Manual therapy and exercise for neck pain: A systematic review

NARCIS (Netherlands)

Miller, Jordan; Gross, Anita; D'Sylva, Jonathan; Burnie, Stephen J.; Goldsmith, Charles H.; Graham, Nadine; Haines, Ted; Brønfort, Gert; Hoving, Jan L.

2010-01-01

Manual therapy is often used with exercise to treat neck pain. This cervical overview group systematic review update assesses if manual therapy, including manipulation or mobilisation, combined with exercise improves pain, function/disability, quality of life, global perceived effect, and patient

Delineation of the neck node levels for head and neck tumors: A 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensus guidelines

DEFF Research Database (Denmark)

Grégoire, Vincent; Ang, Kian; Budach, Wilfried

2014-01-01

In 2003, a panel of experts published a set of consensus guidelines for the delineation of the neck node levels in node negative patients (Radiother Oncol, 69: 227-36, 2003). In 2006, these guidelines were extended to include the characteristics of the node positive and the post-operative neck...... (Radiother Oncol, 79: 15-20, 2006). These guidelines did not fully address all nodal regions and some of the anatomic descriptions were ambiguous, thereby limiting consistent use of the recommendations. In this framework, a task force comprising opinion leaders in the field of head and neck radiation...... of Otolaryngology-Head and Neck Surgery, and in alignment with the TNM atlas for lymph nodes in the neck, 10 node groups (some being divided into several levels) were defined with a concise description of their main anatomic boundaries, the normal structures juxtaposed to these nodes, and the main tumor sites...

European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants - 2010 update

DEFF Research Database (Denmark)

Sweet, David G; Carnielli, Virgilio; Greisen, Gorm

2010-01-01

Despite recent advances in the perinatal management of neonatal respiratory distress syndrome (RDS), controversies still exist. We report the updated recommendations of a European panel of expert neonatologists who had developed consensus guidelines after critical examination of the most up-to-date....... For babies with RDS to have best outcomes, it is essential that they have optimal supportive care, including maintenance of a normal body temperature, proper fluid management, good nutritional support, management of the ductus arteriosus and support of the circulation to maintain adequate tissue perfusion....

A fully updated version of the european utility requirement (EUR) document is available

International Nuclear Information System (INIS)

Berbey, P.

2001-01-01

The major European electricity producers have worked on a common requirement document for future LWR plants since 1992 to get specifications acceptable together by the owners, the public and the authorities. Thus the designers can develop standard LWR designs that could be acceptable everywhere in Europe and the utilities can open their consultations to vendors on common bases. Public and authority's acceptance should be improved as well. Significant savings are expected in development and construction costs. Since the release of the last versions of the EUR texts in 1996, a lot of work has been carried out: reviews by the regulators and other external organisations, comparisons, assessment of compliance of designs vs. EUR and clarification works on the controversial topics that deserved changes or clarification. At the beginning of 1999 enough material was available to start a complete revision of the EUR document. In-depth works have been carried out during the last couple of year to develop this revision. The European utilities and the vendors have now an updated and well-tuned tool that allow them to develop, to assess and eventually to order modern LWR designs well fitted to their actual needs. (author)

Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment

NARCIS (Netherlands)

Gross, Anita; Langevin, Pierre; Burnie, Stephen J.; Bédard-Brochu, Marie-Sophie; Empey, Brian; Dugas, Estelle; Faber-Dobrescu, Michael; Andres, Cristy; Graham, Nadine; Goldsmith, Charles H.; Brønfort, Gert; Hoving, Jan L.; LeBlanc, Francis

2015-01-01

Manipulation and mobilisation are commonly used to treat neck pain. This is an update of a Cochrane review first published in 2003, and previously updated in 2010. To assess the effects of manipulation or mobilisation alone compared wiith those of an inactive control or another active treatment on

Updated European Heart Rhythm Association practical guide on the use of non-vitamin-K antagonist anticoagulants in patients with non-valvular atrial fibrillation: Executive summary.

Science.gov (United States)

Heidbuchel, Hein; Verhamme, Peter; Alings, Marco; Antz, Matthias; Diener, Hans-Christoph; Hacke, Werner; Oldgren, Jonas; Sinnaeve, Peter; Camm, A John; Kirchhof, Paulus

2017-07-14

In 2013, the European Heart Rhythm Association (EHRA) published a Practical Guide on the use of non-VKA oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) (Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P, European Heart Rhythm A. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace 2013;15:625-651; Heidbuchel H, Verhamme P, Alings M, Antz M, Hacke W, Oldgren J, Sinnaeve P, Camm AJ, Kirchhof P. EHRA practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary. Eur Heart J 2013;34:2094-2106). The document received widespread interest, not only from cardiologists but also from neurologists, geriatricians, and general practitioners, as became evident from the distribution of >350 000 copies of its pocket version (the EHRA Key Message Booklet) world-wide. Since 2013, numerous new studies have appeared on different aspects of NOAC therapy in AF patients. Therefore, EHRA updated the Practical Guide, including new information but also providing balanced guiding in the many areas where prospective data are still lacking. The outline of the original guide that addressed 15 clinical scenarios has been preserved, but all chapters have been rewritten. Main changes in the Update comprise a discussion on the definition of 'non-valvular AF' and eligibility for NOAC therapy, inclusion of finalized information on the recently approved edoxaban, tailored dosing information dependent on concomitant drugs, and/or clinical characteristics, an expanded chapter on neurologic scenarios (ischaemic stroke or intracranial haemorrhage under NOAC), an updated anticoagulation card and more specifics on start-up and follow-up issues. There are also many new flow charts, like on appropriate switching between anticoagulants (VKA to NOAC or vice versa), default scenarios for

WEB-DL endovascular treatment of wide-neck bifurcation aneurysms

DEFF Research Database (Denmark)

Lubicz, B; Klisch, J; Gauvrit, J-Y

2014-01-01

BACKGROUND AND PURPOSE: Flow disruption with the WEB-DL device has been used safely for the treatment of wide-neck bifurcation aneurysms, but the stability of aneurysm occlusion after this treatment is unknown. This retrospective multicenter European study analyzed short- and midterm data...... in patients treated with WEB-DL. MATERIALS AND METHODS: Twelve European neurointerventional centers participated in the study. Clinical data and pre- and postoperative short- and midterm images were collected. An experienced interventional neuroradiologist independently analyzed the images. Aneurysm occlusion...... was classified into 4 grades: complete occlusion, opacification of the proximal recess of the device, neck remnant, and aneurysm remnant. RESULTS: Forty-five patients (34 women and 11 men) 35-74 years of age (mean, 56.3 ± 9.6 years) with 45 aneurysms treated with the WEB device were included. Aneurysm locations...

European guidelines for workplace drug testing in urine.

Science.gov (United States)

Taskinen, Sanna; Beck, Olof; Bosch, Tessa; Brcak, Michaela; Carmichael, Duncan; Fucci, Nadia; George, Claire; Piper, Mark; Salomone, Alberto; Schielen, Wim; Steinmeyer, Stefan; Weinmann, Wolfgang

2017-06-01

These European Guidelines for Workplace Drug Testing in Urine have been prepared and updated by the European Workplace Drug Testing Society (EWDTS). The first version of these urine guidelines was published in 2002. Since then, the guidelines have been followed by many laboratories in different European countries and their role has been essential particularly in countries lacking legislation for workplace drug testing. In 2014, the EWDTS started a guidelines updating project and published a new version of the urine guidelines in 2015. Here we represent this updated version of the urine guidelines. The European Guidelines are designed to establish best practice procedures whilst allowing individual countries to operate within the requirements of national customs and legislation. The EWDTS recommends that all European laboratories that undertake legally defensible workplace drug testing should use these guidelines as a template for accreditation. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

An integrated approach towards future ballistic neck protection materials selection.

Science.gov (United States)

Breeze, John; Helliker, Mark; Carr, Debra J

2013-05-01

Ballistic protection for the neck has historically taken the form of collars attached to the ballistic vest (removable or fixed), but other approaches, including the development of prototypes incorporating ballistic material into the collar of an under body armour shirt, are now being investigated. Current neck collars incorporate the same ballistic protective fabrics as the soft armour of the remaining vest, reflecting how ballistic protective performance alone has historically been perceived as the most important property for neck protection. However, the neck has fundamental differences from the thorax in terms of anatomical vulnerability, flexibility and equipment integration, necessitating a separate solution from the thorax in terms of optimal materials selection. An integrated approach towards the selection of the most appropriate combination of materials to be used for each of the two potential designs of future neck protection has been developed. This approach requires evaluation of the properties of each potential material in addition to ballistic performance alone, including flexibility, mass, wear resistance and thermal burden. The aim of this article is to provide readers with an overview of this integrated approach towards ballistic materials selection and an update of its current progress in the development of future ballistic neck protection.

A dummy neck for low severity rear impacts

NARCIS (Netherlands)

Thunnissen, J.G.M.; Ratingen, M.R. van; Beusenberg, C.M.; Janssen, E.G.

1996-01-01

Neck injury in car collisions is rapidly becoming one of the most aggravating traffic safety problems with serious implications for the society. From studies performed in European countries such as Sweden, Germany and the Netherlands, but also in Canada and Japan, it is found that a very large

A new test method for the assessment of neck injuries in rear-end collisions

NARCIS (Netherlands)

Cappon, H.J.; Philippens, M.M.G.M.; Wismans, J.S.H.M.

2001-01-01

Whiplash injuries due to rear-end car collisions is one of the most aggravating traffic safety problems with serious implications for the European society. Yearly more than a million European citizens suffer neck injuries from rear-end car collisions, implying tremendous societal costs. Therefore

Bilateral experimental neck pain reorganize axioscapular muscle coordination and pain sensitivity.

Science.gov (United States)

Christensen, S W; Hirata, R P; Graven-Nielsen, T

2017-04-01

Neck pain is a large clinical problem where reorganized trunk and axioscapular muscle activities have been hypothesised contributing to pain persistence and pain hypersensitivity. This study investigated the effects of bilateral experimental neck pain on trunk and axioscapular muscle function and pain sensitivity. In 25 healthy volunteers, bilateral experimental neck pain was induced in the splenius capitis muscles by hypertonic saline injections. Isotonic saline was used as control. In sitting, subjects performed slow, fast and slow-resisted unilateral arm movements before, during and after injections. Electromyography (EMG) was recorded from eight shoulder and trunk muscles bilaterally. Pressure pain thresholds (PPTs) were assessed bilaterally at the neck, head and arm. Data were normalized to the before-measures. Compared with control and post measurements, experimental neck pain caused (1) decreased EMG activity of the ipsilateral upper trapezius muscles during all but slow-resisted down movements (p neck pain reorganized axioscapular and trunk muscle activity together with local hyperalgesia and widespread hypoalgesia indicating that acute neck pain immediately affects trunk and axioscapular function which may affect both assessment and treatment. Bilateral clinical neck pain alters axioscapular muscle coordination but only effects of unilateral experimental neck pain has been investigated. Bilateral experimental neck pain causes task-dependent reorganized axioscapular and trunk muscle activity in addition to widespread decrease in pressure pain sensitivity. © 2016 European Pain Federation - EFIC®.

Wedel (2006) SVP Poster - sauropod neck elongation

OpenAIRE

Wedel, Mathew

2013-01-01

The poster I presented at the 2006 annual meeting of the Society of Vertebrate Paleontology. The blue 'updated' boxes in the abstract represent changes I made between submitting the abstract and presenting the poster. The abstract appeared as: Wedel, M.J. 2006. Pneumaticity, neck length, and body size in sauropods. Journal of Vertebrate Paleontology 26(3):137A. The email and webpage info at the top of the poster are now out of date. My personal webpage is now http://sauroposeidon.wordpr...

Knowledge and screening of head and neck cancer among American Indians in South Dakota.

Science.gov (United States)

Dwojak, Sunshine; Deschler, Daniel; Sargent, Michele; Emerick, Kevin; Guadagnolo, B Ashleigh; Petereit, Daniel

2015-06-01

We established the level of awareness of risk factors and early symptoms of head and neck cancer among American Indians in South Dakota and determined whether head and neck cancer screening detected clinical findings in this population. We used the European About Face survey. We added questions about human papillomavirus, a risk factor for head and neck cancer, and demographics. Surveys were administered at 2 public events in 2011. Participants could partake in a head and neck cancer screening at the time of survey administration. Of the 205 American Indians who completed the survey, 114 participated in the screening. Mean head and neck cancer knowledge scores were 26 out of 44. Level of education was the only factor that predicted higher head and neck cancer knowledge (b = 0.90; P = .01). Nine (8%) people had positive head and neck cancer screening examination results. All abnormal clinical findings were in current or past smokers (P = .06). There are gaps in American Indian knowledge of head and neck cancer risk factors and symptoms. Community-based head and neck cancer screening in this population is feasible and may be a way to identify early abnormal clinical findings in smokers.

Role of radiotherapy fractionation in head and neck cancers (MARCH)

DEFF Research Database (Denmark)

Lacas, Benjamin; Bourhis, Jean; Overgaard, Jens

2017-01-01

BACKGROUND: The Meta-Analysis of Radiotherapy in squamous cell Carcinomas of Head and neck (MARCH) showed that altered fractionation radiotherapy is associated with improved overall and progression-free survival compared with conventional radiotherapy, with hyperfractionated radiotherapy showing...... the greatest benefit. This update aims to confirm and explain the superiority of hyperfractionated radiotherapy over other altered fractionation radiotherapy regimens and to assess the benefit of altered fractionation within the context of concomitant chemotherapy with the inclusion of new trials. METHODS......: For this updated meta-analysis, we searched bibliography databases, trials registries, and meeting proceedings for published or unpublished randomised trials done between Jan 1, 2009, and July 15, 2015, comparing primary or postoperative conventional fractionation radiotherapy versus altered fractionation...

Neck curve polynomials in neck rupture model

International Nuclear Information System (INIS)

Kurniadi, Rizal; Perkasa, Yudha S.; Waris, Abdul

2012-01-01

The Neck Rupture Model is a model that explains the scission process which has smallest radius in liquid drop at certain position. Old fashion of rupture position is determined randomly so that has been called as Random Neck Rupture Model (RNRM). The neck curve polynomials have been employed in the Neck Rupture Model for calculation the fission yield of neutron induced fission reaction of 280 X 90 with changing of order of polynomials as well as temperature. The neck curve polynomials approximation shows the important effects in shaping of fission yield curve.

A new version of the European tsunami catalogue: updating and revision

Directory of Open Access Journals (Sweden)

S. Tinti

2001-01-01

Full Text Available A new version of the European catalogue of tsunamis is presented here. It differs from the latest release of the catalogue that was produced in 1998 and is known as GITEC tsunami catalogue in some important aspects. In the first place, it is a database built on the Visual FoxPro 6.0 DBMS that can be used and maintained under the PC operating systems currently available. Conversely, the GITEC catalogue was compatible only with Windows 95 and older PC platforms. In the second place, it is enriched by new facilities and a new type of data, such as a database of pictures that can be accessed easily from the main screen of the catalogue. Thirdly, it has been updated by including the newly published references. Minute and painstaking search for new data has been undertaken to re-evaluate cases that were not included in the GITEC catalogue, though they were mentioned in previous catalogues; the exclusion was motivated by a lack of data. This last work has focused so far on Italian cases of the last two centuries. The result is that at least two events have been found which deserve inclusion in the new catalogue: one occurred in 1809 in the Gulf of La Spezia, and the other occurred in 1940 in the Gulf of Palermo. Two further events are presently under investigation.

European Vegetation Archive (EVA): an integrated database of European vegetation plots

DEFF Research Database (Denmark)

Chytrý, M; Hennekens, S M; Jiménez-Alfaro, B

2015-01-01

vegetation- plot databases on a single software platform. Data storage in EVA does not affect on-going independent development of the contributing databases, which remain the property of the data contributors. EVA uses a prototype of the database management software TURBOVEG 3 developed for joint management......The European Vegetation Archive (EVA) is a centralized database of European vegetation plots developed by the IAVS Working Group European Vegetation Survey. It has been in development since 2012 and first made available for use in research projects in 2014. It stores copies of national and regional...... data source for large-scale analyses of European vegetation diversity both for fundamental research and nature conservation applications. Updated information on EVA is available online at http://euroveg.org/eva-database....

Cetuximab And The Head And Neck Squamous Cell Cancer.

Science.gov (United States)

Concu, Riccardo; Cordeiro, Maria Natalia Dias Soeiro

2018-01-12

The head and neck squamous cell cancer (HNSCC) is the most common type of head and neck cancer (more than 90%), and all over the world more than a half million people have been developing this cancer in the last years. This type of cancer is usually marked by a poor prognosis with a really significant morbidity and mortality. Cetuximab received early favor as an exciting and promising new therapy with relatively mild side effect, and due to this received authorization in the 2004 from the European Medicines Agency (EMA) and in the 2006 from the Food and Drug Association (FDA) for the treatment of patients with squamous cell cancer of the head and neck in combination with radiation therapy for locally advanced disease. In this work we will review the application and the efficacy of the Cetuximab in the treatment of the HNSCC. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Cassini Spacecraft Uncertainty Analysis Data and Methodology Review and Update/Volume 1: Updated Parameter Uncertainty Models for the Consequence Analysis

Energy Technology Data Exchange (ETDEWEB)

WHEELER, TIMOTHY A.; WYSS, GREGORY D.; HARPER, FREDERICK T.

2000-11-01

Uncertainty distributions for specific parameters of the Cassini General Purpose Heat Source Radioisotope Thermoelectric Generator (GPHS-RTG) Final Safety Analysis Report consequence risk analysis were revised and updated. The revisions and updates were done for all consequence parameters for which relevant information exists from the joint project on Probabilistic Accident Consequence Uncertainty Analysis by the United States Nuclear Regulatory Commission and the Commission of European Communities.

Neck control after definitive radiochemotherapy without planned neck dissection in node-positive head and neck cancers

International Nuclear Information System (INIS)

Jang, Na Young; Lee, Keun-Wook; Ahn, Soon-Hyun; Kim, Jae-Sung; Ah Kim, In

2012-01-01

The purpose of this study was to evaluate neck control outcomes after definitive radiochemotherapy without planned neck dissection in node-positive head and neck cancer. We retrospectively reviewed medical records of fifty patients with node-positive head and neck cancer who received definitive radiochemotherapy. Twelve patients subsequently underwent neck dissection for suspicious recurrent or persistent disease. A median dose of 70 Gy (range 60-70.6) was delivered to involved nodes. Response evaluation was performed at a median of 5 weeks after completion of radiotherapy. Neck failure was observed in 11 patients and the 3-year regional control (RC) rate was 77.1%. Neck dissection was performed in 10 of the 11 patients; seven of these cases were successfully salvaged, and the ultimate rate of neck control was 92%. The remaining two patients who received neck dissection had negative pathologic results. On univariate analysis, initial nodal size > 2 cm, a less-than-complete response at the primary site, post-radiotherapy nodal size > 1.5 cm, and post-radiotherapy nodal necrosis were associated with RC. On multivariate analysis, less-than-complete primary site response and post-radiotherapy nodal necrosis were identified as independent prognostic factors for RC. The neck failure rate after definitive radiochemotherapy without planned neck dissection was 22%. Two-thirds of these were successfully salvaged with neck dissection and the ultimate neck control rate was 92%. Our results suggest that planned neck dissection might not be necessary in patients with complete response of primary site, no evidence of residual lesion > 1.5 cm, or no necrotic lymph nodes at the 1-2 months follow-up evaluation after radiotherapy

The European Stroke Organisation Guidelines: a standard operating procedure.

Science.gov (United States)

Ntaios, George; Bornstein, Natan M; Caso, Valeria; Christensen, Hanne; De Keyser, Jacques; Diener, Hans-Christoph; Diez-Tejedor, Exuperio; Ferro, Jose M; Ford, Gary A; Grau, Armin; Keller, Emanuella; Leys, Didier; Russell, David; Toni, Danilo; Turc, Guillaume; Van der Worp, Bart; Wahlgren, Nils; Steiner, Thorsten

2015-10-01

In 2008, the recently founded European Stroke Organisation published its guidelines for the management of ischemic stroke and transient ischemic attack. This highly cited document was translated in several languages and was updated in 2009. Since then, the European Stroke Organisation has published guidelines for the management of intracranial aneurysms and subarachnoidal hemorrhage, for the establishment of stroke units and stroke centers, and recently for the management of intracerebral hemorrhage. In recent years, the methodology for the development of guidelines has evolved significantly. To keep pace with this progress and driven by the strong determination of the European Stroke Organisation to further promote stroke management, education, and research, the European Stroke Organisation decided to delineate a detailed standard operating procedure for its guidelines. There are two important cornerstones in this standard operating procedure: The first is the implementation of the Grading of Recommendations Assessment, Development, and Evaluation methodology for the development of its Guideline Documents. The second one is the decision of the European Stroke Organisation to move from the classical model of a single Guideline Document about a major topic (e.g. management of ischemic stroke) to focused modules (i.e. subdivisions of a major topic). This will enable the European Stroke Organisation to react faster when new developments in a specific stroke field occur and update its recommendations on the related module rather swiftly; with the previous approach of a single large Guideline Document, its entire revision had to be completed before an updated publication, delaying the production of up-to-date guidelines. After discussion within the European Stroke Organisation Guidelines Committee and significant input from European Stroke Organisation members as well as methodologists and analysts, this document presents the official standard operating procedure for

[Cardiology update in 2016].

Science.gov (United States)

Gabus, Vincent; Tran, Van Nam; Regamey, Julien; Pascale, Patrizio; Monney, Pierre; Hullin, Roger; Vogt, Pierre

2017-01-11

In 2016 the European Society of Cardiology (ESC) published new guidelines. These documents update the knowledge in various fields such as atrial fibrillation, heart failure, cardiovascular prevention and dyslipidemia. Of course it is impossible to summarize these guidelines in detail. Nevertheless, we decided to highlight the major modifications, and to emphasize some key points that are especially useful for the primary care physician.

Public Policies for ICT Update In Business: Some Key Indicators for Spain in the European Area

Directory of Open Access Journals (Sweden)

José Luis Vázquez

2013-08-01

Full Text Available Purpose—Based on the new face of business in the twenty first century, this general review is aimed at analyzing the use of information and communication technologies (ICT as social technologies by Spanish enterprises in the European context, as a result of recent policy frameworks set at communitarian and national levels.Design/methodology/approach—The paper reviews the guidelines marked by European common policies with regards to ICT update in business, just as the translation of such standards in the Spanish area. From this framework, implications of ICT adoption in the social relationships with consumers, employees, business partners and public authorities are analyzed by providing some figures in the Spanish context in comparison with the European average.Findings—The analysis supports a positive effect of national policies on Spanish enterprises’ use of social technologies in the interactions with their internal and external stakeholders, while some differences can be reported attending size and sector criteria. In this respect, ICT penetration seems to be widespread in Spanish enterprises longer than ten employees, specially within informatics, telecommunications and audiovisuals, whereas automation of interactions is moderated in micro-enterprises in the manufacture, building, retailing, and transportation sectors.Research limitations/implications—The paper offers a general overview of the use of ICT as social technologies in Spanish enterprises based on public reports. However, further research should be oriented to analyze more in deep the impact of public policies on ICT adoption and usage in business, by explaining their determining factors and comparing different clusters of counties and major regions of the world.Practical implications—The analysis reported point to the need of reinforcing the Spanish positioning in the ICT European sector in the long term. In this sense, future policy measures should be devoted to

Public Policies for ICT Update In Business: Some Key Indicators for Spain in the European Area

Directory of Open Access Journals (Sweden)

Ana Lanero

2011-08-01

Full Text Available Purpose—Based on the new face of business in the twenty first century, this general review is aimed at analyzing the use of information and communication technologies (ICT as social technologies by Spanish enterprises in the European context, as a result of recent policy frameworks set at communitarian and national levels. Design/methodology/approach—The paper reviews the guidelines marked by European common policies with regards to ICT update in business, just as the translation of such standards in the Spanish area. From this framework, implications of ICT adoption in the social relationships with consumers, employees, business partners and public authorities are analyzed by providing some figures in the Spanish context in comparison with the European average.Findings—The analysis supports a positive effect of national policies on Spanish enterprises’ use of social technologies in the interactions with their internal and external stakeholders, while some differences can be reported attending size and sector criteria. In this respect, ICT penetration seems to be widespread in Spanish enterprises longer than ten employees, specially within informatics, telecommunications and audiovisuals, whereas automation of interactions is moderated in micro-enterprises in the manufacture, building, retailing, and transportation sectors.Research limitations/implications—The paper offers a general overview of the use of ICT as social technologies in Spanish enterprises based on public reports. However, further research should be oriented to analyze more in deep the impact of public policies on ICT adoption and usage in business, by explaining their determining factors and comparing different clusters of counties and major regions of the world.Practical implications—The analysis reported point to the need of reinforcing the Spanish positioning in the ICT European sector in the long term. In this sense, future policy measures should be devoted to

Updating the Nomographical Diagrams for Dimensioning the Beams

OpenAIRE

Pop Maria T.

2015-01-01

In order to reduce the time period needed for structures design it is strongly recommended to use nomographical diagrams. The base for formation and updating the nomographical diagrams, stands on the charts presented by different technical publications. The updated charts use the same algorithm and calculation elements as the former diagrams in accordance to the latest prescriptions and European standards. The result consists in a chart, having the same properties, similar with the nomogragra...

The European Stroke Organisation Guidelines : a standard operating procedure

NARCIS (Netherlands)

Ntaios, George; Bornstein, Natan M.; Caso, Valeria; Christensen, Hanne; De Keyser, Jacques; Diener, Hans-Christoph; Diez-Tejedor, Exuperio; Ferro, Jose M.; Ford, Gary A.; Grau, Armin; Keller, Emanuella; Leys, Didier; Russell, David; Toni, Danilo; Turc, Guillaume; Van der Worp, Bart; Wahlgren, Nils; Steiner, Thorsten

2015-01-01

In 2008, the recently founded European Stroke Organisation published its guidelines for the management of ischemic stroke and transient ischemic attack. This highly cited document was translated in several languages and was updated in 2009. Since then, the European Stroke Organisation has published

Morbidity of the neck after head and neck cancer therapy

NARCIS (Netherlands)

van Wilgen, C.P.; Dijkstra, P.U.; van der Laan, B.F.; Plukker, J.T.; Roodenburg, J.L.

Background. Studies on morbidity of the neck after head and neck cancer therapy are scarcely described. Methods. Patients who underwent surgery, including neck dissection, with and without radiation therapy at least 1 year before the study were asked to participate. We assessed neck pain, loss of

Text neck and neck pain in 18-21-year-old young adults.

Science.gov (United States)

Damasceno, Gerson Moreira; Ferreira, Arthur Sá; Nogueira, Leandro Alberto Calazans; Reis, Felipe José Jandre; Andrade, Igor Caio Santana; Meziat-Filho, Ney

2018-06-01

The aim of this study was to investigate whether there is an association between text neck and neck pain in young adults. Observational cross-sectional study with 150 18-21-year-old young adults from a public high school in the state of Rio de Janeiro was performed. In the self-report questionnaire, the participants answered questions on sociodemographic factors, anthropometric factors, time spent texting or playing on a mobile phone, visual impairments, and concern with the body posture. The neck posture was assessed by participants' self-perception and physiotherapists' judgment during a mobile phone texting message task. The Young Spine Questionnaire was used to evaluate the neck pain. Four multivariate logistic regression models were fitted to investigate the association between neck posture during mobile phone texting and neck pain, considering potential confounding factors. There is no association between neck posture, assessed by self-perception, and neck pain (OR = 1.66, p = 0.29), nor between neck posture, assessed by physiotherapists' judgment, and neck pain (OR = 1.23, p = 0.61). There was also no association between neck posture, assessed by self-perception, and frequency of neck pain (OR = 2.19, p = 0.09), nor between neck posture, assessed by physiotherapists' judgment, and frequency of neck pain (OR = 1.17, p = 0.68). This study did not show an association between text neck and neck pain in 18-21-year-old young adults. The findings challenge the belief that neck posture during mobile phone texting is associated to the growing prevalence of neck pain.

Neck muscle function in violinists/violists with and without neck pain.

Science.gov (United States)

Steinmetz, Anke; Claus, Andrew; Hodges, Paul W; Jull, Gwendolen A

2016-04-01

Neck pain is associated with changes in neuromuscular control of cervical muscles. Violin and viola playing requires good function of the flexor muscles to stabilize the instrument. This study investigated the flexor muscle behaviour in violin/viola players with and without neck pain using the craniocervical flexion test (CCFT). In total, 12 violin/viola players with neck pain, 21 violin/viola players without neck pain in the preceding 12 weeks and 21 pain-free non-musicians were included. Activity of the sternocleidomastoid muscles (SCM) was measured with surface electromyography (EMG) during the CCFT. Violin/viola players with neck pain displayed greater normalised SCM EMG amplitudes during CCFT than the pain-free musicians and non-musicians (P neck pain in violinists/violists is associated with altered behaviour of the superficial neck flexor muscles consistent with neck pain, despite the specific use of the deep and superficial neck flexors during violin playing.

Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration.

Science.gov (United States)

Wong, Jessica J; Shearer, Heather M; Mior, Silvano; Jacobs, Craig; Côté, Pierre; Randhawa, Kristi; Yu, Hainan; Southerst, Danielle; Varatharajan, Sharanya; Sutton, Deborah; van der Velde, Gabrielle; Carroll, Linda J; Ameis, Arthur; Ammendolia, Carlo; Brison, Robert; Nordin, Margareta; Stupar, Maja; Taylor-Vaisey, Anne

2016-12-01

In 2008, the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders (Neck Pain Task Force) found limited evidence on the effectiveness of manual therapies, passive physical modalities, or acupuncture for the management of whiplash-associated disorders (WAD) or neck pain and associated disorders (NAD). This review aimed to update the findings of the Neck Pain Task Force, which examined the effectiveness of manual therapies, passive physical modalities, and acupuncture for the management of WAD or NAD. This is a systematic review and best evidence synthesis. The sample includes randomized controlled trials, cohort studies, and case-control studies comparing manual therapies, passive physical modalities, or acupuncture with other interventions, placebo or sham, or no intervention. The outcome measures were self-rated or functional recovery, pain intensity, health-related quality of life, psychological outcomes, or adverse events. We systematically searched five databases from 2000 to 2014. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Studies with a low risk of bias were stratified by the intervention's stage of development (exploratory vs. evaluation) and synthesized following best evidence synthesis principles. Funding was provided by the Ministry of Finance. We screened 8,551 citations, and 38 studies were relevant and 22 had a low risk of bias. Evidence from seven exploratory studies suggests that (1) for recent but not persistent NAD grades I-II, thoracic manipulation offers short-term benefits; (2) for persistent NAD grades I-II, technical parameters of cervical mobilization (eg, direction or site of manual contact) do not impact outcomes, whereas one session of cervical manipulation is similar to Kinesio Taping; and (3) for NAD grades I-II, strain-counterstrain treatment is no better than placebo. Evidence from 15 evaluation studies

Health statistics - Atlas on mortality in the European Union: 2009 edition

NARCIS (Netherlands)

Huisman, C.C.; Bonneux, L.G.A.

2009-01-01

Health statistics - Atlas on mortality in the European Union describes the situation regarding mortality in the Member States of the European Union. It is an update of an earlier publication published by Eurostat in 2002, based on data for the years 1994-1996. Since then the number of European

Consensus document on European brain research

DEFF Research Database (Denmark)

Di Luca, Monica; Baker, Mary; Corradetti, Renato

2011-01-01

will increase exponentially in the years to come due to ageing of the European population, it is necessary to act now in order to curb this increase and possibly reverse the trend. Thus, establishing a strong European platform supporting basic and clinical research in neuroscience is needed to confront...... version. Multinational and multidisciplinary teams have once again come together to express their views, not only on the current strengths in European research, but also on what needs to be done in priority, hoping that this update will inspire policy makers and stakeholders in directing funding...

European immigration a sourcebook

CERN Document Server

Triandafyllidou, Anna

2016-01-01

Fully updated and containing chapters on the new EU member states and the attempt to form a common EU migration policy, this new edition of European Immigration: A Sourcebook provides a comprehensive overview of the trends and developments in migration in all EU countries. With chapters following a common structure to facilitate direct international comparisons, it not only examines the internal affairs of each member state, but also explores both migratory trends within the EU itself and the implications for European immigration of wider global events, including the Arab Spring and the world financial crisis.

Imaging of the head and neck. 2. rev. and enl. ed

Energy Technology Data Exchange (ETDEWEB)

Mafee, M.F.; Valvassori, G.E. [University of Illinois, Chicago, IL (United States); Becker, M. [Geneva University Hospital (Switzerland)

2004-07-01

Remarkable advances in medical diagnostic imaging have been made during the past three decades. The development of new imaging techniques and continuous improvements in the display of digital images have opened new horizons in the study of head and neck anatomy and pathology. The American Society of Head and Neck Radiology (ASHNR) and its European and Asiatic counterparts evolved because of the emerging awareness of the roles that head and neck radiologists play in the diagnosis and management of head and neck, base of the skull, neuro-ophthalmologic and neuro-otologic diseases. This edition continues the tradition of excellence set by the first edition of Valvassori's Head and Neck Imaging (which was also the first textbook in head and neck radiology), and provides a comprehensive review of the most pertinent and up-to-date knowledge in the field of head and neck imaging. The content of this edition has been organized into 12 chapters according to anatomic regions. It now includes new material on the temporomandibular joint, the lacrimal drainage system, dental scanning, fibro-osseous and cartilaginous lesions of the head and neck, MRI sialography, MR interventional technique, and thyroid and parathyroid glands. All chapters have been expanded to address new developments in the field and to stress the importance of imaging anatomy, pathologic correlation, and pertinent clinical data. For each anatomic region, the embryology and anatomy are introduced, followed by congenital and developmental disorders, inflammatory processes, benign and malignant neoplastic diseases, trauma, and postoperative changes. The detailed reference lists in each chapter include key references and are as recent as possible. Care has been taken to include exquisitely reproduced illustrations that provide the maximum of pertinent information. It is our hope that this textbook will be useful to students and physicians in the fields of radiology, otolaryngology, neurootology, rhinology

Imaging of the head and neck. 2. rev. and enl. ed.

International Nuclear Information System (INIS)

Mafee, M.F.; Valvassori, G.E.; Becker, M.

2004-01-01

Remarkable advances in medical diagnostic imaging have been made during the past three decades. The development of new imaging techniques and continuous improvements in the display of digital images have opened new horizons in the study of head and neck anatomy and pathology. The American Society of Head and Neck Radiology (ASHNR) and its European and Asiatic counterparts evolved because of the emerging awareness of the roles that head and neck radiologists play in the diagnosis and management of head and neck, base of the skull, neuro-ophthalmologic and neuro-otologic diseases. This edition continues the tradition of excellence set by the first edition of Valvassori's Head and Neck Imaging (which was also the first textbook in head and neck radiology), and provides a comprehensive review of the most pertinent and up-to-date knowledge in the field of head and neck imaging. The content of this edition has been organized into 12 chapters according to anatomic regions. It now includes new material on the temporomandibular joint, the lacrimal drainage system, dental scanning, fibro-osseous and cartilaginous lesions of the head and neck, MRI sialography, MR interventional technique, and thyroid and parathyroid glands. All chapters have been expanded to address new developments in the field and to stress the importance of imaging anatomy, pathologic correlation, and pertinent clinical data. For each anatomic region, the embryology and anatomy are introduced, followed by congenital and developmental disorders, inflammatory processes, benign and malignant neoplastic diseases, trauma, and postoperative changes. The detailed reference lists in each chapter include key references and are as recent as possible. Care has been taken to include exquisitely reproduced illustrations that provide the maximum of pertinent information. It is our hope that this textbook will be useful to students and physicians in the fields of radiology, otolaryngology, neurootology, rhinology, head

European Society of Clinical Microbiology and Infectious Diseases: update of the treatment guidance document for Clostridium difficile infection.

Science.gov (United States)

Debast, S B; Bauer, M P; Kuijper, E J

2014-03-01

In 2009 the first European Society of Clinical Microbiology and Infection (ESCMID) treatment guidance document for Clostridium difficile infection (CDI) was published. The guideline has been applied widely in clinical practice. In this document an update and review on the comparative effectiveness of the currently available treatment modalities of CDI is given, thereby providing evidence-based recommendations on this issue. A computerized literature search was carried out to investigate randomized and non-randomized trials investigating the effect of an intervention on the clinical outcome of CDI. The Grades of Recommendation Assessment, Development and Evaluation (GRADE) system was used to grade the strength of our recommendations and the quality of the evidence. The ESCMID and an international team of experts from 11 European countries supported the process. To improve clinical guidance in the treatment of CDI, recommendations are specified for various patient groups, e.g. initial non-severe disease, severe CDI, first recurrence or risk for recurrent disease, multiple recurrences and treatment of CDI when oral administration is not possible. Treatment options that are reviewed include: antibiotics, toxin-binding resins and polymers, immunotherapy, probiotics, and faecal or bacterial intestinal transplantation. Except for very mild CDI that is clearly induced by antibiotic usage antibiotic treatment is advised. The main antibiotics that are recommended are metronidazole, vancomycin and fidaxomicin. Faecal transplantation is strongly recommended for multiple recurrent CDI. In case of perforation of the colon and/or systemic inflammation and deteriorating clinical condition despite antibiotic therapy, total abdominal colectomy or diverting loop ileostomy combined with colonic lavage is recommended. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Fiscal policy surveillance in the enlarged European Union: Procedural checks or simple arithmetic?

NARCIS (Netherlands)

Groenendijk, Nico; Batten, Jonathan A.; Kearney, Colm

2006-01-01

In its recommendation on the 2004 update of the Broad Economic Policy Guidelines (BEPGs), the European Commission (2004) issued country-specific recommendations for fiscal policy in the Central and Eastern European (CEE) countries that have recently joined the European Union (EU) (henceforth the

Food irradiation. An update of legal and analytical aspects

International Nuclear Information System (INIS)

Masotti, P.; Zonta, F.

1999-01-01

A new European directive concerning ionising radiation treatment of foodstuffs has been recently adopted, although National laws may continue to be applied at least until 31 December 2000. A brief updated review dealing with the legal and analytical aspects of food irradiation is presented. The legal status of the food irradiation issue presently in force in Italy, in the European Union and in the USA is discussed. Some of the most used and reliable analytical methods for detecting irradiated foodstuffs, with special reference to standardised methods of European Committee of Standardization, are listed [it

Sentinel node biopsy in head and neck squamous cell cancer: 5-year follow-up of a European multicenter trial

DEFF Research Database (Denmark)

Alkureishi, Lee W T; Ross, Gary L; Shoaib, Taimur

2010-01-01

Sentinel node biopsy (SNB) may represent an alternative to elective neck dissection for the staging of patients with early head and neck squamous cell carcinoma (HNSCC). To date, the technique has been successfully described in a number of small single-institution studies. This report describes...

Recommendations for an update of the 2010 European regulatory guideline on clinical investigation of medicinal products used in the treatment of osteoarthritis and reflections about related clinically relevant outcomes: expert consensus statement.

Science.gov (United States)

Reginster, J-Y; Reiter-Niesert, S; Bruyère, O; Berenbaum, F; Brandi, M-L; Branco, J; Devogelaer, J-P; Herrero-Beaumont, G; Kanis, J; Maggi, S; Maheu, E; Richette, P; Rizzoli, R; Cooper, C

2015-12-01

The European Society on Clinical and Economic aspects of Osteoporosis and Osteoarthritis (ESCEO) organised a working group to evaluate the need for updating the current European guideline on clinical investigation of drugs used in the treatment of osteoarthritis (OA). Areas of potential attention were identified and the need for modifications, update or clarification was examined. Proposals were then developed based on literature reviews and through a consensus process. It was agreed that the current guideline overall still reflects the current knowledge in OA, although two possible modifications were identified. The first relates to the number and timing of measurements required as primary endpoints during clinical trials of symptom-relieving drugs, either drugs with rapid onset of action or slow acting drugs. The suggested modifications are intended to take into consideration the time related clinical need and expected time response to these drugs - i.e., a more early effect for the first category in addition to the maintenance of effect, a more continuous benefit over the long-term for the latter - in the timing of assessments. Secondly, values above which a benefit over placebo should be considered clinically relevant were considered. Based on literature reviews, the most consensual values were determined for primary endpoints of both symptom-relieving drugs (i.e., pain intensity on a visual analogue scale (VAS)) and disease-modifying drugs (i.e., radiographic joint-space narrowing). This working document might be considered by the European regulatory authorities in a future update of the guideline for the registration of drugs in OA. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Architecture of European Plastic Surgery

NARCIS (Netherlands)

Nicolai, J. -P. A.; Banic, A.; Molea, G.; Mazzola, R.; Poell, J. G.

2006-01-01

The architecture of European Plastic Surgery was published in 1996 [Nicolai JPA, Scuderi N. Plastic surgical Europe in an organogram. Eur J Plast Surg 1996; 19: 253-6.] It is the objective of this paper to update information of that article. Continuing medical education (CME), science, training,

Update in cardiomyopathies and congestive heart failure

Directory of Open Access Journals (Sweden)

The Heart Hospital, London, UK and Monaldi Hospital, Naples, Italy

2012-05-01

Full Text Available This abstract book contains four reports and all abstracts presented to the Joint Meeting: Update in cardiomyopathies and congestive heart failure, 22-23 September 2011 - Naples, Italy, endorsed by the Working Group on Myocardial and Pericardial Diseases (WG 21 of the European Society of Cardiology (ESC.

Atlas-based automatic segmentation of head and neck organs at risk and nodal target volumes: a clinical validation

International Nuclear Information System (INIS)

Daisne, Jean-François; Blumhofer, Andreas

2013-01-01

Intensity modulated radiotherapy for head and neck cancer necessitates accurate definition of organs at risk (OAR) and clinical target volumes (CTV). This crucial step is time consuming and prone to inter- and intra-observer variations. Automatic segmentation by atlas deformable registration may help to reduce time and variations. We aim to test a new commercial atlas algorithm for automatic segmentation of OAR and CTV in both ideal and clinical conditions. The updated Brainlab automatic head and neck atlas segmentation was tested on 20 patients: 10 cN0-stages (ideal population) and 10 unselected N-stages (clinical population). Following manual delineation of OAR and CTV, automatic segmentation of the same set of structures was performed and afterwards manually corrected. Dice Similarity Coefficient (DSC), Average Surface Distance (ASD) and Maximal Surface Distance (MSD) were calculated for “manual to automatic” and “manual to corrected” volumes comparisons. In both groups, automatic segmentation saved about 40% of the corresponding manual segmentation time. This effect was more pronounced for OAR than for CTV. The edition of the automatically obtained contours significantly improved DSC, ASD and MSD. Large distortions of normal anatomy or lack of iodine contrast were the limiting factors. The updated Brainlab atlas-based automatic segmentation tool for head and neck Cancer patients is timesaving but still necessitates review and corrections by an expert

Atlas-based automatic segmentation of head and neck organs at risk and nodal target volumes: a clinical validation.

Science.gov (United States)

Daisne, Jean-François; Blumhofer, Andreas

2013-06-26

Intensity modulated radiotherapy for head and neck cancer necessitates accurate definition of organs at risk (OAR) and clinical target volumes (CTV). This crucial step is time consuming and prone to inter- and intra-observer variations. Automatic segmentation by atlas deformable registration may help to reduce time and variations. We aim to test a new commercial atlas algorithm for automatic segmentation of OAR and CTV in both ideal and clinical conditions. The updated Brainlab automatic head and neck atlas segmentation was tested on 20 patients: 10 cN0-stages (ideal population) and 10 unselected N-stages (clinical population). Following manual delineation of OAR and CTV, automatic segmentation of the same set of structures was performed and afterwards manually corrected. Dice Similarity Coefficient (DSC), Average Surface Distance (ASD) and Maximal Surface Distance (MSD) were calculated for "manual to automatic" and "manual to corrected" volumes comparisons. In both groups, automatic segmentation saved about 40% of the corresponding manual segmentation time. This effect was more pronounced for OAR than for CTV. The edition of the automatically obtained contours significantly improved DSC, ASD and MSD. Large distortions of normal anatomy or lack of iodine contrast were the limiting factors. The updated Brainlab atlas-based automatic segmentation tool for head and neck Cancer patients is timesaving but still necessitates review and corrections by an expert.

Rapid morphological changes, admixture and invasive success in populations of Ring-necked parakeets (Psittacula krameri) established in Europe

OpenAIRE

Le Gros , Ariane; Samadi , Sarah; Zuccon , Dario; Cornette , Raphaël; Braun , Michael P.; Senar , Juan Carlos; Clergeau , Philippe

2016-01-01

International audience; The Ring-necked parakeet (Psittacula krameri), native of Asia and Africa, is a very successful invasive species in Europe: it has been present there for over 50 years. A recent study showed that European invasive populations occupy a colder climatic niche than in their native range but the establishment of this tropical species in temperate regions remains unexplained. Two main hypotheses may explain the success of Ring-necked parakeet in Europe: admixture between indi...

A fully updated version of the European utility requirement (EUR) documents is to be available

International Nuclear Information System (INIS)

Chatry, J.P.; Berbey, P.

2001-01-01

work, the European utilities and the vendors have now an updated and well-tuned tool that allow them to develop, to assess and eventually to order modern LWR designs well fitted to their actual needs

Diagnosis and treatment of melanoma. European consensus-based interdisciplinary guideline - Update 2016

DEFF Research Database (Denmark)

Garbe, Claus; Peris, Ketty; Hauschild, Axel

2016-01-01

Cutaneous melanoma (CM) is potentially the most dangerous form of skin tumour and causes 90% of skin cancer mortality. A unique collaboration of multi-disciplinary experts from the European Dermatology Forum, the European Association of Dermato-Oncology and the European Organisation of Research a...

Benefits from Liberalisation. Update to EURELECTRIC-KEMA report confirms price reductions for customers

International Nuclear Information System (INIS)

2007-07-01

EURELECTRIC believes it important to consider facts and figures when discussing electricity prices. Electricity markets have delivered - and still deliver - lower prices since the beginning of the liberalisation process for a majority of customer categories. A report drawn up by KEMA on behalf of EURELECTRIC in November 2005 ('Review of European Electricity Prices') looked at price evolution from a European perspective. The figures included in this update are based on that report, updated by KEMA for the years 2005 and 2006. It is important to note that all data on electricity prices used are based on official Eurostat data

Asymmetry of neck motion and activation of the cervical paraspinal muscles during prone neck extension in subjects with unilateral posterior neck pain.

Science.gov (United States)

Park, Kyue-Nam; Kwon, Oh-Yun; Kim, Su-Jung; Kim, Si-Hyun

2017-01-01

Although unilateral posterior neck pain (UPNP) is more prevalent than central neck pain, little is known about how UPNP affects neck motion and the muscle activation pattern during prone neck extension. To investigate whether deviation in neck motion and asymmetry of activation of the bilateral cervical paraspinal muscles occur during prone neck extension in subjects with UPNP compared to subjects without UPNP. This study recruited 20 subjects with UPNP and 20 age- and sex-matched control subjects without such pain. Neck motion and muscle onset time during prone neck extension were measured using a three-dimensional motion-analysis system and surface electromyography. The deviation during prone neck extension was greater in the UPNP group than in the controls (p cervical extensor muscle activation in the UPNP group was significantly delayed on the painful side during prone neck extension (p cervical extensors, triggering a need for specific evaluation and exercises in the management of patients with UPNP.

Interdisciplinary European Guidelines on Metabolic and Bariatric Surgery

Science.gov (United States)

Fried, Martin; Yumuk, Volkan; Oppert, Jean-Michel; Scopinaro, Nicola; Torres, Antonio J.; Weiner, Rudolf; Yashkov, Yuri; Frühbeck, Gema

2013-01-01

In 2012, an outstanding expert panel derived from IFSO-EC (International Federation for the Surgery of Obesity - European Chapter) and EASO (European Association for the Study of Obesity), composed by key representatives of both Societies including past and present presidents together with EASO's OMTF (Obesity Management Task Force) chair, agreed to devote the joint Medico-Surgical Workshop of both institutions to the topic of metabolic surgery as a pre-satellite of the 2013 European Congress on Obesity (ECO) to be held in Liverpool given the extraordinarily advancement made specifically in this field during the past years. It was further agreed to revise and update the 2008 Interdisciplinary European Guidelines on Surgery of Severe Obesity produced in cooperation of both Societies by focusing in particular on the evidence gathered in relation to the effects on diabetes during this lustrum and the subsequent changes that have taken place in patient eligibility criteria. The expert panel composition allowed the coverage of key disciplines in the comprehensive management of obesity and obesity-associated diseases, aimed specifically at updating the clinical guidelines to reflect current knowledge, expertise and evidence-based data on metabolic and bariatric surgery. PMID:24135948

Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments

DEFF Research Database (Denmark)

Tesfaye, Solomon; Boulton, Andrew J M; Dyck, Peter J

2010-01-01

Preceding the joint meeting of the 19th annual Diabetic Neuropathy Study Group of the European Association for the Study of Diabetes (NEURODIAB) and the 8th International Symposium on Diabetic Neuropathy in Toronto, Canada, 13-18 October 2009, expert panels were convened to provide updates on cla...... on classification, definitions, diagnostic criteria, and treatments of diabetic peripheral neuropathies (DPNs), autonomic neuropathy, painful DPNs, and structural alterations in DPNs.......Preceding the joint meeting of the 19th annual Diabetic Neuropathy Study Group of the European Association for the Study of Diabetes (NEURODIAB) and the 8th International Symposium on Diabetic Neuropathy in Toronto, Canada, 13-18 October 2009, expert panels were convened to provide updates...

Head and neck cancer

International Nuclear Information System (INIS)

Vogl, S.E.

1988-01-01

This book contains 10 chapters. Some of the titles are: Combined Surgical Resection and Irradiation for Head and Neck Cancers; Analysis of Radiation Therapy Oncology Group Head and Neck Database: Identification of Prognostic Factors and the Re-evaluation of American Joint Committee Stages; Combined Modality Approach to Head and Neck Cancer; Induction Combination Chemotherapy of Regionally Advanced Head and Neck Cancer; and Outcome after Complete Remission to Induction Chemotherapy in Head and Neck Cancer

Sweet Syndrome: A Review and Update.

Science.gov (United States)

Villarreal-Villarreal, C D; Ocampo-Candiani, J; Villarreal-Martínez, A

2016-06-01

Sweet syndrome is the most representative entity of febrile neutrophilic dermatoses. It typically presents in patients with pirexya, neutrophilia, painful tender erytomatous papules, nodules and plaques often distributed asymmetrically. Frequent sites include the face, neck and upper extremities. Affected sites show a characteristical neutrophilic infiltrate in the upper dermis. Its etiology remains elucidated, but it seems that can be mediated by a hypersensitivity reaction in which cytokines, followed by infiltration of neutrophils, may be involved. Systemic corticosteroids are the first-line of treatment in most cases. We present a concise review of the pathogenesis, classification, diagnosis and treatment update of this entity. Copyright © 2015 AEDV. Published by Elsevier España, S.L.U. All rights reserved.

Neck muscle endurance and head posture: A comparison between adolescents with and without neck pain.

Science.gov (United States)

Oliveira, Ana Carolina; Silva, Anabela G

2016-04-01

The main aims of this study were to compare the neck flexor and extensor endurance and forward head posture between adolescents with and without neck pain. The secondary aims were to explore potential associations between muscles endurance, head posture and neck pain characteristics and to assess intra-rater reliability of the measurements used. Adolescents with neck pain (n = 35) and age-matched asymptomatic adolescents (n = 35) had their forward head posture, neck flexor endurance and neck extensor endurance measured using clinical tests. Intra-rater reliability was also assessed. Forward head posture and neck flexor and extensor endurance tests showed moderate to almost perfect intra-rater reliability (ICC between 0.58 and 0.88). Adolescents with neck pain showed significantly less forward head posture (neck pain = 46.62 ± 4.92; asymptomatic = 44.18°± 3.64°, p > 0.05) and less neck flexor (neck pain = 24.50 ± 23.03s; asymptomatic = 35.89 ± 21.53s, p > 0.05) and extensor endurance (neck pain = 12.6.64 ± 77.94s; asymptomatic = 168.66 ± 74.77s, p > 0.05) than asymptomatic adolescents. Results suggest that changes in posture and neck muscle endurance are a feature of adolescents with neck pain. Copyright © 2015 Elsevier Ltd. All rights reserved.

Three-dimensional measurement of femoral neck anteversion and neck shaft angle.

Science.gov (United States)

Sangeux, Morgan; Pascoe, Jessica; Graham, H Kerr; Ramanauskas, Fiona; Cain, Tim

2015-01-01

We present a three-dimensional measurement technique for femoral neck anteversion and neck shaft angles which do not require alignment of the femoral and scanner axes. Two assessors performed the measurements on 11 patients (22 femurs). Repeatability between assessors was 2.7 degrees for femoral neck anteversion and 4.8 degrees for neck shaft angle. Measurements compared with an alternative single slice method were different by 2 degrees (3 degrees) in average. The method was repeatable and appropriate for clinical practice.

Neck Pain

Science.gov (United States)

... too many hours hunched over your computer or smartphone, often triggers muscle strains. Even minor things, such ... your shoulder. The weight can strain your neck. Sleep in a good position. Your head and neck ...

European Society of Clinical Microbiology and Infectious Diseases: update of the diagnostic guidance document for Clostridium difficile infection.

Science.gov (United States)

Crobach, M J T; Planche, T; Eckert, C; Barbut, F; Terveer, E M; Dekkers, O M; Wilcox, M H; Kuijper, E J

2016-08-01

In 2009 the first European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guideline for diagnosing Clostridium difficile infection (CDI) was launched. Since then newer tests for diagnosing CDI have become available, especially nucleic acid amplification tests. The main objectives of this update of the guidance document are to summarize the currently available evidence concerning laboratory diagnosis of CDI and to formulate and revise recommendations to optimize CDI testing. This update is essential to improve the diagnosis of CDI and to improve uniformity in CDI diagnosis for surveillance purposes among Europe. An electronic search for literature concerning the laboratory diagnosis of CDI was performed. Studies evaluating a commercial laboratory test compared to a reference test were also included in a meta-analysis. The commercial tests that were evaluated included enzyme immunoassays (EIAs) detecting glutamate dehydrogenase, EIAs detecting toxins A and B and nucleic acid amplification tests. Recommendations were formulated by an executive committee, and the strength of recommendations and quality of evidence were graded using the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system. No single commercial test can be used as a stand-alone test for diagnosing CDI as a result of inadequate positive predictive values at low CDI prevalence. Therefore, the use of a two-step algorithm is recommended. Samples without free toxin detected by toxins A and B EIA but with positive glutamate dehydrogenase EIA, nucleic acid amplification test or toxigenic culture results need clinical evaluation to discern CDI from asymptomatic carriage. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Neck dissection following chemo radiation for node positive head and neck carcinomas

International Nuclear Information System (INIS)

Thariat, J.; Thariat, J.; Marcy, P.Y.; Bozec, A.; Peyrade, F.; Hofman, P.; Hamoir, M.; Janot, F.; De Mones, E.; Marcy, P.Y.; Carrier, P.; Bozec, I.; Guevara, J.; Santini, J.; Albert, S.; Vedrine, P.O.; Graff, P.; Peyrade, F.; Hofman, P.; Bourhis, J.; Lapeyre, M.

2009-01-01

The optimal timing and extent of neck dissection in the context of chemo radiation for head and neck cancer remains controversial. For some institutions, it is uncertain whether neck dissection should still be performed up front especially for cystic nodes. For others, neck dissection can be performed after chemo radiation and can be omitted for N1 disease as long as a complete response to chemo radiation is obtained. The question is debated for N2 and N3 disease even after a complete response as the correlation between radiological and clinical assessment and pathology may not be reliable. Response rates are greater than or equal to 60% and isolated neck failures are less than or equal to 10% with current chemo radiation protocols. Some therefore consider that systematic up front or planned neck dissection would lead to greater than or equal to 50% unnecessary neck dissections for N2-N3 disease. Positron-emission tomography (PET) scanning to assess treatment response and have shown a very high negative predictive value of greater than or equal to 95% when using a standard uptake value of 3 for patients with a negative PET at four months after the completion of therapy. These data may support the practice of observing PET-negative necks. More evidence-based data are awaited to assess the need for neck dissection on PET. Selective neck dissection based on radiological assessment and preoperative findings and not exclusively on initial nodal stage may help to limit morbidity and to improve the quality of life without increasing the risk of neck failure. Adjuvant regional radiation boosts might be discussed on an individual basis for aggressive residual nodal disease with extra-capsular spread and uncertain margins but evidence is missing. Medical treatments aiming at reducing the metastatic risk especially for N3 disease are to be evaluated

Head and neck cancer: metronomic chemotherapy

International Nuclear Information System (INIS)

De Felice, Francesca; Musio, Daniela; Tombolini, Vincenzo

2015-01-01

In the era of personalized medicine, head and neck squamous cell carcinoma (HNSCC) represents a critical oncologic topic. Conventional chemotherapy regimens consist of drugs administration in cycles near or at the maximum tolerated dose (MDT), followed by a long drug-free period to permit the patient to recover from acute toxicities. Despite this strategy is successful in controlling the cancer process at the beginning, a significant number of HNSCC patients tend to recurred or progress, especially those patients with locally advanced or metastatic disease. The repertoire of drugs directed against tumor cells has greatly increased and metronomic chemotherapy (MC) could be an effective treatment option. It is the purpose of this article to review the concept of MC and describe its potential use in HNSCC. We provide an update of ongoing progress and current challenges related to this issue

Inter-vertebral flexibility of the ostrich neck: implications for estimating sauropod neck flexibility.

Science.gov (United States)

Cobley, Matthew J; Rayfield, Emily J; Barrett, Paul M

2013-01-01

The flexibility and posture of the neck in sauropod dinosaurs has long been contentious. Improved constraints on sauropod neck function will have major implications for what we know of their foraging strategies, ecology and overall biology. Several hypotheses have been proposed, based primarily on osteological data, suggesting different degrees of neck flexibility. This study attempts to assess the effects of reconstructed soft tissues on sauropod neck flexibility through systematic removal of muscle groups and measures of flexibility of the neck in a living analogue, the ostrich (Struthio camelus). The possible effect of cartilage on flexibility is also examined, as this was previously overlooked in osteological estimates of sauropod neck function. These comparisons show that soft tissues are likely to have limited the flexibility of the neck beyond the limits suggested by osteology alone. In addition, the inferred presence of cartilage, and varying the inter-vertebral spacing within the synovial capsule, also affect neck flexibility. One hypothesis proposed that flexibility is constrained by requiring a minimum overlap between successive zygapophyses equivalent to 50% of zygapophyseal articular surface length (ONP50). This assumption is tested by comparing the maximum flexibility of the articulated cervical column in ONP50 and the flexibility of the complete neck with all tissues intact. It is found that this model does not adequately convey the pattern of flexibility in the ostrich neck, suggesting that the ONP50 model may not be useful in determining neck function if considered in isolation from myological and other soft tissue data.

Inter-vertebral flexibility of the ostrich neck: implications for estimating sauropod neck flexibility.

Directory of Open Access Journals (Sweden)

Matthew J Cobley

Full Text Available The flexibility and posture of the neck in sauropod dinosaurs has long been contentious. Improved constraints on sauropod neck function will have major implications for what we know of their foraging strategies, ecology and overall biology. Several hypotheses have been proposed, based primarily on osteological data, suggesting different degrees of neck flexibility. This study attempts to assess the effects of reconstructed soft tissues on sauropod neck flexibility through systematic removal of muscle groups and measures of flexibility of the neck in a living analogue, the ostrich (Struthio camelus. The possible effect of cartilage on flexibility is also examined, as this was previously overlooked in osteological estimates of sauropod neck function. These comparisons show that soft tissues are likely to have limited the flexibility of the neck beyond the limits suggested by osteology alone. In addition, the inferred presence of cartilage, and varying the inter-vertebral spacing within the synovial capsule, also affect neck flexibility. One hypothesis proposed that flexibility is constrained by requiring a minimum overlap between successive zygapophyses equivalent to 50% of zygapophyseal articular surface length (ONP50. This assumption is tested by comparing the maximum flexibility of the articulated cervical column in ONP50 and the flexibility of the complete neck with all tissues intact. It is found that this model does not adequately convey the pattern of flexibility in the ostrich neck, suggesting that the ONP50 model may not be useful in determining neck function if considered in isolation from myological and other soft tissue data.

European Strategy Preparatory Group - CALL FOR SUBMISSIONS

CERN Multimedia

2012-01-01

As part of the Update of the European Strategy for Particle Physics, the European Strategy Preparatory Group (ESPG) welcomes submissions on issues related to the strategy from individual physicists, from groups of scientists representing a community (an experiment, a topic of theoretical research, etc.) as well as from Institutions and Organizations (funding agencies, ministries, etc).   These contributions will be discussed at the meetings of the Preparatory Group and during the Open Symposium to be held on 10-12 September 2012 in Cracow, and will be made available to the Strategy Group for drafting the Update of the Strategy. How to submit a contribution? Send your contribution on the scientific issues below using the form under http://indico.cern.ch/event/espg_input (preferably as an attached PDF file): - Accelerator Physics - Astroparticle Physics, Gravitation and Cosmology - Flavour Physics and Symmetries - Physics at High Energy Frontier - Physics of Neutrinos - Strong Interaction Physics...

Treatment results of the neck by concurrent chemoradiotherapy for advanced head and neck cancer

International Nuclear Information System (INIS)

Tokumaru, Yutaka; Fujii, Masato; Habu, Noboru; Yajima, Yoko; Yorozu, Atsunori

2009-01-01

Concurrent chemoradiotherapy (CCRT) is one of the recent emerging modalities for advanced squamous cell carcinoma of the head and neck (HNSCC). However some of the patients treated by CCRT have residual or recurrent cervical lymph nodes. In these cases, neck dissection is considered to be useful in the point of locolegional control and disease free survival. This study aims to analyze neck control rate by CCRT and usefulness of the neck dissection after CCRT for HNSCC. The medical records of 69 consecutive patients (stage III: 4%, stage IV: 96%) treated with CCRT for SCCHN (hypopharynx: 40, oropharynx: 25, larynx: 4) from 2003 through 2007 were reviewed. Clinical complete response (CR) rates of N1, N2a, N2b, N2c and N3 were 75%, 100%, 71%, 74% and 43% respectively. Among the patients with complete neck response, only 2 patients (5%) had an isolated neck recurrence. Eleven patients underwent surgical neck procedures including 7 planned neck dissections and 4 salvage neck dissections. All the 11 patients with neck dissections had good regional control except 1 case. There were a few minor complications such as wound infection and laryngeal edema. Patients who have a complete clinical regional response to CCRT have a low probability of an isolated recurrence in the neck. Planned and salvage neck dissections can be safely performed and considered to be useful in the point of regional control after intensive CCRT. (author)

Neck movement and muscle activity characteristics in female office workers with neck pain.

Science.gov (United States)

Johnston, V; Jull, G; Souvlis, T; Jimmieson, N L

2008-03-01

Cross-sectional study. To explore aspects of cervical musculoskeletal function in female office workers with neck pain. Evidence of physical characteristics that differentiate computer workers with and without neck pain is sparse. Patients with chronic neck pain demonstrate reduced motion and altered patterns of muscle control in the cervical flexor and upper trapezius (UT) muscles during specific tasks. Understanding cervical musculoskeletal function in office workers will better direct intervention and prevention strategies. Measures included neck range of motion; superficial neck flexor muscle activity during a clinical test, the craniocervical flexion test; and a motor task, a unilateral muscle coordination task, to assess the activity of both the anterior and posterior neck muscles. Office workers with and without neck pain were formed into 3 groups based on their scores on the Neck Disability Index. Nonworking women without neck pain formed the control group. Surface electromyographic activity was recorded bilaterally from the sternocleidomastoid, anterior scalene (AS), cervical extensor (CE) and UT muscles. Workers with neck pain had reduced rotation range and increased activity of the superficial cervical flexors during the craniocervical flexion test. During the coordination task, workers with pain demonstrated greater activity in the CE muscles bilaterally. On completion of the task, the UT and dominant CE and AS muscles demonstrated an inability to relax in workers with pain. In general, there was a linear relationship between the workers' self-reported levels of pain and disability and the movement and muscle changes. These results are consistent with those found in other cervical musculoskeletal disorders and may represent an altered muscle recruitment strategy to stabilize the head and neck. An exercise program including motor reeducation may assist in the management of neck pain in office workers.

Consensus document on European brain research

DEFF Research Database (Denmark)

Di Luca, Monica; Baker, Mary; Corradetti, Renato

2011-01-01

Psychiatric and neurological diseases combined represent a considerable social and economic burden in Europe. A recent study conducted by the European Brain Council (EBC) quantified the 'cost and burden' of major brain diseases in Europe, amounting to €386bn per year. Considering that these costs...... version. Multinational and multidisciplinary teams have once again come together to express their views, not only on the current strengths in European research, but also on what needs to be done in priority, hoping that this update will inspire policy makers and stakeholders in directing funding...

Clinical Practice Guideline: Hoarseness (Dysphonia) (Update).

Science.gov (United States)

Stachler, Robert J; Francis, David O; Schwartz, Seth R; Damask, Cecelia C; Digoy, German P; Krouse, Helene J; McCoy, Scott J; Ouellette, Daniel R; Patel, Rita R; Reavis, Charles Charlie W; Smith, Libby J; Smith, Marshall; Strode, Steven W; Woo, Peak; Nnacheta, Lorraine C

2018-03-01

Objective This guideline provides evidence-based recommendations on treating patients who present with dysphonia, which is characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication and/or quality of life. Dysphonia affects nearly one-third of the population at some point in its life. This guideline applies to all age groups evaluated in a setting where dysphonia would be identified or managed. It is intended for all clinicians who are likely to diagnose and treat patients with dysphonia. Purpose The primary purpose of this guideline is to improve the quality of care for patients with dysphonia, based on current best evidence. Expert consensus to fill evidence gaps, when used, is explicitly stated and supported with a detailed evidence profile for transparency. Specific objectives of the guideline are to reduce inappropriate variations in care, produce optimal health outcomes, and minimize harm. For this guideline update, the American Academy of Otolaryngology-Head and Neck Surgery Foundation selected a panel representing the fields of advanced practice nursing, bronchoesophagology, consumer advocacy, family medicine, geriatric medicine, internal medicine, laryngology, neurology, otolaryngology-head and neck surgery, pediatrics, professional voice, pulmonology, and speech-language pathology. Action Statements The guideline update group made strong recommendations for the following key action statements (KASs): (1) Clinicians should assess the patient with dysphonia by history and physical examination to identify factors where expedited laryngeal evaluation is indicated. These include, but are not limited to, recent surgical procedures involving the head, neck, or chest; recent endotracheal intubation; presence of concomitant neck mass; respiratory distress or stridor; history of tobacco abuse; and whether the patient is a professional voice user. (2) Clinicians should advocate voice therapy for patients with dysphonia from a

Neck Pain

Science.gov (United States)

... Vomiting Nausea and Vomiting in Infants and Children Neck Pain Neck Swelling Shortness of Breath Shortness of Breath ... worse or doesn’t get better. Start OverDiagnosisYour pain may be from DEGENERATIVE CERVICAL ARTHRITIS, a disorder that affects the bones and ...

Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? Results of a prospective cohort study

NARCIS (Netherlands)

Ariens, G.A.M.; Bongers, P.M.; Douwes, M.; Miedema, M.C.; Hoogendoorn, W.E.; van der Wal, G.; Bouter, L.M.; van Mechelen, W.

2001-01-01

Objective: To study the relation between neck pain and work related neck flexion, neck rotation, and sitting. Methods: A prospective cohort study was performed with a follow up of 3 years among 1334 workers from 34 companies. Work related physical load was assessed by analysing objectively measured

Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? : Results of a prospective cohort study

NARCIS (Netherlands)

Ariëns, G A; Bongers, P M; Douwes, M; Miedema, M C; Hoogendoorn, W E; van der Wal, G; Bouter, L M; van Mechelen, W

OBJECTIVE: To study the relation between neck pain and work related neck flexion, neck rotation, and sitting. METHODS: A prospective cohort study was performed with a follow up of 3 years among 1334 workers from 34 companies. Work related physical load was assessed by analysing objectively measured

Neck and Upper Limb Dysfunction in Patients following Neck Dissection: Looking beyond the Shoulder.

Science.gov (United States)

Gane, Elise M; O'Leary, Shaun P; Hatton, Anna L; Panizza, Benedict J; McPhail, Steven M

2017-10-01

Objective To measure patient-perceived upper limb and neck function following neck dissection and to investigate potential associations between clinical factors, symptoms, and function. Study Design Cross-sectional. Setting Two tertiary hospitals in Brisbane, Australia. Subjects and Methods Inclusion criteria: patients treated with neck dissection (2009-2014). aged <18 years, accessory nerve or sternocleidomastoid sacrifice, previous neck dissection, preexisting shoulder/neck injury, and inability to provide informed consent (cognition, insufficient English). Primary outcomes were self-reported function of the upper limb (Quick Disabilities of the Arm, Shoulder, and Hand) and neck (Neck Disability Index). Secondary outcomes included demographics, oncological management, self-efficacy, and pain. Generalized linear models were prepared to examine relationships between explanatory variables and self-reported function. Results Eighty-nine participants (male n = 63, 71%; median age, 62 years; median 3 years since surgery) reported mild upper limb and neck dysfunction (median [quartile 1, quartile 3] scores of 11 [3, 32] and 12 [4, 28], respectively). Significant associations were found between worse upper limb function and longer time since surgery (coefficient, 1.76; 95% confidence interval [CI], 0.01-3.51), having disease within the thyroid (17.40; 2.37-32.44), postoperative radiation therapy (vs surgery only) (13.90; 6.67-21.14), and shoulder pain (0.65; 0.44-0.85). Worse neck function was associated with metastatic cervical lymph nodes (coefficient, 6.61; 95% CI, 1.14-12.08), shoulder pain (0.19; 0.04-0.34), neck pain (0.34; 0.21-0.47), and symptoms of neuropathic pain (0.61; 0.25-0.98). Conclusion Patients can experience upper limb and neck dysfunction following nerve-preserving neck dissection. The upper quadrant as a whole should be considered when assessing rehabilitation priorities after neck dissection.

Risk factors for persistent problems following acute whiplash injury: update of a systematic review and meta-analysis.

Science.gov (United States)

Walton, David M; Macdermid, Joy C; Giorgianni, Anthony A; Mascarenhas, Joanna C; West, Stephen C; Zammit, Caroline A

2013-02-01

Systematic review and meta-analysis. To update a previous review and meta-analysis on risk factors for persistent problems following whiplash secondary to a motor vehicle accident. Prognosis in whiplash-associated disorder (WAD) has become an active area of research, perhaps owing to the difficulty of treating chronic problems. A previously published review and meta-analysis of prognostic factors included primary sources up to May 2007. Since that time, more research has become available, and an update to that original review is warranted. A systematic search of international databases was conducted, with rigorous inclusion criteria focusing on studies published between May 2007 and May 2012. Articles were scored, and data were extracted and pooled to estimate the odds ratio for any factor that had at least 3 independent data points in the literature. Four new cohorts (n = 1121) were identified. In combination with findings of a previous review, 12 variables were found to be significant predictors of poor outcome following whiplash, 9 of which were new (n = 2) or revised (n = 7) as a result of additional data. The significant variables included high baseline pain intensity (greater than 5.5/10), report of headache at inception, less than postsecondary education, no seatbelt in use during the accident, report of low back pain at inception, high Neck Disability Index score (greater than 14.5/50), preinjury neck pain, report of neck pain at inception (regardless of intensity), high catastrophizing, female sex, WAD grade 2 or 3, and WAD grade 3 alone. Those variables robust to publication bias included high pain intensity, female sex, report of headache at inception, less than postsecondary education, high Neck Disability Index score, and WAD grade 2 or 3. Three existing variables (preaccident history of headache, rear-end collision, older age) and 1 additional novel variable (collision severity) were refined or added in this updated review but showed no significant

Guidelines for autopsy investigation of sudden cardiac death: 2017 update from the Association for European Cardiovascular Pathology.

Science.gov (United States)

Basso, Cristina; Aguilera, Beatriz; Banner, Jytte; Cohle, Stephan; d'Amati, Giulia; de Gouveia, Rosa Henriques; di Gioia, Cira; Fabre, Aurelie; Gallagher, Patrick J; Leone, Ornella; Lucena, Joaquin; Mitrofanova, Lubov; Molina, Pilar; Parsons, Sarah; Rizzo, Stefania; Sheppard, Mary N; Mier, Maria Paz Suárez; Kim Suvarna, S; Thiene, Gaetano; van der Wal, Allard; Vink, Aryan; Michaud, Katarzyna

2017-12-01

Although sudden cardiac death (SCD) is one of the most important modes of death in Western countries, pathologists and public health physicians have not given this problem the attention it deserves. New methods of preventing potentially fatal arrhythmias have been developed and the accurate diagnosis of the causes of SCD is now of particular importance. Pathologists are responsible for determining the precise cause and mechanism of sudden death but there is still considerable variation in the way in which they approach this increasingly complex task. The Association for European Cardiovascular Pathology has developed these guidelines, which represent the minimum standard that is required in the routine autopsy practice for the adequate investigation of SCD. The present version is an update of our original article, published 10 years ago. This is necessary because of our increased understanding of the genetics of cardiovascular diseases, the availability of new diagnostic methods, and the experience we have gained from the routine use of the original guidelines. The updated guidelines include a detailed protocol for the examination of the heart and recommendations for the selection of histological blocks and appropriate material for toxicology, microbiology, biochemistry, and molecular investigation. Our recommendations apply to university medical centers, regionals hospitals, and all healthcare professionals practicing pathology and forensic medicine. We believe that their adoption throughout Europe will improve the standards of autopsy practice, allow meaningful comparisons between different communities and regions, and permit the identification of emerging patterns of diseases causing SCD. Finally, we recommend the development of regional multidisciplinary networks of cardiologists, geneticists, and pathologists. Their role will be to facilitate the identification of index cases with a genetic basis, to screen appropriate family members, and ensure that

Oncologic safety of cervical nerve preservation in neck dissection for head and neck cancer.

Science.gov (United States)

Honda, Keigo; Asato, Ryo; Tsuji, Jun; Miyazaki, Masakazu; Kada, Shinpei; Tsujimura, Takashi; Kataoka, Michiko

2017-09-01

Although the functional merits of preserving cervical nerves in neck dissection for head and neck cancer have been reported, the oncologic safety has not yet been determined. Therefore, the purpose of this study was to evaluate the safety of cervical nerve preservation. A retrospective chart review was performed on patients with head and neck cancer who had been treated by neck dissection between 2009 and 2014 at Kyoto Medical Center. Management of cervical nerves and clinical results were analyzed. A total of 335 sides of neck dissection had been performed in 222 patients. Cervical nerves were preserved in 175 neck sides and resected in 160 sides. The 5-year overall survival (OS) rate calculated by the Kaplan-Meier method was 71%. The 5-year neck control rate was 95% in cervical nerve preserved sides and 89% in cervical nerve resected sides. Preserving cervical nerves in neck dissection is oncologically safe in selected cases. © 2017 Wiley Periodicals, Inc.

Effects of neck strength training on isometric neck strength in rugby union players.

Science.gov (United States)

Geary, Kevin; Green, Brian S; Delahunt, Eamonn

2014-11-01

To investigate the effectiveness of a neck strengthening program on the isometric neck strength profile of male rugby union players. Controlled laboratory study. Professional rugby union club. Fifteen professional and 10 semiprofessional rugby union players. The 15 professional players undertook a 5-week neck strengthening intervention, which was performed twice per week, whereas the 10 semiprofessional players acted as the control group. Isometric strength of the neck musculature was tested using a hand-held dynamometer, for flexion (F), extension (E), left-side flexion (LSF), and right-side flexion (RSF). Preintervention and postintervention evaluations were undertaken. No significant between-group differences in isometric neck strength were noted preintervention. A significant main effect for time was observed (P isometric neck strength in all planes after the 5-week intervention (F preintervention = 334.45 ± 39.31 N vs F postintervention 396.05 ± 75.55 N; E preintervention = 606.19 ± 97.34 vs E postintervention = 733.88 ± 127.16 N; LSF preintervention = 555.56 ± 88.34 N vs LSF postintervention = 657.14 ± 122.99 N; RSF preintervention = 570.00 ± 106.53 N vs RSF postintervention = 668.00 ± 142.18 N). No significant improvement in neck strength was observed for control group participants. The results of the present study indicate that a 5-week neck strengthening program improves isometric neck strength in rugby union players, which may have implications for injury prevention, screening, and rehabilitation. The strengthening program described in the present study may facilitate rehabilitation specialists in the development of neck injury prevention, screening, and rehabilitation protocols.

Head, Neck, and Oral Cancer

Medline Plus

Full Text Available ... Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ... Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ...

Head, Neck, and Oral Cancer

Medline Plus

Full Text Available ... and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed with ... and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed with ...

Neck muscle vibration can improve sensorimotor function in patients with neck pain.

Science.gov (United States)

Beinert, Konstantin; Keller, Martin; Taube, Wolfgang

2015-03-01

People with neck pain display a diminished joint position sense and disturbed postural control, which is thought to be a result of impaired somatosensory afferent activity and/or integration. Afferent processing can be artificially manipulated by vibration and was shown to reduce motor performance in healthy subjects. However, the effect of vibration on sensorimotor function in neck pain patients is scarcely investigated. To assess the effect of neck muscle vibration on joint position sense and postural control in neck pain subjects and healthy controls. Case control study. Thirteen neck pain patients and 10 healthy controls participated in the present study. Cervical joint position sense and dynamic and static postural stability. Short-term, targeted neck muscle vibration with 100 Hz was applied after baseline measurement. Vibration had opposite effects in patients and healthy subjects. Patients showed improved joint position sense (pneck pain. Thus, vibration may be used to counteract sensorimotor impairment of the cervical spine. Potential underlying mechanisms are discussed. Copyright © 2015. Published by Elsevier Inc.

Head and neck cancer: Radiotherapeutic precepts in the management of the neck

International Nuclear Information System (INIS)

Million, R.R.; Cassisi, N.J.; Parsons, J.T.; Mendenhall, W.M.

1986-01-01

The authors provide a series of statements regarding the use of radiotherapy and surgery for metastatic squamous cancer to the neck. Some of these precepts are established facts requiring no additional documentation - for example, the combination of radiation and neck dissection for effective treatment of N2B neck disease or for subclinical disease, depending on extracapsular spread. Other precepts of the authors are not as generally accepted by head and neck surgeons, such as the mandatory staging of neck dissections following curative radiation therapy or the routine use of computerized tomography (CT) to confirm pathologic adenopathy. Most of the authors' precepts are supported by a combination of their personal clinical experience and hard data from the University of Florida, Gainesville

Inter-Vertebral Flexibility of the Ostrich Neck: Implications for Estimating Sauropod Neck Flexibility

OpenAIRE

Cobley, Matthew J.; Rayfield, Emily J.; Barrett, Paul M.

2013-01-01

The flexibility and posture of the neck in sauropod dinosaurs has long been contentious. Improved constraints on sauropod neck function will have major implications for what we know of their foraging strategies, ecology and overall biology. Several hypotheses have been proposed, based primarily on osteological data, suggesting different degrees of neck flexibility. This study attempts to assess the effects of reconstructed soft tissues on sauropod neck flexibility through systematic removal o...

Clinical Practice Guideline: Hoarseness (Dysphonia) (Update) Executive Summary.

Science.gov (United States)

Stachler, Robert J; Francis, David O; Schwartz, Seth R; Damask, Cecelia C; Digoy, German P; Krouse, Helene J; McCoy, Scott J; Ouellette, Daniel R; Patel, Rita R; Reavis, Charles Charlie W; Smith, Libby J; Smith, Marshall; Strode, Steven W; Woo, Peak; Nnacheta, Lorraine C

2018-03-01

Objective This guideline provides evidence-based recommendations on treating patients presenting with dysphonia, which is characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication and/or quality of life. Dysphonia affects nearly one-third of the population at some point in its life. This guideline applies to all age groups evaluated in a setting where dysphonia would be identified or managed. It is intended for all clinicians who are likely to diagnose and treat patients with dysphonia. Purpose The primary purpose of this guideline is to improve the quality of care for patients with dysphonia, based on current best evidence. Expert consensus to fill evidence gaps, when used, is explicitly stated and supported with a detailed evidence profile for transparency. Specific objectives of the guideline are to reduce inappropriate variations in care, produce optimal health outcomes, and minimize harm. For this guideline update, the American Academy of Otolaryngology-Head and Neck Surgery Foundation selected a panel representing the fields of advanced practice nursing, bronchoesophagology, consumer advocacy, family medicine, geriatric medicine, internal medicine, laryngology, neurology, otolaryngology-head and neck surgery, pediatrics, professional voice, pulmonology, and speech-language pathology. Action Statements The guideline update group made strong recommendations for the following key action statements (KASs): (1) Clinicians should assess the patient with dysphonia by history and physical examination to identify factors where expedited laryngeal evaluation is indicated. These include but are not limited to recent surgical procedures involving the head, neck, or chest; recent endotracheal intubation; presence of concomitant neck mass; respiratory distress or stridor; history of tobacco abuse; and whether the patient is a professional voice user. (2) Clinicians should advocate voice therapy for patients with dysphonia from a

Head, Neck, and Oral Cancer

Science.gov (United States)

... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ...

Replacement, Reduction, Refinement - Animal welfare progress in European Pharmacopoeia monographs: activities of the European Pharmacopoeia Commission from 2007 to 2017.

Science.gov (United States)

Lang, C; Kolaj-Robin, O; Cirefice, G; Taconet, L; Pel, E; Jouette, S; Buda, M; Milne, C; Charton, E

2018-01-01

Since the opening for signature of the European Convention for the Protection of Animals Used for Experimental and Other Scientific Purposes in 1986, the European Pharmacopoeia Commission and its experts have carried out a programme of work committed to Replacing, Reducing and Refining (3Rs) the use of animals for test purposes. While updates on achievements in the field of the 3Rs are regularly provided, this article summarises the activities of the Ph. Eur. Commission in this field within the last decade.

Head, Neck, and Oral Cancer

Medline Plus

Full Text Available ... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ...

The role of oral hygiene in head and neck cancer: results from International Head and Neck Cancer Epidemiology (INHANCE) consortium.

Science.gov (United States)

Hashim, D; Sartori, S; Brennan, P; Curado, M P; Wünsch-Filho, V; Divaris, K; Olshan, A F; Zevallos, J P; Winn, D M; Franceschi, S; Castellsagué, X; Lissowska, J; Rudnai, P; Matsuo, K; Morgenstern, H; Chen, C; Vaughan, T L; Hofmann, J N; D'Souza, G; Haddad, R I; Wu, H; Lee, Y-C; Hashibe, M; Vecchia, C La; Boffetta, P

2016-08-01

Poor oral hygiene has been proposed to contribute to head and neck cancer (HNC) risk, although causality and independency of some indicators are uncertain. This study investigates the relationship of five oral hygiene indicators with incident HNCs. In a pooled analysis of 8925 HNC cases and 12 527 controls from 13 studies participating in the International Head and Neck Cancer Epidemiology Consortium, comparable data on good oral hygiene indicators were harmonized. These included: no denture wear, no gum disease (or bleeding), oral hygiene indicator and cumulative score on HNC risk, adjusting for tobacco smoking and alcohol consumption. Inverse associations with any HNC, in the hypothesized direction, were observed for cancer sites, especially for tooth brushing and dentist visits. The population attributable fraction for ≤ 2 out of 5 good oral hygiene indicators was 8.9% (95% CI 3.3%, 14%) for oral cavity cancer. Good oral hygiene, as characterized by few missing teeth, annual dentist visits, and daily tooth brushing, may modestly reduce the risk of HNC. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Updated 2016 EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer

NARCIS (Netherlands)

Witjes, J.A.; Lebret, T.; Comperat, E.M.; Cowan, N.C.; Santis, M. de; Bruins, H.M.; Hernandez, V.; Espinos, E.L.; Dunn, J.; Rouanne, M.; Neuzillet, Y.; Veskimae, E.; Heijden, A.G. van der; Gakis, G.; Ribal, M.J.

2017-01-01

CONTEXT: Invasive bladder cancer is a frequently occurring disease with a high mortality rate despite optimal treatment. The European Association of Urology (EAU) Muscle-invasive and Metastatic Bladder Cancer (MIBC) Guidelines are updated yearly and provides information to optimise diagnosis,

Multidisciplinary treatment of the neck

NARCIS (Netherlands)

de Bree, Remco; Langendijk, Johannes A.; Leemans, C. R.

2016-01-01

Since lymph node metastases are one of the most important prognostic factors, treatment of the neck is challenging. In clinically N0 neck, (super)selective neck dissection is indicated, whereas a more extensive neck dissection with preservation of important structures is performed in N2-N3 disease.

EVIDENCE OF EPSTEIN-BARR VIRUS ASSOCIATION WITH HEAD AND NECK CANCERS: A REVIEW.

Science.gov (United States)

Prabhu, Soorebettu R; Wilson, David F

2016-01-01

Epstein-Barr virus (EBV) is ubiquitous: over 90% of the adult population is infected with this virus. EBV is capable of infecting both B lymphocytes and epithelial cells throughout the body including the head and neck region. Transmission occurs mainly by exchange of saliva. The infection is asymptomatic or mild in children but, in adolescents and young adults, it causes infectious mononucleosis, a self-limiting disease characterized by lethargy, sore throat, fever and lymphadenopathy. Once established, the virus often remains latent and people become lifelong carriers without experiencing disease. However, in some people, the latent virus is capable of causing malignant tumours, such as nasopharyngeal carcinoma and various B- and T-cell lymphomas, at sites including the head, neck and oropharyngeal region. As lymphoma is the second-most common malignant disease of the head, neck and oral region after squamous cell carcinoma, oral health care workers including dentists and specialists have a responsibility to carry out a thorough clinical examination of this anatomical region with a view to identifying and diagnosing lesions that may represent lymphomas. Early detection allows early treatment resulting in better prognosis. The focus of this review is on the morphology, transmission and carcinogenic properties of EBV and clinical and diagnostic aspects of a range of EBV-associated malignancies occurring in the head, neck and oral region. As carcinogenic agents, viruses contribute to a significant proportion of the global cancer burden: approximately 15% of all human cancers, worldwide, are attributable to viruses.1,2 Serologic and epidemiologic studies are providing mounting evidence of an etiologic association between viruses and head and neck malignancies.3 To update oral and maxillofacial surgeons and oral medicine specialists and raise awareness of this association, we recently reviewed the evidence of the etiologic role of human papillomavirus in oral disease.4

Why sauropods had long necks; and why giraffes have short necks.

Science.gov (United States)

Taylor, Michael P; Wedel, Mathew J

2013-01-01

The necks of the sauropod dinosaurs reached 15 m in length: six times longer than that of the world record giraffe and five times longer than those of all other terrestrial animals. Several anatomical features enabled this extreme elongation, including: absolutely large body size and quadrupedal stance providing a stable platform for a long neck; a small, light head that did not orally process food; cervical vertebrae that were both numerous and individually elongate; an efficient air-sac-based respiratory system; and distinctive cervical architecture. Relevant features of sauropod cervical vertebrae include: pneumatic chambers that enabled the bone to be positioned in a mechanically efficient way within the envelope; and muscular attachments of varying importance to the neural spines, epipophyses and cervical ribs. Other long-necked tetrapods lacked important features of sauropods, preventing the evolution of longer necks: for example, giraffes have relatively small torsos and large, heavy heads, share the usual mammalian constraint of only seven cervical vertebrae, and lack an air-sac system and pneumatic bones. Among non-sauropods, their saurischian relatives the theropod dinosaurs seem to have been best placed to evolve long necks, and indeed their necks probably surpassed those of giraffes. But 150 million years of evolution did not suffice for them to exceed a relatively modest 2.5 m.

Psychometric properties of the Neck OutcOme Score, Neck Disability Index, and Short Form-36 were evaluated in patients with neck pain

DEFF Research Database (Denmark)

Juul, Tina; Søgaard, Karen; Davis, Aileen M.

2016-01-01

Objective:To assess reliability, construct validity, responsiveness, and interpretability for Neck OutcOme Score (NOOS), Neck Disability Index (NDI), and Short Form–36 (SF-36) in neck pain patients. Study Design and Setting: Internal consistency was assessed by Cronbach alpha. Test-retest reliabi...

Mechanical thrombectomy in acute ischemic stroke: Consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN.

Science.gov (United States)

Wahlgren, Nils; Moreira, Tiago; Michel, Patrik; Steiner, Thorsten; Jansen, Olav; Cognard, Christophe; Mattle, Heinrich P; van Zwam, Wim; Holmin, Staffan; Tatlisumak, Turgut; Petersson, Jesper; Caso, Valeria; Hacke, Werner; Mazighi, Mikael; Arnold, Marcel; Fischer, Urs; Szikora, Istvan; Pierot, Laurent; Fiehler, Jens; Gralla, Jan; Fazekas, Franz; Lees, Kennedy R

2016-01-01

The original version of this consensus statement on mechanical thrombectomy was approved at the European Stroke Organisation (ESO)-Karolinska Stroke Update conference in Stockholm, 16-18 November 2014. The statement has later, during 2015, been updated with new clinical trials data in accordance with a decision made at the conference. Revisions have been made at a face-to-face meeting during the ESO Winter School in Berne in February, through email exchanges and the final version has then been approved by each society. The recommendations are identical to the original version with evidence level upgraded by 20 February 2015 and confirmed by 15 May 2015. The purpose of the ESO-Karolinska Stroke Update meetings is to provide updates on recent stroke therapy research and to discuss how the results may be implemented into clinical routine. Selected topics are discussed at consensus sessions, for which a consensus statement is prepared and discussed by the participants at the meeting. The statements are advisory to the ESO guidelines committee. This consensus statement includes recommendations on mechanical thrombectomy after acute stroke. The statement is supported by ESO, European Society of Minimally Invasive Neurological Therapy (ESMINT), European Society of Neuroradiology (ESNR), and European Academy of Neurology (EAN). © 2016 World Stroke Organization.

The Role of Central Neck Lymph Node Dissection in the Management of Papillary Thyroid Cancer.

Science.gov (United States)

Shirley, Lawrence A; Jones, Natalie B; Phay, John E

2017-01-01

Papillary thyroid cancer (PTC) is the most common thyroid malignancy, and cervical nodal metastases are frequent at presentation. The most common site for nodal metastases from PTC is the central compartment of the ipsilateral neck in the paratracheal and pretracheal regions. The decision to resect these lymph nodes at the time of thyroidectomy often depends on if nodes with suspected malignancy can be identified preoperatively. If nodal spread to the central neck nodes is known, then the consensus is to remove all nodes in this area. However, there remains significant controversy regarding the utility of removing central neck lymph nodes for prophylactic reasons. Herein, we review the potential utility of central neck lymph node dissection as well as the risks of performing this procedure. As well, we review the potential of molecular testing to stratify patients who would most benefit from this procedure. We advocate a selective approach in which patients undergo clinical neck examination coupled with ultrasound to detect any concerning lymph nodes that warrant additional evaluation with either fine needle aspiration or excisional biopsy in the operating room. In lieu of clinical lymphadenopathy, we suggest the use of patient and disease characteristics as identified by multiple groups, such as the American Thyroid Association and European Society of Endocrine Surgeons, which include extremes of ages, large primary tumor size, and male gender, when deciding to perform central neck lymph node dissection. Patients should be educated on the potential long-terms risks versus the lack of known long-term benefits.

The Role of Central Neck Lymph Node Dissection in the Management of Papillary Thyroid Cancer

Directory of Open Access Journals (Sweden)

Lawrence A. Shirley

2017-06-01

Full Text Available Papillary thyroid cancer (PTC is the most common thyroid malignancy, and cervical nodal metastases are frequent at presentation. The most common site for nodal metastases from PTC is the central compartment of the ipsilateral neck in the paratracheal and pretracheal regions. The decision to resect these lymph nodes at the time of thyroidectomy often depends on if nodes with suspected malignancy can be identified preoperatively. If nodal spread to the central neck nodes is known, then the consensus is to remove all nodes in this area. However, there remains significant controversy regarding the utility of removing central neck lymph nodes for prophylactic reasons. Herein, we review the potential utility of central neck lymph node dissection as well as the risks of performing this procedure. As well, we review the potential of molecular testing to stratify patients who would most benefit from this procedure. We advocate a selective approach in which patients undergo clinical neck examination coupled with ultrasound to detect any concerning lymph nodes that warrant additional evaluation with either fine needle aspiration or excisional biopsy in the operating room. In lieu of clinical lymphadenopathy, we suggest the use of patient and disease characteristics as identified by multiple groups, such as the American Thyroid Association and European Society of Endocrine Surgeons, which include extremes of ages, large primary tumor size, and male gender, when deciding to perform central neck lymph node dissection. Patients should be educated on the potential long-terms risks versus the lack of known long-term benefits.

Updated clinical guidelines experience major reporting limitations

Directory of Open Access Journals (Sweden)

Robin W.M. Vernooij

2017-10-01

Full Text Available Abstract Background The Checklist for the Reporting of Updated Guidelines (CheckUp was recently developed. However, so far, no systematic assessment of the reporting of updated clinical guidelines (CGs exists. We aimed to examine (1 the completeness of reporting the updating process in CGs and (2 the inter-observer reliability of CheckUp. Methods We conducted a systematic assessment of the reporting of the updating process in a sample of updated CGs using CheckUp. We performed a systematic search to identify updated CGs published in 2015, developed by a professional society, reporting a systematic review of the evidence, and containing at least one recommendation. Three reviewers independently assessed the CGs with CheckUp (16 items. We calculated the median score per item, per domain, and overall, converting scores to a 10-point scale. Multiple linear regression analyses were used to identify differences according to country, type of organisation, scope, and health topic of updated CGs. We calculated the intraclass coefficient (ICC and 95% confidence interval (95% CI for domains and overall score. Results We included in total 60 updated CGs. The median domain score on a 10-point scale for presentation was 5.8 (range 1.7 to 10, for editorial independence 8.3 (range 3.3 to 10, and for methodology 5.7 (range 0 to 10. The median overall score on a 10-point scale was 6.3 (range 3.1 to 10. Presentation and justification items at recommendation level (respectively reported by 27 and 38% of the CGs and the methods used for the external review and implementing changes in practice were particularly poorly reported (both reported by 38% of the CGs. CGs developed by a European or international institution obtained a statistically significant higher overall score compared to North American or Asian institutions (p = 0.014. Finally, the agreement among the reviewers on the overall score was excellent (ICC 0.88, 95% CI 0.75 to 0.95. Conclusions The

The neck-tongue syndrome.

Science.gov (United States)

Orrell, R W; Marsden, C D

1994-01-01

The neck-tongue syndrome, consisting of pain in the neck and altered sensation in the ipsilateral half of the tongue aggravated by neck movement, has been attributed to damage to lingual afferent fibres travelling in the hypoglossal nerve to the C2 spinal roots. The lingual afferents in the hypoglossal nerve are thought to be proprioceptive. Two further cases of the neck-tongue syndrome are described, the spectrum of its clinical manifestations is explored, and the phenomenon of lingual pseudoathetosis is illustrated as a result of the presumed lingual deafferentation. Images PMID:8158185

Update and revision of WHO air quality guidelines for Europe

Energy Technology Data Exchange (ETDEWEB)

Younes, M. [WHO European Centre for Environment and Health, Bilthoven (Netherlands). Bilthoven Div.

1995-12-31

The WHO Air Quality Guidelines for Europe (AQG), published in 1987, have provided a uniform basis for the development of strategies for the control of air pollution, and have contributed to the maintenance and improvement of public health in several countries. The aim of the guidelines is to provide a basis for protecting public health from adverse effects of air pollutants, and for eliminating or reducing to a minimum, those contaminants that are known or likely to be hazardous to human health and wellbeing. Since the publication of the first edition of the AQG, new scientific data in the fields of air pollution toxicology and epidemiology have accumulated and new developments in risk assessment methodologies have taken place, requiring updating and/or revision of the existing guidelines. This fact was recognized during the preparation of the initial work plan of the European Centre for Environment and Health, and it was recommended that the Centre undertake any necessary amendments and extensions to the Air Quality Guidelines. The updating procedure is being carried out in cooperation with the International Programme on Chemical Safety (IPCS) and the Commission of the European Communities (CEC) and will be implemented through working group meetings which require the preparation of working documents on specific air pollutants or mixtures and a final consultation to discuss the updated document.It was initiated by a Planning Meeting which was organized in January 1993. The purpose of the planning meeting was to set the framework for the updating and revision process, in particular to discuss the scope and purpose, the contents and the format of the revised AQG publication, to define the details of and the time schedule for the updating process and to identify the working groups needed and their way of operation. (author)

Update and revision of WHO air quality guidelines for Europe

Energy Technology Data Exchange (ETDEWEB)

Younes, M [WHO European Centre for Environment and Health, Bilthoven (Netherlands). Bilthoven Div.

1996-12-31

The WHO Air Quality Guidelines for Europe (AQG), published in 1987, have provided a uniform basis for the development of strategies for the control of air pollution, and have contributed to the maintenance and improvement of public health in several countries. The aim of the guidelines is to provide a basis for protecting public health from adverse effects of air pollutants, and for eliminating or reducing to a minimum, those contaminants that are known or likely to be hazardous to human health and wellbeing. Since the publication of the first edition of the AQG, new scientific data in the fields of air pollution toxicology and epidemiology have accumulated and new developments in risk assessment methodologies have taken place, requiring updating and/or revision of the existing guidelines. This fact was recognized during the preparation of the initial work plan of the European Centre for Environment and Health, and it was recommended that the Centre undertake any necessary amendments and extensions to the Air Quality Guidelines. The updating procedure is being carried out in cooperation with the International Programme on Chemical Safety (IPCS) and the Commission of the European Communities (CEC) and will be implemented through working group meetings which require the preparation of working documents on specific air pollutants or mixtures and a final consultation to discuss the updated document.It was initiated by a Planning Meeting which was organized in January 1993. The purpose of the planning meeting was to set the framework for the updating and revision process, in particular to discuss the scope and purpose, the contents and the format of the revised AQG publication, to define the details of and the time schedule for the updating process and to identify the working groups needed and their way of operation. (author)

Why sauropods had long necks; and why giraffes have short necks

Science.gov (United States)

Wedel, Mathew J.

2013-01-01

The necks of the sauropod dinosaurs reached 15 m in length: six times longer than that of the world record giraffe and five times longer than those of all other terrestrial animals. Several anatomical features enabled this extreme elongation, including: absolutely large body size and quadrupedal stance providing a stable platform for a long neck; a small, light head that did not orally process food; cervical vertebrae that were both numerous and individually elongate; an efficient air-sac-based respiratory system; and distinctive cervical architecture. Relevant features of sauropod cervical vertebrae include: pneumatic chambers that enabled the bone to be positioned in a mechanically efficient way within the envelope; and muscular attachments of varying importance to the neural spines, epipophyses and cervical ribs. Other long-necked tetrapods lacked important features of sauropods, preventing the evolution of longer necks: for example, giraffes have relatively small torsos and large, heavy heads, share the usual mammalian constraint of only seven cervical vertebrae, and lack an air-sac system and pneumatic bones. Among non-sauropods, their saurischian relatives the theropod dinosaurs seem to have been best placed to evolve long necks, and indeed their necks probably surpassed those of giraffes. But 150 million years of evolution did not suffice for them to exceed a relatively modest 2.5 m. PMID:23638372

Why sauropods had long necks; and why giraffes have short necks

Directory of Open Access Journals (Sweden)

Michael P. Taylor

2013-02-01

Full Text Available The necks of the sauropod dinosaurs reached 15 m in length: six times longer than that of the world record giraffe and five times longer than those of all other terrestrial animals. Several anatomical features enabled this extreme elongation, including: absolutely large body size and quadrupedal stance providing a stable platform for a long neck; a small, light head that did not orally process food; cervical vertebrae that were both numerous and individually elongate; an efficient air-sac-based respiratory system; and distinctive cervical architecture. Relevant features of sauropod cervical vertebrae include: pneumatic chambers that enabled the bone to be positioned in a mechanically efficient way within the envelope; and muscular attachments of varying importance to the neural spines, epipophyses and cervical ribs. Other long-necked tetrapods lacked important features of sauropods, preventing the evolution of longer necks: for example, giraffes have relatively small torsos and large, heavy heads, share the usual mammalian constraint of only seven cervical vertebrae, and lack an air-sac system and pneumatic bones. Among non-sauropods, their saurischian relatives the theropod dinosaurs seem to have been best placed to evolve long necks, and indeed their necks probably surpassed those of giraffes. But 150 million years of evolution did not suffice for them to exceed a relatively modest 2.5 m.

Dose-response relationship for elective neck irradiation of head and neck cancer - facts and controversies

International Nuclear Information System (INIS)

Suwinski, R.; Maciejewski, B.; Withers, H.R.

1998-01-01

The aim of this study is to assign dose-response relationship for subclinical neck metastases of squamous cell head and neck cancer based on extensive survey of 24 data sets collected from the literature. Neck relapse rates (NRR) without and after elective (ENI) or preoperative irradiation were estimated for each site and stage of primary tumor and the reduction in neck relapse rate was calculated. An average NRR without ENI was 22% (12-35% ) and only 2.5% (0-1 0%) after the ENI with total dose of 46- 50 Gy which gives high reduction rate in the risk of neck recurrences being on the average 89% and 42% (0-46%) after preoperative irradiation using 22-30 Gy. Dose response curve for elective and preoperative irradiation have shown that 50 Gy in 2 Gy fraction reduces the incidence of neck relapses in the NO patients by more than 90% and only by less than 50% after total doses lower than 30 Gy. No correlation between the risk of neck metastases without ENI and the reduction in neck relapses after ENI was found. (authors)

Neck x-ray

Science.gov (United States)

X-ray - neck; Cervical spine x-ray; Lateral neck x-ray ... There is low radiation exposure. X-rays are monitored so that the lowest amount of radiation is used to produce the image. Pregnant women and ...

Targeted therapies and radiation for the treatment of head and neck cancer

International Nuclear Information System (INIS)

Kim, Gwi Eon

2004-01-01

The purpose of this review is to provide an update on novel radiation treatments for head and neck cancer. Despite the remarkable advances in chemotherapy and radiotherapy techniques, the management of advanced head and neck cancer remains challenging. Epidermal growth factor receptor (EGFR) is an appealing target for novel therapies in head and neck cancer because not only EGFR activation stimulates many important signaling pathways associated with cancer development and progression, and importantly, resistance to radiation. Furthermore, EGFR overexpression is known to be portended for a worse outcome in patients with advanced head and neck cancer. Two categories of compounds designed to abrogate EGFR signaling, such as monoclonal antibodies (Cetuximab) and tyrosine kinase inhibitors (ZD1839 and OSI-774) have been assessed and have been most extensively studied in preclinical models and clinical trials. Additional TKIs in clinical trials include a reversible agent, Cl-1033, which blocks activation of all erbB receptors. Encouraging preclinical data for head and neck cancers resulted in rapid translation into the clinic. Results from initial clinical trials show rather surprisingly that only minority of patients benefited from EGFR inhibition as monotherapy or in combination with chemotherapy. In this review, we begin with a brief summary of erbB-mediated signal transduction. Subsequently, we present data on prognostic-predictive value of erbB receptor expression in HNC followed by preclinical and clinical data on the role of EGFR antagonists alone or in combination with radiation in the treatment of HNC. Finally, we discuss the emerging thoughts on resistance to EGFR blockade and efforts in the development of multiple-targeted therapy for combination with chemotherapy or radiation. Current challenges for investigators are to determine (1) who will benefit from targeted agents and which agents are most appropriate to combine with radiation and/or chemotherapy, (2

Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): An update on 93 randomised trials and 17,346 patients

International Nuclear Information System (INIS)

Pignon, Jean-Pierre; Le Maitre, Aurelie; Maillard, Emilie; Bourhis, Jean

2009-01-01

Background: Our previous individual patient data (IPD) meta-analysis showed that chemotherapy improved survival in patients curatively treated for non-metastatic head and neck squamous cell carcinoma (HNSCC), with a higher benefit with concomitant chemotherapy. However the heterogeneity of the results limited the conclusions and prompted us to confirm the results on a more complete database by adding the randomised trials conducted between 1994 and 2000. Methods: The updated IPD meta-analysis included trials comparing loco-regional treatment to loco-regional treatment + chemotherapy in HNSCC patients and conducted between 1965 and 2000. The log-rank-test, stratified by trial, was used to compare treatments. The hazard ratios of death were calculated. Results: Twenty-four new trials, most of them of concomitant chemotherapy, were included with a total of 87 trials and 16,485 patients. The hazard ratio of death was 0.88 (p < 0.0001) with an absolute benefit for chemotherapy of 4.5% at 5 years, and a significant interaction (p < 0.0001) between chemotherapy timing (adjuvant, induction or concomitant) and treatment. Both direct (6 trials) and indirect comparisons showed a more pronounced benefit of the concomitant chemotherapy as compared to induction chemotherapy. For the 50 concomitant trials, the hazard ratio was 0.81 (p < 0.0001) and the absolute benefit 6.5% at 5 years. There was a decreasing effect of chemotherapy with age (p = 0.003, test for trend). Conclusion: The benefit of concomitant chemotherapy was confirmed and was greater than the benefit of induction chemotherapy.

Prevalance of neck pain in computer users

International Nuclear Information System (INIS)

Sabeen, F.; Bashir, M.S.; Hussain, S.I.

2013-01-01

Prolonged use of computers during daily work activities and recreation is often cited as a cause of neck pain. Neck pain and computer users are clearly connected due to extended periods of sitting in a certain position with no breaks to stretch the neck muscles. Pro-longed computer use with neck bent forward, will cause the anterior neck muscles to gradually get shorter and tighter, while the muscles in the back of neck will grow longer and weaker. These changes will lead to development of neck pain. Objectives: To find incidence of neck pain in computer users, association between neck pain and prolong sitting in wrong posture, association between effects of break during prolong work, association between types of chair in use in prolong sitting and occurrence of neck pain. Methodology: For this observational study data was collected through Questionnaires from office workers (computer users), and students. Results: Out of 50 persons 72% of computer users had neck pain. Strong association was found between neck pain and prolonged computer use (p = 0.001). Those who took break during their work had less neck pain. No significant association was found between type of chair in use and neck pain. Neck pain and type of system in use also had no significant association. Conclusion: So duration of computer use and frequency of breaks are associated with neck pain at work. Severe Neck pain was found in people who use computer for more than 5 hours a day. (author)

Neck muscle atrophy and soft-tissue fibrosis after neck dissection and postoperative radiotherapy for oral cancer

Energy Technology Data Exchange (ETDEWEB)

Kim, Jinu; Shin, Eun Seow; Kim, Jeong Eon; Yoon, Sang Pil [Jeju National University School of Medicine, Jeju (Korea, Republic of); Kim, Young Suk [Dept. of Radiation Oncology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of)

2015-12-15

Late complications of head and neck cancer survivors include neck muscle atrophy and soft-tissue fibrosis. We present an autopsy case of neck muscle atrophy and soft-tissue fibrosis (sternocleidomastoid, omohyoid, digastric, sternohyoid, sternothyroid, and platysma muscles) within the radiation field after modified radical neck dissection type I and postoperative radiotherapy for floor of mouth cancer. A 70-year-old man underwent primary tumor resection of the left floor of mouth, left marginal mandibulectomy, left modified radical neck dissection type I, and reconstruction with a radial forearm free flap. The patient received adjuvant radiotherapy. The dose to the primary tumor bed and involved neck nodes was 63 Gy in 35 fractions over 7 weeks. Areas of subclinical disease (left lower neck) received 50 Gy in 25 fractions over 5 weeks. Adjuvant chemotherapy was not administered.

Neck motion, motor control, pain and disability: A longitudinal study of associations in neck pain patients in physiotherapy treatment.

Science.gov (United States)

Meisingset, Ingebrigt; Stensdotter, Ann-Katrin; Woodhouse, Astrid; Vasseljen, Ottar

2016-04-01

Neck pain is associated with several alterations in neck motion and motor control, but most of the findings are based on cross-sectional studies. The aim of this study was to investigate associations between changes in neck motion and motor control, and changes in neck pain and disability in physiotherapy patients during a course of treatment. Prospective cohort study. Subjects with non-specific neck pain (n = 71) participated in this study. Neck flexibility, joint position error (JPE), head steadiness, trajectory movement control and postural sway were recorded before commencement of physiotherapy (baseline), at 2 weeks, and at 2 months. Numerical Rating Scale and Neck Disability Index were used to measure neck pain and disability at the day of testing. To analyze within subjects effects in neck motion and motor control, neck pain, and disability over time we used fixed effects linear regression analysis. Changes in neck motion and motor control occurred primarily within 2 weeks. Reduction in neck pain was associated with increased cervical range of motion in flexion-/extension and increased postural sway when standing with eyes open. Decreased neck disability was associated with some variables for neck flexibility and trajectory movement control. Cervical range of motion in flexion-/extension was the only variable associated with changes in both neck pain and neck disability. This study shows that few of the variables for neck motion and motor control were associated with changes neck pain and disability over a course of 2 months with physiotherapy treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

Perineural spread in head and neck tumors.

Science.gov (United States)

Brea Álvarez, B; Tuñón Gómez, M

2014-01-01

Perineural spread is the dissemination of some types of head and neck tumors along nervous structures. Perineural spread has negative repercussions on treatment because it requires more extensive resection and larger fields of irradiation. Moreover, perineural spread is associated with increased local recurrence, and it is considered an independent indicator of poor prognosis in the TNM classification for tumor staging. However, perineural spread often goes undetected on imaging studies. In this update, we review the concept of perineural spread, its pathogenesis, and the main pathways and connections among the facial nerves, which are essential to understand this process. Furthermore, we discuss the appropriate techniques for imaging studies, and we describe and illustrate the typical imaging signs that help identify perineural spread on CT and MRI. Finally, we discuss the differential diagnosis with other entities. Copyright © 2013 SERAM. Published by Elsevier Espana. All rights reserved.

Failure pattern and salvage treatment after radical treatment of head and neck cancer

DEFF Research Database (Denmark)

Pagh, Anja; Grau, Cai; Overgaard, Jens

2016-01-01

Purpose The aim of the study was to test the hypothesis that head and neck cancer (HNC) patients benefit from specialized follow-up (FU), as this strategy ensures timely detection of relapses for successful salvage treatment. This was done by evaluation of the pattern of failure, the temporal...... recordings of recurrent disease in 567 patients with primary tumors of the larynx, pharynx, oral cavity, nasal cavity, paranasal sinuses and salivary glands. A review of medical records was performed in order to update and supplement the database. Results Failures of the 567 patients were primarily in T...

The Use of Neck Support Pillows and Postural Exercises in the Management of Chronic Neck Pain.

Science.gov (United States)

Jamal, Alisha N; Feldman, Brian M; Pullenayegum, Eleanor

2016-10-01

Chronic neck pain is a common problem with a profound effect on quality of life. Identifying evidence-based management strategies is fundamental in improving patient outcomes. This study is a reanalysis of the data from Helewa, et al to further characterize the effects of postural exercises and neck support pillows on neck pain. A full factorial model was used. All interactions were analyzed adjusting for the Northwick Park Neck Pain Questionnaire (NPQ) at baseline. Postural exercises significantly decreased NPQ scores at ≥ 3 weeks, and the use of a neck support pillow significantly decreased NPQ scores at ≥ 12 weeks. These interventions could be beneficial in reducing neck pain symptoms.

The European Cancer Patient’s Bill of Rights, update and implementation 2016

Science.gov (United States)

Højgaard, Liselotte; Löwenberg, Bob; Selby, Peter; Lawler, Mark; Banks, Ian; Law, Kate; Albreht, Tit; Armand, Jean-Pierre; Barbacid, Mariano; Barzach, Michèle; Bergh, Jonas; Cameron, David; Conte, Pierfranco; de Braud, Filippo; de Gramont, Aimery; De Lorenzo, Francesco; Diehl, Volker; Diler, Sarper; Erdem, Sema; Geissler, Jan; Gore-Booth, Jola; Henning, Geoffrey; Horgan, Denis; Jassem, Jacek; Johnson, Peter; Kaasa, Stein; Kapitein, Peter; Karjalainen, Sakari; Kelly, Joan; Kienesberger, Anita; La Vecchia, Carlo; Lacombe, Denis; Lindahl, Tomas; Luzzatto, Lucio; Malby, Rebecca; Mastris, Ken; Meunier, Françoise; Murphy, Martin; Naredi, Peter; Nurse, Paul; Oliver, Kathy; Pearce, Jonathan; Pelouchov, Jana; Piccart, Martine; Pinedo, Bob; Spurrier-Bernard, Gilly; Sullivan, Richard; Tabernero, Josep; Van de Velde, Cornelis; van Herk, Bert; Vedsted, Peter; Waldmann, Anita; Weller, David; Wilking, Nils; Wilson, Roger; Yared, Wendy; Zielinski, Christoph; zur Hausen, Harald; Le Chevalier, Thierry; Johnston, Patrick

2016-01-01

Abstract In this implementation phase of the European Cancer Patient’s Bill of Rights (BoR), we confirm the following three patient-centred principles that underpin this initiative:The right of every European citizen to receive the most accurate information and to be proactively involved in his/her care.The right of every European citizen to optimal and timely access to a diagnosis and to appropriate specialised care, underpinned by research and innovation.The right of every European citizen to receive care in health systems that ensure the best possible cancer prevention, the earliest possible diagnosis of their cancer, improved outcomes, patient rehabilitation, best quality of life and affordable health care. The key aspects of working towards implementing the BoR are:Agree our high-level goal. The vision of 70% long-term survival for patients with cancer in 2035, promoting cancer prevention and cancer control and the associated progress in ensuring good patient experience and quality of life.Establish the major mechanisms to underpin its delivery. (1) The systematic and rigorous sharing of best practice between and across European cancer healthcare systems and (2) the active promotion of Research and Innovation focused on improving outcomes; (3) Improving access to new and established cancer care by sharing best practice in the development, approval, procurement and reimbursement of cancer diagnostic tests and treatments.Work with other organisations to bring into being a Europe based centre that will (1) systematically identify, evaluate and validate and disseminate best practice in cancer management for the different countries and regions and (2) promote Research and Innovation and its translation to maximise its impact to improve outcomes. PMID:28848664

New science at the European Spallation Source

Energy Technology Data Exchange (ETDEWEB)

Finney, J L [University Coll., London (United Kingdom). Dept. of Physics and Astronomy

1996-05-01

The European Spallation Source is a trans-European project aimed at the ultimate construction of a next-generation pulsed spallation neutron source that will deliver 30 times the beam power of ISIS. The reference design for the proposed source has been set, and work is in progress to develop an updated scientific case for the construction of the source early in the next century. Together with improvements in instrumentation, effective flux gains of over two orders of magnitude are likely in some areas, opening up major new opportunities for the exploitation of neutron studies in fundamental, strategic, and applied science. (author)

Circulating Vitamin D in relation to cancer incidence and survival of the head and neck and oesophagus in the EPIC cohort

NARCIS (Netherlands)

Fanidi, Anouar; Muller, David C.; Midttun, Øivind; Ueland, Per Magne; Vollset, Stein Emil; Relton, Caroline; Vineis, Paolo; Weiderpass, Elisabete; Skeie, Guri; Brustad, Magritt; Palli, Domenico; Tumino, Rosario; Grioni, Sara; Sacerdote, Carlotta; Bueno-De-Mesquita, H. B.; Peeters, Petra H.; Boutron-Ruault, Marie Christine; Kvaskoff, Marina; Cadeau, Claire; Huerta, José María; Sánchez, Maria José; Agudo, Antonio; Lasheras, Cristina; Quirós, J. Ramón; Chamosa, Saioa; Riboli, Elio; Travis, Ruth C.; Ward, Heather; Murphy, Neil; Khaw, Kay Tee; Trichopoulou, Antonia; Lagiou, Pagona; Papatesta, Eleni Maria; Boeing, Heiner; Kuehn, Tilman; Katzke, Verena; Steffen, Annika; Johansson, Anders; Brennan, Paul; Johansson, Mattias

2016-01-01

Experimental and epidemiological data suggest that vitamin D play a role in pathogenesis and progression of cancer, but prospective data on head and neck cancer (HNC) and oesophagus cancer are limited. The European Prospective Investigation into Cancer and Nutrition (EPIC) study recruited 385,747

Neck pain and disability due to neck pain: what is the relation?

DEFF Research Database (Denmark)

Fejer, René; Hartvigsen, Jan

2008-01-01

Pain and disability are interrelated, but the relationship between pain and disability is not straightforward. The objective of this study was to investigate the relationship between neck pain (NP) intensity, NP duration, and disability based on the population-based 'Funen Neck and Chest Pain......' study. Pain intensity was measured using 11-box numerical rating scales, pain duration was measured using the Standardized Nordic Questionnaire, and disability was measured by the Copenhagen Neck Functional Disability Scale. Spearman rank correlation coefficients and logistic regression analyses were...... used to measure correlations and strength of associations between pain intensity, pain duration, and disability given domain specific characteristics (socioeconomic, health and physical, comorbidity, and variables related to consequences of NP). Neck pain was very common, but mainly mild and did...

Comparison of electromyographic activity and range of neck motion in violin students with and without neck pain during playing.

Science.gov (United States)

Park, Kyue-nam; Kwon, Oh-yun; Ha, Sung-min; Kim, Su-jung; Choi, Hyun-jung; Weon, Jong-hyuck

2012-12-01

Neck pain is common in violin students during a musical performance. The purpose of this study was to compare electromyographic (EMG) activity in superficial neck muscles with neck motion when playing the violin as well as neck range of motion (ROM) at rest, between violin students with and without neck pain. Nine violin students with neck pain and nine age- and gender-matched subjects without neck pain were recruited. Muscle activity of the bilateral upper trapezius, sternocleidomastoid, and superficial cervical extensor muscles was measured using surface EMG. Kinematic data on neck motion while playing and active neck ROM were also measured using a three-dimensional motion analysis system. Independent t-tests were used to compare EMG activity with kinematic data between groups. These analyses revealed that while playing, both the angle of left lateral bending and leftward rotation of the cervical spine were significantly greater in the neck pain group than among those without neck pain. Similarly, EMG activity of the left upper trapezius, both cervical extensors, and both sternocleidomastoid muscles were significantly greater in the neck pain group. The active ROM of left axial rotation was significantly lower in the neck pain group. These results suggest that an asymmetric playing posture and the associated increased muscle activity as well as decreased neck axial rotation may contribute to neck pain in violin students.

Labour Market Effects of Parental Leave: A European Perspective

NARCIS (Netherlands)

Akgündüz, Y.E.; Plantenga, J.

2011-01-01

We investigate the aggregate-level effects of parental leave legislation on various labour market outcomes of women in 16 European countries for the period since 1970. The paper updates and extends previous findings in the literature. Results show increases in participation rates that diminish with

European Position Paper on Rhinosinusitis and Nasal Polyps 2012

NARCIS (Netherlands)

Fokkens, Wytske J.; Lund, Valerie J.; Mullol, Joachim; Bachert, Claus; Alobid, Isam; Baroody, Fuad; Cohen, Noam; Cervin, Anders; Douglas, Richard; Gevaert, Philippe; Georgalas, Christos; Goossens, Herman; Harvey, Richard; Hellings, Peter; Hopkins, Claire; Jones, Nick; Joos, Guy; Kalogjera, Livije; Kern, Bob; Kowalski, Marek; Price, David; Riechelmann, Herbert; Schlosser, Rodney; Senior, Brent; Thomas, Mike; Toskala, Elina; Voegels, Richard; Wang, De Yun; Wormald, Peter John

2012-01-01

The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007.The document contains chapters on definitions and classification, we now also proposed definitions for difficult to treat rhinosinusitis, control of

Biogeometry of femoral neck for implant placement

Directory of Open Access Journals (Sweden)

Patwa J

2006-01-01

Full Text Available Background : Treatment of fracture neck femur with three cannulated cancellous screws in an apex proximal configuration is practised in many parts of the world. Methods : Dimensions of femoral neck at the middle of transcervical neck using CT scan (live neck and vernier caliper (dry cadeveric neck in 20 subjects respectively were measured. Results : Inferior half of the neck is narrower than superior half. Conclusion : Biogeometry of the neck of femur does not accomodate two inferior screws and thus fixation of fracture neck femur with three canulated cancellous screws in an apex distal configuration is recommended.

Test Characteristics of Neck Fullness and Witnessed Neck Pulsations in the Diagnosis of Typical AV Nodal Reentrant Tachycardia

Science.gov (United States)

Sakhuja, Rahul; Smith, Lisa M; Tseng, Zian H; Badhwar, Nitish; Lee, Byron K; Lee, Randall J; Scheinman, Melvin M; Olgin, Jeffrey E; Marcus, Gregory M

2011-01-01

Summary Background Claims in the medical literature suggest that neck fullness and witnessed neck pulsations are useful in the diagnosis of typical AV nodal reentrant tachycardia (AVNRT). Hypothesis Neck fullness and witnessed neck pulsations have a high positive predictive value in the diagnosis of typical AVNRT. Methods We performed a cross sectional study of consecutive patients with palpitations presenting to a single electrophysiology (EP) laboratory over a 1 year period. Each patient underwent a standard questionnaire regarding neck fullness and/or witnessed neck pulsations during their palpitations. The reference standard for diagnosis was determined by electrocardiogram and invasive EP studies. Results Comparing typical AVNRT to atrial fibrillation (AF) or atrial flutter (AFL) patients, the proportions with neck fullness and witnessed neck pulsations did not significantly differ: in the best case scenario (using the upper end of the 95% confidence interval [CI]), none of the positive or negative predictive values exceeded 79%. After restricting the population to those with supraventricular tachycardia other than AF or AFL (SVT), neck fullness again exhibited poor test characteristics; however, witnessed neck pulsations exhibited a specificity of 97% (95% CI 90–100%) and a positive predictive value of 83% (95% CI 52–98%). After adjustment for potential confounders, SVT patients with witnessed neck pulsations had a 7 fold greater odds of having typical AVNRT, p=0.029. Conclusions Although neither neck fullness nor witnessed neck pulsations are useful in distinguishing typical AVNRT from AF or AFL, witnessed neck pulsations are specific for the presence of typical AVNRT among those with SVT. PMID:19479968

Updated European Union Risk Assessment Report of Alkanes, C10-13, Chloro

OpenAIRE

2008-01-01

A risk assessment of alkanes, C10-13, chloro (short-chain chlorinated paraffins or SCCPs) produced in accordance with Council Regulation (EEC) 793/93 was published in October 1999 . Subsequent marketing and use restrictions for two uses (metal working and use for fat liquoring of leather) have come into force in the European Union through Directive 2002/45/EC . This Directive also states that all remaining uses of short-chain chlorinated paraffins will be reviewed by the European Commission ...

Combined neck dissection and postoperative radiation therapy in the management of the high-risk neck: a matched-pair analysis

International Nuclear Information System (INIS)

Lundahl, Robert E.; Foote, Robert L.; Bonner, James A.; Suman, Vera J.; Lewis, Jean E.; Kasperbauer, Jan L.; McCaffrey, Thomas V.; Olsen, Kerry D.

1998-01-01

Purpose: The purpose of this study was to determine the efficacy of postoperative adjuvant radiation therapy with regard to reducing the rate of recurrence in the neck, cancer-related death, and death from any cause in patients with squamous cell carcinoma of the head and neck region metastatic to neck nodes. Methods: This was a retrospective review of patients with pathologically confirmed nodal metastases who underwent neck dissection and postoperative adjuvant radiation therapy for squamous cell carcinoma of the head and neck region. Time to recurrence in the dissected area of the neck, any recurrence in the neck, cancer-related death, and death from any cause were estimated with the Kaplan-Meier method. A matched-pair analysis was performed utilizing a cohort of patients who underwent neck dissection without postoperative radiation therapy. The patients from the two cohorts were matched according to previously reported high-risk features for cancer recurrence and death. Cox hazards models for the matched pairs were used to evaluate the relative risk of subsequent recurrence in the dissected side of the neck, any neck recurrence, cancer-related death, and overall survival. Materials: The medical records and pathologic slides of 95 consecutive patients with pathologically confirmed nodal metastases from squamous cell carcinoma of the head and neck region who underwent neck dissection and postoperative adjuvant radiation therapy between January 1974 and December 1990 were reviewed. Previously published data from 284 patients with squamous cell carcinoma of the head and neck region treated with neck dissection alone between January 1970 and December 1980 were used for a matched-pair analysis. Results: The relative risks for recurrence in the dissected side of the neck, any neck recurrence (dissected neck or delayed undissected neck metastasis), cancer-related death, and death from any cause for patients treated with operation alone relative to those treated with

Recommendations on the diagnosis, treatment and monitoring of late-onset hypogonadism in men - a suggested update.

Science.gov (United States)

Lunenfeld, Bruno; Mskhalaya, George; Kalinchenko, Svetlana; Tishova, Yulia

2013-12-01

Recommendations on the diagnosis, treatment and monitoring of late-onset hypogonadism (LOH) in men were first published by ISSAM in 2002 In 2005, and, in 2008, updated recommendations were published in the International Journal of Andrology, the Journal of Andrology, the Aging Male and European Urology. Towards discussions at the next ISSAM/ESSAM meeting in Moscow, 29 November 2013, we suggest the following update.

Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment.

Science.gov (United States)

Gross, Anita; Langevin, Pierre; Burnie, Stephen J; Bédard-Brochu, Marie-Sophie; Empey, Brian; Dugas, Estelle; Faber-Dobrescu, Michael; Andres, Cristy; Graham, Nadine; Goldsmith, Charles H; Brønfort, Gert; Hoving, Jan L; LeBlanc, Francis

2015-09-23

Manipulation and mobilisation are commonly used to treat neck pain. This is an update of a Cochrane review first published in 2003, and previously updated in 2010. To assess the effects of manipulation or mobilisation alone compared wiith those of an inactive control or another active treatment on pain, function, disability, patient satisfaction, quality of life and global perceived effect in adults experiencing neck pain with or without radicular symptoms and cervicogenic headache (CGH) at immediate- to long-term follow-up. When appropriate, to assess the influence of treatment characteristics (i.e. technique, dosage), methodological quality, symptom duration and subtypes of neck disorder on treatment outcomes. Review authors searched the following computerised databases to November 2014 to identify additional studies: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). We also searched ClinicalTrials.gov, checked references, searched citations and contacted study authors to find relevant studies. We updated this search in June 2015, but these results have not yet been incorporated. Randomised controlled trials (RCTs) undertaken to assess whether manipulation or mobilisation improves clinical outcomes for adults with acute/subacute/chronic neck pain. Two review authors independently selected studies, abstracted data, assessed risk of bias and applied Grades of Recommendation, Assessment, Development and Evaluation (GRADE) methods (very low, low, moderate, high quality). We calculated pooled risk ratios (RRs) and standardised mean differences (SMDs). We included 51 trials (2920 participants, 18 trials of manipulation/mobilisation versus control; 34 trials of manipulation/mobilisation versus another treatment, 1 trial had two comparisons). Cervical manipulation versus inactive control: For subacute and chronic neck pain, a single manipulation (three trials, no meta

2013 European guideline on the management of lymphogranuloma venereum.

Science.gov (United States)

de Vries, H J C; Zingoni, A; Kreuter, A; Moi, H; White, J A

2015-01-01

WHAT IS NEW IN THIS UPDATED GUIDELINE?: This is the update version of the 2010 European guideline on the management of lymphogranuloma venereum (LGV). New issues are: Based on clonal relatedness of prevalent LGV strains there is evidence that the LGV epidemic among men who have sex with men (MSM) in the Western world prevailed already in the United States in the 1980s and was introduced into Europe by the end of the last century. A new LGV variant causing severe proctitis was unveiled and designated L2c. The L2b LGV variant causing the vast majority of infections among MSM is now also found among a few heterosexual women. Apart from HIV and STI screening, Hepatitis C Virus (HCV) testing should be offered to all LGV patients. To exclude reinfections, STI screening during a follow-up visit 3 months after an LGV diagnosis should be offered. © 2014 European Academy of Dermatology and Venereology.

IMPLICATIONS OF BANKING SUPERVISION ACROSS THE EUROPEAN MONETARY UNION, A SOVEREIGN DEBT CRISIS UPDATE

Directory of Open Access Journals (Sweden)

Simona Elena IAGAR

2015-09-01

Full Text Available The current paper analyses the latest measures taken by the main European governing bodies with regard to the banking supervision across the European Monetary Union (EMU following the ‘sovereign debt crisis’ phenomenon and its continuing effects throughout the Euro zone for the last five years. Officially preaching financial integration in order to ensure stability of the European banking system, most often the European governing bodies amplify the exact phenomena they expect to reduce doing more harm to both creditors and depositors and ultimately leading to a more fragile business banking environment. The importance of banks is acknowledged at European institutional level as main channel through which the monetary policy is triggered across EMU, therefore active measures have been taken in this regard. Questioning the extent to which these measures are legitimate and meet the purposes that they claim, constitutes the aim of the present paper. Another close linked purpose is a better understanding of what stability means, why it is important and what makes stability occur in a banking system. Having understood and set the theoretical grounds, it therefore follows easily to analyse through this glance the latest actions pursued by the European financial governing bodies focusing on the ones addressing supervision of the banking sector within EMU. The paper concludes and provides a set of recommendations by reminding the nature and role of banks for the real economy, the same objective the European financial governing bodies’ target, but which they consistently fail to meet.

A pain in the neck-Imaging in neck sepsis

International Nuclear Information System (INIS)

Lyle, N.J.; Rutherford, E.E.; Batty, V.B.

2011-01-01

Deep neck infection has a high morbidity and mortality and the extent of infection is often difficult to estimate clinically. The complex anatomy and the communication between neck spaces means that infection can spread along fascial planes leading to life-threatening complications such as airway compromise, vascular erosion/thrombosis, neural dysfunction, and ultimately descending necrotizing mediastinitis. Imaging has an important role to play in identifying the extent of infection and the presence of complications.

A pain in the neck-Imaging in neck sepsis

Energy Technology Data Exchange (ETDEWEB)

Lyle, N.J., E-mail: nickylyle@doctors.org.uk [Department of Diagnostic Imaging, Southampton General Hospital, Southampton (United Kingdom); Rutherford, E.E.; Batty, V.B. [Department of Diagnostic Imaging, Southampton General Hospital, Southampton (United Kingdom)

2011-09-15

Deep neck infection has a high morbidity and mortality and the extent of infection is often difficult to estimate clinically. The complex anatomy and the communication between neck spaces means that infection can spread along fascial planes leading to life-threatening complications such as airway compromise, vascular erosion/thrombosis, neural dysfunction, and ultimately descending necrotizing mediastinitis. Imaging has an important role to play in identifying the extent of infection and the presence of complications.

Stereotactic Body Radiotherapy for Head and Neck Tumors

Science.gov (United States)

2016-04-18

Squamous Cell Carcinoma of the Head and Neck; Nasopharyngeal Carcinoma; Salivary Gland Cancer; Head and Neck Sarcoma; Paraganglioma of Head and Neck; Chordoma of Head and Neck; Chondrosarcoma of Head and Neck; Angiofibroma of Head and Neck

Progressive shoulder-neck exercise on cervical muscle functions in middle-aged and senior patients with chronic neck pain.

Science.gov (United States)

Lin, I-Hsien; Chang, Kwang-Hwa; Liou, Tsan-Hon; Tsou, Chih-Min; Huang, Yi-Ching

2018-02-01

Although neck pain is a common musculoskeletal disorder, there is no consensus on suitable exercise methods for middle-aged and senior patients with chronic neck pain. Therefore, this study investigated the effectiveness of a 6-week shoulder-neck exercise intervention program on cervical muscle function improvement in patients aged 45 years or older with chronic neck pain. The aim of the present study was to evaluate the effects of progressive shoulder-neck exercise on cervical muscle functions of middle-aged and senior patients with chronic neck pain. A randomized controlled single-blind trial. Rehabilitation department of a hospital. A total of 72 subjects aged ≥45 years with chronic neck pain were randomly allocated to either an experimental group (N.=36; age 57.3±8.74 years) or a control group (N.=36; age 58.15±8.17 years). The control group received only traditional physiotherapy, whereas the experimental group participated in a 6-week shoulder-neck exercise program consisting of cranio-cervical flexion and progressive resistance exercises in addition to receiving traditional physiotherapy. The muscle functions of subjects in both groups were tested before the experiment and also after the intervention program. The pretest and posttest measured the cranio-cervical flexion test (CCFT) and the superficial cervical muscle strength. After the intervention, the experimental group had a 56.48 point improvement in the performance index of the CCFT (Pcervical muscle functions. This study confirmed that the 6-week progressive shoulder-neck exercise program can effectively improve cervical muscle function in middle-aged and senior patients with chronic neck pain. Progressive shoulder-neck exercise might provide positive effect on deep and superficial neck muscle strength in patients with chronic neck pain. Therefore, this study may serve as a reference for the clinical rehabilitation of patients with chronic neck pain.

Prediction of Neck Dissection Requirement After Definitive Radiotherapy for Head-and-Neck Squamous Cell Carcinoma

International Nuclear Information System (INIS)

Thariat, Juliette; Ang, K. Kian; Allen, Pamela K.; Ahamad, Anesa; Williams, Michelle D.; Myers, Jeffrey N.; El-Naggar, Adel K.; Ginsberg, Lawrence E.; Rosenthal, David I.; Glisson, Bonnie S.; Morrison, William H.; Weber, Randal S.; Garden, Adam S.

2012-01-01

Background: This analysis was undertaken to assess the need for planned neck dissection in patients with a complete response (CR) of involved nodes after irradiation and to determine the benefit of a neck dissection in those with less than CR by tumor site. Methods: Our cohort included 880 patients with T1-4, N1-3M0 squamous cell carcinoma of the oropharynx, larynx, or hypopharynx who received treatment between 1994 and 2004. Survival curves were calculated by the Kaplan-Meier Method, comparisons of rates with the log–rank test and prognostic factors by Cox's proportional hazard model. Results: Nodal CR occurred in 377 (43%) patients, of whom 365 patients did not undergo nodal dissection. The 5-year actuarial regional control rate of patients with CR was 92%. Two hundred sixty-eight of the remaining patients (53%) underwent neck dissections. The 5-year actuarial regional control rate for patients without a CR was 84%. Those who had a neck dissection fared better with 5-year actuarial regional control rates of 90% and 76% for those operated and those not operated (p < 0.001). Variables associated with poorer regional control rates included higher T and N stage, non-oropharynx cancers, non-CR, both clinical and pathological. Conclusions: With 92% 5-year neck control rate without neck dissection after CR, there is little justification for systematic neck dissection. The addition of a neck dissection resulted in higher neck control after partial response though patients with viable tumor on pathology specimens had poorer outcomes. The identification of that subgroup that benefits from additional treatment remains a challenge.

Neck muscle fatigue alters the cervical flexion relaxation ratio in sub-clinical neck pain patients.

Science.gov (United States)

Zabihhosseinian, Mahboobeh; Holmes, Michael W R; Ferguson, Brad; Murphy, Bernadette

2015-06-01

The cervical flexion relaxation ratio is lower in neck pain patients compared to healthy controls. Fatigue modulates the onset and offset angles of the silent period in both the lumbar and cervical spine in healthy individuals; however, this response has not been studied with neck pain patients. The purpose of this study was to determine if cervical extensor fatigue would alter the parameters of the cervical flexion relaxation more in a neck pain group than a healthy control group. Thirteen healthy and twelve neck pain patients participated. Cervical extensor activity was examined bilaterally and kinematics of the neck and head were collected. An isometric, repetitive neck extension task at 70% of maximum elicited fatigue. Participants performed 3 trials of maximal cervical flexion both pre and post fatigue. The healthy controls and neck pain groups fatigued after 56 (41) and 39 (31) repetitions, respectively. There was a significant interaction effect for the flexion relaxation ratio between the control and neck pain groups from pre to post fatigue trials (F1,96=22.67, P=0.0001), but not for onset and offset angles (F1, 96=0.017, P=0.897), although the onset and offset angles did decrease significantly for both groups following fatigue (F1,96=9.26, P=0.002). Individuals with mild to moderate neck pain have significant differences in their neuromuscular control relative to controls, experienced myoelectric fatigue with fewer repetitions in a shorter time, had a lower cervical flexion relaxation ratio at baseline and had an inability to decrease this ratio further in response to fatigue. Copyright © 2015 Elsevier Ltd. All rights reserved.

The burden of neck pain: its meaning for persons with neck pain and healthcare providers, explored by concept mapping.

Science.gov (United States)

van Randeraad-van der Zee, Carlijn H; Beurskens, Anna J H M; Swinkels, Raymond A H M; Pool, Jan J M; Batterham, Roy W; Osborne, Richard H; de Vet, Henrica C W

2016-05-01

To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the frequently used Neck Disability Index (NDI). Concept mapping, combining qualitative (nominal group technique and group consensus) and quantitative research methods (cluster analysis and multidimensional scaling), was applied to groups of persons with neck pain (n = 3) and professionals treating persons with neck pain (n = 2). Group members generated statements, which were organized into concept maps. Group members achieved consensus about the number and description of domains and the researchers then generated an overall mind map covering the full breadth of the burden of neck pain. Concept mapping revealed 12 domains of burden of neck pain: impaired mobility neck, neck pain, fatigue/concentration, physical complaints, psychological aspects/consequences, activities of daily living, social participation, financial consequences, difficult to treat/difficult to diagnose, difference of opinion with care providers, incomprehension by social environment, and how person with neck pain deal with complaints. All ten items of the NDI could be linked to the mind map, but the NDI measures only part of the burden of neck pain. This study revealed the relevant domains for the burden of neck pain from the viewpoints of persons with neck pain and their care providers. These results can guide the identification of existing measurements instruments for each domain or the development of new ones to measure the burden of neck pain.

Diagnostic Value of the Updated Diamond and Forrester Score to Predict Coronary Artery Disease in Patients with Acute-Onset Chest Pain

DEFF Research Database (Denmark)

Sørgaard, Mathias; Linde, Jesper James; Kofoed, Klaus Fuglsang

2016-01-01

OBJECTIVES: In the recently updated clinical guidelines from the European Society of Cardiology on the management of stable coronary artery disease (CAD), the updated Diamond Forrester score has been included as a pretest probability (PTP) score to select patients for further diagnostic testing. ...... useful tool in risk-stratifying patients with acute-onset chest pain at a low-to-intermediate risk of having CAD. Adding a stress test to PTP does not appear to offer significant diagnostic benefit.......OBJECTIVES: In the recently updated clinical guidelines from the European Society of Cardiology on the management of stable coronary artery disease (CAD), the updated Diamond Forrester score has been included as a pretest probability (PTP) score to select patients for further diagnostic testing. We...... investigated the validity of the new guidelines in a population of patients with acute-onset chest pain. METHODS: We examined 527 consecutive patients with either an exercise-ECG stress test or single-photon emission computed tomography, and subsequently coronary computed tomography angiography (CCTA). We...

Effects of neck exercise on high-school students' neck-shoulder posture.

Science.gov (United States)

Lee, Myoung-Hyo; Park, Su-Jin; Kim, Jin-Sang

2013-05-01

[Purpose] This study examined the effects of deep flexor muscle-strengthening exercise on the neck-shoulder posture, and the strength and endurance of the deep flexor muscles of high-school students. [Subjects] The subjects were 30 seventeen-year-old female high-school students who complained about bad posture and chronic neck-shoulder pain. They were randomly divided into an experimental group of 15 subjects, who performed a deep flexor muscle-strengthening exercise and a control group of 15 subjects, who performed a basic stretching exercise. [Methods] The experimental group of 15 subjects performed a deep flexor muscle-strengthening exercise consisting of low-load training of the cranio-cervical flexor muscle, and the control group of 15 subjects performed a basic stretching exercise consisting of seven motions. [Results] The experimental group showed statistically significant changes in head tilt angle, neck flexion angle, forward shoulder angle, and the result of the cranio-cervical flexion test after the training. In contrast, the control group showed no statistically significant changes in these measures following the training. When the results of the groups were compared, statistically significant differences were found for all items between the experimental group and the control group. [Conclusion] Strengthening cranio-cervical flexor muscles is important for the adjustment of neck posture, and maintaining their stability is required to improve neck-shoulder posture.

Information report by the Commission for European Affairs about energy transition in the European Union. Nr 596

International Nuclear Information System (INIS)

Michels, Thierry

2018-01-01

In order to deal with the issue of energy transition, the European Commission has implemented a complete reworking of the European climate and energy framework, by updating certain existing legislative texts and by putting forward several new ones. In this context, this report first gives an overview of the issue of climate change, and outlines that the struggle against it is a necessity and an obligation, and even a moral one after the US withdrawal from the Paris agreement. In the second part, the author discusses the perfectible efficiency of European regulations related to energy and climate issues, and outlines remaining obstacles and weaknesses for the implementation of an efficient policy. In the third part, he defines a set of axes of action aimed at improving European objectives and make them in compliance with the Paris agreement: to define a floor price for carbon, to strengthen solidarity between member States, to introduce a framework which would suit innovation development and would make citizen empowerment possible, to ensure a financing which would match challenges, and to systematically integrate renewable energies into negotiations

European Economics, Update. Another Ten Theses on the Economic Integration

Directory of Open Access Journals (Sweden)

Liviu C. ANDREI

2010-10-01

Full Text Available These theses, in their enunciation and debate sound like:I. There are both “incipient” and “advanced” integration processes; II. Integration changes its outline; III. There is also the „second European economics”; IV. The Communitarz Agricultural Programme (CAP, as a “mettre à l’abîme” of the whole integration process; V. The national economies convergency reads the condition of the Union itself; VI. The EU budget might be a political stake; VII. The European Monetary System (EMS is a... paradox; VIII. The public economy might be a “thorn in the unique market’s eye”; IX, Is the economic integration predestined to an unachieved strategy example?! X. Beyond all skepticism, it would be better out of the (need of integration.All of these above try to describe the picture of a half century process, in Europe. Plus, this tries to explain why Europe is different from the rest of the world, not necessarily more or less developed or well to do, as for a usual pattern.

Neck pain or spasms - self care

Science.gov (United States)

Pain - neck - self-care; Neck stiffness - self-care; Cervicalgia - self-care; Whiplash - self-care ... some pharmacies or retail stores. Ask your health care provider about using a soft neck collar to ...

''Watch-and-see'' policy for the clinically positive neck in head and neck cancer treated with chemoradiotherapy

International Nuclear Information System (INIS)

Homma, Akihiro; Furuta, Yasushi; Oridate, Nobuhiko

2006-01-01

Chemoradiotherapy (CRT) is becoming more widely used for head and neck cancer. However, there are conflicting theories regarding the best management options for patients with advanced nodal disease. From 1990 to 1999, we treated 96 patients with N1-N2 neck disease by concomitant CRT for organ preservation, using weekly carboplatin or a low daily dose of cisplatin, followed by a ''watch-and-see'' policy for the neck. In the present study, we retrospectively analyzed the treatment outcome in 63 of these patients who received definitive CRT for primary and neck diseases and were monitored for neck disease for more than 2 years. In 12 of the 22 (55%) N1 patients, CRT successfully controlled the neck disease. CRT was successful in 18 of the 41(44%) patients with N2 disease. In 6 (60%) of 10 patients with residual or recurrent N1 disease, salvage surgery was successful. Of the 23 patients with residual or recurrent N2 disease, salvage surgery was successful in 8 patients (35%). The group of patients who showed a clinical complete response (CCR) to CRT had an overall survival rate of 62.4% (33 patients), whereas for those with a less than complete response (< CCR), the figure was 13.3% (30 patients; P<0.001). Among the < CCR-neck group, patients who underwent neck dissection (ND) as well (n=20) did not have a significantly better overall survival than those who did not undergo ND (n=10; P=0.069). We propose a treatment plan for neck disease that involves observing the neck closely following CRT. ND should be planned only when there is evidence that neck disease exists. (author)

Treatment of neglected femoral neck fracture

Directory of Open Access Journals (Sweden)

Anil K Jain

2015-01-01

Full Text Available Intra-capsular femoral neck fractures are seen commonly in elderly people following a low energy trauma. Femoral neck fracture has a devastating effect on the blood supply of the femoral head, which is directly proportional to the severity of trauma and displacement of the fracture. Various authors have described a wide array of options for treatment of neglected/nonunion (NU femoral neck fracture. There is lack of consensus in general, regarding the best option. This Instructional course article is an analysis of available treatment options used for neglected femoral neck fracture in the literature and attempt to suggest treatment guides for neglected femoral neck fracture. We conducted the "Pubmed" search with the keywords "NU femoral neck fracture and/or neglected femoral neck fracture, muscle-pedicle bone graft in femoral neck fracture, fibular graft in femoral neck fracture and valgus osteotomy in femoral neck fracture." A total of 203 print articles were obtained as the search result. Thirty three articles were included in the analysis and were categorized into four subgroups based on treatment options. (a treated by muscle-pedicle bone grafting (MPBG, (b closed/open reduction internal fixation and fibular grafting (c open reduction and internal fixation with valgus osteotomy, (d miscellaneous procedures. The data was pooled from all groups for mean neglect, the type of study (prospective or retrospective, classification used, procedure performed, mean followup available, outcome, complications, and reoperation if any. The outcome of neglected femoral neck fracture depends on the duration of neglect, as the changes occurring in the fracture area and fracture fragments decides the need and type of biological stimulus required for fracture union. In stage I and stage II (Sandhu′s staging neglected femoral neck fracture osteosynthesis with open reduction and bone grafting with MPBG or Valgus Osteotomy achieves fracture union in almost 90

Self-designed femoral neck guide pin locator for femoral neck fractures.

Science.gov (United States)

Xia, Shengli; Wang, Ziping; Wang, Minghui; Wu, Zuming; Wang, Xiuhui

2014-01-01

Closed reduction and fixation with 3 cannulated screws is a widely accepted surgery for the treatment of femoral neck fractures. However, how to obtain optimal screw placement remains unclear. In the current study, the authors designed a guide pin positioning system for femoral neck fracture cannulated screw fixation and examined its application value by comparing it with freehand guide needle positioning and with general guide pin locator positioning provided by equipment manufacturers. The screw reset rate, screw parallelism, triangle area formed by the link line of the entry point of 3 guide pins, and maximum vertical load bearing of the femoral neck after internal fixation were recorded. As expected, the triangle area was largest in the self-designed positioning group, followed by the general positioning group and the freehand positioning group. The difference among the 3 groups was statistically significant (P.05). The authors’ self-designed guide pin positioning system has the potential to accurately insert cannulated screws in femoral neck fractures and may reduce bone loss and unnecessary radiation.

9th annual European Antibody Congress, November 11-13, 2013, Geneva, Switzerland.

Science.gov (United States)

Reichert, Janice M; Beck, Alain; Lugovskoy, Alexey A; Wurch, Thierry; Coats, Steven; Brezski, Randall J

2014-01-01

The annual European Antibody Congress (EAC) has traditionally been the key event for updates on critical scientific advances in the antibody field, and 2013 was no exception. Organized by Terrapinn, the well-attended meeting featured presentations on considerations for developing antibodies and antibody-like therapeutics, with separate tracks for antibody-drug conjugates, naked antibodies, and multispecific antibodies or protein scaffolds. The overall focus of the EAC was current approaches to enhance the functionality of therapeutic antibodies or other targeted proteins, with the ultimate goal being improvement of the safety and efficacy of the molecules as treatments for cancer, immune-mediated disorders and other diseases. Roundtable discussion sessions gave participants opportunities to engage in group discussions with industry leaders from companies such as Genmab, Glenmark Pharmaceuticals, MedImmune, Merrimack Pharmaceuticals, and Pierre Fabre. As the 2013 EAC was co-located with the World Biosimilar Congress, participants also received an update on European Medicines Agency guidelines and thoughts on the future direction and development of biosimilar antibodies in the European Union.

Quantitative Ultrasonic Nakagami Imaging of Neck Fibrosis After Head and Neck Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Yang, Xiaofeng [Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Yoshida, Emi [Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California (United States); Cassidy, Richard J.; Beitler, Jonathan J.; Yu, David S.; Curran, Walter J. [Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Liu, Tian, E-mail: tliu34@emory.edu [Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States)

2015-06-01

Purpose: To investigate the feasibility of ultrasound Nakagami imaging to quantitatively assess radiation-induced neck fibrosis, a common sequela of radiation therapy (RT) to the head and neck. Methods and Materials: In a pilot study, 40 study participants were enrolled and classified into 3 subgroups: (1) a control group of 12 healthy volunteers; (2) an asymptomatic group of 11 patients who had received intensity modulated RT for head and neck cancer and had experienced no neck fibrosis; and (3) a symptomatic group of 17 post-RT patients with neck fibrosis. Each study participant underwent 1 ultrasound study in which scans were performed in the longitudinal orientation of the bilateral neck. Three Nakagami parameters were calculated to quantify radiation-induced tissue injury: Nakagami probability distribution function, shape, and scaling parameters. Physician-based assessments of the neck fibrosis were performed according to the Radiation Therapy Oncology Group late morbidity scoring scheme, and patient-based fibrosis assessments were rated based on symptoms such as pain and stiffness. Results: Major discrepancies existed between physician-based and patient-based assessments of radiation-induced fibrosis. Significant differences in all Nakagami parameters were observed between the control group and 2 post-RT groups. Moreover, significant differences in Nakagami shape and scaling parameters were observed among asymptomatic and symptomatic groups. Compared with the control group, the average Nakagami shape parameter value increased by 32.1% (P<.001), and the average Nakagami scaling parameter increased by 55.7% (P<.001) for the asymptomatic group, whereas the Nakagami shape parameter increased by 74.1% (P<.001) and the Nakagami scaling parameter increased by 83.5% (P<.001) for the symptomatic group. Conclusions: Ultrasonic Nakagami imaging is a potential quantitative tool to characterize radiation-induced asymptomatic and symptomatic neck fibrosis.

Is Planned Neck Dissection Necessary for Head and Neck Cancer After Intensity-Modulated Radiotherapy?

International Nuclear Information System (INIS)

Yao Min; Hoffman, Henry T.; Chang, Kristi; Funk, Gerry F.; Smith, Russell B.; Tan Huaming; Clamon, Gerald H.; Dornfeld, Ken; Buatti, John M.

2007-01-01

Purpose: The objective of this study was to determine regional control of local regional advanced head and neck squamous cell carcinoma (HNSCC) treated with intensity-modulated radiotherapy (IMRT), along with the role and selection criteria for neck dissection after IMRT. Methods and Materials: A total of 90 patients with stage N2A or greater HNSCC were treated with definitive IMRT from December 1999 to July 2005. Three clinical target volumes were defined and were treated to 70 to 74 Gy, 60 Gy, and 54 Gy, respectively. Neck dissection was performed for selected patients after IMRT. Selection criteria evolved during this period with emphasis on post-IMRT [ 18 F] fluorodeoxyglucose positron emission tomography in recent years. Results: Median follow-up for all patients was 29 months (range, 0.2-74 months). All living patients were followed at least 9 months after completing treatment. Thirteen patients underwent neck dissection after IMRT because of residual lymphadenopathy. Of these, 6 contained residual viable tumor. Three patients with persistent adenopathy did not undergo neck dissection: 2 refused and 1 had lung metastasis. Among the remaining 74 patients who were observed without neck dissection, there was only 1 case of regional failure. Among all 90 patients in this study, the 3-year local and regional control was 96.3% and 95.4%, respectively. Conclusions: Appropriately delivered IMRT has excellent dose coverage for cervical lymph nodes. A high radiation dose can be safely delivered to the abnormal lymph nodes. There is a high complete response rate. Routine planned neck dissection for patients with N2A and higher stage after IMRT is not necessary. Post-IMRT [ 18 F] fluorodeoxyglucose positron emission tomography is a useful tool in selecting patients appropriate for neck dissection

Quantitative Ultrasonic Nakagami Imaging of Neck Fibrosis After Head and Neck Radiation Therapy

International Nuclear Information System (INIS)

Yang, Xiaofeng; Yoshida, Emi; Cassidy, Richard J.; Beitler, Jonathan J.; Yu, David S.; Curran, Walter J.; Liu, Tian

2015-01-01

Purpose: To investigate the feasibility of ultrasound Nakagami imaging to quantitatively assess radiation-induced neck fibrosis, a common sequela of radiation therapy (RT) to the head and neck. Methods and Materials: In a pilot study, 40 study participants were enrolled and classified into 3 subgroups: (1) a control group of 12 healthy volunteers; (2) an asymptomatic group of 11 patients who had received intensity modulated RT for head and neck cancer and had experienced no neck fibrosis; and (3) a symptomatic group of 17 post-RT patients with neck fibrosis. Each study participant underwent 1 ultrasound study in which scans were performed in the longitudinal orientation of the bilateral neck. Three Nakagami parameters were calculated to quantify radiation-induced tissue injury: Nakagami probability distribution function, shape, and scaling parameters. Physician-based assessments of the neck fibrosis were performed according to the Radiation Therapy Oncology Group late morbidity scoring scheme, and patient-based fibrosis assessments were rated based on symptoms such as pain and stiffness. Results: Major discrepancies existed between physician-based and patient-based assessments of radiation-induced fibrosis. Significant differences in all Nakagami parameters were observed between the control group and 2 post-RT groups. Moreover, significant differences in Nakagami shape and scaling parameters were observed among asymptomatic and symptomatic groups. Compared with the control group, the average Nakagami shape parameter value increased by 32.1% (P<.001), and the average Nakagami scaling parameter increased by 55.7% (P<.001) for the asymptomatic group, whereas the Nakagami shape parameter increased by 74.1% (P<.001) and the Nakagami scaling parameter increased by 83.5% (P<.001) for the symptomatic group. Conclusions: Ultrasonic Nakagami imaging is a potential quantitative tool to characterize radiation-induced asymptomatic and symptomatic neck fibrosis

Version 2.0 of the European Gas Model. Changes and their impact on the German gas sector

International Nuclear Information System (INIS)

Balmert, David; Petrov, Konstantin

2015-01-01

In January 2015 ACER, the European Agency for the Cooperation of Energy Regulators, presented an updated version of its target model for the inner-European natural gas market, also referred to as version 2.0 of the Gas Target Model. During 2014 the existing model, originally developed by the Council of European Energy Regulators (CEER) and launched in 2011, had been analysed, revised and updated in preparation of the new version. While it has few surprises to offer, the new Gas Target Model contains specifies and goes into greater detail on many elements of the original model. Some of the new content is highly relevant to the German gas sector, not least the deliberations on the current key issues, which are security of supply and the ability of the gas markets to function.

Confirmatory factory analysis of the Neck Disability Index in a general problematic neck population indicates a one-factor model.

Science.gov (United States)

Gabel, Charles Philip; Cuesta-Vargas, Antonio I; Osborne, Jason W; Burkett, Brendan; Melloh, Markus

2014-08-01

The Neck Disability Index frequently is used to measure outcomes of the neck. The statistical rigor of the Neck Disability Index has been assessed with conflicting outcomes. To date, Confirmatory Factor Analysis of the Neck Disability Index has not been reported for a suitably large population study. Because the Neck Disability Index is not a condition-specific measure of neck function, initial Confirmatory Factor Analysis should consider problematic neck patients as a homogenous group. We sought to analyze the factor structure of the Neck Disability Index through Confirmatory Factor Analysis in a symptomatic, homogeneous, neck population, with respect to pooled populations and gender subgroups. This was a secondary analysis of pooled data. A total of 1,278 symptomatic neck patients (67.5% female, median age 41 years), 803 nonspecific and 475 with whiplash-associated disorder. The Neck Disability Index was used to measure outcomes. We analyzed pooled baseline data from six independent studies of patients with neck problems who completed Neck Disability Index questionnaires at baseline. The Confirmatory Factor Analysis was considered in three scenarios: the full sample and separate sexes. Models were compared empirically for best fit. Two-factor models have good psychometric properties across both the pooled and sex subgroups. However, according to these analyses, the one-factor solution is preferable from both a statistical perspective and parsimony. The two-factor model was close to significant for the male subgroup (pfactor structure when analyzed by Confirmatory Factor Analysis in a pooled, homogenous sample of neck problem patients. However, a two-factor model did approach significance for male subjects where questions separated into constructs of mental and physical function. Further investigations in different conditions, subgroup and sex-specific populations are warranted. Copyright © 2014 Elsevier Inc. All rights reserved.

Merkel cell carcinoma of the head and neck: poorer prognosis than non-head and neck sites.

Science.gov (United States)

Morand, G B; Madana, J; Da Silva, S D; Hier, M P; Mlynarek, A M; Black, M J

2016-04-01

Merkel cell carcinoma is a rare, aggressive neurocutaneous malignancy. This study investigated whether patients with Merkel cell carcinoma in the head and neck had poorer outcomes than patients with Merkel cell carcinoma located elsewhere. A retrospective study was performed of patients with Merkel cell carcinoma treated at the Jewish General Hospital in Montréal, Canada, from 1993 to 2013. Associations between clinicopathological characteristics and disease-free and disease-specific survival rates were examined according to the Kaplan-Meier method. Twenty-seven patients were identified. Although basic clinicopathological characteristics and treatments were similar between head and neck and non-head and neck Merkel cell carcinoma groups, disease-free and disease-specific survival rates were significantly lower in the head and neck Merkel cell carcinoma group (log-rank test; p = 0.043 and p = 0.001, respectively). Mortality was mainly due to distant metastasis. Patients with head and neck Merkel cell carcinoma had poorer survival rates than patients with non-head and neck Merkel cell carcinoma in our study. The tendency to obtain close margins, a less predictable metastatic pattern, and/or intrinsic tumour factors related to the head and neck may explain this discrepancy.

Congenital neck masses.

Science.gov (United States)

Rosa, Peter A; Hirsch, David L; Dierks, Eric J

2008-08-01

Congenital neck lesions reflect abnormal embryogenesis in head and neck development. A thorough knowledge of embryology and anatomy is critical in the diagnosis and treatment of these lesions. The appropriate diagnosis of these lesions is necessary to provide appropriate treatment and long-term follow up, because some of these lesions may undergo malignant transformation or be harbingers of malignant disease.

Innovation Policy of the European Union: Concept Strategic Update and Instruments Improvement

Directory of Open Access Journals (Sweden)

Belal Hassouna

2013-01-01

Full Text Available The article characterizes formation of EU innovation policy and its conceptual update, which has strategic character and is concerned with the social and economic model change, determines differences between EU innovation policy and national politics and the forms of its implementation, detects major changes of EU innovation policy instruments, which were the result of support concept and innovation regulations change.

Clinical analysis of neck dissection patients

International Nuclear Information System (INIS)

Sato, Katsuro; Takahashi, Sugata

2008-01-01

Neck dissection is a highly important surgical procedure in the treatment of squamous cell carcinoma (SCC) of the head and neck since the control of the nodal disease is highly important in these patients. In this paper, 131 patients (210 necks) treated in our department were analyzed. The most frequent primary lesion site was the oral cavity, followed by larynx, hypopharynx and mesopharynx, and treatment of metastatic nodes was considered important especially in patients with SCC in those regions. As the surgical procedure for neck dissection, (modified) radical neck dissection was chosen for higher N stage cases, although it was also applied to lower N stage cases. Postoperative irradiation was performed for 70% of the patients, and control of the neck was considered good as recurrent neck disease occurred in 8% of the patients, and only 20% of those died of recurrent neck disease. The most common primary site showing cervical recurrence was the oral cavity, and control of neck disease is considered important, especially in patients with SCC of the oral cavity. Patients with ≤number of pN 1 receiving postoperative irradiation, and patients with pN (-) and ≤number of pN 1 without postoperative irradiation showed significantly higher survival rates. Postoperative irradiation should be done for patients with ≥number of pN 2, and follow-up without postoperative treatment should be considered for the cases of ≤number of pN 1. Further consideration of patient selection with regard to the area of dissection and the indication for postoperative irradiation without decreasing the survival rate is needed to further improve the treatment of head and neck SCCs. (author)

Subcutaneous fibrosis after whole neck irradiation

International Nuclear Information System (INIS)

Hirota, Saeko; Tsujino, Kayoko; Oshitani, Takashi; Hishikawa, Yoshio; Takada, Yoshiki; Kono, Michio; Abe, Mitsuyuki

2002-01-01

Purpose: To identify the risk factors for moderate to severe subcutaneous fibrosis after whole neck irradiation. Methods and Materials: We analyzed 233 cases of patients who had undergone whole neck irradiation with 4-MV X-ray or 8-10-MeV electrons, or both, and had been followed with regard to their skin condition for at least 1 year. The prescribed dose to the whole neck ranged from 19.2 to 72.4 Gy (median 50). The skin-absorbed dose was specified as that at a depth of 4.1 mm (d4.1-mm depth ), and a biologically equivalent dose (BED) of d4.1-mm depth was also estimated (BED 1.8 4.1-mm depth ). Results: Univariate analysis revealed that previous neck dissection, concurrent chemotherapy, corticosteroid administration as a part of chemotherapy, fractionation, and BED 1.8 4.1-mm depth were significant prognostic variables. Multivariate analysis showed that BED 1.8 4.1-mm depth and previous neck dissection were the only prognostic variables for moderate to severe subcutaneous fibrosis. Conclusion: A high dose to a 4.1-mm depth of the skin and a history of neck dissection were identified as the predominant risk factors for moderate to severe subcutaneous fibrosis after whole neck irradiation. A subcutaneous dose should be considered in radiotherapy treatment planning involving the whole neck, especially in cases in which patients have undergone previous neck dissection

Neck pain in different cephalalgias

Directory of Open Access Journals (Sweden)

E. A. Chechet

2014-01-01

Full Text Available The paper reviews the literature related to the investigations of neck pain (cervicalgia in patients with headache (cephalalgia. Neck pain is second to lower back pain as a reason for considerable socioeconomic damage to society. The prevalence of cervicalgia in the population ranges from 5.9 to 38%; the annual incidence is 10.4–21.3%; 14.2 to 71% of people report to have neck pain at some time in their lifetime. Neck pain is concurrent with cephalalgia in 70% of cases. In patients with cervicalgia, the prevalence of headache is 20–40% higher than in those with musculoskeletal pain at another site. Neck pain is as a major risk factor for migraine and tension headache (TH. Neck pain in TH progresses with the increased intensity, frequency, and strength of headache. There is a direct relationship of the quality of life worsening associated withcervicalgia to the frequency of migraine attacks and the risk of its chronization. Neck pain is noted in cervicogenic headache belonging to secondary headaches. The identification of mixed headache in a patient with cervicalgia allows the prescription of a treatment option that may be effective in relieving both headache and neck pain. The paper discusses the causes and pathogenesis of cervicalgia in patients with headache, examination methods, and main approaches to drug and nondrug therapies in relation to the leading pathophysiological mechanism, as well as new possibilities for the effective and safe relief of pain syndrome in this category of patients. Nonsteroidal anti-inflammatory drugs, myorelaxants,and their combination are observed to be effective in treating patients with cervicalgia and cephalalgia.

The European Cancer Patient's Bill of Rights, update and implementation 2016

DEFF Research Database (Denmark)

Højgaard, Liselotte; Löwenberg, Bob; Selby, Peter

2016-01-01

.The right of every European citizen to optimal and timely access to a diagnosis and to appropriate specialised care, underpinned by research and innovation.The right of every European citizen to receive care in health systems that ensure the best possible cancer prevention, the earliest possible diagnosis...... of their cancer, improved outcomes, patient rehabilitation, best quality of life and affordable health care. The key aspects of working towards implementing the BoR are:Agree our high-level goal. The vision of 70% long-term survival for patients with cancer in 2035, promoting cancer prevention and cancer control...... on improving outcomes; (3) Improving access to new and established cancer care by sharing best practice in the development, approval, procurement and reimbursement of cancer diagnostic tests and treatments.Work with other organisations to bring into being a Europe based centre that will (1) systematically...

Thyroid Emphysema Following Penetrating Neck Trauma

Directory of Open Access Journals (Sweden)

Demet Karadağ

2011-03-01

Full Text Available Although traumatic thyroid gland rupture or hemorrhage is usually seen in goitrous glands, injuries of the normal thyroid gland after neck trauma have rarely been described in the literature. We describe a 44-year-old man who presented with thyroid emphysema and subcutaneous emphysema (SCE that occurred after penetrating neck trauma. CT images showed complete resolution of thyroid emphysema and subcutaneous emphysema at follow-up examination. Neck injuries can be life threatening. After penetrating neck traumas, physicians should consider subtle esophageal or tracheal laceration. Thyroid emphysema can occur as the result of penetrating neck trauma. The mechanism of emphysema of the thyroid parenchyma can be explained by the thyroid gland’s presence in a single visceral compartment that encompasses the larynx, trachea and thyroid gland. We describe an unusual case of thyroid emphysema of a normal thyroid gland following a penetrating neck injury.

The variation of the strength of neck extensor muscles and semispinalis capitis muscle size with head and neck position.

Science.gov (United States)

Rezasoltani, A; Nasiri, R; Faizei, A M; Zaafari, G; Mirshahvelayati, A S; Bakhshidarabad, L

2013-04-01

Semispinalis capitis muscle (SECM) is a massive and long cervico-thoracic muscle which functions as a main head and neck extensor muscle. The aim of this study was to detect the effect of head and neck positions on the strength of neck extensor muscles and size of SECM in healthy subjects. Thirty healthy women students voluntarily participated in this study. An ultrasonography apparatus (Hitachi EUB 525) and a system of tension-meter were used to scan the right SECM at the level of third cervical spine and to measure the strength of neck extensor muscles at three head and neck positions. Neck extensor muscles were stronger in neutral than flexion or than extension positions while the size of SECM was larger in extension than neutral or than flexion position. The force generation capacity of the main neck extensor muscle was lower at two head and neck flexion and extension positions than neutral position. Copyright © 2012 Elsevier Ltd. All rights reserved.

Predictors of incident and persistent neck/shoulder pain in Iranian workers: a cohort study.

Directory of Open Access Journals (Sweden)

Farideh Sadeghian

Full Text Available Pain in the neck and shoulder has been linked with various psychosocial risk factors, as well as with occupational physical activities. However, most studies to date have been cross-sectional, making it difficult to exclude reverse causation. Moreover, they have been carried out largely in northern Europe, and the relationship to psychosocial factors might be different in other cultural environments.To explore causes of neck/shoulder pain, we carried out a longitudinal study in Iranian nurses and office workers. Participants (n =383 completed a baseline questionnaire about neck/shoulder pain in the past month and possible risk factors, and were again asked about pain 12 months later. Associations with pain at follow-up were explored by Poisson regression and summarised by prevalence rate ratios (PRRs.After adjustment for other risk factors, new pain at follow-up was more frequent in office workers than nurses (PRR 1.9, 95%CI 1.3-2.8, among those with worst mental health (PRR 1.8, 95%CI 1.0-3.0, in those who reported incentives from piecework or bonuses (PRR1.4, 95%CI 1.0-2.0, and in those reporting job dissatisfaction (PRR 1.5, 95%CI 1.0-2.1. The strongest predictor of pain persistence was somatising tendency.Our findings are consistent with a hazard of neck/shoulder pain from prolonged use of computer keyboards, although it is possible that the association is modified by health beliefs and expectations. They also indicate that the association of low mood with neck/shoulder pain extends to non-European populations, and is not entirely attributable to reverse causation. Psychosocial aspects of work appeared to have relatively weak impact.

Pitfalls in neck imaging

International Nuclear Information System (INIS)

Gay, S.B.; Phillips, C.D.; Cornett, J.B.

1991-01-01

CT and MR imaging have become effective imaging modalities in the evaluation of primary head and neck neoplasms. As radiologists have gained experience in head and neck imaging, certain pitfalls have become evident. Identification of pathologic lymph nodes is the critical element in staging neoplasms of the head and neck. The diagnosis of cervical lymphadenopathy may be complicated by confusion with normal structures, inadequate contrast opacification of vascular structures, and poor scanning technique. This paper illustrates these potential problem areas on both CT and MR images and offers the authors' approach to further evaluation in problem cases

Morbidity after neck dissection in head and neck cancer patients : a study describing shoulder and neck complaints, and quality of life

NARCIS (Netherlands)

Wilgen, Cornelis Paul van

2004-01-01

In this thesis we are aiming at more insight in morbidity after head and neck cancer treatment (resection of the primary tumour, neck dissection and pre-or post-operative radiation therapy). We will study shoulder complaints and the role of the spinal accessory nerve, pain and the underlying pain

Clinical analysis of deep neck space infections

International Nuclear Information System (INIS)

Hatano, Atsushi; Ui, Naoya; Shigeta, Yasushi; Iimura, Jiro; Rikitake, Masahiro; Endo, Tomonori; Kimura, Akihiro

2009-01-01

Deep neck space infections, which affect soft tissues and fascial compartments of the head and neck, can lead to lethal complications unless treated carefully and quickly, even with the advanced antibiotics available. We reviewed our seventeen patients with deep neck abscesses, analyzed their location by reviewing CT images, and discussed the treatment. Deep neck space infections were classified according to the degree of diffusion of infection diagnosed by CT images. Neck space infection in two cases was localized to the upper neck space above the hyoid bone (Stage I). Neck space infection in 12 cases extended to the lower neck space (Stage II), and further extended to the mediastinum in one case (Stage III). The two cases of Stage I and the four cases of Stage II were managed with incision and drainage through a submental approach. The seven cases of Stage II were managed with incision and drainage parallel to the anterior border of the sternocleidomastoid muscle, the ''Dean'' approach. The one case of Stage III received treatment through transcervicotomy and anterior mediastinal drainage through a subxiphodal incision. The parapharyngeal space played an important role in that the inflammatory change can spread to the neck space inferiorly. The anterior cervical space in the infrahyoid neck was important for mediastinal extension of parapharyngeal abscesses. It is important to diagnose deep neck space infections promptly and treat them adequately, and contrast-enhanced CT is useful and indispensable for diagnosis. The point is which kind of drainage has to be performed. If the surgical method of drainage is chosen according to the level of involvement in the neck space and mediastinum, excellent results may be obtained in terms of survival and morbidity. (author)

Passive Nuclear Plants Program (UPDATE)

International Nuclear Information System (INIS)

Chimeno, M. A.

1998-01-01

The light water passive plants program (PCNP), today Advanced Nuclear Power Plants Program (PCNA), was constituted in order to reach the goals of the Spanish Electrical Sector in the field of advanced nuclear power plants, optimize the efforts of all Spanish initiatives, and increase joint presence in international projects. The last update of this program, featured in revision 5th of the Program Report, reflects the consolidation of the Spanish sector's presence in International programs of the advanced power plants on the basis of the practically concluded American ALWR program. Since the beginning of the program , the PCNP relies on financing from the Electrical sector, Ocide, SEPI-Endesa, Westinghouse, General Electric, as well as from the industrial cooperators, Initec, UTE (Initec- Empresarios Agrupados), Ciemat, Enusa, Ensa and Tecnatom. The program is made up of the following projects, already concluded: - EPRI's Advanced Light Water Plants Certification Project - Westinghouse's AP600 Project - General Electric's SBWR Project (presently paralyzed) and ABWR project Currently, the following project are under development, at different degrees of advance: - EPP project (European Passive Plant) - EBWR project (European Advanced Boiling Water Reactor)

Psychological Care, Patient Education, Orthotics, Ergonomics and Prevention Strategies for Neck Pain: An Systematic Overview Update as Part of the ICON§ Project

Science.gov (United States)

Gross, Anita R.; Kaplan, Faith; Huang, Stacey; Khan, Mahweesh; Santaguida, P. Lina; Carlesso, Lisa C.; MacDermid, Joy C.; Walton, David M.; Kenardy, Justin; Söderlund, Anne; Verhagen, Arianne; Hartvigsen, Jan

2013-01-01

Objectives: To conduct an overview on psychological interventions, orthoses, patient education, ergonomics, and 1⁰/2⁰ neck pain prevention for adults with acute-chronic neck pain. Search Strategy: Computerized databases and grey literature were searched (2006-2012). Selection Criteria: Systematic reviews of randomized controlled trials (RCTs) on pain, function/disability, global perceived effect, quality-of-life and patient satisfaction were retrieved. Data Collection & Analysis: Two independent authors selected articles, assessed risk of bias using AMSTAR tool and extracted data. The GRADE tool was used to evaluate the body of evidence and an external panel to provide critical review. Main Results: We retrieved 30 reviews (5-9 AMSTAR score) reporting on 75 RCTs with the following moderate GRADE evidence. For acute whiplash associated disorder (WAD), an education video in emergency rooms (1RCT, 405participants] favoured pain reduction at long-term follow-up thus helping 1 in 23 people [Standard Mean Difference: -0.44(95%CI: -0.66 to -0.23)). Use of a soft collar (2RCTs, 1278participants) was not beneficial in the long-term. For chronic neck pain, a mind-body intervention (2RCTs, 1 meta-analysis, 191participants) improved short-term pain/function in 1 of 4 or 6 participants. In workers, 2-minutes of daily scapula-thoracic endurance training (1RCT, 127participants) over 10 weeks was beneficial in 1 of 4 participants. A number of psychosocial interventions, workplace interventions, collar use and self-management educational strategies were not beneficial. Reviewers' Conclusions: Moderate evidence exists for quantifying beneficial and non-beneficial effects of a limited number of interventions for acute WAD and chronic neck pain. Larger trials with more rigorous controls need to target promising interventions PMID:24133554

The role of FDG PET in management of neck metastasis from head-and-neck cancer after definitive radiation treatment

International Nuclear Information System (INIS)

Yao Min; Smith, Russell B.; Graham, Michael M.; Hoffman, Henry T.; Tan Huaming; Funk, Gerry F.; Graham, Scott M.; Chang, Kristi; Dornfeld, Kenneth J.; Menda, Yusuf; Buatti, John M.

2005-01-01

Purpose: The role of neck dissection after definitive radiation for head-and-neck cancer is controversial. We select patients for neck dissection based on postradiation therapy (post-RT), computed tomography (CT), and [ 18 F] fluorodeoxyglucose positron emission tomography (FDG PET). We summarize the clinical outcomes of patients treated with this policy to further elucidate the role of FDG PET in decision making for neck dissection after primary radiotherapy. Methods and Materials: Between December 1999 and February 2004, 53 eligible patients were identified. These patients had stage N2A or higher head-and-neck squamous cell carcinoma and had complete response of the primary tumor after definitive radiation with or without chemotherapy. PET or computed tomography (CT) scans were performed within 6 months after treatment. Neck dissection was performed in patients with residual lymphadenopathy (identified by clinical examination or CT) and a positive PET scan. Those without residual lymph nodes and a negative PET were observed without neck dissection. For patients with residual lymphadenopathy, but a negative PET scan, neck dissection was performed at the discretion of the attending surgeon and decision of the patient. There was a total of 70 heminecks available for analysis (17 patients had bilateral neck disease). Results: There were 21 heminecks with residual lymphadenopathy identified on CT imaging or clinical examination and negative PET. Of these, 4 had neck dissection and were pathologically negative. The remaining 17 were observed without neck dissection. There was a total of 42 heminecks without residual lymph nodes on post-RT CT imaging or clinical examination with a negative PET. They were also observed without neck dissection. Seven heminecks had a positive PET scan and residual lymphadenopathy. Six of them had neck dissection and 1 had fine-needle aspiration of a residual node; 3 contained residual viable cancer and 4 were pathologically negative. At

"A" shape plate for open rigid internal fixation of mandible condyle neck fracture.

Science.gov (United States)

Kozakiewicz, Marcin; Swiniarski, Jacek

2014-09-01

Reduction of the fracture is crucial for proper outcome of the treatment. The stability of reduction is closed connected to the method of its fixation. The topic of condylar fracture osteosynthesis still remains highly controversial and challenging. That is why authors decided to propose novel design of the fixating plate and the example of its application. The aim of this study was to present A-shape plate dedicated to rigid fixation of mandible condyle neck fracture. A-shape condylar plate (ACP) design is prepared of 1.0 mm thick titanium alloy (grade 5) sheet: posterior and anterior bars are reinforced by widening to 2.5 mm and anatomically curved along the compression and traction lines in ramus and condylar neck. Superior three-hole-group has triangular organization and located on the level of condylar head. The inferior extensions of the bars are equipped in three holes located at each of lower tails. Connecting bar (2.0 mm wide) connects the first hole of each lower tails closing upper part of ACP in triangular shape. The connecting bar runs along compression line of condylar neck. Holes in ACP has 2.0 mm diameter for locking or normal screws. Height of ACP is 31 mm. The proposed new type of plate was compared by finite element analysis (FEA) to nowadays manufactured 9-hole trapezoid plate as the most similar device. ACP design was evaluated by finite element analysis (FEA) and later applied in patient affected with high condylar neck fracture complicated by fracture of coronoid process. FEA revealed high strength of ACP and more stabile fixation than trapezoid plate. The result was caused by multipoint fixation at three regions of the plate and reinforced bars supported by semi-horizontal connecting bar. Clinical application of ACP was as versatile as makes possible to simultaneous fixation of high condylar neck and coronoid process fracture. Application of proposed A-shape condylar plate would be possible in all levels of neck fractures and can be use

Cuba "updates" its economic model: perspectives for cooperation with the European Union

OpenAIRE

Schmieg, Evita

2017-01-01

Following the thawing of relations with the United States under Obama, Cuba is now seeking closer integration into the global economy through a programme of "guidelines" for updating the country’s economic model adopted in 2011. The central goals are increasing exports, substituting imports and encouraging foreign direct investment in order to improve the country’s hard currency situation, increase domestic value creation and reduce dependency on Venezuela. The guidelines also expand the spac...

Are People With Whiplash-Associated Neck Pain Different from People With Nonspecific Neck Pain?

DEFF Research Database (Denmark)

Anstey, Ricci; Kongsted, Alice; Kamper, Steven

2016-01-01

Study Design Secondary analysis of a prospective cohort study with cross sectional and longitudinal analyses. Background The clinical importance of a history of whiplash associated disorder (WAD) in people with neck pain remains uncertain. Objective To compare people with WAD to people with non......-specific neck pain, in terms of their baseline characteristics, and pain and disability outcomes over 1 year. Methods Consecutive patients with neck pain presenting to a secondary care spine centre answered a comprehensive self-report questionnaire and underwent a physical examination. Patients were classified...

Quality of life and neck pain in nurses

Directory of Open Access Journals (Sweden)

Lucy Joslin

2014-04-01

Full Text Available Objectives: To investigate the association between neck pain and psychological stress in nurses. Material and Methods: Nurses from the Avon Orthopaedic Centre completed 2 questionnaires: the Short Form-36 (SF-36 and 1 exploring neck pain and associated psychological stress. Results: Thirty four nurses entered the study (68% response. Twelve (35.3% had current neck pain, 13 (38.2% reported neck pain within the past year and 9 (26.5% had no neck pain. Subjects with current neck pain had significantly lower mental health (47.1 vs. 70.4; p = 0.002, physical health (60.8 vs. 76.8; p = 0.010 and overall SF-36 scores (56.8 vs. 74.9; p = 0.003. Five (41.7% subjects with current neck pain and 5 (38.5% subjects with neck pain in the previous year attributed it to psychological stress. Conclusions: Over 1/3 of nurses have symptomatic neck pain and significantly lower mental and physical health scores. Managing psychological stress may reduce neck pain, leading to improved quality of life for nurses, financial benefits for the NHS, and improved patient care.

Modeling neck mobility in fossil turtles.

Science.gov (United States)

Werneburg, Ingmar; Hinz, Juliane K; Gumpenberger, Michaela; Volpato, Virginie; Natchev, Nikolay; Joyce, Walter G

2015-05-01

Turtles have the unparalleled ability to retract their heads and necks within their shell but little is known about the evolution of this trait. Extensive analysis of neck mobility in turtles using radiographs, CT scans, and morphometry reveals that basal turtles possessed less mobility in the neck relative to their extant relatives, although the anatomical prerequisites for modern mobility were already established. Many extant turtles are able to achieve hypermobility by dislocating the central articulations, which raises cautions about reconstructing the mobility of fossil vertebrates. A 3D-model of the Late Triassic turtle Proganochelys quenstedti reveals that this early stem turtle was able to retract its head by tucking it sideways below the shell. The simple ventrolateral bend seen in this stem turtle, however, contrasts with the complex double-bend of extant turtles. The initial evolution of neck retraction therefore occurred in a near-synchrony with the origin of the turtle shell as a place to hide the unprotected neck. In this early, simplified retraction mode, the conical osteoderms on the neck provided further protection. © 2014 Wiley Periodicals, Inc.

An immediate effect of axial neck rotation training with real time visual feedback using a smartphone inclinometer on improvement in axial neck rotation function.

Science.gov (United States)

Park, Kyue-Nam; Kwon, Oh-Yun; Kim, Si-Hyun; Jeon, In-Cheol

2017-03-01

The purpose of this study was to compare the immediate effects of axial neck rotation training (Axi-NRT) with and without real-time visual feedback (VF) using a smartphone inclinometer on the range of motion (ROM) for axial neck rotation and the onset of compensatory neck lateral bending and extension during active neck rotation. Twenty participants with restricted ROM for neck rotation but no neck pain (21.1 ± 1.6 years and 8 males, 12 females) were recruited for Axi-NRT with VF, and twenty age- and gender-matched participants with restricted ROM for neck rotation were recruited for Axi-NRT without VF. Changes in ROM for neck rotation and the onset time of compensatory neck movement during active neck rotation were measured using an electromagnetic tracking system. Axi-NRT with VF was more effective in increasing ROM for neck rotation and decreasing and delaying the onset of compensatory neck movements during active neck rotation compared with Axi-NRT without VF. Repeated Axi-NRT using VF is useful to educate participants in maintaining the axis of the cervical spine and to increase ROM for axial neck rotation with less compensatory neck motion in participants with a restricted range of neck rotations.

Early-onset dropped head syndrome after radiotherapy for head and neck cancer: dose constraints for neck extensor muscles

International Nuclear Information System (INIS)

Inaba, Koji; Nakamura, Satoshi; Okamoto, Hiroyuki; Kashihara, Tairo; Kobayashi, Kazuma; Harada, Ken; Kitaguchi, Mayuka; Sekii, Shuhei; Takahashi, Kana; Murakami, Naoya; Ito, Yoshinori; Igaki, Hiroshi; Uno, Takashi; Itami, Jun

2016-01-01

Dropped head syndrome (DHS) is a famous but unusual late complication of multimodality treatment for head and neck carcinoma. We reported this early-onset complication and analyzed the dose to the neck extensor muscles. We examined the records of three patients with DHS after radiotherapy. The doses to the neck extensor muscles were compared between three patients with DHS and nine patients without DHS. The mean dose to the neck extensor muscles of the three patients with DHS were 58.5 Gy, 42.3 Gy and 60.9 Gy, while the dose was <50 Gy in all nine patients in the control group. The onset of this syndrome was 5 months, 6 months and 15 months. The early-onset DHS may have something to do with dose to the neck extensor muscles. The proposed dose to the neck extensor muscles might be <46 Gy (or at least <50 Gy)

Psychometric properties of the Neck OutcOme Score, Neck Disability Index, and Short Form-36 were evaluated in patients with neck pain.

Science.gov (United States)

Juul, Tina; Søgaard, Karen; Davis, Aileen M; Roos, Ewa M

2016-11-01

To assess reliability, construct validity, responsiveness, and interpretability for Neck OutcOme Score (NOOS), Neck Disability Index (NDI), and Short Form-36 (SF-36) in neck pain patients. Internal consistency was assessed by Cronbach alpha. Test-retest reliability was evaluated by intraclass correlation coefficient (ICC), and measurement error was estimated from the standard error of measurement. Responsiveness was assessed as standardized response mean (SRM) and interpretability from the minimal important difference (MID). Construct validity was tested correlating subscale scores from NOOS and SF-36 and NDI items. At baseline, 196 neck pain patients were included. Cronbach α was adequate for most NOOS subscales, NDI, and SF-36 with few exceptions. Good to excellent reliability was found for NOOS subscales (ICC 0.88-0.95), for NDI, and for SF-36 with few exceptions. For NOOS, minimal detectable changes varied between 1.1 and 1.9, and construct validity was supported. SRMs were higher for NOOS subscales (0.19-0.42), compared to SF-36 and NDI. MID values varied between 15.0 and 24.1 for NOOS subscales. In conclusion, the NOOS is a reliable, valid, and responsive measure of self-reported disability in neck pain patients, performing at least as well or better than the commonly used SF-36 and NDI. Copyright © 2016 Elsevier Inc. All rights reserved.

Updating the Nomographical Diagrams for Dimensioning the Beams

Directory of Open Access Journals (Sweden)

Pop Maria T.

2015-12-01

Full Text Available In order to reduce the time period needed for structures design it is strongly recommended to use nomographical diagrams. The base for formation and updating the nomographical diagrams, stands on the charts presented by different technical publications. The updated charts use the same algorithm and calculation elements as the former diagrams in accordance to the latest prescriptions and European standards. The result consists in a chart, having the same properties, similar with the nomogragraphical diagrams already in us. As a general conclusion, even in our days, the nomographical diagrams are very easy to use. Taking into consideration the value of the moment it’s easy to find out the necessary reinforcement area and vice-verse, having the reinforcement area you can find out the capable moment. It still remains a useful opportunity for pre-sizing and designs the reinforced concrete sections.

Treatment of Muscle-Invasive and Metastatic Bladder Cancer: Update of the EAU Guidelines.

NARCIS (Netherlands)

Stenzl, A.; Cowan, N.C.; Santis, M. de; Kuczyk, M.A.; Merseburger, A.S.; Ribal, M.J.; Sherif, A.; Witjes, J.A.

2012-01-01

CONTEXT: New data regarding treatment of muscle-invasive and metastatic bladder cancer (MiM-BC) has emerged and led to an update of the European Association of Urology (EAU) guidelines for MiM-BC. OBJECTIVE: To review the new EAU guidelines for MiM-BC with a specific focus on treatment. EVIDENCE

2018 Update of the EULAR recommendations for the management of Behçet's syndrome

DEFF Research Database (Denmark)

Hatemi, Gulen; Christensen, Robin; Bang, Dongsik

2018-01-01

Several new treatment modalities with different mechanisms of action have been studied in patients with Behçet's syndrome (BS). The aim of the current effort was to update the recommendations in the light of these new data under the auspices of the European League Against Rheumatism (EULAR) Stand...

Why sauropods had long necks; and why giraffes have short necks

OpenAIRE

Taylor, Michael P.; Wedel, Mathew J.

2013-01-01

The necks of the sauropod dinosaurs reached 15 m in length: six times longer than that of the world record giraffe and five times longer than those of all other terrestrial animals. Several anatomical features enabled this extreme elongation, including: absolutely large body size and quadrupedal stance providing a stable platform for a long neck; a small, light head that did not orally process food; cervical vertebrae that were both numerous and individually elongate; an efficient air-sac-bas...

Head, Neck, and Oral Cancer

Medline Plus

Full Text Available ... and Neck Pathology Close to 49,750 Americans will be diagnosed with oral or pharyngeal cancer this ... and Neck Pathology Close to 49,750 Americans will be diagnosed with oral or pharyngeal cancer this ...

Meta-analysis of chemotherapy in head and neck cancer (MACH-NC) : an update on 93 randomised trials and 17,346 patients

NARCIS (Netherlands)

Pignon, Jean-Pierre; le Maître, Aurélie; Maillard, Emilie; Bourhis, Jean; Widder, Joachim

BACKGROUND: Our previous individual patient data (IPD) meta-analysis showed that chemotherapy improved survival in patients curatively treated for non-metastatic head and neck squamous cell carcinoma (HNSCC), with a higher benefit with concomitant chemotherapy. However the heterogeneity of the

Head and neck cancer in South Asia: Macroeconomic consequences and the role of the head and neck surgeon.

Science.gov (United States)

Alkire, Blake C; Bergmark, Regan W; Chambers, Kyle; Lin, Derrick T; Deschler, Daniel G; Cheney, Mack L; Meara, John G

2016-08-01

Head and neck cancer constitutes a substantial portion of the burden of disease in South Asia, and there is an undersupply of surgical capacity in this region. The purpose of this study was to estimate the economic welfare losses due to head and neck cancer in India, Pakistan, and Bangladesh in 2010. We used publicly available estimates of head and neck cancer morbidity and mortality along with a concept termed the value of a statistical life to estimate economic welfare losses in the aforementioned countries in 2010. Economic losses because of head and neck cancer in India, Pakistan, and Bangladesh totaled $16.9 billion (2010 US dollars [USD]), equivalent to 0.26% of the region's economic output. Bangladesh, the poorest country, experienced the greatest proportional losses. The economic consequences of head and neck cancer in South Asia are significant, and building surgical capacity is essential to begin to address this burden. © 2016 Wiley Periodicals, Inc. Head Neck 38:1242-1247, 2016. © 2016 Wiley Periodicals, Inc.

Head and Neck Cancer—Health Professional Version

Science.gov (United States)

Head and neck cancers include hypopharyngeal, laryngeal, lip and oral cavity, metastatic squamous neck, nasopharyngeal, oropharyngeal, paranasal sinus, and salivary gland cancers. Find evidence-based information on head and neck cancer treatment, causes and prevention, research, screening, and statistics.

The relationship between physical impairments, quality of life and disability of the neck and upper limb in patients following neck dissection.

Science.gov (United States)

Gane, Elise M; McPhail, Steven M; Hatton, Anna L; Panizza, Benedict J; O'Leary, Shaun P

2018-05-16

The purpose of this study was to examine the relationship between physical impairments, quality of life and disability in patients following neck dissection, with consideration of patient and clinical characteristics. Cross-sectional study of patients < 5 years after neck dissection for head and neck cancer. Quality of life and self-reported disability were measured with the Neck Dissection Impairment Index, Quick Disabilities of the Arm, Shoulder and Hand, and Neck Disability Index. Active neck and shoulder range of motion and isometric muscle strength were also assessed. Generalised linear modelling was used to explore relationships between variables. Eighty-four participants (68% male, median age 61 years) demonstrated reduced quality of life (median (interquartile range) score = 76 (49, 93) from 0 (worst) to 100 (best)), and mild levels of upper limb (14 (2, 32)) and neck disability (14 (6, 28)) (from 0 (best) to 100 (worst)). Bilateral neck dissection was associated with reduced quality of life (coeff (95% CI) = - 12.49 (- 24.69, - 0.29)). Post-operative chemoradiation therapy was associated with reduced quality of life (- 21.46 (- 37.57, - 5.35)) and neck disability (0.71 (0.10, 1.32)). Measures of shoulder flexibility or strength were associated with quality of life and self-reported disability. Quality of life and musculoskeletal disability after neck dissection are associated with factors from multiple domains including physical motor function and treatment modality. Having reduced shoulder flexibility or strength is related to functional deficits and quality of life after neck dissection for head and neck cancer.

Initial conformation of kinesin's neck linker

International Nuclear Information System (INIS)

Geng Yi-Zhao; Yan Shi-Wei; Ji Qing; Liu Shu-Xia

2014-01-01

How ATP binding initiates the docking process of kinesin's neck linker is a key question in understanding kinesin mechanisms. By exploiting a molecular dynamics method, we investigate the initial conformation of kinesin's neck linker in its docking process. We find that, in the initial conformation, the neck linker has interactions with β0 and forms a ‘cover-neck bundle’ structure with β0. From this initial structure, the formation of extra turns and the docking of the cover-neck bundle structure can be achieved. The motor head provides a forward force on the initial cover-neck bundle structure through ATP-induced rotation. This force, together with the hydrophobic interaction of ILE327 with the hydrophobic pocket on the motor head, drives the formation of the extra turn and initiates the neck linker docking process. Based on these findings, a pathway from ATP binding-induced motor head rotation to neck linker docking is proposed. (interdisciplinary physics and related areas of science and technology)

Increased neck muscle activity and impaired balance among females with whiplash-related chronic neck pain

DEFF Research Database (Denmark)

Juul-Kristensen, Birgit; Clausen, Brian; Ris Hansen, Inge

2013-01-01

To investigate neck muscle activity and postural control in patients with whiplash-associated disorder compared with healthy controls.......To investigate neck muscle activity and postural control in patients with whiplash-associated disorder compared with healthy controls....

Chronic neck pain and masticatory dysfunction.

Science.gov (United States)

Catanzariti, Jean-François; Debuse, Thierry; Duquesnoy, Bernard

2005-12-01

Chronic nonspecific neck pain is a common problem in rheumatology and may resist conventional treatment. Pathophysiological links exist between the cervical spine and masticatory system. Occlusal disorders may cause neck pain and may respond to dental treatment. The estimated prevalence of occlusal disorders is about 45%, with half the cases being due to functional factors. Minor repeated masticatory dysfunction (MD) with craniocervical asymmetry is the most common clinical picture. The pain is usually located in the suboccipital region and refractory to conventional treatment. The time pattern may be suggestive, with nocturnal arousals or triggering by temporomandibular movements. MD should be strongly suspected in patients with at least two of the following: history of treated or untreated MD, unilateral temporomandibular joint pain and clicking, lateral deviation during mouth opening, and limitation of mouth opening (less than three fingerbreadths). Rheumatologists should consider MD among causes of neck pain, most notably in patients with abnormal craniocervical posture, signs linking the neck pain to mastication, and clinical manifestations of MD. Evidence suggesting that MD may cause neck pain has been published. However, studies are needed to determine whether treatment of MD can relieve neck pain.

CrossNeck 1.0 XSLT-SVG cross-section analysis tool for analyzing necking state of a sphere bed

CERN Document Server

Pouchon, M A

2002-01-01

A tool for analyzing ceramographic cuts of sphere beds was programmed. The parameter of interest was the neck ratio being formed during sintering. A neck investigation based on such a cross section was programmed in a way, that the cross section discs could be entered graphically, and that the necking data was extracted from this information. In a resulting graphic the neck information on the surface was overlaid and could be crosschecked with the actual visible necking data. This allowed a quality control of the extracted data but was also necessary to exclude some false solution being introduced by the principle how the data was extracted. Some test on cross sections of a Cer-Med Sphere-Bed showed good results.

Femoral neck buttressing: a radiographic and histologic analysis

International Nuclear Information System (INIS)

Dixon, T.; Benjamin, J.; Lund, P.; Graham, A.; Krupinski, E.

2000-01-01

Objective. To examine the incidence, radiographic and histologic findings of medial femoral neck buttressing in a consecutive group of patients undergoing total hip arthroplasty.Design. Biomechanical parameters were evaluated on standard anteroposterior pelvic radiographs of 113 patients prior to hip replacement surgery. Demographic information on all patients was reviewed and histologic evaluation was performed on specimens obtained at the time of surgery.Results. The incidence of medial femoral neck buttressing was found to be 50% in a consecutive series of patients undergoing total hip arthroplasty. The incidence was slightly higher in women (56% vs 41%). Patients with buttressing had increased neck-shaft angles and smaller femoral neck diameters than were seen in patients without buttressing. Histologic evaluation demonstrated that the buttress resulted from deposition bone by the periosteum on the femoral neck in the absence of any evidence of femoral neck fracture.Conclusion. It would appear that femoral neck buttressing occurs in response to increased joint reactive forces seen at the hip being transmitted through the femoral neck. The increased joint reactive force can be related to the increased neck shaft angle seen in patients with buttressing. (orig.)

Spatial Segmentation of MALDI FT-ICR MSI Data: A Powerful Tool to Explore the Head and Neck Tumor in Situ Lipodome

Czech Academy of Sciences Publication Activity Database

Krásný, Lukáš; Hoffmann, F.; Ernst, G.; Trede, D.; Alexandrov, T.; Havlíček, Vladimír; Gruntinas-Lichius, O.; Eggeling, F.; Cerecelius, Anna C.

2015-01-01

Roč. 26, č. 1 (2015), s. 36-43 ISSN 1044-0305 R&D Projects: GA MŠk ECOST-STSM-BM1104-200513-028870; GA MŠk(CZ) LD13038 Grant - others:European Union 7th Framework Programme(CZ) 305259 Institutional support: RVO:61388971 Keywords : spatial segmentation * head tumor * neck tumor * cancer Subject RIV: EE - Microbiology, Virology Impact factor: 3.031, year: 2015

Neck injury tolerance under inertial loads in side impacts.

Science.gov (United States)

McIntosh, Andrew S; Kallieris, Dimitrios; Frechede, Bertrand

2007-03-01

Neck injury remains a major issue in road safety. Current side impact dummies and side impact crashworthiness assessments do not assess the risk of neck injury. These assessments are limited by biofidelity and knowledge regarding neck injury criteria and tolerance levels in side impacts. Side impact tests with PMHS were performed at the Heidelberg University in the 1980s and 1990s to improve primarily the understanding of trunk dynamics, injury mechanisms and criteria. In order to contribute to the definition of human tolerances at neck level, this study presents an analysis of the head/neck biomechanical parameters that were measured in these tests and their relationship to neck injury severity. Data from 15 impact tests were analysed. Head accelerations, and neck forces and moments were calculated from 9-accelerometer array head data, X-rays and anthropometric data. Statistically significant relationships were observed between resultant head acceleration and neck force and neck injury severity. The average resultant head acceleration for AIS 2 neck injuries was 112 g, while resultant neck force was 4925 N and moment 241 Nm. The data compared well to other test data on cadavers and volunteers. It is hoped that the paper will assist in the understanding of neck injuries and the development of tolerance criteria.

Exercises for mechanical neck disorders

NARCIS (Netherlands)

Kay, Theresa M.; Gross, Anita; Goldsmith, Charles H.; Rutherford, Sherrill; Voth, Sandra; Hoving, Jan L.; Brønfort, Gert; Santaguida, Pasqualina L.

2012-01-01

Background Neck disorders are common, disabling and costly. The effectiveness of exercise as a physiotherapy intervention remains unclear. Objectives To improve pain, disability, function, patient satisfaction, quality of life and global perceived effect in adults with neck pain. Search methods

A Planned Neck Dissection Is Not Necessary in All Patients With N2-3 Head-and-Neck Cancer After Sequential Chemoradiotherapy

International Nuclear Information System (INIS)

Soltys, Scott G.; Choi, Clara Y.H.; Fee, Willard E.; Pinto, Harlan A.; Le, Quynh-Thu

2012-01-01

Purpose: To assess the role of a planned neck dissection (PND) after sequential chemoradiotherapy for patients with head-and-neck cancer with N2–N3 nodal disease. Methods and Materials: We reviewed 90 patients with N2–N3 head-and-neck squamous cell carcinoma treated between 1991 and 2001 on two sequential chemoradiotherapy protocols. All patients received induction and concurrent chemotherapy with cisplatin and 5-fluorocuracil, with or without tirapazamine. Patients with less than a clinical complete response (cCR) in the neck proceeded to a PND after chemoradiation. The primary endpoint was nodal response. Clinical outcomes and patterns of failure were analyzed. Results: The median follow-up durations for living and all patients were 8.3 years (range, 1.5–16.3 year) and 5.4 years (range, 0.6–16.3 years), respectively. Of the 48 patients with nodal cCR whose necks were observed, 5 patients had neck failures as a component of their recurrence [neck and primary (n = 2); neck, primary, and distant (n = 1); neck only (n = 1); neck and distant (n = 1)]. Therefore, PND may have benefited only 2 patients (4%) [neck only failure (n = 1); neck and distant failure (n = 1)]. The pathologic complete response (pCR) rate for those with a clinical partial response (cPR) undergoing PND (n = 30) was 53%. The 5-year neck control rates after cCR, cPR→pCR, and cPR→pPR were 90%, 93%, and 78%, respectively (p = 0.36). The 5-year disease-free survival rates for the cCR, cPR→pCR, and cPR→pPR groups were 53%, 75%, and 42%, respectively (p = 0.04). Conclusion: In our series, patients with N2–N3 neck disease achieving a cCR in the neck, PND would have benefited only 4% and, therefore, is not recommended. Patients with a cPR should be treated with PND. Residual tumor in the PND specimens was associated with poor outcomes; therefore, aggressive therapy is recommended. Studies using novel imaging modalities are needed to better assess treatment response.

Impacts of updated green vegetation fraction data on WRF simulations of the 2006 European heat wave

Science.gov (United States)

Refslund, J.; Dellwik, E.; Hahmann, A. N.; Barlage, M. J.; Boegh, E.

2012-12-01

Climate change studies suggest an increase in heat wave occurrences over Europe in the coming decades. Extreme events with excessive heat and associated drought will impact vegetation growth and health and lead to alterations in the partitioning of the surface energy. In this study, the atmospheric conditions during the heat wave year 2006 over Europe were simulated using the Weather Research and Forecasting (WRF) model. To account for the drought effects on the vegetation, new high-resolution green vegetation fraction (GVF) data were developed for the domain using NDVI data from MODIS satellite observations. Many empirical relationships exist to convert NDVI to GVF and both a linear and a quadratic formulation were evaluated. The new GVF product has a spatial resolution of 1 km2 and a temporal resolution of 8 days. To minimize impacts from low-quality satellite retrievals in the NDVI series, as well as for comparison with the default GVF climatology in WRF, a new background climatology using 10 recent years of observations was also developed. The annual time series of the new GVF climatology was compared to the default WRF GVF climatology at 18 km2 grid resolution for the most common land use classes in the European domain. The new climatology generally has higher GVF levels throughout the year, in particular an extended autumnal growth season. Comparison of 2006 GVF with the climatology clearly indicates vegetation stresses related to heat and drought. The GVF product based on a quadratic NDVI relationship shows the best agreement with the magnitude and annual range of the default input data, in addition to including updated seasonality for various land use classes. The new GVF products were tested in WRF and found to work well for the spring of 2006 where the difference between the default and new GVF products was small. The WRF 2006 heat wave simulations were verified by comparison with daily gridded observations of mean, minimum and maximum temperature and

Rupture of the neck in nuclear fission

International Nuclear Information System (INIS)

Davies, K.T.R.; Managan, R.A.; Nix, J.R.; Sierk, A.J.

1977-01-01

We introduce a degree of freedom to describe the rupture of the neck in nuclear fission and calculate the point at which the neck ruptures as the nucleus descends dynamically from its fission saddle point. This is done by mentally slicing the system into two portions at its minimum neck radius and calculating the force required to separate the two portions while keeping their shapes fixed. This force is obtained by differentiating with respect to separation the sum of the Coulomb and nuclear interaction energies between the two portions. For nuclei throughout the Periodic Table we calculate this force along dynamical paths leading from the fission saddle point. The force is initially attractive but becomes repulsive when the neck reaches a critical size. For actinide nuclei the neck radius at which rupture occurs is about 2 fm. This increases the calculated translational kinetic energy of the fission fragments at infinity relative to that calculated for scission occurring at zero neck radius. With the effect of neck rupture taken into account, we calculate and compare with experimental results fission-fragment kinetic energies for two types of nuclear dissipation: ordinary two-body viscosity and one-body dissipation

Assessment of Neck Pain and Its Associated Disorders

Science.gov (United States)

Carragee, Eugene J.; Hogg-Johnson, Sheilah; Weiner, Shira Schecter; Hurwitz, Eric L.; Peloso, Paul M.; Guzman, Jaime; van der Velde, Gabrielle; Carroll, Linda J.; Holm, Lena W.; Côté, Pierre; Cassidy, J. David; Haldeman, Scott

2008-01-01

Study Design Best evidence synthesis. Objective To critically appraise and synthesize the literature on assessment of neck pain. Summary of Background Data The published literature on assessment of neck pain is large and of variable quality. There have been no prior systematic reviews of this literature. Methods The Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders conducted a critical review of the literature (published 1980– 2006) on assessment tools and screening protocols for traumatic and nontraumatic neck pain. Results We found 359 articles on assessment of neck pain. After critical review, 95 (35%) were judged scientifically admissible. Screening protocols have high predictive values to detect cervical spine fracture in alert, low-risk patients seeking emergency care after blunt neck trauma. Computerized tomography (CT) scans had better validity (in adults and elderly) than radiographs in assessing high-risk and/or multi-injured blunt trauma neck patients. In the absence of serious pathology, clinical physical examinations are more predictive at excluding than confirming structural lesions causing neurologic compression. One exception is the manual provocation test for cervical radiculopathy, which has high positive predictive value. There was no evidence that specific MRI findings are associated with neck pain, cervicogenic headache, or whiplash exposure. No evidence supports using cervical provocative discography, anesthetic facet, or medial branch blocks in evaluating neck pain. Reliable and valid self-report questionnaires are useful in assessing pain, function, disability, and psychosocial status in individuals with neck pain. Conclusion The scientific evidence supports screening protocols in emergency care for low-risk patients; and CT-scans for high-risk patients with blunt trauma to the neck. In nonemergency neck pain without radiculopathy, the validity of most commonly used objective tests is lacking. There is

Primary Hydatid Cyst of the Neck

International Nuclear Information System (INIS)

Mujtaba, S. S.; Faridi, N.; Haroon, S.

2013-01-01

Hydatid cysts in the neck are relatively exceptional, even in areas where Echinococcus granulosis is endemic, such as Asia. Although liver and lung are frequent sites of involvement, it can involve all tissues, with neck remaining one of the most rare sites. It should come in the differential diagnosis of cystic lesion of neck, as the treatment options differ widely from common neck cysts. The role of radiological investigation is important and, in these cases, the involvement of other organs should be investigated. Serological tests may be helpful. The major treatment modality is surgical and the cyst should be excised as a whole, without being ruptured, to prevent any treatment complications, as the cyst fluid can initiate an anaphylactic reaction. Postoperative albendazole therapy is recommended particularly when there is intra-operative spillover. We report a case of an isolated hydatid cyst localized in the anterior triangle of the neck without any pulmonary or hepatic involvement. (author)

Planned neck dissection for oropharyngeal and hypopharyngeal cancers

International Nuclear Information System (INIS)

Hanai, Nobuhiro; Hasegawa, Yasuhisa; Terada, Akihiro; Ozawa, Taijiro; Hirakawa, Hitoshi; Kawakita, Daisuke; Maruo, Takashi; Mikami, Shinnji

2010-01-01

Recently, the use of chemoradiotherapy for preserving organs in the treatment of head and neck cancer is increasing. However, there is controversy about advanced neck node management in post-chemoradiation cases. We retrospectively analyzed our 119 cases of chemoradiotherapy for oropharyngeal and hypopharyngeal cancer to examine the effectiveness and indications of planned neck dissection. Regional control rate and survival rate were superior in the neck dissection group. If the cases did not achieve complete response (CR) in imaging, planned neck dissection improved the regional control rate significantly. We should perform planned neck dissection immediately rather than 'wait and see' for this persistent disease. However, in the cases achieving radiological CR, it is possible to omit planned neck dissection because of the high salvage rate of neck disease. However, in these cases, careful observation is essential. We clarified that the presence of pathologically positive lymph node is a prognostic factor. For evaluating persistent disease of cervical lymph nodes, positron emission tomography (PET)-CT was the most accurate method of imaging. (author)

Neck massage induced dural sinus thrombosis

Directory of Open Access Journals (Sweden)

Verma Ashish

2007-01-01

Full Text Available Thrombosis of the intracranial dural sinuses and internal jugular veins may occur as a complication of head and neck infections, surgery, central venous access, local malignancy, polycythemia, hyperhomocysteinemia, neck massage and intravenous drug abuse. A high degree of clinical suspicion followed by adequate imaging is prerequisite to early diagnosis and management. We report a young man who had dural sinus thrombosis with jugular venous thrombosis following neck massage.

Review of patients with dysphasia after a neck dissection

International Nuclear Information System (INIS)

Yokoyama, Junkichi

2007-01-01

The most useful modality for treating neck metastasis is a neck dissection. A neck dissection was previously performed as a radical neck dissection. However, disabilities in shoulder movement and swallowing function often occur after this procedure. Recently, a functional neck dissection has therefore been performed in order to avoid such postoperative complications. The current study for dysphasia after a neck dissection investigates patients with primary unknown neck metastasis and neck recurrence after chemoradiation. Eleven cases of dysphasia occurred after a neck dissection between 2003 and 2006. These cases resected the lower cranial nerves (IX, X, XII), or paralysis of these nerves occurred despite their preservation after surgery. Patients with dysphasia underwent rehabilitation to regain their swallowing function. However, rehabilitation was unsuccessful and the patients were thus required to undergo further surgery. A neck dissection with resection of the lower cranial nerves (IX, X, XII) may sometimes result in dysphasia. Consequently, surgery to prevent dysphasia should be performed simultaneously so that timely postoperative therapy can be carried out. (author)

The Danish Neck Disability Index

DEFF Research Database (Denmark)

Lauridsen, Henrik Hein; O'Neill, Lotte; Kongsted, Alice

2017-01-01

Objective: To (1) translate and culturally adapt and (2) determine the clinimetric properties of the Danish 8-item Neck Disability Index (NDI-8) in primary sector patients (PSPs) and secondary sector patients (SSPs). Methods: Analyses included 326 patients with neck pain. Validity and reliability...

Systematic review on tuberculosis transmission on aircraft and update of the European Centre for Disease Prevention and Control risk assessment guidelines for tuberculosis transmitted on aircraft (RAGIDA-TB).

Science.gov (United States)

Kotila, Saara M; Payne Hallström, Lara; Jansen, Niesje; Helbling, Peter; Abubakar, Ibrahim

2016-01-01

As a setting for potential tuberculosis (TB) transmission and contact tracing, aircraft pose specific challenges. Evidence-based guidelines are needed to support the related-risk assessment and contact-tracing efforts. In this study evidence of TB transmission on aircraft was identified to update the Risk Assessment Guidelines for TB Transmitted on Aircraft (RAGIDA-TB) of the European Centre for Disease Prevention and Control (ECDC). Electronic searches were undertaken from Medline (Pubmed), Embase and Cochrane Library until 19 July 2013. Eligible records were identified by a two-stage screening process and data on flight and index case characteristics as well as contact tracing strategies extracted. The systematic literature review retrieved 21 records. Ten of these records were available only after the previous version of the RAGIDA guidelines (2009) and World Health Organization guidelines on TB and air travel (2008) were published. Seven of the 21 records presented some evidence of possible in-flight transmission, but only one record provided substantial evidence of TB transmission on an aircraft. The data indicate that overall risk of TB transmission on aircraft is very low. The updated ECDC guidelines for TB transmission on aircraft have global implications due to inevitable need for international collaboration in contract tracing and risk assessment.

Metastasis to neck from unknown primary tumor

International Nuclear Information System (INIS)

Jose, B.; Bosch, A.; Caldwell, W.L.; Frias, Z.

1979-01-01

The records of 54 consecutive patients who were irradiated for metastatic disease in the neck from an unknown primary tumor were reviewed. The overall survival results are comparable to those of other reported series. Patients with high or posterior cervical lymph node involvement were irradiated with fields including the nasopharynx and oropharynx. Patients with high neck nodes had a better survival rate than those with low neck nodes. The size of the neck tumors and the local control after treatment also have prognostic significance. (Auth.)

Thyroid Emphysema Following Penetrating Neck Trauma

OpenAIRE

Karadağ, Demet; Doner, Egemen; Adapınar, Baki

2014-01-01

Although traumatic thyroid gland rupture or hemorrhage is usually seen in goitrous glands, injuries of the normal thyroid gland after neck trauma have rarely been described in the literature. We describe a 44-year-old man who presented with thyroid emphysema and subcutaneous emphysema (SCE) that occurred after penetrating neck trauma. CT images showed complete resolution of thyroid emphysema and subcutaneous emphysema at follow-up examination. Neck injuries can be life threatening. After pene...

Modeling neck mobility in fossil turtles

OpenAIRE

Werneburg, Ingmar; Hinz, Juliane K.; Gumpenberger, Michaela; Volpato, Virginie; Natchev, Nikolay; Joyce, Walter G.

2014-01-01

Turtles have the unparalleled ability to retract their heads and necks within their shell but little is known about the evolution of this trait. Extensive analysis of neck mobility in turtles using radiographs, CT scans, and morphometry reveals that basal turtles possessed less mobility in the neck relative to their extant relatives, although the anatomical prerequisites for modern mobility were already established. Many extant turtles are able to achieve hypermobility by dislocating the cent...

Leuprorelin Acetate in Prostate Cancer: a European Update

Directory of Open Access Journals (Sweden)

Persad R

2002-01-01

Full Text Available This review provides an update on leuprorelin acetate, the world's most widely prescribed depot luteinising hormone-releasing hormone analogue. Leuprorelin acetate has been in clinical use in the palliative treatment of prostate cancer for more than 20 years, but advances continue to be made in terms of convenience and flexibility of administration, and in the incorporation of leuprorelin acetate into novel treatment regimens. The drug is administered in the form of a depot injection containing leuprorelin acetate microspheres, and is at least as effective in suppressing testosterone secretion as orchiectomy. In patients with prostate cancer, serum testosterone levels are reduced to castrate levels (= 50 ng/dl within 2-3 weeks of the first one-month depot injection of 3.75 mg or three-month depot injection of 11.25 mg. Both the one-month and three-month formulations are effective in delaying tumour progression and alleviating symptoms of locally advanced and metastatic prostate cancer. Tolerability is generally good, with side-effects reflecting effective testosterone suppression. Recent studies have investigated the place of leuprorelin acetate as part of continuous or intermittent maximal androgen blockade (MAB and in neoadjuvant therapy (ie, to reduce the size of the prostate and downsize the tumour before radiotherapy. Additional formulations and presentations are in development, including a six-month injection, with the aim of adding to the clinical flexibility and patient acceptability of this important palliative treatment for prostate cancer.

Quality of life after neck dissection. Multicenter study

International Nuclear Information System (INIS)

Nibu, Ken-ichi; Onitsuka, Tetsuo; Kawabata, Kazuyoshi

2010-01-01

To assess the impact of modifications to radical neck dissection and radiotherapy on the postoperative quality of life, the study group 'Study on Standardization of Treatment for Lymph Node Metastasis of Head and Neck Cancer' performed a multicenter cross-sectional study using our self-administered neck dissection questionnaire and arm abduction test. While sparing levels IV and V improved most postoperative symptoms, such as stiffness and constriction of the neck were avoided as long as the sternocleidmastoid muscle (SCM) and the spinal accessory nerve were preserved. Resection of the SCM and spinal accessory nerve resulted in a drop shoulder and neck pain, respectively. Irradiation with a total dose of 50 Gy or more worsened stiffness of neck and shoulder. (author)

Are People With Whiplash-Associated Neck Pain Different From People With Nonspecific Neck Pain?

Science.gov (United States)

Anstey, Ricci; Kongsted, Alice; Kamper, Steven; Hancock, Mark J

2016-10-01

Study Design Secondary analysis of a prospective cohort study with cross-sectional and longitudinal analyses. Background The clinical importance of a history of whiplash-associated disorder (WAD) in people with neck pain remains uncertain. Objective To compare people with WAD to people with nonspecific neck pain, in terms of their baseline characteristics and pain and disability outcomes over 1 year. Methods Consecutive patients with neck pain who presented to a secondary-care spine center answered a comprehensive self-report questionnaire and underwent a physical examination. Patients were classified into a group of either those with WAD or those with nonspecific neck pain. We compared the outcomes of baseline characteristics of the 2 groups, as well as pain intensity and activity limitation at follow-ups of 6 and 12 months. Results A total of 2578 participants were included in the study. Of these, 488 (19%) were classified as having WAD. At presentation, patients with WAD were statistically different from patients without WAD for almost all characteristics investigated. While most differences were small (1.1 points on an 11-point pain-rating scale and 11 percentage points on the Neck Disability Index), others, including the presence of dizziness and memory difficulties, were substantial. The between-group differences in pain and disability increased significantly (Pneck pain. Conclusion People referred to secondary care with WAD typically had more self-reported pain and disability and experienced worse outcomes than those with nonspecific neck pain. Caution is required when interpreting the longitudinal outcomes due to lower-than-optimal follow-up rates. Level of Evidence Prognosis, level 2. J Orthop Sports Phys Ther 2016;46(10):894-901. Epub 3 Sep 2016. doi:10.2519/jospt.2016.6588.

Efficacy and safety of biological and targeted-synthetic DMARDs: a systematic literature review informing the 2016 update of the ASAS/EULAR recommendations for the management of axial spondyloarthritis

NARCIS (Netherlands)

Sepriano, Alexandre; Regel, Andrea; van der Heijde, Désirée; Braun, Jürgen; Baraliakos, Xenofon; Landewé, Robert; van den Bosch, Filip; Falzon, Louise; Ramiro, Sofia

2017-01-01

To update the evidence for the efficacy and safety of (b)biological and (ts)targeted-synthetic disease-modifying anti-rheumatic drugs (DMARDs) in patients with axial spondyloarthritis (axSpA) to inform the 2016 update of the Assessment of SpondyloArthritis international Society/European League

Public knowledge of head and neck cancer.

LENUS (Irish Health Repository)

O'Connor, T E

2010-04-01

Studies show 60% of patients with newly diagnosed Head & Neck Squamous Cell Cancer in Ireland, present with advanced disease. A poor level of knowledge and awareness among the public of Head & Neck Cancer, is an important consideration in the often delayed presentation for medical attention in many of these cases. Our study surveyed 200 members of the public to assess their knowledge and awareness of Head & Neck Cancer. One hundred and forty (70%) of respondents had never encountered the term "Head & Neck Cancer". One hundred and forty six (73%) failed to identify excessive alcohol consumption as a risk factor. Less than 100 (50%) would have concern about persisting hoarseness or a prolonged oral ulcer. An urgent need exists to raise awareness of Head & Neck Cancer among the public in Ireland.

Selective neck dissection: a review of the evidence.

Science.gov (United States)

Pagedar, Nitin A; Gilbert, Ralph W

2009-01-01

The management of regional metastatic disease in patients with oral cancer is a topic of controversy. Comprehensive neck dissection has been the mainstay of treatment historically, but clinicians have sought alternatives to limit the morbidity of the classic radical neck dissection. This article will review evidence on the applicability of selective neck dissection in two settings: as primary treatment of the clinically positive neck and as salvage treatment of recurrent neck disease after radiotherapy. In the text, for each article cited we supply the level of evidence thereof according to the Oxford Centre for Evidence-based medicine.

Multiple Myeloma Treatment Strategies with Novel Agents in 2011: A European Perspective

DEFF Research Database (Denmark)

Ludwig, Heinz; Beksac, Meral; Bladé, Joan

2011-01-01

, providing us with data to make evidence-based decisions regarding the optimal management of patients. This review is an update to a previous summary of European treatment practices that examines new data that have been published or presented at congresses up to the end of 2010 and assesses their impact...

The role of USG in neck monitoring after surgery of malignant neoplasms of head and neck

International Nuclear Information System (INIS)

Szmeja, Z.; Kordylewska, M.; Dziamska, K.; Szyfter, W.; Kruk-Zagajewska, A.

1994-01-01

Metastases to regional lymph nodes of the neck in patients with larynx cancer are a more frequent cause of death in comparison to local recurrence. Thus it is necessary to thoroughly examine the treatment and after the treatment. The ultrasound examination introduced significant diagnostic value in the diagnosis of malignant cancers. Ultrasound monitoring of the lymphatic system after surgical treatment or radiation allows to diagnose early metastases which are not visible in palpation examination. In over 200 patients after surgical treatment of larynx cancer several ultrasound examinations of the neck were carried out. The time following the end of the treatment was 4 months to l 8 years. In the ultrasound examination of the neck changes in the lymphatic system were observed, which were not clinically manifested in 10 patients. Metastases to regional lymph nodes of the neck were most frequently observed in the first year after the operation. Patients who were diagnosed with metastases before operation and patients with supraglottic cancers were at more risk of having metastases. The ultrasound examination of the neck should be a routine, systematically repeated examination in the observation of patients after larynx cancer operation. (author)

Prognostic Factor Analysis for Management of Chronic Neck Pain: Can We Predict the Severity of Neck Pain with Lateral Cervical Curvature?

Science.gov (United States)

Seong, Han Yu; Lee, Moon Kyu; Jeon, Sang Ryong; Roh, Sung Woo; Rhim, Seung Chul; Park, Jin Hoon

2017-07-01

Although little is known about its origins, neck pain may be related to several associated anatomical pathologies. We aimed to characterize the incidence and features of chronic neck pain and analyze the relationship between neck pain severity and its affecting factors. Between March 2012 and July 2013, we studied 216 patients with chronic neck pain. Initially, combined tramadol (37.5 mg) plus acetaminophen (325 mg) was administered orally twice daily (b.i.d.) to all patients over a 2-week period. After two weeks, patients were evaluated for neck pain during an outpatient clinic visit. If the numeric rating scale of the patient had not decreased to 5 or lower, a cervical medial branch block (MBB) was recommended after double-dosed previous medication trial. We classified all patients into two groups (mild vs. severe neck pain group), based on medication efficacy. Logistic regression tests were used to evaluate the factors associated with neck pain severity. A total of 198 patients were included in the analyses, due to follow-up loss in 18 patients. While medication was successful in reducing pain in 68.2% patients with chronic neck pain, the remaining patients required cervical MBB. Lateral cervical curvature, such as a straight or sigmoid type curve, was found to be significantly associated with the severity of neck pain. We managed chronic neck pain with a simple pharmacological management protocol followed by MBB. We should keep in mind that it may be difficult to manage the patient with straight or sigmoid lateral curvature only with oral medication.

Purse-string platysmaplasty: the third dimension for neck contouring.

Science.gov (United States)

Gentile, Richard D

2005-11-01

Techniques and concepts for treatment of the aging neck have been evolving since the late 1960s and rely on two-dimensional anterior approximation with lateral imbrication of the platysma with or without submental fat reduction, However, the medial approximation can sometimes give a "boxy" appearance to the anterior neck, especially if anterior shifting of the platysma recurs after platysmaplasty with laxity redeveloping in this midline location. The "purse-string" platysmaplasty (PSP) is a new concept in neck contouring that facilitates an enhanced definition for the cervicomandibular transition to better simulate the well-defined contour of this transition that is present in youth. It aids in the contouring of difficult poorly defined necks and in male patients. The PSP adds a "third dimension" to neck recontouring by invaginating the platysma with a plication suture and pexing the platysma, without incising it, to deeper neck fascia with a technique that adds support and definition to the neck contour. The PSP can be performed in patients undergoing a full rhytidectomy as well as in individuals having isolated neck rejuvenation. The PSP is especially helpful in rejuvenating the male lower face and neck because of the relatively heavier deeper structures of the male neck and the need to enhance definition along the jawline.

The association between a lifetime history of a neck injury in a motor vehicle collision and future neck pain: a population-based cohort study

Science.gov (United States)

Côté, Pierre; Cassidy, J. David; Carroll, Linda J.

2010-01-01

The objective of this population-based cohort study was to investigate the association between a lifetime history of neck injury from a motor vehicle collision and the development of troublesome neck pain. The current evidence suggests that individuals with a history of neck injury in a traffic collision are more likely to experience future neck pain. However, these results may suffer from residual confounding. Therefore, there is a need to test this association in a large population-based cohort with adequate control of known confounders. We formed a cohort of 919 randomly sampled Saskatchewan adults with no or mild neck pain in September 1995. At baseline, participants were asked if they ever injured their neck in a motor vehicle collision. Six and twelve months later, we asked about the presence of troublesome neck pain (grade II–IV) on the chronic pain grade questionnaire. Multivariable Cox regression was used to estimate the association between a lifetime history of neck injury in a motor vehicle collision and the onset of troublesome neck pain while controlling for known confounders. The follow-up rate was 73.5% (676/919) at 6 months and 63.1% (580/919) at 1 year. We found a positive association between a history of neck injury in a motor vehicle collision and the onset of troublesome neck pain after controlling for bodily pain and body mass index (adjusted HRR = 2.14; 95% CI 1.12–4.10). Our analysis suggests that a history of neck injury in a motor vehicle collision is a risk factor for developing future troublesome neck pain. The consequences of a neck injury in a motor vehicle collision can have long lasting effects and predispose individuals to experience recurrent episodes of neck pain. PMID:20213298

Restraining and neck cutting or stunning and neck cutting of veal calves.

Science.gov (United States)

Lambooij, E; van der Werf, J T N; Reimert, H G M; Hindle, V A

2012-05-01

Brain and heart activities were measured in 31 veal calves during restraining and rotating followed by neck cutting with or without stunning to evaluate welfare. After neck cutting correlation dimension analyses and %power of EEG beta wave fraction decreased gradually to lower values resulting in an induction of unconsciousness lasting on average 80s. Corneal reflex response ceased 135±57s after neck cutting. The CD scores and the %power of beta waves fell immediately after post-cut captive bolt and pre-cut electrical stunning to levels indicating unconsciousness. Heart rate in lairage increased upon entrance to the restrainer and again after rotation, heart rate variability decreased. Rotating the restrainer 90°, 120° or 180° compromised veal calf welfare and should be avoided. It is recommended to use post-cut captive bolt stunning or pre-cut electrical stunning inducing immediate unconsciousness. Copyright © 2011 Elsevier Ltd. All rights reserved.

Neck pain

Science.gov (United States)

... cause of neck pain is muscle strain or tension. Most often, everyday activities are to blame. Such ... of a heart attack , such as shortness of breath, sweating, nausea, vomiting, or arm or jaw pain. ...

Shoulder and neck morbidity in quality of life after surgery for head and neck cancer

NARCIS (Netherlands)

van Wilgen, C.P.; Dijkstra, P.U.; van der Laan, B.F.; Plukker, J.T.; Roodenburg, J.L.

2004-01-01

Background. Quality of life has become a major issue in determining the outcome of treatment in head and neck surgery with curative intent. The aim of our study was to determine which factors in the postoperative care, especially shoulder and neck morbidity, are related to quality of life and how

[Volume changes to the neck lymph node metastases in head-neck tumors. The evaluation of radiotherapeutic treatment success].

Science.gov (United States)

Liszka, G; Thalacker, U; Somogyi, A; Németh, G

1997-08-01

This work is engaged with the volume change of neck lymph node metastasis of malignant tumors in the head-neck region during radiotherapy. In 54 patients with head and neck tumors, the volume of neck lymph nodes before and after radiation was measured. The volumetry was done with CT planimetry. The total dose was 66 Gy (2 Gy/d) telecobalt from 2 lateral opponated fields. The time of volume change could be defined with measuring of the half-time and the doubling-time by the help of Schwartz formula. After 10 Gy the volume diminution was about 20% and half-time 24 to 26 days. Afterwards the time of volume diminution picked up speed and finally achieved 60 to 72%. Meanwhile the half-time decreased to the half value. The result was independent of the site of primary tumor, the patient's sex and age. In our opinion the effectivity of radiotherapy can best be judged with defining of the volume change of lymph nodes of the neck.

Neck circumference as a measure of neck fat and abdominal visceral fat in Chinese adults.

Science.gov (United States)

Li, Hong-Xing; Zhang, Fen; Zhao, Dong; Xin, Zhong; Guo, Shu-Qin; Wang, Shu-Mei; Zhang, Jian-Jun; Wang, Jun; Li, Yan; Yang, Guang-Ran; Yang, Jin-Kui

2014-04-04

Visceral adipose tissue (VAT) is a unique pathogenic fatty deposit, in that it is closely correlated with risk of cardiovascular diseases. The present study is to investigate the usefulness of neck circumference (NC) to indicate VAT. Participants aged 35 to 75 years who had taken abdomen and neck computer tomography (CT) examination were included in this study. Neck adipose tissue, abdominal VAT and subcutaneous adipose tissue (SAT) areas, as well as sagittal abdominal diameter (SAD) were measured by CT. Body anthropometrics and metabolic parameters including blood glucose, lipid profiles and blood pressure were also measured. A lower abdomen CT examination was carried out on a total of 177 patients (87 male and 90 female) with a mean age of 59 years. Of the 177 participants, 15 men and 15 women also took a neck CT examination. With a comparable age and BMI, neck adipose area was correlated with abdominal VAT area significantly in men (r = 0.57, p = 0.028) and women (r = 0.53, p = 0.041). NC is positively correlated with VAT both in men (r = 0.49, p fat both in men (r = 0.83, p fat area is significantly correlated with abdominal VAT. Meanwhile, SAD is the best predictor for visceral fat in the Chinese population.

Regional control of melanoma neck node metastasis after selective neck dissection with or without adjuvant radiotherapy

NARCIS (Netherlands)

Hamming-Vrieze, Olga; Balm, Alfons J. M.; Heemsbergen, Wilma D.; Hooft van Huysduynen, Thijs; Rasch, Coen R. N.

2009-01-01

OBJECTIVE: To examine the effect of adjuvant radiotherapy on regional control of melanoma neck node metastasis. DESIGN: A single-institution retrospective study. SETTING: Tertiary care cancer center. PATIENTS: The study included 64 patients with melanoma neck node metastasis who were treated with

Integrated safety assessment report, Haddam Neck Plant (Docket No. 50-213): Integrated Safety Assessment Program: Draft report

International Nuclear Information System (INIS)

1987-07-01

The integrated assessment is conducted on a plant-specific basis to evaluate all licensing actions, licensee initiated plant improvements and selected unresolved generic/safety issues to establish implementation schedules for each item. Procedures allow for a periodic updating of the schedules to account for licensing issues that arise in the future. The Haddam Neck Plant is one of two plants being reviewed under the pilot program. This report indicates how 82 topics selected for review were addressed, and presents the staff's recommendations regarding the corrective actions to resolve the 82 topics and other actions to enhance plant safety. 135 refs., 4 figs., 5 tabs

Developmental framework to validate future designs of ballistic neck protection.

Science.gov (United States)

Breeze, J; Midwinter, M J; Pope, D; Porter, K; Hepper, A E; Clasper, J

2013-01-01

The number of neck injuries has increased during the war in Afghanistan, and they have become an appreciable source of mortality and long-term morbidity for UK servicemen. A three-dimensional numerical model of the neck is necessary to allow simulation of penetrating injury from explosive fragments so that the design of body armour can be optimal, and a framework is required to validate and describe the individual components of this program. An interdisciplinary consensus group consisting of military maxillofacial surgeons, and biomedical, physical, and material scientists was convened to generate the components of the framework, and as a result it incorporates the following components: analysis of deaths and long-term morbidity, assessment of critical cervical structures for incorporation into the model, characterisation of explosive fragments, evaluation of the material of which the body armour is made, and mapping of the entry sites of fragments. The resulting numerical model will simulate the wound tract produced by fragments of differing masses and velocities, and illustrate the effects of temporary cavities on cervical neurovascular structures. Using this framework, a new shirt to be worn under body armour that incorporates ballistic cervical protection has been developed for use in Afghanistan. New designs of the collar validated by human factors and assessment of coverage are currently being incorporated into early versions of the numerical model. The aim of this paper is to describe this developmental framework and provide an update on the current progress of its individual components. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Management of the clinically negative neck in early-stage head and neck cancers after transoral resection

NARCIS (Netherlands)

Rodrigo, J.P.; Shah, J.P.; Silver, C.E.; Medina, J.E.; Takes, R.P.; Robbins, K.T.; Rinaldo, A.; Werner, J.A.; Ferlito, A.

2011-01-01

The decision regarding treatment of the clinically negative neck has been debated extensively. This is particularly true with early-stage tumors for which surgery is the treatment of choice, and the tumor has been resected transorally without a cervical incision. Elective neck dissection in this

Treatment of Neck Pain: Noninvasive Interventions

Science.gov (United States)

Carragee, Eugene J.; van der Velde, Gabrielle; Carroll, Linda J.; Nordin, Margareta; Guzman, Jaime; Peloso, Paul M.; Holm, Lena W.; Côté, Pierre; Hogg-Johnson, Sheilah; Cassidy, J. David; Haldeman, Scott

2008-01-01

Study Design. Best evidence synthesis. Objective. To identify, critically appraise, and synthesize literature from 1980 through 2006 on noninvasive interventions for neck pain and its associated disorders. Summary of Background Data. No comprehensive systematic literature reviews have been published on interventions for neck pain and its associated disorders in the past decade. Methods. We systematically searched Medline and screened for relevance literature published from 1980 through 2006 on the use, effectiveness, and safety of noninvasive interventions for neck pain and associated disorders. Consensus decisions were made about the scientific merit of each article; those judged to have adequate internal validity were included in our best evidence synthesis. Results. Of the 359 invasive and noninvasive intervention articles deemed relevant, 170 (47%) were accepted as scientifically admissible, and 139 of these related to noninvasive interventions (including health care utilization, costs, and safety). For whiplash-associated disorders, there is evidence that educational videos, mobilization, and exercises appear more beneficial than usual care or physical modalities. For other neck pain, the evidence suggests that manual and supervised exercise interventions, low-level laser therapy, and perhaps acupuncture are more effective than no treatment, sham, or alternative interventions; however, none of the active treatments was clearly superior to any other in either the short-or long-term. For both whiplash-associated disorders and other neck pain without radicular symptoms, interventions that focused on regaining function as soon as possible are relatively more effective than interventions that do not have such a focus. Conclusion. Our best evidence synthesis suggests that therapies involving manual therapy and exercise are more effective than alternative strategies for patients with neck pain; this was also true of therapies which include educational interventions

Recommended energy and nutrients intakes in the European Union: 2008-2016

Science.gov (United States)

García Gabarra, Antoni; Castellà Soley, Marta; Calleja Fernández, Alicia

2017-03-30

The aim of this document is to refl ect the changes happened in the European Union legislation and the opinions of the European Food Safety Authority in relation to the nutritional labeling on food, the reference values for energy, macronutrients and micronutrients, and the tolerable upper safe levels. The European legislation in force uses the labeling reference values established by the Scientific Committee on Food in 2003. There would be advisable an update of them from the reference values for vitamins and minerals established by the European Food Safety Authority. Equally, there would be good to include reference labeling values for polyunsaturated fatty acids, dietary fiber and choline, and specific reference labeling values for children from 6 to 36 months. For vitamins and minerals there would be desirable the revision of tolerable upper safe levels and the establishment of maximum amounts allowed in fortified food and food supplements in the European Union; its absence might represent a risk in some population groups for an excessive and unsafe intake of certain minerals and vitamins.

The premature necking of twinning-induced plasticity steels

International Nuclear Information System (INIS)

Yang, C.L.; Zhang, Z.J.; Zhang, P.; Zhang, Z.F.

2017-01-01

An unusual necking behavior was found in twinning-induced plasticity (TWIP) steels during tensile tests, which is quite different from that observed on most ductile metals. A sharp drop of the strain-hardening rate (Θ) arises before necking initiation, rather than after it, leading to the premature necking of TWIP steels. Through carefully examining the evolution of macroscopic defects at various tensile strains using three-dimensional X-ray tomography (3D-XRT), this premature necking behavior was attributed to the multiplication of macroscopic voids during plastic deformation. Combining with the previous theories and present characterizations on the evolution of macroscopic voids, the mechanism of the unusual necking behavior in TWIP steels was quantificationally revealed.

Effectiveness of a tailored neck training program on neck strength, movement, and fatigue in under-19 male rugby players: a randomized controlled pilot study

Directory of Open Access Journals (Sweden)

Barrett MD

2015-05-01

Full Text Available Matthew D Barrett,1 Terence F McLoughlin,2 Kieran R Gallagher,1 Don Gatherer,3 Michael TR Parratt,1 Jonathan R Perera,1 Tim WR Briggs1 1Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom; 2Royal Liverpool University Hospital, Liverpool, Mersey Deanery, United Kingdom; 3The Gatherer Partnership, Aylesbury, United Kingdom Purpose: To investigate the effect of a tailored neck muscle conditioning program on neck muscle strength, neck muscle fatigue, and range of neck movement in 16–18-year-old male rugby players. Materials and methods: Thirty-four male rugby players were divided into forward and back playing positions and randomized within these groups. Seventeen players were randomly assigned to each group. The test group was given a tailored 6-week exercise regime based on their baseline measurements to be performed three times a week in addition to their normal training and playing. The control group trained and played as normal. The outcome measures used were cervical spine range of movement, neck strength, and neck muscle fatigability. Results: There were no clinically relevant statistically significant differences between the two groups. Trends identified between the two groups suggest that a tailored neck exercise program increases neck strength, particularly neck extension, and increases resistance to fatigue, as well as influencing right- and left-sided neck muscle balance. A reduction in range of movement was also demonstrated in the test group. There was a great deal of variability in range of movement and strength within this age group. No previously undiagnosed neck conditions were detected, and there were no adverse events reported. Conclusion: This study has shown that neck strength, range of movement, and susceptibility of the neck muscles to fatigue can be influenced using a focused neck training regime. It forms an important basis for a larger, multicenter study to ensure the neck is given due attention in

Updated folate data in the Dutch Food Composition Database and implications for intake estimates

Directory of Open Access Journals (Sweden)

Susanne Westenbrink

2012-04-01

Full Text Available Background and objective: Nutrient values are influenced by the analytical method used. Food folate measured by high performance liquid chromatography (HPLC or by microbiological assay (MA yield different results, with in general higher results from MA than from HPLC. This leads to the question of how to deal with different analytical methods in compiling standardised and internationally comparable food composition databases? A recent inventory on folate in European food composition databases indicated that currently MA is more widely used than HPCL. Since older Dutch values are produced by HPLC and newer values by MA, analytical methods and procedures for compiling folate data in the Dutch Food Composition Database (NEVO were reconsidered and folate values were updated. This article describes the impact of this revision of folate values in the NEVO database as well as the expected impact on the folate intake assessment in the Dutch National Food Consumption Survey (DNFCS. Design: The folate values were revised by replacing HPLC with MA values from recent Dutch analyses. Previously MA folate values taken from foreign food composition tables had been recalculated to the HPLC level, assuming a 27% lower value from HPLC analyses. These recalculated values were replaced by the original MA values. Dutch HPLC and MA values were compared to each other. Folate intake was assessed for a subgroup within the DNFCS to estimate the impact of the update. Results: In the updated NEVO database nearly all folate values were produced by MA or derived from MA values which resulted in an average increase of 24%. The median habitual folate intake in young children was increased by 11–15% using the updated folate values. Conclusion: The current approach for folate in NEVO resulted in more transparency in data production and documentation and higher comparability among European databases. Results of food consumption surveys are expected to show higher folate intakes

[Disappearance of essential neck tremor after pontine base infarction].

Science.gov (United States)

Urushitani, M; Inoue, H; Kawamura, K; Kageyama, T; Fujisawa, M; Nishinaka, K; Udaka, F; Kameyama, M

1996-08-01

Mechanism of essential tremor remains unknown. Central oscillators, postulated in thalamus, inferior olive, and spinal cord are thought to be important to form rhythmicity, and finally to stimulate spinal or medullary motor cells, leading trembling muscle contraction, tremor. Among several subtypes of essential familial tremor, including hand tremor, neck tremor, and voice tremor, essential neck tremor is a common disorder, and its pathophysiology seems different from that of typical essential hand tremor, since patients with essential hand tremor are responsive to beta blocker, whereas those with neck tremor are usually not. We experienced a 41-year-old left handed woman with essential neck tremor in whom neck titubation disappeared shortly after pontine base infarct. She was our patient in the outpatient clinic with the diagnosis of essential neck tremor. The tremor developed when she was teenage, and has been localized in the neck muscles. Alcohol intake had apparently diminished it transiently. Her mother also had the tremor in her neck. She was admitted to our hospital with sudden onset of right-sided limb weakness and speech disturbance. Neurological examination showed right hemiparesis including the ipsilateral face, scanning speech, and cerebellar limb ataxia on the same side. In addition, there was no tremor in her neck. Brain MR imaging revealed a pontine base infarct at the level of middle pons, which was consistent with paramedian artery territory. The hemiparesis and speech disturbance improved almost completely after treatment, and her neck tremor has never occurred in one year follow-up. In our patient, efficacy of alcohol imply that essential neck tremor and hand tremor had same central nervous pathway including central oscillator in common, and descending cortical fibers is seemingly associated with diminishing patient's tremor. Pathophysiology of essential neck tremor was discussed with reviewing previous literature.

Necked-in superdeformed nuclei

International Nuclear Information System (INIS)

Joensson, L.O.

1997-03-01

In this dissertation the possibility of forming superdeformed states related to two connected spheres, having a more or less pronounced neck, is investigated. Detailed Nilsson-Strutinsky calculations with the cranked Woods-Saxon potential and a finite-range liquid drop model are carried out in the 180 Hg region, where superdeformed states related to two overlapping 90 Zr are predicted. Detailed spectroscopic properties are calculated. The effect of the necking degree of freedom on the giant dipole resonance, GDR, is investigated. The calculations are carried out with the Woods-saxon potential for the single-particle states, and the random phase approximation formalism for the phonon states. The residual interaction and coupling constants are determined by requirements of transitional invariance. The lower energy component of the GDR spectrum for superdeformed shapes, corresponding to vibrations along the symmetry axis, is diminished with increasing necking, and the mean energy of the GDR is increased. The folded Yukawa-plus-exponential liquid drop models take into account the finite range of the nuclear force, which is important when elongated and necked-in nuclear shapes are considered. However, it is shown that they are unstable towards higher multipole deformations, and that unphysical shapes are obtained in free minimizations when too high multipole deformations are included. Limits on multipolarity are given as functions of mass number. 9 refs., 4 figs

Isolated neck-lifting procedure: isolated stork lift.

Science.gov (United States)

Barbarino, Sheila C; Wu, Allan Y; Morrow, David M

2013-04-01

Many patients desire cosmetic improvement of neck laxity when consulting with a plastic surgeon about their face. Neck laxity and loss of the cervicomental angle can be due to multiple components of aging such as skin quality/elasticity, loss of platysma muscle tone, and submental fat accumulation. Traditionally, the procedure of choice for patients with an aging lower face and neck is a cervicofacial rhytidectomy. However, occasionally, a patient wishes to have no other facial surgery than an improvement of their excessive skin of the anterior, lateral, and/or posterior neck. In other instances, a patient may present with having had a face/neck-lifting procedure that left objectionable vertical/diagonal lines at the lateral neck. In both these instances, a surgeon should consider an isolated stork lift (ISL) procedure. An ISL procedure avoids and/or corrects problematic vertical/diagonal lateral neck folds by "walking" the excess skin flaps around the posterior inferior occipital hairline bilaterally, bringing the flaps together at the lateral and posterior neck, which sometimes involves a midline posterior dart excision of the dog ear. A patient presenting with excessive skin of the neck (anterior, lateral, and/or posterior) and/or residual vertical/diagonal skin folds is an excellent candidate for the ISL. The ISL procedure was performed on 273 patients over a 2-year period at The Morrow Institute. Patients were included if they had excessive skin of the anterior, lateral, and/or posterior neck and/or diagonal/vertical lateral bands and did not desire a full face-lifting procedure. Patients were excluded from this study if they would not accept having longer hair in order to cover the scar along the posterior inferior occipital hairline or a midline T-flap skin closure scar at the base of the posterior midline neck. Under a combination of local anesthesia and IV sedation, a postauricular face-lift incision was made that was extended in a circumoccipital fashion

Predictors of Persistent Axial Neck Pain After Cervical Laminoplasty.

Science.gov (United States)

Kimura, Atsushi; Shiraishi, Yasuyuki; Inoue, Hirokazu; Endo, Teruaki; Takeshita, Katsushi

2018-01-01

Retrospective analysis of prospective data. The aim of this study was to reveal baseline predictors of persistent postlaminoplasty neck pain. Axial neck pain is one of the most common complications after cervical laminoplasty; however, baseline predictors of persistent postlaminoplasty neck pain are unclear. We analyzed data from 156 patients who completed a 2-year follow-up after double-door laminoplasty for degenerative cervical myelopathy. Patients rated the average intensity of axial neck pain in the last month using an 11-point numerical rating scale preoperatively and at the 2-year follow-up. The dependent variable was the presence of moderate-to-severe neck pain (numerical rating scale ≥4) at the 2-year follow-up. The independent variables included patient characteristics, baseline radiological parameters, surgical variables, baseline axial neck pain intensity, and baseline functions, which were measured by the Japanese Orthopaedic Association score and the Short Form-36 survey (SF-36). Logistic regression analysis was performed to identify independent predictors of moderate-to-severe neck pain after laminoplasty. At the 2-year follow-up, 51 patients (32%) had moderate-to-severe neck pain, and 106 patients (68%) had no or mild pain. Univariate analysis revealed that the ratio of cervical anterolisthesis, ratio of current smoking, baseline neck pain intensity, and baseline SF-36 Mental Component Summary differed significantly between the groups. Multivariate logistic regression analysis showed that independent predictors of moderate-to-severe neck pain at the 2-year follow-up include the presence of anterolisthesis, current smoking, moderate-to-severe baseline neck pain, and lower SF-36 Mental Component Summary. The presence of anterolisthesis and moderate-to-severe baseline neck pain were also associated with significantly poorer physical function after surgery. The presence of anterolisthesis was associated not only with the highest odds ratio of

Scapulothoracic muscle strength in individuals with neck pain.

Science.gov (United States)

Petersen, Shannon M; Domino, Nathan A; Cook, Chad E

2016-08-10

People with neck pain often present with weakness in the scapulothoracic muscles. Few studies have examined lower trapezius (LT), middle trapezius (MT) and serratus anterior (SA) muscle strength in individuals with neck pain, nor compared strength to asymptomatic individuals. The aim of this study was to examine LT, MT and SA muscle strength in individuals with chronic neck pain. Descriptive cross sectional design. Twenty two individuals with chronic neck pain and 17 asymptomatic individuals were included. Participants were asked to complete a screening questionnaire, Neck Disability Index, and underwent manual muscle testing for the LT, MT, and SA muscles bilaterally. Data analyses included paired and comparative independent t-tests. For individuals with neck pain, significant within subject differences in strength between sides for the LT (Pneck pain were significantly weaker than asymptomatic individuals for the LT (p= 0.02), MT (p= 0.03), and SA (p= 0.01) on their side of neck pain, but not on their non-painful side. Significant within subject differences were found between sides for the LT and MT while significant between group differences were identified for all three muscles tested.

Psychometric properties of the neck disability index amongst patients with chronic neck pain using item response theory.

Science.gov (United States)

Saltychev, Mikhail; Mattie, Ryan; McCormick, Zachary; Laimi, Katri

2017-05-13

The Neck Disability Index (NDI) is commonly used for clinical and research assessment for chronic neck pain, yet the original version of this tool has not undergone significant validity testing, and in particular, there has been minimal assessment using Item Response Theory. The goal of the present study was to investigate the psychometric properties of the original version of the NDI in a large sample of individuals with chronic neck pain by defining its internal consistency, construct structure and validity, and its ability to discriminate between different degrees of functional limitation. This is a cross-sectional cohort study of 585 consecutive patients with chronic neck pain seen in a university hospital rehabilitation clinic. Internal consistency was evaluated using Cronbach's alpha, construct structure was evaluated by exploratory factor analysis, and discrimination ability was determined by Item Response Theory. The NDI demonstrated good internal consistency assessed by Cronbach's alpha (0.87). The exploratory factor analysis identified only one factor with eigenvalue considered significant (cutoff 1.0). When analyzed by Item Response Theory, eight out of 10 items demonstrated almost ideal difficulty parameter estimates. In addition, eight out of 10 items showed high to perfect estimates of discrimination ability (overall range 0.8 to 2.9). Amongst patients with chronic neck pain, the NDI was found to have good internal consistency, have unidimensional properties, and an excellent ability to distinguish patients with different levels of perceived disability. Implications for Rehabilitation The Neck Disability Index has good internal consistency, unidimensional properties, and an excellent ability to distinguish patients with different levels of perceived disability. The Neck Disability Index is recommended for use when selecting patients for rehabilitation, setting rehabilitation goals, and measuring the outcome of intervention.

X-Ray Exam: Neck (For Parents)

Science.gov (United States)

... Staying Safe Videos for Educators Search English Español X-Ray Exam: Neck KidsHealth / For Parents / X-Ray Exam: ... Neck Enlarged Adenoids Croup Sinusitis Getting an X-ray (Video) X-Ray (Video) View more Partner Message About Us ...

Head and Neck Cancer—Patient Version

Science.gov (United States)

Head and neck cancers include cancers in the larynx (voice box), throat, lips, mouth, nose, and salivary glands. Start here to find information on head and neck cancer treatment in adults and children, causes and prevention, screening, research, and statistics.

Radiation-induced neck fibrosis in patients with nasopharyngeal carcinoma

International Nuclear Information System (INIS)

Li Jian; Wang Rensheng; Gan Langge; Liu Wenqi; Zhang Yong

2005-01-01

Objective: To investigate the post-irradiation neck fibrosis in patients with nasopharyngeal carcinoma and its related factors. Methods: A total of 267 patients received conventional fractionated radiotherapy with D T 50-72 Gy on the neck a half year to 10 years ago were observed for the changes of cervical shape and functions. Results: Different degrees of post-irradiation neck fibrosis were seen in all patients. The rate of heavy degree of neck radiation fibrosis was 24.34 %, and it was 2.74% when received preventive dose on the neck. There was a very significant difference between patients who received late course of tangential irradiation on the neck and those who didn't receive (P=0.0001). The incidence of post-irradiation neck fibrosis didn't increase when patients received radiotherapy combined with chemotherapy (P=0.2678). The function of cervical muscles turned weak in patients received radiotherapy delivered by 6 MV accelerator in late course of tangential irradiation, whereas skin damage was severer in patients treated with 60 Co γ-rays. Conclusions: The incidence of heavy degree of post-irradiation neck fibrosis is high ,and is related closely to late course of tangential irradiation. The authors should avoid adopting this sort of irradiation on the neck. (authors)

Comparison of neck skin excision and whole carcass rinse sampling methods for determining Salmonella prevalence and E. coli counts on broiler carcasses before and after immersion chilling

Science.gov (United States)

A regulatory agency (FSIS) in the U.S. rinses whole broiler carcasses with 400 ml of 1% buffered peptone water (BPW) for Salmonella detection, while the European Union (EU) samples a 25g composited neck skin from three carcasses. The purpose of the study was to evaluate the FSIS and EU procedures fo...

EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists

NARCIS (Netherlands)

Fokkens, Wytske J.; Lund, Valerie J.; Mullol, Joachim; Bachert, Claus; Alobid, Isam; Baroody, Fuad; Cohen, Noam; Cervin, Anders; Douglas, Richard; Gevaert, Philippe; Georgalas, Christos; Goossens, Herman; Harvey, Richard; Hellings, Peter; Hopkins, Claire; Jones, Nick; Joos, Guy; Kalogjera, Livije; Kern, Bob; Kowalski, Marek; Price, David; Riechelmann, Herbert; Schlosser, Rodney; Senior, Brent; Thomas, Mike; Toskala, Elina; Voegels, Richard; Wang, De Yun; Wormald, Peter John

2012-01-01

The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007. The document contains chapters on definitions and classification, we now also propose definitions for 'difficult to treat' rhinosinusitis, control

An update on renal replacement therapy in Europe: ERA-EDTA Registry data from 1997 to 2006

NARCIS (Netherlands)

Kramer, Anneke; Stel, Vianda; Zoccali, Carmine; Heaf, James; Ansell, David; Grönhagen-Riska, Carola; Leivestad, Torbjørn; Simpson, Keith; Pálsson, Runólfur; Postorino, Maurizio; Jager, Kitty

2009-01-01

Background. Recent studies have indicated a stabilization in the incidence rates of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in a number of European countries. The aim of this study was to provide an update on the incidence, prevalence and outcomes of RRT in Europe over the

The European Nutrient Database (ENDB) for nutritional epidemiology

DEFF Research Database (Denmark)

Charrondiere, U.R.; Vignat, J.; Møller, Anni Rosendal

2002-01-01

a standardized and critically assessed nutrient database for the 10 countries involved in the European Prospective Investigation into Cancer and Nutrition (EPIC): Denmark, France, Germany, Greece, Great Britain, Italy, The Netherlands, Norway, Spain and Sweden. It will be compiled using the general concept......Food composition databases (FCDB), as well as standardized calculation procedures are required for international studies on nutrition and disease to calculate nutrient intakes across countries. Comparisons of national FCDBs have shown that major improvements are needed in standardization...... for a standardized FCDB, food classification and description, and calculation procedures developed for EPIC. National compilers will provide and document a subset of their nutrient data and some will evaluate them. Updated 'Food Table Input' (FTI) software will be used to evaluate and compile the data. The European...

Basilar artery aneurysm case presented with neck pain

Directory of Open Access Journals (Sweden)

Uygar Utku

2013-04-01

Full Text Available Neck pain related with disorders of the brain and neck vascular structures is not rare but importance was attached to a condition that is often overlooked. Tension as a sudden onset, radiating to the nape, the neck pain becomes unbearable and within seconds the raging 51-year-old female patient with aneurysm at the distal end of basilar artery was found. Case, the only sign of neck pain with unruptured basilar artery aneurysm is presented in terms of raising awareness on the subject.

Quality of life after planned neck dissection

International Nuclear Information System (INIS)

Iwae, Shigemichi; Hirayama, Yuji; Komatsu, Hirokazu

2009-01-01

We evaluated the effect of planned neck dissection (PND) after concurrent chemoradiotherapy (CCRT) on quality of life (QOL) by using a self-administered neck dissection questionnaire and an arm abduction test. Subjects are fourteen patients who had undergone CCRT followed by planned selective neck dissection for the treatment of mesopharyngeal and hypopharyngeal cancer. The findings of the survey were compared with thirty-two patients who had undergone CCRT alone. Patients without PND had better scores on measures of pain, constriction, numbness and appearance of the neck, but had no advantage about arm abduction. After PND, the patients who had dissected dominant hand side had lower satisfaction compared with those who had dissected non-dominant hand side. (author)

A proposal to create an extension to the European baseline series.

Science.gov (United States)

Wilkinson, Mark; Gallo, Rosella; Goossens, An; Johansen, Jeanne D; Rustemeyer, Thomas; Sánchez-Pérez, Javier; Schuttelaar, Marie L; Uter, Wolfgang

2018-02-01

The current European baseline series consists of 30 allergens, and was last updated in 2015. To use data from the European Surveillance System on Contact Allergies (ESSCA) to propose an extension to the European baseline series in response to changes in environmental exposures. Data from departmental and national extensions to the baseline series, together with some temporary additions from departments contributing to the ESSCA, were collated during 2013-2014. In total, 31689 patients were patch tested in 46 European departments. Many departments and national groups already consider the current European baseline series to be a suboptimal screen, and use their own extensions to it. The haptens tested are heterogeneous, although there are some consistent themes. Potential haptens to include in an extension to the European baseline series comprise sodium metabisulfite, formaldehyde-releasing preservatives, additional markers of fragrance allergy, propolis, Compositae mix, and 2-hydroxyethyl methacrylate. In combination with other published work from the ESSCA, changes to the current European baseline series are proposed for discussion. As well as addition of the allergens listed above, it is suggested that primin and clioquinol should be deleted from the series, owing to reduced environmental exposure. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Arm and neck pain in ultrasonographers.

Science.gov (United States)

Claes, Frank; Berger, Jan; Stassijns, Gaëtane

2015-03-01

The aim of this study was to evaluate the prevalence of upper-body-quadrant pain among ultrasonographers and to evaluate the association between individual ergonomics, musculoskeletal disorders, and occurrence of neck pain. A hundred and ten (N = 110) Belgian and Dutch male and female hospital ultrasonographers were consecutively enrolled in the study. Data on work-related ergonomic and musculoskeletal disorders were collected with an electronic inquiry, including questions regarding ergonomics (position of the screen, high-low table, and ergonomic chair), symptoms (neck pain, upper-limb pain), and work-related factors (consecutive working hours a day, average working hours a week). Subjects with the screen on their left had significantly more neck pain (odds ratio [OR] = 3.6, p = .0286). Depending on the workspace, high-low tables increased the chance of developing neck pain (OR = 12.9, p = .0246). A screen at eye level caused less neck pain (OR = .22, p = .0610). Employees with a fixed working space were less susceptible to arm pain (OR = 0.13, p = .0058). The prevalence of arm pain was significantly higher for the vascular department compared to radiology, urology, and gynecology departments (OR = 9.2, p = .0278). Regarding prevention of upper-limb pain in ultrasonograph, more attention should be paid to the work environment and more specialty to the ultrasound workstation layout. Primary ergonomic prevention could provide a painless work situation for the ultrasonographer. Further research on the ergonomic conditions of ultrasonography is necessary to develop ergonomic solutions in the work environment that will help to alleviate neck and arm pain. © 2014, Human Factors and Ergonomics Society.

The management of vacuum neck drains in head and neck surgery and the comparison of two different practice protocols for drain removal.

Science.gov (United States)

Kasbekar, A V; Davies, F; Upile, N; Ho, M W; Roland, N J

2016-01-01

Introduction The management of vacuum neck drains in head and neck surgery is varied. We aimed to improve early drain removal and therefore patient discharge in a safe and effective manner. Methods The postoperative management of head and neck surgical patients with vacuum neck drains was reviewed retrospectively. A new policy was then implemented to measure drainage three times daily (midnight, 6am, midday). The decision for drain removal was based on the most recent drainage period (at Measuring drainage volumes three times daily allows for more accurate assessment of wound drainage, and this can lead to earlier removal of neck drains and safe discharge.

MR of head and neck hemangiomas

International Nuclear Information System (INIS)

Bilaniuk, L.T.; Zimmerman, R.A.; Gusnard, D.A.

1990-01-01

This paper defines the MR characteristics of head and neck hemangiomas and to evaluate the role of MR in their diagnosis and management. Eighteen pediatric and young adult patients with head and neck hemangiomas (six neck, six face, three eyelid, two scalp, and one parotid) underwent high-field-strength 1.5-T MR imaging. Conventional spin-echo sequences with T1 and T2 weighting were performed. In addition, one-third of patients underwent MR angiography and gadolinium enhancement. The hemangiomas were isointense to muscle on T1-weighted images and hyperintense on proton-density and T2-weighted images

Musculoskeletal networks reveal topological disparity in mammalian neck evolution.

Science.gov (United States)

Arnold, Patrick; Esteve-Altava, Borja; Fischer, Martin S

2017-12-13

The increase in locomotor and metabolic performance during mammalian evolution was accompanied by the limitation of the number of cervical vertebrae to only seven. In turn, nuchal muscles underwent a reorganization while forelimb muscles expanded into the neck region. As variation in the cervical spine is low, the variation in the arrangement of the neck muscles and their attachment sites (i.e., the variability of the neck's musculoskeletal organization) is thus proposed to be an important source of neck disparity across mammals. Anatomical network analysis provides a novel framework to study the organization of the anatomical arrangement, or connectivity pattern, of the bones and muscles that constitute the mammalian neck in an evolutionary context. Neck organization in mammals is characterized by a combination of conserved and highly variable network properties. We uncovered a conserved regionalization of the musculoskeletal organization of the neck into upper, mid and lower cervical modules. In contrast, there is a varying degree of complexity or specialization and of the integration of the pectoral elements. The musculoskeletal organization of the monotreme neck is distinctively different from that of therian mammals. Our findings reveal that the limited number of vertebrae in the mammalian neck does not result in a low musculoskeletal disparity when examined in an evolutionary context. However, this disparity evolved late in mammalian history in parallel with the radiation of certain lineages (e.g., cetartiodactyls, xenarthrans). Disparity is further facilitated by the enhanced incorporation of forelimb muscles into the neck and their variability in attachment sites.

Neck Pain Occurrence and Characteristics in Nigerian University Undergraduates

Directory of Open Access Journals (Sweden)

Olufunke Patience Iroko

2010-06-01

Full Text Available AIM: University students seem to be a high risk group for neck pain which often leads to diminished concentration and academic performance among them. This study examined the occurrence and characteristics of neck pain in undergraduate students from the University of Ibadan, Nigeria. METHOD: One thousand and sixty nine (512 male and 557 female undergraduate students with the mean age of 23.49 ± 2.54 years responded in this cross-sectional survey. An adapted questionnaire that sought information on demographics, occurrence, characteristics and the consequence of neck pain on activities of daily living served as the survey instrument. Data were summarized using descriptive statistics. RESULTS: Lifetime prevalence and current frequency of neck pain among the respondents was 34.9% and 9.8% respectively. Female students had a higher preponderance of lifetime neck pain prevalence than their male counterparts (52.8 vs. 47.2%. There was higher frequency of neck pain after admission into the university than before (68.6 vs. 28.7%. Neck pain increased according to level of study and commoner among clinical students. 20% of the respondents reported chronic neck pain and was commoner in males than females (13% vs. 7% females. Seats without back supports used during lectures (48.0%, long reading hours (31.4%, poor self perpetuating posture (16.6%, and types of pillow used when sleeping (14.2% were the most implicated predisposing factors to neck pain. Reading (49.7% and concentration on school work (27.9% were the most limited activities of daily living. CONCLUSION: Neck pain is common among Nigerian university undergraduate students and affects females than males. The prevalence increased with higher level of study and commoner among clinical students. Neck pain mostly affects reading and concentration on school work among university undergraduate students. [TAF Prev Med Bull 2010; 9(3.000: 167-174

Evaluation of dried salted pork ham and neck quality

Directory of Open Access Journals (Sweden)

Simona Kunová

2015-12-01

Full Text Available The aim of the present study was analysed chemical and physical parameters of dried salted pork ham and neck. Dry-cured meat is a traditional dry-cured product obtained after 12 - 24 months of ripening under controlled environmental conditions.  Ham and neck was salted by nitrite salt mixture during 1 week. Salted meat products were dried at 4 °C and relative humidity 85% 1 week after salting. The quality of dry-cured meat is influenced by the processing technology, for example length of drying and ripening period. The average moisture of dried salted pork ham was 63.77% and dried salted pork neck was 59.26%. The protein content was 24.87% in dried salted pork ham and significantly lower (20.51% in dried salted pork neck. The value of intramuscular fat in dried salted pork ham was 4.97% and 14.40% in dried salted pork neck. The salt content was 5.39% in dried salted pork ham and 4.83% in dried salted pork neck. The cholesterol content was 1.36 g.kg-1 in dried salted pork ham and significant lower in dried salted pork neck (0.60 g.kg-1. The value of lightness was 44.36 CIE L* in dried salted pork ham and significantly lower in dried salted pork neck (40.74 CIE L*. The pH value was 5.84 in dried salted pork ham and 5.80 in dried salted pork neck. The shear work was 9.99 kg.s-1 in dried salted pork ham and 6.34 in dried salted pork neck. The value of water activity (aw was 0.929 in dried salted pork ham and similar 0.921 in dried salted pork neck. 

Physical risk factors for neck pain

NARCIS (Netherlands)

Ariëns, Geertje A M; Van Mechelen, Willem; Bongers, Paulien M.; Bouter, Lex M.; Van Der Wal, Gerrit

2000-01-01

To identify physical risk factors for neck pain, a systematic review of the literature was carried out. Based on methodological quality and study design, 4 levels of evidence were defined to establish the strength of evidence for the relationship between risk factors and neck pain. Altogether, 22

Primary Radiation Therapy for Head-and-Neck Cancer in the Setting of Human Immunodeficiency Virus

International Nuclear Information System (INIS)

Klein, Emily A.; Guiou, Michael; Farwell, D. Gregory; Luu, Quang; Lau, Derick H.; Stuart, Kerri; Vaughan, Andrew; Vijayakumar, Srinivasan; Chen, Allen M.

2011-01-01

Purpose: To analyze outcomes after radiation therapy for head-and-neck cancer among a cohort of patients with human immunodeficiency virus (HIV). Methods and Materials: The medical records of 12 patients with serologic evidence of HIV who subsequently underwent radiation therapy to a median dose of 68 Gy (range, 64-72 Gy) for newly diagnosed squamous cell carcinoma of the head and neck were reviewed. Six patients (50%) received concurrent chemotherapy. Intensity-modulated radiotherapy was used in 6 cases (50%). All patients had a Karnofsky performance status of 80 or 90. Nine patients (75%) were receiving antiretroviral therapies at the time of treatment, and the median CD4 count was 460 (range, 266-800). Toxicity was graded according to the Radiation Therapy Oncology Group / European Organization for the Treatment of Cancer toxicity criteria. Results: The 3-year estimates of overall survival and local-regional control were 78% and 92%, respectively. Acute Grade 3+ toxicity occurred in 7 patients (58%), the most common being confluent mucositis (5 patients) and moist skin desquamation (4 patients). Two patients experienced greater than 10% weight loss, and none experienced more than 15% weight loss from baseline. Five patients (42%) experienced treatment breaks in excess of 10 cumulative days, although none required hospitalization. There were no treatment-related fatalities. Conclusions: Radiation therapy for head-and-neck cancer seems to be relatively well tolerated among appropriately selected patients with HIV. The observed rates of toxicity were comparable to historical controls without HIV.

Neck and scleral hemorrhage in drowning.

Science.gov (United States)

Alexander, Russell T; Jentzen, Jeffrey M

2011-03-01

The determination of the cause and manner of death for a body recovered from the water can be difficult because of a lack of autopsy findings specific for drowning. This case report describes a 30-year-old man found submerged at the bottom of a hotel pool. An autopsy revealed scleral hemorrhages and fascial hemorrhages of multiple muscles of the anterior and posterior neck bilaterally. No evidence of traumatic injury was on the surface of the body. An investigation by law enforcement found no evidence of foul play. The occurrence of petechial and neck hemorrhage in a body recovered from the water is controversial, and a review of this literature will be given. We suggest that fascial hemorrhages of the muscles of the neck, as well as cephalic hemorrhages, can be explained by drowning-related elevated central venous pressure that is communicated to the head through the valveless veins of the neck. © 2010 American Academy of Forensic Sciences.

Sauropod necks: are they really for heat loss?

Directory of Open Access Journals (Sweden)

Donald M Henderson

Full Text Available Three-dimensional digital models of 16 different sauropods were used to examine the scaling relationship between metabolism and surface areas of the whole body, the neck, and the tail in an attempt to see if the necks could have functioned as radiators for the elimination of excess body heat. The sauropod taxa sample ranged in body mass from a 639 kg juvenile Camarasaurus to a 25 t adult Brachiosaurus. Metabolism was assumed to be directly proportional to body mass raised to the ¾ power, and estimates of body mass accounted for the presence of lungs and systems of air sacs in the trunk and neck. Surface areas were determined by decomposing the model surfaces into triangles and their areas being computed by vector methods. It was found that total body surface area was almost isometric with body mass, and that it showed negative allometry when plotted against metabolic rate. In contrast, neck area showed positive allometry when plotted against metabolic rate. Tail area show negative allometry with respect to metabolic rate. The many uncertainties about the biology of sauropods, and the variety of environmental conditions that different species experienced during the groups 150 million years of existence, make it difficult to be absolutely certain about the function of the neck as a radiator. However, the functional combination of the allometric increase of neck area, the systems of air sacs in the neck and trunk, the active control of blood flow between the core and surface of the body, changing skin color, and strategic orientation of the neck with respect to wind, make it plausible that the neck could have functioned as a radiator to avoid over-heating.

The European Federation of Organisations for Medical Physics Policy Statement No. 6.1: Recommended Guidelines on National Registration Schemes for Medical Physicists

OpenAIRE

Christofides, S; Isidoro, J; Pesznyak, C; Bumbure, L; Cremers, Fn; Schmidt, WF

2016-01-01

This EFOMP Policy Statement is an update of Policy Statement No. 6 first published in 1994. The present version takes into account the European Union Parliament and Council Directive 2013/55/EU that amends Directive 2005/36/EU on the recognition of professional qualifications and the European Union Council Directive 2013/59/EURATOM laying down the basic safety standards for protection against the dangers arising from exposure to ionising radiation. The European Commission Radiation Protection...

An Unusual Neck Mass: Ingested Chicken Bone

OpenAIRE

Demirhan, Erhan; İber, Metin; Yağız, Özlem; Kandoğan, Tolga; Çukurova, İbrahim

2016-01-01

Background: Foreign bodies in the upper aerodigestive tract are frequently seen in otolaryngological practice, but migration of an ingested foreign body to the neck is a very rare condition. Case Report: We present a 66-year-old woman admitted to our outpatient department with a painful neck mass. She had a history of emergency department admission 4 months prior with odynophagia after eating chicken meal. A physical examination revealed a painful and hyperemic mass on the left neck. Ant...

Heritability of neck pain

DEFF Research Database (Denmark)

Fejer, R; Hartvigsen, J; Kyvik, K O

2006-01-01

73%) answered the questions regarding neck pain. Probandwise concordance rates, zygosity-specific odds ratios and tetrachoric correlations showed a significant genetic effect on neck pain. An overall additive genetic component of 44% was found. The genetic effect decreased with age, accounting...... for only 10% in the oldest male group and 0% in the oldest female group. There was a statistically significant difference in heritability between males and females (34 vs 52%, P... gradually less important with increasing age, and environmental factors dominate almost completely in the older age groups....

Assessing quality of life in patients with colorectal cancer: an update of the EORTC quality of life questionnaire

NARCIS (Netherlands)

Gujral, S.; Conroy, T.; Fleissner, C.; Sezer, O.; King, P. M.; Avery, K. N. L.; Sylvester, P.; Koller, M.; Sprangers, M. A. G.; Blazeby, J. M.

2007-01-01

The European Organisation for Research and Treatment of Cancer (EORTC) has a portfolio of questionnaire modules to supplement the QLQ-C30 to assess patient reported outcomes in cancer clinical trials. This study updated the module for colorectal cancer. A review of the literature identified 20

Management of bleeding and coagulopathy following major trauma: an updated European guideline

Science.gov (United States)

2013-01-01

Introduction Evidence-based recommendations are needed to guide the acute management of the bleeding trauma patient. When these recommendations are implemented patient outcomes may be improved. Methods The multidisciplinary Task Force for Advanced Bleeding Care in Trauma was formed in 2005 with the aim of developing a guideline for the management of bleeding following severe injury. This document represents an updated version of the guideline published by the group in 2007 and updated in 2010. Recommendations were formulated using a nominal group process, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) hierarchy of evidence and based on a systematic review of published literature. Results Key changes encompassed in this version of the guideline include new recommendations on the appropriate use of vasopressors and inotropic agents, and reflect an awareness of the growing number of patients in the population at large treated with antiplatelet agents and/or oral anticoagulants. The current guideline also includes recommendations and a discussion of thromboprophylactic strategies for all patients following traumatic injury. The most significant addition is a new section that discusses the need for every institution to develop, implement and adhere to an evidence-based clinical protocol to manage traumatically injured patients. The remaining recommendations have been re-evaluated and graded based on literature published since the last edition of the guideline. Consideration was also given to changes in clinical practice that have taken place during this time period as a result of both new evidence and changes in the general availability of relevant agents and technologies. Conclusions A comprehensive, multidisciplinary approach to trauma care and mechanisms with which to ensure that established protocols are consistently implemented will ensure a uniform and high standard of care across Europe and beyond. Please see related letter by Morel

The relationship between neck pain and physical activity.

Science.gov (United States)

Cheung, Janice; Kajaks, Tara; Macdermid, Joy C

2013-01-01

Neck pain is a significant societal burden due to its high prevalence and healthcare costs. While physical activity can help to manage other forms of chronic musculoskeletal pain, little data exists on the relationship between physical activity and neck pain. The purpose of this study was to compare physical activity levels between individuals with neck pain and healthy controls, and then to relate disability, fear of movement, and pain sensitivity measures to physical activity levels in each of the two participant groups. 21 participants were recruited for each of the two participant groups (n = 42). Data collection included the use of the Neck Disability Index, the Tampa Scale for Kinesiophobia, electrocutaneous (Neurometer® CPT) and pressure stimulation (JTech algometer) for quantitative sensory testing, and 5 days of subjective (Rapid Assessment of Physical Activity) and objective (BioTrainer II) measurements of physical activity. Analysis of Variance and Pearson's Correlation were used to determine if differences and relationships exist between dependent variables both within and between groups. The results show that individuals with mild neck pain and healthy controls do not differ in subjectively and objectively measured physical activity. While participants with neck pain reported higher neck disability and fear of movement, these factors did not significantly relate to physical activity levels. Perceived activity level was related to pain threshold and tolerance at local neck muscles sites (C2 paraspinal muscle and upper trapezius muscle), whereas measured activity was related to generalized pain sensitivity, as measured at the tibialis anterior muscle site.

Pain education combined with neck- and aerobic training is more effective at relieving chronic neck pain than pain education alone--A preliminary randomized controlled trial.

Science.gov (United States)

Brage, K; Ris, I; Falla, D; Søgaard, K; Juul-Kristensen, B

2015-10-01

To evaluate the effect of training and pain education vs pain education alone, on neck pain, neck muscle activity and postural sway in patients with chronic neck pain. Twenty women with chronic neck pain were randomized to receive pain education and specific training (neck-shoulder exercises, balance and aerobic training) (INV), or pain education alone (CTRL). Effect on neck pain, function and Global Perceived Effect (GPE) were measured. Surface electromyography (EMG) was recorded from neck flexor and extensor muscles during performance of the Cranio-Cervical Flexion Test (CCFT) and three postural control tests (two-legged: eyes open and closed, one-legged: eyes open). Sway parameters were calculated. Fifteen participants (CTRL: eight; INV: seven) completed the study. Per protocol analyses showed a larger pain reduction (p = 0.002) for the INV group with tendencies for increased GPE (p = 0.06), reduced sternocleidomastoid activity during the CCFT (p = 0.09), reduced sway length (p = 0.09), and increased neck extensor activity (p = 0.02) during sway compared to the CTRL group. Pain education and specific training reduce neck pain more than pain education alone in patients with chronic neck pain. These results provide encouragement for a larger clinical trial to corroborate these observations. Copyright © 2015 Elsevier Ltd. All rights reserved.

Intraoperative monitoring of marginal mandibular nerve during neck dissection.

Science.gov (United States)

Tirelli, Giancarlo; Bergamini, Pier Riccardo; Scardoni, Alessandro; Gatto, Annalisa; Boscolo Nata, Francesca; Marcuzzo, Alberto Vito

2018-05-01

The purpose of this study was to assess the efficacy of intraoperative nerve integrity monitoring (NIM) to prevent marginal mandibular nerve injuries during neck dissection. This prospective study compared 36 patients undergoing NIM-assisted neck dissection from July 2014 to March 2015 to a cohort of 35 patients subjected to neck dissection over an identical period of time before the technique was introduced. We also assessed possible correlations between marginal mandibular nerve injuries and other factors, such as anthropometric measurements, presence of clinical neck metastases, type of neck dissection, and site of primary tumor. The incidence of marginal mandibular nerve paralyses was significantly lower among the group of patients undergoing NIM-assisted neck dissection (P = .021). There was no significant difference in the duration of the procedure, and the technique resulted in a limited increase of cost. No other factor seemed to influence the onset of marginal mandibular nerve palsy. In our opinion, NIM is a valuable aid for preventing marginal mandibular nerve injuries during neck dissection. © 2018 Wiley Periodicals, Inc.

Bilateral femoral neck fractures following pelvic irradiation

International Nuclear Information System (INIS)

Mitsuda, Kenji; Nishi, Hosei; Oba, Hiroshi

1977-01-01

Over 300 cases of femoral neck fractures following radiotherapy for intrapelvic malignant tumor have been reported in various countries since Baensch reported this disease in 1927. In Japan, 40 cases or so have been reported, and cases of bilateral femoral neck fractures have not reached to ten cases. The authors experienced a case of 75 year-old female who received radiotherapy for cancer of the uterus, and suffered from right femoral neck fracture 3 months after and left femoral neck fracture one year and half after. As clinical symptoms, she had not previous history of trauma in bilateral femurs, but she complained of a pain in a hip joint and of gait disturbance. The pain in left femoral neck continued for about one month before fracture was recognized with roentgenogram. As histopathological findings, increase of fat marrow, decrease of bone trabeculae, and its marked degeneration were recognized. Proliferation of some blood vessels was found out, but thickness of the internal membrane and thrombogenesis were not recognized. Treatment should be performed according to degree of displacement of fractures. In this case, artificial joint replacement surgery was performed to the side of fracture of this time, because this case was bilateral femoral neck fractures and the patient had received artificial head replacement surgery in the other side of fracture formerly. (Tsunoda, M.)

Digital subtraction angiography in head and neck radiology

Energy Technology Data Exchange (ETDEWEB)

Carmody, R F; Seeger, J F; Smith, R L; Horsley, W W; Miller, R W

1984-07-01

Intravenous digital subtraction angiography (IVDSA) was used to evaluate 44 patients with suspected otolaryngologic abnormalities. Sixteen had IVDSA for pulsatile tinnitus or suspected glomus tumor of the petrous bone. Nine patients were evaluated because of pulsatile neck masses, and 12 others had suspected tumors of the neck, face, and paranasal sinuses. Seven had IVDSA following head and neck trauma. The technique of examination is described. The current indications of IVDSA in head and neck radiology are discussed. It is concluded that IVDSA is a suitable substitute for conventional angiography for many otolaryngologic conditions and, because of its safety, can be used more liberally.

Genetics Home Reference: head and neck squamous cell carcinoma

Science.gov (United States)

... and neck squamous cell carcinoma Head and neck squamous cell carcinoma Printable PDF Open All Close All Enable Javascript ... Consumer Version: Overview of Mouth, Nose, and Throat Cancers Orphanet: Squamous cell carcinoma of head and neck University of Michigan ...

Pocket Proteins Suppress Head and Neck Cancer

Science.gov (United States)

Shin, Myeong-Kyun; Pitot, Henry C.; Lambert, Paul F.

2012-01-01

Head and neck squamous cell carcinomas (HNSCC) is a common cancer in humans long known to be caused by tobacco and alcohol use, but now an increasing percentage of HNSCC is recognized to be caused by the same human papillomaviruses (HPVs) that cause cervical and other anogenital cancers. HPV-positive HNSCCs differ remarkably from HPV-negative HNSCCs in their clinical response and molecular properties. From studies in mice, we know that E7 is the dominant HPV oncoprotein in head and neck cancer. E7 is best known for its ability to inactivate pRb, the product of the retinoblastoma tumor susceptibility gene. However loss of pRb function does not fully account for E7’s potency in causing head and neck cancer. In this study, we characterized the cancer susceptibility of mice deficient in the expression of pRb and either of two related “pocket” proteins, p107 and p130, that are also inactivated by E7. pRb/p107 deficient mice developed head and neck cancer as frequently as do HPV16 E7 transgenic mice. The head and neck epithelia of the pRb/p107 deficient mice also displayed the same acute phenotypes and biomarker readouts as observed in the epithelia of E7 transgenic mice. Mice deficient for pRb and p130 in their head and neck epithelia showed intermediate acute and tumor phenotypes. We conclude that pRb and p107 act together to efficiently suppress head and neck cancer, and are therefore highly relevant targets of HPV16 E7 in its contribution to HPV-positive HNSCC. PMID:22237625

Neck Muscle Fatigue with Helmet-Mounted Systems

National Research Council Canada - National Science Library

Eveland, Edward S; Pellettiere, Joseph A

2006-01-01

.... Changes in neck muscle strength were identified along with EMG evidence of fatigue. When flights occurred on an almost daily basis over 4 days, the force imparted to the neck was reduced each day...

The Erasmus programme for postgraduate education in orthodontics in Europe: an update of the guidelines.

Science.gov (United States)

Huggare, J; Derringer, K A; Eliades, T; Filleul, M P; Kiliaridis, S; Kuijpers-Jagtman, A; Martina, R; Pirttiniemi, P; Ruf, S; Schwestka-Polly, R

2014-06-01

In 1989, the ERASMUS Bureau of the European Cultural Foundation of the Commission of the European Communities funded the development of a new 3-year curriculum for postgraduate education in orthodontics. The new curriculum was created by directors for orthodontic education representing 15 European countries. The curriculum entitled 'Three years Postgraduate Programme in Orthodontics: the Final Report of the Erasmus Project' was published 1992. In 2012, the 'Network of Erasmus Based European Orthodontic Programmes' developed and approved an updated version of the guidelines. The core programme consists of eight sections: general biological and medical subjects; basic orthodontic subjects; general orthodontic subjects; orthodontic techniques; interdisciplinary subjects; management of health and safety; practice management, administration, and ethics; extramural educational activities. The programme goals and objectives are described and the competencies to be reached are outlined. These guidelines may serve as a baseline for programme development and quality assessment for postgraduate programme directors, national associations, and governmental bodies and could assist future residents when selecting a postgraduate programme.

INCLUSION OF GUAVA WASTES IN THE DIET OF EUROPEAN QUAILS

Directory of Open Access Journals (Sweden)

Luiz Carlos Lemos Camelo

2015-07-01

Full Text Available This experiment was conducted to analyze the performance and carcass characteristics of European quail fed agroindustry residue of guava in substitution of corn. 140 birds were used, distributed in a completely randomized design. The treatments consisted of a control diet and four diets with levels of guava waste inclusion (2.5, 5.0, 7.5 and 10.0% to a diet based on corn and soybean meal. There were no significant differences (P> 0.05 for the variables: weight gain, feed intake, feed conversion, feed efficiency, weight and carcass yield and prime cuts (breast, drumstick and thigh wings, back , neck, head, feet and foodstuffs organs (heart, liver and gizzard. The guava waste can be used as alternative ingredient in the diets of European quail in the period of 16-38 days of age, up to the level of 10% inclusion without depressing the performance and yield of poultry carcasses.

Evolution of neck vertebral shape and neck retraction at the transition to modern turtles: an integrated geometric morphometric approach.

Science.gov (United States)

Werneburg, Ingmar; Wilson, Laura A B; Parr, William C H; Joyce, Walter G

2015-03-01

The unique ability of modern turtles to retract their head and neck into the shell through a side-necked (pleurodiran) or hidden-necked (cryptodiran) motion is thought to have evolved independently in crown turtles. The anatomical changes that led to the vertebral shapes of modern turtles, however, are still poorly understood. Here we present comprehensive geometric morphometric analyses that trace turtle vertebral evolution and reconstruct disparity across phylogeny. Disparity of vertebral shape was high at the dawn of turtle evolution and decreased after the modern groups evolved, reflecting a stabilization of morphotypes that correspond to the two retraction modes. Stem turtles, which had a very simple mode of retraction, the lateral head tuck, show increasing flexibility of the neck through evolution towards a pleurodiran-like morphotype. The latter was the precondition for evolving pleurodiran and cryptodiran vertebrae. There is no correlation between the construction of formed articulations in the cervical centra and neck mobility. An increasing mobility between vertebrae, associated with changes in vertebral shape, resulted in a more advanced ability to retract the neck. In this regard, we hypothesize that the lateral tucking retraction of stem turtles was not only the precondition for pleurodiran but also of cryptodiran retraction. For the former, a kink in the middle third of the neck needed to be acquired, whereas for the latter modification was necessary between the eighth cervical vertebra and first thoracic vertebra. Our paper highlights the utility of 3D shape data, analyzed in a phylogenetic framework, to examine the magnitude and mode of evolutionary modifications to vertebral morphology. By reconstructing and visualizing ancestral anatomical shapes, we provide insight into the anatomical features underlying neck retraction mode, which is a salient component of extant turtle classification. © The Author(s) 2014. Published by Oxford University Press

Updated German S3-guideline regarding the diagnosis of Crohn's disease. Implementation of radiological modalities

International Nuclear Information System (INIS)

Schreyer, A.G.; Ludwig, D.; Koletzko, S.; Hoffmann, J.C.; Preiss, J.C.; Zeitz, M.; Stange, E.; Herrlinger, K.R.

2010-01-01

The recently updated German S3-guideline regarding the diagnosis and treatment of Crohn's disease incorporates several changes concerning the radiological approach compared to the former guideline. This article focuses on guideline-based radiological imaging techniques for patients with Crohn's disease. The new guideline is also compared to former European and German guidelines in the context of recently published radiological literature. (orig.)

Pain education combined with neck- and aerobic training is more effective at relieving chronic neck pain than pain education alone - A preliminary randomized controlled trial

DEFF Research Database (Denmark)

Brage, K; Ris Hansen, Inge; Falla, D

2015-01-01

-shoulder exercises, balance and aerobic training) (INV), or pain education alone (CTRL). Effect on neck pain, function and Global Perceived Effect (GPE) were measured. Surface electromyography (EMG) was recorded from neck flexor and extensor muscles during performance of the Cranio-Cervical Flexion Test (CCFT......OBJECTIVE: To evaluate the effect of training and pain education vs pain education alone, on neck pain, neck muscle activity and postural sway in patients with chronic neck pain. METHODS: Twenty women with chronic neck pain were randomized to receive pain education and specific training (neck......) and three postural control tests (two-legged: eyes open and closed, one-legged: eyes open). Sway parameters were calculated. RESULTS: Fifteen participants (CTRL: eight; INV: seven) completed the study. Per protocol analyses showed a larger pain reduction (p = 0.002) for the INV group with tendencies...

Neck proprioception shapes body orientation and perception of motion.

Science.gov (United States)

Pettorossi, Vito Enrico; Schieppati, Marco

2014-01-01

This review article deals with some effects of neck muscle proprioception on human balance, gait trajectory, subjective straight-ahead (SSA), and self-motion perception. These effects are easily observed during neck muscle vibration, a strong stimulus for the spindle primary afferent fibers. We first remind the early findings on human balance, gait trajectory, SSA, induced by limb, and neck muscle vibration. Then, more recent findings on self-motion perception of vestibular origin are described. The use of a vestibular asymmetric yaw-rotation stimulus for emphasizing the proprioceptive modulation of motion perception from the neck is mentioned. In addition, an attempt has been made to conjointly discuss the effects of unilateral neck proprioception on motion perception, SSA, and walking trajectory. Neck vibration also induces persistent aftereffects on the SSA and on self-motion perception of vestibular origin. These perceptive effects depend on intensity, duration, side of the conditioning vibratory stimulation, and on muscle status. These effects can be maintained for hours when prolonged high-frequency vibration is superimposed on muscle contraction. Overall, this brief outline emphasizes the contribution of neck muscle inflow to the construction and fine-tuning of perception of body orientation and motion. Furthermore, it indicates that tonic neck-proprioceptive input may induce persistent influences on the subject's mental representation of space. These plastic changes might adapt motion sensitiveness to lasting or permanent head positional or motor changes.

Digital subtraction angiography in head and neck radiology

International Nuclear Information System (INIS)

Carmody, R.F.; Seeger, J.F.; Smith, R.L.; Horsley, W.W.; Miller, R.W.

1984-01-01

Intravenous digital subtraction angiography (IVDSA) was used to evaluate 44 patients with suspected otolaryngologic abnormalities. Sixteen had IVDSA for pulsatile tinnitus or suspected glomus tumor of the petrous bone. Nine patients were evaluated because of pulsatile neck masses, and 12 others had suspected tumors of the neck, face, and paranasal sinuses. Seven had IVDSA following head and neck trauma. The technique of examination is described. The current indications of IVDSA in head and neck radiology are discussed. It is concluded that IVDSA is a suitable substitute for conventional angiography for many otolaryngologic conditions and, because of its safety, can be used more liberally. (orig.)

Validity of the neck disability index, Northwick Park neck pain questionnaire, and problem elicitation technique for measuring disability associated with whiplash-associated disorders

NARCIS (Netherlands)

Hoving, Jan Lucas; O'Leary, Elizabeth F.; Niere, Ken R.; Green, Sally; Buchbinder, Rachelle

2003-01-01

The Neck Disability Index (NDI) and Northwick Park Neck Pain Questionnaire (NPQ) were developed to measure self-perceived disability from neck pain, including that which may arise from whiplash injury. However, there is little data specifically concerning their validity for whiplash-associated

Viable tumor in salvage neck dissections in head and neck cancer : Relation with initial treatment, change of lymph node size and human papillomavirus

NARCIS (Netherlands)

van den Bovenkamp, Karlijn; Dorgelo, Bart; Noordhuis, Maartje G; van der Laan, Bernard F A M; van der Vegt, Bert; Bijl, Hendrik P; Roodenburg, Jan L; van Dijk, Boukje A C; Oosting, Sjoukje F; Schuuring, Ed M D; Langendijk, Johannes A; Halmos, Gyorgy B; Plaat, Boudewijn E C

Objectives: To identify predictive factors for the presence of viable tumor and outcome in head and neck cancer patients who undergo therapeutic salvage neck dissections. Materials and Methods: Retrospective analysis of 76 salvage neck dissections after radiotherapy alone (n = 22), radiotherapy in

Ultrasonographic changes in malignant neck nodes during radiotherapy in head and neck squamous carcinoma

International Nuclear Information System (INIS)

Correa, P.D.; Laskar, S.G.; Shrivastava, S.K.; Dinshaw, K.A.; Gupta, T.; Agarwal, J.P.; Arya, S.

2005-01-01

Limited information is available about the sonomorphological changes in metastatic neck nodes during radiotherapy. The aim of this study was to evaluate the pattern of sonomorphological changes in metastatic neck nodes with radiotherapy. The study population consisted of 16 consecutive patients planned for radical radiotherapy to the head and neck. All patients were subjected to four ultrasound examinations: before therapy, at 46 Gy, at the conclusion of radiation and at first follow up. A total of 59 ultrasound examinations were performed on 16 patients. The difference between the mean number of nodes detected per patient before (10.6) and after (7.8) radiation was significant (P = 0.05). Sixteen nodes were categorized as malignant at first sonography, half of which reverted back to normal by the end of radiation. Changes in the sonomorphology of malignant cervical lymph nodes occur with radiotherapy with more that half demonstrating reversion to normal pattern. Future studies correlating this with histopathology should be considered Copyright (2005) Blackwell Publishing Asia Pty Ltd

European studies on occupational radiation exposure - ESOREX

International Nuclear Information System (INIS)

Petrova, K.; Frasch, G.

2005-01-01

sectors and work subcategories for the years 1995 - 2000 use as far as possible an internationally comparable system of work categories and dose intervals. One major aim of this 10-years time series is to document how occupational radiation exposure in Europe changed after the implementation of the new dose limits by the Council Directive 96/29 EURATOM. Since 1997 the following ESOREX studies have been executed: ESOREX WEST (Austria, Belgium, Denmark, Germany, Finland, France, Greece, Iceland, Ireland, Italy, Luxembourg, The Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, United Kingdom), part I + part II (1995); ESOREX EAST (Bulgaria, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovak Republic, Slovenia), part I + part II (1997); ESOREX 2000, update of part I + part II (1995-2000). At present ESOREX 2005 is executed with an update of part I + part II (2001-2005). The presentation will give an overview of the ESOREX studies already performed and provide selected results on European level (e.g. dose distribution for main occupational sectors such nuclear industry, general industry, medicine, natural exposure). The presentation will be also focused to the comparison of different approaches in the participating countries to control and register occupational radiation exposure, e.g. central dose registration, categorization of workers, official dosemeters, use of the shielding apron. (author)

Outcome-based anatomic criteria for defining the hostile aortic neck.

Science.gov (United States)

Jordan, William D; Ouriel, Kenneth; Mehta, Manish; Varnagy, David; Moore, William M; Arko, Frank R; Joye, James; de Vries, Jean-Paul P M

2015-06-01

There is abundant evidence linking hostile proximal aortic neck anatomy to poor outcome after endovascular aortic aneurysm repair (EVAR), yet the definition of hostile anatomy varies from study to study. This current analysis was undertaken to identify anatomic criteria that are most predictive of success or failure at the aortic neck after EVAR. The study group comprised 221 patients in the Aneurysm Treatment using the Heli-FX Aortic Securement System Global Registry (ANCHOR) clinical trial, a population enriched with patients with challenging aortic neck anatomy and failure of sealing. Imaging protocols were not protocol specified but were performed according to the institution's standard of care. Core laboratory analysis assessed the three-dimensional centerline-reformatted computed tomography scans. Failure at the aortic neck was defined by type Ia endoleak occurring at the time of the initial endograft implantation or during follow-up. Receiver operating characteristic curve analysis was used to assess the value of each anatomic measure in the classification of aortic neck success and failure and to identify optimal thresholds of discrimination. Binary logistic regression was performed after excluding highly intercorrelated variables, creating a final model with significant predictors of outcome after EVAR. Among the 221 patients, 121 (54.8%) remained free of type Ia endoleak and 100 (45.2%) did not. Type Ia endoleaks presented immediately after endograft deployment in 58 (58.0%) or during follow-up in 42 (42.0%). Receiver operating characteristic curve analysis identified 12 variables where the classification of patients with type Ia endoleak was significantly more accurate than chance alone. Increased aortic neck diameter at the lowest renal artery (P = .013) and at 5 mm (P = .008), 10 mm (P = .008), and 15 mm (P = .010) distally; aneurysm sac diameter (P = .001), common iliac artery diameters (right, P = .012; left, P = .032), and a conical (P = .049) neck

Effect of neck warming and cooling on thermal comfort

Science.gov (United States)

Williams, B. A.; Chambers, A. B.

1972-01-01

The potential use of local neck cooling in an area superficial to the cerebral arteries was evaluated by circulating cold or hot water through two copper disks held firmly against the neck. Subjective responses indicated that neck cooling improves the thermal comfort in a hot environment.

Prevention of flight-related neck pain in military aircrew

NARCIS (Netherlands)

van den Oord, M.H.A.H.

2012-01-01

Military pilots and rear aircrew members are occupations with several occupational exposures that might cause neck pain. In addition to the negative impact of neck pain on health, safety is one of the main concerns for the military aviation, because neck pain may interfere with flying performance.

Shoulder morbidity after non-surgical treatment of the neck.

NARCIS (Netherlands)

van Wouwe, V.; de Bree, R.; Kuik, D.J.; de Goede, C.J.T.; de Leeuw, I.M.; Leemans, C.R.

2009-01-01

Background and purpose: Reports on shoulder function after non-surgical treatment are not available. In the present study shoulder morbidity after surgical and non-surgical treatment of the neck is determined and compared. Materials and methods: In 100 head and neck cancer patients 174 neck sides

Conservative Management of Mechanical Neck Pain in a Helicopter Pilot.

Science.gov (United States)

Alagha, Babak

2015-10-01

Acute and chronic spinal symptoms such as neck pain may limit flying performance significantly and disqualify the pilot from flight duty. Mechanical neck pain is very common among pilots because of their exposure to vibration, +GZ forces, helmet weight, poor neck posture during air combat maneuvers, previous neck injuries, and poor treatment plans for such injuries. Successful treatment of such injuries requires appropriate therapeutic procedures as well as an aeromedical assessment. The aim of this case study was to demonstrate the benefits of conservative procedures such as spinal manipulation and mobilization therapy (SMMT) and exercise therapy (ET) in treating chronic mechanical neck pain in an Iranian commercial helicopter pilot. A 36-yr-old male patient presented to the clinic with moderate, intermittent nonradicular chronic neck pain and limited range of motion over a 2-yr period. The patient was treated with cervical and upper thoracic SMMT followed by home ET for 5 wk. After this period, the patient reported significant recovery and improvement in range of motion in his neck. Mechanical neck pain is very common among helicopter pilots. Although Air Force and Navy waiver guides recommend nonsteroidal anti-inflammatory medications as well as SMMT and ET, there are currently very few published studies that examine the benefits of manual and exercise therapy for treating mechanical neck pain in commercial and military pilots. Based on the results of this study, it seems that SMMT and ET may be a safe and effective in treatment of uncomplicated mechanical neck pain in helicopter pilots. Alagha B. Conservative management of mechanical neck pain in a helicopter pilot.

The articulation of sauropod necks: methodology and mythology.

Science.gov (United States)

Stevens, Kent A

2013-01-01

Sauropods are often imagined to have held their heads high atop necks that ascended in a sweeping curve that was formed either intrinsically because of the shape of their vertebrae, or behaviorally by lifting the head, or both. Their necks are also popularly depicted in life with poses suggesting avian flexibility. The grounds for such interpretations are examined in terms of vertebral osteology, inferences about missing soft tissues, intervertebral flexibility, and behavior. Osteologically, the pronounced opisthocoely and conformal central and zygapophyseal articular surfaces strongly constrain the reconstruction of the cervical vertebral column. The sauropod cervico-dorsal vertebral column is essentially straight, in contrast to the curvature exhibited in those extant vertebrates that naturally hold their heads above rising necks. Regarding flexibility, extant vertebrates with homologous articular geometries preserve a degree of zygapophyseal overlap at the limits of deflection, a constraint that is further restricted by soft tissues. Sauropod necks, if similarly constrained, were capable of sweeping out large feeding surfaces, yet much less capable of retracting the head to explore the enclosed volume in an avian manner. Behaviorally, modern vertebrates generally assume characteristic neck postures which are close to the intrinsic curvature of the undeflected neck. With the exception of some vertebrates that can retract their heads to balance above their shoulders at rest (e.g., felids, lagomorphs, and some ratites), the undeflected neck generally predicts the default head height at rest and during locomotion.

The Articulation of Sauropod Necks: Methodology and Mythology

Science.gov (United States)

Stevens, Kent A.

2013-01-01

Sauropods are often imagined to have held their heads high atop necks that ascended in a sweeping curve that was formed either intrinsically because of the shape of their vertebrae, or behaviorally by lifting the head, or both. Their necks are also popularly depicted in life with poses suggesting avian flexibility. The grounds for such interpretations are examined in terms of vertebral osteology, inferences about missing soft tissues, intervertebral flexibility, and behavior. Osteologically, the pronounced opisthocoely and conformal central and zygapophyseal articular surfaces strongly constrain the reconstruction of the cervical vertebral column. The sauropod cervico-dorsal vertebral column is essentially straight, in contrast to the curvature exhibited in those extant vertebrates that naturally hold their heads above rising necks. Regarding flexibility, extant vertebrates with homologous articular geometries preserve a degree of zygapophyseal overlap at the limits of deflection, a constraint that is further restricted by soft tissues. Sauropod necks, if similarly constrained, were capable of sweeping out large feeding surfaces, yet much less capable of retracting the head to explore the enclosed volume in an avian manner. Behaviorally, modern vertebrates generally assume characteristic neck postures which are close to the intrinsic curvature of the undeflected neck. With the exception of some vertebrates that can retract their heads to balance above their shoulders at rest (e.g., felids, lagomorphs, and some ratites), the undeflected neck generally predicts the default head height at rest and during locomotion. PMID:24205266

The incidence of late neck recurrence in N0 maxillary sinus squamous cell carcinomas after superselective intra-arterial chemoradiotherapy without prophylactic neck irradiation.

Science.gov (United States)

Sakashita, Tomohiro; Homma, Akihiro; Hatakeyama, Hiromitsu; Kano, Satoshi; Mizumachi, Takatsugu; Furusawa, Jun; Yoshida, Daisuke; Fujima, Noriyuki; Onimaru, Rikiya; Tsuchiya, Kazuhiko; Yasuda, Koichi; Shirato, Hiroki; Fukuda, Satoshi

2014-10-01

The efficacy of elective neck irradiation (ENI) for patients with N0 carcinoma of the maxillary sinus has been controversial. The purpose of our study was to investigate the incidence of late neck recurrence and the mortality rate from regional disease in patients with N0 maxillary sinus cancer after superselective cisplatin infusion and concomitant radiotherapy (RADPLAT) without ENI. We retrospectively analyzed 48 patients with N0 maxillary sinus cancer who underwent RADPLAT. Chemotherapy consisted of 100-120 mg/m(2) superselective intra-arterial cisplatin administered at a median rate of four times weekly. Concurrent radiation therapy was administered at a median dose of 65 Gy without ENI. Late neck recurrence was observed in 8.3% (4/48). Three patients underwent salvage neck dissection and survived without any evidence of disease. The remaining patient did not undergo neck dissection due to coexistence with distant metastasis, and he died of regional disease. The mortality rate from regional disease was calculated to be 2% (1/48). The incidence of late neck recurrence was not frequent, and the mortality rate from regional disease was low. Salvage neck dissection was considered to be feasible for patients with late neck recurrence. When definitive radiotherapy and concomitant chemotherapy are applied, it is considered that ENI is not required for cases of N0 maxillary sinus cancer.

Acupuncture at Houxi (SI 3) acupoint for acute neck pain caused by stiff neck: study protocol for a pilot randomised controlled trial.

Science.gov (United States)

Sun, Zhong-ren; Yue, Jin-huan; Tian, Hong-zhao; Zhang, Qin-hong

2014-12-23

The use of acupuncture has been suggested for the treatment of acute neck pain caused by stiff neck in China. However, current evidence is insufficient to draw any conclusions about its efficacy. Therefore this pilot study was designed to evaluate the feasibility and efficacy of acupuncture at the Houxi (SI3) acupoint for treatment of acute neck pain. This pilot study will be a two-parallel-group, assessor-blinded, randomised controlled trial. Thirty-six stiff neck participants with acute neck pain will be recruited and randomly divided into two groups in a 1:1 ratio. Participants in the control group will receive massage on the local neck region (5 min each session, three times a day for 3 days). In addition to massage, patients in the treatment group will receive acupuncture (one session a day for 3 days). Measures will be taken at 0, 3 and 15 days. The primary outcome is the Northwick Park Neck Pain Questionnaire (NPQ). The secondary outcome is the Short Form of the McGill Pain Questionnaire (SF-MPQ). The protocol for this pilot randomised clinical trial has undergone ethics scrutiny and been approved by the ethics review boards of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine (Permission number: HZYLL201303502). The findings of this study will provide important clinical evidence on the feasibility and efficacy of acupuncture treatment for stiff neck patients with acute neck pain. In addition, it will explore the feasibility of further acupuncture research. ChiCTR-TRC-13003911. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

TCGA head Neck

Science.gov (United States)

Investigators with The Cancer Genome Atlas (TCGA) Research Network have discovered genomic differences – with potentially important clinical implications – in head and neck cancers caused by infection with the human papillomavirus (HPV).

Clinical Practice Guideline: Evaluation of the Neck Mass in Adults.

Science.gov (United States)

Pynnonen, Melissa A; Gillespie, M Boyd; Roman, Benjamin; Rosenfeld, Richard M; Tunkel, David E; Bontempo, Laura; Brook, Itzhak; Chick, Davoren Ann; Colandrea, Maria; Finestone, Sandra A; Fowler, Jason C; Griffith, Christopher C; Henson, Zeb; Levine, Corinna; Mehta, Vikas; Salama, Andrew; Scharpf, Joseph; Shatzkes, Deborah R; Stern, Wendy B; Youngerman, Jay S; Corrigan, Maureen D

2017-09-01

Objective Neck masses are common in adults, but often the underlying etiology is not easily identifiable. While infections cause most of the neck masses in children, most persistent neck masses in adults are neoplasms. Malignant neoplasms far exceed any other etiology of adult neck mass. Importantly, an asymptomatic neck mass may be the initial or only clinically apparent manifestation of head and neck cancer, such as squamous cell carcinoma (HNSCC), lymphoma, thyroid, or salivary gland cancer. Evidence suggests that a neck mass in the adult patient should be considered malignant until proven otherwise. Timely diagnosis of a neck mass due to metastatic HNSCC is paramount because delayed diagnosis directly affects tumor stage and worsens prognosis. Unfortunately, despite substantial advances in testing modalities over the last few decades, diagnostic delays are common. Currently, there is only 1 evidence-based clinical practice guideline to assist clinicians in evaluating an adult with a neck mass. Additionally, much of the available information is fragmented, disorganized, or focused on specific etiologies. In addition, although there is literature related to the diagnostic accuracy of individual tests, there is little guidance about rational sequencing of tests in the course of clinical care. This guideline strives to bring a coherent, evidence-based, multidisciplinary perspective to the evaluation of the neck mass with the intention to facilitate prompt diagnosis and enhance patient outcomes. Purpose The primary purpose of this guideline is to promote the efficient, effective, and accurate diagnostic workup of neck masses to ensure that adults with potentially malignant disease receive prompt diagnosis and intervention to optimize outcomes. Specific goals include reducing delays in diagnosis of HNSCC; promoting appropriate testing, including imaging, pathologic evaluation, and empiric medical therapies; reducing inappropriate testing; and promoting appropriate

Neck Flexor and Extensor Muscle Endurance in Subclinical Neck Pain: Intrarater Reliability, Standard Error of Measurement, Minimal Detectable Change, and Comparison With Asymptomatic Participants in a University Student Population.

Science.gov (United States)

Lourenço, Ana S; Lameiras, Carina; Silva, Anabela G

2016-01-01

The aims of this study were to assess intrarater reliability and to calculate the standard error of measurement (SEM) and minimal detectable change (MDC) for deep neck flexor and neck extensor muscle endurance tests, and compare the results between individuals with and without subclinical neck pain. Participants were students of the University of Aveiro reporting subclinical neck pain and asymptomatic participants matched for sex and age to the neck pain group. Data on endurance capacity of the deep neck flexors and neck extensors were collected by a blinded assessor using the deep neck flexor endurance test and the extensor endurance test, respectively. Intraclass correlation coefficients (ICCs), SEM, and MDC were calculated for measurements taken within a session by the same assessor. Differences between groups for endurance capacity were investigated using a Mann-Whitney U test. The deep neck flexor endurance test (ICC = 0.71; SEM = 6.91 seconds; MDC = 19.15 seconds) and neck extensor endurance test (ICC = 0.73; SEM = 9.84 minutes; MDC = 2.34 minutes) are reliable. No significant differences were found between participants with and without neck pain for both tests of muscle endurance (P > .05). The endurance capacity of the deep neck flexors and neck extensors can be reliably measured in participants with subclinical neck pain. However, the wide SEM and MDC might limit the sensitivity of these tests. Copyright © 2016. Published by Elsevier Inc.

Fragmentation of neck-like structures

International Nuclear Information System (INIS)

Montoya, C.; Bowman, D.R.; Peaslee, G.F.; Michigan State Univ., East Lansing, MI

1994-01-01

Evidence for intermediate mass fragment emission from neck-like structures joining projectile- and target-like residues has been observed for peripheral 129 Xe+ nat Cu collisions at E/A=50 MeV. These framents are emitted primarily at velocities intermediate between those of the projectile and the target. Relative to the charge distribution for fragments evaporated from the projectile-like residue, the distribution for ''neck'' emission shows an enhanced emission for fragments with 4 f < 8. (orig.)

Unusual head and neck injury in elevator: autopsy study.

Science.gov (United States)

Eren, B; Türkmen, N; Dokgöz, H

2012-10-01

Industrial injuries related to auto-load-carrying vehicles were not frequently reported in the literature. Presented case was, 31-year-old male furniture worker. Deceased was found in awkward position in furniture workshop. Victim was observed on his knees in front of the elevator, head and neck lodged within openings of the elevator, and head and neck structures compressed-guillotined by the lower platform of the elevator were detected. We presented rare case of head and neck compression by elevator. Key words: head - neck - accidents - elevator - autopsy.

Recurrence of ICA-PCoA aneurysms after neck clipping.

Science.gov (United States)

Sakaki, T; Takeshima, T; Tominaga, M; Hashimoto, H; Kawaguchi, S

1994-01-01

Between 1975 and 1992, 2211 patients underwent aneurysmal neck clipping at the Nara Medical University clinic and associated hospitals. The aneurysm in 931 of these patients was situated at the junction of the internal carotid artery (ICA) and posterior communicating artery (PCoA). Seven patients were readmitted 4 to 17 years after the first surgery because of regrowth and rupture of an ICA-PCoA aneurysmal sac that had arisen from the residual neck. On angiograms obtained following aneurysmal neck clipping, a large primitive type of PCoA was demonstrated in six patients and a small PCoA in one. A small residual aneurysm was confirmed in only two patients and angiographically complete neck clipping in five. Recurrent ICA-PCoA aneurysms were separated into two types based on the position of the old clip in relation to the new growth. Type 1 aneurysms regrow from the entire neck and balloon eccentrically. In this type, it is possible to apply the clip at the neck as in conventional clipping for a ruptured aneurysm. Type 2 includes aneurysms in which the proximal portion of a previous clip is situated at the corner of the ICA and aneurysmal neck and the distal portion on the enlarged dome of the aneurysm, because the sac is regrowing from a portion of the residual neck. In this type of aneurysm, a Sugita fenestrated clip can occlude the residual neck, overriding the old clip. Classifying these aneurysms into two groups is very useful from a surgical point of view because it is possible to apply a new clip without removing the old clip, which was found to be adherent to surrounding tissue.

Chronic Neck Pain and Whiplash: A Case-Control Study of the Relationship between Acute Whiplash Injuries and Chronic Neck Pain

OpenAIRE

Freeman, Michael D; Croft, Arthur C; Rossignol, Annette M; Centeno, Christopher J; Elkins, Whitney L

2006-01-01

The authors undertook a case-control study of chronic neck pain and whiplash injuries in nine states in the United States to determine whether whiplash injuries contributed significantly to the population of individuals with chronic neck and other spine pain.Four hundred nineteen patients and 246 controls were randomly enrolled. Patients were defined as individuals with chronic neck pain, and controls as those with chronic back pain. The two groups were surveyed for cause of chronic pain as w...

The European Federation of Organisations for Medical Physics Policy Statement No. 6.1: Recommended Guidelines on National Registration Schemes for Medical Physicists.

Science.gov (United States)

Christofides, Stelios; Isidoro, Jorge; Pesznyak, Csilla; Bumbure, Lada; Cremers, Florian; Schmidt, Werner F O

2016-01-01

This EFOMP Policy Statement is an update of Policy Statement No. 6 first published in 1994. The present version takes into account the European Union Parliament and Council Directive 2013/55/EU that amends Directive 2005/36/EU on the recognition of professional qualifications and the European Union Council Directive 2013/59/EURATOM laying down the basic safety standards for protection against the dangers arising from exposure to ionising radiation. The European Commission Radiation Protection Report No. 174, Guidelines on Medical Physics Expert and the EFOMP Policy Statement No. 12.1, Recommendations on Medical Physics Education and Training in Europe 2014, are also taken into consideration. The EFOMP National Member Organisations are encouraged to update their Medical Physics registration schemes where these exist or to develop registration schemes taking into account the present version of this EFOMP Policy Statement (Policy Statement No. 6.1"Recommended Guidelines on National Registration Schemes for Medical Physicists"). Copyright © 2016. Published by Elsevier Ltd.

Deep Neck Space Infections: A Study of 76 Cases

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Gaurav Kataria

2015-07-01

Full Text Available Introduction: Deep neck space infections (DNSI are serious diseases that involve several spaces in the neck. The common primary sources of DNSI are dental infections, tonsillar and salivary gland infections, malignancies, and foreign bodies. With widespread use of antibiotics, the prevalence of DNSI has been reduced. Common complications of DNSI include airway obstruction, jugular vein thrombosis, and sepsis. Treatment principally comprises airway management, antibiotic therapy, and surgical intervention. This study was conducted to investigate the age and sex distribution of patients, symptoms, presentation, sites involved, bacteriology, and management and complications of DNSI.   Materials and Methods: This retrospective study was performed from October 2010 to January 2013, and included 76 patients with DNSI. Patients of all age groups and gender were included. All parameters including age, gender, co-morbidities, presentation, site, bacteriology, complications, and required interventions were studied.   Results: In our study, the majority of patients were in the 31–50-year age group. Males accounted for 55.26% of the sample and females for 44.74%, with a male:female ratio of 1.23. Most of the patients were from a rural background. Diabetes was found as a co-morbid condition in 10.52% cases. Neck pain was the most common symptom, identified in 89.47% cases. The most common etiological factor was odontogenic infection (34.21%, followed by tonsillar and pharyngeal infection (27.63%. The most common presentation was Ludwig’s angina (28.94%, followed by peritonsillar abscess and submandibular abscess. In 50% of cases, Streptococcus and Staphylococcus were found in the culture. Surgical intervention was carried out in 89.47% cases. Emergency tracheotomy was required in 5.26% cases.   Conclusion:  DNSI can be life-threatening in diabetic patients, the immunocompromised, and elderly patients, and special attention should therefore be given

Neck proprioception shapes body orientation and perception of motion

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Vito Enrico Pettorossi

2014-11-01

Full Text Available This review article deals with some effects of neck muscle proprioception on human balance, gait trajectory, subjective straight-ahead, and self-motion perception. These effects are easily observed during neck muscle vibration, a strong stimulus for the spindle primary afferent fibers.We first remind the early findings on human balance, gait trajectory, subjective straight-ahead, induced by limb and neck muscle vibration. Then, more recent findings on self-motion perception of vestibular origin are described. The use of a vestibular asymmetric yaw-rotation stimulus for emphasizing the proprioceptive modulation of motion perception from the neck is mentioned. In addition, an attempt has been made to conjointly discuss the effects of unilateral neck proprioception on motion perception, subjective straight-ahead and walking trajectory.Neck vibration also induces persistent aftereffects on the subjective straight-ahead and on self-motion perception of vestibular origin. These perceptive effects depend on intensity, duration, side of the conditioning vibratory stimulation, and on muscle status. These effects can be maintained for hours when prolonged high-frequency vibration is superimposed on muscle contraction. Overall, this brief outline emphasizes the contribution of neck muscle inflow to the construction and fine-tuning of perception of body orientation and motion. Furthermore, it indicates that tonic neck proprioceptive input may induce persistent influences on the subject's mental representation of space. These plastic changes might adapt motion sensitiveness to lasting or permanent head positional or motor changes.

Femoral neck radiography: effect of flexion on visualization

International Nuclear Information System (INIS)

Garry, S.C.; Jhangri, G.S.; Lambert, R.G.W.

2005-01-01

To determine whether flexion improves radiographic visualization of the femoral neck when the femur is externally rotated. Five human femora, with varying neck-shaft and anteversion angles, were measured and immobilized. Degree of flexion required to bring the femoral neck horizontal was measured, varying the rotation. Next, one bone was radiographed in 16 positions, varying rotation in 15 o and flexion in 10 o increments. Radiographs were presented in randomized blinded fashion to 15 staff radiologists for scoring of femoral neck visualization. Following this, all 5 bones were radiographed in 4 positions of rotation and at 0 o and 20 o flexion, and blinded randomized review of radiographs was repeated. Comparisons between angles and rotations were made using the Mann-Whitney test. The flexion angle required to bring the long axis of the femoral neck horizontal correlated directly with the degree of external rotation (ρ o internal rotation to 30 o external rotation (ρ o flexion was applied to bones in external rotation, visualization significantly improved at 15 o (ρ o (ρ o ) of flexion can significantly improve radiographic visualization. This manoeuvre could be useful for radiography of the femoral neck when initial radiographs are inadequate because of external rotation of the leg. (author)

Neck pain in children: a retrospective case series.

Science.gov (United States)

Cox, Jocelyn; Davidian, Christine; Mior, Silvano

2016-09-01

Spinal pain in the paediatric population is a significant health issue, with an increasing prevalence as they age. Paediatric patients attend for chiropractor care for spinal pain, yet, there is a paucity of quality evidence to guide the practitioner with respect to appropriate care planning. A retrospective chart review was used to describe chiropractic management of paediatric neck pain. Two researchers abstracted data from 50 clinical files that met inclusion criteria from a general practice chiropractic office in the Greater Toronto Area, Canada. Data were entered into SPSS 15 and descriptively analyzed. Fifty paediatric neck pain patient files were analysed. Patients' age ranged between 6 and 18 years (mean 13 years). Most (98%) were diagnosed with Grade I-II mechanical neck pain. Treatment frequency averaged 5 visits over 19 days; with spinal manipulative therapy used in 96% of patients. Significant improvement was recorded in 96% of the files. No adverse events were documented. Paediatric mechanical neck pain appears to be successfully managed by chiropractic care. Spinal manipulative therapy appears to benefit paediatric mechanical neck pain resulting from day-today activities with no reported serious adverse events. Results can be used to inform clinical trials assessing effectiveness of manual therapy in managing paediatric mechanical neck pain.

Seeing the People’s Republic of China through the Eyes of Montesquieu: Why Sino-European Collaboration on Eco City Development Suffers from European Misinterpretations of “Good Governance”

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Martin de Jong

2017-02-01

Full Text Available China faces a number of impressive challenges in dealing with climate change: rising energy use, growing emission levels of greenhouse gases, dangerous levels of air pollution over cities and low resilience against flood and drought. Sustainable urbanization has been adopted as a keyword in handling these challenges. The Chinese central government has undertaken a variety of measures, including the launch of large Sino-European programs to learn from ‘developed nations’. In the wake of these partnerships, a great variety of cross-national and cross-city agreements were signed. Sino-European cooperation does not often run as smoothly as initially hoped because of diverging interests, cultural misunderstandings and practical limitations. In the background, a mismatch in normative conceptions Chinese and European participants have of ‘good governance’ plays a role. In this contribution, insights taken from Montesquieu’s ‘The Spirit of Laws’ regarding checks and balances and trias politica (updated to ‘sextas politica’ for the 21st century are used to comprehend how the exertion of power is distributed and expected to be distributed differently in Chinese than in European administrative traditions. The article will end with conclusions on how European misconceptions of Chinese governance complicate Sino-European collaboration in sustainable urbanization policies.

Spirometry reference equations for central European populations from school age to old age.

Science.gov (United States)

Rochat, Mascha K; Laubender, Ruediger P; Kuster, Daniela; Braendli, Otto; Moeller, Alexander; Mansmann, Ulrich; von Mutius, Erika; Wildhaber, Johannes

2013-01-01

Spirometry reference values are important for the interpretation of spirometry results. Reference values should be updated regularly, derived from a population as similar to the population for which they are to be used and span across all ages. Such spirometry reference equations are currently lacking for central European populations. To develop spirometry reference equations for central European populations between 8 and 90 years of age. We used data collected between January 1993 and December 2010 from a central European population. The data was modelled using "Generalized Additive Models for Location, Scale and Shape" (GAMLSS). The spirometry reference equations were derived from 118'891 individuals consisting of 60'624 (51%) females and 58'267 (49%) males. Altogether, there were 18'211 (15.3%) children under the age of 18 years. We developed spirometry reference equations for a central European population between 8 and 90 years of age that can be implemented in a wide range of clinical settings.

Spirometry reference equations for central European populations from school age to old age.

Directory of Open Access Journals (Sweden)

Mascha K Rochat

Full Text Available BACKGROUND: Spirometry reference values are important for the interpretation of spirometry results. Reference values should be updated regularly, derived from a population as similar to the population for which they are to be used and span across all ages. Such spirometry reference equations are currently lacking for central European populations. OBJECTIVE: To develop spirometry reference equations for central European populations between 8 and 90 years of age. MATERIALS: We used data collected between January 1993 and December 2010 from a central European population. The data was modelled using "Generalized Additive Models for Location, Scale and Shape" (GAMLSS. RESULTS: The spirometry reference equations were derived from 118'891 individuals consisting of 60'624 (51% females and 58'267 (49% males. Altogether, there were 18'211 (15.3% children under the age of 18 years. CONCLUSION: We developed spirometry reference equations for a central European population between 8 and 90 years of age that can be implemented in a wide range of clinical settings.

Shoulder morbidity after non-surgical treatment of the neck

International Nuclear Information System (INIS)

Wouwe, Merian van; Bree, Remco de; Kuik, Dirk J.; Goede, Cees J.T. de; Verdonck-de Leeuw, Irma M.; Doornaert, Patricia; Rene Leemans, C.

2009-01-01

Background and purpose: Reports on shoulder function after non-surgical treatment are not available. In the present study shoulder morbidity after surgical and non-surgical treatment of the neck is determined and compared. Materials and methods: In 100 head and neck cancer patients 174 neck sides were treated by surgery (n = 51) or (chemo)radiation (n = 123). Abduction, anteflexion, endorotation and exorotation were assessed. Subjective measurements were performed using the Visual Analogue Scale for pain, the Shoulder Disability Questionnaire (SDQ) and stiffness reporting. Results: Predictive factors for SDQ-score > 0 (n = 54) were VAS pain score, stiffness, abduction, anteflexion, physiotherapy, low shoulder position and surgical treatment. The SDQ, stiffness and pain scores were significantly higher in the surgically treated group than in the non-surgical group (p < 0.01). Anteflexion, abduction and exorotation were less impaired in the non-surgically treated group than in the surgically treated group (p < 0.01). No differences between neck dissection and neck dissection with post-operative radiotherapy, and radiotherapy and chemoradiation were found for these movements. Conclusions: Shoulder morbidity is often present after non-surgical treatment of the neck, but to a lesser extent compared to surgical treatment. Radiotherapy adds no morbidity to neck dissection and chemotherapy does not add extra morbidity to primary radiation

Gender differences in head-neck segment dynamic stabilization during head acceleration.

Science.gov (United States)

Tierney, Ryan T; Sitler, Michael R; Swanik, C Buz; Swanik, Kathleen A; Higgins, Michael; Torg, Joseph

2005-02-01

Recent epidemiological research has revealed that gender differences exist in concussion incidence but no study has investigated why females may be at greater risk of concussion. Our purpose was to determine whether gender differences existed in head-neck segment kinematic and neuromuscular control variables responses to an external force application with and without neck muscle preactivation. Forty (20 females and 20 males) physically active volunteers participated in the study. The independent variables were gender, force application (known vs unknown), and force direction (forced flexion vs forced extension). The dependent variables were kinematic and EMG variables, head-neck segment stiffness, and head-neck segment flexor and extensor isometric strength. Statistical analyses consisted of multiple multivariate and univariate analyses of variance, follow-up univariate analyses of variance, and t-tests (P Gender differences existed in head-neck segment dynamic stabilization during head angular acceleration. Females exhibited significantly greater head-neck segment peak angular acceleration (50%) and displacement (39%) than males despite initiating muscle activity significantly earlier (SCM only) and using a greater percentage of their maximum head-neck segment muscle activity (79% peak activity and 117% muscle activity area). The head-neck segment angular acceleration differences may be because females exhibited significantly less isometric strength (49%), neck girth (30%), and head mass (43%), resulting in lower levels of head-neck segment stiffness (29%). For our subject demographic, the results revealed gender differences in head-neck segment dynamic stabilization during head acceleration in response to an external force application. Females exhibited significantly greater head-neck segment peak angular acceleration and displacement than males despite initiating muscle activity earlier (SCM only) and using a greater percentage of their maximum head-neck segment

Tobacco Smoking During Radiation Therapy for Head-and-Neck Cancer Is Associated With Unfavorable Outcome

International Nuclear Information System (INIS)

Chen, Allen M.; Chen, Leon M.; Vaughan, Andrew; Sreeraman, Radhika; Farwell, D. Gregory; Luu, Quang; Lau, Derick H.; Stuart, Kerri; Purdy, James A.; Vijayakumar, Srinivasan

2011-01-01

Purpose: To evaluate the effect of continued cigarette smoking among patients undergoing radiation therapy for head-and-neck cancer by comparing the clinical outcomes among active smokers and quitters. Methods and Materials: A review of medical records identified 101 patients with newly diagnosed squamous cell carcinoma of the head and neck who continued to smoke during radiation therapy. Each active smoker was matched to a control patient who had quit smoking before initiation of radiation therapy. Matching was based on tobacco history (pack-years), primary site, age, sex, Karnofsky Performance Status, disease stage, radiation dose, chemotherapy use, year of treatment, and whether surgical resection was performed. Outcomes were compared by use of Kaplan-Meier analysis. Normal tissue effects were graded according to the Radiation Therapy Oncology Group/European Organization for the Treatment of Cancer toxicity criteria. Results: With a median follow-up of 49 months, active smokers had significantly inferior 5-year overall survival (23% vs. 55%), locoregional control (58% vs. 69%), and disease-free survival (42% vs. 65%) compared with the former smokers who had quit before radiation therapy (p < 0.05 for all). These differences remained statistically significant when patients treated by postoperative or definitive radiation therapy were analyzed separately. The incidence of Grade 3 or greater late complications was also significantly increased among active smokers compared with former smokers (49% vs. 31%, p = 0.01). Conclusions: Tobacco smoking during radiation therapy for head-and-neck cancer is associated with unfavorable outcomes. Further studies analyzing the biologic and molecular reasons underlying these differences are planned.

Prevalence and Risk Factor of Neck Pain in Elderly Korean Community Residents

Science.gov (United States)

Son, Kyeong Min; Cho, Nam H.; Lim, Seung Hun

2013-01-01

Neck pain is a common musculoskeletal condition, which causes substantial medical cost. In Korea, prevalence of neck pain in community based population, especially in elderly subjects, has scarcely been reported. We evaluated the prevalence, the severity and the risk factors of neck pain in elderly Korean community residents. Data for neck pain were collected for 1,655 subjects from a rural farming community. The point, 6-months and cumulative lifetime prevalence of neck pain was obtained in addition to the measurement of the severity of neck pain. The mean age of the study subjects was 61 yr and 57% were females. The lifetime prevalence of neck pain was 20.8% with women having a higher prevalence. The prevalence did not increase with age, and the majority of individuals had low-intensity/low-disability pain. Subjects with neck pain had a significantly worse SF-12 score in all domains except for mental health. The prevalence of neck pain was significantly associated with female gender, obesity and smoking. This is the first large-scale Korean study estimating the prevalence of neck pain in elderly population. Although the majority of individuals had low-intensity/low-disability pain, subjects with neck pain had a significantly worse SF-12 score indicating that neck pain has significant health impact. PMID:23678258

Accelerating science and innovation societal benefits of European research in Particle Physics

CERN Multimedia

Radford, Tim; Jakobsson, Camilla; Marsollier, Arnaud; Mexner, Vanessa; O'Connor, Terry

2013-01-01

The story so far. Collaborative research in particle physics. The lesson for Europe: co-operation pays. Medicine and life sciences. The body of knowledge: particles harnessed for health. Energy and the environment. Think big: save energy and clean up the planet. Communication and new technologies. The powerhouse of invention. Society and skills. Power to the people. The European Strategy for Particle Physics. Update 2013.

A rare differential diagnosis to occupational neck pain: bilateral stylohyoid syndrome

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Vogel Tobias

2006-06-01

Full Text Available Abstract Chronic neck pain is widely prevalent and a common source of disability in the working-age population. Etiology of chronic neck pain includes neck sprain, mechanical or muscular neck pain, myofascial pain syndrome, postural neck pain as well as pain due to degenerative changes. We report the case of a 42 year old secretary, complaining about a longer history of neck pain and limited movement of the cervical spine. Surprisingly, the adequate radiologic examination revealed a bilateral ossification of the stylohyoid ligament complex. Her symptoms remained intractable from conservative treatment consisting of anti-inflammatory medication as well as physical therapy. Hence the patient was admitted to surgical resection of the ossified stylohyoid ligament complex. Afterwards she was free of any complaints and went back to work. Therefore, ossification of the stylohyoid ligament complex causing severe neck pain and movement disorder should be regarded as a rare differential diagnosis of occupational related neck pain.

Topographic Pattern Distribution of Head And Neck Squamous Cell ...

African Journals Online (AJOL)

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value of 71% of SCC in Turkey. Nevertheless a similar report documented a relatively lower value especially in. Yemen where head and neck SCC constituted only 8% of all head and neck cancers. Reports from Yemen revealed that oral cavity SCC was the most common topographic site of all head and. 3 neck cancers.

A Septin-Dependent Diffusion Barrier at Dendritic Spine Necks.

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Helge Ewers

Full Text Available Excitatory glutamatergic synapses at dendritic spines exchange and modulate their receptor content via lateral membrane diffusion. Several studies have shown that the thin spine neck impedes the access of membrane and solute molecules to the spine head. However, it is unclear whether the spine neck geometry alone restricts access to dendritic spines or if a physical barrier to the diffusion of molecules exists. Here, we investigated whether a complex of septin cytoskeletal GTPases localized at the base of the spine neck regulates diffusion across the spine neck. We found that, during development, a marker of the septin complex, Septin7 (Sept7, becomes localized to the spine neck where it forms a stable structure underneath the plasma membrane. We show that diffusion of receptors and bulk membrane, but not cytoplasmic proteins, is slower in spines bearing Sept7 at their neck. Finally, when Sept7 expression was suppressed by RNA interference, membrane molecules explored larger membrane areas. Our findings indicate that Sept7 regulates membrane protein access to spines.

Cervical biomechanics and neck pain of "head-spinning" breakdancers.

Science.gov (United States)

Kauther, M D; Piotrowski, M; Hussmann, B; Lendemans, S; Wedemeyer, C; Jaeger, M

2014-05-01

The cervical spine of breakdancers is at great risk due to reversed body loading during headspin manoeuvers. This study focused on the cervical biomechanics of breakdancers and a correlation with neck pain. A standardized interview and biomechanical testing of the cervical spine of 25 participants with "headspin" ability ages 16-34 years and an age-matched cohort of 25 participants without any cervical spine problems was conducted. Neck pain history, Neck Disability Index (NDI), cervical range of motion (CROM) and cervical torque were recorded. The "headspin" group reported significantly better subjective fitness, more cervical complaints, higher pain intensity, a longer history of neck pain and a worse NDI compared to the "normal" collective. The "headspin" group showed a 2-2.5 times higher rate of neck pain than the normal population, with increased cervical flexion (pcervical torque in all planes (ppain intensity and history of neck pain. Sports medicine practitioners should be aware of headspin maneuver accidents that pose the risk of fractures, dislocations and spinal cord injuries of breakdancers. © Georg Thieme Verlag KG Stuttgart · New York.

Hypothyroidism after Radiotherapy of Locally Advanced Head and Neck Cancer

International Nuclear Information System (INIS)

Lee, Jeong Eun; Eun; Kim, Jae Chul; Park, In Kyu; Yea, Ji Woon

2010-01-01

The aim of the present study was to retrospectively evaluate the incidence of hypothyroidism in locally advanced head and neck cancer patients who received radiotherapy (RT) either with or without neck dissection. From January 2000 to December 2005, 115 patients with locally advanced head and neck cancer and who received definitive RT or postoperative RT including standard anterior low-neck field were recruited to be part of this study. Nineteen patients had undergone ipsilateral neck dissection, whereas, 18 patients underwent bilateral neck dissection, and 78 patients were received RT alone. Patients' ages ranged from 28 to 85 years (median, 59 years) and there were a total of 73 male and 42 female patients. The primary tumor sites were the oral cavity, oropharynx, hypopharynx, larynx, and other sites in 18, 40, 28, 22 and 7 patients, respectively. Radiation dose to the thyroid gland ranged from 44 Gy to 66 Gy with a median dose of 50 Gy. Follow-up time ranged from 2 to 91 months, with a median of 29 months. The 1- and 3- year incidence of hypothyroidism was 28.7% (33 patients) and 33.0% (38 patients), respectively. The median time to detection of hypothyroidism was 8.5 months (range, 0 to 36 months). A univariate analysis revealed that neck node dissection was a risk factor for hypothyroidism (p=0.037). However, no factor was statistically significant from the results of a multivariate analysis. Patients treated for advanced head and neck cancer with radiotherapy with or without neck dissection will develop hypothyroidism. It is important to check the thyroid function periodically in these patients especially with the risk factor of neck node dissection.

Hypothyroidism after Radiotherapy of Locally Advanced Head and Neck Cancer

Energy Technology Data Exchange (ETDEWEB)

Lee, Jeong Eun; Eun; Kim, Jae Chul; Park, In Kyu [Kyungpook National Yonsei University School of Medicine, Daegu (Korea, Republic of); Yea, Ji Woon [Dongguk University Gyeongju Hospital, Gyeongju (Korea, Republic of)

2010-11-15

The aim of the present study was to retrospectively evaluate the incidence of hypothyroidism in locally advanced head and neck cancer patients who received radiotherapy (RT) either with or without neck dissection. From January 2000 to December 2005, 115 patients with locally advanced head and neck cancer and who received definitive RT or postoperative RT including standard anterior low-neck field were recruited to be part of this study. Nineteen patients had undergone ipsilateral neck dissection, whereas, 18 patients underwent bilateral neck dissection, and 78 patients were received RT alone. Patients' ages ranged from 28 to 85 years (median, 59 years) and there were a total of 73 male and 42 female patients. The primary tumor sites were the oral cavity, oropharynx, hypopharynx, larynx, and other sites in 18, 40, 28, 22 and 7 patients, respectively. Radiation dose to the thyroid gland ranged from 44 Gy to 66 Gy with a median dose of 50 Gy. Follow-up time ranged from 2 to 91 months, with a median of 29 months. The 1- and 3- year incidence of hypothyroidism was 28.7% (33 patients) and 33.0% (38 patients), respectively. The median time to detection of hypothyroidism was 8.5 months (range, 0 to 36 months). A univariate analysis revealed that neck node dissection was a risk factor for hypothyroidism (p=0.037). However, no factor was statistically significant from the results of a multivariate analysis. Patients treated for advanced head and neck cancer with radiotherapy with or without neck dissection will develop hypothyroidism. It is important to check the thyroid function periodically in these patients especially with the risk factor of neck node dissection.

Skate blade neck lacerations: a survey and case follow-up.

Science.gov (United States)

Stuart, Michael J; Link, Andrew A; Smith, Aynsley M; Krause, David A; Sorenson, Matthew C; Larson, Dirk R

2009-11-01

To learn about neck lacerations caused by skate blades in hockey. A retrospective Web-based survey and follow-up of registered USA Hockey players. Three hundred twenty-eight thousand eight hundred twenty-one of 457 038 registered USA Hockey players with a current e-mail address were contacted and invited to participate in the survey. Of 26 589 players (5.8% of all USA registered players) who responded to the survey, 247 were excluded due to incomplete data. Of 26 342 surveys analyzed, 23 199 respondents were men (88%), 3015 women (11.4%), and 128 (0.5%) did not designate gender. An original survey instrument was developed, formatted, and linked to a Mayo Clinic Web site. Neck lacerations from a skate blade, including mechanism, severity, treatment required, and the type of neck protector worn. Of the 26 342 respondents, 11 935 (45.4%) currently wear neck protection and 485 (1.8%) have sustained a neck laceration. When the laceration occurred, 132 of the players (27%) were wearing neck protection. Interviews with 33 injured players established that lacerations were superficial: 20 (61%) required bandaging only, 11 were sutured, and 2 were glued. Based on this survey, the currently available neck laceration protectors do not eliminate the risk of a neck laceration from a skate blade.

The Relationship Between Neck Pain and Physical Activity

OpenAIRE

Cheung, Janice; Kajaks, Tara; MacDermid, Joy C.

2013-01-01

Neck pain is a significant societal burden due to its high prevalence and healthcare costs. While physical activity can help to manage other forms of chronic musculoskeletal pain, little data exists on the relationship between physical activity and neck pain. The purpose of this study was to compare physical activity levels between individuals with neck pain and healthy controls, and then to relate disability, fear of movement, and pain sensitivity measures to physical activity levels in each...

Erotylidae (Insecta, Coleoptera) of Poland - problematic taxa, updated keys and new records.

Science.gov (United States)

Ruta, Rafał; Jałoszyński, Paweł; Sienkiewicz, Paweł; Konwerski, Szymon

2011-01-01

New data concerning the occurrence of pleasing fungus beetles (Coleoptera: Erotylidae) in Poland are given, with a focus on rare and difficult to identify Central European taxa. Cryptophilus cf. integer (Heer) (Cryptophilinae) is reported from the Polish territory for the first time based on adult and larval specimens collected in the Wielkopolska-Kujawy Lowland. Identification problems concerning species of Cryptophilus introduced to Europe are discussed. Triplax carpathica Reitter (Erotylinae) is recorded from the Białowieża Primeval Forest, which is the first known non-Carpathian finding of this species, located in the close proximity of the Polish-Belarussian UNESCO World Heritage Site "Białowieża Forest". Discussion of Triplax carpathica being conspecific with Siberian Triplax rufiventris Gebler is provided. New Polish localities of several other Erotylidae are reported, and an updated key to Central European species of Triplax is given. The Triplax key is supplemented with dorsal and ventral habitus images of all treated Triplax species. One of the rarest Central European erotyline species Combocerus glaber (Schaller) is recorded from xerothermic grasslands in North-West Poland.

Update of the ERS international Adult Respiratory Medicine syllabus for postgraduate training.

Science.gov (United States)

Tabin, Nathalie; Mitchell, Sharon; O'Connell, Elaine; Stolz, Daiana; Rohde, Gernot

2018-03-01

First published in 2006, the first European core syllabus in Adult Respiratory Medicine was developed with the intention of harmonising education and training throughout Europe. Internationally recognised by the European Union of Medical Specialists and identified as the first document of its kind in respiratory medicine, it has provided a comprehensive guide for both local and national institutions in the development of adult respiratory training programmes. Like all fields in education, respiratory medicine is an ever-changing area and as such, respective syllabi, curricula and training programmes must adapt and diversify in line with the evolution of core medical concepts. Given the proven importance of the Adult Respiratory Medicine syllabus from both a national and international standpoint, it is of equal importance that said syllabus remains abreast of emerging trends so as to sustain the synchronisation of respiratory medicine in Europe. In order to develop an updated programme, a comprehensive review process of the current syllabus is a necessary endeavour and a step that the European Respiratory Society (ERS) has undertaken through the process of a needs assessment.

Changes of postural control and muscle activation pattern in response to external perturbations after neck flexor fatigue in young subjects with and without chronic neck pain.

Science.gov (United States)

Cheng, Chih-Hsiu; Chien, Andy; Hsu, Wei-Li; Yen, Ling-Wei; Lin, Yang-Hua; Cheng, Hsin-Yi Kathy

2015-03-01

Previous studies have identified sensorimotor disturbances and greater fatigability of neck muscles in patients with neck pain. The purpose of this study was to investigate the effect of neck pain and neck flexor fatigue on standing balance following postural perturbations. Twenty patients with chronic neck pain (CNP) (24.7±3.6 year-old) and 20 age-matched asymptomatic subjects (22.1±2.2 year-old) were recruited. Subjects stood barefoot on a force plate and experienced backward perturbations before and after neck flexor fatigue. Center of pressure, electromyography of cervical and lumbar muscles, and head/trunk accelerations were recorded. Two-way ANOVA (pain×fatigue) was used for statistical analysis. CNP group showed larger body sway during quiet standing but not during perturbed standing compared with asymptomatic adults. In both groups, neck flexor fatigue resulted in greater body sway during the quiet standing but smaller body sway during perturbed standing, increased neck muscle activations and decreased lumbar muscle activations, as well as increased time to maximal head acceleration. Disturbed balance control was observed in CNP patients during the quiet standing. However, a rigid strategy was used to minimize the postural sway and to protect the head against backward perturbations in both CNP and asymptomatic young adults after neck flexor fatigue. The results facilitate the understanding of how the subjects with chronic neck pain and with neck muscle fatigue deal with the challenging condition. Further studies are needed to verify if such phenomenon could be changed after the intervention of specific flexor muscle retraining and balance control exercises. Copyright © 2015 Elsevier B.V. All rights reserved.

A customized head and neck support system

International Nuclear Information System (INIS)

Bentel, Gunilla C.; Marks, Lawrence B.; Sherouse, George W.; Spencer, David P.

1995-01-01

Purpose: To describe a customized head and neck immobilization system for patients receiving radiotherapy including a head support that conforms to the posterior contour of the head and neck. Methods: The system includes a customized headrest to support the posterior head and neck. This is fixed to a thermoplastic face mask that molds to the anterior head/face contours. The shape of these customized head and neck supports were compared to 'standard' supports. Results: This system is comfortable for the patients and appears to be effective in reproducing the setup of the treatment. Conclusions: The variability in the size and shape of the customized posterior supports exceeded that of 'standard' headrests. It is our clinical impression that the customized supports improve reproducibility and are now a standard part of our immobilization system. The quantitative analysis of the customized headrests and some commonly used 'standard' headrests suggests that the customized supports are better able to address variabilities in patient shape

Neck dissection - discharge

Science.gov (United States)

... drain in your neck when you leave the hospital. The provider will tell you how to care for it. Healing time will depend on how much tissue was removed. Diet and Nutrition You can eat your regular foods ...

Astroparticle Physics European Consortium Town Meeting Conference

CERN Document Server

2016-01-01

The Astroparticle Physics European Consortium (APPEC) invites you to a town meeting at the Grand Amphithéatre de Sorbonne in Paris on the 6th and 7th April 2016 to discuss an update of the 2011 APPEC Astroparticle Physics roadmap, to be published in September 2016. In 2014 APPEC decided to launch an update of the 2011 Roadmap, transforming it to a “resource aware” roadmap. The intention was to gauge the financial impact of the beginnings of operation of the large global scale observatories put forward in the previous roadmap and to examine the possibilities of international coordination of future global initiatives. The APPEC Scientific Advisory Committee examined the field and prepared a set of recommendations. Based on these recommendations, the APPEC General Assembly drafted a set of “considerations” to be published by end of February 2016 and be debated in an open dialogue with the community, through the web page but primarily at the town meeting of 6-7 April. Based on this debate the final re...

Is exercise effective for the management of neck pain and associated disorders or whiplash-associated disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration.

Science.gov (United States)

Southerst, Danielle; Nordin, Margareta C; Côté, Pierre; Shearer, Heather M; Varatharajan, Sharanya; Yu, Hainan; Wong, Jessica J; Sutton, Deborah A; Randhawa, Kristi A; van der Velde, Gabrielle M; Mior, Silvano A; Carroll, Linda J; Jacobs, Craig L; Taylor-Vaisey, Anne L

2016-12-01

In 2008, the Neck Pain Task Force (NPTF) recommended exercise for the management of neck pain and whiplash-associated disorders (WAD). However, no evidence was available on the effectiveness of exercise for Grade III neck pain or WAD. Moreover, limited evidence was available to contrast the effectiveness of various types of exercises. To update the findings of the NPTF on the effectiveness of exercise for the management of neck pain and WAD grades I to III. Systematic review and best evidence synthesis. Studies comparing the effectiveness of exercise to other conservative interventions or no intervention. Outcomes of interest included self-rated recovery, functional recovery, pain intensity, health-related quality of life, psychological outcomes, and/or adverse events. We searched eight electronic databases from 2000 to 2013. Eligible studies were critically appraised using the Scottish Intercollegiate Guidelines Network criteria. The results of scientifically admissible studies were synthesized following best-evidence synthesis principles. We retrieved 4,761 articles, and 21 randomized controlled trials (RCTs) were critically appraised. Ten RCTs were scientifically admissible: nine investigated neck pain and one addressed WAD. For the management of recent neck pain Grade I/II, unsupervised range-of-motion exercises, nonsteroidal anti-inflammatory drugs and acetaminophen, or manual therapy lead to similar outcomes. For recent neck pain Grade III, supervised graded strengthening is more effective than advice but leads to similar short-term outcomes as a cervical collar. For persistent neck pain and WAD Grade I/II, supervised qigong and combined strengthening, range-of-motion, and flexibility exercises are more effective than wait list. Additionally, supervised Iyengar yoga is more effective than home exercise. Finally, supervised high-dose strengthening is not superior to home exercises or advice. We found evidence that supervised qigong, Iyengar yoga, and combined

33 CFR 117.800 - Mill Neck Creek.

Science.gov (United States)

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Mill Neck Creek. 117.800 Section 117.800 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements New York § 117.800 Mill Neck Creek. The draw of the...

Prevalence of neck pain among cabin crew of Saudi Airlines.

Science.gov (United States)

Ezzat, Hesham M; Al-Sultan, Alanood; Al-Shammari, Anwar; Alyousef, Dana; Al-Hamidi, Hager; Al-Dossary, Nafla; Al-Zahrani, Nuha; Al-Abdulqader, Wala

2015-01-01

Neck pain is considered to be a major health problem in modern societies. Many previous studies found that certain occupations are related to this problem or are associated with the risk of developing it in future. Although the pain is caused by mechanical factors, it may progress to a serious problem and give rise to other abnormal symptoms such as vertigo, headache, or migraine. To investigate the prevalence of neck pain among the cabin crew of Saudi Airlines. A cross-sectional study was carried out on the available Saudi Airlines cabin crews in King Fahad Airport during our visits, using questionnaires and measurements of several parameters. Neck Pain Questionnaires were distributed to the cabin crews on Saudi Airlines and assessment sheets were completed by all participants of the study to evaluate the prevalence and distribution of neck pain. Physical therapy examination of neck motions in different directions and specific tests were performed by all the participants to identify any symptoms. Using these data the prevalence of neck pain among the cabin crews was calculated. Collected data were analyzed statistically using SPSS software calculating the mean, median, and score of the questionnaire. According to the scoring system of the study, 31 (30.09%) of 105 cabin crew staff of Saudi Airlines had neck pain. Our study confirmed a positive correlation between this occupation and neck pain, and in fact found that according to the results of logistic regression analysis, this occupation is the only significant factor that affects the positive compression test. The prevalence of neck pain among the cabin crews of Saudi Airlines was emphasized. The results show a high prevalence of neck pain in the participants of the study, with most cases appearing to run a chronic - episodic course. Further research is needed to help us understand more about the long-term course of neck pain and its broader outcomes and impacts.

The retrograde transverse cervical artery as a recipient vessel for free tissue transfer in complex head and neck reconstruction with a vessel-depleted neck.

Science.gov (United States)

Ciudad, Pedro; Agko, Mouchammed; Manrique, Oscar J; Date, Shivprasad; Kiranantawat, Kidakorn; Chang, Wei Ling; Nicoli, Fabio; Lo Torto, Federico; Maruccia, Michele; Orfaniotis, Georgios; Chen, Hung-Chi

2017-11-01

Reconstruction in a vessel-depleted neck is challenging. The success rates can be markedly decreased because of unavailability of suitable recipient vessels. In order to obtain a reliable flow, recipient vessels away from the zone of fibrosis, radiation, or infection need to be explored. The aim of this report is to present our experience and clinical outcomes using the retrograde flow coming from the distal transverse cervical artery (TCA) as a source for arterial inflow for complex head and neck reconstruction in patients with a vessel-depleted neck. Between July 2010 and June 2016, nine patients with a vessel-depleted neck underwent secondary head and neck reconstruction using the retrograde TCA as recipient vessel for microanastomosis. The mean age was 49.6 years (range, 36 to 68 years). All patients had previous bilateral neck dissections and all, except one, had also received radiotherapy. Indications included neck contracture release (n = 3), oral (n = 1), mandibular (n = 3) and pharyngoesophageal (n = 2) reconstruction necessitating free anterolateral thigh (n = 3) and medial sural artery (n = 1) perforator flaps, fibula (n = 3) and ileocolon (n = 2) flaps respectively. There was 100% flap survival rate with no re-exploration or any partial flap loss. One case of intra-operative arterial vasospasm at the anastomotic suture line was managed intra-operatively with vein graft interposition. There were no other complications or donor site morbidity during the follow-up period. In a vessel-depleted neck, the reverse flow of the TCA may be a reliable option for complex secondary head and neck reconstruction in selected patients. © 2017 Wiley Periodicals, Inc.

EUROGAS long-term outlook on natural gas demand and supply up to 2020. The approach of the West European gas industry

International Nuclear Information System (INIS)

Roze, J.

1997-01-01

Eurogas is the European Union of the Natural Gas Industry. Since 1994, it has been publishing a booklet presenting the main figures describing natural gas industry in Europe with a view to supporting its positions in the debates taking place with European and international institutions. This paper is presenting the results of the Eurogas outlook updated in 1996, it is based on input from the national members of Eurogas. (au)

[Clinical efficacy of warm needling therapy on cervical spondylosis of neck type based on the theory of "treatment both for the neck and lumbus"].

Science.gov (United States)

Yang, Yu; Pan, Luping; Lin, Xianming

2016-11-12

To compare the difference in the short-term and long-term efficacy on cervical spondylosis of neck type between warm needling therapy in the regions of both neck and lumbus and that only in the region of neck. Eighty-one patients of cervical spondylosis of neck type were randomized into group A (41 cases) and group B (40 cases), in which 2 cases dropped out. Finally, 40 cases in the group A and 39 cases in the group B accomplished the trial. In the group A, the warm needling therapy was applied to the acupoints in the region of neck and the lumbus. Fengchi (GB 20), Tianzhu (BL 10), Neck-Bailao (EX-HN 15), Wangu (GB 12), Tianyou (TE 16) and ashi (including the tender points and code-like masses on palpation) were selected in the region of neck. Dachangshu (BL 25), Qihaishu (BL 24) and Jiaji (EX-B 2) of L5 were selected in the region of lumbus. The warm needling was applied to Fengchi (GB 20), Tianzhu (BL 10), Dachangshu (BL 25). In the group B, the warm needling therapy was applied only to the acupoints in the neck, which were same as the group A. The treatment was given once every two days, three times a week in the two groups. Separately, before treatment, 1 week after treatment, at the end of 2-week treatment and at the end of 1 month follow-up, the score of neck pain questionnaire (NPQ), the score of range of motion (ROM) in the cervical region and the score of the cervical symptoms were recorded. The efficacy at the end of treatment and in the follow-up was evaluated. Compared with those before treatment, the scores at all the observation time points were significantly improved in the two groups after treatment (all P 0.05). In the follow-up, the total effective rate was 87.5% (35/40) in the group A, better than 64.1% (25/39) in the group B ( P lumbar regions with warm needling therapy and the treatment in the local area all achieve the short-term efficacy on cervical spondylosis of neck type. For the long-term efficacy, the treatment for both neck and lumbar

The burden and determinants of neck pain in workers: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.

Science.gov (United States)

Côté, Pierre; van der Velde, Gabrielle; Cassidy, J David; Carroll, Linda J; Hogg-Johnson, Sheilah; Holm, Lena W; Carragee, Eugene J; Haldeman, Scott; Nordin, Margareta; Hurwitz, Eric L; Guzman, Jaime; Peloso, Paul M

2009-02-01

Systematic review and best evidence synthesis. To describe the prevalence and incidence of neck pain and disability in workers; to identify risk factors for neck pain in workers; to propose an etiological diagram; and to make recommendations for future research. Previous reviews of the etiology of neck pain in workers relied on cross-sectional evidence. Recently published cohorts and randomized trials warrant a re-analysis of this body of research. We systematically searched Medline for literature published from 1980-2006. Retrieved articles were reviewed for relevance. Relevant articles were critically appraised. Articles judged to have adequate internal validity were included in our best evidence synthesis. One hundred and nine papers on the burden and determinants of neck pain in workers were scientifically admissible. The annual prevalence of neck pain varied from 27.1% in Norway to 47.8% in Québec, Canada. Each year, between 11% and 14.1% of workers were limited in their activities because of neck pain. Risk factors associated with neck pain in workers include age, previous musculoskeletal pain, high quantitative job demands, low social support at work, job insecurity, low physical capacity, poor computer workstation design and work posture, sedentary work position, repetitive work and precision work. We found preliminary evidence that gender, occupation, headaches, emotional problems, smoking, poor job satisfaction, awkward work postures, poor physical work environment, and workers' ethnicity may be associated with neck pain. There is evidence that interventions aimed at modifying workstations and worker posture are not effective in reducing the incidence of neck pain in workers. Neck disorders are a significant source of pain and activity limitations in workers. Most neck pain results from complex relationships between individual and workplace risk factors. No prevention strategies have been shown to reduce the incidence of neck pain in workers.

The burden of neck pain: its meaning for persons with neck pain and healthcare providers, explored by concept mapping

NARCIS (Netherlands)

Carlijn H. van Randeraad-van der Zee; Anna Beurskens; Raymond Swinkels; Jan Pool; Roy Batterham; Richard Osborne; Henrica de Vet

2015-01-01

Purpose To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the

The burden of neck pain : its meaning for persons with neck pain and healthcare providers, explored by concept mapping

NARCIS (Netherlands)

Carlijn H. van Randeraad-van der Zee; Anna J.H.M. Beurskens; Reymond A.H.M. Swinkels; Jan J.M. Pool; Richard H. Osborne; Roy W. Batterham; Henrica C.W. de Vet

2015-01-01

Purpose To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the

ROLE OF MULTIDETECTOR CT IN EVALUATION OF NECK LESIONS

Directory of Open Access Journals (Sweden)

Reena Mathur

2016-06-01

Full Text Available AIMS AND OBJECTIVES To find out the role of multidetector computed tomography in the evaluation of neck lesions with respect to evaluation of the size, location and extent of tumour. Extension of tumour infiltrating into surrounding vascular and visceral structures. To correlate the findings of MD-CT with final diagnosis by biopsy. MATERIAL AND METHODS Data for the study was collected from patients with suspected neck lesions attending Department of Radio-diagnosis, J.L.N. Medical College and Associated Group of Hospitals, Ajmer, Rajasthan. A prospective study was conducted over a period (From 1st March 2014 to 31 Aug. 2015 on patients with clinically suspected neck lesions or patients who were diagnosed to have neck lesion on ultrasound and were referred to CT for further characterisation. The patients presented with symptoms of palpable neck mass and neck pain. Patients were evaluated using multidetector CT. A provisional diagnosis was made after CT scan and these findings were correlated with histopathology/surgical findings as applicable. RESULT In the present study, 97 out of 100 cases were correctly characterised by computed tomography giving an accuracy of 97%. One case of buccal carcinoma was wrongly diagnosed as benign lesion and another case of malignant lymph node was inaccurately diagnosed as benign lymph node, also another case of benign lymph node was inaccurately diagnosed as malignant lymph node. CONCLUSION Multidetector Computed Tomography of the neck has improved the localisation and characterisation of neck lesions. Accurate delineation of disease by CT scan provides a reliable preoperative diagnosis, plan for radiotherapy ports and posttreatment followup. However, histopathology still remains the gold standard as CT is not 100% accurate.

Ipsilateral femoral neck and trochanter fracture

Directory of Open Access Journals (Sweden)

Devdatta S Neogi

2011-01-01

Full Text Available Ipsilateral fractures in the neck and trochanteric region of the femur are very rare and seen in elderly osteoporotic patients. We present a case of a young man who presented with ipsilateral fracture of the femoral neck and a reverse oblique fracture in the trochanteric region following a motor vehicle accident. A possible mechanism, diagnostic challenge, and awareness required for identifying this injury are discussed.

Schwannomas of the head and neck

Directory of Open Access Journals (Sweden)

Anastasios Kanatas

2011-12-01

Full Text Available Schwannomas are benign encapsulated nerve sheath tumors composed of Schwann cells. Malignant change in head and neck schwannomas is rare, with the incidence varying between 8 and 13.9%. In this review, we discuss the presentation and the management of head and neck schwannomas. The issues and difficulties based on our own experience as well as the experience of published reports from the literature are presented.

Head-neck-radiology; Kopf-Hals-Radiologie

Energy Technology Data Exchange (ETDEWEB)

Cohnen, Mathias (ed.) [Staedtische Kliniken Neuss Lukaskrankenhaus GmbH (Germany). Institut fuer klinische Radiologie

2012-11-01

The book on head-neck-radiology covers the following issues: (1) Methodic fundamentals: conventional radiography, angiography, sonography, computerized tomography, digital volume tomography, NMR imaging, nuclear medicine. (2) Base of the skull. (3) Petrous bone. (4) Pharynx. (5) Paranasal sinuses. (6) Eye socket. (7) Temporomandibular joint. (8) Salivary gland. (9) Oral cavity. (19) Parynx. (11) Neck soft tissue and lymph nodes. (12) Thyroid and parathyroid. (13) Teeth and jaw. (14) Interventions.

European Transportation Policy for better Integration. Shifting the Balance between the Modes of Transport

Directory of Open Access Journals (Sweden)

Ruhet Genç

2011-05-01

Full Text Available The increasing need for transportation and mobility of citizen gives raises the importance oftransportation policy. The development of the European transportation policy has a great significance for theEuropean Union. The common transportation policy of the European Union is reviewed and updated everynine years. The first common transportation policy of the European Commission was published in December1992. Besides the railway sector, most of the objectives listed in this policy were realized in ten years. In2001, the European Commission proffered a new transportation policy with sixty new measures. Thus, thispaper shows the importance of transportation projects -especially in the field of railways- for European Unionmember states. In accounting, cross-border sections of projects are more or less neglected, as member statestend to prioritize the development of sections of the projects, which are economically viable for themselves,thereby delaying the overall connectivity of the trans-European network. The railway modal is the hardestmodal to interoperate between the member countries. Therefore it is not a surprise that the objectives listed inthe first European transportation policy were not realized in the railway sector. There were enormousdifferences between railway systems before the European Union. Some of them still have an influence oncurrent railway infrastructure and operations today. To sum up, this research shall deal with the crucialaspects of common transportation policies as well as problems of its implications.

The Country Profiles of the PHARMINE Survey of European Higher Educational Institutions Delivering Pharmacy Education and Training

Directory of Open Access Journals (Sweden)

Jeffrey Atkinson

2017-06-01

Full Text Available The PHARMINE (Pharmacy Education in Europe consortium surveyed pharmacy education and practice in 2012. Surveys were updated in 2017 for publication. The PHARMINE consortium was especially interested in specialization in pharmacy education and practice (for community, hospital, and industrial pharmacy, and in the impact of the Bologna agreement and the directive of the European Commission on education and training for the sectoral profession of pharmacy on European degree courses. The surveys underline the varying attitudes of the different European countries to these various aspects. The surveys will now be published in Pharmacy. They will be useful to researchers in education, and to staff and students interested in mobility amongst different European and/or non-European countries. In order to assure a full understanding of the country profiles to be published in the journal Pharmacy, this introductory article describes the general format of the survey questionnaire used.

Neck osteotomy for malunion of neglected radial neck fractures in children: a report of 2 cases.

Science.gov (United States)

Ceroni, Dimitri; Campos, José; Dahl-Farhoumand, Agnes; Holveck, Jérôme; Kaelin, André

2010-01-01

Radial neck fractures are a common injury in children as a result of a fall on an extended and supinated outstretched hand. We present 2 cases of osteotomy of the neck of the radius performed in 2 children with neglected radial neck fractures. Preoperatively, both patients complained of pain and severely reduced mobility of the elbow. Surgery was performed at 6 weeks and 3 months, respectively, after the initial injury and the 2 children were reviewed at 6 and 16 months follow-up. Osteotomies healed within the usual time and no avascular necrosis of the radial head, proximal radioulnar synostosis, or myositis ossificans were observed. The Mayo Elbow Performance Index Score improved significantly after the operation with the 2 patients rated as excellent. In this small series, we present a novel technique of proximal osteotomy of the radius to correct this deformity in children. Case series, level IV evidence.

2017 European guideline for the screening, prevention and initial management of hepatitis B and C infections in sexual health settings.

Science.gov (United States)

Brook, Gary; Brockmeyer, Norbert; van de Laar, Thijs; Schellberg, Sven; Winter, Andrew J

2018-01-01

This guideline updates the 2010 European guideline for the management of hepatitis B and C virus infections. It is primarily intended to provide advice on testing, prevention and initial management of viral hepatitis B and C for clinicians working in sexual health clinical settings in European countries. The guideline is in a new question and answer format based on clinical situations, from which population/intervention/comparison/outcome questions were formulated. Updates cover areas such as epidemiology, point-of-care tests for hepatitis B, hepatitis C risk and 'chemsex', and HIV pre-exposure prophylaxis and hepatitis B. We have also included a short paragraph on hepatitis E noting there is no evidence for sexual transmission. The guideline has been prepared in accordance with the Europe protocol for production available at http://www.iusti.org/regions/europe/pdf/2017/ProtocolForProduction2017.pdf.

Neck Pain in Military Helicopter Pilots: Prevalence and Associated Factors

NARCIS (Netherlands)

van den Oord, Marieke H. A. H.; de Loose, Veerle; Meeuwsen, Ted; Sluiter, Judith K.; Frings-Dresen, Monique H. W.

2010-01-01

Our aim is to estimate the self-reported one-year prevalence of neck pain in military helicopter pilots and to compare work-related, individual, and health-related factors in the pilots with (neck pain group) and without (reference group) regular or continuous neck pain. A questionnaire was

Chronic Neck Pain and Whiplash: A Case-Control Study of the Relationship between Acute Whiplash Injuries and Chronic Neck Pain

Directory of Open Access Journals (Sweden)

Michael D Freeman

2006-01-01

Full Text Available The authors undertook a case-control study of chronic neck pain and whiplash injuries in nine states in the United States to determine whether whiplash injuries contributed significantly to the population of individuals with chronic neck and other spine pain.

[A new update of the SIMLII Guidelines on carcinogens].

Science.gov (United States)

Pira, Enrico; Giachino, Gian Mario; Discalzi, Gianluigi

2011-01-01

The second update of the Italian Society of Occupational Medicine and Industrial Hygiene (SIMLII) guidelines on Cancerogens and Mutagens, first published in 2003 and reviewed in 2007, is presented. The general setting of the guidelines remaines unmodified. In this new release some important developments on regulatory system, risk assessment, and health surveillance are discussed. The relevant evolution of the regulatory rules is illustrated in detail, with particular reference to the recent implementation in European Union and in Italy of the Regulation (EC) 1272/2008 on Classification, Labelling and Packaging of substances and mixtures. The recent tendencies of the European Scientific Committee on Occupational Exposure Limits in risk assessment, are presented. Some remarks on the use of new biomarkers in health surveillance, with reference to lung and bladder cancer, are discussed. The more recent results on the effectiveness of the use of LDTC scan on screening in asymptomatic persons at high risk for lung cancer, are presented. The use of this imaging technique in health surveillance of special group of workers (i.e., subjects with relevant past asbestos exposure and smokers) could be adopted.

Matching Intensity-Modulated Radiation Therapy to an Anterior Low Neck Field

International Nuclear Information System (INIS)

Amdur, Robert J.; Liu, Chihray; Li, Jonathan; Mendenhall, William; Hinerman, Russell

2007-01-01

When using intensity-modulated radiation therapy (IMRT) to treat head and neck cancer with the primary site above the level of the larynx, there are two basic options for the low neck lymphatics: to treat the entire neck with IMRT, or to match the IMRT plan to a conventional anterior 'low neck' field. In view of the potential advantages of using a conventional low neck field, it is important to look for ways to minimize or manage the problems of matching IMRT to a conventional radiotherapy field. Treating the low neck with a single anterior field and the standard larynx block decreases the dose to the larynx and often results in a superior IMRT plan at the primary site. The purpose of this article is to review the most applicable studies and to discuss our experience with implementing a technique that involves moving the position of the superior border of the low neck field several times during a single treatment fraction

Postoperative radiation for advanced head and neck cancers

International Nuclear Information System (INIS)

Ang, K. Kian; Garden, Adam S.

1995-01-01

Purpose: To discuss both general and specific indications for radiation following surgery for patients with cancers of the head and neck. Patients with advanced cancers of the head and neck are often not suitable candidates for treatment with definitive radiation, and are treated with surgery. Frequently these patients fail by recurring in either the primary sites or in the necks. Adjuvant radiation is therefore often a critical component in the management of these patients. While radiation can be done either prior to or after surgery, most centers prefer the postoperative setting. This refresher course will review general concepts of postoperative irradiation for the patient with head and neck cancer and apply these concepts to specific situations. The course will begin with a broad review of the indications for postoperative irradiation as not all patients undergoing surgery for cancers of the head and neck require additional treatment. We will also review the concept of using postoperative radiation to allow for more conservative surgery with preservation of function. The second portion of the course will focus on general techniques of postoperative irradiation. We will review concepts of patient setup and treatment portal design and describe how specific techniques are practiced at MDACC. Controversial topics, including field matching, total dose and fractionation, and the timing of postoperative radiation will be discussed. The final section of the course will review the results of postoperative irradiation as applied to the head and neck in general as well as to specific subsites. In addition to results for the common scenarios of squamous cell carcinomas of the oral cavity, pharynx and larynx, we will review results of postoperative irradiation for skin cancers of the head and neck, paranasal sinuses, and salivary glands

Plain Language Summary: Evaluation of the Neck Mass in Adults.

Science.gov (United States)

Pynnonen, Melissa A; Colandrea, Maria; Finestone, Sandra A; O'Connor, Sarah S

2017-09-01

This plain language summary serves as an overview in explaining the evaluation of the neck mass in adults. The summary applies to patients aged ≥18 years and is based on the 2017 "Clinical Practice Guideline: Evaluation of the Neck Mass in Adults." The evidence-based guideline includes research to support more effective evaluation and diagnosis of the neck mass in adults. The guideline was developed as a quality improvement opportunity for evaluation of the neck mass by creating clear recommendations to use in medical practice.

European Federation of Organisations for Medical Physics (EFOMP) policy statement 12.1: Recommendations on medical physics education and training in Europe 2014.

Science.gov (United States)

Caruana, C J; Christofides, S; Hartmann, G H

2014-09-01

In 2010, EFOMP issued Policy Statement No. 12: "The present status of Medical Physics Education and Training in Europe. New perspectives and EFOMP recommendations" to be applied to education and training in Medical Physics within the context of the developments in the European Higher Education Area arising from the Bologna Declaration and with a view to facilitate the free movement of Medical Physics professionals within Europe. Concurrently, new recommendations regarding qualifications frameworks were published by the European Parliament and Council which introduced new terminology and a new qualifications framework - the European Qualifications Framework (EQF) for lifelong learning. In addition, a new European directive involving the medical use of ionizing radiations and set to replace previous directives in this area was in the process of development. This has now been realized as Council Directive 2013/59/Euratom of 5 December 2013 which has repealed directive 97/43/Euratom. In this regard, a new document was developed in the context of the EC financed project "European Guidelines on the Medical Physics Expert" and published as RP174. Among other items, these guidelines refer to the mission statement, key activities, qualification framework and curricula for the specialty areas of Medical Physics relating to radiological devices and protection from ionizing radiation. These developments have made necessary an update of PS12; this policy statement provides the necessary update. Copyright © 2014. Published by Elsevier Ltd.

Neck ultrasound in staging squamous oesophageal carcinoma - a high yield technique

International Nuclear Information System (INIS)

Griffith, J.F.; Chan, A.C.W.; Ahuja, A.T.; Leung, S.F.; Chow, L.T.C.; Chung, S.C.S.; Metreweli, C.

2000-01-01

AIM: This study evaluates the use of neck ultrasound in staging squamous oesophageal carcinoma. MATERIALS AND METHODS: A prospective analysis of the clinical, neck ultrasound (US) and thoraco-abdominal computed tomography (CT) findings in 121 patients with squamous oesophageal carcinoma at presentation was performed. The relationship between malignant neck nodes, mediastinal and abdominal adenopathy, location and size of the primary tumour was analysed. RESULTS: Ten of 121 patients (8%) had clinically palpable neck nodes which were deemed malignant in six (5%) following US and fine-needle aspiration for cytology. Of those 111 patients with no palpable neck nodes, 31 (28%) had malignant nodes shown on US. The more cephalad the location of the primary tumour, the higher the frequency of malignant neck nodes which were found in 80%, 52%, 29% and 9% of cervical, upper thoracic, mid-thoracic and lower thoracic oesophageal tumours, respectively. Eleven (29%) of the 38 patients with malignant neck nodes shown on US had no CT evidence of additional adenopathy in the mediastinum or upper abdomen. Neck US altered TNM staging in 22/121 (18%) patients at presentation. CONCLUSION: Neck US frequently detects clinically impalpable metastatic nodes leading to altered TNM staging in patients with squamous oesophageal carcinoma. We advocate its routine use when staging squamous oesophageal carcinoma. Griffith, J.F. 2000

Factors associated with cervical kinematic impairments in patients with neck pain.

Science.gov (United States)

Treleaven, Julia; Chen, Xiaoqi; Sarig Bahat, Hilla

2016-04-01

Cervical kinematics have functional relevance and are important for assessment and management in patients with neck disorders. A better understanding of factors that might influence cervical kinematics is required. The aim of this study was to determine any relationships between altered kinematics to the symptoms and signs of sensorimotor impairments, neck pain and disability and fear of neck motion in people with neck pain. Kinematics were measured in 39 subjects with chronic neck pain using a customized virtual reality system. Range of cervical motion, mean and peak velocity, time to peak velocity percentage, number of velocity peaks and accuracy were derived. Correlations between these measures to self-reported (neck pain intensity, disability, fear of motion, dizziness, visual disturbances) and sensorimotor measures and regression analyses were conducted. Range and velocity of motion of cervical rotation appeared to be most related to visual disturbances and pain or dynamic balance. Nevertheless these relationships only explained about 30% of the variance of each measure. Signs and symptoms of sensorimotor dysfunction should be considered and monitored in the management of altered cervical rotation kinematics in patients with chronic neck disorders. Future research should consider the effects of addressing these factors on neck kinematics and vice versa to aid functional recovery in those with neck pain. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

An update on MS Nurse PROfessional, an ongoing project of the European Multiple Sclerosis Platform.

Science.gov (United States)

Winslow, Anne

2016-12-01

Within the multidisciplinary team required to manage people with multiple sclerosis (MS) effectively, the nurse is the central component of coordinated care and support. A 2009 survey led by the European Multiple Sclerosis Platform, an umbrella organization of national MS associations, identified variance and disparity across Europe in the nursing care of MS patients. This led to development of MS Nurse PROfessional, a continuing medical education-accredited modular online learning program endorsed and approved by leading international nursing and professional groups, and people with MS, as a tool to support the evolving role of the European MS nurse. Analysis of participant experience and nurse practice to date has been overwhelmingly positive. Expansion of MS Nurse PRO is underway or planned for future.

Brachytherapy in the treatment of head and neck cancer

International Nuclear Information System (INIS)

Yoo, Seong Yul

1999-01-01

Brachytherapy has been proved to be an effective method for the purpose of increasing radiation dose to the tumor and reducing the dose to the surrounding normal tissue. In head and neck cancer, the rationale of brachytherapy is as follows; Firstly, early small lesion is radiocurative and the major cause of failure is local recurrence. Secondly, it can diminish evidently the dose to the normal tissue especially masseteric muscle and salivary gland. Thirdly, the anatomy of head and neck is suitable to various technique of brachytherapy. On background of accumulated experience of LDR iridium brachytherapy of head and neck cancer for the last 15 years, the author reviewed the history of radioisotope therapy, the characteristics of radionuclides, and some important things in the method, clinical technique and treatment planning. The author analyzed the clinical result of 185 cases of head and neck cancer treated in the Korea Cancer Center Hospital. Finally the future prospect of brachytherapy of head and neck cancer is discussed

frequency of ipsilateral femoral neck fractures in patients

African Journals Online (AJOL)

Background: Ipsilateral associated femoral neck and shaft fractures are reported to occur in 2.5-6% of all femoral shaft ... nailing of the shaft fracture, which makes treatment of the neck ... chest, spine), while the other had maxillofacial injuries.

[Effectiveness of an individualised physiotherapy program versus group therapy on neck pain and disability in patients with acute and subacute mechanical neck pain].

Science.gov (United States)

Antúnez Sánchez, Leonardo Gregorio; de la Casa Almeida, María; Rebollo Roldán, Jesús; Ramírez Manzano, Antonio; Martín Valero, Rocío; Suárez Serrano, Carmen

To compare the efficacy in reducing neck pain and disability in an individualised physiotherapy treatment with group treatment in acute and subacute mechanical neck pain. Randomised clinical trial. Health Area of University Hospital Virgen del Rocío, Seville, Spain. A total of 90 patients diagnosed with mechanical neck pain of up to one month onset, distributed randomly into two groups: (i)individualised treatment; (ii)group treatment. The treatment consisted of 15 sessions of about 60minutes for both groups. Individual treatment consisted of 15minutes of infrared heat therapy, 17minutes of massage, and analytical passive stretching of the trapezius muscles and angle of the scapula. The group treatment consisted of a program of active mobilisation, isometric contractions, self-stretching, and postural recommendations. Pain was measured at the beginning and end of treatment pain using a Visual Analogue Scale (VAS) and an algometer applied on the trapezius muscles and angle of the scapula, and neck disability using the Neck Disability Index. Both treatments were statistically significant (P<.001) in improving all variables. Statistically significant differences (P<.001) were found for all of them in favour of individualised treatment compared to group treatment. Patients with acute or subacute mechanical neck pain experienced an improvement in pain and neck disability after receiving either of the physiotherapy treatments used in our study, with the individual treatment being more effective than collective. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Cross-sectional imaging in pediatric neck masses

International Nuclear Information System (INIS)

Koenigsberg, R.A.; Patel, M.; Horowitz, C.

1990-01-01

This paper reports on US, CT, and MR imaging that demonstrates unique roles in the evaluation of pediatric neck masses. The causes of these masses range from infections/abscesses to primary and secondary tumors. The purpose of this paper is to review pediatric neck masses and the current role of cross-sectional imaging. Seventy-one examinations of the neck by means of CT, US, and MR imaging on 62 patients aged 1-21 y were retrospectively reviewed. Diseases were categorized according to benign versus malignant causes. Benign: 9 abscesses/cellulitis, 5 thyroglossal duct cysts, 3 branchial cleft cysts, 2 parotid cysts, 2 benign enlarged lumphadenopathies, 2 cystic hydromas, 1 ranula, and 1 hematoma

TC pathological Neck

International Nuclear Information System (INIS)

Garcia Fontes, M.

2012-01-01

This presentation is about different imaging techniques such as ultrasound, CT, RNM, PET-CT. These techniques permit to detect head and neck tumors, breast and digestive pathologies as well as congenital diseases and glandular tumor in the thyroid, parathyroid, muscles, lymphatic, nerves and vessels

Evaluation of the dynamic and kinematic performance of the THOR dummy : neck performance

NARCIS (Netherlands)

Hoofman, M.; van Ratingen, M.R.; Wismans, J.S.H.M.; Cesari, D.

1998-01-01

The objective of this study is to evaluate the frontal head-neck performance of the THOR neck with respect to the human frontal head-neck performance and the Hybrid-III frontal head-neck performance. For this purpose, tests were carried out with an isolated THOR and Hybrid-III head-neck system on a

Outcomes after primary chemoradiotherapy for N3 (>6 cm) head and neck squamous cell carcinoma after an FDG-PET--guided neck management policy.

Science.gov (United States)

Adams, Gerard; Porceddu, Sandro V; Pryor, David I; Panizza, Benedict; Foote, Matthew; Rowan, Ann; Burmeister, Bryan

2014-08-01

The purpose of this study was to assess whether a positron emission tomography (PET)-directed policy remains appropriate for managing neck nodes (N3; >6 cm) in head and neck squamous cell carcinoma (HNSCC). All patients with N3 (>6 cm) HNSCC treated with definitive chemoradiotherapy (CRT) at our institution between 2005 and 2012 were included in the analysis. Patients underwent PET assessment before and 12 weeks after CRT. Neck dissections were performed for PET-avid residual nodal abnormalities after complete response at the primary site. Rate of isolated nodal failure (INF) was the primary outcome. Median follow-up from diagnosis for 33 patients was 30 months (range, 6-76 months). INF occurred in 2 patients (6%) with neck dissections performed in 4 cases (12%). First failure was predominantly distant metastatic (10; 30%). The rate of INF remains low when following a PET-directed neck management policy after definitive CRT for N3 (>6 cm) HNSCC. Copyright © 2013 Wiley Periodicals, Inc.

Turnover in intracranial aneurysm phantoms: its relation to neck size

International Nuclear Information System (INIS)

Chung, Tae Sub; Lee, Young Jun; Rhim, Yoon Chul

2003-01-01

To evaluate the physiologic background of aneurysms poorly visualized during 3D-TOF MRA, contrast-enhanced MRA (CEMRA) and DSA due to hemodynamic isolation. Using handmade elastic silicon phantoms to represent terminal basilar tip aneurysms, 3D-TOF MRA, CEMRA and DSA were used to determine blood turnover. Aneurysmal neck size was 2 mm and 10 mm, and the use of a pulsatile pump also helped recreate human physiologic parameters. We compared the results with those of computational fluid dynamics. DSA images of the narrow-necked aneurysm showed that a small volume of contrast medium washed into it during the systolic phase. As the width of its neck increased, the turnover volume of fragments of contrast bolus also increased. At CEMRA, the broad-necked aneurysm was visualized as the main bolus of Gd-DTPA passed through it, and at delayed CEMRA, the narrow-necked aneurysm was visualized faintly after the passage of bolus Gd-DTPA. The results correlated closely with those of 3D-TOF MRA and computational fluid dynamics. The visualization of intracranial aneurysms at 3D-TOF MRA, CEMRA and DSA was greatly dependent upon blood turnover, which varied according to aneurysmal neck size. A narrow-necked aneurysm might be missed at 3D-TOF MRA, CEMRA and DSA due to hemodynamic isolation

Chronic neck pain and whiplash: a case-control study of the relationship between acute whiplash injuries and chronic neck pain.

Science.gov (United States)

Freeman, M D; Croft, Arthur C; Rossignol, Annette M; Centeno, Christopher J; Elkins, Whitney L

2006-01-01

The authors undertook a case-control study of chronic neck pain and whiplash injuries in nine states in the United States to determine whether whiplash injuries contributed significantly to the population of individuals with chronic neck and other spine pain. Four hundred nineteen patients and 246 controls were randomly enrolled. Patients were defined as individuals with chronic neck pain, and controls as those with chronic back pain. The two groups were surveyed for cause of chronic pain as well as demographic information. The two groups were compared using an exposure-odds ratio. Forty-five per cent of the patients attributed their pain to a motor vehicle accident. An OR of 4.0 and 2.1 was calculated for men and women, respectively. Based on the results of the present study, it reasonable to infer that a significant proportion of individuals with chronic neck pain in the general population were originally injured in a motor vehicle accident.

Chronic neck pain and whiplash: A case-control study of the relationship between acute whiplash injuries and chronic neck pain

Science.gov (United States)

Freeman, Michael D; Croft, Arthur C; Rossignol, Annette M; Centeno, Christopher J; Elkins, Whitney L

2006-01-01

The authors undertook a case-control study of chronic neck pain and whiplash injuries in nine states in the United States to determine whether whiplash injuries contributed significantly to the population of individuals with chronic neck and other spine pain. Four hundred nineteen patients and 246 controls were randomly enrolled. Patients were defined as individuals with chronic neck pain, and controls as those with chronic back pain. The two groups were surveyed for cause of chronic pain as well as demographic information. The two groups were compared using an exposure-odds ratio. Forty-five per cent of the patients attributed their pain to a motor vehicle accident. An OR of 4.0 and 2.1 was calculated for men and women, respectively. Based on the results of the present study, it reasonable to infer that a significant proportion of individuals with chronic neck pain in the general population were originally injured in a motor vehicle accident. PMID:16770448

Neck sprain after motor vehicle accidents in drivers and passengers

NARCIS (Netherlands)

Versteegen, GJ; Kingma, J; Meijler, WJ; ten Duis, HJ

2000-01-01

Neck sprain is a general term denoting a soft tissue injury of the neck, which seldom causes major disability but is considered a modem epidemic. The purpose of the present study was to determine the prevalence of sprain of the neck injury due to motor vehicle accidents (MVAs) in both drivers and

Neck and arm pain syndromes

DEFF Research Database (Denmark)

de las Peñas, César Fernández; Cleland, Joshua; Huijbregts, Peter

approaches.It uniquely addresses the expanding role of the various health care professions which require increased knowledge and skills in screening for contra-indications and recognizing the need for medical-surgical referral. Neck and Arm Pain Syndromes also stresses the integration of experiential......The first of its kind, Neck and Arm Pain Syndromes is a comprehensive evidence- and clinical-based book, covering research-based diagnosis, prognosis and management of neuromusculoskeletal pathologies and dysfunctions of the upper quadrant, including joint, muscle, myofascial and neural tissue...... of the most commonly seen pain syndromes in clinical practice over 800 illustrations demonstrating examination procedures and techniques....

European Utility Requirements (EUR) - the organisation and its products

International Nuclear Information System (INIS)

Ingemarsson, K.F.

2007-01-01

The idea of a common specification for the development and construction of new nuclear power plants appeared in Usa in the eighties in the framework of the ALWR program (Advanced Light Water Reactors). Several European electricity producers had participated in the writing of the EPRI -Utility Requirement Document (URD)- together with a group of American and Asian companies, but in the early nineties, they also agreed to produce a European document. The point was to write a more open specification (open to non-US designs) that would take into account specific European requirements, in nuclear safety in particular, while still keeping strong references to the EPRI URD. In late 1991, five of the major European electricity producers set up an organisation to develop the EUR document. Their primary objective was to produce a common set of requirements that could be endorsed by the major European electricity producers and that would provide clear guidance to the designers. The EUR document (EUR stands for European Utility Requirements) was born. Building new nuclear plants would require undisputable competitiveness vs. alternate production sources. For that only standardisation could bring an adequate answer in the coming years. Standardisation of the designs call for harmonization of the design rules, especially the ones related to nuclear safety. The EUR utilities support the initiatives that would pave the way to harmonization of the safety design rules at European level. They nevertheless think that it may be needed to go further and eventually consider an overall re-optimisation of the safety design rules. All these developments shall be organised at European level, keeping strong connections with the other methodological works undertaken outside Europe. The European utilities and the vendors have now an updated and well-tuned tool that allows them to develop, to assess and to order modern LWR designs well fitted to their actual needs. It has been used as the base

Evaluation of the dynamic and kinematic performance of the THOR dummy: neck performance

NARCIS (Netherlands)

Hoofman, M.; Ratingen, M.R. van; Wismans, J.S.H.M.

1998-01-01

The objective of this study is to evaluate the frontal head-neck performance of the THOR neck with respect to the human frontal head-neck performance and the Hybrid-III frontal head-neck performance. For this purpose, tests were carried out with an isolated THOR and Hybrid-III-neck system on a HyGe

[Planned neck dissection in the treatment of locally advanced head and neck squamous cell carcinoma].

Science.gov (United States)

Jiang, L; Lou, J L; Wang, K J; Fang, M Y; Fu, Z F

2018-02-07

Objective: To investigate the value of planned neck dissection combined with induction chemotherapy and concurrent chemoradiotherapy in regional control and the outcome of locally advanced head and neck squamous cell carcinoma. Methods: A prospective randomized controlled study totally enrolled sixty-four patients of head and neck squamous cell carcinomas(include oropharynx, hypopharynx, and larynx) in stages Ⅳa-Ⅳb with lymph node metastase was were N2-N3. All patients firstly received 2-3 cycles of induction chemotherapy(ICT), then divided into two groups randomly, according to the efficacy of ICT. Group A(the study group) received planned neck dissection(PND) and concurrent chemoradiotherapy(CCRT). Group B(the control group) received concurrent chemoradiotherapy(CCRT). The differences in clinicopathologic features, local recurrence(LR), regional recurrence(RR), disease-free survival(DFS), and overall survival(OS) between the two groups were estimated. SPSS 19.0 software was used to analyze the data. Results: Group A enrolled twenty-one patients, and group B enrolled forty-three patients.The follow-up of all patients were 4-55 months, median follow-up time was 22 months. In study group, two-year OS and DFS were 80.9% and 68.3%, respectively. In control group, two-year OS and DFS were 90.7% and 67.1%, respectively. There was no significant difference in gender( P =0.215), age( P =0.828), primary tumor site( P =0.927), LR( P =0.126), DFS( P =0.710), and OS( P =0.402) between the two groups, while the RR(χ(2)=5.640, P squamous cell carcinoma.

Version 2.0 of the European Gas Model. Changes and their impact on the German gas sector; Das europaeische Gas Target Model 2.0. Aenderungen und Auswirkungen auf den deutschen Gassektor

Energy Technology Data Exchange (ETDEWEB)

Balmert, David; Petrov, Konstantin [DNV GL, Bonn (Germany)

2015-06-15

In January 2015 ACER, the European Agency for the Cooperation of Energy Regulators, presented an updated version of its target model for the inner-European natural gas market, also referred to as version 2.0 of the Gas Target Model. During 2014 the existing model, originally developed by the Council of European Energy Regulators (CEER) and launched in 2011, had been analysed, revised and updated in preparation of the new version. While it has few surprises to offer, the new Gas Target Model contains specifies and goes into greater detail on many elements of the original model. Some of the new content is highly relevant to the German gas sector, not least the deliberations on the current key issues, which are security of supply and the ability of the gas markets to function.

Has aerobic exercise effect on pain perception in persons with migraine and coexisting tension-type headache and neck pain? A randomized, controlled, clinical trial.

Science.gov (United States)

Krøll, L S; Sjödahl Hammarlund, C; Gard, G; Jensen, R H; Bendtsen, L

2018-04-10

A large subset of persons with migraine suffers from coexisting tension-type headache and neck pain which may adversely affect the prognosis of migraine. Aerobic exercise has been shown to decrease migraine burden in these persons. Therefore, the aim of this study was to investigate whether the effect of aerobic exercise in persons with migraine and coexisting tension-type headache and neck pain can be explained by changes in pain perception. Seventy consecutively recruited persons with migraine and coexisting tension-type headache and neck pain were randomized into exercise group or control group. Aerobic exercise consisted of bike/cross-trainer/brisk walking for 45 min, three times/week for 3 months. Controls continued their usual daily activities. Pericranial tenderness, pain thresholds, supra-thresholds and temporal summation were assessed at baseline, after treatment and at follow-up (6 months from baseline). Fifty-two persons with migraine and coexisting tension-type headache and neck pain completed the study. Aerobic exercise did not induce consistent changes in nociceptive pathways measured by pericranial tenderness, pressure pain thresholds and sensitivity to electrical stimulation. The effect of aerobic exercise cannot be explained by measurable effects on the pain modulation system. Thus, the positive effect on migraine burden may rather be explained by positive alteration of avoidance behaviour. Aerobic exercise can be recommended as a safe and inexpensive migraine treatment strategy. This study adds further knowledge about the positive effect of aerobic exercise for persons with migraine and coexisting tension-type headache and neck pain. This effect cannot be measured by changes in pain modulation, but may rather be explained by positive alteration of avoidance behaviour. © 2018 European Pain Federation - EFIC®.

Ipsilateral humeral neck and shaft fractures

Directory of Open Access Journals (Sweden)

Zhu Bin

2017-01-01

Full Text Available Background/Aim. Fractures of the proximal humerus or shaft are common, however, ipsilateral neck and shaft humerus fracture is a rare phenomenon. This combination injury is challenging for orthopaedic surgeons because of its complex treatment options at present. The purpose of this study was to review a series of ipsilateral humeral neck and shaft fractures to study the fracture pattern, complications and treatment outcomes of each treatment options used. Methods. A total of six patients (four female and two male with the average age of 42.8 years (range: 36–49 years was collected and reviewed retrospectively. Two of them were treated with double plates and four with antegrade intramedullary nail. According to the Neer’s classification, all proximal fractures were two-part surgical neck fractures. All humeral shaft fractures were located at the middle of one third. Five fractures were simple transverse (A3, one fragmented wedge fracture (B3. One patient had associated radial nerve palsy. Results. All surgical neck fractures except one united uneventfully in the average time span of 8.7 weeks. Four humeral shaft fractures healed in near anatomic alignment. The remaining two patients had the nonunion with no radiological signs of fracture healing. The average University of California, Los Angeles End-Results (UCLA score was 23.1. On the contrary, the average American Shoulder and Elbow Surgeon's (ASES score was 73.3. The patients treated with antegrade intramedullary nails presented 70.5 points. The ASES scores were 79 in the double plates group. Conclusions. Ipsilateral humeral shaft and neck fracture is extremely rare. Both antegrade intramedullar nailing and double plates result in healing of fractures. However the risk of complication is lower in the double plating group.

A vision and strategy for the virtual physiological human: 2012 update.

Science.gov (United States)

Hunter, Peter; Chapman, Tara; Coveney, Peter V; de Bono, Bernard; Diaz, Vanessa; Fenner, John; Frangi, Alejandro F; Harris, Peter; Hose, Rod; Kohl, Peter; Lawford, Pat; McCormack, Keith; Mendes, Miriam; Omholt, Stig; Quarteroni, Alfio; Shublaq, Nour; Skår, John; Stroetmann, Karl; Tegner, Jesper; Thomas, S Randall; Tollis, Ioannis; Tsamardinos, Ioannis; van Beek, Johannes H G M; Viceconti, Marco

2013-04-06

European funding under Framework 7 (FP7) for the virtual physiological human (VPH) project has been in place now for 5 years. The VPH Network of Excellence (NoE) has been set up to help develop common standards, open source software, freely accessible data and model repositories, and various training and dissemination activities for the project. It is also working to coordinate the many clinically targeted projects that have been funded under the FP7 calls. An initial vision for the VPH was defined by the FP6 STEP project in 2006. In 2010, we wrote an assessment of the accomplishments of the first two years of the VPH in which we considered the biomedical science, healthcare and information and communications technology challenges facing the project (Hunter et al. 2010 Phil. Trans. R. Soc. A 368, 2595-2614 (doi:10.1098/rsta.2010.0048)). We proposed that a not-for-profit professional umbrella organization, the VPH Institute, should be established as a means of sustaining the VPH vision beyond the time-frame of the NoE. Here, we update and extend this assessment and in particular address the following issues raised in response to Hunter et al.: (i) a vision for the VPH updated in the light of progress made so far, (ii) biomedical science and healthcare challenges that the VPH initiative can address while also providing innovation opportunities for the European industry, and (iii) external changes needed in regulatory policy and business models to realize the full potential that the VPH has to offer to industry, clinics and society generally.

Polymorphism of regulatory region of GHRL gene (-2531C>T) as a promising predictive factor for radiotherapy-induced oral mucositis in patients with head neck cancer.

Science.gov (United States)

Brzozowska, Anna; Homa-Mlak, Iwona; Mlak, Radosław; Gołębiowski, Paweł; Mazurek, Marcin; Ciesielka, Marzanna; Małecka-Massalska, Teresa

2018-03-22

The purpose of this study was to investigate the relationship between single nucleotide polymorphisms (SNP; rs1629816) in the regulatory region (c.-2531C>T) of the ghrelin (GHRL) gene and the occurrence and severity of oral mucositis caused by radiotherapy (RT) in patients with head and neck cancer. Oral mucositis in 65 patients with head and neck cancer who underwent irradiation were assessed according to Radiation Therapy Oncology Group (RTOG)/European Organisation for Research and Treatment of Cancer (EORTC) scale. The DNA from patients with head and neck cancer was isolated from whole blood. The genotypes were determined using the minisequencing method (SNaPshot PCR). The frequency of occurrence of the GHRL gene (c.-2531C>T, rs1629816) genotypes were as follows: AA = 21.5%; GA = 40%; and GG = 38.5%. In case of AA genotype, there was a 7-fold decrease of the risk of occurrence of oral mucositis (of grades 2 and 3) in the sixth week of RT (AA vs GA or GG, respectively: 17.9% vs 82.1% patients; odds ratio [OR] 0.14; 95% confidence interval [CI] 0.02-0.98; P = .0481). No statistically significant differences were observed between the volume of oral cavity contours (V30, V40, and V50) depending on the GHRL genotype in patients with head and neck cancer. The study results have demonstrated an association between the AA genotype of the GHRL gene and the risk of more severe oral mucositis attributed to RT in patients with head and neck cancer. © 2018 Wiley Periodicals, Inc.

A comparison of bladder neck preservation and bladder neck reconstruction for urinary incontinence after radical retro pubic prostatectomy

Directory of Open Access Journals (Sweden)

Mohammad Hossein Izadpanahi

2014-01-01

Full Text Available Background: Prostate cancer is the sixth most common cancer worldwide and will include about 30% of all malignancies in men. Since the initial report of the anatomic radical prostatectomy, refinements in the surgical technique have been made. Several studies show that bladder neck preservation (BNP during radical prostatectomy makes improve early return of urinary continence, erectile function or both. However, some clinical trials have suggested little difference between the return of continence while using modifications. In this study, we compared outcomes of BNP and bladder neck reconstruction (BNR during radical retropubic prostatectomy (RRP. Materials and Methods: This prospective study was performed on 60 patients at a referral university hospital from March 2010 to March 2012. Study population was all patients candidate for RRP (RRP in this period. All patients divided into two groups, A and B (30 patients in each group. Group A (n = 30 who preserved bladder neck (BNP and Group B (n = 30 who had BNR. Prostate specific antigen (PSA before and at 2, 6, 9, 12 and18 months after surgery, anastomotic stricture symptoms, positive bladder neck margin, Gleason score and urine incontinence were compared between two groups. Also, we compared bladder neck contracture, urinary continence and positive surgical margin rates after BNP and BNR while retropubic prostatectomy in 24 months period follow-up. Results: The mean age of the patients was 61.81 ± 7.15 years (range, 50-74 years. After a follow-up period of 24 months, the PSA rising was not different between the two groups. After 2 months, 19 (63.33% of patients in A group and the same number in B group were continent (P = 0.78. Stricture of the bladder neck at the anastomosis site requiring transurethral dilation occurred in 7 (23.33% and 3 (10.0% patients in groups A and B, respectively (P = 0.04. Conclusion: Although there was no difference in prevalence and duration of return of urinary

Updated European core curriculum for radiotherapists (radiation oncologists). Recommended curriculum for the specialist training of medical practitioners in radiotherapy (radiation oncology) within Europe.

NARCIS (Netherlands)

Baumann, M.; Leer, J.W.H.; Dahl, O.; Neve, W. de; Hunter, R.; Rampling, R.; Verfaillie, C.

2004-01-01

AIM: To produce updated state-of-the-art recommendations for harmonised medical specialist training in radiotherapy within Europe. MATERIAL AND METHODS: The Minimum Curriculum for the Theoretical Education in Radiation Oncology in Europe from 1991 was updated under consideration of new developments

Biomechanics of Concussion: The Importance of Neck Tension

Science.gov (United States)

Jadischke, Ronald

Linear and angular velocity and acceleration of the head are typically correlated to concussion. Despite improvements in helmet performance to reduce accelerations, a corresponding reduction in the incidence of concussion has not occurred (National Football League [NFL] 1996-present). There is compelling research that forces on and deformation to the brain stem are related to concussion. The brain stem is the center of control for respiration, blood pressure and heart rate and is the root of most cranial nerves. Injury to the brain stem is consistent with most symptoms of concussion reported in the National Football League and the National Hockey League, such as headaches, neck pain, dizziness, and blurred vision. In the Hybrid III anthropomorphic test device (ATD), the upper neck load cell is in close proximity to the human brain stem. This study found that the additional mass of a football helmet onto the Hybrid III headform increases the upper neck forces and moments in response to helmet-to-helmet impact and helmet-to-chest impacts. A new laboratory impactor device was constructed to simulate collisions using two moving Hybrid III ATDs. The impactor was used to recreate on-field collisions (n = 20) in American football while measuring head, neck and upper torso kinematics. A strong correlation between upper neck forces, upper neck power and the estimated strains and strain rates along the axis of the upper cervical spinal cord and brain stem and concussion was found. These biomechanical responses should be added to head kinematic responses for a more comprehensive evaluation of concussion.

Psychological Care, Patient Education, Orthotics, Ergonomics and Prevention Strategies for Neck Pain

DEFF Research Database (Denmark)

Gross, Anita R; Kaplan, Faith; Huang, Stacey

2013-01-01

To conduct an overview on psychological interventions, orthoses, patient education, ergonomics, and 1⁰/2⁰ neck pain prevention for adults with acute-chronic neck pain.......To conduct an overview on psychological interventions, orthoses, patient education, ergonomics, and 1⁰/2⁰ neck pain prevention for adults with acute-chronic neck pain....

Validity and QOL of neck dissection preceding radiation therapy for hypopharyngeal cancer

International Nuclear Information System (INIS)

Uemura, Hirokazu; Yoshino, Kunitoshi; Fujii, Takashi; Suzuki, Motoyuki

2009-01-01

Thirty-one cases of hypopharyngeal cancer with neck dissection preceding radiation and 16 cases of hypopharyngeal cancer with neck dissection for locoregional recurrences after radiation were reviewed in order to make comparative evaluations of difficulty in surgical operation, postoperative complications, laryngeal preservation rate, and cause specific 5-year survival rate retrospectively. And quality of life (QOL) after neck dissection was additionally evaluated through the questionnaire. Since neck dissection preceding radiation for hypopharyngeal cancer may be superior to neck dissection for radiation failure, with easy surgical approach an non-lymphoid tissue preservation, that modality can be a reasonable choice of treatment for patients with nodal lesions, which are probably difficult to treat with radiation alone. Even though further investigation on QOL questionnaire is necessary, this modality can make a contribution to the neck and shoulder condition after neck dissection. (author)

Five-step neck lift: integrating anatomy with clinical practice to optimize results.

Science.gov (United States)

Narasimhan, Kailash; Stuzin, James M; Rohrich, Rod J

2013-08-01

A harmonious and youthful appearing neckline is arguably the most vital aspect of a successful facial rejuveation. Without sound principles, the neck appears skeletonized, tethered, and hollow. The anatomical studies that the authors have performed regarding the neck, jowl, and subplatysmal elements have influenced the techniques that they now use. The authors' approach modifies the classic techniques of the past, and seeks a nuanced approach to each patient by resuspension and reshaping of deeper neck elements. In this article, the authors apply their anatomical research and cadaveric studies to demonstrate and support their neck-lift techniques. The authors integrate their knowledge to describe how the technique of one of the senior authors (R.J.R.) has evolved over time. The main tenets of the authors' approach have evolved into a sequence that involves skin undermining over the neck and cheek, submental access to the neck, with possible excision of fat and midline plication of the platysma with release of the muscle inferiorly, platysmal window suspension laterally, precise release of the mandibular septum and ligament if needed, and finally redraping of the superficial musculoaponeurotic system (SMAS) by plication or SMASecomy. These five steps ensure correction of jowling, a smooth jawline, and a well-shaped neck. The five-step neck lift helps to optimize results in creating the ideal neck contour. The authors provide four points that should be considered in any neck-lift procedure. The end result is a well-defined, well-contoured neck, with an approach grounded in sound anatomical principles.

A European Database of Fusarium graminearum and F-culmorum Trichothecene Genotypes

DEFF Research Database (Denmark)

Pasquali, Matias; Beyer, Marco; Logrieco, Antonio

2016-01-01

variables (sampling method, host cultivar, previous crop, etc.) that would allow more effective analysis of factors influencing the spatial and temporal population distribution, is lacking. Consequently, based on the available data, it is difficult to identify factors influencing chemotype distribution...... information on the strains was collected in a freely accessible and updatable database (www.catalogueeu.luxmcc.lu), which will serve as a starting point for epidemiological analysis of potential spatial and temporal trichothecene genotype shifts in Europe. The analysis of the currently available European...... and spread at the European level. Here we describe the results of a collaborative integrated work which aims (1) to characterize the trichothecene genotypes of strains from three Fusarium species, collected over the period 2000-2013 and (2) to enhance the standardization of epidemiological data collection...

Wooden Supports in 12th–16th-Century European Paintings

DEFF Research Database (Denmark)

2016-01-01

Jacqueline Marette's Connaissance des primitifs par l'étude du bois du XIIe au XVIe siècle' (1961) is a unique resource on the history of painting techniques that combines scholarship in art history, conservation, and wood science. With support from the Getty Foundation's Panel Paintings Initiati...... features critical readings of the original texts and updated references, as well as commentary from specialists with technical expertise and art-historical knowledge on northern European panel paintings from the 12th to the 16th centuries....

Advances in otolaryngology-Head and neck surgery. Volume 1

International Nuclear Information System (INIS)

Myers, E.N.; Bluestone, C.D.

1987-01-01

This book consists of 14 sections. The section titles are: The impact of AIDS on otolaryngology--head and neck surgery; The management of sleep apneas and snoring; Antimicrobial agents for infections in the ear, nose, and throat--head and neck; Nasal allergy: Medical and surgical treatment; Uses of computerized tomography and magnetic resonance imaging in temporal bone imaging; Surgical management of otitis media with effusion; middle ear reconstruction: Current status; Cochlear implants: an overview; Diagnosis and management of acute facial paralysis; The use of the laser in head and neck surgery; The management and prevention of subglottic stenosis in infants and children; Management of the mass in the thyroid; Suction-assisted lipectomy of the head and neck area; and Ambulatory surgery

Advances in otolaryngology-Head and neck surgery. Volume 1

Energy Technology Data Exchange (ETDEWEB)

Myers, E.N. (Univ. of Pittsburgh School of Medicine, Pittsburgh, PA (US)); Bluestone, C.D. (Univ. of Pittsburgh, Pittsburgh, PA (US))

1987-01-01

This book consists of 14 sections. The section titles are: The impact of AIDS on otolaryngology--head and neck surgery; The management of sleep apneas and snoring; Antimicrobial agents for infections in the ear, nose, and throat--head and neck; Nasal allergy: Medical and surgical treatment; Uses of computerized tomography and magnetic resonance imaging in temporal bone imaging; Surgical management of otitis media with effusion; middle ear reconstruction: Current status; Cochlear implants: an overview; Diagnosis and management of acute facial paralysis; The use of the laser in head and neck surgery; The management and prevention of subglottic stenosis in infants and children; Management of the mass in the thyroid; Suction-assisted lipectomy of the head and neck area; and Ambulatory surgery.

Breastfeeding practices and policies in WHO European Region Member States.

Science.gov (United States)

Bagci Bosi, Ayse Tulay; Eriksen, Kamilla Gehrt; Sobko, Tanja; Wijnhoven, Trudy M A; Breda, João

2016-03-01

To provide an update on current practices and policy development status concerning breastfeeding in the WHO European Region. National surveys and studies conducted by national health institutions were prioritized. Sub-national data were included where no national data or studies existed. Information on national breastfeeding policies was collected mainly from the WHO Seventh Meeting of Baby-Friendly Hospital Initiative Coordinators and European Union projects. Owing to the different data sources and methods, any comparisons between countries must be made with caution. WHO European Member States. Data from fifty-three WHO European Member States were investigated; however, a large proportion had not reported any data. Rates of early initiation of breastfeeding, exclusive breastfeeding and continued breastfeeding to 1 year all varied considerably within the WHO European Region. Exclusive breastfeeding rates declined considerably after 4 months, and were low in infants under 6 months and at 6 months of age. The majority of the countries with existing data reported having a national infant and young child feeding policy and the establishment of a national committee on breastfeeding or infant and young child feeding. The majority of the countries with existing data reported having baby-friendly hospitals, although the proportion of baby-friendly hospitals to the total number of national hospitals with maternity units was low in most countries. Breastfeeding practices within the WHO European Region, especially exclusive breastfeeding rates, are far from complying with the WHO recommendations. There are marked differences between countries in breastfeeding practices, infant and young child feeding policy adoption and proportion of baby-friendly hospitals.

The actual citation impact of European oncological research.

Science.gov (United States)

López-Illescas, Carmen; de Moya-Anegón, Félix; Moed, Henk F

2008-01-01

This study provides an overview of the research performance of major European countries in the field Oncology, the most important journals in which they published their research articles, and the most important academic institutions publishing them. The analysis was based on Thomson Scientific's Web of Science (WoS) and calculated bibliometric indicators of publication activity and actual citation impact. Studying the time period 2000-2006, it gives an update of earlier studies, but at the same time it expands their methodologies, using a broader definition of the field, calculating indicators of actual citation impact, and analysing new and policy relevant aspects. Findings suggest that the emergence of Asian countries in the field Oncology has displaced European articles more strongly than articles from the USA; that oncologists who have published their articles in important, more general journals or in journals covering other specialties, rather than in their own specialist journals, have generated a relatively high actual citation impact; and that universities from Germany, and--to a lesser extent--those from Italy, the Netherlands, UK, and Sweden, dominate a ranking of European universities based on number of articles in oncology. The outcomes illustrate that different bibliometric methodologies may lead to different outcomes, and that outcomes should be interpreted with care.

Change in neck circumference after shoulder arthroscopy: An observational study

Directory of Open Access Journals (Sweden)

Shrividya Chellam

2015-01-01

Full Text Available Background and Aims: Shoulder arthroscopy requires fluid irrigation, which causes soft-tissue oedema around chest, neck, and arm intraoperatively, leading to postoperative airway complications. We decided to study the incidence of increase in the neck circumference in shoulder arthroscopy and its effects on the airway. Methods: We studied 32 cases of shoulder arthroscopies over a period of 1-year, performed under general anaesthesia with interscalene block. The neck circumference of patients before and after the procedure was measured along with other parameters. The endotracheal tube cuff was deflated at the end of surgery to determine air leak around the tube. The negative leak test suggested airway oedema. Results: Thirty out of 32 patients showed positive air leak test. The average change in neck circumference was 1.17 ± 1.16 cm and all could be extubated uneventfully. Two showed negative leak test with an increase in neck circumference by 4.5 and 6.4 cm and were not extubated. Multiple regression analysis for risk factors showed intraoperative hypertension as a single predictor for an increase in neck circumference. Conclusion: Change in the neck circumference beyond 4 cm may suggest airway compromise and below 4 cm, airway compromise is unlikely even in the presence of extensive soft-tissue oedema around the shoulder, upper arm and chest.

Training preferences and motivation for rehabilitation in patients with neck pain

OpenAIRE

Verbrugghe, Jonas; Cuyvers, Bert

2014-01-01

MP2 scientific research "Training preferences and motivation for rehabilitation in patients with neck pain" by Bert Cuyvers & Jonas Verbrugghe Aim: The aim of this investigation is the inventory of training preferences and motives for motor rehabilitation of patients with neck pain. The second aim of this study is to evaluate to which extent patients with neck pain are familiar with the use of technologies. Methods: Semi-structured interviews were conducted based on the Neck Disa...

Head and neck position sense.

Science.gov (United States)

Armstrong, Bridget; McNair, Peter; Taylor, Denise

2008-01-01

Traumatic minor cervical strains are common place in high-impact sports (e.g. tackling) and premature degenerative changes have been documented in sports people exposed to recurrent impact trauma (e.g. scrummaging in rugby) or repetitive forces (e.g. Formula 1 racing drivers, jockeys). While proprioceptive exercises have been an integral part of rehabilitation of injuries in the lower limb, they have not featured as prominently in the treatment of cervical injuries. However, head and neck position sense (HNPS) testing and re-training may have relevance in the management of minor sports-related neck injuries, and play a role in reducing the incidence of ongoing pain and problems with function. For efficacious programmes to be developed and tested, fundamental principles associated with proprioception in the cervical spine should be considered. Hence, this article highlights the importance of anatomical structures in the cervical spine responsible for position sense, and how their interaction with the CNS affects our ability to plan and execute effective purposeful movements. This article includes a review of studies examining position sense in subjects with and without pathology and describes the effects of rehabilitation programmes that have sought to improve position sense. In respect to the receptors providing proprioceptive information for the CNS, the high densities and complex arrays of spindles found in cervical muscles suggest that these receptors play a key role. There is some evidence suggesting that ensemble encoding of discharge patterns from muscle spindles is relayed to the CNS and that a pattern recognition system is used to establish joint position and movement. Sensory information from neck proprioceptive receptors is processed in tandem with information from the vestibular system. There are extensive anatomical connections between neck proprioceptive inputs and vestibular inputs. If positional information from the vestibular system is inaccurate or

Effect of different head-neck-jaw postures on cervicocephalic kinesthetic sense.

Science.gov (United States)

Zafar, H; Alghadir, A H; Iqbal, Z A

2017-12-01

To investigate the effect of different induced head-neck-jaw postures on head-neck relocation error among healthy subjects. 30 healthy adult male subjects participated in this study. Cervicocephalic kinesthetic sense was measured while standing, habitual sitting, habitual sitting with clenched jaw and habitual sitting with forward head posture during right rotation, left rotation, flexion and extension using kinesthetic sensibility test. Head-neck relocation error was least while standing, followed by habitual sitting, habitual sitting with forward head posture and habitual sitting with jaw clenched. However, there was no significant difference in error between different tested postures during all the movements. To the best of our knowledge, this is the first study to see the effect of different induced head-neck-jaw postures on head-neck position sense among healthy subjects. Assuming a posture for a short duration of time doesn't affect head-neck relocation error in normal healthy subjects.

Head and Neck Cancers

Science.gov (United States)

... and neck include the following: Paan (betel quid) . Immigrants from Southeast Asia who use paan (betel quid) ... use this content on your website or other digital platform? Our syndication services page shows you how. ...

Impact of Intensity-Modulated Radiotherapy on Health-Related Quality of Life for Head and Neck Cancer Patients: Matched-Pair Comparison with Conventional Radiotherapy

International Nuclear Information System (INIS)

Graff, Pierre; Lapeyre, Michel; Desandes, Emmanuel; Ortholan, Cecile; Bensadoun, Rene-Jean; Alfonsi, Marc; Maingon, Philippe; Giraud, Philippe; Bourhis, Jean; Marchesi, Vincent; Mege, Alice; Peiffert, Didier

2007-01-01

Purpose: To assess the benefit of intensity-modulated radiotherapy (IMRT) compared with conventional RT for the quality of life (QOL) of head and neck cancer survivors. Methods and Materials: Cross-sectional QOL measures (European Organization for Research and Treatment of Cancer QOL questionnaire C30 and head and neck cancer module) were used with a French multicenter cohort of patients cured of head and neck cancer (follow-up ≥ 1 year) who had received bilateral neck RT (≥ 45 Gy) as a part of their initial treatment. We compared the QOL mean scores regarding RT modality (conventional RT vs. IMRT). The patients of the two groups were matched (one to one) according to the delay between the end of RT and the timing of the QOL evaluation and the T stage. Each QOL item was divided into two relevant levels of severity: 'not severe' (responses, 'not at all' and 'a little') vs. 'severe' (responses 'quite a bit' and 'very much'). The association between the type of RT and the prevalence of severe symptoms was approximated, through multivariate analysis using the prevalence odds ratio. Results: Two comparable groups (67 pairs) were available. Better scores were observed on the head and neck cancer module QOL questionnaire for the IMRT group, especially for dry mouth and sticky saliva (p < 0.0001). Severe symptoms were more frequent with conventional RT concerning saliva modifications and oral discomfort. The adjusted prevalence odds ratios were 3.17 (p = 0.04) for dry mouth, 3.16 (p = 0.02) for sticky saliva, 3.58 (p = 0.02) for pain in the mouth, 3.35 (p = 0.04) for pain in the jaw, 2.60 (p = 0.02) for difficulties opening the mouth, 2.76 (p = 0.02) for difficulties with swallowing, and 2.68 (p = 0.03) for trouble with eating. Conclusion: The QOL assessment of head and neck cancer survivors demonstrated the benefit of IMRT, particularly in the areas of salivary dysfunction and oral discomfort

a Bottom-Up Geosptial Data Update Mechanism for Spatial Data Infrastructure Updating

Science.gov (United States)

Tian, W.; Zhu, X.; Liu, Y.

2012-08-01

Currently, the top-down spatial data update mechanism has made a big progress and it is wildly applied in many SDI (spatial data infrastructure). However, this mechanism still has some issues. For example, the update schedule is limited by the professional department's project, usually which is too long for the end-user; the data form collection to public cost too much time and energy for professional department; the details of geospatial information does not provide sufficient attribute, etc. Thus, how to deal with the problems has become the effective shortcut. Emerging Internet technology, 3S technique and geographic information knowledge which is popular in the public promote the booming development of geoscience in volunteered geospatial information. Volunteered geospatial information is the current "hotspot", which attracts many researchers to study its data quality and credibility, accuracy, sustainability, social benefit, application and so on. In addition to this, a few scholars also pay attention to the value of VGI to support the SDI updating. And on that basis, this paper presents a bottom-up update mechanism form VGI to SDI, which includes the processes of match homonymous elements between VGI and SDI vector data , change data detection, SDI spatial database update and new data product publication to end-users. Then, the proposed updating cycle is deeply discussed about the feasibility of which can detect the changed elements in time and shorten the update period, provide more accurate geometry and attribute data for spatial data infrastructure and support update propagation.

Efficacy of biological disease-modifying antirheumatic drugs: a systematic literature review informing the 2013 update of the EULAR recommendations for the management of rheumatoid arthritis

NARCIS (Netherlands)

Nam, Jackie L.; Ramiro, Sofia; Gaujoux-Viala, Cecile; Takase, Kaoru; Leon-Garcia, Mario; Emery, Paul; Gossec, Laure; Landewe, Robert; Smolen, Josef S.; Buch, Maya H.

2014-01-01

To update the evidence for the efficacy of biological disease-modifying antirheumatic drugs (bDMARD) in patients with rheumatoid arthritis (RA) to inform the European League Against Rheumatism(EULAR) Task Force treatment recommendations. Medline, Embase and Cochrane databases were searched for

Working Memory Updating Latency Reflects the Cost of Switching between Maintenance and Updating Modes of Operation

Science.gov (United States)

Kessler, Yoav; Oberauer, Klaus

2014-01-01

Updating and maintenance of information are 2 conflicting demands on working memory (WM). We examined the time required to update WM (updating latency) as a function of the sequence of updated and not-updated items within a list. Participants held a list of items in WM and updated a variable subset of them in each trial. Four experiments that vary…

Late presentation for HIV care across Europe: update from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) study, 2010 to 2013

NARCIS (Netherlands)

Mocroft, Amanda; Lundgren, Jens; Antinori, Andrea; Monforte, Antonella d'Arminio; Brännström, Johanna; Bonnet, Fabrice; Brockmeyer, Norbert; Casabona, Jordi; Castagna, Antonella; Costagliola, Dominique; de Wit, Stéphane; Fätkenheuer, Gerd; Furrer, Hansjakob; Jadand, Corinne; Johnson, Anne; Lazanas, Mario; Leport, Catherine; Moreno, Santiago; Mussini, Christina; Obel, Niels; Post, Frank; Reiss, Peter; Sabin, Caroline; Skaletz-Rorowski, Adriane; Suarez-Loano, Ignacio; Torti, Carlo; Warszawski, Josiane; Wittkop, Linda; Zangerle, Robert; Chene, Genevieve; Raben, Dorthe; Kirk, Ole; Touloumi, Giota; Meyer, Laurence; Dabis, François; Krause, Murielle Mary; Ghosn, Jade; Wit, Ferdinand; Prins, Maria; Bucher, Heiner; Gibb, Diana; del Amo, Julia; Thorne, Claire; Stephan, Christoph; Pérez-Hoyos, Santiago; Hamouda, Osamah; Bartmeyer, Barbara; Chkhartishvili, Nikoloz; Noguera-Julian, Antoni; van der Valk, Marc

2015-01-01

Late presentation (LP) for HIV care across Europe remains a significant issue. We provide a cross-European update from 34 countries on the prevalence and risk factors of LP for 2010-2013. People aged >= 16 presenting for HIV care (earliest of HIV-diagnosis, first clinic visit or cohort enrolment)

Finding the neck-trunk boundary in snakes: anteroposterior dissociation of myological characteristics in snakes and its implications for their neck and trunk body regionalization.

Science.gov (United States)

Tsuihiji, Takanobu; Kearney, Maureen; Rieppel, Olivier

2012-09-01

The neck and trunk regionalization of the presacral musculoskeletal system in snakes and other limb-reduced squamates was assessed based on observations on craniovertebral and body wall muscles. It was confirmed that myological features characterizing the neck in quadrupedal squamates (i.e., squamates with well-developed limbs) are retained in all examined snakes, contradicting the complete lack of the neck in snakes hypothesized in previous studies. However, the posterior-most origins of the craniovertebral muscles and the anterior-most bony attachments of the body wall muscles that are located at around the neck-trunk boundary in quadrupedal squamates were found to be dissociated anteroposteriorly in snakes. Together with results of a recent study that the anterior expression boundaries of Hox genes coinciding with the neck-trunk boundary in quadrupedal amniotes were dissociated anteroposteriorly in a colubrid snake, these observations support the hypothesis that structures usually associated with the neck-trunk boundary in quadrupedal squamates are displaced relative to one another in snakes. Whereas certain craniovertebral muscles are elongated in some snakes, results of optimization on an ophidian cladogram show that the most recent common ancestor of extant snakes would have had the longest craniovertebral muscle, M. rectus capitis anterior, that is elongated only by several segments compared with that of quadrupedal squamates. Therefore, even such a posteriorly displaced "cervical" characteristic plesiomorphically lies fairly anteriorly in the greatly elongated precloacal region of snakes, suggesting that the trunk, not the neck, would have contributed most to the elongation of the snake precloacal region. A similar dissociation of structures usually associated with the neck-trunk boundary in quadrupedal squamates is observed in limb-reduced squamates, suggesting that these forms and snakes may share a developmental mechanism producing modifications in the

FRMAC Updates

International Nuclear Information System (INIS)

Mueller, P.

1995-01-01

This talks describes updates in the following updates in FRMAC publications concerning radiation emergencies: Monitoring and Analysis Manual; Evaluation and Assessment Manual; Handshake Series (Biannual) including exercises participated in; environmental Data and Instrument Transmission System (EDITS); Plume in a Box with all radiological data stored onto a hand-held computer; and courses given

Is neck circumference measurement an indicator for abdominal ...

African Journals Online (AJOL)

Background: Neck circumference (NC) measurement is one of the simple screening measurements which can be used as an index of upper body fat distribution to identify obesity. Objectives: The aim of this study was to determine the relationship between neck circumferences and obesity. Methods:A total 411 volunteer ...

50 Facts about Oral, Head and Neck Cancer

Science.gov (United States)

... Marketplace Find an ENT Doctor Near You 50 Facts about Oral, Head and Neck Cancer 50 Facts about Oral, Head and Neck Cancer Patient Health ... cancer has increased in all races and both sexes. Thyroid cancers account for ... who work in environments with dust, glues, formaldehyde, mustard gas, ...

Quantifying the prevalence of fuel poverty across the European Union

International Nuclear Information System (INIS)

Thomson, Harriet; Snell, Carolyn

2013-01-01

The literature and policy base for fuel poverty in the UK and Ireland is well established, and there is a growing body of single country studies beyond these two EU member states (for example Brunner et al. (2012), Dubois (2012), and Tirado Herrero and Ürge-Vorsatz (2010)), however, on a European level, the last analysis of fuel poverty was conducted in 2004, prior to the enlargement of the EU. Using survey data this paper presents an updated overview of the prevalence of European fuel poverty in the context of the accession of numerous former social states, and rising fuel prices. Analysis reveals the phenomenon of fuel poverty is occurring across the EU, with particularly high levels of fuel poverty found in Eastern and Southern European states. It is argued that there are both EU and national policy frameworks in place that address climate change and these could be used as a starting point for countries to address fuel poverty through improved domestic energy efficiency measures. This paper reflects research undertaken in 2011, supported by eaga Charitable Trust, within the umbrella of work examining issues of poverty and social exclusion across the EU, which has enabled access to the EU-SILC dataset. - Highlights: ► This research is the first comparative analysis of European fuel poverty since 2004. ► Fuel poverty is a particular problem for eastern and southern European member states. ► Recommendations include the improved integration with current EU climate policies.

The role of radiology in head and neck tumours in children

Science.gov (United States)

McHugh, Kieran

2010-01-01

Abstract Head and neck malignancy is rare in children. However, distinguishing malignant tumours from the more common and numerous benign causes of neck masses in childhood is crucial as many malignant conditions have an excellent prognosis with appropriate oncological management. Ultrasound, computed tomography and magnetic resonance imaging all have crucial roles in the diagnosis of head and neck malignancy in children and there is an emerging role for positron emission tomography, particularly in the management and follow-up of lymphoma. We describe the imaging appearances of the common malignant tumours arising in the extracranial head and neck in children, focusing on lymphoma, rhabdomyosarcoma and nasopharyngeal carcinoma. The clinical presentation and radiological appearances of benign tumours in the head and neck in children may overlap with those seen in malignant disease. We describe the imaging appearances of juvenile angiofibroma, vascular abnormalities involving the extracranial head and neck and cervical teratomas. Advances in both imaging techniques and cancer staging systems, many of the latter aimed at avoiding over-treatment and treatment-related complications, will lead to an increasingly central role for imaging in childhood head and neck cancer. PMID:20199940

Treatment of Childhood Head and Neck Cancer - Patient Version

Science.gov (United States)

Find diagnosis, staging, and treatment information for these head and neck cancers: hypopharynx, larynx, lip and oral cavity, neck cancer with occult primary, nasopharynx, oropharynx, paranasal sinus and nasal cavity, and salivary gland cancer.

PET-CT–Guided Surveillance of Head and Neck Cancers

Science.gov (United States)

Patients with advanced squamous cell carcinoma of the head and neck who underwent PET-CT–guided surveillance had fewer operations but similar overall survival rates to those of patients who underwent planned neck dissection.

Treatment of the femoral neck peudoarthrosis in childhood: Case report

Directory of Open Access Journals (Sweden)

Vukašinović Zoran

2013-01-01

Full Text Available Introduction. Femoral neck fractures in children and adolescents are rare. However, their complications are frequent - avascular necrosis, femoral neck pseudoarthrosis, premature physeal closure with consequent growth disturbance and coxa vara deformity. Case Outline. A 9.5­year­old boy was injured in a car accident, and femoral neck fracture was diagnosed. Prior to admission at our hospital he was surgically treated several times. He was admitted at our hospital eight months following the accident. On the X­ray transcervical pseudoarthrosis of the femoral neck was found, as well as coxa vara deformity and metaphyseal avascular necrosis. He was operated at our hospital; all previously placed ostefixation material was removed, valgus osteotomy of 30 degrees was done as well as additional local osteoplasty using the commercial osteoindactive agent (Osteovit®. Postoperatively, we applied skin traction, bed rest and physical therapy. At the final follow­up, the patient was recovered completely. He is now painless, the legs are of equal length, range of movements in the left hip is full, life activity is normal. The X­ray shows that the femoral neck pseudoarthrosis is fully healed. Conclusion. This case is presented in order to encourage other colleagues to challenge the problematic situation such as this one. Also, we would like to remind them what one should think about and what should be taken into consideration in the primary treatment of femoral neck fractures in children. Valgus femoral osteotomy, as a part of the primary treatment of femoral neck fracture in children (identically as in the adults can prevent the occurrence of femoral neck pseudoarthrosis.

Clinical utility and prospective comparison of ultrasonography and computed tomography imaging in staging of neck metastases in head and neck squamous cell cancer in an Indian setup

International Nuclear Information System (INIS)

Ashraf, M.; Biswas, J.; Jha, J.; Nayak, S.; Singh, V.; Majumdar, S.; Bhowmick, A.; Dam, A.

2011-01-01

Preoperative lymph node screening of all neck compartments is favored by clinicians for the management of the neck. The presence of a metastatic node on one side of the neck reduces the 5-year survival rate to 50%, and the presence of a metastatic node on both sides of the neck reduces the 5-year survival rate to 25%. This study compared the evaluation of lymph node metastases by ultrasonography (USG) and computed tomography (CT) in patients with squamous cell cancer of the head and neck region. Five hundred and eighty-four patients with squamous cell cancer of the head and neck were prospectively evaluated for the presence of cervical lymph node metastases. All patients underwent clinical examination (palpation), USG and CT imaging. Neck dissection was performed in all the patients, and the results of the preoperative evaluation were correlated with the surgical and histopathological findings. Metastases in neck nodes were identified in 148 patients by histopathological examination. Doppler USG correctly identified 136 node-positive patients (n=148; sensitivity 91.8%, specificity 97%). CT imaging correctly identified 122 patients with metastatic lymph nodes (n=148; sensitivity 83%, specificity 93%). Positive predictive values of USG and CT imaging were 95.6% and 91.3%, respectively, whereas the negative predictive values of these two imaging studies were 95.4% and 89.6%, respectively. The accuracy and sensitivity of USG in detection of cervical lymph node metastases make it a potentially promising and cheap preoperative tool for staging neck node metastases and optimizing the treatment plan for surgeons, especially in countries such as India. (author)

Subglottic cysts and asymmetrical subglottic narrowing on neck radiograph

International Nuclear Information System (INIS)

Holinger, L.D.; Torium, D.M.; Anandappa, E.C.

1988-01-01

The congenital subglottic hemangioma typically appears as an asymmetric subglottic narrowing or mass on frontal neck radiograph. Therefore, soft tissue neck radiography has been advocated as a definitive non-operative approach for diagnosing these lesions. However, we have noted similar asymmetric subglottic narrowing in patients with acquired subglottic cysts. These retention cysts occur following long-term intubation in the neonate. The mechanism probably involves subglottic fibrosis which obstructs glands with subsequent cyst formation. Acquired subglottic cysts typically appear as an asymmetric narrowing on frontal or lateral soft tissue neck radiographs. These lesions may produce airway compromise but are effectively treated by forceps or laser removal. Acquired subglottic cysts must be included in the differential diagnosis of asymmetric subglottic narrowing. The definitive diagnosis is made by direct laryngoscopy, not soft tissue neck radiograph. (orig.)

Thyroid gland rupture caused by blunt trauma to the neck.

Science.gov (United States)

Hara, Hirotaka; Hirose, Yoshinobu; Yamashita, Hiroshi

2016-02-19

Thyroid rupture following blunt trauma is extremely rare, and neck pain without swelling may be the only presenting symptom. However, hemorrhage and hematoma subsequently causes severe tracheal compression and respiratory distress. A 71-year-old Japanese woman visited our emergency room with a complaint of increasing right-sided neck pain at the thyroid cartilage level after she tripped and accidentally hit her neck against a pole 3 h back. On admission, her vital signs were stable. There was no swelling or subcutaneous emphysema. Laryngeal endoscopy revealed mild laryngeal edema, although there was no impairment in vocal fold mobility on either side. Contrast-enhanced computed tomography (CT) revealed rupture of the right lobe of the thyroid gland accompanied by a large hematoma extending from the neck to the mediastinum. Under general anesthesia, the right lobe was resected and the hematoma was evacuated. Only a few isolated cases of thyroid rupture caused by blunt neck trauma have been reported in patients with normal thyroid glands and neck pain without swelling may be the only presenting symptom. When suspected, CT should be performed to confirm the diagnosis determine the optimal treatment.

Planned neck dissection after weekly docetaxel and concurrent radiotherapy for advanced oropharyngeal cancer

International Nuclear Information System (INIS)

Tomita, Toshiki; Ozawa, Hiroyuki; Sakamoto, Koji; Fujii, Ryoichi; Ogawa, Kaoru; Fujii, Masato; Yamashita, Taku; Shinden, Seiichi

2007-01-01

Small oropharyngeal carcinomas with advanced neck metastases (stage N2 or greater) are common. Patients with small T with large N oropharyngeal carcinoma have high rates of local control but lower rates of regional control when treated with chemoradiotherapy. Clinical assessment after chemoradiotherapy cannot ensure the absence of neck disease. In the last 5 years, we have treated patients with T1-2 with N2-3 oropharyngeal carcinoma with weekly docetaxel radiotherapy followed by planned neck dissection (PND). Our objectives were to clarify the pathologically complete response (CR) rate of neck metastasis after weekly docetaxel radiotherapy, to identify the clinical predictor of residual neck disease, and to determine the mobidity of planned neck dissection. After chemoradiotherapy, all 12 patients had a complete response at the primary site. We conducted 15 neck dissections. Of these, 6 (40%) had positive nodes. The pathological CR rate of neck metastasis was 58.3%, whereas overall 2-year neck control rate was 91.7%. These findings lend support to the role of PND after chemoradiotherapy in N2-3 neck disease. After chemoradiotherapy, clinical parameters including TN status, feasibility of chemoradiotherapy, largest lymph node size or size reduction in MRI, did not identify patients with residual neck disease. We conducted selective neck dissection (SND) in 80% of patients. SND as PND appears to be appropriate in this group of patients because of the low incidence of complications. A further cohort study including the comparison of PND nonenforcement group is necessary to clarify the validity of the addition of PND in weekly docetaxel radiotherapy. (author)

Respiratory muscle endurance training reduces chronic neck pain: A pilot study.

Science.gov (United States)

Wirth, B; Ferreira, T Duarte; Mittelholzer, M; Humphreys, B K; Boutellier, U

2016-11-21

Patients with chronic neck pain show also respiratory dysfunctions. To investigate the effects of respiratory muscle endurance training (RMET) on chronic neck pain. In this pilot study (single-subject design: 3 baseline measurements, 4 measurements during RMET), 15 neck patients (49.3 ± 13.7 years; 13 females) conducted 20 sessions of home-based RMET using a SpiroTiger® (normocapnic hyperpnoea). Maximal voluntary ventilation (MVV), maximal inspiratory (Pimax) and expiratory (Pemax) pressure were measured before and after RMET. Neck flexor endurance, cervical and thoracic mobility, forward head posture, chest wall expansion and self-assessed neck disability [Neck Disability Index (NDI), Bournemouth questionnaire] were weekly assessed. Repeated measure ANOVA (Bonferroni correction) compared the first and last baseline and the last measurement after RMET. RMET significantly increased MVV (p= 0.025), Pimax (p= 0.001) and Pemax (pneck pain. The underlying mechanisms, including blood gas analyses, need further investigation in a randomized controlled study.

The effect of neck dissection on quality of life after chemoradiation.

Science.gov (United States)

Donatelli-Lassig, Amy Anne; Duffy, Sonia A; Fowler, Karen E; Ronis, David L; Chepeha, Douglas B; Terrell, Jeffrey E

2008-10-01

To determine differences in quality of life (QOL) between patients with head and neck cancer who receive chemoradiation versus chemoradiation and neck dissection. A prospective cohort study was conducted at two tertiary otolaryngology clinics and a Veterans Administration hospital. 103 oropharyngeal patients with Stage IV squamous cell carcinoma treated via chemoradiation +/- neck dissection. self-administered health survey to collect health, demographic, and QOL information pretreatment and 1 year later. QOL via SF-36 and HNQoL. Descriptive statistics were calculated for health/clinical characteristics, demographics, and QOL scores. t tests evaluated changes in QOL over time. Sixty-five patients underwent chemoradiation and 38 patients underwent chemoradiation and neck dissection. Only the pain index of the SF-36 showed a significant difference between groups (P < 0.05) with the neck dissection group reporting greater pain. After post-treatment neck dissection, patients experience statistically significant decrement in bodily pain domain scores, but other QOL scores are similar to those of patients who underwent chemoradiation alone.

PEP725 Pan European Phenological Database

Science.gov (United States)

Koch, E.; Adler, S.; Lipa, W.; Ungersböck, M.; Zach-Hermann, S.

2010-09-01

Europe is in the fortunate situation that it has a long tradition in phenological networking: the history of collecting phenological data and using them in climatology has its starting point in 1751 when Carl von Linné outlined in his work Philosophia Botanica methods for compiling annual plant calendars of leaf opening, flowering, fruiting and leaf fall together with climatological observations "so as to show how areas differ". Recently in most European countries, phenological observations have been carried out routinely for more than 50 years by different governmental and non governmental organisations and following different observation guidelines, the data stored at different places in different formats. This has been really hampering pan European studies as one has to address many network operators to get access to the data before one can start to bring them in a uniform style. From 2004 to 2009 the COST-action 725 established a European wide data set of phenological observations. But the deliverables of this COST action was not only the common phenological database and common observation guidelines - COST725 helped to trigger a revival of some old networks and to establish new ones as for instance in Sweden. At the end of 2009 the COST action the database comprised about 8 million data in total from 15 European countries plus the data from the International Phenological Gardens IPG. In January 2010 PEP725 began its work as follow up project with funding from EUMETNET the network of European meteorological services and of ZAMG the Austrian national meteorological service. PEP725 not only will take over the part of maintaining, updating the COST725 database, but also to bring in phenological data from the time before 1951, developing better quality checking procedures and ensuring an open access to the database. An attractive webpage will make phenology and climate impacts on vegetation more visible in the public enabling a monitoring of vegetation development.

Metastatic carcinoma in the cervical lymph nodes from an unknown primary site: results of bilateral neck plus mucosal irradiation vs. ipsilateral neck irradiation

International Nuclear Information System (INIS)

Reddy, Sarada P.; Marks, James E.

1997-01-01

Purpose: To compare the outcome for patients with squamous cell carcinoma of cervical lymph nodes metastatic from an unknown primary site who were irradiated to both sides of the neck and potential mucosal sites with opposed photon beams, and for those irradiated to the ipsilateral side of the neck alone with an electron beam. Methods and Materials: Fifty-two patients with squamous cell carcinoma metastatic to cervical lymph nodes from an unknown primary site were irradiated by two different methods. Thirty-six were irradiated with a bilateral technique (BT), i.e., to both sides of the neck, including the naso-oro-hypopharyngeal mucosa, and 16 were irradiated with an electron beam (EB) to the ipsilateral side of the neck alone. Twenty patients of the BT group and 11 of the EB group had cervical lymph node dissections, and the remaining 21 patients had lymph node biopsies, prior to radiotherapy. Results: Tumor control in the ipsilateral side of the neck did not differ for either radiation technique, but was significantly higher after lymph node dissection than after biopsy (90 vs. 48%; p = 0.0004). Control of subclinical metastases in the contralateral cervical lymph nodes was higher for patients irradiated with BT than for patients irradiated with EB (86 vs. 56%; p 0.03). The occult primary was later discovered in 8% of the patients in the BT group and 44% of the EB group (p = 0.0005). The disease-free survival rate at 5 years for patients who had lymph node dissection prior to irradiation was 61%, and was 37% for those who had biopsy (p = 0.05). Only 20% of patients who subsequently developed an occult primary were salvaged and survived for 5 years after salvage treatment. Conclusion: Bilateral neck and mucosal irradiation is superior to ipsilateral neck irradiation in preventing contralateral cervical lymph node metastases and the subsequent appearance of an occult primary cancer. Both techniques combined with cervical lymph node dissection were equally effective

Alternative management of the aging jawline and neck.

Science.gov (United States)

Sclafani, Anthony P; Kwak, Edward

2005-02-01

The lower third of the face and neck have distinct changes that occur with aging. These changes can be globally and dramatically addressed with a traditional rhytidectomy. However, as the demographics of facial plastic surgery patients evolve, patients seek increasingly less invasive procedures that will result in faster recovery time and less postoperative morbidity. To accommodate this change, today's facial plastic surgeon must include less invasive procedures in the treatment strategies for the lower face and neck. Correct, patient-specific procedure selection and patient education can yield results similar to those of a traditional facelift. This article discusses options available for treatment of the lower face and neck.

Prognostic factors for neck pain in general practice

NARCIS (Netherlands)

Hoving, Jan L.; de Vet, Henrica C. W.; Twisk, Jos W. R.; Devillé, Walter L. J. M.; van der Windt, Daniëlle; Koes, Bart W.; Bouter, Lex M.

2004-01-01

Prognostic studies on neck pain are scarce and are typically restricted to short-term follow-up only. In this prospective cohort study, indicators of short- and long-term outcomes of neck pain were identified that can easily be measured in general practice. Patients between 18 and 70 years of age,

Joint position sense error in people with neck pain: A systematic review.

Science.gov (United States)

de Vries, J; Ischebeck, B K; Voogt, L P; van der Geest, J N; Janssen, M; Frens, M A; Kleinrensink, G J

2015-12-01

Several studies in recent decades have examined the relationship between proprioceptive deficits and neck pain. However, there is no uniform conclusion on the relationship between the two. Clinically, proprioception is evaluated using the Joint Position Sense Error (JPSE), which reflects a person's ability to accurately return his head to a predefined target after a cervical movement. We focused to differentiate between JPSE in people with neck pain compared to healthy controls. Systematic review according to the PRISMA guidelines. Our data sources were Embase, Medline OvidSP, Web of Science, Cochrane Central, CINAHL and Pubmed Publisher. To be included, studies had to compare JPSE of the neck (O) in people with neck pain (P) with JPSE of the neck in healthy controls (C). Fourteen studies were included. Four studies reported that participants with traumatic neck pain had a significantly higher JPSE than healthy controls. Of the eight studies involving people with non-traumatic neck pain, four reported significant differences between the groups. The JPSE did not vary between neck-pain groups. Current literature shows the JPSE to be a relevant measure when it is used correctly. All studies which calculated the JPSE over at least six trials showed a significantly increased JPSE in the neck pain group. This strongly suggests that 'number of repetitions' is a major element in correctly performing the JPSE test. Copyright © 2015 Elsevier Ltd. All rights reserved.

Technical guidelines for the seismic safety re-evaluation at Eastern European NPPs

International Nuclear Information System (INIS)

Godoy, A.R.; Guerpinar, A.

2001-01-01

The paper describes one of the outcomes of the Engineering Safety Review Services (ESRS) that the IAEA provides as an element of the Agency's national, regional and interregional technical assistance and co-operation programmes and other extrabudgetary programmes to assess the safety of nuclear facilities. This refers to the establishment of detailed guidelines for conducting the seismic safety re-evaluation of existing nuclear power plants in Eastern European countries in line with updated criteria and current international practice. (author)

Clinicopathological correlates of pediatric head and neck cancer

Directory of Open Access Journals (Sweden)

Sengupta Subhabrata

2009-01-01

Full Text Available Background : The spectrum of head and neck tumors in children continues to be the cause of diverse, diagnostically challenging issues. Aims : To demonstrate and compare the unique clinicopathological features in our study population and their correlations with the final histopathological diagnosis. Methods : Fifty-three children with head and neck cancer were examined thoroughly at the Otorhinolaryngology department in a tertiary care teaching hospital followed by histopathological studies. Results : Lymphomas were the most common malignant lesions seen followed by rhabdomyosarcomas, nasopharyngeal carcinomas, and others like thyroid carcinomas and eosinophilic granulomas. In the neck, the commonest cause of primary malignant disease was lymphoma; however, the most frequent lesion was reactive lymphadenitis. In the sinonasal region, the commonest malignancy was rhabdomyosarcoma, which often had extension to the orbit and the face. Recurrent epistaxis was found universally in the malignant cases of this region. In the facial region, disfiguring swelling with proptosis was mainly caused by rhabdomyosarcoma. The only case of tonsillar malignancy was due to non-Hodgkin lymphoma. The duration of disease was less than 1 year. Conclusion : The most common manifestation of the malignant lesions in the pediatric age group was with a history of an enlarging, painless neck swelling. Still, an insignificant lump in the neck or recurrent bleeding from nose may be the manifestation of an underlying cancer.

[Unicentric Castleman's disease in cervical back space neck].

Science.gov (United States)

Chamorro-Oscullo, Jenny; Robles-Ramírez, Fernando; Valenzuela-Tamariz, Jorge; Sánchez-Cortázar, Julián Antonio; Gómez-Pérez, Guadalupe

2017-01-01

Castleman´s disease is a rare, benign condition of lymphoid tissue. There are two clinical types: unicentric and multicentric with three histological variants, hyaline-vascular, plasma celular and mixed. The most common sites of this are mediastinum, adbomen and neck. Magnetic resonance imaging is well suited to depict the characteristics of the masses and their relationship to adjacent structures. The knowledge of this disease and its inclusión in the differential diagnosis from other neck masses will contribute to the therapeutic approach. A 21 years old female patient with a left neck mass characterized by magnetic resonance as solid, heterogeneous, vascularized lesión, pre dominantly isointensa on T1-weighted images an high signal on T2-weighted images and fat sat that demonstrate moderate enhancement after contraste material administration located in posterior space of the neck with extensión at thoracic outlet displacing structures of carotid, anterior cervical and viceral spaces. She underwent complete surgical resectión of the mass with histopathological diagnosis of hyaline-vascular type of Castleman´s disease. Magnetic resonance is well suited to depict characteristic and the extent of mass in the neck contributing to narrow the differential diagnosis. Imaging findings, especially of magnetic resonance are very important to choose the treatment of Castleman´s disease.

Multidimensional features of pain in patients with chronic neck pain

Directory of Open Access Journals (Sweden)

Fabianna Resende de Jesus-Moraleida

Full Text Available Abstract Introduction: Chronic neck pain is associated with significant health costs and loss of productivity at work. Objective: to assess pain and disability in individuals with chronic neck pain. Methods: 31 volunteers with chronic neck pain, mean age 29, 65 years, were assessed using the McGill Pain Questionnaire in Brazilian version (Br-MPQ and Neck Disability Index (NDI. The Br-MPQ analysis was performed based on the numerical values associated with the words selected to describe the experience of pain (Pain Rating Index - PRI, and present pain intensity (PPI. NDI was used to evaluate the influence of neck pain in performance of everyday tasks. Finally, we investigated the association between PPI and NDI. Results: PRI revealed that the most significant dimension was the sensory pain (70%, and the number of chosen words was 10 (2,62 out of 20 words. Mean PPI value was 1,23 (0,76 in five points; 40% of participants described pain intensity as moderate. NDI score was 9,77 (3,34, indicating mild disability. There was a positive association between disability and pain intensity (r = 0,36; p =0,046. Pain intensity and duration of pain were not associated. Conclusions: Findings of this study identified important information related to neck pain experienced by patients when suffering from chronic neck pain, moreover, the association between disability and pain intensity reinforces the importance of complementary investigation of these aspects to optimize function in them.

Unusual Presentation of Meningitis following Stab Neck | Motsitsi ...

African Journals Online (AJOL)

Background: A case report of stab neck presenting at Kalafong Hospital, Pretoria, South Africa with atypical meningitis. The objective was to illustrate the challenge of diagnosing this unusual and late presentation of meningitis. Case Report: A 48 year-old male patient presented to us two days after a stab neck. He was ...

Influence of pain on postural control in women with neck pain

Directory of Open Access Journals (Sweden)

Juliana Soares

2013-04-01

Full Text Available The objective of this study was to investigate the influence of pain on postural control in women with neck pain and the relationship with possible changes in sensory systems and posture. The neck pain group was composed of women, aged between 20 and 50years, complaining of neck pain for more than three months; the control group was composed of women without complaints of neck pain. For the characterization of the groups, we used anamnesis, neck disability index and Visual Analogue Scale. Postural balance was assessed on force platform. Postural balance with manipulation of the sensory systems was measured by Foam Laser Dynamic Posturography, exposing the individual to six sensory organization tests. Posture was assessed by the Postural Assessment Software. The normality of the variables were verified using Shapiro-Wilk test, Student’s t-test and Mann-Whitney test for comparison between groups, with a significance level of5%. Groups were homogeneous in demographic variables. We observed higher amplitude and displacement velocity of the center of pressure in the neck pain group, showing greater postural balance. There were significant diferences incraniovertebral angle, showing forward head posture in symptomatic women. In dynamics posturography, we observed a difference between the groups: the score obtainedin the six sensory conditions showed that neck pain group presented greater balance impairment. Neck pain and forward head posture have a deleterious effect on postural control in symptomatic women, both in the static posture and dynamic posture.

To What Degree Does Active Cervical Range of Motion Differ Between Patients With Neck Pain, Patients With Whiplash, and Those Without Neck Pain? A Systematic Review and Meta-Analysis.

Science.gov (United States)

Stenneberg, Martijn S; Rood, Michiel; de Bie, Rob; Schmitt, Maarten A; Cattrysse, Erik; Scholten-Peeters, Gwendolijne G

2017-07-01

To quantify differences in active cervical range of motion (aCROM) between patients with neck pain and those without neck pain, in patients with whiplash-associated disorders (WADs) and nontraumatic neck pain, and in patients with acute complaints versus those with chronic complaints. Seven bibliographic databases were searched from inception to April 2015. In addition, a manual search was performed. Full articles on a numerical comparison of aCROM in patients with neck pain and asymptomatic control persons of similar ages were included. Two reviewers independently selected studies and assessed risk of bias. Two reviewers extracted the data. Pooled mean differences of aCROM were calculated using a random-effects model. The search yielded 6261 hits; 27 articles (2366 participants, 13 low risk of bias) met the inclusion criteria. The neck pain group showed less aCROM in all movement directions compared with persons without neck pain. Mean differences ranged from -7.04° (95% CI, -9.70° to -4.38°) for right lateral bending (11 studies) to -89.59° (95% CI, -131.67° to -47.51°) for total aCROM (4 studies). Patients with WADs had less aCROM than patients with nontraumatic neck pain. No conclusive differences in aCROM were found between patients with acute and patients with chronic complaints. Patients with neck pain have a significantly decreased aCROM compared with persons without neck pain, and patients with WADs have less aCROM than those with nontraumatic neck pain. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Recurrent neck infection with branchial arch fistula in children.

Science.gov (United States)

Madana, J; Yolmo, Deeke; Kalaiarasi, R; Gopalakrishnan, S; Saxena, S K; Krishnapriya, S

2011-09-01

Acute suppurative neck infections associated with third or fourth branchial arch fistulas are frequently recurrent. Third and fourth branchial arch anomalies are much less common than those of second arch and usually present with left thyroid lobe inflammation. The authors present their experience with 15 cases of pyriform sinus fistulae (PSF) of third branchial arch origin and 3 cases of fourth arch origin, all of which presented as recurrent neck infection mainly on the left side. A retrospective review of 18 cases of third and fourth arch fistulae treated at JIPMER from 2005 to 2010. This study includes 18 patients with PSF diagnosed by the existence of fistulous tract radiologically and intraoperatively with pathological correlation. Neck exploration with excision of tract and left hemithyroidectomy was performed in all cases. The patients consisted of 7 males and 11 females, and the ages ranged from 3 to 15 years. All of them presented with recurrent episodes of neck infection. Investigations performed include computed tomography (CT) fistulography, barium swallow and ultrasound which were useful in delineating pyriform sinus fistulous tract preoperatively. All cases were on the left side and the fistula was identified by barium swallow in 14 cases (80%), while intraoperative and pathologic confirmation of the tract was possible in all cases (100%). Neck exploration with an emphasis on complete exposure of the recurrent laryngeal nerve and exposure of the pyriform sinus opening to facilitate complete fistulous tract excision with left hemithyroidectomy was successful in all patients. A follow up period of 1-3 years showed no recurrence. Recurrent neck infection in a child should alert the physician to the possibility of an underlying pyriform sinus fistula of branchial origin and CT fistulography should be performed after the resolution of the neck infection to delineate the tract anatomically. Crown Copyright © 2011. Published by Elsevier Ireland Ltd. All

Hyperparathyroidism following head and neck irradiation

International Nuclear Information System (INIS)

Rao, S.D.; Frame, B.; Miller, M.J.; Kleerskoper, M.; Block, M.A.; Parfitt, A.M.

1980-01-01

A history of head and neck irradiation in childhood or adolescence was found in 22 of 130 patients with primary hyperparathyroidism compared with only 12 of 400 control patients. Among 200 patients with a known history of childhood irradiation, biochemical or surgical evidence of hyperparathyroidism was found in ten, a prevalence of 5%. This is at least 30 times the prevalence of hyperparathyroidism in the general population. The data indicate that head and neck irradiation should be regarded as an important risk factor in the subsequent development of hyperparathyroidism

Hyperparathyroidism following head and neck irradiation

Energy Technology Data Exchange (ETDEWEB)

Rao, S.D.; Frame, B.; Miller, M.J.; Kleerskoper, M.; Block, M.A.; Parfitt, A.M.

1980-02-01

A history of head and neck irradiation in childhood or adolescence was found in 22 of 130 patients with primary hyperparathyroidism compared with only 12 of 400 control patients. Among 200 patients with a known history of childhood irradiation, biochemical or surgical evidence of hyperparathyroidism was found in ten, a prevalence of 5%. This is at least 30 times the prevalence of hyperparathyroidism in the general population. The data indicate that head and neck irradiation should be regarded as an important risk factor in the subsequent development of hyperparathyroidism.

Role of Met Axis in Head and Neck Cancer

Energy Technology Data Exchange (ETDEWEB)

Xu, Yiru, E-mail: xuyiru@umich.edu; Fisher, Gary J., E-mail: xuyiru@umich.edu [Department of Dermatology, University of Michigan, Ann Arbor, MI 48109 (United States)

2013-11-26

Head and neck cancer is the sixth most common type of cancer worldwide. Despite advances in aggressive multidisciplinary treatments, the 5-year survival rate for this dreadful disease is only 50%, mostly due to high rate of recurrence and early involvement of regional lymph nodes and subsequent metastasis. Understanding the molecular mechanisms responsible for invasion and metastasis is one of the most pressing goals in the field of head and neck cancer. Met, also known as hepatocyte growth factor receptor (HGFR), is a member of the receptor protein tyrosine kinase (RPTK) family. There is compelling evidence that Met axis is dysregulated and plays important roles in tumorigenesis, progression, metastasis, angiogenesis, and drug resistance in head and neck cancer. We describe in this review current understanding of Met axis in head and neck cancer biology and development of therapeutic inhibitors targeting Met axis.

Imaging techniques in the study of lipomatous neck lesions

International Nuclear Information System (INIS)

Munoz, M. M.; Herrero, C.; Garcia, M. J.; Sanchez-Lafuente, J.

2001-01-01

Lipomas of the neck are uncommon lesions. Those situated in deep locations and diffuse lipomatosis of the neck can be clinically mis diagnosed. We reviewed the 20 lipomatous neck lesions treated in our hospital over a 15-year period (1985-1999). Computed tomography was diagnostic in nearly 100% of cases and, this, is the method of choice for the detection and characterization of lipomatous tumors. It also provides data that aid in planning the surgical approach and enables the follow-up of clinically stable lesions that do not require surgical treatment. (Author) 11 refs

International infectious diseases teaching to undergraduate medical students: A successful European collaborative experience.

Science.gov (United States)

Charlier, Caroline; Johannessen, Ingólfur; Mackintosh, Claire L; Wilks, David; Cauda, Roberto; Wolf, Federica I; Le Jeunne, Claire

2017-09-01

The emerging global-health paradigm requires medical teaching to be continuously redefined and updated; to this end, transnational approaches should be encouraged and medical training harmonized. Infectious diseases (ID) teaching in the current context of emerging infections, fast-increasing bacterial resistance and large-scale human migration, was chosen to develop a common international course. We report the successful implementation of a joint European undergraduate course aiming to (i) develop a common ID core curriculum among European medical schools; (ii) promote mobility among teachers and students (iii) promote international cooperation among European teachers. The course was built around teachers' mobility. It was delivered in English by a team of European medical educators from Paris Descartes University, Università Cattolica del Sacro Cuore in Rome and the University of Edinburgh to groups of 25-30 undergraduate medical students at each university. Partner Institutions officially recognized the course as substitutive of or additive to the regular curriculum. The course has been running for 3 years and received excellent satisfaction scores by students and staff as regards to scientific content, pedagogy and international exchanges. This cooperative approach demonstrates the feasibility of a harmonized European undergraduate medical education, having ID as a test experiment for future developments.

CT findings of palpable neck masses in children

International Nuclear Information System (INIS)

Park, Chan Sup; Chung, Won Mo; Seok, Eul Hye; Suh, Chang Hae; Chung, Won Kyun

1994-01-01

We performed this study to assess the value of CT in the differential diagnosis of palpable neck masses in children. We retrospectively reviewed the CT scans of the palpable neck masses in 30 children. The masses were proved histopathologically and classified into cystic, solid, and inflammatory mass and their CT findings were analyzed. Twelve cases were cystic masses, 4 were solid masses, and 14 were inflammatory lesions. Cystic masses included cystic lymphangiomas (n=6), branchial cleft cysts (n=3), thyroglossal duct cysts (n=2), and ranula (n=1). Cystic lymphangiomas showed insinuating appearances into adjacent structures and 4 cases occurred in the posterior cervical space. All branchial cleft cysts were round cystic masses with smooth wall and displaced the submandibular gland anteriorly and the sternocleidomastoid muscle posteriorly. Two thyroglossal duct cysts occurred centrally adjacent to the hyoid bone and 1 ranula in the submental area. Solid masses were juvenile hemangioma, pleomorphic adenoma in submandibular gland, neurilemmoma, and fibromatosis colli. Juvenile hemangioma showed well-enhancing mass with indistinct margin and the other solid masses had well-defined margin with their characteristic location. Inflammatory lesions were abscess (n=4), deep neck infections with lymphadenopathy (n=4), submandibular gland inflammation (n=3), and tuberculous lymphadenitis (n=3) and they showed strand-like enhancement in adjacent subcutaneous tissues. Tuberculous lymphadenitis had multiple lymph node enlargement with internal low attenuation areas and showed less surrounding strand-like enhancement than suppurative lymphadenopathies. Most neck masses in infants and children were of congenital or inflammatory origin. CT is useful for the evaluation of the child presenting with a neck mass, because it can differentiate various forms of neck masses and is able to reveal the relationship of the masses to the adjacent structures with their characteristic location

CT findings of palpable neck masses in children

Energy Technology Data Exchange (ETDEWEB)

Park, Chan Sup; Chung, Won Mo; Seok, Eul Hye; Suh, Chang Hae; Chung, Won Kyun [College of Medicine, Inha University, Incheon (Korea, Republic of)

1994-12-15

We performed this study to assess the value of CT in the differential diagnosis of palpable neck masses in children. We retrospectively reviewed the CT scans of the palpable neck masses in 30 children. The masses were proved histopathologically and classified into cystic, solid, and inflammatory mass and their CT findings were analyzed. Twelve cases were cystic masses, 4 were solid masses, and 14 were inflammatory lesions. Cystic masses included cystic lymphangiomas (n=6), branchial cleft cysts (n=3), thyroglossal duct cysts (n=2), and ranula (n=1). Cystic lymphangiomas showed insinuating appearances into adjacent structures and 4 cases occurred in the posterior cervical space. All branchial cleft cysts were round cystic masses with smooth wall and displaced the submandibular gland anteriorly and the sternocleidomastoid muscle posteriorly. Two thyroglossal duct cysts occurred centrally adjacent to the hyoid bone and 1 ranula in the submental area. Solid masses were juvenile hemangioma, pleomorphic adenoma in submandibular gland, neurilemmoma, and fibromatosis colli. Juvenile hemangioma showed well-enhancing mass with indistinct margin and the other solid masses had well-defined margin with their characteristic location. Inflammatory lesions were abscess (n=4), deep neck infections with lymphadenopathy (n=4), submandibular gland inflammation (n=3), and tuberculous lymphadenitis (n=3) and they showed strand-like enhancement in adjacent subcutaneous tissues. Tuberculous lymphadenitis had multiple lymph node enlargement with internal low attenuation areas and showed less surrounding strand-like enhancement than suppurative lymphadenopathies. Most neck masses in infants and children were of congenital or inflammatory origin. CT is useful for the evaluation of the child presenting with a neck mass, because it can differentiate various forms of neck masses and is able to reveal the relationship of the masses to the adjacent structures with their characteristic location.

Management of common head and neck masses.

Science.gov (United States)

Tracy, Thomas F; Muratore, Christopher S

2007-02-01

Head and neck masses are a common clinical concern in infants, children, and adolescents. The differential diagnosis for a head or neck mass includes congenital, inflammatory, and neoplastic lesions. An orderly and thorough examination of the head and neck with an appropriate directed workup will facilitate the diagnosis. The most common entities occur repeatedly within the various age groups and can be differentiated with a clear understanding of embryology and anatomy of the region, and an understanding of the natural history of a specific lesion. Congenital lesions most commonly found in the pediatric population include the thyroglossal duct cyst and the branchial cleft and arch anomalies. The inflammatory masses are secondary to local or systemic infections. The most common etiology for cervical adenopathy in children is reactive lymphadenopathy following a viral or bacterial illness. Persistent adenopathy raises more concerns, especially enlarged lymph nodes within the posterior triangle or supraclavicular space, nodes that are painless, firm, and not mobile, or a single dominant node that persists for more than 6 weeks should all heighten concern for malignancy. In this review, we discuss the current principles of surgical management of the most common head and neck masses that present to pediatricians and pediatric surgeons.

Comparison of property taxation systems in the European Union

Directory of Open Access Journals (Sweden)

Krzysztof Adam Firlej

2014-08-01

Full Text Available In this paper an attempt has been made to characterize theoretical and empirical determinants of property taxation systems in the European Union with particular emphasis on the fiscal functions of property tax. The study was conducted based on the method for the analysis and critique of literature. Within the theoretical framework, this study touches upon such issues as: theoretical considerations of property taxation and the classification of property taxation systems within the European Union with a distinction between value systems and surface systems. At the practical level characteristics have been established of property taxation volvasystems in the European Union considering the range of subjective and objective methods for determining and updating the tax base, as well as the amount of tax burden. Subsequently, an analysis has been done of the fiscal functions of property tax within the European Union. It has been noted that the role of the property tax in individual Member States of the European Union is different. Results indicate that the key cause of a significant variation in effects of a fiscal nature is the adopted method of determining the so-called tax value of the property (market value or rental value of the property, as determined for the purposes of establishing the tax base as well as accepted rates. It was found that tax revenues in countries where cadastral systems exist are much greater than in the case of surface systems. It should also be noted that, in countries where the dimension of property taxes is made conditional on the data collected in cadastral records, the tax potential varies, and the reasons for this state of affairs are the specific solutions adopted in particular European countries.

Parotid Gland Sparing With Helical Tomotherapy in Head-and-Neck Cancer

International Nuclear Information System (INIS)

Voordeckers, Mia; Farrag, Ashraf; Everaert, Hendrik; Tournel, Koen; Storme, Guy; Verellen, Dirk; De Ridder, Mark

2012-01-01

Purpose: This study evaluated the ability of helical tomotherapy to spare the function of the parotid glands in patients with head-and-neck cancer by analyzing dose–volume histograms, salivary gland scintigraphy, and quality of life assessment. Methods and Materials: Data from 76 consecutive patients treated with helical tomotherapy (Hi-Art Tomotherapy) at University Hospital Brussel were analyzed. During planning, priority was given to planning target volume (PTV) coverage: ≥95% of the dose must be delivered to ≥95% of the PTV. Elective nodal regions received 54 Gy (1.8 Gy/fraction). A dose of 70.5 Gy (2.35 Gy/fraction) was prescribed to the primary tumor and pathologic lymph nodes (simultaneous integrated boost scheme). Objective scoring of salivary excretion was performed by salivary gland scintigraphy. Subjective scoring of salivary gland function was evaluated by the European Organization for Research and Treatment of Cancer quality of life questionnaires Quality of Life Questionnaire—C30 (QLQ-C30) and Quality of Life Questionnaire—Head and Neck 35 (H and N35). Results: Analysis of dose–volume histograms (DVHs) showed excellent coverage of the PTV. The volume of PTV receiving 95% of the prescribed dose (V95%) was 99.4 (range, 96.3–99.9). DVH analysis of parotid gland showed a median value of the mean parotid dose of 32.1 Gy (range, 17.5–70.3 Gy). The median parotid volume receiving a dose <26 Gy was 51.2%. Quality of life evaluation demonstrated an initial deterioration of almost all scales and items in QLQ-C30 and QLQ-H and N35. Most items improved in time, and some reached baseline values 18 months after treatment. Conclusion: DVH analysis, scintigraphic evaluation of parotid function, and quality of life assessment of our patient group showed that helical tomotherapy makes it possible to preserve parotid gland function without compromising disease control. We recommend mean parotid doses of <34 Gy and doses <26 Gy to a maximum 47% of the

The Danish Head and Neck Cancer database

DEFF Research Database (Denmark)

Overgaard, Jens; Jovanovic, Aleksandar; Godballe, Christian

2016-01-01

of continuous clinical trials and subsequent implementation in national guidelines. The database has furthermore been used to describe the effect of reduced waiting time, changed epidemiology, and influence of comorbidity and socioeconomic parameters. CONCLUSION: Half a century of registration of head and neck......AIM OF THE DATABASE: The Danish Head and Neck Cancer database is a nationwide clinical quality database that contains prospective data collected since the early 1960s. The overall aim of this study was to describe the outcome of the national strategy for multidisciplinary treatment of head and neck......) of cancer in the nasal sinuses, salivary glands, or thyroid gland (corresponding to the International Classification of Diseases, tenth revision, classifications C.01-C.11, C.30-C.32, C.73, and C.80). MAIN VARIABLES: The main variables used in the study were symptoms and the duration of the symptoms...

Multidisciplinary management of head and neck cancer: First expert consensus using Delphi methodology from the Spanish Society for Head and Neck Cancer (part 1).

Science.gov (United States)

Mañós, M; Giralt, J; Rueda, A; Cabrera, J; Martinez-Trufero, J; Marruecos, J; Lopez-Pousa, A; Rodrigo, J P; Castelo, B; Martínez-Galán, J; Arias, F; Chaves, M; Herranz, J J; Arrazubi, V; Baste, N; Castro, A; Mesía, R

2017-07-01

Head and neck cancer is one of the most frequent malignances worldwide. Despite the site-specific multimodality therapy, up to half of the patients will develop recurrence. Treatment selection based on a multidisciplinary tumor board represents the cornerstone of head and neck cancer, as it is essential for achieving the best results, not only in terms of outcome, but also in terms of organ-function preservation and quality of life. Evidence-based international and national clinical practice guidelines for head and neck cancer not always provide answers in terms of decision-making that specialists must deal with in their daily practice. This is the first Expert Consensus on the Multidisciplinary Approach for Head and Neck Squamous Cell Carcinoma (HNSCC) elaborated by the Spanish Society for Head and Neck Cancer and based on a Delphi methodology. It offers several specific recommendations based on the available evidence and the expertise of our specialists to facilitate decision-making of all health-care specialists involved. Copyright © 2017. Published by Elsevier Ltd.

Pattern of head and neck cancers among patients attending ...

African Journals Online (AJOL)

Lack of baseline data in Tanzania concerning head and ... that there is a synergistic effect of alcohol consumption and tobacco use in causing head and neck cancers ... risk factors, while radiation around the head and neck is associated with ...

Neck length and mean arterial pressure in the sauropod dinosaurs.

Science.gov (United States)

Hughes, Stephen; Barry, John; Russell, Jeremy; Bell, Robert; Gurung, Som

2016-04-15

How blood was able to reach the heads of the long-necked sauropod dinosaurs has long been a matter of debate and several hypotheses have been presented. For example, it has been proposed that sauropods had exceptionally large hearts, multiple 'normal' sized hearts spaced at regular intervals up the neck or held their necks horizontal, or that the siphon effect was in operation. By means of an experimental model, we demonstrate that the siphon principle is able to explain how blood was able to adequately perfuse the sauropod brain. The return venous circulation may have been protected from complete collapse by a structure akin to the vertebral venous plexus. We derive an equation relating neck height and mean arterial pressure, which indicates that with a mean arterial pressure similar to that of the giraffe, the maximum safe vertical distance between heart and head would have been about 12 m. A hypothesis is presented that the maximum neck length in the fossil record is due to the siphon height limit. The equation indicates that to migrate over high ground, sauropods would have had to either significantly increase their mean arterial pressure or keep their necks below a certain height dependent on altitude. © 2016. Published by The Company of Biologists Ltd.