WorldWideScience

Sample records for lumpectomy 10-year results

  1. Ten-year results of accelerated hypofractionated adjuvant whole-breast radiation with concomitant boost to the lumpectomy cavity after conserving surgery for early breast cancer.

    Science.gov (United States)

    Cante, Domenico; Petrucci, Edoardo; Sciacero, Piera; Piva, Cristina; Ferrario, Silvia; Bagnera, Silvia; Patania, Sebastiano; Mondini, Guido; Pasquino, Massimo; Casanova Borca, Valeria; Vellani, Giorgio; La Porta, Maria Rosa; Franco, Pierfrancesco

    2017-09-01

    Accelerated hypofractionated whole-breast radiotherapy (WBRT) is considered a standard therapeutic option for early breast cancer (EBC) in the postoperative setting after breast conservation (BCS). A boost to the lumpectomy cavity may further increase local control. We herein report on the 10-year results of a series of EBC patients treated after BCS with hypofractionated WBRT with a concomitant photon boost to the surgical bed over 4 weeks. Between 2005 and 2007, 178 EBC patients were treated with a basic course of radiotherapy consisting of 45 Gy to the whole breast in 20 fractions (2.25 Gy daily) with an additional boost dose of 0.25 Gy delivered concomitantly to the lumpectomy cavity, for an additional dose of 5 Gy. Median follow-up period was 117 months. At 10-year, overall, cancer-specific, disease-free survival and local control were 92.2% (95% CI 88.7-93.4%), 99.2% (95% CI 96.7-99.7%), 95.5% (95% CI 91.2-97.2%) and 97.3% (95% CI 94.5-98.9%), respectively. Only eight patients recurred. Four in-breast recurrences, two axillary node relapses and two metastatic localizations were observed. Fourteen patients died during the observation period due to other causes while breast cancer-related deaths were eight. At last follow-up, ≥G2 fibrosis and telangiectasia were seen in 7% and 5% of patients. No major lung and heart toxicities were observed. Cosmetic results were excellent/good in 87.8% of patients and fair/poor in 12.2%. Hypofractionated WBRT with concomitant boost to the lumpectomy cavity after BCS in EBC led to consistent clinical results at 10 years. Hence, it can be considered a valid treatment option in this setting.

  2. Redefining Lumpectomy Using a Modification of the Sick Lobe Hypothesis and Ductal Anatomy

    International Nuclear Information System (INIS)

    Dooley, W.; Bong, J.; Parker, J

    2011-01-01

    Objectives. The Sick Lobe hypothesis states that breast cancers evolve from entire lobes or portions of lobes of the breast where initiation events have occurred early in development. The implication is that some cancers are isolated events and others are truly multi-focal but limited to single lobar-ductal units. Methods. This is a single surgeon retrospective review of early stage breast cancer lumpectomy patients treated from 1/2000 to 2/2005. Ductal endoscopy was used direct lumpectomy surgical margins by defining ductal anatomy and mapping proliferative changes within the sick lobe for complete excision. Results. Breast conservation surgery for stage 02 breast cancer with an attempt to perform endoscopy in association with therapeutic lumpectomy was performed in 554 patients (successful endoscopy in 465 cases). With an average followup of >5 years for the entire group, annual hazard rate for local failure in traditional lumpectomy without ductal mapping was 0.97%/yr. and for lumpectomy with ductal mapping and excision of entire sick lobe was 0.18%/yr. With endoscopy, 42% of patients were found to have extensive disease within their sick lobe. Conclusions. Targeting breast cancer lumpectomy using endoscopy and excision of regional associated proliferation seems associated with lower recurrence in this non-randomized series

  3. Cosmetic results following lumpectomy axillary dissection and radiotherapy for smaal breast cancers

    International Nuclear Information System (INIS)

    Dewar, J.A.; Benhamou, S.; Benhamou, E.; Arriagada, R.; Petit, J.Y.; Fontaine, F.; Sarrazin, D.

    1988-01-01

    Between 1970 and April 1982, 592 women, with T/sub 1/, small T/sub 2/, N/sub 0/, N/sub 1/, M/sub 0/ breast cancer were managed by lumpectomy, axillary dissection and radiotherapy at the Institut Gustave Roussy (IGR). The overall cosmetic result and the degree of assymetry, fibrosis and telangiectasia of the treated breast were assessed by the radiation oncologist at each follow-up visit. The changes in these cosmetic parameters with time are shown. At 5 years the overall cosmetic result was excellent in 58%, good in 38% and fair or poor in 8%. A multivariate analysis was performed of the factors associated with a cosmetic defect. The most significant factors were tumour size, the presence of defect after surgery and the daily applied dose per fraction to the breast. Surgical and radiotherapy technique (especially alternate day fractionation) can significantly affect the cosmetic result obtained

  4. Readability, complexity, and suitability of online resources for mastectomy and lumpectomy.

    Science.gov (United States)

    Tran, Bao Ngoc N; Singh, Mansher; Singhal, Dhruv; Rudd, Rima; Lee, Bernard T

    2017-05-15

    Nearly half of American adults have low or marginal health literacy. This negatively affects patients' participation, decision-making, satisfaction, and overall outcomes especially when there is a mismatch between information provided and the skills of the intended audience. Recommendations that patient information be written below the sixth grade level have been made for over three decades. This study compares online resources for mastectomy versus lumpectomy using expanded metrics including readability level, complexity, and density of data and overall suitability for public consumption. The 10 highest ranked Web sites for mastectomy and lumpectomy were identified using the largest Internet engine (Google). Each Web site was assessed for readability (Simple Measure of Gobbledygook), complexity (PMOSE/iKIRSCH), and suitability (Suitability Assessment of Materials). Scores were analyzed by each Web site and overall. Readability analysis showed a significant reading grade level difference between mastectomy and lumpectomy online information (15.4 and 13.9, P = 0.04, respectively). Complexity analysis via PMOSE/iKIRSCH revealed a mean score of 6.5 for mastectomy materials corresponding to "low" complexity and eighth to 12 th grade education. Lumpectomy literature had a lower PMOSE/iKIRSCH score of 5.8 corresponding to a "very low" complexity and fourth to eighth grade education (P = 0.05). Suitability assessment showed mean values of 41% and 46% (P = 0.83) labeled as the lowest level of "adequacy" for mastectomy and lumpectomy materials, respectively. Inter-rater reliability was high for both complexity and suitability analysis. Online resources for the surgical treatment of breast cancer are above the recommended reading grade level. The suitability level is barely adequate indicating a need for revision. Online resources for mastectomy have a higher reading grade level than do materials for lumpectomy and tend to be more complex. Copyright © 2017 Elsevier

  5. Rationale for a 'Male Lumpectomy,' a Prostate Cancer Targeted Approach Using Cryoablation: Results in 21 Patients with at Least 2 Years of Follow-Up

    International Nuclear Information System (INIS)

    Onik, Gary

    2008-01-01

    Background. Prostate cancer in men raises many of the same issues that breast cancer does in women. Complications of prostate cancer treatment, including impotence and incontinence, affect the self-image and psyche of a man no less than does the loss of a breast in a woman. We present a pilot study in which 21 patients were treated with a focal cryoablation procedure. Methods. Focal cryoablation was performed using biplane transrectal ultrasound if the tumor was confined to only one prostate lobe. Preoperative PSA values were recorded. Cryoablation was planned to encompass the area of known tumor. PSA values were obtained every 3 months for 2 years and every 6 months thereafter. Potency and continence status was obtained at the same intervals. Routine biopsy was obtained at 1 year. Results. Twenty-one patients had focal cryoablation. Follow-up ranged from 24 to 105 months with a mean of 50 months. Twenty of 21 (95%) patients have stable PSA values with no evidence for cancer, despite 10 patients being at medium to high risk for recurrence. All patients biopsied (n = 19) were negative for tumor. Potency was maintained in 17 of 21 patients (80%). No other complications, including incontinence or fistula formation, were noted. Conclusion. These preliminary results indicate a 'male lumpectomy,' in which the prostate tumor region itself is destroyed, appears to preserve potency in a majority of patients and limits other complications, without compromising cancer control. If these results are confirmed by further studies and long-term follow-up, this treatment approach could have a profound effect on prostate cancer management

  6. Proposed protocol for imaging breast carcinoma patients treated with lumpectomy and radiation therapy

    International Nuclear Information System (INIS)

    Mendelson, E.B.; Bhagwanani, D.G.; Bohm-Velez, M.; Rishi, U.S.

    1989-01-01

    Alterations in conservatively treated breasts have been described and include masses (hematomas, seromas), spiculated densities, architectural distortion, increased breast density and edema, skin thickening, and calcifications. Misinterpretations of these findings might result in unnecessary biopsy or delayed diagnosis of tumor recurrence. Changes after lumpectomy and radiation therapy must be evaluated within a temporal context, best defined from a careful review of sequential follow-up studies. From a review of interval studies of 110 cases of conservatively treated breast cancer during a 4-year period, the chronology of findings after lumpectomy and radiation therapy was determined. Of particular importance is the evolution of changes at the lumpectomy site, which was the location of the six recurrences in our series, all developing 36--48 months after surgery. Based on the sequential findings that the authors observed as well s the reported frequency of tumor recurrence over time, the authors propose a protocol for follow-up mammography and offer indications for supplemental sonography in managing patients with conservatively treated breast cancer

  7. Cavity Shaving plus Lumpectomy versus Lumpectomy Alone for Patients with Breast Cancer Undergoing Breast-Conserving Surgery: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Ke Wang

    Full Text Available The margin status is a well-established prognostic predictor for patients undergoing breast-conserving surgery (BCS. Recent data suggested that cavity shaving in addition to lumpectomy might be a promising approach for improving the clinical outcomes. We aimed to compare the efficacy and safety between cavity shaving plus lumpectomy and lumpectomy alone with a systematic review and meta-analysis. We searched the PubMed, Embase, and Cochrane CENTRAL databases for studies comparing cavity shaving with lumpectomy before June 10, 2016. Both comparative studies and self-control studies were included. A random-effects model was used to estimate the odds ratios (ORs for positive margin rate, reoperation rate, recurrence rate, and weighted mean difference (WMD for excised tissue volume. Twenty-six studies were included in the meta-analysis. The cavity shaving group had a significantly lower positive margin rate than the BCS-alone group (16.4% vs. 31.9%; OR = 0.41, 95% CI 0.32-0.53, P < 0.05. Cavity shaving was associated with a significantly decreased rate of reoperation (OR = 0.42, 95% CI 0.30-0.59, P < 0.05. The overall locoregional rate was low for cavity shaving and BCS-alone (3% vs. 4%. Cavity shaving had no significant effect on the risk of locoregional recurrence (OR = 0.86, 95% CI 0.32-2.35; P = 0.78. The excised tissue volume did not differ substantially between cavity shaving and BCS alone (WMD = -23.88, 95% CI -55.20 to 7.44, P = 0.14. For patients undergoing BCS, additional cavity shaving was an effective method to decrease the positive margin rate and avoid reoperation. The addition of cavity shaving did not appear to have excessive excised tissue volume compared with partial mastectomy alone.

  8. Lumpectomy Plus Tamoxifen or Anastrozole With or Without Whole Breast Irradiation in Women With Favorable Early Breast Cancer

    International Nuclear Information System (INIS)

    Poetter, Richard; Gnant, Michael; Kwasny, Werner; Tausch, Christoph; Handl-Zeller, Leonore; Pakisch, Brigitte; Taucher, Susanne; Hammer, Josef; Luschin-Ebengreuth, Gero; Schmid, Marianne; Sedlmayer, Felix; Stierer, Michael; Reiner, Georg; Kapp, Karin; Hofbauer, Friedrich; Rottenfusser, Andrea; Poestlberger, Sabine; Haider, Karin; Draxler, Wolfgang; Jakesz, Raimund

    2007-01-01

    Purpose: In women with favorable early breast cancer treated by lumpectomy plus tamoxifen or anastrazole, it remains unclear whether whole breast radiotherapy is beneficial. Methods and Material: Between January 1996 and June 2004, the Austrian Breast and Colorectal Cancer Study Group (ABCSG) randomly assigned 869 women to receive breast radiotherapy ± boost (n 414) or not (n = 417) after breast-conserving surgery (ABCSG Study 8A). Favorable early breast cancer was specified as tumor size <3 cm, Grading 1 or 2, negative lymph nodes, positive estrogen and/or progesterone receptor status, and manageable by breast-conserving surgery. Breast radiotherapy was performed after lumpectomy with 2 tangential opposed breast fields with mean 50 Gy, plus boost in 71% of patients with mean 10 Gy, in a median of 6 weeks. The primary endpoint was local relapse-free survival; further endpoints were contralateral breast cancer, distant metastases, and disease-free and overall survival. The median follow-up was 53.8 months. Results: The mean age was 66 years. Overall, there were 21 local relapses, with 2 relapses in the radiotherapy group (5-y rate 0.4%) vs. 19 in the no-radiotherapy group (5.1%), respectively (p = 0.0001, hazard ratio 10.2). Overall relapses occurred in 30 patients, with 7 events in the radiotherapy group (5-y rate 2.1%) vs. 23 events in the no-radiotherapy group (6.1%) (p = 0.002, hazard ratio 3.5). No significant differences were found for distant metastases and overall survival. Conclusion: Breast radiotherapy ± boost in women with favorable early breast cancer after lumpectomy combined with tamoxifen/anastrazole leads to a significant reduction in local and overall relapse

  9. Change in volume of lumpectomy cavity during external-beam irradiation of the intact breast

    International Nuclear Information System (INIS)

    Jacobson, Geraldine; Betts, Vicki; Smith, Brian

    2006-01-01

    Purpose: Definition of the lumpectomy cavity is an important component of irradiation of the breast. We use computed tomography (CT)-based planning and contour the lumpectomy volume on the planning CT. We obtained a second CT in the 4th or 5th week of treatment for boost planning and compared the volume change with the first planning-CT scan. Methods and Materials: This retrospective study reviewed the planning-CT data for 20 patients. In the first CT, images were obtained from the mandible to 2 cm below the breast in 3-mm slices. In the second CT, for the boost, images were obtained from the top to the bottom of the clinically defined breast, in 3-mm slices. Lumpectomy cavities were contoured on both CT scans and volumes compared. Results: Sixteen of the 20 patients (80%) had more than a 20% decrease from the first to the second volume, with a corresponding 95% confidence interval. The mean decrease was 16.13 cc, with a standard deviation of 14.05. The Spearman correlation coefficient of 0.18 did not show a significant correlation between the initial volume and the percent change. Conclusions: During external breast irradiation, many patients will have significant volume reduction in the lumpectomy cavity. Because CT-based definition of the lumpectomy cavity can influence the planning of a boost technique, further study appears warranted

  10. Method of localization and implantation of the lumpectomy site for high dose rate brachytherapy after conservative surgery for T1 and T2 breast cancer

    International Nuclear Information System (INIS)

    Perera, F.; Chisela, F.; Engel, J.; Venkatesan, V.

    1995-01-01

    the lumpectomy site are then verified using simulator radiographs. Results: Eight double plane implants and four single plane implants have been done using this method. Five implants were done using direct visualization. It has not been necessary to reorient the implant in any of the patients. If not for the presence of surgical clips, the size of the lumpectomy site cannot be separated from the surrounding normal breast tissue. Conclusion: This technique is an accurate way to localize the lumpectomy site for HDR brachytherapy

  11. The use of high-dose-rate brachytherapy alone after lumpectomy in patients with early-stage breast cancer treated with breast-conserving therapy

    International Nuclear Information System (INIS)

    Baglan, Kathy L.; Martinez, Alvaro A.; Frazier, Robert C.; Kini, Vijay R.; Kestin, Larry L.; Chen, Peter Y.; Edmundson, Greg; Mele, Elizabeth; Jaffray, David; Vicini, Frank A.

    2001-01-01

    Purpose: We present the preliminary results of our in-house protocol using outpatient high-dose-rate (HDR) brachytherapy as the sole radiation modality following lumpectomy in patients with early-stage breast cancer. Methods and Materials: Thirty-seven patients with 38 Stage I-II breast cancers received radiation to the lumpectomy cavity alone using an HDR interstitial implant with 192 Ir. A minimum dose of 32 Gy was delivered on an outpatient basis in 8 fractions of 4 Gy to the lumpectomy cavity plus a 1- to 2-cm margin over consecutive 4 days. Results: Median follow-up is 31 months. There has been one ipsilateral breast recurrence for a crude failure rate of 2.6% and no regional or distant failures. Wound healing was not impaired in patients undergoing an open-cavity implant. Three minor breast infections occurred, and all resolved with oral antibiotics. The cosmetic outcome was good to excellent in all patients. Conclusion: In selected patients with early-stage breast cancer, treatment of the lumpectomy cavity alone with outpatient HDR brachytherapy is both technically feasible and well tolerated. Early results are encouraging, however, longer follow-up is necessary before equivalence to standard whole-breast irradiation can be established and to determine the most optimal radiation therapy technique to be employed

  12. Variability Among Breast Radiation Oncologists in Delineation of the Postsurgical Lumpectomy Cavity

    International Nuclear Information System (INIS)

    Landis, Daniel M.; Luo Weixiu; Song Jun; Bellon, Jennifer R.; Punglia, Rinaa S.; Wong, Julia S.; Killoran, Joseph H.; Gelman, Rebecca; Harris, Jay R.

    2007-01-01

    Purpose: Partial breast irradiation (PBI) is becoming more widely used. Accurate determination of the surgical lumpectomy cavity volume is more critical with PBI than with whole breast radiation therapy. We examined the interobserver variability in delineation of the lumpectomy cavity among four academic radiation oncologists who specialize in the treatment of breast cancer. Methods and Materials: Thirty-four lumpectomy cavities in 33 consecutive patients were evaluated. Each physician contoured the cavity and a 1.5-cm margin was added to define the planning target volume (PTV). A cavity visualization score (CVS) was assigned (1-5). To eliminate bias, the physician of record was eliminated from the analysis in all cases. Three measures of variability of the PTV were developed: average shift of the center of mass (COM), average percent overlap between the PTV of two physicians (PVO), and standard deviation of the PTV. Results: Of variables examined, pathologic resection volume was significantly correlated with CVS, with larger volumes more easily visualized. Shift of the COM decreased and PVO increased significantly as CVS increased. For CVS 4 and 5 cases, the average COM shift was 3 mm and 2 mm, respectively, and PVO was 77% and 87%, respectively. In multiple linear regression, pathologic diameter >4 cm and CVS ≥3 were significantly associated with smaller COM shift. When CVS was omitted from analysis, PVO was significantly larger with pathologic diameter ≥5 cm, days to planning <36, and older age. Conclusions: Even among radiation oncologists who specialize in breast radiotherapy, there can be substantial differences in delineation of the postsurgical radiotherapy target volume. Large treatment margins may be prudent if the cavity is not clearly defined

  13. Phase II trial of brachytherapy alone after lumpectomy for select breast cancer: Toxicity analysis of RTOG 95-17

    International Nuclear Information System (INIS)

    Kuske, Robert R.; Winter, Kathryn; Arthur, Douglas W.; Bolton, John; Rabinovitch, Rachel; White, Julia; Hanson, William; Wilenzick, R.M.

    2006-01-01

    Purpose: Accelerated partial breast irradiation (APBI) can be delivered with brachytherapy within 4-5 days compared with 5-6 weeks for conventional whole breast external beam radiotherapy. Radiation Therapy Oncology Group 95-17 is the first prospective phase I-II cooperative group trial of APBI alone after lumpectomy in select patients with breast cancer. The toxicity rates are reported for low-dose-rate (LDR) and high-dose-rate (HDR) APBI on this trial. Methods and Materials:: The inclusion criteria for this study included invasive nonlobular tumors ≤3 cm after lumpectomy with negative surgical margins and axillary dissection with zero to three positive axillary nodes without extracapsular extension. The patients were treated with either LDR APBI (45 Gy in 3.5-5 days) or HDR APBI (34 Gy in 10 twice-daily fractions within 5 days). Chemotherapy (≥2 weeks after APBI) and/or tamoxifen could be given at the discretion of the treating physicians. Results: Between August 1997 and March 2000, 100 women were enrolled in this study, and 99 were evaluated. Of the 99 women, 33 were treated with LDR and 66 with HDR APBI. The median follow-up for all patients was 2.7 years (range, 0.6-4.4 years) and was 2.9 years for LDR and 2.7 years for HDR patients. Toxicities attributed to APBI included erythema, edema, tenderness, pain, and infection. Of the 66 patients treated with HDR APBI, 2 (3%) had Grade 3 or 4 toxicity. Of the 33 patients treated with LDR, 3 (9%) had Grade 3 or 4 toxicity during brachytherapy. Late toxicities included skin thickening, fibrosis, breast tenderness, and telangiectasias. No patient experienced late Grade 4 toxicity; the rate of Grade 3 toxicity was 18% for the LDR and 4% for the HDR groups. Conclusion: Acute and late toxicity for this invasive breast radiation technique was modest and acceptable. Patients receiving chemotherapy, a nonprotocol therapy, had a greater rate of Grade 3 toxicity. The study design did not allow for this to be tested

  14. Image-Based Treatment Planning of the Post-Lumpectomy Breast Utilizing CT and 3TMRI

    International Nuclear Information System (INIS)

    Jacobson, G.; Betts, V.; Muruganandham, M.; Buechler-Price, J.; Zamba, G.

    2011-01-01

    Accurate lumpectomy cavity definition is critical in breast treatment planning. We compared contouring lumpectomy cavity volume and cavity visualization score (CVS) with CT versus 3T MRI. 29 patients were imaged with CT and 3T MRI. Seven additional boost planning sets were obtained for 36 image sets total. Three observers contoured the lumpectomy cavity on all images, assigning a cavity visualization score (CVS ) of 1 to 5. Measures of consistency and agreement for CT volumes were 98.84% and 98.62%, for T1 MRI were 95.65% and 95.55%, and for T2 MRI were 97.63% and 97.71%. The mean CT, T1 MRI, and T2 MRI CVS scores were 3.28, 3.38, and 4.32, respectively. There was a highly significant difference between CT and T2 scores (P<.00001) and between T1 and T2 scores (P<.00001). Interobserver consistency and agreement regarding volumes were high for all three modalities with T2 MRI CVS the highest. MRI may contribute to target definition in selected patients

  15. Image-Based Treatment Planning of the Post-Lumpectomy Breast Utilizing CT and 3TMRI

    Directory of Open Access Journals (Sweden)

    Geraldine Jacobson

    2011-01-01

    Full Text Available Accurate lumpectomy cavity definition is critical in breast treatment planning. We compared contouring lumpectomy cavity volume and cavity visualization score (CVS with CT versus 3T MRI. 29 patients were imaged with CT and 3T MRI. Seven additional boost planning sets were obtained for 36 image sets total. Three observers contoured the lumpectomy cavity on all images, assigning a cavity visualization score (CVS of 1 to 5. Measures of consistency and agreement for CT volumes were 98.84% and 98.62%, for T1 MRI were 95.65% and 95.55%, and for T2 MRI were 97.63% and 97.71%. The mean CT, T1 MRI, and T2 MRI CVS scores were 3.28, 3.38, and 4.32, respectively. There was a highly significant difference between CT and T2 scores (<.00001 and between T1 and T2 scores (<.00001. Interobserver consistency and agreement regarding volumes were high for all three modalities with T2 MRI CVS the highest. MRI may contribute to target definition in selected patients.

  16. Improvement in Interobserver Accuracy in Delineation of the Lumpectomy Cavity Using Fiducial Markers

    International Nuclear Information System (INIS)

    Shaikh, Talha; Chen Ting; Khan, Atif; Yue, Ning J.; Kearney, Thomas; Cohler, Alan; Haffty, Bruce G.; Goyal, Sharad

    2010-01-01

    Purpose: To determine, whether the presence of gold fiducial markers would improve the inter- and intraphysician accuracy in the delineation of the surgical cavity compared with a matched group of patients who did not receive gold fiducial markers in the setting of accelerated partial-breast irradiation (APBI). Methods and Materials: Planning CT images of 22 lumpectomy cavities were reviewed in a cohort of 22 patients; 11 patients received four to six gold fiducial markers placed at the time of surgery. Three physicians categorized the seroma cavity according to cavity visualization score criteria and delineated each of the 22 seroma cavities and the clinical target volume. Distance between centers of mass, percentage overlap, and average surface distance for all patients were assessed. Results: The mean seroma volume was 36.9 cm 3 and 34.2 cm 3 for fiducial patients and non-fiducial patients, respectively (p = ns). Fiducial markers improved the mean cavity visualization score, to 3.6 ± 1.0 from 2.5 ± 1.3 (p < 0.05). The mean distance between centers of mass, average surface distance, and percentage overlap for the seroma and clinical target volume were significantly improved in the fiducial marker patients as compared with the non-fiducial marker patients (p < 0.001). Conclusions: The placement of gold fiducial markers placed at the time of lumpectomy improves interphysician identification and delineation of the seroma cavity and clinical target volume. This has implications in radiotherapy treatment planning for accelerated partial-breast irradiation and for boost after whole-breast irradiation.

  17. Repeat Computed Tomography Simulation to Assess Lumpectomy Cavity Volume During Whole-Breast Irradiation

    International Nuclear Information System (INIS)

    Flannery, Todd W.; Nichols, Elizabeth M.; Cheston, Sally B.; Marter, Kimberley J.; Naqvi, Shahid A.; Markham, Kristen M.; Ali, Imran; Mohiuddin, Majid M.

    2009-01-01

    Purpose: To determine whether the lumpectomy cavity (LPC) decreases in volume during whole-breast radiotherapy (RT) and what factors influence the decrease. Patients and Methods: Forty-three women with 44 breast lesions were prospectively enrolled. Eligible patients underwent lumpectomy followed by a CT simulation (CT1) within 60 days of surgery. Patients were treated to the entire breast to a dose of 45-50.4 Gy. After 21-23 treatments, a second planning CT simulation (CT2) was done. The LPC was contoured on CT2, and the volumes (LCV) were compared between CT1 and CT2. Results: The median LCV on CT1 and CT2 was 38.2 cm 3 and 21.7 cm 3 , respectively. The median percent change and volume decrease between CT1 and CT2 was -32.0% and 11.2 cm 3 , respectively (n = 44). The LCV decreased in 38 of 44 patients (86%). There was a significant correlation between initial LCV and decrease in volume (p = 0.001) and initial LCV and percent decrease in volume (p < 0.001). There was no correlation between time from surgery to CT1, to start of RT, or to CT2 and change in volume. Conclusions: Patients who undergo lumpectomy almost always have a decrease in their LCV during whole-breast RT. There was a correlation between the initial LCV and decrease in volume on repeat CT simulation. Evaluating patients for this change can potentially lead to decreased doses of radiation to the remaining breast and other critical structures when delivering a small-field boost. Repeat CT simulation should be considered in patients with larger cavities or cavities near critical structures.

  18. Prediction of primary breast cancer size and T-stage using micro-computed tomography in lumpectomy specimens

    Directory of Open Access Journals (Sweden)

    Wafa M Sarraj

    2015-01-01

    Full Text Available Background: Histopathology is the only accepted method to measure and stage the breast tumor size. However, there is a need to find another method to measure and stage the tumor size when the pathological assessment is not available. Micro-computed tomography. (micro-CT has the ability to measure tumor in three dimensions in an intact lumpectomy specimen. In this study, we aimed to determine the accuracy of micro-CT to measure and stage the primary tumor size in breast lumpectomy specimens, as compared to the histopathology. Materials and Methods: Seventy-two women who underwent lumpectomy surgery at the Massachusetts General Hospital Department of Surgery from June 2011 to September 2011, and from August 2013 to December 2013 participated in this study. The lumpectomy specimens were scanned using micro-CT followed by routine pathological processing. The maximum dimension of the invasive breast tumor was obtained from the micro-CT image and was compared to the corresponding pathology report for each subject. Results: The invasive tumor size measurement by micro-CT was underestimated in 24. cases. (33%, overestimated in 37. cases. (51%, and matched it exactly in 11. cases. (15% compared to the histopathology measurement for all the cases. However, micro-CT T.stage classification differed from histopathology in only 11. (15.2% with 6. cases. (8.3% classified as a higher stage by micro-CT, and 5. cases. (6.9% classified as lower compared to histopathology. In addition, micro-CT demonstrated a statically significant strong agreement (κ =0.6, P < 0.05 with pathological tumor size and staging for invasive ductal carcinoma. (IDC group. In contrast, there was no agreement. (κ = .2, P = 0.67 between micro-CT and pathology in estimating and staging tumor size for invasive lobular carcinoma. (ILC group. This could be explained by a small sample size. (7 for ILC group. Conclusions: Micro-CT is a promising modality for measuring and staging the IDC.

  19. Irradiation of the tumor bed alone after lumpectomy in selected patients with early stage breast cancer treated with breast conserving therapy

    International Nuclear Information System (INIS)

    Vicini, F.; Chen, P; Benitez, P.; Johnson, P.; Gustafson, G.; Horwitz, E.; McCarthy, K.; Lacerna, M.; Goldstein, Neil; Martinez, A.

    1997-01-01

    Purpose: We present the initial findings of our in-house protocol treating the tumor bed alone after lumpectomy with low dose rate (LDR) interstitial brachytherapy in selected patients with early stage breast cancer treated with breast conserving therapy (BCT). Materials and Methods: Since 1/1/93, 50 women with early stage breast cancer were entered into a protocol of tumor bed irradiation alone using an interstitial LDR implant. Patients were eligible if their tumor was an infiltrating ductal carcinoma ≤ 3 cm in maximum diameter, pathologic margins were clear by at least 2 mm, the tumor did not contain an extensive intraductal component, the axilla was surgically staged with ≤ 3 nodes involved with cancer, and a postoperative mammogram was performed. Implants were positioned using a template guide delivering 50 Gy over 96 hours to the lumpectomy bed plus a 1-2 cm margin. Local control, cosmetic outcome, and complications were assessed. Results: Patients ranged in age from 40 to 84 years (median 65). The median tumor size was 10 mm (range, 1-25). Seventeen patients (34%) had well differentiated tumors, 22 (4%) had moderately differentiated tumors, and in 11 (22%) the tumor was poorly differentiated. Forty-five patients (90%) were node negative while 5 (10%) had 1-3 positive nodes. A total of 23 (46%) patients were placed on tamoxifen and 3 (6%) received adjuvant systemic chemotherapy. No patient was lost to follow-up. The median follow-up is 40 months (range 29-50). No patient has experienced a local, regional, or distant failure. One patient died from colorectal carcinoma with no evidence of recurrent breast cancer. Good-to-excellent cosmetic results have been observed in all 50 patients (median cosmetic follow-up 36 months). No patient has experienced significant sequelae related to their implant. Conclusions: Early results with treatment of the tumor bed alone with a LDR interstitial implant appear promising. Long-term follow-up of these patients will be

  20. Profiling Surgeon Performance for Breast Cancer Lumpectomy by Composite Measurement of Reoperations, Cosmetic Outcomes, and Patient Preferences.

    Science.gov (United States)

    Dunham, Annie L; Ramirez, Luis D; Vang, Choua A; Linebarger, Jared H; Landercasper, Jeffrey

    2018-07-01

    Patients want information to search for destination of care for breast-conserving surgery (BCS). To inform patients wanting a lumpectomy, we aimed to develop a pilot project that communicated composite quality measure (QM) results using a '4-star' rating system. Two patient-centered QMs were included in the model-reoperation rate (ROR) and cosmetic outcome (COSM). A prospective database was reviewed for stage 0-3 patients undergoing initial lumpectomy by three surgeons from 2010 to 2015. Self-reported COSM was assessed by survey. Multivariate analyses were used to test for interactions between surgeon and other variables known to influence RORs and COSMs. Models of surgeon profiling were developed that summed the ROR and COSM performance scores, then reported results using a Centers for Medicare and Medicaid Services (CMS) star-type system. Functionality for a patient to 'weight' the importance of the ratio of ROR:COSM before profiling was introduced. The unadjusted ROR for stage 1-3 patients for three surgeons was 9.5, 13.0, and 16.3%, respectively (p = 0.179) [overall rate 10.4% (38/366)]. After risk adjustment, differences between surgeons were observed for RORs, but not COSMs. Overall, patients reported excellent, good, fair, and poor COSMs of 55, 30, 11 and 4%, respectively. Composite star scores reflected differences in performance by surgeon, which could increase, or even disappear, dependent on the patient's weighting of the ROR:COSM ratio. Composite measures of performance can be developed that allow patients to input their weighted preferences and values into surgeon profiling before they consider a destination of care for BCS.

  1. True fir spacing trials: 10-year results.

    Science.gov (United States)

    Robert O. Curtis

    2008-01-01

    Eighteen precommercial thinning trials were established in true fir-hemlock stands in the Olympic Mountains and the west side of the Cascade Range during the period 1987 through 1994. This paper updates a previous report, with results for the first 10 years after establishment. Results are given for (1) all trees, (2) the largest 80 per acre of any species, and (3)...

  2. SU-E-J-37: Feasibility of Utilizing Carbon Fiducials to Increase Localization Accuracy of Lumpectomy Cavity for Partial Breast Irradiation

    International Nuclear Information System (INIS)

    Zhang, Y; Hieken, T; Mutter, R; Park, S; Yan, E; Brinkmann, D; Pafundi, D

    2015-01-01

    Purpose To investigate the feasibility of utilizing carbon fiducials to increase localization accuracy of lumpectomy cavity for partial breast irradiation (PBI). Methods Carbon fiducials were placed intraoperatively in the lumpectomy cavity following resection of breast cancer in 11 patients. The patients were scheduled to receive whole breast irradiation (WBI) with a boost or 3D-conformal PBI. WBI patients were initially setup to skin tattoos using lasers, followed by orthogonal kV on-board-imaging (OBI) matching to bone per clinical practice. Cone beam CT (CBCT) was acquired weekly for offline review. For the boost component of WBI and PBI, patients were setup with lasers, followed by OBI matching to fiducials, with final alignment by CBCT matching to fiducials. Using carbon fiducials as a surrogate for the lumpectomy cavity and CBCT matching to fiducials as the gold standard, setup uncertainties to lasers, OBI bone, OBI fiducials, and CBCT breast were compared. Results Minimal imaging artifacts were introduced by fiducials on the planning CT and CBCT. The fiducials were sufficiently visible on OBI for online localization. The mean magnitude and standard deviation of setup errors were 8.4mm ± 5.3 mm (n=84), 7.3mm ± 3.7mm (n=87), 2.2mm ± 1.6mm (n=40) and 4.8mm ± 2.6mm (n=87), for lasers, OBI bone, OBI fiducials and CBCT breast tissue, respectively. Significant migration occurred in one of 39 implanted fiducials in a patient with a large postoperative seroma. Conclusion OBI carbon fiducial-based setup can improve localization accuracy with minimal imaging artifacts. With increased localization accuracy, setup uncertainties can be reduced from 8mm using OBI bone matching to 3mm using OBI fiducial matching for PBI treatment. This work demonstrates the feasibility of utilizing carbon fiducials to increase localization accuracy to the lumpectomy cavity for PBI. This may be particularly attractive for localization in the setting of proton therapy and other scenarios

  3. SU-E-J-37: Feasibility of Utilizing Carbon Fiducials to Increase Localization Accuracy of Lumpectomy Cavity for Partial Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Y; Hieken, T; Mutter, R; Park, S; Yan, E; Brinkmann, D; Pafundi, D [Mayo Clinic, Rochester, MN (United States)

    2015-06-15

    Purpose To investigate the feasibility of utilizing carbon fiducials to increase localization accuracy of lumpectomy cavity for partial breast irradiation (PBI). Methods Carbon fiducials were placed intraoperatively in the lumpectomy cavity following resection of breast cancer in 11 patients. The patients were scheduled to receive whole breast irradiation (WBI) with a boost or 3D-conformal PBI. WBI patients were initially setup to skin tattoos using lasers, followed by orthogonal kV on-board-imaging (OBI) matching to bone per clinical practice. Cone beam CT (CBCT) was acquired weekly for offline review. For the boost component of WBI and PBI, patients were setup with lasers, followed by OBI matching to fiducials, with final alignment by CBCT matching to fiducials. Using carbon fiducials as a surrogate for the lumpectomy cavity and CBCT matching to fiducials as the gold standard, setup uncertainties to lasers, OBI bone, OBI fiducials, and CBCT breast were compared. Results Minimal imaging artifacts were introduced by fiducials on the planning CT and CBCT. The fiducials were sufficiently visible on OBI for online localization. The mean magnitude and standard deviation of setup errors were 8.4mm ± 5.3 mm (n=84), 7.3mm ± 3.7mm (n=87), 2.2mm ± 1.6mm (n=40) and 4.8mm ± 2.6mm (n=87), for lasers, OBI bone, OBI fiducials and CBCT breast tissue, respectively. Significant migration occurred in one of 39 implanted fiducials in a patient with a large postoperative seroma. Conclusion OBI carbon fiducial-based setup can improve localization accuracy with minimal imaging artifacts. With increased localization accuracy, setup uncertainties can be reduced from 8mm using OBI bone matching to 3mm using OBI fiducial matching for PBI treatment. This work demonstrates the feasibility of utilizing carbon fiducials to increase localization accuracy to the lumpectomy cavity for PBI. This may be particularly attractive for localization in the setting of proton therapy and other scenarios

  4. The accuracy of electron-boost fields in the radiation therapy of early breast cancer after lumpectomy

    International Nuclear Information System (INIS)

    Yakar, D.; Bower, D.; Kambouris, A.

    1989-01-01

    Electron boost fields used in the radiotherapy of early breast cancer may be set up either clinically (on the basis of lumpectomy scar location and other clinical data) or on location of surgical clips shown by simulation films. A comparison of these two methods has been conducted on 27 patients. In 13 patients, the clinical set up was good (margin around the clips > 1.5 cm); in four, marginal (margin = 0.5-1.5 cm) and in 10, unacceptable (< 0.5 cm margin). The authors concluded that placement of surgical clips at the margins of the tumor bed and simulation of the electron boost fields is necessary to ensure geographic miss

  5. Development of Patients’ Decision Aid for Older Women With Stage I Breast Cancer Considering Radiotherapy After Lumpectomy

    International Nuclear Information System (INIS)

    Wong, Jennifer; D’Alimonte, Laura; Angus, Jan; Paszat, Larry; Metcalfe, Kelly; Whelan, Tim; Llewellyn-Thomas, Hilary; Warner, Eiran; Franssen, Edmee; Szumacher, Ewa

    2012-01-01

    Purpose: To develop a patient decision aid (PtDA) for older women with Stage I, pathologically node negative, estrogen receptor–positive progesterone receptor–positive breast cancer who are considering adjuvant radiotherapy after lumpectomy and to examine its impact on patients’ decision making. Methods and Materials: A PtDA was developed and evaluated in three steps according to the Ottawa Decision Support Framework: (1) needs assessment (n = 16); (2) Pilot I to examine PtDA acceptability (n = 12); and (3) Pilot II, a pretest posttest (n = 38) with older women with estrogen receptor–positive progesterone receptor–positive breast cancer after lumpectomy who were receiving adjuvant radiation therapy. Measures included patients’ satisfaction with the PtDA, self-reported decisional conflict, level of distress, treatment-related knowledge, and choice predisposition. Results: The PtDA is a booklet that details each adjuvant treatment option’s benefits, risks, and side effects tailored to the patient’s clinical profile; includes a values clarification exercise; and includes steps to guide patients towards their decision. On the basis of qualitative comments and satisfaction ratings, all women thought that the PtDA was helpful and informative. In comparison with their baseline scores, patients had a statistically significant (p < 0.05) reduction in decisional conflict (adjusted mean difference [AMD], −7.18; 95% confidence interval [CI], −13.50 to 12.59); increased clarity of the benefits and risks (AMD, −10.86; CI, −20.33 to 21.49); and improved general treatment knowledge (AMD, 8.99; CI, 2.88–10.28) after using the PtDA. General trends were also reported in the patients’ choice predisposition scores that suggested potential differences in treatment decision after PtDA use. Conclusions: This study provides evidence that this PtDA may be a helpful educational tool for this group of women. The quality of care for older breast cancer patients may

  6. Development of Patients' Decision Aid for Older Women With Stage I Breast Cancer Considering Radiotherapy After Lumpectomy

    Energy Technology Data Exchange (ETDEWEB)

    Wong, Jennifer [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); D' Alimonte, Laura [Department of Radiation Therapy, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Angus, Jan [Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario (Canada); Paszat, Larry [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Metcalfe, Kelly [Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario (Canada); Whelan, Tim [Department of Radiation Oncology, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario (Canada); Llewellyn-Thomas, Hilary [Department of Community and Family Medicine, The Center of Informed Choice, The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Medical School, Lebanon, NH (Lebanon); Warner, Eiran [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Franssen, Edmee [Consultant Statistician, Faculty of Medicine, University of Toronto, Toronto, Ontario (Canada); Szumacher, Ewa, E-mail: Ewa.Szumacher@sunnybrook.ca [Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)

    2012-09-01

    Purpose: To develop a patient decision aid (PtDA) for older women with Stage I, pathologically node negative, estrogen receptor-positive progesterone receptor-positive breast cancer who are considering adjuvant radiotherapy after lumpectomy and to examine its impact on patients' decision making. Methods and Materials: A PtDA was developed and evaluated in three steps according to the Ottawa Decision Support Framework: (1) needs assessment (n = 16); (2) Pilot I to examine PtDA acceptability (n = 12); and (3) Pilot II, a pretest posttest (n = 38) with older women with estrogen receptor-positive progesterone receptor-positive breast cancer after lumpectomy who were receiving adjuvant radiation therapy. Measures included patients' satisfaction with the PtDA, self-reported decisional conflict, level of distress, treatment-related knowledge, and choice predisposition. Results: The PtDA is a booklet that details each adjuvant treatment option's benefits, risks, and side effects tailored to the patient's clinical profile; includes a values clarification exercise; and includes steps to guide patients towards their decision. On the basis of qualitative comments and satisfaction ratings, all women thought that the PtDA was helpful and informative. In comparison with their baseline scores, patients had a statistically significant (p < 0.05) reduction in decisional conflict (adjusted mean difference [AMD], -7.18; 95% confidence interval [CI], -13.50 to 12.59); increased clarity of the benefits and risks (AMD, -10.86; CI, -20.33 to 21.49); and improved general treatment knowledge (AMD, 8.99; CI, 2.88-10.28) after using the PtDA. General trends were also reported in the patients' choice predisposition scores that suggested potential differences in treatment decision after PtDA use. Conclusions: This study provides evidence that this PtDA may be a helpful educational tool for this group of women. The quality of care for older breast cancer patients may be

  7. 'Ukrytie' entombment is 10 years old. Main results of scientific investigations

    International Nuclear Information System (INIS)

    1996-01-01

    The Collection is dedicated to 10-yaer anniversary of the ''Ukrytie''. It comprises articles written by specialists of the National Academy of Sciences of Ukraine, the Interdisciplinary Scientific and Technical Centre ''Shelter'', the ''Ukrytie'', Russian Scientific Centre ''Kurchatov Institute'' (Moscow), Khlopin Radium Institute (Saint-Petersburg), Radioecological Problems Institute (Minsk), who took part in study of this unique object for many years. The articles are written in review form and include all main scientific results obtained owing to common efforts during last 10 years. Of course, these years were not equal as to the research results. There were years of great breaks-through towards new knowledge about the ''Ukrytie'', as well as years of preparation for these breaks-through. Nevertheless, scientific research of the ''Ukrytie'' never stopped and every year of work brought grains of objective truth on base of which our present knowledge about the ''Ukrytie'' was put together. This knowledge, set out in easily understood form, delivers materials of the Collection to the reader concerned

  8. Single fiber beta detector for stereotactic biopsy and intraoperative lumpectomy of breast cancer

    International Nuclear Information System (INIS)

    Atac, M.; Nalcioglu, O.; Roeck, W.W.

    1996-10-01

    We have developed an intraoperative probe for use in early detection of breast cancer and aiding lumpectomy. The probe consists of a small plastic scintillator, 0.8mm dia and 3mm long, coupled to a single clear optical-fiber strand, and solid state photomultiplier. Due to the small size of the probe, it can be placed inside of a small gauge biopsy needle. The scintillator is very efficient in detecting betas and positrons while being very in efficient to energetic gammas due to small size and low density. High quantum efficiency, 80%, and high gain obtainable, solid state photomultiplier makes the probe very low noise device in detecting beta particles. Intrinsic resolution of the probe is expected to be around 1 mm. Preliminary results using beta sources and a rat bearing R320 adenocarcinoma tumor were very successful

  9. A Phase II Trial of Brachytherapy Alone After Lumpectomy for Select Breast Cancer: Tumor Control and Survival Outcomes of RTOG 95-17

    International Nuclear Information System (INIS)

    Arthur, Douglas W.; Winter, Kathryn; Kuske, Robert R.; Bolton, John; Rabinovitch, Rachel; White, Julia; Hanson, William F.; Wilenzick, Raymond M.; McCormick, Beryl

    2008-01-01

    Purpose: Radiation Therapy Oncology Group 95-17 is a prospective Phase II cooperative group trial of accelerated partial breast irradiation (APBI) alone using multicatheter brachytherapy after lumpectomy in select early-stage breast cancers. Tumor control and survival outcomes are reported. Methods and Materials: Eligibility criteria included Stage I/II breast carcinoma confirmed to be <3 cm, unifocal, invasive nonlobular histology with zero to three positive axillary nodes without extracapsular extension. APBI treatment was delivered with either low-dose-rate (LDR) (45 Gy in 3.5-5 days) or high-dose-rate (HDR) brachytherapy (34 Gy in 10 twice-daily fractions over 5 days). End points evaluated included in-breast control, regional control, mastectomy-free rate, mastectomy-free survival, disease-free survival, and overall survival. The study was designed to analyze the HDR and LDR groups separately and without comparison. Results: Between 1997 and 2000, 100 patients were accrued and 99 were eligible; 66 treated with HDR brachytherapy and 33 treated with LDR brachytherapy. Eighty-seven patients had T1 lesions and 12 had T2 lesions. Seventy-nine were pathologically N0 and 20 were N1. Median follow-up in the HDR group is 6.14 years with the 5-year estimates of in-breast, regional, and contralateral failure rates of 3%, 5%, and 2%, respectively. The LDR group experienced similar results with a median follow-up of 6.22 years. The 5-year estimates of in-breast, regional, and contralateral failure rates of 6%, 0%, and 6%, respectively. Conclusion: Patients treated with multicatheter partial breast brachytherapy in this trial experienced excellent in-breast control rates and overall outcome that compare with reports from APBI studies with similar extended follow-up

  10. Ten-year results of treatment of ductal carcinoma in situ (DCIS) of the breast with conservative surgery and radiotherapy.

    Science.gov (United States)

    Amichetti, M; Caffo, O; Richetti, A; Zini, G; Rigon, A; Antonello, M; Arcicasa, M; Coghetto, F; Valdagni, R; Maluta, S; Di Marco, A

    1997-09-01

    The optimal treatment of ductal carcinoma in situ (DCIS) of the breast has not yet been established. The effectiveness of adjuvant postoperative radiotherapy after conservative surgery is debated. Few data are available in Italy on the combined treatment. A collaborative multi-institutional study on this issue in 10 radiation oncology departments of the north-east of Italy was conducted. One hundred and thirty nine women with DCIS of the breast were treated between 1980 and 1990. Age ranged between 28 and 88 years (median 50 years). Surgical procedures were: quadrantectomy in 108, lumpectomy in 22 and wide excision in 9 cases. The axilla was surgically staged in 97 cases: all the patients were node-negative. Radiation therapy was delivered with 60Co units (78%) or 6 MV linear accelerators (22%) for a median total dose to the entire breast of 50 Gy (mean 49.48 Gy; range 45-60 Gy). The tumour bed was boosted in 109 cases (78%) at a dose of 4-30 Gy (median 10 Gy) for a minimum tumour dose of 58 Gy. Median follow-up was 81 months. Thirteen local recurrences were recorded, 7 intraductal and 6 invasive. All recurrent patients had a salvage mastectomy and are alive and free of disease. Actuarial overall, cause-specific and recurrence-free survival at 10 years are of 93%, 100% and 86%, respectively. The results of this retrospective multicentric study substantiate the favourable data reported in the literature and confirm the efficacy of the breast-conserving treatment of DCIS employing conservative surgery and adjuvant radiation therapy.

  11. Long-Term Cancer Outcomes From Study NRG Oncology/RTOG 9517: A Phase 2 Study of Accelerated Partial Breast Irradiation With Multicatheter Brachytherapy After Lumpectomy for Early-Stage Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    White, Julia, E-mail: Julia.White@osumc.edu [Department of Radiation Oncology, The James, Ohio State University, Columbus, Ohio (United States); Winter, Kathryn [NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania (United States); Kuske, Robert R. [Department of Radiation Oncology, Arizona Breast Cancer Specialists, Scottsdale, Arizona (United States); Bolton, John S. [Department of Radiation Oncology, Oschner Clinic, New Orleans, Louisiana (United States); Arthur, Douglas W. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia (United States); Scroggins, Troy [Department of Radiation Oncology, Oschner Clinic, New Orleans, Louisiana (United States); Rabinovitch, Rachel A. [Department of Radiation Oncology, University of Colorado Denver, Aurora, Colorado (United States); Kelly, Tracy [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Toonkel, Leonard M. [Mount Sinai Comprehensive Cancer Center, Miami, Florida (United States); Vicini, Frank A. [Department of Radiation Oncology, Botsford Hospital, Farmington Hills, Michigan (United States); McCormick, Beryl [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2016-08-01

    Purpose: To examine 10-year rates of local, regional, and distant recurrences, patterns of recurrence, and survival rates for breast cancer patients enrolled on Study NRG Oncology/Radiation Therapy Oncology Group 9517, a multi-institutional prospective trial that studied one of the earliest methods of accelerated partial breast irradiation (APBI), multicatheter brachytherapy (MCT). Methods and Materials: Eligibility included stage I/II unifocal breast cancer <3 cm in size after lumpectomy with negative surgical margins and 0 to 3 positive axillary nodes without extracapsular extension. The APBI dose delivered was 34 Gy in 10 twice-daily fractions over 5 days for high-dose-rate (HDR); and 45 Gy in 3.5 to 5 days for low-dose-rate (LDR) brachytherapy. The primary endpoint was HDR and LDR MCT reproducibility. This analysis focuses on long-term ipsilateral breast recurrence (IBR), contralateral breast cancer events (CBE), regional recurrence (RR), and distant metastases (DM), disease-free, and overall survival. Results: The median follow-up was 12.1 years. One hundred patients were accrued from 1997 to 2000; 98 were evaluable; 65 underwent HDR and 33 LDR MCT. Median age was 62 years; 88% had T1 tumors; 81% were pN0. Seventy-seven percent were estrogen receptor and/or progesterone receptor positive; 33% received adjuvant chemotherapy and 64% antiendocrine therapy. There have been 4 isolated IBRs and 1 IBR with RR, for 5.2% 10-year IBR without DM. There was 1 isolated RR, 1 with IBR, and 1 with a CBE, for 3.1% 10-year RR without DM. The 10-year CBE rate was 4.2%, with 5 total events. Eleven patients have developed DM, 8 have died of breast cancer, and 22 have died from other causes. The 10-year DFS and OS rates are 69.8% and 78.0%, respectively. Conclusion: This multi-institutional, phase 2 trial studying MCT-APBI continues to report durable in-breast cancer control rates with long-term follow-up.

  12. Long-Term Cancer Outcomes From Study NRG Oncology/RTOG 9517: A Phase 2 Study of Accelerated Partial Breast Irradiation With Multicatheter Brachytherapy After Lumpectomy for Early-Stage Breast Cancer

    International Nuclear Information System (INIS)

    White, Julia; Winter, Kathryn; Kuske, Robert R.; Bolton, John S.; Arthur, Douglas W.; Scroggins, Troy; Rabinovitch, Rachel A.; Kelly, Tracy; Toonkel, Leonard M.; Vicini, Frank A.; McCormick, Beryl

    2016-01-01

    Purpose: To examine 10-year rates of local, regional, and distant recurrences, patterns of recurrence, and survival rates for breast cancer patients enrolled on Study NRG Oncology/Radiation Therapy Oncology Group 9517, a multi-institutional prospective trial that studied one of the earliest methods of accelerated partial breast irradiation (APBI), multicatheter brachytherapy (MCT). Methods and Materials: Eligibility included stage I/II unifocal breast cancer <3 cm in size after lumpectomy with negative surgical margins and 0 to 3 positive axillary nodes without extracapsular extension. The APBI dose delivered was 34 Gy in 10 twice-daily fractions over 5 days for high-dose-rate (HDR); and 45 Gy in 3.5 to 5 days for low-dose-rate (LDR) brachytherapy. The primary endpoint was HDR and LDR MCT reproducibility. This analysis focuses on long-term ipsilateral breast recurrence (IBR), contralateral breast cancer events (CBE), regional recurrence (RR), and distant metastases (DM), disease-free, and overall survival. Results: The median follow-up was 12.1 years. One hundred patients were accrued from 1997 to 2000; 98 were evaluable; 65 underwent HDR and 33 LDR MCT. Median age was 62 years; 88% had T1 tumors; 81% were pN0. Seventy-seven percent were estrogen receptor and/or progesterone receptor positive; 33% received adjuvant chemotherapy and 64% antiendocrine therapy. There have been 4 isolated IBRs and 1 IBR with RR, for 5.2% 10-year IBR without DM. There was 1 isolated RR, 1 with IBR, and 1 with a CBE, for 3.1% 10-year RR without DM. The 10-year CBE rate was 4.2%, with 5 total events. Eleven patients have developed DM, 8 have died of breast cancer, and 22 have died from other causes. The 10-year DFS and OS rates are 69.8% and 78.0%, respectively. Conclusion: This multi-institutional, phase 2 trial studying MCT-APBI continues to report durable in-breast cancer control rates with long-term follow-up.

  13. Accelerated partial breast irradiation in the elderly: 5-year results of high-dose rate multi-catheter brachytherapy

    International Nuclear Information System (INIS)

    Genebes, Caroline; Hannoun-Levi, Jean-Michel; Chand, Marie-Eve; Gal, Jocelyn; Gautier, Mathieu; Raoust, Ines; Ihrai, Tarik; Courdi, Adel; Ferrero, Jean-Marc; Peyrottes, Isabelle

    2014-01-01

    To evaluate clinical outcome after accelerated partial breast irradiation (APBI) in the elderly after high-dose-rate interstitial multi-catheter brachytherapy (HIBT). Between 2005 and 2013, 70 patients underwent APBI using HIBT. Catheter implant was performed intra or post-operatively (referred patients) after lumpectomy and axillary sentinel lymph node dissection. Once the pathological results confirmed the indication of APBI, planification CT-scan was performed to deliver 34 Gy/10f/5d or 32 Gy/8f/4d. Dose-volume adaptation was manually achieved (graphical optimization). Dosimetric results and clinical outcome were retrospectively analyzed. Physician cosmetic evaluation was reported. With a median follow-up of 60.9 months [4.6 – 90.1], median age was 80.7 years [62 – 93.1]. Regarding APBI ASTRO criteria, 61.4%, 18.6% and 20% were classified as suitable, cautionary and non-suitable respectively. Axillary sentinel lymph node dissection was performed in 94.3%; 8 pts (11.5%) presented an axillary involvement. A median dose of 34 Gy [32 – 35] in 8 to 10 fractions was delivered. Median CTV was 75.2 cc [16.9 – 210], median D90 EQD2 was 43.3 Gy [35 – 72.6] and median DHI was 0.54 [0.19 – 0.74]. One patient experienced ipsilateral recurrence (5-year local free recurrence rate: 97.6%. Five-year specific and overall survival rates were 97.9% and 93.2% respectively. Thirty-four patients (48%) presented 47 late complications classified grade 1 (80.8%) and grade 2 (19.2%) with no grade ≥ 3. Cosmetic results were considered excellent/good for 67 pts (95.7%). APBI using HIBT and respecting strict rules of implantation and planification, represents a smart alternative between no post-operative irradiation and whole breast irradiation delivered over 6 consecutive weeks

  14. Partial Breast Radiation Therapy With Proton Beam: 5-Year Results With Cosmetic Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Bush, David A., E-mail: dbush@llu.edu [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Do, Sharon [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Lum, Sharon; Garberoglio, Carlos [Department of Surgical Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Mirshahidi, Hamid [Department of Medical Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Patyal, Baldev; Grove, Roger; Slater, Jerry D. [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States)

    2014-11-01

    Purpose: We updated our previous report of a phase 2 trial using proton beam radiation therapy to deliver partial breast irradiation (PBI) in patients with early stage breast cancer. Methods and Materials: Eligible subjects had invasive nonlobular carcinoma with a maximal dimension of 3 cm. Patients underwent partial mastectomy with negative margins; axillary lymph nodes were negative on sampling. Subjects received postoperative proton beam radiation therapy to the surgical bed. The dose delivered was 40 Gy in 10 fractions, once daily over 2 weeks. Multiple fields were treated daily, and skin-sparing techniques were used. Following treatment, patients were evaluated with clinical assessments and annual mammograms to monitor toxicity, tumor recurrence, and cosmesis. Results: One hundred subjects were enrolled and treated. All patients completed the assigned treatment and were available for post-treatment analysis. The median follow-up was 60 months. Patients had a mean age of 63 years; 90% had ductal histology; the average tumor size was 1.3 cm. Actuarial data at 5 years included ipsilateral breast tumor recurrence-free survival of 97% (95% confidence interval: 100%-93%); disease-free survival of 94%; and overall survival of 95%. There were no cases of grade 3 or higher acute skin reactions, and late skin reactions included 7 cases of grade 1 telangiectasia. Patient- and physician-reported cosmesis was good to excellent in 90% of responses, was not changed from baseline measurements, and was well maintained throughout the entire 5-year follow-up period. Conclusions: Proton beam radiation therapy for PBI produced excellent ipsilateral breast recurrence-free survival with minimal toxicity. The treatment proved to be adaptable to all breast sizes and lumpectomy cavity configurations. Cosmetic results appear to be excellent and unchanged from baseline out to 5 years following treatment. Cosmetic results may be improved over those reported with photon

  15. Lumpectomy and sentinel lymph node navigation surgery for breast cancer under local anesthesia

    International Nuclear Information System (INIS)

    Nakajima, Hiroo; Fujiwara, Ikuya; Mizuta, Naruhiko; Sakaguchi, Koichi; Hachimine, Yasushi; Nakatsukasa, Katsuhiro; Kobayashi, Aya

    2007-01-01

    We studied and analyzed therapeutic outcomes of a radical surgery under local anesthesia for breast cancer in our department. Subjects were 53 patients with breast cancer whose diagnoses were definitely made before surgery. Indications were: localized ductal carcinoma in situ (DCIS) diagnosed preoperatively; invasive carcinoma less than 3 cm in tumor diameter on ultrasound and magnetic resonance imaging scan; and clinically tumors with negative axillary lymph nodes. Operative procedures included microdochectomy or lumpectomy associated with sentinel lymph node navigation biopsy (SLNB). We could perform the operation under local anesthesia in all the 53 patients, and were not demanded to shift from local to general anesthesia. Surgical stumps were positive in 10 patients (18.9%). Of the ten patients, additional resection was performed in one, and irradiation was added to the remaining nine patients. SLNB was performed in a total of 39 patients, six (15.4%) patients of them had metastasis and two out of the six patients underwent additional axillary lymph node dissection. None of serious complications were encountered. Local recurrence and hepatic metastasis occurred in each one patient in an averaged observation period of 15.1 months. This day's radical operation under local anesthesia for breast cancer is a useful procedure as minimally invasive surgery as for the indications employed in this study. (author)

  16. Contemporary Toxicity Profile of Breast Brachytherapy Versus External Beam Radiation After Lumpectomy for Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Huo, Jinhai [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Giordano, Sharon H. [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D. [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Shaitelman, Simona F. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Grace L., E-mail: glsmith@mdanderson.org [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2016-03-15

    Purpose: We compared toxicities after brachytherapy versus external beam radiation therapy (EBRT) in contemporary breast cancer patients. Methods and Materials: Using MarketScan healthcare claims, we identified 64,112 women treated from 2003 to 2012 with lumpectomy followed by radiation (brachytherapy vs EBRT). Brachytherapy was further classified by multichannel versus single-channel applicator approach. We identified the risks and predictors of 1-year infectious and noninfectious postoperative adverse events using logistic regression and temporal trends using Cochran-Armitage tests. We estimated the 5-year Kaplan-Meier cumulative incidence of radiation-associated adverse events. Results: A total of 4522 (7.1%) patients received brachytherapy (50.2% multichannel vs 48.7% single-channel applicator). The overall risk of infectious adverse events was higher after brachytherapy than after EBRT (odds ratio [OR] = 1.21; 95% confidence interval [CI] 1.09-1.34, P<.001). However, over time, the frequency of infectious adverse events after brachytherapy decreased, from 17.3% in 2003 to 11.6% in 2012, and was stable after EBRT at 9.7%. Beyond 2007, there were no longer excess infections with brachytherapy (P=.97). The overall risk of noninfectious adverse events was higher after brachytherapy than after EBRT (OR=2.27; 95% CI 2.09-2.47, P<.0001). Over time, the frequency of noninfectious adverse events detected increased: after multichannel brachytherapy, from 9.1% in 2004 to 18.9% in 2012 (Ptrend = .64); single-channel brachytherapy, from 12.8% to 29.8% (Ptrend<.001); and EBRT, from 6.1% to 10.3% (Ptrend<.0001). The risk was significantly higher with single-channel than with multichannel brachytherapy (hazard ratio = 1.32; 95% CI 1.03-1.69, P=.03). Of noninfectious adverse events, 70.9% were seroma. Seroma significantly increased breast pain risk (P<.0001). Patients with underlying diabetes, cardiovascular disease, and treatment with chemotherapy had increased

  17. Contemporary Toxicity Profile of Breast Brachytherapy Versus External Beam Radiation After Lumpectomy for Breast Cancer

    International Nuclear Information System (INIS)

    Huo, Jinhai; Giordano, Sharon H.; Smith, Benjamin D.; Shaitelman, Simona F.; Smith, Grace L.

    2016-01-01

    Purpose: We compared toxicities after brachytherapy versus external beam radiation therapy (EBRT) in contemporary breast cancer patients. Methods and Materials: Using MarketScan healthcare claims, we identified 64,112 women treated from 2003 to 2012 with lumpectomy followed by radiation (brachytherapy vs EBRT). Brachytherapy was further classified by multichannel versus single-channel applicator approach. We identified the risks and predictors of 1-year infectious and noninfectious postoperative adverse events using logistic regression and temporal trends using Cochran-Armitage tests. We estimated the 5-year Kaplan-Meier cumulative incidence of radiation-associated adverse events. Results: A total of 4522 (7.1%) patients received brachytherapy (50.2% multichannel vs 48.7% single-channel applicator). The overall risk of infectious adverse events was higher after brachytherapy than after EBRT (odds ratio [OR] = 1.21; 95% confidence interval [CI] 1.09-1.34, P<.001). However, over time, the frequency of infectious adverse events after brachytherapy decreased, from 17.3% in 2003 to 11.6% in 2012, and was stable after EBRT at 9.7%. Beyond 2007, there were no longer excess infections with brachytherapy (P=.97). The overall risk of noninfectious adverse events was higher after brachytherapy than after EBRT (OR=2.27; 95% CI 2.09-2.47, P<.0001). Over time, the frequency of noninfectious adverse events detected increased: after multichannel brachytherapy, from 9.1% in 2004 to 18.9% in 2012 (Ptrend = .64); single-channel brachytherapy, from 12.8% to 29.8% (Ptrend<.001); and EBRT, from 6.1% to 10.3% (Ptrend<.0001). The risk was significantly higher with single-channel than with multichannel brachytherapy (hazard ratio = 1.32; 95% CI 1.03-1.69, P=.03). Of noninfectious adverse events, 70.9% were seroma. Seroma significantly increased breast pain risk (P<.0001). Patients with underlying diabetes, cardiovascular disease, and treatment with chemotherapy had increased

  18. Laparoscopic Heller myotomy for achalasia: results after 10 years.

    Science.gov (United States)

    Cowgill, Sarah M; Villadolid, Desiree; Boyle, Robert; Al-Saadi, Sam; Ross, Sharona; Rosemurgy, Alexander S

    2009-12-01

    Laparoscopic Heller myotomy was first undertaken in the early 1990s, and appreciable numbers of patients with 10-year follow-up periods are now available. This study was undertaken to determine long-term outcomes after laparoscopic Heller myotomy used to treat achalasia. Of 337 patients who have undergone laparoscopic Heller myotomy since 1992, 47 who underwent myotomy more than 10 years ago have been followed through a prospectively maintained registry. Among many symptoms, patients scored dysphagia, chest pain, vomiting, regurgitation, choking, and heartburn before and after myotomy using a Likert scale with choices ranging from 0 (never/not bothersome) to 10 (always/very bothersome). Symptom scores before and after myotomy were compared using a Wilcoxon matched-pairs test. Data are reported as median (mean ± standard deviation). The median length of the hospital stay was 2 days (mean, 3 ± 8.6 days; range, 1-60 days). Notable complications were infrequent after myotomy. There were no perioperative deaths. One patient required a redo myotomy after 5 years due to recurrence of symptoms. At this writing, 33 patients (70%) are still alive. The causes of death after discharge were unrelated to myotomy. The frequency and severity scores for dysphagia, chest pain, vomiting, regurgitation, choking, and heartburn all decreased significantly after laparoscopic Heller myotomy (p Heller myotomy can be undertaken with few complications. This procedure significantly decreases the frequency and severity of achalasia symptoms without promoting heartburn. The symptoms of achalasia are durably ameliorated by laparoscopic Heller myotomy during long-term follow-up evaluation, thereby promoting application of this procedure.

  19. Breast Cancer Patients' Preferences for Adjuvant Radiotherapy Post Lumpectomy: Whole Breast Irradiation vs. Partial Breast Irradiation-Single Institutional Study.

    Science.gov (United States)

    Bonin, Katija; McGuffin, Merrylee; Presutti, Roseanna; Harth, Tamara; Mesci, Aruz; Feldman-Stewart, Deb; Chow, Edward; Di Prospero, Lisa; Vesprini, Danny; Rakovitch, Eileen; Lee, Justin; Paszat, Lawrence; Doherty, Mary; Soliman, Hany; Ackerman, Ida; Cao, Xingshan; Kiss, Alex; Szumacher, Ewa

    2018-02-01

    This study was conducted to elucidate patients with early breast cancer preference for standard whole breast irradiation (WBI) or partial breast irradiation (PBI) following lumpectomy, as well as identify important factors for patients when making their treatment decisions. Based on relevant literature and ASTRO consensus statement guidelines, an educational tool and questionnaire were developed. Consenting, eligible women reviewed the educational tool and completed the trade-off questionnaire. Descriptive statistics were calculated, as well as chi-squares and a logistic regression model. Of the 90 patients who completed the study, 62 % preferred WBI, 30 % preferred PBI, 4 % required more information, and 3 % had no preferences. Of the patients who chose WBI, 58 % preferred hypofractionated RT, whereas 25 % preferred the conventional RT regimen. The majority of patients rated recurrence rate [WBI = 55/55 (100 %), PBI = 26/26 (100 %)] and survival [WBI = 54/55 (98 %), PBI = 26/26 (100 %)] as important factors contributing to their choice of treatment preference. Financial factors [WBI = 21/55 (38 %), PBI = 14/26 (53 %)] and convenience [WBI = 36/54 (67 %), PBI = 18/26 (69 %)] were rated as important less frequently. Significantly, more patients who preferred WBI also rated standard method of treatment as important when compared to patients who preferred PBI [WBI = 52/54 (96 %), PBI = 16/26 (61 %), χ 2  = 16.63, p = 0.001]. The majority of patients with early breast cancer who were surveyed for this study preferred WBI as an adjuvant treatment post lumpectomy, yet there was a sizeable minority who preferred PBI. This was associated with the importance patients place on standard treatment. These results will help medical professionals treat patients according to patient values.

  20. Optimization of registration template of cone-beam CT guided whole breast irradiation after lumpectomy of breast cancer

    International Nuclear Information System (INIS)

    Wang Dongqing; Li Hongsheng; Zhou Tao; Liu Tonghai; Yu Ningsha; Li Baosheng

    2010-01-01

    Objective: To optimize the registration template of kilovoltage cone-beam CT (CBCT) guided radiotherapy in whole breast irradiation (WBI) after lumpectomy of breast cancer. Methods: From April 2006 to July 2009, twelve patients undergoing WBI with intensity-modulated radiotherapy (IMRT) were recruited in this study. All patients were performed with both conventional planning CT and CBCT integrated on Varian 23EX. Six distinguishable reference points (the diameter 1 mm) around the lumpectomy cavity and the surrounding gland on the planning CT image were marked. The images were manually registered offline based on the breast surface, surgical clips, breast gland, contiguous rib, ipsilateral lung and its external contours, respectively. The same six reference points were then marked on the CBCT image. The performance of the five registration templates was compared using the concept of registration error, while the registration time was taken into account. The registration error was calculated based on the six reference points' translations between the planning CT image and CBCT image, and analyzed with SPSS 13.0 software using one-way ANOVA. Results: The values of the registration error for the breast surface, surgical clips, breast gland, contiguous rib, ipsilateral lung and its external contours were (0.60±0.20), (0.43±0.15), (0.49±0.19), (0.69±0.36) and (0.94±0.49) cm, respectively, and the registration time were (3.8±1.1), (3.0±0.9), (4.7±1.7), (4.3±1.3) and (4.5±1.3) min, respectively. There was no statistical difference between the breast surface, surgical clips and breast gland registration template (t=0.48-1.36, P<0.05), the same result trend to contiguous rib compared with ipsilateral lung (t=2.00, P=0.055), however, there was significant difference between surgical clips and the last two registration methods (t=2.08-4.08, P<0.05). Conclusions: In this initial study with a modest number of patients, surgical clips show a best registration template

  1. Intraoperative Ir-192 implantation for early breast cancer. Techniques and results

    International Nuclear Information System (INIS)

    Mansfield, C.M.

    1990-01-01

    Patients with early breast cancer (T1-2 N0-1) can be treated by lumpectomy and irradiation with a local control and survival equal to more radical surgery. Between 1982 and 1988, 323 patients with early breast cancer were treated, when possible, with Ir-192 implants at the time of lumpectomy to a local dose of 2000 cGy in 40-50 hours. Ten to 14 days later, the whole breast was treated to 4500 cGy at 180 per fraction in 5 weeks. The 6-year actuarial survival for stages I and II disease was 98% and 91%, respectively, and the recurrence-free survival was 96% and 98%, respectively. When these 323 patients were evaluated by T status, a local control of 97% was the same for T1 and T2 lesions. The cosmetic results were good to excellent in 95% of the patients. This approach has improved our ability to accurately place the boost dose in the breast

  2. Cognitive dysfunction improves in systemic lupus erythematosus: Results of a 10 years prospective study.

    Directory of Open Access Journals (Sweden)

    Fulvia Ceccarelli

    Full Text Available Cognitive impairment (CI has been described in 3-80% of Systemic lupus erythematosus (SLE patients but only short-term studies evaluated its over-time changes, suggesting that CI is usually a stable finding. We aimed at evaluating the changes of SLE-related CI in a 10-years prospective single center cohort study.We evaluated 43 patients (M/F 5/38; mean age = 45.7±10.1 years; mean disease duration = 230.8±74.3 months at baseline (T0 and after 10 years (T1. A test battery designed to detect fronto-subcortical dysfunction across five domains (memory, attention, abstract reasoning, executive and visuospatial function was administered. A global cognitive dysfunction score (GCD was obtained and associated with clinical and laboratory features.Prevalence of CI was 20.9% at T0 and 13.9% at T1 (P = NS. This impairment was prevalently mild at T0 (55.5% and mild or moderate at T1 (36.3% for both degrees. After 10 years, CI improved in 50% of patients, while 10% worsened. Impaired memory (P = 0.02, executive functions (P = 0.02 and abstract reasoning (P = 0.03 were associated with dyslipidemia at T0. Worsening of visuospatial functions was significantly associated with dyslipidemia and Lupus Anticoagulant (P = 0.04 for both parameters. Finally, GCD significantly correlated with chronic damage measured by SLICC/damage index at T0 (r = 0.3; P = 0.04 and T1 (r = 0.3; P = 0.03.For the first time, we assessed CI changes over 10-years in SLE. CI improved in the majority of the patients. Furthermore, we observed an improvement of the overall cognitive functions. These results could suggest that an appropriate management of the disease during the follow-up could be able to control SLE-related CI.

  3. High-Dose-Rate Monotherapy for Localized Prostate Cancer: 10-Year Results

    Energy Technology Data Exchange (ETDEWEB)

    Hauswald, Henrik; Kamrava, Mitchell R.; Fallon, Julia M.; Wang, Pin-Chieh; Park, Sang-June; Van, Thanh; Borja, Lalaine; Steinberg, Michael L.; Demanes, D. Jeffrey, E-mail: JDemanes@mednet.ucla.edu

    2016-03-15

    Purpose: High-dose-rate (HDR) brachytherapy was originally used with external beam radiation therapy (EBRT) to increase the dose to the prostate without injuring the bladder or rectum. Numerous studies have reported HDR brachytherapy is safe and effective. We adapted it for use without EBRT for cases not requiring lymph node treatment. Patients and Methods: We entered the patient demographics, disease characteristics, and treatment parameters into a prospective registry and serially added follow-up data for 448 men with low-risk (n=288) and intermediate-risk (n=160) prostate cancer treated from 1996 to 2009. Their median age was 64 years (range 42-90). The median prostate-specific antigen (PSA) level was 6.0 ng/mL (range 0.2-18.2). The Gleason score was ≤6 in 76% and 7 in 24%. The median dose was 43.5 Gy in 6 fractions. The clinical and biochemical disease control and survival rates were calculated. Adverse events were graded according to the Common Toxicity Criteria of Adverse Events. Results: The median follow-up period was 6.5 years (range 0.3-15.3). The actuarial 6- and 10-year PSA progression-free survival was 98.6% (95% confidence interval [CI] 96.9%-99.4%) and 97.8% (95% CI 95.5%-98.9%). Overall survival at 10 years was 76.7% (95% CI 69.9%-82.2%). The local control, distant metastasis-free survival, and cause-specific survival were 99.7% (95% CI 97.9%-99.9%), 98.9% (95% CI 96.3%-99.7%), and 99.1% (95% CI 95.8%-99.8%). T stage, initial PSA level, Gleason score, National Comprehensive Cancer Network risk group, patient age, and androgen deprivation therapy did not significantly correlate with disease control or survival. No late grade 3 to 4 rectal toxicities developed. Late grade 3 to 4 genitourinary toxicity occurred in 4.9% (grade 3 in 4.7%). Conclusions: HDR monotherapy is a safe and highly effective treatment of low- and intermediate-risk prostate cancer.

  4. 10-year results of a new low-monomer cement: follow-up of a randomized RSA study.

    Science.gov (United States)

    Söderlund, Per; Dahl, Jon; Röhrl, Stephan; Nivbrant, Bo; Nilsson, Kjell G

    2012-12-01

    The properties and performance of a new low-monomer cement were examined in this prospective randomized, controlled RSA study. 5-year data have already been published, showing no statistically significant differences compared to controls. In the present paper we present the 10-year results. 44 patients were originally randomized to receive total hip replacement with a Lubinus SPII titanium-aluminum-vanadium stem cemented either with the new Cemex Rx bone cement or with control bone cement, Palacos R. Patients were examined using RSA, Harris hip score, and conventional radiographs. At 10 years, 33 hips could be evaluated clinically and 30 hips could be evaluated with RSA (16 Cemex and 14 Palacos). 9 patients had died and 4 patients were too old or infirm to be investigated. Except for 1 hip that was revised for infection after less than 5 years, no further hips were revised before the 10-year follow-up. There were no statistically significant clinical differences between the groups. The Cemex cement had magnitudes of migration similar to or sometimes lower than those of Palacos cement. In both groups, most hips showed extensive radiolucent lines, probably due to the use of titanium alloy stems. At 10 years, the Cemex bone cement tested performed just as well as the control (Palacos bone cement).

  5. Conservative surgery and radiotherapy for stage I/II breast cancer using lung density correction: 10-year and 15-year results

    International Nuclear Information System (INIS)

    Pierce, Lori J.; Griffith, Kent A.; Hayman, James A.; Douglas, Kathye R.; Lichter, Allen S.

    2005-01-01

    Purpose: Radiotherapy (RT) planning for breast cancer using lung density correction improves dose homogeneity. Its use obviates the need for a medial wedge, thus reducing scatter to the opposite breast. Although lung density correction is used at many centers in planning for early-stage breast cancer, long-term results of local control and survival have not been reported. Since 1984, we have used lung density correction for dose calculations at the University of Michigan. We now present our 10-year and 15-year results. Methods and Materials: The records of 867 patients with Stage I/II breast cancer treated with breast-conserving surgery and RT with or without systemic therapy were reviewed. Tangential fields delivering 45-50 Gy to the whole breast calculated using lung density correction were used. A boost was added in 96.8% of patients for a total median dose of 61.8 Gy. Results: With a median follow-up of 6.6 years (range, 0.2-18.9 years), 5-, 10-, and 15-year actuarial rates of in-breast tumor recurrence as only first failure were 2.2%, 3.6%, and 5.4%, respectively. With surgical salvage, the 15-year cumulative rate of local control was 99.7%. Factors that significantly predicted for increased rate of local recurrence in multivariate analysis were age ≤ 35 years, hazard ratio 4.8 (95% confidence interval [CI], 1.6-13.9) p = 0.004; negative progesterone receptor status, hazard ratio 6.8 (95% CI, 2.3-20.3) p = < 0.001; negative estrogen receptor status, hazard ratio 4.0 (95% CI, 1.5-11.1) p = 0.007; and lack of adjuvant tamoxifen therapy, hazard ratio 7.7 (95% CI, 1.7-33.3) p = 0.008. Relapse-free survival rates at 5, 10, and 15 years were 84.6%, 70.8%, and 55.9%, respectively; breast cancer-specific survival rates were 94.4%, 90.5%, and 86.9%, respectively; and corresponding estimates for overall survival were 89.7%, 75.7%, and 61.3%. Conclusions: Use of lung density correction was associated with high rates of local control, relapse-free survival, breast

  6. Labral Reattachment in Femoroacetabular Impingement Surgery Results in Increased 10-year Survivorship Compared With Resection.

    Science.gov (United States)

    Anwander, Helen; Siebenrock, Klaus A; Tannast, Moritz; Steppacher, Simon D

    2017-04-01

    Since the importance of an intact labrum for normal hip function has been shown, labral reattachment has become the standard method for open or arthroscopic treatment of hips with femoroacetabular impingement (FAI). However, no long-term clinical results exist evaluating the effect of labral reattachment. A 2-year followup comparing open surgical treatment of FAI with labral resection versus reattachment was previously performed at our clinic. The goal of this study was to report a concise followup of these patients at a minimum of 10 years. We asked if patients undergoing surgical hip dislocation for the treatment of mixed-type FAI with labral reattachment compared with labral resection had (1) improved hip pain and function based on the Merle d'Aubigné-Postel score; and (2) improved survival at 10-year followup. Between June 1999 and July 2002, we performed surgical hip dislocation with femoral neck osteoplasty and acetabular rim trimming in 52 patients (60 hips) with mixed-type FAI. In the first 20 patients (25 hips) until June 2001, a torn labrum or a detached labrum in the area of acetabular rim resection was resected. In the next 32 patients (35 hips), reattachment of the labrum was performed. The same indications were used to perform both procedures during the periods in question. Of the 20 patients (25 hips) in the first group, 19 patients (95%) (24 hips [96%]) were available for clinical and/or radiographic followup at a minimum of 10 years (mean, 13 years; range, 12-14 years). Of the 32 patients (35 hips) in the second group, 29 patients (91%) (32 hips [91%]) were available for clinical and/or radiographic followup at a minimum of 10 years (mean, 12 years; range, 10-13 years). We used the anterior impingement test to assess pain. Function was assessed using the Merle d'Aubigné- Postel score and ROM. Survivorship calculation was performed using the method of Kaplan-Meier with failure defined as conversion to THA, progression of osteoarthritis (of one

  7. Long-Term Results after Placement of Aortic Bifurcation Self-Expanding Stents: 10 Year Mortality, Stent Restenosis, and Distal Disease Progression

    International Nuclear Information System (INIS)

    Houston, J. Graeme; Bhat, Raj; Ross, Rose; Stonebridge, Peter A.

    2007-01-01

    Purpose. To retrospectively evaluate the 10 year follow-up results in patients who had 'kissing' self-expanding stent aortic bifurcation reconstruction. Methods. Forty-three patients were treated with 'kissing' self-expanding stents for aortoiliac occlusive disease. Early follow-up with clinical and ankle brachial pressure indices (ABPI) was performed at 3, 6, 12, and 24 months and with intra-arterial digital subtraction angiography at 12-24 months; clinical and angiographic follow-up was performed for symptom recurrence up to 10 years after treatment. Retrospective record review was performed to assess mortality, clinical patency, angiographic patency, and secondary assisted patency of both stents and downstream peripheral vessels at 5 and 10 years follow-up. Results. The 2 year primary angiographic and secondary assisted stent patencies were 89% and 93%, respectively. At 10 years follow-up in 40 patients the mortality was 38% (due to myocardial infarction, stroke, chronic renal failure, malignancy, and liver failure). At 5 and 10 years follow-up the primary clinical stent patency was 82% and 68%, and the secondary assisted stent patency 93% and 86%, respectively. At 5 and 10 years, the distal vessel patency was 86% and 72%, and the secondary assisted distal vessel patency treated by surgical or endovascular techniques was 94% and 88%, respectively. At 10 years there was no limb loss. Conclusion. The long-term (10 year) results of aortic bifurcation arterial self-expanding stent placement in patients with arterial occlusive disease show a 10 year primary stent patency rate of 68% but a secondary assisted patency rate of 86%. In addition there is a high overall mortality due to other cardiovascular causes and the rate of distal disease progression and loss of patency is similar to the loss of stent patency rate

  8. Evora® chromium-cobalt dual mobility socket: results at a minimum 10 years' follow-up.

    Science.gov (United States)

    Leclercq, S; Benoit, J Y; de Rosa, J P; Tallier, E; Leteurtre, C; Girardin, P H

    2013-12-01

    The Evora chromium-cobalt alloy dual mobility socket claims to display a large articulation tribology different from that of stainless steel models, limiting the risk of intraprosthetic dislocation and wear. The present study reports a minimum of 10years' follow-up in a multicenter prospective series of 200 sockets previously reported on at 5years. The use of chromium-cobalt in dual mobility sockets provides a low rate of failure at 10years, especially as regards to osteolysis and intraprosthetic dislocation. Two hundred hydroxyapatite-coated molded chromium-cobalt sockets without titanium interface were implanted without cement in 194 patients with a mean age of 70 years (range, 32-91 years). Clinical results were assessed on Postel Merle d'Aubigné and Harris scores, plain radiographs and survival analysis. At a mean 11 years' follow-up (10-13 years), 56 patients had died and 31 were lost to follow-up. Four underwent surgical revision (3 femoral components, and 1 socket for migration at 9 years with complete disappearance of the hydroxyapatite). A total of 109 implants were analyzable in 107 patients with a mean age of 81 years (55-93 years). At follow-up, the mean Harris score was 90 (75-96) and the PMA score 16.3 (14-18). There were no cases of loosening (except for the case reoperated on at 9 years) and no acetabular radiolucency or cysts. There were 2 cases of non-evolutive femoral radiolucency and 10 of femoral granuloma, involving head size > 22 mm (P<0.0001) and a cemented titanium stem (P=0.004) as risk factors. There were no dislocations in the large or small articulation. Ten-year survival was 99% (95% CI: 97.3%-100%) with socket revision as censorship criterion. The absence of dislocation in both small and large articulations confirmed the efficacy of the dual mobility concept and suggested an advantage for chromium-cobalt sockets in reducing the rate of intraprosthetic dislocation and preventing blockage of the large articulation by a better

  9. Meniscectomy versus meniscal repair: 10 years radiological and clinical results in vertical lesions in stable knee.

    Science.gov (United States)

    Lutz, C; Dalmay, F; Ehkirch, F P; Cucurulo, T; Laporte, C; Le Henaff, G; Potel, J F; Pujol, N; Rochcongar, G; Salledechou, E; Seil, R; Gunepin, F-X; Sonnery-Cottet, B

    2015-12-01

    Surgical management of meniscal lesion consists of either a meniscectomy or meniscal repair. Although repair offers immediate recovery after surgery, it is also associated with higher rates of revision. A meniscectomy, on the other hand is known to be associated with an early onset of osteoarthritis. The present study compared clinical and radiological results at 10 years between meniscectomy and meniscal repair in isolated vertical lesion in an otherwise stable knee. The hypothesis was that repair shows functional and radiological benefit over meniscectomy. A multi-centric retrospective comparative study of 32 patients (24 male, 8 female). Mean follow-up was 10.6 years (range, 10-13 years). There were 10 meniscal repairs (group R) and 22 meniscectomies (group M), in 17 right and 15 left knees. Mean age at surgery was 33.45±12.3 years (range, 9-47 years). There were 28 medial and 4 lateral meniscal lesions; 26 were in the red-red zone and 6 in red-white zone. Functional score: KOOS score was significantly higher in group R than M on almost all parameters: 98±4.69 versus 77.38±21.97 for symptoms (P=0.0043), 96.89±7.20 versus 78.57±18.9 for pain (P=0.0052), 99.89±0.33 versus 80.88±19.6 for daily life activities (P=0.0002), 96.11±9.83 versus 54.05±32.85 for sport and leisure (P=0.0005), but 91±16.87 versus 68.15±37.7 for quality of life (P=0.1048). Radiology score: in group R, 7 patients had no features of osteoarthritis, and 2 had grade 1 osteoarthritis. In group M, 5 patients had grade 1 osteoarthritis, 10 grade 2, 3 grade 3 and 3 grade 4. Mean quantitative score was 0 (mean, 0.22±0.44) in-group R and 2 (mean, 2.19±0.98) in group M (P<0.0001). At more than 10year's follow-up, functional scores were significantly better with meniscal repair than meniscectomy on all parameters of the KOOS scale except quality of life. Functional and radiological scores correlated closely. These results show that meniscal repair for vertical lesions in stable knees

  10. Results of cemented bipolar hemiarthroplasty for fracture of the femoral neck - 10 year study

    Directory of Open Access Journals (Sweden)

    Maini P

    2006-01-01

    Full Text Available Background : One of the most common treatments of displaced fracture of femoral neck in elderly is bipolar hemiarthroplasty. Method : Two hundred and seventy patients of displaced fracture of femoral neck were treated by bipolar hemiarthroplasty. The Mean age of the patients at the time of surgery was 69.80 years. Results : Follow up ranged between 12 months and 120 months. There were 8 cases each of acetabular erosion and protrusion with 10 cases of femoral stem loosening. Eight cases had post operative dislocation requiring open reduction. Eighteen patients got revision surgery to total hip replacement. The overall incidence of DVT/PE was 9.9% which declined after regular use of low molecular weight heparin. Eleven patients had post operative infection. There were 54.2 % excellent results, 21.0 % good results, 10.7 % fair and 3.7% poor results. Conclusion : Elderly patients with displaced fracture of neck femur are able to ambulate early after Cemented bipolar hemi arthroplasty. The complication rate is low, the component survival long and pre injury functional status is restored in majority of patients.

  11. Reduced Cardiovascular Mortality 10 Years after Supplementation with Selenium and Coenzyme Q10 for Four Years: Follow-Up Results of a Prospective Randomized Double-Blind Placebo-Controlled Trial in Elderly Citizens.

    Directory of Open Access Journals (Sweden)

    Urban Alehagen

    Full Text Available Selenium and coenzyme Q10 are important antioxidants in the body. As the intake of selenium is low in Europe, and the endogenous production of coenzyme Q10 decreases as age increases, an intervention trial using selenium and coenzyme Q10 for four years was performed. As previously reported, the intervention was accompanied by reduced cardiovascular mortality. The objective of the present study was to analyze cardiovascular mortality for up to 10 years after intervention, to evaluate if mortality differed in subgroups differentiated by gender, diabetes, ischemic heart disease (IHD, and functional class.Four-hundred forty-three healthy elderly individuals were included from a rural municipality in Sweden. All cardiovascular mortality was registered, and no participant was lost to the follow-up. Based on death certificates and autopsy results mortality was registered.Significantly reduced cardiovascular mortality could be seen in those on selenium and coenzyme Q10 intervention. A multivariate Cox regression analysis demonstrated a reduced cardiovascular mortality risk in the active treatment group (HR: 0.51; 95%CI 0.36-0.74; P = 0.0003. The reduced mortality could be seen to persist during the 10-year period. Subgroup analysis showed positive effects in both genders. An equally positive risk reduction could be seen in those with ischemic heart disease (HR: 0.51; 95%CI 0.27-0.97; P = 0.04, but also in the different functional classes.In a 10-year follow-up of a group of healthy elderly participants given four years of intervention with selenium and coenzyme Q10, significantly reduced cardiovascular mortality was observed. The protective action was not confined to the intervention period, but persisted during the follow-up period. The mechanism explaining the persistency remains to be elucidated. Since this was a small study, the observations should be regarded as hypothesis-generating.

  12. Surgical perspectives from a prospective, nonrandomized, multicenter study of breast conserving surgery and adjuvant electronic brachytherapy for the treatment of breast cancer

    Directory of Open Access Journals (Sweden)

    Beatty J David

    2011-03-01

    Full Text Available Abstract Background Accelerated partial breast irradiation (APBI may be used to deliver radiation to the tumor bed post-lumpectomy in eligible patients with breast cancer. Patient and tumor characteristics as well as the lumpectomy technique can influence patient eligibility for APBI. This report describes a lumpectomy procedure and examines patient, tumor, and surgical characteristics from a prospective, multicenter study of electronic brachytherapy. Methods The study enrolled 65 patients of age 45-84 years with ductal carcinoma or ductal carcinoma in situ, and 44 patients, who met the inclusion and exclusion criteria, were treated with APBI using the Axxent® electronic brachytherapy system following lumpectomy. The prescription dose was 34 Gy in 10 fractions over 5 days. Results The lumpectomy technique as described herein varied by site and patient characteristics. The balloon applicator was implanted by the surgeon (91% or a radiation oncologist (9% during or up to 61 days post-lumpectomy (mean 22 days. A lateral approach was most commonly used (59% for insertion of the applicator followed by an incision site approach in 27% of cases, a medial approach in 5%, and an inferior approach in 7%. A trocar was used during applicator insertion in 27% of cases. Local anesthetic, sedation, both or neither were administered in 45%, 2%, 41% and 11% of cases, respectively, during applicator placement. The prescription dose was delivered in 42 of 44 treated patients. Conclusions Early stage breast cancer can be treated with breast conserving surgery and APBI using electronic brachytherapy. Treatment was well tolerated, and these early outcomes were similar to the early outcomes with iridium-based balloon brachytherapy.

  13. Long-Term Results of Targeted Intraoperative Radiotherapy (Targit) Boost During Breast-Conserving Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Vaidya, Jayant S., E-mail: jayant.vaidya@ucl.ac.uk [Research Department of Surgery, Division of Surgery and Interventional Science, University College London, London (United Kingdom); Baum, Michael [Research Department of Surgery, Division of Surgery and Interventional Science, University College London, London (United Kingdom); Tobias, Jeffrey S. [Department of Radiation Oncology, University College London Hospitals, London (United Kingdom); Wenz, Frederik [Radiation Oncology and Gynaecology, University Medical Centre of Mannheim (Germany); Massarut, Samuele [Surgery and Radiation Oncology, Centro di Riferimento Oncologico (CRO), Aviano (Italy); Keshtgar, Mohammed [Research Department of Surgery, Division of Surgery and Interventional Science, University College London, London (United Kingdom); Hilaris, Basil [Radiation Oncology, Our Lady of Mercy, New York Medical College, New York (United States); Saunders, Christobel [Institute of Health and Rehabilitation Research, University of Notre Dame, Fremantle, Western Australia (Australia); Williams, Norman R.; Brew-Graves, Chris [Research Department of Surgery, Division of Surgery and Interventional Science, University College London, London (United Kingdom); Corica, Tammy [Institute of Health and Rehabilitation Research, University of Notre Dame, Fremantle, Western Australia (Australia); Roncadin, Mario [Surgery and Radiation Oncology, Centro di Riferimento Oncologico (CRO), Aviano (Italy); Kraus-Tiefenbacher, Uta; Suetterlin, Marc [Radiation Oncology and Gynaecology, University Medical Centre of Mannheim (Germany); Bulsara, Max [Institute of Health and Rehabilitation Research, University of Notre Dame, Fremantle, Western Australia (Australia); Joseph, David [Radiation Oncology, Sir Charles Gairdner Hospital and School of Surgery, University of Western Australia, Perth (Australia)

    2011-11-15

    Purpose: We have previously shown that delivering targeted radiotherapy to the tumour bed intraoperatively is feasible and desirable. In this study, we report on the feasibility, safety, and long-term efficacy of TARGeted Intraoperative radioTherapy (Targit), using the Intrabeam system. Methods and Materials: A total of 300 cancers in 299 unselected patients underwent breast-conserving surgery and Targit as a boost to the tumor bed. After lumpectomy, a single dose of 20 Gy was delivered intraoperatively. Postoperative external beam whole-breast radiotherapy excluded the usual boost. We also performed a novel individualized case control (ICC) analysis that computed the expected recurrences for the cohort by estimating the risk of recurrence for each patient using their characteristics and follow-up period. Results: The treatment was well tolerated. The median follow up was 60.5 months (range, 10-122 months). Eight patients have had ipsilateral recurrence: 5-year Kaplan Meier estimate for ipsilateral recurrence is 1.73% (SE 0.77), which compares well with that seen in the boosted patients in the European Organization for Research and Treatment of Cancer study (4.3%) and the UK STAndardisation of breast RadioTherapy study (2.8%). In a novel ICC analysis of 242 of the patients, we estimated that there should be 11.4 recurrences; in this group, only 6 recurrences were observed. Conclusions: Lumpectomy and Targit boost combined with external beam radiotherapy results in a low local recurrence rate in a standard risk patient population. Accurate localization and the immediacy of the treatment that has a favorable effect on tumour microenvironment may contribute to this effect. These long-term data establish the long-term safety and efficacy of the Targit technique and generate the hypothesis that Targit boost might be superior to an external beam boost in its efficacy and justifies a randomized trial.

  14. 5 year Survey of Carcinoma Breast at No.(2) Military Hospital (1987 to 1991)

    Energy Technology Data Exchange (ETDEWEB)

    Pe, Aye; Saw, Kaythi; Mon, Shu; Aung, Yin Yin [Department of Medical Oncology, Yangon, (Myanmar)

    1993-03-15

    Over 250 cases of carcinoma of Breast in different stages, treated by Joint Cancer Clinic (JCC) of No (2) Military Hospital over 5 years (1987 to 1991) were analysed. Different combination of drugs CMF, CMF(P),CMFVP and COFA regimes were given either alone on in combination with local radiation therapy after surgery- lumpectomy or extended simple mastectomy. Hormonal therapy was also added to the standard method of treatment in most of the cases. Results were evaluated in different arms of treatment. The value of immunotherapy and neochemotherapy were also studied.

  15. 5 year Survey of Carcinoma Breast at No.(2) Military Hospital (1987 to 1991)

    International Nuclear Information System (INIS)

    Aye Pe; Kaythi Saw; Shu Mon; Yin Yin Aung

    1993-03-01

    Over 250 cases of carcinoma of Breast in different stages, treated by Joint Cancer Clinic (JCC) of No (2) Military Hospital over 5 years (1987 to 1991) were analysed. Different combination of drugs CMF, CMF(P),CMFVP and COFA regimes were given either alone on in combination with local radiation therapy after surgery- lumpectomy or extended simple mastectomy. Hormonal therapy was also added to the standard method of treatment in most of the cases. Results were evaluated in different arms of treatment. The value of immunotherapy and neochemotherapy were also studied

  16. [Anatomical and functional results of macular hole surgery with internal limiting membrane peeling after 10-year follow-up].

    Science.gov (United States)

    Foveau, P; Conart, J-B; Hubert, I; Selton, J; Berrod, J-P

    2016-09-01

    To evaluate the anatomical and functional results of macular hole surgery with internal limiting membrane (ILM) peeling after 10 years follow-up. Monocentric retrospective study of patients who had undergone macular hole surgery between 2003 and 2005 in the Nancy University Medical Center and still followed in the department in 2014. All patients underwent pars plana vitrectomy and ILM peeling without staining. Clinical examination at ten years including determination of best-corrected visual acuity (BCVA), evaluation of quality of life and spectral domain optical coherence tomography was performed. Four men and six women with mean age of 64±8 years were included. The mean diameter of the MH was 395±133μm. The mean best corrected visual acuity improved significantly from 0.90±0.22 logMAR to 0.14±0.14 logMAR after 10 years with a satisfactory quality of life in 90 % of patients. The integrity of the IS/OS layer was preserved in 9 eyes. Inner retinal dimples located in the temporal quadrant related to ILM peeling initiation were observed in 8 eyes. No significant RNFL or ganglion cell complex changes were found compared to the contralateral eye. Macular hole surgery with ILM peeling in this series resulted in a visual acuity gain of 8 ETDRS lines and persistent improvement in quality of life after a 10-year follow-up. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. Mineral Trioxide Aggregate (MTA direct pulp capping: 10 years clinical results

    Directory of Open Access Journals (Sweden)

    Lucio Daniele

    2017-06-01

    After 10-years follow-up period, 6 out of 80 teeth required an endodontic treatment, we did not find an increase of pulp calcifications, root resorptions, endodontic lesions. All teeth still alive have responded positively to the cold-temperature test. The three lesions had disappeared at the last X-ray control. All four symptomatic teeth preserved their pulp vitality. The successful treatment rate was 92.5%. Direct pulp capping with MTA can be considered an effective treatment of exposure due to tooth decay and can be considered a valid treatment option for teeth with a diagnosis of not-severe reversible pulpitis.

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

    Science.gov (United States)

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

    2017-12-15

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

  19. The Advanced Glaucoma Intervention Study (AGIS): 13. Comparison of treatment outcomes within race: 10-year results.

    Science.gov (United States)

    Ederer, Fred; Gaasterland, Douglas A; Dally, Leonard G; Kim, Jonghyeon; VanVeldhuisen, Paul C; Blackwell, Beth; Prum, Bruce; Shafranov, George; Allen, Robert C; Beck, Allen

    2004-04-01

    To present for black and white patients with medically uncontrolled glaucoma 10-year results of treatment with 1 of 2 randomly assigned surgical intervention sequences. Randomized clinical trial. Three hundred thirty-two black patients (451 eyes) and 249 white patients (325 eyes). Eyes had glaucoma that could not be controlled with medications alone. Eyes were randomly assigned to 1 of 2 sequences: argon laser trabeculoplasty (ALT)-trabeculectomy-trabeculectomy (ATT) or trabeculectomy-ALT-trabeculectomy (TAT). Second and third interventions were offered after failure of the preceding intervention. Minimum required intraocular pressure (IOP) for intervention failure ranged upward from 18 mmHg, the value depending on whether recent optic disc or visual field (VF) deterioration occurred, and on the magnitude of the field defect. Patients were observed every 6 months, with total potential follow-up ranging from 8 years, 4 months to 13 years. The averages over follow-up of (1) the percentage of eyes having moderate loss of VF and (2) the percentage of eyes having moderate loss of visual acuity (VA). Race-treatment interactions in VF and VA loss are significant for the 2 main outcome measures; therefore, results of treatment sequence differences are presented by race. In black patients the average percent of eyes with VF loss was less in the ATT sequence than in the TAT sequence, a difference that is not statistically significant at any visit. In white patients, conversely, after 18 months the average percent of eyes with VF loss was less in the TAT sequence, a difference that increases and is statistically significant in years 8 to 10. In both black and white patients, the average percent of eyes with VA loss was less in the ATT sequence; this difference is statistically significant throughout 10 follow-up years in black patients and is statistically significant only for the first year in white patients. In both black and white patients, average IOP reductions were

  20. In situ Tournemire argillite / iron metal interactions: results after 10 years

    International Nuclear Information System (INIS)

    Maillet, A.

    2012-01-01

    Within the framework of a long lived radioactive waste storage concept in deep geological layer developed by Andra, IRSN leads an in situ study on the Experimental Station of Tournemire, in association with EDF to determine the interactions steel/argillite in a natural context. After 10 years of interaction, two drillings overcoring performed to characterize the processing of the Tournemire argillite in contact with carbon and stainless steels and to compare reactive phenomena highlighted and those induced by simulations tools combining chemistry and transport. Argillite/carbon steel samples show a significant corrosion of steel disk. Iron released, in the form of rings and cracks in the rock, disrupts the argillite in contact resulting in mineralogical and structural changes. Iron oxides precipitation and a calcite and smectitic leaf of mixed-layers I/S dissolution are identified. A succession of areas: metal/metal corroded/argillite disturbed/argillite is highlighted and porosity variations are observed on the interfaces between two areas. Geochemical simulations show that major changes are initiated speedily during establishment of the system and the oxygen trapped in the closed system is consumed by the corrosion of steel but mostly it diffuses into the surrounding material through concentration gradient. Argillite/stainless steel samples have a very low pitting corrosion of steel disk. This does not seem to affect the mineralogy of the argillite in contact. (author)

  1. Veneered zirconia inlay-retained fixed dental prostheses: 10-Year results from a prospective clinical study.

    Science.gov (United States)

    Rathmann, Friederike; Bömicke, Wolfgang; Rammelsberg, Peter; Ohlmann, Brigitte

    2017-09-01

    The purpose of this study was to evaluate the 10-year clinical performance of zirconia-based inlay-retained fixed dental prostheses (IRFDP). For replacement of a molar in 27 patients, 30 IRFDP were luted by use of different cements, Panavia F (Kuraray Europe GmbH) or Multilink Automix (Ivoclar Vivadent GmbH), with use of inlay/inlay, inlay/full-crown, or inlay/partial-crown retainers for anchorage. Frameworks were milled from yttria-stabilized zirconia (IPS e.maxZirCAD; Ivoclar Vivadent GmbH) and fully veneered with pressable ceramic (IPS e.max ZirPress; Ivoclar Vivadent GmbH). Before luting, the IRFDP were silica-coated (Rocatec; 3M Espe) and silanized (Monobond S; Ivoclar Vivadent GmbH). Complications (for example, chipping or delamination of the veneering ceramic, debonding, secondary caries, endodontic treatment, and abutment tooth fracture) and failure were reported, by use of standardized report forms, 2 weeks, 6 months, and 1, 2, and 10 years after cementation. Statistical analysis included Kaplan-Meier survival and success (complication-free survival) and Cox regression analysis (α=0.05 for all). During the 10-year observation period, the complications most often observed were chipping of the veneer and debonding. Twenty-five restorations failed and one participant dropped out. Cumulative 10-year survival and success were 12.1% and 0%, respectively. The design of the retainer, use of a dental dam, choice of cement, and location in the dental arch had no statistically significant effect on the occurrence of complications. Use of fully veneered zirconia-based IRFDP with this technique cannot be recommended. A large incidence of complications and poor survival were observed for fully veneered zirconia-based IRFDP, revealing an urgent need for further design improvements for this type of restoration. This, again, emphasizes the need for testing of new restoration designs in clinical trials before implementation in general dental practice. Copyright © 2017

  2. The de-greening of the Netherlands. Results of 10 years of nature and environmental policy of the Dutch government

    International Nuclear Information System (INIS)

    Van den Biggelaar, A.; Duyvendak, W.

    2001-09-01

    The results of an analysis and evaluation of 10 years of environmental policy in the Netherlands are presented. The evaluation includes the ecological quality of nature in the Netherlands, acidifying deposition, energy consumption in the Netherlands per sector, data on traffic and transport, land use by the agricultural sector and in general [nl

  3. Adaptive Replanning to Account for Lumpectomy Cavity Change in Sequential Boost After Whole-Breast Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Xiaojian [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Qiao, Qiao [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Department of Radiotherapy, First Hospital of China Medical University, Shenyang (China); DeVries, Anthony [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Li, Wenhui [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Department of Radiotherapy, Yunnan Tumor Hospital, Kunming (China); Currey, Adam; Kelly, Tracy; Bergom, Carmen; Wilson, J. Frank [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Li, X. Allen, E-mail: ali@mcw.edu [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin (United States)

    2014-12-01

    Purpose: To evaluate the efficiency of standard image-guided radiation therapy (IGRT) to account for lumpectomy cavity (LC) variation during whole-breast irradiation (WBI) and propose an adaptive strategy to improve dosimetry if IGRT fails to address the interfraction LC variations. Methods and Materials: Daily diagnostic-quality CT data acquired during IGRT in the boost stage using an in-room CT for 19 breast cancer patients treated with sequential boost after WBI in the prone position were retrospectively analyzed. Contours of the LC, treated breast, ipsilateral lung, and heart were generated by populating contours from planning CTs to boost fraction CTs using an auto-segmentation tool with manual editing. Three plans were generated on each fraction CT: (1) a repositioning plan by applying the original boost plan with the shift determined by IGRT; (2) an adaptive plan by modifying the original plan according to a fraction CT; and (3) a reoptimization plan by a full-scale optimization. Results: Significant variations were observed in LC. The change in LC volume at the first boost fraction ranged from a 70% decrease to a 50% increase of that on the planning CT. The adaptive and reoptimization plans were comparable. Compared with the repositioning plans, the adaptive plans led to an improvement in target coverage for an increased LC case (1 of 19, 7.5% increase in planning target volume evaluation volume V{sub 95%}), and breast tissue sparing for an LC decrease larger than 35% (3 of 19, 7.5% decrease in breast evaluation volume V{sub 50%}; P=.008). Conclusion: Significant changes in LC shape and volume at the time of boost that deviate from the original plan for WBI with sequential boost can be addressed by adaptive replanning at the first boost fraction.

  4. Transtrochanteric rotational osteotomy for avascular necrosis of the femoral head after unstable slipped capital femoral epiphysis: 10-year clinical results.

    Science.gov (United States)

    Nakashima, Yasuharu; Yamamoto, Takuaki; Fukushi, Jun-Ichi; Motomura, Goro; Hamai, Satoshi; Kohno, Yusuke; Iwamoto, Yukihide

    2016-11-01

    Avascular necrosis of the femoral head (AVN) is the most serious complication after unstable slipped capital femoral epiphysis (SCFE), and is often unsalvageable. We report a minimum 10 years of clinical results for transtrochanteric rotational osteotomy of the femoral head (TRO) for AVN. This study included 7 patients (7 hips) with a mean age at surgery of 13.3 years, and the follow-up period was 15.8 years. All patients had prior treatment via closed reduction and pinning of the unstable SCFE, and showed severely collapsed femoral heads. The direction of rotation was anterior in 3 hips and posterior in 4. The Merle d'Aubigné-Postel score (MDPS) was used for clinical assessment, and joint degeneration was assessed with the Kellgren and Lawrence classification (KL-grade). The spherical intact area of the femoral head was moved to the weight-bearing portion, and subluxation was corrected via rotation combined with intentional varus positioning. The mean MDPS improved from 10.3 points to 15.6 points at 5 years, and it was maintained at 15.0 points by 10 years; 3 hips were excellent, 1 was good, 2 were fair, and 1 showed poor outcomes. No patient experienced re-collapse after TRO or required conversion to hip replacement or arthrodesis. After 10 years, degenerative changes became evident over time, and 2 hips progressed to KL-4 with a decreased MDPS. Although some joint degeneration is inevitable in the long-term, TRO is an effective salvage procedure for treating AVN after unstable SCFE. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  5. Intraoperative HDR implant boost for breast cancer (preliminary results)

    International Nuclear Information System (INIS)

    Rodriguez, I.; Torre, M. de la; Gonzalez, E.; Bourel, V.

    1996-01-01

    Introduction: In spite of the fact that it is been discussed whether or not a boost is necessary for all conservative treated breast cancer patients, it is a generalized radiotherapy practice. Since september 1993 we developed a breast conservative protocol for early stage breast cancer (T1-T2) with intraoperative HDR implant boost. Side effects, cosmetic results and recurrence rates are reviewed. Method and Material: From September 1993 we treated 55 patients with intraoperative HDR implant boost to the lumpectomy site for clinical T1 or T2 invasive breast cancer, followed by external megavoltage radiotherapy to the entire breast. We used the Nucletron microselectron HDR remote afterloading system with flexible implant tubes. The geometric distribution of the tubes was performed according to the 'Paris' configuration. Each implant was evaluated by calculating the dose-volume natural histograms. The HDR fractionation schedule consists of three fractions of 4.5Gy each given at least 48 hs apart, and starting between 48-72hs from surgical procedure. The external radiotherapy to the entire breast started one week after the completion of brachytherapy, using conventional fractionation of 5 fractions per week, 1,8Gy per fraction up to 45-50Gy. Results: So far there is not any local recurrence, but medium follow up is only 18 months. We did not observe any acute damage and the cosmetic outcome was 60% excellent, 30% good and 10% acceptable. Two patients developed localized fibrosis, in both the implant involved the submamary fold. Conclusion: The intraoperative implant is the most accurate way to localize the lumpectomy site, to define the target volume, decrease the total treatment time and avoid a second anesthetic procedure without delaying the inpatient time or the initial wound healing process

  6. 10 years with TAPS

    International Nuclear Information System (INIS)

    Loehneer, H.

    1997-01-01

    During the IV TAPS (two arm photon spectrometer) workshop held at Mont Saint Odile near Strasbourg the third of September, the TAPS collaboration celebrated its 10. anniversary. At this occasion a compilation entitled 'The first 10 years with TAPS' was issued. The foreword of the spokesperson of the TAPS collaboration is presented. (K.A.)

  7. ENLIGHT 10 year Anniversary

    CERN Multimedia

    Alvarez, Paul

    2012-01-01

    Ten years ago, in February 2002, the European Network for Light Ion Hadron Therapy (ENLIGHT) had its inaugural meeting at CERN. As a pioneering multidisciplinary network celebrates its 10th anniversary, some of the founders recall how it all started. Picture 1 : Participants at the 10th anniversary meeting of ENLIGHT at CNAO, Pavia, in September 2012.

  8. Balance ability of 7 and 10 year old children in the population: results from a large UK birth cohort study.

    Science.gov (United States)

    Humphriss, Rachel; Hall, Amanda; May, Margaret; Macleod, John

    2011-01-01

    The literature contains many reports of balance function in children, but these are often on atypical samples taken from hospital-based clinics and may not be generalisable to the population as a whole. The purpose of the present study is to describe balance test results from a large UK-based birth cohort study. Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) were analysed. A total of 5402 children completed the heel-to-toe walking test at age 7 years. At age 10 years, 6915 children underwent clinical tests of balance including beam-walking, standing heel-to-toe on a beam and standing on one leg. A proportion of the children returned to the clinic for retesting within 3 months allowing test-retest agreement to be measured. Frequency distributions for each of the balance tests are given. Correlations between measures of dynamic balance at ages 7 and 10 years were weak. The static balance of 10 year old children was found to be poorer with eyes closed than with eyes open, and poorer in boys than in girls for all measures. Balance on one leg was poorer than heel-to-toe balance on a beam. A significant learning effect was found when first and second attempts of the tests were compared. Measures of static and dynamic balance appeared independent. Consistent with previous reports in the literature, test-retest reliability was found to be low. This study provides information about the balance ability of children aged 7 and 10 years and provides clinicians with reference data for balance tests commonly used in the paediatric clinic. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  9. Efficacy of Psychoeducational Intervention on Allograft Function in Kidney Transplant Patients: 10-Year Results of a Prospective Randomized Study.

    Science.gov (United States)

    Breu-Dejean, Nathalie; Driot, Damien; Dupouy, Julie; Lapeyre-Mestre, Maryse; Rostaing, Lionel

    2016-02-01

    Improving treatment adherence to immunosuppressive agents could have positive effects on the morbidity and mortality of kidney transplant recipients. Our objective was to determine whether psychoeducational intervention aimed at improving treatment adherence also could improve 10-year kidney allograft survival rates. A randomized open-label study compared a group who received psychoeducational intervention (n = 55) with a control group (n = 55), with all patients being kidney transplant recipients in the Department of Nephrology and Organ Transplantation (University Hospital, Toulouse, France). Psychoeducational intervention comprised 8 weekly sessions provided by multidisciplinary teams. Patients were included between 2002 and 2003. The primary endpoint was allograft survival at 10 years (ie, by 2012). A failed allograft or death with a functioning allograft was considered an event. Mean overall allograft survival rate at 10 years was 78.2% (95% confidence interval, 70.5-25.3). In the control group, 48 patients (43.6%) still had a functioning graft at 10 years versus 38 patients (34.5%) in the psychoeducational intervention group (P = .02). However, a log-rank test did not find any significant difference in allograft survival between the groups (P = .06). In multivariate analyses (Cox model), no factor was significantly associated with allograft survival at 10 years. After an initial 6-month observational adherence survey, there was no benefit to kidney allograft survival at 10 years after the psychoeducational intervention, which had aimed to improve patient adherence to treatment with immunosuppressive agents. This might be related to the fact that booster interventions are needed (eg, on a yearly basis).

  10. Cosmetic results of conservative treatment for early breast cancer

    International Nuclear Information System (INIS)

    Kim, Bo Kyoung; Shin, Seong Soo; Kim, Seong Deok; Ha, Sung Whan; Noh, Dong Young

    2001-01-01

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

  11. Enhanced anticaries efficacy of a 0.243% sodium fluoride/10% xylitol/silica dentifrice: 3-year clinical results.

    Science.gov (United States)

    Sintes, J L; Escalante, C; Stewart, B; McCool, J J; Garcia, L; Volpe, A R; Triol, C

    1995-10-01

    To evaluate the efficacy of a sodium fluoride (NaF)/silica/xylitol dentifrice compared with that of a positive control NaF/silica dentifrice on caries increments in school children over a 3-year period in an area without an optimal level of fluoride in the drinking water (mean level schools in the San Jose, Costa Rica metropolitan area. Clinical dental examinations were performed at participating schools utilizing portable dental equipment. Caries evaluations employed conventional tactile/visual methodology consisting of artificial light, dental mirrors and single-edge #23 explorers. Children accepted into the study were stratified by age and sex into two balanced groups within each school, and randomly assigned to use either a positive control dentifrice containing 0.243% NaF/silica or a test dentifrice containing 0.234% NaF/silica/10% xylitol. Children were instructed to brush with the assigned dentifrice twice daily. Caries evaluations were conducted at baseline, 2 years, and 3 years. After 3 years, subjects using the 0.234% NaF/silica/10% xylitol dentifrice had statistically significantly reduced decayed/filled surfaces (DFS; -12.3% reduction; P < or = 0.001) and decayed/filled buccal and lingual surfaces (DFS-BL; -10.5% reduction; P < or = 0/01).

  12. Investigation on overexposed workers during past 10 years in Iran

    International Nuclear Information System (INIS)

    Zakeri, F.; Kardan, M.R.; Rajabpoor, M.R.; Haeri, A; Ahmadpoor, M.J.

    2008-01-01

    Full text: The primary purpose of this study was to evaluate the progress in the control of occupational radiation exposure by comparing the cytogenetic analysis carried out for workers overexposed or suspected of being overexposed to ionizing radiation who referred to Medical Care and Radiobiology Division for investigation by cytogenetic analysis, during past 10 years. The total number of overexposed cases to ionizing radiation, the results of biological dosimetry as indicated by aberrations in chromosomes from blood lymphocytes, their recent and annual equivalent whole body doses and where possible biological and physical estimates of dose were compared in each year during the past 10 years. The procedure adopted to score 500 metaphases and the frequencies are referred to appropriate in vitro dose response calibration curves. The results showed that fortunately the overexposure cases resulted in deterministic effects significantly decreased during past 10 years. The most cases arose from industrial radiographic procedures, especially gamma-radiography sources used for non-destructive testing of metal objects. The factors associated with overexposure events will be characterized. No evidence of serious cases investigated during last 10 years shows that through implementing related regulations and regulatory control, good progress is being made towards achievement of overall objectives of radiation safety. (author)

  13. 10 non seminomatous testicular germ cell tumors: therapeutic results and behavior at the University Hospital in the last 10 years

    International Nuclear Information System (INIS)

    Martinez, A.; Xavier, F.; Cepellini, R.; Fresco, R.

    2010-01-01

    Objective: Retrospectively analyze about the characteristics, therapeutic behavior and treatment results in patients with non-seminomatous testicular germ cell tumours (NSGCT) Stage III assisted in the University Hospital. Materials and Methods: The medical records of patients (pts) with histologically reviewed of NSGCT assisted in the Department of Clinical Oncology, Hospital das Clinicas (H C), among January 2000 and December 2009. We analyzed in detail the clinico pathological features of those belonging to pts with stage III tumors TNM classification. Results: 23 pts were included; median age 24 years (range: 17-40); median follow-up: 19 months (range: 2-104). Stadiums: I: 9/23; II: 7/23; III: 7/23. Among ptes E III.They corresponded to: high risk: 3/7; means: 3/7; Low: 1/7. Only in 1 patient (pte) of the E III It is not explicitly consisted risk rating in history but, based on data present is able to allocate retrospectively. The chemotherapy was the first line chosen, PE B plan pts 6/7 and 1/7 VIP (pte. athlete). All patients received 4 sets of PE B / VIP (including low risk). Imaging responses post chemotherapy (Q T): Complete: 1/7; Partial: 5/7; Stabilization: 1/7. In the 7 pts M T post Q T were normal. In 4 of the 7 pts who achieved partial response and normalized MTwe proceeded to surgery residual mass. The current status of patients is alive: 6/23; Dead: 4/23; monitoring loss (PDS): 13/23. The patients E III: Live 2/7, 4/7 dead, PDS 1/7.4 E III patients were dead with diagnosis (high risk 3/4, 1/4 medium). He did not make the survival analysis given the low and high percentage of patients PDS. Conclusions: In the last 10 years only 7 patients with NSGCT E III attended the H C (0.7 / year). Overall front line management adjusted to the recommendations international but the management of patients with residual mass and not normal M T necessarily. While the number of patients is too low to definitive conclusions, the C R rate to Q T 1st line impresses be

  14. Noise-Induced Hearing Loss – A Preventable Disease? Results of a 10-Year Longitudinal Study of Workers Exposed to Occupational Noise

    Science.gov (United States)

    Frederiksen, Thomas W.; Ramlau-Hansen, Cecilia H.; Stokholm, Zara A.; Grynderup, Matias B.; Hansen, Åse M.; Kristiansen, Jesper; Vestergaard, Jesper M.; Bonde, Jens P.; Kolstad, Henrik A.

    2017-01-01

    Aims: To survey current, Danish industrial noise levels and the use of hearing protection devices (HPD) over a 10-year period and to characterise the association between occupational noise and hearing threshold shift in the same period. Furthermore, the risk of hearing loss among the baseline and the follow-up populations according to first year of occupational noise exposure is evaluated. Materials and Methods: In 2001–2003, we conducted a baseline survey of noise- and hearing-related disorders in 11 industries with suspected high noise levels. In 2009–2010, we were able to follow up on 271 out of the 554 baseline workers (49%). Mean noise levels per industry and self-reported HPD use are described at baseline and follow-up. The association between cumulative occupational noise exposure and hearing threshold shift over the 10-year period was assessed using linear regression, and the risk of hearing loss according to year of first occupational noise exposure was evaluated with logistic regression. Results: Over the 10-year period, mean noise levels declined from 83.9 dB(A) to 82.8 dB(A), and for workers exposed >85 dB(A), the use of HPD increased from 70.1 to 76.1%. We found a weak, statistically insignificant, inverse association between higher ambient cumulative noise exposure and poorer hearing (−0.10 dB hearing threshold shift per dB-year (95% confidence interval (CI): −0.36; 0.16)). The risk of hearing loss seemed to increase with earlier first year of noise exposure, but odds ratios were only statistically significant among baseline participants with first exposure before the 1980s (odds ratio: 1.90, 95% CI: 1.11; 3.22). Conclusions: We observed declining industrial noise levels, increased use of HPD and no significant impact on hearing thresholds from current ambient industrial noise levels, which indicated a successful implementation of Danish hearing conservation programs. PMID:29192620

  15. Noise-Induced Hearing Loss – A Preventable Disease? Results of a 10-Year Longitudinal Study of Workers Exposed to Occupational Noise

    Directory of Open Access Journals (Sweden)

    Thomas W Frederiksen

    2017-01-01

    Full Text Available Aims: To survey current, Danish industrial noise levels and the use of hearing protection devices (HPD over a 10-year period and to characterise the association between occupational noise and hearing threshold shift in the same period. Furthermore, the risk of hearing loss among the baseline and the follow-up populations according to first year of occupational noise exposure is evaluated. Materials and Methods: In 2001–2003, we conducted a baseline survey of noise- and hearing-related disorders in 11 industries with suspected high noise levels. In 2009–2010, we were able to follow up on 271 out of the 554 baseline workers (49%. Mean noise levels per industry and self-reported HPD use are described at baseline and follow-up. The association between cumulative occupational noise exposure and hearing threshold shift over the 10-year period was assessed using linear regression, and the risk of hearing loss according to year of first occupational noise exposure was evaluated with logistic regression. Results: Over the 10-year period, mean noise levels declined from 83.9 dB(A to 82.8 dB(A, and for workers exposed >85 dB(A, the use of HPD increased from 70.1 to 76.1%. We found a weak, statistically insignificant, inverse association between higher ambient cumulative noise exposure and poorer hearing (−0.10 dB hearing threshold shift per dB-year (95% confidence interval (CI: −0.36; 0.16. The risk of hearing loss seemed to increase with earlier first year of noise exposure, but odds ratios were only statistically significant among baseline participants with first exposure before the 1980s (odds ratio: 1.90, 95% CI: 1.11; 3.22. Conclusions: We observed declining industrial noise levels, increased use of HPD and no significant impact on hearing thresholds from current ambient industrial noise levels, which indicated a successful implementation of Danish hearing conservation programs.

  16. Primary cemented total hip arthroplasty: 10 years follow-up

    Directory of Open Access Journals (Sweden)

    Nath Rajendra

    2010-01-01

    Full Text Available Background: Primary cemented total hip arthroplasty is a procedure for non-traumatic and traumatic affections of the hip. Long term follow-up is required to assess the longevity of the implant and establish the procedure. Indo-Asian literature on long term result of total hip arthroplasty is sparse. We present a 10-year follow-up of our patients of primary cemented total hip arthroplasty. Materials and Methods: We operated 31 hips in 30 patients with primary cemented total hip arthroplasty. We followed the cases for a minimum period of 10 years with a mean follow-up period of 12.7 years. The mean age of the patients was 60.7 years (range 37-82 yrs male to female ratio was 2:1. The clinical diagnoses included - avascular necrosis of femoral head (n=15, sero positive rheumatoid arthritis (n=5, seronegative spondylo-arthropathy (n=4, neglected femoral neck fractures (n=3, healed tubercular arthritis (n=2 and post traumatic osteoarthritis of hip (n=2. The prostheses used were cemented Charnley′s total hip (n=12 and cemented modular prosthesis (n=19. The results were assessed according to Harris hip score and radiographs taken at yearly intervals. Results: The mean follow-up is 12.7 yrs (range 11-16 yrs Results in all operated patients showed marked improvement in Harris hip score from preoperative mean 29.2 to 79.9 at 10 years or more followup. However, the non-inflammatory group showed more sustained long term improvement as compared to the inflammatory group, as revealed by the Harris hip score. Mean blood loss was 450ml (±3.7 ml, mean transfusion rate was 1.2 units (±.3. The complications were hypotension (n=7, shortening> 1.5 cm (n=9, superficial infection (n=2 and malposition of prosthesis (n=1. Conclusion: The needs of Indian Asian patients, vary from what is discussed in literature. The pain tolerance is greater than western population and financial constraints are high. Thus revision surgery among Indian-Asian patients is less compared

  17. Human factors and safety: 10 years of experience

    International Nuclear Information System (INIS)

    Chevallon; Colas; Ellia-Hervy

    1990-01-01

    The impact of TMI Accident on the operation of French PWR was great. The analysis of TMI accident and the conclusions have been displayed during 5-6 years until 1986. The main points of the reflexion are the formalization of instructions used in accidental conditions, the ergonomy of control rooms, the development of methods and organizations for retiring lessons of incidents. After 10 years of ergonomy, instructions changes, automation and organization amelioration, the result is globally positive [fr

  18. TIPSS: 10 years of experience

    International Nuclear Information System (INIS)

    Richter, G.M.; Brado, M.; Simon, C.; Radeleff, B.; Kauffmann, G.W.; Noeldge, G.; Scharf, J.; Hansmann, J.

    1998-01-01

    Purpose: To demonstrate and document 10 years of clinical experience gathered by us with TIPSS and to discuss achievements, problems and outlook. Results: Variceal filling was widely reduced by TIPSS, and significantly reduced portal liver perfusion as assessed morphologically and rheologically. However, there was an immediate onset of compensated liver perfusion by increased arterial inflow. Total liver perfusion did not change significantly. In TIPSS portal decompression was readily achieved, the portosystemic gradient dropping from an average of 24 mm Hg to 10.5 mm Hg. In our series we could not demonstrate an increased incidence of hepatic encephalopathy during the 30-day post-TIPSS period. Early mortality was 4% and early rebleeding rate 3%. The 12-month re-intervention rate based on an invasive portography follow-up protocol was 76%, and the 24-month re-intervention rate was 90%. The definite occlusion rate was below 5%. Beyond a follow-up time span of 24-months the necessity for re-intervention dropped significantly: Less than one-third of our patients required some sort of re-intervention. (orig./AJ) [de

  19. 10 YEARS AFTER NATO MEMBERSHIP

    DEFF Research Database (Denmark)

    10 years after NATO Membership. An Anniversary in the Shadow of a Crisis”, indeholder artikler fra politiske aktører, diplomater og forskere, der alle bidrog til til konferencen af samme navn, hvor den 10-året for baltisk medlemskab af NATO var omdrejningspunktet. Udover den danske...... forsvarsminister, er den estiske og litauiske forsvarsminister og NATO’s vicegeneralsekretær blandt bidragyderne. Konferencens formål var at fejre, inddrage og diskutere 10 års forsvarspolitisk NATO-samarbejde i Østersøområdet. Den internationale udvikling i Europa betød at konferencens dagsorden i stedet for kom...

  20. Benefit of Adjuvant Brachytherapy Versus External Beam Radiation for Early Breast Cancer: Impact of Patient Stratification on Breast Preservation

    International Nuclear Information System (INIS)

    Smith, Grace L.; Jiang, Jing; Buchholz, Thomas A.; Xu, Ying; Hoffman, Karen E.; Giordano, Sharon H.; Hunt, Kelly K.; Smith, Benjamin D.

    2014-01-01

    Purpose: Brachytherapy after lumpectomy is an increasingly popular breast cancer treatment, but data concerning its effectiveness are conflicting. Recently proposed “suitability” criteria guiding patient selection for brachytherapy have never been empirically validated. Methods: Using the Surveillance, Epidemiology, and End Results–Medicare linked database, we compared women aged 66 years or older with invasive breast cancer (n=28,718) or ductal carcinoma in situ (n=7229) diagnosed from 2002 to 2007, treated with lumpectomy alone, brachytherapy, or external beam radiation therapy (EBRT). The likelihood of breast preservation, measured by subsequent mastectomy risk, was compared by use of multivariate proportional hazards, further stratified by American Society for Radiation Oncology (ASTRO) brachytherapy suitability groups. We compared 1-year postoperative complications using the χ 2 test and 5-year local toxicities using the log-rank test. Results: For patients with invasive cancer, the 5-year subsequent mastectomy risk was 4.7% after lumpectomy alone (95% confidence interval [CI], 4.1%-5.4%), 2.8% after brachytherapy (95% CI, 1.8%-4.3%), and 1.3% after EBRT (95% CI, 1.1%-1.5%) (P<.001). Compared with lumpectomy alone, brachytherapy achieved a more modest reduction in adjusted risk (hazard ratio [HR], 0.61; 95% CI, 0.40-0.94) than achieved with EBRT (HR, 0.22; 95% CI, 0.18-0.28). Relative risks did not differ when stratified by ASTRO suitability group (P=.84 for interaction), although ASTRO “suitable” patients did show a low absolute subsequent mastectomy risk, with a minimal absolute difference in risk after brachytherapy (1.6%; 95% CI, 0.7%-3.5%) versus EBRT (0.8%; 95% CI, 0.6%-1.1%). For patients with ductal carcinoma in situ, EBRT maintained a reduced risk of subsequent mastectomy (HR, 0.40; 95% CI, 0.28-0.55; P<.001), whereas the small number of patients treated with brachytherapy (n=179) precluded definitive comparison with lumpectomy alone. In

  1. Falls prevention in community care: 10 years on

    Directory of Open Access Journals (Sweden)

    Burton E

    2018-02-01

    Full Text Available Elissa Burton,1 Gill Lewin,2 Hilary O’Connell,3 Keith D Hill1 1School of Physiotherapy and Exercise Science, Curtin University, 2School of Nursing, Midwifery and Paramedicine, Curtin University, 3Independent Living Centre WA, Perth, WA, Australia Background: A million older people living in Australia receive community care services each year due to experiencing functional or mental health difficulties. This group may be at greater risk of falling than similar-aged people not receiving services. However, there is limited falls prevention research for this population.Purpose: The aim of this study was to identify the falls prevalence rates of older people from 10 Australian community care organizations and compare current falls prevention data to a study 10 years prior that utilized the same 10 organizations. This study also identified factors associated with falling for this population.Patients and methods: This is a cross-sectional descriptive study, in which 5,338 questionnaires were mailed to a random sample of community care recipients aged ≥65 years. Results: A total of 1,991 questionnaires were returned (37.3%, with 47.7% of respondents having fallen in the previous year, and 32.7% in the month prior to completing the questionnaire, similar to 10 years prior. Community care clients had a 50% higher falls rate than that reported for similar-aged people not receiving services, and this remained unchanged over the last 10 years. Eighty-six per cent of fallers had fallen once or twice, and 60% reported being injured. Thirty-six per cent of respondents reported not being able to get up independently, and only 27.4% of fallers were referred to a falls prevention program (significantly fewer than 10 years ago; 95% CI: 0.821–6.366, p=0.01. Balance issues (odds ratio [OR]: 2.06, 95% CI: 1.288–3.290, p=0.003 and perceived risk of falling in the future being “definite” (OR: 6.42, 95% CI: 1.890–21.808, p=0.003 or “unsure” (OR: 3

  2. Noise-Induced Hearing Loss - A Preventable Disease? Results of a 10-Year Longitudinal Study of Workers Exposed to Occupational Noise.

    Science.gov (United States)

    Frederiksen, Thomas W; Ramlau-Hansen, Cecilia H; Stokholm, Zara A; Grynderup, Matias B; Hansen, Åse M; Kristiansen, Jesper; Vestergaard, Jesper M; Bonde, Jens P; Kolstad, Henrik A

    2017-01-01

    To survey current, Danish industrial noise levels and the use of hearing protection devices (HPD) over a 10-year period and to characterise the association between occupational noise and hearing threshold shift in the same period. Furthermore, the risk of hearing loss among the baseline and the follow-up populations according to first year of occupational noise exposure is evaluated. In 2001-2003, we conducted a baseline survey of noise- and hearing-related disorders in 11 industries with suspected high noise levels. In 2009-2010, we were able to follow up on 271 out of the 554 baseline workers (49%). Mean noise levels per industry and self-reported HPD use are described at baseline and follow-up. The association between cumulative occupational noise exposure and hearing threshold shift over the 10-year period was assessed using linear regression, and the risk of hearing loss according to year of first occupational noise exposure was evaluated with logistic regression. Over the 10-year period, mean noise levels declined from 83.9 dB(A) to 82.8 dB(A), and for workers exposed >85 dB(A), the use of HPD increased from 70.1 to 76.1%. We found a weak, statistically insignificant, inverse association between higher ambient cumulative noise exposure and poorer hearing (-0.10 dB hearing threshold shift per dB-year (95% confidence interval (CI): -0.36; 0.16)). The risk of hearing loss seemed to increase with earlier first year of noise exposure, but odds ratios were only statistically significant among baseline participants with first exposure before the 1980s (odds ratio: 1.90, 95% CI: 1.11; 3.22). We observed declining industrial noise levels, increased use of HPD and no significant impact on hearing thresholds from current ambient industrial noise levels, which indicated a successful implementation of Danish hearing conservation programs.

  3. Giant Bilateral Juvenile Fibroadenoma of the Breast in Prepubescent Girl.

    Science.gov (United States)

    Khan, Salma; Khan, Momna; Rafique, Sadia

    2015-10-01

    Juvenile fibroadenoma accounts for 4% of the total fibroadenomas. Giant juvenile fibroadenoma is found in only 0.5% of all fibroadenomas. The authors report a 10-year girl presenting with progressive enlargement of both breasts for one year. Based on clinical findings and Fine Needle Aspiration Cytology (FNAC), a diagnosis of bilateral giant juvenile fibroadenomas of breast was made. She underwent bilateral lumpectomy with breast conservation and made uneventful postoperative recovery.

  4. External beam and HDR intracavitary irradiation: an effective tool in the primary treatment of cervical cancer - excellent 10 year results and low side effects

    International Nuclear Information System (INIS)

    Hammer, J.; Zoidl, J.P.; Track, C.; Seewald, D.H.; Labeck, W.

    1996-01-01

    Introduction: The purpose of this paper is to present our 15 years experience in the primary treatment of cervical cancer with a combination of external beam irradiation and high dose rate brachytherapy. Survival data will be presented and the safe use of intrauterine HDR applications will be demonstrated. Material and Methods: From August 1980 to December 1990, 303 patients with cancer of the uterine cervix underwent primary irradiation in a combination of external beam and HDR intracavitary treatment at the Department of Radiation Oncology at the Sisters of Mercy Hospital in Linz, Austria. All patients were classified according to the FIGO rules: Stage I 54 patients, stage II 171, stage III 75 and stage IV 3 patients. 8 patients were lost to follow up. The mean follow up time of survivors is 110 months. Results and Discussion: A complete remission could be achieved in 282 patients, which is 93%; persistent tumour was found in 21 patients at the first follow up check 3 to 5 months after completion of irradiation. The actuarial overall survival probability for all patients at 5 and 10 years is 62 % and 42 % respectively, the disease specific survival probability is 68 % and 64 %. The local control rate at 5 and 10 years is 73 % and 72 % respectively. According to stage, disease specific survival lies at 90 % for stage I, 69 % for stage II, and 48 % for stage III and IV at 5 years, and at 10 years 87 %, 66 % and 41 % respectively. The actuarial local control probability for stages I, II, and III/IV is 90 %, 74 %, and 60 % respectively at 5 yr, and 88 %, 74 %, and 56 % at 10 yr. (Kaplan-Meier calculations). From all 303 patients 34 suffered from 40 severe and moderate side effects (glossary of Chassagne and Sismondi). The rate for grade II complications is 10 % and for grade III 3 %. Conclusion: Intrauterine HDR brachycurietherapy in addition to external beam irradiation for primary treatment of invasive carcinoma of the uterine cervix provides the same treatment

  5. 10 years of SIN

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1984-11-15

    The Schweizerisches Institut fur Nuklearforschung (Swiss Institute for Nuclear Research, or SIN) proudly celebrated its 10th anniversary earlier this year. Welcoming the audience at a reception on 22 June, Swiss Federal Councillor Alphons Egli recalled that only about one human lifetime ago was it demonstrated that the atom, despite its name (from the Greek for indivisible), could in fact be split. Since then, questions arising from this discovery have continued to fascinate research workers all over the world.

  6. 10 years of SIN

    International Nuclear Information System (INIS)

    Anon.

    1984-01-01

    The Schweizerisches Institut fur Nuklearforschung (Swiss Institute for Nuclear Research, or SIN) proudly celebrated its 10th anniversary earlier this year. Welcoming the audience at a reception on 22 June, Swiss Federal Councillor Alphons Egli recalled that only about one human lifetime ago was it demonstrated that the atom, despite its name (from the Greek for indivisible), could in fact be split. Since then, questions arising from this discovery have continued to fascinate research workers all over the world

  7. Results of a 10-year survey of workload for 10 treatment vaults at a high-throughput comprehensive cancer center.

    Science.gov (United States)

    Saleh, Ziad H; Jeong, Jeho; Quinn, Brian; Mechalakos, James; St Germain, Jean; Dauer, Lawrence T

    2017-05-01

    The workload for shielding purposes of modern linear accelerators (linacs) consists of primary and scatter radiation which depends on the dose delivered to isocenter (cGy) and leakage radiation which depends on the monitor units (MUs). In this study, we report on the workload for 10 treatment vaults in terms of dose to isocenter (cGy), monitor units delivered (MUs), number of treatment sessions (Txs), as well as, use factors (U) and modulation factors (CI) for different treatment techniques. The survey was performed for the years between 2006 and 2015 and included 16 treatment machines which represent different generations of Varian linear accelerators (6EX, 600C, 2100C, 2100EX, and TrueBeam) operating at different electron and x-ray energies (6, 9, 12, 16 and 20 MeV electrons and, 6 and 15 MV x-rays). An institutional review board (IRB) approval was acquired to perform this study. Data regarding patient workload, dose to isocenter, number of monitor units delivered, beam energies, gantry angles, and treatment techniques were exported from an ARIA treatment management system (Varian Medical Systems, Palo Alto, Ca.) into Excel spreadsheets and data analysis was performed in Matlab. The average (± std-dev) number of treatment sessions, dose to isocenter, and number of monitor units delivered per week per machine in 2006 was 119 ± 39 Txs, (300 ± 116) × 10 2 cGys, and (78 ± 28) × 10 3 MUs respectively. In contrast, the workload in 2015 was 112 ± 40 Txs, (337 ± 124) × 10 2 cGys, and (111 ± 46) × 10 3 MUs. 60% of the workload (cGy) was delivered using 6 MV and 30% using 15 MV while the remaining 10% was delivered using electron beams. The modulation factors (MU/cGy) for IMRT and VMAT were 5.0 (± 3.4) and 4.6 (± 1.6) respectively. Use factors using 90° gantry angle intervals were equally distributed (~0.25) but varied considerably among different treatment techniques. The workload, in terms of dose to isocenter (cGy) and subsequently monitor units (MUs), has

  8. Can Good Infection Control Be Obtained in One-stage Exchange of the Infected TKA to a Rotating Hinge Design? 10-year Results.

    Science.gov (United States)

    Zahar, Akos; Kendoff, Daniel O; Klatte, Till O; Gehrke, Thorsten A

    2016-01-01

    Prosthetic joint infection (PJI) occurs in 1% to 2% of total knee arthroplasties (TKAs). Although two-stage exchange is the preferred management method of patients with chronic PJI in TKA in North America, one-stage exchange is an alternative treatment method, but long-term studies of this approach have not been conducted. We reviewed our minimum 9-year results of 70 patients who underwent one-stage exchange arthroplasty with a rotating hinge design to determine: (1) What was the proportion of patients free of infection? (2) What was the patient rate of survival free of any reoperation? (3) What were the clinical outcomes as measured by Hospital for Special Surgery scores? (4) What proportion of patients developed radiographic evidence of loosening? All one-stage revision TKAs for infection between January 1 and December 31, 2002, with a minimum 9-year followup (mean, 10 years; range, 9-11 years), in which patients had been seen within the last 1 year, were included in this retrospective review. During that period, 11 patients with infected TKAs were treated with other approaches (including two-stage approaches in eight); the general indication for one-stage revision was the diagnosis of PJI with a known causative organism. Exclusion criteria were culture-negative preoperative aspiration, known allergy to local antibiotics or bone cement, or cases in which radical débridement was impossible as a result of the involvement of important anatomical structures. Eighty-one patients with PJI were seen during this period; 70 underwent one-stage exchange using our strict protocol and were reimplanted with a rotating hinge TKA. Eleven patients (15.7%) were lost to followup. Hospital for Special Surgery scores were recorded and all radiographs were evaluated for prosthetic loosening. Failure was defined as revision surgery for infection or any other cause. Our 10-year infection-free survival was 93% (mean, 4.1; 95% confidence interval [CI], 89%-96%; p exchange techniques for

  9. Retinopathy of prematurity: results from 10 years in a single neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Inês Coutinho

    2017-01-01

    Full Text Available Introduction: Retinopathy of prematurity (ROP is a vasoproliferative disorder of the retina of preterm newborns and is an important and preventable cause of visual impairment in childhood. This study aimed to assess the incidence and main risk factors associated with the development of ROP in the last 10 years at Hospital Prof. Doutor Fernando Fonseca in Lisbon, Portugal.Methods: Observational and retrospective study conducted between 2005 and 2014 at Hospital Prof. Doctor Fernando Fonseca. The study included newborns of gestational age < 32 weeks. We analyzed maternal, prenatal and neonatal factors associated with the development of ROP. Statistical analysis were performed with Statistical Package for Social Sciences (SPSS® software. Univariate and multivariate analyses were performed and a multiple logistic regression model was carried out with a significance level α = 0.05.Results: 527 premature infants with a gestational age < 32 weeks were studied, of which 165 developed ROP. 60 of these patients needed treatment. In the univariate analysis, the risk factors for the development of ROP were maternal infection in pregnancy, low birth weight, low gestational age, low Apgar score at 5 minutes, need for oxygen therapy until the 28th day of life, a high score on the CRIB and SNAPPE2 scales, use of surfactant, respiratory distress syndrome, persistence of patent ductus arteriosus, peri-intraventricular hemorrhage and neonatal sepsis. In the multiple logistic regression analysis, risk factors for ROP were the presence of neonatal sepsis, respiratory distress syndrome, persistence of patent ductus arteriosus and a high score on the neonatal SNAPPE2 scale.Conclusions: We found a ROP incidence rate of 31.3%, with risk factors similar to those observed in other studies.

  10. External beam and HDR intracavitary irradiation: an effective tool in the primary treatment of cancer of the uterine cervix - excellent 10 year results and low side effects

    International Nuclear Information System (INIS)

    Hammer, Josef; Zoidl, Johann P.; Track, Christine; Seewald, Dietmar H.; Labeck, Werner

    1996-01-01

    Purpose/Objective: The purpose of this paper is to present our 15 years experience in the primary treatment of cervical cancer with a combination of external beam irradiation and high dose rate brachytherapy. Survival data will be presented and the safe use of intrauterine HDR applications will be demonstrated. Material and Methods: From August 1980 to December 1990, 303 patients with cancer of the uterine cervix underwent primary irradiation in a combination of external beam and HDR intracavitary treatment at the Department of Radiation Oncology at the Sisters of Mercy Hospital in Linz, Austria. All patients were classified according to the FIGO rules: Stage I 54 patients, stage II 171, stage III 75 and stage IV 3 patients. 8 patients were lost to follow up. The mean follow up time of survivors is 110 months. Results: A complete remission could be achieved in 282 patients (93%); persistent tumour was found in 21 patients at the first follow up check 3 to 5 months after completion of irradiation. The actuarial overall survival probability for all patients at 5 and 10 years is 62 % and 49 % respectively, the disease specific survival probability is 68 % and 64 %. The local control rate at 5 and 10 years is 73 % and 72 % respectively. According to stage, disease specific survival lies at 90 % for stage I, 69 % for stage II, and 49 % for stage III and IV at 5 years, and at 10 years 87 %, 66 % and 41 % respectively. The actuarial local control probability for stages I, II, and III/IV is 90 %, 74 %, and 60 % respectively at 5 years, and 88 %, 74 %, and 57 % at 10 years (Kaplan-Meier calculations). From all 303 patients 34 suffered from 40 severe and moderate side effects (glossary of Chassagne and Sismondi). The rate for grade II complications is 10 % and for grade III 3 %. Conclusion: Intrauterine HDR brachycurietherapy in addition to external beam irradiation for primary treatment of invasive carcinoma of the uterine cervix provides the same treatment results as LDR

  11. Trends in Radical Surgical Treatment Methods for Breast Malignancies in China: A Multicenter 10-Year Retrospective Study.

    Science.gov (United States)

    Zhang, Bai-Lin; Sivasubramaniam, Priya G; Zhang, Qian; Wang, Jing; Zhang, Bin; Gao, Ji-Dong; Tang, Zhong-Hua; Chen, Guo-Ji; Xie, Xiao-Ming; Wang, Zhongzhao; Yang, Hong-Jian; He, Jian-Jun; Li, Hui; Li, Jia-Yuan; Fan, Jin-Hu; Wang, Xiang; Qiao, You-Lin

    2015-09-01

    Incidence rates of breast cancer continue to rise in the People's Republic of China. The purpose of this study was to describe Chinese trends in radical surgical modalities and influential imaging and demographic factors for breast malignancies. This study was a hospital-based, multicenter, 10-year (1999-2008), retrospective study. Descriptive statistical tests were used to illustrate information regarding radical surgical trends for the treatment of breast malignancies. Chi-square tests were used to assess effect of demographic factors in addition to imaging and pathological data on the specific surgical method. A total of 4,211 patients were enrolled in the survey. Among them, 3,335 patients with stage 0 to stage III disease undergoing mastectomy or breast-conserving surgery (BCS) were included in the final analysis. The rate of BCS increased from 1.53% in 1999 to 11.88% in 2008. The rate of mastectomy declined over this time period, from 98.47% in 1999 to 88.12% in 2008, with increasing use of diagnostic imaging methods and pathological biopsies. A significantly greater percentage of patients with office work, high education levels, unmarried status, younger age, and early pathological stages preferred BCS compared with mastectomy. Rates of mastectomy in China remain elevated due to diagnosis at higher stages; however, because of increased use of diagnostic imaging, improvement of biopsy methods, and patient education, rates of less invasive lumpectomy are increasing and rates of mastectomy have decreased in China. In this study, 4,211 cases were collected from 1999 to 2008 through a multicenter retrospective study of varying geographic and socioeconomic areas to illustrate trends of surgeries in the People's Republic of China. The correlations between demographic and tumor characteristics and among methods of surgical treatment were explored. This study shows that the rate of breast-conserving surgery (BCS) increased and the rate of mastectomy declined over

  12. FIVE-YEAR RESULTS OF ADJUVANT RADIOTHER

    Science.gov (United States)

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

    2015-01-01

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

  13. Grade 10 PSAT Participation and Performance--School Year 2015-2016. Memorandum

    Science.gov (United States)

    Navarro, Maria V.

    2016-01-01

    The 2015-2016 school year marks the first administration of the redesigned PSAT, which is composed of two sections: (1) Evidence-based Reading and Writing (EBRW) and (2) Math. This memorandum presents results of 2015-2016 Grade 10 PSAT participation and performance of Montgomery County Public Schools (MCPS) students. Among 10,859 MCPS first-time…

  14. How much does PSA matter after 10 years? Outcomes in 10-year clinical NED survivors after definitive radiotherapy for T1-3N0M0 prostate cancer

    International Nuclear Information System (INIS)

    Johnstone, Peter A. S.; Powell, Curt; Riffenburgh, Robert; Saunders, Eric L.; Bethel, Kelly J.; Huisman, Thomas

    1996-01-01

    Objective: Institutional policy in the 1970's and 80's dictated that patients with potentially curable prostate cancer undergo PLND prior to definitive XRT. Our group has reported 80% 15-year actuarial cause-specific survival for the 147 patients so treated. Analysis was made of PSA values and clinical outcomes of patients who were clinically without evidence of disease (NED) 10 years after a negative staging pelvic lymphadenectomy and definitive radiation therapy (XRT) for prostate cancer. Materials and Methods: One hundred patients underwent staging pelvic lymphadenectomy between 11/1/74 and 1/1/86, of which 98 had pathologically negative lymph nodes (N 0 ). These patients subsequently underwent definitive radiotherapy; a median dose of 66.6 Gy (range 63-70.2 Gy) was delivered. Forty-two N 0 patients with sufficient follow-up were alive and clinically NED 10 years post-operatively. None of these patients had ever received hormonal therapy. Distribution by disease stage at diagnosis was: Stage A2: 12 pts; Stage B: 19 pts; Stage B2/ C: 6 pts; Stage C: 5 pts. Median follow-up was 12 years 4 months, with a minimum follow-up of 10 years. Results: Of the 42 NED survivors at 10 years, 5 pts died subsequently without PSA data, remaining clinically NED (median 13y 3m post-operatively); 37 patients were alive and without evidence of disease off all therapy at 10 years post-operatively. Most recent PSA data reveal: Bone scans were performed on the 8 patients with elevated PSA. These revealed a single patient with diffuse but asymptomatic bone metastases. Ultrasound-guided sextant biopsies were performed on one 78-year-old patient with elevated PSA 19 years post-operatively, revealing an asymptomatic local recurrence. Conclusions: Radiation therapy delivered to a surgically staged population of prostate cancer patients contributes to normalization of PSA in 78% ((29(37))) of patients with ≥10 year follow-up. Most of these patients will have PSA levels ≤ 1.5 ng/ml. More

  15. Safety for Your Child: 10 Years

    Science.gov (United States)

    ... Stages Listen Español Text Size Email Print Share Safety for Your Child: 10 Years Page Content Article ... out if your child's friends carry guns. Sports Safety At this age your child may be playing ...

  16. Cosmesis with bilateral mammoreduction for conservative breast cancer treatment.

    Science.gov (United States)

    Goffman, Thomas E; Schneider, Heather; Hay, Karen; Elkins, David E; Schnarrs, Robert A; Carman, Claire

    2005-01-01

    Over 7 years, 57 women with breast cancer underwent lumpectomy and bilateral mammoreduction. Physical complaints about large or lax breast shape were the predominate rationale. Two patients were immediately lost to follow-up, 55 patients remained and were followed every 3 months for an average of 1.6 years. This is the largest series traceable by computer and literature search. Chart review and patient examination in this retrospective review were utilized as the basis for data within the article. Collated notes from patients' doctors were assessed, as well as documented patient responses to the procedure. Pictures without head/face for identifiers were taken of the patients. Chart data were collected by clinicians, but were reviewed blindly by a statistician. The overall control and cosmesis rates as well as alleviation of heavy breast problems were noted. Only 6% of women had fair to poor cosmetic results; the majority (82%) had excellent to good results. Women with very large breasts or markedly relaxed breast tissue of concern to the patients proved optimal candidates for lumpectomy of cancer and bilateral mammoreduction in the conservative treatment of these cancers. There was a significant reduction in the physical complaints of the patients as well. For women with very pendulous or extremely large breasts, lumpectomy and bilateral mammoreduction may prove to be the optimal course of action.

  17. Infant-onset eczema in relation to mental health problems at age 10 years: results from a prospective birth cohort study (German Infant Nutrition Intervention plus).

    Science.gov (United States)

    Schmitt, Jochen; Apfelbacher, Christian; Chen, Chih-Mei; Romanos, Marcel; Sausenthaler, Stefanie; Koletzko, Sibylle; Bauer, Carl-Peter; Hoffmann, Ute; Krämer, Ursula; Berdel, Dietrich; von Berg, Andrea; Wichmann, H-Erich; Heinrich, Joachim

    2010-02-01

    Cross-sectional studies suggest an association between eczema and mental health problems, but the temporal relationship is unclear. To assess the association between infant-onset eczema and mental health problems in a prospective study. Between 1995 and 1998, a birth cohort study was recruited and followed until age 10 years. Physician-diagnosed eczema, comorbidities, and a broad set of environmental exposures were assessed at age 1, 2, 3, 4, 6, and 10 years. First, we investigated the association between infant-onset eczema (age 1-2 years) and mental health problems at age 10 years according to the Strengths and Difficulties Questionnaire. Second, we analyzed the likelihood of mental health problems at age 10 years in relation to the course of eczema. A total of 2916 infants were eligible for analysis. Compared with participants never diagnosed as having eczema, children with infant-onset eczema had a significantly increased risk for possible/probable mental health problems (Strengths and Difficulties Questionnaire total score) at age 10 years (odds ratio, 1.49; 95% CI, 1.13-1.96) and for emotional symptoms (odds ratio, 1.62; 95% CI, 1.25-2.09). Eczema limited to infancy predicted a significantly higher risk for conduct problems at age 10 years. The strength of the association between eczema and emotional problems at age 10 years increased with increasing eczema persistence. Infants with eczema are at increased risk for mental health problems at age 10 years. Even if cleared afterward, eczema at age 1 to 2 years may cause persistent emotional and behavioral difficulties. Copyright 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  18. A population-based study of the effectiveness of breast conservation for newly diagnosed breast cancer

    International Nuclear Information System (INIS)

    Paszat, Lawrence F.; Groome, Patti A.; Schulze, Karleen; Holowaty, Eric J.; Mackillop, William J.

    2000-01-01

    Purpose: Our objective was to evaluate the effectiveness of breast conservation for newly diagnosed breast cancer. Effectiveness was operationalized as two outcomes within 5 years of the diagnosis of breast cancer: the probability of mastectomy-free survival (either death or mastectomy count as event, whichever comes first), and the probability of mastectomy conditional on survival (mastectomy counts as event, observations censored at death). Methods and Materials: We linked records of 46,687 new cases of breast cancer from 1982 to 1991 in the Ontario Cancer Registry to records of surgery from 1982 to 1995, radiotherapy (RT) from 1982 to 1992, and median household income from the 1986 census. We labeled breast surgery within 4 months and postoperative RT within 12 months of diagnosis as treatment for newly diagnosed breast cancer. Surgery was categorized as mastectomy, lumpectomy plus RT, lumpectomy alone, or no surgical procedure. Among cases that did not undergo mastectomy within 4 months of diagnosis, we labeled mastectomy subsequent to 4 months after diagnosis as treatment failure. We performed life-table analysis and Cox proportional hazards regression, to describe the probability of mastectomy conditional on survival and the probability of mastectomy-free survival. Results: A total of 16,279 cases underwent lumpectomy as the maximum procedure on the breast within 4 months of diagnosis, and 49.7% of these received postoperative RT. Compared to the provincial mean, regions with higher rates of lumpectomy plus RT have higher probability of mastectomy-free survival and lower probability of mastectomy conditional upon survival 5 years after diagnosis of breast cancer. Conclusions: These findings are consistent with a hypothesis that breast conservation is effective in the overall breast cancer population of Ontario within the first 5 years after diagnosis

  19. Fourteen-Year Long-Term Results after Gastric Banding

    Directory of Open Access Journals (Sweden)

    Christine Stroh

    2011-01-01

    Full Text Available Background. Gastric banding (GB is a common bariatric procedure that is performed worldwide. Weight loss can be substantial after this procedure, but it is not sufficient in a significant portion of patients. Long-term rates for associated complications increase with every year of follow up, and only a few long-term studies have been published that examine these rates. We present our results after 14 years of postoperative follow up. Methods. Two hundred patients were operated upon form 01.02.1995 to 31.01.2009. Data collection was performed prospectively. In retrospective analysis, we analyzed weight loss, short- and long-term complications, amelioration of comorbidities and long-term outcome. Results. The mean postoperative follow up time was 94.4 months (range 2–144. The follow up rate was 83.5%. The incidence of postoperative complications for slippage was 2.5%, for pouch dilatation was 9.5%, for band migration was 5.5% and 12.0% for overall band removal. After 14 years, the reoperation rate was 30.5% with a reoperation rate of 2.2% for every year of follow up. Excess weight loss was 40.2% after 1 year, 46.3% after 2 years, 45.9% after 3 years, 41.9% after five years, 33.3% after 8 years, 30.8% after 10 years, 33.3% after 12 years and 15.6% after 14 years of follow up. Conclusion. The complication and reoperation rate after GB is high. Nevertheless, GB is still a therapeutic option in morbid obese patients, but the criteria for patient selection should be carefully evaluated.

  20. Avian response to bottomland hardwood reforestation: the first 10 years

    Science.gov (United States)

    Twedt, D.J.; Wilson, R.R.; Henne-Kerr, J.L.; Grosshuesch, D.A.

    2002-01-01

    Bttomland hardwood forests were planted on agricultural fields in Mississippi and Louisiana using either predominantly Quercus species (oaks) or Populus deltoides (eastern cottonwood). We assessed avian colonization of these reforested sites between 2 and 10 years after planting. Rapid vertical growth of cottonwoods (circa 2 - 3 m / yr) resulted in sites with forest structure that supported greater species richness of breeding birds, increased Shannon diversity indices, and supported greater territory densities than on sites planted with slower-growing oak species. Grassland birds (Spiza americana [Dickcissel], and Sturnella magna [Eastern Meadowlark]) were indicative of species breeding on oak-dominated reforestation # 10 years old. Agelaius phoeniceus (Red-winged Blackbird) and Colinus virginianus (Northern Bobwhite) characterized cottonwood reforestation # 4 years old, whereas 14 species of shrub-scrub birds (e.g., Passerina cyanea [Indigo Bunting]) and early-successional forest birds (e.g., Vireo gilvus [Warbling Vireo]) typified cottonwood reforestation 5 to 9 years after planting. Rates of daily nest survival did not differ between reforestation strategies. Nest parasitism increased markedly in older cottonwood stands, but was overwhelmed by predation as a cause of nest failure. Based on Partners in Flight prioritization scores and territory densities, the value of cottonwood reforestation for avian conservation was significantly greater than that of oak reforestation during their first 10 years. Because of benefits conferred on breeding birds, we recommend reforestation of bottomland hardwoods include a high proportion of fast-growing, early successional species such as cottonwood.

  1. Results of breast conservation therapy from a single-institution community hospital in Hawaii with a predominantly Japanese population

    International Nuclear Information System (INIS)

    Kanemori, Mark; Prygrocki, Maria C.T.R.

    2005-01-01

    Purpose: To evaluate the outcome data from breast conservation therapy performed at the Kuakini Medical Center in Honolulu, Hawaii. The remarkably low rates of recurrence found in this study prompted a review of the literature and evaluation of the prognostic factors that may explain these results. Methods and materials: The data from patients with Tis, T1 or T2 breast tumors, treated with lumpectomy and radiotherapy during the 12-year period between January 1990 and December 2001 were retrospectively reviewed and compared to results found in national publications. Results: Current follow-up data was available in 97.1% of patients who met these criteria, identifying a total of 896 patients who were analyzed in this study. With a median follow-up exceeding 6 years, the local in-breast failure rate was 0.67%. Survival data was superior to the National Cancer Data Base for each stage of disease. Conclusion: This low rate of local relapse is extraordinary and unmatched by the published results generally cited in the literature. The findings are consistent with other studies reporting unusually low rates of breast cancer recurrence in patients of Japanese ancestry

  2. PBL – Reflections after 10 years

    DEFF Research Database (Denmark)

    Soler, José

    The poster describes course 34357 at DTU, where PBL has been used in the last 10 years. While the course responsibles where not aware initially that the used methodology was PBL, the poster describes the triggering idea for the initial taken choices, i.e. homogenize working methodologies...

  3. Acetabular Reconstruction with the Burch-Schneider Antiprotrusio Cage and Bulk Allografts: Minimum 10-Year Follow-Up Results

    Directory of Open Access Journals (Sweden)

    Dario Regis

    2014-01-01

    Full Text Available Reconstruction of severe pelvic bone loss is a challenging problem in hip revision surgery. Between January 1992 and December 2000, 97 hips with periprosthetic osteolysis underwent acetabular revision using bulk allografts and the Burch-Schneider antiprotrusio cage (APC. Twenty-nine patients (32 implants died for unrelated causes without additional surgery. Sixty-five hips were available for clinical and radiographic assessment at an average follow-up of 14.6 years (range, 10.0 to 18.9 years. There were 16 male and 49 female patients, aged from 29 to 83 (median, 60 years, with Paprosky IIIA (27 cases and IIIB (38 cases acetabular bone defects. Nine cages required rerevision because of infection (3, aseptic loosening (5, and flange breakage (1. The average Harris hip score improved from 33.1 points preoperatively to 75.6 points at follow-up (P<0.001. Radiographically, graft incorporation and cage stability were detected in 48 and 52 hips, respectively. The cumulative survival rates at 18.9 years with removal for any reason or X-ray migration of the cage and aseptic or radiographic loosening as the end points were 80.0% and 84.6%, respectively. The use of the Burch-Schneider APC and massive allografts is an effective technique for the reconstructive treatment of extensive acetabular bone loss with long-lasting survival.

  4. Prevalence of Irritable Bowel Syndrome and Chronic Fatigue 10 Years After Giardia Infection.

    Science.gov (United States)

    Litleskare, Sverre; Rortveit, Guri; Eide, Geir Egil; Hanevik, Kurt; Langeland, Nina; Wensaas, Knut-Arne

    2018-03-06

    Irritable bowel syndrome (IBS) is a complication that can follow gastrointestinal infection, but it is not clear if patients also develop chronic fatigue. We investigated the prevalence and odds ratio of IBS and chronic fatigue 10 years after an outbreak of Giardia lamblia, compared with a control cohort, and changes in prevalence over time. We performed a prospective follow-up study of 1252 laboratory-confirmed cases of giardiasis (exposed), which developed in Bergen, Norway in 2004. Statistics Norway provided us with information from 2504 unexposed individuals from Bergen, matched by age and sex (controls). Questionnaires were mailed to participants 3, 6, and 10 years after the outbreak. Results from the 3- and 6-year follow-up analyses have been published previously. We report the 10-year data and changes in prevalence among time points, determined by logistic regression using generalized estimating equations. The prevalence of IBS 10 years after the outbreak was 43% (n = 248) among 576 exposed individuals and 14% (n = 94) among 685 controls (adjusted odds ratio for development of IBS in exposed individuals, 4.74; 95% CI, 3.61-6.23). At this time point, the prevalence of chronic fatigue was 26% (n = 153) among 587 exposed individuals and 11% (n = 73) among 692 controls (adjusted odds ratio, 3.01; 95% CI, 2.22-4.08). The prevalence of IBS among exposed persons did not change significantly from 6 years after infection (40%) to 10 years after infection (43%; adjusted odds ratio for the change 1.03; 95% CI, 0.87-1.22). However, the prevalence of chronic fatigue decreased from 31% at 6 years after infection to 26% at 10 years after infection (adjusted odds ratio for the change 0.74; 95% CI, 0.61-0.90). The prevalence of IBS did not change significantly from 6 years after an outbreak of Giardia lamblia infection in Norway to 10 years after. However, the prevalence of chronic fatigue decreased significantly from 6 to 10 years afterward. IBS and chronic fatigue were

  5. Monomorphic Epithelial Proliferations of the Breast: A Possible Precursor Lesion Associated With Ipsilateral Breast Failure After Breast Conserving Therapy in Patients With Negative Lumpectomy Margins

    International Nuclear Information System (INIS)

    Goldstein, Neal S.; Kestin, Larry L.; Vicini, Frank A.

    2011-01-01

    Background: It is generally believed that ipsilateral breast failures (IBFs) after breast-conserving therapy (BCT) develop from incompletely eradicated carcinoma. We previously suggested that monomorphic epithelial proliferations (MEPs) in the breast may be a pool of partially transformed clones from which breast carcinomas can arise and that radiation therapy (RT) may also reduce the risk of IBF by eradicating MEPs. We examined salvage mastectomy specimens in patients experiencing an IBF to define the relationship between MEPs and IBFs and an additional potential mechanism for IBF risk reduction by RT. Methods and Materials: The location, number, and distribution of radiation changes and MEPs relative to 51 IBFs were mapped in salvage mastectomy specimens from BCT patients with adequately excised, initial carcinomas (negative lumpectomy margins). Results: All 51 salvage mastectomies had diffuse, late radiation changes. None had active fibrocystic lesions. MEPs were predominantly located in the immediate vicinity of the IBFs. A mean of 39% of MEP cases were located within the IBF, 46% were located within 2 cm of the IBF, and 14% were 2-3 cm from the IBF. Conclusions: MEPs appear to be a pool of partially transformed precursor lesions that can give rise to ductal carcinoma in situ and invasive carcinomas (CAs). Many IBFs may arise from MEPs that reemerge after RT. Radiation may also reduce IBF risk after BCT (including in patients with negative margins) by primarily eradicating MEPs.

  6. Community structure and quality after 10 years in two central Ohio mitigation bank wetlands.

    Science.gov (United States)

    Spieles, Douglas J; Coneybeer, Meagan; Horn, Jonathan

    2006-11-01

    We evaluate two 10-year-old mitigation bank wetlands in central Ohio, one created and one with restored and enhanced components, by analysis of vegetation characteristics and by comparison of the year-10 vegetation and macroinvertebrate communities with reference wetlands. To assess different measures of wetland development, we compare the prevalence of native hydrophytes with an index of floristic quality and we evaluate the predictability of these parameters in year 10, given 5 years of data. Results show that the mitigation wetlands in this study meet vegetation performance criteria of native hydrophyte establishment by year 5 and maintain these characteristics through year 10. Species richness and floristic quality, as well as vegetative similarity with reference wetlands, differ among mitigation wetlands in year 1 and also in their rate of change during the first 10 years. The prevalence of native hydrophytes is reasonably predictable by year 10, but 5 years of monitoring is not sufficient to predict future trends of floristic quality in either the created or restored wetland. By year 10, macroinvertebrate taxa richness does not statistically differ among these wetlands, but mitigation wetlands differ from reference sites by tolerance index and by trophic guild dominance. The created wetland herbivore biomass is significantly smaller than its reference, whereas detritivore biomass is significantly greater in the created wetland and smaller in the restored wetland as compared with respective reference wetlands. These analyses illustrate differences in measures of wetland performance and contrast the monitoring duration necessary for legal compliance with the duration required for development of more complex indicators of ecosystem integrity.

  7. Perinatal characteristics among early (10–14 years old and late (15–19 years old pregnant adolescents

    Directory of Open Access Journals (Sweden)

    Alves João

    2012-09-01

    Full Text Available Abstract Background Pregnancy in adolescents is a worldwide health problem and has been mostly common in poor populations. It is not clear if socioeconomic or biological factors are the main determinants of perinatal adverse outcomes in pregnant adolescents. Adolescents under 15 years old may present a high growth rate which may contribute to impair fetal growth. Our aim is to compare perinatal characteristics among early (aged 10 to 14 years and late (aged 15 to 19 years pregnant adolescents. Methods A cross-sectional study was performed using data from Pernambuco State 2009, obtained from DATASUS/SISNAC, a Brazilian Government, open-access public health database. Maternal and neonatal outcomes were compared between early (aged 10–14 years and late (aged 15–19 years pregnant adolescents. Family income was compared between early and late pregnant adolescents using a sample of 412 subjects evaluated at Instituto de Medicina Integral Prof. Fernando Figueira (IMIP during 2011. Statistical comparisons were made using the chi-square test was used with a significant level of 0.05; bivariate and multivariate analysis were performed. This project was approved by the Institutional Ethics Review Board. Results Data from 31,209 pregnant adolescents were analyzed. 29,733 (95.2% were aged 15 to 19 years and 1,476 (4.7% were aged 10 to 14 years. There were significant differences with respect to marital status, education level and number of prenatal visits of mothers aged 10 to 14 years compared to 15 to 19 years. Of importance, early adolescents had a greater rate of neonates born premature and with low birth weight. Prematurity and low birth weight remained statistically significant after multivariate analysis. Conclusions Early aged adolescents may have an increased risk of prematurity and low birth weight. These findings highlight the potential role of biological factors in newborn outcomes in pregnant adolescents.

  8. Correlation in Rectal Cancer Between Clinical Tumor Response After Neoadjuvant Radiotherapy and Sphincter or Organ Preservation: 10-Year Results of the Lyon R 96-02 Randomized Trial

    Energy Technology Data Exchange (ETDEWEB)

    Ortholan, Cecile [Department of Radiation Oncology, Antoine Lacassagne Cancer Center, Nice, UNSA (Universite de Nice Sophia-Antipolis) (France); Department of Oncology-Radiotherapy, Hopital Princesse Grace, Monaco (France); Romestaing, Pascale [Hopital Prive Jean Mermoz, Lyon (France); Chapet, Olivier [Department of Radiation Oncology, Lyon Sud University Hospital, Hospices Civils de Lyon, Lyon (France); Gerard, Jean Pierre, E-mail: jean-pierre.gerard@nice.unicancer.fr [Department of Radiation Oncology, Antoine Lacassagne Cancer Center, Nice, UNSA (Universite de Nice Sophia-Antipolis) (France)

    2012-06-01

    Purpose: To investigate, in rectal cancer, the benefit of a neoadjuvant radiation dose escalation with endocavitary contact radiotherapy (CXRT) in addition to external beam radiotherapy (EBRT). This article provides an update of the Lyon R96-02 Phase III trial. Methods and Materials: A total of 88 patients with T2 to T3 carcinoma of the lower rectum were randomly assigned to neoadjuvant EBRT 39 Gy in 13 fractions (43 patients) vs. the same EBRT with CXRT boost, 85 Gy in three fractions (45 patients). Median follow-up was 132 months. Results: The 10-year cumulated rate of permanent colostomy (CRPC) was 63% in the EBRT group vs. 29% in the EBRT+CXRT group (p < 0.001). The 10-year rate of local recurrence was 15% vs. 10% (p = 0.69); 10-year disease-free survival was 54% vs. 53% (p = 0.99); and 10-year overall survival was 56% vs. 55% (p = 0.85). Data of clinical response (CR) were available for 78 patients (36 in the EBRT group and 42 in the EBRT+CXRT group): 12 patients were in complete CR (1 patient vs. 11 patients), 53 patients had a CR {>=}50% (24 patients vs. 29 patients), and 13 patients had a CR <50% (11 patients vs. 2 patients) (p < 0.001). Of the 65 patients with CR {>=}50%, 9 had an organ preservation procedure (meaning no rectal resection) taking advantage of major CR. The 10-year CRPC was 17% for patients with complete CR, 42% for patients with CR {>=}50%, and 77% for patients with CR <50% (p = 0.014). Conclusion: In cancer of the lower rectum, CXRT increases the complete CR, turning in a significantly higher rate of long-term permanent sphincter and organ preservation.

  9. Localized cutaneous sporotrichosis lasting for 10 years

    Directory of Open Access Journals (Sweden)

    Rathi S

    2003-05-01

    Full Text Available A case of localized cutaneous sporotrichosis lasting for 10 years is being reported. The fixed cutaneous variety creates diagnostic difficulty by mimicking other conditions, chiefly lupus vulgaris.

  10. 10 Year Publication Trends in Dermatology in Mainland China

    Science.gov (United States)

    Xin, Shujun; Mauro, Jacqueline A; Mauro, Theodora M; Elias, Peter M; Man, Mao-Qiang

    2013-01-01

    Background China has been experiencing huge changes in all aspects including dermatologic research since its reform in 1978. However, how the economic and intellectual development has influenced the publication trends in the field of dermatology, which could mirror the scientific development in other medical disciplines, is unknown. In the present study, we analyzed the publication trends from departments of dermatology in mainland China from 2002 to 2011. Materials and Methods All publication data were obtained from www.pubmed.com. Only papers published from dermatology departments of mainland China were used for analysis. Results The number of publications increased 10-fold over this 10 year period. A total 1,231 of articles were published in English in 251 journals between 2002 and 2011. A total of 129 journals published only one paper from dermatology departments of mainland China. Over 60% of articles were original research and 21.7% were case reports. Among these 251 journals, foremost was the Journal of Clinical Experimental Dermatology, which published 5.9% of all papers from mainland China. 2.7% papers were published in the Journal of Investigative Dermatology. The number of publications positively correlated with the changes in gross domestic product per capita during the study period. Conclusions These results suggest that the number of publications in the dermatology field has increased markedly in mainland China over the last 10 years. This dramatic increase in publications could be, at least partially, attributed to the significant improvement in economic conditions in mainland China. PMID:23968296

  11. Influence training process program for coach physiological quality of players 10–12 years

    Directory of Open Access Journals (Sweden)

    Sergey Lebedev

    2016-02-01

    Full Text Available The practice of sport shows with proper evidence-based construction training process, not all young athletes can achieve high-level sports technics that puts them at further sporting destiny. Purpose: identify the dynamics of psychophysiologic рreparations young players aged 10–12 years. Material & Methods: analysis and synthesis of the literature; pedagogical testing laboratory method; methods of mathematical statistics. Results: significant difference in evaluating the capacity for predicting the situation in the field: between 10 and 11 years – on 0.16 points (t=3,57; p<0,001 and between 11 and 12 at 0.27 points (t=2,99; p<0,05. In 11-year-old young players improved 0.79 points relative to 10-year (t=2,30; p<0,05, and 12 years 1.09 points respectively to 11 years (t=4,12; p<0,001. Retrieved changes in terms Tapping test from 10 to 12 years (t=3,15; p<0.01, due to a higher physical activity (both in terms of employment and volume load. Conclusions: with age, physiological indicators improved significantly.

  12. The effects of 10 years Railway investment in Denmark

    DEFF Research Database (Denmark)

    Hansen, Sten A.

    1998-01-01

    The paper retrives the impacts of the last 10 years of investment in railway infrastructure in Denmark and ooncludes, that traveltimes and frequency is large unchanged during that period.......The paper retrives the impacts of the last 10 years of investment in railway infrastructure in Denmark and ooncludes, that traveltimes and frequency is large unchanged during that period....

  13. Swift: 10 Years of Discovery

    Science.gov (United States)

    2014-12-01

    The conference Swift: 10 years of discovery was held in Roma at La Sapienza University on Dec. 2-5 2014 to celebrate 10 years of Swift successes. Thanks to a large attendance and a lively program, it provided the opportunity to review recent advances of our knowledge of the high-energy transient Universe both from the observational and theoretical sides. When Swift was launched on November 20, 2004, its prime objective was to chase Gamma-Ray Bursts and deepen our knowledge of these cosmic explosions. And so it did, unveiling the secrets of long and short GRBs. However, its multi-wavelength instrumentation and fast scheduling capabilities made it the most versatile mission ever flown. Besides GRBs, Swift has observed, and contributed to our understanding of, an impressive variety of targets including AGNs, supernovae, pulsars, microquasars, novae, variable stars, comets, and much more. Swift is continuously discovering rare and surprising events distributed over a wide range of redshifts, out to the most distant transient objects in the Universe. Such a trove of discoveries has been addressed during the conference with sessions dedicated to each class of events. Indeed, the conference in Rome was a spectacular celebration of the Swift 10th anniversary. It included sessions on all types of transient and steady sources. Top scientists from around the world gave invited and contributed talks. There was a large poster session, sumptuous lunches, news interviews and a glorious banquet with officials attending from INAF and ASI. All the presentations, as well as several conference pictures, can be found in the conference website (http://www.brera.inaf.it/Swift10/Welcome.html). These proceedings have been collected owing to the efforts of Paolo D’Avanzo who has followed each paper from submission to final acceptance. Our warmest thanks to Paolo for all his work. The Conference has been made possible by the support from La Sapienza University as well as from the ARAP

  14. LIVER FUNCTION CHANGES IN PATIENTS WITH SPONDYLOARTHRITIS TAKING NONSTEROIDAL ANTI-INFLAMMATORY DRUGS OVER A LONG PERIOD: RESULTS OF A 10-YEAR PROGRESS PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    A. P. Rebrov

    2016-01-01

    Full Text Available Objective: to assess liver function changes in patients with spondyloarthritis (SpA taking NSAIDs regularly over a long period.Patients and methods. The data obtained during a 10-year PROGRESS prospective single-center cohort study of functional status, activity, and comorbidity (including gastrointestinal tract diseases in patients with SpA were analyzed. The data of 363 SpA patients receiving NSAIDs regularly over a long period and followed up for 10 years were also explored. The changes that had occurred over a decade in the liver enzyme levels, the number of discontinued NSAID treatments because of a persistent increase in liver enzyme levels, and the number of prescriptions of hepatoprotective agents were analyzed.Results. For 10 years, 18 patients with SpA discontinued their NSAID intake due to elevated liver enzyme levels (≥3 times greater than the reference value; during that time, the same increase in enzyme levels was observed in 2 healthy individuals (χ2 =1.39; p=0.2. In the patients with SpA as compared to the healthy individuals, the relative risk of abnormal liver function was 1.19 (95% CI, 1.009–1.405; odds ratio was 2.9 (95% CI, 0.65–12.95. There was no increased risk for discontinuation of some NSAIDs, including nimesulide (χ2 =0.03, p=0.85, the frequency of using hepatoprotective drugs was proved to be highest for diclofenac sodium, ibuprofen, nimesulide, and ketoprofen.Conclusion. The regular long-term (as long as 10 years use of NSAIDs to treat SpA is associated with treatment discontinuation because of elevated enzyme levels in every 10 patients. The maximum rate of discontinuation of NSAIDs due to a persistent increase in liver enzyme levels is observed 6–8 years after their regular use, so long-term NSAID therapy requires continuous monitoring of hepatic safety. The longterm intake of nimesulide, as compared with other NSAIDs, is shown to be unassociated with the higher rate of its discontinuation because of

  15. Are we improving after 10 years of humanitarian paediatric cardiac assistance?

    Science.gov (United States)

    Novick, William M; Stidham, Gregory L; Karl, Thomas R; Guillory, Karen L; Ivanćan, Visnja; Malcić, Ivan; Sandoval, Nestor; Reid, Robert W; Lazorishisnets, Vasily V; Davis, Matthew C; Baum, Victor C; Di Sessa, Thomas G

    2005-08-01

    Paediatric cardiovascular services are frequently absent or poorly developed in many countries around the world. Our foundation made 83 trips in support of cardiovascular services between April 1993 and March 2003 to help alleviate this problem. In this study, we present an analysis of our results over these period of 10 years. We performed a review of all available records relating to the trips, including patient databases, audited financial statements, donated product inventory lists, lists of team members, and follow-up data from the host sites concerning the state of the patients treated. We made 83 trips to 14 countries, 40 of these being in Central Europe, 5 in Eastern Europe, 10 in Caribbean, and Central America, 18 in South America, 9 in Asia, and 1 in the Middle East. In the first 5 years, we made 23, as opposed to 60 in the second 5 years, this difference being significant (p less than 0.01). The total number of primary operations performed over 10 years was 1,580. The number of procedures performed yearly increased over the two intervals from 97.0 plus or minus 32.7 to 219.0 plus or minus 41.7, p less than 0.002. The probability of survival between the periods increased from 84.6 to 93.3 per cent, and this was also significantly different (p less than 0.001). Overall, the rate of survival for the period of 10 years was 90.5 per cent. Moreover, the value of services donated to support each trip also differed significantly, decreasing from 105,900 dollars plus or minus 14,581 dollars for the first period to 54,617 dollars plus or minus 11,425 dollars for the second period (p less than 0.001). Improving paediatric cardiac services in under-served countries requires significant financial and personnel commitments, but can produce reasonable outcomes.

  16. Publication and non-publication of drug trial results: a 10-year cohort of trials in Norwegian general practice.

    Science.gov (United States)

    Brænd, Anja Maria; Straand, Jørund; Jakobsen, Rune Bruhn; Klovning, Atle

    2016-04-11

    Previously, we identified a 10-year cohort of protocols from applications to the Norwegian Medicines Agency 1998-2007, consisting of 196 drug trials in general practice. The aim of this study was to examine whether trial results were published and whether trial funding and conflicts of interest were reported. Cohort study of trials with systematic searches for published results. Clinical drug trials in Norwegian general practice. We performed systematic literature searches of MEDLINE, Embase and CENTRAL to identify publications originating from each trial using characteristics such as test drug, comparator and patient groups as search terms. When no publication was identified, we contacted trial sponsors for information regarding trial completion and reference to any publications. We determined the frequency of publication of trial results and trial characteristics associated with publication of results. Of the 196 trials, 5 were never started. Of the remaining 191 trials, 71% had results published in a journal, 11% had results publicly available elsewhere and 18% of trials had no results available. Publication was more common among trials with an active comparator drug (χ(2) test, p=0.040), with a larger number of patients (total sample size≥median, p=0.010) and with a longer trial period (duration≥median, p=0.025). Trial funding was reported in 85% of publications and increased over time, as did reporting of conflicts of interest among authors. Among the 134 main journal articles from the trials, 60% presented statistically significant results for the investigational drug, and the conclusion of the article was favourable towards the test drug in 78% of papers. We did not identify any journal publication of results for 29% of the general practice drug trials. Trials with an active comparator, larger and longer trials were more likely to be published. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a

  17. 10 years after the largest river restoration project in Northern Europe

    DEFF Research Database (Denmark)

    Astrup Kristensen, Esben Astrup; Kronvang, B.; Wiberg-Larsen, P.

    2014-01-01

    that erosion and sedimentation have changed the cross-sectional profiles over the last 10 years, resulting in a net input of sediment to the lower reaches of the river. However, the change of channel form was a slow process and predicted bank retreat over a 100 year period was only up to 6.8 m. Hence......The lower river Skjern (Denmark) historically contained a large variation in habitats and the river ran through large areas with wetlands, many backwaters, islands and oxbow lakes. During the 1960s the river was channelized and the wetland drained. A restoration during 2001–2002 transformed 19 km...... of channelized river into 26 km meandering river. The short-term effects of this restoration have previously been reported and for this study we revisited the river and with new data evaluated the long-term (10 years) hydrological effects of the restoration. The evaluation was done on three different scales: (1...

  18. Long-term Stability of Soft Tissue Esthetic Outcomes Following Conventional Single Implant Treatment in the Anterior Maxilla: 10-12 Year Results.

    Science.gov (United States)

    Rokn, A; Bassir, S H; Rasouli Ghahroudi, A A; Kharazifard, M J; Manesheof, R

    2016-01-01

    The present study aimed to evaluate the long-term stability of esthetic outcomes of soft tissue around maxillary anterior single-tooth implants after 10-to-12 years of loading. Patients who had been treated for single-tooth implants in the anterior maxilla between February 2000 and July 2002 were invited to participate in the study. All implants had been placed according to delayed implant placement and conventional loading protocols without any connective tissue graft or papilla preservation flaps. Pink Esthetic Score (PES) was rated using standardized clinical photographs to assess the esthetic outcomes of the implant treatment at the time of crown placement and at time of follow-up examination which was at least 10 years after the crown placement. A total of 19 patients were included. The mean score of PES was 11.63 (SD 1.61; range 7-14) at baseline. After 10-to-12 years of function, a mean PES score of 11.05 (SD 2.09; range 6-14) was recorded. No significant differences were found in the esthetic outcomes, categorized based on clinically relevant levels, between the baseline and follow-up session (p>0.05). Within limitation of the present study, it can be concluded that the esthetic outcomes of soft tissue around the maxillary anterior single-tooth implants placed using conventional implant placement technique remained stable in the long-term.

  19. Ten Year Operating Test Results and Post-Test Analysis of a 1/10 Segment Stirling Sodium Heat Pipe, Phase III

    Science.gov (United States)

    Rosenfeld, John, H; Minnerly, Kenneth, G; Dyson, Christopher, M.

    2012-01-01

    High-temperature heat pipes are being evaluated for use in energy conversion applications such as fuel cells, gas turbine re-combustors, Stirling cycle heat sources; and with the resurgence of space nuclear power both as reactor heat removal elements and as radiator elements. Long operating life and reliable performance are critical requirements for these applications. Accordingly, long-term materials compatibility is being evaluated through the use of high-temperature life test heat pipes. Thermacore, Inc., has carried out a sodium heat pipe 10-year life test to establish long-term operating reliability. Sodium heat pipes have demonstrated favorable materials compatibility and heat transport characteristics at high operating temperatures in air over long time periods. A representative one-tenth segment Stirling Space Power Converter heat pipe with an Inconel 718 envelope and a stainless steel screen wick has operated for over 87,000 hr (10 yr) at nearly 700 C. These life test results have demonstrated the potential for high-temperature heat pipes to serve as reliable energy conversion system components for power applications that require long operating lifetime with high reliability. Detailed design specifications, operating history, and post-test analysis of the heat pipe and sodium working fluid are described.

  20. Natural History of Thyroid Function in Adults with Down Syndrome--10-Year Follow-Up Study

    Science.gov (United States)

    Prasher, V.; Gomez, G.

    2007-01-01

    Background: The natural history of thyroid function in adults with Down syndrome (DS) is unknown. Method: This study investigated annual thyroid function tests in 200 adults with DS over a 10-year period. Results: Transient and persistent thyroid dysfunction was common. The 5- and 10-year incidence of definite hypothyroidism was 0.9%-1.64% and…

  1. Predictors of subjective health status 10 years post-PCI.

    Science.gov (United States)

    van den Berge, Jan C; Dulfer, Karolijn; Utens, Elisabeth M W J; Hartman, Eline M J; Daemen, Joost; van Geuns, Robert J; van Domburg, Ron T

    2016-06-01

    Subjective health status is an increasingly important parameter to assess the effect of percutaneous coronary intervention (PCI) in clinical practice. Aim of this study was to determine medical and psychosocial predictors of poor subjective health status over a 10 years' post-PCI period. We included a series of consecutive PCI patients (n = 573) as part of the RESEARCH registry, a Dutch single-center retrospective cohort study. These patients completed the 36-item Short-Form Health Survey (SF-36) at baseline and 10 years post-PCI. We found 6 predictors of poor subjective health status 10 years post-PCI: SF-36 at baseline, age, previous PCI, obesity, acute myocardial infarction as indication for PCI, and diabetes mellitus (arranged from most to least numbers of sub domains). SF-36 scores at baseline, age, and previous PCI were significant predictors of subjective health status 10 years post-PCI. Specifically, the SF-36 score at baseline was an important predictor. Thus assessment of subjective health status at baseline is useful as an indicator to predict long-term subjective health status. Subjective health status becomes better by optimal medical treatment, cardiac rehabilitation and psychosocial support. This is the first study determining predictors of subjective health status 10 years post-PCI.

  2. Past and next 10 years of medical informatics

    NARCIS (Netherlands)

    Ückert, Frank; Ammenwerth, Elske; Dujat, Carl; Grant, Andrew; Haux, Reinhold; Hein, Andreas; Hochlehnert, Achim; Knaup-Gregori, Petra; Kulikowski, Casimir; Mantas, John; Maojo, Victor; Marschollek, Michael; Moura, Lincoln; Plischke, Maik; Röhrig, Rainer; Stausberg, Jürgen; Takabayashi, Katsuhiko; Winter, Alfred; Wolf, Klaus-Hendrik; Hasman, Arie

    2014-01-01

    More than 10 years ago Haux et al. tried to answer the question how health care provision will look like in the year 2013. A follow-up workshop was held in Braunschweig, Germany, for 2 days in May, 2013, with 20 invited international experts in biomedical and health informatics. Among other things

  3. Delayed vaginal and urethral mesh exposure: 10 years after TVT surgery.

    Science.gov (United States)

    Khanuengkitkong, Siwatchaya; Lo, Tsia-Shu; Dass, Anil Krishna

    2013-03-01

    Delayed mesh exposure after tension-free vaginal tape (TVT) procedure is rare. We report a case of mesh exposure into the vagina and urethra that developed 10 years after TVT surgery. A 58-year-old postmenopausal woman presented with mixed urinary incontinence. She was investigated, and her stress urinary incontinence was cured with a TVT procedure 10 years ago. She was then scheduled follow-up annually. Two years postsurgery, a granulation tissue was observed and excised at the vaginal incision site. Vaginal examination 10 years postsurgery showed vaginal mesh erosion 0.5 cm from urethral meatus. Cystoscopy revealed concomitant urethral erosion at the posterior urethral wall. Mesh excision was performed, and urethra and vagina were repaired in layers. Postoperative recovery was uneventful. This finding shows that, although rare, complications can occur even after 10 years of TVT surgery.

  4. Preoperative Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer: Preliminary Results of a Prospective, Phase 2 Trial

    International Nuclear Information System (INIS)

    Nichols, Elizabeth; Kesmodel, Susan B.; Bellavance, Emily; Drogula, Cynthia; Tkaczuk, Katherine; Cohen, Randi J.; Citron, Wendla; Morgan, Michelle; Staats, Paul; Feigenberg, Steven; Regine, William F.

    2017-01-01

    Purpose: To assess the feasibility of utilizing 3-dimensional conformal accelerated partial-breast irradiation (APBI) in the preoperative setting followed by standard breast-conserving therapy. Patients and Methods: This was a prospective trial testing the feasibility of preoperative APBI followed by lumpectomy for patients with early-stage invasive ductal breast cancer. Eligible patients had T1-T2 ( 21 days after radiation therapy. Adjuvant therapy was given as per standard of care. Results: Twenty-seven patients completed treatment. With a median follow-up of 3.6 years (range, 0.5-5 years), there have been no local or regional failures. A complete pathologic response according to hematoxylin and eosin stains was seen in 4 patients (15%). There were 4 grade 3 seromas. Patient-reported cosmetic outcome was rated as good to excellent in 79% of patients after treatment. Conclusions: Preoperative 3-dimensional conformal radiation therapy−APBI is feasible and well tolerated in select patients with early-stage breast cancer, with no reported local recurrences and good to excellent cosmetic results. The pathologic response rates associated with this nonablative APBI dose regimen are particularly encouraging and support further exploration of this paradigm.

  5. Clinical results of posterolateral fusion for degenerative lumbar spinal diseases. A follow-up study of more than 10 years

    International Nuclear Information System (INIS)

    Kuroki, Hiroshi; Tajima, Naoya; Kubo, Shinichiro

    2002-01-01

    The objective of this retrospective study was to evaluate the long-term clinical outcomes and the effects on unfused motion segments of posterolateral fusion. This study involved 35 cases (37 intervertebral levels) of posterolateral fusion performed to treat degenerative lumbar spinal diseases. There were 20 male and 15 female patients ranging in age from 30 to 67 years, with a mean age of 49 years. The postoperative period ranged from 10 years to 17 years and 8 months, with a mean period of 13 years. The clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) score for assessment of treatment for low back pain. The effects on unfused motion segments were investigated with radiographic and magnetic resonance (MR) imaging. Postoperative satisfactory improvement (mean recovery rate, 66.9%) reached a plateau at 1 year and was maintained at final follow-up. Radiographically, the union rate was 86.5%. There were few cases of induced instability of unfused motion segments. On MR imaging, increased signal intensity in both T 1 - and T 2 -weighted images was seen in the paravertebral muscles in 15 of 20 cases (75.0%). Posterolateral fusion is a useful technique for the treatment of degenerative lumbar spinal diseases. Clinical outcomes were stable throughout follow-up. Instability of unfused motion segments rarely occurred. (author)

  6. Patient-Reported Outcomes following Breast Conservation Therapy and Barriers to Referral for Partial Breast Reconstruction.

    Science.gov (United States)

    Vrouwe, Sebastian Q; Somogyi, Ron B; Snell, Laura; McMillan, Catherine; Vesprini, Danny; Lipa, Joan E

    2018-01-01

    The purpose of this study was to evaluate the self-reported aesthetic outcome of breast conservation therapy in a generalized sample of patients, and to describe potential barriers to referral for partial breast reconstruction. Consecutive breast conservation therapy patients completing radiotherapy over a 1-year period at a regional cancer center were identified. Eligible patients were contacted by means of mail/e-mail and invited to participate. Participants completed the BREAST-Q breast conservation therapy module along with a questionnaire examining feelings about breast reconstruction. Multiple regression analysis was performed using the satisfaction with breasts scale as the dependent variable. Surveys were completed by 185 of 592 eligible participants (response rate, 31.3 percent; mean age, 61 years) an average of 38 months after lumpectomy. The mean score for the BREAST-Q satisfaction with breasts scale was 59 of 100. Younger age (p = 0.038), lumpectomy reexcision (p = 0.018), and lumpectomy at a nonacademic center (p = 0.026) were significantly associated with lower satisfaction. Bra size, months from lumpectomy, and tumor quadrant/size were not significantly associated with satisfaction (p > 0.05). The most common statements regarding reconstruction were "I don't feel the need for it" (60.0 percent), "I don't like the thought of having breast implants" (22.7 percent), and "I don't want any more surgeon/doctor visits" (22.2 percent). Before lumpectomy, only 1.6 percent had a consultation for reconstruction, and only 22.7 percent were aware of this option. If offered, 33.1 percent of patients would have attended this consultation. There is an unmet demand for partial breast reconstruction, with an opportunity to advocate and increase awareness on behalf of patients undergoing breast conservation therapy.

  7. TIPSS: 10 years of experience; TIPSS: 10 Jahre klinische Erfahrung

    Energy Technology Data Exchange (ETDEWEB)

    Richter, G.M.; Brado, M.; Simon, C.; Radeleff, B.; Kauffmann, G.W. [Heidelberg Univ. (Germany). Abt. Radiodiagnostik; Noeldge, G.; Scharf, J.; Hansmann, J.

    1998-04-01

    Purpose: To demonstrate and document 10 years of clinical experience gathered by us with TIPSS and to discuss achievements, problems and outlook. Results: Variceal filling was widely reduced by TIPSS, and significantly reduced portal liver perfusion as assessed morphologically and rheologically. However, there was an immediate onset of compensated liver perfusion by increased arterial inflow. Total liver perfusion did not change significantly. In TIPSS portal decompression was readily achieved, the portosystemic gradient dropping from an average of 24 mm Hg to 10.5 mm Hg. In our series we could not demonstrate an increased incidence of hepatic encephalopathy during the 30-day post-TIPSS period. Early mortality was 4% and early rebleeding rate 3%. The 12-month re-intervention rate based on an invasive portography follow-up protocol was 76%, and the 24-month re-intervention rate was 90%. The definite occlusion rate was below 5%. Beyond a follow-up time span of 24-months the necessity for re-intervention dropped significantly: Less than one-third of our patients required some sort of re-intervention. (orig./AJ) [Deutsch] Ziel: Darstellung der nach 10jaehriger klinischer Anwendung von TIPSS gewonnenen Erfahrungen unter Beruecksichtigung der technischen Grundlagen, der Veraenderungen in der Haemodynamik der Leber und der Langzeitergebnisse. Ergebnisse: TIPSS reduziert die Varizenfuellung und verringert morphologisch und haemodynamisch die portale Perfusion. Die Gesamtleberperfusion aendert sich nicht signifikant. Unter TIPSS kommt es zu einer unmittelbaren Zunahme der arteriellen Leberperfusion. Die portale Drucksenkung erfolgt von einem portosystemischen Mitteldruck von 24 mmHg auf 10,5 mmHg im Durchschnitt. Die spontane hepatische Enzephalopathierate von etwa 20% aendert sich durch TIPSS nicht wesentlich. Die Fruehletalitaet betraegt 4% und die Nachblutungsrate 3%. Insbesondere die Standardisierung von Indikationen und Kontraindikationen, des Punktionsbesteckes, der

  8. 10 CFR 503.31 - Lack of alternate fuel supply for the first 10 years of useful life.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Lack of alternate fuel supply for the first 10 years of useful life. 503.31 Section 503.31 Energy DEPARTMENT OF ENERGY (CONTINUED) ALTERNATE FUELS NEW FACILITIES Permanent Exemptions for New Facilities § 503.31 Lack of alternate fuel supply for the first 10 years of...

  9. Occupational accidents in dental school: a 10-year retrospective

    Directory of Open Access Journals (Sweden)

    Viviane Maia Araújo

    2009-12-01

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

  10. Resident wellness: institutional trends over 10 years since 2003

    Directory of Open Access Journals (Sweden)

    Choi D

    2017-07-01

    Full Text Available Dongseok Choi,1,2 Andrea Cedfeldt,3,4 Christine Flores,5 Kimberly Irish,3 Patrick Brunett,3,6 Donald Girard3,4 1OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA; 2School of Dentistry, Kyung Hee University, Seoul, Korea; 3Division of Graduate Medical Education, 4Department of Medicine, 5Division of Continuing Professional Development, 6Department of Emergency Medicine, Oregon Health & Science University, Portland, OR, USA Background: The surveys in this study were carried out at the Graduate Medical Education Division at Oregon Health & Science University (OHSU. OHSU implemented two significant wellness initiatives: a wellness program in 2004, and a policy allowing 4 half-days off each academic year to pursue personal or family health care needs in 2010. This study provides a secondary data analysis of five cross-sectional surveys of career satisfaction of resident and fellow trainees. Methods: All trainees were surveyed five times over a 10-year period using anonymous, cross-sectional web-based survey instruments. Surveys included questions about career satisfaction, perceived stress, sleep hours, burnout, and related factors.Results: This represents 10 years of accumulated responses from over 2,200 residents with results showing continual improvement in their career satisfaction. Response rates ranged from 56% to 72%. During the study period, there was a significant positive change in overall resident career satisfaction, with little change in factors traditionally considered to be predictive of overall career satisfaction such as sleep hours or perceived stress level. In addition, our data support that availability of time for personal tasks could positively impact the overall training experience.Conclusion: We postulate that the improvements in satisfaction relate to two major institutional innovations designed to promote resident wellness. Keywords: satisfaction, burnout, graduate medical education

  11. Basal Cell Carcinoma: 10 Years of Experience

    International Nuclear Information System (INIS)

    Cigna, E.; Tarallo, M.; Maruccia, M.; Sorvillo, V.; Pollastrini, A.; Scuderi, N.

    2011-01-01

    Introduction. Basal cell carcinoma (BCC) is a locally invasive malignant epidermal tumour. Incidence is increasing by 10% per year; incidence of metastases is minimal, but relapses are frequent (40%-50%). The complete excision of the BCC allows reduction of relapse. Materials and Methods. The study cohort consists of 1123 patients underwent surgery for basal cell carcinoma between 1999 and 2009. Patient and tumor characteristics recorded are: age; gender; localization (head and neck, trunk, and upper and lower extremities), tumor size, excisional margins adopted, and relapses. Results. The study considered a group of 1123 patients affected by basal cell carcinoma. Relapses occurred in 30 cases (2,67%), 27 out of 30 relapses occurred in noble areas, where peripheral margin was <3mm. Incompletely excised basal cell carcinoma occurred in 21 patients (1,87%) and were treated with an additional excision. Discussion. Although guidelines indicate 3mm peripheral margin of excision in BCC <2cm, in our experience, a margin of less than 5mm results in a high risk of incomplete excisions

  12. Spectrally encoded confocal microscopy (SECM) for rapid assessment of breast excision specimens (Conference Presentation)

    Science.gov (United States)

    Brachtel, Elena F.; Johnson, Nicole B.; Huck, Amelia E.; Rice-Stitt, Travis L.; Vangel, Mark G.; Smith, Barbara L.; Tearney, Guillermo J.; Kang, DongKyun

    2016-03-01

    Unacceptably large percentage (20-40%) of breast cancer lumpectomy patients are required to undergo multiple surgeries when positive margins are found upon post-operative histologic assessment. If the margin status can be determined during surgery, surgeon can resect additional tissues to achieve tumor-free margin, which will reduce the need for additional surgeries. Spectrally encoded confocal microscopy (SECM) is a high-speed reflectance confocal microscopy technology that has a potential to image the entire surgical margin within a short procedural time. Previously, SECM was shown to rapidly image a large area (10 mm by 10 mm) of human esophageal tissue within a short procedural time (15 seconds). When used in lumpectomy, SECM will be able to image the entire margin surface of ~30 cm2 in around 7.5 minutes. SECM images will then be used to determine margin status intra-operatively. In this paper, we present results from a study of testing accuracy of SECM for diagnosing malignant breast tissues. We have imaged freshly-excised breast specimens (N=46) with SECM. SECM images clearly visualized histomorphologic features associated with normal/benign and malignant breast tissues in a similar manner to histologic images. Diagnostic accuracy was tested by comparing SECM diagnoses made by three junior pathologists with corresponding histologic diagnoses made by a senior pathologist. SECM sensitivity and specificity were high, 0.91 and 0.93, respectively. Intra-observer agreement and inter-observer agreement were also high, 0.87 and 0.84, respectively. Results from this study showed that SECM has a potential to accurately determine margin status during breast cancer lumpectomy.

  13. Childhood Rabies: A 10 Year Review of Management and Outcome ...

    African Journals Online (AJOL)

    Background: Rabies is still a cause of death among children in our environment. We undertook a 10-year retrospective review to evaluate the aetiology and outcome of management of childhood rabies in our setting. Methodology: This was a 10-year retrospective study of rabies cases managed in the Paediatrics Unit of the ...

  14. History of 10 years of KEPCO

    International Nuclear Information System (INIS)

    1985-10-01

    This book is the history of Korea power engineering company for 10 years. It describes the background of establishment of the company and development of nuclear energy and engineering, the procession of the establishment, the course of development in three parts of period, organization of the company, the progression of the business in the nuclear energy, hydraulic power and thermal power, development of technique and manpower and management for prospect of the company.

  15. Aesthetic results following partial mastectomy and radiation therapy

    International Nuclear Information System (INIS)

    Matory, W.E. Jr.; Wertheimer, M.; Fitzgerald, T.J.; Walton, R.L.; Love, S.; Matory, W.E.

    1990-01-01

    This study was undertaken to determine the aesthetic changes inherent in partial mastectomy followed by radiation therapy in the treatment of stage I and stage II breast cancer. A retrospective analysis of breast cancer patients treated according to the National Surgical Adjuvant Breast Project Protocol B-06 was undertaken in 57 patients from 1984 to the present. The size of mastectomy varied between 2 x 1 cm and 15 x 8 cm. Objective aesthetic outcome, as determined by physical and photographic examination, was influenced primarily by surgical technique as opposed to the effects of radiation. These technical factors included orientation of resections, breast size relative to size of resection, location of tumor, and extent and orientation of axillary dissection. Regarding cosmesis, 80 percent of patients treated in this study judged their result to be excellent or good, in comparison to 50 percent excellent or good as judged by the plastic surgeon. Only 10 percent would consider mastectomy with reconstruction for contralateral disease. Asymmetry and contour abnormalities are far more common than noted in the radiation therapy literature. Patients satisfaction with lumpectomy and radiation, however, is very high. This satisfaction is not necessarily based on objective criteria defining aesthetic parameters, but is strongly influenced by retainment of the breast as an original body part

  16. Maternal Prenatal Nutrition and Birth Outcomes on Malnutrition among 7- to 10-Year-Old Children: A 10-Year Follow-Up.

    Science.gov (United States)

    Zhou, Jing; Zeng, Lingxia; Dang, Shaonong; Pei, Leilei; Gao, Wenlong; Li, Chao; Yan, Hong

    2016-11-01

    To identify postnatal predictors of malnutrition among 7- to 10-year-old children and to assess the long-term effects of antenatal micronutrient supplementation on malnutrition. A follow-up study was conducted to assess the nutritional status of 7- to 10-year-olds (1747 children) whose mothers participated in a cluster-randomized double-blind controlled trial from 2002 to 2006. The rate of malnourished 7- to 10-year-olds was 11.1%. A mixed-effects logistic regression model adjusted for the cluster-sampling design indicated that mothers with low prepregnant midupper arm circumference had boys with an increased risk of thinness (aOR  2.05, 95% CI  1.11, 3.79) and girls who were more likely to be underweight (aOR 2.01, 95% CI 1.05, 3.85). Antenatal micronutrient supplementation was not significantly associated with malnutrition. Low birth weight was significantly associated with increased odds of malnutrition among boys (aOR 4.34, 95% CI 1.82, 10.39) and girls (aOR  7.50, 95% CI 3.48, 16.13). Being small for gestational age significantly increased the odds of malnutrition among boys (aOR 1.75, 95% CI 1.01, 3.04) and girls (aOR 4.20, 95% CI  2.39, 7.39). In addition, household wealth, parental height, being picky eater, and illness frequency also predicted malnutrition. Both maternal prenatal nutrition and adverse birth outcomes are strong predictors of malnutrition among early school-aged children. Currently, available evidence is insufficient to support long-term effects of antenatal micronutrient supplementation on children's nutrition. www.isrctn.com: ISRCTN08850194. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Drowning in Pretoria, South Africa: A 10-year review.

    Science.gov (United States)

    Morris, N K; du Toit-Prinsloo, L; Saayman, G

    2016-01-01

    Drowning is classified as the 3rd leading cause of accidental deaths worldwide and is deemed to be a preventable cause of death. Bodies retrieved from a water medium pose several challenges to the forensic pathologist with the diagnosis of drowning being primarily one of exclusion. The aim of this study was to do a retrospective descriptive case audit of bodies retrieved from water and immersion related deaths, which were investigated at the Pretoria Medico-Legal Laboratory (PMLL) over a 10 year period (January 2002 through December 2011). A total of 346 cases were identified for inclusion into this study. In 6% (20) of these cases, the death was not related to drowning; in 14% (48) no clear cause of death could be ascertained and in 278 cases (80%) the cause of death was considered to have been due to drowning. Infants (under 1 year, of age) constituted 41 (15%) of the cases; toddlers (aged 1-2 years) comprised 52 (19%) cases; children (aged 2-13 years) 49 (18%) cases; adolescents (aged 13-18 years) comprised 10 (3%) cases; adults (above 18, years) made up 126 (45%) of the cases. The majority of the drownings, occurred in swimming pools [125 cases (38%)]. In infants 23 (56%) of, drownings occurred in swimming pools followed by buckets [7 cases (17%)]. Sixty-nine per cent of toddler drownings (36 cases) occurred in swimming, pools. In the adult population, 40 (32%) of cases occurred in pools and 35 cases (28%) in rivers. Positive blood alcohol results were recorded in 48, (42%) out of 113 cases where the test was requested, 40 (35%) of these, cases higher than 0.05 g per 100 ml. This study suggests that many drowning deaths in Pretoria may be preventable by introducing greater public awareness of the risks and instituting relatively simple, protective measures. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  18. Nodular hidradenoma and hidradenocarcinoma. A 10-year review.

    Science.gov (United States)

    Hernández-Pérez, E; Cestoni-Parducci, R

    1985-01-01

    We studied eighty-nine nodular hidradenomas (NHs) and six clear cell hidradenocarcinomas (CCHs) reported in a 10-year period. NHs were more commonly seen in women (ratio of 1.7 to 1); the average age was 37.2 years, and they were located mainly on the head. One CCH had widely disseminated metastasis that led to death. Other CCHs underwent spontaneous regression.

  19. Implante coclear em crianças pós-linguais: resultados funcionais após 10 anos da cirurgia Cochlear implant in postlingual children: functional results 10 years after the surgery

    Directory of Open Access Journals (Sweden)

    Liege Franzini Tanamati

    2012-04-01

    Full Text Available Os benefícios do implante coclear (IC às habilidades comunicativas são obtidos ao longo de anos de uso. Há poucos estudos sobre os resultados a longo prazo em crianças pós-linguais que cresceram usando o dispositivo. OBJETIVO: Reportar os resultados funcionais em crianças pós-linguais, após 10 anos de uso do dispositivo. MATERIAL E MÉTODO: Dez crianças pós-linguais, implantadas antes dos 18 anos, participaram deste estudo. Foram avaliadas: a percepção da fala para sentenças e a inteligibilidade de fala. Informações sobre o uso/funcionamento do dispositivo e nível acadêmico/ocupacional foram documentadas. Desenho científico: Estudo de série. RESULTADOS: O reconhecimento para sentenças no silêncio foi igual a 73% e, no ruído, 40%. Para o método de transcrição, a média de acertos foi igual a 92% e, na escala de inteligibilidade, 4.15. Não houve falhas no dispositivo interno. Três participantes haviam concluído o ensino superior e, outros cinco, o ensino médio. Oito participantes estavam empregados. CONCLUSÃO: Este estudo mostrou que o IC é um procedimento seguro e confiável. As crianças pós-linguais após 10 anos de uso do IC alcançaram resultados funcionais em relação à percepção e a inteligibilidade da fala, concluíram ao menos o ensino superior e estavam inseridas no mercado de trabalho.The benefits of cochlear implants (CI for communication skills are obtained over the years. There are but a few studies regarding the long-term outcomes in postlingual deaf children who grew up using the electronic device. AIM: To assess the functional results in a group of postlingual children, 10 years after using a CI. METHODS: Ten postlingual deaf children, implanted before 18 years of age, participated in this study. We assessed: sentence recognition and speech intelligibility. We documented: device use and function and the patient's academic/occupational status. Study design: series. RESULTS: The mean scores were

  20. Physical activity level of school children of age 10-13 years

    OpenAIRE

    Ronghe, Dr. Rashmi N; Gotmare, Dr. Neha A; Kawishwar, Dr. Shraddha

    2016-01-01

    Aim: To assess physical activity level of school children of age 10-13 years.Objectives: To assess and grade physical activity level in children of age 10-13 years using Physical Activity Questionnaire for Children (PAQ-C) classified into: Light Physical activity; Moderate Physical activity; Moderate to vigorous Physical activity and High Physical activity.Methodology: This is Questionnaire based survey study which was conducted on 100 school going children of 10-13 years who were present on ...

  1. Clinical characteristics of optic neuritis in Hong Kong population: 10-year review.

    Science.gov (United States)

    Choy, Bonnie Nga Kwan; Ng, Alex Lap Ki; Lai, Jimmy Shiu Ming

    2018-04-01

    To review the clinical course of adult patients with acute optic neuritis over 10 years in Hong Kong, and the results were compared with other studies among Asian and Caucasian patients. This study retrospectively analysed the clinical features of 38 adult patients (51 eyes) presented with optic neuritis in a Hong Kong hospital over 10 years (2001-2010). Optic neuritis had a female predominance (68%). The mean age of presentation was 40 years old. Disc swelling (39%) was more common compared to the optic neuritis treatment trial (ONTT). The recovery time ranged from no recovery to 5 years, with a mean of 6.0 months. However, vision continued to deteriorate despite initial improvement in 45% of patients. Only 11.8% of the eyes attained final visual acuity (VA) of 1.0 or better, while 31.4% had VA 0.1 or worse. Multiple sclerosis or neuromyelitis optica only occurred in 10.4% of patients. Three of our patients who did not receive any treatment showed faster recovery than the average. Optic neuritis in Hong Kong is mostly a clinically isolated syndrome. Our patients presented at a later age and showed a worse visual outcome. Corticosteroid according to ONTT protocol remained our mainstay of treatment although it did not benefit our patients as much as ONTT study. More work on the long-term prognosis and treatment strategies is worthwhile among Chinese optic neuritis patients.

  2. Epidemiology of ovarian cancers in Zaria, Northern Nigeria: a 10-year study

    Directory of Open Access Journals (Sweden)

    Zayyan MS

    2017-11-01

    Full Text Available Marliyya Sanusi Zayyan,1 Saad Aliyu Ahmed,2 Adekunle O Oguntayo,1 Abimbola O Kolawole,1 Tajudeen Ayodeji Olasinde3 1Gynaecological Oncology Unit, 2Department of Histopathology, 3Department of Radiation Oncology, Ahmadu Bello University, Zaria, Nigeria Background: Globally, the absence of a premalignant stage of ovarian cancer and a reliable screening tool make early diagnosis difficult. Locally, poverty, ignorance, and lack of organized cancer services make prognosis poor. We describe the epidemiological features of ovarian cancer seen at Ahmadu Bello University Teaching Hospital Zaria, Northern Nigeria, a tertiary referral center, over a 10-year period in this challenging setting. Methods: All cases of histologically diagnosed ovarian cancer between January 1, 2004 and December 31, 2013 were included in the study. Case notes were retrieved to collect clinical data including age, parity, clinical stage of disease at presentation, and known associated factors. Results were analyzed using Epi info™. Results: A total of 78 patients were included in the study. About 4–13 cases were seen every year with a tendency to increasing incidence. The patients were aged 8–80 years with mean of 37 years. Sixty-two (79.5% patients were premenopausal while postmenopausal women accounted for only seven cases or 9.0%. There were 17 cases (22.3% of aggressive cancers in patients aged ≤20 years. A majority of the patients, 65 (83.3%, were parous with only nine (11.5% patients being nulliparous. Serous cyst adenocarcinoma accounted for 32 (41% cases. Granulosa cell tumor was the second commonest with 18 cases (23.1%. The mean age of occurrence of serous cyst adenocarcinoma was 31 years and for epithelial ovarian cancers in general it was 33.5 years. Endometrioid adenocarcinoma was rare with only one case in 10 years. Factors like age, parity, and premenopausal status did not appear to be protective to the occurrence of malignant ovarian tumor in this group

  3. Fall-related injuries among initially 75- and 80-year old people during a 10-year follow-up.

    Science.gov (United States)

    Saari, Päivi; Heikkinen, Eino; Sakari-Rantala, Ritva; Rantanen, Taina

    2007-01-01

    The aim of this study was to investigate the occurrence, type, scene and seasonal variation of fall related injuries, and the impact of socio-economic factors, mobility limitation, and the most common diseases on the risk of injurious falls over a 10-year follow-up. Elderly residents of Jyväskylä, Finland, aged initially 75 and 80 years, took part in the study in 1989-1990. The health and functional capacity assessments were carried out at the baseline. Injurious falls were monitored over a 10-year period. The rate of injurious falls per thousand person-years was 188 among women and 78 among men. Of all fall-related diagnoses, head injuries comprised 32%, upper limb injuries 27% and hip injuries 19%. Majority of injurious falls took place indoors and no seasonal variation in fall occurrence was observed. Recurring falls were more likely to take place in institutions. Osteoarthritis increased the risk of injurious falls but no effect was observed for coronary heart diseases or mobility limitation. All in all, intrinsic factors, such as chronic diseases and mobility limitation had only minor effect on risk of injurious falls among older people. The current results suggest that preventive interventions for injurious falls among older people should pay attention to the risk factors present indoors.

  4. A 10,000 YEAR OLD EXPLOSION IN DR21

    International Nuclear Information System (INIS)

    Zapata, Luis A.; Pérez-Goytia, Nadia; Rodríguez, Luis F.; Loinard, Laurent; Schmid-Burgk, Johannes; Ho, Paul T. P.; Cruz-González, Irene

    2013-01-01

    Sensitive high angular resolution (∼2'') CO(2-1) line observations made with the Submillimeter Array of the flow emanating from the high-mass star-forming region DR21 located in the Cygnus X molecular cloud are presented. These new interferometric observations indicate that this well known enigmatic outflow appears to have been produced by an explosive event that took place about 10,000 years ago, and that might be related to the disintegration of a massive stellar system such as the one that occurred in Orion Becklin-Neugebauer/Kleinman-Low 500 years ago, but about 20 times more energetic. This result therefore argues in favor of the idea that the disintegration of young stellar systems perhaps is a frequent phenomenon present during the formation of massive stars. However, many more theoretical and observational studies are still needed to confirm our hypothesis.

  5. METEONETWORK: 2002-2012, 10 years of activities

    Science.gov (United States)

    Mazza, Edoardo

    2013-04-01

    waves and cold advections have on human health. Following the encouraging results of the "Weatherness" project the organization decided to invest even greater resources into such cooperations and during the summer 2012 started a fruitful collaboration with the DRIHM project. The data collected by its network of weather stations will be transferred to the DRIHM platform where will be used in the context of hydro-meteorological research. High-end model simulations will be performed with the aim of investigating the dynamics involved in hydro-meteorology. Several different projects are still underway but the results obtained in these 10 years of hard work encourage us to pursue our activity and look for new challenges and opportunities.

  6. Foetal growth restriction is associated with poor reading and spelling skills at eight years to 10 years of age.

    Science.gov (United States)

    Partanen, Lea; Korkalainen, Noora; Mäkikallio, Kaarin; Olsén, Päivi; Laukkanen-Nevala, Päivi; Yliherva, Anneli

    2018-01-01

    Foetal growth restriction (FGR) is associated with communication problems, which might lead to poor literacy skills. The reading and spelling skills of eight- to 10-year-old FGR children born at 24-40 gestational weeks were compared with those of their gestational age-matched, appropriately grown (AGA) peers. A prospectively collected cohort of 37 FGR and 31 AGA children was recruited prenatally at a Finnish tertiary care centre during 1998-2001. The children's reading and spelling skills were assessed using standardised tests for Finnish-speaking second and third graders. Significantly more children performed below the 10th percentile normal values for reading and spelling skills in the FGR group than in the AGA group. At nine years of age, the FGR children had significantly poorer performance in word reading skills and reading fluency, reading accuracy and reading comprehension than the AGA controls. No between-group differences were detected at eight years of age. FGR is associated with poor performance in reading and spelling skills. A third of the FGR children performed below the 10th percentile normal values at nine years of age. These results indicate a need to continuously evaluate linguistic and literacy skills as FGR children age to ensure optimal support. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  7. Microbial Communities as Environmental Indicators of Ecological Disturbance in Restored Carbonate Fen-Results of 10 Years of Studies.

    Science.gov (United States)

    Mieczan, Tomasz; Tarkowska-Kukuryk, Monika

    2017-08-01

    Interactions between bacteria and protists are essential to the ecosystem ecology of fens. Until now, however, there has been almost no information on how restoration procedures in carbonate fens affect the functioning of microbial food webs. Changes in vegetation patterns resulting from restoration may take years to be observed, whereas microbial processes display effects even after short-term exposure to changes in environmental conditions caused by restoration. Therefore, microbial processes and patterns can be used as sensitive indicators of changes in environmental conditions. The present study attempts to verify the hypothesis that the species richness and abundance of microbial loop components would differ substantially before and after restoration. The effect of restoration processes on the functioning of the food web was investigated for a 10 years in a carbonate-rich fen, before and after restoration. The restoration procedure (particularly the improvement in hydrological conditions) distinctly modified the taxonomic composition and functioning of microbial food webs. This is reflected in the increased abundance and diversity of testate amoeba, i.e. top predators, within the microbial food web and in the pronounced increase in the abundance of bacteria. This study suggests potential use of microbial loop components as bio-indicators and bio-monitoring tools for hydrological status of fens and concentrations of nutrients. Better understanding of what regulates microbial populations and activity in fens and unravelling of these fundamental mechanisms are particularly critical in order to more accurately predict how fens will respond to global change or anthropogenic disturbances.

  8. Molecular nanomagnets: the first 10 years

    International Nuclear Information System (INIS)

    Gatteschi, Dante; Sessoli, Roberta

    2004-01-01

    We review here the main achievements reached in the field of magnetic molecules in the first 10 years of activity. After introducing the concept of magnetic molecules we report at some length on the archetypal Mn12Ac, pointing out what is understood and what is still left to do. Other systems will also be reported including Fe8 and Mn4. A section will be devoted to magnetic chains and a final section will give perspectives for future developments

  9. Molecular nanomagnets: the first 10 years

    Energy Technology Data Exchange (ETDEWEB)

    Gatteschi, Dante E-mail: dante.gatteschi@unifi.it; Sessoli, Roberta

    2004-05-01

    We review here the main achievements reached in the field of magnetic molecules in the first 10 years of activity. After introducing the concept of magnetic molecules we report at some length on the archetypal Mn12Ac, pointing out what is understood and what is still left to do. Other systems will also be reported including Fe8 and Mn4. A section will be devoted to magnetic chains and a final section will give perspectives for future developments.

  10. Mammary fat necrosis following radiotherapy in the conservative management of localized breast cancer: Does it matter?

    International Nuclear Information System (INIS)

    Trombetta, Mark; Valakh, Vladimir; Julian, Thomas B.; Werts, E. Day; Parda, David

    2010-01-01

    Purpose: Fat necrosis is a well-described and relatively common complication arising from post-lumpectomy irradiation of the breast, most commonly breast brachytherapy. We wish to assess the clinical significance of fat necrosis resulting from post-lumpectomy breast irradiation. Methods: We reviewed the literature to determine the overall incidence and significance of fat necrosis to determine whether or not fat necrosis poses a significant clinical problem. Results: Fat necrosis occurs in up to one-quarter of patients following post-lumpectomy breast irradiation. Only rarely is invasive intervention required however, it does significantly degrade the quality of all modalities of breast imaging. Conclusions: Fat necrosis is a common complication of radiotherapy which rarely requires therapeutic intervention. However, post-therapeutic clinical imaging such as mammography, ultrasound and magnetic resonance imaging are affected which may result in additional diagnostic procedures up to and including biopsy.

  11. MMI's Metadata and Vocabulary Solutions: 10 Years and Growing

    Science.gov (United States)

    Graybeal, J.; Gayanilo, F.; Rueda-Velasquez, C. A.

    2014-12-01

    The Marine Metadata Interoperability project (http://marinemetadata.org) held its public opening at AGU's 2004 Fall Meeting. For 10 years since that debut, the MMI guidance and vocabulary sites have served over 100,000 visitors, with 525 community members and continuous Steering Committee leadership. Originally funded by the National Science Foundation, over the years multiple organizations have supported the MMI mission: "Our goal is to support collaborative research in the marine science domain, by simplifying the incredibly complex world of metadata into specific, straightforward guidance. MMI encourages scientists and data managers at all levels to apply good metadata practices from the start of a project, by providing the best guidance and resources for data management, and developing advanced metadata tools and services needed by the community." Now hosted by the Harte Research Institute at Texas A&M University at Corpus Christi, MMI continues to provide guidance and services to the community, and is planning for marine science and technology needs for the next 10 years. In this presentation we will highlight our major accomplishments, describe our recent achievements and imminent goals, and propose a vision for improving marine data interoperability for the next 10 years, including Ontology Registry and Repository (http://mmisw.org/orr) advancements and applications (http://mmisw.org/cfsn).

  12. Annual incidences of visual impairment during 10-year period in Mie prefecture, Japan.

    Science.gov (United States)

    Ikesugi, Kengo; Ichio, Takako; Tsukitome, Hideyuki; Kondo, Mineo

    2017-07-01

    To determine the annual incidence of visual impairment in a Japanese population during a 10-year period. We examined the physical disability certificates issued yearly between 2004 and 2013 in Mie prefecture, Japan. During this period 2468 visually impaired people were registered under the newly defined Act on Welfare of the Physically Disabled Persons' criteria. The age, sex distribution, and causes of visual impairment were determined from the certificates. The major causes of visual impairment during the ten-year period were glaucoma (23.3%), diabetic retinopathy (17.3%), retinitis pigmentosa (12.2%), macular degeneration (9.0%), chorioretinal degeneration or high myopia (7.4%), optic atrophy (5.8%), stroke or brain tumor (5.4%) and cataracts (3.7%). The incidence of glaucoma was significantly higher throughout the period (2004-2013), and that of diabetic retinopathy was lower between 2007 and 2013. The incidence of retinitis pigmentosa did not change significantly during the 10-year period. The incidence of macular degeneration tended to increase between 2004 and 2007, but it decreased significantly between 2007 and 2013. The results indicate that in Japan, the rates of the major causes of visual impairment altered in the most recent 10-year period reflecting the recent changes in the social background and advances in ocular and systemic treatment.

  13. Reflecting on 10 Years of the TIM Review

    Directory of Open Access Journals (Sweden)

    Chris McPhee

    2017-07-01

    Full Text Available In July 2007, the first issue of this journal was published under the banner of the Open Source Business Resource. Re-launched with a broader scope in 2011 as the Technology Innovation Management Review, the journal now celebrates its 10th anniversary. In this article, we review the 10-year history of the journal to examine what themes have been covered, who has contributed, and how much the articles have been read and cited. During those 10 years, the journal has published 120 monthly issues, including more than 800 publications by more than 800 international authors from industry, academia, the public sector, and beyond. As discovered with topic modelling, the journal has covered seven themes: open source business, technology entrepreneurship, growing a business, research approaches, social innovation, living labs, and cybersecurity. Overall, the website has attracted over 1 million readers from around the world – 31% from Asia, 30% from the Americas, 26% from Europe, 8% from Africa, and 5% from Oceania – with over 25,000 readers now accessing the site each month.

  14. Childhood hospitalisation for otitis media in Western Australia: A 10-year retrospective analysis

    Directory of Open Access Journals (Sweden)

    Nicholas Liu

    2016-04-01

    Full Text Available Background The aim of this study was to assess the prevalence of hospitalisation for otitis media across the different risk indicators for Western Australian children (less than 15 years old over a 10-year period. Method This retrospective population-based study used the deidentified detailed data of children under the age of 15 years, hospitalised for otitis media (OM, as determined by principal diagnosis (ICD-10AM and obtained from the Western Australian (WA Hospital Morbidity Dataset for 10 financial years from 1999–2000 to 2008–2009. Various risk indicators, including age, gender, Indigenous status, insurance status, hospital area, hospital type, and length of stay were also analysed. Results Out of 26,294 cases of in-hospital care, Indigenous children comprised 4.7 per cent (n=1,226, while the non-Indigenous children comprised 95.3 per cent (n=25,068. The majority of the children, nearly 98.8 per cent, were admitted for chronic OM. The children were grouped into three age groups, namely, 0–4 years, 5–9 years, and 10–14 years. Nearly two-thirds of all cases were in the 0–4-year age group. Significantly more non-Indigenous (51 per cent than Indigenous children (2 per cent had private health insurance. The hospitalisation rates were directly proportional between the number of Indigenous children living in the area and the increasing remoteness of the area along with greater socioeconomic disadvantage. There were 24 per cent more cases from very remote areas compared to highly accessible areas, and there were 60 per cent more cases from the most disadvantaged socioeconomic category, compared with the least disadvantaged category, for Indigenous children. Conclusion These data depict the variations in prevalence of otitis media hospitalisations within the community, as affected by various risk indicators.

  15. A 10,000 YEAR OLD EXPLOSION IN DR21

    Energy Technology Data Exchange (ETDEWEB)

    Zapata, Luis A.; Perez-Goytia, Nadia; Rodriguez, Luis F.; Loinard, Laurent [Centro de Radioastronomia y Astrofisica, UNAM, Apdo. Postal 3-72 (Xangari), 58089 Morelia, Michoacan (Mexico); Schmid-Burgk, Johannes [Max-Planck-Institut fuer Radioastronomie, Auf dem Huegel 69, D-53121 Bonn (Germany); Ho, Paul T. P. [Academia Sinica Institute of Astronomy and Astrophysics, Taipei, Taiwan (China); Cruz-Gonzalez, Irene [Instituto de Astronomia, Universidad Nacional Autonoma de Mexico, Ap. 70-264, 04510 DF (Mexico)

    2013-03-10

    Sensitive high angular resolution ({approx}2'') CO(2-1) line observations made with the Submillimeter Array of the flow emanating from the high-mass star-forming region DR21 located in the Cygnus X molecular cloud are presented. These new interferometric observations indicate that this well known enigmatic outflow appears to have been produced by an explosive event that took place about 10,000 years ago, and that might be related to the disintegration of a massive stellar system such as the one that occurred in Orion Becklin-Neugebauer/Kleinman-Low 500 years ago, but about 20 times more energetic. This result therefore argues in favor of the idea that the disintegration of young stellar systems perhaps is a frequent phenomenon present during the formation of massive stars. However, many more theoretical and observational studies are still needed to confirm our hypothesis.

  16. One-Month to 10-Year Survival in the Copenhagen Stroke Study

    DEFF Research Database (Denmark)

    Andersen, Klaus Kaae; Olsen, Tom Skyhøj

    2011-01-01

    .0 years; 56% women; mean Scandinavian Stroke Scale [SSS], 38.0 ± 17.4). Evaluation included stroke severity (based on the SSS), computed tomography scan, and a cardiovascular risk profile. Using logistic regression models, we examined the relevance of the SSS on mortality at 1 month and 1, 5, and 10 years....... We analyzed the proportion of the variation explained by the models and bias of risk factors estimates with and without the SSS in the model. Mortality rate was 16.6% at 1 month, 31.5% at 1 year, 60.2% at 5 years, and 81.3% at 10 years. In models including the SSS, 22.4%, 20.9%, 32.8%, and 39.......5% of the variance was explained for the endpoints of 1 month, 1 year, 5 years, and 10 years, respectively. When SSS was left out of the model, the corresponding values were 6.9%, 13.3%, 29.0%, and 35.1%. Factors significantly associated with survival were SSS at 1 month; SSS, age, diabetes, and stroke type at 1...

  17. [Lessons from 10 years of the Advanced Glaucoma Intervention Study (AGIS)].

    Science.gov (United States)

    Dietlein, T S

    2005-03-01

    The 10-year results of the AGIS have revealed different outcomes of therapeutic strategies depending on ethnic factors, but also different success rates of trabeculectomy depending on age, preoperative intraocular pressure, and presence of diabetes or postoperative complications. Conclusions from the study may be limited by the fact that medical options and surgical strategies in glaucoma treatment have obviously changed during the last decade.

  18. Hepatitis C virus recurrence after liver transplantation: a 10-year evaluation.

    Science.gov (United States)

    Gitto, Stefano; Belli, Luca Saverio; Vukotic, Ranka; Lorenzini, Stefania; Airoldi, Aldo; Cicero, Arrigo Francesco Giuseppe; Vangeli, Marcello; Brodosi, Lucia; Panno, Arianna Martello; Di Donato, Roberto; Cescon, Matteo; Grazi, Gian Luca; De Carlis, Luciano; Pinna, Antonio Daniele; Bernardi, Mauro; Andreone, Pietro

    2015-04-07

    To evaluate the predictors of 10-year survival of patients with hepatitis C recurrence. Data from 358 patients transplanted between 1989 and 2010 in two Italian transplant centers and with evidence of hepatitis C recurrence were analyzed. A χ(2), Fisher's exact test and Kruskal Wallis' test were used for categorical and continuous variables, respectively. Survival analysis was performed at 10 years after transplant using the Kaplan-Meier method, and a log-rank test was used to compare groups. A P level less than 0.05 was considered significant for all tests. Multivariate analysis of the predictive role of different variables on 10-year survival was performed by a stepwise Cox logistic regression. The ten-year survival of the entire population was 61.2%. Five groups of patients were identified according to the virological response or lack of a response to antiviral treatment and, among those who were not treated, according to the clinical status (mild hepatitis C recurrence, "too sick to be treated" and patients with comorbidities contraindicating the treatment). While the 10-year survival of treated and untreated patients was not different (59.1% vs 64.7%, P = 0.192), patients with a sustained virological response had a higher 10-year survival rate than both the "non-responders" (84.7% vs 39.8%, P < 0.0001) and too sick to be treated (84.7% vs 0%, P < 0.0001). Sustained virological responders had a survival rate comparable to patients untreated with mild recurrence (84.7% vs 89.3%). A sustained virological response and young donor age were independent predictors of 10-year survival. Sustained virological response significantly increased long-term survival. Awaiting the interferon-free regimen global availability, antiviral treatment might be questionable in selected subjects with mild hepatitis C recurrence.

  19. Occupational accidents in dental school: a 10-year retrospective - doi:10.5020/18061230.2009.p240

    Directory of Open Access Journals (Sweden)

    Ítalo Sarto Carvalho Rodrigues

    2012-01-01

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

  20. Psychological impact of providing women with personalised 10-year breast cancer risk estimates.

    Science.gov (United States)

    French, David P; Southworth, Jake; Howell, Anthony; Harvie, Michelle; Stavrinos, Paula; Watterson, Donna; Sampson, Sarah; Evans, D Gareth; Donnelly, Louise S

    2018-05-08

    The Predicting Risk of Cancer at Screening (PROCAS) study estimated 10-year breast cancer risk for 53,596 women attending NHS Breast Screening Programme. The present study, nested within the PROCAS study, aimed to assess the psychological impact of receiving breast cancer risk estimates, based on: (a) the Tyrer-Cuzick (T-C) algorithm including breast density or (b) T-C including breast density plus single-nucleotide polymorphisms (SNPs), versus (c) comparison women awaiting results. A sample of 2138 women from the PROCAS study was stratified by testing groups: T-C only, T-C(+SNPs) and comparison women; and by 10-year risk estimates received: 'moderate' (5-7.99%), 'average' (2-4.99%) or 'below average' (<1.99%) risk. Postal questionnaires were returned by 765 (36%) women. Overall state anxiety and cancer worry were low, and similar for women in T-C only and T-C(+SNPs) groups. Women in both T-C only and T-C(+SNPs) groups showed lower-state anxiety but slightly higher cancer worry than comparison women awaiting results. Risk information had no consistent effects on intentions to change behaviour. Most women were satisfied with information provided. There was considerable variation in understanding. No major harms of providing women with 10-year breast cancer risk estimates were detected. Research to establish the feasibility of risk-stratified breast screening is warranted.

  1. Vesical Calculus 10 Years Post Missing Intrauterine Contraceptive ...

    African Journals Online (AJOL)

    Vesical Calculus 10 Years Post Missing Intrauterine. Contraceptive Device. Abdullahi Abdulwahab-Ahmed, Oluwagbemiga Olabisi Ogunleye. INTRODUCTION. Intrauterine contraceptive devices (IUCD) are acceptable means of contraception world over.[1-4] There have been reports of its migration to other adjourning sites ...

  2. 10-Year Framework of Programmes on Sustainable Consumption and Production

    Science.gov (United States)

    One of the important programmatic outcomes from the U.N. Conference on Sustainable Development (Rio+20) was the adoption of the 10-Year Framework of Programmes (10YFP) on Sustainable Consumption and Production (SCP).

  3. Pluripotent stem cells: the last 10 years.

    Science.gov (United States)

    Kimbrel, Erin A; Lanza, Robert

    2016-12-01

    Pluripotent stem cells (PSCs) can differentiate into virtually any cell type in the body, making them attractive for both regenerative medicine and drug discovery. Over the past 10 years, technological advances and innovative platforms have yielded first-in-man PSC-based clinical trials and opened up new approaches for disease modeling and drug development. Induced PSCs have become the foremost alternative to embryonic stem cells and accelerated the development of disease-in-a-dish models. Over the years and with each new discovery, PSCs have proven to be extremely versatile. This review article highlights key advancements in PSC research, from 2006 to 2016, and how they will guide the direction of the field over the next decade.

  4. Evolution of migraine after a 10-year follow-up.

    Science.gov (United States)

    Nachit-Ouinekh, Fatima; Dartigues, Jean-François; Chrysostome, Virginie; Henry, Patrick; Sourgen, Christophe; El Hasnaoui, Abdelkader

    2005-01-01

    To assess the evolution of headaches in a workplace cohort over a 10-year period. Migraine headaches are associated with significant handicap in everyday activities and poor quality of life. The prevalence of migraine shows a bell-shaped age distribution with a peak during the third and fourth decades. However, there is little longitudinal data available on the natural history of this condition. A prospective health survey undertaken in a large workplace cohort since 1989 provides an opportunity to assess the evolution of migraine and other headache syndromes over a 10-year period. A sample of 2500 subjects who reported regular headaches was chosen at random from those with headache identified in a cohort of 46,244 employees of the French national power company aged between 35 and 50 years in 1989 participating in a yearly health survey. In 1993, all subjects were sent a headache questionnaire to complete and return. In 2003, an identical questionnaire was sent to all subjects who had returned exploitable data in 1993. Headache diagnosis was assigned retrospectively using the International Headache Society (IHS) criteria to migraine (IHS categories 1.1 and 1.2), migrainous disorder (IHS category 1.7), or other episodic headaches. Of 2500 subjects sampled, 2051 (82%) returned exploitable data for the first questionnaire in 1993. In 2003, 1250 (61%) of these provided a second data set. In 1993, 623 (30.4%) of subjects fulfilled diagnostic criteria for migraine. However, only 37% of these retained the diagnosis 10 years later. In contrast, the proportion of subjects with other forms of episodic headache rose from 23.7% to 31.6%. In 2003, 9.5% of the sample were headache-free. Retention or acquisition of a diagnosis of migraine was more common in women than in men, and age was associated with evolution to a less severe headache syndrome. In those subjects who continued to have headaches, frequency and severity were lower at the second assessment. Only a minority of

  5. Self-Esteem during University Studies Predicts Career Characteristics 10 Years Later

    Science.gov (United States)

    Salmela-Aro, Katariina; Nurmi, Jari-Erik

    2007-01-01

    To examine how self-esteem measured during university studies would impact on the characteristics of the work career 10 years later, 297 university students completed the Rosenberg's self-esteem inventory four times while at university and various career-related questionnaires 10 years later. Latent Growth Curve Modeling showed that a high overall…

  6. 10 CFR 26.169 - Reporting Results.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Reporting Results. 26.169 Section 26.169 Energy NUCLEAR... specific gravity test. (4) For a specimen that has an invalid result, the laboratory shall contact the MRO... transmission and ensure only authorized access to any data transmission, storage, and retrieval system. (f) For...

  7. The Corail stem as a reverse hybrid - survivorship and x-ray analysis at 10 years.

    Science.gov (United States)

    Wangen, Helge; Nordsletten, Lars; Boldt, Jens G; Fenstad, Anne M; Beverland, David E

    2017-07-25

    The use of a cemented cup together with an uncemented stem in total hip arthroplasty (THA) has become popular in Norway and Sweden during the last decade. The results of this prosthetic concept, reverse hybrid THA have been sparsely described.We report our experience of reverse hybrid THA, using the Elite plus polyethylene cemented cup together with the Corail fully hydroxyapatite-coated uncemented stem and a 28-mm alumina ceramic head. 132 consecutive reverse hybrid hip arthroplasties were performed from January 2000 to December 2003 in 126 patients with a mean age of 54.3 years (28-65). All patients were routinely reviewed at 3 months, 1, 5, 7 and 10 years postoperatively. At each follow-up patients were seen either by a consultant orthopaedic surgeon or a senior trainee. Anteroposterior pelvic and lateral x-rays of the hip were taken at each visit. To estimate the survival of the THAs we used the Kaplan-Meier method with 95% confidence interval (CI). Logistic regression analysis was performed to determine which factors affected the presence of radiolucency around the femoral stem. The mean follow-up was 11.1 years (9.0-14.2). 1 patient was lost to follow-up, and 7 patients were deceased at the time of 10-year follow up. At 10 years 7 patients have had further surgery. 5 for infection, 1 periprosthetic femoral fracture and 1 heterotopic bone formation. All stems were classified as well fixed. 2 cups were defined as loose at 10 years. 1 patient is scheduled for revision the other refused revision. The clinical outcome and radiological findings were assessed in 123 hips. The mean Harris Hip Score was 94 (35-100) at 10 years and the mean WOMAC score was 89 (30.2-100). We report good results with respect to clinical outcome and survival of the reverse hybrid concept in patients younger than 65. A successful outcome depends on meticulous preoperative planning, use of modern cementing techniques in the acetabulum and experience in implanting an uncemented stem.

  8. THE TAOS PROJECT: RESULTS FROM SEVEN YEARS OF SURVEY DATA

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Z.-W.; Lehner, M. J.; Wang, J.-H.; Wen, C.-Y.; Wang, S.-Y.; King, S.-K.; Cook, K. H.; Lee, T. [Institute of Astronomy and Astrophysics, Academia Sinica. 11F of Astronomy-Mathematics Building, National Taiwan University. No. 1, Sec. 4, Roosevelt Road, Taipei 10617, Taiwan (China); Granados, A. P. [Instituto de Astronomia, Universidad Nacional Autonoma de Mexico, Apdo. Postal 106, Ensenada, Baja California 22800 (Mexico); Alcock, C.; Protopapas, P. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Axelrod, T. [Steward Observatory, 933 North Cherry Avenue, Room No. 204, Tucson AZ 85721 (United States); Bianco, F. B. [Center for Cosmology and Particle Physics, New York University, 4 Washington Place, New York, NY 10003 (United States); Byun, Y.-I. [Department of Astronomy and University Observatory, Yonsei University, 134 Shinchon, Seoul 120-749 (Korea, Republic of); Chen, W. P. [Institute of Astronomy, National Central University, No. 300, Jhongda Road, Jhongli City, Taoyuan County 320, Taiwan (China); Coehlo, N. K. [Department of Statistics, University of California Berkeley, 367 Evans Hall, Berkeley, CA 94720 (United States); De Pater, I. [Department of Astronomy, University of California Berkeley, 601 Campbell Hall, Berkeley, CA 94720 (United States); Kim, D.-W. [Max Planck Institute for Astronomy, Koenigstuhl 17, D-69117 Heidelberg (Germany); Lissauer, J. J. [Space Science and Astrobiology Division 245-3, NASA Ames Research Center, Moffett Field, CA 94035 (United States); Marshall, S. L., E-mail: zwzhang@asiaa.sinica.edu.tw [Kavli Institute for Particle Astrophysics and Cosmology, 2575 Sand Hill Road, MS 29, Menlo Park, CA 94025 (United States); and others

    2013-07-01

    The Taiwanese-American Occultation Survey (TAOS) aims to detect serendipitous occultations of stars by small ({approx}1 km diameter) objects in the Kuiper Belt and beyond. Such events are very rare (<10{sup -3} events per star per year) and short in duration ({approx}200 ms), so many stars must be monitored at a high readout cadence. TAOS monitors typically {approx}500 stars simultaneously at a 5 Hz readout cadence with four telescopes located at Lulin Observatory in central Taiwan. In this paper, we report the results of the search for small Kuiper Belt objects (KBOs) in seven years of data. No occultation events were found, resulting in a 95% c.l. upper limit on the slope of the faint end of the KBO size distribution of q = 3.34-3.82, depending on the surface density at the break in the size distribution at a diameter of about 90 km.

  9. Surgical management of gynecomastia--a 10-year analysis.

    Science.gov (United States)

    Handschin, A E; Bietry, D; Hüsler, R; Banic, A; Constantinescu, M

    2008-01-01

    Gynecomastia is defined as the benign enlargement of the male breast. Most studies on surgical treatment of gynecomastia show only small series and lack histopathology results. The aim of this study was to analyze the surgical approach in the treatment of gynecomastia and the related outcome over a 10-year period. All patients undergoing surgical gynecomastia corrections in our department between 1996 and 2006 were included for retrospective evaluation. The data were analyzed for etiology, stage of gynecomastia, surgical technique, complications, risk factors, and histological results. A total of 100 patients with 160 operations were included. Techniques included subcutaneous mastectomy alone or with additional hand-assisted liposuction, isolated liposuction, and formal breast reduction. Atypical histological findings were found in 3% of the patients (spindle-cell hemangioendothelioma, papilloma). The surgical revision rate among all patients was 7%. Body mass index and a weight of the resected specimen higher than 40 g were identified as significant risk factors for complications (p gynecomastia requires an individualized approach. Caution must be taken in performing large resections, which are associated with increased complication rates. Histological tissue analysis should be routinely performed in all true gynecomastia corrections, because histological results may reveal atypical cellular pathology.

  10. Photovoltaics - 10 years after Cherry Hill

    Science.gov (United States)

    Ralph, E. L.

    The status of R&D programs connected with photovoltaic (PV) systems 10 years after the Cherry Hill workshop on 'Photovoltaic Conversion of Solar Energy for Terrestrial Applications' is assessed. The five categories of research recommended by the Cherry Hill Workshop are listed in a table together with their recommended research budget allocations. The workshop categories include: single-crystal Si cells; poly-Si cells; systems and diagnostics. Categories for thin film CdS/Cu2S and CuInSe2 cells are also included. The roles of government and private utility companies in providing adequate financial support for PV research programs is emphasized.

  11. Plastia da valva mitral com a técnica do "Duplo Teflon": resultados de 10 anos Mitral valve repair with "Double Teflon" technique: 10-year results

    Directory of Open Access Journals (Sweden)

    Carlos Manuel de Almeida Brandão

    2007-12-01

    1994 and 2003, 133 patients with degenerative mitral insufficiency due to ruptured or elongated chordae in the posterior leaflet underwent repair with this technique. The mean patient age was 60.4 years and 60.9% patients were male. According to clinical evaluation, 29.3% of the patients were in New York Heart Association functional class IV, 55.7% in class III and 15.0% in class II. Associated techniques of mitral valve repair were used in 15.2% of the patients; the most common was chordal shortening. Twenty six (19.5% patients had associated procedures. RESULTS: There was one (0.75% operative death. In the late postoperative period, 95.5% of the surviving patients were in New York Heart Association functional class I. Linearized rates of thromboembolism, reoperation and death were 0.9%, 0.3% and 0.6% patient/year, respectively. The actuarial survival at 10 years was 94.7% ± 3.6%. Actuarial freedom from thromboembolism and reoperation were 97.3 ± 1.5% and 99.2 ±0.8%, respectively. There were no episodes of hemolysis or endocarditis. CONCLUSION: Mitral valve repair with "Double Teflon" technique presents low morbimorbidity and good clinical late evolution.

  12. A new 10,000 year pollen record from Lake Kinneret (Israel) - first results

    Science.gov (United States)

    Schiebel, V.; Litt, T.; Nowaczyk, N.; Stein, M.; Wennrich, V.

    2012-04-01

    Lake Kinneret - as part of the Jordan Rift Valley in Israel - is situated in the southern Levant, which is affected by Eastern Mediterranean climate. The present lake level is around 212 m below msl. Lake Kinneret has a surface of ca. 165 km2 and its watershed comprises the Galilee, the Golan Heights, the Hermon Range and the Anti-Lebanon Mountains. Its most important tributary is the Jordan River. The geography of the Lake Kinneret region is characterised by big differences in altitude. Steep slopes rise up to 560 m above the lake level in the west, north, and east. Mount Hermon (2814 m above mean sea level, amsl) is the highest summit of the Anti-Lebanon Range, and Mount Meron (1208 m amsl) located in the Upper Galilee encircle Lake Kinneret within a 100-km range in the northwest. Due to the pattern of average precipitation, distinct plant-geographical territories converge in the region: The Mediterranean and the Irano-Turanian biom (after Zohary). Varying ratios of characteristic pollen taxa representing certain plant associations serve as proxy data for the reconstruction of paleovegetation, paleoenvironment, and paleoclimate. We present a pollen record based on analyses of sediment cores obtained during a drilling campaign on Lake Kinneret in March 2010. A composite profile of 17.8 m length was established by correlating two parallel cores by using magnetic susceptibility data. Our record encompasses the past ca. 10,000 years of a region, which has been discussed as migration corridor of humans to Europe and, being part of the Fertile Crescent, as the cradle of agriculture in West Asia. Conclusions concerning human impact on vegetation and therefore population density can be drawn by analysing changes of ratios of certain plant taxa such as Olea europaea cultivated in this region since the Chalcolithic Period (6,500 BP). In addition, stable isotope data were produced from discrete bulk samples, and the elemental composition of the sediments was determined by

  13. Chronic pain in multiple sclerosis: A 10-year longitudinal study.

    Science.gov (United States)

    Young, Jamie; Amatya, Bhasker; Galea, Mary P; Khan, Fary

    2017-07-01

    Pain is a common symptom associated with multiple sclerosis (MS), and has lasting effects on an individual's functional capacity and quality of life. A wide range of prevalence rates of pain (between 23% and 90%)have been reported in MS and this is mainly due to the methodological differences amongst the studies such as variability in patient sources, method of sampling and the definition of pain used. Chronic pain in MS, defined as pain lasting for greater than 3-6 months, can have a significant impact on their biopsychosocial health, including negative impact on activities of daily living, relationships and social participation. The long-term course of MS-related pain and its impact in an Australian cohort over a 7-year period has been investigated earlier. The aim of this longitudinal study was to describe the impact of chronic pain, pain-related disability and carer burden in persons with MS over a 10-year period. The aim of this longitudinal study was to describe the impact of chronic pain, pain-related disability and carer burden in persons with MS over a 10-year period. This was a prospective longitudinal study conducted at the Rehabilitation Department of Royal Melbourne Hospital (RMH), a tertiary referral hospital in Victoria and Australia. The source of participants was from the RMH MS database and contains detailed MS patient information including demographic data, diagnosis details (using McDonald's criteria), pain characteristics. Structured face-face interviews and validated measures were used, which include the visual analogue scale (VAS); chronic pain grade (CPG); the assessment of quality of life (AQoL) and the carer strain index (CSI). The mean age of the participants (n=70) was 55.3 years and majority (70%) were female. The mean age of the participants (n=70) was 55.3 years and majority (70%) were female. The findings show that over time (10 years), participants report having greater bilateral bodily pain and greater description of pain as 'worse

  14. Sacrococcygeal teratoma: 10-year experience in upper Egypt ...

    African Journals Online (AJOL)

    Purpose To evaluate our experience with 45 patients with sacrococcygeal teratoma (SCT) in our community (upper Egypt) over a period of 10 years between 2001 and 2011 and determine the outcome of the management and recommendations for treatment strategies. Patients and methods A retrospective study was ...

  15. Long Term Corrosion/Degradation Test Six Year Results

    Energy Technology Data Exchange (ETDEWEB)

    M. K. Adler Flitton; C. W. Bishop; M. E. Delwiche; T. S. Yoder

    2004-09-01

    The Subsurface Disposal Area (SDA) of the Radioactive Waste Management Complex (RWMC) located at the Idaho National Engineering and Environmental Laboratory (INEEL) contains neutron-activated metals from non-fuel, nuclear reactor core components. The Long-Term Corrosion/Degradation (LTCD) Test is designed to obtain site-specific corrosion rates to support efforts to more accurately estimate the transfer of activated elements to the environment. The test is using two proven, industry-standard methods—direct corrosion testing using metal coupons, and monitored corrosion testing using electrical/resistance probes—to determine corrosion rates for various metal alloys generally representing the metals of interest buried at the SDA, including Type 304L stainless steel, Type 316L stainless steel, Inconel 718, Beryllium S200F, Aluminum 6061, Zircaloy-4, low-carbon steel, and Ferralium 255. In the direct testing, metal coupons are retrieved for corrosion evaluation after having been buried in SDA backfill soil and exposed to natural SDA environmental conditions for times ranging from one year to as many as 32 years, depending on research needs and funding availability. In the monitored testing, electrical/resistance probes buried in SDA backfill soil will provide corrosion data for the duration of the test or until the probes fail. This report provides an update describing the current status of the test and documents results to date. Data from the one-year and three-year results are also included, for comparison and evaluation of trends. In the six-year results, most metals being tested showed extremely low measurable rates of general corrosion. For Type 304L stainless steel, Type 316L stainless steel, Inconel 718, and Ferralium 255, corrosion rates fell in the range of “no reportable” to 0.0002 mils per year (MPY). Corrosion rates for Zircaloy-4 ranged from no measurable corrosion to 0.0001 MPY. These rates are two orders of magnitude lower than those specified in

  16. [Collagenous gastritis and colitis in a 10-year-old girl].

    Science.gov (United States)

    Hangard, P; Lasfargue, M; Rubio, A

    2016-07-01

    There are few data in the literature on microscopic gastritis and colitis in the pediatric population. The diagnosis is often made after the occurrence of complications. We report the case of a 10.5 year-old girl for whom the diagnosis was made several years after the initial symptoms. Test for infections, inflammation, and auto-immunity yielded normal results. Upper endoscopy and colonoscopy revealed an abnormal mucosa. However, histology showed microscopic inflammation and fibrotic lesions in the lamina propria, and a thick subepithelial collagenous band. This led to the diagnosis of collagenous gastritis and colitis. Budesonide treatment resulted in the cessation of diarrhea and significant weight gain. Treatment by oral budesonide indeed seems to be highly effective but relapses are frequent when the treatment is stopped. This case shows the importance of being vigilant regarding transit disorders with impact on growth kinetics. Upper endoscopy and colonoscopy need to be carried out when children have organic diarrhea with normal blood tests. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Sullivan Debra K

    2008-07-01

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

  18. Percutaneous local ablation of unifocal subclinical breast cancer: clinical experience and preliminary results of cryotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Manenti, Guglielmo; Perretta, Tommaso; Gaspari, Eleonora; Pistolese, Chiara A.; Scarano, Lia; Cossu, Elsa; Simonetti, Giovanni; Masala, Salvatore [University Hospital ' ' Tor Vergata' ' , Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, Rome (Italy); Bonanno, Elena [University Hospital ' ' Tor Vergata' ' , Department of Biopathology, Rome (Italy); Buonomo, Oreste C.; Petrella, Giuseppe [University Hospital ' ' Tor Vergata' ' , Department of General Surgery Division, Rome (Italy)

    2011-11-15

    To assess the ablative effectiveness, the oncological and cosmetic efficacy of image-guided percutaneous cryoablation in the treatment of single breast nodules with subclinical dimensions after identification with ultrasonography (US), mammography, magnetic resonance (MRI) and characterization by vacuum assisted biopsy. Fifteen women with a mean age of 73 {+-} 5 years (range 64-82 years) and lesion diameter of 8 {+-} 4 mm were undergoing cryotherapy technology with a single probe under US-guidance associated with intra-procedural lymph-node mapping and excision of the sentinel node. All the patients underwent surgical resection (lumpectomy) from 30 to 45 days after the percutaneous ablation. The iceball size generated by the cryoprobe during the procedure at minus 40 C was 16 x 41 mm. In 14 of the 15 patients was observed a complete necrosis of the cryo-ablated lesion both in post-procedural MRI follow-up and anatomo-pathological evaluation after surgical resection. In one case there was a residual disease in post-procedural MRI and postoperative histological examination, probably justified by an incorrect positioning of the probe. The percutaneous cryoablation as a ''minimally invasive'' technique can provide excellent oncological and cosmetic results on selected cases handled by experienced operators by using the tested devices. (orig.)

  19. Percutaneous local ablation of unifocal subclinical breast cancer: clinical experience and preliminary results of cryotherapy

    International Nuclear Information System (INIS)

    Manenti, Guglielmo; Perretta, Tommaso; Gaspari, Eleonora; Pistolese, Chiara A.; Scarano, Lia; Cossu, Elsa; Simonetti, Giovanni; Masala, Salvatore; Bonanno, Elena; Buonomo, Oreste C.; Petrella, Giuseppe

    2011-01-01

    To assess the ablative effectiveness, the oncological and cosmetic efficacy of image-guided percutaneous cryoablation in the treatment of single breast nodules with subclinical dimensions after identification with ultrasonography (US), mammography, magnetic resonance (MRI) and characterization by vacuum assisted biopsy. Fifteen women with a mean age of 73 ± 5 years (range 64-82 years) and lesion diameter of 8 ± 4 mm were undergoing cryotherapy technology with a single probe under US-guidance associated with intra-procedural lymph-node mapping and excision of the sentinel node. All the patients underwent surgical resection (lumpectomy) from 30 to 45 days after the percutaneous ablation. The iceball size generated by the cryoprobe during the procedure at minus 40 C was 16 x 41 mm. In 14 of the 15 patients was observed a complete necrosis of the cryo-ablated lesion both in post-procedural MRI follow-up and anatomo-pathological evaluation after surgical resection. In one case there was a residual disease in post-procedural MRI and postoperative histological examination, probably justified by an incorrect positioning of the probe. The percutaneous cryoablation as a ''minimally invasive'' technique can provide excellent oncological and cosmetic results on selected cases handled by experienced operators by using the tested devices. (orig.)

  20. Breast Cancer Treatment Practices in Elderly Women in a Community Hospital

    International Nuclear Information System (INIS)

    Wang, H.; Singh, A.P.; Luce, S.A.St.; Go, A.R.

    2011-01-01

    Background. Elderly women with breast cancer are considered under diagnosed and under treated, and this adversely affects their overall survival. Methods. A total of 393 female breast cancer patients aged 70 years and older, diagnosed within the years 1989-1999, were identified from the tumor registry of The Brooklyn Hospital Center. Comparisons between the 3 different subgroups 70-74, 75-79, and 80 years and older were made using the Pearson Chi Square test. Results. Lumpectomy was performed in 42% of all patients, while mastectomy was done in 46% of patients. Adjuvant therapy such as chemotherapy, radiation therapy, and hormonal therapy were done in 12%, 25%, and 38%, respectively. Forty-seven percent of patients with positive lymph nodes received chemotherapy. Eighty-six percent of patients who were estrogen receptor-positive received adjuvant hormonal therapy. Overall five-year survival was only 14% for the =80 age group, compared to that of 32% and 35% for the 70-74 and the 75-79 age groups, respectively. Conclusions. Surgery was performed in majority of these patients, about half received lumpectomy, the other half mastectomy. Adjuvant therapies were frequently excluded, with only hormonal therapy being the most commonly used. Overall five-year survival is significantly worse in patients =80 years with breast cancer

  1. Secular trends in impact factor of neonatology publications over a 10-year period.

    Science.gov (United States)

    Marom, Ronella; Mimouni, Francis B; Cohen, Shlomi; Lubetzky, Ronit; Mandel, Dror

    2012-10-01

      To test the hypotheses that published randomized clinical trials (RCTs) in neonatology with negative results (NR) are more likely to be published in journals with lower impact factor (IF) than those with positive results (PR); that there is an increase in the number of yearly published RCTs; that studies with large sample sizes are likely to be published in journals with higher IF.   We used all English-written RCTs registered in MEDLINE between 1/1/2001-31/12/2010 in the field of neonatology. Each RCT was classified as having a PR or NR. IF of each journal was determined for the year of publication.   We identified 329 RCTs. Yearly number of RCTs varied between 19 and 46, with no significant consistent linear increase over the years. There was no significant change over the years in average IF or in average patient size. IF and sample size of the studies were not significantly higher in studies with PR than in studies with NR.   The number of RCTs per year in the field of neonatology has stabilized in the past 10years, and RCTs with positive or negative results are published in journals of similar IF. © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.

  2. Northern Idaho ponderosa racial variation study - 50-year results

    Science.gov (United States)

    R. J. Steinhoff

    1970-01-01

    Ponderosa pine trees from 19 geographic sources planted on a test area in northern Idaho have been measured 12, 20, 40, and 50 years after outplanting. From the 12th through the 50th years after outplanting, trees from one nonlocal source have been tallest. Trees from the local source now rank second in height, having risen from sixth during the last 10 years. In...

  3. Anterior cruciate ligament reconstruction with 4-strand hamstring autograft and accelerated rehabilitation: a 10-year prospective study on clinical results, knee osteoarthritis and its predictors.

    Science.gov (United States)

    Janssen, Rob P A; du Mée, Arthur W F; van Valkenburg, Juliette; Sala, Harm A G M; Tseng, Carroll M

    2013-09-01

    Analysis of long-term clinical and radiological outcomes after anterior cruciate ligament (ACL) reconstruction with special attention to knee osteoarthritis and its predictors. A prospective, consecutive case series of 100 patients. Arthroscopic transtibial ACL reconstruction was performed using 4-strand hamstring tendon autografts with a standardized accelerated rehabilitation protocol. Analysis was performed preoperatively and 10 years postoperatively. Clinical examination included Lysholm and Tegner scores, IKDC, KT-1000 testing (MEDmetric Co., San Diego, CA, USA) and leg circumference measurements. Radiological evaluation included AP weight bearing, lateral knee, Rosenberg and sky view X-rays. Radiological classifications were according to Ahlbäck and Kellgren & Lawrence. Statistical analysis included univariate and multivariate logistic regressions. RESULTS CLINICAL OUTCOME: A significant improvement (p test, IKDC score and one-leg hop test. A pivot shift phenomenon (glide) was still present in 43 (50%) patients and correlated with lower levels of activity (p test. Transtibial ACL reconstruction with 4-strand hamstring autograft and accelerated rehabilitation restored anteroposterior knee stability. Clinical parameters and patient satisfaction improved significantly. At 10-year follow-up, radiological signs of OA were present in 53.5 % of the subjects. Risk factors for OA were meniscectomy prior to or at the time of ACL reconstruction and chondral lesions at the time of ACL reconstruction. II.

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

    Science.gov (United States)

    Morrison, John E; Jacobs, Volker R

    2006-01-01

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

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

    International Nuclear Information System (INIS)

    Jujuratisbela, U.

    1998-08-01

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

  6. [Long-term 10-year outcome after chemonucleolysis for lumbar disc herniation].

    Science.gov (United States)

    Aribit, F; Charissoux, J L; Arnaud, J P

    2002-05-01

    We studied the efficacy of papaine for treatment of herniated discs at a mean 10-year follow-up and compared results with other series and other treatments. From an initial group of 160 patients, 96 patients, 53 men and 43 women, mean age 39 years, were selected for evaluation. These patients had 46 L4L5 herniations and 50 L5S1 herniations. All 96 patients were operated in the same department and received the same dose of papaine under the same anesthesia conditions. All patients were followed regularly to 3 months postoperatively then were reviewed 3 to 17 years after surgery. Inquiries were made about return to work, pain, and activity. Physical examination and x-rays were obtained for all patients. There were no neurological complications in our series. Seventeen patients required a second procedure for sciatic pain. Most of the patients continued their normal occupational and social activities after papaine treatment, but many of them had chronic lumbar pain. Our results were comparable with series reporting a similar long follow-up. Surgery is more efficient than papaine but long-term results are equivalent. Chemopapaine treatment provided good long-term results in our patients, similar to surgery. Chemonucleolysis may be employed as first line treatment for young patients with non-excluded disc herniation with sciatic pain.

  7. Do gender disparities persist in gastroenterology after 10 years of practice?

    Science.gov (United States)

    Singh, Aparajita; Burke, Carol A; Larive, Brett; Sastri, Suriya V

    2008-07-01

    Cross-sectional studies confirm gender disparity in many aspects of the practice of medicine and surgery. Some data suggest the disparities diminish after 10 yr of practice. This study aims to examine gender discrepancies in income, social, and professional status of gastroenterologists after 10 yr of practice. Prospective, observational, cohort study of gastroenterologists incepted upon graduation from a U.S. GI fellowship program in 1993 and 1995. A 36-item questionnaire was sent to the cohort at 3, 5, and 10 yr after graduation from GI fellowship training. The following are the results of the final, 10th year survey. A total of 168 men and 25 women (mean age 45.5 yr) responded. Men and women were equally likely to be board certified and married, however, women had fewer children. Men earned a mean annual gross income of $375,000 versus$245,000 for women (P= 0.001). After adjusting for practice setting, work hours, practice-ownership, free endoscopy center practice, and vacation time, female gastroenterologists earned $82,000 (22%) less per year than their male colleagues (95% CI $34,000-130,000, P= 0.001). Women were more frequently in academic practice (38%vs 17%), but were less likely to hold the most advanced academic positions. After 10 yr of practice, significant economic, professional, and social disparities persist between male and female gastroenterologists in this cohort. Women were more likely to practice in a setting with flexible work hours, a family leave provision, and in a practice with other women. Initiatives to equalize pay and ensure opportunities for professional advancement for women may diminish the significant practice disparities incurred by women in gastroenterology.

  8. Vesical Calculus 10 Years Post Missing Intrauterine Contraceptive ...

    African Journals Online (AJOL)

    Intravesical migration of intrauterine contraceptive device (IUCD) is rare. Early diagnosis of this rare entity is difficult because of its non‑specific manifestations and very low index of suspicion. We present this case of bladder stone following intravesical migration of IUCD found to have been missing since insertion 10 years ...

  9. Experience gained during 10 years transmutation experiments in Dubna

    Science.gov (United States)

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

    2006-05-01

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

  10. Parent-Child Relations and Adolescent Self-Image Following Divorce: A 10-Year Study.

    Science.gov (United States)

    Dunlop, Rosemary; Burns, Ailsa; Bermingham, Suzanne

    2001-01-01

    Explored links between self-image, family structure (divorced or intact), parent-child relations, and gender at 3 intervals over 10 years during adolescence to early adulthood. Results suggest a consistent relationship between high parental care, low overprotective control, and better self-image scores with a stronger effect among subjects from…

  11. Preoperative Nomogram Predicting the 10-Year Probability of Prostate Cancer Recurrence After Radical Prostatectomy

    Science.gov (United States)

    Stephenson, Andrew J.; Scardino, Peter T.; Eastham, James A.; Bianco, Fernando J.; Dotan, Zohar A.; Fearn, Paul A.; Kattan, Michael W.

    2008-01-01

    An existing preoperative nomogram predicts the probability of prostate cancer recurrence, defined by prostate-specific antigen (PSA), at 5 years after radical prostatectomy based on clinical stage, serum PSA, and biopsy Gleason grade. In an updated and enhanced nomogram, we have extended the predictions to 10 years, added the prognostic information of systematic biopsy results, and enabled the predictions to be adjusted for the year of surgery. Cox regression analysis was used to model the clinical information for 1978 patients treated by two high-volume surgeons from our institution. The nomogram was externally validated on an independent cohort of 1545 patients with a concordance index of 0.79 and was well calibrated with respect to observed outcome. The inclusion of the number of positive and negative biopsy cores enhanced the predictive accuracy of the model. Thus, a new preoperative nomogram provides robust predictions of prostate cancer recurrence up to 10 years after radical prostatectomy. PMID:16705126

  12. Mental and somatic health in a non-clinical sample 10 years after a diagnosis of encopresis.

    Science.gov (United States)

    Hultén, Ib; Jonsson, Jakob; Jonsson, Carl-Otto

    2005-12-01

    The aim of this study was to assess the relation between the diagnosis of encopresis at 8 and 10 years of age, and mental and somatic health 10 years later. The importance of type of encopresis (primary or secondary) at 8 years was also studied. Subjects were a non-clinical encopretic sample (N=73) and control subjects (N=75) [2]. Seven assessment variables from conscription surveys provided information about mental and somatic health status at 18 years of age. Former encopretics (n=66) did not differ significantly from the controls (n=67) at 18 years of age, although there were consistent, small negative differences. The boys who at 10 years of age had still been encopretic did not differ significantly at 18 years of age from the boys who at 10 years had recovered from encopresis, and the signs indicating the small differences varied. For former primary and secondary encopretic boys, there were two significant differences, the men in the secondary group being more often exempted from conscription than the primary group and the control cases. The results indicate that boys with non-clinical encopresis show only small, if any, mental and somatic disturbances at the beginning of adulthood. Comprehensive investigations of encopretic patients are recommended as important clinical problems, in addition to encopresis, might be present.

  13. Level of physical development and physical preparedness of weight-lifters of 10–12 years old

    Directory of Open Access Journals (Sweden)

    Viktor Dzhym

    2016-10-01

    Full Text Available Purpose: to determine the level of physical development and physical preparedness of weight-lifters of 10–12 years old. Material & Methods: boys of 10–12 years old, who go in for weightlifting sections in CYSS HTZ, and also in sports boarding school No 2 of Kharkiv, participated in this research. 34 boys were attracted to the experiment. Research methods: theoretical method and generalization of literature, pedagogical observation, pedagogical experiment, method of mathematical statistics. Results: differences in intensity of gain of indicators of physical development for the biennium of observations display unevenness and heterochrony of ripening of organism of children were found. The noticeable difference in intensity of gain of the majority of the studied indicators of physical development is noted even for such rather short period (two years. The increase during the whole biennium is established for absolute values of the general physical operability of the tested. However, the size of relative intensity of gain of absolute values of general physical working capacity at stages of observations is different: the first year10,48%, the second – 0,86% (t=22,3; р<0,01. In other words, indicators of general physical working capacity considerably grow for the first year of observations (10–11 years old, and practically do not change for the second year (11–12 years old. Conclusions: the established decrease in relative sizes of the general physical working capacity, which is noted at boys in total with the deterioration in results in run at distance of 1000 m, allowed to draw conclusion on the underdevelopment at them the major physical qualities and systems of organism, which define endurance and general physical working capacity. Undoubtedly, the insufficient level of endurance and general physical working capacity reduces adaptation opportunities of boys-weight-lifters.

  14. Duodenal adenocarcinoma in a 10-year-old boy.

    Science.gov (United States)

    Mohamed, Zouari; Habib, Bouthour; Rabia, Ben Abdallah; Youssef, Hlel; Riath, Ben Malek; Youssef, Gharbi; Nejib, Kaabar

    2014-01-01

    Gastrointestinal malignancies are extremely rare in the paediatric population and duodenal cancers represent an even more unusual entity. It represents 0.3-1% of all gastrointestinal tumours. A case report of a 10-year-old boy with duodenal adenocarcinoma is reported and the difficulties of diagnosing and treating this rare tumour are discussed.

  15. Dental age estimation: the role of probability estimates at the 10 year threshold.

    Science.gov (United States)

    Lucas, Victoria S; McDonald, Fraser; Neil, Monica; Roberts, Graham

    2014-08-01

    The use of probability at the 18 year threshold has simplified the reporting of dental age estimates for emerging adults. The availability of simple to use widely available software has enabled the development of the probability threshold for individual teeth in growing children. Tooth development stage data from a previous study at the 10 year threshold were reused to estimate the probability of developing teeth being above or below the 10 year thresh-hold using the NORMDIST Function in Microsoft Excel. The probabilities within an individual subject are averaged to give a single probability that a subject is above or below 10 years old. To test the validity of this approach dental panoramic radiographs of 50 female and 50 male children within 2 years of the chronological age were assessed with the chronological age masked. Once the whole validation set of 100 radiographs had been assessed the masking was removed and the chronological age and dental age compared. The dental age was compared with chronological age to determine whether the dental age correctly or incorrectly identified a validation subject as above or below the 10 year threshold. The probability estimates correctly identified children as above or below on 94% of occasions. Only 2% of the validation group with a chronological age of less than 10 years were assigned to the over 10 year group. This study indicates the very high accuracy of assignment at the 10 year threshold. Further work at other legally important age thresholds is needed to explore the value of this approach to the technique of age estimation. Copyright © 2014. Published by Elsevier Ltd.

  16. 10 years of denosumab treatment in postmenopausal women with osteoporosis: results from the phase 3 randomised FREEDOM trial and open-label extension.

    Science.gov (United States)

    Bone, Henry G; Wagman, Rachel B; Brandi, Maria L; Brown, Jacques P; Chapurlat, Roland; Cummings, Steven R; Czerwiński, Edward; Fahrleitner-Pammer, Astrid; Kendler, David L; Lippuner, Kurt; Reginster, Jean-Yves; Roux, Christian; Malouf, Jorge; Bradley, Michelle N; Daizadeh, Nadia S; Wang, Andrea; Dakin, Paula; Pannacciulli, Nicola; Dempster, David W; Papapoulos, Socrates

    2017-07-01

    Long-term safety and efficacy of osteoporosis treatment are important because of the chronic nature of the disease. We aimed to assess the long-term safety and efficacy of denosumab, which is widely used for the treatment of postmenopausal women with osteoporosis. In the multicentre, randomised, double-blind, placebo-controlled, phase 3 FREEDOM trial, postmenopausal women aged 60-90 years with osteoporosis were enrolled in 214 centres in North America, Europe, Latin America, and Australasia and were randomly assigned (1:1) to receive 60 mg subcutaneous denosumab or placebo every 6 months for 3 years. All participants who completed the FREEDOM trial without discontinuing treatment or missing more than one dose of investigational product were eligible to enrol in the open-label, 7-year extension, in which all participants received denosumab. The data represent up to 10 years of denosumab exposure for women who received 3 years of denosumab in FREEDOM and continued in the extension (long-term group), and up to 7 years for women who received 3 years of placebo and transitioned to denosumab in the extension (crossover group). The primary outcome was safety monitoring, comprising assessments of adverse event incidence and serious adverse event incidence, changes in safety laboratory analytes (ie, serum chemistry and haematology), and participant incidence of denosumab antibody formation. Secondary outcomes included new vertebral, hip, and non-vertebral fractures as well as bone mineral density (BMD) at the lumbar spine, total hip, femoral neck, and one-third radius. Analyses were done according to the randomised FREEDOM treatment assignments. All participants who received at least one dose of investigational product in FREEDOM or the extension were included in the combined safety analyses. All participants who enrolled in the extension with observed data were included in the efficacy analyses. The FREEDOM trial (NCT00089791) and its extension (NCT00523341) are both

  17. Foreign body aspiration and language spoken at home: 10-year review.

    Science.gov (United States)

    Choroomi, S; Curotta, J

    2011-07-01

    To review foreign body aspiration cases encountered over a 10-year period in a tertiary paediatric hospital, and to assess correlation between foreign body type and language spoken at home. Retrospective chart review of all children undergoing direct laryngobronchoscopy for foreign body aspiration over a 10-year period. Age, sex, foreign body type, complications, hospital stay and home language were analysed. At direct laryngobronchoscopy, 132 children had foreign body aspiration (male:female ratio 1.31:1; mean age 32 months (2.67 years)). Mean hospital stay was 2.0 days. Foreign bodies most commonly comprised food matter (53/132; 40.1 per cent), followed by non-food matter (44/132; 33.33 per cent), a negative endoscopy (11/132; 8.33 per cent) and unknown composition (24/132; 18.2 per cent). Most parents spoke English (92/132, 69.7 per cent; vs non-English-speaking 40/132, 30.3 per cent), but non-English-speaking patients had disproportionately more food foreign bodies, and significantly more nut aspirations (p = 0.0065). Results constitute level 2b evidence. Patients from non-English speaking backgrounds had a significantly higher incidence of food (particularly nut) aspiration. Awareness-raising and public education is needed in relevant communities to prevent certain foods, particularly nuts, being given to children too young to chew and swallow them adequately.

  18. GRTgaz 10-year development statement 2008-2017

    International Nuclear Information System (INIS)

    2008-01-01

    GRTgaz is a European leader in natural gas transmission, a world expert in gas transmission networks and systems, and an operator firmly committed to the energy transition. It owns and operates the gas transmission network throughout most of France and it manages the transmission network in Germany, thereby helping to ensure correct operation of the French and European gas market. It contributes to the energy security of regional supply systems and performs a public service mission to ensure the continuity of consumer supply. In accordance with the French Energy Code, GRTgaz publishes a 10-year development plan for its gas distribution network in France every year. This document is produced in line with European and French energy policies. It identifies the transport infrastructure that will need to be built over the next three years, and presents the main infrastructure that is likely to be developed within the next ten years. It incorporates the supply security obligations that TSOs are required to fulfil. It takes account of interested parties' needs and projects at the national, supranational and European levels. It is based on existing gas supply and demand and reasonable medium-term development forecasts for gas infrastructure, consumption and international trade

  19. Trends in Local Therapy Utilization and Cost for Early-Stage Breast Cancer in Older Women: Implications for Payment and Policy Reform

    International Nuclear Information System (INIS)

    Shirvani, Shervin M.; Jiang, Jing; Likhacheva, Anna; Hoffman, Karen E.; Shaitelman, Simona F.; Caudle, Abigail; Buchholz, Thomas A.; Giordano, Sharon H.; Smith, Benjamin D.

    2016-01-01

    Purpose: Older women with early-stage disease constitute the most rapidly growing breast cancer demographic, yet it is not known which local therapy strategies are most favored by this population in the current era. Understanding utilization trends and cost of local therapy is important for informing the design of bundled payment models as payers migrate away from fee-for-service models. We therefore used the Surveillance, Epidemiology, and End Results Medicare database to determine patterns of care and costs for local therapy among older women with breast cancer. Methods and Materials: Treatment strategy and covariables were determined in 55,327 women age ≥66 with Tis-T2N0-1M0 breast cancer who underwent local therapy between 2000 and 2008. Trends in local therapy were characterized using Joinpoint. Polychotomous logistic regression determined predictors of local therapy. The median aggregate cost over the first 24 months after diagnosis was determined from Medicare claims through 2010 and reported in 2014 dollars. Results: The median age was 75. Local therapy distribution was as follows: 27,896 (50.3%) lumpectomy with external beam radiation, 18,356 (33.1%) mastectomy alone, 6159 (11.1%) lumpectomy alone, 1488 (2.7%) mastectomy with reconstruction, and 1455 (2.6%) lumpectomy with brachytherapy. Mastectomy alone declined from 39.0% in 2000 to 28.2% in 2008, and the use of breast conserving local therapies rose from 58.7% to 68.2%. Mastectomy with reconstruction was more common among the youngest, healthiest patients, whereas mastectomy alone was more common among patients living in rural low-income regions. By 2008, the costs were $36,749 for lumpectomy with brachytherapy, $35,030 for mastectomy with reconstruction, $31,388 for lumpectomy with external beam radiation, $21,993 for mastectomy alone, and $19,287 for lumpectomy alone. Conclusions: The use of mastectomy alone in older women declined in favor of breast conserving strategies between 2000 and 2008

  20. Trends in Local Therapy Utilization and Cost for Early-Stage Breast Cancer in Older Women: Implications for Payment and Policy Reform

    Energy Technology Data Exchange (ETDEWEB)

    Shirvani, Shervin M. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona (United States); Jiang, Jing [Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Likhacheva, Anna [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona (United States); Hoffman, Karen E.; Shaitelman, Simona F. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Caudle, Abigail [Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Buchholz, Thomas A. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Giordano, Sharon H. [Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D., E-mail: bsmith3@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2016-06-01

    Purpose: Older women with early-stage disease constitute the most rapidly growing breast cancer demographic, yet it is not known which local therapy strategies are most favored by this population in the current era. Understanding utilization trends and cost of local therapy is important for informing the design of bundled payment models as payers migrate away from fee-for-service models. We therefore used the Surveillance, Epidemiology, and End Results Medicare database to determine patterns of care and costs for local therapy among older women with breast cancer. Methods and Materials: Treatment strategy and covariables were determined in 55,327 women age ≥66 with Tis-T2N0-1M0 breast cancer who underwent local therapy between 2000 and 2008. Trends in local therapy were characterized using Joinpoint. Polychotomous logistic regression determined predictors of local therapy. The median aggregate cost over the first 24 months after diagnosis was determined from Medicare claims through 2010 and reported in 2014 dollars. Results: The median age was 75. Local therapy distribution was as follows: 27,896 (50.3%) lumpectomy with external beam radiation, 18,356 (33.1%) mastectomy alone, 6159 (11.1%) lumpectomy alone, 1488 (2.7%) mastectomy with reconstruction, and 1455 (2.6%) lumpectomy with brachytherapy. Mastectomy alone declined from 39.0% in 2000 to 28.2% in 2008, and the use of breast conserving local therapies rose from 58.7% to 68.2%. Mastectomy with reconstruction was more common among the youngest, healthiest patients, whereas mastectomy alone was more common among patients living in rural low-income regions. By 2008, the costs were $36,749 for lumpectomy with brachytherapy, $35,030 for mastectomy with reconstruction, $31,388 for lumpectomy with external beam radiation, $21,993 for mastectomy alone, and $19,287 for lumpectomy alone. Conclusions: The use of mastectomy alone in older women declined in favor of breast conserving strategies between 2000 and 2008

  1. Emergency peripartum hysterectomy in Nnewi, Nigeria: A 10-year ...

    African Journals Online (AJOL)

    Emergency peripartum hysterectomy in Nnewi, Nigeria: A 10-year review. ... Nigerian Journal of Clinical Practice ... were 6,137 deliveries and 38 cases of emergency peripartum hysterectomies, giving an incidence of 6.2 per 1000 deliveries.

  2. Safety in transport of radioactive materials - the next 10 years

    International Nuclear Information System (INIS)

    Barker, R.

    1981-01-01

    The number of shipments of radioactive material is increasing steadily - some estimates indicate by about 10 per cent a year. Several million packages are already shipped about the world each year and this number will increase at least for the next 10 years. Part of this increase will come from the expected growth in the number of nuclear power plants which will be shipping irradiated fuel that had previously been stored on-site or in use, and from the associated shipments of nuclear waste. The increase in production and use of nuclear fuel requires increased production (and hence increased shipments) or uranium and thorium ores; and of concentrates, nitrates, fluorides and fresh fuel. Shipments of highly active waste from reprocessing nuclear fuels, already occurring to some extent in Europe, will increase and may begin again in the USA in the next few years. Also in the next 10 years, decommissioning of some reactors will take place requiring special types of shipments. A new type of shipment that may arise within the next 10 years is that of several kilograms (millions of curies) of tritium. A few of these large, easily controlled shipments will be required for the operation of the prototype fusion reactor, a joint project supported through the IAEA by the USSR, USA, and others. The technology for designing such packaging is well established, but it does not appear that any of the existing designs are capable of handling such large amounts of tritium and so new designs will be needed. The medical, industrial, and research uses of radioactivity are expected to continue to grow and the associated shipments of radioactive material to become even more frequent. The Agency is collecting data on shipments in all Member States and will issue an analysis of that data in 1981. For several years to come, however, we can expect the largest number of packages to be exempt shipments (e.g. smoke detectors and luminous watches) and medical isotopes; the greatest volume to be

  3. [Atherosclerotic renovascular hypertension: clinical findings and results of treatment over 15 years].

    Science.gov (United States)

    Alfonzo, J P; Rosario, M N; Ugarte, C; Banasco, J; Fraxedas, R; Lahera, J

    2003-01-01

    The aim of this study was to present our clinical experience and results of different treatments in 83 atherosclerotic renovascular hypertensive patients treated in the last 15 years in the Instituto de nefrologia in Havana. Regardless of the type of treatment the patients were divided in two groups. Group I: 52 (62.3%) cases with standard oral hypotensive drugs alone and control of other cardiovascular risk factors (mean age 53 years old, sex m/f 50/50%, race white/no-white 75/25%, mean known hypertension follow-up 10.2 +/- 10 years, mean SBP 208 +/- 30 mmHg, mean DBP 123 +/- 17 mmHg, mean serum creatinina 1.62 mg/dl and increase peripheral plasma renin value in 61.6% of patients) and group II: 31 (37.7%) cases treated with revascularización procedures (PTA or surgery) or nephrectomy in selected patients (mean age 50 years old, sex m/f 68/32%, race white/no-white 16/84%, mean known hypertension follow-up 8.5 +/- 8.6 years, mean SBP 214 +/- 32 mmHg, mean DBP 1.31 +/- 16 mmHg, mean serum creatinina 1.85 mg/dl and increase peripheral plasma renin value 78.3% of patients). As end point for treatment results we selected: 1) hypertension cure or control, 2) evolution of the serum creatinine value and 3) kidney and patients survival. In those cases with a follow up for more than one year, in 82.9% the blood pressure was cure (21.4%) or controlled (61.4%). The proportion of failed was superior in group I (20.9%) than in group II (11.1%). All 18 cases treated by PTA with a follow up period longer than a year, blood pressure cure in 10 (55.6%), ameliorate in 5 (27.8%) and in 3 (16.6%) was unchanged (one patient lost of follow up). Nine patients were treated by surgery (3 revascularization and 6 nephrectomy), 5 (55.5%) cases cured and 4 (44.5%) ameliorate his blood pressure. Patients in group II maintain normal renal function in more cases than in group I (48.4% vs 30.8%). Both group had similar percentage of normal-normal + pathology-normal renal function (G I: 65.4% vs G

  4. Duodenal adenocarcinoma in a 10-year-old boy

    Directory of Open Access Journals (Sweden)

    Zouari Mohamed

    2014-01-01

    Full Text Available Gastrointestinal malignancies are extremely rare in the paediatric population and duodenal cancers represent an even more unusual entity. It represents 0.3-1% of all gastrointestinal tumours. A case report of a 10-year-old boy with duodenal adenocarcinoma is reported and the difficulties of diagnosing and treating this rare tumour are discussed.

  5. Dysplasia and cancer in inflammatory bowel disease 10 years after diagnosis: results of a population-based European collaborative follow-up study.

    Science.gov (United States)

    Katsanos, K H; Vermeire, S; Christodoulou, D K; Riis, L; Wolters, F; Odes, S; Freitas, J; Hoie, Ole; Beltrami, Marina; Fornaciari, G; Clofent, J; Bodini, P; Vatn, M; Nunes, Paula Borralho; Moum, B; Munkholm, P; Limonard, C; Stockbrugger, R; Rutgeerts, P; Tsianos, E V

    2007-01-01

    To determine dysplasia and cancer in the 1991-2004 European Collaborative Inflammatory Bowel Disease (EC-IBD) Study Group cohort. A patient questionnaire and a physician per patient form were completed for each of the 1,141 inflammatory bowel disease patients (776 ulcerative colitis/365 Crohn's disease) from 9 centers (7 countries) derived from the EC-IBD cohort. Rates of detection of intestinal cancer and dysplasia as well as extra-intestinal neoplasms were computed. Patient follow-up time was 10.3 +/- 0.8 (range 9.4-11) years. The mean age of the whole group of IBD patients was 37.8 +/- 11.3 (range 16-76) years. Thirty-eight patients (3.3%; 26 with ulcerative colitis/12 with Crohn's disease, 21 males/17 females, aged 61.3 +/- 13.4, range 33-77 years), were diagnosed with 42 cancers. Cancers occurred 5.4 +/- 3.3 (range 0-11) years after inflammatory bowel disease diagnosis. Colorectal cancer was diagnosed in 8 (1 Crohn's disease and 7 ulcerative colitis patients--0.3 and 0.9% of the Crohn's disease and ulcerative colitis cohort, respectively) of 38 patients and 30 cancers were extra-intestinal. Four of 38 patients (10.5%) were diagnosed as having 2 cancers and they were younger compared to patients with one cancer (p = 0.0008). There was a trend for a higher prevalence of intestinal cancer in the northern centers (0.9%) compared to southern centers (0.3%, p = NS). Southern centers had more cases of extra-intestinal cancer compared to northern centers (2 vs. 3.8%, p = 0.08). Ten patients (0.9%; 8 with ulcerative colitis/2 with Crohn's disease, 8 males, aged 62.3 +/- 14.1 years) had colorectal dysplasia. In the first decade of the EC-IBD Study Group cohort follow-up study, the prevalence of cancer was as expected with most patients having a single neoplasm and an extra-intestinal neoplasm. In northern centers there was a trend for more intestinal cancers, while in southern centers there was a trend for more extra-intestinal cancers compared to northern centers. 2007

  6. Twenty-Seven Years Experience With Transvenous Pacemaker Implantation in Children Weighing <10 kg.

    Science.gov (United States)

    Konta, Laura; Chubb, Mark Henry; Bostock, Julian; Rogers, Jan; Rosenthal, Eric

    2016-02-01

    Epicardial pacemaker implantation is the favored approach in children weighing pacemaker implantation in neonates and infants from 1987. To date there have been no long-term follow-up reports of what is for many a controversial strategy. Between 1987 and 2003, 37 neonates and infants-median age 6.7 months (1 day to 3 years) and median weight 4.6 kg (2.7-10 kg)-had a permanent transvenous pacing system implanted. Pacing leads were placed into the right ventricular apex/outflow tract through a subclavian vein puncture with a redundant loop in the atrium. Three patients were lost to follow-up, 4 patients died from complications of cardiac surgery, and 2 patients had their system removed. At long-term follow-up in 28 patients at a median of 17.2 (range, 11.2-27.4) years, 10 patients have a single chamber ventricular pacemaker, 14 a dual chamber pacemaker, 3 a biventricular pacemaker, and 1 has a single chamber implantable cardioverter defibrillator. Subclavian vein patency was assessed in 26 patients. The overall subclavian vein occlusion rate was 10 of 13 (77%) 5 kg during long-term follow-up. After a median of 14.3 (range, 13.4-17.6) years of pacing, 7 patients continue with their original lead. Transvenous pacing in infants <10 kg results in encouraging short- and long-term clinical outcomes. Subclavian vein occlusion remains an important complication, occurring predominantly in those weighing <5 kg. © 2016 American Heart Association, Inc.

  7. Oncoplastic breast surgery does not delay the onset of adjuvant chemotherapy

    DEFF Research Database (Denmark)

    Klit, Anders; Tvedskov, Tove Filtenborg; Kroman, Niels

    2017-01-01

    BACKGROUND: Only a few studies of limited size have examined whether oncoplastic breast surgery delays the onset of adjuvant chemotherapy as compared to conventional breast surgery. We investigated whether oncoplastic breast surgery causes a delay in the onset of adjuvant chemotherapy in comparison...... to lumpectomy and mastectomy. MATERIAL AND METHODS: The study is a population-based cohort study. Within the nationwide registry of the Danish Breast Cancer Group (DBCG), we identified 1798 patients who received adjuvant chemotherapy following mastectomy, lumpectomy or oncoplastic breast surgery for early...... and unilateral invasive breast cancer. Women treated with neoadjuvant chemotherapy were excluded. RESULTS: We found no significant difference between the three groups (mastectomy, lumpectomy, oncoplastic breast surgery) in the time from biopsy to surgery (mean time 17.9, 17.0 and 18.3 days, respectively...

  8. Integrating Energy Efficiency into the 10 Year Framework of Programmes on Sustainable Consumption and Production Patterns (10YFP)

    DEFF Research Database (Denmark)

    This report summarises the discussions and conclusions from the workshop 'Integrating Energy Efficiency into the 10 Year Framework of Programmes on Sustainable Consumption and Production Patterns (10YFP)' jointly organised by the 10YFP Secretariat and the Copenhagen Centre on Energy Efficiency (C2E...

  9. 4-Valent Human Papillomavirus (4vHPV) Vaccine in Preadolescents and Adolescents After 10 Years

    DEFF Research Database (Denmark)

    Ferris, Daron G; Samakoses, Rudiwilai; Block, Stanley L

    2017-01-01

    OBJECTIVES: We describe the final 10-year data for the long-term follow-up study of the 4-valent human papillomavirus (4vHPV) vaccine in preadolescents and adolescents. METHODS: In the base study (V501-018), 1661 sexually inactive boys and girls received the 4vHPV vaccine (early vaccination group...... assessed. Effectiveness was estimated by calculating the incidence rate of the primary endpoints (HPV types 6, 11, 16, and 18-related disease or persistent infection). RESULTS: For HPV types 6, 11, and 16, 89% to 96% of subjects remained seropositive through 10-years postvaccination. The preadolescents had...... 38% to 65% higher geometric mean titers at month 7, which remained 16% to 42% higher at 10 years compared with adolescents. No cases of HPV type 6, 11, 16, and 18-related diseases were observed. Ten subjects had a persistent infection of ≥6 months duration with vaccine-type HPV and 2 subjects had...

  10. A controlled clinical trial of implant-retained mandibular overdentures : 10 years' results of clinical aspects and aftercare of IMZ implants and Branemark implants

    NARCIS (Netherlands)

    Meijer, HJA; Raghoebar, GM; Van't Hof, MA; Visser, A

    The aim of this prospective randomized controlled clinical trial was to evaluate the clinical outcomes and prosthetic aftercare of edentulous patients with a mandibular overdenture retained by two IMZ implants or two Branemark implants during a 10-year period. Patients were allocated to the IMZ

  11. Fractures of the mandible and maxilla: A 10-year analysis

    Directory of Open Access Journals (Sweden)

    Estie Kruger

    2016-01-01

    Full Text Available Background Previous analysis of jaw fracture hospitalisations in Western Australia (WA indicated disproportionately high rates of hospitalisations for Aboriginal people. This study was to follow-up on the earlier analysis to determine if inequalities in terms of jaw fracture hospitalisation rates between Aboriginal and non-Aboriginal people have changed. Aims This study, done over a 10-year period from 1999/2000 to 2008/2009, aimed to determine rates of hospitalisations for jaw fractures in WA, trends over the 10year period, and direct costs associated with these hospital admissions. Methods Hospitalisation data were obtained from the Western Australian Hospital Morbidity Data System (HMDS. Episodes were selected on the basis of an ICD10-AM code being S02.4 (Fracture of the malar and maxillary bones and S02.6 (Fracture of the mandible. Self-reported Aboriginality were used to compare Aboriginal to non-Aboriginal populations. Estimated cost of care was determined for each episode using the national standard diagnostic-related group (DRG average price. Results Our findings indicate that inequalities between Aboriginal and non-Aboriginal people in terms of hospital admissions for jaw fractures exist in WA, and continued over a decade-long period. Higher fracture rates occurred amongst males, Aboriginal people, younger adult age-groups, those from low socioeconomic areas, and those from remote and very remote areas. The DRG cost per person for jaw fractures ranged between AUD $842 and $109,002, with a median cost of $4,965. Conclusion Hospital admission rates for the treatment of maxillary and mandibular fractures is very strongly divided along racial and socioeconomic lines in WA.

  12. Motor Skills in Children Aged 7-10 Years, Diagnosed with Autism Spectrum Disorder

    Science.gov (United States)

    Whyatt, Caroline P.; Craig, Cathy M.

    2012-01-01

    This study used the Movement Assessment Battery for Children (M-ABC2) to assess motor skills in children aged 7-10 years with autism (n = 18) in comparison to two groups of age-matched typically developing children; a receptive vocabulary matched group (n = 19) and a nonverbal IQ matched group (n = 22). The results supported previous work, as…

  13. Fixed Income Market Efficiency: Evidence from Kenya's 10-Year ...

    African Journals Online (AJOL)

    volatility of South Africa's local currency 10-year bond using methods based on wavelets, and. Thupayagale .... Auction style. Multiple- ... of long memory in returns and volatility using the ARFIMA-FIGARCH model, which is the subject of the ...

  14. Field Lysimeter Investigations - test results: Low-Level Waste Data Base Development Program: Test results for fiscal years 1994-1995

    International Nuclear Information System (INIS)

    McConnell, J.W. Jr.; Rodgers, R.D.; Hilton, L.D.; Neilson, R.M. Jr.

    1996-06-01

    The Field Lysimeter Investigations: Low-Level Waste Data Base Development Program, funded by the U.S. Nuclear Regulatory Commission (NRC), is (1) studying the degradation effects in EPICOR-II organic ion-exchange resins caused by radiation, (2) examining the adequacy of test procedures recommended in the Branch Technical Position on Waste Form to meet the requirements of 10 CFR 61 using solidified EPICOR-II resins, (3) obtaining performance information on solidified EPICOR-II ion-exchange resins in a disposal environment, and (4) determining the condition of EPICOR-II liners. Results of the final 2 (10 total) years of data acquisition from operation of the field testing are presented and discussed. During the continuing field testing, both portland type I-II cement and Dow vinyl ester-styrene waste forms are being tested in lysimeter arrays located at Argonne National Laboratory-East in Illinois and at Oak Ridge National Laboratory. The experimental equipment is described and results of waste form characterization using tests recommended by the NRC's open-quotes Technical Position on Waste Formclose quotes are presented. The study is designed to provide continuous data on nuclide release and movement, as well as environmental conditions, over a 20-year period. At the end of the tenth year, the experiment was closed down. Examination of soil and waste forms is planned to be conducted next and will be reported later

  15. Five-Year Risk of Interval-Invasive Second Breast Cancer

    Science.gov (United States)

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

    2015-01-01

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

  16. 10 ways to improve NSS results

    OpenAIRE

    Byrd, Hugh

    2014-01-01

    This presentation is a series of suggestions and ideas for improving NSS results in an architectural course, though much of it is applicable to other design-based courses. The slides are not intended to be in any order of priority. 50 practical suggestions around 10 themes that correspond to NSS questions

  17. Irradiation needs in the 10 years coming

    International Nuclear Information System (INIS)

    Joly, C.; Auclair, M.; Couffin, P.

    1999-01-01

    By their contribution to a better knowledge of the behaviour of fuel and materials under irradiation the Material Research Reactors have allowed a higher safety level of the power plants. More and more the research programmes request fine well instrumented analytical irradiations with on line follow up of the phenomena. To answer these requests high technology level is needed. The paper gives a first answer to the following question ''what could be the needs in the 10 years coming?'', as well for materials as for fuel research programmes. (author)

  18. 10 Years at Saturn, and More Excitement to Come!

    Science.gov (United States)

    Edgington, S. G.; Spilker, L. J.; Altobelli, N.

    2014-04-01

    After 10 years in orbit, the Cassini-Huygens Mission to Saturn, a collaboration of NASA, ESA, and ASI, continues to wow the imagination. Every year Cassini produces answers to questions raised by the Voyager flybys, while at the same time posing new questions that can only be answered with a long duration mission using a flagship-class spacecraft. In this talk, we sample a few of Cassini's discoveries from the past decade and give an overview of what comes next.

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

    African Journals Online (AJOL)

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

  20. An 18-year-old man with recurrent pneumothorax since he was 10-year-old.

    Science.gov (United States)

    Demir, Meral; Çobanoğlu, Nazan

    2016-12-01

    An 18-year-old male patient was referred to the department of pediatric pulmonology with a history of recurrent pneumothorax. Initial pneumothorax occurred at the age of 10. Following diagnosis of congenital lobar emphysema, he had five episodes of pneumothorax and subsequently underwent right-lower lobe anterobasal segmentectomy. Based on thoracic computed tomography (CT) and clinical manifestation, Birt-Hogg-Dube (BHD) syndrome was suspected and confirmed following genetic testing. BHD syndrome is a rare tumor predisposition syndrome first described in 1977. The syndrome is characterized by skin fibrofolliculomas, lung cysts, recurrent spontaneous pneumothorax, and renal cell cancer. The underlying cause is a germline mutation in the folliculin (FLCN) gene located on chromosome 17p11.2. Clinical manifestation usually appears after the age of 20 years. In this case, we report a case of BHD with episodes of recurrent pneumothorax, the first of which occurred at the age of 10 years. Pulmonologists should be aware of this syndrome in patients with a personal and family history of pneumothoraces and CT findings of multiple pulmonary cysts as additional evaluation and testing may be warranted. Pediatr Pulmonol. 2016;51:E41-E43. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  1. ESO and Chile: 10 Years of Productive Scientific Collaboration

    Science.gov (United States)

    2006-06-01

    ESO and the Government of Chile launched today the book "10 Years Exploring the Universe", written by the beneficiaries of the ESO-Chile Joint Committee. This annual fund provides grants for individual Chilean scientists, research infrastructures, scientific congresses, workshops for science teachers and astronomy outreach programmes for the public. In a ceremony held in Santiago on 19 June 2006, the European Organisation for Astronomical Research in the Southern Hemisphere (ESO) and the Chilean Ministry of Foreign Affairs marked the 10th Anniversary of the Supplementary Agreement, which granted to Chilean astronomers up to 10 percent of the total observing time on ESO telescopes. This agreement also established an annual fund for the development of astronomy, managed by the so-called "ESO-Chile Joint Committee". ESO PR Photo 21/06 ESO PR Photo 21/06 Ten Years ESO-Chile Agreement Ceremony The celebration event was hosted by ESO Director General, Dr. Catherine Cesarsky, and the Director of Special Policy for the Chilean Ministry of Foreign Affairs, Ambassador Luis Winter. "ESO's commitment is, and always will be, to promote astronomy and scientific knowledge in the country hosting our observatories", said ESO Director General, Dr. Catherine Cesarsky. "We hope Chile and Europe will continue with great achievements in this fascinating joint adventure, the exploration of the universe." On behalf of the Government of Chile, Ambassador Luis Winter outlined the historical importance of the Supplementary Agreement, ratified by the Chilean Congress in 1996. "Such is the magnitude of ESO-Chile Joint Committee that, only in 2005, this annual fund represented 8 percent of all financing sources for Chilean astronomy, including those from Government and universities", Ambassador Winter said. The ESO Representative and Head of Science in Chile, Dr. Felix Mirabel, and the appointed Chilean astronomer for the ESO-Chile Joint Committee, Dr. Leonardo Bronfman, also took part in the

  2. Airborne grass (Poaceae) pollen in southern Spain. Results of a 10-year study (1987-96).

    Science.gov (United States)

    González Minero, F J; Candau, P; Tomás, C; Morales, J

    1998-03-01

    This work reports an exhaustive study of the aerobiology of the Gramineae in Seville, Spain, which is typical of coastal Mediterranean areas. Sampling was done with a Cour trap installed on the roof terrace of the School of Pharmacy, Seville, from 1987 to 1996, both inclusive. The climatic pattern of that period was characterized by two exceptionally wet years (1989 and 1996), between which were 5 consecutive years of drought (1990-5). This typically Mediterranean climate affects grass aerobiology. The annual amounts of total grass pollen are low, never exceeding 2500 grains/m3. The start, length, and intensity of the pollen season are significantly correlated with preseasonal meteorologic factors (precipitation and temperature), but intraseasonal meteorologic conditions have no effect on the three variables. The relationships are stated by three equations that, while further years of observations are anticipated, can be considered models to forecast the characteristics of the pollen season: the starting date depends on the mean temperatures of January and February, and the length and intensity of the season depend on the rainfall between the beginning of January and the starting date of the season. For the study period, the weekly concentrations (pollen curves) throughout the year showed no typical pattern of variation over the years, so that it was impossible to make mid- and long-term forecasts of the variation in weekly concentration. The most noteworthy aspects of grass pollen curves are a long pollen season, which starts in February or March and lasts until September or October; peaks of higher concentration (> 100 grains/m3) in May and June, associated with increases in temperature and absence of precipitation; and other peaks in the summer months that may be as high as the spring peaks.

  3. Public Health in Europe : 10 years EUPHA

    Directory of Open Access Journals (Sweden)

    Wilhelm Kirch

    2004-12-01

    Full Text Available

    What is Public Health (PH? What are the links between Public Health research and policy in Europe? Where is PH coming from in the 20th century and where is it directed to?

    These are some of the questions addressed by Public Health in Europe – 10 years EUPHA, the volume, edited by Prof.W. Kirch and published by Springer in 2004, that presents a selection of the manuscripts from the 10th Annual Congress of EUPHA, held in Dresden in 2002.

    Gunnar Tellness, the President of EUPHA, reminds us what PH is, or what it should be: the science devoted to reduce in the population the amount of disease, premature death and disease-related discomfort, sickness and disability.

    In addressing these themes,Tellness suggests to improve PH by employing healthpromoting and cultural activities, in order to establish strong collaborations between public agencies, private business, organisations and pioneers.

  4. Preoperative Accelerated Partial Breast Irradiation for Early-Stage Breast Cancer: Preliminary Results of a Prospective, Phase 2 Trial

    Energy Technology Data Exchange (ETDEWEB)

    Nichols, Elizabeth, E-mail: Enichols1@umm.edu [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Kesmodel, Susan B.; Bellavance, Emily; Drogula, Cynthia [Department of Surgical Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Tkaczuk, Katherine [Department of Medical Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Cohen, Randi J.; Citron, Wendla; Morgan, Michelle [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Staats, Paul [Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland (United States); Feigenberg, Steven; Regine, William F. [Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland (United States)

    2017-03-15

    Purpose: To assess the feasibility of utilizing 3-dimensional conformal accelerated partial-breast irradiation (APBI) in the preoperative setting followed by standard breast-conserving therapy. Patients and Methods: This was a prospective trial testing the feasibility of preoperative APBI followed by lumpectomy for patients with early-stage invasive ductal breast cancer. Eligible patients had T1-T2 (<3 cm), N0 tumors. Patients received 38.5 Gy in 3.85-Gy fractions delivered twice daily. Surgery was performed >21 days after radiation therapy. Adjuvant therapy was given as per standard of care. Results: Twenty-seven patients completed treatment. With a median follow-up of 3.6 years (range, 0.5-5 years), there have been no local or regional failures. A complete pathologic response according to hematoxylin and eosin stains was seen in 4 patients (15%). There were 4 grade 3 seromas. Patient-reported cosmetic outcome was rated as good to excellent in 79% of patients after treatment. Conclusions: Preoperative 3-dimensional conformal radiation therapy−APBI is feasible and well tolerated in select patients with early-stage breast cancer, with no reported local recurrences and good to excellent cosmetic results. The pathologic response rates associated with this nonablative APBI dose regimen are particularly encouraging and support further exploration of this paradigm.

  5. Do musculoskeletal degenerative diseases affect mortality and cause of death after 10 years in Japan?

    Science.gov (United States)

    Tsuboi, Masaki; Hasegawa, Yukiharu; Matsuyama, Yukihiro; Suzuki, Sadao; Suzuki, Koji; Imagama, Shiro

    2011-03-01

    There are several reports from Europe and the United States on mortality from musculoskeletal degenerative diseases; however, no reports have been published from Japan. This study is the first that has examined whether musculoskeletal degenerative diseases affect life prognosis in Japan. As many as 944 persons who were 60 years of age and older and who underwent one or more musculoskeletal checkups (knee, lower back, and bone mineral density examination) were enrolled. Survival and death after 10 years were examined. For each knee, lower back, and bone mineral density examination, subjects were divided into normal and abnormal groups. For each of the examinations (knee, lower back, or bone mineral density), 10-year mortality was compared between the two groups. Also, causes of death were examined after 10 years. As many as 805 subjects survived and 125 died. For those with and without osteoarthritis of the knee, mortality after 10 years was 17 and 10%, respectively. For those with and without lower back abnormalities, mortality after 10 years was 12 and 14%, respectively. For those with or without low bone mineral density, mortality after 10 years was 17 and 10%, respectively. Multivariate analysis adjusted for age, gender, body mass index, and lifestyle revealed that odds ratio of death after 10 years was 2.32 and 2.33 in the presence of osteoarthritis of the knee and a low bone mineral density, respectively, and thus the risk of death after 10 years was significantly high. With regard to the cause of death, cerebrovascular and cardiovascular diseases were most frequently evident in patients with osteoarthritis of the knee. Musculoskeletal degenerative diseases influence mortality after 10 years.

  6. Evolution in Practice: How has British Neurosurgery Changed in the Last 10 Years?

    Science.gov (United States)

    Tarnaris, A; Arvin, B; Ashkan, K

    2008-01-01

    INTRODUCTION Neurosurgery is a fast-evolving surgical subspecialty driven by technological advances, socio-economic factors and patient expectations. In this study, we have compared the work-load volume in a single institution in the years of 1994 and 2004 and commented on the possible reasons for the changes and the impacts they may have for the future. PATIENTS AND METHODS A retrospective, log-book review of all operations performed in the years 1994 and 2004 in a single, tertiary, neurosurgical centre was performed. RESULTS Neurosurgical practice has evolved over this period. Current practice has moved away from clipping of aneurysms and towards coil embolisation performed by interventional radiologists. Electrode stimulation of deep brain regions for movement disorders is the current practice, whereas 10 years ago the same disorders were dealt with by lesioning of the relevant regions. In spinal neurosurgery, instrumentation is increasingly favoured currently. In the field of neuro-oncology, current practice favours minimal access to the target area by the use of stereotactic localisation. CONCLUSIONS Changes were most pronounced in the subspecialties of vascular, functional and spinal neurosurgery within this 10-year period. Knowledge of such dynamics is valuable in health resource management as well as planning for neurosurgical training programmes. PMID:18765031

  7. The Protective Role of Family Meals for Youth Obesity: 10-year Longitudinal Associations

    Science.gov (United States)

    Berge, Jerica M.; Wall, Melanie; Hsueh, Tsun-Fang; Fulkerson, Jayne A.; Larson, Nicole; Neumark-Sztainer, Dianne

    2014-01-01

    Objective To examine whether having family meals as an adolescent protects against becoming overweight or obese 10 years later as a young adult. Study design Data from Project EAT-III, a longitudinal cohort study with emerging young adults, were used. At baseline (1998-1999) adolescents completed surveys in middle or high schools and at 10-year follow-up (2008-2009) surveys were completed online or via mailed surveys. Young adult participants (n=2117) were racially/ethnically and socioeconomically diverse (52% minority; 38% low income) between the ages of 19-31 (mean age=25.3; 55% female). Logistic regression was used to associate weight status at follow-up with family meal frequency 10-years earlier during adolescence, controlling and testing for interactions with demographic characteristics. Results All levels of baseline family meal frequency (i.e., 1-2, 3-4, ≥5 family meals/week) during adolescence were significantly associated with reduced odds of overweight or obesity ten years later in young adulthood as compared with never having family meals as an adolescent. Interactions by race indicated that family meals had a stronger protective effect for obesity in black versus white young adults. Conclusions Family meals during adolescence were protective against the development of overweight and obesity in young adulthood. Professionals who work with adolescents and parents may want to strategize with them how to successfully carry out at least one to two family meals per week in order to protect adolescents from overweight or obesity in young adulthood. PMID:25266343

  8. Predictors of subjective health status 10 years post-PCI

    NARCIS (Netherlands)

    van den Berge, Jan C.; Dulfer, Karolijn; Utens, Elisabeth M. W. J.; Hartman, Eline M. J.; Daemen, Joost; van Geuns, Robert J.; van Domburg, Ron T.

    2016-01-01

    Subjective health status is an increasingly important parameter to assess the effect of percutaneous coronary intervention (PCI) in clinical practice. Aim of this study was to determine medical and psychosocial predictors of poor subjective health status over a 10 years' post-PCI period. We included

  9. Comorbid personality disorder predicts suicide after major depression: a 10-year follow-up

    DEFF Research Database (Denmark)

    Hansen, Poul Erik Buchholtz; Wang, A.G.; Stage, K.B.

    2003-01-01

    OBJECTIVE: To identify psychopathological predictors for suicide in a population of major depressed Diagnostic Statistical Manual-III (DSM-III) in-patients. METHOD: A total of 210 previous participants in multicentre antidepressant drug trials, carried out in a randomized double-blind design, were...... followed prospectively through a maximum of 10 years. Patients with a drug or alcohol abuse were excluded. The association between suicide and the pretreatment psychopathological profile was analysed using survival statistics. RESULTS: The suicide rate for non-melancholic depressed patients...... was significantly higher than for melancholic depressed patients. Comorbid personality disorder was independently associated with an increased suicide rate [relative hazard 3.41(CI: 1.15-10.10)]. CONCLUSION: The study indicates that the non-melancholic aspect of depression, and especially comorbid personality...

  10. The 10,000 Year Plan

    International Nuclear Information System (INIS)

    L.Srisaro

    2006-01-01

    Pallavi Pharkya thinks a lot about the future. Pharkya, a Ph.D. candidate in materials science and engineering, works in the area of corrosion science, predicting how materials will perform over extended periods of time. Her particular focus is a nickel-chromium-molybdenum alloy called C-22, a highly corrosion-resistant metal. Pharkya's aim is to help determine whether containers made from C-22 can be used to store high-energy nuclear waste--for 10,000 years and longer. Pharkya's work is part of a plan by the U.S. Department of Energy to consolidate the country's nuclear waste in a single proposed repository. The proposed repository is in Yucca Mountain located in a remote Nevada desert. Currently about 70,000 metric tons of spent nuclear fuel and high-level radioactive waste are divided between approximately 100 sites around the country. The undertaking, Pharkya emphasizes, is massive. To study just the corrosion aspects of the packaging, Case is collaborating with eight other universities, five national labs and Atomic Energy of Canada Limited. Even with so many players, the study will likely take several years to complete. Heading the entire group is Joe Payer, a professor of materials science and engineering at Case and Pharkya's mentor. ''I came here to have the opportunity to work with Dr. Payer, an expert in corrosion, but I didn't know specifically what I would be working on'', Pharkya recalls. ''I was pretty thrilled when I learned about the vastness of the project--my research would be just a small part of this huge topic--and the impact of the research we would be doing''

  11. A longitudinal study of grapheme-colour synaesthesia in childhood: 6/7 years to 10/11 years

    Directory of Open Access Journals (Sweden)

    Julia eSimner

    2013-11-01

    Full Text Available Grapheme-colour synaesthesia is a condition characterised by enduring and consistent associations between letter/digits and colours. This study is the continuation of longitudinal research begun by Simner, Harrold, Creed, Monro and Foulkes (2009 which aimed to explore the development of this condition in real time within a childhood population. In that earlier study we randomly sampled over 600 children and tested them aged 6/7 years and 7/8 years. We identified the child synaesthetes within that cohort and measured their development over 1 year, in comparison to a group of nonsynaesthetic children with both average and superior memories. We were able to show the beginnings of a developmental progression in which synaesthetic associations (e.g. A = red mature over time from relatively chaotic pairings into a system of fixed consistent associations. In the current study we return to this same population three years later when participants are now 10/11 years. We used the same paired-association memory task to determine the synaesthetic status of our participants and to also establish synaesthetes’ inventories of grapheme-colour associations. We compared their inventories to those from age 6/7 year and 7/8 years to examine how synaesthesia matures over time. Together with earlier findings, our study shows that grapheme-colour synaesthesia emerges with a protracted lineal trajectory, with 34% of letters/digits fixed at age 6/7 years, 48% fixed at 7/8 years and 71% fixed at 10/11 years. We also show several cases where synaesthesia is not developing in the same time-frame as peers, either because it has died out at an older age, or because it was slower to develop than other cases. Our study paints the first picture of the emergence of synaesthesia in real-time over four years within a randomly sampled population of child synaesthetes.

  12. The gender- and age-specific 10-year and lifetime absolute fracture risk in Tromso, Norway

    International Nuclear Information System (INIS)

    Ahmed, Luai A.; Schirmer, Henrik; Bjornerem, Ashild; Emaus, Nina; Jorgensen, Lone; Stormer, Jan; Joakimsen, Ragnar M.

    2009-01-01

    Aim of this study is to estimate the gender- and age-specific 10-year and lifetime absolute risks of non-vertebral and osteoporotic (included hip, distal forearm and proximal humerus) fractures in a large cohort of men and women. This is a population-based 10 years follow-up study of 26,891 subjects aged 25 years and older in Tromso, Norway. All non-vertebral fractures were registered from 1995 throughout 2004 by computerized search in radiographic archives. Absolute risks were estimated by life-table method taking into account the competing risk of death. The absolute fracture risk at each year of age was estimated for the next 10 years (10-year risk) or up to the age of 90 years (lifetime risk). The estimated 10-year absolute risk of all non-vertebral fracture was higher in men than women before but not after the age of 45 years. The 10-year absolute risk for non-vertebral and osteoporotic fractures was over 10%, respectively, in men over 65 and 70 years and in women over 45 and 50 years of age. The 10-year absolute risks of hip fractures at the age of 65 and 80 years were 4.2 and 18.6% in men, and 9.0 and 24.0% in women, respectively. The risk estimates for distal forearm and proximal humerus fractures were under 5% in men and 13% in women. The estimated lifetime risks for all fracture locations were higher in women than men at all ages. At the age of 50 years, the risks were 38.1 and 24.8% in men and 67.4 and 55.0% in women for all non-vertebral and osteoporotic fractures, respectively. The estimated gender- and age-specific 10-year and lifetime absolute fracture risk were higher in Tromso than in other populations. The high lifetime fracture risk reflects the increased burden of fractures in this cohort

  13. Personal Dosimetry in UHC Sestre Milosrdnice: 10-Years Review

    International Nuclear Information System (INIS)

    Bokulic, T.; Budanec, M; Gregov, M.; Kusic, Z.; Mlinaric, M.; Mrcela, I.; Suric Mihic, M.

    2013-01-01

    Personal dose monitoring in UHC 'Sestre milosrdnice' is regulary performed for about 300 exposed workers involved in a variety of tasks with different sources of ionizing radiation. Exposed workers are required to wear personal dosimeters which are read on monthly basis and dose records are kept in the hospital. In this paper an overview of personal dosimetry data from year 2003 till 2013 is presented. Film dosimeters were used for personal dosimetry untill 2010 when the thermoluminescent (TL) dosimetry was introduced. Dosimeters are calibrated to measure personal dose equivalent H p (10). Received doses are analyzed for workers in the field of nuclear medicine, radiotherapy (external beam and brachytherapy), general diagnostic radiology and interventional radiology. Analysis of received doses in the whole period resulted with an average individual dose in nuclear medicine of 0.6 mSv/y, which decreased to 0.21 mSv/y in the last three years, caused by more precise dosimetric methods with TL dosimetry and improved conditions of radiation protection. In the same three-year period, in interventional radiology doses were 0.32 mSv/y, compared to 0.29 mSv/y obtained for a previous seven years. This was expected due to the escalation in a number of interventions and new installed equipment. There was no such difference in diagnostic radiology doses, showing that film dosimetry is suitable for x ray energies. Analysis of all the readings showed a significant influence of measurement procedures on personal dosimeter dose and also the importance of continuous monitoring of the dose records in order to improve the conditions of radiation protection and achieving the ALARA goal.(author)

  14. 10-Year prospective study of noise exposure and hearing damage among construction workers

    Science.gov (United States)

    Seixas, Noah S; Neitzel, Rick; Stover, Bert; Sheppard, Lianne; Feeney, Patrick; Mills, David; Kujawa, Sharon

    2015-01-01

    Objectives To characterise the effects of noise exposure, including intermittent and peaky exposure, on hearing damage as assessed by standard pure-tone thresholds and otoacoustic emissions, a longitudinal study was conducted on newly hired construction apprentices and controls over a 10-year period. Methods Among the 456 subjects recruited at baseline, 316 had at least two (mean 4.6) examinations and were included in this analysis. Annual examinations included hearing threshold levels (HTLs) for air conducted pure tones and distortion product otoacoustic emission (DPOAE) amplitudes. Task-based occupational noise exposure levels and recreational exposures were estimated. Linear mixed models were fit for HTLs and DPOAEs at 3, 4 and 6 kHz in relation to time since baseline and average noise level since baseline, while controlling for hearing level at baseline and other risk factors. Results Estimated LEQ noise exposures were 87±3.6 dBA among the construction workers. Linear mixed modelling demonstrated significant exposure-related elevations in HTL of about 2–3 dB over a projected 10-year period at 3, 4 or 6 kHz for a 10 dB increase in exposure. The DPOAE models (using L1=40) predicted about 1 dB decrease in emission amplitude over 10 years for a 10 dB increase in exposure. Conclusions The study provides evidence of noise-induced damage at an average exposure level around the 85 dBA level. The predicted change in HTLs was somewhat higher than would be predicted by standard hearing loss models, after accounting for hearing loss at baseline. Limited evidence for an enhanced effect of high peak component noise was observed, and DPOAEs, although similarly affected, showed no advantage over standard hearing threshold evaluation in detecting effects of noise on the ear and hearing. PMID:22693267

  15. Lung cancer - hopelessness when inoperability? The 10-year follow-up study; Lungenkrebs - Hoffnungslosigkeit bei Inoperabilitaet? 10 Jahre danach

    Energy Technology Data Exchange (ETDEWEB)

    Schwegler, N. [Kantonsspital Aarau (Switzerland). Abt. fuer Strahlentherapie

    1997-07-01

    Background: According to reports of Durrant et al. [19] and Berry et al. [5] it was concluded that non-operable non-small cell lung tumors cannot be cured. In this consequence initiation of radiotherapy was fixed at the beginning of symptoms. However, long-time survivors in our follow-up lead us to analyse not only quality of life and secondary therapeutic effects but also this special group with the results of the whole collective treated in the same period of interest. Results: From 145 patients with non-small cell lung cancer 64.1% (93/145) survived 6 months, 42.8% (62/145) 1 year, 19.3% (28/145) 2 years and 7.6% (11/145) 5 and 4.8 (7/145) more than 10 years. According to TN-stages T1-4 N0 collective had a survival rate of 67.8% (40/59) after half a year, 50.8% (30/59) after 1 year, 23.7% (14/59) after 2 and 11.9% (7/59) after 5 years. Treatment results by patients with positive lymph nodes T1-4 N1-3 after the same intervals are: 61.6% (53/86), 37.2% (32/86), 16.2% (14/86) respectively 4.7% (4/86). In the period 5 to 10 years after irradiation 4 patients died, 1 with local relapse, 2 with contralateral lung cancer - ipsilateral region was endoscopically and histologically free of tumor - and 1 patient in consequence of heart insufficency of several years. Seven patients are still alive after 13 to 16 years. There is no sign of tumor in this group or any effects limitating their quality of life. Twenty-four patients received less than 50 Gy. All patients but 2 did not survive 6 months. One patient survived half a year and 1 patient 2 years. (orig./AJ) [Deutsch] Hintergrund: Nach Publikationen von Durrant et al. [19] und Berry et al. [5] im Laufe der siebziger Jahre machte sich beim inoperablen Bronchuskarzinom in manchen onkologischen Zentren ein therapeutischer Nihilismus breit. Diesem damaligen Trend hatten wir uns trotz begrenzter technischer Mittel nicht angeschlossen. Begegnungen im Rahmen der Nachsorge mit Langzeitueberlebenden nach lokal

  16. Second conservative radiosurgical treatment for ipsilateral breast cancer recurrence

    International Nuclear Information System (INIS)

    Castelli, J.; Courdi, A.; Hannoun-Levi, J.M.; Figl, A.; Raoust, I.; Lallement, M.; Flipo, B.; Ettore, F.; Chapelier, C.; Ferrero, J.M.

    2011-01-01

    Purpose. - Currently, radical mastectomy represents the gold standard for ipsilateral breast cancer recurrence. However, we already showed that a second conservative treatment was feasible combining lumpectomy plus low-dose rate interstitial brachytherapy. In this study, we reported the preliminary results of a second conservative treatment using a high-dose rate brachytherapy. Patients and methods. - From June 2005 to July 2009, 42 patients presenting with an ipsilateral breast cancer recurrence underwent a second conservative treatment. Plastic tubes were implanted intraoperatively at the time of the lumpectomy. After a post-implant CT scan, a total dose of 34 Gy in 10 fractions over 5 consecutive days was delivered through an ambulatory procedure. The toxicity evaluation used the Common Terminology Criteria for Adverse Events v3.0. Results. - The median follow-up was 21 months (6-50 months), median age at the time of the local recurrence was 65 years (30-85 years). The median delay between the primary and the recurrence was 11 years (1-35 years). The location of the recurrence was in the tumor bed for 22 patients (52.4%), in the same quadrant for 14 patients (33.3%) and unknown for six patients (14.3%). The median tumor size of the recurrence was 12 mm (2-30 mm). The median number of plastic tubes and plans were nine (5-12) and two (1-3) respectively. The median CTV was 68 cm 3 (31.2-146 cm 3 ). The rate of second local control was 97%. Twenty-two patients (60%) experienced complications. The most frequent side effect consisted in cutaneous and sub-cutaneous fibrosis (72% of all the observed complications). Conclusion. - A second conservative treatment for ipsilateral breast cancer recurrence using high-dose rate brachytherapy appears feasible leading to encouraging results in terms of second local control with an acceptable toxicity. Considering that a non-inferiority randomized trial comparing mastectomy versus second conservative treatment could be difficult

  17. The past 10 years of gastroenterology and hepatology-reflections and predictions.

    Science.gov (United States)

    Friedman, Scott L; Quigley, Eamonn M M; Sharkey, Keith A; Sung, Joseph J Y; Whitcomb, David C

    2014-11-01

    In November 2004, the very first issue of this journal featured articles on the pathogenesis of ulcerative colitis, mechanisms leading to chronic pancreatitis, and treatment of recurrent Clostridium-difficile-associated diarrhoea. Although those topics might seem familiar, much has changed in the intervening years in our understanding, diagnosis and treatment of many different diseases across the field of gastroenterology and hepatology. Nonetheless, many challenges remain. Here, we have asked five of our Advisory Board members-international experts across different subspecialties in gastroenterology and hepatology-to reflect on the progress and frustrations of the past 10 years. They also comment on where effort and money should be invested now, as well as their predictions for progress in the next 10 years.

  18. Prostate-specific antigen (PSA) testing of men in UK general practice: a 10-year longitudinal cohort study.

    Science.gov (United States)

    Young, Grace J; Harrison, Sean; Turner, Emma L; Walsh, Eleanor I; Oliver, Steven E; Ben-Shlomo, Yoav; Evans, Simon; Lane, J Athene; Neal, David E; Hamdy, Freddie C; Donovan, Jenny L; Martin, Richard M; Metcalfe, Chris

    2017-10-30

    Cross-sectional studies suggest that around 6% of men undergo prostate-specific antigen (PSA) testing each year in UK general practice (GP). This longitudinal study aims to determine the cumulative testing pattern of men over a 10-year period and whether this testing can be considered equivalent to screening for prostate cancer (PCa). Patient-level data on PSA tests, biopsies and PCa diagnoses were obtained from the UK Clinical Practice Research Datalink (CPRD) for the years 2002 to 2011. The cumulative risks of PSA testing and of being diagnosed with PCa were estimated for the 10-year study period. Associations of a man's age, region and index of multiple deprivation with the cumulative risk of PSA testing and PCa diagnosis were investigated. Rates of biopsy and diagnosis, following a high test result, were compared with those from the programme of PSA testing in the Prostate Testing for Cancer and Treatment (ProtecT) study. The 10-year risk of exposure to at least one PSA test in men aged 45 to 69 years in UK GP was 39.2% (95% CI 39.0 to 39.4%). The age-specific risks ranged from 25.2% for men aged 45-49 years to 53.0% for men aged 65-69 years (p for trend PSA level ≥3, a test in UK GP was less likely to result in a biopsy (6%) and/or diagnosis of PCa (15%) compared with ProtecT study participants (85% and 34%, respectively). A high proportion of men aged 45-69 years undergo PSA tests in UK GP: 39% over a 10-year period. A high proportion of these tests appear to be for the investigation of lower urinary tract symptoms and not screening for PCa. ISRCTN20141297,NCT02044172. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Effects of time and recall of patch test results on quality of life (QoL) after testing. Cross-sectional study analyzing QoL in hand eczema patients 1, 5 and 10years after patch testing.

    Science.gov (United States)

    Jamil, Wasim N; Lindberg, Magnus

    2017-08-01

    Patch testing can improve health-related quality of life (HRQOL). To study the impact on HRQOL of elapsed time after patch testing (1-10years), and how the outcome of testing and patients' recall affects HRQOL. The Dermatology Life Quality Index (DLQI) questionnaire was sent to all patients (aged 18-65 years) who were patch tested for suspected contact allergy in 2009, 2005 and 2000 at the Department of Dermatology in Örebro. The response rate was 51% (n = 256). The DLQI score was significantly lower at 10years after patch testing (mean DLQI = 5.5) than at 1 year (mean DLQI = 7.7). Work was the most impaired aspect. A binary logistic model showed that only time (10years after testing) was associated with no effect, a light effect or a moderate effect (DLQI negative or positive test results concerning full recall, partial recall or no recall of diagnosed allergens. Although there was an improvement in HRQOL over time, the work aspect remained a major problem. The improvement was not affected by the outcome of testing and patients' recall of test results. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Syndrome! Polysplenia ina 10 year old girl | Ganiyu | Tropical ...

    African Journals Online (AJOL)

    We present a case of 10 year old patient with polysplenia, situs inversus abdominus, malrotation of bowel and renal anomalies. Polyspenia Syndrome refers to presence of two or more spleens associated with various abnormalities in chest and abdomen. Situs inversus is present in about 20% of cases Polysplenia ...

  1. Posterior circulation aneurysms: A 10-year institutional analysis

    Directory of Open Access Journals (Sweden)

    Saurabh Sharma

    2012-01-01

    Full Text Available Background : Aneurysms are uncommon and challenging to manage. Materials and Methods: A retrospective study was designed to report 53 patients who are treated from June 2002 to June 2011. Results: The mean age at presentation was 46.34 ± 13.67 years (males, 26. Clinical features included subarachnoid hemorrhage (median Hunt and Hess Grade II, n = 42, cranial nerve palsies (9, hydrocephalus (5, and incidentally diagnosed (5. Locations included superior cerebellar artery (3, posterior cerebral artery (2, basilar trunk (4, vertebral (8, anterior inferior cerebellar artery (AICA (5, posterior inferior cerebellar artery (PICA (13, vertebrobasilar junction (6, and basilar top (13. Management included both endovascular intervention (26 and surgery (19, and both (2. Five patients presented as poor grade and underwent only extraventricular drain placement while one patient had thrombosed aneurysm and was managed conservatively. Mortality was 26.4% (n = 14 and morbidity included vasospasm (10, meningitis (2, pseudomeningocele (2, pneumonitis (2, and myocardial infarction (1. Conclusion: Posterior circulation aneurysms are highly challenging. They require the multimodality approach, and decision regarding surgery or embolization has to be individualized.

  2. Outcomes of multiple wire localization for larger breast cancers: when can mastectomy be avoided?

    Science.gov (United States)

    Kirstein, Laurie J; Rafferty, Elizabeth; Specht, Michelle C; Moore, Richard H; Taghian, Alphonse G; Hughes, Kevin S; Gadd, Michele A; Smith, Barbara L

    2008-09-01

    Mastectomy is often recommended when mammography shows a breast cancer with extensive calcifications. We wished to determine whether the use of multiple localizing wires to guide lumpectomy in this setting was associated with increased rates of breast conservation. We also wanted to identify factors that predicted a poor chance of successful lumpectomy, to avoid multiple lumpectomy attempts in a patient who would ultimately require mastectomy. Records of 153 women with breast cancer who underwent lumpectomy for larger lesions that required multiple wire localization and 196 controls who required only single wire localization were reviewed retrospectively. The number of localizing wires, specimen volume, largest specimen dimension, number of surgical procedures, and rates of breast conservation were scored. Seventy-seven percent of patients requiring multiple wire localization had successful breast conservation, compared with 90% of those needing only single wire localization. Only 28% of multiple wire patients required more than 1 excision to achieve clear margins, compared with 36% of single wire patients (p localizing wires for excision. The use of multiple wires can decrease the number of procedures required to obtain clear lumpectomy margins.

  3. Duodenal adenocarcinoma in a 10-year-old boy | Mohamed ...

    African Journals Online (AJOL)

    Gastrointestinal malignancies are extremely rare in the paediatric population and duodenal cancers represent an even more unusual entity. It represents 0.3-1% of all gastrointestinal tumours. A case report of a 10-year-old boy with duodenal adenocarcinoma is reported and the diffi culties of diagnosing and treating this ...

  4. 10-year survival of total ankle arthroplasties: a report on 780 cases from the Swedish Ankle Register.

    Science.gov (United States)

    Henricson, Anders; Nilsson, Jan-Åke; Carlsson, Ake

    2011-12-01

    There is an ongoing need to review large series of total ankle replacements (TARs) for monitoring of changes in practice and their outcome. 4 national registries, including the Swedish Ankle Register, have previously reported their 5-year results. We now present an extended series with a longer follow-up, and with a 10-year survival analysis. Records of uncemented 3-component TARs were retrospectively reviewed, determining risk factors such as age, sex, and diagnosis. Prosthetic survival rates were calculated with exchange or removal of components as endpoint-excluding incidental exchange of the polyethylene meniscus. Of the 780 prostheses implanted since 1993, 168 (22%) had been revised by June 15, 2010. The overall survival rate fell from 0.81 (95% CI: 0.79-0.83) at 5 years to 0.69 (95% CI: 0.67-0.71) at 10 years. The survival rate was higher, although not statistically significantly so, during the latter part of the period investigated. Excluding the STAR prosthesis, the survival rate for all the remaining designs was 0.78 at 10 years. Women below the age of 60 with osteoarthritis were at a higher risk of revision, but age did not influence the outcome in men or women with rheumatoid arthritis. Revisions due to technical mistakes at the index surgery and instability were undertaken earlier than revisions for other reasons. The results have slowly improved during the 18-year period investigated. However, we do not believe that the survival rates of ankle replacements in the near future will approach those of hip and knee replacements-even though improved instrumentation and design of the prostheses, together with better patient selection, will presumably give better results.

  5. Organizational results : annual report, fiscal year 2010.

    Science.gov (United States)

    2010-01-01

    What can you do in five years? Pay off a car? Send your kid to college? How about change an : organizations culture? Over the past five years thats what Organizational Results has attempted to do. : By placing business process experts and resea...

  6. Results of patch testing in 10 patients with peristomal dermatitis.

    Science.gov (United States)

    Landis, Megan N; Keeling, James H; Yiannias, James A; Richardson, Donna M; Nordberg Linehan, Diane L; Davis, Mark D P

    2012-09-01

    Peristomal dermatitis is a common problem in patients with ostomies that is a source of considerable morbidity. Irritant contact dermatitis is most common, but allergic contact dermatitis can also occur. Because of the lack of published reports on patch testing for this indication, we undertook a retrospective study of patch testing results in patients with suspected peristomal allergic contact dermatitis. We sought to describe our patch testing experience with patients referred with peristomal dermatitis. This was a retrospective review of medical records of patients with ostomies and peristomal dermatitis who underwent patch testing in the Mayo Clinic Departments of Dermatology in Jacksonville, FL; Rochester, MN; and Scottsdale, AZ, during a 10-year period (2000-2010). Ten patients with peristomal dermatitis were referred for patch testing (6 in Minnesota, 2 in Florida, and 2 in Arizona). Patients were patch tested to the materials used in their stoma devices, to the standard series, and in some cases to supplemental series. All 10 had at least one allergic patch test reaction, most commonly to stoma paste (3 of 10 patients). Retrospective nature of study via chart review is a limitation. Patch testing is a useful tool for identification of allergens in patients with peristomal dermatitis. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  7. A longitudinal study of grapheme-color synesthesia in childhood: 6/7 years to 10/11 years.

    Science.gov (United States)

    Simner, Julia; Bain, Angela E

    2013-01-01

    Grapheme-color synesthesia is a condition characterized by enduring and consistent associations between letter/digits and colors. This study is the continuation of longitudinal research begun by Simner et al. (2009) which aimed to explore the development of this condition in real time within a childhood population. In that earlier study we randomly sampled over 600 children and tested them aged 6/7 and 7/8 years. We identified the child synesthetes within that cohort and measured their development over 1 year, in comparison to a group of non-synesthetic children with both average and superior memories. We were able to show the beginnings of a developmental progression in which synesthetic associations (e.g., A = red) mature over time from relatively chaotic pairings into a system of fixed consistent associations. In the current study we return to this same population three years later when participants are now 10/11 years. We used the same paired-association memory task to determine the synesthetic status of our participants and to also establish synesthetes' inventories of grapheme-color associations. We compared their inventories to those from age 6/7 and 7/8 years to examine how synesthesia matures over time. Together with earlier findings, our study shows that grapheme-color synesthesia emerges with a protracted trajectory, with 34% of letters/digits fixed at age 6/7 years, 48% fixed at 7/8 years and 71% fixed at 10/11 years. We also show several cases where synesthesia is not developing in the same time-frame as peers, either because it has died out at an older age, or because it was slower to develop than other cases. Our study paints the first picture of the emergence of synesthesia in real-time over four years within a randomly sampled population of child synesthetes.

  8. Assessment of imatinib as first-line treatment of chronic myeloid leukemia: 10-year survival results of the randomized CML study IV and impact of non-CML determinants.

    Science.gov (United States)

    Hehlmann, R; Lauseker, M; Saußele, S; Pfirrmann, M; Krause, S; Kolb, H J; Neubauer, A; Hossfeld, D K; Nerl, C; Gratwohl, A; Baerlocher, G M; Heim, D; Brümmendorf, T H; Fabarius, A; Haferlach, C; Schlegelberger, B; Müller, M C; Jeromin, S; Proetel, U; Kohlbrenner, K; Voskanyan, A; Rinaldetti, S; Seifarth, W; Spieß, B; Balleisen, L; Goebeler, M C; Hänel, M; Ho, A; Dengler, J; Falge, C; Kanz, L; Kremers, S; Burchert, A; Kneba, M; Stegelmann, F; Köhne, C A; Lindemann, H W; Waller, C F; Pfreundschuh, M; Spiekermann, K; Berdel, W E; Müller, L; Edinger, M; Mayer, J; Beelen, D W; Bentz, M; Link, H; Hertenstein, B; Fuchs, R; Wernli, M; Schlegel, F; Schlag, R; de Wit, M; Trümper, L; Hebart, H; Hahn, M; Thomalla, J; Scheid, C; Schafhausen, P; Verbeek, W; Eckart, M J; Gassmann, W; Pezzutto, A; Schenk, M; Brossart, P; Geer, T; Bildat, S; Schäfer, E; Hochhaus, A; Hasford, J

    2017-11-01

    Chronic myeloid leukemia (CML)-study IV was designed to explore whether treatment with imatinib (IM) at 400 mg/day (n=400) could be optimized by doubling the dose (n=420), adding interferon (IFN) (n=430) or cytarabine (n=158) or using IM after IFN-failure (n=128). From July 2002 to March 2012, 1551 newly diagnosed patients in chronic phase were randomized into a 5-arm study. The study was powered to detect a survival difference of 5% at 5 years. After a median observation time of 9.5 years, 10-year overall survival was 82%, 10-year progression-free survival was 80% and 10-year relative survival was 92%. Survival between IM400 mg and any experimental arm was not different. In a multivariate analysis, risk group, major-route chromosomal aberrations, comorbidities, smoking and treatment center (academic vs other) influenced survival significantly, but not any form of treatment optimization. Patients reaching the molecular response milestones at 3, 6 and 12 months had a significant survival advantage. For responders, monotherapy with IM400 mg provides a close to normal life expectancy independent of the time to response. Survival is more determined by patients' and disease factors than by initial treatment selection. Although improvements are also needed for refractory disease, more life-time can currently be gained by carefully addressing non-CML determinants of survival.

  9. Results of LIA-10M accelerator investigations

    CERN Document Server

    Gordeev, V S; Filippov, V O

    2001-01-01

    There are presented basic results of experiments on the LIA-10M accelerator since its putting into operation (1994) till today. There were investigated various modes of accelerator operation and its output characteristics depending on the parameters of injected electron beam,number of connected accelerator modules,time program of inductors switch-in etc. There was obtained a large scope of experimental data that are of interest for LIA-10M accelerator practical use and for the development of new facilities of this type. The investigations that have been performed recently make it possible to considerably (half as much again) increase the output dose parameters of the accelerator as compared to the level achieved before:maximal dose(Si) and dose rate on the output flange constitute 400 Gy and 2.5 centre dot 10 Gy/s, while at a 1 meter distance from the target they are equal to 7.5 Gy and 5 centre dot 10 sup 8 Gy/s, respectively.

  10. 10-year evaluation of train accidents.

    Science.gov (United States)

    Akkaş, Meltem; Ay, Didem; Metin Aksu, Nalan; Günalp, Müge

    2011-09-01

    Although less frequent than automobile accidents, train accidents have a major impact on victims' lives. Records of patients older than 16 years of age admitted to the Adult Emergency Department of Hacettepe University Medical Center due to train accidents were retrospectively evaluated. 44 patients (30 males, 14 females) with a mean age of 31.8±11.4 years were included in the study. The majority of the accidents occurred during commuting hours. 37 patients were discharged, 22 of them from the emergency department. The mortality rate was 7/44 (16%). Overall mean Revised Trauma Score (RTS) was 10.5 (3 in deaths and 11.9 in survivors). In 5 patients, the cause of death was pelvic trauma leading to major vascular injury and lower limb amputation. In 1 patient, thorax and abdomen trauma and in 1 patient head injury were the causes of mortality. Primary risk factors for mortality were alcohol intoxication (100%), cardiopulmonary resuscitation on admittance (100%), recurrent suicide attempt (75%), presence of psychiatric illness (60%), and low RTS. In this study, most train accidents causing minor injuries were due to falling from the train prior to acceleration. Nevertheless, train accidents led to a mortality rate of 16% and morbidity rate of 37%. These findings draw attention to the importance of developing preventive strategies.

  11. Weight Suppression Predicts Maintenance and Onset of Bulimic Syndromes at 10-Year Follow-up

    Science.gov (United States)

    Keel, Pamela K.; Heatherton, Todd F.

    2010-01-01

    Conflicting results have emerged regarding the prognostic significance of weight suppression for maintenance of bulimic symptoms. This study examined whether the magnitude of weight suppression would predict bulimic syndrome maintenance and onset in college-based samples of men (n=369) and women (n=968) at 10-year follow-up. Data come from a longitudinal study of body weight and disordered eating with high retention (80%). Among those with a bulimic syndrome at baseline, greater weight suppression significantly predicted maintenance of the syndrome, and, among those without a bulimic syndrome at baseline, greater weight suppression predicted onset of a bulimic syndrome at 10-year follow-up in multivariate models that included baseline body mass index, diet frequency, and weight perception. Future research should address mechanisms that could account for the effects of weight suppression over a long duration of follow-up. PMID:20455599

  12. Hong Kong domestic health spending: financial years 1989/90 to 2009/10.

    Science.gov (United States)

    Tin, K Y K; Tsoi, P K O; Lee, Y H; Tsui, E L H; Lam, D W S; Chui, A W M; Lo, S V

    2013-04-01

    This report presents the latest estimates of Hong Kong domestic health spending for financial years 1989/90 to 2009/10, cross-stratified and categorised by financing source, provider and function. Total expenditure on health (TEH) was HK$88,721 million in financial year 2009/10, which represents an increase of HK$5031 million or 6.0% over the preceding year. As a result of a slow revival in the economy from the financial tsunami in 2008, TEH grew faster relative to gross domestic product (GDP) leading to a marked increase in TEH as a percentage of GDP from 5.0% in 2008/09 to 5.2% in 2009/10. During the period 1989/90 to 2009/10, total health spending per capita (at constant 2010 prices) grew at an average annual rate of 4.9%, which was faster than the average annual growth rate of per capita GDP by 2.0 percentage points. In 2009/10, public and private expenditure on health increased by 6.2% and 5.8% when compared with 2008/09, reaching HK$43,823 million and HK$44,898 million, respectively. Consequently, public and private shares of total health expenditure stayed at similar levels (49% and 51% respectively) in the 2 years. With respect to private spending, the most important source of health financing was out-of-pocket payments by households (34.9% of TEH), followed by employer-provided group medical benefits (7.4%) and private insurance (6.8%). During the period, a growing number of households (mostly in middle to high income groups) have taken out pre-payment plans to finance health care. As such, private insurance has taken on an increasingly important role in financing private spending. Of the HK$88,721 million total health expenditure in 2009/10, current expenditure comprised HK$84,874 million (95.7%), whereas HK$3847 million (4.3%) was for capital expenses (ie investment in medical facilities). Analysed by health care function, services for curative care accounted for the largest share (66.2%), which was made up of ambulatory services (33.5%), in

  13. Growing up with Down syndrome: Development from 6 months to 10.7 years

    NARCIS (Netherlands)

    Marchal, Jan Pieter; Maurice-Stam, Heleen; Houtzager, Bregje A.; Rutgers van Rozenburg-Marres, Susanne L.; Oostrom, Kim J.; Grootenhuis, Martha A.; van Trotsenburg, A. S. Paul

    2016-01-01

    We analysed developmental outcomes from a clinical trial early in life and its follow-up at 10.7 years in 123 children with Down syndrome. To determine 1) strengths and weaknesses in adaptive functioning and motor skills at 10.7 years, and 2) prognostic value of early-life characteristics (early

  14. Gingival recession in school kids aged 10-15 years in Udaipur, India

    Directory of Open Access Journals (Sweden)

    Mathur Anmol

    2009-01-01

    Full Text Available Aim : The study aimed to determine the incidence of gingival recession in the mandibular central incisor region among school children aged 10-15 years in Udaipur (India. Materials and Methods : A sample of 1800 males and female kids were examined in a mobile dental unit. World Health Organisation (WHO rules and standards were followed. Result : Gingival recession, when compared, with respect to age, mean clinical crown length, anterior crowding and frenal involvement was significant (p less than 0.00 with respect to affected teeth.

  15. Kinematic characteristics of the ski jump inrun: a 10-year longitudinal study.

    Science.gov (United States)

    Janura, Miroslav; Cabell, Lee; Elfmark, Milan; Vaverka, Frantisek

    2010-05-01

    The athlete's inrun position affects the outcome for take-off in ski jumping. The purpose of this study was to examine the kinematic parameters between skiers' adjacent body segments during their first straight path of the inrun. Elite ski jumpers participated in the study at the World Cup events in Innsbruck, Austria, during the years 1992 through 2001. A video image was taken at a right angle to the tracks of the K-110 (meter) jumping hill. Kinematic data were collected from the lower extremities and trunk of the athletes. Findings indicated that jumpers had diminished ankle and knee joint angles and increased trunk and hip angles over the 10 years. In recent years, the best athletes achieved a further length of their jumps, while they experienced slower inrun average velocity. These results are perhaps explained by several possible contributing factors, such as new technique of the jumper's body kinematics, advancements in equipment technology, and somatotype of the jumpers.

  16. Nebraska wind resource assessment first year results

    Energy Technology Data Exchange (ETDEWEB)

    Hurley, P.J.F.; Vilhauer, R. [RLA Consulting, Inc., Bothell, WA (United States); Stooksbury, D. [Univ. of Nebraska, Lincoln, NE (United States)

    1996-12-31

    This paper presents the preliminary results from a wind resource assessment program in Nebraska sponsored by the Nebraska Power Association. During the first year the measured annual wind speed at 40 meters ranged from 6.5 - 7.5 m/s (14.6 - 16.8 mph) at eight stations across the state. The site selection process is discussed as well as an overview of the site characteristics at the monitoring locations. Results from the first year monitoring period including data recovery rate, directionality, average wind speeds, wind shear, and turbulence intensity are presented. Results from the eight sites are qualitatively compared with other midwest and west coast locations. 5 figs., 2 tabs.

  17. Antipsychotic medication and remission of psychotic symptoms 10 years after a first-episode psychosis

    DEFF Research Database (Denmark)

    Wils, Regitze Sølling; Gotfredsen, Ditte Resendal; Hjorthøj, Carsten

    2017-01-01

    medication for a period of time. This study investigated the long-term outcome and characteristics of patients in remission of psychotic symptoms with no use of antipsychotic medication at the 10-year follow-up. METHODS: The study was a cohort study including 496 patients diagnosed with schizophrenia...... spectrum disorders (ICD 10: F20 and F22-29). Patients were included in the Danish OPUS Trial and followed up 10years after inclusion, where patient data was collected on socio-demographic factors, psychopathology, level of functioning and medication. FINDINGS: 61% of the patients from the original cohort...... attended the 10-year follow up and 30% of these had remission of psychotic symptoms at the time of the 10-year follow up with no current use of antipsychotic medication. This outcome was associated with female gender, high GAF-F score, participation in the labour market and absence of substance abuse...

  18. Alternative Evaluation of the Agrarian Sector in Guatemala 10 Years ...

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

    Alternative Evaluation of the Agrarian Sector in Guatemala 10 Years after the ... in research and advocacy for agrarian legislation ever since the adoption of the ... conference of McGill's Institute for the Study of International Development.

  19. Ten-year results of thoracoscopic unilateral extended thymectomy performed in nonthymomatous myasthenia gravis.

    Science.gov (United States)

    Tomulescu, Victor; Sgarbura, Olivia; Stanescu, Codrut; Valciu, Crisanda; Campeanu, Ana; Herlea, Vlad; Popescu, Irinel

    2011-11-01

    The aim of this study was to analyze the 10-year results of thoracoscopic unilateral extended thymectomy (TUET) performed in nontumoral myasthenia gravis according to the Myasthenia Gravis Foundation of America recommendations. Thoracoscopic unilateral extended thymectomy has the benefits of a minimally invasive approach. Previous data have shown promising midterm results but long-term results were lacking. Two hundred forty patients with nontumoral myasthenia gravis who underwent surgery between 1999 and 2009 were eligible for the study. The mean follow-up was of 67 months (range: 12-125), 134 patients completed follow-up assessments more than 60 months after TUET. There were 39 males (16.3%) and 201 females (83.7%), with an age range from 8 to 60 years. The mean preoperative disease duration was 21.5 months. All patients underwent preoperative steroid therapy. Anticholinesterase drugs were required for 123 patients (51.3%), and immunosuppressive drugs were required for 87 (36.3%) patients. The pathologic findings were as follows: normal thymus in 13 patients (5.5%), involuted thymus in 65 patients (27%), and hyperplastic thymus in 162 patients (67.5%). The average weight of the thymus was 110 ± 45 g. Ectopic thymic tissue was found in 147 patients (61.3%). There was no mortality, and morbidity consisted of 12 patients (5%). Complete stable remission was achieved in 61% of the patients, and the cumulative probability of achieving complete stable remission was 0.88 at 10 years. With zero mortality, low morbidity, and comparable long-term results to open surgery, TUET can be regarded as the best treatment option for patients undergoing surgery for myasthenia gravis.

  20. 24 CFR 203.203 - Issuance and nature of insured 10-year protection plans.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Issuance and nature of insured 10... Underwriting Procedures Insured Ten-Year Protection Plans (plan) § 203.203 Issuance and nature of insured 10-year protection plans. (a) Plans may be issued: (1) By a builder, warranty company, insurance company...

  1. GRTgaz 10-year indicative development plan 2007-2016

    International Nuclear Information System (INIS)

    2007-01-01

    GRTgaz is a European leader in natural gas transmission, a world expert in gas transmission networks and systems, and an operator firmly committed to the energy transition. It owns and operates the gas transmission network throughout most of France and it manages the transmission network in Germany, thereby helping to ensure correct operation of the French and European gas market. It contributes to the energy security of regional supply systems and performs a public service mission to ensure the continuity of consumer supply. In accordance with the French Energy Code, GRTgaz publishes a 10-year development plan for its gas distribution network in France every year. This document is produced in line with European and French energy policies. It identifies the transport infrastructure that will need to be built over the next three years, and presents the main infrastructure that is likely to be developed within the next ten years. It incorporates the supply security obligations that TSOs are required to fulfil. It takes account of interested parties' needs and projects at the national, supranational and European levels. It is based on existing gas supply and demand and reasonable medium-term development forecasts for gas infrastructure, consumption and international trade

  2. Relationship Between Somatotype and PHV in Iranian 7-10 Years Old Boys

    OpenAIRE

    Amir Hossein Barati; Ali Pashabadi; Mohamadreza Mahmoudkhani; Majid Nayeri

    2013-01-01

    Introduction: An important variable in investigation of agility during puberty is the age of reaching peak high velocity, which like other agility indicators is under the effect of different factors such as physical condition and type. The purpose of present research was to examine relationship between somatotype and peak high velocity (PHV) among Iranian 7-10 years old boys. Methods: Participants were 313 7-10 year-old members of Basij talent identification centers in all Iran's provinces...

  3. INTRASTROMAL CORNEAL RING SEGMENTS (ICRS, KERAVISION RING, INTACSTM: CLINICAL RESULTS AFTER 2 YEARS

    Directory of Open Access Journals (Sweden)

    Josef Ruckhofer

    2002-12-01

    Full Text Available Background. Since 1996 Intrastromal Corneal Ring Segments (IntacsTM, KeraVision, Inc.Fremont, Ca, USA have been used for the correction of mild to moderate myopia at the Salzburg Eye Clinic. Aim of this study was to evaluate the stability, reversibility and adjustability for this new method.Patients and methods. Our experience and final results of 54 surgeries – 30 eyes with a minimum follow-up of 2 years – as well as the potential reversibility (3 explantations, 2 of them followed by PRK and adjustability (3 exchanges are reported in detail.Results. None of the eyes lost more than one line in BSCVA (in 14 of 30 eyes the BSCVA improved. 73% (22/30 eyes reached an UCVA of 1.0 or better, 47% (14/30 eyes of 1.25 or better. After 2 years 47% (14/30 eyes were within ± 0.5 Dsph of the attempted correction. We observed no significant intraor postoperative complications. After ICRS removal the refractive data returned within ± 0.75 Dsph (MRSE and ± 0.5 Dsph (mean keratometry of preoperative values, respectively. Patients with an ICRS exchange obtained an improved visual acuity between 0.8 and 1.0, gaining between 2 to 4 lines.Conclusions. With the follow-up period of 2 years the ICRS seem to provide a very stable correction of low to moderate myopia. The procedure is reversible to a large extent, potentially adjustable (within certain limits and carries a minimal risk only. After explantation PRK can be performed with good visual results.

  4. [Accelerated partial breast irradiation with multicatheters during breast conserving surgery for cancer].

    Science.gov (United States)

    Rodríguez-Spiteri Sagredo, Natalia; Martínez Regueira, Fernando; Olartecoechea Linaje, Begoña; Arredondo Chaves, Jorge; Cambeiro Vázquez, Mauricio; Pina Insausti, Luis Javier; Elizalde Pérez, Arlette; y García-Lallana, Amaya; Sola Gallego, Jose Javier

    2013-10-01

    Accelerated partial breast irradiation (APBI) with multicatheters after lumpectomy for breast cancer (BC) may be an alternative to whole breast irradiation in selected patients. The aim is to show our 5 year experience. Between June 2007 and June 2012, 87 BC patients have been evaluated for APBI. Inclusion criteria were: age over 40 years, unifocal tumour, infiltrating ductal or intraductal carcinoma, tumour size smaller than 3 cm and no lymph node involvement. Complications, cosmetic results and local and distant recurrences were evaluated. Treatment was completed in 48 patients and contraindicated in 39. The average age of treated patients was 59 years. Operating time was 123 min with 9 implanted catheters in each patient. No complications were observed during surgery or radiotherapy. Patients were discharged from hospital after 4 days. Tumour size was 11 mm. Of these, 35 were infiltrating ductal and 13 intraductal carcinomas. A total of 44 patients received adjuvant treatment. Mean follow-up was 22 months with no evidence of local or distant recurrence. The cosmetic outcome was good or excellent in 66% of cases. APBI with multicatheter placed after lumpectomy for BC is feasible and safe but requires a strict selection of patients. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  5. Prevalence of 10-Year Risk of Cardiovascular Diseases and Associated Risks in Canadian Adults: The Contribution of Cardiometabolic Risk Assessment Introduction

    Directory of Open Access Journals (Sweden)

    Solmaz Setayeshgar

    2013-01-01

    Full Text Available Background. Cardiovascular disease (CVD is the leading cause of death in adult Canadians. Cardiometabolic risk (CMR derived from 10-year risk of cardiovascular diseases and metabolic syndrome (MetS needs to be evaluated in Canadian adults. Objective. To determine CMR among Canadian adults by sociodemographic and lifestyle characteristics. Subjects and Methods. Data from the Canadian Health Measures Survey (CHMS, Cycle 1, 2007–2009, was used. Framingham Risk Score (FRS was implemented to predict 10-year risk of CVD, and metabolic syndrome was identified using the most recent criteria. The 10-year risk of CVD was multiplied by 1.5 in individuals with MetS to obtain CMR. Data were weighted and bootstrapped to be able to generalize the results nationally. Results and Conclusion. CMR gave more accurate estimation of 10-year risk of CVD in Canadian adults from 30 to 74 years than using only FRS. The 10-year risk of CVD in Canadian adults significantly increased when CMR was taken into account from 8.10% to 9.86%. The CVD risk increased by increase in age, decrease in education, and decrease in physical activity and in smokers. Canadians with medium risk of CVD consumed significantly less fruit and vegetable juice compared to Canadians with low risk. No other dietary differences were found.

  6. Effect of Anticholinergic Medications on Falls, Fracture Risk, and Bone Mineral Density Over a 10-Year Period.

    Science.gov (United States)

    Fraser, Lisa-Ann; Adachi, Jonathan D; Leslie, William D; Goltzman, David; Josse, Robert; Prior, Jerilynn; Kaiser, Stephanie; Kreiger, Nancy; Kovacs, Christopher S; Anastassiades, Tassos P; Papaioannou, Alexandra

    2014-08-01

    Many medications used in older adults have strong anticholinergic (ACH) properties, which may increase the risk of falls and fractures. Use of these medications was identified in a population-based Canadian cohort. To identify the fall and fracture risk associated with ACH medication use. Data collection and analysis were conducted at baseline, year 5, and year 10. Cross-sectional analyses were performed to examine associations between ACH medication use and falls. Time-dependent Cox regression was used to examine time to first nontraumatic fracture. Finally, change in bone mineral density (BMD) over 10 years was compared in ACH medication users versus nonusers. Strongly ACH medications were used by 618 of 7753 participants (8.0%) at study baseline, 592 (9.5%) at year 5, and 334 (7.7%) at year 10. Unadjusted ACH medication use was associated with falls at baseline (odds ratio = 1.50; 95% CI = 1.14-1.98; P = 0.004), but the association was no longer significant after covariate adjustment. Similar results occurred at years 5 and 10. ACH medication use was associated with increased incident fracture risk before (hazard ratio = 1.22; CI = 1.13-1.32; P < 0.001) but not after covariate adjustment. Mean (SD) change in femoral neck BMD T-score over 10 years, in those using ACH medications at both years 0 and 5, was -0.60 (0.63) in ACH users versus -0.49 (0.45) in nonusers (P = 0.041), but this was not significant after covariate adjustment. ACH medications were not found to be independently associated with an increased risk of falling, fractures, or BMD loss. Rather, factors associated with ACH medication use explained the apparent associations. © The Author(s) 2014.

  7. Association between metabolic syndrome and 10-year risk of developing cardiovascular disease in a Nigerian population

    DEFF Research Database (Denmark)

    Oguoma, Victor M.; Nwose, Ezekiel U.; Skinner, Timothy C.

    2016-01-01

    Background: Prevalence of metabolic syndrome (MetS) and consequential cardiovascular disease (CVD) events are on the increase in Nigeria. The study aimed to identify the prevalence of 10-year CVD risk in a Nigerian population and assess its relationship with different indices of MetS. Method....... MetS was defined based on the Joint Scientific Statement on Harmonizing the MetS. Result: Of the 211 subjects, mean age was 51.3±17.3 years. Average risk of developing CVD in the next 10 years was 3.7±5.3%. Prevalence of low, moderate and high risk of developing CVD among study participants was 86.......3% (95% CI 82.0-91.3%), 11.8% (95% CI 6.9-16.1%) and 1.9% (95% CI 0.0-3.8%), respectively. Prevalence of MetS was 26.7% (95% CI 21.0-33.3%). There was poor agreement between MetS and the CVD risk scores (kappa=0.209, p=0.001) Conclusions: The results showed that complementary use of MetS and CVD risk...

  8. Meniscus suture repair: minimum 10-year outcomes in patients younger than 40 years compared with patients 40 and older.

    Science.gov (United States)

    Steadman, J Richard; Matheny, Lauren M; Singleton, Steven B; Johnson, Nicholas S; Rodkey, William G; Crespo, Bernardo; Briggs, Karen K

    2015-09-01

    Few studies have compared outcomes after meniscus suture repair in patients younger than 40 years versus patients 40 years and older. To document failure rates and long-term outcomes after meniscus suture repair by a single surgeon, using the inside-out technique, at a minimum 10-year follow-up in patients younger than 40 years versus those 40 years and older. Cohort study; Level of evidence, 3. This study included all patients 18 years or older who underwent meniscus suture repair with the inside-out technique by a single surgeon between January 1992 and December 2003. Patients were divided into 2 cohorts according to age: meniscus as repaired in the index surgery. Patients completed a subjective questionnaire at minimum of 10 years after arthroscopy. Outcomes measures included Lysholm, Tegner, and patient satisfaction with outcome. All data were collected prospectively. The surgeon performed 339 meniscus repairs between 1992 and 2003. The study included 181 knees in 178 patients, who had a mean age of 33 years (range, 18-70 years). Cohort 1 contained 136 knees; 16 patients (12%) were lost to follow-up and 47 (35%) underwent a subsequent knee arthroscopy. Cohort 2 contained 45 knees; 2 patients (4.4%) were lost to follow-up, 3 patients had a total knee arthroplasty, and 12 patients (28%) underwent a subsequent knee arthroscopy. In cohort 1, the meniscus repair failure rate was 5.5% (6/110), and in cohort 2 it was 5.3% (2/38) (P = .927). There was no significant difference in failure rate based on which meniscus was repaired (P = .257), concomitant anterior cruciate ligament (ACL) reconstruction (P = .092), or microfracture (P = .674). Average follow-up time for cohort 1 was 16.1 years (range, 10.0-21.9 years), with 82% follow-up (n = 73/89); average follow-up time for cohort 2 was 16.2 years (range, 10.1-21.0 years), with 93% follow-up (n = 28/30). There were no significant differences in outcomes scores after meniscus suture repair based on age cohort or meniscus

  9. Assessment of dental caries predictors in 6-year-old school children - results from 5-year retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Masood Mohd

    2012-11-01

    Full Text Available Abstract Background This was a retrospective cohort study undertaken to assess the rate and pattern of dental caries development in 6-year-old school children followed-up for a period of 5 years, and to identify baseline risk factors that were associated with 5 years caries experience in Malaysian children. Methods This 5-years retrospective cohort study comprised primary school children initially aged 6 years in 2004. Caries experience of each child was recorded annually using World Health Organization criteria. The rates of dental caries were recorded in prevalence and incidence density of carious lesions from baseline to final examination. Risk assessment was done to assess relative risk for caries after 5 years in children with baseline caries status. Simple and multiple logistic regression analysis were performed to identify significant independent risk factors for caries. Results The sample consisted of 1830 school children. All components of DMFT showed significant differences between baseline and final examination. Filled teeth (FT component of the DMFT showed the greatest increases. Results revealed the initial baseline caries level in permanent dentition was a strong predictor for future caries after 5 years (RR=3.78, 95% CI=3.48-4.10, P0.001. Logistic regression analysis showed significant association between caries occurrence and residence (urban/rural (OR=1.80, Pp observed from baseline and after 5 years was 5.80 persons/100 person-year of observation. The rate of new caries-affected tooth (IDt in the period from baseline and after 5-years was 0.76 teeth/100 teeth-year of observation. Conclusion The majority of 12-year-old school children (70% were caries-free and most of the caries were concentrated in only a small proportion (30% of them. We found that the presence of caries in permanent teeth at the age of 6 years was a strong predictor of future caries development in this population. The strong evidence of early permanent teeth

  10. Results of winglet development studies for DC-10 derivatives

    Science.gov (United States)

    Shollenberger, C. A.; Humphreys, J. W.; Heiberger, F. S.; Pearson, R. M.

    1983-01-01

    The results of investigations into the application of winglets to the DC-10 aircraft are presented. The DC-10 winglet configuration was developed and its cruise performance determined in a previous investigation. This study included high speed and low speed wind tunnel tests to evaluate aerodynamic characteristics, and a subsonic flutter wind tunnel test with accompanying analysis and evaluation of results. Additionally, a configuration integration study employed the results of the wind tunnel studies to determine the overall impact of the installation of winglets on the DC-10 aircraft. Conclusions derived from the high speed and low speed tests indicate that the winglets had no significant effects on the DC-10 stability characteristics or high speed buffet. It was determined that winglets had a minimal effect on aircraft lift characteristics and improved the low speed aircraft drag under high lift conditions. The winglets affected the DC-10 flutter characteristics by reducing the flutter speed of the basic critical mode and introducing a new critical mode involving outer wing torsion and longitudinal bending. The overall impact of winglets was determined to be of sufficient benefit to merit flight evaluation.

  11. Long-term clinical outcomes in type 1 Gaucher disease following 10 years of imiglucerase treatment.

    Science.gov (United States)

    Weinreb, Neal J; Goldblatt, Jack; Villalobos, Jacobo; Charrow, Joel; Cole, J Alexander; Kerstenetzky, Marcelo; vom Dahl, Stephan; Hollak, Carla

    2013-05-01

    We studied the effect of long-term alglucerase/imiglucerase (Ceredase®/Cerezyme®, Genzyme, a Sanofi company, Cambridge, MA, USA) treatment on hematological, visceral, and bone manifestations of Gaucher disease type 1 (GD1). The International Collaborative Gaucher Group (ICGG) Gaucher Registry identified GD1 patients treated with alglucerase/imiglucerase who had dose and clinical data at first infusion and after 10 years of follow-up. Data for hemoglobin, platelet count, organ volumes, bone pain, and bone crisis were analyzed. Tests of the null hypothesis (no change from first infusion to 10 years) were performed using t tests for within-patient absolute change in continuous measurements and McNemar/chi-square tests for change in distributions using categorical values. An alpha level of 0.05 designated statistical significance. As of October 2011, 557 nonsplenectomized and 200 splenectomized patients met the inclusion criteria. The majority of GD1 patients had at least one N370S allele. Compared with nonsplenectomized patients at first infusion, splenectomized patients had lower percentages of anemia (26.0 % vs. 42.8 %) and thrombocytopenia (14.2 % vs. 76.3 %), similar percentages of moderate or severe hepatomegaly (81.2 % vs. 80.0 %), and higher percentages of bone pain (88.9 % vs. 52.4 %) and bone crises (38.3 % vs. 16.0 %). After 10 years, both groups showed significant (p < 0.05) improvements in mean hemoglobin levels, platelet count, liver, and spleen (nonsplenectomized) volumes, and bone crises. Initial dosing in both groups ranged from <15 U/kg to ≤90 U/kg every 2 weeks. After 10 years, the majority was receiving 15 to ≤45 U/kg every 2 weeks. Ten years of imiglucerase treatment results in sustainable improvements in all GD1 parameters.

  12. BIPM direct on-site Josephson voltage standard comparisons: 20 years of results

    International Nuclear Information System (INIS)

    Solve, Stephane; Stock, Michael

    2012-01-01

    The discovery of the Josephson effect has for the first time given national metrology institutes (NMIs) the possibility of maintaining voltage references which are stable in time. In addition, the introduction in 1990 of a conventional value for the Josephson constant, K J-90 , has greatly improved world-wide consistency among representations of the volt. For 20 years, the Bureau International des Poids et Mesures (BIPM) has conducted an ongoing, direct, on-site key comparison of Josephson voltage standards among NMIs under the denominations BIPM.EM-K10.a (1 V) and BIPM.EM-K10.b (10 V) in the framework of the mutual recognition arrangement (CIPM MRA). The results of 41 comparisons illustrate the consistency among primary voltage standards and have demonstrated that a relative total uncertainty of a few parts in 10 10 is achievable if a few precautions are taken with regard to the measurement set-up. Of particular importance are the grounding, efficient filters and high insulation resistance of the measurement leads, and clean microwave distribution along the propagation line to the Josephson array. This paper reviews the comparison scheme and technical issues that need to be taken into account to achieve a relative uncertainty at the level of a few parts in 10 10 or even a few parts in 10 11 in the best cases. (paper)

  13. Evaluation of Single-Bundle versus Double-Bundle PCL Reconstructions with More Than 10-Year Follow-Up

    Directory of Open Access Journals (Sweden)

    Masataka Deie

    2015-01-01

    Full Text Available Background. Posterior cruciate ligament (PCL injuries are not rare in acute knee injuries, and several recent anatomical studies of the PCL and reconstructive surgical techniques have generated improved patient results. Now, we have evaluated PCL reconstructions performed by either the single-bundle or double-bundle technique in a patient group followed up retrospectively for more than 10 years. Methods. PCL reconstructions were conducted using the single-bundle (27 cases or double-bundle (13 cases method from 1999 to 2002. The mean age at surgery was 34 years in the single-bundle group and 32 years in the double-bundle group. The mean follow-up period was 12.5 years. Patients were evaluated by Lysholm scoring, the gravity sag view, and knee arthrometry. Results. The Lysholm score after surgery was 89.1±5.6 points for the single-bundle group and 91.9±4.5 points for the double-bundle group. There was no significant difference between the methods in the side-to-side differences by gravity sag view or knee arthrometer evaluation, although several cases in both groups showed a side-to-side difference exceeding 5 mm by the latter evaluation method. Conclusions. We found no significant difference between single- and double-bundle PCL reconstructions during more than 10 years of follow-up.

  14. Safety of Quadrivalent Meningococcal Conjugate Vaccine in Children 2-10 Years.

    Science.gov (United States)

    Tartof, Sara Yee; Sy, Lina S; Ackerson, Bradley K; Hechter, Rulin C; Haag, Mendel; Slezak, Jeffrey M; Luo, Yi; Fischetti, Christine A; Takhar, Harp S; Miao, Yan; Solano, Zendi; Jacobsen, Steven J; Tseng, Hung-Fu

    2017-11-01

    Quadrivalent meningococcal conjugate vaccine is recommended for children, adolescents and adults at increased risk of meningococcal disease. In 2011, MenACWY-CRM (Menveo, GSK, Siena, Italy) was approved for children 2-10 years of age in the United States. Although no safety concerns arose from clinical trials, it remains important to monitor its safety in routine clinical settings. Kaiser Permanente Southern California members 2-10 years old who received MenACWY-CRM between September 2011 and September 2014 were included. Electronic health records were searched using a validated algorithm to identify 26 prespecified events of interests (EOIs) and serious medically attended events (SMAEs) from inpatient or emergency settings up to 1 year after MenACWY-CRM vaccination. SMAEs were categorized by International Classification of Diseases, 9th revision diagnostic categories. All events were reviewed to confirm the diagnosis and symptom onset date. The study was descriptive (NCT01452438); no statistical tests were performed. Among 387 vaccinated children, 327 with ≥6 months membership before vaccination were analyzed. Among EOIs, 9 asthma cases and 1 myasthenia gravis case underwent chart review which confirmed 1 incident asthma case occurring 237 days after concomitant vaccination with MenACWY-CRM and typhoid vaccine. Thirty-one children experienced SMAEs, most commonly because of unrelated injury and poisoning. The remaining events occurred sporadically after vaccination and most were unlikely related to vaccination based on medical record review. One incident EOI of asthma late in the 1-year observation period and sporadic distribution of SMAEs were observed. These data do not suggest safety concerns associated with MenACWY-CRM vaccination in children 2-10 years old.

  15. Adjuvant Radiation Therapy and Survival for Pure Tubular Breast Carcinoma-Experience From the SEER Database

    Energy Technology Data Exchange (ETDEWEB)

    Li Baoqing, E-mail: bal9018@med.cornell.edu [Department of Radiation Oncology, Weill Cornell Medical College, New York, New York (United States); Chen, Margaret [Department of Surgery, Weill Cornell Medical College, New York, New York (United States); Nori, Dattatreyudu; Chao, K.S. Clifford [Department of Radiation Oncology, Weill Cornell Medical College, New York, New York (United States); Chen, Allen M. [Department of Radiation Oncology, University of California Davis Cancer Center, Sacramento, California (United States); Chen, Steven L. [Department of Surgery, University of California Davis Cancer Center, Sacramento, California (United States)

    2012-09-01

    Purpose: Pure tubular carcinoma of the breast (PTCB) represents a distinct subtype of invasive ductal carcinoma (IDC) that is generally thought to be associated with better prognosis than even low-grade IDC. There has been controversy as to the role of adjuvant radiation therapy (RT) in this population. We hypothesized that adjuvant RT would demonstrate a survival improvement. Methods and Materials: We queried the Surveillance, Epidemiology and End Results database for the years 1992-2007 to identify patients with pure tubular carcinomas of the breast. Patient demographics, tumor characteristics, and surgical and RT treatments were collected. Survival analysis was performed using the Kaplan-Meier method for univariate comparisons and Cox proportional hazards modeling for multivariate comparisons, stratifying on the basis of age with a cutoff age of 65. Results: A total of 6465 patients were identified: 3624 (56.1%) patients underwent lumpectomy with RT (LUMP+RT), 1525 (23.6%) patients underwent lumpectomy alone (LUMP), 1266 (19.6%) patients received mastectomy alone (MAST), and 50 (0.8%) patients underwent mastectomy with RT (MAST+RT). When we compared the LUMP+RT and LUMP groups directly, those receiving adjuvant RT tended to be younger and were less likely to be hormone receptor-positive. Overall survival was 95% for LUMP+RT and 90% for LUMP patients at 5 years. For those 65 or younger, the absolute overall survival benefit of LUMP+RT over LUMP was 1% at 5 years and 3% at 10 years. On stratified multivariate analysis, adjuvant RT remained a significant predictor in both age groups (P=.003 in age {<=}65 and P=.04 in age >65 patients). Other significant unfavorable factors were older age and higher T stage (age >65 only). Conclusions: Since sufficiently powered large scale clinical trials are unlikely, we would recommend that adjuvant radiation be considered in PTCB patients age 65 or younger, although consideration of the small absolute survival benefit is

  16. Food and nutrient consumption trends in older Australians: a 10-year cohort study.

    Science.gov (United States)

    Flood, V M; Burlutsky, G; Webb, K L; Wang, J J; Smith, W T; Mitchell, P

    2010-06-01

    Few longitudinal population-based cohort studies of older people have described dietary intakes over time. The objective of this study was to assess changes in the food and nutrient intake in a cohort of older Australians, using longitudinal data collected over 10 years. Population-based cohort of people aged 49 years and over at baseline (82% of those eligible) living in two postcode areas, west of Sydney. In 1992-1994, 3654 people were examined; 2334 were reexamined after 5 years and 1952 after 10 years (75% survivors at both examinations). A 145-item food frequency questionnaire was used to assess food and nutrient intake on each occasion, and 1166 participants provided usable dietary data at all three examinations. Energy and sugar intake significantly increased among women over the 10-year period (P-value for trend bread consumption decreased in both men and women (P-value for trend choices. This information could be used to inform nutrition policy and programs targeted to older persons. These data highlight the need to identify barriers to better food choices.

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

    Science.gov (United States)

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

    2015-09-01

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

  18. 42 CFR 411.10 - Services required as a result of war.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Services required as a result of war. 411.10... and Exclusion of Particular Services § 411.10 Services required as a result of war. Medicare does not pay for services that are required as a result of war, or an act of war, that occurs after the...

  19. Surgeons' Knowledge and Practices Regarding the Role of Radiation Therapy in Breast Cancer Management

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Jessica [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Griffith, Kent A. [Department of Biostatistics, University of Michigan, Ann Arbor, Michigan (United States); Hawley, Sarah T.; Zikmund-Fisher, Brian J. [Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan (United States); Janz, Nancy K. [Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan (United States); Sabel, Michael S. [Department of Surgery, University of Michigan, Ann Arbor, Michigan (United States); Katz, Steven J. [Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan (United States); Jagsi, Reshma, E-mail: rjagsi@med.umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

    2013-12-01

    Purpose: Population-based studies suggest underuse of radiation therapy, especially after mastectomy. Because radiation oncology is a referral-based specialty, knowledge and attitudes of upstream providers, specifically surgeons, may influence patients' decisions regarding radiation, including whether it is even considered. Therefore, we sought to evaluate surgeons' knowledge of pertinent risk information, their patterns of referral, and the correlates of surgeon knowledge and referral in specific breast cancer scenarios. Methods and Materials: We surveyed a national sample of 750 surgeons, with a 67% response rate. We analyzed responses from those who had seen at least 1 breast cancer patient in the past year (n=403), using logistic regression models to identify correlates of knowledge and appropriate referral. Results: Overall, 87% of respondents were general surgeons, and 64% saw >10 breast cancer patients in the previous year. In a scenario involving a 45-year-old undergoing lumpectomy, only 45% correctly estimated the risk of locoregional recurrence without radiation therapy, but 97% would refer to radiation oncology. In a patient with 2 of 20 nodes involved after mastectomy, 30% would neither refer to radiation oncology nor provide accurate information to make radiation decisions. In a patient with 4 of 20 nodes involved after mastectomy, 9% would not refer to radiation oncology. Fewer than half knew that the Oxford meta-analysis revealed a survival benefit from radiation therapy after lumpectomy (45%) or mastectomy (32%). Only 16% passed a 7-item knowledge test; female and more-experienced surgeons were more likely to pass. Factors significantly associated with appropriate referral to radiation oncology included breast cancer volume, tumor board participation, and knowledge. Conclusions: Many surgeons have inadequate knowledge regarding the role of radiation in breast cancer management, especially after mastectomy. Targeted educational

  20. Contribution Of Autopsy To Medical Practice In Cameroon: A 10 year ...

    African Journals Online (AJOL)

    Of 12.000 bodies received at the mortuary of the Yaounde General Hospital, 126 were autopsied in this 10-year retrospective study from 1997 to 2007, giving a rate of 1 autopsy in 100 deaths. 72.2% of cases were males against 27.8% females. The predominant age group was 20-69 years (57.1%). The main causes of ...

  1. A 10-year performance trajectory of top nutrition journals′ impact factors

    Directory of Open Access Journals (Sweden)

    Narges Jani

    2012-01-01

    Full Text Available Background and Aim: This study was performed to evaluate the impact factors (IFs and total citations of ISI-indexed nutrition journals in a 10-year period from 1999 to 2008 in order to assess the quality of nutrition journals. Materials and Methods: For this retrospective study, the IF and total citation data from 1998 to 2008 were collected through Journal Citation Reports of Thomson Scientific Corporation Web of Knowledge. We selected five highly cited journals in the "nutrition and dietetics" category for our analysis. These journals include Annual Reviews in Nutrition (ANNU REV NUTR, American Journal of Clinical Nutrition (AJCN, Progress in Lipid Research (PROG LIPID RES, Journal of Nutrition (J NUTR, and International Journal of Obesity (INT J OBESITY Results: All five selected journals were ranked as one of the top ten "nutrition and dietetics" journals between 1999 and 2008 in ISI database. Most of selected journals′ IF had an upward trend during the 10-year period with fluctuation in some cases. AJCN consistently received the greatest number of total citations during the study period, although its IF was not the highest among the five journals studied. Conclusion: The IF illustrated changes in relative rankings of five highly cited journals included in the "nutrition and dietetics" category of the Web of Knowledge. Rank according to the absolute number of citations received, however, did not correlate with rank according to IF.

  2. Internet Use and Psychological Well-Being among 10-Year-Old and 11-Year-Old Children

    Science.gov (United States)

    Devine, Paula; Lloyd, Katrina

    2012-01-01

    This paper uses data from the 2009 Kids' Life and Times Survey, involving 3657 children aged 10 or 11 years old in Northern Ireland. The survey indicated high levels of use of Internet applications, including social-networking sites and online games. Using the KIDSCREEN-27 instrument, the data indicate that the use of social-networking sites and…

  3. Temporal trends and epidemiological aspects of ciguatera in French Polynesia: a 10-year analysis.

    Science.gov (United States)

    Chateau-Degat, Marie-Ludivine; Dewailly, Eric; Cerf, Nicole; Nguyen, Ngoc Lam; Huin-Blondey, Marie-Odile; Hubert, Bruno; Laudon, François; Chansin, René

    2007-04-01

    The purpose of this study was to report the temporal trends of the incidence of ciguatera poisoning from 1992 to 2001 in French Polynesia. This retrospective study analysed 7842 cases of ciguatera disease recorded over a period of 10 years. The annual incidence varied from 26.3 to 41.9 per 10,000 person-years. An analysis of cases grouped by archipelago revealed differences in incidences (P ciguatera poisoning appeared relatively stable during the 10 years of the study period. However, the gradient of remoteness observed suggests an adaptation of management of ciguatera disease to each archipelago.

  4. Long-Term Efficacy and Patterns of Failure After Accelerated Partial Breast Irradiation: A Molecular Assay-Based Clonality Evaluation

    International Nuclear Information System (INIS)

    Vicini, Frank A.; Antonucci, J. Vito; Wallace, Michelle R.N.; Gilbert, Samuel; Goldstein, Neal S.; Kestin, Larry; Chen, Peter; Kunzman, Jonathan; Boike, Thomas; Benitez, Pamela; Martinez, Alvaro

    2007-01-01

    Purpose: To determine the long-term efficacy and cosmetic results of accelerated partial breast irradiation (APBI) by reviewing our institution's experience. Methods and Materials: A total of 199 patients with early-stage breast cancer were treated prospectively with adjuvant APBI after lumpectomy using interstitial brachytherapy. All patients had negative margins, 82% had Stage I disease, median tumor size was 1.1 cm, and 12% had positive lymph nodes. The median follow-up for surviving patients was 8.6 years. Fifty-three patients (27%) have been followed for ≥10 years. Results: Six ipsilateral breast tumor recurrences (IBTRs) were observed, for a 5-year and 10-year actuarial rate of 1.6% and 3.8%, respectively. A total of three regional nodal failures were observed, for a 10-year actuarial rate of 1.6%. Five contralateral breast cancers developed, for a 5- and 10-year actuarial rate of 2.2% and 5.2%, respectively. The type of IBTR (clonally related vs. clonally distinct) was analyzed using a polymerase chain reaction-based loss of heterozygosity assay. Eighty-three percent of IBTRs (n = 5) were classified as clonally related. Multiple clinical, pathologic, and treatment-related factors were analyzed for an association with the development of an IBTR, regional nodal failure, or contralateral breast cancer. On multivariate analysis, no variable was associated with any of these events. Cosmetic results were rated as excellent/good in 99% of patients. Conclusions: Long-term results with APBI using interstitial brachytherapy continue to demonstrate excellent long-term local and regional control rates and cosmetic results. According to a polymerase chain reaction-based loss of heterozygosity assay, 83% of recurrences were classified as clonally related

  5. Career Theory Building in AJCD during Its Inaugural 10 Years.

    Science.gov (United States)

    Prideaux, Lee-Ann; Creed, Peter

    2002-01-01

    A review of the first 10 years of the Australian Journal of Career Development identified 26 articles meeting methodological criteria. These topics predominated: cross-sectional analyses, Holland's theory of vocational choice, self-efficacy/self-concept theory, gender issues, and career counseling/career education. A need for an…

  6. Areva - 2014 Half-year results

    International Nuclear Information System (INIS)

    Duperray, Julien; Berezowskyj, Katherine; Grange, Aurelie; Rosso, Jerome; Thebault, Alexandre; Scorbiac, Marie de; Repaire, Philippine du

    2014-01-01

    The group posted a net loss in the first half of the year. This is the consequence of losses recorded in renewable operations, additional project-related provisions, asset write-downs and a nuclear market environment that has still deteriorated. Areva's backlog has strengthened thanks to the signing of the agreement through 2020 with EDF for used fuel treatment and MOX fuel production. Though it has a short-term adverse impact on the group's results, it provides these operations with long-term visibility and strengthens our strategic partnership with EDF. Despite a decline in revenue that was greater than anticipated, the group achieved positive free operating cash flow, an increase compared with the first half of 2013. The success of Areva's recovery actions partially offset the downturn in activity. These actions will be reinforced in the second half of the year to adapt to market conditions. The group continues to restructure its operations in renewable energies by entering into partnerships in promising markets, such as offshore wind and energy storage, and by discontinuing loss-making operations, such as concentrated solar power. 2014 Half-year results: - Backlog: euro 44.9 bn (euro +3.5 bn vs. 12/31/2013 thanks to the treatment-recycling agreement with EDF); - Negative net income attributable to equity owners of the parent (euro -694 m): Losses in discontinued renewable activities (euro -373 m), One-off impact of treatment-recycling agreement with EDF (euro -95 m), Provisions and assets impairment: - Positive free operating cash flow despite lower activity level: Revenue: euro 3.889 bn (-12.4% LFL), EBITDA: euro 256 m (euro -231 m vs. H1 2013), Free operating cash flow: euro 98 m (euro +256 m vs. H1 2013); - Strengthened recovery actions in an unfavorable economic environment: 2015 cost reduction objective secured and raised to euro 1.2 bn by 2016, Capital expenditure reduced over 2014-16; - Revised financial outlook

  7. Can repair increase the longevity of composite resins? Results of a 10-year clinical trial.

    Science.gov (United States)

    Fernández, E; Martín, J; Vildósola, P; Oliveira Junior, O B; Gordan, V; Mjor, I; Bersezio, C; Estay, J; de Andrade, M F; Moncada, G

    2015-02-01

    The aim of this double-blind clinical trial was to assess the longevity of repairs to localized clinical defects in composite resin restorations that were initially planned to be treated with a restoration replacement. Twenty-eight patients aged 18-80 years old with 50 composite resin restorations (CR) were recruited. The restorations with localized, marginal, anatomical deficiencies and/or secondary caries adjacent to CR that were "clinically judged" to be suitable for repair or replacement according to the USPHS criteria were randomly assigned to Repair (n=25) or Replacement (n=25) groups, and the quality of the restorations was scored according to the modified USPHS criteria. The restorations were blind and two examiners scored them at baseline (Cohen Kappa agreement score 0.74) and at ten years (Cohen Kappa agreement score 0.87) restorations. Wilcoxon tests were performed for comparisons within the same group (95% CI), and Friedman tests were utilized for multiple comparisons between the different years within each group. Over the decade, the two groups behaved similarly on the parameters of marginal adaptation (MA) (p>0.05), secondary caries (SC) (p>0.05), anatomy (A) (p0.05). Given that the MA, SC, A and C parameters behaved similarly in both groups, the repair of composite resins should be elected when clinically indicated, because it is a minimally invasive treatment that can consistently increase the longevity of restorations. The repair of defective composite resins as an alternative treatment to increase their longevity proved to be a safe and effective treatment in the long term. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Prognostic factors in glioblastoma multiforme. 10 years experience of a single institution

    International Nuclear Information System (INIS)

    Hulshof, M.C.C.M.; Schimmel, E.C.; Gonzalez, D.G.; Koot, R.W.; Bosch, D.A.; Dekker, F.

    2001-01-01

    Background: To analyze prognostic factors in patients with a glioblastoma multiforme treated in an academic institute over the last 10 years. Patients and method: From 1988 to 1998, 198 patients with pathologically confirmed glioblastoma multiforme were analyzed. Five radiation schedules were used mainly based on pretreatment selection criteria: 1. 60 Gy in 30 fractions followed by an interstitial iridium-192 (Ir-192) boost for selected patients with a good performance and a small circumscribed tumor, 2. 66 Gy in 33 fractions for good performance patients, 3. 40 Gy in eight fractions or 4. 28 Gy in four fractions for poor prognostic patients and 5. no irradiation. Results: Median survival was 16 months, 7 months, 5.6 months, 6.6 months and 1.8 months for the groups treated with Ir-192, 66 Gy, 40 Gy, 28 Gy and the group without treatment, respectively. No significant improvement in survival was encountered over the last 10 years. At multivariate analysis patients treated with a hypofractionated scheme showed a similar survival probability and duration of palliative effect compared to the conventionally fractionated group. The poor prognostic groups receiving radiotherapy had a highly significant better survival compared to the no-treatment group. Patients treated with an Ir-192 boost had a better median survival compared to a historical group matched on selection criteria but without boost treatment (16 vs 9.7 months, n.s.). However, survival at 2 years was similar. Analysis on pretreatment characteristics at multivariate analysis revealed age, neurological performance, addition of radiotherapy, total resection, tumor size post surgery and deterioration before start of radiotherapy (borderline) as significant prognostic factors for survival. Conclusion: Despite technical developments in surgery and radiotherapy over the last 10 years, survival of patients with a glioblastoma multiforme has not improved in our institution. The analysis of prognostic factors

  9. 10 CFR 436.13 - Presuming cost-effectiveness results.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Presuming cost-effectiveness results. 436.13 Section 436... Methodology and Procedures for Life Cycle Cost Analyses § 436.13 Presuming cost-effectiveness results. (a) If the investment and other costs for an energy or water conservation measure considered for retrofit to...

  10. Retransplantation in 7,290 primary transplant patients: a 10-year multi-institutional study.

    Science.gov (United States)

    Radovancevic, Branislav; McGiffin, David C; Kobashigawa, Jon A; Cintron, Guillermo B; Mullen, G Martin; Pitts, Douglas E; O'Donnell, Jacqueline; Thomas, Cindi; Bourge, Robert C; Naftel, David C

    2003-08-01

    Cardiac retransplantation is a controversial procedure due to the disparity between donor heart demand and supply. Of 7,290 patients undergoing primary cardiac transplantation between January 1990 and December 1999 at 42 institutions contributing to the Cardiac Transplant Research Database (CTRD), 106 patients later underwent a second and 1 patient a third cardiac transplant procedure. The actuarial freedom from retransplantation was 99.2% and 96.8% at 1 and 10 years, respectively. Reasons for retransplantation included early graft failure (n = 34), acute cardiac rejection (n = 15), coronary allograft vasculopathy (CAV, n = 39), non-specific graft failure (n = 7), and miscellaneous (n = 10). The only risk factor associated with retransplantation was younger age, reflecting the policy of preferential retransplantation of younger patients. Survival after retransplantation was inferior to that after primary transplantation (56% and 38% at 1 and 5 years, respectively). Risk factors associated with death after retransplantation included retransplantation for acute rejection (p = 0.0005), retransplantation for early graft failure (p = 0.03), and use of a female donor (p = 0.005). Survival after retransplantation for acute rejection was poorest (32% and 8% at 1 and 5 years, respectively) followed by retransplantation for early graft failure (50% and 39% at 1 and 5 years, respectively). Survival after retransplantation for CAV has steadily improved with successive eras. The results of retransplantation for acute rejection and early graft failure are poor enough to suggest that this option is not advisable. However, retransplantation for CAV is currently associated with satisfactory survival and should continue to be offered to selected patients.

  11. Long-term exposure to tenofovir continuously decrease renal function in HIV-1-infected patients with low body weight: results from 10 years of follow-up.

    Science.gov (United States)

    Nishijima, Takeshi; Kawasaki, Yohei; Tanaka, Noriko; Mizushima, Daisuke; Aoki, Takahiro; Watanabe, Koji; Kinai, Ei; Honda, Haruhito; Yazaki, Hirohisa; Tanuma, Junko; Tsukada, Kunihisa; Teruya, Katsuji; Kikuchi, Yoshimi; Gatanaga, Hiroyuki; Oka, Shinichi

    2014-08-24

    To investigate the effect of long-term tenofovir disoproxil fumarate (TDF) use on renal function, especially in patients with low body weight who are vulnerable to TDF nephrotoxicity. A single-center, observational study in Tokyo, Japan. We performed a 10 years cohort study of 792 HIV-1-infected patients. The effect of long-term TDF use on estimated glomerular filtration rate (eGFR) was investigated on treatment-naive patients who started TDF-containing antiretroviral therapy (n = 422) and those who started abacavir-containing antiretroviral therapy as control (n = 370). Three renal endpoints were examined by the logistic regression model: decrement in eGFR of higher than 10 ml/min per 1.73 m relative to the baseline, more than 25% decrement in eGFR, and eGFR lower than 60 ml/min per 1.73 m at least 3 months apart. The loss in eGFR was estimated using linear mixed models for repeated measures. The median weight at baseline was 63 kg. TDF use increased the risk of all three renal outcomes compared with the control group: higher than 10 ml/min per 1.73 m decrement in eGFR [adjusted odds ratio (OR) = 2.1, 95% confidence interval (CI) 1.45-3.14, P decrement (adjusted OR = 2.1, 95% CI 1.50-2.90, P < 0.001), and eGFR lower than 60 ml/min per 1.73 m at least 3 months apart (adjusted OR = 3.9, 95% CI 1.62-9.36, P = 0.002). The cumulative mean loss relative to the control after 1, 2, 3, 4, and 5 years of TDF exposure was -3.8, -3.6, -5.5, -6.6, and -10.3 ml/min per 1.73 m, respectively, indicating that the loss in eGFR increased over time (P < 0.001). In this cohort of patients with low body weight, TDF exposure increased the risk of renal dysfunction. Furthermore, the loss in eGFR relative to the control increased continuously up to 5 years.

  12. The operative treatment of pressure sores in the pelvic region: A 10-year period overview.

    Science.gov (United States)

    Jósvay, János; Klauber, András; Both, Béla; Kelemen, Péter B; Varga, Zsombor Z; Pesthy, Pál Cs

    2015-07-01

    Pelvic region pressure sores often develop following spinal cord injury. Surgery is often necessary for long standing, large-sized pressure sores not responding to conservative treatment. Authors analyze their results of a 10-year period, and identify factors contributing to the reduction of the recurrence rate. A total of 119 pressure sores were operated on 98 patients in two institutions during a 10-year period (1 January 2003 to 31 December 2012). The encountered perioperative complications are summarized, and the recurrence rate is analyzed with a patient follow-up questionnaire. We experienced 15 perioperative complications (12.6%). All complications were fully resolved by conservative treatment. Fifty-eight returned patient replies were processed. The average follow-up time after surgery was 5.2 years. The recurrence rate was 5.47%. The strict adherence to surgical indications, full patient compliance, specialized pre- and post-operative patient care, our routinely used preferred surgical method, all contribute to a low post-operative complication rate, long-term flap survival, and an extended recurrence free period.

  13. Customising turnaround time indicators to requesting clinician: a 10-year study through balanced scorecard indicators.

    Science.gov (United States)

    Salinas, Maria; López-Garrigós, Maite; Santo-Quiles, Ana; Gutierrez, Mercedes; Lugo, Javier; Lillo, Rosa; Leiva-Salinas, Carlos

    2014-09-01

    The purpose of this study is, first to present a 10-year monitoring of postanalytical turnaround time (TAT) adapted to different clinicians and patient situations, second to evaluate and analyse the indicators results during that period of time, and finally to show a synthetic appropriate indicator to be included in the balanced scorecard management system. TAT indicator for routine samples was devised as the percentage of certain key tests that were verified before a specific time on the phlebotomy day. A weighted mean synthetic indicator was also designed. They were calculated for inpatients at 15:00 and 12:00 and for primary care patients only at 15:00. The troponin TAT of emergency department patients, calculated as the difference between the troponin verification and registration time, was selected as the stat laboratory TAT indicator. The routine and stat TAT improved along the 10-year study period. The synthetic indicator showed the same trend. The implementation of systematic and continuous monitoring over years, promoted a continuous improvement in TAT which will probably benefit patient outcome and safety.

  14. Sustained stimulation of soil respiration after 10 years of experimental warming

    International Nuclear Information System (INIS)

    Reth, S; Graf, W; Reichstein, M; Munch, J C

    2009-01-01

    A number of forest and grassland studies indicated that stimulation of the soil respiration by soil warming ceases after a couple of years (Luo et al 2001 Nature 413 622-5). Here we present results from a long-term soil warming lysimeter experiment in southern Germany showing sustained stimulation of soil respiration after 10 years. Moreover, both warmed and control treatments exhibited a similar temperature response of soil respiration, indicating that adaptation in terms of temperature sensitivity was absent. Carbon dioxide concentration measurements within the profiles are supporting these findings. The increased soil respiration occurred although vegetation productivity in the warmed treatment was not higher than in the control plots. These findings strongly contrast with current soil carbon modeling concepts, where carbon pools decay according to first-order kinetics, and thus a depletion of labile soil carbon pools leads to an apparent down-regulation of microbial respiration (Knorr et al 2005 Nature 433 298-301). Consequently, the potential for positive climate carbon cycle feedback may be larger than represented in current models of soil carbon turnover.

  15. Pulsed Light Accelerated Crosslinking versus Continuous Light Accelerated Crosslinking: One-Year Results

    Directory of Open Access Journals (Sweden)

    Cosimo Mazzotta

    2014-01-01

    Full Text Available Purpose. To compare functional results in two cohorts of patients undergoing epithelium-off pulsed (pl-ACXL and continuous light accelerated corneal collagen crosslinking (cl-ACXL with dextran-free riboflavin solution and high-fluence ultraviolet A irradiation. Design. It is a prospective, comparative, and interventional clinical study. Methods. 20 patients affected by progressive keratoconus were enrolled in the study. 10 eyes of 10 patients underwent an epithelium-off pl-ACXL by the KXL UV-A source (Avedro Inc., Waltham, MS, USA with 8 minutes (1 sec. on/1 sec. off of UV-A exposure at 30 mW/cm2 and energy dose of 7.2 J/cm2; 10 eyes of 10 patients underwent an epithelium-off cl-ACXL at 30 mW/cm2 for 4 minutes. Riboflavin 0.1% dextran-free solution was used for a 10-minutes corneal soaking. Patients underwent clinical examination of uncorrected distance visual acuity and corrected distance visual acuity (UDVA and CDVA, corneal topography and aberrometry (CSO EyeTop, Florence, Italy, corneal OCT optical pachymetry (Cirrus OCT, Zeiss Meditec, Jena, Germany, endothelial cells count (I-Conan Non Co Robot, and in vivo scanning laser confocal microscopy (Heidelberg, Germany at 1, 3, 6, and 12 months of follow-up. Results. Functional results one year after cl-ACXL and pl-ACXL demonstrated keratoconus stability in both groups. Functional outcomes were found to be better in epithelium-off pulsed light accelerated treatment together with showing a deeper stromal penetration. No endothelial damage was recorded during the follow-up in both groups. Conclusions. The study confirmed that oxygen represents the main driver of collagen crosslinking reaction. Pulsed light treatment optimized intraoperative oxygen availability improving postoperative functional outcomes compared with continuous light treatment.

  16. The effectiveness of the developed program of 10-13 years girls' coordinative abilities going in for calisthenics.

    Directory of Open Access Journals (Sweden)

    Belokopitova G.A.

    2011-06-01

    Full Text Available It's developed and practically based the program on developing coordinative abilities according to age group of 10-13 years old gymnastics. This program is for special stage of training and it is aimed for developing coordinating abilities connected to individual-psychological peculiarities of girls going for gymnastics. It was shown that sport result of 10-13 years girls' influences on index of psycho-moving futures - abilities for correction of their actions to free mobilization and moving coordination during performing fast work. It can be explained that index which is being expected shows the set of time-hour moves and allows evaluating gymnasts moves.

  17. Necrotizing fasciitis of breast | Salati | East and Central African ...

    African Journals Online (AJOL)

    Necrotizing fasciitis is an uncommon and rapidly progressive, life-threatening soft tissue infection. Necrotizing fasciitis of breast is even rarely encountered. We managed one such 32 years old nondiabetic, obese lady who developed necrotising fascitis of right breast after lumpectomy. Management involved wide ...

  18. Clinical experiences with laser-welded titanium frameworks supported by implants in the edentulous mandible: a 10-year follow-up study.

    Science.gov (United States)

    Ortorp, Anders; Jemt, Torsten

    2006-01-01

    Long-term follow-up studies for more than 5 years are not available on laser-welded titanium frameworks. To report and compare 10-year data on implant-supported prostheses in the edentulous mandible provided with laser-welded titanium frameworks and conventional gold alloy frameworks. Altogether, 155 patients were consecutively treated with prostheses at abutment level with two generations of fixed laser-welded titanium frameworks (test groups). A control group of 53 randomly selected patients with conventional gold alloy castings was used for comparison. Clinical and radiographic 10-year data were collected for the three groups. All patients followed-up for 10 years (n=112) still had fixed prostheses in the mandible (cumulative success rate [CSR] 100%). The overall 10-year cumulative success rate (CSR) was 92.8 and 100.0% for titanium and gold alloy frameworks, respectively. Ten-year implant cumulative survival rate (CSR) was 99.4 and 99.6% for the test and control groups, respectively. Average 10-year bone loss was 0.56 (SD 0.45) mm for the titanium group and 0.77 (SD 0.36) mm for the control group (p screw components were below 3%. Excellent overall long-term results with 100% CSR could be achieved with the present treatment modality. Fractures of the metal frames and remade prostheses were more common for the laser-welded titanium frameworks, and the first generation of titanium frameworks worked poorly when compared with gold alloy frameworks during 10 years (p < 0.05). However, on average more bone loss was observed for implants supporting gold alloy frameworks during 10 years. The reasons for this difference are not clear.

  19. [Development of Human Health Discoveries. 10 years results of Young Innovative Company incubation].

    Science.gov (United States)

    Marsac, Jean

    2014-01-01

    Medicine is evolving every day in its operating procedures and the services offered to patients, emphasizing personalized medicine, safety and medical benefits. The individual patient is more than ever the hub of healthcare organization. Medical innovation is thus a public health priority. However it requires an accurate assessment of medical utility and risk-benefit ratios, and in-depth analysis of economic and organizational impacts. Ten years of experience in the Paris Biotech Santé company incubator has identified key actions for effective support of research projects and the success of innovative companies. Strong expertise is needed to prepare development plans, ensure compliance with regulatory requirements and obtain research funding. During its first decade, this incubator has created 87 innovative companies employing 1500 people, raised more than 90 million euros of funding, and reached a cumulative company value of 1200 million euros. Key factors of success have been identified, but an analysis of the causes of failure shows that operational adjustments are mandatory, particularly a strong commitment from medical experts, in order to promote access to new and useful products for patients while at the same time assessing their social impact.

  20. Using the Debate Method for Teaching Argumentation to 10-12 Year-Old Children

    Directory of Open Access Journals (Sweden)

    Y. V. Rybka

    2012-01-01

    Full Text Available The paper is devoted to peculiarities of using the debate method in teaching argumentation to 10–12 year-old children. The research is aimed at identifying the most effective ways and means of applying the given method. According to the author’s hypothesis, regular integration of discussions into the training course of rhetoric should promote learners’ argumentation, changing it from a mere fantasy through egocentric attitudes to the objective position expressed in a conclusive argumentative way. To achieve the research objectives, the experimental training method was developed applying the debate technique in the form of role plays adapted to peculiarities of children’s age. The experimental results indicated the decentration dynamics in the training process and, therefore, the effectiveness of the experimental training course. The presented training program can be used in teaching rhetoric to 10–12 year- olds, as well as in the optional argumentation course based on the debate technique. In addition, the analysis of children’s argumentation position in the context of socio-cognitive approach can give an impetus for further studies of children’s speech and thinking. 

  1. Peritoneal dialysis in an ageing population: a 10-year experience.

    LENUS (Irish Health Repository)

    Smyth, Andrew

    2012-02-01

    Chronic kidney disease (CKD) is becoming increasingly prevalent and there are increasing numbers of older patients with advanced CKD. Peritoneal dialysis (PD) is a potential treatment. This study aims to compare PD outcomes in age-defined populations in the largest PD centre in the Republic of Ireland over 10 years.

  2. Post Neonatal Tetanus in Calabar, Nigeria: A 10 Year Review ...

    African Journals Online (AJOL)

    1997-01-01

    A 10 year retrospective study of post neonatal tetanus in University of Calabar Teaching Hospital was carried out. The study period spanned from January 1, 1997 to December 31, 2006. The aim was to determine the incidence of post neonatal tetanus and associated bio-characteristics. Information was extracted from case ...

  3. China's Contribution to Anesthesiology Research: A 10-Year Survey of the Literature.

    Science.gov (United States)

    Xie, Guohao; Zhang, Kai; Wood, Chris; Hoeft, Andreas; Liu, Jin; Fang, Xiangming

    2016-05-01

    Anesthesiology has advanced in China over the past decade. We compared the trends in publication of anesthesiology articles from China between 2005 and 2014 with the trends in 5 developed countries. We included all journals listed in the ''Anesthesiology'' category of Journal Citation Reports. Anesthesiology-related publications from 2005 to 2014 were retrieved from the PubMed and Web of Knowledge online databases. The total number of articles, publication type categories, number of citations, and citation rate (number of citations/years since publication) were analyzed. The sample size was the n = 10 years for all confidence intervals and P values. We additionally evaluated the total number of articles published in the 10 top-ranking journals. From 2005 to 2014, 41,344 articles were published in anesthesiology journals. Of these, 3.07% were contributed by authors from Chinese institutions. Although this contribution was less than the Unites States, Great Britain, Germany, France, or Japan, publications from Chinese institutions grew at an annual rate of 13% (95% confidence interval: 3.08%-23.38%, P United States (2.71, P = 0.545), Great Britain (2.57, P = 0.999), Germany (2.35, P = 0.999), France (1.50, P = 0.520), and Japan (1.24, P = 0.065). In the 10 highest impact anesthesiology journals, China published 780 articles during the decade. The 3 journals with the most publications from Chinese institutions were Anesthesia & Analgesia, Anesthesiology, and Acta Anaesthesiologica Scandinavica. In the studied decade, anesthesiology research published by Chinese institutions lagged behind publications from developed countries. There was a steady increase in the number of articles every year, resulting in recent rates of publication similar to several developed countries. The citation rate of articles from Chinese institutions was similar to the citation rate of articles from developed countries, indicating that the quality of articles from China in these journals is

  4. OPEC: 10 years after the Arab oil boycott

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, M.H.

    1983-09-23

    OPEC's dominance over world oil markets is waning 10 years after precipitating world-wide energy and economic crises. The 1979 revolution in Iran and the start of the Iranian-Iraqi war in 1980 introduced a second shock that caused oil importers to seek non-OPEC supplies and emphasize conservation. No breakup of the cartel is anticipated, however, despite internal disagreements over production and price levels. Forecasters see OPEC as the major price setter as an improved economy increases world demand for oil. Long-term forecasts are even more optimistic. 24 references, 2 figures, 2 tables. (DCK)

  5. Focal therapy with high-intensity focused ultrasound for prostate cancer in the elderly: a feasibility study with 10 years follow-up

    Directory of Open Access Journals (Sweden)

    Amine B. El Fegoun

    2011-04-01

    Full Text Available PURPOSE: To evaluate the long-term efficacy of prostate cancer control and complication rates, in the elderly, after focal therapy with high-intensity focused ultrasound (HIFU. MATERIALS AND METHODS: Between June 1997 and March 2000, patients with localized prostate cancer were included into a focal therapy protocol. Inclusion criteria were: PSA < 10 ng/mL, < 3 positive biopsies with only 1 lobe involved, clinical stage < T2a, Gleason score < 7 (3+4, negative CT scan and bone scan. Hemi-ablation of the prostate was performed with the Ablatherm(R device. Survival, complication rates and urinary continence were evaluated. Control biopsies were performed at 1 year. Treatment failure was defined as a positive biopsy or need for salvage therapy. RESULTS: Twelve patients with a mean age 70 years were included. Median follow-up was 10 years. Control prostate biopsies were negative in 11/12 (91% patients. Overall survival was 83% (10/12 and cancer specific survival was 100% at 10 years. Two patients died from other causes. Recurrence free survival was 90% (95% CI; 0.71-1 at 5 years, and 38% (95% CI; 0.04-0.73 at 10 years. Five patients had salvage therapy with repeat HIFU (n = 1 or hormonal therapy (n = 4 and all salvage patients were alive at 10 years. No patients developed lymph node or bone metastasis. No patients suffered from urinary incontinence. International Prostate Symptom Score was stable at 1 year. Complications included two urinary tract infections and one episode of acute urinary retention. CONCLUSIONS: Hemi-prostate ablation with HIFU can be safely performed in selected elderly patients with adequate long-term cancer control and low complication rates. Results from larger prospective studies using improved imaging techniques and extensive biopsy protocols are awaited.

  6. Deformities of contour after breast conserving therapy and the possibilities of correction

    International Nuclear Information System (INIS)

    Deutinger, M.; Tairych, G.

    1999-01-01

    Background: Breast conserving treatment is increasing for primary treatment of breast carcinoma because of the importance of the cosmetic outcome. Patients and method: We examined 195 patients after breast conserving therapy which was performed between 1983 and 1992. For evaluation of the cosmetic result symmetry, contour of the breast and location of the areola were examined. Radiation effect on breast tissue was evaluated by the Lent score. 72% of the patients had been treated with quadrantectomy and 28% with lumpectomy. Results: Deformities of the contour were visible in 59% of the patients depending on the primary location of the tumor. Lumpectomy from medial quadrants caused poor results. Dislocation of the areola of more than 2 cm was detected in 32% of the patients. The dislocation depended on the primary kind of incision and resulted in 89% of the patients after a radial incision and only in 11% after curvilinear incisions. Telangiectasies were absent in 84% of the patients, the others showed telangiectasies Grade 1 to 3. In 48% of the patients no signs of fibrosis could be detected, in 49% fibrosis Grade 1 to 2 was found. 68% of the patients estimated the cosmetic result as very good or good. Only 10% of the patients estimated the result as fair or bad. The examiner estimated the results as good or very good in 28%. Examples of operative procedures for primary and secondary correction are demonstrated. Conclusions: Our results showed an adverse effect of long radial incisions. For lumpectomy and axillary node dissection separate incisions should be used. Correction of contour deformities should be done primarily in breast conserving procedures. This is possible by using modified reduction mammaplasties, local flaps of the breast tissue or switching a latissimus dorsi muscle flap. For secondary correction of defects after breast conserving treatment a latissimus dorsi muscle can be used as well as z-plasty for scar contracture. (orig.) [de

  7. Waste Area Group 10, Operable Unit 10-08, Remedial Investigation/Feasibility Study Annual Status Report for Fiscal Year 2006

    Energy Technology Data Exchange (ETDEWEB)

    R. P. Wells

    2007-05-09

    This report provides a status of the progress made in Fiscal Year 2006 on tasks identified in the Waste Area Group 10, Operable Unit 10-08, Remedial Investigation/Feasibility Study Work Plan. Major accomplishments include: (1) groundwater sampling and review of the groundwater monitoring data, (2) installation of a Sitewide groundwater-level monitoring network, (3) update of the Groundwater Monitoring and Field Sampling Plan of Operable Unit 10-08, (4) re-evaluation of the risk at Site TSF-08, (5) progress on the Operable Unit 10-08 Sitewide Groundwater Model.

  8. Accelerated Intensity-Modulated Radiotherapy to Breast in Prone Position: Dosimetric Results

    International Nuclear Information System (INIS)

    De Wyngaert, J. Keith; Jozsef, Gabor; Mitchell, James; Rosenstein, Barry; Formenti, Silvia C.

    2007-01-01

    Purpose: To report the physics and dosimetry results of a trial of accelerated intensity-modulated radiotherapy to the whole breast with a concomitant boost to the tumor bed in patients treated in the prone position. Methods and Materials: Patients underwent computed tomography planning and treatment in the prone position on a dedicated treatment platform. The platform has an open aperture on the side to allow for the index breast to fall away from the chest wall. Noncontrast computed tomography images were acquired at 2.5- or 3.75-mm-thick intervals, from the level of the mandible to below the diaphragm. A dose of 40.5 Gy was delivered to the entire breast at 2.7-Gy fractions in 15 fractions. An additional dose of 0.5 Gy was delivered as a concomitant boost to the lumpectomy site, with a 1-cm margin, using inverse planning, for a total dose of 48 Gy in 15 fractions. No more than 10% of the heart and lung volume was allowed to receive >18 and >20 Gy, respectively. Results: Between September 2003 and August 2005, 91 patients were enrolled in the study. The median volume of heart that received ≥18 Gy was 0.5%, with a maximal value of 4.7%. The median volume of ipsilateral lung that received ≥20 Gy was 0.8%, with a maximum of 7.2%. Conclusion: This technique for whole breast radiotherapy is feasible and enables an accelerated regimen in the prone position while sparing the lung and heart

  9. The OMERACT Ultrasound Working Group 10 Years On

    DEFF Research Database (Denmark)

    Bruyn, George A; Naredo, Esperanza; Iagnocco, Annamaria

    2015-01-01

    Musculoskeletal ultrasound (US) now thrives as an established imaging modality for the investigation and management of chronic inflammatory arthritis. We summarize here results of the Outcome Measures in Rheumatology (OMERACT) US working group (WG) projects of the last 2 years. These results were...

  10. Results from 10 Years of a CBT Pain Self-Management Outpatient Program for Complex Chronic Conditions

    Directory of Open Access Journals (Sweden)

    Kathryn A. Boschen

    2016-01-01

    Full Text Available Background. Traditional unimodal interventions may be insufficient for treating complex pain, as they do not address cognitive and behavioural contributors to pain. Cognitive Behavioural Therapy (CBT and physical exercise (PE are empirically supported treatments that can reduce pain and improve quality of life. Objectives. To examine the outcomes of a pain self-management outpatient program based on CBT and PE at a rehabilitation hospital in Toronto, Ontario. Methods. The pain management group (PMG consisted of 20 sessions over 10 weeks. The intervention consisted of four components: education, cognitive behavioural skills, exercise, and self-management strategies. Outcome measures included the sensory, affective, and intensity of pain experience, depression, anxiety, pain disability, active and passive coping style, and general health functioning. Results. From 2002 to 2011, 36 PMGs were run. In total, 311 patients entered the program and 214 completed it. Paired t-tests showed significant pre- to posttreatment improvements in all outcomes measured. Patient outcomes did not differ according to the number or type of diagnoses. Both before and after treatment, women reported more active coping than men. Discussion. The PMGs improved pain self-management for patients with complex pain. Future research should use a randomized controlled design to better understand the outcomes of PMGs.

  11. Elastic nailing of tibia shaft fractures in young children up to 10 years of age.

    Science.gov (United States)

    Heo, Jeong; Oh, Chang-Wug; Park, Kyeong-Hyeon; Kim, Joon-Woo; Kim, Hee-June; Lee, Jong-Chul; Park, Il-Hyung

    2016-04-01

    Although tibia shaft fractures in children usually have satisfactory results after closed reduction and casting, there are several surgical indications, including associated fractures and soft tissue injuries such as open fractures. Titanium elastic nails (TENs) are often used for pediatric tibia fractures, and have the advantage of preserving the open physis. However, complications such as delayed union or nonunion are not uncommon in older children or open fractures. In the present study, we evaluated children up to 10 years of age with closed or open tibial shaft fractures treated with elastic nailing technique. A total of 16 tibia shaft fractures treated by elastic nailing from 2001 to 2013 were reviewed. The mean patient age at operation was 7 years (range: 5-10 years). Thirteen of 16 cases were open fractures (grade I: 4, grade II: 6, grade IIIA: 3 cases); the other cases had associated fractures that necessitated operative treatments. Closed, antegrade intramedullary nailing was used to insert two nails through the proximal tibial metaphysis. All patients were followed up for at least one year after the injury. Outcomes were evaluated using modified Flynn's criteria, including union, alignment, leg length discrepancies, and complications. All fractures achieved union a mean of 16.1 weeks after surgery (range: 11-26 weeks). No patient reported knee pain or experienced any loss of knee or ankle motion. There was a case of superficial infection in a patient with grade III open fracture. Three patients reported soft tissue discomfort due to prominent TEN tips at the proximal insertion site, which required cutting the tip before union or removing the nail after union. At the last follow-up, there were no angular or rotational deformities over 10° in either the sagittal or coronal planes. With the exception of one case with an overgrowth of 15 mm, no patient showed shortening or overgrowth exceeding 10mm. Among final outcomes, 15 were excellent and 1 was

  12. Vitamin D Insufficiency in Adolescents: Results of Year-Round Screening in Moscow

    Directory of Open Access Journals (Sweden)

    I. N. Zakharova

    2015-01-01

    Full Text Available Goal. Study of vitamin D sufficiency in children of puberty and pre-puberty age in Moscow. Methods. We examined children aged from 10 to 17 years living in Moscow. In order to appraise seasonal changes in the blood vitamin D status, we determined the average level of the main vitamin D metabolite — 25(OHD — in different months of the year. The criteria for involving children into a laboratory examination were age (11–17 years, absence of organic or genetic pathology, permanent residence in Moscow, no intake of calcium and active vitamin D metabolite preparations at the time of examination. Results. The study involved 360 children (i. e. 30 children were examined every month aged from 10 to 17 years. Analysis of the obtained data demonstrated differences in vitamin D sufficiency in the examined children in winter, spring, summer and autumn months. The serum concentration of vitamin D was significantly higher in summer months than in winter months. We did not reveal sex-related differences in vitamin D sufficiency among Moscow adolescents. Diet evaluation demonstrated that children extremely rarely consume fish as the main food source of vitamin D. Conclusions. Special attention should be given to the development of effective methods of correction of low vitamin D status and prevention thereof. Maintenance of the optimal vitamin D status in winter is infeasible due to insufficient exposure to sunlight, short duration of children’s walking during the schoolyear and absence of cholecalciferol sources in children’s diets. Special attention should be given to vitamin D intake by means of prescribing enriched food additives. 

  13. Parental stress and perceived vulnerability at 5 and 10 years after pediatric SCT.

    Science.gov (United States)

    Vrijmoet-Wiersma, C M J; Egeler, R M; Koopman, H M; Bresters, D; Norberg, A L; Grootenhuis, M A

    2010-06-01

    With the aim of assessing parental stress after SCT, 73 parents of children and adolescents who underwent SCT 5 or 10 years ago responded to questionnaires on general distress (General Health Questionnaire (GHQ)), disease-related stress (Pediatric Inventory for Parents-short form (PIP-SF)) and perceptions of child vulnerability (Child Vulnerability Scale (CVS)). General distress scores were comparable with the reference groups, but 40% of the mothers at 5 years after SCT reported increased stress levels as compared with 26% in the community-based reference group. Disease-related stress was comparable with the reference group of parents of children who were just off cancer treatment, 5 years after SCT. At 10 years after SCT, scores were lower than the reference group. Perceived child vulnerability did diminish over time, but remained high in parents of SCT survivors, compared with parents of healthy children: 96% of the parents at 5 years after SCT and 76% of the parents at 10 years after SCT scored above the cutoff point. Perceived vulnerability was found to be a predictor for parental disease-related stress. To conclude, although most parents of SCT survivors are resilient, the majority of parents perceive their child to be much more vulnerable as compared with parents of healthy children. This perception is associated with disease-related stress and may induce overprotective parenting.

  14. Partial breast irradiation as second conservative treatment for local breast cancer recurrence

    International Nuclear Information System (INIS)

    Hannoun-Levi, Jean-Michel; Houvenaeghel, Gilles; Ellis, Steve; Teissier, Eric; Alzieu, Claude; Lallement, Michel; Cowen, Didier

    2004-01-01

    Purpose: Mastectomy is the treatment of reference for local relapse after breast cancer (BC). The aim of this study was to document the feasibility and the results of associating lumpectomy with partial breast irradiation by interstitial brachytherapy (IB) as local treatment for an isolated ipsilateral BC local recurrence (LR). Methods and materials: Between 1975 and 1996 at Marseille and Nice Cancer Institutes, 4026 patients received lumpectomy and radiotherapy (RT) (50-80 Gy) for a localized breast cancer of which 473 presented a LR. Among these patients, 69 (14.6%) received a second lumpectomy followed by IB, which delivered 30 Gy (Nice, n = 24) or 45-50 Gy (Marseille, n = 45) with 3 to 8 192 Ir wires in 1 or 2 planes on the 85% isodose. Results: Median age at LR was 58.2 years, median follow-up since primary BC was 10 years, and median follow-up after the second conservative treatment was 50.2 months (range, 2-139 months). Immediate tolerance was good in all cases. Grade 2 to 3 long-term complications (LTC) according to IB dose were 0%, 28%, and 32%, respectively, for 30 Gy, 45 to 46 Gy, and 50 Gy (p 0.01). Grade 2 to 3 LTC according to total dose were 4% and 30%, respectively, for total doses (initial RT plus IB) ≤ 100 Gy or >100 Gy (p = 0.008). Logistic regression showed that the only factor associated with Grade 2 to 3 complications was higher IB doses (p = 0.01). We noted 11 second LRs (LR2), 10 distant metastases (DM), and 5 specific deaths. LR2 occurred either in the tumor bed (50.8%) or close to the tumor bed (34.3%) or in another quadrant (14.9%). Kaplan-Meier 5-year freedom from (FF) LR2 (FFLR2), FFDM, and DFS were 77.4%, 86.7%, and 68.9%, respectively. Overall 5-year survival (OS) was 91.8%. Univariate analysis showed the following factors associated with a higher FFLR2: (1) number of wires used for IB (3-4 vs. 5-8 wires, p = 0.006), (2) IB doses (30-45 Gy vs. 46-60 Gy, p = 0.05), (3) number of planes (1 vs. 2, p = 0.05), (4) interval between

  15. PERIPHERAL RETINAL FINDINGS IN HIGHLY MYOPIC CHILDREN ≤10 YEARS OF AGE

    Science.gov (United States)

    Bansal, Alok S.; Hubbard, G. Baker

    2011-01-01

    Purpose The purpose of this study was to characterize the peripheral retinal findings in highly myopic young children without other known risk factors for retinal detachment. Methods A retrospective review of all cases of children ≤10 years of age with high myopia (>6.00 diopters) who were evaluated for presumed risk of retinal detachment by either an examination under anesthesia or office examination by a single retina specialist from January 2001 through December 2008. Patients with regressed retinopathy of pre-maturity, retinal detachment in the fellow eye, or known Stickler syndrome were excluded. Results Fifty-four eyes of 30 patients with high myopia were examined. Twenty-six eyes of 14 patients were examined under anesthesia because of the examiner’s inability to adequately visualize the peripheral retina during an office examination. Mean age at examination was 6 ± 3 (range, 1–10) years. Mean spherical equivalent refractive error was −13.88 ± 3.79 (range, −6.00 to −25.00) diopters. Peripheral retinal findings were identified in 33% of eyes, the most common being lattice degeneration (20%), white without pressure (11%), and retinal holes with subretinal fluid (4%). Conclusion Approximately one third of highly myopic children in our study showed peripheral retinal findings. If the peripheral retina is not adequately visualized during an office evaluation, examination under anesthesia should be considered. PMID:20224463

  16. Air pollution "holiday effect" resulting from the Chinese New Year

    Science.gov (United States)

    Tan, Pei-Hua; Chou, Chia; Liang, Jing-Yi; Chou, Charles C.-K.; Shiu, Chein-Jung

    Our study was an attempt to conduct a comprehensive and systematical examination of the holiday effect, defined as the difference in air pollutant concentrations between holiday and non-holiday periods. This holiday effect can be applied to other countries with similar national or cultural holidays. Hourly and daily surface measurements of six major air pollutants from thirteen air quality monitoring stations of the Taiwan Environmental Protection Administration during the Chinese New Year (CNY) and non-Chinese New Year (NCNY) periods were used. We documented evidence of a "holiday effect", where air pollutant concentrations were significantly different between holidays (CNY) and non-holidays (NCNY), in the Taipei metropolitan area over the past thirteen years (1994-2006). The concentrations of NO x, CO, NMHC, SO 2 and PM 10 were lower in the CNY than in the NCNY period, while the variation in the concentration of O 3 was reversed, which was mainly due to the NO titration effect. Similar differences in these six air pollutants between the CNY and NCNY periods were also found in the diurnal cycle and in the interannual variation. For the diurnal cycle, a common traffic-related double-peak variation was observed in the NCNY period, but not in the CNY period. Impacts of dust storms were also observed, especially on SO 2 and PM 10 in the CNY period. In the 13-year period of 1994-2006, decreasing trends of NO x and CO in the NCNY period implied a possible reduction of local emissions. Increasing trends of SO 2 and PM 10 in the CNY period, on the other hand, indicated a possible enhancement of long-range transport. These two mechanisms weakened the holiday effect.

  17. Search Results | Page 10 | IDRC - International Development ...

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

    Results 91 - 100 of 102 ... A vibrant civil society sector in some Middle Eastern states has managed over the years to fill a role traditionally held by state institutions, that of providing social services such as health care, education and housing. Project. -. Program and Institutional Support : North-South Institute. The North-South ...

  18. Malignant renal tumors in pediatrics

    International Nuclear Information System (INIS)

    Pena, C.; Torterolo, J.; Irigoyen, B.; Bel, M.; Elias, E.

    2004-01-01

    Introduction: Professionals who work in pediatric oncology, we see childhood cancer as a common disease, but in fact constitutes about 2% of all cancers diagnosed worldwide. Wilms tumor accounts for 6% of all childhood tumors and presentation bilateral accounts for 4-6% of all Wilms tumors diagnosed. Theoretical Framework: In the period between the year 1994-2003 period were attended in the Pediatric Hematology-Oncology Center, a total of 29 cases of malignant renal tumors, corresponding to 86% (25 cases) to Wilms tumor or nephroblastoma tumor. The Wilms is of embryonic origin, capable of metastatic spread, (85% lungs 15% liver). Very sensitive to chemotherapy and radiotherapy, which confers high cure rates (85%); having a multidisciplinary treatment model, combining surgery, chemotherapy, and radiotherapy. The role of nursing in comprehensive cancer care child is essential in the prevention and early detection of side effects or complications. Case report: S.D. currently 10 years old. In 10/1994, at 8 months of age, was diagnosed with bilateral Wilms tumor. On admission her weight was 8200gr with abdominal circumference 50cm. Conducted pre-operative MDT and 02/1995 nephrectomy of the left kidney and right kidney lumpectomy (tumor nodule 420gr. and a 250gr.). MDT begins in 03/1995 01/1996 ending. 09/2003 with abdominal pain and vomiting, and kidney failure. 10/2003 lumpectomy biopsy (sclerotic nodule associated with maturation nephroblastoma). Currently severe renal insufficiency plan enters dialysis. Nursing process: Objectives: 1) To prepare the child and family to the side effects and possible complications of chemotherapy and / or radiotherapy 2) Prevent and minimize related complications tumor and / or treatment. Care Plan comprises four stages: A) rating and customer income. B) Implement care chemotherapy C) post-operative Care D) Implement radiation care

  19. Twelve-Year Trends of PM10 and Visibility in the Hefei Metropolitan Area of China

    Directory of Open Access Journals (Sweden)

    Lin Huang

    2016-01-01

    Full Text Available China has been experiencing severe air pollution and previous studies have mostly focused on megacities and a few hot spot regions. Hefei, the provincial capital city of Anhui province, has a population of near 5 million in its metropolitan area, but its air quality has not been reported in literature. In this study, daily PM10 and visibility data in 2001–2012 were analyzed to investigate the air quality status as well as the twelve-year pollution trends in Hefei. The results reveal that Hefei has been suffering high PM10 pollution and low visibility during the study period. The annual average PM10 concentrations are 2~3 times of the Chinese Ambient Air Quality Standard. PM10 shows fluctuating variation in 2001–2007 and has a slightly decreasing trend after 2008. The annual average visibility range is generally lower than 7 km and shows a worsening trend from 2001 to 2006 followed by an improving trend from 2007 to 2012. Wind speed, precipitation, and relative humidity have negative effects on PM10 concentrations in Hefei, while temperature could positively or negatively affect PM10. The results provide a general understanding of the status and long-term trends of PM10 pollution and visibility in a typical second-tier city in China.

  20. Periodontitis and cancer mortality: Register-based cohort study of 68,273 adults in 10-year follow-up.

    Science.gov (United States)

    Heikkilä, Pia; But, Anna; Sorsa, Timo; Haukka, Jari

    2018-06-01

    Periodontitis, a multifactorial infection-induced low-grade chronic inflammation, can influence the process of carcinogenesis. We studied with 10 years follow-up of 68,273 adults-based cohort the involvement of periodontitis as a risk factor for cancer mortality. Periodontal status was defined based on procedure codes of periodontal treatment. Rate ratios and absolute differences of overall and cancer mortality rates were assessed with respect to periodontal status using multiplicative and additive Poisson regression models, respectively. We adjusted for effect of age, sex, calendar time, socio-economic status, oral health, dental treatments and diabetes. Data about smoking or alcohol consumption were not available. Altogether 797 cancer deaths occurred during 664,020 person-years accumulated over a mean 10.1-year follow-up. Crude cancer mortality rate per 10,000 person-years for participants without and with periodontitis was 11.36 (95% CI 10.47-12.31) and 14.45 (95% CI 12.51-16.61), respectively. Crude rate ratios for periodontitis indicated an increased risk of overall (RR 1.27, 95% CI 1.08-1.39) and pancreatic cancer (RR 1.69, 95% CI 1.04-2.76) mortality. After adjustment, the results showed even stronger associations of periodontitis with increased overall (RR 1.33, 95% CI 1.10-1.58) and pancreatic cancer (RR 2.32, 95% CI 1.31-3.98) mortality. A higher pancreatic cancer mortality among individuals with periodontitis contributed considerably to the difference in overall cancer mortality, but this difference was not due to pancreatic cancer deaths alone. © 2018 UICC.

  1. Prevalence and Trends of Cigarette Smoking Among Military Personnel in Taiwan: Results of 10-Year Anti-Smoking Health Promotion Programs in Military.

    Science.gov (United States)

    Chu, Nain-Feng; Lin, Fu-Huang; Wu, Yi-Chang

    2017-07-01

    The purpose of this study is to evaluate the prevalence and trends of cigarette smoking among young military conscripts, military officers, and military university students during recently 10 years in Taiwan. Repeated cross-sectional surveys were conducted annually among young military conscripts and military university students from 2006 to 2014. All the young conscripts were reviewed within 1 month at the military training center and before retiring after 1 year of military services. The military officers were included using purposive sampling from 2004 to 2008 and 2013 to 2014 in different military services. Military university students were included in this study. Freshman and senior students were random sampled as the study subjects. Participants completed a structured questionnaire that included questions on general demographics and health-related behaviors. Current smokers is defined as subjects who smoked ≥1 cigarette/day during the past 30 days or had smoked ≥100 cigarettes in their lifetime or still have the habit of smoking during study. We used a χ 2 test to examine the difference between the prevalence of cigarette smoking among different groups. The Cochran-Armitage test for trend was applied to examine the change of prevalence of smoking after repeated cross-sectional surveys among populations. The prevalence of cigarette smoking within military training center and after 1-year military services was 48.6% and 48.1% on 2006, which became 39.2% and 38.6% on 2010, and then further declined to 31.0% and 30.1% on 2014. For military officers, the trends of prevalence of smoking among different military services showed slight decline from 2004 to 2008, but decreased significantly between 2013 and 2014. The prevalence of smoking in 2014 was 32.1%, 32.8%, and 32.4% for the Army, Navy, and Air Force, respectively. More interestingly, the prevalence of smoking of freshman and senior students increased during the first 5 years (2007-2011) of survey and then

  2. Long-term results of aortic valve replacement with Edwards Prima Plus stentless bioprosthesis: eleven years' follow up.

    Science.gov (United States)

    Auriemma, Stefano; D'Onofrio, Augusto; Brunelli, Massimo; Magagna, Paolo; Paccanaro, Mariemma; Rulfo, Fanny; Fabbri, Alessandro

    2006-09-01

    The Edwards Lifesciences Prima Plus stentless valve (ELSV) is a bioprosthesis manufactured from a porcine aortic root. The study aim was to evaluate late clinical outcomes after aortic valve replacement (AVR) with ELSV implanted as a miniroot in patients with aortic valve disease. Between 1993 and 2004, 318 patients (232 males, 86 females; mean age 69 +/- 9 years; range: 37-83 years) underwent AVR with the ELSV. Preoperatively, 102 patients (32%), 162 (51%) and 54 (17%) were in NYHA classes I/II, III and IV, respectively. Aortic stenosis, aortic regurgitation and combined lesions were present in 124 patients (39%), 114 (36%) and 41 (13%), respectively. Twenty patients (6%) were referred for an acute aortic dissection, 20 (6%) for an aortic root aneurysm, and 139 (44%) had an associated aneurysmal dilatation of the ascending aorta. The ascending aorta was replaced in 159 patients (50%); aortic arch replacement was required in 10 (3%). Coronary artery bypass graft was performed in 86 patients (27%). The follow up was based on clinical data. Operative mortality was 5% (n = 17). There were 49 late deaths (5.2%/pt-yr). Valve-related mortality occurred in 10 patients (1%/pt-yr). Actuarial survival at five and 10 years was 78% and 33%, respectively. Actuarial freedom from valve reoperation and structural valve deterioration at 10 years were 100% and 64%. Actuarial freedom from embolic events and endocarditis at 10 years were 84% and 81%, respectively. The ELSV, when implanted as a miniroot, provided good early and long-term results in terms of survival and freedom from major complications.

  3. CRESESB: 10 years of activities aimed at the future; CRESESB - 10 anos de atividades visando o futuro

    Energy Technology Data Exchange (ETDEWEB)

    Galdino, Marco Antonio; Souza, Hamilton Moss de; Silva, Patricia de Castro da; Dutra, Ricardo Marques [Centro de Pesquisas de Energia Eletrica (CEPEL), Rio de Janeiro, RJ (Brazil). Dept. de Tecnologias Especiais], Emails: marcoag@cepel.br, moss@cepel.br, patricia@cepel.br, dutra@cepel.br

    2007-07-01

    The Centro de Referencia para as Energias Solar e Eolica Sergio de Salvo Brito - CRESESB was created in late 1994 through a agreement between CEPEL and the Ministry of Mines and Energy, at the recommendation of the 'Declaration of Belo Horizonte'. In 10 years of activities, CRESESB / CEPEL has developed several studies, the most important: support for various government programs of the MME and the MCT, Internet dissemination of information, assembling and running courses in solar energy and wind power, edition of publications, maintenance of a specialized library and visits to 'Casa Solar Eficiente' (Efficient Solar House). Other activities also include: attendance at meetings, participation in working groups, reporting, feasibility studies, installation and support of numerous events, etc.. The aim of this paper is to present the scientific community of solar and wind power a historical record of 10 years of activities developed by CRESESB, an assessment of achievements and planned targets for the future.

  4. Carcinoma of vagina 10 or more years following pelvic irradiation therapy

    International Nuclear Information System (INIS)

    Pride, G.L.; Buchler, D.A.

    1977-01-01

    Gynecologic cancer records of 4,238 patients treated between 1956 and 1974 were reviewed. Sixteen patients developed neoplasia in the cervix or vagina 10 or more years following pelvic irradiation. Three patients had squamous carcinoma in situ; the other 13 patients had invasive squamous cancer involving the upper vagina. Only 1.26 percent of invasive carcinoma of the cervix treated by radiation therapy from 1956 to 1966 presented with a late or recurrent or new primary tumor involving the vagina or cervix 10 or more years after primary treatment. The authors conclude that the risk of developing radiation-induced carcinoma in the upper vagina or cervix following pelvic irradiation is low. Follow-up Pap smears are indicated for all patients treated for cervical or vaginal malignancies by radiation therapy in order to detect vaginal neoplasia as well as recurrent carcinoma of the cervix

  5. Treatment results of glioblastoma during the last 30 years in a single institute

    International Nuclear Information System (INIS)

    Kumabe, Toshihiro; Saito, Ryuta; Kanamori, Masayuki

    2013-01-01

    Treatment results of glioblastoma (GB) during the last 30 years in Tohoku University were analyzed to identify any improvements in patient outcome in all 332 histologically proven cases of newly diagnosed GB treated consecutively in our department between 1982 and 2011. These 30 years was divided into 5 treatment eras, Group 1 (1982-1988, without preoperative evaluation by magnetic resonance [MR] imaging, n=46), Group 2 (1989-1996, with preoperative MR imaging, n=41), Group 3 (1997-1999, additionally underwent intraoperative functional brain mapping and neuronavigation system, n=38), Group 4 (2000-August 2006, underwent 30 Gy of whole brain radiation followed by 30 Gy of extended local accelerated hyperfractionated radiation therapy, n=96), and Group 5 (September 2006-2011, adjuvant usage of temozolomide [TMZ], n=111). Overall survival (OS) was calculated from the date of surgery to the death from any cause. The median survival time/2-year OS/5-year OS of Groups 1 to 5 were 10.7 months/10.9%/0%, 17.3 months/26.2%/6.9%, 15.9 months/23.7%/5.3%, 20.1 months/34.8%/15.5%, and 20.9 months/45.5%/19.7%. The prognosis for patients with GB improved significantly after the introduction of MR imaging. Younger GB, defined as patients aged below 60 years, or total tumor resection with all ages in Group 5 had 5-year OS of 31.0% and 30.1%, respectively. The prognosis of GB was improved significantly after the introduction of TMZ for elderly GB, recursive partitioning analysis class 5, or totally resected GB. Introduction of MR imaging and TMZ, and total resection of the tumor were important in the improvement of outcome for patients with GB. (author)

  6. Etude Climat no. 37 '10 lessons from 10 years of the CDM'

    International Nuclear Information System (INIS)

    Shishlov, Igor; Bellassen, Valentin

    2012-01-01

    Among the publications of CDC Climat Research, 'Climate Reports' offer in-depth analyses on a given subject. This issue addresses the following points: The Clean Development Mechanism (CDM) is the first and by far the largest carbon offset instrument in the world. To date, it is the only market based on an environmental commodity which managed to attract several billions of euros of private capital on an annual basis. Being the first-of-a-kind climate change mitigation instrument, the CDM followed a 'learning by doing' pattern undergoing numerous reforms throughout its more than 10-year history. Although the post-2012 fate of the mechanism remains uncertain, one should not 'throw out the baby with the bath water' as the lessons from the CDM experience may be useful not only for the CDM reform but also for new market instruments

  7. Risk of Local Failure in Breast Cancer Patients With Lobular Carcinoma In Situ at the Final Surgical Margins: Is Re-excision Necessary?

    Energy Technology Data Exchange (ETDEWEB)

    Sadek, Betro T.; Shenouda, Mina N.; Abi Raad, Rita F. [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Niemierko, Andrzej [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Statistics Section, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Keruakous, Amany R. [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Goldberg, Saveli I. [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Statistics Section, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States)

    2013-11-15

    Purpose: To compare the outcome of patients with invasive breast cancer both with and without lobular carcinoma in situ (LCIS)-positive/close surgical margins after breast-conserving treatment. Methods and Materials: We retrospectively studied 2358 patients with T1-T2 invasive breast cancer treated with lumpectomy and radiation therapy from January 1980 to December 2009. Median age was 57 years (range, 24-91 years). There were 82 patients (3.5%) with positive/close LCIS margins (<0.2 cm) and 2232 patients (95.7%) with negative margins. A total of 1789 patients (76%) had negative lymph nodes. Patients who received neoadjuvant chemotherapy were excluded. A total of 1783 patients (76%) received adjuvant systemic therapy. Multivariable analysis (MVA) was performed using Cox's proportional hazards model. Results: The 5-year cumulative incidence of locoregional recurrence (LRR) was 3.2% (95% confidence interval [CI] 2.5%-4.1%) for the 2232 patients with LCIS-negative surgical margins (median follow-up 104 months) and 2.8% (95% CI 0.7%-10.8%) for the 82 patients with LCIS-positive/close surgical margins (median follow-up 90 months). This was not statistically significant (P=.5). On MVA, LCIS-positive margins after the final surgery were not associated with increased risk of LRR (hazard ratio [HR] 3.4, 95% CI 0.5-24.5, P=.2). Statistically significant prognostic variables on Cox's MVA for risk of LRR included systemic therapy (HR 0.5, 95% CI 0.33-0.75, P=.001), number of positive lymph nodes (HR 1.11, 95% CI 1.05-1.18, P=.001), menopausal status (HR 0.96, 95% CI 0.95-0.98, P=.001), and histopathologic grade (grade 3 vs grade 1/2) (HR 2.6, 95% CI 1.4-4.7, P=.003). Conclusion: Our results suggest that the presence of LCIS at the surgical margin after lumpectomy does not increase the risk of LRR or the final outcome. These findings suggest that re-excision or mastectomy in patients with LCIS-positive/close final surgical margins is unnecessary.

  8. Graft survival rate of renal transplantation during a period of 10 years in Iran

    Directory of Open Access Journals (Sweden)

    Fatemeh Shahbazi

    2015-01-01

    Full Text Available Background: Kidney transplantation is a preferred treatment for many patients with end-stage renal disease (ESRD and is far more profitable than hemodialysis. Analyzing renal transplantation data can help to evaluate the effectiveness of transplantation interventions. The aim of this study was to determine the organ survival rate after kidney transplantation during a period of 10 years (March 2001-March 2011 among transplanted patients in Arak, Markazi Province, Iran. Materials and Methods: In this historical cohort study, all recipients of kidney transplantation from Arak, Markazi Province, Iran who had medical records in Valiasr Hospital and "charity for kidney patients" of Arak, Markazi Province, Iran during a period of 10 years from March 2001 to March 2011 were included. Data collected by using checklists were completed from patients′ hospital records. Kaplan-Meier method was used to determine the graft cumulative survival rate, log-rank test to compare survival curves in subgroups, and Cox regression model to define the hazard ratio and for ruling out the intervening factors. Statistical analysis was conducted by Statistical Package for the Social Sciences (SPSS 20 and Stata 11. Results: Mean duration of follow-up was 55.43 ± 42.02 months. By using the Kaplan-Meier method, the cumulative probability of graft survival at 1, 3, 5, 7, and 10 years was 99.1, 97.7, 94.3, 85.7, and 62.1%, respectively. The number of dialysis by controlling the effect of other variables had a significant association with the risk of graft failure [hazard ratios and 95% confidence interval (CI: 1.47 (1.02-2.13]. Conclusion: This study showed that the graft survival rate was satisfactory in this community and was similar to the results of single-center studies in the world. Dialysis time after transplantation was a significant predictor of survival in the recipients of kidney transplantation that should be considered.

  9. First results from the T-10 tokamak

    International Nuclear Information System (INIS)

    Berlizov, A.B.; Bobrovskij, G.A.; Bagdasarov, A.A.

    1977-01-01

    Measurements of plasma parameters are made on the T-10 tokamak with a toroidal magnetic field of 3.5 T and a plasma current of 0.4 MA. In macroscopically stable discharges of 1 s duration, the central electron temperature is Tsub(e)(0)=1.2 keV, the mean electron density reaches a value of nsub(e)=5X10 13 cm -3 , and the central ion temperature is measured to be 0.6-0.8 keV. The thermonuclear neutron yield reaches a value of 4X10 9 neutrons per shot, in agreement with the Tsub(i)(0) value measured by charge exchange. Sawtooth X-ray oscillations are observed. The effective ionic charge is found to be less than 2 for the inner region of the plasma column. The energy confinement time tausub(E) is calculated from the experimental profiles of the plasma parameters. The value of tausub(E) is 40 ms and increases up to 60 ms, while nsub(e) is increased up to 8.5X10 13 cm -3 as a result of cold-gas injection by a pulse valve. Violent disruption is observed in several regimes. Hard-X-ray and neutron radiation bursts take place during the disruption, both in hydrogen and in deuterium. More intensive and prolonged radiation fluxes of hard X-rays and non-thermonuclear neutrons are observed in some discharges where very intensive beams of relativistic runaway electrons seem to exist. (author)

  10. Decreased risk of stroke among 10-year survivors of breast cancer.

    NARCIS (Netherlands)

    Hooning, M.J.; Dorresteijn, L.D.A.; Aleman, B.; Kappelle, A.C.; Klijn, J.G.M.; Boogerd, W.; Leeuwen, F.E. van

    2006-01-01

    PURPOSE: To assess treatment-specific risk of cerebrovascular events in early breast cancer (BC) patients, accounting for cerebrovascular risk factors. PATIENTS AND METHODS: We studied the incidence of cerebrovascular accidents (CVA; stroke and transient ischemic attack [TIA]) in 10-year survivors

  11. A 10-year review of perioperative complications in pharyngeal flap surgery

    NARCIS (Netherlands)

    Hofer, SOP; Dhar, BK; Robinson, PH; Goorhuis-Brouwer, SM; Nicolai, JPA

    2002-01-01

    A 10-year retrospective study was undertaken to investigate perioperative complications in pharyngeal flap surgery in one institution using inferiorly and superiorly based flaps. In this fashion the current practice of surgical technique based on local findings and perioperative care, through

  12. [Primary prevention of cardiovascular diseases: long term results of five year long preventive intervention in 12-year old boys (ten year prospective study)].

    Science.gov (United States)

    Rozanov, V B; Aleksandov, A A; Shugaeva, E N; Perova, N V; Maslennikova, G Ia; Smirnova, S G; Olfer'ev, A M

    2007-01-01

    In a longitudinal cohort (prevention group, n=213, comparison group, n=163) of 10-year prospective follow-up we addressed efficacy of 5-year-long multifactor preventive intervention, conducted in a sample of population of 12 year old boys. Preventive intervention was carried out both at populational level and among persons with risk factors of development of cardiovascular diseases with the use of group, individual, and partly family approaches, and was directed at rationalization of nutrition, elevation of physical activity and prevention of harmful habits. During first 3 years of prevention we succeeded to achieve stable statistically significant lowering of mean levels of total cholesterol, low density lipoprotein cholesterol, triglycerides, and atherogeneity index, as well as to affect fatty component of body mass (skinfold thickness). Long term effect of 5-year long preventive intervention manifested as significantly lower level of systolic blood pressure, lower prevalence of low levels of high density lipoprotein cholesterol, smaller increment of low density lipoprotein cholesterol and index of atherogeneity in the prevention group. These results evidence that prevention of main factors of risk of development of cardiovascular diseases (obesity, arterial hypertension, disorders of lipid composition of the blood, and low physical activity) in child and adolescent age in the period of active growth and development is feasible, effective, safe and is able to lead to decrease of levels of these factors in adults, but should last uninterruptedly until formation of stable habits of healthy life style.

  13. Residual lifetime and 10 year absolute risks of osteoporotic fractures in Chinese men and women.

    Science.gov (United States)

    Si, Lei; Winzenberg, Tania M; Chen, Mingsheng; Jiang, Qicheng; Palmer, Andrew J

    2015-06-01

    To determine the residual lifetime and 10 year absolute risks of osteoporotic fractures in Chinese men and women. A validated state-transition microsimulation model was used. Microsimulation and probabilistic sensitivity analyses were performed to address the uncertainties in the model. All parameters including fracture incidence rates and mortality rates were retrieved from published literature. Simulated subjects were run through the model until they died to estimate the residual lifetime fracture risks. A 10 year time horizon was used to determine the 10 year fracture risks. We estimated the risk of only the first osteoporotic fracture during the simulation time horizon. The residual lifetime and 10 year risks of having the first osteoporotic (hip, clinical vertebral or wrist) fracture for Chinese women aged 50 years were 40.9% (95% CI: 38.3-44.0%) and 8.2% (95% CI: 6.8-9.3%) respectively. For men, the residual lifetime and 10 year fracture risks were 8.7% (95% CI: 7.5-9.8%) and 1.2% (95% CI: 0.8-1.7%) respectively. The residual lifetime fracture risks declined with age, whilst the 10 year fracture risks increased with age until the short-term mortality risks outstripped the fracture risks. Residual lifetime and 10 year clinical vertebral fracture risks were higher than those of hip and wrist fractures in both sexes. More than one third of the Chinese women and approximately one tenth of the Chinese men aged 50 years are expected to sustain a major osteoporotic fracture in their remaining lifetimes. Due to increased fracture risks and a rapidly ageing population, osteoporosis will present a great challenge to the Chinese healthcare system. While national data was used wherever possible, regional Chinese hip and clinical vertebral fracture incidence rates were used, wrist fracture rates were taken from a Norwegian study and calibrated to the Chinese population. Other fracture sites like tibia, humerus, ribs and pelvis were not included in the analysis, thus these

  14. Predictors for Employment Status in People With Multiple Sclerosis: A 10-Year Longitudinal Observational Study.

    Science.gov (United States)

    Forslin, Mia; Fink, Katharina; Hammar, Ulf; von Koch, Lena; Johansson, Sverker

    2018-01-31

    To identify predictors for employment status after 10 years in a cohort of people with multiple sclerosis (MS), with the aim to increase knowledge concerning factors present at an early stage that are important for working life and work-life balance. A 10-year longitudinal observational cohort study. University hospital. A consecutive sample of people with MS (N=154) of working age were included at baseline, of which a total of 116 people participated in the 10-year follow-up; 27 people declined participation and 11 were deceased. Not applicable. Baseline data on personal factors and functioning were used as independent variables. Employment status 10 years after baseline, categorized as full-time work, part-time work, and no work, was used as the dependent variable. A generalized ordinal logistic regression was used to analyze the predictive value of the independent variables. Predictors for full- or part-time work after 10 years were young age (P=.002), low perceived physical impact of MS (P=.02), fatigue (P=.03), full-time work (P=.001), and high frequency of social/lifestyle activities (P=.001) at baseline. Low perceived physical impact of MS (P=.02) at baseline also predicted full-time work after 10 years. This study underlines the complexity of working life for people with MS, and indicates that it may be valuable to give more attention to the balance between working and private life, both in clinical practice and future research, to achieve a sustainable working life over time. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. 10 years with Planet Earth essence in the primary school children drawings

    Science.gov (United States)

    D'Addezio, Giuliana

    2016-04-01

    "10 years with Planet Earth" is the title of the 2016 INGV calendar for primary schools representing the review of a project conceived as support and complement of 15 years long INGV dissemination activities with schools. We realized 10 calendars together with and for primary schools, every year with a subject related to a World in constant evolution. Earthquakes, volcanic eruptions, tsunami waves, magnetic storms and other phenomena are manifestations of the complexity and dynamicity, which began more than four billion years ago and never halted. Since the Earth originated to the first presence of water, life and oxygen, the Cambrian explosion of species, the domain of dinosaurs, the great extinctions and glaciations, the surface of our planet experiences continents collisions, mountains and oceans formation and life forms emerging and disappearing. Every year we have launched a competition asking children to send drawings on themes chosen to stimulate learning about Earth Sciences and Planet Earth dynamics. We intended to raise awareness on issues as water resources availability, protection against natural disasters and control of environmental degradation. For each competition, we chose the most significant drawings to be included in the yearly calendar about the Earth. The authors of drawings were awarded by scientists, journalists, artists and science communicators and even by a minister. Besides the competitions, these drawings depict their own impressions and reflections, providing an opportunity to illustrate the children's point of view. From drawings and texts arise a great consideration and respect for the Planet, raising hopes that similar initiatives can contribute to increase the knowledge of the Earth and of the fragile human ecosystem in the hearts and minds of future active citizens. The project was made possible thanks to the teachers and to the wonderful students of more than 200 schools that sent about 10,000 drawings that have intrigued

  16. Atypical presentation of macrophagic myofasciitis 10 years post vaccination.

    LENUS (Irish Health Repository)

    Ryan, Aisling M

    2012-02-03

    Macrophagic myofasciitis (MMF) is an uncommon inflammatory disorder of muscle believed to be due to persistence of vaccine-derived aluminium hydroxide at the site of injection. The condition is characterised by diffuse myalgias, arthralgia and fatigue. We describe a patient with histologically confirmed MMF whose presentation was atypical with left chest and upper limb pain beginning more than 10 years post vaccination. Treatment with steroids led to symptomatic improvement. Although rare, clinicians should consider MMF in cases of atypical myalgia.

  17. Injuries in a Professional Ballet Dance Company: A 10-year Retrospective Study.

    Science.gov (United States)

    Ramkumar, Prem N; Farber, Joseph; Arnouk, Johnny; Varner, Kevin E; Mcculloch, Patrick C

    2016-03-01

    Ballet dancers are high-performance athletes who are particularly susceptible to a wide variety of musculoskeletal injuries. However, they are relatively understudied, and data on their injury rates are lacking. This retrospective study features the largest aggregate data on professional ballet dancers to date and aims to identify the most common diagnoses and areas of injury in this unique population to better direct preventative and clinical practices. The study encompassed a 10-year period from January 2000 to December 2010 of dancers from a single company. Data regarding the dancers' age, gender, location of injury, and diagnosis were collected from workers' compensation claims, company records, and medical records maintained by the treating doctors. These were analyzed to determine metrics on injury incidence, frequency, and diagnosis. Over the 10-year span, 574 injuries occurred. There were approximately 52 dancers per year for a total of 153 who danced at least one complete season during the study period. The average age was 27, and 53% were female. Given turnover with retirement and replacements, the total number of dancer-years was 520, indicating an injury incidence per annum of 1.10 (574 injuries per 520 dancer-years). The most common locations of injury were foot and ankle and the lumbar spine, with the three most common diagnoses making up greater than a third (37%) of the total. As the current largest study in professional ballet, the findings set the benchmark metrics for musculoskeletal injury to the foot, ankle, and lumbar spine sites. Future studies should aim to identify injury risk factors and modalities for prevention of these injuries.

  18. Cardiovascular assessment of asymptomatic patients with juvenile-onset localized and systemic scleroderma: 10 years prospective observation.

    Science.gov (United States)

    Borowiec, A; Dabrowski, R; Wozniak, J; Jasek, S; Chwyczko, T; Kowalik, I; Musiej-Nowakowska, E; Szwed, H

    2012-02-01

    The aim of the present study was non-invasive evaluation of the cardiovascular system in asymptomatic young adult patients with juvenile localized scleroderma (JLS) and juvenile systemic sclerosis (JSS). A group of 34 consecutive children with scleroderma were prospectively observed in the study. The control group (CG) consisted of 20 healthy subjects. In each subject 12-lead electrocardiographic, echocardiographic, ECG Holter, and ambulatory blood pressure monitoring examinations were performed at the baseline visit and after 10 years. Additionally, B-type natriuretic peptide (BNP) concentrations were measured after 10 years. Examinations were performed in 13 patients with JLS and 15 with JSS at the final visit. Two children had died (one from each group). Four patients were alive but refused the final visit. After 10 years, a higher prevalence of ventricular extrasystoles (p = 0.01) and an elevated pulmonary arterial pressure (JLS: p = 0.04, JSS: p = 0.03) were observed in both groups, but in comparison with the controls there was no significant difference at the final visit. In JLS patients more cases of left ventricle diastolic dysfunction, hypertension, and sinus tachycardia were diagnosed at the final visit (p ≤ 0.05). More atrioventricular block episodes in both groups of scleroderma patients were observed. Over the 10 years, arterial hypertension was diagnosed in three patients from the JLS group and in two with JSS. There were no significant differences in BNP concentrations at the final visit. The results of the present study show that juvenile scleroderma seems to be more benign than adult-onset disease. This observational study shows subclinical, not severe, cardiac abnormalities in adult patients with juvenile-onset disease.

  19. Secular trends: 10 and 20-year comparisons of sexual maturation among students. http://dx.doi.org/10.5007/1980-0037.2012v14n6p680

    Directory of Open Access Journals (Sweden)

    Rodrigo Mateus Farias

    2012-11-01

    Full Text Available The objective of this study was to verify the secular trends of sexual matu­ration of students between 11 and 15 years old, during a period of 10 and 20 years. The sample was composed by 1,002 students aged between 11 and 15 years; 536 boys (12.6±1.3 years old and 466 girls (12.5±1.2 years old who took part in the Ilhabela Mixed-Longitudinal Project on Growth, Development, and Physical Fitness. The students’ assessment period occurred in 1990/91 (initial, 2000/01 (10 years later, and 2009/10 (20 years later. Sexual maturation was analyzed according to the self-assessment method and age at menarche (month and year was collected retrospectively. The statistical analysis used was: one-way ANOVA, and Tukey’s post-hoc test. The level of significance was p<0.01. The onset of menarche in the initial analysis was at: 12.5±1.2 years old; in the 2000/01 group: 12.3±1.0 years old (Δ=-1.6%, and in the 2009/10 group: 12.2±1.0 years old (Δ=-2.4%. Although there was a tendency towards reduction in age at menarche along the periods in­vestigated, differences were not significant. There were significant differences only in genitals (G4, and pubic hair (P3 in boys after 10 and 20 years. In the same period, it did not occur any significant difference in maturational stages for girls. In conclusion, there was no secular trend of secondary sexual characteristics in boys (genital and pubic hair and girls (breast and pubic hair and in age at menarche over 10 and 20 years.

  20. Two-phase orthodontic treatment in a unilateral cleft lip and palate patient with 1-year follow-up results

    Directory of Open Access Journals (Sweden)

    Prashant M Dhole

    2017-01-01

    Full Text Available Treatment of a patient with cleft lip and palate can be challenging. A 10-year and 10-month-old girl presented with uneven and crowded teeth. She had unilateral cleft lip and palate on left side for which she had undergone primary lip repair and palatoplasty when she was younger. On examination, she had concave facial appearance, crossbite of upper arch with reverse overjet of 2 mm, wits appraisal of 6 mm and impacted 23. She was treated with two-phase orthodontic treatment; growth modification appliances followed by fixed mechanotherapy. Total treatment time was 5 years. 1-year follow-up shows that results have been stable with good facial aesthetics and functional occlusion.

  1. Patch testing for allergic contact dermatitis: Three years retrospective results in Tekirdağ

    Directory of Open Access Journals (Sweden)

    Gamze Erfan

    2015-06-01

    Full Text Available Background and Design: Allergic contact dermatitis is a delayed type hypersensitivity reaction to allergens in individuals who were sensitized with same allergens before. The causative allergens may change in time as well as vary among geographical and population based differences. Materials and Methods: The characteristics of 169 patients-107 (63.3% male, 62 (36.7% female, who patch tested between 2011- 2014 with allergic contact dermatitis diagnosis and test results were retrospectively analysed. Results: The mean age of all patients who had the most frequent occupation as service sector/house wife (26.6% were 41.06 years and the mean disease duration of all patients was 19.5 months. The most frequent localization of disease was hands (n: 105,%73 and %50.3 of patients had positivity with at least one allergen. The most frequent seven allergens with positivity were nickel sulfate (n: 50, %29.6, cobalt chloride (n: 23, %13.6, potassium dichromate (n: 22, %13, sesquiterpene lactone mix (n: 18, %10.7, thiuram (n: 10, %5.9, clioquinol mix (n: 10, %5.9 and 4-tert-butilfenol formaldehyde resin (n: 10, %5.9, respectively. On the other hand in all patients there were no positivity with N-Isopropyl-N-phenyl-4-phenylenediamine, epoxy resin, balsam of peru, formaldehyde, quaternium-15, primin, tixocortol-21-pivalate, fragrance mix-2. Conclusion: In comparison of this study which first reports patch test results of patients in Tekirdağ-a city in Trakya region and other studies that report patch test results of different regions of our country; the mean age of patients of present study were older and there were similar results for occupations and localization of disease in between eastern region and present study. We believe that further studies are needed to specify allergen characteristics of Trakya region using multicenter studies, which include other cities as well.

  2. Influence of anterior tooth alignment on peer perception in 8- to 10-year-old children.

    Science.gov (United States)

    Verdecchia, Federica; Bee, Marco; Lombardo, Luca; Sgarbanti, Chiara; Gracco, Antonio

    2011-04-01

    The purpose of this research was to investigate whether anterior dental alignment in 8- to 10-year-old children influences the first impressions of their peers, and to verify the validity of the tested method. From colour photographs of two attractive children, one male and one female, Adobe Photoshop 5.0 was used to alter the images and create three versions of each photograph: one with good anterior dental alignment (OK smile), a second with proclination of the upper incisors (P-type smile), and finally one with moderate-to-severe anterior crowding (C-type smile). The six different photographs were shown to 121 subjects with mean age of 9.2 years (65 females and 56 males). Each subject was asked to view one photograph and subsequently respond to a questionnaire, the 'Smile perception questionnaire for children between the ages of 8 and 10' (SPQ 8-10), composed of 13 questions with graded responses. The responses for each photograph were analysed using linear regression analysis to determine the questionnaires validity as a whole and to investigate five area of common interest (honesty, intelligence, personal happiness, pleasantness, and extroversion). The results demonstrated that the questionnaire was reliable both from an internal coherence standpoint and from a test-retest reliability perspective. Data regarding the five areas of interest showed that 8- to 10-year-olds viewed their peers with well-aligned teeth more favourably as far as honesty, personal happiness, and intelligence were concerned. However, there was no statistically significant difference with regard to pleasantness and extroversion in children with harmonious, as opposed to crowded or proclined anterior teeth.

  3. Revenues and Expenditures for Public Elementary and Secondary School Districts: School Year 2009-10 (Fiscal Year 2010): First Look. NCES 2013-307

    Science.gov (United States)

    Cornman, Stephen Q.

    2013-01-01

    This report presents data from the School District Finance Survey (F-33) of the Common Core of Data (CCD) survey system for school year (SY) 2009-10, fiscal year 2010 (FY 10). The F-33 is a district-level financial survey that consists of data submitted annually to the National Center for Education Statistics (NCES) and the Governments Division of…

  4. Nightguard vital bleaching: side effects and patient satisfaction 10 to 17 years post-treatment.

    Science.gov (United States)

    Boushell, Lee W; Ritter, André V; Garland, Glenn E; Tiwana, Karen K; Smith, Lynn R; Broome, Angela; Leonard, Ralph H

    2012-06-01

      The long-term patient satisfaction and safety of nightguard vital bleaching (NGVB) requires further evaluation.   The purpose of this study was to evaluate patients' satisfaction and identify side effects of NGVB up to 17 years post-treatment.   Thirty-one participants who had completed previous NGVB studies using 10% carbamide peroxide were contacted at least 10 years post-treatment (range 10-17 years, average 12.3 years). Participants reported shade satisfaction (very satisfied [VS], partially satisfied [PS], or not satisfied [NS]) as well as potential complications. Participants had teeth # 6 to 11 examined for tooth vitality, gingival inflammation (Löe's Gingival Index [GI]), and radiographically for external cervical resorption (ECR).   All of the participants had successful lightening of their teeth. Sixty-one percent (19) had not retreated their teeth. Of those who had not retreated their teeth and who responded to the question of whitening satisfaction, 31% (4/13) were VS, 54% (7/13) were PS, and 15% (2/13) were NS with their current shade. Of those who had retreated their teeth, all were VS or PS. Ninety-one percent of the examined teeth had GI = 0 (normal), 7% had GI = 1 (mild inflammation), and 2% had GI = 2 (moderate inflammation). Sixty-nine percent of teeth tested responded to a cold stimulus. Radiographs did not detect ECR or apical lesions. No participant reported having a gingival biopsy post-treatment, and 87% would whiten again.   Patient satisfaction with NGVB may last as long as 12.3 years in average (range 10-17 years) post-treatment. GI and ECR findings were considered within the normal expectations for the sample studied, suggesting minimal clinical post-NGVB side effects up to 17 years. Nightguard vital bleaching provides patient satisfaction with minimal side effects up to 17 years post-treatment. © 2011 Wiley Periodicals, Inc.

  5. 10 years of engineering and physics achievements by the Large Helical Device project

    International Nuclear Information System (INIS)

    Yamada, H.; Imagawa, S.; Takeiri, Y.; Kaneko, O.; Mutoh, T.; Mito, T.; Chikaraishi, H.; Hamaguchi, S.; Ida, K.; Igami, H.; Ikeda, K.; Kasahara, H.; Kobayashi, M.; Kubo, S.; Kumazawa, R.; Maekawa, R.; Masuzaki, S.; Miyazawa, J.; Morisaki, T.; Morita, S.

    2009-01-01

    This article reviews 10 years of engineering and physics achievements by the Large Helical Device (LHD) project with emphasis on the latest results. The LHD is the largest magnetic confinement device among diversified helical systems and employs the world's largest superconducting coils. The cryogenic system has been operated for 50,000 h in total without any serious trouble and routinely provides a confining magnetic field up to 2.96 T in steady state. The heating capability to date is 23 MW of NBI, 2.9 MW of ICRF and 2.1 MW of ECH. Negative-ion-based ion sources with the accelerating voltage of 180 keV are used for a tangential NBI with the power of 16 MW. The ICRF system has full steady-state operational capability with 1.6 MW. In these 10 years, operational experience as well as a physics database have been accumulated and the advantages of stable and steady-state features have been demonstrated by the combination of advanced engineering and the intrinsic physical advantage of helical systems in LHD. Highlighted physical achievements are high beta (5% at the magnetic field of 0.425 T), high density (1.1 x 10 21 m -3 at the central temperature of 0.4 keV), high ion temperature (T i of 5.2 keV at 1.5 x 10 19 m -3 ), and steady-state operation (3200 s with 490 kW). These physical parameters have elucidated the potential of net-current free helical plasmas for an attractive fusion reactor. It also should be pointed out that a major part of these engineering and physics achievements is complementary to the tokamak approach and even contributes directly to ITER.

  6. The Boehringer Ingelheim employee study (Part 2): 10-year cardiovascular diseases risk estimation.

    Science.gov (United States)

    Kempf, K; Martin, S; Döhring, C; Dugi, K; Haastert, B; Schneider, M

    2016-10-01

    Cardiovascular disease (CVD) may cause an economic burden to companies, but CVD risk estimations specific to working populations are lacking. To estimate the 10-year CVD risk in the Boehringer Ingelheim (BI) employee cohort and analyse the potential effect of hypothetical risk reduction interventions. We estimated CVD risk using the Framingham (FRS), PROCAM (PRS) and Reynolds (RRS) risk scores, using cross-sectional baseline data on BI Pharma employees collected from 2005 to 2011. Results were compared using Fisher's exact and Wilcoxon tests. The predictive ability of the score estimates was assessed using receiver-operating characteristics analyses. Among the 4005 study subjects, we estimated 10-year CVD risks of 35% (FRS), 9% (PRS) and 6% (RRS) for men and 10% (FRS), 4% (PRS) and 1% (RRS) for women. One hundred and thirty-four (6%) men and 111 (6%) women employees had current CVD. The best predictors of prevalent CVD were the FRS and the RRS for men [area-under-the-curve 0.62 (0.57-0.67) for both]. A hypothetical intervention that would improve systolic blood pressure, HbA1c (for diabetes), C-reactive protein, triglycerides and total and high-density lipoprotein cholesterol by 10% each would potentially reduce expected CVD cases by 36-41% in men and 30-45% in women, and if smoking cessation is incorporated, by 39-45% and 30-55%, respectively, depending on the pre-intervention risk score. There was a substantial risk of developing CVD in this working cohort. Occupational health programmes with lifestyle interventions for high-risk individuals may be an effective risk reduction measure. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  7. Acceptability of biscuits containing 10% cricket (Acheta domesticus) compared to milk biscuits among 5-10-year-old Kenyan schoolchildren

    DEFF Research Database (Denmark)

    Homann, A M; Ayieko, M A; Konyole, S O

    2017-01-01

    of the study was to develop a recipe for cricket biscuits suitable for school feeding programmes and test acceptability of the biscuits in Kenyan schoolchildren, in comparison with a similar biscuit with milk. The study was randomised and parallel. Fifty-four children aged 5-10 years were served 100 g (range...... 98-102 g) biscuits containing either 10% cricket powder or 10% milk powder during school days for four weeks. At baseline anthropometry (weight, height, mid upper arm circumference) was measured and information on insect consumption and allergies collected. Daily, weight of biscuits eaten...

  8. The Mataró Stroke Registry: a 10-year registry in a community hospital.

    Science.gov (United States)

    Palomeras Soler, E; Fossas Felip, P; Casado Ruiz, V; Cano Orgaz, A; Sanz Cartagena, P; Muriana Batiste, D

    2015-06-01

    A prospective stroke registry leads to improved knowledge of the disease. We present data on the Mataró Hospital Registry. In February-2002 a prospective stroke registry was initiated in our hospital. It includes sociodemographic data, previous diseases, clinical, topographic, etiological and prognostic data. We have analyzed the results of the first 10 years. A total of 2,165 patients have been included, 54.1% male, mean age 73 years. The most frequent vascular risk factor was hypertension (65.4%). Median NIHSS on admission: 3 (interquartile range, 1-8). Stroke subtype: 79.7% ischemic strokes, 10.9% hemorrhagic, and 9.4% TIA. Among ischemic strokes, the etiology was cardioembolic in 26.5%, large-vessel disease in 23.7%, and small-vessel in 22.9%. The most frequent topography of hemorrhages was lobar (47.4%), and 54.8% were attributed to hypertension. The median hospital stay was 8 days. At discharge, 60.7% of patients were able to return directly to their own home, and 52.7% were independent for their daily life activities. After 3 months these percentages were 76.9% and 62.9%, respectively. Hospital mortality was 6.5%, and after 3 months 10.9%. Our patient's profile is similar to those of other series, although the severity of strokes was slightly lower. Length of hospital stay, short-term and medium term disability, and mortality rates are good, if we compare them with other series. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  9. Stump appendicitis 10 years after appendectomy, a rare, but serious complication of appendectomy, a case report.

    Science.gov (United States)

    Van Paesschen, Carl; Haenen, Filip; Bestman, Raymond; Van Cleemput, Marc

    2017-02-01

    We describe a case of stump appendicitis with the formation of abdominal abscesses in a 41-year-old patient 10 years prior appendectomy. The patient consulted with fever (38.1 °C) and abdominal pain, located at the right iliac fossa. Imaging studies showed signs of abscesses, located at the right iliac fossa, without clear origin of these abscesses. The abscesses were drained through diagnostic laparoscopy, no bowel perforation or clear origin of the abscedation was found during laparoscopy. During postoperative stay, the inflammatory parameters rose and the abscesses reoccurred. Re-laparoscopy was performed, the abscesses were drained and on careful inspection and adhesiolysis, a perforated stump appendicitis was revealed, covered underneath layers of fibrous tissue. Stump appendicitis is a rare complication seen after appendectomy and is generally not considered a possible etiology in patients presenting with fever and right iliac fossa abdominal pain with a history of appendectomy. This often delays the correct diagnosis and results in an associated increased incidence of complications. We describe a case of stump appendicitis occurring 10 years after initial appendectomy.

  10. Predictors and longitudinal course of cognitive functioning in schizophrenia spectrum disorders, 10 years after baseline

    DEFF Research Database (Denmark)

    Bergh, Sara; Hjorthøj, Carsten; Sørensen, Holger J.

    2016-01-01

    of illness is another matter of interest. METHODS: Participants from The Danish OPUS Trial, aged 18-45years, with a baseline ICD-10 schizophrenia spectrum diagnosis, were assessed on psychopathology, social and vocational functioning at baseline, and cognitive functioning 5 (N=298) and 10years (N=322) after...

  11. Dynamics of social-psychological consequences 10 years after Chernobyl

    International Nuclear Information System (INIS)

    Rumyantseva, G.M.; Levina, T.M.; Archangelskaya, H.V.; Zykova, I.A.

    1996-01-01

    The study has been carried out according to the long-term JSP2 in comparison with the results of data acquired by the authors in previous years in other programs in 1988-95 for more then 5 thousand people. In working out the strategy of post-catastrophe situation it is necessary to have a joint effort of the population and authority. The studies have showed that cooperation has not been achieved in this case. Hence, the effect of protective measures have been seriously decreased. Countermeasures taken after the catastrophe have had not only a positive, but in some cases a negative impact. The results of many previous studies as will as JSP2 program have shown serious social and psychological consequences of Chernobyl Accident. There is a constant year-to-year comprehension among population anxiety concerning their health. The main result of the study is that social and psychological consequences of the Chernobyl Accident include nonradiological risks as seriously as the radiation risk.23

  12. Late Urinary Side Effects 10 Years After Low-Dose-Rate Prostate Brachytherapy: Population-Based Results From a Multiphysician Practice Treating With a Standardized Protocol and Uniform Dosimetric Goals

    International Nuclear Information System (INIS)

    Keyes, Mira; Miller, Stacy; Pickles, Tom; Halperin, Ross; Kwan, Winkle; Lapointe, Vincent; McKenzie, Michael; Spadinger, Ingrid; Pai, Howard; Chan, Elisa K.; Morris, W. James

    2014-01-01

    Purpose: To determine late urinary toxicity (>12 months) in a large cohort of uniformly treated low-dose-rate prostate brachytherapy patients. Methods and Materials: From 1998 to 2009, 2709 patients with National Comprehensive Cancer Network–defined low-risk and low-tier intermediate-risk prostate cancer were treated with Iodine 125 ( 125 I) low-dose-rate prostate brachytherapy; 2011 patients with a minimum of 25 months of follow-up were included in the study. Baseline patients, treatment, implant factors, and late urinary toxicity (Radiation Therapy Oncology Group [RTOG] grading system and International Prostate Symptom Score [IPSS]) were recorded prospectively. Time to IPSS resolution, late RTOG genitourinary toxicity was examined with Kaplan-Meier and log-rank tests. Cox proportional hazards regression was done for individual covariates and multivariable models. Results: Median follow-up was 54.5 months (range, 2-13 years). Actuarial toxicity rates reached 27% and 10% (RTOG ≥2 and ≥3, respectively) at 9-13 years. Symptoms resolved quickly in the majority of patients (88% in 6-12 months). The prevalence of RTOG 0, 1, 2, 3, and 4 toxicity with a minimum of 7 years' follow-up was 70%, 21%, 6.4%, 2.3%, and 0.08%, respectively. Patients with a larger prostate volume, higher baseline IPSS, higher D90, acute toxicity, and age >70 years had more late RTOG ≥2 toxicity (all P≤.02). The IPSS resolved slower in patients with lower baseline IPSS and larger ultrasound prostate volume, those not receiving androgen deprivation therapy, and those with higher D90. The crude rate of RTOG 3 toxicity was 6%. Overall the rate of transurethral resection of the prostate was 1.9%; strictures, 2%; incontinence, 1.3%; severe symptoms, 1.8%; late catheterization, 1.3%; and hematuria, 0.8%. The majority (80%) resolved their symptoms in 6-12 months. Conclusion: Long-term urinary toxicity after brachytherapy is low. Although actuarial rates increase with longer follow

  13. Late Urinary Side Effects 10 Years After Low-Dose-Rate Prostate Brachytherapy: Population-Based Results From a Multiphysician Practice Treating With a Standardized Protocol and Uniform Dosimetric Goals

    Energy Technology Data Exchange (ETDEWEB)

    Keyes, Mira, E-mail: mkeyes@bccancer.bc.ca; Miller, Stacy; Pickles, Tom; Halperin, Ross; Kwan, Winkle; Lapointe, Vincent; McKenzie, Michael; Spadinger, Ingrid; Pai, Howard; Chan, Elisa K.; Morris, W. James

    2014-11-01

    Purpose: To determine late urinary toxicity (>12 months) in a large cohort of uniformly treated low-dose-rate prostate brachytherapy patients. Methods and Materials: From 1998 to 2009, 2709 patients with National Comprehensive Cancer Network–defined low-risk and low-tier intermediate-risk prostate cancer were treated with Iodine 125 ({sup 125}I) low-dose-rate prostate brachytherapy; 2011 patients with a minimum of 25 months of follow-up were included in the study. Baseline patients, treatment, implant factors, and late urinary toxicity (Radiation Therapy Oncology Group [RTOG] grading system and International Prostate Symptom Score [IPSS]) were recorded prospectively. Time to IPSS resolution, late RTOG genitourinary toxicity was examined with Kaplan-Meier and log-rank tests. Cox proportional hazards regression was done for individual covariates and multivariable models. Results: Median follow-up was 54.5 months (range, 2-13 years). Actuarial toxicity rates reached 27% and 10% (RTOG ≥2 and ≥3, respectively) at 9-13 years. Symptoms resolved quickly in the majority of patients (88% in 6-12 months). The prevalence of RTOG 0, 1, 2, 3, and 4 toxicity with a minimum of 7 years' follow-up was 70%, 21%, 6.4%, 2.3%, and 0.08%, respectively. Patients with a larger prostate volume, higher baseline IPSS, higher D90, acute toxicity, and age >70 years had more late RTOG ≥2 toxicity (all P≤.02). The IPSS resolved slower in patients with lower baseline IPSS and larger ultrasound prostate volume, those not receiving androgen deprivation therapy, and those with higher D90. The crude rate of RTOG 3 toxicity was 6%. Overall the rate of transurethral resection of the prostate was 1.9%; strictures, 2%; incontinence, 1.3%; severe symptoms, 1.8%; late catheterization, 1.3%; and hematuria, 0.8%. The majority (80%) resolved their symptoms in 6-12 months. Conclusion: Long-term urinary toxicity after brachytherapy is low. Although actuarial rates increase with longer

  14. Association between metabolic syndrome and 10-year risk of developing cardiovascular disease in a Nigerian population.

    Science.gov (United States)

    Oguoma, Victor M; Nwose, Ezekiel U; Skinner, Timothy C; Richards, Ross S; Digban, Kester A; Onyia, Innocent C

    2016-09-01

    Prevalence of metabolic syndrome (MetS) and consequential cardiovascular disease (CVD) events are on the increase in Nigeria. The study aimed to identify the prevalence of 10-year CVD risk in a Nigerian population and assess its relationship with different indices of MetS. A cross-sectional study was carried out on apparently healthy persons aged 18 years of age or older. Ten-year risk was calculated using the ATPIII/Framingham criteria. Subjects with risk score 20% at high risk of developing CVD in 10 years. MetS was defined based on the Joint Scientific Statement on Harmonizing the MetS. Of the 211 subjects, mean age was 51.3±17.3 years. Average risk of developing CVD in the next 10 years was 3.7±5.3%. Prevalence of low, moderate and high risk of developing CVD among study participants was 86.3% (95% CI 82.0-91.3%), 11.8% (95% CI 6.9-16.1%) and 1.9% (95% CI 0.0-3.8%), respectively. Prevalence of MetS was 26.7% (95% CI 21.0-33.3%). There was poor agreement between MetS and the CVD risk scores (kappa=0.209, p=0.001) CONCLUSIONS: The results showed that complementary use of MetS and CVD risk score is imperative, as there is indication of risk in individuals without MetS. Also a large proportion of the study population requires lifestyle intervention. These findings provide the evidence necessary to tailor public health interventions in this population, especially towards younger age groups. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Development of 5 and 10 years old infant phantoms based on polygonal meshes

    International Nuclear Information System (INIS)

    Lima, Vanildo Junior de Melo; Kramer, Richard; Cassola, Vagner Ferreira; Lira, Carlos Alberto Brayner de Oliveira; Khoury, Helen Jamil; Vieira, Jose Wilson; Universidade de Pernambuco

    2011-01-01

    This paper focuses the development of reference infant phantoms of 5 and 10 years old to be used in calculation of equivalent doses in the area of radiological protection. The method uses tools developed for the modelling of 3D objects. The forms and positions are available in the literature. The mass values of each organ and tissue were adjusted according to the reference data published by the International Commission Radiological Protection. The results are presented in image of organs and tissues, and in tables. Dosimetric calculations show concordance with adult and infant phantoms, considering the differences among phantoms

  16. Terminal Posterior Tilted Implants Planned as a Sinus Graft Alternative for Fixed Full-Arch Implant-Supported Maxillary Restoration: A Case Series with 10- to 19-Year Results on 44 Consecutive Patients Presenting for Routine Maintenance.

    Science.gov (United States)

    Fortin, Yvan; Sullivan, Richard M

    2017-02-01

    Posterior maxillary tilted implants are gaining prevalence as an alternative to sinus grafts supporting fixed maxillary restorations. This paper reports long-term results after loading using this technique. Consecutive patients presenting for either routine hygiene maintenance or unplanned emergency care who had received tilted implants as a sinus graft alternative to support fixed fully implant-supported restoration of an edentulous maxilla and were followed for a minimum of 10 years from initial implant placement were included in this evaluation. Forty-four patients were identified: 40 with bilateral tilted implants and 4 with one tilted and one axial posterior implant. Eight patients received one-piece fixed porcelain-to-gold screw-retained restorations, and thirty-six patients received a fully implant-supported patient-removable Marius Bridge. Seventy-nine out of 84 originally loaded posterior tilted implants survived a minimum of 10 years loading; one tilted implant was lost at 10 years. Eight additional posterior implants were placed for either these lost tilted posterior implants or as proactive supplemental support; one of these replacement tilted implants survived for at least 10 years and is included in the data. All patients have maintained continuous fixed function throughout the follow-up period. Forty-one out of 44 patients continue with the original restoration, 33 without modification or removal of the fixed restoration or implant-connecting bar. One porcelain-to-gold and seven Marius Bridges had framework modifications to accommodate additional implants; 3 Marius Bridge restorations were replaced with a newer generation. Within the limits of this retrospective study, the results show that continuous fixed function of fully implant-supported maxillary restorations using posterior tilted implants in terminal positions of support as a sinus graft alternative combined with axial anterior implants is possible over a prolonged period. Loss of a posterior

  17. Prevalence of overweight and obesity in Danish preschool children over a 10-year period

    DEFF Research Database (Denmark)

    Larsen, Lone Marie; Hertel, Niels Thomas; Mølgaard, Christian

    2012-01-01

    Aim:  To determine change in the prevalence of overweight and obesity in preschool children, over a 10-year period and to identify possible predictors of overweight in 5-year-old children. Methods:  Anthropometric data from birth and routine child health examinations at 3 and 5 years of age...... of preschool children, the average BMI and prevalence of overweight and obesity did not vary significantly during the 10-year period. No significant changes in mean birth weight were registered and mean BMI in the group of obese children did not increase. Overweight or obesity at 5 years was strongly...... associated with overweight and obesity at 3 years and with birth weight and gender. Conclusion:  The prevalence of overweight and obesity was observed to be stable over a decade in Danish preschool children without changes in mean BMI in the group of obese children. A strong association between overweight...

  18. Cow-related trauma: a 10-year review of injuries admitted to a single institution.

    LENUS (Irish Health Repository)

    Murphy, Colin G

    2012-02-01

    INTRODUCTION: Bovine-related injuries to farmers are common in rural communities. Many injuries are significant requiring hospital admission and surgery. We reviewed all cattle-related injuries admitted to a regional trauma centre over 10 years and detail the nature of the injuries. METHOD: A retrospective review was undertaken, using hospital inpatient coding system (HIPE) to identify patients admitted following cow-related trauma for the last 10 years. From retrieved charts mechanism of injury was identified, demographics recorded and Injury Severity Score (ISS) and Trauma Injury Severity Score (TRISS) calculated based on the injuries sustained. RESULTS: 47 patients were identified, with a median age of 53 years. 4 injuries occurred in children, and 12 in patients over 65 years old. Three-quarters of those injured were male. Kicking was the most common mechanism of injury (n=21), but charge\\/head-butt injuries and trampling injuries were associated with more serious injury scores. 72% of patients were admitted under Orthopaedics as their primary care team, 25% under General Surgeons, with one patient admitted medically. Mean ISS score was 6.9 (range 1-50). 41 operative interventions were performed on 30 patients during their admission. 6.3% of patients required admission to Intensive Care with a mean length of stay of 12.3 days (range 2-21 days). There was no mortality. CONCLUSION: Cow-related trauma is a common among farming communities and is a potentially serious mechanism of injury that appears to be under-reported in a hospital context. Bovine-related head-butt and trampling injuries should be considered akin to high-velocity trauma.

  19. Fluvoxamine-induced intracranial hypertension in a 10-year-old boy.

    Science.gov (United States)

    Samant, Hemalini; Samant, Preetam

    2018-05-01

    Drug-induced intracranial hypertension is a well-established entity. We report a rare case of intracranial hypertension with papilledema in a 10-year-old boy following use of fluvoxamine, a selective serotonin reuptake inhibitor. On discontinuing the drug, the papilledema resolved over 4 months without any residual visual anomalies. To the best of our knowledge, this is the first report of fluvoxamine-induced intracranial hypertension with papilledema.

  20. Healthcare-associated Pneumonia: Clinical Features and Retrospective Analysis Over 10 Years

    Science.gov (United States)

    Qi, Fei; Zhang, Guo-Xin; She, Dan-Yang; Liang, Zhi-Xin; Wang, Ren-Tao; Yang, Zhen; Chen, Liang-An; Cui, Jun-Chang

    2015-01-01

    Background: Healthcare-associated pneumonia (HCAP) is associated with drug-resistant pathogens and high mortality, and there is no clear evidence that this is due to inappropriate antibiotic therapy. This study was to elucidate the clinical features, pathogens, therapy, and outcomes of HCAP, and to clarify the risk factors for drug-resistant pathogens and prognosis. Methods: Retrospective observational study among hospitalized patients with HCAP over 10 years. The primary outcome was 30-day all-cause hospital mortality after admission. Demographics (age, gender, clinical features, and comorbidities), dates of admission, discharge and/or death, hospitalization costs, microbiological results, chest imaging studies, and CURB-65 were analyzed. Antibiotics, admission to Intensive Care Unit (ICU), mechanical ventilation, and pneumonia prognosis were recorded. Patients were dichotomized based on CURB-65 (low- vs. high-risk). Results: Among 612 patients (mean age of 70.7 years), 88.4% had at least one comorbidity. Commonly detected pathogens were Acinetobacter baumannii, Pseudomonas aeruginosa, and coagulase-negative staphylococci. Initial monotherapy with β-lactam antibiotics was the most common initial therapy (50%). Mean age, length of stay, hospitalization expenses, ICU admission, mechanical ventilation use, malignancies, and detection rate for P. aeruginosa, and Staphylococcus aureus were higher in the high-risk group compared with the low-risk group. CURB-65 ≥3, malignancies, and mechanical ventilation were associated with an increased mortality. Logistic regression analysis showed that cerebrovascular diseases and being bedridden were independent risk factors for HCAP. Conclusion: Initial treatment of HCAP with broad-spectrum antibiotics could be an appropriate approach. CURB-65 ≥3, malignancies, and mechanical ventilation may result in an increased mortality. PMID:26481734

  1. Healthcare-associated Pneumonia: Clinical Features and Retrospective Analysis Over 10 Years

    Directory of Open Access Journals (Sweden)

    Fei Qi

    2015-01-01

    Full Text Available Background: Healthcare-associated pneumonia (HCAP is associated with drug-resistant pathogens and high mortality, and there is no clear evidence that this is due to inappropriate antibiotic therapy. This study was to elucidate the clinical features, pathogens, therapy, and outcomes of HCAP, and to clarify the risk factors for drug-resistant pathogens and prognosis. Methods: Retrospective observational study among hospitalized patients with HCAP over 10 years. The primary outcome was 30-day all-cause hospital mortality after admission. Demographics (age, gender, clinical features, and comorbidities, dates of admission, discharge and/or death, hospitalization costs, microbiological results, chest imaging studies, and CURB-65 were analyzed. Antibiotics, admission to Intensive Care Unit (ICU, mechanical ventilation, and pneumonia prognosis were recorded. Patients were dichotomized based on CURB-65 (low- vs. high-risk. Results: Among 612 patients (mean age of 70.7 years, 88.4% had at least one comorbidity. Commonly detected pathogens were Acinetobacter baumannii, Pseudomonas aeruginosa, and coagulase-negative staphylococci. Initial monotherapy with β-lactam antibiotics was the most common initial therapy (50%. Mean age, length of stay, hospitalization expenses, ICU admission, mechanical ventilation use, malignancies, and detection rate for P. aeruginosa, and Staphylococcus aureus were higher in the high-risk group compared with the low-risk group. CURB-65 ≥3, malignancies, and mechanical ventilation were associated with an increased mortality. Logistic regression analysis showed that cerebrovascular diseases and being bedridden were independent risk factors for HCAP. Conclusion: Initial treatment of HCAP with broad-spectrum antibiotics could be an appropriate approach. CURB-65 ≥3, malignancies, and mechanical ventilation may result in an increased mortality.

  2. A 10-Year Mechatronics Curriculum Development Initiative: Relevance, Content, and Results--Part I

    Science.gov (United States)

    Das, S.; Yost, S. A.; Krishnan, M.

    2010-01-01

    This paper describes the first phase of a Mechatronics Curriculum Development effort--the design of an "Introduction to Mechatronics" course, the infusion of mechatronics activities throughout the curriculum and in outreach activities, and assessment results. In addition, the relevance and impact of such a curriculum on the education of engineers…

  3. Breast conserving surgery in locoregional treatment of breast carcinoma after Hodgkin lymphoma

    International Nuclear Information System (INIS)

    Haberer, S.; Le Scodan, R.; Kirova, Y.M.; Moisson, P.; Campana, F.; Fourquet, A.; Bollet, M.A.; Belin, L.; Savignoni, A.; Stevens, D.; Decaudin, D.; Pierga, J.Y.; Reyal, F.

    2012-01-01

    Purpose. - To report characteristics and outcome of breast cancer after irradiation for Hodgkin lymphoma with special focus on breast conservation surgery. Patients and methods. - Medical records of 72 women who developed either ductal carcinoma in situ or stage I-III invasive carcinoma of the breast after Hodgkin lymphoma between 1978 and 2009 were retrospectively reviewed. Results. - Median age at Hodgkin lymphoma diagnosis was 23 years old. Median total dose received by the mediastinum was 40 Gy, mostly by a mantle field technique. Breast cancer occurred after a median time interval of 21 years. Ductal invasive carcinoma and ductal carcinoma in situ represented respectively 71% and 19% of the cases. Locoregional treatment for breast cancer consisted of mastectomy with or without radiotherapy in 39 patients and of lumpectomy with or without adjuvant radiotherapy in 32 patients. The isocentric lateral decubitus radiation technique was used in 17 patients after breast conserving surgery (57%). With a median follow-up of 7 years, 5-year overall survival rate and locoregional control rate were respectively 74.5% and 82% for invasive carcinoma and 100% and 92% for in situ carcinoma. Thirteen patients died of progressive breast cancer and contralateral breast cancer was diagnosed in ten patients (14%). Conclusions. - Breast conserving treatment can be an option for breast cancers that occur after Hodgkin lymphoma despite prior thoracic irradiation. It should consist of lumpectomy and adjuvant breast radiotherapy with use of adequate techniques, such as the lateral decubitus isocentric position. (authors)

  4. 4-Valent Human Papillomavirus (4vHPV) Vaccine in Preadolescents and Adolescents After 10 Years.

    Science.gov (United States)

    Ferris, Daron G; Samakoses, Rudiwilai; Block, Stanley L; Lazcano-Ponce, Eduardo; Restrepo, Jaime Alberto; Mehlsen, Jesper; Chatterjee, Archana; Iversen, Ole-Erik; Joshi, Amita; Chu, Jian-Li; Krick, Andrea Likos; Saah, Alfred; Das, Rituparna

    2017-12-01

    We describe the final 10-year data for the long-term follow-up study of the 4-valent human papillomavirus (4vHPV) vaccine in preadolescents and adolescents. In the base study (V501-018), 1661 sexually inactive boys and girls received the 4vHPV vaccine (early vaccination group [EVG], managed for 9.9 years) or a placebo at day 1, month 2, and month 6. Thereafter, at month 30, the placebo group (catch-up vaccination group [CVG], managed for 7.4 years) received the 4vHPV vaccine by using the same dosing schedule. Long-term anti-HPV type 6, 11, 16, and 18 immune responses were assessed. Effectiveness was estimated by calculating the incidence rate of the primary endpoints (HPV types 6, 11, 16, and 18-related disease or persistent infection). For HPV types 6, 11, and 16, 89% to 96% of subjects remained seropositive through 10-years postvaccination. The preadolescents had 38% to 65% higher geometric mean titers at month 7, which remained 16% to 42% higher at 10 years compared with adolescents. No cases of HPV type 6, 11, 16, and 18-related diseases were observed. Ten subjects had a persistent infection of ≥6 months duration with vaccine-type HPV and 2 subjects had persistent infection for ≥12 months. No new serious adverse events were reported through 10 years. A 3-dose regimen of the 4vHPV vaccine was immunogenic, clinically effective, and generally well tolerated in preadolescents and adolescents during 10 years of follow-up. These long-term findings support efforts to vaccinate this population against HPV before exposure. Copyright © 2017 by the American Academy of Pediatrics.

  5. Acute Cholangitis following Intraductal Migration of Surgical Clips 10 Years after Laparoscopic Cholecystectomy

    Directory of Open Access Journals (Sweden)

    Natalie E. Cookson

    2015-01-01

    Full Text Available Background. Laparoscopic cholecystectomy represents the gold standard approach for treatment of symptomatic gallstones. Surgery-associated complications include bleeding, bile duct injury, and retained stones. Migration of surgical clips after cholecystectomy is a rare complication and may result in gallstone formation “clip cholelithiasis”. Case Report. We report a case of a 55-year-old female patient who presented with right upper quadrant pain and severe sepsis having undergone an uncomplicated laparoscopic cholecystectomy 10 years earlier. Computed tomography (CT imaging revealed hyperdense material in the common bile duct (CBD compatible with retained calculus. Endoscopic retrograde cholangiopancreatography (ERCP revealed appearances in keeping with a migrated surgical clip within the CBD. Balloon trawl successfully extracted this, alleviating the patient’s jaundice and sepsis. Conclusion. Intraductal clip migration is a rarely encountered complication after laparoscopic cholecystectomy which may lead to choledocholithiasis. Appropriate management requires timely identification and ERCP.

  6. The SEVAN Worldwide network of particle detectors: 10 years of operation

    Science.gov (United States)

    Chilingarian, A.; Babayan, V.; Karapetyan, T.; Mailyan, B.; Sargsyan, B.; Zazyan, M.

    2018-05-01

    The Space Environment Viewing and Analysis Network (SEVAN) aims to improve the fundamental research on particle acceleration in the vicinity of the sun, on space weather effects and on high-energy physics in the atmosphere and lightning initiation. This new type of a particle detector setup simultaneously measures fluxes of most species of secondary cosmic rays, thus being a powerful integrated device for exploration of solar modulation effects and electron acceleration in the thunderstorm atmosphere. The SEVAN modules are operating at the Aragats Space Environmental Center (ASEC) in Armenia, in Croatia, Bulgaria, Slovakia, the Czech Republic (from 2017) and in India. In this paper, we present the most interesting results of the SEVAN network operation during the last decade. We present this review on the occasion of the 10th anniversary of the International Heliophysical Year in 2007.

  7. Long-term intrathecal baclofen: outcomes after more than 10 years of treatment.

    Science.gov (United States)

    Mathur, Sunjay N; Chu, Samuel K; McCormick, Zack; Chang Chien, George C; Marciniak, Christina M

    2014-06-01

    To report outcomes of intrathecal baclofen (ITB) therapy for spasticity management in a cohort of patients who had received this treatment for at least 10 years. A cross-sectional survey and retrospective chart review. An academic rehabilitation outpatient clinic. Adult patients with spasticity treated with ITB for at least 10 years. Surveys included the Brief Pain Inventory, Penn Spasm Frequency Scale, Epworth Sleepiness Scale, Fatigue Severity Scale, Diener Satisfaction with Life, Life Satisfaction Questionnaire, and Intrathecal Baclofen Survey. Twenty-four subjects completed the surveys. The subjects had been treated with ITB from 10.0-28.4 years, with a mean (standard deviation) of 14.7 ± 4.2 years. The mean (standard deviation) dose of ITB was 627.9 ± 306.7 μg/d, with only 6 subjects averaging daily dose changes of more than 10% compared with 3 years earlier. The mean (standard deviation) scores on outcomes surveys were the following: 2.6 ± 2.3 for pain severity on the Brief Pain Inventory, 1.4 ± 0.7 for spasm severity on the Penn Spasm Frequency Scale, 7.9 ± 5.4 on the Epworth Sleepiness Scale, 4.1 ± 1.6 on the Fatigue Severity Scale, 19.4 ± 8.1 on the Diener Satisfaction with Life, 3.9 ± 0.9 on the Life Satisfaction Questionnaire, and 8.8 ± 1.9 for overall satisfaction with ITB on the Intrathecal Baclofen Survey. On the Brief Pain Inventory, the mean scores for pain severity and interference of pain with life showed moderate inverse correlations with ITB dose (r = -0.386, P = .115; and r = -0.447, P = .062, respectively). On the Life Satisfaction Questionnaire, the mean scores for life satisfaction showed statistically significant positive correlation with ITB dose (r = 0.549, P = .021). The subjects reported low levels of pain, moderate levels of life satisfaction, normal levels of sleepiness, low-to-moderate levels of fatigue, infrequent spasms at mild-to-moderate severity, and high levels of satisfaction. The efficacy and favorable adverse

  8. Regions Subject to Rainfall Oscillation in the 5–10 Year Band

    Directory of Open Access Journals (Sweden)

    Jean-Louis Pinault

    2018-01-01

    Full Text Available The decadal oscillation of rainfall in Europe that has been observed since the end of the 20th century is a phenomenon well known to climatologists. Consequences are considerable because the succession of wet or dry years produces floods or, inversely, droughts. Moreover, much research has tried to answer the question about the possible link between the frequency and the intensity of extra-tropical cyclones, which are particularly devastating, and global warming. This work aims at providing an exhaustive description of the rainfall oscillation in the 5–10 year band during one century on a planetary scale. It is shown that the rainfall oscillation results from baroclinic instabilities over the oceans. For that, a joint analysis of the amplitude and the phase of sea surface temperature anomalies and rainfall anomalies is performed, which discloses the mechanisms leading to the alternation of high and low atmospheric pressure systems. For a prospective purpose, some milestones are suggested on a possible link with very long-period Rossby waves in the oceans.

  9. World trend - a 10% growth per year for small wind turbines

    International Nuclear Information System (INIS)

    Kane, M.

    2016-01-01

    A decline was expected for small wind turbine business with the advent of bigger wind turbines but it is really not the case. In 2014 the growth rate was about 10 % with a cumulated power installed that year of 830 MW for small wind turbines. China (41% of the installed capacity), United-States (30%) and Great-Britain (15%) are the 3 main players. About 1 million wind turbines are operating in the world - it means 8.3% (∼ 70.000 units) more than a year before. (A.C.)

  10. Epidemiology of bronchial asthma in school children (10–16 years in Srinagar

    Directory of Open Access Journals (Sweden)

    Uruj Altaf Qureshi

    2016-01-01

    Full Text Available Objectives: To assess the epidemiological profile of asthma in school going children in Srinagar, Kashmir. Study design: Cross-sectional study. Setting: Thirty-one schools with proportionate representation from both government and private schools as well as from primary, middle, and high schools. Participants: School children aged 10–16 years with equal representation of sex and all ages. Main Outcome Measure: Prevalence of current and past asthma. Methods and Results: After administering a modified pretested questionnaire, peak expiratory flow measurement was carried. Children who had asthma-like symptoms or positive family history of asthma or physician-labeled asthma were subjected to spirometry and bronchodilator reversibility. Out of 806 children, bronchial asthma was seen in 60 (prevalence of 7.4% which included 34 boys and 26 girls. Majority of asthmatic children (78.3% [n = 47] had probable asthma; 6.7% (n = 4 had definite asthma; and 15% (n = 9 had physician-diagnosed asthma. Majority of children had intermittent asthma (78.3% [n = 47]. Mild persistent asthma was seen in 12.7% (n = 7 and 10% (n = 6 had moderate persistent asthma. None of the children had severe persistent asthma. The prevalence of current asthma was 3.2% (n = 26. On univariate analysis, the factors found to be statistically significant were family history of asthma (odds ratio [OR] =8.174; confidence interval [CI] =4.403–15.178, seasonal cough (OR = 4.266; CI = 2.336–7.791, allergic rhinitis (OR = 2.877; CI = 1.414–5.852, atopic dermatitis (OR = 6.597; CI = 2.72–16.004, and obesity (OR = 6.074; CI = 2.308–18.034. On multivariate analysis, family history, seasonal cough, allergic rhinitis, atopic dermatitis, and obesity were found to be significant independent risk factors. Conclusions: Srinagar qualifies as a low prevalence area for bronchial asthma in the age group of 10–16 years. Majority of children had mild intermittent asthma resulting in under

  11. A 10-year review of the dose history of radiation workers in the University of Surrey

    International Nuclear Information System (INIS)

    Parami, V.K.

    1991-09-01

    This thesis presents data on internally and externally received doses for radiation workers whose records are kept at the Safety Office of the University of Surrey for the period 1981-1990. The distribution of doses by range is presented and analysed. The patterns of the collective equivalent dose (CED) and the average individual equivalent dose (IED) over the 10-year period are presented. The annual CED is very low, so that even the total for the 10-year period is less than 1 man-Sv. Likewise, the annual average IED is extremely low, well below the average annual dose to the U.K. population from overall sources of ionising radiation. Some relevant aspects of the 1990 ICRP Recommendations are examined and the impact of these to the 'practices' and sources of ionising radiation in the University is given consideration. The results of the 10-year review provide more evidence of over designation of radiation workers in the University. A recommendation is made to reduce the number of workers who are routinely monitored and justification and options are presented. This study is viewed as a useful database which could be of particular importance in the procedure of optimisation of radiation protection in the University of Surrey and U.K. establishments for higher education as a whole. (author)

  12. Availability and cost of wood fuel in 10 years time

    International Nuclear Information System (INIS)

    Loenner, G.; Danielsson, B.O.; Vikinge, B.; Parikka, M.; Hektor, B.; Nilsson, P.O.

    1998-09-01

    The potential supply of wood fuel in Sweden is very large. Without reductions from ecological, technical and economic reasons the supply is around 125 TWh per year, depending among other things on the future cut of industrial wood. How much of this gross volume of wood fuel will be available on various time horizons, is however not so clear. The aim of this work has been to estimate technically and economically available quantities of wood fuel in a medium time horizon, around 10 years, and considering ecological considerations. This horizon means that today's best available techniques and methods are assumed to be applied widely, which means that today's lowest cost level will dominate in real terms within around 10 years. The applied methodology means that the potential supply of wood fuel of various types is distributed on different cost influencing factors like terrain class, wood fuel concentration and location in relation to nearest road and final user. All types of wood fuels are included, i.e. logging residues, direct fuel cuttings, industrial by-products and recycled wood. As a whole a large part of the total supply is available with today's best technique and with today's average price level of around 115 SEK per MWh (560 SEK per oven dry tonne). Around 60% or 75 TWh can be considered to be economically available in the medium term. In the long range perspective these figures will probably increase considerably, due primarily to the technical development, and provided that sufficient demand is there 44 refs, 8 figs, 12 tabs, 14 appendixes

  13. Epidemiological, Clinical and Paraclinical Study of Hydatid Cysts in Three Educational Medical Centers in 10 Years

    Directory of Open Access Journals (Sweden)

    Simindokht Shoaee

    2016-01-01

    Full Text Available Background: Echinococcosis or hydatidosis, caused by the larval stage of Echinococcus granulosus (E. granulosus, is an important public health problem in many areas of the world  and  Iran is a country of endemic situation for hydatidosis In the present study, we evaluated epidemiological, complications and clinical characteristics of hydatidosis at three University Medical Centers in Tehran over a 10-year period.Materials and Methods: This is a descriptive cross-sectional study performed in patients with hydatid cysts. Information about age, gender, number of cysts, organ involvement, morbidity and mortality and relapse were collected from medical records of hydatid patients. Paraclinic information such as CT Scan, MRI, ultrasound, complete blood count, pathological diagnosis and complication of disease were collected.Results: Overall, 81 patients, 35 (43.2% male and 46 (56.8% female, who were diagnosed as having hydatid cyst by clinical and radiological findings, with pathologic documentation were studied in three university medical center registries over a 10-year period (2003- 2012 in Tehran. Fourteen patients (17% of cases had complications resulting from this disease. Patients' age ranged from 5 to 86 years, and the peak prevalence of the disease was between 20 and 40 (34% of cases.Conclusion: Iran  is a country of endemic situation for hydatidosis. Prevalence rate of hydatidosis in Iran was reported to be 0.61-2 in 100000 populations. The highest  rate of infection and complications were in patients of 20-40 years age. Clinical examination revealed that abdominal pain was the most common complaint and was present in 51.7% of the cases. Other most common complain were cough, abdominal mass, dyspnea, icterus, chest pain, dyspepsia, back pain and seizure; and it was result of occupying effect of cysts in organs. This is similar with previous studies in Iran

  14. Natural history of heartburn: a 10-year population-based study.

    Science.gov (United States)

    Olafsdottir, Linda Bjork; Gudjonsson, Hallgrimur; Jonsdottir, Heidur Hrund; Thjodleifsson, Bjarni

    2011-02-07

    To study the natural history and prevalence of heartburn at a 10-year interval, and to study the effect of heartburn on various symptoms and activities. A population-based postal study was carried out. Questionnaires were mailed to the same age- and gender-stratified random sample of the Icelandic population (aged 18-75 years) in 1996 and again in 2006. Subjects were classified with heartburn if they reported heartburn in the preceding year and/or week, based on the definition of heartburn. Heartburn in the preceding year was reported in 42.8% (1996) and 44.2% (2006) of subjects, with a strong relationship between those who experienced heartburn in both years. Heartburn in the preceding week was diagnosed in 20.8%. There was a significant relationship between heartburn, dyspepsia and irritable bowel syndrome. Individuals with a body mass index (BMI) below or higher than normal weight were more likely to have heartburn. Heartburn caused by food or beverages was reported very often by 20.0% of subjects. Heartburn is a common and chronic condition. Subjects with a BMI below or higher than normal weight are more likely to experience heartburn. Heartburn has a great impact on daily activities, sleep and quality of life.

  15. Paleolimnological Evaluation of Lake Chapala (Western Mexico) During the Past 10,000 Years (CONACYT CB2011, Grant 168685, In Progress). PHASE II: Laboratory Work: First Results.

    Science.gov (United States)

    Zarate, P. F.; Israde-Alcantara, I.; Dorfler, W.; Unkel, I. B.; Dominguez Vazquez, G.; Nelle, O.; Espinoza Encinas, I. R.

    2015-12-01

    At Lake Chapala (103° 02'W, 20° 15'N) a linear sedimentation rate of 2 mm a-1 for the last 12,000 years was deduced from ten 14C dates. Due to the presence of very old hydrothermal bitumen (14C date: >40,000 years BP) a reservoir effect of c. 2000 years must be taken into account. Pollen results indicate a generally increase in dry forest taxa with an interruption during the middle Holocene. Diatom results allow a zonation into 6 paleoenvironmental phases. Zone 1: From 27 to 26m depth (c. 12,000 yBP), Stephanodiscus niagaraeis the dominant taxa in coincidence with high TOC percents; a transgression into moister conditions is indicated. Zone 2: From 26 to 17m (10,310-8720 cal BP) it is characterized by Aulacoseira granulata indicating an increase in ionic conditions and turbidity in lake as result of a decrease in lacustrine levels. Zone 3: From 17 to 13m (8720-5950 cal BP) it is dominated by C. aff. kuetzingiana and the presence of temperate pollen taxa at 12 m (ca. 5000 YBP) suggest an increase in humid conditions in this interval. Zone 4: From 13 to 8.5m (5950-2840 cal BP) encompass the middle Holocene. Stephanodiscus medius alternating with Surirella ovalis characterize this period and indicate very fluctuant conditions in coincidence with at a decrease of low TOC percents. Zone 5: From 8.5 to 4m (2840-1580 cal BP), mark the establishment of modern conditions until present, with a peak in S. ovalis in coincidence with the high A. granulata, indicating low lake, saline, turbid and more extreme conditions at the base and top of this interval. Zone 6: From 4 to 0m (1580 cal BP to Present) S. medius (over 50%), C. aff. dubius (20 to 40%), perifitic diatoms in low percents (<5%), and A. granulata and S.ovallis in spite of few percents, are observed in concordance with a return of saline conditions of the lake, indicate a regressive phase. Magnetic (susceptibility and paleomagnetism), microprobe analyses on tephra levels, X-ray Fluorescence (XRF) and Difraction (XRD

  16. Fluvoxamine-induced intracranial hypertension in a 10-year-old boy

    Directory of Open Access Journals (Sweden)

    Hemalini Samant

    2018-01-01

    Full Text Available Drug-induced intracranial hypertension is a well-established entity. We report a rare case of intracranial hypertension with papilledema in a 10-year-old boy following use of fluvoxamine, a selective serotonin reuptake inhibitor. On discontinuing the drug, the papilledema resolved over 4 months without any residual visual anomalies. To the best of our knowledge, this is the first report of fluvoxamine-induced intracranial hypertension with papilledema.

  17. Study of the effectiveness of the traditional system of training 6-10-years-old involved in football

    Directory of Open Access Journals (Sweden)

    I.G. Maksymenko

    2014-05-01

    Full Text Available Purpose : to identify the degree of efficiency traditionally used in Ukraine, the organization and conduct classes on football with students 6 to 10 years. Material : the study involved 57 students, ages 6-10 years. Investigations were carried out through the use of Polar Team System. Results : the indexes of the pulse energy and the cost of various options for training sessions, traditionally held in the sections with the children in groups of initial training. Marked reaction parameters organism beginners to competitive load. Substantiated quantitative characteristics of the diet of children. The data of the comparative analysis of energy cost of training sessions and daily food intake of children. Conclusions : It was found that classes with beginners accompanied by the use of heavy loads, often diet does not provide full recovery in children.

  18. Psychosocial Family Treatment for a 10-Year-Old with Schizoaffective Disorder

    Science.gov (United States)

    Klaus, Nicole M.; Fristad, Mary A.; Malkin, Catherine; Mackinaw-Koons, Barbara

    2008-01-01

    Schizophrenia spectrum disorders are rare in childhood and little is known about their psychosocial treatment. Relevant findings from the adult and child literature are reviewed. The case of 10-year-old "Michael" is presented, who participated in a randomized clinical trial of a psychoeducational family treatment for mood disorders. Following…

  19. Crossover effect of spouse weekly working hours on estimated 10-years risk of cardiovascular disease.

    Directory of Open Access Journals (Sweden)

    Mo-Yeol Kang

    Full Text Available To investigate the association between spouse weekly working hours (SWWH and the estimated 10-years risk of cardiovascular disease (CVD.This cross-sectional study was based on the data obtained from the Korean National Health and Nutrition Examination Survey 2007-2012. Data of 16,917 participants (8,330 husbands, 8,587 wives were used for this analysis. The participants' clinical data were collected to estimate the 10-years risk of CVD, as well as weekly working hours. Multiple logistic regression was conducted to investigate the association between SWWH and the estimated 10-years risk of CVD. We also performed a stratified analysis according to each participant's and their spouse's employment status.Compared to those whose spouses worked 30 hours per week, estimated 10-years risk of CVD was significantly higher as SWWH increase among those whose spouses worked >30 hours per week. After adjusting for covariates, the odds ratio for high CVD risk was found to increase as SWWH increased, up to 2.52 among husbands and 2.43 among wives. We also found that the association between SWWH and the estimated 10-years risk of CVD varied according to the employment status. Analysis of each component included in the CVD appraisal model showed that SWWH had close relationship with diabetes in men, and smoking habits in women.Spouse's long working hours are associated with individual's risk of CVD in future, especially among husbands.

  20. Maxillary Three-Implant Overdentures Opposing Mandibular Two-Implant Overdentures: 10-Year Surgical Outcomes of a Randomized Controlled Trial.

    Science.gov (United States)

    Ma, Sunyoung; Tawse-Smith, Andrew; De Silva, Rohana K; Atieh, Momen A; Alsabeeha, Nabeel H M; Payne, Alan G T

    2016-06-01

    The surgical placement of four maxillary implants for overdentures may not be obligatory when opposing mandibular two-implant overdentures. To determine 10-year surgical outcomes and implant success of three narrow diameter implants in edentulous maxillae with conventional loading. Forty participants with mandibular two-implant overdentures were randomly allocated for surgery for maxillary overdentures. Using osteotomes, three implants of similar systems were placed with a one-stage procedure and 12-week loading with splinted and unsplinted prosthodontic designs. Marginal bone and stability measurements were done at surgery, 12 weeks, 1-, 2-, 5-, 7-, 10 years. One hundred seventeen implants were placed in 39 participants, with 35 being seen at 1 year; 29 at 2 years; 28 at 5 years; 26 at 7 years; and 23 (59%) at 10 years. Marginal bone loss was 1.35 mm between surgery and 12 weeks; 0.36 mm between 12 weeks and 1 year; 0.48 mm between 1 and 5 years; and 0.22 mm between 5 and 10 years. Implant stability quotients were 56.05, 57.54, 60.88, 58.80, 61.17 at surgery, 12 weeks, 1 year, 5 years, and 10 years. Four-field tables by implant showed success rates of 82% at 1 year; 69.2% at 2 years; 66.7% at 5 years; 61.5% at 7 years; 51.3% at 10 years. Data showed no differences between surgical technique, systems, or prosthodontic designs. Surgical placement with osteotomes of three narrow diameter implants for maxillary overdentures, opposing mandibular two-implant overdentures, is an acceptable approach, subject to strict patient selection. Implant success is independent of prosthodontic design. © 2015 Wiley Periodicals, Inc.

  1. Dental caries and treatment needs of children (6-10 years in rural Udaipur, Rajasthan

    Directory of Open Access Journals (Sweden)

    Dhar Vineet

    2009-01-01

    Full Text Available Objective : This study was done to examine caries prevalence and corresponding treatment needs in school children of rural areas of Udaipur, Rajasthan. Materials and Methods : A total of 750 children of rural areas in the age group of 6-10 years were examined, using WHO index, to record the prevalence of dental caries and treatment needs. The results were subjected to statistical analysis using chi square test. Results : Dental caries was found in 63.20% children, and 85.07% children needed dental treatment. The highest need was of one surface filling (85.73% followed by sealant (51.20%. Conclusion : Dental caries showed to be a significant health issue in the rural population requiring immediate attention.

  2. Healthcare-associated Pneumonia: Clinical Features and Retrospective Analysis Over 10 Years.

    Science.gov (United States)

    Qi, Fei; Zhang, Guo-Xin; She, Dan-Yang; Liang, Zhi-Xin; Wang, Ren-Tao; Yang, Zhen; Chen, Liang-An; Cui, Jun-Chang

    2015-10-20

    Healthcare-associated pneumonia (HCAP) is associated with drug-resistant pathogens and high mortality, and there is no clear evidence that this is due to inappropriate antibiotic therapy. This study was to elucidate the clinical features, pathogens, therapy, and outcomes of HCAP, and to clarify the risk factors for drug-resistant pathogens and prognosis. Retrospective observational study among hospitalized patients with HCAP over 10 years. The primary outcome was 30-day all-cause hospital mortality after admission. Demographics (age, gender, clinical features, and comorbidities), dates of admission, discharge and/or death, hospitalization costs, microbiological results, chest imaging studies, and CURB-65 were analyzed. Antibiotics, admission to Intensive Care Unit (ICU), mechanical ventilation, and pneumonia prognosis were recorded. Patients were dichotomized based on CURB-65 (low- vs. high-risk). Among 612 patients (mean age of 70.7 years), 88.4% had at least one comorbidity. Commonly detected pathogens were Acinetobacter baumannii, Pseudomonas aeruginosa, and coagulase-negative staphylococci. Initial monotherapy with β-lactam antibiotics was the most common initial therapy (50%). Mean age, length of stay, hospitalization expenses, ICU admission, mechanical ventilation use, malignancies, and detection rate for P. aeruginosa, and Staphylococcus aureus were higher in the high-risk group compared with the low-risk group. CURB-65 ≥3, malignancies, and mechanical ventilation were associated with an increased mortality. Logistic regression analysis showed that cerebrovascular diseases and being bedridden were independent risk factors for HCAP. Initial treatment of HCAP with broad-spectrum antibiotics could be an appropriate approach. CURB-65 ≥3, malignancies, and mechanical ventilation may result in an increased mortality.

  3. The acceptability of human papillomavirus vaccine among parents and guardians of newborn to 10-year-old children.

    Science.gov (United States)

    Gillespie, Laura; Hicks, Caitlin W; Santana, Melissa; Worley, Sarah E; Banas, David A; Holmes, Sumayya; Rome, Ellen S

    2011-04-01

    The purpose of our study was to evaluate HPV vaccine acceptance among parents and guardians of children aged 0-10 years. Prospective questionnaire study. Cleveland Clinic Children's Hospital. Parents and guardians of children aged 0-10 years. Brief HPV vaccine educational intervention. Desire for child to get HPV vaccine. We enrolled 81 participants in the study; 70 (86%) were female, and 39 (49%) were Caucasian. Prior to receiving an educational fact sheet about HPV and the HPV vaccine, only 49% of participants reported that they wanted their young child to receive the HPV vaccine when it becomes available. After receiving the fact sheet, this number increased to 70%, suggesting that a simple educational intervention could significantly affect vaccine acceptance in this population (P = .001). Other significant results of this study included that HPV vaccination would receive greater acceptance if the participants believed that it can prevent HPV infection in their child (P = .0024), it was perceived to be safe (P = .0005), and if the vaccine were recommended by a physician (P HPV vaccination were not affected by concerns over whether receiving the vaccine might mean the child is more likely to have sex or to have multiple sexual partners. Our results suggest that if it were approved for children aged 0-10 years, the HPV vaccine would be accepted by the parents and guardians provided they received adequate educational information about it. Copyright © 2011 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  4. Students (ages 6, 10, and 15 years in six countries knowledge of animals

    Directory of Open Access Journals (Sweden)

    Patricia Patrick

    2013-04-01

    Full Text Available This article considers the knowledge students (ages 6, 10, and 15 years have of animals from a cross-cultural perspective. Students from six countries (Brazil, England, Finland, Iceland, Portugal, and the United States of America were asked to free-list as many animals as possible and state where they had seen or learned about the animals. The results were analyzed and they indicate that 1 Students are aware of animals. 2 Students are more aware of mammals as examples of animals. 3 There is a globally shared folk biological knowledge of animals. 4 Students learn about animals during sociocultural interactions. The educational implications are discussed.

  5. Decline of Cosmetic Outcomes Following Accelerated Partial Breast Irradiation Using Intensity Modulated Radiation Therapy: Results of a Single-Institution Prospective Clinical Trial

    International Nuclear Information System (INIS)

    Liss, Adam L.; Ben-David, Merav A.; Jagsi, Reshma; Hayman, James A.; Griffith, Kent A.; Moran, Jean M.; Marsh, Robin B.; Pierce, Lori J.

    2014-01-01

    Purpose: To report the final cosmetic results from a single-arm prospective clinical trial evaluating accelerated partial breast irradiation (APBI) using intensity modulated radiation therapy (IMRT) with active-breathing control (ABC). Methods and Materials: Women older than 40 with breast cancer stages 0-I who received breast-conserving surgery were enrolled in an institutional review board-approved prospective study evaluating APBI using IMRT administered with deep inspiration breath-hold. Patients received 38.5 Gy in 3.85-Gy fractions given twice daily over 5 consecutive days. The planning target volume was defined as the lumpectomy cavity with a 1.5-cm margin. Cosmesis was scored on a 4-category scale by the treating physician. Toxicity was scored according to National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE version 3.0). We report the cosmetic and toxicity results at a median follow-up of 5 years. Results: A total of 34 patients were enrolled. Two patients were excluded because of fair baseline cosmesis. The trial was terminated early because fair/poor cosmesis developed in 7 of 32 women at a median follow-up of 2.5 years. At a median follow-up of 5 years, further decline in the cosmetic outcome was observed in 5 women. Cosmesis at the time of last assessment was 43.3% excellent, 30% good, 20% fair, and 6.7% poor. Fibrosis according to CTCAE at last assessment was 3.3% grade 2 toxicity and 0% grade 3 toxicity. There was no correlation of CTCAE grade 2 or greater fibrosis with cosmesis. The 5-year rate of local control was 97% for all 34 patients initially enrolled. Conclusions: In this prospective trial with 5-year median follow-up, we observed an excellent rate of tumor control using IMRT-planned APBI. Cosmetic outcomes, however, continued to decline, with 26.7% of women having a fair to poor cosmetic result. These results underscore the need for continued cosmetic assessment for patients treated with APBI by technique

  6. Decline of Cosmetic Outcomes Following Accelerated Partial Breast Irradiation Using Intensity Modulated Radiation Therapy: Results of a Single-Institution Prospective Clinical Trial

    Energy Technology Data Exchange (ETDEWEB)

    Liss, Adam L. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Ben-David, Merav A. [Department of Radiation Oncology, The Sheba Medical Center, Ramat Gan (Israel); Jagsi, Reshma; Hayman, James A. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Griffith, Kent A. [Biostatistics Unit, University of Michigan, Ann Arbor, Michigan (United States); Moran, Jean M.; Marsh, Robin B. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Pierce, Lori J., E-mail: ljpierce@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

    2014-05-01

    Purpose: To report the final cosmetic results from a single-arm prospective clinical trial evaluating accelerated partial breast irradiation (APBI) using intensity modulated radiation therapy (IMRT) with active-breathing control (ABC). Methods and Materials: Women older than 40 with breast cancer stages 0-I who received breast-conserving surgery were enrolled in an institutional review board-approved prospective study evaluating APBI using IMRT administered with deep inspiration breath-hold. Patients received 38.5 Gy in 3.85-Gy fractions given twice daily over 5 consecutive days. The planning target volume was defined as the lumpectomy cavity with a 1.5-cm margin. Cosmesis was scored on a 4-category scale by the treating physician. Toxicity was scored according to National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE version 3.0). We report the cosmetic and toxicity results at a median follow-up of 5 years. Results: A total of 34 patients were enrolled. Two patients were excluded because of fair baseline cosmesis. The trial was terminated early because fair/poor cosmesis developed in 7 of 32 women at a median follow-up of 2.5 years. At a median follow-up of 5 years, further decline in the cosmetic outcome was observed in 5 women. Cosmesis at the time of last assessment was 43.3% excellent, 30% good, 20% fair, and 6.7% poor. Fibrosis according to CTCAE at last assessment was 3.3% grade 2 toxicity and 0% grade 3 toxicity. There was no correlation of CTCAE grade 2 or greater fibrosis with cosmesis. The 5-year rate of local control was 97% for all 34 patients initially enrolled. Conclusions: In this prospective trial with 5-year median follow-up, we observed an excellent rate of tumor control using IMRT-planned APBI. Cosmetic outcomes, however, continued to decline, with 26.7% of women having a fair to poor cosmetic result. These results underscore the need for continued cosmetic assessment for patients treated with APBI by technique.

  7. Osteosarcoma of mandible in a 10-year-old girl

    Directory of Open Access Journals (Sweden)

    SVSG Nirmala

    2014-01-01

    Full Text Available Osteosarcoma (OS of the jaws is a relatively rare malignant bone tumor. Like, its counterpart in the long bones, OS affecting the head and neck region shows distinct yet diverse clinical, histologic and prognostic characteristics. Here, we report a rare case of OS of fibroblastic variant in a 10-year-old girl, who came with a bony swelling in the left mandibular posterior region, with a radiographic presentation of sunburst appearance, the histopathological examination confirmed the diagnosis. The patient underwent partial mandibulectomy under general anesthesia followed by prosthodontic rehabilitation and is currently undergoing regular follow-up examination.

  8. Past and next 10 years of medical informatics.

    Science.gov (United States)

    Ückert, Frank; Ammenwerth, Elske; Dujat, Carl; Grant, Andrew; Haux, Reinhold; Hein, Andreas; Hochlehnert, Achim; Knaup-Gregori, Petra; Kulikowski, Casimir; Mantas, John; Maojo, Victor; Marschollek, Michael; Moura, Lincoln; Plischke, Maik; Röhrig, Rainer; Stausberg, Jürgen; Takabayashi, Katsuhiko; Winter, Alfred; Wolf, Klaus-Hendrik; Hasman, Arie

    2014-07-01

    More than 10 years ago Haux et al. tried to answer the question how health care provision will look like in the year 2013. A follow-up workshop was held in Braunschweig, Germany, for 2 days in May, 2013, with 20 invited international experts in biomedical and health informatics. Among other things it had the objectives to discuss the suggested goals and measures of 2002 and how priorities on MI research in this context should be set from the viewpoint of today. The goals from 2002 are now as up-to-date as they were then. The experts stated that the three goals: "patient-centred recording and use of medical data for cooperative care"; "process-integrated decision support through current medical knowledge" and "comprehensive use of patient data for research and health care reporting" have not been reached yet and are still relevant. A new goal for ICT in health care should be the support of patient centred personalized (individual) medicine. MI as an academic discipline carries out research concerning tools that support health care professionals in their work. This research should be carried out without the pressure that it should lead to systems that are immediately and directly accepted in practice.

  9. UAHuntsville and NASA-MSFC Heliophysics REU: Year One Strategy and Results

    Science.gov (United States)

    Farid, S.; Heerikhuisen, J.; Winebarger, A. R.

    2012-12-01

    Scientists from the University of Alabama in Huntsville and NASA Marshall Space Fight Center (MSFC) received a 3-year National Science Foundation (NSF) award to create a unique Heliophysics Research Experience for Undergraduates (REU). For 10 weeks, 10 undergraduate students engaged in cutting edge heliophysics research with NASA or UAHuntsville astrophysicists specializing in research from the solar interior to the heliopause. Research projects included theory, modeling, computer simulations, data analysis and instrument design. The primary objectives of this REU are to 1.) increase minority participation in science, technology and mathematics (STEM) fields in general, and heliophysics in particular, and 2.) decrease the STEM attrition rate in first and second year students. This REU is unique because of our focus on recruiting talented students that may not have otherwise participated in an REU. In addition to the usual criteria of most REUs, consideration of need was also given to those students who were sophomores, students with little or no previous research experience, those from small or non-PhD granting institutions, students with less than average GPA, minorities, women, etc. In this poster, we review the effectiveness of the first year strategy. We evaluate the recruitment and application process, mentor placement, living and working arrangements, introductory tutorials, and merit of final research projects. We present modifications for next year's effort, and make suggestions to similar REU programs.

  10. Eastern Michigan University's Automated Storage and Retrieval System: 10 Years Later

    Science.gov (United States)

    Bullard, Rita; Wrosch, Jackie

    2009-01-01

    Automated storage/retrieval systems (ASRSs) are playing an integral part in today's library operations and collections management. Eastern Michigan University installed an ASRS as part of the new Halle Library, which opened in May 1998, to provide "storage" for up to 800,000 items. Over the past 10 years our policies and procedures have…

  11. The effectiveness of the developed program of 10-13 years girls' coordinative abilities who are going in for calisthenics.

    Directory of Open Access Journals (Sweden)

    Belokopitova G. A.

    2011-04-01

    Full Text Available It's developed and practically based the program on developing coordinative abilities according to the age group of 10-13 years old gymnastics. This program is for special stage of training and it is aimed for developing coordinating abilities connected to individual-psychological peculiarities of girls going for gymnastics. It was shown that sport result of 10-13 years girls' influences on index of psycho-moving futures - abilities for correction of their actions to free mobilization and moving coordination during performing fast work. It can be explained that index which is being expected shows the set of time-hour moves and allows evaluating gymnasts moves.

  12. Initial 10-year Experience of Sperm Cryopreservation Services for Cancer Patients

    Directory of Open Access Journals (Sweden)

    Hong-Chiang Chang

    2006-01-01

    Full Text Available Offering sperm cryopreservation to preserve the fertility of male cancer patients is a relatively recent service in Asia. This study analyzed the types of cancer, timing of collection, sperm quality, and utilization for reproductive services by patients during a 10-year period at a medical center in Taiwan. A total of 75 oncology patients elected to freeze sperm for fertility preservation at our medical center during the initial 10 years of the availability of this service. The mean age of the patients was 25.7 years. Storage was discontinued in 13 (17% patients and their survival duration was 13.1 ±11.1 months. The utilization rate of sperm cryo-preservation was 2.8% (75/2642. The types of cancer varied, with leukemia (35%, lymphoma (25%, and testicular cancer (13% comprising the largest groups. A significantly lower sperm count was found in patients with chronic myelogenous leukemia, suggesting the need for earlier sperm collection after initiation of cancer treatment. Only three (4% patients utilized their specimens for reproductive purposes. There was no clinical pregnancy during the study period, although one biochemical pregnancy was achieved. The low rates of sperm cryostorage for fertility preservation in cancer patients in this study suggest that there is a need for greater emphasis of this option for male oncology patients whose fertility is likely to be affected by chemotherapeutic treatment.

  13. Is maternal education level associated with diet in 10-year-old children?

    Science.gov (United States)

    Cribb, Victoria L; Jones, Louise R; Rogers, Imogen S; Ness, Andrew R; Emmett, Pauline M

    2011-11-01

    To examine the associations between maternal education level and diet in 10-year-old children. Three-day diet diaries (child completed with parental help) were collected. Height and weight were measured in research clinics. Maternal education level was derived from a questionnaire completed during pregnancy and classified into low, medium or high. One-way ANOVA was undertaken to compare maternal education groups for nutrient intakes and the Kruskal-Wallis test used for food consumption. Avon Longitudinal Study of Parents and Children (ALSPAC), Bristol, UK. Children (n 7474) who provided dietary data at age 10 years. A large proportion (60 %) of the sample was classified as plausible reporters, with under-reporting accounting for 36 %. No clear differences were found for intakes of energy or macronutrients between maternal education groups for plausible reporters. However, there were marked differences in micronutrient intakes especially for vitamin C, retinol equivalents and folate, highlighting lower diet quality with lower maternal education level. Intakes of fruit and vegetables showed a positive gradient with increasing maternal education (57 % v. 79 % consumed fresh fruit in low and high educational groups, respectively). A trend towards higher intake in the lower educated group was shown for less healthy foods (meat pies P children's diet at 10 years was related to maternal education level. Lower maternal education was associated with less healthy food choices that could be detrimental to health. Further research is needed to establish if these associations can be explained by other socio-economic factors.

  14. Illness Perception Profiles and Their Association with 10-Year Survival Following Cardiac Valve Replacement.

    Science.gov (United States)

    Crawshaw, Jacob; Rimington, Helen; Weinman, John; Chilcot, Joseph

    2015-10-01

    The aim of the present study was to examine whether profiles of illness perceptions are associated with 10-year survival following cardiac valve replacement surgery. Illness perceptions were evaluated in 204 cardiac patients awaiting first-time valve replacement and again 1 year post-operatively using cluster analysis. All-cause mortality was recorded over a 10-year period. At 1 year, 136 patients were grouped into one of four profiles (stable positive, stable negative, changed from positive to negative, changed from negative to positive). The median follow-up was 3063 days (78 deaths). After controlling for clinical covariates, including markers of function, patients who changed illness perceptions from positive to negative beliefs 1 year post-surgery had an increased mortality risk (hazard ratio (HR) = 3.2, 95% confidence interval (CI) 1.2-8.3, p = .02) compared to patients who held positive stable perceptions. Following cardiac valve replacement, developing negative illness perceptions over the first post-operative year predicts long-term mortality. Early screening and intervention to alter this pattern of beliefs may be beneficial.

  15. Estimating 10-year cardiovascular disease risk in Asian patients with schizophrenia.

    Science.gov (United States)

    Rekhi, Gurpreet; Khyne, Toe Toe; Lee, Jimmy

    This study aims to describe the cardiovascular risk profile of Asian patients with schizophrenia. Data was extracted from the databases of 139 patients with schizophrenia and 206 controls from two previous studies conducted at the Institute for Mental Health (IMH), Singapore. Their medical and smoking histories were obtained, and anthropometric parameters measured. Framingham risk score (FRS) calculator using body mass index was used to compute the 10-year cardiovascular disease risk (FRS BMI ) and the vascular age (VA BMI ) for each participant. Data on fasting lipids were available for 80 patients and all the controls; hence the FRS for lipids (FRS lipids ) and VA (VA lipids ) were also computed. The difference between VA and actual age was computed as VA diff . The 10-year CVD risk and VA diff based on lipids as well as BMI were significantly higher for patients compared to controls (all prisk of CVD in patients with schizophrenia as compared to controls; and conclude that patients with schizophrenia need regular physical health monitoring, especially for cardiovascular risk factors. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Exposure to air pollutants and mortality in hypertensive patients according to demography: a 10 year case-crossover study.

    Science.gov (United States)

    Wong, Martin C S; Tam, Wilson W S; Wang, Harry H X; Lao, X Q; Zhang, Daisy Dexing; Chan, Sky W M; Kwan, Mandy W M; Fan, Carmen K M; Cheung, Clement S K; Tong, Ellen L H; Cheung, N T; Tse, L A; Yu, Ignatius T S

    2014-09-01

    This study evaluated whether short term exposures to NO2, O3, particulate matter <10 mm in diameter (PM10) were associated with higher risk of mortality. A total of 223,287 hypertensive patients attended public health-care services and newly prescribed at least 1 antihypertensive agent were followed-up for up to 5 years. A time-stratified, bi-directional case-crossover design was adopted. For all-cause mortality, significant positive associations were observed for NO2 and PM10 at lag 0-3 days per 10 μg/m(3) increase in concentration (excess risks 1.187%-2.501%). Significant positive associations were found for O3 at lag 1 and 2 days and the excess risks were 1.654% and 1.207%, respectively. We found similarly positive associations between these pollutants and respiratory disease mortality. These results were significant among those aged ≥65 years and in cold seasons only. Older hypertensive patients are susceptible to all-cause and respiratory disease-specific deaths from these air pollutants in cold weather. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Chronological changes in functional cup position at 10 years after total hip arthroplasty.

    Science.gov (United States)

    Okanoue, Yusuke; Ikeuchi, Masahiko; Takaya, Shogo; Izumi, Masashi; Aso, Koji; Kawakami, Teruhiko

    2017-09-19

    This study aims to clarify the chronological changes in functional cup position at a minimum follow-up of 10 years after total hip arthroplasty (THA), and to identify the risk factors influencing a significant difference in functional cup position during the postoperative follow-up period. We evaluated the chronological changes in functional cup position at a minimum follow-up of 10 years after THA in 58 patients with unilateral hip osteoarthritis. Radiographic cup position was measured on anteroposterior pelvic radiographs with the patient in the supine position, whereas functional cup position was recorded in the standing position. Radiographs were obtained before, 3 weeks after, and every 1 year after surgery. Functional cup anteversion (F-Ant) increased over time, and was found to have significantly increased at final follow-up compared to that at 3 weeks after surgery (p10° anteriorly. Preoperative posterior pelvic tilt in the standing position and vertebral fractures after THA were significant predictors of increasing functional cup anteversion. Although chronological changes in functional cup position do occur after THA, their magnitude is relatively low. However, posterior impingement is likely to occur, which may cause edge loading, wear of the polyethylene liner, and anterior dislocation of the hip. We believe that, for the combined anteversion technique, the safe zone should probably be 5°-10° narrower in patients predicted to show considerable changes in functional cup position compared with standard cases.

  18. The Psychological Effects of Unemployment and Unsatisfactory Employment on Young Adults: Findings from a 10-Year Longitudinal Study.

    Science.gov (United States)

    Winefield, Anthony H; Delfabbro, Paul H; Winefield, Helen R; Duong, David; Malvaso, Catia

    2017-01-01

    The purpose of the present study was to extend the external validity of an earlier longitudinal study of school leavers by including participants from a representative sample of secondary schools. Questionnaires were administered annually to a sample of South Australian school leavers over a 10-year period. At Time 1 participants were in the last compulsory year of high school aged around 15 years and at Time 10 they were aged around 25 years. Results confirmed those from an earlier longitudinal study showing that the transition from school to satisfactory employment was associated with significant improvements in psychological well-being, whereas transition from school to unemployment or unsatisfactory employment showed no change in psychological well-being. The current findings extended the external validity of the earlier study because whereas participants in the earlier study were sampled from co-educational metropolitan public high schools, the current study included participants from every kind of high school: single sex as well as co-educational, rural as well as metropolitan, and private as well as public.

  19. Symptoms 10-17 years after breast cancer radiotherapy data from the randomised SWEBCG91-RT trial

    International Nuclear Information System (INIS)

    Lundstedt, Dan; Gustafsson, Magnus; Malmstroem, Per; Johansson, Karl-Axel; Alsadius, David; Sundberg, Agnetha; Wilderaeng, Ulrica; Holmberg, Erik; Anderson, Harald; Steineck, Gunnar; Karlsson, Per

    2010-01-01

    Background: Postoperative radiotherapy decreases the risk for local recurrence and improves overall survival in women with breast cancer. We have limited information on radiotherapy-induced symptoms 10-17 years after therapy. Material and methods: Between 1991 and 1997, women with lymph node-negative breast cancer were randomised in a Swedish multi-institutional trial to breast conserving surgery with or without postoperative radiotherapy. In 2007, 10-17 years after randomisation, the group included 422 recurrence-free women. We collected data with a study-specific questionnaire on eight pre-selected symptom groups. Results: For six symptom groups (oedema in breast or arm, erysipelas, heart symptoms, lung symptoms, rib fractures, and decreased shoulder mobility) we found similar occurrence in both groups. Excess occurrence after radiotherapy was observed for pain in the breast or in the skin, reported to occur 'occasionally' by 38.1% of survivors having undergone radiotherapy and surgery versus 24.0% of those with surgery alone (absolute difference 14.1%; p = 0.004) and at least once a week by 10.3% of the radiotherapy group versus 1.7% (absolute difference 8.6%; p = 0.001). Daily life and analgesic use did not differ between the groups. Conclusions: Ten to 17 years after postoperative radiotherapy 1 in 12 women had weekly pain that could be attributed to radiotherapy. The symptoms did not significantly affect daily life and thus the reduced risk for local recurrence seems to outweigh the risk for long-term symptoms for most women.

  20. Work stress, sleep deficiency, and predicted 10-year cardiometabolic risk in a female patient care worker population.

    Science.gov (United States)

    Jacobsen, Henrik B; Reme, Silje E; Sembajwe, Grace; Hopcia, Karen; Stiles, Tore C; Sorensen, Glorian; Porter, James H; Marino, Miguel; Buxton, Orfeu M

    2014-08-01

    The aim of this study was to investigate the longitudinal effect of work-related stress, sleep deficiency, and physical activity on 10-year cardiometabolic risk among an all-female worker population. Data on patient care workers (n=99) was collected 2 years apart. Baseline measures included: job stress, physical activity, night work, and sleep deficiency. Biomarkers and objective measurements were used to estimate 10-year cardiometabolic risk at follow-up. Significant associations (Pwork-related stress and sleep deficiency, maintaining sleep and exercise patterns had a strong impact on modifiable 10-year cardiometabolic risk. © 2014 Wiley Periodicals, Inc.

  1. Energy-water analysis of the 10-year WECC transmission planning study cases.

    Energy Technology Data Exchange (ETDEWEB)

    Tidwell, Vincent Carroll; Passell, Howard David; Castillo, Cesar; Moreland, Barbara

    2011-11-01

    modules for calculating water withdrawal and consumption for current and planned electric power generation; projected water demand from competing use sectors; and, surface and groundwater availability. WECC's long range planning is organized according to two target planning horizons, a 10-year and a 20-year. This study supports WECC in the 10-year planning endeavor. In this case the water implications associated with four of WECC's alternative future study cases (described below) are calculated and reported. In future phases of planning we will work with WECC to craft study cases that aim to reduce the thermoelectric footprint of the interconnection and/or limit production in the most water stressed regions of the West.

  2. 10-year cumulative and bidirectional associations of domain-specific physical activity and sedentary behaviour with health-related quality of life in French adults: Results from the SU.VI.MAX studies.

    Science.gov (United States)

    Omorou, Abdou Y; Vuillemin, Anne; Menai, Medhi; Latarche, Clotilde; Kesse-Guyot, Emmanuelle; Galan, Pilar; Hercberg, Serge; Oppert, Jean-Michel; Briançon, Serge

    2016-07-01

    The directionality of the associations of domain-specific physical activity (PA) and sedentary behaviour (SB) with health-related quality of life (HRQoL) in adults remain insufficiently known. This study investigated the longitudinal associations of 10-year cumulative levels of PA and SB with HRQoL and the reverse associations. A sample of 2093 (47.8% men) participants from a cohort of French adult (SU.VI.MAX) was included. Data were collected at 3 time points (1998, 2001 and 2007) using the Modifiable Activity Questionnaire (MAQ) for PA (leisure-time and occupational) and SB (screen-viewing, reading and total sitting time) and the DUKE Health Profile for HRQoL. The cumulative level (from 0 to 3) referred to the number of time points where a high PA level, high SB or good HRQoL was reported. Regression models examined the 10-year cumulative level of PA, SB as predictors of HRQoL and reverse associations. The 10-year cumulative level of high PA, both leisure-time and occupational, predicted a higher HRQoL while the 10-year cumulative level of high screen-viewing time and high total sitting time was associated with lower HRQoL. For the reverse association, cumulative level of good HRQoL predicted more leisure-time PA, less screen-viewing time and less total sitting time but was not related to occupational PA. Relationships between PA, SB and HRQoL are complex and should not be oversimplified in one or the other direction. Taking into account domain-specific PA and SB in health promotion programs appears of prime importance to design interventions aiming at improving HRQoL. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. A 10-year retrospective study on odontogenic tumors in Iran

    Directory of Open Access Journals (Sweden)

    Nasim Taghavi

    2013-01-01

    Full Text Available Objective: The aim of this study was to review cases of odontogenic tumors diagnosed in two pathology centers in Tehran, Iran, during a 10-year period. Study Design: Patients′ records were seen at two teaching pathology Centre′s of Shahid Beheshti University between the months of March 2000 to 2010 with histologic diagnosis of any type of odontogenic tumors. The records were analyzed for frequency, age, sex, site, as well as clinical, radiographic and histopathologic findings. Results: Of 30706 biopsies, 4767 (15.5% cases were diagnosed as oral and maxillofacial lesions. Among these, 720 cases were tumoral with 188 (26.1% cases of odontogenic tumors. Tumors with odontogenic epithelium origin formed 70.2% of total numbers of odontogenic tumors. Mixed odontogenic tumors and tumors of odontogenic ectomesenchyme comprised 12.2% and 17.5% of the cases respectively. Ameloblastoma, with a frequency of 62.2% was the most common tumor in this review which was followed by odontoma and odontogenic myxoma. Conclusion: Although there are few studies on odontogenic tumors in literature, the comparison of our results with existing data shows significant differences in the distribution of tumors and age of patients, which may be due to ethnic features and geographic distribution of patients. Future studies on other ethnic groups are essential for further clarification of the findings in this research.

  4. 10 years of Terra Outreach over the Internet

    Science.gov (United States)

    Yuen, K.; Riebeek, H.; Chambers, L. H.

    2009-12-01

    1 Author Yuen, Karen JPL (818) 393-7716 2 Author Riebeek, Holli Sigma Space Corporation (department) at NASA Goddard Space Flight Center (Institution), Greenbelt, Maryland 3 Author Chambers, Lin NASA Abstract: Since launch, Terra has returned about 195 gigabytes (level 0) of data per day or 1 terabyte every 5 days. Few outlets were able to accommodate and quickly share that amount of information as well as the Internet. To honor the 10-year anniversary of the launch of Terra, we would like to highlight the education and outreach efforts of the Terra mission on the Internet and its reach to the science attentive public. The Internet or web has been the primary way of delivering Terra content to different groups- from formal and informal education to general public outreach. Through the years, many different web-based projects have been developed, and they were of service to a growing population of the science attentive public. One of Terra’s original EPO activities was the Earth Observatory. It was initially dedicated to telling the remote sensing story of Terra, but quickly grew to include science and imagery from other sensors. The web site allowed for collaboration across NASA centers, universities and other organizations by exchanging and sharing of story ideas, news and images. The award winning Earth Observatory helped pave the way for the more recently funded development of the Climate Change website. With its specific focus on climate change studies, once again, Terra stories and images are shared with an even more specific audience base. During the last 10 years, Terra as a mission has captured the imagination of the public through its visually stunning and artistically arresting images. With its five instruments of complementary but unique capabilities, the mission gave the world not just pretty pictures, but scientific data-based images. The world was able to see from space everything from calving icebergs to volcanic eruption plumes and the eye of a

  5. Language complexity modulates 8- and 10-year-olds' success at using their theory of mind abilities in a communication task.

    Science.gov (United States)

    Wang, J Jessica; Ali, Muna; Frisson, Steven; Apperly, Ian A

    2016-09-01

    Basic competence in theory of mind is acquired during early childhood. Nonetheless, evidence suggests that the ability to take others' perspectives in communication improves continuously from middle childhood to the late teenage years. This indicates that theory of mind performance undergoes protracted developmental changes after the acquisition of basic competence. Currently, little is known about the factors that constrain children's performance or that contribute to age-related improvement. A sample of 39 8-year-olds and 56 10-year-olds were tested on a communication task in which a speaker's limited perspective needed to be taken into account and the complexity of the speaker's utterance varied. Our findings showed that 10-year-olds were generally less egocentric than 8-year-olds. Children of both ages committed more egocentric errors when a speaker uttered complex sentences compared with simple sentences. Both 8- and 10-year-olds were affected by the demand to integrate complex sentences with the speaker's limited perspective and to a similar degree. These results suggest that long after children's development of simple visual perspective-taking, their use of this ability to assist communication is substantially constrained by the complexity of the language involved. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. JSPS-CAS Core University Program seminar on summary of 10-year collaborations in plasma and nuclear fusion research area

    International Nuclear Information System (INIS)

    Toi, Kazuo; Wang Kongjia

    2011-07-01

    The JSPS-CAS Core University Program (CUP) seminar on “Summary of 10-year Collaborations in Plasma and Nuclear Fusion Research Area” was held from March 9 to March 11, 2011 in the Okinawa Prefectural Art Museum, Naha city, Okinawa, Japan. The collaboration program on plasma and nuclear fusion started from 2001 under the auspices of Japanese Society of Promotion of Science (JSPS) and Chinese Academy of Sciences (CAS). This year is the last year of the CUP. This seminar was organized in the framework of the CUP. In the seminar, 29 oral talks were presented, having 14 Chinese and 30 Japanese participants. These presentations covered key topics related to the collaboration categories: (1) improvement of core plasma properties, (2) basic research on fusion reactor technologies, and (3) theory and numerical simulation. This seminar aims at summarizing the results obtained through the collaborations for 10 years, and discussing future prospects of China-Japan collaboration in plasma and nuclear fusion research areas. (author)

  7. Socioeconomic disadvantage and oral-health-related hospital admissions: a 10-year analysis.

    Science.gov (United States)

    Kruger, Estie; Tennant, Marc

    2016-01-01

    The aim of this Western Australian population study was to assess the relationship of socioeconomic disadvantage and: 1) trends in hospitalisations for oral-health-related conditions over 10 years; 2) insurance status, costs and length of stay in hospital; and 3) specific conditions (principal diagnosis) patients were admitted for. Hospitalisation data (of oral-health-related conditions) were obtained for every episode of discharge from all hospitals in Western Australia for the financial years 1999-2000 to 2008-2009. Area based measures (using the Index of Relative Socioeconomic Disadvantage) was used to determine relationships between socioeconomic status and other variables. The most disadvantaged in the population are being hospitalised at significantly higher rates than other groups, stay in hospital for longer, and at higher costs. This trend remained over a period of 10 years. Those least disadvantaged have the second highest rates of hospitalisation, but the likelihood of being admitted for different procedures differ between these two extremes. The importance of socioeconomic determinants of health are evident when analysing these hospitalisations. Recognition that lifestyle choices are severely restricted among the most marginalised and disadvantaged groups in the population can no longer be ignored in attempts to reduce health inequalities.

  8. Two-year results of femtosecond assisted LASIK versus PRK for different severity of astigmatism.

    Science.gov (United States)

    Miraftab, Mohammad; Hashemi, Hassan; Asgari, Soheila

    2018-03-01

    To compare two-year results of femtosecond laser assisted LASIK (femto-LASIK) and photorefractive keratectomy (PRK) in terms of astigmatism correction in patients with less than 2.0 diopters (D) of spherical error and more than 2.0 D of cylinder error. In this retrospective study, data were extracted from 100 patient charts. The two study groups were matched by age, gender, and baseline uncorrected distance visual acuity (UDVA) and refractive astigmatism (RA). Preoperative astigmatism was categorized as mild: 2.00 to LASIK and PRK groups was respectively -3.15 ± 0.94 D (-7.00 to -2.00 D) and -3.29 ± 0.95 D (-6.25 to -2.00 D) at baseline ( P  = 0.284), and -0.61 ± 0.40 D and -0.62 ± 0.60 D one year after surgery ( P  = 0.674), but significantly lower in the femto-LASIK group (-0.61 ± 0.39 vs. -0.83 ± 0.56 D, P  = 0.021) at 2 years when the rate of residual astigmatism more than 1.0 D was 6.3% in the femto-LASIK and 19.6% in the PRK group ( P  = 0.046). Mean UDVA in the femto-LASIK group (0.02 ± 0.05 logMAR) was better than the PRK group (0.06 ± 0.10 logMAR) ( P  = 0.025). Mean corrected distance visual acuity (CDVA) was not significantly different between groups (0.01 ± 0.03 vs. 0.01 ± 0.04 logMAR, P  = 0.714). Both groups had 1-4 Snellen lines CDVA improvement. The three subgroups of baseline astigmatism did not differ significantly in terms of residual astigmatism (all P  > 0.05). However, in subgroups with ≥4.00 D cylinder, there was less astigmatic regression at 1 year in the femto-LASIK group (0.28 ± 0.43 D) than the PRK group (0.54 ± 0.68 D) ( P  = 0.007). Our results pointed to better two-year results with femto-LASIK in the treatment of different degrees of astigmatism. UDVA improvement was superior with femto-LASIK, but the two methods did not significantly differ in terms of CDVA improvement.

  9. Tumor bed delineation for external beam accelerated partial breast irradiation: A systematic review

    International Nuclear Information System (INIS)

    Yang, T. Jonathan; Tao, Randa; Elkhuizen, Paula H.M.; Vliet-Vroegindeweij, Corine van; Li, Guang; Powell, Simon N.

    2013-01-01

    In recent years, accelerated partial breast irradiation (APBI) has been considered an alternative to whole breast irradiation for patients undergoing breast-conserving therapy. APBI delivers higher doses of radiation in fewer fractions to the post-lumpectomy tumor bed with a 1–2 cm margin, targeting the area at the highest risk of local recurrence while sparing normal breast tissue. However, there are inherent challenges in defining accurate target volumes for APBI. Studies have shown that significant interobserver variation exists among radiation oncologists defining the lumpectomy cavity, which raises the question of how to improve the accuracy and consistency in the delineation of tumor bed volumes. The combination of standardized guidelines and surgical clips significantly improves an observer’s ability in delineation, and it is the standard in multiple ongoing external-beam APBI trials. However, questions about the accuracy of the clips to mark the lumpectomy cavity remain, as clips only define a few points at the margin of the cavity. This paper reviews the techniques that have been developed so far to improve target delineation in APBI delivered by conformal external beam radiation therapy, including the use of standardized guidelines, surgical clips or fiducial markers, pre-operative computed tomography imaging, and additional imaging modalities, including magnetic resonance imaging, ultrasound imaging, and positron emission tomography/computed tomography. Alternatives to post-operative APBI, future directions, and clinical recommendations were also discussed

  10. Conservation irradiation in the treatment of breast cancer

    International Nuclear Information System (INIS)

    Faria, S.L.; Chiminazzo Junior, H.

    1985-01-01

    Techniques of treatment and cosmetic results of 130 patients with breast cancer are presented. All patients received conservative treatment, with lumpectomy and radiotherapy at Centro de Oncologia Campinas. (M.A.C.) [pt

  11. Adolescent Drug Trafficking Trends in the United Kingdom--A 10-Year Retrospective Analysis

    Science.gov (United States)

    Vale, Ellen Louise Eva; Kennedy, Patrick John

    2004-01-01

    This paper reports data from HM Customs and Excise (HMCE) of recorded cases of adolescent drug trafficking through all sea and air points of entry into the UK over a 10-year period (May 1992-May 2002). We report the characteristics of 38 cases of mixed gender and nationality ranging in age between 13 and 18 years who have been apprehended by HMCE…

  12. Impact of magnetic resonance imaging on preoperative planning for breast cancer surgery.

    Science.gov (United States)

    Law, Y; Cheung, Polly S Y; Lau, Silvia; Lo, Gladys G

    2013-08-01

    To review the impact of preoperative breast magnetic resonance imaging on the management of planned surgery, and the appropriateness of any resulting alterations. Retrospective review. A private hospital in Hong Kong. PATIENTS; For the 147 consecutive biopsy-proven breast cancer patients who underwent preoperative magnetic resonance imaging to determine tumour extent undergoing operation by a single surgeon between 1 January 2006 and 31 December 2009, the impact of magnetic resonance imaging findings was reviewed in terms of management alterations and their appropriateness. The most common indication for breast magnetic resonance imaging was the presence of multiple indeterminate shadows on ultrasound scans (53%), followed by ill-defined border of the main tumour on ultrasound scans (19%). In 66% (97 out of 147) of the patients, the extent of the operation was upgraded. Upgrading entailed: lumpectomy to wider lumpectomy (23 out of 97), lumpectomy to mastectomy (47 out of 97), lumpectomy to bilateral lumpectomy (15 out of 97), and other (12 out of 97). Mostly, these management changes were because magnetic resonance imaging showed more extensive disease (n=29), additional cancer foci (n=39), or contralateral disease (n=24). In five instances, upgrading was due to patient preference. In 34% (50 out of 147) of the patients, there was no change in the planned operation. Regarding 97 of the patients having altered management, in 12 the changes were considered inappropriately extensive (due to false-positive magnetic resonance imaging findings). In terms of magnetic resonance imaging detection of more extensive, multifocal, multicentric, or contralateral disease, the false-positive rate was 13% and false-negative rate 7%. Corresponding rates for sensitivity and specificity were 95% and 81%, using the final pathology as the gold standard. Preoperative magnetic resonance imaging had a clinically significant and mostly correct impact on management plans. Magnetic resonance

  13. Functional disorders of T-cell immunity at persons engaged in the Chernobyl emergency operations in a 10 years after the accident

    International Nuclear Information System (INIS)

    Potapnev, M.P.; Kuz'menok, O.I.; Potapova, S.M.; Smol'nikova, V.V.; Myslitskj, V.F.; Rzheutskij, V.A.; Vaslevskaya, T.A.; Vasyukhina, L.V.

    1998-01-01

    Functional disorders of T-cell immunity in persons engaged in Chernobyl emergency operations - 10 years after the accident. The results evaluating T-cell immunity of 148 liquidators of Chernobyl accident are presented. It was estimated that 10 years after the accident immuno phenotyping of peripheral blood lymphocytes did not reveal marked disturbance in lymphocyte subpopulation content in exposed group as compared with healthy control. Determination of cell proliferation in vitro indicated the decrease in DNA synthesis of T-lymphocytes stimulated with optimal and particularly suboptimal concentrations of polyclonal T-cell activators. Based on individual deviation of the results of T-lymphocyte proliferation the groups with high and low level of response were sorted out for future examination

  14. VINKA, ten years on. Main scientific results

    International Nuclear Information System (INIS)

    1979-01-01

    The VINKA facility in the TRITON swimming-pool reactor at Fontenay-aux-Roses allows the irradiation of solids at low temperatures in order to study crystalline defects. After ten years of operation the main scientific results obtained in the fields of creep and growth (chapter I), point defects (chapter II), amorphisation (chapter III) and dechanneling of particles (chapter IV) are summarised [fr

  15. Performance and bacterial community structure of a 10-years old constructed mangrove wetland.

    Science.gov (United States)

    Tian, Tingting; Tam, Nora F Y; Zan, Qijie; Cheung, S G; Shin, Paul K S; Wong, Y S; Zhang, Li; Chen, Zhanghe

    2017-11-30

    Constructed mangrove wetland has been used for wastewater treatment but its long-term performance has not been reported. One-year monitoring of a 10-years old horizontal subsurface-flow constructed mangrove wetland consisting of three belts, two with mangrove plants and one without, revealed that the system maintained high and stable removal percentages of organic matter and nutrients, and planted belts performed better than unplanted control. Substrates in belts planted with Aegiceras corniculatum or Kandelia obovata had higher abundance of ammonifiers, nitrifiers and denitrifiers but lower total heterotrophic bacteria than unplanted substrate. Denaturing gradient gel electrophoresis showed that microbial diversity in planted substrate was significantly lower than that in unplanted one. The bacteria in substrates, irrespective to belts, were phylogenetically related to Proteobacteria (most dominant), Acidobacteria, Firmicutes, Nitrospirae, Gemmatimonadetes, Chloroflexi and Cyanobacteria. The steady performance of this 10-year old constructed mangrove wetland was affected by the abundance and diversity of bacterial community in substrate. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Postoperative Nomogram Predicting the 10-Year Probability of Prostate Cancer Recurrence After Radical Prostatectomy

    Science.gov (United States)

    Stephenson, Andrew J.; Scardino, Peter T.; Eastham, James A.; Bianco, Fernando J.; Dotan, Zohar A.; DiBlasio, Christopher J.; Reuther, Alwyn; Klein, Eric A.; Kattan, Michael W.

    2007-01-01

    Purpose A postoperative nomogram for prostate cancer recurrence after radical prostatectomy (RP) has been independently validated as accurate and discriminating. We have updated the nomogram by extending the predictions to 10 years after RP and have enabled the nomogram predictions to be adjusted for the disease-free interval that a patient has maintained after RP. Methods Cox regression analysis was used to model the clinical information for 1,881 patients who underwent RP for clinically-localized prostate cancer by two high-volume surgeons. The model was externally validated separately on two independent cohorts of 1,782 patients and 1,357 patients, respectively. Disease progression was defined as a rising prostate-specific antigen (PSA) level, clinical progression, radiotherapy more than 12 months postoperatively, or initiation of systemic therapy. Results The 10-year progression-free probability for the modeling set was 79% (95% CI, 75% to 82%). Significant variables in the multivariable model included PSA (P = .002), primary (P < .0001) and secondary Gleason grade (P = .0006), extracapsular extension (P < .0001), positive surgical margins (P = .028), seminal vesicle invasion (P < .0001), lymph node involvement (P = .030), treatment year (P = .008), and adjuvant radiotherapy (P = .046). The concordance index of the nomogram when applied to the independent validation sets was 0.81 and 0.79. Conclusion We have developed and validated as a robust predictive model an enhanced postoperative nomogram for prostate cancer recurrence after RP. Unique to predictive models, the nomogram predictions can be adjusted for the disease-free interval that a patient has achieved after RP. PMID:16192588

  17. 1992 Resource Program, 10 Year Plan : Draft II.

    Energy Technology Data Exchange (ETDEWEB)

    United States. Bonneville Power Administration.

    1992-05-01

    The Resource Program is the Bonneville Power Administration's primary process for deciding how to meet future electricity resource needs, how much new resources to develop, which types of resources to acquire or option and how to go about acquiring them, and how much BPA will have to spend for these resources. Recognizing that BPA must make a long-term commitment to acquiring conservation effectively, the 1992 Resource Program outlines a 10-year plan. Draft 2 of the 1992 Resource Program provides a framework for discussing the funding levels proposed in the Programs in Perspective (PIP) process. Previous final resource programs have been released prior to the PIP process. This version of the Resource Program recognizes that the PIP discussions are an integral part of the resource decision-making process and, therefore, it will be finalized after PIP.

  18. 1992 Resource Program, 10 Year Plan : Draft II.

    Energy Technology Data Exchange (ETDEWEB)

    United States. Bonneville Power Administration.

    1992-05-01

    The Resource Program is the Bonneville Power Administration`s primary process for deciding how to meet future electricity resource needs, how much new resources to develop, which types of resources to acquire or option and how to go about acquiring them, and how much BPA will have to spend for these resources. Recognizing that BPA must make a long-term commitment to acquiring conservation effectively, the 1992 Resource Program outlines a 10-year plan. Draft 2 of the 1992 Resource Program provides a framework for discussing the funding levels proposed in the Programs in Perspective (PIP) process. Previous final resource programs have been released prior to the PIP process. This version of the Resource Program recognizes that the PIP discussions are an integral part of the resource decision-making process and, therefore, it will be finalized after PIP.

  19. Updated prevalence rates of overweight and obesity in 4- to 10-year-old children in Germany. Results from the telephone-based KiGGS Wave 1 after correction for bias in parental reports.

    Science.gov (United States)

    Brettschneider, Anna-Kristin; Schienkiewitz, Anja; Schmidt, Steffen; Ellert, Ute; Kurth, Bärbel-Maria

    2017-04-01

    The nationwide 'German Health Interview and Examination Survey for Children and Adolescents' (KiGGS), conducted in 2003-2006, showed an increase in the prevalence rates of overweight and obesity compared to the early 1990s, indicating the need for regular monitoring. Recently, a follow-up-KiGGS Wave 1 (2009-2012)-was carried out as a telephone-based survey, providing parent-reported height and weight from 5155 children aged 4-10 years. Since parental reports lead to a bias in prevalence rates of weight status, a correction is needed. From a subsample of KiGGS Wave 1 participants, measurements for height and weight were collected in a physical examination. In order to correct prevalence rates derived from parent reports, weight status categories based on parent-reported and measured height and weight were used to estimate a correction formula according to an established procedure. The corrected prevalence rates derived from KiGGS Wave 1 for overweight, including obesity, in children aged 4-10 years in Germany showed that stagnation is reached compared to the KiGGS baseline study (2003-2006). The rates for overweight, including obesity, in Germany have levelled off. However, they still remain at a high level, indicating a need for further public health action. What is Known: • In the last decades, prevalence of overweight and obesity has risen. Now a days, the prevalence seems to be stagnating. • In Germany, prevalence estimates of overweight and obesity are only available from regional or non-representative studies. What is New: • This article gives an update for prevalence rates of overweight and obesity amongst children aged 4-10 years in Germany based on a nationwide and representative sample. • Results show that stagnation in prevalence rates for overweight in children in Germany is reached.

  20. Surrogacy families 10 years on: relationship with the surrogate, decisions over disclosure and children's understanding of their surrogacy origins

    Science.gov (United States)

    Jadva, V.; Blake, L.; Casey, P.; Golombok, S.

    2012-01-01

    BACKGROUND This study aimed to prospectively examine families created using surrogacy over a 10-year period in the UK with respect to intending parents' and children's relationship with the surrogate mother, parents' decisions over disclosure and children's understanding of the nature of their conception. METHODS Semi-structured interviews were administered by trained researchers to intending mothers, intending fathers and children on four occasions over a 10-year period. Forty-two families (19 with a genetic surrogate mother) participated when the child was 1-year old and by age 10 years, 33 families remained in the study. Data were collected on the frequency of contact with the surrogate mother, relationship with the surrogate, disclosure of surrogacy to the child and the child's understanding of their surrogacy birth. RESULTS Frequency of contact between surrogacy families and their surrogate mother decreased over time, particularly for families whose surrogate was a previously unknown genetic carrier (P surrogate mother's egg was used to conceive the child). Most families reported harmonious relationships with their surrogate mother. At age 10 years, 19 (90%) children who had been informed of the nature of their conception had a good understanding of this and 13 of the 14 children who were in contact with their surrogate reported that they liked her. CONCLUSIONS Surrogacy families maintained good relationships with the surrogate mother over time. Children felt positive about their surrogate mother and their surrogacy birth. The sample size of this study was small and further, larger investigations are needed before firm conclusions can be drawn. PMID:22814484

  1. Safety and immunogenicity of tetanus-diphtheria-acellular pertussis vaccine administered to children 10 or 11 years of age.

    Science.gov (United States)

    Marshall, Gary S; Pool, Vitali; Greenberg, David P; Johnson, David R; Sheng, Xiaohua; Decker, Michael D

    2014-11-01

    Boosting immunity to tetanus, diphtheria, and pertussis through the use of Tdap vaccines is routinely recommended at 11 to 12 years of age; some states, however, require Tdap for entry into middle school, which may begin at 10 years of age. This study was conducted to determine whether Tdap5 (Adacel), which is licensed for use in children beginning at 11 years of age, is as safe and immunogenic in 10-year-olds as it is in 11-year-olds. Children who had received 5 previous doses of any diphtheria-tetanus-acellular pertussis (DTaP) vaccine were enrolled in a phase IV clinical trial; 646 10-year-olds and 645 11-year-olds completed the study, which involved a single intramuscular dose of Tdap5 along with pre- and postvaccination serologies. Postvaccination geometric mean concentrations (GMCs) of antibody to pertussis antigens (pertussis toxoid, filamentous hemagglutinin, pertactin, and fimbria types 2 and 3) of 10-year-olds were noninferior to those of 11-year-olds, as were booster response rates for all pertussis antibodies, except for those to fimbrial antigens (94% and 97%, respectively). Seroprotection rates among 10-year-olds for tetanus and diphtheria were noninferior to those in 11-year-olds. Rates of injection site reactions, solicited systemic reactions, and unsolicited adverse events, adverse reactions, and serious adverse events were similar in the two groups. These data support the conclusion that Tdap5 is safe and immunogenic in 10-year-olds. (This study has been registered at ClinicalTrials.gov under registration no. NCT01311557.). Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  2. 10-Year prospective study of noise exposure and hearing damage among construction workers.

    Science.gov (United States)

    Seixas, Noah S; Neitzel, Rick; Stover, Bert; Sheppard, Lianne; Feeney, Patrick; Mills, David; Kujawa, Sharon

    2012-09-01

    To characterise the effects of noise exposure, including intermittent and peaky exposure, on hearing damage as assessed by standard pure-tone thresholds and otoacoustic emissions, a longitudinal study was conducted on newly hired construction apprentices and controls over a 10-year period. Among the 456 subjects recruited at baseline, 316 had at least two (mean 4.6) examinations and were included in this analysis. Annual examinations included hearing threshold levels (HTLs) for air conducted pure tones and distortion product otoacoustic emission (DPOAE) amplitudes. Task-based occupational noise exposure levels and recreational exposures were estimated. Linear mixed models were fit for HTLs and DPOAEs at 3, 4 and 6 kHz in relation to time since baseline and average noise level since baseline, while controlling for hearing level at baseline and other risk factors. Estimated L(EQ) noise exposures were 87±3.6 dBA among the construction workers. Linear mixed modelling demonstrated significant exposure-related elevations in HTL of about 2-3 dB over a projected 10-year period at 3, 4 or 6 kHz for a 10 dB increase in exposure. The DPOAE models (using L1=40) predicted about 1 dB decrease in emission amplitude over 10 years for a 10 dB increase in exposure. The study provides evidence of noise-induced damage at an average exposure level around the 85 dBA level. The predicted change in HTLs was somewhat higher than would be predicted by standard hearing loss models, after accounting for hearing loss at baseline. Limited evidence for an enhanced effect of high peak component noise was observed, and DPOAEs, although similarly affected, showed no advantage over standard hearing threshold evaluation in detecting effects of noise on the ear and hearing.

  3. Subsequent fracture rates in a nationwide population-based cohort study with a 10-year perspective

    DEFF Research Database (Denmark)

    Hansen, L; Petersen, K D; Eriksen, S A

    2014-01-01

    with an index fracture (ICD-10 codes: S22.x, S32.x, S42.x, S52.x, S62.x, S72.x, S82.x, S92.x, T02.x, T08.x, T10.x and T12.x) between January 1st, 2001 and December 31st, 2001 and if older than 50 years at time of fracture. The patients were investigated for future subsequent fractures from January 1st, 2002......Summary: Fractures after the age of 50 are frequently observed in Denmark, and many of these may be osteoporotic. This study examined the incidence of all and subsequent fractures in a 10-year period from 2001 to 2011. The incidence of subsequent fractures was high, especially following hip...... fracture. Introduction: The purpose of this study is to examine patterns of subsequent fractures and mortality rates over a 10-year period in patients already suffering from fracture. Methods: The study was designed as a nationwide, registerbased follow-up study. Patients were included if diagnosed...

  4. 10 anos com Mafalda / 10 years with Mafalda

    OpenAIRE

    Santos, José Douglas Alves dos

    2013-01-01

    10 anos com Mafalda (2010), publicado pela Editora WMF Martins Fontes e traduzido por Monica Stahel, é um livro que reproduz as tiras de Mafalda e sua turma desenhadas por Quino, Joaquín Salvador Lavado, organizadas em 13 temas – a família, a rua, a escola, assim vai o mundo, Mafalda e a sopa, Férias, TV, Guile, Susanita, Felipe, Manolito, Miguelito e Liberdade.

  5. Stunted at 10 Years. Linear Growth Trajectories and Stunting from Birth to Pre-Adolescence in a Rural Bangladeshi Cohort.

    Directory of Open Access Journals (Sweden)

    Pernilla Svefors

    Full Text Available Few studies in low-income settings analyse linear growth trajectories from foetal life to pre-adolescence. The aim of this study is to describe linear growth and stunting from birth to 10 years in rural Bangladesh and to analyse whether maternal and environmental determinants at conception are associated with linear growth throughout childhood and stunting at 10 years.Pregnant women participating in the MINIMat trial were identified in early pregnancy and a birth cohort (n = 1054 was followed with 19 growth measurements from birth to 10 years. Analyses of baseline predictors and mean height-for-age Z-scores (HAZ over time were modelled using GLMM. Logistic regression analysis was used to investigate the associations between baseline predictors and stunting (HAZ<-2 at 10 years. HAZ decreased to 2 years, followed by an increase up to 10 years, while the average height-for-age difference in cm (HAD to the WHO reference median continued to increase up to 10 years. Prevalence of stunting was highest at 2 years (50% decreasing to 29% at 10 years. Maternal height, maternal educational level and season of conception were all independent predictors of HAZ from birth to pre-adolescence (p<0.001 and stunting at 10 years. The highest probability to be stunted at 10 years was for children born by short mothers (<147.5 cm (ORadj 2.93, 95% CI: 2.06-4.20, mothers with no education (ORadj 1.74, 95% CI 1.17-2.81 or those conceived in the pre-monsoon season (ORadj 1.94, 95% CI 1.37-2.77.Height growth trajectories and prevalence of stunting in pre-adolescence showed strong intergenerational associations, social differentials, and environmental influence from foetal life. Targeting women before and during pregnancy is needed for the prevention of impaired child growth.

  6. Individualized Fracture Risk Feedback and Long-term Benefits After 10 Years.

    Science.gov (United States)

    Wu, Feitong; Wills, Karen; Laslett, Laura L; Riley, Malcolm D; Oldenburg, Brian; Jones, Graeme; Winzenberg, Tania

    2018-02-01

    This study aimed to determine if beneficial effects of individualized feedback of fracture risk on osteoporosis preventive behaviors and bone mineral density observed in a 2-year trial were sustained long-term. This was a 10-year follow-up of a 2-year RCT in 470 premenopausal women aged 25-44 years, who were randomized to one of two educational interventions (the Osteoporosis Prevention and Self-Management Course [OPSMC] or an osteoporosis information leaflet) and received tailored feedback of their relative risk of fracture in later life (high versus normal risk groups). Bone mineral density of lumbar spine and femoral neck were measured by dual-energy X-ray absorptiometry. Physical activity, dietary calcium intake, calcium and vitamin D supplements, and smoking status were measured by questionnaires. From 2 to 12 years, the high-risk group had a smaller decrease in femoral neck bone mineral density (β=0.023, 95% CI=0.005, 0.041 g/cm 2 ) but similar lumbar spine bone mineral density change as the normal-risk group. They were more likely to use calcium (relative risk=1.66, 95% CI=1.22, 2.24) and vitamin D supplements (1.99, 95% CI=1.27, 3.11). The OPSMC had no effects on bone mineral density change. Both high-risk (versus normal-risk) and the OPSMC groups (versus leaflet) had a more favorable pattern of smoking behavior change (relative risk=1.85, 95% CI=0.70, 4.89 and relative risk=2.27, 95% CI=0.86, 6.01 for smoking cessation; relative risk=0.33, 95% CI=0.13, 0.80 and relative risk=0.28, 95% CI=0.10, 0.79 for commenced or persistent smoking). Feedback of high fracture risk to younger women was associated with long-term improvements in osteoporosis preventive behaviors and attenuated femoral neck bone mineral density loss. Therefore, this could be considered as a strategy to prevent osteoporosis. Australian New Zealand Clinical Trials Registry (ANZCTR) NCT00273260. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights

  7. Weight loss as treatment for knee osteoarthritis symptoms in obese patients: 1-year results from a randomised controlled trial

    DEFF Research Database (Denmark)

    Bliddal, Henning; Leeds, Anthony R; Stigsgaard, Lise

    2011-01-01

    OBJECTIVE: To evaluate 1-year symptomatic improvement in obese patients with knee osteoarthritis (OA) on an intensive low-energy diet (LED) maintained by frequent consultations with a dietician compared to minimal attention. METHODS: The LED programme consisted of group therapy with dietary......) was assessed as the mean group difference during and after 1 year. RESULTS: The study population consisted of 89 patients, 89% women, average age 63 years. After 1 year, mean weight loss in the LED group was -10.9 kg (11%) versus -3.6 kg (4%) in the control group (p...

  8. PVC flooring at home and development of asthma among young children in Sweden, a 10-year follow-up.

    Science.gov (United States)

    Shu, H; Jönsson, B A; Larsson, M; Nånberg, E; Bornehag, C-G

    2014-06-01

    The incidence of asthma and allergy has increased throughout the developed world over the past decades. During the same period of time, the use of industrial chemicals such as phthalates, commonly used as plasticizers in polyvinylchloride (PVC) flooring material, has increased. The aim of this study was to investigate whether PVC flooring in the home of children in the age of 1-5 years is associated with the development of asthma in 5- and 10-year follow-up investigations (n = 3228). Dampness in Buildings and Health Study (DBH Study) commenced in 2000 in Värmland, Sweden. The current analyses included subjects who answered all baseline and follow-up questionnaires. Logistic regression analyses were applied to questionnaire results. Children who had PVC floorings in the bedroom at baseline were more likely to develop doctor-diagnosed asthma during the following 10-year period when compared with children living without. There were indications that PVC flooring in the parents' bedrooms was strongly associated with the new cases of doctor-diagnosed asthma when compared with child's bedroom. Our results suggest that PVC flooring exposure during pregnancy could be a critical period in the development of asthma in children at a later time; prenatal exposure and measurements of phthalate metabolites should be included in the future. This study has found that PVC flooring material in early life was related to incidence of asthma during the following 10 years when compared with other flooring materials and especially when comparing with wood flooring type.The study has further indicated that PVC flooring in the parents’ bedroom (proxy for prenatal exposure) was more associated with the development of asthma than PVC in the child’s bedroom was. Our results suggest that PVC flooring exposure during pregnancy could be a critical period in the development of asthma in children at a later time. In future prospective cohort study, prenatal exposure and measurements of

  9. Evolution of Helicobacter pylori susceptibility to antibiotics during a 10-year period in Lithuania

    DEFF Research Database (Denmark)

    Kupcinskas, Limas; Rasmussen, Lone; Jonaitis, Laimas

    2013-01-01

    .5 times, the total macrolide consumption remains one of the lowest in Europe. We have not observed any significant changes in the susceptibility of H. pylori to the most widely used antibiotics during the recent 10-year period. The low resistance rate to clarithromycin might be related to the policy......The study evaluated the changes in the prevalence of Helicobacter pylori strains with primary resistance to antibiotics during the last 10 years in Lithuania. H. pylori susceptibilities to antibiotics were tested in 89 patients in 1998, in 81 patients in 2001 and in 90 patients in 2007...

  10. Redarkening of port-wine stains 10 years after pulsed-dye-laser treatment

    NARCIS (Netherlands)

    Huikeshoven, Menno; Koster, Petra H. L.; de Borgie, Corianne A. J. M.; Beek, Johan F.; van Gemert, Martin J. C.; van der Horst, Chantal M. A. M.

    2007-01-01

    BACKGROUND: Although pulsed-dye-laser therapy is currently the gold standard for the treatment of port-wine stains, few objective data are available on its long-term efficacy. Using objective color measurements, we performed a 10-year follow-up of a previously conducted prospective clinical study of

  11. Five Year Outcome of 145 Patients With Ductal Carcinoma In Situ (DCIS) After Accelerated Breast Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ciervide, Raquel [Department of Radiation Oncology, New York University School of Medicine, NYU Langone Medical Center, New York, New York (United States); Dhage, Shubhada; Guth, Amber; Shapiro, Richard L.; Axelrod, Deborah M.; Roses, Daniel F. [Department of Surgery, New York University School of Medicine, NYU Langone Medical Center, New York, New York (United States); Formenti, Silvia C., E-mail: silvia.formenti@nyumc.org [Department of Radiation Oncology, New York University School of Medicine, NYU Langone Medical Center, New York, New York (United States)

    2012-06-01

    Background: Accelerated whole-breast radiotherapy (RT) with tumor bed boost in the treatment of early invasive breast cancer has demonstrated equivalent local control and cosmesis when compared with standard RT. Its efficacy in the treatment of ductal carcinoma in situ (DCIS) remains unknown. Methods and Materials: Patients treated for DCIS with lumpectomy and negative margins were eligible for 2 consecutive hypofractionated whole-breast RT clinical trials. The first trial (New York University [NYU] 01-51) prescribed to the whole breast 42 Gy (2.8 Gy in 15 fractions) and the second trial (NYU 05-181) 40.5 Gy (2.7 Gy in 15 fractions) with an additional daily boost of 0.5 Gy to the surgical cavity. Results: Between 2002 and 2009, 145 DCIS patients accrued, 59 to the first protocol and 86 to the second trial. Median age was 56 years and 65% were postmenopausal at the time of treatment. Based on optimal sparing of normal tissue, 79% of the patients were planned and treated prone and 21% supine. At 5 years' median follow-up (60 months; range 2.6-105.5 months), 6 patients (4.1%) experienced an ipsilateral breast recurrence in all cases of DCIS histology. In 3/6 patients, recurrence occurred at the original site of DCIS and in the remaining 3 cases outside the original tumor bed. New contralateral breast cancers arose in 3 cases (1 DCIS and 2 invasive carcinomas). Cosmetic self-assessment at least 2 years after treatment is available in 125 patients: 91% reported good-to-excellent and 9% reported fair-to-poor outcomes. Conclusions: With a median follow-up of 5 years, the ipsilateral local recurrence rate is 4.1%, comparable to that reported from the NSABP (National Surgical Adjuvant Breast and Bowel Project) trials that employed 50 Gy in 25 fractions of radiotherapy for DCIS. There were no invasive recurrences. These results provide preliminary evidence that accelerated hypofractionated external beam radiotherapy is a viable option for DCIS.

  12. Progress in Global Surveillance and Response Capacity 10 Years After Severe Acute Respiratory Syndrome

    Centers for Disease Control (CDC) Podcasts

    2013-04-10

    Dr. Mike Miller reads an abridged version of the Emerging Infectious Diseases' synopsis, Progress in Global Surveillance and Response Capacity 10 Years after Severe Acute Respiratory Syndrome.  Created: 4/10/2013 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/11/2013.

  13. The Predictive Value of Preschool Language Assessments on Academic Achievement: A 10-Year Longitudinal Study of Icelandic Children.

    Science.gov (United States)

    Einarsdóttir, Jóhanna T; Björnsdóttir, Amalía; Símonardóttir, Ingibjörg

    2016-02-01

    The purpose of this study was to investigate the relationship between language knowledge at 5 years of age and later academic achievement throughout compulsory school in Iceland. Between 1997 and 1998, 267 Icelandic preschool children aged from 5;4 (years;months) to 5;10 were tested with the HLJÓM-2 (an Icelandic test of phonological awareness; Símonardóttir, Einarsdóttir, & Björnsdóttir, 2002) and the Icelandic version of the Test of Language Development-Primary: Second Edition (TOLD-2P; oral comprehension tasks; Símonardóttir, Guðmundsson, Skúlason, & Pétursdóttir, 1995). In 2011 these individuals, now aged 18-19 years, were contacted again. Of the original 267 participants, 221 (83%) gave permission to link their results from the preschool language assessments with their performance on national tests in 4th, 7th, and 10th grades. The results showed strong correlation between phonological awareness (as measured by the HLJÓM-2) and academic achievement (Icelandic and mathematics) in 4th, 7th, and 10th grades. There was also a significant but lower correlation with oral comprehension skills, as measured with the TOLD-2P. Regression analysis showed that the preschool oral-language assessments in phonological awareness and oral comprehension explained between 35% and 43% of variability in scores on national tests in Icelandic and between 20% and 39% of variability in scores in mathematics. Preschool language knowledge is a reliable predictor of later academic achievement.

  14. Influence of smoking by family and best friend on adolescent tobacco smoking: results from the 2002 New Zealand national survey of year 10 students.

    Science.gov (United States)

    Scragg, Robert; Laugesen, Murray

    2007-06-01

    To compare the relative importance on adolescent smoking of the influence from parental smoking and peer smoking. National New Zealand crosssectional survey of 14,936 female and 14,349 male Year 10 students (aged 14 and 15 years) who answered an anonymous self-administered questionnaire in November 2002. Adolescents with both parents smoking had the highest smoking risk compared with those with one or neither parent smoking. The relative risk of adolescent daily smoking associated with both parents smoking, compared with neither, varied with ethnicity, being 2.34 (95% Cl 2.05-2.67) in Maori, 2.87 (2.21-3.73) in Pacific Islanders, 11.37 (7.87-16.42) in Asian, and 4.92 (4.35-5.55) in European/Other students, adjusting for age and sex. These values were lower than the adjusted relative risks of daily adolescent smoking associated with having a best friend who smoked: 4.18 (3.59-4.88) in Maori, 5.19 (3.98-6.76) in Pacific Island, 14.35 (9.48-21.71) in Asian and 10.18 (9.07-11.43) in European/Other students. Adolescent smoking was also positively associated with pocket money amount and living in a home where smoking was allowed, both parental-related factors. Combined exposure to one or more of the following factors - parental smoking, pocket money >$5 per week and smoking in the house - explained 64% of daily adolescent smoking, very similar to the 67% attributable to best friend smoking. Parental behaviour is a key determinant of smoking by New Zealand adolescents and explains a similar proportion of daily adolescent smoking to that by peer smoking.

  15. [Association between the types of obesity and the 10-year-coronary heart disease risk, in Tibet Autonomous Region and Xinjiang Uygur Autonomous Region].

    Science.gov (United States)

    Zheng, C Y; Wang, Z W; Chen, Z; Zhang, L F; Wang, X; Dong, Y; Nie, J Y; Wang, J L; Shao, L; Tian, Y

    2017-06-10

    Objective: To investigate the association between types of obesity and the 10-year-coronary heart disease risk in Tibet and Xinjiang of China. Methods: Using the multi-stage random sampling method, 7 631 participants aged 35 or older were examined under the International Standardized Examination process but with only 5 802 were eligible for analysis, in the 2015-2016 season. Results: The prevalence rates of general obesity, central obesity, visceral obesity and compound obesity were 0.53 % , 12.62 % , 10.08 % and 42.35 % , respectively. Out of all the compound obesity cases, 58.65 % (1 441/2 457) of them appeared as having all types of obesity in our study. Risk related to the 10-year-coronary heart disease was higher in men than in women [(3.05±4.14) % vs. (1.42±2.37) % , P obesity (30.16 % ) showed the highest proportion on the risk of 10-year-coronary heart disease than central obesity (28.01 % ), visceral obesity (18.46 % ) or the general obesity (19.35 % ). After adjustment for confounding factors, results from the multivariate analysis showed the risk in compound obesity was higher than central obesity, visceral obesity or general obesity and was associated with the highest risk on the 10-year-coronary heart disease ( OR =2.889, 95 %CI : 2.525-3.305). People with anomalous BMI and WC seemed to have had the higher risk ( OR =3.168, 95 %CI : 2.730-3.677). Conclusions: Obesity was popular in the residents of Tibet and Xinjiang areas of China. Men and people with compound obesity (especially both BMI and WC were abnormal) seemed to carry greater risk on the 10-year-coronary heart disease.

  16. OzDES multifibre spectroscopy for the Dark Energy Survey: first-year operation and results

    Energy Technology Data Exchange (ETDEWEB)

    Yuan, Fang; Lidman, C.; Davis, T. M.; Childress, M.; Abdalla, F. B.; Banerji, M.; Buckley-Geer, E.; Carnero Rosell, A.; Carollo, D.; Castander, F. J.; D' Andrea, C. B.; Diehl, H. T.; Cunha, C. E.; Foley, R. J.; Frieman, J.; Glazebrook, K.; Gschwend, J.; Hinton, S.; Jouvel, S.; Kessler, R.; Kim, A. G.; King, A. L.; Kuehn, K.; Kuhlmann, S.; Lewis, G. F.; Lin, H.; Martini, P.; McMahon, R. G.; Mould, J.; Nichol, R. C.; Norris, R. P.; O' Neill, C. R.; Ostrovski, F.; Papadopoulos, A.; Parkinson, D.; Reed, S.; Romer, A. K.; Rooney, P. J.; Rozo, E.; Rykoff, E. S.; Sako, M.; Scalzo, R.; Schmidt, B. P.; Scolnic, D.; Seymour, N.; Sharp, R.; Sobreira, F.; Sullivan, M.; Thomas, R. C.; Tucker, D.; Uddin, S. A.; Wechsler, R. H.; Wester, W.; Wilcox, H.; Zhang, B.; Abbott, T.; Allam, S.; Bauer, A. H.; Benoit-L?vy, A.; Bertin, E.; Brooks, D.; Burke, D. L.; Carrasco Kind, M.; Covarrubias, R.; Crocce, M.; da Costa, L. N.; DePoy, D. L.; Desai, S.; Doel, P.; Eifler, T. F.; Evrard, A. E.; Fausti Neto, A.; Flaugher, B.; Fosalba, P.; Gaztanaga, E.; Gerdes, D.; Gruen, D.; Gruendl, R. A.; Honscheid, K.; James, D.; Kuropatkin, N.; Lahav, O.; Li, T. S.; Maia, M. A. G.; Makler, M.; Marshall, J.; Miller, C. J.; Miquel, R.; Ogando, R.; Plazas, A. A.; Roodman, A.; Sanchez, E.; Scarpine, V.; Schubnell, M.; Sevilla-Noarbe, I.; Smith, R. C.; Soares-Santos, M.; Suchyta, E.; Swanson, M. E. C.; Tarle, G.; Thaler, J.; Walker, A. R.

    2015-07-29

    We present results for the first three years of OzDES, a six-year program to obtain redshifts for objects in the Dark Energy Survey (DES) supernova fields using the 2dF fibre positioner and AAOmega spectrograph on the Anglo-Australian Telescope. OzDES is a multi-object spectroscopic survey targeting multiple types of targets at multiple epochs over a multi-year baseline, and is one of the first multi-object spectroscopic surveys to dynamically include transients into the target list soon after their discovery. At the end of three years, OzDES has spectroscopically confirmed almost 100 supernovae, and has measured redshifts for 17,000 objects, including the redshifts of 2,566 supernova hosts. We examine how our ability to measure redshifts for targets of various types depends on signal-to-noise, magnitude, and exposure time, finding that our redshift success rate increases significantly at a signal-to-noise of 2 to 3 per 1-A° ngstrom bin. We also find that the change in signal-to-noise with exposure time closely matches the Poisson limit for stacked exposures as long as 10 hours.We use these results to predict the redshift yield of the full OzDES survey, as well as the potential yields of future surveys on other facilities such as 4MOST, PFS, and MSE. This work marks the first OzDES data release, comprising 15,327 redshifts. OzDES is on target to obtain over 30,000 redshifts over the six-year duration of the survey, including a yield of approximately 5,700 supernova host-galaxy redshifts.

  17. Morbidity and mortality in the antiphospholipid syndrome during a 10-year period

    DEFF Research Database (Denmark)

    Cervera, R; Serrano, R; Pons-Estel, G J

    2015-01-01

    OBJECTIVES: To assess the prevalence of the main causes of morbi-mortality in the antiphospholipid syndrome (APS) during a 10-year-follow-up period and to compare the frequency of early manifestations with those that appeared later. METHODS: In 1999, we started an observational study of 1000 APS ...

  18. Influence of fractionation of dose on 3 year results of X-ray therapy of skin cancer

    International Nuclear Information System (INIS)

    Szymczyk, W.; Radziszewska, J.; Cyplik, I.; Glinska, H.

    1985-01-01

    Three-year results of X-ray therapy of skin cancer in 345 patients are presented. The dependence of results on the size of irradiated field and the method of dose fractionation is analysed. The clinical usefulness of a cumulative radiation effect (CRE) is evaluated. 96.5% of three-year cures were obtained. Recurrences amounted to 1.6% and necroses to 1.9% of treated lesions. It has been shown that treatment of small fields with 8-fractions gave equally positive results as with 15-fractions whereas in the treatment of large lesions the selection of CRE value, a number of fractions and dose should let the value of CRE minimally exceeds the level of tolerance of healthy tissues. The regard to CRE value in the treatment of large lesions or the introduction of additional dosimetric acts seems to be useful. 10 refs., 1 fig., 5 tabs. (author)

  19. Paediatric percutaneous nephrolithotomy: single-centre 10-year experience.

    Science.gov (United States)

    Bhageria, Anand; Nayak, Brusabhanu; Seth, Amlesh; Dogra, Prem Nath; Kumar, Rajeev

    2013-08-01

    Percutaneous nephrolithotomy (PCNL) is a standard management option for complex and large renal calculi. In children, there is some concern over potential perioperative complications. We reviewed our 10 years of experience of PCNL in children and present our data. Data for paediatric patients who underwent PCNL at our centre in the last decade were retrieved. PCNL was performed in standard prone position under fluoroscopic guidance. Patient characteristics, outcomes and complications were reviewed. Complications were graded according to the modified Clavien system. A comparison was also made between supracostal and infracostal accesses. 95 children underwent PCNL in our institute in the last decade. 7 patients had bilateral PCNL. The most common presentation was flank pain (85%). 83% patients were stone-free after first PCNL and overall 94% were stone free after second-look PCNL and auxillary procedures. 6 cases had clinically insignificant residual fragments. Supracostal puncture was performed in 32 cases. Complications were higher in the supracostal puncture group (16 (50%)) and included fever in 11, sepsis in 2 and hydrothorax in 3 patients. There were 7 (10%) complications in the infracostal group: fever in 5 and perinephric collection in 2 patients. 16 patients had grade 1, 9 had grade 2 and another 2 cases developed grade 3 complications. PCNL is a safe and effective procedure in children. It enables excellent stone clearance with minimal number of interventions. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  20. Femoral Neck Stress Fractures in Children Younger Than 10 Years of Age.

    Science.gov (United States)

    Boyle, Matthew J; Hogue, Grant D; Heyworth, Benton E; Ackerman, Kathryn; Quinn, Bridget; Yen, Yi-Meng

    2017-03-01

    Femoral neck stress fractures are rare in healthy children, with only 9 cases previously reported. The present article reviews our institutional experience with femoral neck stress fractures in children younger than 10 years of age, to highlight the unique features of this condition. We undertook a retrospective review of clinical records of patients who had been treated at our institution for an idiopathic femoral neck stress fracture between 2000 and 2014. To focus on children rather than adolescents, the World Health Organization's definition of adolescent as a person between 10 and 19 years of age was used; we thereby limited our analysis to patients younger than 10 years of age. The study included 6 patients (3 males, 3 females) treated for an idiopathic femoral neck stress fracture, with a mean age at diagnosis of 7.7 years (range, 5.2 to 8.9 y). All patients presented with a limp, which worsened with activity and had persisted for a mean of 5 weeks (range, 2 to 9 wk). None of the patients had experienced an increase in activity level or sporting volume before symptom onset. On examination, 3 patients experienced pain with terminal hip flexion and 3 patients demonstrated pain-free hip range of motion. Plain radiography demonstrated inferior femoral neck cortical disruption, suggesting a compression-type stress fracture mechanism. The diagnosis was confirmed by cross-sectional imaging in all cases. All patients were initially treated with 6 to 8 weeks of non-weight-bearing followed by 4 to 6 weeks of partial weight-bearing, leading to complete healing in 4 patients. Two patients demonstrated incomplete healing and were managed with spica casting for an additional 6 weeks. Our case series illustrates the unique features of this rare condition in children, with a history and examination profile distinct from those of adolescents and adults. Compliance with weight-bearing restrictions is difficult in this population and hip spica casting may be required to permit

  1. 10 years of Ws

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    Ten years ago, on 25 January 1983, the discovery of the W particle at CERN's proton-antiproton collider was announced to the world. The W, the electrically charged carrier of the weak nuclear force, had been predicted 24 years earlier in the classic formulations of modern weak interaction theory by Feynman and Gell- Mann and by Marshak and Sudarshan, and went on to play an important role in the subsequent electroweak unification of electromagnetism and the weak nuclear force. Following the discovery of the neutral current at CERN in 1973, it became clear that the W was an extremely heavy particle, some 80 times heavier than the proton, too heavy to be detected by any accelerator in operation at the time. Pushed by Carlo Rubbia, the CERN proton-antiproton collider was built to find the W and its electrically neutral companion, the Z. Collider operations at CERN in 1982 had been compressed into a two month run, from October to December. The teams at the big UA1 and UA2 experiments eagerly sifting through their 1982 data noticed the first signs of Ws. The initial candidate W events were announced in CERN seminars by Carlo Rubbia, for UA1, on 20 January 1983*, and the following day by Luigi Di Leila for UA2. As well as new science, these two seminars also set a trend for packing the CERN auditorium to overflowing

  2. Structural and functional cardiac adaptations to a 10-week school-based football intervention for 9-10-year-old children

    DEFF Research Database (Denmark)

    Krustrup, Peter; Hansen, Peter Riis; Nielsen, Claus Malta

    2014-01-01

    -randomized into a control group that maintained their usual activities (CON; two classes, n = 51, 21 boys and 30 girls) and a football training group that performed an additional 3 × 40 min of small-sided football training per week (FT; two classes, n = 46, 23 boys and 23 girls). No baseline differences were observed......The present study investigated the cardiac effects of a 10-week football training intervention for school children aged 9-10 years using comprehensive transthoracic echocardiography as a part of a larger ongoing study. A total of 97 pupils from four school classes were cluster...

  3. Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women.

    Science.gov (United States)

    Sinaki, M; Itoi, E; Wahner, H W; Wollan, P; Gelzcer, R; Mullan, B P; Collins, D A; Hodgson, S F

    2002-06-01

    The long-term protective effect of stronger back muscles on the spine was determined in 50 healthy white postmenopausal women, aged 58-75 years, 8 years after they had completed a 2 year randomized, controlled trial. Twenty-seven subjects had performed progressive, resistive back-strengthening exercises for 2 years and 23 had served as controls. Bone mineral density, spine radiographs, back extensor strength, biochemical marker values, and level of physical activity were obtained for all subjects at baseline, 2 years, and 10 years. Mean back extensor strength (BES) in the back-exercise (BE) group was 39.4 kg at baseline, 66.8 kg at 2 years (after 2 years of prescribed exercises), and 32.9 kg at 10 years (8 years after cessation of the prescribed exercises). Mean BES in the control (C) group was 36.9 kg at baseline, 49.0 kg at 2 years, and 26.9 kg at 10 years. The difference between the two groups was still statistically significant at 10 year follow-up (p = 0.001). The difference in bone mineral density, which was not significant between the two groups at baseline and 2 year follow-up, was significant at 10 year follow-up (p = 0.0004). The incidence of vertebral compression fracture was 14 fractures in 322 vertebral bodies examined (4.3%) in the C group and 6 fractures in 378 vertebral bodies examined (1.6%) in the BE group (chi-square test, p = 0.0290). The relative risk for compression fracture was 2.7 times greater in the C group than in the BE group. To our knowledge, this is the first study reported in the literature demonstrating the long-term effect of strong back muscles on the reduction of vertebral fractures in estrogen-deficient women.

  4. Prediction of transition from common adolescent bipolar experiences to bipolar disorder: 10-year study.

    Science.gov (United States)

    Tijssen, Marijn J A; van Os, Jim; Wittchen, Hans-Ulrich; Lieb, Roselind; Beesdo, Katja; Mengelers, Ron; Wichers, Marieke

    2010-02-01

    Although (hypo)manic symptoms are common in adolescence, transition to adult bipolar disorder is infrequent. To examine whether the risk of transition to bipolar disorder is conditional on the extent of persistence of subthreshold affective phenotypes. In a 10-year prospective community cohort study of 3021 adolescents and young adults, the association between persistence of affective symptoms over 3 years and the 10-year clinical outcomes of incident DSM-IV (hypo)manic episodes and incident use of mental healthcare was assessed. Transition to clinical outcome was associated with persistence of symptoms in a dose-dependent manner. Around 30-40% of clinical outcomes could be traced to prior persistence of affective symptoms. In a substantial proportion of individuals, onset of clinical bipolar disorder may be seen as the poor outcome of a developmentally common and usually transitory non-clinical bipolar phenotype.

  5. A Content Analysis of 10 Years of Clinical Supervision Articles in Counseling

    Science.gov (United States)

    Bernard, Janine M.; Luke, Melissa

    2015-01-01

    This content analysis follows Borders's (2005) review of counseling supervision literature and includes 184 counselor supervision articles published over the past 10 years. Articles were coded as representing 1 of 3 research types or 1 of 3 conceptual types. Articles were then analyzed for main topics producing 11 topic categories.

  6. Stakeholders' perceptions of 10years of the Global Action Plan for Influenza Vaccines (GAP) - Results from a survey.

    Science.gov (United States)

    Nannei, Claudia; Goldin, Shoshanna; Torelli, Guido; Fatima, Hiba; Kumar, Kaveri; Bubb-Humfryes, Oliver; Stenson, Bo; Sparrow, Erin

    2016-10-26

    Ten years after the launch of the Global Action Plan for Influenza Vaccines (GAP), the World Health Organization (WHO) surveyed stakeholders to understand their perceptions of what the programme had achieved. This article provides a summary of the findings; the full report will be available on-line on the GAP website in November 2016 (http://www.who.int/influenza_vaccines_plan/en/). Seventy-seven responses were received from stakeholders including medical doctors, national influenza center officials, country immunization programme teams, surveillance and disease centers, policy-makers, researchers, vaccine manufacturers, and non-governmental organizations from 28 countries, representing all six WHO regions. Respondents cited GAP's biggest successes as capacity building in developing countries; raising international awareness of global needs in the event of a pandemic; and collaborative alignment of influenza stakeholders. The most commonly reported challenges were the limited progress in development of a broadly protective or universal vaccine and the perceived absence of a major increase in seasonal demand. These findings aligned with the perception that less global progress had been made under the third GAP objective, focused on research and development of better vaccines, than on increasing seasonal vaccine use (objective 1) and pandemic vaccine production capacity (objective 2). Respondents explained what they saw as the major challenges to development of better vaccines, including to development of a universal influenza vaccine. The majority of respondents agreed that the goal chosen at the GAP II consultation is still relevant. Results highlighted the importance of promoting research and development of better vaccines, both for facilitating uptake of seasonal vaccines and for ensuring timely vaccine availability in the event of a pandemic. As the GAP concludes its mandate this year, these findings will contribute to discussions on the impact of programme

  7. College Sports-Related Injuries - United States, 2009-10 Through 2013-14 Academic Years.

    Science.gov (United States)

    Kerr, Zachary Y; Marshall, Stephen W; Dompier, Thomas P; Corlette, Jill; Klossner, David A; Gilchrist, Julie

    2015-12-11

    Sports-related injuries can have a substantial impact on the long-term health of student-athletes. The National Collegiate Athletic Association (NCAA) monitors injuries among college student-athletes at member schools. In academic year 2013-14, a total of 1,113 member schools fielded 19,334 teams with 478,869 participating student-athletes in NCAA championship sports (i.e., sports with NCAA championship competition) (1). External researchers and CDC used information reported to the NCAA Injury Surveillance Program (NCAA-ISP) by a sample of championship sports programs to summarize the estimated national cumulative and annual average numbers of injuries during the 5 academic years from 2009-10 through 2013-14. Analyses were restricted to injuries reported among student-athletes in 25 NCAA championship sports. During this period, 1,053,370 injuries were estimated to have occurred during an estimated 176.7 million athlete-exposures to potential injury (i.e., one athlete's participation in one competition or one practice). Injury incidence varied widely by sport. Among all sports, men's football accounted for the largest average annual estimated number of injuries (47,199) and the highest competition injury rate (39.9 per 1,000 athlete-exposures). Men's wrestling experienced the highest overall injury rate (13.1 per 1,000) and practice injury rate (10.2 per 1,000). Among women's sports, gymnastics had the highest overall injury rate (10.4 per 1,000) and practice injury rate (10.0 per 1,000), although soccer had the highest competition injury rate (17.2 per 1,000). More injuries were estimated to have occurred from practice than from competition for all sports, with the exception of men's ice hockey and baseball. However, injuries incurred during competition were somewhat more severe (e.g., requiring ≥7 days to return to full participation) than those acquired during practice. Multiple strategies are employed by NCAA and others to reduce the number of injuries in

  8. Class II young adult treatment with Twin Force Bite corrector: 10-year follow-up

    Directory of Open Access Journals (Sweden)

    Ozge Uslu-Akcam

    2017-01-01

    Full Text Available One of the most preferred compliance free fixed functional appliances in nongrowing patients is Twin Force Bite corrector (TFBC. The aim of this case report is to evaluate the effectiveness of TFBC in the treatment of an adult Class II case. A 16-year 1-month-old boy having skeletal and dental Class II relationship was selected. Roth 0.018 × 0.025 inch slots brackets were attached; a fixed lingual arch in the mandibular dental arch and a Nance appliance in the maxillary dental arch were used to increase anchorage. The TFBC therapy used for sagittal activation and stimulation of forward mandibular growth lasted for 3 months. The post-TFBC treatment lasted 6 months and the total treatment time was 9 months. Treatment of a young adult Class II malocclusion with TFBC resulted in a Class I molar occlusion, an ideal overjet, overbite, and incisor angulation in a short time and maintained in the 10-year follow-up.

  9. Genetic contributions to age-related decline in executive function: a 10-year longitudinal study of COMT and BDNF polymorphisms

    Directory of Open Access Journals (Sweden)

    Kirk I Erickson

    2008-09-01

    Full Text Available Genetic variability in the dopaminergic and neurotrophic systems could contribute to age-related impairments in executive control and memory function. In this study we examined whether genetic polymorphisms for catechol-O-methyltransferase (COMT and brain-derived neurotrophic factor (BDNF were related to the trajectory of cognitive decline occurring over a 10-year period in older adults. A single-nucleotide polymorphism (SNP in the COMT (Val158/108Met gene affects the concentration of dopamine in the prefrontal cortex. In addition, a Val/Met substitution in the pro-domain for BDNF (Val66Met affects the regulated secretion and trafficking of BDNF with Met carriers showing reduced secretion and poorer cognitive function. We found that impairments over the 10-year span on a task-switching paradigm did not vary as a function of the COMT polymorphism. However, for the BDNF polymorphism the Met carriers performed worse than Val homozygotes at the first testing session but only the Val homozygotes demonstrated a significant reduction in performance over the 10-year span. Our results argue that the COMT polymorphism does not affect the trajectory of age-related executive control decline, whereas the Val/Val polymorphism for BDNF may promote faster rates of cognitive decay in old age. These results are discussed in relation to the role of BDNF in senescence and the transforming impact of the Met allele on cognitive function in old age.

  10. Dose-volume analysis for quality assurance of interstitial brachytherapy for breast cancer

    International Nuclear Information System (INIS)

    Vicini, Frank A.; Kestin, Larry L.; Edmundson, Gregory K.; Jaffray, David A.; Wong, John W.; Kini, Vijay R.; Chen, Peter Y.; Martinez, Alvaro A.

    1999-01-01

    Purpose/Objective: The use of brachytherapy in the management of breast cancer has increased significantly over the past several years. Unfortunately, few techniques have been developed to compare dosimetric quality and target volume coverage concurrently. We present a new method of implant evaluation that incorporates computed tomography-based three-dimensional (3D) dose-volume analysis with traditional measures of brachytherapy quality. Analyses performed in this fashion will be needed to ultimately assist in determining the efficacy of breast implants. Methods and Materials: Since March of 1993, brachytherapy has been used as the sole radiation modality after lumpectomy in selected protocol patients with early-stage breast cancer treated with breast-conserving therapy. Eight patients treated with high-dose-rate (HDR) brachytherapy who had surgical clips outlining the lumpectomy cavity and underwent computed tomography (CT) scanning after implant placement were selected for this study. For each patient, the postimplant CT dataset was transferred to a 3D treatment planning system. The lumpectomy cavity, target volume (lumpectomy cavity plus a 1-cm margin), and entire breast were outlined on each axial slice. Once all volumes were entered, the programmed HDR brachytherapy source positions and dwell times were imported into the 3D planning system. Using the tools provided by the 3D planning system, the implant dataset was then registered to the visible implant template in the CT dataset. The distribution of the implant dose was analyzed with respect to defined volumes via dose-volume histograms (DVH). Isodose surfaces, the dose homogeneity index, and dosimetric coverage of the defined volumes were calculated and contrasted. All patients received 32 Gy to the entire implanted volume in 8 fractions of 4 Gy over 4 days. Results: Three-plane implants were used for 7 patients and a two-plane implant for 1 patient. The median number of needles per implant was 16.5 (range

  11. 2007-2017: 10 years of IASI CO retrievals

    Science.gov (United States)

    George, M.; Clerbaux, C.; Hadji-Lazaro, J.; Pierre-Francois, C.; Hurtmans, D.; Edwards, D. P.; Worden, H. M.; Deeter, M. N.; Mao, D.; August, T.; Crapeau, M.

    2017-12-01

    Carbon monoxide (CO) is an important trace gas for understanding air quality and atmospheric composition. It is a good tracer of pollution plumes and atmospheric dynamics. IASI CO concentrations are retrieved from the radiance data using the Fast Operational Retrievals on Layers for IASI (FORLI) algorithm, based on the Optimal Estimation theory. The operational production is performed at EUMETSAT and the products are distributed in NRT via EUMETCast under the AC SAF auspices. We present here an analysis of 10 years of global distributions of CO. Improvements of the last FORLI-CO version (v20151001) will be shown. Updates in the auxiliary parameters (temperature, cloud information) have an impact on the retrieved product. Comparison with MOPITT CO data (v7T, record starting in 2000) was performed, both for partial and total columns. Harmonizing IASI and MOPITT CO products is challenging: a method using corrective factors (developed in the framework of the QA4ECV project) will be presented.

  12. [10 years of external quality assurance in dialysis in Germany: Results and future prospects].

    Science.gov (United States)

    Büchtemann, Dorothea; Meinhold, Stefan; Follert, Peter

    2017-10-01

    In 2006, the Federal Joint Committee introduced a quality assurance programme for ambulatory dialysis treatment in Germany. Regarding the impact of chronic dialysis treatment on the quality of life of patients and on health care costs, quality assurance in dialysis is considered highly relevant. The directive on Quality Assurance in Dialysis (QSD-RL) established an external quality assurance programme on the basis of the assessment of certain quality parameters combined with an internal quality management system based on benchmarking parameters in all dialysis practices and centres. Data on quality parameters are collected and analysed quarterly. Regional associations of statutory health insurance physicians take responsibility for quality improvement measures and sanctions. This article aims to provide an overview of the development of quality parameters from 2008 to 2015. We analysed the summarised annual quality reports published on the website of the Federal Joint Committee between 2009 and 2016. We present results on the so-called core quality parameters duration and frequency of dialysis sessions (both for haemodialysis patients), wKt/V for peritoneal dialysis patients, and percentage of haemodialysis patients with central venous catheters which has only been measured since 2014. In 2015, 92,000 patients received outpatient dialysis. Between 2008 and 2015, the results for the core quality parameters duration and frequency of haemodialysis improved while the results for wKt/V seemingly show an unfavourable trend. The percentage of patients with central venous catheters appears to be quite high, and thus indicates that there is potential for quality improvement. For the future, the Federal Joint Committee has resolved to merge the quality assurance programmes in dialysis and in kidney transplantation into a newly designed programme that has the potential to follow patients through all stages and kinds of renal replacement therapy and to focus on further aspects

  13. Ten-year results of a randomized clinical trial comparing radical mastectomy and total mastectomy with or without radiation

    International Nuclear Information System (INIS)

    Fisher, B.; Redmond, C.; Fisher, E.R.

    1985-01-01

    In 1971 a randomized trial was begun to compare alternative local and regional treatments of breast cancer, all of which employ breast removal. Life-table estimates were obtained for 1665 women enrolled in the study for a mean of 126 months. There were no significant differences among three groups of patients with clinically negative auxillary nodes, with respect to disease-free survival, distant-disease-free survival, or overall survival (about 57%) at 10 years. The patients were treated by radical mastectomy, total (simple) mastectomy without auxillary dissection but with regional irradiation, or total mastectomy without irradiation plus auxillary dissection only if nodes were subsequently positive. Similarly, no differences, were observed between patients with clinically positive nodes treated by radical mastectomy or by total mastectomy without auxillary dissection but with regional irradiation. Survival at 10 years was about 38% in both groups. Our findings indicate that the location of a breast tumor does not influence the prognosis and that irradiation of internal mammary nodes in patients with inner-quadrant lesions does not improve survival. The data also demonstrate that the results obtained at five years accurately predict the outcome at 10 years. It was concluded that the variations of local and regional treatment used in this study are not important in determining survival of patients with breast cancer. 25 references, 6 figures, 1 table

  14. Health Care Finance Executive Personalities Revisited: A 10-Year Follow-up Study.

    Science.gov (United States)

    Lieneck, Cristian; Nowicki, Michael

    2015-01-01

    A dynamic health care industry continues to call upon health care leaders to possess not one but multiple competencies. Inherent personality characteristics of leaders often play a major role in personal as well as organizational success to include those in health care finance positions of responsibility. A replication study was conducted to determine the Myers-Briggs personality-type differences between practicing health care finance professionals in 2014, as compared with a previous 2003 study. Results indicate a significant shift between both independent samples of health care finance professionals over the 10-year period from original high levels of introversion to that of extraversion, as well as higher sensing personality preferences, as compared with the original sample's high level of intuition preferences. Further investigation into the evolving role of the health care finance manager is suggested, while continued alignment of inherent, personal characteristics is suggested to meet ongoing changes in the industry.

  15. Omental infarction in an obese 10-year-old boy

    Directory of Open Access Journals (Sweden)

    Katerina Kambouri

    2011-09-01

    Full Text Available Primary omental infarction (POI has a low incidence worldwide, with most cases occurring in adults. This condition is rarely considered in the differential diagnosis of acute abdominal pain in childhood. Herein, we present a case of omental infarction in an obese 10-year-old boy who presented with acute abdominal pain in the right lower abdomen. The ultrasound (US examination did not reveal the appendix but showed secondary signs suggesting acute appendicitis. The child was thus operated on under the preoperative diagnosis of acute appendicitis but the intraoperative finding was omental infarct. Since the omental infarct as etiology of acute abdominal pain is uncommon, we highlight some of the possible etiologies and emphasize the importance of accurate diagnosis and appropriate treatment of omental infarction.

  16. Inverse association between docosahexaenoic acid and mortality in patients on hemodialysis during over 10 years.

    Science.gov (United States)

    Terashima, Yoshihiro; Hamazaki, Kei; Itomura, Miho; Tomita, Shin; Kuroda, Masahiro; Hirata, Hitoshi; Hamazaki, Tomohito; Inadera, Hidekuni

    2014-07-01

    We have previously conducted a cohort study to investigate n-3 polyunsaturated fatty acids (PUFAs) in red blood cells (RBCs) and risk of all-cause mortality in hemodialysis (HD) patients over 5 years and found that n-3 PUFAs, especially docosahexaenoic acid (DHA), might be an independent predictor of all-cause mortality. In the present study, we extended the study for another 5 years to determine whether DHA levels in RBCs still predict the mortality of HD patients during a 10-year study period. The study cohort consisted of 176 patients (64.1 ± 12.0 [mean ± standard deviation] years of age, 96 men and 80 women) under HD treatment. The fatty acid composition of patients' RBCs was analyzed by gas chromatography. During the study period of 10 years, 97 deaths occurred. After adjustment for 10 confounding factors, the hazard ratio of all-cause mortality of the HD patients in the highest DHA tertile (>8.1%) was 0.52 (95% confidence interval 0.30-0.91) compared with those in the lowest DHA tertile (acid and docosapentaenoic acid (n-3) did not reveal any significant correlations. The level of DHA in RBCs could be an independent predictor of all-cause mortality in HD patients even during a long period of follow-up. © 2014 International Society for Hemodialysis.

  17. Dynamics of comprehensive physical fitness in artistic gymnasts aged 7-10 years

    Directory of Open Access Journals (Sweden)

    Sandra Boraczyńska

    2014-12-01

    Full Text Available Purpose: The aim of the study was to evaluate the somatic development and comprehensive physical fitness of artistic gymnasts aged 7-10 years. Materials and methods: Gymnasts (n = 307, split up into four age groups performed eight Eurofit tests. The results were evaluated in points according to the development standards prepared in scale T for the Polish girls population. Results : The gymnasts obtained the highest growth rate in balance test - FLB (13 points, arm and shoulder muscular endurance test - BAH (7 points and speed of the upper limb movement test - PLT (4 points out of eight physical fitness tests. Conclusions. High and very high level of performance in the six Eurofit tests and increased total number of points in the subsequent age groups of artistic gymnasts proved high effectiveness of training in shaping the key components of a comprehensive physical fitness in artistic gymnastics - balance, strength, endurance, speed and flexibility. Relatively little progress in isometric hand strength (HGR and standing broad jump (SBJ suggests a significant influence of genetic factors on the level of these abilities. The results provide an objective information useful in optimizing control system of training effects in comprehensive physical fitness and optimization of artistic gymnasts training at the comprehensive stage of sports training.

  18. The Cognitive Foundations of Reading and Arithmetic Skills in 7- to 10-Year-Olds

    Science.gov (United States)

    Durand, Marianne; Hulme, Charles; Larkin, Rebecca; Snowling, Margaret

    2005-01-01

    A range of possible predictors of arithmetic and reading were assessed in a large sample (N=162) of children between ages 7 years 5 months and 10 years 4 months. A confirmatory factor analysis of the predictors revealed a good fit to a model consisting of four latent variables (verbal ability, nonverbal ability, search speed, and phonological…

  19. 10-year incidence of diabetes and associated risk factors in Greece: the ATTICA study (2002-2012).

    Science.gov (United States)

    Koloverou, Efi; Panagiotakos, Demosthenes B; Pitsavos, Christos; Chrysohoou, Christina; Georgousopoulou, Ekavi N; Pitaraki, Evangelia; Metaxa, Vassiliki; Stefanadis, Christodoulos

    2014-01-01

    The incidence of diabetes in the general population is increasing world-wide. The increase is attributed to the consumption of saturated fatty acids, obesity, lack of physical activity, genetic predisposition, and other factors, but knowledge about the reasons, biological mechanisms, and late complications is insufficient. It is therefore important to clarify the reasons more exactly through long-term clinical trials to stop the rise of diabetes and its complications. To evaluate the 10-year incidence of type 2 diabetes in apparently healthy Greek adults. In 2001-2002, a random sample of 1514 men (18-87 years old) and 1528 women (18-89 years old) was selected to participate in the ATTICA study. During 2011-2012, the 10-year follow-up was performed. Patients diagnosed with diabetes at baseline (n = 210) and those lost at the 10-year follow-up (n = 1347) were excluded, yielding a final sample of 1485 participants. During the period of investigation, diabetes was diagnosed in 191 cases corresponding to a 12.9% incidence (95%CI: 10.4-15.4), with 13.4% (95%CI: 10.8-16) in men and 12.4% (95%CI: 10.1-14.7) in women. A relative increase was observed in the second half of the 10-year follow-up when age became significant. Multiple logistic regression analysis revealed that age (OR = 1.14, 95%CI: 1.09-1.19), abnormal waist-to-height ratio (OR = 3.27, 95%CI: 1.07-10.0), fasting blood glucose (OR per 1 mg/dl = 0.05, 95%CI: 1.02-1.08), energy intake (OR per 500 kcal = 1.02, 95%CI: 1.01-1.35), and family history of diabetes (OR = 2.8, 95%CI: 1.30-6.03) were the most significant baseline predictors for diabetes, after adjusting for potential confounders. Waist-to-height ratio showed the best explanatory power of all anthropometric variables. Physical activity exerts an effect on risk factors. Being active was found to eliminate the aggravating effect of diabetes family history and fasting blood glucose. The findings confirm the escalating increase of type 2 diabetes incidence in

  20. A 10 year follow-up study after Roux-Elmslie-Trillat treatment for cases of patellar instability

    Directory of Open Access Journals (Sweden)

    Wilke Axel

    2011-02-01

    Full Text Available Abstract Background A retrospective study concerning patients presenting with patella instability, treated using a Roux-Elmslie-Trillat reconstruction operation and followed up for 10 years following surgery, is presented. Methods Pre-operative and follow-up radiographic evaluation included the weight-bearing anteroposterior and merchant views. Evaluation was carried out using the Insall-Salvati index, sulcus and congruence angle. The Roux-Elmslie-Trillat reconstruction operation was performed on 18 patients. The clinical evaluation at follow-up was performed using the Knee-Society-Score (KSS and Tegner-Score. Results Subjective results of the operation were classed as excellent or good in 16 of the 18 patients ten years after surgery; persistent instability of the patella was recorded in only one of the 18 patients. The majority of patients returned to the same level of sporting activity after surgery as they had participated in before injury. Conclusions The Roux-Elmslie-Trillat procedure could be recommended in cases presenting with an increased q-angle, trochlea dysplasia or failed soft tissue surgery. In the present study the majority of patients report a return to previous sporting activity ten years after surgery.

  1. Ocular Surface Reconstruction with Cultivated Limbal Epithelial Cells in Limbal Stem Cell Deficiency: One-year Follow-up Results

    Directory of Open Access Journals (Sweden)

    İsmet Durak

    2012-05-01

    Full Text Available Pur po se: To evaluate the 1-year follow-up results of cultivated limbal epithelial cell (CLEC transplantation in unilateral limbal stem cell deficiency (LSCD. Ma te ri al and Met hod: One-year follow-up results of five unilateral LSCD patients who had undergone CLEC transplantation were evaluated. Parameters for this evaluation were: fluorescein staining of ocular surface, corneal vascularization and status of epithelium with slit lamp, and visual acuity. 1.5-mm limbal biopsy was performed from the superior limbus of the healthy eyes, broke into two equal pieces, expanded on human amniotic membrane (hAM and inserts for 14 days until getting 20 mm in size. CLECs on hAMs were used directly, and cells on inserts were usedafter detachment procedure. The symblepharon and pannus tissues were removed, superficial keratectomy was performed. CLEC on hAMs were transplanted with the epithelial side up onto the bare corneal stroma, sutured to the conjunctiva with 10-0 nylon sutures. Free CLEC layer from insert was placed on hAM as a second layer, additional hAM was used as a protective layer all over other tissues. Re sults: Median age was 44.4 years (14-71. The etiology was chemical burn in all patients. Median duration of symptoms was 10 years (2-18, median follow-up period was 12.6 (12-12.5 months. Preoperative best corrected visual acuities (BCVA were light perception in three patients, counting fingers at 50 cm in one patient and 3/10 in one patient. Visions were improved in all patients. Postoperative BCVA 12 months after the surgery were between counting fingers at 3 meters to 6/10. There was a temporary hemorrhage between the two layers of hAMs in one patient at the early postoperative period. Peripheral corneal vascularization has occurred in three patients, in patient corneal vascularization has reached to the paracentral area. Dis cus si on: CLEC transplantation is an efficient treatment option for unilateral LSCD in mid-long term. (Turk J

  2. A hhase I/II trial to evaluate three-dimensional conformal radiation therapy confined to the region of the lumpectomy cavity for Stage I/II breast carcinoma: Initial report of feasibility and reproducibility of Radiation Therapy Oncology Group (RTOG) Study 0319

    International Nuclear Information System (INIS)

    Vicini, Frank; Winter, Kathryn M.S.; Straube, William; Wong, John; Pass, Helen; Rabinovitch, Rachel; Chafe, Susan; Arthur, Douglas; Petersen, Ivy; McCormick, Beryl

    2005-01-01

    Background: This prospective study (Radiation Therapy Oncology Group Study 0319) examines the use of three-dimensional conformal external beam radiation therapy to deliver accelerated partial breast irradiation. Reproducibility, as measured by technical feasibility, was the primary end point with the goal of demonstrating whether the technique is widely applicable in a multicenter setting before a Phase III trial is undertaken. Methods and Materials: This study was designed such that if fewer than 5 cases out of the first 42 patients evaluable were scored as unacceptable, the treatment would be considered reproducible. Patients received 38.5 Gy in 3.85 Gy/fraction delivered twice daily. The clinical target volume included the lumpectomy cavity plus a 10-15-mm margin bounded by 5 mm within the skin surface and the lung-chest wall interface. The planning target volume (PTV) included the clinical target volume plus a 10-mm margin. Treatment plans were judged as follows: (1) No variations (total coverage), 95% isodose surface covers 100% of the PTV and all specified critical normal tissue dose-volume histogram (DVH) limits met. (2) Minor variation (marginal coverage), 95% isodose surface covers between ≥95% and <100% of the PTV. No portion of PTV receives <93% of prescription (isocenter) dose. All specified critical normal tissue DVH limits fall within 5% of the guidelines. (3) Major variation (miss), 95% isodose surface covers <95% of the PTV. Portion of PTV receives <93% of prescription isocenter dose. Any critical normal tissue DVH limit exceeds 5% of the specified value. Results: A total of 58 patients were enrolled on this study between 8/15/03 and 4/30/04, 5 of whom were ineligible or did not receive protocol treatment. Two additional patients were excluded, one because the on-study form was not submitted, and the other because no treatment planning material was submitted. This primary end point analysis is based on the first 42 (out of 51) evaluable patients

  3. Prognostic factors in glioblastoma multiforme. 10 years experience of a single institution

    Energy Technology Data Exchange (ETDEWEB)

    Hulshof, M C.C.M.; Schimmel, E C; Gonzalez, D G [Amsterdam Univ. (Netherlands). Dept. of Radiotherapy; Koot, R W; Bosch, D A [Amsterdam Univ. (Netherlands). Dept. of Neurosurgery; Dekker, F [Amsterdam Univ. (Netherlands). Dept. of Epidemiology

    2001-06-01

    Background: To analyze prognostic factors in patients with a glioblastoma multiforme treated in an academic institute over the last 10 years. Patients and method: From 1988 to 1998, 198 patients with pathologically confirmed glioblastoma multiforme were analyzed. Five radiation schedules were used mainly based on pretreatment selection criteria: 1. 60 Gy in 30 fractions followed by an interstitial iridium-192 (Ir-192) boost for selected patients with a good performance and a small circumscribed tumor, 2. 66 Gy in 33 fractions for good performance patients, 3. 40 Gy in eight fractions or 4. 28 Gy in four fractions for poor prognostic patients and 5. no irradiation. Results: Median survival was 16 months, 7 months, 5.6 months, 6.6 months and 1.8 months for the groups treated with Ir-192, 66 Gy, 40 Gy, 28 Gy and the group without treatment, respectively. No significant improvement in survival was encountered over the last 10 years. At multivariate analysis patients treated with a hypofractionated scheme showed a similar survival probability and duration of palliative effect compared to the conventionally fractionated group. The poor prognostic groups receiving radiotherapy had a highly significant better survival compared to the no-treatment group. Patients treated with an Ir-192 boost had a better median survival compared to a historical group matched on selection criteria but without boost treatment (16 vs 9.7 months, n.s.). However, survival at 2 years was similar. Analysis on pretreatment characteristics at multivariate analysis revealed age, neurological performance, addition of radiotherapy, total resection, tumor size post surgery and deterioration before start of radiotherapy (borderline) as significant prognostic factors for survival. Conclusion: Despite technical developments in surgery and radiotherapy over the last 10 years, survival of patients with a glioblastoma multiforme has not improved in our institution. The analysis of prognostic factors

  4. Antibody persistence 5 years after vaccination at 2 to 10 years of age with Quadrivalent MenACWY-CRM conjugate vaccine, and responses to a booster vaccination.

    Science.gov (United States)

    Block, Stan L; Christensen, Shane; Verma, Bikash; Xie, Fang; Keshavan, Pavitra; Dull, Peter M; Smolenov, Igor

    2015-04-27

    In a multi-center extension study, children 2-10 years of age, initially vaccinated with one or two doses (2-5 year-olds) or one dose (6-10 year-olds) of quadrivalent meningococcal CRM197-conjugate vaccine (MenACWY-CRM), were assessed five years later for antibody persistence and booster response using serum bactericidal assay with human complement (hSBA). Children 7-10 and 11-15 years of age, who received MenACWY-CRM in the original study, and age-matched vaccine-naïve children, were enrolled in this extension study. After an initial blood draw, children received one dose of MenACWY-CRM as booster or primary dose, with a second blood draw 28 days later. hSBA titers decreased five years after primary vaccination, but were higher than in non-vaccinated controls against serogroups C, W and Y, with substantial proportions having titers ≥8: 7-22% for A, 32-57% for C, 74-83% for W, and 48-54% for Y. Previously-vaccinated children demonstrated booster responses to revaccination against all four serogroups. Responses to primary vaccination in vaccine-naïve controls were lower and similar to primary responses observed in the original study. All vaccinations were generally well tolerated, with no safety concern raised. Approximately half the children vaccinated as 2-10 year-olds maintained protective antibodies against serogroups C, W and Y five years later, but fewer did against serogroup A. Declining titers five years after vaccination and robust booster responses suggest that five years may be an appropriate interval to revaccinate children, subject to epidemiology and delivery considerations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. TubercuList--10 years after.

    Science.gov (United States)

    Lew, Jocelyne M; Kapopoulou, Adamandia; Jones, Louis M; Cole, Stewart T

    2011-01-01

    TubercuList (http://tuberculist.epfl.ch/), the relational database that presents genome-derived information about H37Rv, the paradigm strain of Mycobacterium tuberculosis, has been active for ten years and now presents its twentieth release. Here, we describe some of the recent changes that have resulted from manual annotation with information from the scientific literature. Through manual curation, TubercuList strives to provide current gene-based information and is thus distinguished from other online sources of genome sequence data for M. tuberculosis. New, mostly small, genes have been discovered and the coordinates of some existing coding sequences have been changed when bioinformatics or experimental data suggest that this is required. Nucleotides that are polymorphic between different sources of H37Rv are annotated and gene essentiality data have been updated. A host of functional information has been gleaned from the literature and many new activities of proteins and RNAs have been included. To facilitate basic and translational research, TubercuList also provides links to other specialized databases that present diverse datasets such as 3D-structures, expression profiles, drug development criteria and drug resistance information, in addition to direct access to PubMed articles pertinent to particular genes. TubercuList has been and remains a highly valuable tool for the tuberculosis research community with >75,000 visitors per month. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. Epidemiology of breast lesions in eastern Nigeria. A 10- year ...

    African Journals Online (AJOL)

    Results: The most common breast lesion is fibroadenoma with n = 674 (30.5%). Its mean age of presentation is 23.8 years Standard Deviation (SD) 7.4 years. All were diagnosed as palpable lumps, the average sizes of these lumps at presentation were 3.2cm x 2.3cm x 1.4cm. Next was fibrocystic change with n = 343 ...

  7. Correction of coronal plane deformities around the knee using a tension band plate in children younger than 10 years

    Directory of Open Access Journals (Sweden)

    Ruta M Kulkarni

    2015-01-01

    Full Text Available Background: Guided growth through temporary hemiepiphysiodesis has gained acceptance as the preferred primary treatment in treating pediatric lower limb deformities as it is minimally invasive with a lesser morbidity than the traditional osteotomy. The tension band plate is the most recent development in implants used for temporary hemiepiphysiodesis. Our aim was to determine its safety and efficacy in correcting coronal plane deformities around the knee in children younger than 10 years. Materials and Methods: A total of 24 children under the age of 10 were operated for coronal plane deformities around the knee with a single extra periosteal tension band plate and two nonlocking screws. All the children had a pathological deformity for which a detailed preoperative work-up was carried out to ascertain the cause of the deformity and rule out physiological ones. The average age at hemiepiphysiodesis was 5 years 3 months (range: 2 years to 9 years 1 month. Results: The plates were inserted for an average of 15.625 months (range: 7 months to 29 months. All the patients showed improvement in the mechanical axis. Two patients showed partial correction. Two cases of screw loosening were observed. In the genu valgum group, the tibiofemoral angle improved from a preoperative mean of 19.89° valgus (range: 10° valgus to 40° valgus to 5.72° valgus (range: 2° varus to 10° valgus. In patients with genu varum the tibiofemoral angle improved from a mean of 28.27° varus (range: 13° varus to 41° varus to 1.59° valgus (range: 0-8° valgus. Conclusion: Temporary hemiepiphysiodesis through the application of the tension band plate is an effective method to correct coronal plane deformities around the knee with minimal complications. Its ease and accuracy of insertion has extended the indication of temporary hemiepiphysiodesis to patients younger than 10 years and across a wide variety of diagnosis including pathological physis, which were traditionally

  8. Results of six years of cytogenetic studies in amniotic fluid

    Directory of Open Access Journals (Sweden)

    Enelis Reyes Reyes

    2015-10-01

    Full Text Available Background: research into different genetic diseases is one of the preventive programs of paramount importance at public health level. The early detection of chromosomopathies and the establishment of an appropriate strategy reduce the morbidity-morality rate and improve the patients’ quality of life.Objective: to describe the behavior of the results of the cytogenetic studies in the amniotic fluid of pregnant women from Las Tunas province during six years: from 2008 to 2014.Methods: a retrospective and descriptive study was carried out to assess the results of cytogenetic studies in amniotic liquid during six years: from 2008 to 2014. The statistical records were checked and the results, the indication criteria, the behavior of the age groups in women advanced in age and the diagnosed chromosomopathies were assessed.Results: the samples with results that exceeded the non-conclusive and positive women prevailed; 2, 3 positive cases of chromosomopathies were diagnosed out of 100 studied women at risk; pregnant women of advanced gestational years prevailed as indication criterion, being the 37 to 40 years old age group the predominant one; in the positive cases, numeric chromosomopathies of the type trisomy 21 or Down’s syndrome prevailed, with a frequency of 1, 2 out of 100 pregnant women at risk.Conclusions: the program of the cytogenetic diagnosis in the amniotic fluid has been an effective tool to detect congenital prenatal defects by chromosomopathies, very useful in the process of genetic advice.

  9. Infant eczema, infant sleeping problems, and mental health at 10 years of age: the prospective birth cohort study LISAplus.

    Science.gov (United States)

    Schmitt, J; Chen, C-M; Apfelbacher, C; Romanos, M; Lehmann, I; Herbarth, O; Schaaf, B; Kraemer, U; von Berg, A; Wichmann, H-E; Heinrich, J

    2011-03-01

    Cross-sectional studies suggest an association between eczema and mental health problems, possibly modified by sleeping problems, but prospective evidence is missing. We aimed to prospectively investigate the relationship between infant eczema (within first 2 years of age), infant sleeping problems (within first 2 years of age), and the risk of mental health problems at 10 years of age. Between 1997 and 1999, a population-based birth cohort was recruited in Munich, Leipzig, Wesel, and Bad Honnef, Germany, and followed until 10 years of age. Physician-diagnosed eczema, parent-reported sleeping problems, and known environmental risk factors for atopy were regularly assessed until 10 years of age. Mental health was measured using the Strengths and Difficulties Questionnaire (parent version) at 10 years of age. We applied logistic regression modeling adjusting for environmental and lifestyle factors, allergic comorbidity, and family history of eczema. From the original cohort of 3097 neonates, 1658 (54%) were followed until age 10, while 1578 (51%) were eligible for analysis. In the fully adjusted model, children with infant eczema were at increased risk of hyperactivity/inattention at 10 years of age [odds ratio (OR) 1.78; 95% confidence interval (95% CI) 1.02-3.09]. Infant eczema with concurrent sleeping problems predicted emotional problems [OR 2.63; 95% confidence interval (95% CI) 1.20-5.76] and conduct problems (OR 3.03; 95% CI 1.01-9.12) at 10 years of age. Infant eczema with concurrent sleeping problems appears to be a risk factor for the development of mental health problems. © 2010 John Wiley & Sons A/S.

  10. Report of joint utilization results in fiscal year 1994

    International Nuclear Information System (INIS)

    1995-01-01

    Joint utilization seems to aim at the effective use of limited funds by concentrating facilities. There is a demerit that for doing experiment, it is necessary to take a trouble of going to the place. However by utilizing jointly one facility, there is the possibility of the occurrence of sympathizing phenomena directly connected to new ideas among researchers, and it is just the state joint utilization should be in. In fiscal year 1994, the Yayoi and the linac were put to joint utilization as expected, and many results of researches were obtained by the users. In this book, in addition to the report of the results of joint utilization, the report of the Yayoi research meetings held in fiscal year 1994 is included. Eight lectures on fast neutron science, the reports of joint utilization results of 15 Yayoi on-pile studies, 9 Yayoi off-pile studies and 16 linac studies, and the reports of 11 Yayoi research meetings are included in this book. The list of the events held in the Nuclear Engineering Research Laboratory, University of Tokyo, in fiscal year 1994, the list of the names of various committee members, and the list of the names of the persons in charge of joint utilization experiments are attached. (K.I.)

  11. Ten-Year Survival Results of a Randomized Trial of Irradiation of Internal Mammary Nodes After Mastectomy

    International Nuclear Information System (INIS)

    Hennequin, Christophe; Bossard, Nadine; Servagi-Vernat, Stéphanie; Maingon, Philippe; Dubois, Jean-Bernard; Datchary, Jean; Carrie, Christian; Roullet, Bernard; Suchaud, Jean-Philippe; Teissier, Eric; Lucardi, Audrey; Gerard, Jean-Pierre; Belot, Aurélien

    2013-01-01

    Purpose: To evaluate the efficacy of irradiation of internal mammary nodes (IMN) on 10-year overall survival in breast cancer patients after mastectomy. Methods and Patients: This multicenter phase 3 study enrolled patients with positive axillary nodes (pN+) or central/medial tumors with or without pN+. Other inclusion criteria were age <75 and a Karnofsky index ≥70. All patients received postoperative irradiation of the chest wall and supraclavicular nodes and were randomly assigned to receive IMN irradiation or not. Randomization was stratified by tumor location (medial/central or lateral), axillary lymph node status, and adjuvant therapy (chemotherapy vs no chemotherapy). The prescribed dose of irradiation to the target volumes was 50 Gy or equivalent. The first 5 intercostal spaces were included in the IMN target volume, and two-thirds of the dose (31.5 Gy) was given by electrons. The primary outcome was overall survival at 10 years. Disease-free survival and toxicity were secondary outcomes. Results: T total of 1334 patients were analyzed after a median follow-up of 11.3 years among the survivors. No benefit of IMN irradiation on the overall survival could be demonstrated: the 10-year overall survival was 59.3% in the IMN-nonirradiated group versus 62.6% in the IMN-irradiated group (P=.8). According to stratification factors, we defined 6 subgroups (medial/central or lateral tumor, pN0 [only for medial/central] or pN+, and chemotherapy or not). In all these subgroups, IMN irradiation did not significantly improve overall survival. Conclusions: In patients treated with 2-dimensional techniques, we failed to demonstrate a survival benefit for IMN irradiation. This study cannot rule out a moderate benefit, especially with more modern, conformal techniques applied to a higher risk population

  12. Long-Term Results of Laparoscopic Sleeve Gastrectomy for Morbid Obesity: 5 to 8-Year Results.

    Science.gov (United States)

    Gadiot, Ralph P M; Biter, L Ulas; van Mil, Stefanie; Zengerink, Hans F; Apers, J; Mannaerts, Guido H H

    2017-01-01

    Although long-term results of sleeve gastrectomy (LSG) remain scarce in the literature, its popularity as a stand-alone procedure has accounted for a global increase in LSG performance. In this retrospective study, the authors present 5 to 8-year follow-up results in terms of weight loss, failure/revision rate, and comorbidity resolution from a single center. A prospectively maintained database was reviewed for patients who underwent LSG between 2007 and 2010. Data analysis on weight loss, comorbid conditions, revision surgery, and mortality was conducted. Median percentage excess BMI loss (%EBMIL) was 59.0, and 53.9 %, and median percentage total weight loss (%TWL) was 25.1, and 22.9 % at 5 and 8 years, respectively. Revision to gastric bypass due to insufficient weight loss or gastroesophageal reflux disease (GERD) was performed in 42 patients (15.2 %). Resolution of comorbid condition was achieved in 91 % of patients with obstructive sleep apnea syndrome (OSAS), 68 % of patients with type 2 diabetes (T2DM), 53 % of patients with hypertension, and 25 % of patients with dyslipedemia. Loss to follow-up rate was 45 % at 5 years, 28 % at 6 years, 23 % at 7 years, and 13 % at 8 years. This study adds to the currently available data confirming the LSG to be a safe and effective procedure at long term. Data from high-volume studies are needed to establish the definite role of the LSG in the spectrum of bariatric procedures.

  13. WE-G-BRE-09: Targeted Radiotherapy Enhancement During Accelerated Partial Breast Irradiation (ABPI) Using Controlled Release of Gold Nanoparticles (GNPs)

    International Nuclear Information System (INIS)

    Cifter, G; Ngwa, W; Chin, J; Cifter, F; Sajo, E; Sinha, N; Bellon, J

    2014-01-01

    Purpose: Several studies have demonstrated low rates of local recurrence with brachytherapy-based accelerated partial breast irradiation (APBI). However, long-term outcomes on toxicity (e.g. telangiectasia), and cosmesis remain a major concern. The purpose of this study is to investigate the dosimetric feasibility of using targeted non-toxic radiosensitizing gold nanoparticles (GNPs) for localized dose enhancement to the planning target volume (PTV) during APBI while reducing dose to normal tissue. Methods: Two approaches for administering the GNPs were considered. In one approach, GNPs are assumed to be incorporated in a micrometer-thick polymer film on the surface of routinely used mammosite balloon applicators, for sustained controlled in-situ release, and subsequent treatment using 50-kVp Xoft devices. In case two, GNPs are administered directly into the lumpectomy cavity e.g. via injection or using fiducials coated with the GNP-loaded polymer film. Recent studies have validated the use of fiducials for reducing the PTV margin during APBI with 6 MV beams. An experimentally determined diffusion coefficient was used to determine space-time customizable distribution of GNPs for feasible in-vivo concentrations of 43 mg/g. An analytic calculational approach from previously published work was employed to estimate the dose enhancement due to GNPs (2 and 10 nm) as a function of distance up to 1 cm from lumpectomy cavity. Results: Dose enhancement due to GNP was found to be about 130% for 50-kVp x-rays, and 110% for 6-MV external beam radiotherapy, 1 cm away from the lumpectomy cavity wall. Higher customizable dose enhancement could be achieved at other distances as a function of nanoparticle size. Conclusion: Our preliminary results suggest that significant dose enhancement can be achieved to residual tumor cells targeted with GNPs during APBI with electronic brachytherapy or external beam therapy. The findings provide a useful basis for developing nanoparticle

  14. 10-Year-Old Female with Acute Abdominal Pain with Pancreatic Mass

    OpenAIRE

    Charles K. Powers; Molly Posa; Dhanashree Rajderkar; Jaclyn Otero

    2017-01-01

    A previously healthy 10-year-old female presented to a local emergency department following three days of nausea and vomiting diagnosed with a solid pseudopapillary tumor. Solid pseudopapillary neoplasms are a rare form of pancreatic cystic neoplasm that typically presents in young females in their 20–30s and are very rare in children. These neoplasms often present as an asymptomatic tumor found on incidental imaging. When symptomatic they most commonly present with abdominal pain and can als...

  15. Individual and maternal determinants of self-reported dental health among Turkish school children aged 10-12 years

    DEFF Research Database (Denmark)

    Cinar, A B; Kosku, N; Sandalli, N

    2008-01-01

    To assess the influence of maternal and individual characteristics on self-reported dental health of Turkish school children aged 10-12 years with different socio-economic backgrounds.......To assess the influence of maternal and individual characteristics on self-reported dental health of Turkish school children aged 10-12 years with different socio-economic backgrounds....

  16. Hepatitis B seroprotection in children aged 10-15 years after completion of basic hepatitis B immunizations

    Directory of Open Access Journals (Sweden)

    Novie Homenta Rampengan

    2017-04-01

    Full Text Available Background The prevalence of hepatitis B viral (HBV infection in Indonesia is high. The most effective way to control HBV infection is by hepatitis B (HB immunization. Many studies reported that hepatitis B surface antibody (anti-HBs seroprotection declines in children > 10 years of age. In addition many factors can influence anti-HBs titer. Objective To measure anti-HBs titer and evaluate possible factors associated with anti-HBs titer. Methods This cross sectional  study was conducted in children 10-15 years of age from ten schools at Tuminting District, Manado, North Sulawesi, from October to November 2014. All subjects had completed the hepatitis B immunization scheme. By stratified random sampling, 105 children were selected as subjects. Data was analyzed with SPSS version 22. Results. From 48 schools, we selected 10 schools from which to draw a total of 105 children, but only 23 (21.9% children had detectable anti-HBs . Of all subjects, 76 (72.4%  were female, 78 (74.3%  had good nutritional status, and 98 (93.3%  had birth weight ≥2,500 grams. Data from immunization record books showed that 26 (24.8% subjects received the HB-1 vaccination at ≤7 days of age and 45 (42.9% subjects had a ≥2 month interval between the HB-2 and HB-3 vaccinations. Multivariate analysis showed that administration of HB-1 at ≤7 days of age  and a ≥2 month interval between HB-2 and HB-3  had significant associations with anti-HB seroprotection in children. Conclusion A low proportion of subjects who had completed the hepatitis B immunization scheme had detectable anti-HBs titer (21.9%. Administration of HB-1 at ≤7 days of age and a ≥2-month interval between HB-2 and HB-3 vaccinations are important factors in anti-HB seroprotection in children aged 10-15 years.

  17. Prone Breast Intensity Modulated Radiation Therapy: 5-Year Results

    International Nuclear Information System (INIS)

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

    2014-01-01

    Purpose: To report the 5-year results of a technique of prone breast radiation therapy delivered by a regimen of accelerated intensity modulated radiation therapy with a concurrent boost to the tumor bed. Methods and Materials: Between 2003 and 2006, 404 patients with stage I-II breast cancer were prospectively enrolled into 2 consecutive protocols, institutional trials 03-30 and 05-181, that used the same regimen of 40.5 Gy/15 fractions delivered to the index breast over 3 weeks, with a concomitant daily boost to the tumor bed of 0.5 Gy (total dose 48 Gy). All patients were treated after segmental mastectomy and had negative margins and nodal assessment. Patients were set up prone: only if lung or heart volumes were in the field was a supine setup attempted and chosen if found to better spare these organs. Results: Ninety-two percent of patients were treated prone, 8% supine. Seventy-two percent had stage I, 28% stage II invasive breast cancer. In-field lung volume ranged from 0 to 228.27 cm 3 , mean 19.65 cm 3 . In-field heart volume for left breast cancer patients ranged from 0 to 21.24 cm 3 , mean 1.59 cm 3 . There was no heart in the field for right breast cancer patients. At a median follow-up of 5 years, the 5-year cumulative incidence of isolated ipsilateral breast tumor recurrence was 0.82% (95% confidence interval [CI] 0.65%-1.04%). The 5-year cumulative incidence of regional recurrence was 0.53% (95% CI 0.41%-0.69%), and the 5-year overall cumulative death rate was 1.28% (95% CI 0.48%-3.38%). Eighty-two percent (95% CI 77%-85%) of patients judged their final cosmetic result as excellent/good. Conclusions: Prone accelerated intensity modulated radiation therapy with a concomitant boost results in excellent local control and optimal sparing of heart and lung, with good cosmesis. Radiation Therapy Oncology Group protocol 1005, a phase 3, multi-institutional, randomized trial is ongoing and is evaluating the equivalence of a similar dose and fractionation

  18. Prone Breast Intensity Modulated Radiation Therapy: 5-Year Results

    Energy Technology Data Exchange (ETDEWEB)

    Osa, Etin-Osa O.; DeWyngaert, Keith [Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States); Roses, Daniel [Department of Surgery, New York University School of Medicine, New York, New York (United States); Speyer, James [Department of Medical Oncology, New York University School of Medicine, New York, New York (United States); Guth, Amber; Axelrod, Deborah [Department of Surgery, New York University School of Medicine, New York, New York (United States); Fenton Kerimian, Maria [Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States); Goldberg, Judith D. [Department of Population Health, New York University School of Medicine, New York, New York (United States); Formenti, Silvia C., E-mail: Silvia.formenti@nyumc.org [Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States)

    2014-07-15

    Purpose: To report the 5-year results of a technique of prone breast radiation therapy delivered by a regimen of accelerated intensity modulated radiation therapy with a concurrent boost to the tumor bed. Methods and Materials: Between 2003 and 2006, 404 patients with stage I-II breast cancer were prospectively enrolled into 2 consecutive protocols, institutional trials 03-30 and 05-181, that used the same regimen of 40.5 Gy/15 fractions delivered to the index breast over 3 weeks, with a concomitant daily boost to the tumor bed of 0.5 Gy (total dose 48 Gy). All patients were treated after segmental mastectomy and had negative margins and nodal assessment. Patients were set up prone: only if lung or heart volumes were in the field was a supine setup attempted and chosen if found to better spare these organs. Results: Ninety-two percent of patients were treated prone, 8% supine. Seventy-two percent had stage I, 28% stage II invasive breast cancer. In-field lung volume ranged from 0 to 228.27 cm{sup 3}, mean 19.65 cm{sup 3}. In-field heart volume for left breast cancer patients ranged from 0 to 21.24 cm{sup 3}, mean 1.59 cm{sup 3}. There was no heart in the field for right breast cancer patients. At a median follow-up of 5 years, the 5-year cumulative incidence of isolated ipsilateral breast tumor recurrence was 0.82% (95% confidence interval [CI] 0.65%-1.04%). The 5-year cumulative incidence of regional recurrence was 0.53% (95% CI 0.41%-0.69%), and the 5-year overall cumulative death rate was 1.28% (95% CI 0.48%-3.38%). Eighty-two percent (95% CI 77%-85%) of patients judged their final cosmetic result as excellent/good. Conclusions: Prone accelerated intensity modulated radiation therapy with a concomitant boost results in excellent local control and optimal sparing of heart and lung, with good cosmesis. Radiation Therapy Oncology Group protocol 1005, a phase 3, multi-institutional, randomized trial is ongoing and is evaluating the equivalence of a similar dose and

  19. School results and access test results as indicators of first-year performance at university

    Directory of Open Access Journals (Sweden)

    A Bothma

    2004-06-01

    Full Text Available The goals set by the National Plan for Higher Education, the fact that many schools are still severely disadvantaged as well as far-reaching changes in the school system demand that South African universities urgently reconsider their admission procedures. Redesigning admission procedures calls for a thorough understanding of the interrelationships between school marks, results in existing access tests and first-year university performance. These interrelationships were statistically investigated in the case of the 1999, 2000 and 2001 intake groups, who were compelled to write access tests before being admitted to Stellenbosch University. The results of this investigation confirm an alarming degree of unpreparedness among many prospective students regarding what is expected of them at university. This is aggravated by school marks creating a totally unrealistic expectation of performance in the first year at university. It is emphasised that schools and authorities dealing with admission of prospective students at universities should be cognisant of the findings reported here. Furthermore, the statistical analyses demonstrate several novel techniques for investigating the interrelationship between school marks, access test results and university performance.

  20. Using Intelligent Techniques in Construction Project Cost Estimation: 10-Year Survey

    Directory of Open Access Journals (Sweden)

    Abdelrahman Osman Elfaki

    2014-01-01

    Full Text Available Cost estimation is the most important preliminary process in any construction project. Therefore, construction cost estimation has the lion’s share of the research effort in construction management. In this paper, we have analysed and studied proposals for construction cost estimation for the last 10 years. To implement this survey, we have proposed and applied a methodology that consists of two parts. The first part concerns data collection, for which we have chosen special journals as sources for the surveyed proposals. The second part concerns the analysis of the proposals. To analyse each proposal, the following four questions have been set. Which intelligent technique is used? How have data been collected? How are the results validated? And which construction cost estimation factors have been used? From the results of this survey, two main contributions have been produced. The first contribution is the defining of the research gap in this area, which has not been fully covered by previous proposals of construction cost estimation. The second contribution of this survey is the proposal and highlighting of future directions for forthcoming proposals, aimed ultimately at finding the optimal construction cost estimation. Moreover, we consider the second part of our methodology as one of our contributions in this paper. This methodology has been proposed as a standard benchmark for construction cost estimation proposals.

  1. White matter lesions and temporal lobe atrophy related to incidence of both dementia and major depression in 70-year-olds followed over 10 years.

    Science.gov (United States)

    Gudmundsson, P; Olesen, P J; Simoni, M; Pantoni, L; Östling, S; Kern, S; Guo, X; Skoog, I

    2015-05-01

    A number of studies have suggested associations between dementia and depression in older adults. One reason could be that these disorders share structural correlates, such as white matter lesions (WMLs) and cortical atrophy. No study has examined whether these lesions precede both dementia and depression independently of each other in the general population. Whether WMLs and cortical atrophy on computed tomography predict dementia and depression was investigated in a population-based sample of 70-year-olds (n = 380) followed over 10 years. Exclusion criteria were dementia, major depression, history of stroke and a Mini-Mental State Examination score below 26 at baseline in 2000-2001. Dementia was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, third edition, revised, and depression according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Primary outcomes included dementia and major depression at 10-year follow-up. Adjusted logistic regression models, including both WMLs and temporal lobe atrophy, showed that moderate to severe WMLs [odds ratio (OR) 3.96, 95% confidence interval (CI) 1.23-12.76] and temporal lobe atrophy (OR 2.93, 95% CI 1.13-7.60) predicted dementia during a 10-year follow-up independently of major depression. Similarly, both moderate to severe WMLs (OR 3.84, 95% CI 1.25-11.76) and temporal lobe atrophy (OR 2.52, 95% CI 1.06-5.96) predicted depression even after controlling for incident dementia. White matter lesions and temporal lobe atrophy preceded 10-year incidence of both dementia and depression in 70-year-olds. Shared structural correlates could explain the reported associations between dementia and depression. These brain changes may represent independent and complementary pathways to dementia and depression. Strategies to slow progression of vascular pathology and neurodegeneration could indirectly prevent both dementia and depression in older adults. © 2015 EAN.

  2. Prematures with and without Regressed Retinopathy of Prematurity: Comparison of Long-Term (6-10 Years) Ophthalmological Morbidity.

    Science.gov (United States)

    Cats, Bernard P.; Tan, Karel E. W. P.

    Reporting long-term ophthalmologic sequelae among ex-prematures at 6 to 10 years of age, this study compares 42 ex-premature infants who had had regressed forms of retinopathy of prematurity (ROP) during the neonatal period with 42 matched non-ROP ex-premature controls at 6 to 10 years of age. Subjects were subdivided into four groups: (1) ROP…

  3. CERN Library | Herwig Schopper and Luigi Di Lella present "60 Years of CERN Experiments and Discoveries" | 10 March

    CERN Document Server

    CERN Library

    2016-01-01

    "60 Years of CERN Experiments and Discoveries" edited by Herwig Schopper and Luigi Di Lella. Presentation on Thursday, 10 March at 4 p.m. in Room C The book is a compilation of the most important experimental results achieved during the past 60 years at CERN - from the mid-1950s to the recent discovery of the Higgs particle. It covers the results from the early accelerators at CERN to those at the LHC and provides an excellent review of CERN's achievements. Not only presented is the impressive scientific progress achieved during the past six decades presented, but also is demonstrated the special way in which successful international collaboration exists at CERN. The book has been reviewed in the January-February issue of the CERN Courier: see here. Thanks to an agreement between CERN and the publisher, the e-book is available online Open Access. 60 Years of CERN Experiments and Discoveries Edited by Herwig Schopper and Luigi Di Lella W...

  4. Ten-year results of cartilage palisades versus fascia in eardrum reconstruction after surgery for sinus or tensa retraction cholesteatoma in children

    DEFF Research Database (Denmark)

    Cayé-Thomasen, Per; Andersen, Janne; Uzun, Cem

    2009-01-01

    threshold, and pure tone air-bone gap). RESULTS: All but two patients in both groups attended the 10-year follow-up examination (94% attendance). The mean overall follow-up period was 119 months (115 months in the palisade and 125 months in the fascia group). Total number of retractions during follow....... METHODS: A total of 64 children underwent surgery for either sinus or tensa retraction cholesteatoma during the period 1995 to 2000 (mean age 9 years, range 5-15). The eardrum was reconstructed using cartilage palisades in 32 children (32 ears) and fascia or perichondrium in 32 children (33 ears......). The patients were followed for at least one year postoperatively and re-evaluated 4 years after surgery, and again recently at a mean of 10 years. The main outcome measures were postoperative drum retraction and perforation, cholesteatoma recurrence, and hearing acuity (pure tone average, speech reception...

  5. Upper Gastrointestinal Bleeding in Chinese Children: A Multicenter 10-Year Retrospective Study.

    Science.gov (United States)

    Yu, Yi; Wang, Baoxiang; Yuan, Lan; Yang, Hui; Wang, Xinqiong; Xiao, Yuan; Mei, Hong; Xu, Chundi

    2016-08-01

    Objective This study aims to analyze the clinical and endoscopic presentations of upper gastrointestinal bleeding (UGIB) in the Chinese children. Methods A 10-year retrospective study was made on children with UGIB and undertaken esophagogastroduodenoscopy (EGD) from 4 tertiary referral centers in China. Results Of the 1218 children studied, the bleeding source was found in 76.4%. Erosive gastritis was the most common endoscopic finding (33.5%), followed by duodenal ulcer (23.2%). The proportion of erosive gastritis decreased with age (correlation coefficient = -0.787), and duodenal ulcer increased with age (correlation coefficient = 0.958). The bleeding source was more likely to be determined in children having EGDs within 48 hours (80.6% vs 67.9%). Conclusions In Chinese children with UGIB, erosive gastritis and duodenal ulcer were the leading causes, and their proportions varied with age. EGDs performed within 48 hours may improve the possibility of finding the source of bleeding. © The Author(s) 2015.

  6. Long-term Clinical Outcomes of Whole-Breast Irradiation Delivered in the Prone Position

    International Nuclear Information System (INIS)

    Stegman, Lauren D.; Beal, Katherine P.; Hunt, Margie A.; Fornier, Monica N.; McCormick, Beryl

    2007-01-01

    Purpose: The aim of this study was to evaluate retrospectively the effectiveness and toxicity of post-lumpectomy whole-breast radiation therapy delivered with prone positioning. Methods and Materials: Between September 1992 and August 2004, 245 women with 248 early-stage invasive or in situ breast cancers were treated using a prone breast board. Photon fields treated the whole breast to 46 to 50.4 Gy with standard fractionation. The target volume was clinically palpable breast tissue; no attempt was made to irradiate chest wall lymphatics. Tumor bed boosts were delivered in 85% of cases. Adjuvant chemotherapy and hormonal therapy were administered to 42% and 62% of patients, respectively. Results: After a median follow-up of 4.9 years, the 5 year actuarial true local and elsewhere ipsilateral breast tumor recurrence rates were 4.8% and 1.3%, respectively. The 5-year actuarial rates of regional nodal recurrence and distant metastases were 1.6% and 7.4%. Actuarial disease-free, disease-specific, and overall survival rates at 5 years were 89.4%, 97.3%, and 93%, respectively. Treatment breaks were required by 2.4% of patients. Grade 3 acute dermatitis and edema were each limited to 2% of patients. Only 4.9% of patients complained of acute chest wall discomfort. Chronic Grade 2 to 3 skin and subcutaneous tissue toxicities were reported in 4.4% and 13.7% of patients, respectively. Conclusions: Prone position breast radiation results in similar long-term disease control with a favorable toxicity profile compared with standard supine tangents. The anatomic advantages of prone positioning may contribute to improving the therapeutic ratio of post-lumpectomy radiation by improving dose homogeneity and minimizing incidental cardiac and lung dose

  7. Radiation therapy in differentiated cancers of thyroid. A report on 10 year experience

    International Nuclear Information System (INIS)

    Caoui, M.; Zekri, A.; Doudouh, Z.; Biyi, M.; Chbicheb, A.; Benrais, N.

    1997-01-01

    More than 800 cases of differentiated cancers of thyroid were selected at the service of radioisotopes of CHU Avicenne, RABAT, during a period of more than 13 years. The ages situate between the extremes 5 years and longer than 85 years, while more than 2/3 of patients are females. Almost 300 patients have received a cure of radiotherapy with 100 mCi of iodine 131. Less than 10% of them have benefited by a second cure. We deplore 4 deceases in our series. The goal of this work is to report the experience of our service in radiotherapy, which recorded an important impetus since the last ten years in spite of all the administrative constraints which this therapy technique implies (costs - importation...) and which limits its generalization to all the patients lacking social support

  8. MRSA Incidence and Antibiotic Trends in Urban Hand Infections: A 10-Year Longitudinal Study.

    Science.gov (United States)

    Kistler, Justin M; Thoder, Joseph J; Ilyas, Asif M

    2018-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) is the most reported pathogen in hand infections at urban medical centers throughout the country. Antibiotic sensitivity trends are not well known. The purposes of this study were to examine and determine the drug resistance trends for MRSA infections of the hand and to provide recommendations for empiric antibiotic treatment based on sensitivity profiles. A 10-year longitudinal, retrospective chart review was performed on all culture-positive hand infections encountered at a single urban medical center from 2005 to 2014. The proportions of all organisms were calculated for each year and collectively. MRSA infections were additionally subanalyzed for antibiotic sensitivity. A total of 815 culture-positive hand infections were identified. Overall, MRSA grew on culture in 46% of cases. A trend toward decreasing annual MRSA incidence was noted over the 10-year study period. There was a steady increase in polymicrobial infections during the same time. Resistance to clindamycin increased steadily during the 10-year study, starting at 4% in 2008 but growing to 31% by 2014. Similarly, levofloxacin resistance consistently increased throughout the study, reaching its peak at 56% in 2014. The annual incidence of MRSA in hand infections has declined overall but remains the most common pathogen. There has been an alternative increase in the number of polymicrobial infections. MRSA resistance to clindamycin and levofloxacin consistently increased during the study period. Empiric antibiotic therapy for hand infections should not only avoid penicillin and other beta-lactams but should also consider avoiding clindamycin and levofloxacin for empiric treatment.

  9. Parental Stress Scale: Validation study with a Portuguese population of parents of children from 3 to 10 years old.

    Science.gov (United States)

    Algarvio, Susana; Leal, Isabel; Maroco, João

    2018-01-01

    The aim of this study was to validate the Parental Stress Scale (PSS) for Portuguese parents and to further investigate the scale's criterion-related validity. A two-stage stratified sample of the Portuguese population of parents, with children attending public preschools and primary schools, was obtained, totalizing 3842 parents of children between 3 and 10 years old. Parents completed a Parental Concerns Scale and the Portuguese version of the PSS. Results support the four-factor structure of the Portuguese version of the PSS. Higher levels of parental stress were reported by parents of boys, with lower educational levels; older, divorced or single parents; unemployed mothers; and with a higher number of children. Parental concerns and parental stress' comparative study reported very low correlations between the two constructs. This study supported evidence for the PSS' validity with a stratified sample of Portuguese parents of children between 3 and 10 years old. Moreover, our findings reported the scale's divergent validity with a Parental Concerns Scale. These results point to the importance of assessing both dimensions in family practice.

  10. Parental stress and perceived vulnerability at 5 and 10 years after pediatric SCT

    NARCIS (Netherlands)

    Vrijmoet-Wiersma, C. M. J.; Egeler, R. M.; Koopman, H. M.; Bresters, D.; Norberg, A. L.; Grootenhuis, M. A.

    2010-01-01

    With the aim of assessing parental stress after SCT, 73 parents of children and adolescents who underwent SCT 5 or 10 years ago responded to questionnaires on general distress (General Health Questionnaire (GHQ)), disease-related stress (Pediatric Inventory for Parents-short form (PIP-SF)) and

  11. Baseline estradiol concentration in community-dwelling Japanese American men is not associated with intra-abdominal fat accumulation over 10 years.

    Science.gov (United States)

    Kocarnik, Beverly M; Boyko, Edward J; Matsumoto, Alvin M; Fujimoto, Wilfred Y; Hayashi, Tomoshige; Leonetti, Donna L; Page, Stephanie T

    The role of plasma estradiol in the accumulation of intra-abdominal fat (IAF) in men is uncertain. Cross-sectional studies using imaging of IAF have shown either a positive or no association. In contrast, a randomised controlled trial using an aromatase inhibitor to suppress estradiol production found an association between oestrogen deficiency and short-term IAF accumulation. No longitudinal study has been conducted to examine the relationship between plasma estradiol concentration and the change in IAF area measured using direct imaging. This is a longitudinal observational study in community-dwelling Japanese-American men (n=215, mean age 52 years, BMI 25.4kg/m 2 ). IAF and subcutaneous fat areas were assessed using computerized tomography (CT) at baseline, 5 and 10 years. Baseline plasma estradiol concentrations were measured using liquid chromatography-tandem mass spectrometry. Univariate analysis found no association between baseline estradiol concentration and baseline IAF, or 5- or 10-year changes in IAF area (r=-0.05 for both time points, p=0.45 and p=0.43, respectively). Multivariate linear regression analysis of the change in IAF area by baseline estradiol concentration adjusted for age, baseline IAF area, and weight change found no association with either the 5- or 10-year IAF area change (p=0.52 and p=0.55, respectively). Plasma estradiol concentration was not associated with baseline IAF nor with change in IAF area over 5 or 10 years based on serial CT scans in community-dwelling Japanese-American men. These results do not support a role for oestrogen deficiency in IAF accumulation in men. Copyright © 2015 Asia Oceania Association for the Study of Obesity. All rights reserved.

  12. Estudio sobre el consumo de sustancias psicoactivas en niños entre 10 y 12 años: Estado del arte y resultados preliminares Study on the use of psychoactive substances in children between 10 and 12 years old: State of the art and preliminary results

    Directory of Open Access Journals (Sweden)

    Marcelo Juan Grigoravicius

    2009-12-01

    Full Text Available Se presentan los resultados preliminares de la primera etapa de una investigación multidimensional sobre el consumo de sustancias psicoactivas. Se indagaron niños entre 10 y 12 años provenientes de familias con escasos recursos económicos y que concurren a una escuela pública del sur del conurbano bonaerense. Asimismo, se indagaron sus actitudes, valores y creencias hacia dichas sustancias. Metodología: Muestra: niños y niñas de 10 a 12 años que asisten a dicha escuela pública. n= 162; Varones n=61; Mujeres n= 101. Instrumentos: CORIN (conducta de riesgo en niños, Fuente: CONICET. Protocolo de datos sociodemográficos. Resultados y Conclusiones: El 46,3% de los niños manifiesta haber consumido alcohol y el 7,4% tabaco. Se concluye que las sustancias legales, principalmente el alcohol, se consumen y toleran en mayor proporción que las ilegales. Asimismo, se observa una discordancia entre las creencias y valores de los niños respecto del alcohol y sus conductas hacia esta sustancia.This paper presents the preliminary results from the first stage of a multidimensional research about the psychoactive substances use. Children between 10 and 12 years old were investigated. All of them belong to low socioeconomic status families and attend to public schools in the south of Buenos Aires province. Also, their attitudes, values and beliefs towards psychoactive substances were investigated. Methods: Sample: boys and girls between 10 and 12 years old attending to a public school. N=162; boys n= 61; girls n=101. Intruments: CORIN (risk behavior in children, source: CONICET; and Sociodemographic data protocol. Results and conclusions: The 46,3% of the children reports to have consumed alcohol and the 7,4% reports to have consumed tobacco. It is concluded that legal substances, specially alcohol, are consumed and tolerated better than illegal ones. Also, there is a dissonance between beliefs and values in children regarding to alcohol and their

  13. The Cryptophlebia Leucotreta Granulovirus—10 Years of Commercial Field Use

    Directory of Open Access Journals (Sweden)

    Sean D. Moore

    2015-03-01

    Full Text Available In the last 15 years, extensive work on the Cryptophlebia leucotreta granulovirus (CrleGV has been conducted in South Africa, initially in the laboratory, but subsequently also in the field. This culminated in the registration of the first CrleGV-based biopesticide in 2004 (hence, the 10 years of commercial use in the field and the second one three years later. Since 2000, more than 50 field trials have been conducted with CrleGV against the false codling moth, Thaumatotibia leucotreta, on citrus in South Africa. In a representative sample of 13 field trials reported over this period, efficacy (measured by reduction in larval infestation of fruit ranged between 30% and 92%. Efficacy was shown to persist at a level of 70% for up to 17 weeks after application of CrleGV. This only occurred where the virus was applied in blocks rather than to single trees. The addition of molasses substantially and sometimes significantly enhanced efficacy. It was also established that CrleGV should not be applied at less than ~2 × 1013 OBs per ha in order to avoid compromised efficacy. As CrleGV-based products were shown to be at least as effective as chemical alternatives, persistent and compatible with natural enemies, their use is recommended within an integrated program for control of T. leucotreta on citrus and other crops.

  14. Initial 2-year results of CardioCel® patch implantation in children.

    Science.gov (United States)

    Pavy, Carine; Michielon, Guido; Robertus, Jan Lukas; Lacour-Gayet, François; Ghez, Olivier

    2018-03-01

    We present the initial 2-year results of CardioCel® patch (Admedus Regen Pty Ltd, Perth, WA, Australia) implantation in paediatric patients with congenital heart diseases. This was a single-centre retrospective study with prospectively collected data of all patients aged 18 years and under operated for congenital heart disease. The patch was introduced in 2014, with clinical practice committee approval and a special consent in case of an Ozaki procedure. Standard follow-up was performed with systematic clinical exams and echocardiograms. In case of reoperation or graft failure, the patch was removed and sent for a histological examination. Between March 2014 and April 2016, 101 patients had surgical repair using a CardioCel patch. The mean age was 22 (±36.3) months, and the mean weight was 9.7 (±10.3) kg. No infections and no intraoperative implantation difficulties were associated with the patch. The median follow-up period was 212 (range 4-726) days. The overall 30-day postoperative mortality was 3.8% (n = 4), none of which were related to graft failure. Five children were reoperated because of graft failure, 4 of whom had the patch implanted for aortic and were aged less than 10 days. The indications for patch implantation in the aortic position were aortopulmonary window, truncus arteriosus, coarctation and aortic arch hypoplasia repair. The median time between the first and the second operation for graft failure was 245 (range 5-480) days. Our experience shows that the patch is well tolerated in the septal, valvar and pulmonary artery positions. However, we experienced graft failures in infants in the aortic position. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  15. Etiology of precocious puberty, 10 years study in Endocrine Reserch Centre (Firouzgar, Tehran

    Directory of Open Access Journals (Sweden)

    Fatemeh Safari

    2012-01-01

    Full Text Available Background: Precocious puberty, as early physical development and low final height might lead to psychosocial problems.Objective: To evaluate etiology and clinical feature of precocious puberty in a cohort of Iranian children.Materials and Methods: In this case-series study, 44 girls and 8 boys with precocious puberty referred to Endocrine Reserch Centre (Firouzgar, Institute of Endocrinology and Metabolism (Hemmat Campus, were examined in a 10 years period of time. Results: Mean age of girls and boys was 7.43±1.4 years and 5.8±2.1 years respectively. Most of the patients fell within the age category of 7-7.9 years old (40.9% for girls and 50% for boys. Patients, concerning etiology of precocious puberty were classified in three categories: 42.6% of patients had central precocious puberty (CPP, including idiopathic CPP (87.5% and neurogenic CPP (12.5%. 23.3% of patients had peripheral precocious puberty (PPP, including congenital adrenal hyperplasia (CAH (42.8%, ovarian cysts (28.4%, McCune-Albright syndrome (14.2% and adrenal carcinoma (14.2%. 34.1% of girls and 25% of boys had normal variant puberty including premature thelarche (57%, premature adrenarche (38% as well as premature menarche (4.7%l. Conclusion: The most common etiology of precocious puberty in girls was idiopathic central precocious puberty and premature thelarche, while in boys they were neurogenic central precocious puberty and CAH. Therefore precocious puberty in girls is usually benign. In boys, CNS anomalies should first be considered in the differential diagnosis of CPP. Therefore brain Magnetic Resonance Imaging (MRI is mandatory in all cases.

  16. Management Of Anorectal Malformation In Children: A 10 Year ...

    African Journals Online (AJOL)

    Bowel control was assessed after three years in 48 patients and classified as good control in 39 (81.3%) and fair in 9 (18.8%) patients. ... Our results can improve further with early presentation of patients, accurate definition of anomalies, careful choice of available techniques and reduced utilization of neonatal colostomy.

  17. Marital status and living situation during a 5-year period are associated with a subsequent 10-year cognitive decline in older men: The FINE study

    NARCIS (Netherlands)

    Gelder, van B.M.; Tijhuis, M.; Kalmijn, S.; Giampaoli, S.; Nissinen, A.; Kromhout, D.

    2006-01-01

    We investigate the association between marital status and living situation (over 5 years) on 10-year subsequent cognitive decline. The study population consisted of 1,042 men aged 70-89 years in 1990, who participated in the longitudinal Finland, Italy, the Netherlands Elderly (known as FINE) Study.

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  19. Calculated compositions of porewater affected by a nuclear waste repository in a tuff geologic environment from 0 to 10,000 years

    International Nuclear Information System (INIS)

    Criscenti, L.C.; Arthur, R.C.

    1994-01-01

    Porewater compositions were estimated for an environment assuming that high-level radioactive waste has been stored for 10,000 years under geologic conditions analogous to those at the Yucca Mountain site in Nevada. The porewater compositions calculated with the EQ3/EQ6 geochemical code are intended for use in preliminary performance assessments of borosilicate glass waste packages. The porewater compositions were calculated using water-rock interaction models that are loosely coupled with two time-temperature periods in the host rocks: a cooling period between 900 years and 3,000 years after repository closure and an isothermal period from 3,000 years to 10,000 years. Significant changes in water composition are predicted to occur during the initial period of water-rock interaction; for example, the pH of the porewater increases from 6.4 to 9.1. Constant porewater compositions are predicted during the isothermal period. The results suggest that major changes in porewater composition will occur over a relatively short time frame and that these changes will persevere throughout the repository lifetime. (author) 5 figs., 3 tabs., 28 refs

  20. Endometrial cancers occurring 10 or more years after pelvic irradiation for carcinoma

    International Nuclear Information System (INIS)

    Rodriguez, J.; Hart, W.R.

    1982-01-01

    Fifteen patients who developed cancer of the endometrium 10 or more years after pelvic irradiation for carcinoma were selected for study from a group of 64 cases of postirradiation malignant pelvic tumors diagnosed during a 48-year span. The average interval between radiotherapy and diagnosis of the subsequent endometrial cancer was 17.2 years. Irradiation initially had been done for squamous cell carcinoma of the cervix in 13 cases (87%) and for ovarian tumors in two instances. Almost all patients had received megavoltage external radiation combined with radium implants. Two-thirds of the tumors were adenocarcinomas and one-third were carcinosarcomas (either homologous or heterologous). Although the risk of second primary malignant tumors following therapeutic irradiation for pelvic tumors probably is very low, the emergence of new genital tract cancers in long-term survivors must be anticipated, regardless of whether the postirradiation cancers are spontaneous or radiation-induced