiatric illness and long-term outcome in LAGB has been established. This is to our knowledge the first study to evaluate long-term outcomes in LAGB for a full range of DSM-IV defined psychiatric and eating disorders, and forms part of a research portfolio developed by the authors aimed at defining psychological predictors of bariatric surgery in the short-, medium- and long-term. Case notes of 37 subjects operated on between April 1997 and June 2000, who had undergone structured clinical interview during pre-surgical assessment to yield diagnoses of mental and eating disorders according to DSM-IV criteria were analyzed according to a set of operationally defined criteria. Statistical analysis was carried out to compare those with a poor outcome and those considered to have a good outcome in terms of psychiatric profile. In this group of mainly female, Caucasian subjects, ranging in age from 27 to 60 years, one-third were diagnosed with a mental disorder according to DSM-IV criteria. The development of postoperative DSM-IV defined binge eating disorder (BED) or depression strongly predicted poor surgical outcome, but pre-surgical psychiatric factors alone did not. Although pre-surgical psychiatric assessment alone cannot predict outcome, an absence of preoperative psychiatric illness should not reassure surgeons who should be mindful of postoperative psychiatric sequelae, particularly BED. The importance of providing an integrated biopsychosocial model of care in bariatric teams is highlighted.

  14. Delayed neuropsychological sequelae after carbon monoxide poisoning: predictive risk factors in the Emergency Department. A retrospective study

    Directory of Open Access Journals (Sweden)

    Botti Primo

    2011-03-01

    Full Text Available Abstract Background Delayed neuropsychological sequelae (DNS commonly occur after recovery from acute carbon monoxide (CO poisoning. The preventive role and the indications for hyperbaric oxygen therapy in the acute setting are still controversial. Early identification of patients at risk in the Emergency Department might permit an improvement in quality of care. We conducted a retrospective study to identify predictive risk factors for DNS development in the Emergency Department. Methods We retrospectively considered all CO-poisoned patients admitted to the Emergency Department of Careggi University General Hospital (Florence, Italy from 1992 to 2007. Patients were invited to participate in three follow-up visits at one, six and twelve months from hospital discharge. Clinical and biohumoral data were collected; univariate and multivariate analysis were performed to identify predictive risk factors for DNS. Results Three hundred forty seven patients were admitted to the Emergency Department for acute CO poisoning from 1992 to 2007; 141/347 patients participated in the follow-up visit at one month from hospital discharge. Thirty four/141 patients were diagnosed with DNS (24.1%. Five/34 patients previously diagnosed as having DNS presented to the follow-up visit at six months, reporting a complete recovery. The following variables (collected before or upon Emergency Department admission were associated to DNS development at one month from hospital discharge in the univariate analysis: CO exposure duration >6 hours, a Glasgow Coma Scale (GCS score Conclusions Our study identified several potential predictive risk factors for DNS. Treatment algorithms based on an appropriate risk-stratification of patients in the Emergency Department might reduce DNS incidence; however, more studies are needed. Adequate follow-up after hospital discharge, aimed at correct recognition of DNS, is also important.

  15. Epidemiology and integrated control of potato late blight in Europe

    DEFF Research Database (Denmark)

    Cooke, L R; Schepers, H T A M; Hermansen, A

    2011-01-01

    tend not to be grown on a large scale. From the grower’s perspective, the savings in fungicide input that can be achieved with these varieties are not compensated by the higher (perceived) risk of blight. Fungicides play a crucial role in the integrated control of late blight. The spray strategies...

  16. Neurological Sequelae of Lupus

    Science.gov (United States)

    ... psychological problems (including personality changes, paranoia, mania, and schizophrenia), seizures, transverse myelitis, and paralysis and stroke. Treatment There is no cure for lupus. Treatment is symptomatic. With a combination ...

  17. Late Quaternary climate change shapes island biodiversity.

    Science.gov (United States)

    Weigelt, Patrick; Steinbauer, Manuel Jonas; Cabral, Juliano Sarmento; Kreft, Holger

    2016-04-07

    Island biogeographical models consider islands either as geologically static with biodiversity resulting from ecologically neutral immigration-extinction dynamics, or as geologically dynamic with biodiversity resulting from immigration-speciation-extinction dynamics influenced by changes in island characteristics over millions of years. Present climate and spatial arrangement of islands, however, are rather exceptional compared to most of the Late Quaternary, which is characterized by recurrent cooler and drier glacial periods. These climatic oscillations over short geological timescales strongly affected sea levels and caused massive changes in island area, isolation and connectivity, orders of magnitude faster than the geological processes of island formation, subsidence and erosion considered in island theory. Consequences of these oscillations for present biodiversity remain unassessed. Here we analyse the effects of present and Last Glacial Maximum (LGM) island area, isolation, elevation and climate on key components of angiosperm diversity on islands worldwide. We find that post-LGM changes in island characteristics, especially in area, have left a strong imprint on present diversity of endemic species. Specifically, the number and proportion of endemic species today is significantly higher on islands that were larger during the LGM. Native species richness, in turn, is mostly determined by present island characteristics. We conclude that an appreciation of Late Quaternary environmental change is essential to understand patterns of island endemism and its underlying evolutionary dynamics.

  18. Late neurotoxicity after nasopharyngeal carcinoma treatment

    International Nuclear Information System (INIS)

    Siala, W.; Mnejja, W.; Daoud, J.; Khabir, A.; Boudawara, T.; Ben Mahfoudh, K.; Ghorbel, A.; Frikha, M.

    2009-01-01

    Purpose A retrospective analysis of risk factors for late neurological toxicity after nasopharyngeal carcinoma radiotherapy. Patients and methods Between 1993 and 2004, 239 patients with non metastatic nasopharyngeal carcinoma were treated by radiotherapy associated or not to chemotherapy. Radiotherapy was delivered with two modalities: hyperfractionated for 82 patients and conventional fractionation for 157 patients. We evaluated the impact of tumour stage, age, gender, radiotherapy schedule and chemotherapy on neurological toxicity. Results After a mean follow-up of 107 months (35-176 months), 21 patients (8.8%) developed neurological complications, such as temporal necrosis in nine cases, brain stem necrosis in five cases, optics nerve atrophy in two cases and myelitis in one case. Five- and ten-year free of toxicity survival was 95 and 84% respectively. Young patients had greater risk of temporal necrosis, and hyperfractionated radiotherapy was associated with a significantly higher risk of neurological complications (14.6% vs 5.7%, p = 0.02). On multivariate analysis, hyperfractionation and age were insignificant. Conclusion Late neurological toxicity after radiotherapy for nasopharyngeal carcinoma was rare. Younger age and hyperfractionation were considered as risk factors of neurological toxicity in our study

  19. Late baryogenesis faces primordial nucleosynthesis

    International Nuclear Information System (INIS)

    Delbourgo-Salvador, P.; Audouze, J.; Salati, P.

    1991-11-01

    Since the sphalleron mechanism present in the standard theory of electro-weak interactions violates B+L, models have been suggested where baryogenesis takes place at late epochs and is concomitant with primordial nucleosynthesis. The possibility for the baryon asymmetry to be generated was numerically investigated at the same time as the light elements are cooked. The primordial yields of D, 3 He, 4 He and 7 Li were shown to exceed the upper limits inferred from observation, unless baryogenesis is anterior to the freeze-out of the weak interactions. This implies strong constraints on scenarios where the baryon asymmetry originates from the late decay of massive gravitinos. (author) 18 refs., 6 figs

  20. Late radiation pathology of mammals

    Energy Technology Data Exchange (ETDEWEB)

    Alexandrov, S N

    1982-01-01

    The comprehensive monograph on delayed radiation effects in mammals including man comprises 3 main chapters dealing with non-neoplastic as well as neoplastic manifestations of late radiation pathology, with the prophylaxis of delayed radiation effects, and with the therapy of radiation injuries. Alterations induced by whole-body irradiation and delayed radiation effects caused by partial body irradiation are described in detail. The developmental mechanisms and pathogenesis of non-neoplastic pathological changes and of radiation-induced neoplasms are elaborated.

  1. LATE NEUROSYPHILIS: TRENDS AND CHALLENGES.

    Directory of Open Access Journals (Sweden)

    Ivan Dimitrov

    2015-09-01

    Full Text Available Background: Syphilis is not only a disease of historical importance. It has been recognized that nowadays, in the era of AIDS, it still remains a serious challenge. For the last two decades there has been a resumption of neurosyphilis cases. This has revived the interest in the diagnostic and therapeutic challenges that the disease presents to clinical practice and to healthcare systems. Material/Methods: We present the overall picture of newly registered cases of syphilis in Varna municipality between 2009 and 2013, and report a case of neurosyphilis diagnosed at the first clinic of neurological diseases of St. Marina University Hospital during this period. Results: For the 5-year period, newly registered cases of syphilis in Varna have shown a tendency towards a decrease. Patients were typically in the early stages of the disease, primary and secondary. Late manifestations dropped from 29 in 2009 to 0 in 2010, but increased again to 15 in 2013. Only 1 case of neurosyphilis was registered during the 5-year period, in 2013. Conclusions: Neurological syndromes observed in cases of late neurosyphilis, presenting in different clinical forms, require a broad spectrum of differential diagnoses. Attention in everyday clinical practice should be focused on these cases which, though rare, are of high medical and social importance. Clinical cases of late neurosyphilis are often atypical and the early consideration of serologic tests or even biopsy may be of critical importance.

  2. The late-M dwarfs

    International Nuclear Information System (INIS)

    Bessell, M.S.

    1991-01-01

    Far-red spectra and VRIJHK photometry have been obtained for a sample of late-M dwarfs selected on the basis of large reduced red magnitudes from the LHS Catalog. Half of the stars in the three faintest 1 mag bins are late-M stars, the other red stars are metallic-hydride subdwarfs. Relations between various colors for the late-M dwarfs are investigated. Of all the colors I - K most reliably correlates with spectral type. FeH bands near 9900 A are clearly seen in the spectra of all dwarf stars later than M5. Two stars cooler than VB10, and similar in temperature to LHS2924 have been identified; both have H-alpha in emission and appear variable in magnitude and R - I color; one is a flare star. The other stars are of earlier spectral type and resemble W359 and VB8. The observed MI, I - K main sequence is in good agreement with the IG theoretical main sequence of Stringfellow, and the faintest stars could be about 0.09 solar mass red dwarfs or lower mass brown dwarfs. 65 refs

  3. The late biological effects of ionizing radiation

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1978-06-15

    surveillance. As far as medical exposure is concerned, current practices involving radiation exposure seems well justified in most of the cases, except some where radiation is used for diagnostic purposes of benign disorders. Cytological, histological and physiological studies were reported on experimental animals, apart from cancer induction, on the effect of neonatal exposure and effects on central nervous system. These provided basic data by which human data can be interpreted and analysed. Several novel approaches were reported for prediction of late effects, e.g. DNA repair capability, and some cytogenetic and physiological parameters which are expected to be of practical merit in future. The dose-effect relationship, by which human risk estimates at low doses are derived by extrapolation, was another topic of lively discussion. Several new models based on theoretical analysis or experimental data were proposed and compared with the available human and animal data. Although the validity of these awaits further research, some shed a new light on the problems of extrapolation. Radiation effects in practice are complicated by other environmental factor;, such chemical pollutants which may be additional causal agents. The importance of theoretical approach for prediction of such combined effects was stressed. Of interest was the combined effect of smoking and radon-222 in lung cancer induction. Lung cancer incidence was significantly elevated by combination of the two in the rat, which was also substantiated by the observation in Hiroshima-Nagasaki study where incidence of lung cancer in the smoking population was shown to be higher than the non-smoking population, suggesting synergistic effects of radiation and smoking. This meeting brought together people with a remarkably wide range of interests including the practicalities of radiological protection, epidemiology, medical practices and theoretical and experimental radiobiology. It was stressed that research co

  4. Prevalence and magnitude of acidosis sequelae to rice-based feeding regimen followed in Tamil Nadu, India.

    Science.gov (United States)

    Murugeswari, Rathinam; Valli, Chinnamani; Karunakaran, Raman; Leela, Venkatasubramanian; Pandian, Amaresan Serma Saravana

    2018-04-01

    In Tamil Nadu, a southern state of India, rice is readily available at a low cost, hence, is cooked (cooking akin to human consumption) and fed irrationally to cross-bred dairy cattle with poor productivity. Hence, a study was carried out with the objective to examine the prevalence of acidosis sequelae to rice-based feeding regimen and assess its magnitude. A survey was conducted in all the 32 districts of Tamil Nadu, by randomly selecting two blocks per districts and from each block five villages were randomly selected. From each of the selected village, 10 dairy farmers belonging to the unorganized sector, owning one or two cross-bred dairy cows in early and mid-lactation were randomly selected so that a sample size of 100 farmers per district was maintained. The feeding regimen, milk yield was recorded, and occurrence of acidosis and incidence of laminitis were ascertained by the veterinarian with the confirmative test to determine the impact of feeding cooked rice to cows. It is observed that 71.5% of farmers in unorganized sector feed cooked rice to their cattle. The incidence of acidosis progressively increased significantly (p<0.05) from 29.00% in cows fed with 0.5 kg of cooked rice to 69.23% in cows fed with more than 2.5 kg of cooked rice. However, the incidence of acidosis remained significantly (p<0.05) as low as 9.9% in cows fed feeding regimen without cooked rice which is suggestive of a correlation between excessive feeding cooked rice and onset of acidosis. Further, the noticeable difference in the incidence of acidosis observed between feeding cooked rice and those fed without rice and limited intake of oil cake indicates that there is a mismatch between energy and protein supply to these cattle. Among cooked rice-based diet, the incidence of laminitis increased progressively (p<0.05) from 9.2% to 37.9% with the increase in the quantum of cooked rice in the diet. The study points out the importance of protein supplementation in rice-based feeding

  5. Prevalence and magnitude of acidosis sequelae to rice-based feeding regimen followed in Tamil Nadu, India

    Directory of Open Access Journals (Sweden)

    Rathinam Murugeswari

    2018-04-01

    Full Text Available Background and Aim: In Tamil Nadu, a southern state of India, rice is readily available at a low cost, hence, is cooked (cooking akin to human consumption and fed irrationally to cross-bred dairy cattle with poor productivity. Hence, a study was carried out with the objective to examine the prevalence of acidosis sequelae to rice-based feeding regimen and assess its magnitude. Materials and Methods: A survey was conducted in all the 32 districts of Tamil Nadu, by randomly selecting two blocks per districts and from each block five villages were randomly selected. From each of the selected village, 10 dairy farmers belonging to the unorganized sector, owning one or two cross-bred dairy cows in early and mid-lactation were randomly selected so that a sample size of 100 farmers per district was maintained. The feeding regimen, milk yield was recorded, and occurrence of acidosis and incidence of laminitis were ascertained by the veterinarian with the confirmative test to determine the impact of feeding cooked rice to cows. Results: It is observed that 71.5% of farmers in unorganized sector feed cooked rice to their cattle. The incidence of acidosis progressively increased significantly (p<0.05 from 29.00% in cows fed with 0.5 kg of cooked rice to 69.23% in cows fed with more than 2.5 kg of cooked rice. However, the incidence of acidosis remained significantly (p<0.05 as low as 9.9% in cows fed feeding regimen without cooked rice which is suggestive of a correlation between excessive feeding cooked rice and onset of acidosis. Further, the noticeable difference in the incidence of acidosis observed between feeding cooked rice and those fed without rice and limited intake of oil cake indicates that there is a mismatch between energy and protein supply to these cattle. Among cooked rice-based diet, the incidence of laminitis increased progressively (p<0.05 from 9.2% to 37.9% with the increase in the quantum of cooked rice in the diet. Conclusion: The

  6. Frequency, risk factors, and adverse sequelae of bone loss in patients with ostomy for inflammatory bowel diseases.

    Science.gov (United States)

    Gupta, Supriya; Wu, Xianrui; Moore, Travis; Shen, Bo

    2014-02-01

    Bone loss in patients with inflammatory bowel disease (IBD) with ostomy has not been systemically studied. The aims of the study were to evaluate the frequency, risk factors, and sequelae of bone loss in patients with IBD and stomas and to monitor the change in bone mineral density (BMD) over time after ostomy. A total of 126 patients met the inclusion criteria (i.e., those with IBD diagnosis and stoma), including ileostomy (N = 120), colostomy (N = 3), and jejunostomy (N = 3). BMD was measured on dual-energy X-ray absorptiometry (DEXA). Patients were classified as having normal or low BMD based on the International Society for Clinical Densitometry criteria. Thirty-two demographic and clinical variables were evaluated with logistic regression models. At a median of 6.6 years (interquartile range, 2-18.7 yr) after stoma, 37 (29.4%) patients had a low BMD. On univariate analysis, there were no significant differences between the normal and low BMD groups in the following variables: gender, race, age at diagnosis of IBD, prevalence of Crohn's disease and ulcerative colitis, age at ostomy, duration from diagnosis to DEXA and from ostomy to DEXA, menopausal age, diabetes, hypothyroidism, renal stones, short bowel syndrome, history of smoking or excessive alcohol use, family history of IBD or osteoporosis, daily calcium and vitamin D supplement, estrogen replacement, and steroid use. Body mass index was significantly lower in the low BMD group than the normal BMD group (23.3 ± 5.5 versus 26.0 ± 5.2, P = 0.013). Fragility fracture occurred in 8 (21.6%) patients in low BMD group and 4 (4.5%) patients in normal BMD group (P = 0.006). In a multivariate analysis, low body mass index was the only covariate-adjusted factor associated with low BMD. In patients with multiple DEXA scans available over time after ostomy, hip BMD was found to improve marginally, and the lumbar and femoral BMD remained stable. Low BMD was common in patients with IBD after ostomy, largely based on

  7. Late cataractogenesis in rhesus monkeys irradiated with protons and radiogenic cataract in other species

    International Nuclear Information System (INIS)

    Lett, J.T.; Lee, A.C.; Cox, A.B.

    1991-01-01

    Rhesus monkeys (Macaca mulatta) which were irradiated at ca. 2 years of age with acute doses (less than or equal to 5 Gy) of protons (32-2300 MeV) are exhibiting the late progressive phase of radiation cataractogenesis 20-24 years after exposure, the period during which we have been monitoring the sequelae of irradiation of the lens. The median life span of the primate is approximately 24 years. Analogous late ocular changes also occur in a similar period of the lifetimes of New Zealand White (NZW) rabbits (Oryctolagus cuniculus) exposed at 8-10 weeks of age to 460-MeV 56 Fe ions. In this experiment, which has been in progress for ca. 6 years, we are following the development of radiation-induced lenticular opacification (cataractogenic profiles) throughout the life span. The median life span of the lagomorph is 5-7 years. Cataractogenic profiles for NZW rabbits irradiated with 20 Ne and 40 Ar ions and 60 Co gamma photons were obtained previously. Reference is also made to measurements of the cataractogenic profiles of a short-lived rodent, the Fischer 344 rat (Rattus norvegicus) during the first year after exposure at 8-10 weeks of age to spread-Bragg-peak protons of 55 MeV nominal energy. The median life span of the rodent is reported to be 2-3 years

  8. Late effects of cancer therapy on the central nervous system

    International Nuclear Information System (INIS)

    Kramer, J.; Moore, I.M.

    1989-01-01

    The number of studies documenting the long-term morbidity of CNS treatment has increased dramatically in recent years. Cranial irradiation, in particular, has been associated with cognitive deficits and neuroanatomic pathology. Children who are treated at an early age and individuals who receive higher doses (2,400 cGy or greater) appear to be at greatest risk for these sequelae. Much more research on the pathogenesis of delayed injury following CNS treatment is needed. Although several compelling mechanisms have been proposed, little empirical evidence is available. This knowledge is essential to the identification of agents that may protect normal brain tissue from injury. Even less is known about the effects of age at time of treatment, type of treatment (radiation v chemotherapy), or dose of radiation in relation to delayed injury. Of utmost importance are studies that will establish the predictive relationship between brain injury and cognitive deficits. This would allow clinicians to predict patients who are at risk for cognitive impairment in order to institute appropriate preventive or remedial interventions.65 references

  9. Late-onset ADHD in adults: milder, but still dysfunctional.

    Science.gov (United States)

    Karam, Rafael G; Bau, Claiton H D; Salgado, Carlos A I; Kalil, Katiane L S; Victor, Marcelo M; Sousa, Nyvia O; Vitola, Eduardo S; Picon, Felipe A; Zeni, Gregory D; Rohde, Luis A; Belmonte-de-Abreu, Paulo; Grevet, Eugenio H

    2009-04-01

    The requirement in classificatory systems that some impairment from attention-deficit/hyperactivity disorder (ADHD) symptoms starts before 7 years of age (age of onset of impairment criteria - AOC) has been harshly criticized. Although there is evidence that late-onset ADHD is a valid diagnosis, little is known about the role of age of onset of impairment on the clinical profile of adult patients. The diagnoses of 349 adults with ADHD followed DSM-IV criteria. ADHD and oppositional defiant disorder (ODD) were evaluated with the K-SADS-E, and other comorbidities with the SCID-IV and the MINI. Subjects were divided in early and late-onset groups (age of onset of impairment between 7 and 12 years old). The effect of age of onset over clinical and demographic characteristics was tested by regression models. Late-onset subjects were diagnosed later (P=0.04), had a lower frequency of problems with authority and discipline (P=0.004), and lower scores in SNAP-IV (Pactivities (P=0.03). On the other hand, late-onset patients presented a higher prevalence of comorbid general anxiety disorder (GAD) (P=0.01). Both groups had a similar profile in the remaining comorbidities and sociodemographic characteristics. This study provides initial evidence that adults with late-onset ADHD have less severity, lower frequency of externalizing symptoms and increased comorbidity with GAD, but similar profile in other comorbidities. In addition, the data suggest that late-onset patients have a higher probability of delayed diagnosis despite the significant impairment of their condition.

  10. Late Jute seed production in cropland agroforestry system

    Directory of Open Access Journals (Sweden)

    Kazi Noor-E-Alam Jewel

    2015-12-01

    Full Text Available Farmers were not self-sufficient in jute seed production and cultivation to avoid use exotic jute seed from different resources. Though the conventional method of jute seed production was not enough to meet the demand of farmers because of shrinkage of jute seed production land. So, late jute seed production technique was applied in agroforestry systems at both established and newly developed orchards. The study was conducted in the selected three sites of Rangpur, Dinajpur and Faridpur. Both White (Corchorus capsularis L.cv. CVL-1 and Tossa (two popular cultivars, eg., Corchorus olitorius L. cv. O-9897, and cv. O-72 varieties were used for to evaluate the late jute seed production in cropland agroforestry in 2011- 2013. It was observed that 600 kg ha-1 to 725 kg ha-1 of jute seed was produced in different types of orchard plantation. Seeds from Litchi orchard showed the higher fiber yield (1051.11, 2511.11 and 3555.56 kg ha-1 at Rangpur, Dinajpur and Faridpur, respectively than the mango orchard. Nutrient contents of soil in three sits were improved significantly due to the cultivation of late jute seed production. Moreover, late jute seed production in early stages of orchard plantation was more profitable and late jute can be produced economically for five to seven years depending on the plantations type and age.

  11. Electromagnetic navigation-guided neuroendoscopic removal of radiation-induced intraforniceal cavernoma as a late complication of medulloblastoma treatment.

    Science.gov (United States)

    Liby, Petr; Zamecnik, J; Kyncl, M; Zackova, J; Tichy, M

    2017-11-01

    Medulloblastoma is the most frequent malignant brain tumour in children. Radiation-induced cavernous haemangiomas (RICHs) are a known late complication of radiation exposure, especially in young children. We present a patient who underwent subtotal resection of posterior fossa medulloblastoma with subsequent chemotherapy and radiotherapy at the age of 10 years. A new lesion in the region of the left foramen of Monro appeared 16 years later. Based on the imaging results, metastasis or radiation-induced cavernoma was considered. The lesion had the same appearance on imaging as a rarely published intraventricular cavernoma of the foramen of Monro. Unlike the cavernoma of the foramen of Monro, this lesion was subependymal and intraforniceal. Using electromagnetic navigation and neuroendoscopy, the lesion was completely removed. Histopathological examination revealed a cavernous haemangioma. This is a unique case of intraforniceal paraforaminal cavernoma that was successfully removed endoscopically using electromagnetic neuronavigation and without neurological sequelae.

  12. Interleukin 1 beta (IL1ß) rs16944 genetic variant as a genetic marker of severe renal manifestations and renal sequelae in Henoch-Schönlein purpura.

    Science.gov (United States)

    López-Mejías, Raquel; Genre, Fernanda; Remuzgo-Martínez, Sara; Sevilla Pérez, Belen; Castañeda, Santos; Llorca, Javier; Ortego-Centeno, Norberto; Ubilla, Begoña; Mijares, Verónica; Pina, Trinitario; Calvo-Río, Vanesa; Miranda-Filloy, Jose A; Navas Parejo, Antonio; Argila, Diego; Sánchez-Pérez, Javier; Rubio, Esteban; Luque, Manuel León; Blanco-Madrigal, Juan María; Galíndez-Aguirregoikoa, Eva; Martín, Javier; Blanco, Ricardo; González-Gay, Miguel A

    2016-01-01

    Data from a small series suggested that the Interleukin 1 beta (IL1ß) rs16944 polymorphism may be associated with severe renal involvement and persistent renal damage (renal sequelae) in Henoch-Schönlein purpura (HSP). To confirm this association, we assessed the largest cohort of Caucasian HSP patients ever considered for genetic studies. 338 Spanish HSP patients and 635 sex and ethnically matched controls were recruited in this study. All patients were required to have had at least 6 months' follow-up. Patients and controls were genotyped for IL1β rs16944 by TaqMan genotyping assay. No differences between IL1β rs16944 genotype or allele frequencies were found either in the case/control study or when HSP patients were stratified according to the age at disease onset, presence of nephritis or gastrointestinal manifestations. Nevertheless, 4 (25%) of the 16 HSP patients who developed severe renal manifestations carried the TT genotype versus 29 (9%) of 322 who did not develop this complication (p=0.01, OR=5.48, 95% CI: 1.01-28.10). Accordingly, patients carrying the mutant T allele had an increased risk of developing severe nephropathy (p=0.016, OR=2.35, 95% CI: 1.09-5.07). Additionally, a significant increase of the TT genotype was observed in patients with persistent renal damage when compared with those patients without this complication (25% versus 8.6%, respectively; p=0.0035, OR=4.90, 95% CI: 1.26- 18.51). Moreover, renal sequelae were more common in patients carrying the mutant T allele (p=0.0076, OR=2.20, 95% CI: 1.17-4.14). Our results support that the IL1ß rs16944 polymorphism may be a potential marker of severe renal manifestations and renal sequelae in HSP.

  13. Comparative Evaluation of Immediate Post-Operative Sequelae after Surgical Removal of Impacted Mandibular Third Molar with or without Tube Drain - Split-Mouth Study.

    Science.gov (United States)

    Kumar, Barun; Bhate, Kalyani; Dolas, R S; Kumar, Sn Santhosh; Waknis, Pushkar

    2016-12-01

    Third molar surgery is one of the most common surgical procedures performed in general dentistry. Post-operative variables such as pain, swelling and trismus are major concerns after impacted mandibular third molar surgery. Use of passive tube drain is supposed to help reduce these immediate post-operative sequelae. The current study was designed to compare the effect of tube drain on immediate post-operative sequelae following impacted mandibular third molar surgery. To compare the post-operative sequelae after surgical removal of impacted mandibular third molar surgery with or without tube drain. Thirty patients with bilateral impacted mandibular third molars were divided into two groups: Test (with tube drain) and control (without tube drain) group. In the test group, a tube drain was inserted through the releasing incision, and kept in place for three days. The control group was left without a tube drain. The post-operative variables like, pain, swelling, and trismus were calculated after 24 hours, 72 hours, 7 days, and 15 days in both the groups and analyzed statistically using chi-square and t-test analysis. The test group showed lesser swelling as compared to control group, with the swelling variable showing statistically significant difference at post-operative day 3 and 7 (p≤ 0.05) in both groups. There were no statistically significant differences in pain and trismus variables in both the groups. The use of tube drain helps to control swelling following impacted mandibular third molar surgery. However, it does not have much effect on pain or trismus.

  14. Objective quantification of pulmonary effects in X-ray chest images; Quantificacao objetiva das sequelas pulmonares em imagens de raios-X de torax

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Marcela de; Giacomini, Guilherme; Alvarez, Matheus; Pereira, Paulo M.C.; Ribeiro, Sergio M.; Pina, Diana R. de [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil)

    2016-07-01

    Tuberculosis (TB) is an infectious lung disease of great concern worldwide. Even after treatment, TB leaves pulmonary sequelae that compromise the quality of life of patients. The exam of diagnostic imaging done more frequently is the X-ray chest. The evaluation of pulmonary involvement of these patients is performed visually by the radiologist. The detection and quantification aided by computer systems are of great importance for the more accurate assessment of pulmonary involvement. The objective of this study was to evaluate computationally the reduction of lung damage in X-ray of chest in patients treated with two different medication regimens. (author)

  15. Cross-Sectional Analysis of Late HAART Initiation in Latin America and the Caribbean: Late Testers and Late Presenters

    Science.gov (United States)

    Crabtree-Ramírez, Brenda; Caro-Vega, Yanink; Shepherd, Bryan E.; Wehbe, Firas; Cesar, Carina; Cortés, Claudia; Padgett, Denis; Koenig, Serena; Gotuzzo, Eduardo; Cahn, Pedro; McGowan, Catherine; Masys, Daniel; Sierra-Madero, Juan

    2011-01-01

    Background Starting HAART in a very advanced stage of disease is assumed to be the most prevalent form of initiation in HIV-infected subjects in developing countries. Data from Latin America and the Caribbean is still lacking. Our main objective was to determine the frequency, risk factors and trends in time for being late HAART initiator (LHI) in this region. Methodology Cross-sectional analysis from 9817 HIV-infected treatment-naïve patients initiating HAART at 6 sites (Argentina, Chile, Haiti, Honduras, Peru and Mexico) from October 1999 to July 2010. LHI had CD4+ count ≤200cells/mm3 prior to HAART. Late testers (LT) were those LHI who initiated HAART within 6 months of HIV diagnosis. Late presenters (LP) initiated after 6 months of diagnosis. Prevalence, risk factors and trends over time were analyzed. Principal Findings Among subjects starting HAART (n = 9817) who had baseline CD4+ available (n = 8515), 76% were LHI: Argentina (56%[95%CI:52–59]), Chile (80%[95%CI:77–82]), Haiti (76%[95%CI:74–77]), Honduras (91%[95%CI:87–94]), Mexico (79%[95%CI:75–83]), Peru (86%[95%CI:84–88]). The proportion of LHI statistically changed over time (except in Honduras) (p≤0.02; Honduras p = 0.7), with a tendency towards lower rates in recent years. Males had increased risk of LHI in Chile, Haiti, Peru, and in the combined site analyses (CSA). Older patients were more likely LHI in Argentina and Peru (OR 1.21 per +10-year of age, 95%CI:1.02–1.45; OR 1.20, 95%CI:1.02–1.43; respectively), but not in CSA (OR 1.07, 95%CI:0.94–1.21). Higher education was associated with decreased risk for LHI in Chile (OR 0.92 per +1-year of education, 95%CI:0.87–0.98) (similar trends in Mexico, Peru, and CSA). LHI with date of HIV-diagnosis available, 55% were LT and 45% LP. Conclusion LHI was highly prevalent in CCASAnet sites, mostly due to LT; the main risk factors associated were being male and older age. Earlier HIV-diagnosis and earlier treatment initiation

  16. Late graft explants in endovascular aneurysm repair.

    Science.gov (United States)

    Turney, Eric J; Steenberge, Sean P; Lyden, Sean P; Eagleton, Matthew J; Srivastava, Sunita D; Sarac, Timur P; Kelso, Rebecca L; Clair, Daniel G

    2014-04-01

    With more than a decade of use of endovascular aneurysm repair (EVAR), we expect to see a rise in the number of failing endografts. We review a single-center experience with EVAR explants to identify patterns of presentation and understand operative outcomes that may alter clinical management. A retrospective analysis of EVARs requiring late explants, >1 month after implant, was performed. Patient demographics, type of graft, duration of implant, reason for removal, operative technique, length of stay, complications, and in-hospital and late mortality were reviewed. During 1999 to 2012, 100 patients (91% men) required EVAR explant, of which 61 were placed at another institution. The average age was 75 years (range, 50-93 years). The median length of time since implantation was 41 months (range, 1-144 months). Explanted grafts included 25 AneuRx (Medtronic, Minneapolis, Minn), 25 Excluder (W. L. Gore & Associates, Flagstaff, Ariz), 17 Zenith (Cook Medical, Bloomington, Ind), 15 Talent (Medtronic), 10 Ancure (Guidant, Indianapolis, Ind), 4 Powerlink (Endologix, Irvine, Calif), 1 Endurant (Medtronic), 1 Quantum LP (Cordis, Miami Lakes, Fla), 1 Aorta Uni Iliac Rupture Graft (Cook Medical, Bloomington, Ind), and 1 homemade tube graft. Overall 30-day mortality was 17%, with an elective case mortality of 9.9%, nonelective case mortality of 37%, and 56% mortality for ruptures. Endoleak was the most common indication for explant, with one or more endoleaks present in 82% (type I, 40%; II, 30%; III, 22%; endotension, 6%; multiple, 16%). Other reasons for explant included infection (13%), acute thrombosis (4%), and claudication (1%). In the first 12 months, 23 patients required explants, with type I endoleak (48%) and infection (35%) the most frequent indication. Conversely, 22 patients required explants after 5 years, with type I (36%) and type III (32%) endoleak responsible for most indications. The rate of EVAR late explants has increased during the past decade at our

  17. Neuropsychological functioning in late-life depression

    Directory of Open Access Journals (Sweden)

    Gro Strømnes Dybedal

    2013-06-01

    Full Text Available Background: The literature describing neurocognitive function in patients with late-life depression (LLD show inconsistent findings in regard to incidence and main deficits. Reduced information processing speed is in some studies found to explain deficits in higher order cognitive function, while other studies report specific deficits in memory and executive function. Our aim was to determine the characteristics of neuropsychological functioning in non-demented LLD patients.Methods; A comprehensive neuropsychological battery was administered to a group of hospitalized LLD patients and healthy control subjects. Thirty-nine patients without dementia, 60 years or older meeting DSM-IV criteria for current episode of major depression, and 18 nondepressed control subjects were included. The patient group was characterized by having a long lasting current depressive episode of late-onset depression and by being non-responders to treatment with antidepressants. Neurocognitive scores were calculated for the domains of information processing speed, verbal memory, visuospatial memory, executive function, and language. Number of impairments (performance below the 10th percentile of the control group per domain for each participant was calculated. Results: Nearly half of the patients had a clinically significant cognitive impairment in at least one neurocognitive domain. Relative to healthy control subjects, LLD patients performed significantly poorer in the domains of information processing speed and executive function. Executive abilities were most frequently impaired in the patient group (39 % of the patients. Even when controlling for differences in processing speed, patients showed more executive deficits than controls. CONCLUSIONS: Controlling for processing speed, patients still showed impaired executive function compared to healthy controls. Reduced executive function thus appears to be the core neurocognitive deficit in LLD. Executive function seems

  18. Comparative study of reference points by dosimetric analyses for late complications after uniform external radiotherapy and high-dose-rate brachytherapy for cervical cancer

    International Nuclear Information System (INIS)

    Chen, S.-W.; Liang, J.-A.; Yeh, L.-S.; Yang, S.-N.; Shiau, A.-C.; Lin, F.-J.

    2004-01-01

    Purpose: This study aimed to correlate and compare the predictive values of rectal and bladder reference doses of uniform external beam radiotherapy without shielding and high-dose-rate intracavitary brachytherapy (HDRICB) with late sequelae in patients with uterine cervical cancer. Methods and materials: Between September 1992 and December 1998, 154 patients who survived more than 12 months after treatment were studied. Initially, they were treated with 10-MV X-rays (44 to 45 Gy/22 to 25 fractions over 4 to 5 weeks) to the whole pelvis, after which HDRICB was performed using 192 Ir remote afterloading at 1-week intervals for 4 weeks. The standard prescribed dose for each HDRICB was 6.0 Gy to point A. Patient- and treatment-related-factors were evaluated for late rectal complications using logistic regression modeling. Results: The probability of rectal complications showed better correlation of dose-response with increasing total ICRU (International Committee on Radiotherapy Units and Measurements) rectal dose. Multivariate logistic regression demonstrated a high risk of late rectal sequelae in patients who developed rectal complications (p 0.0001;relative risk, 15.06;95% CI, 2.89∼43.7) and total ICRU rectal dose greater than 16 Gy (p = 0.02;relative risk, 2.07;95% CI, 1.13∼4.55). The high risk factors for bladder complications were seen in patients who developed rectal complications (p = 0.0001;relative risk, 15.2;95% CI, 2.81∼44.9) and total ICRU bladder dose greater than 24 Gy (p = 0.02;relative risk, 8.93;95% CI, 1.79∼33.1). Conclusion: This study demonstrated the predictive value of ICRU rectal and bladder reference dosing in HDRICB for patients receiving uniform external beam radiation therapy without central shielding. Patients who had a total ICRU rectal dose greater than 16 Gy, or a total ICRU bladder dose over 24 Gy, were at risk of late sequelae

  19. Students and the Governance of Higher Education: A UK Perspective

    Science.gov (United States)

    Rodgers, Timothy; Freeman, Rebecca; Williams, James; Kane, David

    2011-01-01

    In the United Kingdom, the higher education landscape has undergone a transformation since the late 1980s as seen in the "massification" of higher education and the "quality revolution". These changes have resulted in an increased sense of accountability, to principle stakeholders: the government, the taxpayer and students…

  20. Responses of Chinese Higher Education to the Information Society

    Science.gov (United States)

    Cai, Yuzhuo; Guo, Wenge

    2006-01-01

    Compared to the advanced industrial countries, the use of information technology in Chinese higher education came relatively late. Nevertheless, recent Chinese practices have achieved significant progress in the country's efforts to bridge the digital divide. This article focuses special attention on the responses of Chinese higher education to…

  1. Globalisation and Higher Education

    NARCIS (Netherlands)

    Marginson, Simon; van der Wende, Marijk

    2007-01-01

    Economic and cultural globalisation has ushered in a new era in higher education. Higher education was always more internationally open than most sectors because of its immersion in knowledge, which never showed much respect for juridical boundaries. In global knowledge economies, higher education

  2. Musical Training and Late-Life Cognition.

    Science.gov (United States)

    Gooding, Lori F; Abner, Erin L; Jicha, Gregory A; Kryscio, Richard J; Schmitt, Fredrick A

    2014-06-01

    This study investigated the effects of early- to midlife musical training on cognition in older adults. A musical training survey examined self-reported musical experience and objective knowledge in 237 cognitively intact participants. Responses were classified into low-, medium-, and high-knowledge groups. Linear mixed models compared the groups' longitudinal performance on the Animal Naming Test (ANT; semantic verbal fluency) and Logical Memory Story A Immediate Recall (LMI; episodic memory) controlling for baseline age, time since baseline, education, sex, and full-scale IQ. Results indicate that high-knowledge participants had significantly higher LMI scores at baseline and over time compared to low-knowledge participants. The ANT scores did not differ among the groups. Ability to read music was associated with higher mean scores for both ANT and LMI over time. Early- to midlife musical training may be associated with improved late-life episodic and semantic memory as well as a useful marker of cognitive reserve. © The Author(s) 2013.

  3. Infectious flare-ups and serious sequelae following endodontic treatment: a prospective randomized trial on efficacy of antibiotic prophylaxis in cases of asymptomatic pulpal-periapical lesions.

    Science.gov (United States)

    Morse, D R; Furst, M L; Belott, R M; Lefkowitz, R D; Spritzer, I B; Sideman, B H

    1987-07-01

    Without peritreatment antibiotics, infectious flare-ups (about 15% incidence) and serious sequelae follow endodontic treatment of asymptomatic teeth with necrotic pulps and associated periapical lesions. Antibiotics administered after endodontic treatment (4-day regimen) reduce the flare-up incidence to about 2%, but hypersensitivity responses, sensitization, resistant microbes, and drug-taking compliance are potential problems. To ascertain whether a specific prophylactic antibiotic (high-dose, 1-day regimen) would preferentially maintain this low flare-up incidence while overcoming antibiotic-related problems, 315 patients with quiescent pulpal necrosis and an associated periapical lesion were randomly given either penicillin V or erythromycin (base or stearate). Evaluations of flare-up after endodontic treatment were done at 1 day, 1 week, and 2 months. A 2.2% flare-up incidence was found, with no statistically significant differences for penicillin (0.0%), base (2.9%), and stearate (3.8%). No hypersensitivity responses occurred. Gastrointestinal side effects were found primarily with the erythromycins (12.4%). A comparative analysis of the data from our first study (no peritreatment antibiotics) and the pooled data from our last two investigations (including the current trial) showed that peritreatment antibiotic coverage significantly reduced flare-ups and serious sequelae after endodontic treatment (p less than 0.001).

  4. Antibiotics in late clinical development.

    Science.gov (United States)

    Fernandes, Prabhavathi; Martens, Evan

    2017-06-01

    Most pharmaceutical companies have stopped or have severely limited investments to discover and develop new antibiotics to treat the increasing prevalence of infections caused by multi-drug resistant bacteria, because the return on investment has been mostly negative for antibiotics that received marketing approved in the last few decades. In contrast, a few small companies have taken on this challenge and are developing new antibiotics. This review describes those antibiotics in late-stage clinical development. Most of them belong to existing antibiotic classes and a few with a narrow spectrum of activity are novel compounds directed against novel targets. The reasons for some of the past failures to find new molecules and a path forward to help attract investments to fund discovery of new antibiotics are described. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  5. Late Onset Bipolar Disorder: Case Report

    OpenAIRE

    Filipa Araújo; Adriana Horta

    2016-01-01

    Background: Bipolar disorder affects approximately 1% of the population, with diagnosis often being made during late adolescence and early adulthood, and only rarely (0.1%) in the elderly. Late onset bipolar disorder in the elderly has a impact on the nature and course of bipolar disorder. Aims: The authors report a case of bipolar disorder emerging in late life  (76years old) with no cleary identified organic cause. Conclusion: This case highlights the importance of a broad different...

  6. Late onset rheumatoid arthritis an observational study.

    Science.gov (United States)

    Rexhepi, Sylejman; Rexhepi, Mjellma; Sahatçiu-Meka, Vjollca; Rexhepi, Blerta; Bahtiri, Elton; Mahmutaj, Vigan

    Rheumatoid arthritis (RA) may have an onset at older age. The onset of the disease at the age of 60 and over is called late-onset rheumatoid arthritis (LORA). The aim of this study was to analyze the clinical, laboratory, radiological, and treatment characteristics of patients with LORA compared to those with early-onset RA (EaORA), provided that all the patients had an approximately equal duration of the disease. This is an observational single-center study, which involved 120 patients with an established diagnosis of RA, of which 60 patients had LORA, and 60 patients EaORA. The disease activity, measured by the Disease Activity Score 28 (DAS28-ESR), was significantly higher in the LORA group compared to the EaORA group (p0.05), while the number of patients positive for anti-citrullinated protein antibody (ACPA) was signifi cantly greater in the EaORA group (p<0.05). The values of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were significantly higher in the LORA than in the EaORA group. Hemoglobin levels were lower in the LORA group (11.96±1.64 g/dL) than in the EaORA group (12.18±1.56 g/dL). The most used disease-modifying antirheumatic drugs (DMARDs) were methotrexate and sulfasalazine, while biological drugs were not used. In conclusion, based on the results of our study, LORA has some features that distinguish it from EaORA, such as higher disease activity, more frequent involvement of large joints, and more pronounced structural damage. This should be taken in account in clinical practice, especially regarding treatment choices.

  7. Consequential late radiation damage in the skin in nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Li Wei; Kong Ling; Zhang Youwang; Hu Chaosu; Wu Yongru

    2008-01-01

    Objective: To evaluate the relationship between early and late radiation damage in skin. Methods: 335 patients with nasopharyngeal carcinoma treated with radical radiotherapy were evaluated. 240 patients had lymph nodes in the neck at initial diagnosis. The median doses were 70 Gy (55-86 Gy) to the nasopharyngeal region by external beam radiotherapy. The median doses were 64 Gy (46-72 Gy) to the neck with lymph node metastases, 55 Gy (21-67 Gy) to the node-negative neck. 71 patients were treated with facial-neck fields, while 264 patients were treated with pre-auricular fields. Chemotherapy was given in 48 patients. According to the 1995 SOMA scales late radiation damage in the skin was evaluated. Results: The median time from the radiotherapy to follow up was 14 years (range, 5-38 years). 63 patients have grade 0 late radiation reactions in the neck skin, the grade 1,2, 3,4 late radiation reactions in the neck skin were 43.9% (147 patients), 20.9% (70 patients), 13.7% (46 patients) and 2.7% (9 patients), respectively. 44 patients had moist desquamation in the medical records. The grade 1,2,3,4 late radiation reactions in the neck skin were 41%, 23%, 30% and 5%, respectively in patients with moist desquamation, while in patients without moist desquamation, the corresponding rates were 44.3%, 20.6%, 11.3% and 2.4%, respectively. The difference were significant between these two groups by chi-square analysis(χ 2 =17.42, P=0.002). Furthermore, whether patients had positive lymph node in the neck or not, the size of facial-neck fields and higher doses to the neck had more severe late radiation reaction in the neck skin, while age, gender and chemotherapy failed to show any effects on the development of late radiation reactions in the neck skin. Conclusion: The severe early radiation damage in the skin possibly increases the late radiation damage in the neck skin. (authors)

  8. Early versus Late Parenteral Nutrition in Critically Ill Children.

    Science.gov (United States)

    Fivez, Tom; Kerklaan, Dorian; Mesotten, Dieter; Verbruggen, Sascha; Wouters, Pieter J; Vanhorebeek, Ilse; Debaveye, Yves; Vlasselaers, Dirk; Desmet, Lars; Casaer, Michael P; Garcia Guerra, Gonzalo; Hanot, Jan; Joffe, Ari; Tibboel, Dick; Joosten, Koen; Van den Berghe, Greet

    2016-03-24

    Recent trials have questioned the benefit of early parenteral nutrition in adults. The effect of early parenteral nutrition on clinical outcomes in critically ill children is unclear. We conducted a multicenter, randomized, controlled trial involving 1440 critically ill children to investigate whether withholding parenteral nutrition for 1 week (i.e., providing late parenteral nutrition) in the pediatric intensive care unit (ICU) is clinically superior to providing early parenteral nutrition. Fluid loading was similar in the two groups. The two primary end points were new infection acquired during the ICU stay and the adjusted duration of ICU dependency, as assessed by the number of days in the ICU and as time to discharge alive from ICU. For the 723 patients receiving early parenteral nutrition, parenteral nutrition was initiated within 24 hours after ICU admission, whereas for the 717 patients receiving late parenteral nutrition, parenteral nutrition was not provided until the morning of the 8th day in the ICU. In both groups, enteral nutrition was attempted early and intravenous micronutrients were provided. Although mortality was similar in the two groups, the percentage of patients with a new infection was 10.7% in the group receiving late parenteral nutrition, as compared with 18.5% in the group receiving early parenteral nutrition (adjusted odds ratio, 0.48; 95% confidence interval [CI], 0.35 to 0.66). The mean (±SE) duration of ICU stay was 6.5±0.4 days in the group receiving late parenteral nutrition, as compared with 9.2±0.8 days in the group receiving early parenteral nutrition; there was also a higher likelihood of an earlier live discharge from the ICU at any time in the late-parenteral-nutrition group (adjusted hazard ratio, 1.23; 95% CI, 1.11 to 1.37). Late parenteral nutrition was associated with a shorter duration of mechanical ventilatory support than was early parenteral nutrition (P=0.001), as well as a smaller proportion of patients

  9. Control of Late Blight of Tomato and Potato by Oilgochitosan

    Directory of Open Access Journals (Sweden)

    Yong Ho Choi

    2011-08-01

    Full Text Available Chitosan is a linear polysaccharide composed of randomly distributed β-(1-4-linked D-glucosamine and Nacetyl- D-glucosamine. There have been many reports on the induced systemic resistance and in vivo antifungal activities of higher molecular weight chitosans with molecular weights over 3,000 amu (atomatic mass unit, but there are few papers on in vivo antifungal activities of low molecular weight chitosans (oligochitosans with molecular weights less than 3,000 amu. In our study, an oligochitosan sample (320?3,000 amu showed a potent 1-day protective activity with control values more than 94% at concentrations of 500 and 1,000 ?g/ml especially against tomato late blight caused by Phytophthora infestans under growth chamber conditions. It also displayed a moderate 1-day protective activity with control values of 67?89% at concentrations of 500 and 1,000 ?g/ml against wheat leaf rust and red pepper anthracnose. On the other hand, it showed a 16-hr curative activity against red pepper anthracnose, but not against tomato late blight and wheat leaf rust. In field experiments, oligochitosan effectively suppressed the development of late blight on potato and tomato plants with control values of 72% and 48%, respectively. The results strongly indicate that oligochitosan can be used as an eco-friendly organic material for the control of late blight on tomato and potato plants.

  10. Daytime activity and risk factors for late-life insomnia.

    Science.gov (United States)

    Morgan, Kevin

    2003-09-01

    Laboratory evidence linking exercise with improved sleep quality raises the possibility that the lower levels of physical activity characteristic of older age groups may contribute to late-life insomnia. While support for this hypothesis appears to come from epidemiological surveys, few such studies have distinguished satisfactorily between social and physical activities which differ widely in terms of energy cost and theoretical significance. The present analyses were, therefore, designed to assess the independent influence of physical and social activity levels on the prevalence and natural history of late-life insomnia. Survivors from a nationally representative UK sample (n = 1042) of elderly people originally interviewed in 1985 were reassessed in 1989 (n = 690) and 1993 (n = 410). Detailed assessments of physical and social activities, mental and physical health status, and sleep quality were made at each survey wave. Logistic regression models, adjusted for age, sex and health status, were used to assess relationships between activity levels and the prevalence, remission/persistence, and incidence of late-life insomnia. Lower physical health, depressed mood and lower physical (but not social) activity levels consistently emerged as significant risk factors for prevalent, persistent and incident insomnia. Age was unrelated to insomnia variables in all the cross-sectional models, but did emerge as a significant risk for cumulative 4-8-year insomnia incidence. These findings suggest that, independent of those activities more closely associated with social engagement, higher levels of customary physical activity per se appear to be protective against incident and chronic late-life insomnia.

  11. Higher Education and Inequality

    Science.gov (United States)

    Brown, Roger

    2018-01-01

    After climate change, rising economic inequality is the greatest challenge facing the advanced Western societies. Higher education has traditionally been seen as a means to greater equality through its role in promoting social mobility. But with increased marketisation higher education now not only reflects the forces making for greater inequality…

  12. Higher Education in California

    Science.gov (United States)

    Public Policy Institute of California, 2016

    2016-01-01

    Higher education enhances Californians' lives and contributes to the state's economic growth. But population and education trends suggest that California is facing a large shortfall of college graduates. Addressing this short­fall will require strong gains for groups that have been historically under­represented in higher education. Substantial…

  13. Reimagining Christian Higher Education

    Science.gov (United States)

    Hulme, E. Eileen; Groom, David E., Jr.; Heltzel, Joseph M.

    2016-01-01

    The challenges facing higher education continue to mount. The shifting of the U.S. ethnic and racial demographics, the proliferation of advanced digital technologies and data, and the move from traditional degrees to continuous learning platforms have created an unstable environment to which Christian higher education must adapt in order to remain…

  14. Happiness in Higher Education

    Science.gov (United States)

    Elwick, Alex; Cannizzaro, Sara

    2017-01-01

    This paper investigates the higher education literature surrounding happiness and related notions: satisfaction, despair, flourishing and well-being. It finds that there is a real dearth of literature relating to profound happiness in higher education: much of the literature using the terms happiness and satisfaction interchangeably as if one were…

  15. Gender and Higher Education

    Science.gov (United States)

    Bank, Barbara J., Ed.

    2011-01-01

    This comprehensive, encyclopedic review explores gender and its impact on American higher education across historical and cultural contexts. Challenging recent claims that gender inequities in U.S. higher education no longer exist, the contributors--leading experts in the field--reveal the many ways in which gender is embedded in the educational…

  16. Quality of Higher Education

    DEFF Research Database (Denmark)

    Zou, Yihuan

    is about constructing a more inclusive understanding of quality in higher education through combining the macro, meso and micro levels, i.e. from the perspectives of national policy, higher education institutions as organizations in society, individual teaching staff and students. It covers both......Quality in higher education was not invented in recent decades – universities have always possessed mechanisms for assuring the quality of their work. The rising concern over quality is closely related to the changes in higher education and its social context. Among others, the most conspicuous...... changes are the massive expansion, diversification and increased cost in higher education, and new mechanisms of accountability initiated by the state. With these changes the traditional internally enacted academic quality-keeping has been given an important external dimension – quality assurance, which...

  17. Late complications of radiation therapy

    International Nuclear Information System (INIS)

    Masaki, Norie

    1998-01-01

    There are cases in which, although all traces of acute radiation complications seem to have disappeared, late complications may appear months or years to become apparent. Trauma, infection or chemotherapy may sometimes recall radiation damage and irreversible change. There were two cases of breast cancer that received an estimated skin dose in the 6000 cGy range followed by extirpation of the residual tumor. The one (12 y.o.) developed atrophy of the breast and severe teleangiectasis 18 years later radiotherapy. The other one (42 y.o.) developed severe skin necrosis twenty years later radiotherapy after administration of chemotherapy and received skin graft. A case (52 y.o.) of adenoidcystic carcinoma of the trachea received radiation therapy. The field included the thoracic spinal cord which received 6800 cGy. Two years and 8 months after radiation therapy she developed complete paraplegia and died 5 years later. A truly successful therapeutic outcome requires that the patient be alive, cured and free of significant treatment-related morbidity. As such, it is important to assess quality of life in long-term survivors of cancer treatment. (author)

  18. Late Disciform Endotheliitis after LASIK

    Directory of Open Access Journals (Sweden)

    Faik Oruçoğlu

    2013-08-01

    Full Text Available Clinical and imaging features of the patient with late herpetic keratouveitis after LASIK were investigated. A 25-year-old male patient applied with a chief complaint of blurred vision and photophobia in the left eye. He had a history of herpetic keratitits and elsewhere underwent LASIK procedure in 2005. Oral and topical acyclovir treatments were started a week ago when his complaints started. His corrected distance visual acuity was 0.2 and intraocular pressure was 14 mmHg on the left eye. Slit-lamp revealed deep central disciform edema, keratic precipitates, and 2 positive cells in the anterior chamber. Although the patient had myopic LASIK ablation, the central corneal thickness was 652 microns. Scheimpflug imaging was drawing attention to the thickening of the posterior cornea and the keratic precipitates. Sagital and anterior elevation maps were not affected, however, posterior elevation map showed marked central flattening. Asphericity value Q was within normal limits anteriorly (Q=-0.14 and it was in oblate appearance posteriorly (Q=+5.24. In addition to the antiviral medications, a topical dexamethasone treatment was started. The vision improved to 0.6, and the edema was markedly reduced after 4 days of treatment. Scheimpflug imaging parameters were significantly improved. (Turk J Ophthalmol 2013; 43: 282-5

  19. Late complications of radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Masaki, Norie [Osaka Prefectural Center for Adult Diseases (Japan)

    1998-03-01

    There are cases in which, although all traces of acute radiation complications seem to have disappeared, late complications may appear months or years to become apparent. Trauma, infection or chemotherapy may sometimes recall radiation damage and irreversible change. There were two cases of breast cancer that received an estimated skin dose in the 6000 cGy range followed by extirpation of the residual tumor. The one (12 y.o.) developed atrophy of the breast and severe teleangiectasis 18 years later radiotherapy. The other one (42 y.o.) developed severe skin necrosis twenty years later radiotherapy after administration of chemotherapy and received skin graft. A case (52 y.o.) of adenoidcystic carcinoma of the trachea received radiation therapy. The field included the thoracic spinal cord which received 6800 cGy. Two years and 8 months after radiation therapy she developed complete paraplegia and died 5 years later. A truly successful therapeutic outcome requires that the patient be alive, cured and free of significant treatment-related morbidity. As such, it is important to assess quality of life in long-term survivors of cancer treatment. (author)

  20. Severe Anaemia during Late Pregnancy

    Directory of Open Access Journals (Sweden)

    Mahenaz Akhtar

    2012-01-01

    Full Text Available Vitamin B12 deficiency is uncommon in pregnancy, it occurs in 10–28% of uncomplicated pregnancies, and is associated with a few complications. We present a case report of a 21-year-old patient with severe anaemia during late pregnancy caused by vitamin B12 deficiency. At 38 weeks gestation and with a BMI of 48.9, a history of rupture of membranes was given but not confirmed. On examination, she appeared pale and therefore full blood counts were done. Interestingly her haemoglobin (Hb levels were 3.7 g/dL. Folate and vitamin B12 levels were also found to be low, and the diagnosis of anaemia caused by vitamin B12 deficiency was made. After treatment with vitamin B12 injections, folic acid and blood transfusions, the patient’s haemoglobin levels improved from 3.7 g/dL to 10.7 g/dL. The conclusion is that effective history taking, diagnosis, and management can prevent many complications that are usually associated with vitamin B12 deficiency anaemia.

  1. Childhood abuse in late-life depression

    NARCIS (Netherlands)

    Comijs, Hannie C; van Exel, Eric; van der Mast, Roos C; Paauw, Anna; Oude Voshaar, Richard; Stek, Max L

    Background: Little is known about the role of childhood abuse in late-life depression. The aim of the study is therefore to study whether childhood abuse is associated with late-life depression according to its onset, and which clinical characteristics play a role in this association. Methods: Data

  2. Are we ready to predict late effects?

    DEFF Research Database (Denmark)

    Salz, Talya; Baxi, Shrujal S; Raghunathan, Nirupa

    2015-01-01

    BACKGROUND: After completing treatment for cancer, survivors may experience late effects: consequences of treatment that persist or arise after a latent period. PURPOSE: To identify and describe all models that predict the risk of late effects and could be used in clinical practice. DATA SOURCES:...

  3. Higher English for CFE

    CERN Document Server

    Bridges, Ann; Mitchell, John

    2015-01-01

    A brand new edition of the former Higher English: Close Reading , completely revised and updated for the new Higher element (Reading for Understanding, Analysis and Evaluation) - worth 30% of marks in the final exam!. We are working with SQA to secure endorsement for this title. Written by two highly experienced authors this book shows you how to practice for the Reading for Understanding, Analysis and Evaluation section of the new Higher English exam. This book introduces the terms and concepts that lie behind success and offers guidance on the interpretation of questions and targeting answer

  4. [Long-term clinical course of sequelae in patients with neonatal anoxic encephalopathy resulting in profound mental retardation and motor disturbance].

    Science.gov (United States)

    Ishizaki, A; Kubota, M; Fueki, N; Shinozaki, M; Kurata, K; Takei, M; Sakamoto, K

    1993-01-01

    A long-term observation has been made in 58 patients (30 males and 28 females) with severe sequelae of neonatal anoxic encephalopathy. They aged from 8 months to 65 years. All of them had motor disturbances and profound mental retardation. Motor function was improved in 4 patients with aging. In contrast, motor activity deteriorated in 11 cases, of which 4 showed a mental regression. Among them, patients who had originally better motor ability than sitting were likely to deteriorate by uncontrollable epilepsy and/or excessive administration of anticonvulsants. Regression of the patients with worse motor ability like bedridden appeared to attributable hypertonia of muscles and bodily deformation. Fifteen cases showed an exacerbation of general condition which originated predominantly to respiratory distress. Twelve patients died including 6 exacerbated cases. Exacerbation or death may have occurred frequently in specific periods of infancy, adolescence and youth with the patients who showed very low motor function such as bedridden and no locomotion.

  5. Late effects of childhood leukemia therapy.

    Science.gov (United States)

    Fulbright, Joy M; Raman, Sripriya; McClellan, Wendy S; August, Keith J

    2011-09-01

    As survival rates for children treated for childhood cancers become significantly better, the focus is increasingly on determining the late effects of treatments and the best ways to monitor for them and prevent their occurrence. This review focuses on recent literature discussing the late effects of treatment in patients treated for acute myeloid leukemia and acute lymphoblastic leukemia during childhood. The late effects of therapy for childhood leukemia include secondary malignancy, cardiotoxicity, obesity, endocrine abnormalities, reproductive changes, neurocognitive deficits, and psychosocial effects. As clinicians have become more aware of the late effects of therapy, treatment regimens have been changed to decrease late effects, but patients still require long-term follow-up for their prevention and treatment.

  6. Late effects on normal tissues: oesophagus

    International Nuclear Information System (INIS)

    Pavy, J.J.; Bosset, J.F.

    1997-01-01

    Radiation-induced late effects of oesophagus are observed after treatment of various cancers. Acute reactions, mainly oesophagitis, are well known and accurately described; late effects share, for most of these, a common consequence: alteration of the main oesophageal function, namely to conduct the food bolus; clinically they are impaired in terms of mobility and stenosis. More rarely, ulcerations and pseudodiverticulae can be observed. Chemotherapy further increases the risk of late effects, especially in case of concomitant chemo-radiotherapy. All numbers and statistical data on oesophagus late effects should be regarded with caution due to recent changes in the therapeutic attitudes (more and more combined chemotherapy-radiotherapy) and some progress in given cancer locations. A common scale like the LENT-SOMA should enable the clinician to better know these late effects on oesophagus which is required to initiate effective prevention measures and adapted treatments. (authors)

  7. Planning for Higher Education.

    Science.gov (United States)

    Lindstrom, Caj-Gunnar

    1984-01-01

    Decision processes for strategic planning for higher education institutions are outlined using these parameters: institutional goals and power structure, organizational climate, leadership attitudes, specific problem type, and problem-solving conditions and alternatives. (MSE)

  8. Advert for higher education

    OpenAIRE

    N.V. Provozin; А.S. Teletov

    2011-01-01

    The article discusses the features advertising higher education institution. The analysis results of marketing research students for their choice of institutions and further study. Principles of the advertising campaign on three levels: the university, the faculty, the separate department.

  9. Evidence supporting pre-radiation elimination of oral foci of infection in head and neck cancer patients to prevent oral sequelae. A systematic review.

    Science.gov (United States)

    Schuurhuis, Jennifer M; Stokman, Monique A; Witjes, Max J H; Dijkstra, Pieter U; Vissink, Arjan; Spijkervet, Frederik K L

    2015-03-01

    Pre-radiation dental screening of head-neck cancer patients aims to identify and eliminate oral foci of infection to prevent post-radiation oral problems. The evidence for the efficacy of dental screening is unclear. In this systematic review, we analyzed available evidence on the efficacy of pre-radiation elimination of oral foci of infection in preventing oral sequelae. A search was conducted (MEDLINE/EMBASE) for papers published up to May 2014. Papers on head-neck cancer patients subjected to pre-radiation dental screening, (chemo)radiation and oral follow-up were included. Of the 1770 identified papers, 20 studies fulfilled the inclusion criteria of which 17 were retrospective. A great heterogeneity in patient groups, dental screening techniques, definitions of oral foci of infection and techniques for eliminating foci was found. Most papers lacked essential details on how dental screening was performed and a clear definition of an oral focus of infection. The evidence for efficacy of elimination of oral foci of infection to prevent post-radiotherapy oral sequelae was inconclusive. Consequently, the efficacy of pre-radiation elimination of oral foci of infection remains unclear. No conclusions can be drawn about a definition of an oral focus of infection and whether pre-radiation elimination of these foci should be mandatory. We therefore suggest prospective studies with well-defined criteria for oral foci of infection, a clear description of which foci were eliminated and how, a detailed description of pre-radiation dental screening, clearly described patient and tumor characteristics, and a detailed dental history and dental status. Subsequently, oral problems that occur post-radiation should be systematically recorded. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Volumetric lipoinjection of the fronto-orbital and temporal complex with adipose stem cells for the aesthetic restoration of sequelae of craniosynostosis

    Directory of Open Access Journals (Sweden)

    Yanko Castro-Govea

    2018-03-01

    Full Text Available Background Non-syndromic craniosynostosis causes craniofacial asymmetry and may persist after cranioplasty. These postoperative asymmetries are primarily depressions. In some cases, patients may be subjected to pranks and harassment by their peers, affecting their psychosocial development. We propose lipoinjection enriched with adipose stem cells (ASCs to treat the sequelae of craniosynostosis in the fronto-orbital and temporal complex in cranioplasty patients, with the goal of improving the appearance of the upper third of the face. Methods Twelve children (four boys and eight girls between 4 and 8 years of age (mean age, 6 years in the postoperative period after treatment for plagiocephaly, brachycephaly, and trigonocephaly were included, with a follow-up period of 1 to 18 months. Fat tissue was obtained from the lower abdomen, and ASCs were isolated using the Yoshimura technique. Lipoinjection was performed using several mini-approaches to ensure adequate distribution. Results Two different scales were used to evaluate the aesthetic outcomes. At 6 months, three plastic surgeons independent of the study classified the results using a Likert scale. The patients’ parents categorized the results using a visual analog scale at 6, 9, and 18 months. R esults were favorable on both scales, as the patients’ facial appearance improved and they reported increased happiness and self-esteem due to their remodeled facial appearance. Conclusions We suggest that lipoinjection enriched with ASCs is a good alternative for correcting asymmetry of the fronto-orbital and temporal contour in patients with sequelae of craniosynostosis. This treatment will help boost patients’ self-esteem starting at an early age.

  11. On higher derivative gravity

    International Nuclear Information System (INIS)

    Accioly, A.J.

    1987-01-01

    A possible classical route conducting towards a general relativity theory with higher-derivatives starting, in a sense, from first principles, is analysed. A completely causal vacuum solution with the symmetries of the Goedel universe is obtained in the framework of this higher-derivative gravity. This very peculiar and rare result is the first known vcuum solution of the fourth-order gravity theory that is not a solution of the corresponding Einstein's equations.(Author) [pt

  12. Higher Spins & Strings

    CERN Multimedia

    CERN. Geneva

    2014-01-01

    The conjectured relation between higher spin theories on anti de-Sitter (AdS) spaces and weakly coupled conformal field theories is reviewed. I shall then outline the evidence in favour of a concrete duality of this kind, relating a specific higher spin theory on AdS3 to a family of 2d minimal model CFTs. Finally, I shall explain how this relation fits into the framework of the familiar stringy AdS/CFT correspondence.

  13. Late Abortion: A Comprehensive Review

    Directory of Open Access Journals (Sweden)

    Sheng Chiang

    2005-12-01

    Full Text Available Late termination of pregnancy (LTOP is defined as an abortion carried out beyond 24 gestational weeks, when the fetus has arguably attained viability. In Taiwan, the current abortion law, bearing a eugenic title, allows LTOP on certain medical grounds. However, the fetal and maternal conditions that constitute medical grounds are not clarified and remain legally untested. Professional debate on the abortion issue is also lacking in academia in Taiwan, despite societal concerns. With the advent of technology to detect fetal abnormalities, obstetricians are now confronted more frequently with acute dilemmas regarding LTOP. Quite often, they sail in an uncharted sea with no clinical guidelines from their professional societies or affiliated hospitals. Recently, LTOP at 35 gestational weeks for a fetus with Down syndrome, complicated with polyhydramnios and tetralogy of Fallot, triggered media scrutiny and aroused much public attention. Although the clinical decision making for pregnancies with fetal abnormalities entails increasingly balanced information and consideration in terms of the medical, ethical, legal, psychologic, and societal aspects, society at large is unaware of the complexity and intertwined nature of various abortion issues, especially LTOP. Obstetricians are now in a vulnerable position in Taiwanese society, where litigations relevant to the practice of early abortions are not rare. Therefore, a global and in-depth look into abortion issues from legal and ethical dimensions is indispensable for modern obstetric practice. This review considers the core issues in LTOP, including what conditions constitute a “serious” fetal abnormality to justify LTOP, the incidence of LTOP, legislation regarding LTOP in Western countries, and recent research on ambivalent fetal pain. It will also present procedures, some under the auspices of the ethical committee of a Presbyterian hospital in Taiwan, for clinical decision making, particularly

  14. Late side effects of Ruthenium 106 therapy for uveal melanomas

    International Nuclear Information System (INIS)

    Langmann, G.; Faulborn, J.; Poier, E.

    1994-01-01

    When effectiveness is evaluated in brachytherapy with Ruthenium 106 special emphasis has to be put on tumor destruction and late side effects responsible for the definite functional results. We evaluated the late side effects of 22 uveal melanomas, which had been treated with 106 Ruthenium plaques. The tumor prominences ranged from 3 to 10 mm, the diameter from 4 to 9 disc diameters. In 4 patients the tumor involved the posterior pole, 14 melanomas were located in the midperiphery of the fundus, 4 tumors were ciliary body melanomas. The total radiation dose of the apex ranged from 100 to 240 Gy with a corresponding dose to the sclera between 540 to 1000 Gy. Because of the short half life of the plaque we have been using different dose rates (1.6-11 Gy/h). In 17/22 eyes adequate regression could be achieved by Ruthenium therapy alone. In one case additional laser treatment of the macular part of the melanoma had to be performed, Gamma Knife therapy was necessary in another melanoma with 10 mm tumor prominence. 3 recurrences led to enucleation. The mean follow up was 4.8 years ranging from 1 to 7 years. In 2/22 patients opticopathy caused severe visual impairment, in another 2 patients radiation maculopathy and opticopathy was observed. 7/22 developed vasculopathy with neovascularization treated by photocoagulation. In one case of focal radiation maculopathy laser treatment could prevent further visual impairment. The following factors are responsible for a higher incidence of late side effects: 1. High dose rate of the plaques in combination with a high radiation dose to the sclera 2. Location of the tumor within a minimum distance of 2 disc diameters to the optic nerve or macula 3. Tumor location at the ciliary body Laser treatment in case of neovascularization and focal radiation maculopathy is the only effective treatment with regard to late side effects. Ischemic maculopathy and radiation opticopathy are responsible for late visual impairment. (authors)

  15. A Cost-effectiveness Analysis of Early vs Late Tracheostomy.

    Science.gov (United States)

    Liu, C Carrie; Rudmik, Luke

    2016-10-01

    The timing of tracheostomy in critically ill patients requiring mechanical ventilation is controversial. An important consideration that is currently missing in the literature is an evaluation of the economic impact of an early tracheostomy strategy vs a late tracheostomy strategy. To evaluate the cost-effectiveness of the early tracheostomy strategy vs the late tracheostomy strategy. This economic analysis was performed using a decision tree model with a 90-day time horizon. The economic perspective was that of the US health care third-party payer. The primary outcome was the incremental cost per tracheostomy avoided. Probabilities were obtained from meta-analyses of randomized clinical trials. Costs were obtained from the published literature and the Healthcare Cost and Utilization Project database. A multivariate probabilistic sensitivity analysis was performed to account for uncertainty surrounding mean values used in the reference case. The reference case demonstrated that the cost of the late tracheostomy strategy was $45 943.81 for 0.36 of effectiveness. The cost of the early tracheostomy strategy was $31 979.12 for 0.19 of effectiveness. The incremental cost-effectiveness ratio for the late tracheostomy strategy compared with the early tracheostomy strategy was $82 145.24 per tracheostomy avoided. With a willingness-to-pay threshold of $50 000, the early tracheostomy strategy is cost-effective with 56% certainty. The adaptation of an early vs a late tracheostomy strategy depends on the priorities of the decision-maker. Up to a willingness-to-pay threshold of $80 000 per tracheostomy avoided, the early tracheostomy strategy has a higher probability of being the more cost-effective intervention.

  16. Adolescent environmental enrichment prevents behavioral and physiological sequelae of adolescent chronic stress in female (but not male) rats.

    Science.gov (United States)

    Smith, Brittany L; Morano, Rachel L; Ulrich-Lai, Yvonne M; Myers, Brent; Solomon, Matia B; Herman, James P

    2017-11-22

    The late adolescent period is characterized by marked neurodevelopmental and endocrine fluctuations in the transition to early adulthood. Adolescents are highly responsive to the external environment, which enhances their ability to adapt and recover from challenges when given nurturing influences, but also makes them vulnerable to aberrant development when exposed to prolonged adverse situations. Female rats are particularly sensitive to the effects of chronic stress in adolescence, which manifests as passive coping strategies and blunted hypothalamo-pituitary adrenocortical (HPA) stress responses in adulthood. We sought to intervene by exposing adolescent rats to environmental enrichment (EE) immediately prior to and during chronic stress, hypothesizing that EE would minimize or prevent the long-term effects of stress that emerge in adult females. To test this, we exposed male and female rats to EE on postnatal days (PND) 33-60 and implemented chronic variable stress (CVS) on PND 40-60. CVS consisted of twice-daily unpredictable stressors. Experimental groups included: CVS/unenriched, unstressed/EE, CVS/EE and unstressed/unenriched (n = 10 of each sex/group). In adulthood, we measured behavior in the open field test and forced swim test (FST) and collected blood samples following the FST. We found that environmental enrichment given during the adolescent period prevented the chronic stress-induced transition to passive coping in the FST and reversed decreases in peak adrenocortical responsiveness observed in adult females. Adolescent enrichment had little to no effect on males or unstressed females tested in adulthood, indicating that beneficial effects are specific to females that were exposed to chronic stress.

  17. Surfactant therapy in late preterm infants

    Directory of Open Access Journals (Sweden)

    Murat Yurdakök

    2013-06-01

    Full Text Available Late preterm (LPT neonates are at a high risk for respiratory distress soon after birth due to respiratory distress syndrome (RDS, transient tachypnea of the newborn, persistent pulmonary hypertension, and pneumonia along with an increased need for surfactant replacement therapy, continuous positive airway pressure, and ventilator support when compared with the term neonates. In the past, studies on outcomes of infants with respiratory distress have primarily focused on extremely premature infants, leading to a gap in knowledge and understanding of the developmental biology and mechanism of pulmonary diseases in LPT neonates. Surfactant deficiency is the most frequent etiology of RDS in very preterm and moderately preterm infants, while cesarean section and lung infection play major roles in RDS development in LPT infants. The clinical presentation and the response to surfactant therapy in LPT infants may be different than that seen in very preterm infants. Incidence of pneumonia and occurrence of pneumothorax are significantly higher in LPT and term infants. High rates of pneumonia in these infants may result in direct injury to the type II alveolar cells of the lung with decreasing synthesis, release, and processing of surfactant. Increased permeability of the alveolar capillary membrane to both fluid and solutes is known to result in entry of plasma proteins into the alveolar hypophase, further inhibiting the surface properties of surfactant. However, the oxygenation index value do not change dramatically after ventilation or surfactant administration in LPT infants with RDS compared to very preterm infants. These finding may indicate a different pathogenesis of RDS in late preterm and term infants. In conclusion, surfactant therapy may be of significant benefit in LPT infants with serious respiratory failure secondary to a number of insults. However, optimal timing and dose of administration are not so clear in this group. Additional

  18. Cognition and adjustment after late and early operation for ruptured aneurysm.

    Science.gov (United States)

    Sonesson, B; Ljunggren, B; Säveland, H; Brandt, L

    1987-09-01

    Does early aneurysm operation, while lowering the overall management mortality, result in an unacceptable morbidity in terms of increased cognitive disturbances and psychosocial maladjustment? The present study evaluates quality of life, degree of cognitive dysfunction, and adjustment of 93 patients with satisfactory neurological recoveries after operations for ruptured supratentorial aneurysms. All patients had been in neurological Grades I to III (Hunt and Hess) after subarachnoid hemorrhage (SAH). Fifty-five patients were operated upon during the acute state, i.e., within 72 hours after bleeding (early surgery = ES), and 38 patients had been subjected to late surgery (LS), i.e., were operated on 9 days or more after SAH. Each patient was subjected to a clinical interview and a comprehensive neuropsychological investigation. The time interval between SAH and assessment varied between 12 and 103 months (mean, 56 months). The results confirm that there are indication of cognitive malfunctioning and psychosocial disturbances of varying severity and distribution in patients who have undergone LS. The pattern and distribution of sequelae after LS did not differ substantially from that in patients subjected to ES. The results offer strong support to the concept that remaining disturbances in cognition are mainly related to the impact of the initial hemorrhage per se. In patients with anterior communicating artery aneurysms, a larger decrease in tempo and perceptual vigilance was noted, suggesting that the subfrontal midline structures are particularly involved in processes demanding flexibility, attention, and capacity to adapt to novel demands in a perceptual situation.

  19. Late Prosthetic Shoulder Hemiarthroplasty after Failed Management of Complex Proximal Humeral Fractures

    Directory of Open Access Journals (Sweden)

    A. Panagopoulos

    2013-01-01

    Full Text Available Background. The purpose of this study was to report our experience with shoulder hemiarthroplasty in the context of old trauma. Methods. 33 patients with failed treatment for a complex proximal humeral fracture underwent prosthetic hemiarthroplasty. There were 15 men and 18 women with a mean age of 58.1 years. The average period from initial treatment was 14.9 months. Sequelae included 11 malunions, 4 nonunions, 15 cases with avascular necrosis (AVN and 3 neglected posterior locked dislocations. Follow up investigation included radiological assessment and clinical evaluation using the Constant score and a visual analogue pain scale. Results. After a mean follow up of 82.5 months the median Constant score was 75.7 points, improved by 60% in comparison to preoperative values. Greater tuberosity displacement, large cuff tears and severe malunion were the factors most affected outcome. No cases of stem loosening or severe migration were noted. 60% of the patients were able to do activities up to shoulder level compared with 24% before reconstruction. Conclusions. Late shoulder hemiarthroplasty is technically difficult and the results are inferior to those reported for acute humeral head replacement, nonetheless remains a satisfactory reconstructive option when primary treatment fails.

  20. Impact of TBI on late effects in children treated by megatherapy for Stage IV neuroblastoma. A study of the French Society of Pediatric oncology

    International Nuclear Information System (INIS)

    Flandin, Isabelle; Hartmann, Olivier; Michon, Jean; Pinkerton, Ross; Coze, Carole; Stephan, Jean Louis; Fourquet, Bernard; Valteau-Couanet, Dominique; Bergeron, Christophe; Philip, Thierry; Carrie, Christian

    2006-01-01

    Purpose: To determine the contribution of total body irradiation (TBI) to late sequelae in children treated with high-dose chemotherapy and autologous bone marrow transplantation for Stage IV neuroblastoma. Patients and Methods: We compared two populations that were similar with regard to age, stage, pre-autologous bone marrow transplantation chemotherapy (CT) regimen, period of treatment, and follow-up (12 years). The TBI group (n = 32) received TBI as part of the megatherapy procedure (1982-1993), whereas the CT group (n 30) received conditioning without TBI (1985-1992). Analysis 12 years later focused on growth, weight and corpulence (body mass index) delay; hormonal deficiencies; liver, kidney, heart, ear, eye, and dental sequelae; school performance; and the incidence of secondary tumors. Results: Impact of TBI was most marked in relation to growth and weight delay, although the mean delay was not severe, probably because of treatment with growth hormones. Other consequences of TBI were thyroid insufficiency, cataracts, and a high incidence of secondary tumors. Hearing loss and dental agenesis were more prominent in the group treated with CT alone. No differences were observed in school performance. Conclusion: The most frequent side effects of TBI were cataracts, thyroid insufficiency, and growth delay, but more worrying is the risk of secondary tumors. Because of the young mean age of patients and the toxicity of TBI regimens without any survival advantage, regimens without TBI are preferable in the management of Stage IV neuroblastoma

  1. Epidemiological Study of Mild Traumatic Brain Injury Sequelae Caused by Blast Exposure During Operations Iraqi Freedom and Enduring Freedom

    Science.gov (United States)

    2014-11-01

    Distribution Interview diagnosis of mTBI after blast Page 12 of 30 low certainty using 90% or higher confidence as the anchor for high certainty...n = 32), ankle (n = 19), and hip (n = 16) regions. Full results of each of the preliminary hierarchical linear regressions are presented in Table 2

  2. Reporting Late Rectal Toxicity in Prostate Cancer Patients Treated With Curative Radiation Treatment

    International Nuclear Information System (INIS)

    Faria, Sergio L.; Souhami, Luis; Joshua, Bosede; Vuong, Te; Freeman, Carolyn R.

    2008-01-01

    Purpose: Long-term rectal toxicity is a concern for patients with prostate cancer treated with curative radiation. However, comparing results of late toxicity may not be straightforward. This article reviews the complexity of reporting long-term side effects by using data for patients treated in our institution with hypofractionated irradiation. Methods and Materials: Seventy-two patients with localized prostate cancer treated with hypofractionated radiotherapy alone to a dose of 66 Gy in 22 fractions were prospectively assessed for late rectal toxicity according to the Common Toxicity Criteria, Version 3, scoring system. Ninety percent of patients had more than 24 months of follow-up. Results are compared with data published in the literature. Results: We found an actuarial incidence of Grade 2 or higher late rectal toxicity of 27% at 30 months and a crude incidence of Grade 2 or higher late rectal toxicity of 18%. This was mostly severe toxicity documented during follow-up. The incidence of Grade 3 rectal toxicity at the last visit was 3% compared with 13% documented at any time during follow-up. Conclusion: Comparison of late toxicity after radiotherapy in patients with prostate cancer must be undertaken with caution because many factors need to be taken into consideration. Because accurate assessment of late toxicity in the evaluation of long-term outcome after radiotherapy in patients with localized prostate cancer is essential, there is a need to develop by consensus guidelines for assessing and reporting late toxicity in this group of patients

  3. Radiologic findings in late-onset systemic lupus erythematosus

    International Nuclear Information System (INIS)

    Braunstein, E.M.; Weissman, B.N.; Sosman, J.L.; Schur, P.H.

    1983-01-01

    Systemic lupus erythematosus in the elderly has a different clinical and serologic course from that in young patients. Radiographic findings in patients in whom the diagnosis was made after age 50 were compared with findings in younger patients to see if the radiologic patterns are also different. The only significant radiographic difference between the two groups was that the older group had a greater incidence of soft-tissue swelling of the hands and wrists (p < 0.001). There was no significant difference in osteopenia, erosion, soft-tissue calcification, alignment abnormalities, or intrathoracic findings. Of 24 patients over age 50, two developed lymphoma and another developed multiple myeloma. The data agree with clinical observations that there is a higher incidence of arthritis in late-onset lupus, but clinical findings of increased incidence of pleuropericardial disease are not confirmed radiographically. The coincidence of hematologic malignancy with late-onset lupus in this series is noteworthy

  4. Fuel Class Higher Alcohols

    KAUST Repository

    Sarathy, Mani

    2016-08-17

    This chapter focuses on the production and combustion of alcohol fuels with four or more carbon atoms, which we classify as higher alcohols. It assesses the feasibility of utilizing various C4-C8 alcohols as fuels for internal combustion engines. Utilizing higher-molecular-weight alcohols as fuels requires careful analysis of their fuel properties. ASTM standards provide fuel property requirements for spark-ignition (SI) and compression-ignition (CI) engines such as the stability, lubricity, viscosity, and cold filter plugging point (CFPP) properties of blends of higher alcohols. Important combustion properties that are studied include laminar and turbulent flame speeds, flame blowout/extinction limits, ignition delay under various mixing conditions, and gas-phase and particulate emissions. The chapter focuses on the combustion of higher alcohols in reciprocating SI and CI engines and discusses higher alcohol performance in SI and CI engines. Finally, the chapter identifies the sources, production pathways, and technologies currently being pursued for production of some fuels, including n-butanol, iso-butanol, and n-octanol.

  5. Late lung parenchymal changes on HRCT in children with mycoplasma pneumonia

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Soo Hyeon; Kim, Joung Sook; Yoon, Jung Hee; Hur, Gham; Kim, Chang Gun [Inje Univ. Sanggye Paik Hospital, Seoul (Korea, Republic of)

    1999-08-01

    To evaluate late lung parenchymal change, as seen on high-resolution CT(HRCT) in children with mycoplasma pneumonia. Twenty-three patients [15 boys and 8 girls aged two to 13 (mean, 6) years] with mycoplasma pneumonia underwent HRCT four to 39 (mean, 10) months after initial infection. Using increased mycoplasma antibody titer( > 1;640) mycoplasma pneumonia was diagnosed, and patients were divided into two groups : high titer group (antibody titer > 1:5120), and lower titer group ( < 1:5120). CT scans were performed using 2mm collimation and 5-10mm interval from apex to diaphragm. In seven patients who were cooperative, both inspiratory scans were obtained at a window width of 1600 HU and level of 700. HRCT findings of mosaic low attenuations and changes in bronchioles and bronchial walls were assessed by three radiologists and correlated with initial chest radiographic findings. On HRCT, 17 of 23 patients (74%) demonstrated abnormal findings. These included mosaic attenuation of lung density alone in 11 of 17 patients (65%), mosaic attenuation associated with bronchiectasis in five(29%), and bronchiectasis only in one(6%). Mosaic attenuation was more accentuated on expiratory scans than on inspiratory. These findings were obtained in 10 of 12 high titer group and in 7 of 11 in the lower titer group. In 15 of 23 patients(65%), involved areas seen on HRCT exactly corresponded with initially involved areas seen on chest radiographs (CXR). Two patients in whom findings on initial CXR were normal showed mosaic attenuation on HRCT. Six patients in whom such findings were abnormal showed normal findings on HRCT, a fact which reflected their complete recovery. The most common late parenchymal change in mycoplasma pneumonia, as seen on HRCT, was mosaic attenuation of lung density followed by bronchiectasis. The latter is presumably due to bronchiolitis obliterans, a well-known complication. We believe that HRCT is very useful for the evaluation of long-term sequelae of

  6. Late lung parenchymal changes on HRCT in children with mycoplasma pneumonia

    International Nuclear Information System (INIS)

    Lee, Soo Hyeon; Kim, Joung Sook; Yoon, Jung Hee; Hur, Gham; Kim, Chang Gun

    1999-01-01

    To evaluate late lung parenchymal change, as seen on high-resolution CT(HRCT) in children with mycoplasma pneumonia. Twenty-three patients [15 boys and 8 girls aged two to 13 (mean, 6) years] with mycoplasma pneumonia underwent HRCT four to 39 (mean, 10) months after initial infection. Using increased mycoplasma antibody titer( > 1;640) mycoplasma pneumonia was diagnosed, and patients were divided into two groups : high titer group (antibody titer > 1:5120), and lower titer group ( < 1:5120). CT scans were performed using 2mm collimation and 5-10mm interval from apex to diaphragm. In seven patients who were cooperative, both inspiratory scans were obtained at a window width of 1600 HU and level of 700. HRCT findings of mosaic low attenuations and changes in bronchioles and bronchial walls were assessed by three radiologists and correlated with initial chest radiographic findings. On HRCT, 17 of 23 patients (74%) demonstrated abnormal findings. These included mosaic attenuation of lung density alone in 11 of 17 patients (65%), mosaic attenuation associated with bronchiectasis in five(29%), and bronchiectasis only in one(6%). Mosaic attenuation was more accentuated on expiratory scans than on inspiratory. These findings were obtained in 10 of 12 high titer group and in 7 of 11 in the lower titer group. In 15 of 23 patients(65%), involved areas seen on HRCT exactly corresponded with initially involved areas seen on chest radiographs (CXR). Two patients in whom findings on initial CXR were normal showed mosaic attenuation on HRCT. Six patients in whom such findings were abnormal showed normal findings on HRCT, a fact which reflected their complete recovery. The most common late parenchymal change in mycoplasma pneumonia, as seen on HRCT, was mosaic attenuation of lung density followed by bronchiectasis. The latter is presumably due to bronchiolitis obliterans, a well-known complication. We believe that HRCT is very useful for the evaluation of long-term sequelae of

  7. Higher spin gauge theories

    CERN Document Server

    Henneaux, Marc; Vasiliev, Mikhail A

    2017-01-01

    Symmetries play a fundamental role in physics. Non-Abelian gauge symmetries are the symmetries behind theories for massless spin-1 particles, while the reparametrization symmetry is behind Einstein's gravity theory for massless spin-2 particles. In supersymmetric theories these particles can be connected also to massless fermionic particles. Does Nature stop at spin-2 or can there also be massless higher spin theories. In the past strong indications have been given that such theories do not exist. However, in recent times ways to evade those constraints have been found and higher spin gauge theories have been constructed. With the advent of the AdS/CFT duality correspondence even stronger indications have been given that higher spin gauge theories play an important role in fundamental physics. All these issues were discussed at an international workshop in Singapore in November 2015 where the leading scientists in the field participated. This volume presents an up-to-date, detailed overview of the theories i...

  8. INTERNATIONALIZATION IN HIGHER EDUCATION

    Directory of Open Access Journals (Sweden)

    Catalina Crisan-Mitra

    2016-03-01

    Full Text Available Internationalization of higher education is one of the key trends of development. There are several approaches on how to achieve competitiveness and performance in higher education and international academic mobility; students’ exchange programs, partnerships are some of the aspects that can play a significant role in this process. This paper wants to point out the student’s perception regarding two main directions: one about the master students’ expectation regarding how an internationalized master should be organized and should function, and second the degree of satisfaction of the beneficiaries of internationalized master programs from Babe-Bolyai University. This article is based on an empirical qualitative research that was implemented to students of an internationalized master from the Faculty of Economics and Business Administration. This research can be considered a useful example for those preoccupied to increase the quality of higher education and conclusions drawn have relevance both theoretically and especially practically.

  9. Quality of Higher Education

    DEFF Research Database (Denmark)

    Zou, Yihuan; Zhao, Yingsheng; Du, Xiangyun

    . This transformation involves a broad scale of change at individual level, organizational level, and societal level. In this change process in higher education, staff development remains one of the key elements for university innovation and at the same time demands a systematic and holistic approach.......This paper starts with a critical approach to reflect on the current practice of quality assessment and assurance in higher education. This is followed by a proposal that in response to the global challenges for improving the quality of higher education, universities should take active actions...... of change by improving the quality of teaching and learning. From a constructivist perspective of understanding education and learning, this paper also discusses why and how universities should give more weight to learning and change the traditional role of teaching to an innovative approach of facilitation...

  10. Early versus late traumatic cataract surgery and intraocular lens implantation.

    Science.gov (United States)

    Tabatabaei, S A; Rajabi, M B; Tabatabaei, S M; Soleimani, M; Rahimi, F; Yaseri, M

    2017-08-01

    PurposeTo determine the proper time for traumatic cataract surgery after open globe injuries.SettingFarabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.DesignRandomized clinical trial.Patients and methodsIn a randomized clinical trial, 30 eyes with traumatic cataract after open globe injury with IOL implantation underwent early (in the first week after the trauma) and 30 eyes underwent late cataract surgery (from the first to second month after the trauma). We excluded patients who were under 12-year-old. All patients were visited at 1 week, 4 weeks, 12 weeks, and 6 months after surgery. In each visit, patients were examined regarding visual acuity, intraocular pressure (IOP), anterior chamber inflammation, IOL position, and posterior synechiae. In addition, posterior segment evaluation and fundoscopy were performed. Intraoperative complication including posterior capsular rupture, anterior vitrectomy, and zonulysis as well as the site of IOL implantation were documented and post-operative complications including raised IOP, anterior chamber inflammation, visual axis opacity, posterior synechiae, subluxation of IOL, and IOL pigment deposition were listed.ResultsBest-corrected visual acuity 6 months after surgery was not different between the two groups. Also in early cataract surgery group, the rate of posterior capsular rupture was not significantly higher than the late surgery group (P=0.069). On the other hand, zonulysis was significantly higher in the late procedure group (P=0.039). Other complications including anterior vitrectomy, raised IOP, anterior chamber inflammation, visual axis opacity, posterior synechiae, subluxation of IOL, and IOL pigment deposition were not different in the two groups.ConclusionsEarly and late traumatic cataract surgery and IOL implantation after open globe injuries, have no significant difference regarding the post-surgical BCVA and prominent intraoperative and post-operative complications.

  11. LATE VISION: PROCESSES AND EPISTEMIC STATUS

    Directory of Open Access Journals (Sweden)

    Athanassios eRaftopoulos

    2011-12-01

    Full Text Available In this paper, I examine the processes that occur in late vision and address the problem of whether late vision should be construed as a properly speaking perceptual stage, or as a thought-like discursive stage. Specifically, I argue that late vision, its (partly conceptual nature notwithstanding, neither is constituted by nor does it implicate what I call pure thoughts, that is, propositional structures that are formed in the cognitive areas of the brain through, and participate in, discursive reasoning and inferences. At the same time, the output of late vision, namely an explicit belief concerning the identity and category membership of an object (that is, a recognitional belief or its features, eventually enters into discursive reasoning. Using Jackendoff’s distinction between visual awareness, which characterizes perception, and visual understanding, which characterizes pure thought, I claim that the contents of late vision belong to visual awareness and not to visual understanding and that although late vision implicates beliefs, either implicit or explicit, these beliefs are hybrid visual/conceptual constructs and not pure thoughts. Distinguishing between these hybrid representations and pure thoughts and delineating the nature of the representations of late vision lays the ground for examining, among other things, the process of conceptualization that occurs in visual processing and the way concepts modulate perceptual content affecting either its representational or phenomenal character. I also do not discuss the epistemological relations between the representations of late vision and the perceptual judgments they ‘support’, or ‘guide’ or ‘render possible’ or ‘evidence’ or ‘entitle’. However, the specification of the epistemology of late vision lays the ground for attacking that problem as well.

  12. Cruziana traces from the Late Silurian (Pridoli carbonate shelf of Saaremaa, Estonia

    Directory of Open Access Journals (Sweden)

    Olev Vinn

    2014-05-01

    Full Text Available Late Pridoli Cruziana traces have recently been found in carbonate shelf sediments of the Ohesaare Formation on Saaremaa Island, Estonia. Cruziana isp. is interpreted here as a locomotory trace (repichnia of an arthropod, possibly a trilobite. Cruziana traces previously known from the Silurian of Baltica differ from Cruziana isp., indicating that the diversity of Cruziana traces in the late Silurian of Baltica was higher than previously thought.

  13. Identifying the role of emotion regulation strategies in predicting school adjustment in late childhood and adolescence

    OpenAIRE

    Murphy, Rebecca Jane

    2013-01-01

    Emotion regulation (ER) strategies, as conceptualised within the influential process model of ER (Gross, 1998), are found to be important predictors of psychological outcomes in adults. Less research has examined the use of ER strategies in late childhood and adolescence. However adolescence is a key period of pubertal and environmental changes leading to higher demands to regulate emotions. This thesis had two goals; to understand the origins of ER strategy use in late childhood and adolesce...

  14. Reputation in Higher Education

    DEFF Research Database (Denmark)

    Martensen, Anne; Grønholdt, Lars

    2005-01-01

    leaders of higher education institutions to set strategic directions and support their decisions in an effort to create even better study programmes with a better reputation. Finally, managerial implications and directions for future research are discussed.Keywords: Reputation, image, corporate identity......The purpose of this paper is to develop a reputation model for higher education programmes, provide empirical evidence for the model and illustrate its application by using Copenhagen Business School (CBS) as the recurrent case. The developed model is a cause-and-effect model linking image...

  15. Reputation in Higher Education

    DEFF Research Database (Denmark)

    Plewa, Carolin; Ho, Joanne; Conduit, Jodie

    2016-01-01

    Reputation is critical for institutions wishing to attract and retain students in today's competitive higher education setting. Drawing on the resource based view and configuration theory, this research proposes that Higher Education Institutions (HEIs) need to understand not only the impact...... of independent resources but of resource configurations when seeking to achieve a strong, positive reputation. Utilizing fuzzy set qualitative comparative analysis (fsQCA), the paper provides insight into different configurations of resources that HEIs can utilize to build their reputation within their domestic...

  16. Navigating in higher education

    DEFF Research Database (Denmark)

    Thingholm, Hanne Balsby; Reimer, David; Keiding, Tina Bering

    Denne rapport er skrevet på baggrund af spørgeskemaundersøgelsen – Navigating in Higher Education (NiHE) – der rummer besvarelser fra 1410 bachelorstuderende og 283 undervisere fordelt på ni uddannelser fra Aarhus Universitet: Uddannelsesvidenskab, Historie, Nordisk sprog og litteratur, Informati......Denne rapport er skrevet på baggrund af spørgeskemaundersøgelsen – Navigating in Higher Education (NiHE) – der rummer besvarelser fra 1410 bachelorstuderende og 283 undervisere fordelt på ni uddannelser fra Aarhus Universitet: Uddannelsesvidenskab, Historie, Nordisk sprog og litteratur...

  17. Late Onset Bipolar Disorder: Case Report

    Directory of Open Access Journals (Sweden)

    Filipa Araújo

    2016-07-01

    Full Text Available Background: Bipolar disorder affects approximately 1% of the population, with diagnosis often being made during late adolescence and early adulthood, and only rarely (0.1% in the elderly. Late onset bipolar disorder in the elderly has a impact on the nature and course of bipolar disorder. Aims: The authors report a case of bipolar disorder emerging in late life  (76years old with no cleary identified organic cause. Conclusion: This case highlights the importance of a broad differential diagnosis and pharmacologic management when approaching new-onset manic/depressive symptoms among geriatric patients.

  18. Late washing filter cleaning cycle demonstration

    International Nuclear Information System (INIS)

    Meyer, M.L.; McCabe, D.J.

    1992-01-01

    The DWPF Late Washing Facility will filter cesium and potassium tetraphenyl borate (TPB) solids using a Mott sintered metal filter, identical to the filter now used in the In-tank Precipitation Facility. The purpose of the late wash step is primarily to remove the nitrite salts from the slurry prior to delivery to DWPF. Periodic chemical cleaning of the filter will be required, presumably after each batch although the actual required frequency could not be determined on the lab-scale. Minimization of chemical cleaning solution volumes is key to maximizing the attainment of the Late Wash facility. This report summarizes work completed in experiments designed to identify minimum cleaning solution requirements

  19. Exploring Higher Thinking.

    Science.gov (United States)

    Conover, Willis M.

    1992-01-01

    Maintains that the social studies reform movement includes a call for the de-emphasis of rote memory and more attention to the development of higher-order thinking skills. Discusses the "thinking tasks" concept derived from the work of Hilda Taba and asserts that the tasks can be used with almost any social studies topic. (CFR)

  20. Higher-Order Hierarchies

    DEFF Research Database (Denmark)

    Ernst, Erik

    2003-01-01

    This paper introduces the notion of higher-order inheritance hierarchies. They are useful because they provide well-known benefits of object-orientation at the level of entire hierarchies-benefits which are not available with current approaches. Three facets must be adressed: First, it must be po...

  1. Inflation from higher dimensions

    International Nuclear Information System (INIS)

    Shafi, Q.

    1987-01-01

    We argue that an inflationary phase in the very early universe is related to the transition from a higher dimensional to a four-dimensional universe. We present details of a previously considered model which gives sufficient inflation without fine tuning of parameters. (orig.)

  2. Higher Education Funding Formulas.

    Science.gov (United States)

    McKeown-Moak, Mary P.

    1999-01-01

    One of the most critical components of the college or university chief financial officer's job is budget planning, especially using formulas. A discussion of funding formulas looks at advantages, disadvantages, and types of formulas used by states in budgeting for higher education, and examines how chief financial officers can position the campus…

  3. Liberty and Higher Education.

    Science.gov (United States)

    Thompson, Dennis F.

    1989-01-01

    John Stuart Mill's principle of liberty is discussed with the view that it needs to be revised to guide moral judgments in higher education. Three key elements need to be modified: the action that is constrained; the constraint on the action; and the agent whose action is constrained. (MLW)

  4. Fuel Class Higher Alcohols

    KAUST Repository

    Sarathy, Mani

    2016-01-01

    This chapter focuses on the production and combustion of alcohol fuels with four or more carbon atoms, which we classify as higher alcohols. It assesses the feasibility of utilizing various C4-C8 alcohols as fuels for internal combustion engines

  5. Evaluation in Higher Education

    Science.gov (United States)

    Bognar, Branko; Bungic, Maja

    2014-01-01

    One of the means of transforming classroom experience is by conducting action research with students. This paper reports about the action research with university students. It has been carried out within a semester of the course "Methods of Upbringing". Its goal has been to improve evaluation of higher education teaching. Different forms…

  6. Higher-level Innovization

    DEFF Research Database (Denmark)

    Bandaru, Sunith; Tutum, Cem Celal; Deb, Kalyanmoy

    2011-01-01

    we introduce the higher-level innovization task through an application of a manufacturing process simulation for the Friction Stir Welding (FSW) process where commonalities among two different Pareto-optimal fronts are analyzed. Multiple design rules are simultaneously deciphered from each front...

  7. Benchmarking for Higher Education.

    Science.gov (United States)

    Jackson, Norman, Ed.; Lund, Helen, Ed.

    The chapters in this collection explore the concept of benchmarking as it is being used and developed in higher education (HE). Case studies and reviews show how universities in the United Kingdom are using benchmarking to aid in self-regulation and self-improvement. The chapters are: (1) "Introduction to Benchmarking" (Norman Jackson…

  8. Creativity in Higher Education

    Science.gov (United States)

    Gaspar, Drazena; Mabic, Mirela

    2015-01-01

    The paper presents results of research related to perception of creativity in higher education made by the authors at the University of Mostar from Bosnia and Herzegovina. This research was based on a survey conducted among teachers and students at the University. The authors developed two types of questionnaires, one for teachers and the other…

  9. California's Future: Higher Education

    Science.gov (United States)

    Johnson, Hans

    2015-01-01

    California's higher education system is not keeping up with the changing economy. Projections suggest that the state's economy will continue to need more highly educated workers. In 2025, if current trends persist, 41 percent of jobs will require at least a bachelor's degree and 36 percent will require some college education short of a bachelor's…

  10. Cyberbullying in Higher Education

    Science.gov (United States)

    Minor, Maria A.; Smith, Gina S.; Brashen, Henry

    2013-01-01

    Bullying has extended beyond the schoolyard into online forums in the form of cyberbullying. Cyberbullying is a growing concern due to the effect on its victims. Current studies focus on grades K-12; however, cyberbullying has entered the world of higher education. The focus of this study was to identify the existence of cyberbullying in higher…

  11. Competitiveness - higher education

    Directory of Open Access Journals (Sweden)

    Labas Istvan

    2016-03-01

    Full Text Available Involvement of European Union plays an important role in the areas of education and training equally. The member states are responsible for organizing and operating their education and training systems themselves. And, EU policy is aimed at supporting the efforts of member states and trying to find solutions for the common challenges which appear. In order to make our future sustainable maximally; the key to it lies in education. The highly qualified workforce is the key to development, advancement and innovation of the world. Nowadays, the competitiveness of higher education institutions has become more and more appreciated in the national economy. In recent years, the frameworks of operation of higher education systems have gone through a total transformation. The number of applying students is continuously decreasing in some European countries therefore only those institutions can “survive” this shortfall, which are able to minimize the loss of the number of students. In this process, the factors forming the competitiveness of these budgetary institutions play an important role from the point of view of survival. The more competitive a higher education institution is, the greater the chance is that the students would like to continue their studies there and thus this institution will have a greater chance for the survival in the future, compared to ones lagging behind in the competition. Aim of our treatise prepared is to present the current situation and main data of the EU higher education and we examine the performance of higher education: to what extent it fulfils the strategy for smart, sustainable and inclusive growth which is worded in the framework of Europe 2020 programme. The treatise is based on analysis of statistical data.

  12. Nephrogenic systemic fibrosis: late skin manifestations

    DEFF Research Database (Denmark)

    Bangsgaard, Nannie; Marckmann, Peter; Rossen, Kristian

    2009-01-01

    BACKGROUND: Nephrogenic systemic fibrosis (NSF) is a serious disease that occurs in patients with severe renal disease and is believed to be caused by gadolinium-containing contrast agents. A detailed description of the late skin manifestations of NSF is important to help dermatologists...... and nephrologists recognize the disease. OBSERVATIONS: We studied 17 patients with NSF late in the disease. All patients showed epidermal atrophy and hairlessness of the affected regions, primarily the lower legs. Affected areas were symmetrically distributed and hyperpigmented in most cases. Eleven patients showed......: This descriptive case series of patients with NSF gives a detailed clinical picture of the skin manifestations late in the disease. It demonstrates that the clinical picture in the late stage has a varied presentation and that NSF has a significant effect on the quality of life....

  13. Late onset depression: A recent update

    Directory of Open Access Journals (Sweden)

    Ananya Mahapatra

    2015-01-01

    Full Text Available Late onset depression has recently emerged as a serious mental health issue in the geriatric population with significant public health implications. It is often challenging to diagnose and treat this entity. Various theories have been postulated to elucidate the etiology of late onset depression, but a unifying hypothesis is lacking. Although the vascular hypothesis is most researched; a complex interaction of multiple vulnerability factors is the current focus of attention. Numerous psychosocial variables have been implicated to play a significant role in predicting the onset and severity of late-life depression. Phenomenological differences have been delineated from depression occurring at a younger age, but the findings are equivocal. A better understanding of the natural trajectory of depression in the elderly is required for early diagnosis and effective treatment. This review attempts to summarize the current status of evidence regarding epidemiology, etiology, clinical features, and treatment options available for late-onset depression.

  14. Early- and Late-Onset Inherited Erythromelalgia

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-08-01

    Full Text Available A genotype-phenotype relationship at the clinical, cellular and molecular levels is shown in a case of erythromelalgia of relatively late onset, in a study at Yale University School of Medicine, and centers in China.

  15. From Centralization to Decentralization in Chinese Higher Education

    Science.gov (United States)

    Qian, Xiaohong; Verhoeven, Jef C.

    2004-01-01

    Since the late 1970's, the Chinese government has been gradually changing its traditional policy for providing higher education and has begun to emphasize the comprehensiveness of the universities. Interdisciplinary cooperation and the synergization of resources are being promoted, and institutional autonomy is gradually increasing. Schools and…

  16. Tunnel Vision: New England Higher Education Ignores Demographic Peril

    Science.gov (United States)

    Hodgkinson, Harold L.

    2004-01-01

    This author states that American higher education ignores about 90 percent of the environment in which it operates. Colleges change admissions requirements without even informing high schools in their service areas. Community college graduates are denied access to four-year programs because of policy changes made only after it was too late for the…

  17. Parapneumonic pleural effusion: early versus late thoracoscopy

    Directory of Open Access Journals (Sweden)

    Rodrigo Romualdo Pereira

    2017-07-01

    Full Text Available ABSTRACT Objective: To evaluate the best time to perform thoracoscopy for the treatment of complicated parapneumonic pleural effusion in the fibrinopurulent phase in patients ≤ 14 years of age, regarding the postoperative evolution and occurrence of complications. Methods: This was a retrospective comparative study involving patients with parapneumonic pleural effusion presenting with septations or loculations on chest ultrasound who underwent thoracoscopy between January of 2000 and January of 2013. The patients were divided into two groups: early thoracoscopy (ET, performed by day 5 of hospitalization; and late thoracoscopy (LT, performed after day 5 of hospitalization. Results: We included 60 patients, 30 in each group. The mean age was 3.4 years; 28 patients (46.7% were male; and 47 (78.3% underwent primary thoracoscopy (no previous simple drainage. The two groups were similar regarding gender, age, weight, and type of thoracoscopy (p > 0.05 for all. There was a significant difference between the ET and the LT groups regarding the length of the hospital stay (14.5 days vs. 21.7 days; p < 0.001. There were also significant differences between the groups regarding the duration of fever in days; the total number of days from admission to the initiation of drainage; and the total number of days with the drain in place. Eight patients (13.6% had at least one post-thoracoscopy complication, there being no difference between the groups. There were no deaths. Conclusions: Performing ET by day 5 of hospitalization was associated with shorter hospital stays, shorter duration of drainage, and shorter duration of fever, although not with a higher frequency of complications, requiring ICU admission, or requiring blood transfusion.

  18. Progression of Late-Onset Stargardt Disease

    OpenAIRE

    Lambertus, Stanley; Lindner, Moritz; Bax, Nathalie M.; Mauschitz, Matthias M.; Nadal, Jennifer; Schmid, Matthias; Schmitz-Valckenberg, Steffen; den Hollander, Anneke I.; Weber, Bernhard H. F.; Holz, Frank G.; van der Wilt, Gert Jan; Fleckenstein, Monika; Hoyng, Carel B.

    2016-01-01

    Purpose: Identification of sensitive biomarkers is essential to determine potential effects of emerging therapeutic trials for Stargardt disease. This study aimed to describe the natural history of late-onset Stargardt, and demonstrates the accuracy of retinal pigment epithelium (RPE) atrophy progression as an outcome measure. Methods: We performed a retrospective cohort study collecting multicenter data from 47 patients (91 eyes) with late-onset Stargardt, defined by clinical phenotype...

  19. Radiosensitivity of higher plants

    International Nuclear Information System (INIS)

    Feng Zhijie

    1992-11-01

    The general views on radiosensitivity of higher plants have been introduced from published references. The radiosensitivity varies with species, varieties and organs or tissues. The main factors of determining the radiosensitivity in different species are nucleus volume, chromosome volume, DNA content and endogenous compounds. The self-repair ability of DNA damage and chemical group of biological molecules, such as -SH thiohydroxy of proteins, are main factors to determine the radiosensitivity in different varieties. The moisture, oxygen, temperature radiosensitizer and protector are important external factors for radiosensitivity. Both the multiple target model and Chadwick-Leenhouts model are ideal mathematical models for describing the radiosensitivity of higher plants and the latter has more clear significance in biology

  20. Higher Education Language Policy

    DEFF Research Database (Denmark)

    Lauridsen, Karen M.

    2013-01-01

    Summary of recommendations HEIs are encouraged, within the framework of their own societal context, mission, vision and strategies, to develop the aims and objectives of a Higher Education Language Policy (HELP) that allows them to implement these strategies. In this process, they may want......: As the first step in a Higher Education Language Policy, HEIs should determine the relative status and use of the languages employed in the institution, taking into consideration the answers to the following questions:  What is/are the official language(s) of the HEI?  What is/are the language...... and the level of internationalisation the HEI has or wants to have, and as a direct implication of that, what are the language proficiency levels expected from the graduates of these programme?  Given the profile of the HEI and its educational strategies, which language components are to be offered within...

  1. Analysis of acute and late toxicity of adjuvant radiotherapy in women with cervical and endometrial cancer

    International Nuclear Information System (INIS)

    Warenczak-Florczak, Z.; Roszak, A.; Wlodarczyk, H.; Wojciechowska-Lacka, A.

    2011-01-01

    Background: In case of pure prognostic factors women with cervical and endometrial cancer after surgical operation need to be treated with radiotherapy . Every radiation treatment may be involved with toxicity, acute and late. Material and methods: Performed was detailed analysis of 173 patients with cervical (38) and endometrial (135) cancer. We evaluated early and late post radiation reactions in all patients. Results: Acute reactions were found in 48.5% and late toxicity was found in 9.8% of patients. Women with endometrial cancer were significantly older then patients with cervical cancer (p < 0.002). Higher percentage of acute and late toxicity was observed from the bowel tah urinary tract (26% and 22.5% - acute; 8.1% and 1.73% - late). Higher percentage of acute side effects was observed in patients with cervical than with endometrial cancer (60.5% and 33.7%). Late post radiation reaction predominate also in patient with cervical cancer (13.2% and 8.9%). The adverse effects were associated with prolonged time of treatment due to breaks in radiotherapy. Higher percentage of breaks was found in older patients, more frequent in patient with endometrial than in cervical cancer group (7.4% and 2.6%).To conclude early postradiation reaction appeared more frequently, than late post radiation reactions. It was stated that early and late post radiation reaction appear more frequently in women with cervical than in endometrial cancer. Interruption in radiation delivery was longer than seven days in group with endometrial cancer that leads to extension of complete radiation treatment. (authors)

  2. Late whiplash syndrome: a clinical and magnetic resonance imaging study.

    Science.gov (United States)

    Bonuccelli, U; Pavese, N; Lucetti, C; Renna, M R; Gambaccini, G; Bernardini, S; Canapicchi, R; Carrozzi, L; Murri, L

    1999-01-01

    Cervical hyperextension injuries are common and are associated with significant morbidity. Clinically two syndromes are described: "acute" whiplash syndrome and "late" whiplash syndrome (in which the patients are still symptomatic after six months despite normal physical and radiological examination). In order to clarify the pathology of the persistent pain in late whiplash syndrome we performed a cervical spine magnetic resonance imaging (MRI) in 33 consecutive patients suffering from this condition. Twenty-six patients (78.8%) showed MRI abnormalities, the most common MRI finding (57.6%) was pre-existent spondylosis. Indeed, the group of patients with spondylosis and other MRI changes had higher clinical scores than those without MRI abnormalities as measured by a three-point grading system based upon the symptoms and signs shown. Several MRI changes, most of them already demonstrable by standard X-ray were seen among 33 patients suffering from late whiplash syndrome. Although no one of these findings appears to be specific and certainly related to the previous neck injury, they could represent a risk factor for a longer pain duration.

  3. Analysis of effect of late water injection on RCS repressurization

    International Nuclear Information System (INIS)

    Tao Jun; Cao Xuewu

    2011-01-01

    Effect of late water injection on RCS repressurization during high pressure severe accident sequence in a typical PWR was analyzed. As the results shown, late water injection could increase RCS pressure when RPV failed without RCS passive depressurization. Especially in the condition of opening one PORV, RCS pressure could reach high pressure limit when RPV failed and the risk of HPME and DCH was dramatically increased. Integrity of containment could be threatened. However, in the condition of RCS passive depressurization induced by pressurizer surge line creep failure, RCS pressure could be decreased to very low level even only one PORV was opened and two trains of emergency core cooling were implemented. The risk of HPME and DCH was eliminated. The more PORVs were opened, the faster accident progression was and the earlier RPV failed. RCS pressure was a little higher when PRV failed if two trains of emergency core cooling was implemented comparing with the condition with only one train of emergency core cooling. However the time of RPV failure was obviously delayed. From the point of delaying RPV failure and preventing containment early failure of view, the optimized late water injection was opening three PORVs and implementing two trains of emergency core cooling. (authors)

  4. The impact of fire on the Late Paleozoic Earth System

    Directory of Open Access Journals (Sweden)

    Ian J. Glasspool

    2015-09-01

    Full Text Available Analyses of bulk petrographic data indicate that during the Late Paleozoic wildfires were more prevalent than at present. We propose that the development of fire systems through this interval was controlled predominantly by the elevated atmospheric oxygen concentration (p(O2 that mass balance models predict prevailed. At higher levels of p(O2, increased fire activity would have rendered vegetation with high moisture contents more susceptible to ignition and would have facilitated continued combustion. We argue that coal petrographic data indicate that p(O2 rather than global temperatures or climate, resulted in the increased levels of wildfire activity observed during the Late Paleozoic and can therefore be used to predict it. These findings are based upon analyses of charcoal volumes in multiple coals distributed across the globe and deposited during this time period, and that were then compared with similarly diverse modern peats and Cenozoic lignites and coals. Herein, we examine the environmental and ecological factors that would have impacted fire activity and we conclude that of these factors p(O2 played the largest role in promoting fires in Late Paleozoic peat-forming environments and, by inference, ecosystems generally, when compared with their prevalence in the modern world.

  5. The impact of fire on the Late Paleozoic Earth system.

    Science.gov (United States)

    Glasspool, Ian J; Scott, Andrew C; Waltham, David; Pronina, Natalia; Shao, Longyi

    2015-01-01

    Analyses of bulk petrographic data indicate that during the Late Paleozoic wildfires were more prevalent than at present. We propose that the development of fire systems through this interval was controlled predominantly by the elevated atmospheric oxygen concentration (p(O2)) that mass balance models predict prevailed. At higher levels of p(O2), increased fire activity would have rendered vegetation with high-moisture contents more susceptible to ignition and would have facilitated continued combustion. We argue that coal petrographic data indicate that p(O2) rather than global temperatures or climate, resulted in the increased levels of wildfire activity observed during the Late Paleozoic and can, therefore, be used to predict it. These findings are based upon analyses of charcoal volumes in multiple coals distributed across the globe and deposited during this time period, and that were then compared with similarly diverse modern peats and Cenozoic lignites and coals. Herein, we examine the environmental and ecological factors that would have impacted fire activity and we conclude that of these factors p(O2) played the largest role in promoting fires in Late Paleozoic peat-forming environments and, by inference, ecosystems generally, when compared with their prevalence in the modern world.

  6. Functioning in early and late stages of schizophrenia

    Directory of Open Access Journals (Sweden)

    Leonardo Gazzi Costa

    2014-12-01

    Full Text Available INTRODUCTION: Schizophrenia is frequently associated with a debilitating course and prominent impairment in social and occupational functioning. Although the criteria for classification into stages have not been defined in the literature, illness duration and functioning seem to be good candidates.OBJECTIVE:To compare functioning of patients with schizophrenia at different stages of the disease (early vs. late and healthy sex- and age-matched controls.METHODS: This double-blinded, case-controlled study included 79 individuals: 23 patients with schizophrenia diagnosed up to 5 years earlier; 19 patients with schizophrenia diagnosed at least 20 years earlier; and healthy matched controls. Diagnoses were established using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV Axis I Disorder. Functioning was assessed using the Functioning Assessment Short Test (FAST.RESULTS: Patients in the early stage had significantly higher scores than healthy controls in total FAST and in autonomy, occupational functioning, cognitive functioning and interpersonal relationships. Individuals in the late stage had significantly poorer functioning than controls in all domains. The comparison of functioning between the two groups of patients revealed no significant differences, except in occupational functioning, in which late stage patients had a poorer performance.CONCLUSION: Functioning impairment in schizophrenia tends to remain stable despite illness duration. Therefore, functioning should be effectively assessed at an early stage, as illness duration alone may not be the most reliable criterion to stage patients with schizophrenia.

  7. Efficacy of brain scanning in epilepsy of late onset

    International Nuclear Information System (INIS)

    Jain, A.N.; Ramanathan, P.; Ganatra, R.D.

    1978-01-01

    Brain scans of 513 patients with epilepsy of late onset were analysed with reference to the patient's age and sex and to the nature of convulsion. Only 17 of them showed an abnormal concentration of radionuclide indicating a space-occupying lesion in the brain. The findings of those patients who had positive brain scans were correlated with EEG findings. It was found that the incidence of epilepsy of late onset is almost 3 times higher in males than in females and that the age cannot be considered as a criterion for screening the patients for brain scan investigation as far as epilepsy of late onset is concerned. In the authors' opinion, the incidence of 3.3% is not too low. A positive brain scan finding calls for further investigation and helps in deciding the management and further line of treatment of the patients. Moreover, a normal scan rules out the presence of a space-occupying lesion and helps as a screening procedure. (orig.) 891 MG [de

  8. Salivary Markers and Microbial Flora in Mouth Breathing Late Adolescents

    Directory of Open Access Journals (Sweden)

    Stefano Mummolo

    2018-01-01

    Full Text Available Objective. This is a 6-month observational case-control study that aims to estimate plaque index (PI, salivary flow, buffering capacity of saliva, and specific Streptococcus mutans (S. mutans and Lactobacillus rates in a mouth breathing late adolescents sample, after a professional oral hygiene procedure and home oral hygiene instructions. Subjects and Methods. A sample of 20 mouth breathing late adolescents/young adults (average: 19.2±2.5; range: 18–23 years and a matched control group of nose breathing subjects (average: 18.3±3.2; range 18–23 years were included in the study. All the participants were subjected to a professional oral hygiene procedure and appropriate home oral hygiene instructions (t0. After three months (t1 and six months (t2, the PI, salivary flow, buffering capacity of saliva, and S. mutans and Lactobacilli rates were recorded. Results. The mean buffering capacity of saliva and the salivary flow rate showed no significant difference between the two groups, all over the observational period. For PI, a significantly higher mode (score 1 of PI was observed in the study group at t1 (score 0 = 35% of subjects; score 1 = 60%; score 2 = 5% and t2 (score 1 = 65% of subjects, score 2 = 35%, with respect to control group. Furthermore, mouth breathing subjects show a significant 4 times higher risk to develop S. mutans CFU > 105 (CI lower limit: 0.95; CI upper limit: 9.48; chi-square: 4.28; p=0.03, with respect to the control subjects. Conclusions. Mouth breathing late adolescents show a significantly higher risk to develop S. mutans CFU > 105 and an increased level of PI. Interceptive orthodontic treatments in growing subjects, like palatal expansion, are encouraged to improve the nasal air flow. In older subjects, orthodontic treatments should be performed with removable appliances like clear aligners, in order to allow a better oral hygiene level.

  9. Amelioration of acute sequelae of blast induced mild traumatic brain injury by N-acetyl cysteine: a double-blind, placebo controlled study.

    Directory of Open Access Journals (Sweden)

    Michael E Hoffer

    Full Text Available BACKGROUND: Mild traumatic brain injury (mTBI secondary to blast exposure is the most common battlefield injury in Southwest Asia. There has been little prospective work in the combat setting to test the efficacy of new countermeasures. The goal of this study was to compare the efficacy of N-acetyl cysteine (NAC versus placebo on the symptoms associated with blast exposure mTBI in a combat setting. METHODS: This study was a randomized double blind, placebo-controlled study that was conducted on active duty service members at a forward deployed field hospital in Iraq. All symptomatic U.S. service members who were exposed to significant ordnance blast and who met the criteria for mTBI were offered participation in the study and 81 individuals agreed to participate. Individuals underwent a baseline evaluation and then were randomly assigned to receive either N-acetyl cysteine (NAC or placebo for seven days. Each subject was re-evaluated at 3 and 7 days. Outcome measures were the presence of the following sequelae of mTBI: dizziness, hearing loss, headache, memory loss, sleep disturbances, and neurocognitive dysfunction. The resolution of these symptoms seven days after the blast exposure was the main outcome measure in this study. Logistic regression on the outcome of 'no day 7 symptoms' indicated that NAC treatment was significantly better than placebo (OR = 3.6, p = 0.006. Secondary analysis revealed subjects receiving NAC within 24 hours of blast had an 86% chance of symptom resolution with no reported side effects versus 42% for those seen early who received placebo. CONCLUSION: This study, conducted in an active theatre of war, demonstrates that NAC, a safe pharmaceutical countermeasure, has beneficial effects on the severity and resolution of sequelae of blast induced mTBI. This is the first demonstration of an effective short term countermeasure for mTBI. Further work on long term outcomes and the potential use of NAC in civilian m

  10. Reconstrucción de las secuelas de la pared abdominal en pacientes con extrofia de cloaca Reconstruction of abdominal wall sequelae in patients with cloacal extrophy

    Directory of Open Access Journals (Sweden)

    P. Iwanyk

    2009-06-01

    Full Text Available Los defectos abdominales congénitos de la línea media inferior, como la extrofia cloacal, se producen por fallos en el mesodermo entre la región umbilical y la membrana cloacal provocando severos defectos viscerales, musculares y óseos. Los reiterados intentos para la reconstrucción de los tractos intestinal y génitourinario en este tipo de malformaciones, pueden ocasionar secuelas graves en la pared malformada. La complejidad de esta malformación y los numerosos procedimientos a los que deben ser sometidos estos pacientes, requieren de un abordaje interdisciplinario desde el inicio del tratamiento y en cada una de las etapas reconstructivas a fin de evitar, al máximo, las lesiones de los tejidos abdominales para lograr, al final, una pared adecuada. Presentamos 2 casos de reconstrucción de la pared abdominal en sendos pacientes de sexo femenino con secuelas importantes de extrofia cloacal, utilizando tejidos expandidos, colgajos musculares y complementando el tratamiento en una de las pacientes con una malla protésica. En ambos casos, y a pesar de la falta de tejido provocada por la malformación y las secuelas de múltiples cirugías, obtuvimos un buen resultado funcional y estético.Abdominal congenital defects of the middle line have their origin in developmental faults of mesoderm between the umbilical region and the cloacal membrane, originating visceral, muscular and osseous defects in the abdominal wall. Repeated attempts to reconstruct the intestinal and genitourinary tract here and in other malformations, can cause serious sequeals in the previously deformed abdominal wall. We present 2 cases of abdominal wall reconstruction in patients with serious sequelae of cloacal extrophy. Complexity of this malformation calls for an interdisciplinary treatment to avoid the severe damage that may be caused during reconstructive attempts. In spite of lack of tissue because of the malformation and the sequelae of multiple surgeries we

  11. Clinical aspects and self-reported symptoms of sequelae of Yersinia enterocolitica infections in a population-based study, Germany 2009-2010.

    Science.gov (United States)

    Rosner, Bettina M; Werber, Dirk; Höhle, Michael; Stark, Klaus

    2013-05-23

    Foodborne Yersinia enterocolitica infections continue to be a public health problem in many countries. Consumption of raw or undercooked pork is the main risk factor for yersiniosis in Germany. Small children are most frequently affected by yersiniosis. In older children and young adults, symptoms of disease may resemble those of appendicitis and may lead to hospitalization and potentially unnecessary appendectomies. Y. enterocolitica infections may also cause sequelae such as reactive arthritis (ReA), erythema nodosum (EN), and conjunctivitis. We studied clinical aspects of yersiniosis, antimicrobial use, and self-reported occurrence of appendectomies, reactive arthritis, erythema nodosum and conjunctivitis. To assess post-infectious sequelae participants of a large population-based case-control study on laboratory-confirmed Y. enterocolitica infections conducted in Germany in 2009-2010 were followed for 4 weeks. Diarrhea occurred most frequently in children ≤4 years (95%); abdominal pain in the lower right quadrant was most common in children 5-14 years of age (63%). Twenty-seven per cent of patients were hospitalized, 37% were treated with antimicrobials. In 6% of yersiniosis patients ≥5 years of age, appendectomies were performed. Self-reported symptoms consistent with ReA were reported by 12% of yersiniosis patients compared to 5% in a reference group not exposed to yersiniosis. Symptoms consistent with EN were reported by 3% of yersiniosis patients compared to 0.1% in the reference group. Symptoms of conjunctivitis occurred with the same frequency in yersiniosis patients and the reference group. Acute Y. enterocolitica infections cause considerable burden of illness with symptoms lasting for about 10 days and hospitalizations in more than a quarter of patients. The proportion of yersiniosis patients treated with antimicrobial drugs appears to be relatively high despite guidelines recommending their use only in severe cases. Appendectomies and post

  12. Clinical aspects and self-reported symptoms of sequelae of Yersinia enterocolitica infections in a population-based study, Germany 2009–2010

    Science.gov (United States)

    2013-01-01

    Background Foodborne Yersinia enterocolitica infections continue to be a public health problem in many countries. Consumption of raw or undercooked pork is the main risk factor for yersiniosis in Germany. Small children are most frequently affected by yersiniosis. In older children and young adults, symptoms of disease may resemble those of appendicitis and may lead to hospitalization and potentially unnecessary appendectomies. Y. enterocolitica infections may also cause sequelae such as reactive arthritis (ReA), erythema nodosum (EN), and conjunctivitis. Methods We studied clinical aspects of yersiniosis, antimicrobial use, and self-reported occurrence of appendectomies, reactive arthritis, erythema nodosum and conjunctivitis. To assess post-infectious sequelae participants of a large population-based case–control study on laboratory-confirmed Y. enterocolitica infections conducted in Germany in 2009–2010 were followed for 4 weeks. Results Diarrhea occurred most frequently in children ≤4 years (95%); abdominal pain in the lower right quadrant was most common in children 5–14 years of age (63%). Twenty-seven per cent of patients were hospitalized, 37% were treated with antimicrobials. In 6% of yersiniosis patients ≥5 years of age, appendectomies were performed. Self-reported symptoms consistent with ReA were reported by 12% of yersiniosis patients compared to 5% in a reference group not exposed to yersiniosis. Symptoms consistent with EN were reported by 3% of yersiniosis patients compared to 0.1% in the reference group. Symptoms of conjunctivitis occurred with the same frequency in yersiniosis patients and the reference group. Conclusions Acute Y. enterocolitica infections cause considerable burden of illness with symptoms lasting for about 10 days and hospitalizations in more than a quarter of patients. The proportion of yersiniosis patients treated with antimicrobial drugs appears to be relatively high despite guidelines recommending their use only in

  13. Higher Education in Scandinavia

    DEFF Research Database (Denmark)

    Nielsen, Jørgen Lerche; Andreasen, Lars Birch

    2015-01-01

    Higher education systems around the world have been undergoing fundamental changes through the last 50 years from more narrow self-sustaining universities for the elite and into mass universities, where new groups of students have been recruited and the number of students enrolled has increased...... an impact on the educational systems in Scandinavia, and what possible futures can be envisioned?...... dramatically. In adjusting to the role of being a mass educational institution, universities have been challenged on how to cope with external pressures, such as forces of globalization and international markets, increased national and international competition for students and research grants, increased...

  14. Higher engineering mathematics

    CERN Document Server

    John Bird

    2014-01-01

    A practical introduction to the core mathematics principles required at higher engineering levelJohn Bird's approach to mathematics, based on numerous worked examples and interactive problems, is ideal for vocational students that require an advanced textbook.Theory is kept to a minimum, with the emphasis firmly placed on problem-solving skills, making this a thoroughly practical introduction to the advanced mathematics engineering that students need to master. The extensive and thorough topic coverage makes this an ideal text for upper level vocational courses. Now in

  15. On the Importance of the Flare's Late Phase for the Solar Extreme Ultraviolet Irradiance

    Science.gov (United States)

    Woods, Thomas N.; Eparvier, Frank; Jones, Andrew R.; Hock, Rachel; Chamberlin, Phillip C.; Klimchuk, James A.; Didkovsky, Leonid; Judge, Darrell; Mariska, John; Bailey, Scott; hide

    2011-01-01

    The new solar extreme ultraviolet (EUV) irradiance observations from NASA Solar Dynamics Observatory (SDO) have revealed a new class of solar flares that are referred to as late phase flares. These flares are characterized by the hot 2-5 MK coronal emissions (e.g., Fe XVI 33.5 nm) showing large secondary peaks that appear many minutes to hours after an eruptive flare event. In contrast, the cool 0.7-1.5 MK coronal emissions (e.g., Fe IX 17.1 nm) usually dim immediately after the flare onset and do not recover until after the delayed second peak of the hot coronal emissions. We refer to this period of 1-5 hours after the fl amrea sin phase as the late phase, and this late phase is uniquely different than long duration flares associated with 2-ribbon flares or large filament eruptions. Our analysis of the late phase flare events indicates that the late phase involves hot coronal loops near the flaring region, not directly related to the original flaring loop system but rather with the higher post-eruption fields. Another finding is that space weather applications concerning Earth s ionosphere and thermosphere need to consider these late phase flares because they can enhance the total EUV irradiance flare variation by a factor of 2 when the late phase contribution is included.

  16. Towards higher intensities

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    Over the past 2 weeks, commissioning of the machine protection system has advanced significantly, opening up the possibility of higher intensity collisions at 3.5 TeV. The intensity has been increased from 2 bunches of 1010 protons to 6 bunches of 2x1010 protons. Luminosities of 6x1028 cm-2s-1 have been achieved at the start of fills, a factor of 60 higher than those provided for the first collisions on 30 March.   The recent increase in LHC luminosity as recorded by the experiments. (Graph courtesy of the experiments and M. Ferro-Luzzi) To increase the luminosity further, the commissioning crews are now trying to push up the intensity of the individual proton bunches. After the successful injection of nominal intensity bunches containing 1.1x1011 protons, collisions were subsequently achieved at 450 GeV with these intensities. However, half-way through the first ramping of these nominal intensity bunches to 3.5 TeV on 15 May, a beam instability was observed, leading to partial beam loss...

  17. Origin and mixing timescale of Earth's late veneer

    Science.gov (United States)

    Prescher, C.; Allu Peddinti, D.; Bell, E. A.; Bello, L.; Cernok, A.; Ghosh, N.; Tucker, J.; Wielicki, M. M.; Zahnle, K. J.

    2012-12-01

    Experimental studies on the partitioning behavior of highly siderophile elements (HSE) between silicate and metallic melts imply that the Earth's mantle should have been highly depleted in these elements by core formation in an early magma ocean. However, present HSE contents of the Earth's mantle are ~3 orders of magnitude higher than that expected by experiments. The apparent over-abundance of HSE has commonly been explained by the addition of meteoritic material in the "late veneer" which describes the exogenous mass addition following the moon forming impact and concluding with the late heavy bombardment at ~3.8-3.9 Ga. The strongest evidence for this theory is that the platinum group element (PGE) contents in today's mantle are present in chondritic relative abundances, as opposed to a fractionated pattern expected with metal-silicate partitioning. Archean komatiites indicate that the PGE content of the Earth's mantle increased from about half their present abundances at 3.5 Ga to their present abundances at 2.9 Ga. This secular increase in PGE content suggests a progressive mixing of the late veneer material into the Earth's mantle. However, this time scale also implies that the whole mantle was relatively well mixed by 2.9 Ga. We use a compilation of existing isotopic and trace element data in order to constrain the origin and composition of the late veneer. We use PGE abundances, W abundances and W isotopic compositions in chondritic meteorites and the primitive upper mantle to compute the amount of mass delivered during the late veneer and find the late veneer mass to be ~0.6 % the mass of the bulk silicate Earth (consistent with earlier estimates). We also use the 187Re-187Os and 190Pt-186Os systems to constrain the composition and timing of delivery of the impacting population. We model the efficiency of mantle mixing in this time frame by using 3-dimensional numerical geodynamical simulations and geochemical constraints. Initial parameters include the

  18. Paternal exposure to cigarette smoke condensate leads to reproductive sequelae and developmental abnormalities in the offspring of mice.

    Science.gov (United States)

    Esakky, Prabagaran; Hansen, Deborah A; Drury, Andrea M; Felder, Paul; Cusumano, Andrew; Moley, Kelle H

    2016-10-01

    Paternal smoking is associated with infertility, birth defects and childhood cancers. Our earlier studies using cigarette smoke condensate (CSC) demonstrated several deleterious changes in male germ cells. Here, we hypothesize that chronic paternal exposure to CSC causes molecular and phenotypic changes in the sire and the offspring, respectively. In this mouse study, CSC caused DNA damage and cytotoxicity in testes via accumulation of benzo(a)pyrene (B[a]P) and cotinine. Decreased expression of growth arrest and DNA damage inducible alpha (Gadd45a), aryl hydrocarbon receptor (Ahr), and cyclin-dependent kinase inhibitor 1A (P21) was seen in CSC exposed testes. Apoptotic germ cell death was detected by induction of Fas, FasL, and activated caspase-3. The CSC-exposed males displayed reduction in sperm motility and fertilizing ability and sired pups with reduced body weight and crown-rump length, and smaller litter size with higher numbers of resorption. This model of CSC exposure demonstrates testicular toxicity and developmental defects in the offspring. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Teaching at higher levels

    Science.gov (United States)

    1998-11-01

    Undergraduate physics programmes for the 21st century were under discussion at a recent event held in Arlington, USA, open to two or three members of the physics faculties of universities from across the whole country. The conference was organized by the American Association of Physics Teachers with co-sponsorship from the American Institute of Physics, the American Physical Society and Project Kaleidoscope. Among the various aims were to learn about physics departments that have successfully revitalized their undergraduate physics programmes with innovative introductory physics courses and multi-track majors programmes. Engineers and life scientists were to be asked directly how physics programmes can better serve their students, and business leaders would be speaking on how physics departments can help to prepare their students for the diverse careers that they will eventually follow. It was planned to highlight ways that departments could fulfil their responsibilities towards trainee teachers, to identify the resources needed for revitalizing a department's programme, and to develop guidelines and recommendations for a funding programme to support collaborative efforts among physics departments for carrying out the enhancements required. More details about the conference can be found on the AAPT website (see http://www.aapt.org/programs/rupc.html). Meanwhile the UK's Higher Education Funding Council has proposed a two-pronged approach to the promotion of high quality teaching and learning, as well as widening participation in higher education from 1999-2000. A total of £60m should be available to support these initiatives by the year 2001-2002. As part of this scheme the Council will invite bids from institutions to support individual academics in enhancing learning and teaching, as well as in recognition of individual excellence. As with research grants, such awards would enable staff to pursue activities such as the development of teaching materials

  20. Severe Late Toxicities Following Concomitant Chemoradiotherapy Compared to Radiotherapy Alone in Cervical Cancer: An Inter-era Analysis

    International Nuclear Information System (INIS)

    Gondi, Vinai; Bentzen, Søren M.; Sklenar, Kathryn L.; Dunn, Emily F.; Petereit, Daniel G.; Tannehill, Scott P.; Straub, Margaret; Bradley, Kristin A.

    2012-01-01

    Purpose: To compare rates of severe late toxicities following concomitant chemoradiotherapy and radiotherapy alone for cervical cancer. Methods and Materials: Patients with cervical cancer were treated at a single institution with radiotherapy alone or concomitant chemoradiotherapy for curative intent. Severe late toxicity was defined as grade ≥3 vaginal, urologic, or gastrointestinal toxicity or any pelvic fracture, using Common Terminology Criteria for Adverse Events version 4.0 (CTCAE), occurring ≥6 months from treatment completion and predating any salvage therapy. Severe late toxicity rates were compared after adjusting for pertinent covariates. Results: At 3 years, probability of vaginal severe late toxicity was 20.2% for radiotherapy alone and 35.1% for concomitant chemoradiotherapy (P=.026). At 3 years, probability of skeletal severe late toxicity was 1.6% for radiotherapy alone and 7.5% for concomitant chemoradiotherapy (P=.010). After adjustment for case mix, concomitant chemoradiotherapy was associated with higher vaginal (hazard ratio [HR] 3.0, 95% confidence interval [CI], 1.7-5.2, P 50 was associated with higher vaginal (HR 1.8, 95% CI 1.1-3.0, P=.013) and skeletal (HR 5.7, 95% CI 1.2-27.0, P=.028) severe late toxicity. Concomitant chemoradiotherapy was not associated with higher gastrointestinal (P=.886) or urologic (unadjusted, P=.053; adjusted, P=.063) severe late toxicity. Conclusion: Compared to radiotherapy alone, concomitant chemoradiotherapy is associated with higher rates of severe vaginal and skeletal late toxicities. Other predictive factors include dilator compliance for severe vaginal late toxicity and age for severe vaginal and skeletal late toxicities.

  1. Higher Order Mode Fibers

    DEFF Research Database (Denmark)

    Israelsen, Stine Møller

    This PhD thesis considers higher order modes (HOMs) in optical fibers. That includes their excitation and characteristics. Within the last decades, HOMs have been applied both for space multiplexing in optical communications, group velocity dispersion management and sensing among others......-radial polarization as opposed to the linear polarization of the LP0X modes. The effect is investigated numerically in a double cladding fiber with an outer aircladding using a full vectorial modesolver. Experimentally, the bowtie modes are excited using a long period grating and their free space characteristics...... and polarization state are investigated. For this fiber, the onset of the bowtie effect is shown numerically to be LP011. The characteristics usually associated with Bessel-likes modes such as long diffraction free length and selfhealing are shown to be conserved despite the lack of azimuthal symmetry...

  2. Spiky higher genus strings

    International Nuclear Information System (INIS)

    Ambjoern, J.; Bellini, A.; Johnston, D.

    1990-10-01

    It is clear from both the non-perturbative and perturbative approaches to two-dimensional quantum gravity that a new strong coupling regime is setting in at d=1, independent of the genus of the worldsheet being considered. It has been suggested that a Kosterlitz-Thouless (KT) phase transition in the Liouville theory is the cause of this behaviour. However, it has recently been pointed out that the XY model, which displays a KT transition on the plane and the sphere, is always in the strong coupling, disordered phase on a surface of constant negative curvature. A higher genus worldsheet can be represented as a fundamental region on just such a surface, which might seem to suggest that the KT picture predicts a strong coupling region for arbitrary d, contradicting the known results. We resolve the apparent paradox. (orig.)

  3. Relationship between acute and late normal tissue injury after postoperative radiotherapy in endometrial cancer

    International Nuclear Information System (INIS)

    Jereczek-Fossa, Barbara A.; Jassem, Jacek; Badzio, Andrzej

    2002-01-01

    bowel and bladder toxicity did not correlate with the time to occurrence of late toxicity in these locations (p=0.34 and p=0.47, respectively). Conclusion: Patients with increased acute bowel toxicity during postoperative RT for endometrial cancer have an increased risk of late bowel injury. A higher grade of acute bowel complications correlated with more severe late events, but was not predictive for its latency time. These findings suggest the possibility of an early indication of patients with an increased risk of late toxicity in whom preventive measures might be attempted

  4. A Comparative Study on the Efficacy of Submucosal Injection of Dexamethasone Versus Methylprednisolone in Reducing Postoperative Sequelae After Third Molar Surgery.

    Science.gov (United States)

    Lim, Daniel; Ngeow, Wei Cheong

    2017-11-01

    To compare the efficacy of preoperative submucosal injection of 4 mg of dexamethasone versus 40 mg of methylprednisolone in reducing postoperative sequelae after surgical removal of impacted mandibular third molars. This prospective, randomized, double-blind study included 65 patients who required surgical removal of impacted mandibular third molars with Class II or position B impaction (Pell and Gregory classification). Patients were randomly assigned to 1 of 3 groups: dexamethasone, methylprednisolone, or placebo (control). Surgery was performed with patients under local anesthesia. Baseline measurements were obtained preoperatively, and subsequent assessments were made on postoperative day 1, 2, 5, and 7 to measure postoperative facial swelling by use of 2 linear measurements: interincisal mouth opening width and visual analog scale score for pain. The amount of analgesics consumed was recorded. Wound healing also was assessed on postoperative day 7. Descriptive and multivariate statistics were computed, and significance was set at P Kruskal-Wallis test), whereas the methylprednisolone group had significantly less pain (P Kruskal-Wallis test) and consumed a lower amount of analgesics (P test) during the early postoperative days. The study findings suggest that a single preoperative dose of dexamethasone versus methylprednisolone was equally effective in reducing postoperative swelling and trismus. Pain control by these corticosteroids, however, was variable. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Culture Negative Listeria monocytogenes Meningitis Resulting in Hydrocephalus and Severe Neurological Sequelae in a Previously Healthy Immunocompetent Man with Penicillin Allergy

    Directory of Open Access Journals (Sweden)

    Shahin Gaini

    2015-01-01

    Full Text Available A previously healthy 74-year-old Caucasian man with penicillin allergy was admitted with evolving headache, confusion, fever, and neck stiffness. Treatment for bacterial meningitis with dexamethasone and monotherapy ceftriaxone was started. The cerebrospinal fluid showed negative microscopy for bacteria, no bacterial growth, and negative polymerase chain reaction for bacterial DNA. The patient developed hydrocephalus on a second CT scan of the brain on the 5th day of admission. An external ventricular catheter was inserted and Listeria monocytogenes grew in the cerebrospinal fluid from the catheter. The patient had severe neurological sequelae. This case report emphasises the importance of covering empirically for Listeria monocytogenes in all patients with penicillin allergy with suspected bacterial meningitis. The case also shows that it is possible to have significant infection and inflammation even with negative microscopy, negative cultures, and negative broad range polymerase chain reaction in cases of Listeria meningitis. Follow-up spinal taps can be necessary to detect the presence of Listeria monocytogenes.

  6. Effects of “Danzhi Decoction” on Chronic Pelvic Pain, Hemodynamics, and Proinflammatory Factors in the Murine Model of Sequelae of Pelvic Inflammatory Disease

    Directory of Open Access Journals (Sweden)

    Xiaoling Bu

    2015-01-01

    Full Text Available Objective. To evaluate the effect of Danzhi decoction (DZD on chronic pelvic pain (CPP, hemodynamics, and proinflammatory factors of sequelae of pelvic inflammatory diseases (SPID in murine model. Methods. SPID mice were randomly treated with high-dose DZD, mid-dose DZD, low-dose DZD, aspirin, and vehicle for 3 estrous circles. The Mouse Grimace Scale (MGS was performed to evaluate CPP; blood flows of the upper genital tract, pelvic wall, and mesentery were used to assess hemodynamics in SPID mice; expressions of vascular endothelial growth factor (VEGF, angiopoietin-2 (Ang-2, and osteopontin (OPN were measured by Western blot and immunochemistry. Results. Treatment with dose-dependent DZD significantly decreased the MGS scores, accelerated blood flows of the pelvis, and reduced expressions of VEGF, Ang-2, and OPN in the upper genital tract. Conclusions and Discussions. DZD was effective in relieving CPP and improving hemodynamics of the pelvic blood-stasis microenvironment in SPID mice. There was a relationship between CPP and the pelvic blood-stasis microenvironment. Furthermore, DZD might play a positive role in the anti-inflammatory process.

  7. Psychiatric Sequelae of Former “Comfort Women,” Survivors of the Japanese Military Sexual Slavery during World War II

    Science.gov (United States)

    Lee, Jeewon; Kwak, Young-Sook; Kim, Yoon-Jung; Kim, Eun-Ji; Park, E Jin; Shin, Yunmi; Lee, Bun-Hee; Lee, So Hee; Jung, Hee Yeon; Lee, Inseon; Hwang, Jung Im; Kim, Dongsik; Lee, Soyoung Irene

    2018-01-01

    “Comfort women” refers to young women and girls who were forced into sexual slavery by the Imperial Japanese military during World War II. They were abducted from their homes in countries under Imperial Japanese rule, mostly from Korea, and the rest from China, Philippines, Malaysia, Taiwan, Indonesia, the Netherlands, etc. “Comfort women” endured extreme trauma involving rape, sexual torture, physical abuse, starvation, threats of death, and witnessed many others being tortured and killed. This article reviews all the studies that have investigated the psychiatric or psychosocial sequelae of the survivors of the Japanese military sexual slavery. Most importantly, a recent study which conducted a psychiatric evaluation on the former “comfort women” currently alive in South Korea is introduced. The participants’ unmarried rate was relatively high and their total fertility rate was relatively low. Majority of the participants reported having no education and being the low economic status. They showed high current and lifetime prevalence of posttraumatic disorder, major depressive disorder, somatic symptom disorder, social anxiety disorder, panic disorder, and alcohol use disorder. Participants showed high suicidality and majority of the participants still reported being ashamed of being former “comfort women” after all these years. This article high-lights the fact that the trauma has affected the mental health and social functioning of former “comfort women” throughout their lives, and even to the present day. PMID:29669407

  8. A Comparative Clinical Evaluation of the Effect of Preoperative and Postoperative Antimicrobial Therapy on Postoperative Sequelae after Impacted Mandibular Third Molar Extraction

    Directory of Open Access Journals (Sweden)

    Olurotimi Akanbi Olojede

    2014-07-01

    Full Text Available Objectives: To compare the effect of preoperative and postoperative antibiotics therapy on postoperative sequelae after impacted mandibular third molar extractions. Material and Methods: This was a prospective study conducted at Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospitalon consecutive patients with impacted third molar extractions for a 12 month period. Group I (n = 31 had administration of 1 gram of oral metronidazole and 1 gram of amoxicillin capsules 30 minutes preoperative and Group II (n = 31 had 500 milligrams of amoxicillin capsule 8 hourly and 400 milligrams of metronidazole tablets administered post operatively for 5 days. Pain, facial swelling and mouth opening assessment were done postoperatively and on days 1, 3 and 7. Results: The general pattern of postoperative pain, regardless of antimicrobial use revealed that pain increased from day 1 to day 3 postoperatively and began to decrease in intensity subsequently up to the seventh day. There was however a statistically significant difference (P = 0.0001 between the two groups on the 7th postoperative day with the subjects in Group I showing lower pain intensity. The mean difference of the facial width on days 1 and 3 was significant (P = 0.04 and P = 0.0001 respectively with subjects in Group II having a reduced facial width compared to those in Group I. Conclusions: This study suggested that the administration of preoperative or postoperative antibiotics showed no marked differences in the degree of postoperative sequaele that occur after impacted mandibular third molar extractions.

  9. Data on medicinal plants used in Central America to manage diabetes and its sequelae (skin conditions, cardiovascular disease, kidney disease, urinary problems and vision loss

    Directory of Open Access Journals (Sweden)

    Peter Giovannini

    2016-06-01

    Full Text Available The data described in this article is related to the review article “Medicinal plants used in the traditional management of diabetes and its sequelae in Central America: a review” (Giovannini et al., 2016 [1]. We searched publications on the useful plants of Central America in databases and journals by using selected relevant keywords. We then extracted reported uses of medicinal plants within the disease categories: diabetes mellitus, kidney disease, urinary problems, skin diseases and infections, cardiovascular disease, sexual dysfunction, vision loss, and nerve damage. The following countries were included in our definition of Central America: Belize, Guatemala, Honduras, El Salvador, Nicaragua, Costa Rica and Panama. Data were compiled in a bespoke Access database. Plant names from the published sources were validated against The Plant List (TPL, (The Plant List, 2013 [2] and accepted names and synonyms were extracted. In total, the database includes 607 plant names obtained from the published sources which correspond to 537 plant taxa, 9271 synonyms and 1055 use reports.

  10. Paradox of Prescribing Late Chemotherapy: Oncologists Explain.

    Science.gov (United States)

    Bluhm, Minnie; Connell, Cathleen M; De Vries, Raymond G; Janz, Nancy K; Bickel, Kathleen E; Silveira, Maria J

    2016-12-01

    The value of chemotherapy for patients with cancer in the last weeks of life warrants examination. Late chemotherapy may not improve survival or quality of life but typically precludes hospice enrollment and may result in additional symptoms, increased use of other aggressive treatments, and worsening quality of life. Few studies have explored oncologists' rationales for administering chemotherapy near death. This study examines the self-reported factors that influence oncologists' decisions about late chemotherapy. In-depth individual interviews were conducted with 17 oncologists through a semistructured interview guide. Interviews were audio recorded and transcribed verbatim. Transcripts were coded and analyzed using conventional content analysis, a qualitative method that allows the detection and analysis of patterns in the data. Clinical factors take priority in determining late chemotherapy decisions when clear treatment choices exist. When clinical factors are ambiguous, emotion becomes a highly salient influence. Oncologists view late chemotherapy to be patient driven and use it to palliate emotional distress and maintain patient hope even when physical benefit is unexpected. Oncologists experience unique and difficult challenges when caring for dying patients, including emotionally draining communication, overwhelming responsibility for life/death, limitations of oncology to heal, and prognostic uncertainty. These challenges are also eased by offering late chemotherapy. The findings reveal a nuanced understanding of why oncologists find it difficult to refuse chemotherapy treatment for patients near death. Optimal end-of-life treatment decisions require supportive interventions and system change, both of which must take into account the challenges oncologists face.

  11. The polyimage poetics in Ibsen's late plays

    Directory of Open Access Journals (Sweden)

    Wang Yuli

    2015-02-01

    Full Text Available The unique poetics of polyimage implied in Ibsen’s late plays can be excavated with aesthetic reading. The term polyimage is coined to describe Ibsen’s original design in aesthetic form and ingenious realm in aesthetic reaction in his late plays; that is, beyond an imagery realm, another imagery realm exists, which construct a deep vision of significance. In each of the excellent late plays, what Ibsen creates is one or more veiled holistic imagery realms in addition to an ordinary entire imagery realm perceived by most audiences. The “layers of imagery realm” result from Ibsen’s “double self-examinations”, including self-examination of soul and of art. It is these “double self-examinations” that make polyimage possible in his late plays and generates the attribute of “meta-art” in these works. Compared with polyphony in Dostoevsky’s novels, the polyimage in Ibsen’s late plays contains a unique modernity, which is of great significance to modern artistic creation.

  12. Pathological review of late cerebral radionecrosis

    International Nuclear Information System (INIS)

    Yoshii, Yoshihiko

    2008-01-01

    Late cerebral radionecrosis may be considered to be a specific chronic inflammatory response, although it is unknown whether the initial damage by brain irradiation is to an endothelial cell or a glial cell. I discuss the pathological specificity of late cerebral radionecrosis by studying the published literature and a case that I experienced. In late cerebral radionecrosis, there are typical coagulation necrosis areas containing fibrinoid necrosis with occlusion of the lumina and poorly active inflammatory areas with many inflammatory ghost cells, focal perivascular lymphocytes, hyalinized vessels, and telangiectatic vascularization near and in the necrotic tissue, and more active inflammatory areas formed as a partial rim of the reactive zone by perivascular lymphocytes, much vascularization, and glial fibrillary acidic protein (GFAP)-positive astrocytes at the corticomedullary border adjacent to necrotic tissue in the white matter. It is difficult to believe that coagulation necrosis occurs without first disordering the vascular endothelial cells because fibrinoid necrosis is a main feature and a diffusely multiple lesion in late cerebral radionecrosis. Because various histological findings do develop, progress, and extend sporadically at different areas and times in the irradiated field of the brain for a long time after radiation, uncontrolled chronic inflammation containing various cytokine secretions may also play a key role in progression of this radionecrosis. Evaluation of the mechanism of the development/aggravation of late cerebral radionecrosis requires a further study for abnormal cytokine secretions and aberrant inflammatory reactions. (author)

  13. Early- versus Late-Onset Dysthymia

    Science.gov (United States)

    Sansone, Lori A.

    2009-01-01

    In the current Diagnostic and Statistical Manual of Mental Disorders, dysthymic disorder is categorized as either early-onset or late-onset, based upon the emergence of symptoms before or after the age of 21, respectively. Does this diagnostic distinction have any meaningful clinical implications? In this edition of The Interface, we present empirical studies that have, within a single study, compared individuals with early-versus late-onset dysthymia. In this review, we found that, compared to those with late-onset dysthymia, early-onset patients are more likely to harbor psychiatric comorbidity both on Axis I and II, exhibit less psychological resilience, and have more prominent family loadings for mood disorders. These findings suggest that this distinction is meaningful and that the early-onset subtype of dysthymia is more difficult to effectively treat. PMID:20049145

  14. Mobile ICT Acceptance in Late Adopter Countries

    DEFF Research Database (Denmark)

    Gimpel, Gregory; Sudzina, Frantisek; Petrovcikova, Katarina

    2014-01-01

    Despite the rapid global diffusion of the smartphone, some countries have experienced much slower uptake of the technology. The low smartphone penetration within Slovakia provides the opportunity to explore what drives smartphone use in late majority countries. Slovakia is a central European nation...... and part of the Eurozone. It has advanced telecommunications infrastructure and is subject to the same telecommunications regulations as other EU members. While neighbours have high smartphone penetration, Slovakia is a late majority adopter. This study uses Triandis’ theory of interpersonal behavior...... to investigate the question: What drives the use of smartphones in late majority countries? By studying the differences between current and potential smartphone users, the study revisits Karahanna et al.’s research question: Do potential adopters and users of IT hold the same behavioral and normative beliefs...

  15. Climate predictors of late quaternary extinctions

    DEFF Research Database (Denmark)

    Nogués-Bravo, David; Ohlemüller, Ralf; Batra, Persaram

    2010-01-01

    Between 50,000 and 3,000 years before present (BP) 65% of mammal genera weighing over 44 kg went extinct, together with a lower proportion of small mammals. Why species went extinct in such large numbers is hotly debated. One of the arguments proposes that climate changes underlie Late Quaternary...... extinctions, but global quantitative evidence for this hypothesis is still lacking. We test the potential role of global climate change on the extinction of mammals during the Late Quaternary. Our results suggest that continents with the highest climate footprint values, in other words, with climate changes...... of greater magnitudes during the Late Quaternary, witnessed more extinctions than continents with lower climate footprint values, with the exception of South America. Our results are consistent across species with different body masses, reinforcing the view that past climate changes contributed to global...

  16. Learning higher mathematics

    CERN Document Server

    Pontrjagin, Lev Semenovič

    1984-01-01

    Lev Semenovic Pontrjagin (1908) is one of the outstanding figures in 20th century mathematics. In a long career he has made fundamental con­ tributions to many branches of mathematics, both pure and applied. He has received every honor that a grateful government can bestow. Though in no way constrained to do so, he has through the years taught mathematics courses at Moscow State University. In the year 1975 he set himself the task of writing a series of books on secondary school and beginning university mathematics. In his own words, "I wished to set forth the foundations of higher mathematics in a form that would have been accessible to myself as a lad, but making use of all my experience as a scientist and a teacher, ac­ cumulated over many years. " The present volume is a translation of the first two out of four moderately sized volumes on this theme planned by Pro­ fessor Pontrjagin. The book begins at the beginning of modern mathematics, analytic ge­ ometry in the plane and 3-dimensional space. Refin...

  17. Late Cretaceous vicariance in Gondwanan amphibians.

    Directory of Open Access Journals (Sweden)

    Ines Van Bocxlaer

    Full Text Available Overseas dispersals are often invoked when Southern Hemisphere terrestrial and freshwater organism phylogenies do not fit the sequence or timing of Gondwana fragmentation. We used dispersal-vicariance analyses and molecular timetrees to show that two species-rich frog groups, Microhylidae and Natatanura, display congruent patterns of spatial and temporal diversification among Gondwanan plates in the Late Cretaceous, long after the presumed major tectonic break-up events. Because amphibians are notoriously salt-intolerant, these analogies are best explained by simultaneous vicariance, rather than by oceanic dispersal. Hence our results imply Late Cretaceous connections between most adjacent Gondwanan landmasses, an essential concept for biogeographic and palaeomap reconstructions.

  18. A case of late-onset oligomeganephronia

    Directory of Open Access Journals (Sweden)

    Rafael José Vargas Alves

    2012-12-01

    Full Text Available A 33-year old caucasian man was investigated for pain in the right flank, proteinuria, hemathuria and an elevated serum creatinine level. He also presented an abnormal ultrasonography, which revealed asymmetric kidneys. Through renal biopsy, the diagnosis of oligomeganephronia (OMN was confirmed. OMN is a very rare form of renal hypoplasia, and late-onset in adulthood is even rarer. In the pediatric population, OMN leads to end-stage-renal-failure(ESRF in a few years. This is the sixth case related in the literature of a late-onset OMN who have not yet developed ESRF.

  19. Late complication after radiotherapy for testicular tumor

    Energy Technology Data Exchange (ETDEWEB)

    Mineyama, Hirotada; Komatsubara, Shuichi; Sakata, Yasunosuke; Abe, Norio (Niigata Prefectural Cancer Center (Japan). Niigata Hospital)

    1983-12-01

    During the past 21 years, 105 patients with germinal testicular tumor were treated in our hospital; 86 out of 105 patients were irradiated postoperatively. Late radiation injury was observed in 14 patients: Cutaneosigmoidal fistula in 1 patient, ileus (jejunum necrosis) in 1 patient, gastric ulcer in 1 patient, duodenal ulcer and stenosis in 1 patient, lung fibrosis in 1 patient, radiation cystitis in 1 patient, severe lymph edema of lower extremity in 1 patient, muscle atrophy of lower extremity in 1 patient, lower extremity growth disturbances in 3 children and severe abdominal cutancosubcutaneal fibrosis in 3 patient. Two cases of late radiation injury are presented and discussed.

  20. Correlates and prevalence of hypogonadism in patients with early- and late-onset type 2 diabetes.

    Science.gov (United States)

    Li, Y; Zhang, M; Liu, X; Cui, W; Rampersad, S; Li, F; Lin, Z; Yang, P; Li, H; Sheng, C; Cheng, X; Qu, S

    2017-07-01

    This study aims to compare the prevalence of hypogonadism between male patients with early-onset type 2 diabetes mellitus (T2DM) and late-onset type 2 diabetes. A total of 122 male patients with early-onset T2DM (diagnosis age ≤40 years) and 100 male patients with late-onset T2DM (diagnosis age >40 years) were recruited from our in-patient department between 1 January 2013 and 28 December 2015. Serum FSH, LH, testosterone, lipid profile, uric acid, HbA1c, and beta-cell function were determined in blood samples. The diagnosis of hypogonadism was based on the levels of LH, FSH, and total testosterone. The mean onset age was 29.86 ± 6.31 and 54.47 ± 9.97 years old in the early-onset group and late-onset group, respectively. Compared with late-onset T2DM, those with early-onset T2DM had a higher proportion of new-onset diabetes, were more likely to be obese, and had worse glycemic control, lipid control, and lower sex hormone-binding globulin (SHBG). The prevalence of hypogonadism was much higher in the early-onset group than in the late-onset group (48.0% vs. 26.7%, p hypogonadism in the early-onset group and late-onset group were 44.3% and 25.0%, respectively (p hypogonadism was higher in the patients with early-onset T2DM than that of late-onset T2DM. This prevalence might be attributable to greater obesity, worse lipid control, and lower SHBG levels in those patients. © 2017 American Society of Andrology and European Academy of Andrology.

  1. Higher Efficiency HVAC Motors

    Energy Technology Data Exchange (ETDEWEB)

    Flynn, Charles Joseph [QM Power, Inc., Kansas City, MO (United States)

    2018-02-13

    failure prone capacitors from the power stage. Q-Sync’s simpler electronics also result in higher efficiency because it eliminates the power required by the PCB to perform the obviated power conversions and PWM processes after line synchronous operating speed is reached in the first 5 seconds of operation, after which the PWM circuits drop out and a much less energy intensive “pass through” circuit takes over, allowing the grid-supplied AC power to sustain the motor’s ongoing operation.

  2. Study of cerebral vascular diseases with radioisotopes in cerebral atherosclerotical subjects and/for subjects with sequelae of cerebral stroke, before and after use of the association piracetam-dihydroergotoxine

    International Nuclear Information System (INIS)

    Lara, P.F.; Ferreira, A.; Paulillo, L.F.; Cukierman, M.

    1985-01-01

    Twently subjects with cerebral sclerosis and/or sequelas of cerebral stroke were studied, before and after use of piracetam-dihydroergotoxine. We performed the complete hemispheric cerebral blood flow and cerebral scintigraphy, beyond clinical and neurological examination. Scintigraphies were unchanged. Cerebral circulation times, or both hemispheres, diminished. This occurred, probably, in relation with metabolic effects of both pharmaceutical drugs. The alpha sympatolytic and modulatory effects of dihydroergotoxine should be considered. (author) [pt

  3. Progression of Late-Onset Stargardt Disease

    NARCIS (Netherlands)

    Lambertus, S.; Lindner, M.; Bax, N.M.; Mauschitz, M.M.; Nadal, J.; Schmid, M.; Schmitz-Valckenberg, S.; Hollander, A.I. den; Weber, B.H.; Holz, F.G.; Wilt, G.J. van der; Fleckenstein, M.; Hoyng, C.B.

    2016-01-01

    Purpose: Identification of sensitive biomarkers is essential to determine potential effects of emerging therapeutic trials for Stargardt disease. This study aimed to describe the natural history of late-onset Stargardt, and demonstrates the accuracy of retinal pigment epithelium (RPE) atrophy

  4. Late effects of radiation: host factors

    International Nuclear Information System (INIS)

    Fry, R.J.M.; Storer, J.B.

    1983-01-01

    The paper discusses the influence of host factors on radiation late effects and in particular cancer. Radiation induces cellular changes that result in initiated cells with a potential to become cancers. The expression of the initiated cells as tumors is influenced, if not determined, by both tissue and systemic factors that are sex-, age-, and species-dependent

  5. 30 CFR 870.21 - Late payments.

    Science.gov (United States)

    2010-07-01

    ... Government. The Treasury current value of funds rate is published annually in the Federal Register and on... fees and interest. (c) When a reclamation fee debt is more than 91 days overdue, a 6 percent annual... fee was owed are subject to interest. Late reclamation fee payments are subject to interest at the...

  6. Late time phase transition as dark energy

    Indian Academy of Sciences (India)

    Abstract. We show that the dark energy field can naturally be described by the scalar condensates of a non-abelian gauge group. This gauge group is unified with the standard model gauge groups and it has a late time phase transition. The small phase transition explains why the positive acceleration of the universe is ...

  7. Late Miocene magnetostratigraphy in the Mediterranean

    NARCIS (Netherlands)

    Langereis, C.G.

    1984-01-01

    Reversals of the geomagnetic field In the geological past are recorded globally in the natural remanent magnetization (NRM) of igneous and sedimentary rock sequences. The accurate and rei iable reconstruction of this record is the basis of magnetostratigraphy. The magnetostratigraphy of Late

  8. Late Miocene magnetostratigraphy in the Mediterranean

    NARCIS (Netherlands)

    Langereis, C.G.

    1984-01-01

    Reversals of the geomagnetic field In the geological past are recorded globally in the natural remanent magnetization (NRM) of igneous and sedimentary rock sequences. The accurate and rei iable reconstruction of this record is the basis of magnetostratigraphy. The magnetostratigraphy of Late Miocene

  9. Language Control Abilities of Late Bilinguals

    Science.gov (United States)

    Festman, Julia

    2012-01-01

    Although all bilinguals encounter cross-language interference (CLI), some bilinguals are more susceptible to interference than others. Here, we report on language performance of late bilinguals (Russian/German) on two bilingual tasks (interview, verbal fluency), their language use and switching habits. The only between-group difference was CLI:…

  10. Causes for Late onset Alcohol Use Disorder

    DEFF Research Database (Denmark)

    Emiliussen, Jakob; Nielsen, Anette Søgaard; Andersen, Kjeld

    the studies. The results of this review are generally inconclusive. In spite of the low quality scores, we did find that chronic stress, role/identity loss and friends approval of drinking, was associated with an increased risk for late-onset AUD whereas retirement, death of spouse or close relative does...

  11. The late Cainozoic East Antarctic ice sheet

    International Nuclear Information System (INIS)

    Colhoun, E.A.

    1999-01-01

    A review, mainly of East Antarctic late Cainozoic (post 40 Ma) geological and geomorphological evidence, supports the hypothesis of the continuous presence of an ice sheet, of about the present size, since the late Miocene. Evidence is presented and the view advanced that, during the late Wisconsin maximum of isotope stage 2, ice was not nearly as thick or extensive over the continental shelf as required by the model of 'maximum' Antarctic glaciation. Some of the factors influencing the contribution of Antarctica to post-glacial sea-level rise are discussed. It is considered that Antarctica's contribution was probably considerably less than previously estimated. The dating of marine and freshwater sequences in the Vestfold and Bunger Hills is consistent with deglaciation around the Pleistocene Holocene boundary, after the Late Wisconsin maximum. A date of ∼25 ka BP from permafrost in the Larsemann Hills means that either the Larsemann Hills were not glaciated during the Late Wisconsin or the ice failed to erode much of the permafrost surface. The degree of weathering of rock and glacial drifts in the Vestfold, Larsemann and Bunger Hills suggests a long time for formation, perhaps considerably longer than indicated by the dated marine and freshwater sediment sequences. Cosmogenic isotope dating in the Vestfold Hills has provided equivocal ages for deglaciation. While the results could indicate deglaciation before 80 ka BP, they do not confirm such early deglaciation. If the ice cover was thin and failed to remove the previous rock exposure profile, then the assays could predate the last ice advance. Weathered iron crust fragments in the till suggest little erosion. The raised beaches of the oases are Holocene. Assuming they have been produced by post Late Wisconsin isostatic uplift and by the Holocene transgression, calculations show that the Antarctic continental ice sheet could not have been more than ∼500 m thicker in the inner shelf-coastal zone. The

  12. Secuelas de la violencia colectiva: hablan las víctimas del estudio ISAVIC Sequelae of collective violen victims' voices in the ISAVIC study

    Directory of Open Access Journals (Sweden)

    Itziar Larizgoitia

    2011-04-01

    estimate the effects of collective violence on health. The assessment included victims' perceptions of these sequelae and their impact on health. Methods: A purposive sample of 36 primary victims was selected through contact networks and mediators. The victims' perceptions were collected through semi-structured in-depth interviews, which were later analyzed according to the study's conceptual framework. Results: The victims' testimony suggests that they were profoundly traumatized by the collective violence experienced, which was often not yet completely overcome and significantly impaired their quality of life. The main functional, physical, emotional and social limitations described by the victims were identified. Conclusions: The qualitative results of this study are coherent with those obtained through the parametric phase of the ISAVIC study and provide a more complete overview of the nature of the sequelae of collective violence and its impact on quality of life. These results should be verified in larger studies and the influence of the social context on the relationship between collective violence and health should be analyzed in greater depth.

  13. Simultaneous occurrence of a severe Morel-Lavallée lesion and gluteal muscle necrosis as a sequela of transcatheter angiographic embolization following pelvic fracture: a case report.

    Science.gov (United States)

    Shimizu, Takayoshi; Matsuda, Shuichi; Sakuragi, Atsushi; Tsukie, Tomio; Kawanabe, Keiichi

    2015-03-26

    Morel-Lavallée lesions are posttraumatic hemolymphatic collections caused by disruption of the interfascial planes between the subcutaneous soft tissue and muscle. Severe peripelvic Morel-Lavallée lesions have rarely been reported in the literature. By contrast, a number of cases of gluteal muscle necrosis following transcatheter angiographic embolization for pelvic fracture have been reported. Each entity can result in severe infection and sepsis, and the mortality rate in such cases is quite high. However, to date, no previous reports have described a case in which these life-threatening entities occurred simultaneously. A 32-year-old Asian man simultaneously developed severe peripelvic Morel-Lavallée lesions and gluteal muscle necrosis with sepsis following transcatheter angiographic embolization after an unstable pelvic fracture. Extremely large skin and soft tissue defects, which were untreatable with any commonly used flaps, were generated after repeated debridement. In addition, a deep-bone infection was suspected in his left fractured iliac bone, while motor function was almost completely lost in his left leg, possibly as a sequela of transcatheter angiographic embolization. As a result of his condition, a left hemipelvectomy was unavoidable. A pedicled fillet flap from his sacrificed left limb was used for the treatment of the defects and to provide a durable base for a prosthesis. Our patient survived and returned to his previous job 24 months after the surgery wearing a prosthetic left leg. As illustrated by the present case, severe peripelvic Morel-Lavallée lesions and gluteal muscle necrosis following transcatheter angiographic embolization can occur simultaneously after unstable pelvic fractures. Physicians should recognize that these entities can result in life-threatening sepsis and, therefore, should attempt to detect them as early as possible. When hemipelvectomy is unavoidable, a pedicled upper and lower leg in-continuity fillet flap may

  14. Psychosocial predator-based animal model of PTSD produces physiological and behavioral sequelae and a traumatic memory four months following stress onset.

    Science.gov (United States)

    Zoladz, Phillip R; Park, Collin R; Fleshner, Monika; Diamond, David M

    2015-08-01

    We have a well-established animal model of PTSD composed of predator exposure administered in conjunction with social instability that produces PTSD-like behavioral and physiological abnormalities one month after stress initiation. Here, we assessed whether the PTSD-like effects would persist for at least 4months after the initiation of the psychosocial stress regimen. Adult male Sprague-Dawley rats were exposed to either 2 or 3 predator-based fear conditioning sessions. During each session, rats were placed in a chamber for a 3-min period that terminated with a 30-s tone, followed by 1h of immobilization of the rats during cat exposure (Day 1). All rats in the stress groups received a second fear conditioning session 10days later (Day 11). Half of the stress rats received a third fear conditioning session 3weeks later (Day 32). The two cat-exposed groups were also exposed to daily unstable housing conditions for the entire duration of the psychosocial stress regimen. The control group received stable (conventional) housing conditions and an equivalent amount of chamber exposure on Days 1, 11 and 32, without cat exposure. Behavioral testing commenced for all groups on Day 116. The stress groups demonstrated increased anxiety on the elevated plus maze, impaired object recognition memory and robust contextual and cued fear conditioned memory 3months after the last conditioning session. Combined data from the two stress groups revealed lower post-stress corticosterone levels and greater diastolic blood pressure relative to the control group. These findings indicate that predator-based psychosocial stress produces persistent PTSD-like physiological and behavioral abnormalities that may provide insight into the neurobiological and endocrine sequelae in traumatized people with PTSD. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Reproductive rights: Current issues of late abortion

    Directory of Open Access Journals (Sweden)

    Mujović-Zornić Hajrija

    2009-01-01

    Full Text Available This article considers the legal issues surrounding induced late abortion in cases when severe medical, therapeutic or ethical reasons have not been in dispute. Generally discussing the essential question about abortion today, it means not anymore legality of abortion but, in the first place, safety of abortion. From the aspect of woman health the most important aim is to detect and avoid possible risks of medical intervention, such as late abortion present. This is the matter of medical law context and also the matter of the woman's reproductive rights, here observed through legislation and court practice. The gynecologist has an obligation to obtain the informed consent of each patient. Information's should be presented in reasonably understandable terms and include alternative modes of treatment, objectives, risks, benefits, possible complications, and anticipated results of such treatment. Pregnant woman should receive supportive counseling before and particularly after the procedure. The method chosen for all terminations should ensure that the fetus is born dead. This should be undertaken by an appropriately trained practitioner. Reform in abortion law, making it legally accessible to woman, is not necessarily the product of a belief in woman's rights, but can be a means of bringing the practice of abortion back under better control. Counseling and good medical practice in performing late abortion are the instruments to drive this point even further home. It does not undermine the woman who wants to make a positive decision about her life and its purpose is not to produce feelings of insecurity and guilt. It concludes that existing law should not be changed but that clear rules should be devised and board created to review late term abortion. In Serbia, this leads to creation and set up guidelines for reconciling medical justification for late abortion with existing law, especially with solutions which brings comparative law. .

  16. LATE RENAL GRAFT REJECTION: PATHOLOGY AND PROGNOSIS

    Directory of Open Access Journals (Sweden)

    E.S. Stolyarevich

    2014-01-01

    Full Text Available Rejection has always been one of the most important cause of late renal graft dysfunction. Aim of the study was to analyze the prevalence of different clinico-pathological variants of rejection that cause late graft dysfunction, and evaluate their impact on long-term outcome. Materials and methods. This is a retrospective study that analyzed 294 needle core biopsy specimens from 265 renal transplant recipients with late (48,8 ± 46,1 months after transplantation allograft dysfunction caused by late acute rejection (LAR, n = 193 or chronic rejection (CR, n = 78 or both (n = 23. C4d staining was performed by immunofl uorescence (IF on frozen sections using a standard protocol. Results. Peritubular capillary C4d deposition was identifi ed in 36% samples with acute rejection and in 62% cases of chronic rejection (including 67% cases of transplant glomerulopathy, and 50% – of isolated chronic vasculopathy. 5-year graft survival for LAR vs CR vs their combination was 47, 13 and 25%, respectively. The outcome of C4d– LAR was (p < 0,01 better than of C4d+ acute rejection: at 60 months graft survival for diffuse C4d+ vs C4d− was 33% vs 53%, respectively. In cases of chronic rejection C4d+ vs C4d– it was not statistically signifi cant (34% vs 36%. Conclusion. In long-term allograft biopsy C4d positivity is more haracteristic for chronic rejection than for acute rejection. Only diffuse C4d staining affects the outcome. C4d– positivity is associated with worse allograft survival in cases of late acute rejection, but not in cases of chronic rejection. 

  17. Impact of Urban Neighborhood Disadvantage on Late Stage Breast Cancer Diagnosis in Virginia.

    Science.gov (United States)

    DeGuzman, Pam Baker; Cohn, Wendy F; Camacho, Fabian; Edwards, Brandy L; Sturz, Vanessa N; Schroen, Anneke T

    2017-04-01

    Research suggests that residents of inner-city urban neighborhoods have higher rates of late stage cancer diagnosis. Identifying urban neighborhoods with high rates of both concentrated disadvantage and late stage cancer diagnosis may assist health care providers to target screening interventions to reduce disparities. The purposes of this study were to (1) create an index to evaluate concentrated disadvantage (CD) using non-racial measures of poverty, (2) determine the impact of neighborhood CD on late stage breast cancer diagnosis in US cities, and (3) to understand the role of obesity on this relationship. We used census block group- (CBG) level poverty indicators from five Virginia cities to develop the index. Breast cancer cases of women aged 18-65 who lived in the five cities were identified from the 2000-2012 Virginia Cancer Registry. A logistic regression model with random intercept was used to evaluate the impact of disadvantage on late stage breast cancer diagnosis. CBG-level maps were developed to geographically identify neighborhoods with both high rates of CD and late breast cancer staging. Over 900 CBGs and 6000 breast cases were included. Global fit of the concentrated disadvantage model was acceptable. The effect of disadvantage on late stage was significant (OR = 1.0083, p = 0.032). Inner-city poverty impacts risk of late stage breast cancer diagnosis. Area-level obesity is highly correlated with neighborhood poverty (ρ = 0.74, p diagnosis for urban poor and for minorities living in these underserved neighborhoods, but more study is needed to understanding the complex relationship between concentrated neighborhood poverty, obesity, and late stage diagnosis.

  18. Predictors of the Transition from Experimental to Daily Smoking in Late Adolescence and Young Adulthood

    Science.gov (United States)

    Park, Sunhee; Weaver, Terri E.; Romer, Daniel

    2010-01-01

    Although smoking initiation is rare in young adulthood, the progression to a higher level of smoking still occurs at this developmental stage. Thus, this study was aimed at exploring predictors of the transition from experimental to daily smoking in late teens and young adults using the 2nd and 3rd waves from the National Longitudinal Study of…

  19. 7 CFR 792.10 - Late payment interest, penalty and administrative charges.

    Science.gov (United States)

    2010-01-01

    ... State and local governments. Interest on debts owed by such entities shall be charged to the extent... debts. The late payment interest rate shall be equal to the higher of the Treasury Department's current... Prompt Payment Act was chosen as an alternative rate to ensure that the Government would recoup interest...

  20. Induced abortion and psychological sequelae.

    Science.gov (United States)

    Cameron, Sharon

    2010-10-01

    The decision to seek an abortion is never easy. Women have different reasons for choosing an abortion and their social, economic and religious background may influence how they cope. Furthermore, once pregnant, the alternatives of childbirth and adoption or keeping the baby may not be psychologically neutral. Research studies in this area have been hampered by methodological problems, but most of the better-quality studies have shown no increased risk of mental health problems in women having an abortion. A consistent finding has been that of pre-existing mental illness and subsequent mental health problems after either abortion or childbirth. Furthermore, studies have shown that only a minority of women experience any lasting sadness or regret. Risk factors for this include ambivalence about the decision, level of social support and whether or not the pregnancy was originally intended. More robust, definitive research studies are required on mental health after abortion and alternative outcomes such as childbirth. Copyright 2010 Elsevier Ltd. All rights reserved.

  1. Childhood Bereavement and Lower Stress Resilience in Late Adolescence.

    Science.gov (United States)

    Kennedy, Beatrice; Chen, Ruoqing; Valdimarsdóttir, Unnur; Montgomery, Scott; Fang, Fang; Fall, Katja

    2018-04-30

    Although childhood traumatic experiences are recognized as important determinants for adolescent psychiatric health in general, our objective was to explore the specific influence of childhood bereavement on the stress resilience development trajectory. In this national register-based cohort study, we identified 407,639 men born in Sweden between 1973 and 1983, who underwent compulsory military enlistment examinations in late adolescence, including measures of psychological stress resilience. We defined exposure as loss of a first-degree family member in childhood, and estimated relative risk ratios (RRRs) for reduced (moderate or low), compared with high, stress resilience with 95% confidence intervals (CIs) using multinomial logistic regression. Loss of a parent or sibling in childhood conferred a 49% increased risk of subsequent low stress resilience (RRR, 1.49, 95% CI, 1.41-1.57) and an 8% increased risk of moderate stress resilience (RRR, 1.08, 95% CI, 1.03-1.13) in late adolescence. There was also a graded increase in risk with increasing age at loss; teenagers were at higher risk for low resilience (RRR, 1.64, 95% CI, 1.52-1.77) than children aged 7-12 (RRR, 1.47, 95% CI, 1.34-1.61) and ≤6 years (RRR, 1.16 95% CI, 1.02-1.32). The excess risk was observed for all causes of death, including suicide and unexpected deaths as well as deaths due to other illnesses. The associations remained after exclusion of parents with a history of hospitalization for psychiatric diagnoses. The long-term consequences of childhood bereavement may include lower stress resilience in late adolescence. Copyright © 2018 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  2. Long-Term Treatment Sequelae After External Beam Irradiation With or Without Hormonal Manipulation for Adenocarcinoma of the Prostate: Analysis of Radiation Therapy Oncology Group Studies 85-31, 86-10, and 92-02

    International Nuclear Information System (INIS)

    Lawton, Colleen A.; Bae, Kyoungwha; Pilepich, Miljenko; Hanks, Gerald; Shipley, William

    2008-01-01

    Purpose: Late gastrointestinal (GI) and genitourinary (GU) morbidity from external beam irradiation used to treat adenocarcinoma of the prostate continue to be a concern of physicians and patients alike. In addition, for locally advanced/high-risk cancer, the appropriate use of hormonal manipulation in addition to radiation therapy (RT) may increase toxicity. We analyzed three large Radiation Therapy Oncology Group (RTOG) studies (85-31, 86-10, and 92-02) to try to address these issues. Methods and Materials: A total of 2,922 patients were accrued with a median follow-up of 10.3 years for surviving patients. The RTOG scoring scheme was used to assess GI, GU, and other toxicities. Toxicity reported was Grade 3 or higher late toxicity. Patient toxicity level was assessed by study and by treatment type combining RT only vs. RT + short-course hormone therapy (STH) vs. RT + long-term hormone therapy (LTH). Results: Multivariate analysis reveals that age >70 was statistically significantly associated with a decrease in late any Grade 3+ toxicity (hazard ratio [HR] = 0.78, p = 0.0476) adjusted for treatment type. Comparing treatment type, patients treated with RT+STH had a statistically significant lower probability of Grade 3+ GI, GU, and other toxicity compared with RT alone (p = .00006; p = 0.0037; p = 0.0127, respectively). Patients treated with RT+LTH had a statistically significant lower probability of Grade 3+ GU toxicity compared with RT alone (p = 0.023). Conclusions: These data show that external beam radiation therapy remains a safe option for locally advanced/high-risk prostate cancer, and the use of hormonal manipulation does appear to be protective for GU and GI toxicity depending upon length of treatment

  3. An Ecological Community-Based Participatory Research Study of Late Diagnosed HIV/AIDS in Oakland, California: Investigating influential factors in racial/ ethnic health inequities

    OpenAIRE

    Chopel, Alison Marie

    2014-01-01

    Nationwide, there is a racial/ethnic disparity in incidence of HIV infection and AIDS mortality, with African Americans and Latinos having disproportionately higher rates of both HIV and AIDS than Whites and Asian/ Pacific Islanders. The racial disparity in late diagnosis of HIV/AIDS reflects that of timely –diagnosed HIV, suggesting that late diagnosis may be one important driver of the widening racial disparities seen in the AIDS epidemic. Late HIV diagnosis is defined as a diagnosis ...

  4. Late intestinal adverse effects of radiotherapy for uterine cervical cancer

    International Nuclear Information System (INIS)

    Tsukada, Seiji; Yamamoto, Yasuaki; Kaneko, Toru; Maruhashi, Toshihiro; Takahashi, Takeshi

    1993-01-01

    We investigated the incidence and clinical appearance of late adverse intestinal effects in 88 patients treated with postoperative radiotherapy and 46 patients treated with radiotherapy alone for uterine cervical cancer. In the postoperative radiotherapy group, colitis, ileus and bowel fistules were seen in 13 patients (14.8%), 8 (9.1%), and 3 (3.4%) of the patients, respectively. Of these patients, 11 (12.5%) needed to have surgical therapy for these adverse effects. In the radiation alone group, 18 patients (39.1%) had colitis and 2 (4.3%) had ileus; of them, 2 patients (4.3%) needed to have surgical therapy. The higher incidence of so severe adverse effects as to require surgical therapy in the postoperative radiotherapy group indicates that adhesion caused by operation might have caused the occurrence of these adverse effects. Four of a total of 134 patients died of causes which might be attributable to irradiation. In 61 patients treated by radical hysterectomy without postoperative radiotherapy, intestinal adverse effects were not found. These results indicate that late intestinal adverse effects after radiotherapy are likely to occur in some cases very severely; therefore, careful consideration is necessary in the decision to use radiotherpay for uterine cervical cancer. (J.P.N.)

  5. Kynurenine pathway changes in late-life depression.

    Science.gov (United States)

    Wu, Yujie; Zhong, Xiaomei; Mai, Naikeng; Wen, Yuguan; Shang, Dewei; Hu, Lijun; Chen, Ben; Zhang, Min; Ning, Yuping

    2018-08-01

    Kynurenine pathway (KP) activation is associated with several neuropsychiatric diseases, including major depression disorder (MDD). Although several investigations have been conducted on MDD, these have seldom shed light on KP changes in late-life depression (LLD). We aimed to investigate whether tryptophan (TRP) metabolism and kynurenine (KYN) metabolism are imbalanced in LLD patients and to explore the differences in KP characteristics between early onset depression (EOD) and late onset depression (LOD) patients. We investigated 170 LLD patients (EOD 90, LOD 80) and 135 normal controls. Serum concentrations of TRP, KYN and kynurenic acid (KYNA) were detected by the liquid chromatography-tandem mass spectrometry method. Depressive symptoms were assessed by the 17-item Hamilton Depression Scale (HAMD-17). LLD patients exhibited lower levels of TRP, KYN, KYNA and KYNA/KYN ratio and a higher level of KYN/TRY ratio than normal controls. The decrease in TRP and the increase in KYN/TRP ratio were found in LOD patients. A low TRP level without increased KYN/TRP ratio was found in EOD patients. The "Depression" factor, which was extracted from HAMD-17 by the principal component factor analysis, was correlated with the TRP level and KYNA/KYN ratio in the EOD group, but no such correlation was found in the LOD group. KP changes were observed in LLD patients; LOD patients showed profound shifts in TRP metabolism, while EOD patients showed low TRP level and a shift in KYN metabolism. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Effect of Ahmed valve implantation on late neovascular glaucoma

    Directory of Open Access Journals (Sweden)

    Ping-An Mao

    2013-09-01

    Full Text Available AIM: To discuss the effect and safety of Ahmed valve implantation in late neovascular glaucoma. METHODS: The Ahmed glaucoma valve were implanted in 41 eyes(41 caseswith late neovascular glaucoma, the follow-up was 12 months on average, intraocular pressure was recorded at 1 day, 1 week, 1 month, 3, 6, 12 months respectively after operation and compared with that before operation, at the same time, the complications and treatment were analyzed.RESULTS: The mean intraocular pressure before operation, 1 day, 1 week, 1 month, 3, 6, 12 months after operation was 59.83±5.53, 19.27±8.19, 19.69±6.86, 20.67±6.73, 21.05±6.93, 21.49±7.42, 22.14±8.08mmHg, the mean intraocular pressure before operation was higher than that after operation and the difference was obvious in statistics. Major complications included hyphema, low intraocular pressure early postoperation, shallow anterior chamber, obstruction of the tube, the plate wrapped or exposed.CONCLUSION: Ahmed valve implantation is an effective method to treatlate neovascular glaucoma.

  7. Late Bronze Age hoard studied by PIXE

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez Neira, P.C., E-mail: carolina.gutierrez@uam.es [CMAM, Universidad Autonoma de Madrid, c/Farady 3, E-28049 Madrid (Spain); Zucchiatti, A., E-mail: alessandro.zucchiatti@uam.es [CMAM, Universidad Autonoma de Madrid, c/Farady 3, E-28049 Madrid (Spain); Montero-Ruiz, I., E-mail: ignacio.montero@cchs.csic.es [CCHS-CSIC, Albasanz 26-28, E 28037 Madrid (Spain); Vilaca, R., E-mail: rvilaca@fl.uc.pt [University of Coimbra, Largo da Porta Ferrea, 3000-447 Coimbra (Portugal); Bottaini, C., E-mail: keret18@yahoo.it [University of Coimbra, Largo da Porta Ferrea, 3000-447 Coimbra (Portugal); Gener, M., E-mail: marc.gener@cchs.csic.es [CCHS-CSIC, Albasanz 26-28, E 28037 Madrid (Spain); Climent-Font, A., E-mail: acf@uam.es [CMAM, Universidad Autonoma de Madrid, c/Farady 3, E-28049 Madrid (Spain); Department of Applied Physics, Universidad Autonoma de Madrid, Campus Cantobalanco, E-28049 Madrid (Spain)

    2011-12-15

    The hoards of metallic objects belonging to the Late European Bronze Age can be interpreted differently depending on the type, number and composition of the artefacts. PIXE analysis has been performed in nine items from the Hoard of Freixanda in Portugal comprising four socket axes, a palstave axe, a ring, a chisel, a dagger, and a casting debris. Besides the composition of the main matrix elements, that is Cu and Sn, the amount of trace elements of interest like, As, Pb, Ni, and Ag has been determined using this ion beam technique. The high tin content alloy and the high purity of the metals from the Freixanda hoard are characteristic of the Portuguese and Spanish Late Bronze Age metallurgy, supporting the idea of a regional production.

  8. Features of Social Cognition in Late Adulthood

    Directory of Open Access Journals (Sweden)

    Melehin A.I.

    2015-12-01

    Full Text Available The paper presents outcomes of researches on the central component of social cognition — theory of mind in late adulthood. The outcomes show that, in normal aging, in advanced adulthood (55—74 years as well as in old age (75—90 years there are several qualitative changes in the affective (understanding and differentiation of emotions and cognitive (understanding irony and deceit components of theory of mind. Also, at these ages individuals may develop various forms of theory of mind deficits. They may encounter difficulties with reading facial expressions and recognizing other people’s emotions. It becomes harder for them to recognize negative emotions (such as sorrow, fear, anger than positive ones (joy. The paper describes features of pragmatic interpretation of events and understanding of deceit and irony in late adulthood.

  9. Educating Citizens in Late Modern Societies

    DEFF Research Database (Denmark)

    Christensen, Torben Spanget

    2011-01-01

    One way or the other democratic states need to take on the task of educating its rising generation in governmental affairs, societal matters and citizenship in order to sustain the democracy itself. This article presents a model for analysing civic education in late modern, globalised world....... The model is based on the fundamental belief that the overall aim of civic education in democratic, late modern and global societies is empowerment of the citizen in order to establish a self governing citizen who simultaneous is capable of managing and keeping together partly contradictory citizens tasks...... studies and evaluations of the Danish upper secondary school completed at my department at University of Southern Denmark in recent years, especially connected to a quite far reaching curriculum reform from 2005. It is assumed that this Danish development is an expression of a more general phenomenon...

  10. Late presentation of posterior urethral valves.

    Science.gov (United States)

    Jalbani, Imran Khan; Biyabani, Syed Raziuddin

    2014-05-01

    Presence of posterior urethral valves (PUV) is the most common cause of urinary tract obstruction in the male neonate. Late presentation occurs in 10% of cases. We present a case of PUVs in an adult male who presented with history of obstructive lower urinary tract symptoms and hematuria. On evaluation, he was found to have raised serum creatinine level. A voiding cystourethrogram (VCUG) could not be completely performed because of narrowing in the posterior urethra. A rigid urethrocystoscopy was performed at which he was found to have type-I posterior urethral valve which were fulgurated. A repeat uroflowmetry revealed maximum flow rate of 12 ml/second. This case highlights that PUVs is not solely a disease of infancy but may also present late. VCUG is the radiological investigation of choice but the diagnosis may be missed. A urethrocystoscopy is advised if there is a high index of suspicion.

  11. Early and late arrhythmogenic effects of doxorubicin.

    Science.gov (United States)

    Kilickap, Saadettin; Barista, Ibrahim; Akgul, Ebru; Aytemir, Kudret; Aksoy, Sercan; Tekuzman, Gulten

    2007-03-01

    To determine the incidence of early and late arrhythmogenic effects of doxorubicin-containing chemotherapy regimens. A prospective study including 29 patients who were treated with doxorubicin-containing regimens. Cardiac evaluation was based on 24-hour electrocardiographic monitorization (Holter), which was performed during the first cycle of doxorubicin-containing regimens, as well as after the last cycle of chemotherapy. The mean age of the patients was 45.8 +/- 15.1 (range 18-69). Holter records obtained during the first cycle of treatment revealed varying arrhythmias in 19 patients (65.5%) and in 18 (62.1%) patients after completion of therapy. One patient presented with syncope and both Mobitz Type 2 atrioventricular block and complete atrioventricular block were demonstrated. The patient subsequently underwent permanent pacemaker implantation. Doxorubicin may result in arrhythmias both in early and late periods of treatment. These arrhythmias are rarely life threatening.

  12. Tephra compositions from Late Quaternary volcanoes around the Antarctic Peninsula

    Science.gov (United States)

    Kraus, S.

    2009-12-01

    Crustal extension and rifting processes opened the Bransfield Strait between the South Shetland Islands and the Antarctic Peninsula during the last 4 Ma. Similar processes on the Peninsula's eastern side are responsible for volcanism along Larsen Rift. There are at least 11 volcanic centers with known or suspected Late Pleistocene / Holocene explosive activity (Fig. 1). Fieldwork was carried out on the islands Deception, Penguin, Bridgeman and Paulet, moreover at Melville Peak (King George Is.) and Rezen Peak (Livingston Is.). Of special importance is the second ever reported visit and sampling at Sail Rock, and the work on never before visited outcrops on the northern slopes and at the summit of Cape Purvis volcano (Fig. 1). The new bulk tephra ICP-MS geochemical data provide a reliable framework to distinguish the individual volcanic centers from each other. According to their Mg-number, Melville Peak and Penguin Island represent the most primitive magma source. Nb/Y ratios higher than 0.67 in combination with elevated Th/Yb and Ta/Yb ratios and strongly enriched LREE seem to be diagnostic to distinguish the volcanoes located along the Larsen Rift from those associated with Bransfield Rift. Sr/Y ratios discriminate between the individual Larsen Rift volcanoes, Paulet Island showing considerably higher values than Cape Purvis volcano. Along Bransfield Rift, Bridgeman Island and Melville Peak have notably lower Nb/Y and much higher Th/Nb than Deception Island, Penguin Island and Sail Rock. The latter displays almost double the Th/Yb ratio as compared to Deception Island, and also much higher LREE enrichment but extraordinarily low Ba/Th, discriminating it from Penguin Island. Such extremely low Ba/Th ratios are also typical for Melville Peak, but for none of the other volcanoes. Penguin Island has almost double the Ba/Th and Sr/Y ratios higher than any other investigated volcano. Whereas the volcanoes located in the northern part of Bransfield Strait have Zr

  13. [Late primary abdominal pregnancy. Case report].

    Science.gov (United States)

    Farías, Emigdio Torres; Gómez, Luis Guillermo Torres; Allegre, René Márquez; Higareda, Salvador Hernández

    2008-09-01

    Abdominal advanced pregnancy is an obstetric complication that put at risk maternal and fetal life. We report a case of advanced abdominal pregnancy with intact ovaries and fallopian tubes, without ureteroperitoneal fistulae and, late prenatal diagnosis, in a multiparous patient without risk factors, with alive newborn, and whose pregnancy was attended at Unidad Medica de Alta Especialidad, Hospital de Gineco-Obstetricia, Centro Medico Nacional de Occidente del IMSS, Guadalajara, Jalisco, México.

  14. A Late Pleistocene sea level stack

    OpenAIRE

    Spratt Rachel M; Lisiecki Lorraine E

    2016-01-01

    Late Pleistocene sea level has been reconstructed from ocean sediment core data using a wide variety of proxies and models. However, the accuracy of individual reconstructions is limited by measurement error, local variations in salinity and temperature, and assumptions particular to each technique. Here we present a sea level stack (average) which increases the signal-to-noise ratio of individual reconstructions. Specifically, we perform principal componen...

  15. The Accelerated Late Adsorption of Pulmonary Surfactant

    OpenAIRE

    Loney, Ryan W.; Anyan, Walter R.; Biswas, Samares C.; Rananavare, Shankar B.; Hall, Stephen B.

    2011-01-01

    Adsorption of pulmonary surfactant to an air−water interface lowers surface tension (γ) at rates that initially decrease progressively, but which then accelerate close to the equilibrium γ. The studies here tested a series of hypotheses concerning mechanisms that might cause the late accelerated drop in γ. Experiments used captive bubbles and a Wilhelmy plate to measure γ during adsorption of vesicles containing constituents from extracted calf surfactant. The faster fall in γ reflects faster...

  16. Intermediate Inflation or Late Time Acceleration?

    International Nuclear Information System (INIS)

    Sanyal, A.K.

    2008-01-01

    The expansion rate of intermediate inflation lies between the exponential and power law expansion but corresponding accelerated expansion does not start at the onset of cosmological evolution. Present study of intermediate inflation reveals that it admits scaling solution and has got a natural exit form it at a later epoch of cosmic evolution, leading to late time acceleration. The corresponding scalar field responsible for such feature is also found to behave as a tracker field for gravity with canonical kinetic term.

  17. VERY LATE PHOTOMETRY OF SN 2011fe

    International Nuclear Information System (INIS)

    Kerzendorf, W. E.; Taubenberger, S.; Seitenzahl, I. R.; Ruiter, A. J.

    2014-01-01

    The Type Ia supernova SN 2011fe is one of the closest supernovae of the past decades. Due to its proximity and low dust extinction, this object provides a very rare opportunity to study the extremely late time evolution (>900 days) of thermonuclear supernovae. In this Letter, we present our photometric data of SN 2011fe taken at an unprecedented late epoch of ≈930 days with GMOS-N mounted on the Gemini North telescope (g = 23.43 ± 0.28, r = 24.14 ± 0.14, i = 23.91 ± 0.18, and z = 23.90 ± 0.17) to study the energy production and retention in the ejecta of SN 2011fe. Together with previous measurements by other groups, our result suggests that the optical supernova light curve can still be explained by the full thermalization of the decay positrons of 56 Co. This is in spite of theoretical predicted effects (e.g., infrared catastrophe, positron escape, and dust) that advocate a substantial energy redistribution and/or loss via various processes that result in a more rapid dimming at these very late epochs

  18. Late-time cosmological phase transitions

    International Nuclear Information System (INIS)

    Schramm, D.N.

    1990-11-01

    It is shown that the potential galaxy formation and large-scale structure problems of objects existing at high redshifts (Z approx-gt 5), structures existing on scales of 100M pc as well as velocity flows on such scales, and minimal microwave anisotropies (ΔT/T) approx-lt 10 -5 can be solved if the seeds needed to generate structure form in a vacuum phase transition after decoupling. It is argued that the basic physics of such a phase transition is no more exotic than that utilized in the more traditional GUT scale phase transitions, and that, just as in the GUT case, significant random gaussian fluctuations and/or topological defects can form. Scale lengths of ∼100M pc for large-scale structure as well as ∼1 M pc for galaxy formation occur naturally. Possible support for new physics that might be associated with such a late-time transition comes from the preliminary results of the SAGE solar neutrino experiment, implying neutrino flavor mixing with values similar to those required for a late-time transition. It is also noted that a see-saw model for the neutrino masses might also imply a tau neutrino mass that is an ideal hot dark matter candidate. However, in general either hot or cold dark matter can be consistent with a late-time transition. 47 refs., 2 figs

  19. Anatomy of the late radiation encephalopathy

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    De Reuck, J; vander Eecken, H

    1975-01-01

    The clinico-pathological data and the topography of the lesions were determined in 13 cases of late radiation encephalopathy. In one case the arterial vascularisation was studied by the translucidation technique after filling of the blood vessels with a colloidal barium sulphate solution. The radiation lesions consisted of areas of focal necrosis and of diffuse demyelination and necrosis of the deep cerebral structures and the brain stem. Demyelination was predominantly present in cases of late appearance of the neurological symptoms while necrosis was found in cases with a short latency period. The cerebral cortex and the arcuate fibres were always the most preserved structures. The topography of the focal lesions in the cerebral hemispheres and in the brain stem corresponded well to the vascular supply areas of the deep perforating arteries, while the diffuse lesions always had a predominant distribution in the periventricular arterial end- and border-zones. These observations were also confirmed by a post mortem angiographic study. The present report argues once more for a vascular aetiology as cause of the late radiation encephalopathy.

  20. Overexpression Analysis of emv2 gene coding for Late Embryogenesis Abundant Protein from Vigna radiata (Wilczek

    Directory of Open Access Journals (Sweden)

    Rajesh S.

    2008-10-01

    Full Text Available Late embryogenesis abundant (LEA proteins are speculated to protect against water stress deficit in plants. An over expression system for mungbean late embryogenesis abundant protein, emv2 was constructed in a pET29a vector, designated pET-emv2 which is responsible for higher expression under the transcriptional/translational control of T7/lac promoter incorporated in the Escherichia coli BL21 (DE3.Induction protocol was optimized for pET recombinants harboring the target gene. Overexpressed EMV2 protein was purified to homogeneity and the protein profile monitored by SDS-PAGE.