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Sample records for previously untreated extensive-stage

  1. Belotecan/cisplatin versus etoposide/cisplatin in previously untreated patients with extensive-stage small cell lung carcinoma: a multi-center randomized phase III trial

    International Nuclear Information System (INIS)

    Oh, In-Jae; Kim, Kyu-Sik; Park, Cheol-Kyu; Kim, Young-Chul; Lee, Kwan-Ho; Jeong, Jin-Hong; Kim, Sun-Young; Lee, Jeong-Eun; Shin, Kye-Chul; Jang, Tae-Won; Lee, Hyun-Kyung; Lee, Kye-Young; Lee, Sung-Yong

    2016-01-01

    No novel chemotherapeutic combinations have demonstrated superior efficacy to etoposide/cisplatin (EP), a standard treatment regimen for extensive-stage small cell lung carcinoma (ES-SCLC) over the past decade. We aimed to compare the efficacy and safety of belotecan/cisplatin (BP) and EP regimens in chemotherapy- and radiotherapy-naïve patients with previously untreated ES-SCLC. We conducted a multi-center, randomized, open-label, parallel-group, phase III clinical study. A total of 157 patients were recruited at 14 centers with 147 patients meeting the inclusion/exclusion criteria and randomized to either BP (n = 71) or EP (n = 76) treatment arms. A non-inferior response rate (RR) in the BP arm, analyzed by intent-to-treat analysis according to Response Evaluation Criteria in Solid Tumors version 1.0 criteria, was used as the primary endpoint. The secondary endpoints were progression-free survival (PFS) and overall survival (OS). In the BP arm, one patient had a complete response, 41 had a partial response (PR), and 17 had stable disease (SD). In the EP arm, 35 patients had PR and 28 had SD. The RR in the BP arm was non-inferior to the EP regimen in patients with ES-SCLC (BP: 59.2 %, EP: 46.1 %, difference: 13.1 %, 90 % two-sided confidence interval: -0.3–26.5, meeting the predefined non-inferiority criterion of -15.0 %). No significant differences in OS or PFS were observed between the treatment arms. Hematologic toxicities, including grade 3/4 anemia and thrombocytopenia, were significantly more prevalent in the BP arm than the EP arm. The RR to the BP regimen was non-inferior to the EP regimen in chemotherapy- and radiotherapy-naïve patients with previously untreated ES-SCLC. Hematologic toxicities were significantly more prevalent in the BP group, indicating that BP should be used with care, particularly in patients with a poor performance status. Further studies assessing PFS and OS are required to validate the superiority of the BP regimen. Clinical

  2. Phase II study of a 3-day schedule with topotecan and cisplatin in patients with previously untreated small cell lung cancer and extensive disease

    DEFF Research Database (Denmark)

    Sorensen, M.; Lassen, Ulrik Niels; Jensen, Peter Buhl

    2008-01-01

    INTRODUCTION: Treatment with a topoisomerase I inhibitor in combination with a platinum results in superior or equal survival compared with etoposide-based treatment in extensive disease small cell lung cancer (SCLC). Five-day topotecan is inconvenient and therefore shorter schedules of topotecan...... and cisplatin are needed. The aim of this phase II study was to establish the response rate and response duration in chemo-naive patients with SCLC receiving a 3-day topotecan and cisplatin schedule. METHODS: Simons optimal two-stage design was used. Patients with previously untreated extensive disease SCLC...... age was 59 (range 44-74), 79% had performance status 0 or 1. Thirty-one patients completed all six cycles. Grade 3/4 anemia, neutrocytopenia, and thrombocytopenia were recorded in 9.5%, 66.7%, and 21.4% of patients, respectively. Fourteen percent of patients experienced neutropenic fever. No episodes...

  3. Subcortical grey matter changes in untreated, early stage Parkinson's disease without dementia.

    Science.gov (United States)

    Lee, Hye Mi; Kwon, Kyum-Yil; Kim, Min-Jik; Jang, Ji-Wan; Suh, Sang-Il; Koh, Seong-Beom; Kim, Ji Hyun

    2014-06-01

    Previous MRI studies have investigated cortical or subcortical grey matter changes in patients with Parkinson's disease (PD), yielding inconsistent findings between the studies. We therefore sought to determine whether focal cortical or subcortical grey matter changes may be present from the early disease stage. We recruited 49 untreated, early stage PD patients without dementia and 53 control subjects. Voxel-based morphometry was used to evaluate cortical grey matter changes, and automated volumetry and shape analysis were used to assess volume changes and shape deformation of the subcortical grey matter structures, respectively. Voxel-based morphometry showed neither reductions nor increases in grey matter volume in patients compared to controls. Compared to controls, PD patients had significant reductions in adjusted volumes of putamen, nucleus accumbens, and hippocampus (corrected p grey matter and clinical variables representing disease duration and severity. Our results suggest that untreated, early stage PD without dementia is associated with volume reduction and shape deformation of subcortical grey matter, but not with cortical grey matter reduction. Our findings of structural changes in the posterolateral putamen and ventromedial putamen/nucleus accumbens could provide neuroanatomical basis for the involvement of motor and limbic striatum, further implicating motor and non-motor symptoms in PD, respectively. Early hippocampal involvement might be related to the risk for developing dementia in PD patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Aflibercept and FOLFOX6 Treatment for Previously Untreated Stage IV Colorectal Cancer

    Science.gov (United States)

    2018-04-03

    Mucinous Adenocarcinoma of the Colon; Mucinous Adenocarcinoma of the Rectum; Signet Ring Adenocarcinoma of the Colon; Signet Ring Adenocarcinoma of the Rectum; Stage IV Colon Cancer; Stage IV Rectal Cancer

  5. Economic impact of feeding a phenylalanine-restricted diet to adults with previously untreated phenylketonuria.

    Science.gov (United States)

    Brown, M C; Guest, J F

    1999-02-01

    The aim of the present study was to estimate the direct healthcare cost of managing adults with previously untreated phenylketonuria (PKU) for one year before any dietary restrictions and for the first year after a phenylalanine- (PHE-) restricted diet was introduced. The resource use and corresponding costs were estimated from medical records and interviews with health care professionals experienced in caring for adults with previously untreated PKU. The mean annual cost of caring for a client being fed an unrestricted diet was estimated to be 83 996 pound silver. In the first year after introducing a PHE-restricted diet, the mean annual cost was reduced by 20 647 pound silver to 63 348 pound silver as a result of a reduction in nursing time, hospitalizations, outpatient clinic visits and medications. However, the economic benefit of the diet depended on whether the clients were previously high or low users of nursing care. Nursing time was the key cost-driver, accounting for 79% of the cost of managing high users and 31% of the management cost for low users. In contrast, the acquisition cost of a PHE-restricted diet accounted for up to 6% of the cost for managing high users and 15% of the management cost for low users. Sensitivity analyses showed that introducing a PHE-restricted diet reduces the annual cost of care, provided that annual nursing time was reduced by more than 8% or more than 5% of clients respond to the diet. The clients showed fewer negative behaviours when being fed a PHE-restricted diet, which may account for the observed reduction in nursing time needed to care for these clients. In conclusion, feeding a PHE-restricted diet to adults with previously untreated PKU leads to economic benefits to the UK's National Health Service and society in general.

  6. Casodex (bicalutamide) 150-mg monotherapy compared with castration in patients with previously untreated nonmetastatic prostate cancer

    DEFF Research Database (Denmark)

    Iversen, P; Tyrrell, C J; Kaisary, A V

    1998-01-01

    To compare the efficacy, tolerability, and quality of life benefits of bicalutamide (Casodex) 150-mg/day monotherapy and castration in previously untreated nonmetastatic (M0) advanced prostate cancer....

  7. Distinctive distribution of lymphocytes in unruptured and previously untreated brain arteriovenous malformation

    Directory of Open Access Journals (Sweden)

    Yi Guo

    2014-12-01

    Full Text Available Aim: To test the hypothesis that lymphocyte infiltration in brain arteriovenous malformation (bAVM is not associated with iron deposition (indicator of micro-hemorrhage. Methods: Sections of unruptured, previously untreated bAVM specimens (n = 19 were stained immunohistochemically for T-lymphocytes (CD3 + , B-lymphocytes (CD20 + , plasma cells (CD138 + and macrophages (CD68 + . Iron deposition was assessed by hematoxylin and eosin and Prussian blue stains. Superficial temporal arteries (STA were used as control. Results: Both T-lymphocytes and macrophages were present in unruptured, previously untreated bAVM specimens, whereas few B cells and plasma cells were detected. Iron deposition was detected in 8 specimens (42%; 95% confidence intervals = 20-67%. The samples with iron deposition tended to have more macrophages than those without (666 ± 313 vs. 478 ± 174 cells/mm 2 ; P = 0.11. T-cells were clustered on the luminal side of the endothelial surface, on the vessel-wall, and in the perivascular regions. There was no correlation between T-lymphocyte load and iron deposition (P = 0.88. No macrophages and lymphocytes were detected in STA controls. Conclusion: T-lymphocytes were present in bAVM specimens. Unlike macrophages, the load and location of T-lymphocytes were not associated with iron deposition, suggesting the possibility of an independent cell-mediated immunological mechanism in bAVM pathogenesis.

  8. Emergence of multidrug-resistant, extensively drug-resistant and untreatable gonorrhea

    Science.gov (United States)

    Unemo, Magnus; Nicholas, Robert A

    2013-01-01

    The new superbug Neisseria gonorrhoeae has retained resistance to antimicrobials previously recommended for first-line treatment and has now demonstrated its capacity to develop resistance to the extended-spectrum cephalosporin, ceftriaxone, the last remaining option for first-line empiric treatment of gonorrhea. An era of untreatable gonorrhea may be approaching, which represents an exceedingly serious public health problem. Herein, we review the evolution, origin and spread of antimicrobial resistance and resistance determinants (with a focus on extended-spectrum cephalosporins) in N. gonorrhoeae, detail the current situation regarding verified treatment failures with extended-spectrum cephalosporins and future treatment options, and highlight essential actions to meet the large public health challenge that arises with the possible emergence of untreatable gonorrhea. Essential actions include: implementing action/response plans globally and nationally; enhancing surveillance of gonococcal antimicrobial resistance, treatment failures and antimicrobial use/misuse; and improving prevention, early diagnosis and treatment of gonorrhea. Novel treatment strategies, antimicrobials (or other compounds) and, ideally, a vaccine must be developed. PMID:23231489

  9. Chemoimmunotherapy with ofatumumab in combination with CHOP in previously untreated follicular lymphoma

    DEFF Research Database (Denmark)

    Czuczman, Myron S; Hess, Georg; Gadeberg, Ole V

    2012-01-01

    An international, Phase II trial was conducted to assess two doses of ofatumumab, a human CD20 monoclonal antibody, combined with cyclophosphamide (750 mg/m(2) ), doxorubicin (50 mg/m(2) ), prednisone (100 mg days 3-7) and vincristine (1·4 mg/m(2) ) (O-CHOP), as frontline treatment for follicular...... lymphoma (FL). 59 patients with previously untreated FL were randomized to ofatumumab 500 mg (n = 29) or 1000 mg (n = 30) day 1, with CHOP on day 3 every 3 weeks for six cycles. Median duration of FL was 0·1 years for both dose groups; 34% and 38% of patients had high-risk Follicular Lymphoma International...

  10. Prognostic factors in multiple myeloma: definition of risk groups in 410 previously untreated patients: a Grupo Argentino de Tratamiento de la Leucemia Aguda study.

    Science.gov (United States)

    Corrado, C; Santarelli, M T; Pavlovsky, S; Pizzolato, M

    1989-12-01

    Four hundred ten previously untreated multiple myeloma patients entered onto two consecutive Grupo Argentino de Tratamiento de la Leucemia Aguda (GATLA) protocols were analyzed to identify significant prognostic factors influencing survival. The univariate analysis selected the following variables: performance status, renal function, percentage of bone marrow plasma cells at diagnosis, hemoglobin, and age. A multivariate analysis showed that performance status, renal function, percentage of bone marrow plasma cells, hemoglobin, and age were the best predictive variables for survival. A score was assigned to each patient according to these variables, which led to their classification in three groups: good, intermediate, and poor risk, with a probability of survival of 26% and 10% at 96 months, and 5% at 56 months, and median survival of 60, 37, and 14 months, respectively (P = .0000). In our patient population, this model proved to be superior to the Durie-Salmon staging system in defining prognostic risk groups, and separating patients with significantly different risks within each Durie-Salmon stage.

  11. Ifosfamide in previously untreated disseminated neuroblastoma. Results of Study 3A of the European Neuroblastoma Study Group.

    Science.gov (United States)

    Kellie, S J; De Kraker, J; Lilleyman, J S; Bowman, A; Pritchard, J

    1988-05-01

    A prospective study of the effectiveness of ifosfamide as a single agent in the management of previously untreated patients with Evans stage IV neuroblastoma was undertaken. Eighteen children aged more than 1 year were treated with ifosfamide (IFX) 3 g/m2 daily for 2 days immediately after diagnosis and 3 weeks later. Treatment was continued with combination chemotherapy using vincristine, cyclophosphamide, cisplatinum and etoposide (OPEC) or a variant. Mesna (2-mercaptoethane sulphonate) was given to all patients during IFX treatment to prevent urotoxicity. Eight of the 18 patients (44%) responded to IFX. Nine had greater than 66% reduction in baseline tumor volume. Of 15 evaluable patients with raised pre-treatment urinary catecholamine excretion, six (40%) achieved greater than 50% reduction in pretreatment levels. Two of 10 patients evaluable for bone marrow response had complete clearance. Toxicity was mild in all patients. Upon completing 'first line' therapy, only four patients (22%) achieved a good partial remission (GPR) or complete response (CR). Median survival was 11 months. There was a lower rate of attaining GPR and shortened median survival in patients receiving phase II IFX before OPEC or variant, compared to patients with similar pre-treatment characteristics treated with OPEC from diagnosis in an earlier study.

  12. Curcumin and Cholecalciferol in Treating Patients With Previously Untreated Stage 0-II Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

    Science.gov (United States)

    2018-01-26

    Contiguous Stage II Small Lymphocytic Lymphoma; Noncontiguous Stage II Small Lymphocytic Lymphoma; Stage 0 Chronic Lymphocytic Leukemia; Stage I Chronic Lymphocytic Leukemia; Stage I Small Lymphocytic Lymphoma; Stage II Chronic Lymphocytic Leukemia

  13. The effects of anticholinergic drugs on regional cerebral blood flow, and oxygen metabolism in previously untreated patients with Parkinson's disease

    International Nuclear Information System (INIS)

    Obara, Satoko; Takahashi, Satoshi; Yonezawa, Hisashi; Sato, Yoshitomo

    1998-01-01

    Regional cerebral blood flow (rCBF) and oxygen metabolism (rCMRO 2 ) were measured using the steady-state 15 O technique and positron emission tomography (PET) in six previously untreated patients with Parkinson's disease before and after trihexyphenidyl (THP) treatment. The patients comprised of 4 men and 2 women with Hoehn-Yahr stage II-III. Their ages at the onset of the study ranged from 46 to 57 years (mean±SD, 51.8±3.7) and the duration of the illness ranged from 10 to 48 months (mean±SD, 28.8±15.5). The PET study, assessments of the disability and cognitive function were undergone twice. The first time assessments were done was when the patients were not receiving any drugs, and the second time was one to three months after administration of 6 mg THP. All patients showed clinical improvement after THP treatment. The mean disability score of Unified Parkinson's Disease Rating Scale decreased from 35.1 (SD±11.3) to 25.7 (SD±11.6). The cognitive function assessed by Hasegawa's dementia rating scale-revised, Mini-Mental State Examination, Wechsler Adult Intelligence Scale-Revised, and Wechsler Memory Scale-Revised, were not significantly different before and after the THP treatment. After the THP treatment, rCBF and rCMRO 2 decreased significantly in the striatum (about 15%) and all cerebral cortices (about 10%) on both sides contralateral and ipsilateral to the predominantly symptomatic limbs. We conclude that an anticholinergic THP decreases the rCBF and rCMRO 2 significantly in the cerebral cortices without cognitive impairment in early untreated patients with Parkinson's disease. (author)

  14. The effects of anticholinergic drugs on regional cerebral blood flow, and oxygen metabolism in previously untreated patients with Parkinson`s disease

    Energy Technology Data Exchange (ETDEWEB)

    Obara, Satoko; Takahashi, Satoshi; Yonezawa, Hisashi; Sato, Yoshitomo [Iwate Medical Univ., Morioka (Japan). School of Medicine

    1998-12-01

    Regional cerebral blood flow (rCBF) and oxygen metabolism (rCMRO{sub 2}) were measured using the steady-state {sup 15}O technique and positron emission tomography (PET) in six previously untreated patients with Parkinson`s disease before and after trihexyphenidyl (THP) treatment. The patients comprised of 4 men and 2 women with Hoehn-Yahr stage II-III. Their ages at the onset of the study ranged from 46 to 57 years (mean{+-}SD, 51.8{+-}3.7) and the duration of the illness ranged from 10 to 48 months (mean{+-}SD, 28.8{+-}15.5). The PET study, assessments of the disability and cognitive function were undergone twice. The first time assessments were done was when the patients were not receiving any drugs, and the second time was one to three months after administration of 6 mg THP. All patients showed clinical improvement after THP treatment. The mean disability score of Unified Parkinson`s Disease Rating Scale decreased from 35.1 (SD{+-}11.3) to 25.7 (SD{+-}11.6). The cognitive function assessed by Hasegawa`s dementia rating scale-revised, Mini-Mental State Examination, Wechsler Adult Intelligence Scale-Revised, and Wechsler Memory Scale-Revised, were not significantly different before and after the THP treatment. After the THP treatment, rCBF and rCMRO{sub 2} decreased significantly in the striatum (about 15%) and all cerebral cortices (about 10%) on both sides contralateral and ipsilateral to the predominantly symptomatic limbs. We conclude that an anticholinergic THP decreases the rCBF and rCMRO{sub 2} significantly in the cerebral cortices without cognitive impairment in early untreated patients with Parkinson`s disease. (author)

  15. Outcome of combination chemotherapy in extensive stage small-cell lung cancer

    DEFF Research Database (Denmark)

    Lassen, U N; Hirsch, F R; Osterlind, K

    1998-01-01

    During the past two decades many different treatment regimens of combination chemotherapy have been applied in extensive stage small-cell lung cancer (SCLC). This study was carried out to identify whether these modifications have resulted in an improved overall survival for extensive stage during...

  16. Ibrutinib for previously untreated and relapsed or refractory chronic lymphocytic leukaemia with TP53 aberrations

    DEFF Research Database (Denmark)

    Farooqui, Mohammed Z H; Valdez, Janet; Martyr, Sabrina

    2015-01-01

    BACKGROUND: Patients with chronic lymphocytic leukaemia (CLL) with TP53 aberrations respond poorly to first-line chemoimmunotherapy, resulting in early relapse and short survival. We investigated the safety and activity of ibrutinib in previously untreated and relapsed or refractory CLL with TP53...... aberrations. METHODS: In this investigator-initiated, single-arm phase 2 study, we enrolled eligible adult patients with active CLL with TP53 aberrations at the National Institutes of Health Clinical Center (Bethesda, MD, USA). Patients received 28-day cycles of ibrutinib 420 mg orally once daily until...... in one (2%) patient. INTERPRETATION: The activity and safety profile of single-agent ibrutinib in CLL with TP53 aberrations is encouraging and supports its consideration as a novel treatment option for patients with this high-risk disease in both first-line and second-line settings. FUNDING: Intramural...

  17. Two-stage categorization in brand extension evaluation: electrophysiological time course evidence.

    Directory of Open Access Journals (Sweden)

    Qingguo Ma

    Full Text Available A brand name can be considered a mental category. Similarity-based categorization theory has been used to explain how consumers judge a new product as a member of a known brand, a process called brand extension evaluation. This study was an event-related potential study conducted in two experiments. The study found a two-stage categorization process reflected by the P2 and N400 components in brand extension evaluation. In experiment 1, a prime-probe paradigm was presented in a pair consisting of a brand name and a product name in three conditions, i.e., in-category extension, similar-category extension, and out-of-category extension. Although the task was unrelated to brand extension evaluation, P2 distinguished out-of-category extensions from similar-category and in-category ones, and N400 distinguished similar-category extensions from in-category ones. In experiment 2, a prime-probe paradigm with a related task was used, in which product names included subcategory and major-category product names. The N400 elicited by subcategory products was more significantly negative than that elicited by major-category products, with no salient difference in P2. We speculated that P2 could reflect the early low-level and similarity-based processing in the first stage, whereas N400 could reflect the late analytic and category-based processing in the second stage.

  18. Dabrafenib plus trametinib in patients with previously untreated BRAFV600E-mutant metastatic non-small-cell lung cancer: an open-label, phase 2 trial.

    Science.gov (United States)

    Planchard, David; Smit, Egbert F; Groen, Harry J M; Mazieres, Julien; Besse, Benjamin; Helland, Åslaug; Giannone, Vanessa; D'Amelio, Anthony M; Zhang, Pingkuan; Mookerjee, Bijoyesh; Johnson, Bruce E

    2017-10-01

    BRAF V600E mutation occurs in 1-2% of lung adenocarcinomas and acts as an oncogenic driver. Dabrafenib, alone or combined with trametinib, has shown substantial antitumour activity in patients with previously treated BRAF V600E -mutant metastatic non-small-cell lung cancer (NSCLC). We aimed to assess the activity and safety of dabrafenib plus trametinib treatment in previously untreated patients with BRAF V600E -mutant metastatic NSCLC. In this phase 2, sequentially enrolled, multicohort, multicentre, non-randomised, open-label study, adults (≥18 years of age) with previously untreated metastatic BRAF V600E -mutant NSCLC were enrolled into cohort C from 19 centres in eight countries within North America, Europe, and Asia. Patients received oral dabrafenib 150 mg twice per day plus oral trametinib 2 mg once per day until disease progression, unacceptable adverse events, consent withdrawal, or death. The primary endpoint was investigator-assessed overall response, defined as the percentage of patients who achieved a confirmed complete response or partial response per Response Evaluation Criteria In Solid Tumors version 1.1. The primary and safety analyses were by intention to treat in the protocol-defined population (previously untreated patients). The study is ongoing, but no longer recruiting patients. This trial is registered with ClinicalTrials.gov, number NCT01336634. Between April 16, 2014, and Dec 28, 2015, 36 patients were enrolled and treated with first-line dabrafenib plus trametinib. Median follow-up was 15·9 months (IQR 7·8-22·0) at the data cutoff (April 28, 2017). The proportion of patients with investigator-assessed confirmed overall response was 23 (64%, 95% CI 46-79), with two (6%) patients achieving a complete response and 21 (58%) a partial response. All patients had one or more adverse event of any grade, and 25 (69%) had one or more grade 3 or 4 event. The most common (occurring in more than two patients) grade 3 or 4 adverse events were

  19. Adverse obstetric outcomes in women with previous cesarean for dystocia in second stage of labor.

    Science.gov (United States)

    Jastrow, Nicole; Demers, Suzanne; Gauthier, Robert J; Chaillet, Nils; Brassard, Normand; Bujold, Emmanuel

    2013-03-01

    To evaluate obstetric outcomes in women undergoing a trial of labor (TOL) after a previous cesarean for dystocia in second stage of labor. A retrospective cohort study of women with one previous low transverse cesarean undergoing a first TOL was performed. Women with previous cesarean for dystocia in first stage and those with previous dystocia in second stage were compared with those with previous cesarean for nonrecurrent reasons (controls). Multivariable regressions analyses were performed. Of 1655 women, those with previous dystocia in second stage of labor (n = 204) had greater risks than controls (n = 880) to have an operative delivery [odds ratio (OR): 1.5; 95% confidence intervals (CI) 1.1 to 2.2], shoulder dystocia (OR: 2.9; 95% CI 1.1 to 8.0), and uterine rupture in the second stage of labor (OR: 4.9; 95% CI 1.1 to 23), and especially in case of fetal macrosomia (OR: 29.6; 95% CI 4.4 to 202). The median second stage of labor duration before uterine rupture was 2.5 hours (interquartile range: 1.5 to 3.2 hours) in these women. Previous cesarean for dystocia in the second stage of labor is associated with second-stage uterine rupture at next delivery, especially in cases of suspected fetal macrosomia and prolonged second stage of labor. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  20. Long-term safety and outcome of fludarabine, cyclophosphamide and mitoxantrone (FCM) regimen in previously untreated patients with advanced follicular lymphoma: 12 years follow-up of a phase 2 trial.

    Science.gov (United States)

    Magnano, Laura; Montoto, Silvia; González-Barca, Eva; Briones, Javier; Sancho, Juan Manuel; Muntañola, Ana; Salar, Antonio; Besalduch, Joan; Escoda, Lourdes; Moreno, Carol; Domingo-Domenech, Eva; Estany, Cristina; Oriol, Albert; Altés, Albert; Pedro, Carmen; Gardella, Santiago; Asensio, Antoni; Vivancos, Pilar; Fernández de Sevilla, Alberto; Ribera, Josep María; Colomer, Dolors; Campo, Elias; López-Guillermo, Armando

    2017-04-01

    Fludarabine combinations are very affective in follicular lymphoma (FL) with high rates of complete response and prolonged survival. However, late toxicities could be a concern. The aim of the present study was to analyze the long-term impact on survival, relapse and late toxicities of a trial of treatment with fludarabine, mitoxantrone and cyclophosphamide (FCM regimen) for untreated patients with advanced stage FL. One hundred and twenty patients enrolled in a phase 2 trial of treatment with FCM regimen between 2000 and 2003 were evaluated. After a median follow-up of 12 years, 52 patients eventually relapsed/progressed with 10 year progression-free survival (PFS) of 46 %. Ten patients showed histological transformation to aggressive lymphoma with a risk of transformation of 2 and 9 % at 5 and 10 years, respectively. Three patients developed therapy-related myelodysplastic syndrome/acute myeloid leukaemia (MDS/AML) and seven solid neoplasms with an overall risk of 3 and 8 % at 5 and 10 years, respectively. Twenty-six patients eventually died during the follow-up. Overall survival at 10 years was 83 %. In conclusion, FCM regimen allows excellent long-lasting response in previously untreated patients with FL. The incidence of late events including histological transformation and secondary neoplasia is low but not negligible.

  1. Current Treatments for Surgically Resectable, Limited-Stage, and Extensive-Stage Small Cell Lung Cancer.

    Science.gov (United States)

    Stinchcombe, Thomas E

    2017-12-01

    The prevalence of small cell lung cancer (SCLC) has declined in the U.S. as the prevalence of tobacco use has declined. However, a significant number of people in the U.S. are current or former smokers and are at risk of developing SCLC. Routine histological or cytological evaluation can reliably make the diagnosis of SCLC, and immunohistochemistry stains (thyroid transcription factor-1, chromogranin, synaptophysin, and CD56) can be used if there is uncertainty about the diagnosis. Rarely do patients present with SCLC amendable to surgical resection, and evaluation requires a meticulous workup for extra-thoracic metastases and invasive staging of the mediastinum. Resected patients require adjuvant chemotherapy and/or thoracic radiation therapy (TRT), and prophylactic cranial radiation (PCI) should be considered depending on the stage. For limited-stage disease, concurrent platinum-etoposide and TRT followed by PCI is the standard. Thoracic radiation therapy should be started early in treatment, and can be given twice daily to 45 Gy or once daily to 60-70 Gy. For extensive-stage disease, platinum-etoposide remains the standard first-line therapy, and the standard second-line therapy is topotecan. Preliminary studies have demonstrated the activity of immunotherapy, and the response rate is approximately 10-30% with some durable responses observed. Rovalpituzumab tesirine, an antibody drug conjugate, has shown promising activity in patients with high delta-like protein 3 tumor expression (approximately 70% of patients with SCLC). The emergence of these and other promising agents has rekindled interest in drug development in SCLC. Several ongoing trials are investigating novel agents in the first-line, maintenance, and second-line settings. This review will provide an update on the standard therapies for surgically resected limited-stage small cell lung cancer and extensive-stage small cell lung cancer that have been investigated in recent clinical trials. © Alpha

  2. The Discovery of Processing Stages: Extension of Sternberg's Method

    NARCIS (Netherlands)

    Anderson, John R; Zhang, Qiong; Borst, Jelmer P; Walsh, Matthew M

    2016-01-01

    We introduce a method for measuring the number and durations of processing stages from the electroencephalographic signal and apply it to the study of associative recognition. Using an extension of past research that combines multivariate pattern analysis with hidden semi-Markov models, the approach

  3. Prostate cancer staging with extracapsular extension risk scoring using multiparametric MRI

    DEFF Research Database (Denmark)

    Boesen, Lars; Chabanova, Elizaveta; Løgager, Vibeke

    2015-01-01

    OBJECTIVES: To evaluate the diagnostic performance of preoperative multiparametric MRI with extracapsular extension (ECE) risk-scoring in the assessment of prostate cancer tumour stage (T-stage) and prediction of ECE at final pathology. MATERIALS AND METHODS: Eighty-seven patients with clinically....../87 (36 %) patients. ECE risk-scoring showed an AUC of 0.65-0.86 on ROC-curve for both readers, with sensitivity and specificity of 81 % and 78 % at best cutoff level (reader A), respectively. When tumour characteristics were influenced by personal opinion, the sensitivity and specificity for prediction...... technique for preoperative prostate cancer staging • ECE risk scoring predicts extracapsular tumour extension at final pathology • ECE risk scoring shows an AUC of 0.86 on the ROC-curve • ECE risk scoring shows a moderate inter-reader agreement (K = 0.45) • Multiparametric MRI provides essential knowledge...

  4. Gefitinib plus cisplatin and radiotherapy in previously untreated head and neck squamous cell carcinoma: A phase II, randomized, double-blind, placebo-controlled study

    International Nuclear Information System (INIS)

    Gregoire, Vincent; Hamoir, Marc; Chen Changhu; Kane, Madeleine; Kawecki, Andrzej; Julka, Pramod K.; Wang, Hung-Ming; Prasad, Srihari; D'Cruz, Anil K.; Radosevic-Jelic, Ljiljana; Kumar, Rejnish R.; Korzeniowski, Stanislaw; Fijuth, Jacek; Machiels, Jean-Pascal; Sellers, Mark V.; Tchakov, Ilian; Raben, David

    2011-01-01

    Background and purpose: To assess the efficacy and safety of gefitinib given concomitantly and/or as maintenance therapy to standard cisplatin/radiotherapy for previously untreated, unresected, stage III/IV non-metastatic SCCHN. Materials and methods: In this phase II, double-blind, study, 226 patients were randomized to gefitinib 250 mg/day, 500 mg/day or placebo in two phases: a concomitant phase (gefitinib or placebo with chemoradiotherapy), followed by a maintenance phase (gefitinib or placebo alone). Primary endpoint was local disease control rate (LDCR) at 2 years; secondary endpoints were LDCR at 1 year, objective response rate, progression-free survival, overall survival, and safety and tolerability. Results: Gefitinib (250 and 500 mg/day) did not improve 2-year LDCR compared with placebo either when given concomitantly with chemoradiotherapy (32.7% vs. 33.6%, respectively; OR 0.921, 95% CI 0.508, 1.670 [1-sided p = 0.607]) or as maintenance therapy (28.8% vs. 37.4%, respectively; OR 0.684, 95% CI 0.377, 1.241 [1-sided p = 0.894]). Secondary efficacy outcomes were broadly consistent with the 2-year LDCR results. In both doses, gefitinib was well-tolerated and did not adversely affect the safety and tolerability of concomitant chemoradiotherapy. Conclusion: Gefitinib was well-tolerated, but did not improve efficacy compared with placebo when given concomitantly with chemoradiotherapy, or as maintenance therapy alone.

  5. A phase II study of VP-16-ifosfamide-cisplatin combination chemotherapy plus early concurrent thoracic irradiation for previously untreated limited small cell lung cancer

    International Nuclear Information System (INIS)

    Woo, In Sook; Park, Young Suk; Kwon, Sung Hee

    2000-01-01

    At present the addition of thoracic irradiation to combination chemotherapy is a standard treatment for limited staged small cell ling cancer. However, there is still controversy about the optimum timing of chest irradiation. We conducted a phase II study of etoposide (VP-16)-ifosfamide-cisplatin (VIP) combination chemotherapy plus early concurrent thoracic irradiation for the patients with previously untreated limited small cell lung cancer in order to assess if the treatment modality could improve the response rate and the toxicity. Forty-four patients with limited small cell lung cancer were treated with etoposide-ifosfamide-cisplatin and concurrent thoracic irradiation. Combination chemotherapy consisted of etoposide 100 mg/m 2 (on day 1-3), ifosfamide 1000 mg/m 2 (on days 1 and 2) and cisplatin 100 mg/m 2 (on day 1). Concurrent thoracic irradiation consisted of a total of 4000 cGy over 4 weeks starting on the first day of the first chemotherapy. All patients who showed a complete response were given prophylactic cranial irradiation for 2.5 weeks. Forty-four of the 49 patients who entered the study from May 1994 to August 1998 were evaluable. The median age was 59 years and 40 patients had a performance status of 0 or 1. The median survival time was 22.5 months. Twenty-eight patients (62%) showed a complete response and 16 (38%) a partial response. Twenty-four patients (54%) developed grade 3 or 4 neutropenia; there was a 9% RTOG score 3 or 4 esophagitis. VIP combination chemotherapy and early concurrent thoracic irradiation for patients with limited stage small cell lung cancer revealed excellent antitumor response with tolerable toxicity. (author)

  6. Alternative normalization methods demonstrate widespread cortical hypometabolism in untreated de novo Parkinson's disease

    DEFF Research Database (Denmark)

    Berti, Valentina; Polito, C; Borghammer, Per

    2012-01-01

    , recent studies suggested that conventional data normalization procedures may not always be valid, and demonstrated that alternative normalization strategies better allow detection of low magnitude changes. We hypothesized that these alternative normalization procedures would disclose more widespread...... metabolic alterations in de novo PD. METHODS: [18F]FDG PET scans of 26 untreated de novo PD patients (Hoehn & Yahr stage I-II) and 21 age-matched controls were compared using voxel-based analysis. Normalization was performed using gray matter (GM), white matter (WM) reference regions and Yakushev...... normalization. RESULTS: Compared to GM normalization, WM and Yakushev normalization procedures disclosed much larger cortical regions of relative hypometabolism in the PD group with extensive involvement of frontal and parieto-temporal-occipital cortices, and several subcortical structures. Furthermore...

  7. Daunorubicin Hydrochloride, Cytarabine and Oblimersen Sodium in Treating Patients With Previously Untreated Acute Myeloid Leukemia

    Science.gov (United States)

    2013-06-04

    Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Secondary Acute Myeloid Leukemia; Untreated Adult Acute Myeloid Leukemia

  8. WIMS library update project: first stage extension

    International Nuclear Information System (INIS)

    Santo, A.C.F. de; Santos Bastos, W. dos.

    1994-09-01

    This paper reports the results of nine structural lattices obtained through the WIMS-TRACA computer program. This work was performed by request of the managers of the WLU/IAEA project, for the extension of the first stage. These benchmark lattices include regular arrays with heavy water and data of the thorium cycle. Besides K ∞ and K eff (employing the experimental buckling to account for the leakages) spectrum index and ratio at reaction rates are also determined for comparison with the experimental values. The input data for each lattice, are given in the appendix to help exploring possible differences in the results. (author). 4 refs, 1 fig, 11 tabs

  9. Diversity and population dynamics of pests and predators in irrigated rice fields with treated and untreated pesticide.

    Science.gov (United States)

    Rattanapun, W

    2012-01-01

    The monitoring of rice pests and their predators in pesticide untreated and treated rice fields was conducted at the southern of Thailand. Twenty-two species in 15 families and 6 orders of rice pests were sampled from untreated rice field. For treated rice field, 22 species in 14 families and 5 orders of rice pest were collected. Regardless of treatment type, dominant species and individual number of rice pest varied to physiological stage of rice. Lepidopteran pests had highest infestation during the vegetative stage of rice growth, while hemipteran pests composed of hopper species (Hemipetra: Auchenorrhyncha) and heteropteran species (Hemiptera: Heteroptera) were dominant groups during the reproductive stage and grain formation and ripening stage of rice growth. In contrast, dominant species of predator did not change throughout rice growing season. There were 35 species in 25 families and seven orders and 40 species in 29 families and seven orders of predators collected from untreated and treated rice field, respectively. Major predators of both rice fields were Micraspis discolor (Fabricius) (Coleoptera: Coccinellidae), Tetragnatha sp. (Araneae: Tetragnathidae) and Agriocnemis pygmaea Rambur (Odonata: Agrionidae). The population dynamic of predators were not related with rice pest population in both treatments. However, the fluctuation of population pattern of rice pests in the untreated treatment were more distinctly synchronized with their predators than that of the treated treatment. There were no significant differences in the total number of rice pest and predator between two treatments at vegetative and reproductive stages of rice growth. Untreated rice field had a higher population number of predator and a lower population number of rice pest than that of treated rice field during grain formation and ripening stages. These results indicated the ago-ecosystem balance in rice fields could be produced through minimal pesticide application, in order to allow

  10. Concurrent Chemoradiotherapy Followed by Consolidation Chemotherapy With Bi-Weekly Docetaxel and Carboplatin for Stage III Unresectable, Non-Small-Cell Lung Cancer: Clinical Application of a Protocol Used in a Previous Phase II Study

    International Nuclear Information System (INIS)

    Saitoh, Jun-Ichi; Saito, Yoshihiro; Kazumoto, Tomoko; Kudo, Shigehiro; Yoshida, Daisaku; Ichikawa, Akihiro; Sakai, Hiroshi; Kurimoto, Futoshi; Kato, Shingo; Shibuya, Kei

    2012-01-01

    Purpose: To assess the clinical applicability of a protocol evaluated in a previously reported phase II study of concurrent chemoradiotherapy followed by consolidation chemotherapy with bi-weekly docetaxel and carboplatin in patients with stage III, unresectable, non-small-cell lung cancer (NSCLC). Methods and Materials: Between January 2000 and March 2006, 116 previously untreated patients with histologically proven, stage III NSCLC were treated with concurrent chemoradiotherapy. Radiation therapy was administered in 2-Gy daily fractions to a total dose of 60 Gy in combination with docetaxel, 30 mg/m 2 , and carboplatin at an area under the curve value of 3 every 2 weeks during and after radiation therapy. Results: The median survival time for the entire group was 25.5 months. The actuarial 2-year and 5-year overall survival rates were 53% and 31%, respectively. The 3-year cause-specific survival rate was 60% in patients with stage IIIA disease, whereas it was 35% in patients with stage IIIB disease (p = 0.007). The actuarial 2-year and 5-year local control rates were 62% and 55%, respectively. Acute hematologic toxicities of Grade ≥3 severity were observed in 20.7% of patients, while radiation pneumonitis and esophagitis of Grade ≥3 severity were observed in 2.6% and 1.7% of patients, respectively. Conclusions: The feasibility of the protocol used in the previous phase II study was reconfirmed in this series, and excellent treatment results were achieved.

  11. Concurrent Chemoradiotherapy Followed by Consolidation Chemotherapy With Bi-Weekly Docetaxel and Carboplatin for Stage III Unresectable, Non-Small-Cell Lung Cancer: Clinical Application of a Protocol Used in a Previous Phase II Study

    Energy Technology Data Exchange (ETDEWEB)

    Saitoh, Jun-Ichi, E-mail: junsaito@sannet.ne.jp [Division of Radiation Oncology, Saitama Cancer Center, Saitama (Japan); Saito, Yoshihiro; Kazumoto, Tomoko; Kudo, Shigehiro; Yoshida, Daisaku; Ichikawa, Akihiro [Division of Radiation Oncology, Saitama Cancer Center, Saitama (Japan); Sakai, Hiroshi; Kurimoto, Futoshi [Division of Respiratory Disease, Saitama Cancer Center, Saitama (Japan); Kato, Shingo [Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Shibuya, Kei [Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma (Japan)

    2012-04-01

    Purpose: To assess the clinical applicability of a protocol evaluated in a previously reported phase II study of concurrent chemoradiotherapy followed by consolidation chemotherapy with bi-weekly docetaxel and carboplatin in patients with stage III, unresectable, non-small-cell lung cancer (NSCLC). Methods and Materials: Between January 2000 and March 2006, 116 previously untreated patients with histologically proven, stage III NSCLC were treated with concurrent chemoradiotherapy. Radiation therapy was administered in 2-Gy daily fractions to a total dose of 60 Gy in combination with docetaxel, 30 mg/m{sup 2}, and carboplatin at an area under the curve value of 3 every 2 weeks during and after radiation therapy. Results: The median survival time for the entire group was 25.5 months. The actuarial 2-year and 5-year overall survival rates were 53% and 31%, respectively. The 3-year cause-specific survival rate was 60% in patients with stage IIIA disease, whereas it was 35% in patients with stage IIIB disease (p = 0.007). The actuarial 2-year and 5-year local control rates were 62% and 55%, respectively. Acute hematologic toxicities of Grade {>=}3 severity were observed in 20.7% of patients, while radiation pneumonitis and esophagitis of Grade {>=}3 severity were observed in 2.6% and 1.7% of patients, respectively. Conclusions: The feasibility of the protocol used in the previous phase II study was reconfirmed in this series, and excellent treatment results were achieved.

  12. Variation in duration of untreated psychosis in an 18-year perspective

    DEFF Research Database (Denmark)

    Ten Velden Hegelstad, Wenche; Joa, Inge; Barder, Helene

    2014-01-01

    AIM: The Scandinavian TIPS project engineered an early detection of psychosis programme that sought to reduce the duration of untreated psychosis (DUP) through early detection teams and extensive information campaigns since 1997. In 1997-2000, DUP was reduced from 26 to 4.5 weeks median. The prog......AIM: The Scandinavian TIPS project engineered an early detection of psychosis programme that sought to reduce the duration of untreated psychosis (DUP) through early detection teams and extensive information campaigns since 1997. In 1997-2000, DUP was reduced from 26 to 4.5 weeks median....... The programme was continued beyond the initial project in modified forms for over 13 years. The aim of this study was to track the vicissitudes of DUP over an 18-year period (1993-2010) with differing early detection efforts in a defined catchment area. METHOD: The DUP of all patients meeting criteria for first...

  13. Two-stage bargaining with coverage extension in a dual labour market

    DEFF Research Database (Denmark)

    Roberts, Mark A.; Stæhr, Karsten; Tranæs, Torben

    2000-01-01

    This paper studies coverage extension in a simple general equilibrium model with a dual labour market. The union sector is characterized by two-stage bargaining whereas the firms set wages in the non-union sector. In this model firms and unions of the union sector have a commonality of interest...

  14. Stability management of high speed axial flow compressor stage through axial extensions of bend skewed casing treatment

    Directory of Open Access Journals (Sweden)

    DilipkumarBhanudasji Alone

    2016-09-01

    Full Text Available This paper presents the experimental results to understand the performance of moderately loaded high speed single stage transonic axial flow compressor subjected to various configurations of axial extensions of bend skewed casing treatment with moderate porosity. The bend skewed casing treatment of 33% porosity was coupled with rectangular plenum chamber of depth equal to the slots depth. The five axial extensions of 20%, 40%, 60%, 80% and 100% were used for the experimental evaluations of compressor performance. The main objective was to identify the optimum extension of the casing treatment with reference to rotor leading edge which results in maximum stall margin improvements with minimum loss in the stage efficiency. At each axial extension the compressor performance is distinctive. The improvement in the stall margin was very significant at some axial extensions with 4%–5% penalty in the stage efficiency. The compressors stage shows recovery in terms of efficiency at lower axial extensions of 20% and 40% with increase in the peak stage efficiency. Measurements of flow parameters showed the typical behaviors at near stall flow conditions. Hot wire sensor was placed at the rotor upstream in the tip region to capture the oscillations in the inlet axial and tangential velocities at stall conditions. In the absence of casing treatment the compressor exhibit abrupt stall with very high oscillations in the inlet axial and tangential velocity of the flow. The extents of oscillations reduce with bend skewed casing treatment. Few measurements were also performed in the plenum chamber and salient results are presented in this paper.

  15. Severe radiation morbidity in carcinoma of the cervix: impact of pretherapy surgical staging and previous surgery

    International Nuclear Information System (INIS)

    Fine, Bruce A.; Hempling, Ronald E.; Piver, M. Steven; Baker, Trudy R.; McAuley, Michael; Driscoll, Deborah

    1995-01-01

    Purpose: The purpose of this study is to delineate the factors which (a) contribute to an increase in the severe, radiation induced complication rate and (b) have a significant effect on survival in patients with International Federation of Gynecologists and Obstetricians (FIGO) Stage I-IVA cervical cancer undergoing pretherapy surgical staging. Methods and Materials: From 1971-1991, 189 patients underwent pretherapy surgical staging via a retroperitoneal approach (67) or transperitoneal approach (122). Seventy-nine patients had previously experienced a laparotomy. Patients subsequently received a median of 85 Gy to point A. In patients receiving paraaortic radiation, a median of 45 Gy was administered. One hundred and thirty-two (69.8%) patients received hydroxyurea as a radiation sensitizer. Results: Pretherapy surgical evaluation revealed that 21 of 89 (23.6%) Stage II patients and 32 of 85 (37.6%) Stage III patients had paraaortic lymph node metastases. Multivariate logistic regression analysis detailed the significant factors favorably influencing the radiation-induced complication rate to be a retroperitoneal approach of pretherapy surgical staging and no previous laparotomy. Survival was significantly prolonged in patients receiving hydroxyurea, evaluated via a retroperitoneal incision, with negative paraaortic lymph nodes, and with an early stage of disease. Conclusion: A retroperitoneal approach to pretherapy surgical staging and absence of previous surgery reduced the incidence of subsequent radiation-induced complications. Despite improvements in the detection of occult disease, prolonged survival is impaired when the therapeutic measures currently available are used

  16. Dentofacial growth changes in subjects with untreated Class II malocclusion from late puberty through young adulthood.

    Science.gov (United States)

    Baccetti, Tiziano; Stahl, Franka; McNamara, James A

    2009-02-01

    The purpose of this longitudinal study was to compare dentofacial growth changes in untreated subjects with Class II Division 1 malocclusion with those in subjects with normal (Class I) occlusion from late puberty through young adulthood. The Class II Division 1 sample consisted of 23 subjects (10 male, 13 female). The Class I sample included 30 subjects (13 male, 17 female). The lateral cephalograms of the subjects in both groups were analyzed at 2 consecutive stages of development: T1, postpubertal observation (cervical vertebral maturation stage 6), and T2, young adulthood stage. The average time between T1 and T2 was 3.5 years. The statistical comparisons of the growth changes in the 2 groups were performed with Mann-Whitney U tests. From late puberty through young adulthood, dentofacial growth in subjects with untreated Class II malocclusion does not show significant differences when compared with that observed in untreated subjects with normal occlusion. These findings show that Class II dentoskeletal disharmony does not exhibit significant growth change from late puberty through young adulthood.

  17. Phase II study of ipilimumab in adolescents with unresectable stage III or IV malignant melanoma

    DEFF Research Database (Denmark)

    Geoerger, Birgit; Bergeron, Christophe; Gore, Lia

    2017-01-01

    BACKGROUND: Ipilimumab is approved for the treatment of advanced melanoma in adults; however, little information on the efficacy and safety of ipilimumab in younger patients is available. METHODS: Patients aged 12 to <18 years with previously treated or untreated, unresectable stage III or IV mal...

  18. Computed tomography, lymphography, and staging laparotomy: correlations in initial staging of Hodgkin disease

    Energy Technology Data Exchange (ETDEWEB)

    Castellino, R.A.; Hoppe, R.T.; Blank, N.; Young, S.W.; Neumann, C.; Rosenberg, S.A.; Kaplan, H.S.

    1984-07-01

    One hundred twenty-one patients with newly diagnosed, previously untreated Hodgkin disease underwent abdominal and pelvic computed tomographic (CT) scanning and bipedal lymphography. These studies were followed by staging laparotomy, which included biopsy of the liver, retroperitoneal and mesenteric lymph nodes, and splenectomy. Correlation of the results of the imaging studies with the histopathologic diagnoses revealed a small - but significant - increased accuracy of lymphography compared with CT in assessing the retroperitoneal lymph nodes. The theoretical advantages of CT scanning in detecting lymphomatous deposits in lymph nodes about the celiac axis and the mesentery, or in the liver and spleen, were not confirmed.

  19. Association of Previous Clinical Breast Examination With Reduced Delays and Earlier-Stage Breast Cancer Diagnosis Among Women in Peru.

    Science.gov (United States)

    Romanoff, Anya; Constant, Tara Hayes; Johnson, Kay M; Guadiamos, Manuel Cedano; Vega, Ana María Burga; Zunt, Joseph; Anderson, Benjamin O

    2017-11-01

    Mammographic screening is impractical in most of the world where breast cancers are first identified based on clinical signs and symptoms. Clinical breast examination may improve early diagnosis directly by finding breast cancers at earlier stages or indirectly by heightening women's awareness of breast health concerns. To investigate factors that influence time to presentation and stage at diagnosis among patients with breast cancer to determine whether history of previous clinical breast examination is associated with earlier presentation and/or earlier cancer stage at diagnosis. In this cross-sectional analysis of individual patient interviews using a validated Breast Cancer Delay Questionnaire, 113 (71.1%) of 159 women with breast cancer treated at a federally funded tertiary care referral cancer center in Trujillo, Peru, from February 1 through May 31, 2015, were studied. Method of breast cancer detection and factors that influence time to and stage at diagnosis. Of 113 women with diagnosed cancer (mean [SD] age, 54 [10.8] years; age range, 32-82 years), 105 (92.9%) had self-detected disease. Of the 93 women for whom stage was documented, 45 (48.4%) were diagnosed with early-stage disease (American Joint Committee on Cancer [AJCC] stage 0, I, or II), and 48 (51.6%) were diagnosed with late-stage disease (AJCC stage III or IV). Mean (SD) total delay from symptom onset to initiation of treatment was 407 (665) days because of patient (mean [SD], 198 [449] days) and health care system (mean [SD], 241 [556] days) delay. Fifty-two women (46.0%) had a history of clinical breast examination, and 23 (20.4%) had undergone previous mammography. Women who underwent a previous clinical breast examination were more likely to have shorter delays from symptom development to presentation compared with women who had never undergone a previous clinical breast examination (odds ratio, 2.92; 95% CI, 1.30-6.60; P = .01). Women diagnosed with shorter patient delay were more

  20. Flexural properties of treated and untreated kenaf/epoxy composites

    International Nuclear Information System (INIS)

    Yousif, B.F.; Shalwan, A.; Chin, C.W.; Ming, K.C.

    2012-01-01

    Graphical abstract: Untreated kenaf fibre/epoxy composites. Treated kenaf fibre/epoxy composites. Highlights: ► Treatment of kenaf fibres with 6% NaOH has improved the flexural properties of epoxy composites. ► Interfacial adhesion of the natural fibres is controlled by the microstructure of the fibres. ► Kenaf fibres have a potential to replace glass fibres for flexural applications. -- Abstract: In the current work, flexural properties of unidirectional long kenaf fibre reinforced epoxy (KFRE) composites are studied. The kenaf fibres were prepared into two types as untreated and treated (with 6% NaOH). The failure mechanism and damage features of the materials were categorized with the surface observation by scanning electron microscope (SEM). The results revealed that reinforcement of epoxy with treated kenaf fibres increased the flexural strength of the composite by about 36%, while, untreated fibres introduced 20% improvement. This was mainly due to the high improvement of the chemical treatment (NaOH) on the interfacial adhesion of the fibres and the porosity of the composites which prevented the debonding, detachments or pull out of fibres. For untreated KFRE, the fracture mechanisms were debonding, tearing, detachments and pull out of fibres. The developed composite exhibited superior properties compared to the previous composites based on natural and synthetic fibres.

  1. Predictors of untreated dental decay among 15-34-year-old Australians.

    Science.gov (United States)

    Jamieson, Lisa M; Mejía, Gloria C; Slade, Gary D; Roberts-Thomson, Kaye F

    2009-02-01

    To determine predictors of untreated dental decay among 15-34-year-olds in Australia. Data were from Australia's National Survey of Adult Oral Health, a representative survey that utilized a three-stage, stratified clustered sampling design. Models representing demographic, socioeconomic, dental service utilization and oral health perception variables were tested using multivariable logistic regression to produce odds ratios. An estimated 25.8% (95% CI 22.4-29.5) of 15-34-year-old Australians had untreated dental decay. After controlling for other covariates, those who lived in a location other than a capital city had 2.0 times the odds of having untreated dental decay than their capital city-dwelling counterparts (95% CI 1.29-3.06). Similarly, those whose highest level of education was not a university degree had 2.1 times the odds of experiencing untreated dental decay (95% CI 1.35-3.31). Perceived need of extractions or restorations predicted untreated coronal decay, with 2.9 times the odds for those who perceived a treatment need over those with no such treatment need perception (95% CI 1.84-4.53). Participants who experienced dental fear had 2.2 times the odds of having untreated dental decay (95% CI 1.38-3.41), while those who reported experiencing toothache, orofacial pain or food avoidance in the last 12 months had 1.9 times the odds of having untreated dental decay than their counterparts with no such oral health-related quality-of-life impact (95% CI 1.20-2.92). The multivariate model achieved a 'useful' level of accuracy in predicting untreated decay (area under the ROC curve = 0.74; sensitivity = 0.63; specificity = 0.73). In the Australian young adult population, residential location, education level, perceived need for dental care, dental fear, toothache, orofacial pain or food avoidance together were predictors of untreated dental decay. The prediction model had acceptable specificity, indicating that it may be useful as part of a triage system for

  2. Pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis

    DEFF Research Database (Denmark)

    Kierkegaard, Signe; Jørgensen, Peter Bo; Dalgas, Ulrik

    2015-01-01

    advancing functional tasks, and how these strategies are associated with leg extension power. The aim of the study was to investigate pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis compared with controls. MATERIALS AND METHODS: 57...... patients (mean age 65.6 years) scheduled for medial uni-compartmental knee arthroplasty, and 29 age and gender matched controls were included in this cross-sectional study. Leg extension power was tested with the Nottingham Leg Extension Power-Rig. Pelvic range of motion was derived from an inertia......-based measurement unit placed over the sacrum bone during walking, stair climbing and stepping. RESULTS: Patients had lower leg extension power than controls (20-39 %, P

  3. Talimogene Laherparepvec in Combination With Ipilimumab in Previously Untreated, Unresectable Stage IIIB-IV Melanoma.

    Science.gov (United States)

    Puzanov, Igor; Milhem, Mohammed M; Minor, David; Hamid, Omid; Li, Ai; Chen, Lisa; Chastain, Michael; Gorski, Kevin S; Anderson, Abraham; Chou, Jeffrey; Kaufman, Howard L; Andtbacka, Robert H I

    2016-08-01

    Combining immunotherapeutic agents with different mechanisms of action may enhance efficacy. We describe the safety and efficacy of talimogene laherparepvec (T-VEC; an oncolytic virus) in combination with ipilimumab (a cytotoxic T-lymphocyte-associated antigen 4 checkpoint inhibitor) in patients with advanced melanoma. In this open-label, multicenter, phase Ib trial of T-VEC in combination with ipilimumab, T-VEC was administered intratumorally in week 1 (10(6) plaque-forming units/mL), then in week 4 and every 2 weeks thereafter (10(8) plaque-forming units/mL). Ipilimumab (3 mg/kg) was administered intravenously every 3 weeks for four infusions, beginning in week 6. The primary end point was incidence of dose-limiting toxicities. Secondary end points were objective response rate by immune-related response criteria and safety. Median duration of treatment with T-VEC was 13.3 weeks (range, 2.0 to 95.4 weeks). Median follow-up time for survival analysis was 20.0 months (1.0 to 25.4 months). Nineteen patients were included in the safety analysis. No dose-limiting toxicities occurred, and no new safety signals were detected. Grade 3/4 treatment-related adverse events (AEs) were seen in 26.3% of patients; 15.8% had AEs attributed to T-VEC, and 21.1% had AEs attributed to ipilimumab. The objective response rate was 50%, and 44% of patients had a durable response lasting ≥ 6 months. Eighteen-month progression-free survival was 50%; 18-month overall survival was 67%. T-VEC with ipilimumab had a tolerable safety profile, and the combination appeared to have greater efficacy than either T-VEC or ipilimumab monotherapy. © 2016 by American Society of Clinical Oncology.

  4. 33 CFR 159.307 - Untreated sewage.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Untreated sewage. 159.307 Section 159.307 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED... Operations § 159.307 Untreated sewage. No person shall discharge any untreated sewage from a cruise vessel...

  5. Survival after early-stage breast cancer of women previously treated for depression

    DEFF Research Database (Denmark)

    Suppli, Nis Frederik Palm; Johansen, Christoffer; Kessing, Lars Vedel

    2017-01-01

    treatment of depression and risk of receiving nonguideline treatment of breast cancer were assessed in multivariable logistic regression analyses. We compared the overall survival, breast cancer-specific survival, and risk of death by suicide of women who were and were not treated for depression before......Purpose The aim of this nationwide, register-based cohort study was to determine whether women treated for depression before primary early-stage breast cancer are at increased risk for receiving treatment that is not in accordance with national guidelines and for poorer survival. Material...... and Methods We identified 45,325 women with early breast cancer diagnosed in Denmark from 1998 to 2011. Of these, 744 women (2%) had had a previous hospital contact (as an inpatient or outpatient) for depression and another 6,068 (13%) had been treated with antidepressants. Associations between previous...

  6. One-Stage Correction Surgery of Scoliosis Associated With Syringomyelia: Is it Safe to Leave Untreated a Syrinx Without Neurological Symptom?

    Science.gov (United States)

    Wang, Guodong; Sun, Jianmin; Jiang, Zhensong; Cui, Xingang; Cui, Jiangchao

    2015-06-01

    Retrospective study. To investigate the safety to leave a syrinx untreated in 1-stage correction surgery of scoliosis associated with syringomyelia without progressive neurological symptom. The present protocol for patients with scoliosis secondary to syringomyelia advocated to treat the syrinx first because of the increased risk in correction surgery. However, in daily life, these patients could still do lateral bending, in which spinal cord distracted albeit without any neurological symptom occurred. Twenty-one consecutive patients with scoliosis associated with syringomyelia with or without Chiari malformation underwent surgery in our department from 2003 to 2010 were included in this study. Patients with progressive neural deficits were excluded. Every patient received detailed neurological and radiologic examination before the surgery, including whole spine films, lateral-bending and fulcrum-bending films, 3-dimensional computed tomography scan, and magnetic resonance imaging. All the patients underwent 1-stage correction surgery without treatment of syrinx. During the surgery, Spinal Cord Monitor (SCM) and wake-up test were used to prevent serious neurological complications. At follow-up, patients received neurological examination and whole spine x-ray films. There were 13 male and 8 female patients. Before the surgery, 3 patients complained wasting of the intrinsic muscles of hand, 1 complained numbness of left upper extremity, and 4 complained back pain. Negative abdomen reflex occurred on 12 of 21 patients. All the patients were single major curve, including 14 thoracic curves and 7 thoracolumbar curves. The mean preoperative Cobb angle of scoliosis was 68.05±20.1 degrees, on bending films was 39.48±21.56 degrees, postoperative was 23.19±14.14 degrees, at final follow-up was 25.76±14.46 degrees. The mean flexibility was 0.452±0.158, correction ratio was 0.685±0.140. During the operation, SCM showed motor evoked potential (MEP) loss transiently in 2

  7. A Systematic Review of Mortality from Untreated Scrub Typhus (Orientia tsutsugamushi.

    Directory of Open Access Journals (Sweden)

    Andrew J Taylor

    Full Text Available Scrub typhus, a bacterial infection caused by Orientia tsutsugamushi, is increasingly recognized as an important cause of fever in Asia, with an estimated one million infections occurring each year. Limited access to health care and the disease's non-specific symptoms mean that many patients are undiagnosed and untreated, but the mortality from untreated scrub typhus is unknown. This review systematically summarizes the literature on the untreated mortality from scrub typhus and disease outcomes.A literature search was performed to identify patient series containing untreated patients. Patients were included if they were symptomatic and had a clinical or laboratory diagnosis of scrub typhus and excluded if they were treated with antibiotics. The primary outcome was mortality from untreated scrub typhus and secondary outcomes were total days of fever, clinical symptoms, and laboratory results. A total of 76 studies containing 89 patient series and 19,644 patients were included in the final analysis. The median mortality of all patient series was 6.0% with a wide range (min-max of 0-70%. Many studies used clinical diagnosis alone and had incomplete data on secondary outcomes. Mortality varied by location and increased with age and in patients with myocarditis, delirium, pneumonitis, or signs of hemorrhage, but not according to sex or the presence of an eschar or meningitis. Duration of fever was shown to be long (median 14.4 days Range (9-19.Results show that the untreated mortality from scrub typhus appears lower than previously reported estimates. More data are required to clarify mortality according to location and host factors, clinical syndromes including myocarditis and central nervous system disease, and in vulnerable mother-child populations. Increased surveillance and improved access to diagnostic tests are required to accurately estimate the untreated mortality of scrub typhus. This information would facilitate reliable quantification of

  8. A Systematic Review of Mortality from Untreated Scrub Typhus (Orientia tsutsugamushi).

    Science.gov (United States)

    Taylor, Andrew J; Paris, Daniel H; Newton, Paul N

    2015-01-01

    Scrub typhus, a bacterial infection caused by Orientia tsutsugamushi, is increasingly recognized as an important cause of fever in Asia, with an estimated one million infections occurring each year. Limited access to health care and the disease's non-specific symptoms mean that many patients are undiagnosed and untreated, but the mortality from untreated scrub typhus is unknown. This review systematically summarizes the literature on the untreated mortality from scrub typhus and disease outcomes. A literature search was performed to identify patient series containing untreated patients. Patients were included if they were symptomatic and had a clinical or laboratory diagnosis of scrub typhus and excluded if they were treated with antibiotics. The primary outcome was mortality from untreated scrub typhus and secondary outcomes were total days of fever, clinical symptoms, and laboratory results. A total of 76 studies containing 89 patient series and 19,644 patients were included in the final analysis. The median mortality of all patient series was 6.0% with a wide range (min-max) of 0-70%. Many studies used clinical diagnosis alone and had incomplete data on secondary outcomes. Mortality varied by location and increased with age and in patients with myocarditis, delirium, pneumonitis, or signs of hemorrhage, but not according to sex or the presence of an eschar or meningitis. Duration of fever was shown to be long (median 14.4 days Range (9-19)). Results show that the untreated mortality from scrub typhus appears lower than previously reported estimates. More data are required to clarify mortality according to location and host factors, clinical syndromes including myocarditis and central nervous system disease, and in vulnerable mother-child populations. Increased surveillance and improved access to diagnostic tests are required to accurately estimate the untreated mortality of scrub typhus. This information would facilitate reliable quantification of DALYs and

  9. Adjuvant brachytherapy removes survival disadvantage of local disease extension in stage IIIC endometrial cancer: a SEER registry analysis.

    Science.gov (United States)

    Rossi, Peter J; Jani, Ashesh B; Horowitz, Ira R; Johnstone, Peter A S

    2008-01-01

    To assess the role of radiotherapy (RT) in women with Stage IIIC endometrial cancer. The 17-registry Survival, Epidemiology, and End Results (SEER) database was searched for patients with lymph node-positive non-Stage IV epithelial endometrial cancer diagnosed and treated between 1988 and 1998. Two subgroups were identified: those with organ-confined Stage IIIC endometrial cancer and those with Stage IIIC endometrial cancer with direct extension of the primary tumor. RT was coded as external beam RT (EBRT) or brachytherapy (BT). Observed survival (OS) was reported with a minimum of 5 years of follow-up; the survival curves were compared using the log-rank test. The therapy data revealed 611 women with Stage IIIC endometrial cancer during this period. Of these women, 51% were treated with adjuvant EBRT, 21% with EBRT and BT, and 28% with no additional RT (NAT). Of the 611 patients, 293 had organ-confined Stage IIIC endometrial cancer and 318 patients had Stage IIIC endometrial cancer with direct extension of the primary tumor. The 5-year OS rate for all patients was 40% with NAT, 56% after EBRT, and 64% after EBRT/BT. Adjuvant RT improved survival compared with NAT (p primary tumor was present, the addition of BT to EBRT was even more beneficial.

  10. Bevacizumab plus chemotherapy in elderly patients with previously untreated metastatic colorectal cancer: single center experience

    International Nuclear Information System (INIS)

    Ocvirk, Janja; Moltara, Maja Ebert; Mesti, Tanja; Boc, Marko; Rebersek, Martina; Volk, Neva; Benedik, Jernej; Hlebanja, Zvezdana

    2016-01-01

    Metastatic colorectal cancer (mCRC) is mainly a disease of elderly, however, geriatric population is underrepresented in clinical trials. Patient registries represent a tool to assess and follow treatment outcomes in this patient population. The aim of the study was with the help of the patients’ register to determine the safety and efficacy of bevacizumab plus chemotherapy in elderly patients who had previously untreated metastatic colorectal cancer. The registry of patients with mCRC was designed to prospectively evaluate the safety and efficacy of bevacizumab-containing chemotherapy as well as selection of patients in routine clinical practice. Patient baseline clinical characteristics, pre-specified bevacizumab-related adverse events, and efficacy data were collected, evaluated and compared according to the age categories. Between January 2008 and December 2010, 210 patients with mCRC (median age 63, male 61.4%) started bevacizumab-containing therapy in the 1 st line setting. Majority of the 210 patients received irinotecan-based chemotherapy (68%) as 1 st line treatment and 105 patients (50%) received bevacizumab maintenance therapy. Elderly (≥ 70 years) patients presented 22.9% of all patients and they had worse performance status (PS 1/2, 62.4%) than patients in < 70 years group (PS 1/2, 35.8%). Difference in disease control rate was mainly due to inability to assess response in elderly group (64.6% in elderly and 77.8% in < 70 years group, p = 0.066). The median progression free survival was 10.2 (95% CI, 6.7–16.2) and 11.3 (95% CI, 10.2–12.6) months in elderly and < 70 years group, respectively (p = 0.58). The median overall survival was 18.5 (95% CI, 12.4–28.9) and 27.4 (95% CI, 22.7–31.9) months for elderly and < 70 years group, respectively (p = 0.03). Three-year survival rate was 26% and 37.6% in elderly vs. < 70 years group (p = 0.03). Overall rates of bevacizumab-related adverse events were similar in both groups: proteinuria 21

  11. Subretinal lipid exudation associated with untreated choroidal melanoma

    Directory of Open Access Journals (Sweden)

    C K Minija

    2011-01-01

    Full Text Available Subretinal lipid exudation in an untreated choroidal melanoma is very rare. It is seen following plaque radiotherapy in choroidal melanoma. There is only one case report of untreated choroidal melanoma with massive lipid exudation in a patient with metastatic hypernephroma. We report here a rare case of untreated choroidal melanoma with lipid exudation. Subretinal exudation that is rarely seen following plaque brachytherapy was noted at the borders of this untreated tumor. Lipid exudation partially resolved following brachytherapy.

  12. Correlation between epithelial thickness in normal corneas, untreated ectatic corneas, and ectatic corneas previously treated with CXL; is overall epithelial thickness a very early ectasia prognostic factor?

    Science.gov (United States)

    Kanellopoulos, Anastasios John; Aslanides, Ioannis M; Asimellis, George

    2012-01-01

    To determine and correlate epithelial corneal thickness (pachymetric) measurements taken with a digital arc scanning very high frequency ultrasound biomicroscopy (HF UBM) imaging system (Artemis-II), and compare mean and central epithelial thickness among normal eyes, untreated keratoconic eyes, and keratoconic eyes previously treated with collagen crosslinking (CXL). Epithelial pachymetry measurements (topographic mapping) were conducted on 100 subjects via HF UBM. Three groups of patients were included: patients with normal eyes (controls), patients with untreated keratoconic eyes, and patients with keratoconic eyes treated with CXL. Central, mean, and peripheral corneal epithelial thickness was examined for each group, and a statistical study was conducted. Mean, central, and peripheral corneal epithelial thickness was compared between the three groups of patients. Epithelium thickness varied substantially in the keratoconic group, and in some cases there was a difference of up to 20 μm between various points of the same eye, and often a thinner epithelium coincided with a thinner cornea. However, on average, data from the keratoconic group suggested an overall thickening of the epithelium, particularly over the pupil center of the order of +3 μm, while the mean epithelium thickness was on average +1.1 μm, compared to the control population (P = 0.005). This overall thickening was more pronounced in younger patients in the keratoconic group. Keratoconic eyes previously treated with CXL showed, on average, virtually the same average epithelium thickness (mean -0.7 μm, -0.2 μm over the pupil center, -0.9 μm over the peripheral zone) as the control group. This finding further reinforces our novel theory of the "reactive" component of epithelial thickening in corneas that are biomechanically unstable, becoming stable when biomechanical rigidity is accomplished despite persistence of cornea topographic irregularity. A highly irregular epithelium may be

  13. Natural history of untreatable hepatocellular carcinoma: A retrospective cohort study.

    Science.gov (United States)

    Cabibbo, Giuseppe; Maida, Marcello; Genco, Chiara; Parisi, Pietro; Peralta, Marco; Antonucci, Michela; Brancatelli, Giuseppe; Cammà, Calogero; Craxì, Antonio; Di Marco, Vito

    2012-09-27

    To investigate the clinical course of untreatable hepatocellular carcinoma (HCC) identified at any stage and to identify factors associated with mortality. From January 1999 to December 2010, 320 out of 825 consecutive patients with a diagnosis of HCC and not appropriate for curative or palliative treatments were followed and managed with supportive therapy. Cirrhosis was diagnosed by histological or clinical features and liver function was evaluated according to Child-Pugh score. The diagnosis of HCC was performed by Ultra-Sound guided biopsy or by multiphasic contrast-enhanced computed tomography or gadolinium-enhanced magnetic resonance imaging. Data were collected for each patient including all clinical, laboratory and imaging variables necessary for the outcome prediction staging systems considered. HCC staging was performed according Barcelona Clinic Liver Cancer (BCLC) and Cancer of the Liver Italian Program scores. Follow-up time was defined as the number of months from the diagnosis of HCC to death. Prognostic baseline variables were analyzed by multivariate Cox analysis to identify the independent predictors of survival. Seventy-five per cent of patients had hepatitis C. Ascites was present in 169 patients (53%), while hepatic encephalopathy was present in 49 patients (15%). The Child-Pugh score was class A in 105 patients (33%), class B in 142 patients (44%), and class C in 73 patients (23%). One hundred patients (31%) had macroscopic vascular invasion and/or extra-hepatic spread of the tumor. A single lesion > 10 cm was observed in 34 patients (11%), while multinodular HCC was present in 189 patients (59%). Thirty nine patients (12%) were BCLC early (A) stage, 55 (17%) were BCLC intermediate (B) stage, 124 (39%) were BCLC advanced (C) stage, and 102 (32%) were end-stage BCLC (D). At the time of this analysis (July 2011), 28 (9%) patients were still alive. Six (2%) patients who were lost during follow-up were censored at the last visit. The overall

  14. Routine conventional karyotyping of lymphoma staging bone marrow samples does not contribute clinically relevant information.

    Science.gov (United States)

    Nardi, Valentina; Pulluqi, Olja; Abramson, Jeremy S; Dal Cin, Paola; Hasserjian, Robert P

    2015-06-01

    Bone marrow (BM) evaluation is an important part of lymphoma staging, which guides patient management. Although positive staging marrow is defined as morphologically identifiable disease, such samples often also include flow cytometric analysis and conventional karyotyping. Cytogenetic analysis is a labor-intensive and costly procedure and its utility in this setting is uncertain. We retrospectively reviewed pathological reports of 526 staging marrow specimens in which conventional karyotyping had been performed. All samples originated from a single institution from patients with previously untreated Hodgkin and non-Hodgkin lymphomas presenting in an extramedullary site. Cytogenetic analysis revealed clonal abnormalities in only eight marrow samples (1.5%), all of which were positive for lymphoma by morphologic evaluation. Flow cytometry showed a small clonal lymphoid population in three of the 443 morphologically negative marrow samples (0.7%). Conventional karyotyping is rarely positive in lymphoma staging marrow samples and, in our cohort, the BM karyotype did not contribute clinically relevant information in the vast majority of cases. Our findings suggest that karyotyping should not be performed routinely on BM samples taken to stage previously diagnosed extramedullary lymphomas unless there is pathological evidence of BM involvement by lymphoma. © 2015 Wiley Periodicals, Inc.

  15. Factor VIII brand and the incidence of factor VIII inhibitors in previously untreated UK children with severe hemophilia A, 2000-2011

    Science.gov (United States)

    Palmer, Benedict P.; Chalmers, Elizabeth A.; Hart, Daniel P.; Liesner, Ri; Rangarajan, Savita; Talks, Katherine; Williams, Michael; Hay, Charles R. M.

    2014-01-01

    The effect of recombinant factor VIII (rFVIII) brand on inhibitor development was investigated in all 407 severe hemophilia A previously untreated patients born in the United Kingdom (UK) between 1 January 2000 and 31 December 2011. Eighty-eight (22%) had been in the RODIN study. Information was extracted from the National Haemophilia Database. Because exposure days (EDs) were not known for some patients, time from first treatment was used as a surrogate for rFVIII exposure. An inhibitor developed in 118 (29%) patients, 60 high and 58 low titer, after a median (interquartile range) of 7.8 (3.3-13.5) months from first exposure and 16 (9-30) EDs. Of 128 patients treated with Kogenate Bayer/Helixate NexGen, 45 (35.2%, 95% confidence interval [CI] 27.4-43.8) developed an inhibitor compared with 42/172 (24.4%, 95% CI 18.6% to 31.4%) with Advate (P = .04). The adjusted hazard ratio (HR) (95% CI) for Kogenate Bayer/Helixate NexGen compared with Advate was 2.14 (1.12-4.10) (P = .02) for high titer and 1.75 (1.11-2.76) (P = .02) for all inhibitors. When excluding UK-RODIN patients, the adjusted HR (95% CI) for high-titer inhibitors was 2.00 (0.93-4.34) (P = .08). ReFacto AF was associated with a higher incidence of all, but not high-titer, inhibitors than Advate. These results will help inform debate around the relative immunogenicity and use of rFVIII brands. PMID:25339360

  16. Correlation between epithelial thickness in normal corneas, untreated ectatic corneas, and ectatic corneas previously treated with CXL; is overall epithelial thickness a very early ectasia prognostic factor?

    Directory of Open Access Journals (Sweden)

    Kanellopoulos AJ

    2012-05-01

    Full Text Available Anastasios John Kanellopoulos,1,2 Ioannis M Aslanides,3 George Asimellis11Laservision Eye Institute, Athens, 2Emmetropia Mediterranean Eye Clinic, Crete, Greece, 3New York University School of Medicine, NY, USAPurpose: To determine and correlate epithelial corneal thickness (pachymetric measurements taken with a digital arc scanning very high frequency ultrasound biomicroscopy (HF UBM imaging system (Artemis-II, and compare mean and central epithelial thickness among normal eyes, untreated keratoconic eyes, and keratoconic eyes previously treated with collagen crosslinking (CXL.Methods: Epithelial pachymetry measurements (topographic mapping were conducted on 100 subjects via HF UBM. Three groups of patients were included: patients with normal eyes (controls, patients with untreated keratoconic eyes, and patients with keratoconic eyes treated with CXL. Central, mean, and peripheral corneal epithelial thickness was examined for each group, and a statistical study was conducted.Results: Mean, central, and peripheral corneal epithelial thickness was compared between the three groups of patients. Epithelium thickness varied substantially in the keratoconic group, and in some cases there was a difference of up to 20 µm between various points of the same eye, and often a thinner epithelium coincided with a thinner cornea. However, on average, data from the keratoconic group suggested an overall thickening of the epithelium, particularly over the pupil center of the order of +3 µm, while the mean epithelium thickness was on average +1.1 µm, compared to the control population (P = 0.005. This overall thickening was more pronounced in younger patients in the keratoconic group. Keratoconic eyes previously treated with CXL showed, on average, virtually the same average epithelium thickness (mean –0.7 µm, –0.2 µm over the pupil center, –0.9 µm over the peripheral zone as the control group. This finding further reinforces our novel theory of the

  17. Natural History of Untreated Hepatocellular Carcinoma in a US Cohort and the Role of Cancer Surveillance.

    Science.gov (United States)

    Khalaf, Natalia; Ying, Jun; Mittal, Sahil; Temple, Sarah; Kanwal, Fasiha; Davila, Jessica; El-Serag, Hashem B

    2017-02-01

    Determining the natural history and predictors of survival in patients with untreated hepatocellular carcinoma (HCC) in the United States is useful to test existing tumor classifications, identify subgroups of patients likely to benefit from treatment, and estimate lead time related to HCC surveillance. We identified a national cohort of 518 veterans diagnosed with HCC from 2004 through 2011, with follow-up ending in 2014, who received no palliative or curative treatment. We examined the association between postdiagnosis survival and patient factors, tumor characteristics, and prediagnosis surveillance. The mean age at HCC diagnosis was 65.7 years and most patients had hepatitis C (60.6%). Almost all patients (99%) died within the observation period; the median overall survival time was 3.6 months and survival times were 13.4, 9.5, 3.4, and 1.6 months for patients of Barcelona Clinic Liver Cancer stages 0/A, B, C, and D, respectively. In addition, model for end-stage liver disease and levels of α-fetoprotein were predictive of survival. Nearly 28% received prediagnosis HCC surveillance, which was associated with detection of disease at an earlier stage (Barcelona Clinic Liver Cancer 0/A/B; 26.4% vs 14.4%; P = .0006) and slightly longer survival than patients with no surveillance overall (5.2 months vs 3.4 months; P = .021); there was no difference in survival times of patients with 0/A stage who did versus did not receive surveillance (10.3 months vs 10.5 months). Patients with HCCs, including those detected through surveillance, survived for short time periods in the absence of treatment, irrespective of their initial stage at diagnosis. Model for end-stage liver disease scores and levels of α-fetoprotein were prognostic factors, independent of Barcelona Clinic Liver Cancer stage. The lead time related to detection by surveillance was modest (<2 months) and therefore unlikely to explain the survival benefit associated with surveillance in previous studies

  18. (hydronsan) in previously untreated cases of pulmo

    African Journals Online (AJOL)

    B., M.D., King George V. Hospital, Durban. SUMMARY. The results of a randomized, single-blind, between-paTienI trial of various combinations of rifampicin, .... clearing after 16 weeks of trial is higher in the rifampicin- treated groups than in the ethambutol-plus-Hydronsan group. Table III shows the radiological clearing.

  19. Novel mitochondrial extensions provide evidence for a link between microtubule-directed movement and mitochondrial fission

    International Nuclear Information System (INIS)

    Bowes, Timothy; Gupta, Radhey S.

    2008-01-01

    Mitochondrial dynamics play an important role in a large number of cellular processes. Previously, we reported that treatment of mammalian cells with the cysteine-alkylators, N-ethylmaleimide and ethacrynic acid, induced rapid mitochondrial fusion forming a large reticulum approximately 30 min after treatment. Here, we further investigated this phenomenon using a number of techniques including live-cell confocal microscopy. In live cells, drug-induced fusion coincided with a cessation of fast mitochondrial movement which was dependent on microtubules. During this loss of movement, thin mitochondrial tubules extending from mitochondria were also observed, which we refer to as 'mitochondrial extensions'. The formation of these mitochondrial extensions, which were not observed in untreated cells, depended on microtubules and was abolished by pretreatment with nocodazole. In this study, we provide evidence that these extensions result from of a block in mitochondrial fission combined with continued application of motile force by microtubule-dependent motor complexes. Our observations strongly suggest the existence of a link between microtubule-based mitochondrial trafficking and mitochondrial fission

  20. Untreated pain, narcotics regulation, and global health ideologies.

    Science.gov (United States)

    King, Nicholas B; Fraser, Veronique

    2013-01-01

    Pain management is marginalized or ignored, with millions of people worldwide unnecessarily living with untreated pain. Reducing global inequalities in untreated pain requires a concerted global effort, say Veronique Fraser and colleagues, which must attend to the complexity of pain and promote multimodal, multidisciplinary pain management.

  1. Extension of the Laufenburg power station on the Rhine with STRAFLO turbines

    Energy Technology Data Exchange (ETDEWEB)

    Ruoss, R.; Gyenge, J.; Fischer, F.

    1988-01-01

    The Laufenburg power station on the Rhine built at the beginning of this century, after a previous modernisation (increase in output from 40 to 81 MW), was now extended to a total output of 106 MW in a further modernisation phase. The existing Francis turbines are being replaced by 10 STRAFLO turbines. There is a generously illustrated report on the advantages of the STRAFLO solution and on the two previous stages of building and extension (tables of basic figures for machines, extension water flow, height of head, gross and house service power, average annual output) and on details of the contruction of the STRAFLO turbines (rotor, bearings, windings, seals, wall rings, oil supply, braking device, choice of material). (HWJ).

  2. Cervical vertebrae staging in pre-orthodontic patients in Benin City ...

    African Journals Online (AJOL)

    Method: The first six cervical vertebrae of 105 untreated orthodontic patients attending the clinic of the University of Benin Teaching Hospital were assessed on the cephalometric radiograph to determine the stages of maturation. Correlations between age, gender, type of malocclusion and skeletal maturation stages were ...

  3. Causes of anorexia in untreated hyperthyroidism: a prospective study.

    Science.gov (United States)

    Dai, W X; Meng, X W

    2000-05-01

    Seventeen consecutive patients (mean (SD) 46 (11) years) with untreated hyperthyroidism and anorexia and 29 patients (35 (9) years) with untreated hyperthyroidism without anorexia were studied. The study was conducted at the thyroid clinic of the PUMC Hospital, Beijing, China from March to August 1997. The patients' ages, serum free calcium, liver function and emotional state, specifically the level of anxiety (using the self anxiety scale, Chinese version), were compared before and/or after antithyroid drug treatment in the two groups. This prospective study suggested that the causes of anorexia in untreated hyperthyroidism are complicated. Older age, abnormal liver function, and the level of anxiety are significantly related to anorexia in untreated hyperthyroidism, but hypercalcaemia was not confirmed to be related to anorexia in the study.

  4. Phase II trial of paclitaxel and cisplatin in patients with extensive stage small cell lung cancer: Cancer and Leukemia Group B Trial 9430.

    Science.gov (United States)

    Stinchcombe, Thomas E; Mauer, Ann M; Hodgson, Lydia D; Herndon, James E; Lynch, Thomas J; Green, Mark R; Vokes, Everett E

    2008-11-01

    Cancer and Leukemia Group B trial 9430 was a randomized phase II trial which investigated the safety and activity of four novel doublets in untreated extensive stage small cell lung cancer. The results of the paclitaxel and cisplatin arm have not been reported. Patients received paclitaxel 230 mg/m followed by cisplatin 75 mg/m on day 1 every 21 days. All patients received granulocyte colony stimulating factor 5 microg/kg/d beginning on day 3 of each cycle. The patient characteristics of the 34 patients assigned to this treatment arm were: median age 61.5 years (range 41-82), male (76%), performance status 0 (41%), 1 (32%), and 2 (26%). An objective response was observed in 23 patients (68%; 95% confidence interval (CI): 49-83%); 2 complete responses (6%) and 21 partial responses (62%). Median progression-free survival time was 5.6 months (95% CI: 4.8-7.1 month), and median overall survival time was 7.7 months (95% CI: 7.2-12.6 months). The 1-year survival rate observed was 29% (95% CI: 15-45%). Grade 3/4 neutropenia and thrombocytopenia was observed in 5 (15%) and 4 (12%) patients, respectively. Two patients developed febrile neutropenia including one patient who died of neutropenic sepsis. Grade 3/4 nonhematologic observed were: sensory neuropathy in eight patients (24%); and hyperglycemia, malaise and nausea were all observed in four patients (12%). Cancer and Leukemia Group B will not pursue further investigation of paclitaxel and cisplatin due to the modest activity and the toxicity observed on this trial.

  5. Less extensive surgery compared to extensive surgery

    DEFF Research Database (Denmark)

    Lauszus, Finn F; Petersen, Astrid C; Neumann, Gudrun

    2014-01-01

    -up by hospital data files, general practitioner, death certificate, and autopsy report. Revision of histopathology by a single pathologist. Main outcome measures: Survival and relapse by clinical data, stage, and type of surgery. RESULTS: The incidence of AGCT was 1.37 per year per 100,000 women (95% CI: 1.08, 1.......68). The median follow-up time was 15 years and for the 79 surviving women 22 years. Stage I was found in 94% of cases. Relapse occurred in 24% of women in stage I and 100% of the other stages. Survival in stage I was 95%, 89% and 84% after 5, 10 and 20 years respectively. Increased survival of stage I......: The survival of women was better in AGCT than in epithelial ovarian tumor. Age and type of surgery, besides stage, influenced survival. Total abdominal hysterectomy and bilateral salpingo-oophorectomy is the recommended treatment with advancing age. At younger age less extensive surgery was associated...

  6. FDG-PET and CT patterns of bone metastases and their relationship to previously administered anti-cancer therapy

    International Nuclear Information System (INIS)

    Israel, Ora; Bar-Shalom, Rachel; Keidar, Zohar; Goldberg, Anat; Nachtigal, Alicia; Militianu, Daniela; Fogelman, Ignac

    2006-01-01

    To assess 18 F-fluorodeoxyglucose (FDG) uptake in bone metastases in patients with and without previous treatment, and compare positive positron emission tomography (PET) with osteolytic or osteoblastic changes on computed tomography (CT). One hundred and thirty-one FDG-PET/CT studies were reviewed for bone metastases. A total of 294 lesions were found in 76 patients, 81 in untreated patients and 213 in previously treated patients. PET was assessed for abnormal FDG uptake localised by PET/CT to the skeleton. CT was evaluated for bone metastases and for blastic or lytic pattern. The relationship between the presence and pattern of bone metastases on PET and CT, and prior treatment was statistically analysed using the chi-square test. PET identified 174 (59%) metastases, while CT detected 280 (95%). FDG-avid metastases included 74/81 (91%) untreated and 100/213 (47%) treated lesions (p<0.001). On CT there were 76/81 (94%) untreated and 204/213 (96%) treated metastases (p NS). In untreated patients, 85% of lesions were seen on both PET and CT (26 blastic, 43 lytic). In treated patients, 53% of lesions were seen only on CT (95 blastic, 18 lytic). Of the osteoblastic metastases, 65/174 (37%) were PET positive and 98/120 (82%), PET negative (p<0.001). The results of the present study indicate that when imaging bone metastases, prior treatment can alter the relationship between PET and CT findings. Most untreated bone metastases are PET positive and lytic on CT, while in previously treated patients most lesions are PET negative and blastic on CT. PET and CT therefore appear to be complementary in the assessment of bone metastases. (orig.)

  7. Priorities for Extension.

    Science.gov (United States)

    Hayward, J. A.

    Agricultural extension is one component in an array including research, training, education, marketing, international trade, etc. which develop together to bring about growth, and sustained growth determines the priorities for extension. These priorities depend inevitably on the stage of development of a country or region, and on the current…

  8. Low cortical bone density measured by computed tomography in children and adolescents with untreated hyperthyroidism.

    Science.gov (United States)

    Numbenjapon, Nawaporn; Costin, Gertrude; Gilsanz, Vicente; Pitukcheewanont, Pisit

    2007-05-01

    To determine whether increased thyroid hormones levels have an effect on various bone components (cortical vs cancellous bone). The anthropometric and 3-dimensional quantitative computed tomography (CT) bone measurements, including bone density (BD), cross-sectional area (CSA) of the lumbar spine and femur, and cortical bone area (CBA) of the femur, of 18 children and adolescents with untreated hyperthyroidism were reviewed and compared with those of age-, sex-, and ethnicity-matched historical controls. No significant differences in height, weight, body mass index (BMI), or pubertal staging between patients and controls were found. Cortical BD was significantly lower (P hyperthyroidism compared with historical controls. After adjusting for weight and height, no difference in femur CSA between hyperthyroid children and historical controls was evident. No significant correlations among thyroid hormone levels, antithyroid antibody levels, and cortical BD values were found. As determined by CT, cortical bone is the preferential site of bone loss in children and adolescents with untreated hyperthyroidism.

  9. Management of untreated advanced stage follicular lymphoma: Role of patient discernment.

    Science.gov (United States)

    Umakanthan, Jayadev Manikkam; Lunning, Mathew A

    2018-03-01

    Follicular lymphoma is the most common indolent non-Hodgkin lymphoma. Advanced stage disease is common at diagnosis. The timing of treatment for follicular lymphoma is best approached by considering the combination of presence or absence of symptoms along with estimation of tumor burden. Upfront treatment strategies should take into initial presentation variables, pace of disease progression and goals of care after discussion with the patient. Treatment approaches remain diverse and patient discernment is paramount. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Reducing the duration of untreated first-episode psychosis

    DEFF Research Database (Denmark)

    Melle, Ingrid; Larsen, Tor K; Haahr, Ulrik

    2004-01-01

    Most studies on first-episode psychosis show an association between a long duration of untreated psychosis (DUP) and poorer short-term outcome, but the mechanisms of this relationship are poorly understood.......Most studies on first-episode psychosis show an association between a long duration of untreated psychosis (DUP) and poorer short-term outcome, but the mechanisms of this relationship are poorly understood....

  11. Subscale Carbon-Carbon Nozzle Extension Development and Hot Fire Testing in Support of Upper Stage Liquid Rocket Engines

    Science.gov (United States)

    Gradl, Paul; Valentine, Peter; Crisanti, Matthew; Greene, Sandy Elam

    2016-01-01

    Upper stage and in-space liquid rocket engines are optimized for performance through the use of high area ratio nozzles to fully expand combustion gases to low exit pressures increasing exhaust velocities. Due to the large size of such nozzles and the related engine performance requirements, carbon-carbon (C/C) composite nozzle extensions are being considered for use in order to reduce weight impacts. NASA and industry partner Carbon-Carbon Advanced Technologies (C-CAT) are working towards advancing the technology readiness level of large-scale, domestically-fabricated, C/C nozzle extensions. These C/C extensions have the ability to reduce the overall costs of extensions relative to heritage metallic and composite extensions and to decrease weight by 50%. Material process and coating developments have advanced over the last several years, but hot fire testing to fully evaluate C/C nozzle extensions in relevant environments has been very limited. NASA and C-CAT have designed, fabricated and hot fire tested multiple subscale nozzle extension test articles of various C/C material systems, with the goal of assessing and advancing the manufacturability of these domestically producible materials as well as characterizing their performance when subjected to the typical environments found in a variety of liquid rocket and scramjet engines. Testing at the MSFC Test Stand 115 evaluated heritage and state-of-the-art C/C materials and coatings, demonstrating the capabilities of the high temperature materials and their fabrication methods. This paper discusses the design and fabrication of the 1.2k-lbf sized carbon-carbon nozzle extensions, provides an overview of the test campaign, presents results of the hot fire testing, and discusses potential follow-on development work.

  12. Rib cage deformity during two-stage tissue expander breast reconstruction in patient with previous radiotherapy: a case report

    Directory of Open Access Journals (Sweden)

    Aleš Porčnik

    2016-02-01

    Full Text Available Patients undergoing two-stage breast reconstruction with tissue expander and a history of previous irradiation are predisposed to a various chest-wall deformations more than non-irradiated patients. If chest-wall depression with/without rib fracture is found intra-operatively, bigger implant should be used, with a subsequent radiologic evaluation. In the future, the development of a new, modified expander with a harder base could minimise such complications.

  13. Staging of untreated nasopharyngeal carcinoma with PET/CT: comparison with conventional imaging work-up

    International Nuclear Information System (INIS)

    Ng, Shu-Hang; Chan, Sheng-Chieh; Yen, Tzu-Chen; Liu, Feng-Yuan; Chang, Joseph Tung-Chieh; Fan, Kang-Hsing; Liao, Chun-Ta; Ko, Sheung-Fat; Chin, Shu-Chyn; Hsu, Cheng-Lung

    2009-01-01

    We prospectively compared PET/CT and conventional imaging for initial staging of nasopharyngeal carcinoma (NPC). A total of 111 patients with histologically proven NPC were investigated with PET/CT and conventional imaging (head-and-neck MRI, chest X-ray, abdominal ultrasound, and bone scan) before treatment. The respective findings were reviewed independently and then compared with each other. With regard to T staging, PET/CT showed a discrepancy with head-and-neck MRI in 36 (32.4%) of the study subjects. With regard to N staging, PET/CT showed a discrepancy with head-and-neck MRI in 15 (13.5%) patients. Among the discordant cases, MRI was superior in demonstrating tumor involvement in the parapharyngeal space, skull base, intracranial area, sphenoid sinus, and retropharyngeal nodes while PET/CT was superior in demonstrating neck nodal metastasis. PET/CT disclosed 13 of 16 patients with distant malignancy compared with four patients disclosed by conventional imaging work-up. The false-positive rate of PET/CT was 18.8%. PET/CT correctly modified M staging in eight patients (7.2%) and disclosed a second primary lung malignancy in one patient (0.9%). In NPC patients, MRI appears to be superior to PET/CT for the assessment of locoregional invasion and retropharyngeal nodal metastasis. PET/CT is more accurate than MRI for determining cervical nodal metastasis and should be the better reference for the neck status. PET/CT has an acceptable diagnostic yield and a low false-positive rate for the detection of distant malignancy and can replace conventional work-up to this aim. PET/CT and head-and-neck MRI are suggested for the initial staging of NPC patients. (orig.)

  14. Characteristics of Human Brain Activity during the Evaluation of Service-to-Service Brand Extension

    Directory of Open Access Journals (Sweden)

    Taeyang Yang

    2018-02-01

    Full Text Available Brand extension is a marketing strategy to apply the previously established brand name into new goods or service. A number of studies have reported the characteristics of human event-related potentials (ERPs in response to the evaluation of goods-to-goods brand extension. In contrast, human brain responses to the evaluation of service extension are relatively unexplored. The aim of this study was investigating cognitive processes underlying the evaluation of service-to-service brand extension with electroencephalography (EEG. A total of 56 text stimuli composed of service brand name (S1 followed by extended service name (S2 were presented to participants. The EEG of participants was recorded while participants were asked to evaluate whether a given brand extension was acceptable or not. The behavioral results revealed that participants could evaluate brand extension though they had little knowledge about the extended services, indicating the role of brand in the evaluation of the services. Additionally, we developed a method of grouping brand extension stimuli according to the fit levels obtained from behavioral responses, instead of grouping of stimuli a priori. The ERP analysis identified three components during the evaluation of brand extension: N2, P300, and N400. No difference in the N2 amplitude was found among the different levels of a fit between S1 and S2. The P300 amplitude for the low level of fit was greater than those for higher levels (p < 0.05. The N400 amplitude was more negative for the mid- and high-level fits than the low level. The ERP results of P300 and N400 indicate that the early stage of brain extension evaluation might first detect low-fit brand extension as an improbable target followed by the late stage of the integration of S2 into S1. Along with previous findings, our results demonstrate different cognitive evaluation of service-to-service brand extension from goods-to-goods.

  15. Characteristics of Human Brain Activity during the Evaluation of Service-to-Service Brand Extension

    Science.gov (United States)

    Yang, Taeyang; Lee, Seungji; Seomoon, Eunbi; Kim, Sung-Phil

    2018-01-01

    Brand extension is a marketing strategy to apply the previously established brand name into new goods or service. A number of studies have reported the characteristics of human event-related potentials (ERPs) in response to the evaluation of goods-to-goods brand extension. In contrast, human brain responses to the evaluation of service extension are relatively unexplored. The aim of this study was investigating cognitive processes underlying the evaluation of service-to-service brand extension with electroencephalography (EEG). A total of 56 text stimuli composed of service brand name (S1) followed by extended service name (S2) were presented to participants. The EEG of participants was recorded while participants were asked to evaluate whether a given brand extension was acceptable or not. The behavioral results revealed that participants could evaluate brand extension though they had little knowledge about the extended services, indicating the role of brand in the evaluation of the services. Additionally, we developed a method of grouping brand extension stimuli according to the fit levels obtained from behavioral responses, instead of grouping of stimuli a priori. The ERP analysis identified three components during the evaluation of brand extension: N2, P300, and N400. No difference in the N2 amplitude was found among the different levels of a fit between S1 and S2. The P300 amplitude for the low level of fit was greater than those for higher levels (p < 0.05). The N400 amplitude was more negative for the mid- and high-level fits than the low level. The ERP results of P300 and N400 indicate that the early stage of brain extension evaluation might first detect low-fit brand extension as an improbable target followed by the late stage of the integration of S2 into S1. Along with previous findings, our results demonstrate different cognitive evaluation of service-to-service brand extension from goods-to-goods. PMID:29479313

  16. Decreased local control following radiation therapy alone in early-stage glottic carcinoma with anterior commissure extension

    International Nuclear Information System (INIS)

    Zouhair, A.; Azria, D.; Coucke, P.; Matzinger, O.; Mirimanoff, R.O.; Ozsahin, M.; Bron, L.; Moeckli, R.; Do, H.P.

    2004-01-01

    Purpose: to assess the patterns of failure in the treatment of early-stage squamous cell carcinoma of the glottic larynx. Patients and methods: between 1983-2000, 122 consecutive patients treated for early laryngeal cancer (UICC T1N0 and T2N0) by radical radiation therapy (RT) were retrospectively studied. Male-to-female ratio was 106: 16, and median age 62 years (35-92 years). There were 68 patients with T1a, 18 with T1b, and 36 with T2 tumors. Diagnosis was made by biopsy in 104 patients, and by laser vaporization or stripping in 18. Treatment planning consisted of three-dimensional (3-D) conformal RT in 49 (40%) patients including nine patients irradiated using arytenoid protection. A median dose of 70 Gy (60-74 Gy) was given (2 Gy/fraction) over a median period of 46 days (21-79 days). Median follow-up period was 85 months. Results: the 5-year overall, cancer-specific, and disease-free survival amounted to 80%, 94%, and 70%, respectively. 5-year local control was 83%. Median time to local recurrence in 19 patients was 13 months (5-58 months). Salvage treatment consisted of surgery in 17 patients (one patient refused salvage and one was inoperable; total laryngectomy in eleven, and partial laryngectomy or cordectomy in six patients). Six patients died because of laryngeal cancer. Univariate analyses revealed that prognostic factors negatively influencing local control were anterior commissure extension, arytenoid protection, and total RT dose < 66 Gy. Among the factors analyzed, multivariate analysis (cox model) demonstrated that anterior commissure extension, arytenoid protection, and male gender were the worst independent prognostic factors in terms of local control. Conclusion: for early-stage laryngeal cancer, outcome after RT is excellent. In case of anterior commissure extension, surgery or higher RT doses are warranted. Because of a high relapse risk, arytenoid protection should not be attempted. (orig.)

  17. Association between treated/untreated traumatic dental injuries and impact on quality of life of Brazilian schoolchildren

    Directory of Open Access Journals (Sweden)

    Pordeus Isabela A

    2010-10-01

    Full Text Available Abstract Background Traumatic dental injury (TDI could have physical and psychosocial consequences for children. Thus, it is important to measure the impact of TDI on the quality of life of children (QoL. The aim of the present study was to investigate the association between treated/untreated TDI and the impact on the quality of life of 11-to-14-year-old Brazilian schoolchildren. Methods A cross-sectional study was carried out involving 1612 male and female schoolchildren aged 11 to 14 years attending public and private elementary schools in the city of Belo Horizonte, Brazil. A multi-stage sampling technique was adopted to select the children. Three calibrated examiners used the Andreasen classification for the diagnosis of TDI. Oral health-related quality of life was assessed using the Brazilian version of the Child Perceptions Questionnaire (CPQ11-14 - Impact Short Form (ISF:16, composed of 16 items and self-administered by all children. Other oral conditions (dental caries and malocclusion and the Social Vulnerability Index were determined and used as controlling variables. Results Two hundred nineteen children were diagnosed with untreated TDI and 64 were diagnosed with treated TDI. There were no statistically significant associations between untreated or treated TDI and overall CPQ11-14 (Fisher = 0.368 and Fisher = 0.610, respectively. Children with an untreated TDI were 1.4-fold (95% CI = 1.1-2.1 more likely to report impact on the item "avoided smiling/laughing" than those without TDI, whereas children with a treated TDI were twofold (95% CI = 1.1-3.5 more likely to report impact on the item "other children asked questions" than those without TDI. Conclusions Neither treated nor untreated TDI was associated with oral symptoms, functional limitations or emotional wellbeing. However, children with a TDI in the anterior teeth experienced a negative impact on social wellbeing, mainly with regard to avoiding smiling or laughing and being

  18. Hand size and growth in untreated and IGF-I treated patients with Laron syndrome.

    Science.gov (United States)

    Konen, O; Silbergeld, A; Lilos, P; Kornreich, L; Laron, Z

    2009-03-01

    We have previously reported on the linear growth, growth of the head circumference and foot length in untreated and IGF-I treated patients with Laron syndrome (LS) (primary GH insensitivity). To assess the size and growth of the hands in patients with LS from early childhood to adult age. Ten IGF-I treated children with LS (4 M, 6 F) and 24 untreated patients (10 M, 14 F) were studied. Measurements of palm length were made on available standardized hand X-rays from infancy to adult age. The measurements were compared to normal references and SD values were calculated for each measurement. The growth of the hand was compared to the concomitant height of the body. Hand SDS in untreated patients with LS decreased with age, from a mean of -2.8 +/- 0.7 (age 1-3 years) to -7.3 +/- 0.8 (age 13-15 years) and to -9.0 +/- 3.9 (age 40-50 years). During 9 years of IGF-I treatment the hand size deficit SDS did not improve in contradistinction to the height SDS which decreased from -6.2 +/- 1.2 to -3.9 +/- 0.5. Congenital IGF-I deficiency, as in Laron syndrome, profoundly affects the size and growth of the hand as part of its growth retardation characteristics, resulting in acromicria.

  19. An Investigation of the Neurological and Neuropsychiatric Disturbances in Adults with Undiagnosed and/or Untreated Phenylketonuria in Poland

    Science.gov (United States)

    Mazur, Artur; Jarochowicz, Sabina; Oltarzewski, Mariusz; Sykut-Cegielska, Jolanta; Gradowska, Wanda; Januszek-Trzciakowska, Aleksandra; O'Malley, Grace; Kwolek, Andrzej

    2011-01-01

    Background: The aim of the study was to determine neurological and neuropsychiatric manifestations in a group of patients with previously undiagnosed or untreated phenylketonuria (PKU) in the south-eastern part of Poland. Methods: The study was conducted among 400 adults with severe intellectual disability who were born prior to neonatal screening…

  20. Effects of previous growth hormone excess and current medical treatment for acromegaly on cognition

    NARCIS (Netherlands)

    Brummelman, Pauline; Koerts, Janneke; Dullaart, Robin P. F.; van den Berg, Gerrit; Tucha, Oliver; Wolffenbuttel, Bruce H. R.; van Beek, Andre P.

    2012-01-01

    Background In untreated acromegaly patients, decreased cognitive functioning is reported to be associated with the degree of growth hormone (GH) and IGF-1 excess. Whether previous GH excess or current medical treatment for acromegaly specifically affects cognition remains unclear. The aim of this

  1. CT staging of renal cell carcinoma using the revised 1997 TNM staging criteria: in comparison with the previous one

    International Nuclear Information System (INIS)

    Sung, Deuk Jae; Kim, Yun Hwan; Chung, Hwan Hoon; Chung, Kyoo Byung; Suh, Won Hyuck

    2001-01-01

    To assess the accuracy of preoperative CT staging of RCC and to compare the relationship between T stage and the incidence of metastasis on the basis of the old (1992) and the new (1997) UICC and AJCC tumor classification system. In 112 cases of surgically resected RCC, the stagings of preoperative CT scans were determined retrospectively by two radiologists and were compared with the results of pathologic examinations. In 70 cases which had been followed up over three years after surgery, the incidence of metastasis at initial diagnosis and during the follow-up period was assessed. All cases were reconsidered, and using the old and the new TNM classification, the incidence of metastasis was compared. According to the old TNM classification, 5 cases (4%) were staged at T1, 73(65%) at T2, 21(19%) at T3a, 9(8%) at T3b, 0 at T3c, and 4(4%) at T4. Using the new TNM classification, we also staged 54 cases (48%) at T1 and 24(21%) at T2. Overall, using this new classification, CT correctly staged 79% of patients (88/112) overstaged 15%(17/112) and understaged 6%(7/112). CT had a sensitivity of 84% and specificity of 91% in new T1 tumors, 71% and 95%, respectively, in new T2 tumors, 69% and 88% in T3a tumors, 78% and 98% in T3b tumors, and 75% and 99% in T4 tumors. CT had a sensitivity of 44% and a specificity of 99% in old T1 tumors, and 82% and 71%, respectively, in old T2 tumors. The incidence of metastasis in CT-staged (cT) tumors was 0% (0/4) in old cT1, 8% (3/39) in new cT1, 29% (4/14) in new cT2, 67% (6/9) in cT3a, and 75% (6/8) in cT3b. In the staging of T1 tumors, CT is more sensitive when the new TNM classification is used. Even though the cut off point between T1 and T2 tumors had been in creased from 2.5 to 7.0 cm, T1 tumors staged according to the new system did not show a significantly higher incidence of metastasis than those staged according to the old

  2. An extension of fuzzy decisi

    Directory of Open Access Journals (Sweden)

    Basem Mohamed Elomda

    2013-07-01

    Full Text Available This paper presents a new extension to Fuzzy Decision Maps (FDMs by allowing use of fuzzy linguistic values to represent relative importance among criteria in the preference matrix as well as representing relative influence among criteria for computing the steady-state matrix in the stage of Fuzzy Cognitive Map (FCM. The proposed model is called the Linguistic Fuzzy Decision Networks (LFDNs. The proposed LFDN provides considerable flexibility to decision makers when solving real world Multi-Criteria Decision-Making (MCDM problems. The performance of the proposed LFDN model is compared with the original FDM using a previously published case study. The result of comparison ensures the ability to draw the same decisions with a more realistic decision environment.

  3. Combined laser and photodynamic treatment in extensive purulent wounds

    Science.gov (United States)

    Solovieva, A. B.; Tolstih, P. I.; Melik-Nubarov, N. S.; Zhientaev, T. M.; Kuleshov, I. G.; Glagolev, N. N.; Ivanov, A. V.; Karahanov, G. I.; Tolstih, M. P.; Timashev, P. S.

    2010-05-01

    Recently, photodynamic therapy (PDT) has been used for the treatment of festering wounds and trophic ulcers. An important advantage of PDT is its ability to affect bacterial cultures that are resistant to antibiotics. However the use of PDT alone does not usually guarantee a stable antiseptic effect and cannot prevent an external infection of wounds and burns. In this work attention is focused on the healing of the extensive soft tissues wounds with combined laser therapy (LT) and PDT treatment. At the first stage of this process festering tissues (for example spacious purulent wounds with area more than 100 cm2) were illuminated with high-energy laser beam (with power 20 W) in continues routine. The second stage involves “softer” PDT affect, which along with the completion stages of destruction pathological cells, stimulating the process of wound granulation and epithelization. Also, according to our previous results, photosensitizer (photoditazin) is introduced inside the wound with different amphiphilic polymers for increasing the PDT efficacy.

  4. Pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis: a cross-sectional study.

    Science.gov (United States)

    Kierkegaard, Signe; Jørgensen, Peter Bo; Dalgas, Ulrik; Søballe, Kjeld; Mechlenburg, Inger

    2015-09-01

    During movement tasks, patients with medial compartment knee osteoarthritis use compensatory strategies to minimise the joint load of the affected leg. Movement strategies of the knees and trunk have been investigated, but less is known about movement strategies of the pelvis during advancing functional tasks, and how these strategies are associated with leg extension power. The aim of the study was to investigate pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis compared with controls. 57 patients (mean age 65.6 years) scheduled for medial uni-compartmental knee arthroplasty, and 29 age and gender matched controls were included in this cross-sectional study. Leg extension power was tested with the Nottingham Leg Extension Power-Rig. Pelvic range of motion was derived from an inertia-based measurement unit placed over the sacrum bone during walking, stair climbing and stepping. Patients had lower leg extension power than controls (20-39 %, P 0.06). Furthermore, an inverse association (coefficient: -0.03 to -0.04; R (2) = 13-22 %) between leg extension power and pelvic range of motion during stair and step descending was found in the patients. Compared to controls, patients with medial compartment knee osteoarthritis use greater pelvic movements during advanced functional performance tests, particularly when these involve descending tasks. Further studies should investigate if it is possible to alter these movement strategies by an intervention aimed at increasing strength and power for the patients.

  5. Causes of anorexia in untreated hyperthyroidism: a prospective study

    OpenAIRE

    Dai, W.; Meng, X.

    2000-01-01

    Seventeen consecutive patients (mean (SD) 46 (11) years) with untreated hyperthyroidism and anorexia and 29 patients (35 (9) years) with untreated hyperthyroidism without anorexia were studied. The study was conducted at the thyroid clinic of the PUMC Hospital, Beijing, China from March to August 1997. The patients' ages, serum free calcium, liver function and emotional state, specifically the level of anxiety (using the self anxiety scale, Chinese version), were compared before and/or after ...

  6. Disparities in untreated caries among children and adults in the U.S., 2011-2014.

    Science.gov (United States)

    Gupta, Niodita; Vujicic, Marko; Yarbrough, Cassandra; Harrison, Brittany

    2018-03-06

    The Affordable Care Act of 2010 increased dental coverage for children in the United States, (U.S.) but not for adults. Few studies in current scholarship make use of up-to-date, nationally representative data to examine oral health disparities in the U.S. The purpose of this study is to use nationally representative data to determine the prevalence of untreated caries among children and adults of different socioeconomic and racial/ethnic groups and to examine the factors associated with untreated caries among children and adults. This study used the 2011-2014 National Health and Nutrition Examination Survey (NHANES) demographic, oral health questionnaire, and oral health dentition examination data (n = 7008 for children; n = 9673 for adults). Participants that had a standardized oral health examination and at least one natural primary or permanent tooth considering 28 tooth spaces were included in this study. Our main outcome measure was untreated coronal caries defined as decay on the crown or enamel surface of a tooth that had not been treated or filled. Population estimates were calculated to determine the prevalence of untreated caries among children and adults in the United States. Frequencies and Pearson's chi-square tests were used to compare those with and without untreated caries. Multivariate logistic regression models were used to evaluate the factors associated with untreated caries. We conducted analyses among children and adults separately. From 2011 to 2014, 12.4 million children and 57.6 million adults in the United States had untreated caries. Age, family income level, recent dental visit, and financial and non-financial barriers were significantly associated with untreated caries in both children and adults. Race/ethnicity, gender and education level were also significantly associated with untreated caries among adults. The odds of untreated caries associated with financial barriers were 2.06 for children and 2.84 for adults while the

  7. Effect of Cuscuta campestris parasitism on the physiological and anatomical changes in untreated and herbicide-treated sugar beet.

    Science.gov (United States)

    Saric-Krsmanovic, Marija M; Bozic, Dragana M; Radivojevic, Ljiljana M; Umiljendic, Jelena S Gajic; Vrbnicanin, Sava P

    2017-11-02

    The effects of field dodder on physiological and anatomical processes in untreated sugar beet plants and the effects of propyzamide on field dodder were examined under controlled conditions. The experiment included the following variants: N-noninfested sugar beet plants (control); I - infested sugar beet plants (untreated), and infested plants treated with propyzamide (1500 g a.i. ha -1 (T 1 ) and 2000 g a.i. ha -1 (T 2 )). The following parameters were checked: physiological-pigment contents (chlorophyll a, chlorophyll b, total carotenoids); anatomical -leaf parameters: thickness of epidermis, parenchyma and spongy tissue, mesophyll and underside leaf epidermis, and diameter of bundle sheath cells; petiole parameters: diameter of tracheid, petiole hydraulic conductance, xylem surface, phloem cell diameter and phloem area in sugar beet plants. A conventional paraffin wax method was used to prepare the samples for microscopy. Pigment contents were measured spectrophotometrically after methanol extraction. All parameters were measured: prior to herbicide application (0 assessment), then 7, 14, 21, 28 and 35 days after application (DAA). Field dodder was found to affect the pigment contents in untreated sugar beet plants, causing significant reductions. Conversely, reduction in the treated plants decreased 27% to 4% for chlorophyll a, from 21% to 5% for chlorophyll b, and from 28% to 5% for carotenoids (T 1 ). Also, in treatment T 2, reduction decreased in infested and treated plants from 19% to 2% for chlorophyll a, from 21% to 2% for chlorophyll b, from 23% to 3% for carotenoids and stimulation of 1% and 2% was observed 28 and 35 DAA, respectively. Plants infested (untreated) by field dodder had lower values of most anatomical parameters, compared to noninfested plants. The measured anatomical parameters of sugar beet leaves and petiole had significantly higher values in noninfested plants and plants treated with propyzamide than in untreated plants. Also, the

  8. Anaerobic digestion of autoclaved and untreated food waste

    International Nuclear Information System (INIS)

    Tampio, Elina; Ervasti, Satu; Paavola, Teija; Heaven, Sonia; Banks, Charles; Rintala, Jukka

    2014-01-01

    Highlights: • Autoclaving decreased the formation of NH4-N and H 2 S during food waste digestion. • Stable digestion was achieved with untreated and autoclaved FW at OLR 6 kg VS/m 3 day. • Use of acclimated inoculum allowed very rapid increases in OLR. • Highest CH 4 yields were observed at OLR 3 kg VS/m 3 day with untreated FW. • Autoclaved FW produced highest CH 4 yields during OLR 4 kgVS/m 3 day. - Abstract: Anaerobic digestion of autoclaved (160 °C, 6.2 bar) and untreated source segregated food waste (FW) was compared over 473 days in semi-continuously fed mesophilic reactors with trace elements supplementation, at organic loading rates (OLRs) of 2, 3, 4 and 6 kg volatile solids (VS)/m 3 d. Methane yields at all OLR were 5–10% higher for untreated FW (maximum 0.483 ± 0.013 m 3 CH 4 /kg VS at 3 kg VS/m 3 d) than autoclaved FW (maximum 0.439 ± 0.020 m 3 CH 4 /kg VS at 4 kg VS/m 3 d). The residual methane potential of both digestates at all OLRs was less than 0.110 m 3 CH 4 /kg VS, indicating efficient methanation in all cases. Use of acclimated inoculum allowed very rapid increases in OLR. Reactors fed on autoclaved FW showed lower ammonium and hydrogen sulphide concentrations, probably due to reduced protein hydrolysis as a result of formation of Maillard compounds. In the current study this reduced biodegradability appears to outweigh any benefit due to thermal hydrolysis of ligno-cellulosic components

  9. Frames and extension problems I

    DEFF Research Database (Denmark)

    Christensen, Ole

    2014-01-01

    In this article we present a short survey of frame theory in Hilbert spaces. We discuss Gabor frames and wavelet frames and set the stage for a discussion of various extension principles; this will be presented in the article Frames and extension problems II (joint with H.O. Kim and R.Y. Kim)....

  10. A review of findings of a study of rocket based combined cycle engines applied to extensively axisymmetric single stage to orbit vehicles

    Science.gov (United States)

    Foster, Richard W.

    1992-01-01

    Extensively axisymmetric and non-axisymmetric Single Stage To Orbit (SSTO) vehicles are considered. The information is presented in viewgraph form and the following topics are presented: payload comparisons; payload as a percent of dry weight - a system hardware cost indicator; life cycle cost estimations; operations and support costs estimation; selected engine type; and rocket engine specific impulse calculation.

  11. The Dutch Measure for quantification of Treatment Resistance in Depression (DM-TRD) : an extension of the Maudsley Staging Method

    NARCIS (Netherlands)

    Peeters, Frenk P. M. L.; Ruhe, Henricus G.; Wichers, Marieke; Abidi, Latifa; Kaub, Karin; van der Lande, H. Josephine; Spijker, Jan; Huibers, Marcus J. H.; Schene, Aart H.

    2016-01-01

    Background: Treatment resistant depression (TRD) is common in daily practice. An empirical, widely accepted and applicable measure to quantify TRD is lacking. Previously, the Maudsley Staging Method (MSM) showed good validity. We aimed to improve the MSM by refining and extending its items resulting

  12. 77 FR 59242 - Extension of a Previously Approved Collection; Public Charters

    Science.gov (United States)

    2012-09-26

    ... previous notice. DATES: Comments on this notice should be received by October 26, 2012: attention OMB/OST... operator's advertising, selling or operating the charter. If the prospectus information were not collected...

  13. Efficacy of emamectin benzoate against sea lice infestations of Atlantic salmon, Salmo salar L.: evaluation in the absence of an untreated contemporary control.

    Science.gov (United States)

    Gustafson, L; Ellis, S; Robinson, T; Marenghi, F; Endris, R

    2006-10-01

    The efficacy of emamectin benzoate (SLICE) against sea lice infestations of Atlantic salmon, Salmo salar L., is typically assessed using untreated fish, or fish treated with alternative therapeutants, as controls. The State of Maine, USA, is currently under active management for the OIE-notifiable pathogen, infectious salmon anaemia virus (ISAV); consequently, neither control group is feasible in this region. Untreated salmon risk extensive damage from the ectoparasites, and threaten to increase vector-borne exposure or susceptibility of farms to ISAV; and the only treatment presently available in Maine is SLICE. However, because sea lice infestations are unlikely to resolve spontaneously, and response to treatment occurs within weeks, use of a pretreatment baseline is a reasonable alternative for confirmatory studies. We evaluated SLICE efficacy on Atlantic salmon farms in Cobscook Bay 2002-2005, in the absence of untreated controls, using pretreatment lice loads as a reference for calculation. Maximum efficacy ranged from 68% to 100% reduction from initial levels. Time-to-maximum efficacy ranged from 1 to 8 weeks after treatment initiation. Efficacy duration, measured between first reduction and first progressive rise in counts, ranged from 4 to 16 weeks.

  14. Anaerobic digestion of autoclaved and untreated food waste

    Energy Technology Data Exchange (ETDEWEB)

    Tampio, Elina, E-mail: elina.tampio@mtt.fi [Bioenergy and Environment, MTT Agrifood Research Finland, FI-31600 Jokioinen (Finland); Ervasti, Satu; Paavola, Teija [Bioenergy and Environment, MTT Agrifood Research Finland, FI-31600 Jokioinen (Finland); Heaven, Sonia; Banks, Charles [University of Southampton, Faculty of Engineering and the Environment, Southampton SO17 1BJ (United Kingdom); Rintala, Jukka [Bioenergy and Environment, MTT Agrifood Research Finland, FI-31600 Jokioinen (Finland)

    2014-02-15

    Highlights: • Autoclaving decreased the formation of NH4-N and H{sub 2}S during food waste digestion. • Stable digestion was achieved with untreated and autoclaved FW at OLR 6 kg VS/m{sup 3}day. • Use of acclimated inoculum allowed very rapid increases in OLR. • Highest CH{sub 4} yields were observed at OLR 3 kg VS/m{sup 3}day with untreated FW. • Autoclaved FW produced highest CH{sub 4} yields during OLR 4 kgVS/m{sup 3}day. - Abstract: Anaerobic digestion of autoclaved (160 °C, 6.2 bar) and untreated source segregated food waste (FW) was compared over 473 days in semi-continuously fed mesophilic reactors with trace elements supplementation, at organic loading rates (OLRs) of 2, 3, 4 and 6 kg volatile solids (VS)/m{sup 3} d. Methane yields at all OLR were 5–10% higher for untreated FW (maximum 0.483 ± 0.013 m{sup 3} CH{sub 4}/kg VS at 3 kg VS/m{sup 3} d) than autoclaved FW (maximum 0.439 ± 0.020 m{sup 3} CH{sub 4}/kg VS at 4 kg VS/m{sup 3} d). The residual methane potential of both digestates at all OLRs was less than 0.110 m{sup 3} CH{sub 4}/kg VS, indicating efficient methanation in all cases. Use of acclimated inoculum allowed very rapid increases in OLR. Reactors fed on autoclaved FW showed lower ammonium and hydrogen sulphide concentrations, probably due to reduced protein hydrolysis as a result of formation of Maillard compounds. In the current study this reduced biodegradability appears to outweigh any benefit due to thermal hydrolysis of ligno-cellulosic components.

  15. Quality of Life in Patients With Untreated and Symptomatic Hallux Valgus.

    Science.gov (United States)

    Yamamoto, Yohei; Yamaguchi, Satoshi; Muramatsu, Yuta; Terakado, Atsushi; Sasho, Takahisa; Akagi, Ryuichiro; Endo, Jun; Sato, Yasunori; Takahashi, Kazuhisa

    2016-11-01

    The purposes of this study were to compare the quality of life (QOL) of subjects who had untreated symptomatic hallux valgus with the QOL of the general population and to investigate factors associated with the QOL of the subjects. One hundred sixteen subjects with previously untreated and symptomatic hallux valgus were surveyed. QOL was assessed using the 36-item Short Form Health Survey (SF-36). Additionally, clinical evaluations (the visual analog scale for pain, Japanese Society for Surgery of the Foot Scale, lesser toe pain, and pain in other parts of the body) and radiographic evaluations (hallux valgus angle, intermetatarsal angle between the first and second metatarsals, and dislocation of the second metatarsophalangeal joint) were performed. Differences in the SF-36 between the subjects and the general population were tested using independent t tests. Correlations between the QOL measurements, clinical evaluations, and radiographic evaluations were assessed using Spearman rank correlation coefficient. All SF-36 subscales and physical component summary scores for the subjects were significantly lower than those of the general population. Notably, the standardized physical function subscale (38.2 ± 15.8, P hallux valgus subjects was lower than that of the general population. All QOL and clinical evaluation parameters were not significantly or negligibly correlated with the severity of toe deformities. Surgical decision making should not be based on the severity of the deformity alone, but rather patient QOL should also be carefully assessed. Level III, comparative series. © The Author(s) 2016.

  16. [S3 guideline. Part 2: Non-Traumatic Avascular Femoral Head Necrosis in Adults - Untreated Course and Conservative Treatment].

    Science.gov (United States)

    Roth, A; Beckmann, J; Smolenski, U; Fischer, A; Jäger, M; Tingart, M; Rader, C; Peters, K M; Reppenhagen, S; Nöth, U; Heiss, C; Maus, U

    2015-10-01

    In Germany there are 5000 to 7000 new cases of atraumatic avascular necrosis of the femoral head in adults per year. It occurs mostly in middle age. An increased frequency of idiopathic cases can be observed. Chemotherapy, corticoids and kidney transplants are frequently associated with the disease. In most cases the disease occurs on both sides. Early diagnosis is of particular importance, since in early stages it is most likely to avoid late damage with joint destruction. Whereas previously the temporary operational joint preservation and subsequent joint replacement were often the only option of treatment, conservative and joint-preserving measures today play an increasing role. After the AWMF guidelines for S3 guideline clinical questions were formulated. Over the period from 01/01/1970 to 31/05/2013 a literature search was conducted. Systematic reviews, metaanalyses, original papers and clinical trials of all designs were evaluated. There were a total of 3715 references, of which 422 for the assessment regarding SIGN were eligible and finally 180 were in accord with the defined inclusion and exclusion criteria. For the untreated course and the assessment of conservative measures, a total of 42 references was suitable. In formulating the recommendations the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system was used, which distinguishes A "shall", B "should" and 0 "can". If left untreated, the aFKN within 2 years leads to a subchondral fracture and subsequent collapse. After the diagnosis of femoral head necrosis, the risk of a disease of the opposite side is high within the next 2 years, then unlikely. The sole conservative treatment brings no benefit for the treatment of atraumatic avascular necrosis in the adult. Although it improves function, less pain can be obtained, and surgical intervention can be delayed, the progression is not stopped. Conservative treatment must therefore always be part of the overall treatment. In ARCO

  17. Global issues related to the impact of untreated attention-deficit/hyperactivity disorder from childhood to young adulthood.

    Science.gov (United States)

    Barkley, Russell A

    2008-09-01

    Attention-deficit/hyperactivity disorder (ADHD) is a common, chronic, and costly disorder, with an impact that can span from preschool into adulthood. There are safe and effective therapies that can manage and help prevent many of the associated negative outcomes of ADHD, but treatment rates are far from optimal and considerable obstacles exist in achieving satisfactory treatment adherence. Individuals with untreated ADHD, their families, and other caregivers must be made aware of the impact that this disorder may have on them at every stage of life and, correspondingly, the improved outcomes that can be achieved with the successful management of ADHD.

  18. Age-dependent cognitive dysfunction in untreated hereditary transthyretin amyloidosis.

    Science.gov (United States)

    Martins da Silva, Ana; Cavaco, Sara; Fernandes, Joana; Samões, Raquel; Alves, Cristina; Cardoso, Márcio; Kelly, Jeffery W; Monteiro, Cecília; Coelho, Teresa

    2018-02-01

    Central nervous system (CNS) involvement in hereditary transthyretin (TTR) amyloidosis has been described in patients whose disease course was modified by liver transplant. However, cognitive dysfunction has yet to be investigated in those patients. Moreover, CNS involvement in untreated patients or asymptomatic mutation carriers remains to be studied. A series of 340 carriers of the TTRVal30Met mutation (180 symptomatic and 160 asymptomatic) underwent a neuropsychological assessment, which included the Dementia Rating Scale-2 (DRS-2), auditory verbal learning test, semantic fluency, phonemic fluency, and trail making test. Cognitive deficits were identified at the individual level, after adjusting the neuropsychological test scores for demographic characteristics (sex, age, and education), based on large national normative data. The presence of cognitive dysfunction was determined by deficit in DRS-2 and/or multiple cognitive domains. Participants were also screened for depression based on a self-report questionnaire. The frequency of cognitive dysfunction was higher (p = 0.003) in symptomatic (9%) than in asymptomatic (2%) carriers. Among older carriers (≥ 50 years), the frequency of cognitive dysfunction was higher (p hereditary TTR amyloidosis patients with peripheral polyneuropathy, even in the early stages of the disease.

  19. Effect of late-stage therapy on disease progression in AAV-mediated rescue of photoreceptor cells in the retinoschisin-deficient mouse.

    Science.gov (United States)

    Janssen, Andreas; Min, Seok H; Molday, Laurie L; Tanimoto, Naoyuki; Seeliger, Mathias W; Hauswirth, William W; Molday, Robert S; Weber, Bernhard H F

    2008-06-01

    Proof-of-concept for a successful adeno-associated virus serotype 5 (AAV5)-mediated gene therapy in X-linked juvenile retinoschisis (XLRS) has been demonstrated in an established mouse model for this condition. The initial studies concentrated on early time-points of treatment. In this study, we aimed to explore the consequences of single subretinal injections administered at various stages of more advanced disease. By electroretinogram (ERG), functional improvement in treated versus untreated eyes is found to be significant in retinoschisin-deficient mice injected at the time-points of 15 days (P15), 1 month (PM1), and 2 months (PM2) after birth. In mice treated at 7 months after birth (PM7), an age previously shown to exhibit advanced retinal disease, ERG responses reveal no beneficial effects of vector treatment. Generally, functional rescue is paralleled by sustained retinoschisin expression and significant photoreceptor survival relative to untreated eyes. Quantitative measures of photoreceptors and peanut agglutinin-labeled ribbon synapses demonstrate rescue effects even in mice injected as late as PM7. Taken together, AAV5-mediated gene replacement is beneficial in slowing disease progression in murine XLRS. In addition, we show the effectiveness of rescue efforts even if treatment is delayed until advanced signs of disease have developed. Human XLRS patients might benefit from these findings, which suggest that the effectiveness of treatment appears not to be restricted to the early stages of the disease, and that treatment may prove to be valuable even when administered at more advanced stages.

  20. 7 CFR 319.56-44 - Untreated grapefruit, sweet oranges, and tangerines from Mexico for processing.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 5 2010-01-01 2010-01-01 false Untreated grapefruit, sweet oranges, and tangerines... QUARANTINE NOTICES Fruits and Vegetables § 319.56-44 Untreated grapefruit, sweet oranges, and tangerines from Mexico for processing. Untreated grapefruit (Citrus paradisi), sweet oranges (Citrus sinensis), and...

  1. Fludarabine-based versus CHOP-like regimens with or without rituximab in patients with previously untreated indolent lymphoma: a retrospective analysis of safety and efficacy

    Directory of Open Access Journals (Sweden)

    Xu XX

    2013-10-01

    Full Text Available Xiao-xiao Xu,1 Bei Yan,2 Zhen-xing Wang,3 Yong Yu,1 Xiao-xiong Wu,2 Yi-zhuo Zhang11Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, 2Department of Hematology, First Affiliated Hospital of Chinese People's Liberation Army General Hospital, Beijing, 3Department of Stomach Oncology, TianJin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of ChinaAbstract: Fludarabine-based regimens and CHOP (doxorubicin, cyclophosphamide, vincristine, prednisone-like regimens with or without rituximab are the most common treatment modalities for indolent lymphoma. However, there is no clear evidence to date about which chemotherapy regimen should be the proper initial treatment of indolent lymphoma. More recently, the use of fludarabine has raised concerns due to its high number of toxicities, especially hematological toxicity and infectious complications. The present study aimed to retrospectively evaluate both the efficacy and the potential toxicities of the two main regimens (fludarabine-based and CHOP-like regimens in patients with previously untreated indolent lymphoma. Among a total of 107 patients assessed, 54 patients received fludarabine-based regimens (FLU arm and 53 received CHOP or CHOPE (doxorubicin, cyclophosphamide, vincristine, prednisone, or plus etoposide regimens (CHOP arm. The results demonstrated that fludarabine-based regimens could induce significantly improved progression-free survival (PFS compared with CHOP-like regimens. However, the FLU arm showed overall survival, complete response, and overall response rates similar to those of the CHOP arm. Grade 3–4 neutropenia occurred in 42.6% of the FLU arm and 7.5% of the CHOP arm (P 60 years and presentation of grade 3–4 myelosuppression were the independent factors to infection, and the FLU arm had significantly

  2. Evaluation of an omental pedicle extension technique in the dog.

    Science.gov (United States)

    Ross, W E; Pardo, A D

    1993-01-01

    A two-step omental pedicle extension technique was performed on 10 dogs. Step 1 of the pedicle extension involved release of the dorsal leaf of the omentum from its pancreatic attachment, whereas step 2 consisted of an inverse L-shaped incision to double the length of the pedicle. The pedicle dimensions were measured and the distance reached when extended toward the hind limb, forelimb, and the muzzle recorded after each stage of the procedure. The vascular patency of the pedicle was determined by intravenous injection of fluorescein dye after the second stage of omental extension. Mean pedicle lengths were 44.5 cm with the first stage of extension and 82.0 cm after full extension. The mean width at the caudal extent of the pedicles after dorsal and full extension was 30.4 cm and 17.2 cm, respectively. Eight of the 10 pedicles were patent after full extension. The fully extended omental pedicles reached and, in most cases, extended beyond the distal extremities and the muzzle. The findings in this study suggest that the canine omentum can be extended to any part of the body without being detached from its vascular supply.

  3. The study of untreated syphilis in the Negro male

    International Nuclear Information System (INIS)

    Brawley, Otis W.

    1998-01-01

    Purpose: The participation of minorities in clinical studies is the subject of much discussion and has even become the subject of Federal law. The project known as the Tuskegee Syphilis Study and officially titled 'The Tuskegee Study of Untreated Syphilis in the Negro Male', is one of the great debacles of American medicine and a national shame. Despite the fact that its existence is well known, many do not know the historical facts of the study nor the context of the study. My purpose here is to recount the facts of the study and its historical context. Methods: The history recounted here is taken from documents gathered during a U.S. Senate investigation of the study, original papers located in National Library of Medicine, and books about the trial. Results: The trial began in 1931 as a survey of the natural history of untreated tertiary syphilis in Black men. This study enrolled 399 men with syphilis and 201 uninfected men to serve as controls. All were at least 25 years old at enrollment. The men were told they were in a study, but never educated about the implications. Later, men were not informed that there was a treatment for effective treatment for their disease - a treatment that was being withheld from them. This trial continued till 1972. Conclusion: Many of the issues that led to the study and caused it to continue for 40 years still exist. The lessons of the Public Health Study of Untreated Syphilis in the Untreated Negro include the dangers of paternalism, arrogance, blind loyalty, and misuse of science. 'Those who do not appreciate history are condemned to repeat it' (Alfred North Whitehead)

  4. Repair of Extensive Composite Alar Defects with Single Stage ...

    African Journals Online (AJOL)

    Extensive and total (through and through) loss of ala or lobule of the nose as seen in severe traumas and neglected tumours should be replaced by the three anatomical layers of skin, cartilage and vestibular lining. A technique of nasolabial turnover flap transfer covered by a two layered auricular chondrocutaneous graft is ...

  5. Brain single-photon emission tomography with technetium-99m hexamethylpropylene amine oxime in adolscents with intial-stage schizophrenia

    International Nuclear Information System (INIS)

    Batista, J.F.; Galiano, M.C.; Torres, L.A.; Hernandez, M.C.; Sosa, F.; Perera, A.; Perez, M.

    1995-01-01

    The objective of this study was to search for regional cerebral blood flow (rCBF) abnormalities in adolescents with initial-stage schizophrenia by means of brain single-photon emission tomography (SPET) using technetium-99m hexamethylpropylene amine oxime (HMPAO). SPET studies were performed on a homogeneous sample of 15 carefully selected adolescents with a recent diagnosis of schizophrenia, and without previous electroconvulsive or antipsychotic drug treatment. Computed tomography (CT) and electro-encephalographic (EEG) studies were performed in all patients. Qualitative and semiquantitative analysis of 99m Tc-HMPAO SPET studies showed an impaired rCBF in 12 patients (80%). The most common pattern was a decreased uptake of 99m Tc-HMPAO in the frontal lobes, usually in the left hemisphere. Conventional and quantitative EEG was positive in 12 (80%) and 15 (100%) patients, respectively. CT findings were positive in two patients (13%). There was a high level of concordance between SPET and EEG results and between SPET and clinical features (P > 0.05). This study suggests that previously untreated patients in the first stages of schizophrenia present functional abnormalities that are revealed by brain SPET. (orig.)

  6. Comparison of untreated adolescent idiopathic scoliosis with normal controls: a review and statistical analysis of the literature.

    Science.gov (United States)

    Rushton, Paul R P; Grevitt, Michael P

    2013-04-20

    Review and statistical analysis of studies evaluating health-related quality of life (HRQOL) in adolescents with untreated adolescent idiopathic scoliosis (AIS) using Scoliosis Research Society (SRS) outcomes. To apply normative values and minimum clinical important differences for the SRS-22r to the literature. Identify whether the HRQOL of adolescents with untreated AIS differs from unaffected peers and whether any differences are clinically relevant. The effect of untreated AIS on adolescent HRQOL is uncertain. The lack of published normative values and minimum clinical important difference for the SRS-22r has so far hindered our interpretation of previous studies. The publication of this background data allows these studies to be re-examined. Using suitable inclusion criteria, a literature search identified studies examining HRQOL in untreated adolescents with AIS. Each cohort was analyzed individually. Statistically significant differences were identified by using 95% confidence intervals for the difference in SRS-22r domain mean scores between the cohorts with AIS and the published data for unaffected adolescents. If the lower bound of the confidence interval was greater than the minimum clinical important difference, the difference was considered clinically significant. Of the 21 included patient cohorts, 81% reported statistically worse pain than those unaffected. Yet in only 5% of cohorts was this difference clinically important. Of the 11 cohorts included examining patient self-image, 91% reported statistically worse scores than those unaffected. In 73% of cohorts this difference was clinically significant. Affected cohorts tended to score well in function/activity and mental health domains and differences from those unaffected rarely reached clinically significant values. Pain and self-image tend to be statistically lower among cohorts with AIS than those unaffected. The literature to date suggests that it is only self-image which consistently differs

  7. Microbiota-dependent metabolite and cardiovascular disease marker trimethylamine-N-oxide (TMAO) is associated with monocyte activation but not platelet function in untreated HIV infection

    DEFF Research Database (Denmark)

    Haissman, Judith M; Haugaard, Anna K; Ostrowski, Sisse R

    2017-01-01

    and combination anti-retroviral therapy (cART) HIV infection. METHODS: TMAO and the pre-cursors betaine, choline, and carnitine were quantified by mass-spectrometry in plasma samples from a previously established cross-sectional cohort of 50 untreated and 50 cART treated HIV-infected individuals. Whole...... agonists, or with overall hypo- or hyperreactivity in untreated or treated HIV-infected individuals. In contrast, sCD14 a marker of both monocyte activation and microbial translocation was independently associated with TMAO in untreated HIV-infection (R = 0.381, P = 0.008). Lower levels of carnitine [32.......2 (28.4-36.8) vs. 38.2 (33.6-42.0), P = 0.001] and betaine [33.1 (27.3-43.4) vs.37.4 (31.5-48.7, P = 0.02], but similar TMAO levels [3.8 (2.3-6.1), vs. 2.9 μM (1.9-4.8) P = 0.15] were found in cART treated compared to untreated HIV-infected individuals, resulting in higher ratios of TMAO/carnitine [0...

  8. Brand Extension: a Case Study of Starbucks

    OpenAIRE

    Bokii, Artem

    2017-01-01

    The thesis investigates the topic of brand extension and its importance in the business practice of companies. The theoretical part of the research outlines the key theoretical aspects related to brand and brand extension. The practical part investigates the case study of Starbucks brand extension and compares it with other famous brand extension cases. The paper illustrates how Starbucks brand extension from coffee onto the ice cream market had been successful on the initial stage, and how i...

  9. Crizotinib for Untreated Anaplastic Lymphoma Kinase-Positive Non-Small-Cell Lung Cancer: An Evidence Review Group Perspective of a NICE Single Technology Appraisal.

    Science.gov (United States)

    Morgan, Philip; Woolacott, Nerys; Biswas, Mousumi; Mebrahtu, Teumzghi; Harden, Melissa; Hodgson, Robert

    2017-09-01

    As part of the National Institute for Health and Care Excellence (NICE) single technology appraisal process, the manufacturer of crizotinib submitted evidence on the clinical and cost effectiveness of crizotinib in untreated anaplastic lymphoma kinase-positive (ALK-positive) non-small-cell lung cancer (NSCLC). Crizotinib has previously been assessed by NICE for patients with previously treated ALK-positive NSCLC (TA 296). It was not approved in this previous appraisal, but had been made available through the cancer drugs fund. As part of this new appraisal, the company included a price discount patient access scheme (PAS). The Centre for Reviews and Dissemination and Centre for Health Economics Technology Appraisal Group at the University of York was commissioned to act as the independent Evidence Review Group (ERG). This article provides a description of the company's submission and the ERG's review and summarises the resulting NICE guidance issued in August 2016. The main clinical-effectiveness data were derived from a multicentre randomised controlled trial-PROFILE 1014-that compared crizotinib with pemetrexed chemotherapy in combination with carboplatin or cisplatin in patients with untreated non-squamous ALK-positive NSCLC. In the trial, crizotinib demonstrated improvements in progression-free survival (PFS) and overall survival (OS). The company's economic model was a three-state 'area under the curve' Markov model. The base-case incremental cost-effectiveness ratio (ICER) was estimated to be greater than £50,000 per quality-adjusted life-year (QALY) gained (excluding the PAS discount). The ERG assessment of the evidence submitted by the company raised a number of concerns. In terms of the clinical evidence, the OS benefit was highly uncertain due to the cross-over permitted in the trial and the immaturity of the data; only 26% of events had occurred by the data cut-off point. In the economic modelling, the most significant concerns related to the analysis

  10. Vorinostat, Rituximab, Ifosfamide, Carboplatin, and Etoposide in Treating Patients With Relapsed or Refractory Lymphoma or Previously Untreated T-Cell Non-Hodgkin Lymphoma or Mantle Cell Lymphoma

    Science.gov (United States)

    2017-04-17

    Adult Nasal Type Extranodal NK/T-cell Lymphoma; Anaplastic Large Cell Lymphoma; Angioimmunoblastic T-cell Lymphoma; Contiguous Stage II Mantle Cell Lymphoma; Cutaneous B-cell Non-Hodgkin Lymphoma; Extranodal Marginal Zone B-cell Lymphoma of Mucosa-associated Lymphoid Tissue; Nodal Marginal Zone B-cell Lymphoma; Noncontiguous Stage II Mantle Cell Lymphoma; Recurrent Adult Burkitt Lymphoma; Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Adult Diffuse Mixed Cell Lymphoma; Recurrent Adult Diffuse Small Cleaved Cell Lymphoma; Recurrent Adult Grade III Lymphomatoid Granulomatosis; Recurrent Adult Hodgkin Lymphoma; Recurrent Adult Immunoblastic Large Cell Lymphoma; Recurrent Adult Lymphoblastic Lymphoma; Recurrent Cutaneous T-cell Non-Hodgkin Lymphoma; Recurrent Grade 1 Follicular Lymphoma; Recurrent Grade 2 Follicular Lymphoma; Recurrent Grade 3 Follicular Lymphoma; Recurrent Mantle Cell Lymphoma; Recurrent Marginal Zone Lymphoma; Recurrent Mycosis Fungoides/Sezary Syndrome; Recurrent Small Lymphocytic Lymphoma; Splenic Marginal Zone Lymphoma; Stage I Cutaneous T-cell Non-Hodgkin Lymphoma; Stage I Mantle Cell Lymphoma; Stage I Mycosis Fungoides/Sezary Syndrome; Stage II Cutaneous T-cell Non-Hodgkin Lymphoma; Stage II Mycosis Fungoides/Sezary Syndrome; Stage III Cutaneous T-cell Non-Hodgkin Lymphoma; Stage III Mantle Cell Lymphoma; Stage III Mycosis Fungoides/Sezary Syndrome; Stage IV Cutaneous T-cell Non-Hodgkin Lymphoma; Stage IV Mantle Cell Lymphoma; Stage IV Mycosis Fungoides/Sezary Syndrome; Waldenström Macroglobulinemia

  11. Shortened duration of untreated first episode of psychosis

    DEFF Research Database (Denmark)

    Larsen, Tor Ketil; McGlashan, T H; Johannessen, Jan Olav

    2001-01-01

    OBJECTIVE: This study examined whether duration of untreated psychosis can be shortened in patients with first episodes of DSM-IV schizophrenia spectrum disorders and whether shorted duration alters patient appearance at treatment. METHOD: Two study groups were ascertained in the same Norwegian h...

  12. CLINICAL CASE OF PERFORMING A TWO-ST AGE LOVER RESECTION BY TYPE ALPPS IN PATIENT WHO PREVIOUSLY UNDERWENT ANATOMIC RESECTION OF THE RIGHT LOBE OF THE LIVER

    Directory of Open Access Journals (Sweden)

    D. V. Sidorov

    2015-01-01

    Full Text Available Abstract:One of the variants for the surgical treatment of patients with bilobal liver metastases is to perform two-stage anatomic resections. Thus, at least in a quarter of the patients it is impossible to perform the second stage of intervention because of absence of hypertrophy of the remaining liver parenchyma or progression of disease during standby. The most modern and promising way of overcoming this obstacle is to perform the so-called ALPPS (Associating Liver Partition and Portal vein Ligation for Staged hepatectomy or «in situ slit» liver resections. In this article we present a clinical case of performing a two-stage hepatectomy by type ALPPS in patients with metastatic colorectal cancer liver, who previously undergone the anatomic bisegmentectomy SVI-SVII. The present observation is the first in the available literature, evidence of justification perform repeated liver resections in patients with metastatic colorectal cancer and demonstrates the possibility of ALPPS techniques when performing extensive anatomical liver resections in patients who have undergone previous removal of the parenchyma of the right lobe.

  13. Universal extensions to simulate specifications

    NARCIS (Netherlands)

    Hesselink, Wim H.

    A previous paper introduced eternity variables as an alternative to the prophecy variables of Abadi and Lamport and proved the formalism to be semantically complete: every simulation F. K -> L that preserves quiescence contains a composition of a history extension, an extension with eternity

  14. Treatment outcome of 40 patients with early stage nongastric mucosa-associated lymphoid tissue lymphoma

    International Nuclear Information System (INIS)

    Wang Hua; Li Yexiong; Liu Qingfeng

    2010-01-01

    Objective: To analyze the clinical features and prognosis of patients with stage I E /II E nongastric mucosa-associated lymphoid tissue (MALT) lymphoma. Methods: Between 2000 and 2006, 40 patients with previously untreated nongrastric MALT lymphoma were retrospectively reviewed. The primary site of lymphoma was the intestinal tract in 10 patients, the orbit in 9, the thyroid in 8, the lung in 5, the Waldeyer ring in 2, and the others organs in 6. At diagnosis, 27 patients had stage I E , and 13 had stage II E disease. Seventeen patients were treated with radiotherapy with or without chemotherapy, 18 with chemotherapy without radiotherapy, and 5 with surgery alone. The median age was 54 years. The ratio of male to female was 2: 1. Results: With a median follow-up of 58 months, the estimated 5-year overall survival (OS) rate and progression-free survival (PFS) rate were 86% and 82%, respectively. The 5-year OS and PFS rates were 92% and 85% for stage I E , 76% and 82% for stage II E disease, respectively (χ 2 =3.66, P =0. 060; χ 2 =1.04, P=0. 300). The 5-year OS and PFS rates were both 100% for patients with MALT lymphoma of the orbit and ocular adnexa. None of the 17 patients with radiotherapy had locoregional relapse, whereas 3 of 23 (13%) patients without radiotherapy had locoregional relapse. Conclusions: Patients with stage I E nongastric MALT lymphoma have a favorable prognosis. Radiotherapy is still a standard care for early stage disease. The treatment outcome of patients with MALT lymphoma of the orbit and ocular adnexa is even better. (authors)

  15. Collecting and Storing Tissue, Blood, and Bone Marrow Samples From Patients With Rhabdomyosarcoma or Other Soft Tissue Sarcoma

    Science.gov (United States)

    2017-12-11

    Adult Rhabdomyosarcoma; Childhood Desmoplastic Small Round Cell Tumor; Chordoma; Desmoid Tumor; Metastatic Childhood Soft Tissue Sarcoma; Nonmetastatic Childhood Soft Tissue Sarcoma; Previously Treated Childhood Rhabdomyosarcoma; Previously Untreated Childhood Rhabdomyosarcoma; Recurrent Adult Soft Tissue Sarcoma; Recurrent Childhood Rhabdomyosarcoma; Recurrent Childhood Soft Tissue Sarcoma; Stage I Adult Soft Tissue Sarcoma; Stage II Adult Soft Tissue Sarcoma; Stage III Adult Soft Tissue Sarcoma; Stage IV Adult Soft Tissue Sarcoma

  16. Influence of more extensive radiotherapy and adjuvant chemotherapy on long-term outcome of early-stage Hodgkin's disease: a meta-analysis of 23 randomized trials involving 3,888 patients. International Hodgkin's Disease Collaborative Group

    DEFF Research Database (Denmark)

    Specht, L.; Gray, R.G.; Clarke, M.J.

    1998-01-01

    PURPOSE: To assess the effect of more extensive radiotherapy and of adjuvant combination chemotherapy on long-term outcome of early-stage Hodgkin's disease. METHODS: In a collaborative worldwide systematic overview, individual patient data were centrally reviewed on 1,974 patients in eight.......7%; P counterbalanced by a nonsignificant excess of deaths from other...... causes (12.4% v 10.0% 10-year risk). CONCLUSION: More extensive radiotherapy fields or the addition of chemotherapy to radiotherapy in the initial treatment of early-stage Hodgkin's disease had a large effect on disease control, but only a small effect on overall survival. Recurrences could be prevented...

  17. Fermentation of Ammonia Fiber Expansion Treated and Untreated Barley Straw in a Rumen Simulation Technique using Rumen Inoculum from Cattle with Slow Versus Fast Rate of Fiber Disappearance

    Directory of Open Access Journals (Sweden)

    Karen Ann Beauchemin

    2016-11-01

    Full Text Available The purpose of this study was to determine the effect of rumen inoculum from heifers with fast vs. slow rate of in situ fiber digestion on the fermentation of complex versus easily digested fiber sources in the forms of untreated and Ammonia Fiber Expansion (AFEX treated barley straw, respectively, using an artificial rumen simulation technique (Rusitec. In situ fiber digestion was measured in a previous study by incubating untreated barley straw in the rumen of sixteen heifers fed a diet consisting of 700 g/kg barley straw and 300 g/kg concentrate. The two heifers with fastest rate of digestion (Fast > 4.18 % h-1 and the two heifers with the slowest rate of digestion (Slow 0.05 methane per gram of digested material for both untreated and AFEX straw, and reduced (interaction, P < 0.05 acetate: propionate ratio for untreated straw. Greater relative populations of Ruminococcus albus (P < 0.05 and increased microbial N production (P = 0.045 were observed in Fast rumen inoculum. AFEX straw in Fast inoculum had greater total bacterial populations than Slow, but for untreated straw this result was reversed (interaction, P = 0.013. These findings indicate that differences in microbial populations in rumen fluid contribute to differences in the capacity of rumen inoculum to digest fiber.

  18. Complications of untreated molar-incisor hypomineralization in a 12-year-old boy

    Directory of Open Access Journals (Sweden)

    Shubha Arehalli Bhaskar

    2012-11-01

    Full Text Available Complications arising because of untreated molar-incisor hypomineralization (MIH have received little mention in the dental literature. However, this can be an area of concern, with severe consequences in rare cases. Hence, early recognition and prompt management of MIH is essential for long-term oral health of affected individuals. This paper describes an untreated case of severe MIH that resulted in infection of facial spaces.

  19. The untreated dental caries in primary teeth: would it be problems?

    Directory of Open Access Journals (Sweden)

    Udijanto Tedjosasongko

    2016-06-01

    Full Text Available Dental caries still remain as the most prevalent oral health disease in children. Many efforts have been done to prevent dental caries in children, but unfortunately there are dental practitioners who still have false mindset and prefer not to treat the dental caries case in primary teeth with the most common reasons are because it will be replaced with the permanent teeth. There are many negative effect will occur if the dental caries treatments in primary teeth are neglected.This topic would review the effects of untreated dental caries in children based on research reports.Severely decayed teeth have an important impact on children’s general health, nutrition, growth and body weight by causing discomfort, pain, sleeping problems, learning disorders and absence from school.  Untreated caries may affect seriously the quality of children’s life because of pain and discomfort, which could lead to acute and chronic infections, oral mucosal conditions and altered eating and sleeping habits. Furthermore, untreated caries in primary teeth can have a lasting detrimental impact on the permanent dentition by causing high caries risk or developmental defects of the permanent successor tooth. Moreover it has been reported that children at each higher level of caries had significantly lower height and weight outcomes than those with lower caries levels. The untreated dental caries in primary teeth would lead the children to poor growth and health which lowering the their quality of life.

  20. Caffeine as an indicator for the quantification of untreated wastewater in karst systems.

    Science.gov (United States)

    Hillebrand, Olav; Nödler, Karsten; Licha, Tobias; Sauter, Martin; Geyer, Tobias

    2012-02-01

    Contamination from untreated wastewater leakage and related bacterial contamination poses a threat to drinking water quality. However, a quantification of the magnitude of leakage is difficult. The objective of this work is to provide a highly sensitive methodology for the estimation of the mass of untreated wastewater entering karst aquifers with rapid recharge. For this purpose a balance approach is adapted. It is based on the mass flow of caffeine in spring water, the load of caffeine in untreated wastewater and the daily water consumption per person in a spring catchment area. Caffeine is a source-specific indicator for wastewater, consumed and discharged in quantities allowing detection in a karst spring. The methodology was applied to estimate the amount of leaking and infiltrating wastewater to a well investigated karst aquifer on a daily basis. The calculated mean volume of untreated wastewater entering the aquifer was found to be 2.2 ± 0.5 m(3) d(-1) (undiluted wastewater). It corresponds to approximately 0.4% of the total amount of wastewater within the spring catchment. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Platelets in blood stored in untreated and siliconed glass bottles and plastic bags

    Science.gov (United States)

    Kissmeyer-Nielsen, F.; Madsen, C. B.; Nedergaard, Jytte

    1961-01-01

    Platelet survival was determined using untreated and siliconed glass bottles and plastic bags (Fenwal) for collecting and storing blood. The platelets were tagged in vivo with P32 in six polycythaemic patients undergoing treatment with P32. The results showed that fresh ACD blood collected in untreated glass, siliconed glass, and plastic gave the same recovery of platelets in the recipients. The use of EDTA (Fenwal formula) as anticoagulant gave results inferior to those obtained with blood using ACD as anticoagulant. Even after storage up to 24 hours in untreated glass bottles (ordinary bank blood) a satisfactory recovery of platelets was observed. After storage for 72 hours the recovery was less but not negligible. PMID:14456481

  2. Relationship of carotid arterial functional and structural changes to left atrial volume in untreated hypertension.

    Science.gov (United States)

    Jaroch, Joanna; Rzyczkowska, Barbara; Bociąga, Zbigniew; Vriz, Olga; Driussi, Caterina; Loboz-Rudnicka, Maria; Dudek, Krzysztof; Łoboz-Grudzień, Krystyna

    2016-04-01

    The contribution of arterial functional and structural changes to left ventricular (LV) diastolic dysfunction has been the area of recent research. There are some studies on the relationship between arterial stiffness (a.s.) and left atrial (LA) remodelling as a marker of diastolic burden. Little is known about the association of arterial structural changes and LA remodelling in hypertension (H). The aim of this study was to examine the relationship between carotid a.s. and intima-media thickness (IMT) and LA volume in subjects with H. The study included 245 previously untreated hypertensives (166 women and 79 men, mean age 53.7 ± 11.8 years). Each patient was subjected to echocardiography with measurement of LA volume, evaluation of left ventricular hypertrophy (LVH) and LV systolic/diastolic function indices, integrated assessment of carotid IMT and echo-tracking of a.s. and wave reflection parameters. Univariate regression analysis revealed significant correlations between indexed LA volume and selected clinical characteristics, echocardiographic indices of LVH and LV diastolic/systolic function and a.s./wave reflection parameters. The following parameters were identified as independent determinants of indexed LA volume on multivariate regression analysis: diastolic blood pressure (beta = -0.229, P arterial stiffness but not intima-media thickness and LA volume in patients with untreated hypertension.

  3. Uncoupling of collagen II metabolism in newly diagnosed, untreated rheumatoid arthritis is linked to inflammation and antibodies against cyclic citrullinated peptides

    DEFF Research Database (Denmark)

    Christensen, Anne Friesgaard; Hørslev-Petersen, Kim; Christgau, Stephan

    2010-01-01

    . METHODS: One hundred sixty patients with newly diagnosed, untreated RA entered the Cyclosporine, Methotrexate, Steroid in RA (CIMESTRA) trial. Disease activity and radiograph status were measured at baseline and 4 years. The N-terminal propeptide of collagen IIA (PIIANP) and the cross-linked C...... associations of collagen II anabolism (PIIANP) and collagen II degradation (CTX-II) with anti-CCP, synovitis, and radiographic progression indicate that at this early stage of RA, cartilage collagen degradation is mainly driven by synovitis, while anti-CCP antibodies may interfere with cartilage regeneration...

  4. Treated and Untreated Alcohol-Use Disorders: Course and Predictors of Remission and Relapse

    Science.gov (United States)

    Moos, Rudolf H.; Moos, Bernice S.

    2007-01-01

    The research described here focused on personal, life context, and help-related factors to trace the long-term course of treated and untreated alcohol-use disorders. A group of 461 individuals who sought help for alcohol problems was surveyed at baseline and 1, 3, 8, and 16 years later. Compared with individuals who remained untreated, individuals…

  5. Ammonia Fiber Expansion Pretreatment and Enzymatic Hydrolysis on Two Different Growth Stages of Reed Canarygrass

    Science.gov (United States)

    Bradshaw, Tamika C.; Alizadeh, Hasan; Teymouri, Farzaneh; Balan, Venkatesh; Dale, Bruce E.

    Plant materials from the vegetative growth stage of reed canarygrass and the seed stage of reed canarygrass are pretreated by ammonia fiber expansion (AFEX) and enzymatically hydrolyzed using 15 filter paper units (FPU) cellulase/g glucan to evaluate glucose and xylose yields. Percent conversions of glucose and xylose, effects of temperature and ammonia loading, and hydrolysis profiles are analyzed to determine the most effective AFEX treatment condition for each of the selected materials. The controls used in this study were untreated samples of each biomass material. All pretreatment conditions tested enhanced enzyme digestibility and improved sugar conversions for reed canarygrass compared with their untreated counterparts. Based on 168 h hydrolysis results using 15 FPU Spezyme CP cellulase/g glucan the most effective AFEX treatment conditions were determined as: vegetative growth stage of reed canarygrass—100°C, 60% moisture content, 1.2∶1 kg ammonia/kg of dry matter (86% glucose and 78% xylose) and seed stage of reed canarygrass—100°C, 60% moisture content, 0.8∶1 kg ammonia/kg of dry matter (89% glucose and 81% xylose). Supplementation by commercial Multifect 720 xylanase along with cellulase further increased both glucose and xylose yields by 10-12% at the most effective AFEX conditions.

  6. Effects of hydrodynamic mixing intensity coupled with ionic strength on the initial stage dynamics of bridging flocculation of polystyrene latex particles with polyelectrolyte

    NARCIS (Netherlands)

    Adachi, Y.; Matsumoto, T.; Cohen Stuart, M.A.

    2002-01-01

    Effects of hydrodynamic mixing intensity on the initial stage dynamics of bridging flocculation induced by adsorbing polyelectrolyte were analyzed as an extension of previous report on the effect of ionic strength (J. Coll. Int. Sci. 204 (1998) 328). Mixing condition were changed by adopting forked

  7. Effect of Single and Double Stage Chemically Treated Kenaf Fibers on Mechanical Properties of Polyvinyl Alcohol Film

    Directory of Open Access Journals (Sweden)

    Md Ershad Ali

    2014-12-01

    Full Text Available The physico-mechanical properties of lignocellulosic kenaf fiber reinforced polyvinyl alcohol (PVA biocomposite films were investigated. To improve the properties of the biocomposite, kenaf fibers were chemically treated separately in a single stage (with Cr2(SO4312(H2O and double stages (with CrSO4 and NaHCO3 to improve the adhesion and compatibility between the kenaf fiber and PVA matrix. PVA was reinforced with various compositions of chemically treated kenaf fiber by using a solution casting technique. Microstructural analyses and mechanical tests were subsequently conducted. Scanning electron microscopic analysis indicated that chemical treatment improved the uniformity distribution of kenaf fiber within the PVA matrix. FTIR and XRD analyses confirmed the presence of chromium on the fiber surface. The tensile strength of PVA reinforced with chemical treated kenaf fiber was found to be higher than those reinforced with untreated kenaf. The Young’s modulus, flexural strength, and flexural modulus increased with fiber loading for both untreated and treated kenaf fiber reinforced PVA films. The double stage treated kenaf fiber showed better mechanical properties and lower moisture uptake than the single stage treated kenaf fiber.

  8. Marrow hypoplasia: a rare complication of untreated Grave's disease.

    Science.gov (United States)

    Garcia, Juliana; França, Larissa de; Ellinger, Vivian; Wolff, Mônica

    2014-12-01

    Atypical presentation forms of hyperthyroidism are always a challenge to the clinician. We present a female patient with the typical symptoms of thyrotoxicosis, without any thionamides treatment before, associated with pancytopenia, which recovered after euthyroidism state was achieved. Although the major cases of pancytopenia in Grave's disease are seen as a complication of antithyroid drugs (thioamides), in this case report the alteration in blood tests was associated with untreated hyperthyroidism. In the literature review, we found 19 case reports between 1981 to 2012, but it has been related to a hypercellular bone marrow with periferic destruction. Our case, however, is about a hypocellular bone marrow without fibrosis or fat tissue replacement, which proceeded with a periferic improvement following thyroid treatment. Although rare, pancytopenia, when present, may develop as an unusual and severe manifestation in untreated subjects.

  9. Prediction of Radial Distance of Extraprostatic Extension From Pretherapy Factors

    International Nuclear Information System (INIS)

    Schwartz, David J.; Sengupta, Shomik; Hillman, David W.; Sargent, Daniel J.; Cheville, John C.; Wilson, Torrence M.; Mynderse, Lance A.; Choo, Richard; Davis, Brian J.

    2007-01-01

    Purpose: Extraprostatic extension (EPE) of tumor conveys an adverse prognosis in early-stage prostate cancer. Previous studies reported on the linear and radial distance of EPE (EPEr) as measured from the prostate edge. In this study, the correlation of the EPEr from a large whole mount prostatectomy series was determined with respect to the needle biopsy and prostatectomy specimen findings. Methods and Materials: In a 24-month period, 404 patients underwent radical prostatectomy and the specimens were whole mounted. The preoperative records, biopsy findings, and EPEr from these specimens were evaluated. Results: The range of the EPEr distance was 0.0-5.7 mm. A three-category model was used that included 283 patients (70%) with no EPE, 59 (15%) with 'near EPE' (range, 0.01-0.59 mm), and 62 (15%) with 'far EPE' (≥0.6 mm). Univariate analysis revealed that patient age and prostate volume did not correlate with EPEr, in contrast to all other factors evaluated. Multivariate analysis identified the preoperative serum prostate-specific antigen, the percentage of cancer in the biopsy cores, and clinical tumor stage as significant. However, the Gleason score was not associated with the EPEr. Greater discrimination was possible in estimating the probability of extension in the 'near' category than in the 'far' category. Conclusion: EPEr is associated with the preoperative prostate-specific antigen level, percentage of cancer in the biopsy cores, and clinical tumor stage. These data might be useful in planning local therapies for prostate cancer, but additional studies identifying factors associated with EPEr beyond 3-5 mm could have relevance regarding the appropriate radiotherapeutic management strategies

  10. Circulating Tumor DNA in Predicting Outcomes in Patients With Stage IV Head and Neck Cancer or Stage III-IV Non-small Cell Lung Cancer

    Science.gov (United States)

    2018-01-12

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Salivary Gland Squamous Cell Carcinoma; Stage IIIA Non-small Cell Lung Cancer; Stage IIIB Non-small Cell Lung Cancer; Stage IV Non-small Cell Lung Cancer; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Salivary Gland Cancer; Stage IVC Squamous Cell Carcinoma of the Larynx; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Verrucous Carcinoma of the Larynx; Stage IVC Verrucous Carcinoma of the Oral Cavity; Tongue Cancer; Untreated Metastatic Squamous Neck Cancer With Occult Primary

  11. Effectiveness of insecticide-treated and untreated nets to prevent malaria in India.

    Science.gov (United States)

    Van Remoortel, Hans; De Buck, Emmy; Singhal, Maneesh; Vandekerckhove, Philippe; Agarwal, Satya P

    2015-08-01

    India is the most malaria-endemic country in South-East Asia, resulting in a high socio-economic burden. Insecticide-treated or untreated nets are effective interventions to prevent malaria. As part of an Indian first-aid guideline project, we aimed to investigate the magnitude of this effect in India. We searched MEDLINE, Embase and Central to systematically review Indian studies on the effectiveness of treated or untreated vs. no nets. Parasite prevalence and annual parasite incidence served as malaria outcomes. The overall effect was investigated by performing meta-analyses and calculating the pooled risk ratios (RR) and incidence rate ratios. Of 479 articles, we finally retained 16 Indian studies. Untreated nets decreased the risk of parasite prevalence compared to no nets [RR 0.69 (95% CI; 0.55, 0.87) in high-endemic areas, RR 0.49 (95% CI; 0.28, 0.84) in low-endemic areas], as was the case but more pronounced for treated nets [RR 0.35 (95% CI; 0.26, 0.47) in high-endemic areas, risk ratio 0.16 (95% CI; 0.06, 0.44) in low-endemic areas]. Incidence rate ratios showed a similar observation: a significantly reduced rate of parasites in the blood for untreated nets vs. no nets, which was more pronounced in low-endemic areas and for those who used treated nets. The average effect of treated nets (vs. no nets) on parasite prevalence was higher in Indian studies (RR 0.16-0.35) than in non-Indian studies (data derived from a Cochrane systematic review; RR 0.58-0.87). Both treated and untreated nets have a clear protective effect against malaria in the Indian context. This effect is more pronounced there than in other countries. © 2015 John Wiley & Sons Ltd.

  12. Reirradiation of recurrent node-positive non-small cell lung cancer after previous stereotactic radiotherapy for stage I disease. A multi-institutional treatment recommendation

    International Nuclear Information System (INIS)

    Nieder, Carsten; Ruysscher, Dirk de; Gaspar, Laurie E.; Guckenberger, Matthias; Mehta, Minesh P.; Cheung, Patrick; Sahgal, Arjun

    2017-01-01

    Practice guidelines have been developed for early-stage and locally advanced non-small cell lung cancer (NSCLC). However, many common clinical scenarios still require individualized decision making. This is true for locoregional relapse after initial stereotactic radiotherapy (stereotactic body radiation therapy or stereotactic ablative radiotherapy; SBRT or SABR), an increasingly utilized curative treatment option for stage I NSCLC. A consortium of expert radiation oncologists was established with the aim of providing treatment recommendations. In this scenario, a case was distributed to six radiation oncologists who provided their institutions' treatment recommendations. In this case, a patient developed local and mediastinal relapse after SABR (45 Gy, 3 fractions), comparable to the tumor burden in de novo stage IIIA NSCLC. Treatment recommendations were tabulated and a consensus conclusion was developed. Three institutions recommended evaluation for surgery. If the patient was not a surgical candidate, and/or refused surgery, definitive chemoradiation was recommended, including retreating the primary to full dose. European participants were more in favor of a non-surgical approach. None of the participants were reluctant to prescribe reirradiation, but two institutions prescribed doses lower than 60 Gy. Platinum-based doublets together with intensity-modulated radiotherapy were preferred. The institutional recommendations reflect the questions and uncertainties discussed in current stage III guidelines. All institutions agreed that previous SABR is not a contraindication for salvage chemoradiation. In the absence of high-quality prospective trials for recurrent NSCLC, all treatment options recommended in current guidelines for stage III disease can be considered in clinical scenarios such as this. (orig.) [de

  13. Stage-by-Stage and Parallel Flow Path Compressor Modeling for a Variable Cycle Engine

    Science.gov (United States)

    Kopasakis, George; Connolly, Joseph W.; Cheng, Larry

    2015-01-01

    This paper covers the development of stage-by-stage and parallel flow path compressor modeling approaches for a Variable Cycle Engine. The stage-by-stage compressor modeling approach is an extension of a technique for lumped volume dynamics and performance characteristic modeling. It was developed to improve the accuracy of axial compressor dynamics over lumped volume dynamics modeling. The stage-by-stage compressor model presented here is formulated into a parallel flow path model that includes both axial and rotational dynamics. This is done to enable the study of compressor and propulsion system dynamic performance under flow distortion conditions. The approaches utilized here are generic and should be applicable for the modeling of any axial flow compressor design.

  14. Laparoscopy After Previous Laparotomy

    Directory of Open Access Journals (Sweden)

    Zulfo Godinjak

    2006-11-01

    Full Text Available Following the abdominal surgery, extensive adhesions often occur and they can cause difficulties during laparoscopic operations. However, previous laparotomy is not considered to be a contraindication for laparoscopy. The aim of this study is to present that an insertion of Veres needle in the region of umbilicus is a safe method for creating a pneumoperitoneum for laparoscopic operations after previous laparotomy. In the last three years, we have performed 144 laparoscopic operations in patients that previously underwent one or two laparotomies. Pathology of digestive system, genital organs, Cesarean Section or abdominal war injuries were the most common causes of previouslaparotomy. During those operations or during entering into abdominal cavity we have not experienced any complications, while in 7 patients we performed conversion to laparotomy following the diagnostic laparoscopy. In all patients an insertion of Veres needle and trocar insertion in the umbilical region was performed, namely a technique of closed laparoscopy. Not even in one patient adhesions in the region of umbilicus were found, and no abdominal organs were injured.

  15. Assessment of veterinary extension services to livestock farmers in ...

    African Journals Online (AJOL)

    The study examined operational modes of providing veterinary extension services to livestock farmers in Egba-Division, Ogun-State Nigeria. Information was obtained from 120 livestock farmers and 8 extension agents selected through multi-stage random sampling technique with the use of both structured questionnaire ...

  16. Individuals with currently untreated mental illness: causal beliefs and readiness to seek help.

    Science.gov (United States)

    Stolzenburg, S; Freitag, S; Evans-Lacko, S; Speerforck, S; Schmidt, S; Schomerus, G

    2018-01-16

    Many people with mental illness do not seek professional help. Beliefs about the causes of their current health problem seem relevant for initiating treatment. Our aim was to find out to what extent the perceived causes of current untreated mental health problems determine whether a person considers herself/himself as having a mental illness, perceives need for professional help and plans to seek help in the near future. In a cross-sectional study, we examined 207 untreated persons with a depressive syndrome, all fulfilling criteria for a current mental illness as confirmed with a structured diagnostic interview (Mini International Neuropsychiatric Interview). The sample was recruited in the community using adverts, flyers and social media. We elicited causal explanations for the present problem, depression literacy, self-identification as having a mental illness, perceived need for professional help, help-seeking intentions, severity of depressive symptoms (Patient Health Questionnaire - Depression), and whether respondents had previously sought mental healthcare. Most participants fulfilled diagnostic criteria for a mood disorder (n = 181, 87.4%) and/or neurotic, stress-related and somatoform disorders (n = 120, 58.0%) according to the ICD-10. N = 94 (45.4%) participants had never received mental health treatment previously. Exploratory factor analysis of a list of 25 different causal explanations resulted in five factors: biomedical causes, person-related causes, childhood trauma, current stress and unhealthy behaviour. Attributing the present problem to biomedical causes, person-related causes, childhood trauma and stress were all associated with stronger self-identification as having a mental illness. In persons who had never received mental health treatment previously, attribution to biomedical causes was related to greater perceived need and stronger help-seeking intentions. In those with treatment experience, lower attribution to person-related causes and

  17. LGBT Identity, Untreated Depression, and Unmet Need for Mental Health Services by Sexual Minority Women and Trans-Identified People.

    Science.gov (United States)

    Steele, Leah S; Daley, Andrea; Curling, Deone; Gibson, Margaret F; Green, Datejie C; Williams, Charmaine C; Ross, Lori E

    2017-02-01

    Previous studies have found that transgender, lesbian, and bisexual people report poorer mental health relative to heterosexuals. However, available research provides little information about mental health service access among the highest need groups within these communities: bisexual women and transgender people. This study compared past year unmet need for mental health care and untreated depression between four groups: heterosexual cisgender (i.e., not transgender) women, cisgender lesbians, cisgender bisexual women, and transgender people. This was a cross-sectional Internet survey. We used targeted sampling to recruit 704 sexual and gender minority people and heterosexual cisgendered adult women across Ontario, Canada. To ensure adequate representation of vulnerable groups, we oversampled racialized and low socioeconomic status (SES) women. Trans participants were 2.4 times (95% confidence intervals [CI] = 1.6-3.8, p mental healthcare as cisgender heterosexual women. Trans participants were also 1.6 times (95% CI = 1.0-27, p = 0.04) more likely to report untreated depression. These differences were not seen after adjustment for social context factors such as discrimination and social support. We conclude that there are higher rates of unmet need and untreated depression in trans and bisexual participants that are partly explained by differences in social factors, including experiences of discrimination, lower levels of social support, and systemic exclusion from healthcare. Our findings suggest that the mental health system in Ontario is not currently meeting the needs of many sexual and gender minority people.

  18. Early stages of technology intensive companies

    OpenAIRE

    Muhos, M. (Matti)

    2011-01-01

    Abstract This study aims to clarify the early development stages of technology intensive companies. The current literature does not offer an extensive review of stage perspectives for company growth – the overall picture of the field is somewhat vague. The evolution of this field remains unclear as well as the current state. Further, recent empirical stage models focusing on technology intensive companies have not been delineated. As companies move through their early stages, they face ev...

  19. Profile of obinutuzumab for the treatment of patients with previously untreated chronic lymphocytic leukemia

    Directory of Open Access Journals (Sweden)

    Hill BT

    2015-08-01

    Full Text Available Brian T Hill, Matt Kalaycio Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA Abstract: Chronic lymphocytic leukemia (CLL is a hematologic malignancy derived from a clonal population of mature B-lymphocytes characterized by relatively low CD20 antigen expression. Although the disease often takes an indolent course, the majority of patients will eventually require therapy. Standard treatment for medically fit patients includes purine analogs and/or alkylating agents in addition to the type I anti-CD20 monoclonal antibody, rituximab. This therapy is inherently myelosuppressive and can result in significant morbidity and even mortality in patients with impaired performance status due to age and/or medical comorbidities. Historically, treatment options for the elderly or frail patient population were limited to monotherapy with the oral alkylating agent, chlorambucil, rituximab, or another type I anti-CD20 monoclonal antibody ofatumumab. Recently, a newer-generation anti-CD20 monoclonal antibody, obinutuzumab, was developed for patients with CLL. Obinutuzumab is a humanized type II monoclonal antibody that appears to have more direct antibody-dependent cell-mediated cytotoxicity (ADCC and possibly more direct cytotoxicity in vitro than previously available type I antibodies. A large Phase III prospective randomized clinical trial for older patients with impaired renal function and/or significant medical comorbidities demonstrated that when compared to conventionally-dosed rituximab and chlorambucil, the combination of chlorambucil and obinutuzumab administered at a dose and schedule involving early loading doses improved response rates and progression-free survival without significantly increasing toxicity. Results of this pivotal trial led to the FDA (US Food and Drug Administration approval of obinutuzumab in combination with chlorambucil for frontline treatment of CLL. Obinutuzumab

  20. Effects of irritant chemicals on Aedes aegypti resting behavior: is there a simple shift to untreated "safe sites"?

    Directory of Open Access Journals (Sweden)

    Hortance Manda

    2011-07-01

    Full Text Available BACKGROUND: Previous studies have identified the behavioral responses of Aedes aegypti to irritant and repellent chemicals that can be exploited to reduce man-vector contact. Maximum efficacy of interventions based on irritant chemical actions will, however, require full knowledge of variables that influence vector resting behavior and how untreated "safe sites" contribute to overall impact. METHODS: Using a laboratory box assay, resting patterns of two population strains of female Ae. aegypti (THAI and PERU were evaluated against two material types (cotton and polyester at various dark:light surface area coverage (SAC ratio and contrast configuration (horizontal and vertical under chemical-free and treated conditions. Chemicals evaluated were alphacypermethrin and DDT at varying concentrations. RESULTS: Under chemical-free conditions, dark material had significantly higher resting counts compared to light material at all SAC, and significantly increased when material was in horizontal configuration. Cotton elicited stronger response than polyester. Within the treatment assays, significantly higher resting counts were observed on chemical-treated dark material compared to untreated light fabric. However, compared to matched controls, significantly less resting observations were made on chemical-treated dark material overall. Most importantly, resting observations on untreated light material (or "safe sites" in the treatment assay did not significantly increase for many of the tests, even at 25% SAC. Knockdown rates were ≤5% for all assays. Significantly more observations of flying mosquitoes were made in test assays under chemical-treatment conditions as compared to controls. CONCLUSIONS/SIGNIFICANCE: When preferred Ae. aegypti resting sites are treated with chemicals, even at reduced treatment coverage area, mosquitoes do not simply move to safe sites (untreated areas following contact with the treated material. Instead, they become agitated

  1. Retrospective study of irinotecan/cisplatin followed by etoposide/cisplatin or the reverse sequence in extensive-stage small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Xiao XG

    2015-08-01

    Full Text Available Xiaoguang Xiao, Shujing Wang, Shu Xia, Man Zou, Yang Li, Yao Wei, Qi Mei, Yuan Chen Department of Oncology, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, People’s Republic of China Background: Much research has confirmed the favorable effect of irinotecan/cisplatin (IP and etoposide/cisplatin (EP on extensive-stage small cell lung cancer (E-SCLC. This study investigated two sequential orders of IP and EP in the treatment of E-SCLC. We also compared the efficacy and safety of IP and EP in first-line chemotherapy in E-SCLC. Methods: Ninety-three untreated patients with E-SCLC were randomly allocated to two groups. Group A received IP as first-line therapy until progression and then changed to EP; group B received EP as first-line therapy until tumor progression followed by IP. The primary endpoints were overall survival and time to second tumor progression. The secondary endpoints were first progression-free survival (PFS, ie, time from randomization to first occurrence of tumor progression after first-line treatment with IP or EP, tumor response, and safety of the different sequential treatment orders of IP and EP. Results: Median overall survival was 15.4 months in group A (IP followed by EP versus 15.7 months in group B (EP followed by IP; P=0.483. The median time to second tumor progression was 9.5 months in group A versus 9.9 months in group B (P=0.361. As first-line and second-line therapy, IP achieved a 95.9% and 60% disease control rate, respectively, and EP achieved 95.6% and 59% disease control rate. The median first PFS was not significantly different between group A and group B (6.5 months and 6.3 months, respectively; P=0.256. Grade 3/4 diarrhea appeared to be significantly more frequent with IP than with EP. The probability of anemia and thrombocytopenia was not significantly different between the two groups. However, significantly more patients who received the IP regimen as

  2. Level Of Extension Agents Motivation And Effectiveness In Abia State Nigeria.

    Directory of Open Access Journals (Sweden)

    Machiadikwe N. Benjamin Agbarevo Nwogu

    2015-08-01

    Full Text Available Motivation is known to affect effectiveness of workers but the level of extension agents motivation and how this has affected their effectiveness in Abia state is apparently unknown. A study was therefore conducted to determine the effect of motivation on effectiveness of extension agents in Abia State Nigeria. Two blocks were selected from each of the three zones in the state at the first stage giving total of 6 blocks. The second stage involved the selection of two sub-circles from each of the 6 blocks selected giving a total of 12 extension sub-circles. At the third stage 10 extension agents from each of the sub-circles were randomly selected giving a sample size of 120 extension agents. The data for the study was collected with use of a structured questionnaire. The extension agents level of motivation and effectiveness were measured with the aid of a 5 point Likert rating scale. Data collected was analyzed using both descriptive and inferential statistics. Descriptive statistics used were the mean frequencies and the Pearsons Product Moment Correlation Co-efficient which was used to determine the coefficient of correlation r . The inferential statistic used was the t-test of significance of relationship. The study found a significant relationship between the level of motivation and effectiveness of extension agents. Hence the null hypothesis which stated that there is no significant relationship between the level of motivation and effectiveness of extension agents was rejected and the alternative hypothesis accepted at 95 confidence level and 119 degrees of freedom.

  3. Impairment of attention networks in patients with untreated hyperthyroidism.

    Science.gov (United States)

    Yuan, Lili; Tian, Yanghua; Zhang, Fangfang; Dai, Fang; Luo, Li; Fan, Jin; Wang, Kai

    2014-06-27

    Attention disorders are common symptoms in patients with untreated hyperthyroidism. Nevertheless, it is unknown whether they represent a global attention deficit or selective impairment of attention networks. Thirty-seven patients with hyperthyroidism were recruited and underwent the Attention Network Test (ANT), which provided measures of three independent attention networks (alerting, orienting and executive control), before being treated with methimazole. This study demonstrated that patients with untreated hyperthyroidism had significant deficits in the alerting and executive control networks. Interestingly, a significant positive association was also found between T4 level and the value of the executive network in patients with hyperthyroidism. These results suggest that the patients with hyperthyroidism may not just exist a specific impairment of attention networks, and there was some relationship between the level of T4, not T3 or TSH, and the value of the executive control network in patients with hyperthyroidism. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Quantification of newly produced B and T lymphocytes in untreated chronic lymphocytic leukemia patients

    Directory of Open Access Journals (Sweden)

    Caimi Luigi

    2010-11-01

    Full Text Available Abstract Background The immune defects occurring in chronic lymphocytic leukemia are responsible for the frequent occurrence of infections and autoimmune phenomena, and may be involved in the initiation and maintenance of the malignant clone. Here, we evaluated the quantitative defects of newly produced B and T lymphocytes. Methods The output of B and T lymphocytes from the production and maturation sites was analyzed in chronic lymphocytic leukemia patients and healthy controls by quantifying kappa-deleting recombination excision circles (KRECs and T-cell receptor excision circles (TRECs by a Real-Time PCR assay that simultaneously detects both targets. T-lymphocyte subsets were analyzed by six-color flow cytometric analysis. Data comparison was performed by two-sided Mann-Whitney test. Results KRECs level was reduced in untreated chronic lymphocytic leukemia patients studied at the very early stage of the disease, whereas the release of TRECs+ cells was preserved. Furthermore, the observed increase of CD4+ lymphocytes could be ascribed to the accumulation of CD4+ cells with effector memory phenotype. Conclusions The decreased number of newly produced B lymphocytes in these patients is likely related to a homeostatic mechanism by which the immune system balances the abnormal B-cell expansion. This feature may precede the profound defect of humoral immunity characterizing the later stages of the disease.

  5. Resectable stage III lung cancer: CT, surgical, and pathologic correlation

    International Nuclear Information System (INIS)

    Scott, I.R.; Muller, N.L.; Miller, R.R.; Evans, K.G.; Nelems, B.

    1987-01-01

    Patients with stage IIIa lung cancer have improved survival following surgery. The authors reviewed the CT, surgical, and pathologic findings in 26 patients with completely resected stage IIIa lung cancer. These include examples of the different subsets of stage IIIa disease. CT correctly predicted chest-wall invasion in only two of ten patients, pericardial involvement in one of three, and tumor extension to within 2 cm of the carina in one of three patients. It detected mediastinal nodal disease in eight of 11 patients. CT is of limited value in assessing chest-wall or pericardial extension; however, such extension does not preclude complete resection. Ipsilateral nodal involvement also doses not preclude surgery

  6. Fermentation of Ammonia Fiber Expansion Treated and Untreated Barley Straw in a Rumen Simulation Technique Using Rumen Inoculum from Cattle with Slow versus Fast Rate of Fiber Disappearance.

    Science.gov (United States)

    Griffith, Candace L; Ribeiro, Gabriel O; Oba, Masahito; McAllister, Tim A; Beauchemin, Karen A

    2016-01-01

    The purpose of this study was to determine the effect of rumen inoculum from heifers with fast vs. slow rate of in situ fiber digestion on the fermentation of complex versus easily digested fiber sources in the forms of untreated and Ammonia Fiber Expansion (AFEX) treated barley straw, respectively, using an artificial rumen simulation technique (Rusitec). In situ fiber digestion was measured in a previous study by incubating untreated barley straw in the rumen of 16 heifers fed a diet consisting of 700 g/kg barley straw and 300 g/kg concentrate. The two heifers with fastest rate of digestion (Fast ≥ 4.18% h -1 ) and the two heifers with the slowest rate of digestion (Slow ≤ 3.17% h -1 ) were chosen as inoculum donors for this study. Two Rusitec apparatuses each equipped with eight fermenters were used in a completely randomized block design with two blocks (apparatus) and four treatments in a 2 × 2 factorial arrangement of treatments (Fast or Slow rumen inoculum and untreated or AFEX treated straw). Fast rumen inoculum and AFEX straw both increased ( P 0.05) methane production per gram of digested material for both untreated and AFEX straw, and reduced (interaction, P < 0.05) acetate: propionate ratio for untreated straw. Greater relative populations of Ruminococcus albus ( P < 0.05) and increased microbial N production ( P = 0.045) were observed in Fast rumen inoculum. AFEX straw in Fast inoculum had greater total bacterial populations than Slow, but for untreated straw this result was reversed (interaction, P = 0.013). These findings indicate that differences in microbial populations in rumen fluid contribute to differences in the capacity of rumen inoculum to digest fiber.

  7. Adsorption properties of stearic acid onto untreated kaolinite | Sari ...

    African Journals Online (AJOL)

    The focus of the study is to investigate adsorption property and determine thermodynamic parameters for the adsorption of stearic acid onto untreated kaolinite at the temperatures of 25, 35 and 45 oC. The equilibrium adsorption isotherms were analyzed by linear Langmuir and Freundlich models. Adsorption experiments ...

  8. The key to reducing duration of untreated first psychosis

    DEFF Research Database (Denmark)

    Joa, Inge; Johannessen, Jan Olav; Auestad, Bjørn

    2008-01-01

    The TIPS early intervention program reduced the duration of untreated psychosis (DUP) in first-episode schizophrenia from 16 to 5 weeks in a health care sector using a combination of easy access detection teams (DTs) and a massive information campaign (IC) about the signs and symptoms of psychosis...

  9. Sperm quality before treatment in patients with early stage Hodgkin's lymphoma enrolled in EORTC-GELA Lymphoma Group trials.

    NARCIS (Netherlands)

    Kaaij, M.A. van der; Heutte, N.; Echten-Arends, J. van; Raemaekers, J.M.M.; Carde, P.; Noordijk, E.M.; Ferme, C.; Thomas, J.; Eghbali, H.; Brice, P.; Bonmati, C.; Henry-Amar, M.; Kluin-Nelemans, H.C.

    2009-01-01

    BACKGROUND: Although widely recommended, cryopreservation of sperm is sometimes not performed for patients with Hodgkin's lymphoma because of presumed poor sperm quality related to the disease. We investigated sperm quality and factors determining it in untreated patients with early stage Hodgkin's

  10. Sperm quality before treatment in patients with early stage Hodgkin's lymphoma enrolled in EORTC-GELA Lymphoma Group trials

    NARCIS (Netherlands)

    van der Kaalj, Marleen A. E.; Heutte, Natacha; van Echten-Arends, Jannie; Raemaekers, John M. M.; Carde, Patrice; Noordijk, Evert M.; Ferme, Christophe; Thomas, Jose; Eghbali, Houchingue; Brice, Pauline; Bonmati, Caroline; Henry-Amar, Michel; Kluin-Nelemans, Hanneke C.

    2009-01-01

    Background Although widely recommended, cryopreservation of sperm is sometimes not performed for patients with Hodgkin's lymphoma because of presumed poor sperm quality related to the disease. We investigated sperm quality and factors determining it in untreated patients with early stage Hodgkin's

  11. Diet quality and adherence to a healthy diet in Japanese male workers with untreated hypertension.

    Science.gov (United States)

    Kanauchi, Masao; Kanauchi, Kimiko

    2015-07-10

    As Japanese societies rapidly undergo westernisation, the prevalence of hypertension is increasing. We investigated the association between dietary quality and the prevalence of untreated hypertension in Japanese male workers. We conducted a cross-sectional study of 433 male workers who completed a brief food frequency questionnaire. Adherence to the WHO-based Healthy Diet Indicator (HDI), the American Heart Association 2006 Diet and Lifestyle Recommendations, the Dietary Approaches to Stop Hypertension (DASH) diet, and Mediterranean-style diet was assessed using four adherence indexes (HDI score, AI-84 score, DASH score and MED score). Hypertension classes were classified into three categories: non-hypertension, untreated hypertension and treated hypertension (ie, taking antihypertensive medication). The prevalence of untreated hypertension and treated hypertension was 22.4% and 8.5%, respectively. Patients with untreated hypertension had significantly lower HDI and AI-84 scores compared with non-hypertension. DASH and MED scores across the three hypertension classes were comparable. After adjusting for age, energy intake, smoking habit, alcohol drinking, physical activity and salt intake, a low adherence to HDI and a lowest quartile of AI-84 score were associated with a significantly higher prevalence of untreated hypertension, with an OR of 3.33 (95% CI 1.39 to 7.94, p=0.007) and 2.23 (1.09 to 4.53, p=0.027), respectively. A lower dietary quality was associated with increased prevalence of untreated hypertension in Japanese male workers. Our findings support a potential beneficial impact of nutritional assessment using diet qualities. 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.

  12. Cost-Effectiveness Model for Chemoimmunotherapy Options in Patients with Previously Untreated Chronic Lymphocytic Leukemia Unsuitable for Full-Dose Fludarabine-Based Therapy.

    Science.gov (United States)

    Becker, Ursula; Briggs, Andrew H; Moreno, Santiago G; Ray, Joshua A; Ngo, Phuong; Samanta, Kunal

    2016-06-01

    To evaluate the cost-effectiveness of treatment with anti-CD20 monoclonal antibody obinutuzumab plus chlorambucil (GClb) in untreated patients with chronic lymphocytic leukemia unsuitable for full-dose fludarabine-based therapy. A Markov model was used to assess the cost-effectiveness of GClb versus other chemoimmunotherapy options. The model comprised three mutually exclusive health states: "progression-free survival (with/without therapy)", "progression (refractory/relapsed lines)", and "death". Each state was assigned a health utility value representing patients' quality of life and a specific cost value. Comparisons between GClb and rituximab plus chlorambucil or only chlorambucil were performed using patient-level clinical trial data; other comparisons were performed via a network meta-analysis using information gathered in a systematic literature review. To support the model, a utility elicitation study was conducted from the perspective of the UK National Health Service. There was good agreement between the model-predicted progression-free and overall survival and that from the CLL11 trial. On incorporating data from the indirect treatment comparisons, it was found that GClb was cost-effective with a range of incremental cost-effectiveness ratios below a threshold of £30,000 per quality-adjusted life-year gained, and remained so during deterministic and probabilistic sensitivity analyses under various scenarios. GClb was estimated to increase both quality-adjusted life expectancy and treatment costs compared with several commonly used therapies, with incremental cost-effectiveness ratios below commonly referenced UK thresholds. This article offers a real example of how to combine direct and indirect evidence in a cost-effectiveness analysis of oncology drugs. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  13. Direct surface plasmon resonance immunosensing of pyraclostrobin residues in untreated fruit juices.

    Science.gov (United States)

    Mauriz, E; García-Fernández, C; Mercader, J V; Abad-Fuentes, A; Escuela, A M; Lechuga, L M

    2012-12-01

    A surface plasmon resonance (SPR) immunoassay for on-line detection of the strobilurin fungicide pyraclostrobin in untreated fruit juices is presented. The analysis of pyraclostrobin residues is accomplished in apple, grape, and cranberry samples by monitoring the recognition events occurring separately in a two-channel home-made SPR biosensor. Covalent coupling of the analyte derivative results in a reversible method, enabling more than 80 measurements on the same sensor surface. Optimization of the immunoassay conditions provides limits of detection as low as 0.16 μg L(-1). The selectivity and reproducibility of the analysis is ensured by studying both non-specific interactions with unrelated compounds and inter-assay coefficients of variation. Excellent recovery ranging from 98 to 103% was achieved by a simple 1:5 dilution of fruit juice with assay buffer before the analysis. The lack of previous cleaning and homogenization procedures reduces the analysis time of a single food sample to only 25 min, including the regeneration cycle.

  14. An Analysis of Kohlberg's "Stage 4 1/2" within an Enhanced Framework of Moral Stages.

    Science.gov (United States)

    Minnameier, Gerhard

    This paper discusses a well-known problem of stage categorization within Kohlberg's theory of moral stages (L. Kohlberg, 1973), that of "Stage 4 1/2." Some subjects previously scored at stage 4 in Kohlberg's framework took on some characteristics of stage 2 reasoning, which suggested the possibility of regression. To reconcile this…

  15. Comparative study of nasopharyngeal carcinoma staging system between the chinese 2008 and '92 Fuzhou

    International Nuclear Information System (INIS)

    Zong Jingfeng; Lin Shaojun; Zhang Yu; Chen Yunbin; Guo Qiaojuan; Pan Jianji

    2010-01-01

    Objective: To carry out a comparative study between the Chinese 2008 and '92 staging system of nasopharyngeal carcinoma (NPC). Methods: A total of 777 patients presented with untreated non disseminated NPC who had received MRI scan of nasopharynx and neck were studied retrospectively. The clinical materials and information of imaging were collected. All patients were restaged according to the Chinese 2008 and 92 staging system of nasopharyngeal carcinoma. Distribution of T, N stage, survival and prognostic value were compared. 513 patients of the 777 cases were treated with conventional radiotherapy, 264 cases with intensity modulated radiation therapy. Results: The 3-year follow-up rate was 97.6%. The consistency of T stages was 95.0%. T, N and clinical stage distributions in two systems were similar ( Kappa = 0.93, P = 0.000; Kappa = 0.58, P = 0.000; Kappa = 0.74, P = 0.000). Local failure-free survival and disease specific survival were also similar. There was no difference of distant metastasis between N 0 and N 1 (χ 2 = 1.94, P=0. 164), and a marginal difference between N 1 and N 2 (χ 2 =3.83, P=0.051) in the Chinese '92 staging system. However, although there was also no difference of distant metastasis-free survival between N 0 and N 1a (χ 2 =0.07, P =0.797), ) the difference of overall survival among N 1b , N 2 , and N 3 were significant (χ 2 = 4.95, P = 0.026; χ 2 = 6.74, P = 0.009) in the Chinese 2008 staging system. Conventional radiotherapy or intensity modulated radiation therapy was not a prognostic factor for survival (χ 2 = 3.60, P =0.058). It is reasonable for the Chinese 2008 staging system integrated lymph node characteristics such as laterality, level and extra nodal neoplastic spread into the N staging criteria (χ 2 = 6.59, P = 0.010; χ 2 =4.78, P=0. 029; χ 2 =9.32, P=0.002). Conclusions: For the Chinese 2008 staging system, it was reasonable to simplify the previous T stage. The N stage showed a better predictive role of distant

  16. Neratinib Plus Paclitaxel vs Trastuzumab Plus Paclitaxel in Previously Untreated Metastatic ERBB2-Positive Breast Cancer: The NEfERT-T Randomized Clinical Trial.

    Science.gov (United States)

    Awada, Ahmad; Colomer, Ramon; Inoue, Kenichi; Bondarenko, Igor; Badwe, Rajendra A; Demetriou, Georgia; Lee, Soo-Chin; Mehta, Ajay O; Kim, Sung-Bae; Bachelot, Thomas; Goswami, Chanchal; Deo, Suryanarayan; Bose, Ron; Wong, Alvin; Xu, Feng; Yao, Bin; Bryce, Richard; Carey, Lisa A

    2016-12-01

    Efficacious ERBB2 (formerly HER2 or HER2/neu)-directed treatments, in addition to trastuzumab and lapatinib, are needed. To determine whether neratinib, an irreversible pan-ERBB tyrosine kinase inhibitor, plus paclitaxel improves progression-free survival compared with trastuzumab plus paclitaxel in the first-line treatment of recurrent and/or metastatic ERBB2-positive breast cancer. In the randomized, controlled, open-label NEfERT-T trial conducted from August 2009 to December 2014 at 188 centers in 34 countries in Europe, Asia, Africa, and North America, 479 women with previously untreated recurrent and/or metastatic ERBB2-positive breast cancer were randomized to 1 of 2 treatment arms (neratinib-paclitaxel [n = 242] or trastuzumab-paclitaxel [n = 237]). Women with asymptomatic central nervous system metastases were eligible, and randomization was stratified by prior trastuzumab and lapatinib exposure, hormone-receptor status, and region. Women received neratinib (240 mg/d orally) or trastuzumab (4 mg/kg then 2 mg/kg weekly), each combined with paclitaxel (80 mg/m2 on days 1, 8, and 15 every 28 days). Primary prophylaxis for diarrhea was not mandatory. The primary outcome was progression-free survival. Secondary end points were response rate, clinical benefit rate, duration of response, frequency, and time to symptomatic and/or progressive central nervous system lesions, and safety. The intent-to-treat population comprised 479 women 18 years or older (neratinib-paclitaxel, n = 242; trastuzumab-paclitaxel, n = 237) randomized and stratified in their respective treatment arms by prior trastuzumab and lapatinib exposure, hormone-receptor status, and region. Median progression-free survival was 12.9 months (95% CI, 11.1-14.9) with neratinib-paclitaxel and 12.9 months (95% CI, 11.1-14.8) with trastuzumab-paclitaxel (hazard ratio [HR], 1.02; 95% CI, 0.81-1.27; P =.89). With neratinib-paclitaxel, the incidence of central nervous system recurrences was

  17. Substitution of lucerne hay by untreated, urea-enriched and urea ...

    African Journals Online (AJOL)

    Wheat straw was left untreated (WS), enriched with 1.5% urea (UWS), or ammoniated with 5.5% urea in a stack for 8 .... nitrogen concentration for maximal microbial synthesis is in ... faeces and urine samples were taken daily and pooled for.

  18. Down-regulated resistin level in consequence of decreased neutrophil counts in untreated Grave's disease.

    Science.gov (United States)

    Peng, Ying; Qi, Yicheng; Huang, Fengjiao; Chen, Xinxin; Zhou, Yulin; Ye, Lei; Wang, Weiqing; Ning, Guang; Wang, Shu

    2016-11-29

    Resistin, belongs to cysteine-rich secretory protein, is mainly produced by circulating leukocytes, such as neutrophils monocytes and macrophages in humans. To date, few but controversial studies have reported about resistin concentrations in hyperthyroid patients, especially in Graves' disease (GD). We undertaked a controlled, prospective study to explore the serum resistin concentration in GD patients before and after -MMI treatment. In addition, we also investigated the main influencing factor on serum resistin level and discuessed the potential role of serum resistin plays in GD patients. 39 untreated GD (uGD) patients, including 8 males and 31 females, were enrolled in our investigation. All of these patients were prescribed with MMI treatment, in addition to 25 healthy controls. Anthropometric parameters and hormone assessment were measured. Enzyme-linked immunosorbent assay was used to detect serum resistin concentration in different stages of GD patients. Furthermore, neutrophil cell line NB4 with or without T3 treatment to detect the effect of thyroid hormones on resistin expression. The serum resistin level and neutrophil counts in untreated GD patients were significantly declined. And all of these parameters were recovered to normal after MMI treatment in ethyroid GD (eGD) and TRAb-negative conversion (nGD) patients. Resistin concentration exhibited a negative correlation with FT3 and FT4, but a positive correlation with absolute number of neutrophiles in uGD patients, whereas did not correlate with thyroid autoimmune antibodies and BMI. Neutrophile cell line, NB4, produced decreased expression of resistin when stimulated with T3. Our study showed a decrease of serum resistin level in GD patients and we suggested that the serum resistin might primarily secreted from circulating neutrophils and down-regulated by excessive thyroid hormones in GD patients.

  19. Efficacy and safety of bevacizumab plus chemotherapy compared to chemotherapy alone in previously untreated advanced or metastatic colorectal cancer: a systematic review and meta-analysis

    International Nuclear Information System (INIS)

    Botrel, Tobias Engel Ayer; Clark, Luciana Gontijo de Oliveira; Paladini, Luciano; Clark, Otávio Augusto C.

    2016-01-01

    Colorectal cancer (CRC) is the fourth most frequently diagnosed cancer and the second leading cause of neoplasm-related death in the United States. Several studies analyzed the efficacy of bevacizumab combined with different chemotherapy regimens consisting on drugs such as 5-FU, capecitabine, irinotecan and oxaliplatin. This systematic review aims to evaluate the effectiveness and safety of chemotherapy plus bevacizumab versus chemotherapy alone in patients with previously untreated advanced or metastatic colorectal cancer (mCRC). Several databases were searched, including MEDLINE, EMBASE, LILACS, and CENTRAL. The primary endpoints were overall survival and progression-free survival. Data extracted from the studies were combined by using hazard ratio (HR) or risk ratio (RR) with their corresponding 95 % confidence intervals (95 % CI). The final analysis included 9 trials comprising 3,914 patients. Patients who received the combined treatment (chemotherapy + bevacizumab) had higher response rates (RR = 0.89; 95 % CI: 0.82 to 0.96; p = 0.003) with heterogeneity, higher progression-free survival (HR = 0.69; 95 % CI: 0.63 to 0.75; p < 0.00001) and also higher overall survival rates (HR = 0.87; 95 % CI: 0.80 to 0.95; p = 0.002) with moderate heterogeneity. Regarding adverse events and severe toxicities (grade ≥ 3), the group receiving the combined therapy had higher rates of hypertension (RR = 3.56 95 % CI: 2.58 to 4.92; p < 0.00001), proteinuria (RR = 1.89; 95 % CI: 1.26 to 2.84; p = 0.002), gastrointestinal perforation (RR = 3.63; 95 % CI: 1.31 to 10.09; p = 0.01), any thromboembolic events (RR = 1.44; 95 % CI: 1.20 to 1.73; p = 0.0001), and bleeding (RR = 1.81; 95 % CI: 1.22 to 2.67; p = 0.003). The combination of chemotherapy with bevacizumab increased the response rate, progression-free survival and overall survival of patients with mCRC without prior chemotherapy. The results of progression-free survival (PFS) and overall survival (OS) were comparatively higher

  20. Consumer Evaluation of a Vertical Brand Extension in the Lodging Industry: Relationships among Brand Trust, Band Loyalty, Brand Distance, and Brand Extension

    OpenAIRE

    Lim, Yu Mi

    2013-01-01

    Vertical brand extensions have been used as popular strategies in the lodging industry. Research on brand extension that is related with brand trust and brand loyalty has been useful in making brand extensions successful. However, previous research focused on aggregated relationships among brand trust, brand loyalty, and brand extension. In addition, it has been found that quality and price distance from a core brand of the brand extension has an impact on the success of the brand extension. ...

  1. Effects of Untreated Periodontitis on Osseointegration of Dental Implants in a Beagle Dog Model.

    Science.gov (United States)

    Lee, Daehyun; Sohn, Byungjin; Kim, Kyoung Hwa; Kim, Sungtae; Koo, Ki-Tae; Kim, Tae-Il; Seol, Yang-Jo; Lee, Yong-Moo; Rhyu, In-Chul; Ku, Young

    2016-10-01

    There have been previous studies on the relationship between periodontitis and peri-implantitis, but limited information is available on how periodontitis affects osseointegration and wound healing of newly placed dental implants adjacent to natural teeth. The objective of the present experiment is to evaluate healing around dental implants adjacent to teeth with untreated experimental periodontitis. The study included six male beagle dogs. Scaling and plaque control procedures were performed on three dogs (control group). In the other three dogs (experimental group), retraction cords and ligature wires were placed subgingivally around all premolars and the first molars. Induced experimental periodontitis was confirmed after 3 months. Each control or experimental group was divided into two subgroups depending on the timing of implant placement (immediate/delayed). Twelve dental implants (two implants for each dog) were placed immediately, and the other 12 dental implants (two implants for each dog) were placed 2 months after extraction. The animals were sacrificed 2 months after implant placement. Histologic and histometric analyses were performed. Four implants (three from the immediate placement group and one from the delayed placement group) failed in the experimental group. There were significant differences in the percentage of bone-to-implant contact and marginal bone volume density between the control and experimental groups. Both parameters were significantly lower in the experimental group than in the control group (P implants is associated with a higher failure rate compared with delayed placement. Untreated experimental periodontitis was correlated with compromised osseointegration in the implants with delayed placement.

  2. Imaging Microglial Activation in Untreated First-Episode Psychosis: A PET Study With [18F]FEPPA.

    Science.gov (United States)

    Hafizi, Sina; Tseng, Huai-Hsuan; Rao, Naren; Selvanathan, Thiviya; Kenk, Miran; Bazinet, Richard P; Suridjan, Ivonne; Wilson, Alan A; Meyer, Jeffrey H; Remington, Gary; Houle, Sylvain; Rusjan, Pablo M; Mizrahi, Romina

    2017-02-01

    Neuroinflammation and abnormal immune responses are increasingly implicated in the pathophysiology of schizophrenia. Previous positron emission tomography (PET) studies targeting the translocator protein 18 kDa (TSPO) have been limited by high nonspecific binding of the first-generation radioligand, low-resolution scanners, small sample sizes, and psychotic patients being on antipsychotics or not being in the first episode of their illness. The present study uses the novel second-generation TSPO PET radioligand [ 18 F]FEPPA to evaluate whether microglial activation is elevated in the dorsolateral prefrontal cortex and hippocampus of untreated patients with first-episode psychosis. Nineteen untreated patients with first-episode psychosis (14 of them antipsychotic naive) and 20 healthy volunteers underwent a high-resolution [ 18 F]FEPPA PET scan and MRI. Dynamic PET data were analyzed using the validated two-tissue compartment model with arterial plasma input function with total volume of distribution (V T ) as outcome measure. All analyses were corrected for TSPO rs6971 polymorphism (which is implicated in differential binding affinity). No significant differences were observed between patients and healthy volunteers in microglial activation, as indexed by [ 18 F]FEPPA V T , in either the dorsolateral prefrontal cortex or the hippocampus. There were no significant correlations between [ 18 F]FEPPA V T and duration of illness, clinical presentation, or neuropsychological measures after adjusting for multiple testing. The lack of significant differences in [ 18 F]FEPPA V T between groups suggests that microglial activation is not present in first-episode psychosis.

  3. Idiopathic focal segmental glomerulosclerosis: a favourable prognosis in untreated patients?

    NARCIS (Netherlands)

    Deegens, J.K.J.; Assmann, K.J.M.; Steenbergen, E.; Hilbrands, L.B.; Gerlag, P.G.G.; Jansen, J.L.; Wetzels, J.F.M.

    2005-01-01

    BACKGROUND: Patients with focal segmental glomerulosclerosis (FSGS) are considered to have a poor prognosis and spontaneous remissions are seldom reported. However, FSGS is not a single disease entity. Our aim was to describe the clinical course in initially untreated patients with recently

  4. Substance use and duration of untreated psychosis in KwaZulu ...

    African Journals Online (AJOL)

    Background: Substance use and psychiatric disorders cause significant burden of disease in low- and middle-income countries. Co-morbid psychopathology and longer duration of untreated psychosis (DUP) can negatively affect treatment outcomes. Objectives: The study assessed substance use amongst adults with ...

  5. Replacement Value of Untreated or Fungal Treated Carrot Leaves for Corn in Broiler Diet

    International Nuclear Information System (INIS)

    El-Faramawy, A.A.

    2006-01-01

    Three hundred (21 days old) Arbor Acre chicks were used to evaluate the replacement value of untreated or Aspergillus niger treated carrot leaves for corn in broiler diets. Birds were fed a control diet or diets in which 10% untreated or treated carrot leaves was quantitatively substituted for corn in the control diet. Replacement of yellow corn with 10% untreated and treated carrot leaves caused insignificant (P 0.01) in both experimental groups compared to control. These results denoted that although there were negligible changes in body weight and mortality rate in broiler chicken fed untreated and treated carrot leaves the amino acid profile of carcasses lessen their nutritive value which is in consequence reflected negatively on human amino acids intake. Poultry production represents one of the quickest means of correcting the anomaly of protein inadequacy, yet the rising cost of feed which represents 70-80% of the cost of production among other costs, is a major setback (Opera. 1996). The price of most conventional feed ingredients such as yellow corn, soybean meal and fish meal is so high in recent time that it is becoming uneconomical to use them in poultry feeding (Esonu et al., 2001). Consequently poultry feed researchers have been forced to seek alternative and cheaper feed resources

  6. Do adult men with untreated hypospadias have adverse outcomes? A pilot study using a social media advertised survey.

    Science.gov (United States)

    Schlomer, Bruce; Breyer, Benjamin; Copp, Hillary; Baskin, Laurence; DiSandro, Michael

    2014-08-01

    Hypospadias is usually treated in childhood. Therefore, the natural history of untreated mild hypospadias is unknown. We hypothesized that men with untreated hypospadias, especially mild, do not have adverse outcomes. Facebook was used to advertise an electronic survey to men older than 18 years. Men with untreated hypospadias identified themselves and indicated the severity of hypospadias with a series of questions. Outcomes included: Sexual Health Inventory for Men (SHIM), penile curvature and difficulty with intercourse, International Prostate Symptom Score (IPSS), Penile Perception Score (PPS), psychosexual milestones, paternity, infertility, sitting to urinate, and the CDC HRQOL-4 module. 736 men completed self-anatomy questions and 52 (7.1%) self-identified with untreated hypospadias. Untreated hypospadias participants reported worse SHIM (p < 0.001) and IPSS scores (p = 0.05), more ventral penile curvature (p = 0.003) and resulting difficulty with intercourse (p < 0.001), worse satisfaction with meatus (p = 0.011) and penile curvature (p = 0.048), and more sitting to urinate (p = 0.07). When stratified by mild and severe hypospadias, severe hypospadias was associated with more adverse outcomes than mild hypospadias. Men with untreated hypospadias reported worse outcomes compared with non-hypospadiac men. Mild untreated hypospadias had fewer adverse outcomes than severe hypospadias. Research is needed to determine if treatment of childhood hypospadias improves outcomes in adults, especially for mild hypospadias. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  7. Withholding stereotactic radiotherapy in elderly patients with stage I non-small cell lung cancer and co-existing COPD is not justified: Outcomes of a markov model analysis

    International Nuclear Information System (INIS)

    Louie, Alexander V.; Rodrigues, George; Hannouf, Malek; Lagerwaard, Frank; Palma, David; Zaric, Gregory S.; Haasbeek, Cornelis; Senan, Suresh

    2011-01-01

    Background and purpose: To model outcomes of SBRT versus best supportive care (BSC) in elderly COPD patients with stage I NSCLC. Material and methods: A Markov model was constructed to simulate the quality-adjusted and overall survival (OS) in patients ≥75 years undergoing either SBRT or BSC for a five-year timeframe. SBRT rates of local, regional and distant recurrences were obtained from 247 patients treated at the VUMC, Amsterdam. Recurrence rates were converted into transition probabilities and stratified into four groups according to T stage (1, 2) and COPD GOLD score (I-II, III-IV). Data for untreated patients were obtained from the California Cancer Registry. Tumor stage and GOLD score utilities were adapted from the literature. Results: Our model correlated closely with the source OS data for SBRT treated and untreated patients. After SBRT, our model predicted for 6.8-47.2% five-year OS and 14.9-27.4 quality adjusted life months (QALMs). The model predicted for 9.0% and 2.8% five-year OS, and 10.1 and 6.1 QALMs for untreated T1 and T2 patients, respectively. The benefit of SBRT was the least for T2, GOLD III-IV patients. Conclusion: Our model indicates that SBRT should be considered in elderly stage I NSCLC patients with COPD.

  8. The effect of supplementing untreated, urea-supplemented and urea ...

    African Journals Online (AJOL)

    3x2x2 factorial experiment, involving an intake and in vivo digestibility trial with 48 adult S.A. Mutton Merino wethers. Straw dry matter (OM) intake on ammoniated wheat-straw diets was 27 and 22% higher (P ';;0,01) than on untreated and urea-supplemented diets, respectively. No significant difference was found between ...

  9. Evaluation of untreated dental caries in children with PUFA index

    Directory of Open Access Journals (Sweden)

    Nagehan Aktaş

    2018-01-01

    Full Text Available Objective: Tooth decay continues to come up as a serious health problem particularly in developing countries. Limited number of studies investigated the prevalence of complication of untreated dental caries as abscess, fistula and ulceration. The purpose of the present study was to investigate the prevalence of the clinical consequences of untreated dental caries among a group of children. Materials and Method: The study was conducted on 1200 children with ages between 5-12 years in the Department of Pedodontics, Faculty of Dentistry, GaziUniversity between the dates 1-31 March 2012. Caries in deciduous and permanent teeth were scored using DMFT/dmft and PUFA/pufa indexes (D/d: decayed, M/m: missing, F/f: filled, P/p: carious lesion with pulpal involvement, U/u: ulceration of the mucosa due to root fragments, F/f: fistula, A/a: abscess. Results: DMFT index was 2.34 ± 1.37 and dmft index was 4.25 ± 3.46. The prevalence of PUFA/pufa for permanent and deciduous teeth was 2.30% and 22.25%, respectively. The highest score in both permanent and deciduous teeth was caries lesions with pulpal involvement (%11.24 for deciduous teeth and %1.67 for permanent teeth. This was followed by abscess and fistula formation. Conclusion: The prevalence of clinical consequences of untreated dental caries was high for deciduous teeth in the selected population. The PUFA/pufa index is seen as an epidemiological tool complementary to the existing caries index aimed to assess dental caries.

  10. Association of translocator protein total distribution volume with duration of untreated major depressive disorder: a cross-sectional study.

    Science.gov (United States)

    Setiawan, Elaine; Attwells, Sophia; Wilson, Alan A; Mizrahi, Romina; Rusjan, Pablo M; Miler, Laura; Xu, Cynthia; Sharma, Sarita; Kish, Stephen; Houle, Sylvain; Meyer, Jeffrey H

    2018-04-01

    People with major depressive disorder frequently exhibit increasing persistence of major depressive episodes. However, evidence for neuroprogression (ie, increasing brain pathology with longer duration of illness) is scarce. Microglial activation, which is an important component of neuroinflammation, is implicated in neuroprogression. We examined the relationship of translocator protein (TSPO) total distribution volume (V T ), a marker of microglial activation, with duration of untreated major depressive disorder, and with total illness duration and antidepressant exposure. In this cross-sectional study, we recruited participants aged 18-75 years from the Toronto area and the Centre for Addiction and Mental Health (Toronto, ON, Canada). Participants either had major depressive episodes secondary to major depressive disorder or were healthy, as confirmed with a structured clinical interview and consultation with a study psychiatrist. To be enrolled, participants with major depressive episodes had to score a minimum of 17 on the 17-item Hamilton Depression Rating Scale, and had to be medication free or taking a stable dose of medication for at least 4 weeks before PET scanning. Eligible participants were non-smokers; had no history of or concurrent alcohol or substance dependence, neurological illness, autoimmune disorder, or severe medical problems; and were free from acute medical illnesses for the previous 2 weeks before PET scanning. Participants were excluded if they had used brain stimulation treatments within the 6 months before scanning, had used anti-inflammatory drugs lasting at least 1 week within the past month, were taking hormone replacement therapy, had psychotic symptoms, had bipolar disorder (type I or II) or borderline antisocial personality disorder, or were pregnant or breastfeeding. We scanned three primary grey-matter regions of interest (prefrontal cortex, anterior cingulate cortex, and insula) and 12 additional regions and subregions using 18

  11. Health services determinants of the duration of untreated psychosis among African-American first-episode patients.

    Science.gov (United States)

    Compton, Michael T; Ramsay, Claire E; Shim, Ruth S; Goulding, Sandra M; Gordon, Tynessa L; Weiss, Paul S; Druss, Benjamin G

    2009-11-01

    The duration of untreated psychosis is associated with poor outcomes in multiple domains in the early course of nonaffective psychotic disorders, although relatively little is known about determinants of this critical period, particularly health services-level determinants. This study examined three hypothesized predictors of duration of untreated psychosis (lack of insurance, financial problems, and broader barriers) among urban, socioeconomically disadvantaged African Americans, while controlling for the effects of three patient-level predictors (mode of onset of psychosis, living with family versus alone or with others before hospitalization, and living above versus below the federally defined poverty level). Analyses included data from 42 patient-family member dyads from a larger sample of 109 patients with a first episode of nonaffective psychosis. The duration of untreated psychosis and all other variables were measured in a rigorous, standardized fashion in a study designed specifically to examine determinants of treatment delay. Survival analyses and Cox regression assessed the effects of the independent predictors on time from onset of psychosis to hospital admission for initial evaluation and treatment. The median duration of untreated psychosis was 24.5 weeks. When the analyses controlled for the three patient-level covariates, patients without health insurance, with financial problems, or with barriers to seeking help had a significantly longer duration of untreated psychosis. Health services-related factors, such as lack of insurance, are predictive of longer treatment delay. Efforts to eliminate uninsurance and underinsurance, as well as minimize barriers to treatment, would be beneficial for improving the prognosis of young patients with emerging nonaffective psychotic disorders.

  12. Comparative Study of Fluorodeoxyglucose Positron Emission Tomography and Magnetic Resonance Imaging for the Detection of Spinal Bone Marrow Infiltration in Untreated Patients with Multiple Myeloma

    International Nuclear Information System (INIS)

    Hur, J.; Yoon, C.S.; Hoon Ryu, Y.; Yun, M.J.; Suh, J.S.

    2008-01-01

    Background: The presence and extent of osteolytic bone lesions in untreated patients with multiple myeloma are important factors in the staging of the disease, and the extent of bone lesions in multiple myeloma cases significantly influences decisions regarding therapy. Recently, fluorodeoxyglucose positron emission tomography (FDG-PET) and magnetic resonance imaging (MRI) have been used to detect bone marrow involvement in patients with multiple myeloma. Purpose: To compare the efficacy of FDG-PET and MRI for the detection of bone marrow infiltration into the spine in untreated patients with multiple myeloma. Material and Methods: Twenty-two patients with multiple myeloma underwent both FDG-PET and spine MRI. The examined spinal regions by MRI included 21 thoracic and lumbar spines, one lumbar spine, and 12 cervical spines. The following imaging sequences were performed: T1-weighted spin-echo MRI with and without fat suppression, and T2-weighted spin-echo MRI in the sagittal plane. In the patients with bone marrow abnormalities, an additional contrast-enhanced T1-weighted spin-echo MR image and a fat-suppressed T1-weighted spin-echo MR image were obtained. Patients were divided into three groups on the basis of the criteria defined by Durie and Salmon: stage I (n=9), stage II (n=3), and stage III (n=10). The number and location of lesions detected in both FGD-PET and MRI were recorded, and the lesions were compared using the McNemar test. Bone marrow biopsy results, the patient's clinical examinations, and other imaging findings (MRI, FDG-PET, etc.) were used as references. Results: In stages I and II (37 lesions in 12 patients), FDG-PET and MRI detected lesions in 78% (29 of 37 lesions) and 86% (32 of 37 lesions), respectively. However, the difference between the abilities of FDG-PET and MRI to detect lesions was not statistically significant (P=0.317). In stage III (101 lesions in 10 patients), FDG-PET and MRI detected lesions in 80% (81 of 101 lesions) and 92

  13. Comparative Study of Fluorodeoxyglucose Positron Emission Tomography and Magnetic Resonance Imaging for the Detection of Spinal Bone Marrow Infiltration in Untreated Patients with Multiple Myeloma

    Energy Technology Data Exchange (ETDEWEB)

    Hur, J.; Yoon, C.S.; Hoon Ryu, Y.; Yun, M.J.; Suh, J.S. (Dept. of Diagnostic Radiology and Research Inst. of Radiological Science, and Dept. of Nuclear Medicine, Yonsei Univ. College of Medicine, Seoul (KR))

    2008-05-15

    Background: The presence and extent of osteolytic bone lesions in untreated patients with multiple myeloma are important factors in the staging of the disease, and the extent of bone lesions in multiple myeloma cases significantly influences decisions regarding therapy. Recently, fluorodeoxyglucose positron emission tomography (FDG-PET) and magnetic resonance imaging (MRI) have been used to detect bone marrow involvement in patients with multiple myeloma. Purpose: To compare the efficacy of FDG-PET and MRI for the detection of bone marrow infiltration into the spine in untreated patients with multiple myeloma. Material and Methods: Twenty-two patients with multiple myeloma underwent both FDG-PET and spine MRI. The examined spinal regions by MRI included 21 thoracic and lumbar spines, one lumbar spine, and 12 cervical spines. The following imaging sequences were performed: T1-weighted spin-echo MRI with and without fat suppression, and T2-weighted spin-echo MRI in the sagittal plane. In the patients with bone marrow abnormalities, an additional contrast-enhanced T1-weighted spin-echo MR image and a fat-suppressed T1-weighted spin-echo MR image were obtained. Patients were divided into three groups on the basis of the criteria defined by Durie and Salmon: stage I (n=9), stage II (n=3), and stage III (n=10). The number and location of lesions detected in both FGD-PET and MRI were recorded, and the lesions were compared using the McNemar test. Bone marrow biopsy results, the patient's clinical examinations, and other imaging findings (MRI, FDG-PET, etc.) were used as references. Results: In stages I and II (37 lesions in 12 patients), FDG-PET and MRI detected lesions in 78% (29 of 37 lesions) and 86% (32 of 37 lesions), respectively. However, the difference between the abilities of FDG-PET and MRI to detect lesions was not statistically significant (P=0.317). In stage III (101 lesions in 10 patients), FDG-PET and MRI detected lesions in 80% (81 of 101 lesions) and

  14. Parenchymal neurocysticercosis: follow-up and staging by MRI

    International Nuclear Information System (INIS)

    Dumas, J.L.; Visy, J.M.; Belin, C.; Gaston, A.; Goldlust, D.; Dumas, M.

    1997-01-01

    We describe the evolution of parenchymal cerebral cysticerci on MRI, to assess signs of early cyst degeneration. We studied 15 lesions in four treated and one untreated patient. MRI was performed before therapy and repeated in the 1st month after each course of anticysticercus drugs, every 4 months during the 1st year and then annually; the follow-up period was 8-48 months. Lesions were classified according to changes in four features: cyst content and capsule signal, gadolinium enhancement and oedema signal. We were able to recognise each of the pathological phases; five MRI stages were identified. Stage 1 showed oedema and/or nodular gadolinium enhancement in the tissue invasion phase; stage 2 was cerebrospinal fluid-like signal within a cyst in the vesicular phase; stage 3 showed a thick capsule with an impure liquid content signal and surrounding oedema, in the cystic phase; stage 4 showed the disappearance of the cyst fluid content signal in the degenerative phase; stage 5 showed a calcified lesion in the residual phase. Stage 1 lesions disappeared after therapy; the other progressed from one stage to another. Stage 4 indicated the end of viability of the parasite and determined the point after which treatment was useless. On T2-weighted images changes in the cyst content differed according to the history of the lesion; nodular low intensity followed the natural degeneration of the parasite and a mixed fluid signal with punctate low signal seemed to represent the specific result of therapy. MRI staging can help in the evaluation of indications for treatment and facilitate clinical therapeutic trials. (orig.). With 4 figs., 1 tab

  15. Parenchymal neurocysticercosis: follow-up and staging by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Dumas, J.L. [Dept. of Radiology, Hopital Avicenne, Bobigny (France)]|[Inst. of Tropical Neurology, Faculty of Medicine, Limoges (France); Visy, J.M. [Dept. of Neurology, Hopital Lariboisiere, Paris (France); Belin, C. [Dept. of Neurology, Hopital Avicenne, Bobigny (France); Gaston, A. [Dept. of Neuroradiology, Hopital Henri-Mondor, Creteil (France); Goldlust, D. [Dept. of Radiology, Hopital Avicenne, Bobigny (France); Dumas, M. [Inst. of Tropical Neurology, Faculty of Medicine, Limoges (France)

    1997-01-01

    We describe the evolution of parenchymal cerebral cysticerci on MRI, to assess signs of early cyst degeneration. We studied 15 lesions in four treated and one untreated patient. MRI was performed before therapy and repeated in the 1st month after each course of anticysticercus drugs, every 4 months during the 1st year and then annually; the follow-up period was 8-48 months. Lesions were classified according to changes in four features: cyst content and capsule signal, gadolinium enhancement and oedema signal. We were able to recognise each of the pathological phases; five MRI stages were identified. Stage 1 showed oedema and/or nodular gadolinium enhancement in the tissue invasion phase; stage 2 was cerebrospinal fluid-like signal within a cyst in the vesicular phase; stage 3 showed a thick capsule with an impure liquid content signal and surrounding oedema, in the cystic phase; stage 4 showed the disappearance of the cyst fluid content signal in the degenerative phase; stage 5 showed a calcified lesion in the residual phase. Stage 1 lesions disappeared after therapy; the other progressed from one stage to another. Stage 4 indicated the end of viability of the parasite and determined the point after which treatment was useless. On T2-weighted images changes in the cyst content differed according to the history of the lesion; nodular low intensity followed the natural degeneration of the parasite and a mixed fluid signal with punctate low signal seemed to represent the specific result of therapy. MRI staging can help in the evaluation of indications for treatment and facilitate clinical therapeutic trials. (orig.). With 4 figs., 1 tab.

  16. Reoperative sentinel lymph node biopsy after previous mastectomy.

    Science.gov (United States)

    Karam, Amer; Stempel, Michelle; Cody, Hiram S; Port, Elisa R

    2008-10-01

    Sentinel lymph node (SLN) biopsy is the standard of care for axillary staging in breast cancer, but many clinical scenarios questioning the validity of SLN biopsy remain. Here we describe our experience with reoperative-SLN (re-SLN) biopsy after previous mastectomy. Review of the SLN database from September 1996 to December 2007 yielded 20 procedures done in the setting of previous mastectomy. SLN biopsy was performed using radioisotope with or without blue dye injection superior to the mastectomy incision, in the skin flap in all patients. In 17 of 20 patients (85%), re-SLN biopsy was performed for local or regional recurrence after mastectomy. Re-SLN biopsy was successful in 13 of 20 patients (65%) after previous mastectomy. Of the 13 patients, 2 had positive re-SLN, and completion axillary dissection was performed, with 1 having additional positive nodes. In the 11 patients with negative re-SLN, 2 patients underwent completion axillary dissection demonstrating additional negative nodes. One patient with a negative re-SLN experienced chest wall recurrence combined with axillary recurrence 11 months after re-SLN biopsy. All others remained free of local or axillary recurrence. Re-SLN biopsy was unsuccessful in 7 of 20 patients (35%). In three of seven patients, axillary dissection was performed, yielding positive nodes in two of the three. The remaining four of seven patients all had previous modified radical mastectomy, so underwent no additional axillary surgery. In this small series, re-SLN was successful after previous mastectomy, and this procedure may play some role when axillary staging is warranted after mastectomy.

  17. Productivity losses attributable to untreated chlamydial infection and associated pelvic inflammatory disease in reproductive-aged women.

    Science.gov (United States)

    Blandford, John M; Gift, Thomas L

    2006-10-01

    The productivity losses attributable to disease-related morbidity and mortality impose a burden on society in general and on employers in particular. A reliable assessment of the productivity losses associated with untreated infection with Chlamydia trachomatis (Ct) would complement earlier work on direct medical costs and contribute to an estimate of the full cost of chlamydial disease. The goal of this study was to estimate the discounted lifetime productivity losses attributable to untreated chlamydial infection in reproductive-aged women. We developed a cost model using Monte Carlo methods to estimate the lifetime discounted productivity losses attributable to untreated lower genital tract Ct infection among reproductive-aged women. The model considered the impact of disability resulting from acute pelvic inflammatory disease (PID) associated with untreated Ct infection and from the sequelae of acute PID, including chronic pelvic pain, ectopic pregnancy, and infertility. To accommodate disparate Ct infection rates and labor market characteristics across age groups, we matched age-based risk factors for Ct infection with labor market patterns. Data sources included the 2001 National Chlamydia Surveillance Data, the 2001 Current Population Survey, and published literature. Estimates indicate that the mean weighted productivity losses per untreated Ct infection were approximately US dollars 130 (in year 2001 dollars). Mean weighted productivity losses per case of acute PID were estimated at US dollars 649. Estimated productivity losses were highly correlated with age, reflecting age-dependent differences in labor market characteristics. The productivity losses attributable to untreated infection with Ct and to sequelae of this infection form a substantial portion of the total economic burden of disease. Effective programs to prevent chlamydial infection and effective screening, diagnosis, and treatment of Ct-infected women may reduce productivity losses and

  18. Randomized Phase II Study of R-CHOP With or Without Bortezomib in Previously Untreated Patients With Non-Germinal Center B-Cell-Like Diffuse Large B-Cell Lymphoma.

    Science.gov (United States)

    Leonard, John P; Kolibaba, Kathryn S; Reeves, James A; Tulpule, Anil; Flinn, Ian W; Kolevska, Tatjana; Robles, Robert; Flowers, Christopher R; Collins, Robert; DiBella, Nicholas J; Papish, Steven W; Venugopal, Parameswaran; Horodner, Andrew; Tabatabai, Amir; Hajdenberg, Julio; Park, Jaehong; Neuwirth, Rachel; Mulligan, George; Suryanarayan, Kaveri; Esseltine, Dixie-Lee; de Vos, Sven

    2017-11-01

    Purpose To evaluate the impact of the addition of bortezomib to rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) on outcomes in previously untreated patients with non-germinal center B-cell-like (non-GCB) diffuse large B-cell lymphoma (DLBCL). Patients and Methods After real-time determination of non-GCB DLBCL using the Hans immunohistochemistry algorithm, 206 patients were randomly assigned (1:1; stratified by International Prognostic Index [IPI] score) to six 21-day cycles of standard R-CHOP alone or R-CHOP plus bortezomib 1.3 mg/m 2 intravenously on days 1 and 4 (VR-CHOP). The primary end point, progression-free survival (PFS), was evaluated in 183 patients with centrally confirmed non-GCB DLBCL who received one or more doses of study drug (91 R-CHOP, 92 VR-CHOP). Results After a median follow-up of 34 months, with 25% (R-CHOP) and 18% (VR-CHOP) of patients having had PFS events, the hazard ratio (HR) for PFS was 0.73 (90% CI, 0.43 to 1.24) with VR-CHOP ( P = .611). Two-year PFS rates were 77.6% with R-CHOP and 82.0% with VR-CHOP; they were 65.1% versus 72.4% in patients with high-intermediate/high IPI (HR, 0.67; 90% CI, 0.34 to 1.29), and 90.0% versus 88.9% (HR, 0.85; 90% CI, 0.35 to 2.10) in patients with low/low-intermediate IPI. Overall response rate with R-CHOP and VR-CHOP was 98% and 96%, respectively. The overall survival HR was 0.75 (90% CI, 0.38 to 1.45); 2-year survival rates were 88.4% and 93.0%, respectively. In the safety population (100 R-CHOP and 101 VR-CHOP patients), grade ≥ 3 adverse events included neutropenia (53% v 49%), thrombocytopenia (13% v 29%), anemia (7% v 15%), leukopenia (26% v 25%), and neuropathy (1% v 5%). Conclusion Outcomes for newly diagnosed, prospectively enrolled patients with non-GCB DLBCL were more favorable than expected with R-CHOP and were not significantly improved by adding bortezomib.

  19. Microbiological composition of untreated water during different weather conditions

    Directory of Open Access Journals (Sweden)

    Adna Bešić

    2011-09-01

    Full Text Available Introduction: Water can support the growth of different microorganisms which may result in contamination. Therefore, the microbiological examination is required for testing the hygienic probity of water. In the study of microbial composition of untreated, natural spring and mineral water differences in the presence and number of bacteria during the two periods, winter and summer, are detectable.Methods: In our study, we analyzed and compared the following parameters, specified in the Rulebook: total bacteria and total aerobic bacteria (ml/22 and 37°C, total Coliform bacteria and Coliforms of fecalorigin (MPN/100ml, fecal streptococci as Streptococcus faecalis  (MPN/100ml, Proteus spp (MPN/100ml, and Pseudomonas aeruginosa (MPN/100 ml Sulphoreducing Clostridia (cfu / ml. The paper is a retrospective study in which we processed data related to the period of 2005-2009 year. While working, we used the descriptive-analytical comparative statistical treatment.Results: The obtained results show statistically significant differences in the microbial composition of untreated water in the two observed periods,Conclusions: Findings were consequence of different weather conditions in these periods, which imply a number of other variable factors.

  20. The transition from diffuse to focused extension: Modeled evolution of the West Antarctic Rift system

    Science.gov (United States)

    Huerta, Audrey D.; Harry, Dennis L.

    2007-03-01

    Two distinct stages of extension are recognized in the West Antarctic Rift system (WARS). During the first stage, beginning in the Late Cretaceous, extension was broadly distributed throughout much of West Antarctica. A second stage of extension in the late Paleogene was focused primarily in the Victoria Land Basin, near the boundary with the East Antarctic craton. The transition to focused extension was roughly coeval with volcanic activity and strike-slip faulting in the adjacent Transantarctic Mountains. This spatial and temporal correspondence suggests that the transition in extensional style could be the result of a change in plate motions or impingement of a plume. Here we use finite element models to study the processes and conditions responsible for the two-stage evolution of rifting in the WARS. Model results indicate that the transition from a prolonged period of broadly distributed extension to a later period of focused rifting did not require a change in the regional stress regime (changes in plate motion), or deep mantle thermal state (impingement of a plume). Instead, we attribute the transition from diffuse to focused extension to an early stage dominated by the initially weak accreted lithosphere of West Antarctica, and a later stage that concentrated around a secondary weakness located at the boundary between the juvenile West Antarctica lithosphere and Precambrian East Antarctic craton. The modeled transition in extension from the initially weak West Antarctica region to the secondary weakness at the West Antarctic-East Antarctic boundary is precipitated by strengthening of the West Antarctica lithosphere during syn-extensional thinning and cooling. The modeled syn-extensional strengthening of the WARS lithosphere promotes a wide-rift mode of extension between 105 and ˜ 65 Ma. By ˜ 65 Ma most of the extending WARS region becomes stronger than the area immediately adjacent to the East Antarctic craton and extension becomes concentrated near the

  1. Morbidity after Hemorrhage in Children with Untreated Brain Arteriovenous Malformation

    Science.gov (United States)

    Ma, Li; Kim, Helen; Chen, Xiao-Lin; Wu, Chun-Xue; Ma, Jun; Su, Hua; Zhao, Yuanli

    2017-01-01

    Background Children with untreated brain arteriovenous malformations (bAVM) are at risk of encountering life-threatening hemorrhage very early in their lives. The primary aim of invasive treatment is to reduce unfavorable outcome associated with a bAVM rupture. A better understanding of the morbidity of bAVM hemorrhage might be helpful for weighing the risks of untreated bAVM and invasive treatment. Our aim was to assess the clinical outcome after bAVM rupture and identify features to predict severe hemorrhage in children. Methods We identified all consecutive children admitted to our institution for bAVMs between July 2009 and December 2014. Clinical outcome after hemorrhagic presentation and subsequent hemorrhage was evaluated using the modified Rankin Scale (mRS) for children. The association of demographic characteristics and bAVM morphology with severe hemorrhage (mRS >3 or requiring emergency hematoma evacuation) was studied using univariate and multivariable regression analyses. A nomogram based on multivariable analysis was formulated to predict severe hemorrhage risk for individual patients. Results A total of 134 patients were identified with a mean treatment-free follow-up period of 2.1 years. bAVM ruptured in 83 (62%) children: 82 had a hemorrhage at presentation and 6 of them experienced a recurrent hemorrhage during follow-up; 1 patient had other diagnostic symptoms but bled during follow-up. Among them, 49% (41/83) had a severe hemorrhage; emergency hematoma evacuation was required in 28% of them (23/83), and 24% (20/83) remained as disabled (mRS ≥ 3) at last follow-up. Forty-six percent (38/82) of children with hemorrhagic presentation were severely disabled (mRS >3). Forty-three percent (3/7) were severely disabled after subsequent hemorrhage. The annual rate of severe subsequent hemorrhage was 1% in the overall cohort and 3.3% in children with ruptured presentation. All the subsequent severe hemorrhage events occurred in children with severe

  2. Augmented therapy of extensive Hodgkin's disease: radiation to bulk disease or prolongation of induction chemotherapy did not improve survival

    International Nuclear Information System (INIS)

    Rafla, S.; Coleman, M.; Propert, K.; Glicksman, A.; Peterson, B.; Nissen, N.; Brunner, K.; Kaufmann, T.; Holland, J.; Anderson, J.; Gottlieb, A.

    1996-01-01

    Purpose: This prospective, randomized trial in extensive, untreated Hodgkin's disease was undertaken to assess the potential benefit of augmented therapy (12 months chemotherapy or radiation to 'bulk' disease) compared to standard, six months chemotherapy. Materials and Methods: Two-hundred fifty-eight patients, mostly stage IV, were randomized to four treatment regimens consisting of 6 cycles of CCNU, vinblastine, procarbazine, and prednisone (CVPP); 12 cycles of CVPP; 6 cycles of CVPP followed by 25 Gray (Gy) radiotherapy; or 3 cycles CVPP, 25 Gy radiotherapy, and 3 cycles CVPP. Results: Complete remissions were achieved in 65% of all patients. A 58% overall 5 year survival was obtained. Relapses in irradiated areas of bulk disease occurred in only 6% of responding patients. There was, however, no statistical difference in response frequency, disease free survival or overall survival amongst the four regimens. Elderly patients responded less frequently. Conclusion: While radiotherapy provided control of local (bulk) disease, no impact on overall survival was apparent. Likewise doubling the duration of chemotherapy did not improve response or survival. Augmentation of therapy with either radiotherapy or more chemotherapy in this study was of no benefit when compared to the standard six months of treatment

  3. Is boundary extension emotionally selective?

    Science.gov (United States)

    Ménétrier, Emmanuelle; Didierjean, André; Vieillard, Sandrine

    2013-01-01

    When they have to memorize a picture, people usually build a memory trace including more extensive boundaries than the original picture, a phenomenon known as boundary extension or BE. This article looks at whether the emotion category expressed (i.e., happiness, pleasure, irritation, or anger) by actors in short films could have an influence on the BE effect. The results showed that positively valenced emotions (happiness, pleasure) led to an extension effect, while the negatively valenced ones (anger, irritation) did not produce any significant memory distortion. The arousal dimension of emotions had no significant effect on BE. The current results were discussed in the light of previous studies on the links between BE and emotions.

  4. Cortical hypometabolism and hypoperfusion in Parkinson's disease is extensive: probably even at early disease stages

    DEFF Research Database (Denmark)

    Borghammer, Per; Chakravarty, Mallar; Jonsdottir, Kristjana Yr

    2010-01-01

    independent samples of PD patients. We compared SPECT CBF images of 32 early-stage and 33 late-stage PD patients with that of 60 matched controls. We also compared PET FDG images from 23 late-stage PD patients with that of 13 controls. Three different normalization methods were compared: (1) GM normalization...

  5. Preventive effects of etodolac, a selective cyclooxygenase-2 inhibitor, on cancer development in extensive metaplastic gastritis, a Helicobacter pylori-negative precancerous lesion.

    Science.gov (United States)

    Yanaoka, Kimihiko; Oka, Masashi; Yoshimura, Noriko; Deguchi, Hisanobu; Mukoubayashi, Chizu; Enomoto, Shotaro; Maekita, Takao; Inoue, Izumi; Ueda, Kazuki; Utsunomiya, Hirotoshi; Iguchi, Mikitaka; Tamai, Hideyuki; Fujishiro, Mitsuhiro; Nakamura, Yasushi; Tsukamoto, Tetsuya; Inada, Kenichi; Takeshita, Tatsuya; Ichinose, Masao

    2010-03-15

    The present study investigated the preventive effects of etodolac, a selective cyclo-oxygenase (COX)-2 inhibitor, on metachronous cancer development after endoscopic resection of early gastric cancer. Among 267 early gastric cancer patients who underwent endoscopic resection, 47 patients with extensive metaplastic gastritis were selected based on endoscopic findings and our previously described criteria of serum pepsinogen (PG) test-positive and Helicobacter pylori antibody-negative conditions. Nonrandomized etodolac treatment (300 mg/day) was administered to 26 patients (Group A), while the remaining 21 patients were untreated (Group B). No significant differences in age, sex distribution, lifestyle factors or extent of metaplastic gastritis at baseline were identified between groups. Patients were followed for metachronous cancer development with endoscopy every 6-12 months for up to 5 years. Mean (standard deviation) follow-up period was 4.2 (0.9) years. In Group B, 5 cancers developed (incidence rate = 6,266/100,000 person-years), significantly more than the 1 cancer in Group A (incidence rate = 898/100,000 person-years; p gastritis as revealed by endoscopic findings or by serum PG levels, but effectively reduced metachronous cancer development in patients with extensive metaplastic gastritis. These results strongly suggest that chemoprevention of cancer in the metaplastic stomach is possible by controlling COX-2 expression.

  6. End-Stage Renal Disease From Cast Nephropathy in a Teenager With Neuroendocrine Carcinoma.

    Science.gov (United States)

    Butani, Lavjay; Ducore, Jonathan

    2016-07-01

    Cast nephropathy is the most common manifestation of renal injury in patients with multiple myeloma but is rarely reported in other conditions. We are reporting our experience in caring for a teenager with a metastatic neuroendocrine carcinoma who developed rapidly progressive kidney injury that advanced to end-stage renal disease. On renal biopsy extensive tubular necrosis and intratubular eosinophilic casts were noted. This previously unreported finding should prompt oncologists to closely monitor for such a complication in patients with secretory tumors. Whether early plasmapheresis could be of benefit, as has been tried in multiple myeloma, remains to be determined.

  7. Effect of untreated bed nets on blood-fed Phlebotomus argentipes in kala-azar endemic foci in Nepal and India.

    Science.gov (United States)

    Picado, Albert; Kumar, Vijay; Das, Murari; Burniston, Ian; Roy, Lalita; Suman, Rijal; Dinesh, Diwakar; Coosemans, Marc; Sundar, Shyam; Shreekant, Kesari; Boelaert, Marleen; Davies, Clive; Cameron, Mary

    2009-12-01

    Observational studies in the Indian subcontinent have shown that untreated nets may be protective against visceral leishmaniasis (VL). In this study, we evaluated the effect of untreated nets on the blood feeding rates of Phlebotomus argentipes as well as the human blood index (HBI) in VL endemic villages in India and Nepal. The study had a 'before and after intervention' design in 58 households in six clusters. The use of untreated nets reduced the blood feeding rate by 85% (95% CI 76.5-91.1%) and the HBI by 42.2% (95% CI 11.1-62.5%). These results provide circumstantial evidence that untreated nets may provide some degree of personal protection against sand fly bites.

  8. Fitness, daily activity and body composition in children with newly diagnosed, untreated asthma

    DEFF Research Database (Denmark)

    Vahlkvist, S; Pedersen, S

    2009-01-01

    Background: Information about how the asthma disease affects the life style and health in children is sparse. Aim: To measure fitness, daily physical activity and body composition in children with newly diagnosed, untreated asthma and healthy controls, and to assess the association between...... the level of asthma control and these parameters. Methods: Daily physical activity measured using accelerometry, cardiovascular fitness and body composition (per cent fat, per cent lean tissue and bone mineral density) were measured in 57 children with newly diagnosed, untreated asthma and in 157 healthy...... fitness and daytime spent in intensive activity. Overweight children are physically less active than normal weight children....

  9. Influence of untreated and bacterial-treated Yamuna water on the ...

    African Journals Online (AJOL)

    In present study an attempt has been made to study the pollution level of river Yamuna at Agra, by analyzing the physico-chemical parameters of untreated and bacterial-treated water and its effect on the growth of maize plant. Among different concentrations (25, 50, 75 and 100%) of treated water, the 100% concentration of ...

  10. Compulsive buying disorder: an untreated patient for 20 years

    OpenAIRE

    Gonca Karakus; Lut Tamam

    2017-01-01

    Compulsive buying disorder is characterized by impulsive drives and compulsive behaviors (buying unneeded things), personal distress, impaired social and vocational functioning and financial problems. In this case report, we presented diagnostic and treatment process of 49 year old, female patient who had complaints amnesia, weight loss and insomnia. In her medical history, she had compulsive buying disorder for nearly twenty years but untreated until her current evaluation. Comorbid psychi...

  11. On-the-road driving performance and driving-related skills in older untreated insomnia patients and chronic users of hypnotics.

    Science.gov (United States)

    Leufkens, T R M; Ramaekers, J G; de Weerd, A W; Riedel, W J; Vermeeren, A

    2014-07-01

    Many older adults report sleep problems and use of hypnotics. Several studies have shown that hypnotics can have acute adverse effects on driving the next morning. It is unclear however whether driving of chronic hypnotic users is impaired. Therapeutic effects on insomnia and development of tolerance may reduce the residual effects on driving. The present study aimed to compare actual driving performance and driving-related skills of chronic hypnotic users to good sleepers. To determine whether insomnia itself affects driving performance, driving and driving-related skills were compared between insomnia patients who do not or infrequently use hypnotics and good sleepers. Twenty-two frequent users of hypnotics (using hypnotics ≥ 4 nights per week for more than 3 months), 20 infrequent users (using hypnotics ≤ 3 nights per week), and 21 healthy, age-matched controls participated in this study. On the night before testing, all subjects were hospitalized for an 8-h sleep recorded by polysomnography. Frequent hypnotic users used their regular medication at bedtime (2330 hours), while infrequent users and controls received no medication. Cognitive performance (word learning, digit span, tracking, divided attention, vigilance, and inhibitory control) was assessed 8.5 h and driving performance between 10 and 11 h after bedtime and dosing. Polysomnographic recordings did not significantly differ between the groups, but the insomnia patients, treated or untreated, still reported subjective sleep complaints. Results show no differences in driving performance and driving-related skills between both groups of insomnia patients and controls. Driving performance in chronic users of hypnotics and untreated insomnia patients is not impaired. For chronic users, this may be due to prescription of relatively safe drugs and low doses. For untreated insomniacs, this corroborates previous findings showing an absence of neuropsychological deficits in this group of patients.

  12. Dynamics of cesium-134 and biomass in treated and untreated turkey oak leaf-litter bags

    International Nuclear Information System (INIS)

    Croom, J.M.; Ragsdale, H.L.

    1978-01-01

    Litter bags were prepared from leaves harvested in late fall from turkey oak trees (Quercus laevis) tagged with 134 Cs. Untreated bags and bags treated by soaking in 1000 ppM HgCl 2 were placed in the field on Dec. 7, 1974. Five bags of each treatment were retrieved at 7-, 14-, and 30-day intervals as the experiment progressed. Treated bags remained free of visible fungal hyphae growth for 12 weeks. Untreated bags had lost more weight but less 134 Cs than treated bags after 14 and 56 days, respectively. After 9 months, untreated bags had lost 33% weight and 90% 134 Cs. Although 134 Cs is rapidly leached from litter (ecological half-life approximately equal to 12 weeks), some is retained by fungal hyphae on leaf-litter surfaces. This mechanism of mineral retention in the litter layer could represent adaptation at the ecosystem level for nutrient conservation

  13. Improving production of treated and untreated verbs in aphasia: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Vânia de Aguiar

    2016-09-01

    Full Text Available BACKGROUND. Demographic and clinical predictors of aphasia recovery have been identified in the literature. However, little attention has been devoted to identifying and distinguishing predictors of improvement for different outcomes, e.g., production of treated vs. untreated materials. These outcomes may rely on different mechanisms, and therefore be predicted by different variables. Furthermore, treatment features are not typically accounted for when studying predictors of aphasia recovery. This is partly due to the small numbers of cases reported in studies, but also to limitations of data analysis techniques usually employed. METHOD. We reviewed the literature on predictors of aphasia recovery, and conducted a meta-analysis of single-case studies designed to assess the efficacy of treatments for verb production. The contribution of demographic, clinical, and treatment-related variables was assessed by means of Random Forests (a machine-learning technique used in classification and regression. Two outcomes were investigated: production of treated (for 142 patients and untreated verbs (for 166 patients. RESULTS. Improved production of treated verbs was predicted by a three-way interaction of pre-treatment scores on tests for verb comprehension and word repetition, and the frequency of treatment sessions. Improvement in production of untreated verbs was predicted by an interaction including the use of morphological cues, presence of grammatical impairment, pre-treatment scores on a test for noun comprehension and frequency of treatment sessions. CONCLUSION. Improvement in the production of treated verbs occurs frequently. It may depend on restoring access to and/or knowledge of lexeme representations, and requires relative sparing of semantic knowledge (as measured by verb comprehension and phonological output abilities (including working memory, as measured by word repetition. Improvement in the production of untreated verbs has not been

  14. Predictors of vertigo in patients with untreated vestibular schwannoma.

    Science.gov (United States)

    Andersen, Jan Fredrik; Nilsen, Kathrin Skorpa; Vassbotn, Flemming Slinning; Møller, Per; Myrseth, Erling; Lund-Johansen, Morten; Goplen, Frederik Kragerud

    2015-04-01

    Previous studies have shown that vertigo is the most powerful negative predictor of quality of life in patients with vestibular schwannomas, but the variability in vertigo symptom severity is still poorly understood. We wanted to find out whether vertigo could be related to objective parameters such as tumor size, location, vestibular nerve function, hearing, and postural stability in patients with untreated vestibular schwannomas. Baseline data from prospective cohort study. Tertiary referral center. Four hundred thirty-four consecutive patients with unilateral VS diagnosed on MRI. Mean age 56 years (range 16-84 yr). Fifty-three percent women. Diagnostic, with a medical history, otolaryngological examination, pure-tone and speech audiometry, MRI, posturography, and videonystagmography with bithermal caloric tests. Dizziness measured on a 100-mm visual analog scale (VAS). Secondary outcome measures were canal paresis and postural imbalance (static and dynamic posturography). Three hundred three patients (70%) completed the VAS. Severe dizziness, defined as VAS 75 or greater, was reported by 9% of the patients. Larger tumors were associated with higher risk of postural instability and canal paresis. Moderate to severe dizziness was associated with postural imbalance and canal paresis, and possibly with small to medium-sized tumors. Postural instability was related to tumor size and canal paresis when measured by dynamic, but not with static, posturography. A minority of VS patients experience severe vestibular symptoms related to canal paresis and postural instability. A curvilinear relationship is hypothesized between tumor size and dizziness.

  15. Limitations of fecal calprotectin at diagnosis in untreated pediatric Crohn's disease

    DEFF Research Database (Denmark)

    Shaoul, Ron; Sladek, Marlgozata; Turner, Dan

    2012-01-01

    Fecal Calprotectin (FC) is a validated screening test for intestinal inflammation in Crohn's disease (CD). The objective of the study was to prospectively evaluate the limitations of FC for identifying CD in newly diagnosed untreated pediatric patients and to assess the association of FC levels w...

  16. Staging of bronchogenic carcinoma by computerized tomography

    International Nuclear Information System (INIS)

    Sommer, B.; Bauer, W.M.; Rath, M.; Fenzl, G.; Stelter, W.J.; Lissner, J.

    1981-01-01

    It was possible to check the information obtained by CT scanning in 36 patients out of 49 who had been subjected to computerized tomography, in respect of the extension of the primary tumour (T stage), and in 25 patients in respect of the degree of mediastinal lymphatic node involvement (N stage). In all 49 patients, the presence of bronchogenic carcinoma had been safely established. In 97% of the cases, assessment of the extension of the primary tumour was found to be correct. Assessment of the N stage, however, is more problematic, since detection of mediastinal lymphatic nodes by computerized tomography does not necessarily tell us something about their metastatic involvement. If all recognizable lymphatic nodes are interpreted as potential metastases, we have no false negative but 61% false positive results because of the frequency of postinflammatory or anthracotic lymphatic nodes. In case of exclusive assessment of lymphatic node enlargement above 1 cm diameter, the rate of metastatic nodes increases considerably (83%). Computerized tomography is definitely superior to all roentgenological methods in assessing the stage of a bronchogenic carcinoma; hence, it could occupy a key position in determining the diagnostic and therapeutic approach in patients with this disease. (orig.) [de

  17. Prospective memory and its correlates and predictors in schizophrenia: an extension of previous findings.

    Science.gov (United States)

    Ungvari, Gabor S; Xiang, Yu-Tao; Tang, Wai-Kwong; Shum, David

    2008-09-01

    Prospective memory (PM) is the ability to remember to do something in the future without explicit prompts. Extending the number of subjects and the scope of our previously published study, this investigation examined the relationship between PM and socio-demographic and clinical factors, activities of daily living (ADL) and frontal lobe functions in patients with chronic schizophrenia. One hundred and ten Chinese schizophrenia patients, 60 from the previous study and 50 additional patients recruited for this study, and 110 matched healthy comparison subjects (HC) formed the study sample. Patients' clinical condition and activity of daily living were evaluated with the Brief Psychiatric Rating Scale (BPRS) and the Functional Needs Assessment (FNA). Time- and event-based PM tasks and three tests of prefrontal lobe functions (Design Fluency Test [DFT], Tower of London [TOL], Wisconsin Card Sorting Test [WCST]) were also administered. Patients' level of ADL and psychopathology were not associated with PM functions and only anticholinergic medications (ACM) showed a significant negative correlational relationship with PM tasks. Confirming the findings of the previous study, patients performed significantly more poorly on all two PM tasks than HC. Performance on time-based PM task significantly correlated with age, education level and DFT in HC and with age, DFT, TOL and WCST in patients. Patients' performance on the event-based PM correlated with DFT and one measure of WCST. In patients, TOL and age predicted the performance on time-based PM task; DFT and WCST predicted the event-based task. Involving a large sample of patients with matched controls, this study confirmed that PM is impaired in chronic schizophrenia. Deficient PM functions were related to prefrontal lobe dysfunction in both HC and patients but not to the patients' clinical condition, nor did they significantly affect ADL. ACMs determined certain aspects of PM.

  18. Computerized tomography for diagnosis and staging of renal pelvic tumor

    International Nuclear Information System (INIS)

    Fukuoka, Hiroshi; Goto, Akihiko; Kitamura, Hajime

    1985-01-01

    Although we have no definite criteria available yet for clinical staging of renal pelvic tumor, the preoperative staging of this disease is nevertheless important in view of the current tendency that the necessity for renal conservative operation is considered. CT is now a routine work also for diagnosing renal pelvic tumor. The present study was performed in order to validate its usefulness for diagnosing and staging the disease. Our series consisted of 8 patients with renal pelvic tumor, in 6 of whom a definite diagnosis was established after demonstrating filling defect on pyelogram, but in the remaining two with extensive infiltration, and squamous cell carcinoma associated with staghorn calculus respectively, CT failed to provide a definite diagnosis. CT findings of an extension of the mass in the renal pelvis or renal calyces into adipose tissue of the renal sinus or renal parenchyma were judged to indicate an invasive type (Stage III), while a non-invasive type (Stage I or II) was defined on the basis of otherwise CT findings. Consistency with pathological stages was noted in 7 of the 8 cases (87.5 %). It was difficult to differentiate Stage I and Stage II on CT findings. CT was considered to be extremely useful tool for preoperative staging of renal pelvic tumor. (author)

  19. Hepatopathy in an adult, secondary to congenital untreated panhypopituitarism and ectopic posterior pituitary gland

    Directory of Open Access Journals (Sweden)

    Miguel A Valle-Murillo

    2012-01-01

    Full Text Available We report a rare case of an adult with advanced liver failure in the setting of an untreated congenital panhypopituitarism. A 32-years-old man presented with a newly onset seizure episode secondary to hypoglycemia. In the initial exploration, we found eunuchoid habitus, absence of secondary sexual characteristics, ascites, and hepatic encephalopathy. Hormonal evaluation confirmed the absence of anterior hypophyseal hormones and the liver function tests showed derangement of liver function. Magnetic Resonance Imaging (MRI showed hypoplastic adenohypophysis and ectopic posterior pituitary gland. In the approach to liver disease, no cause was identified, besides the untreated panhypopituitarism.

  20. Hepatopathy in an adult, secondary to congenital untreated panhypopituitarism and ectopic posterior pituitary gland.

    Science.gov (United States)

    Valle-Murillo, Miguel A; Perez-Diaz, Ivan

    2012-09-01

    We report a rare case of an adult with advanced liver failure in the setting of an untreated congenital panhypopituitarism. A 32-years-old man presented with a newly onset seizure episode secondary to hypoglycemia. In the initial exploration, we found eunuchoid habitus, absence of secondary sexual characteristics, ascites, and hepatic encephalopathy. Hormonal evaluation confirmed the absence of anterior hypophyseal hormones and the liver function tests showed derangement of liver function. Magnetic Resonance Imaging (MRI) showed hypoplastic adenohypophysis and ectopic posterior pituitary gland. In the approach to liver disease, no cause was identified, besides the untreated panhypopituitarism.

  1. Ipilimumab 10 mg/kg versus ipilimumab 3 mg/kg in patients with unresectable or metastatic melanoma

    DEFF Research Database (Denmark)

    Ascierto, Paolo A; Del Vecchio, Michele; Robert, Caroline

    2017-01-01

    of ipilimumab 10 mg/kg versus 3 mg/kg. METHODS: This randomised, double-blind, multicentre, phase 3 trial was done in 87 centres in 21 countries worldwide. Patients with untreated or previously treated unresectable stage III or IV melanoma, without previous treatment with BRAF inhibitors or immune checkpoint...

  2. Features and prognostic impact of distant metastases in 45 dogs with de novo stage IV cutaneous mast cell tumours: A prospective study.

    Science.gov (United States)

    Pizzoni, S; Sabattini, S; Stefanello, D; Dentini, A; Ferrari, R; Dacasto, M; Giantin, M; Laganga, P; Amati, M; Tortorella, G; Marconato, L

    2018-03-01

    Distant metastases in dogs with cutaneous mast cell tumors (cMCT) are rare and incurable. The aims of this prospective study were to clarify the clinico-pathological features of stage IV cMCTs and to identify possible prognostic factors for progression-free interval (PFI) and survival time (ST). Dogs were eligible for recruitment if they had a previously untreated, histologically confirmed cMCT and if they underwent complete staging demonstrating stage IV disease. Dogs were uniformly followed-up, whereas treatment was not standardized and included no therapy, surgery, radiation therapy, chemotherapy, tyrosine-kinase inhibitors or a combination of these. 45 dogs with stage IV cMCT were enrolled. All dogs had distant metastatic disease, and 41 (91.1%) dogs had also metastasis in the regional lymph node. Histopathological grade and mutational status greatly varied among dogs. Median ST was 110 days. Notably, PFI and ST were independent of well-known prognostic factors, including anatomic site, histological grade, and mutational status. Conversely, tumor diameter >3 cm, more than 2 metastatic sites, bone marrow infiltration, and lack of tumor control at the primary site were confirmed to be negative prognostic factors by multivariate analysis. Currently, there is no satisfactory treatment for stage IV cMCT. Asymptomatic dogs with tumor diameter <3 cm and a low tumor burden, without bone marrow infiltration may be candidates for multimodal treatment. Stage IV dogs without lymph node metastasis may enjoy a surprisingly prolonged survival. The achievement of local tumor control seems to predict a better outcome in dogs with stage IV cMCT. © 2017 John Wiley & Sons Ltd.

  3. Pleural tuberculosis in a patient with untreated type 1 Gaucher disease.

    Science.gov (United States)

    Dulgar, Ozgecan; Eskazan, Ahmet Emre; Ersen, Ezel; Demiroz, Ahu Senem; Turna, Akif; Oz, Buge; Tuzuner, Nukhet

    2016-01-01

    Gaucher disease (GD) is an autosomal recessive glycolipid storage disorder, due to deficiency of the lysosomal enzyme glucocerebrosidase, leading to accumulation of the substrate glucocerebroside in the cells of the macrophage-monocyte system. Patients with GD have alteration in their immune system and impaired microbicidal capacity of mononuclear phagocytes. It has also been demonstrated that monocyte dysfunction may correlate with the plasma glucocerebrosidase concentrations. Tuberculosis (TB) is a major public health problem in developing countries. Pleural TB is one of the most common forms of extra-pulmonary TB. Since immune system can be impaired due to the deficiency of glucocerebrosidase in various ways, TB can be observed in patients with GD especially when left untreated. Cytopenia(s) is also general finding in untreated Gaucher patients, and they may be observed most frequently due to the infiltration of the bone marrow with Gaucher cells together with the additional factor of splenomegaly. We herein present a case of an adult patient with heterozygous untreated GD1, who developed pleural TB complicated by ipsilateral pulmonary fibrosis. Before his admission to our clinic, pleurectomy operation was performed and 4-drug combination anti-TB therapy was initiated including isoniazid, rifampicin, ethambutol and pyrazinamide. Fever complaint was disappeared with anti-TB treatment but he also had fatigue and pain. After initiation of enzyme replacement therapy in addition to anti-TB treatment, clinical and hematological improvement was observed. To our knowledge, this is the first reported case of GD1 with pleural TB. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  4. Progression of Treated versus Untreated Liver Imaging Reporting and Data System Category 4 Masses after Transcatheter Arterial Embolization Therapy.

    Science.gov (United States)

    Ronald, James; Gupta, Rajan T; Marin, Daniele; Wang, Qi; Durocher, Nicholas S; Suhocki, Paul V; Kim, Charles Y

    2018-05-01

    To compare outcomes of treated vs untreated Liver Imaging Reporting and Data System category 4 (LR-4) masses after transcatheter arterial embolization. In 167 patients undergoing embolization for HCC from January 2005 to December 2012, LR-4 masses were retrospectively identified on CT and MR imaging examinations performed before embolization. In 149 patients undergoing embolization from January 2013 to December 2016, masses prospectively classified as LR-4 were identified. In total, there were 81 LR-4 masses in 62 patients (16 women; mean age 62 y; range 29-83 y). Procedures were reviewed to determine whether LR-4 masses were within or outside the liver volume that received embolization during treatment of dominant masses. Time to progression to LR-5 and by modified Response Evaluation Criteria in Solid Tumors (mRECIST) was estimated for treated vs untreated LR-4 masses using the Kaplan-Meier method and compared using the log rank test. LR-4 masses averaged 1.8 cm; 88%, 60%, 14%, and 14% demonstrated arterial phase hyperenhancement, washout, a capsule, and growth. Of LR-4 masses, 62 were within the liver volume that received embolization and considered treated, and 19 were outside and considered untreated. Response rates according to mRECIST were 37% vs 21% for treated vs untreated masses (P = .27). The 6- and 12-month rates of progression to LR-5 were 7% and 26% for treated masses vs 27% and 75% for untreated masses (P = .001). According to mRECIST, 7% and 27% of treated masses progressed vs 30% and 65% of untreated masses (P = .001). LR-4 masses that receive embolization in the setting of dominant masses elsewhere show lower rates of progression compared with untreated masses. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  5. Improving Production of Treated and Untreated Verbs in Aphasia : A Meta-Analysis

    NARCIS (Netherlands)

    de Aguiar, Vânia; Bastiaanse, Roelien; Miceli, Gabriele

    2016-01-01

    Background: Demographic and clinical predictors of aphasia recovery have been identified in the literature. However, little attention has been devoted to identifying and distinguishing predictors of improvement for different outcomes, e.g., production of treated vs. untreated materials. These

  6. Prevalence, species differentiation, haemolytic activity, and antibiotic susceptibility of aeromonads in untreated well water

    Directory of Open Access Journals (Sweden)

    Khalifa Sifaw Ghenghesh

    2001-02-01

    Full Text Available The use of untreated water for drinking and other activities have been associated with intestinal and extraintestinal infections in humans due to Aeromonas species. In the present study aeromonads were isolated from 48.7% of 1,000 water samples obtained from wells and other miscellaneous sources. Aeromonas species were detected in 45% of samples tested in spring, 34.5% in summer, 48% in autumn and 60% of samples tested in winter. Speciation of 382 strains resulted in 225 (59% being A. hydrophila, 103 (27% A. caviae, 42 (11% A. sobria and 11 (3% atypical aeromonads. Of 171 Aeromonas strains tested for their haemolytic activity, 53%, 49%, 40% and 37% were positive in this assay using human, horse, sheep and camel erythrocytes respectively. The results obtained indicate that potentially enteropathogenic Aeromonas species are commonly present in untreated drinking water obtained from wells in Libya (this may also apply to other neighbouring countries which may pose a health problem to users of such water supplies. In addition, ceftriaxone and ciprofloxacin are suitable drugs that can be used in the treatment of Aeromonas-associated infections, particularly in the immunocompromised, resulting from contact with untreated sources of water.

  7. Assessment of Physical and Mechanical Properties of Cement Panel Influenced by Treated and Untreated Coconut Fiber Addition

    Science.gov (United States)

    Abdullah, Alida; Jamaludin, Shamsul Baharin; Anwar, Mohamed Iylia; Noor, Mazlee Mohd; Hussin, Kamarudin

    This project was conducted to produce a cement panel with the addition of treated and untreated coconut fiber in cement panel. Coconut fiber was added to replace coarse aggregate (sand) in this cement panel. In this project, the ratios used to design the mixture were 1:1:0, 1:0.97:0.03, 1:0.94:0.06, 1:0.91:0.09 (cement: sand: coconut fiber). The water cement ratio was constant at 0.55. The sizes of sample tested were, 160 mm x 40 mm x 40 mm for compression test, and 100 mm x 100 mm x 40 mm for density, moisture content and water absorption tests. After curing samples for 28 days, it was found that the addition of coconut fiber, further increase in compressive strength of cement panel with untreated coconut fiber. Moisture content of cement panel with treated coconut fiber increased with increasing content of coconut fiber whereas water absorption of cement panel with untreated coconut fiber increased with increasing content of coconut fiber. The density of cement panel decreased with the addition of untreated and treated coconut fiber.

  8. Dominant Fecal Microbiota in Newly Diagnosed Untreated Inflammatory Bowel Disease Patients

    Directory of Open Access Journals (Sweden)

    Lill Therese Thorkildsen

    2013-01-01

    Full Text Available Our knowledge about the microbiota associated with the onset of IBD is limited. The aim of our study was to investigate the correlation between IBD and the fecal microbiota for early diagnosed untreated patients. The fecal samples used were a part of the Inflammatory Bowel South-Eastern Norway II (IBSEN II study and were collected from CD patients (n=30, UC patients (n=33, unclassified IBD (IBDU patients (n=3, and from a control group (n=34. The bacteria associated with the fecal samples were analyzed using a direct 16S rRNA gene-sequencing approach combined with a multivariate curve resolution (MCR analysis. In addition, a 16S rRNA gene clone library was prepared for the construction of bacteria-specific gene-targeted single nucleotide primer extension (SNuPE probes. The MCR analysis resulted in the recovery of five pure components of the dominant bacteria present: Escherichia/Shigella, Faecalibacterium, Bacteroides, and two components of unclassified Clostridiales. Escherichia/Shigella was found to be significantly increased in CD patients compared to control subjects, and Faecalibacterium was found to be significantly reduced in CD patients compared to both UC patients and control subjects. Furthermore, a SNuPE probe specific for Escherichia/Shigella showed a significant overrepresentation of Escherichia/Shigella in CD patients compared to control subjects. In conclusion, samples from CD patients exhibited an increase in Escherichia/Shigella and a decrease in Faecalibacterium indicating that the onset of the disease is associated with an increase in proinflammatory and a decrease in anti-inflammatory bacteria.

  9. Expression of c-Fos in the rat retrosplenial cortex during instrumental re-learning of appetitive bar-pressing depends on the number of stages of previous training

    Science.gov (United States)

    Svarnik, Olga E.; Bulava, Alexandra I.; Alexandrov, Yuri I.

    2013-01-01

    Learning is known to be accompanied by induction of c-Fos expression in cortical neurons. However, not all neurons are involved in this process. What the c-Fos expression pattern depends on is still unknown. In the present work we studied whether and to what degree previous animal experience about Task 1 (the first phase of an instrumental learning) influenced neuronal c-Fos expression in the retrosplenial cortex during acquisition of Task 2 (the second phase of an instrumental learning). Animals were progressively shaped across days to bar-press for food at the left side of the experimental chamber (Task 1). This appetitive bar-pressing behavior was shaped by nine stages (“9 stages” group), five stages (“5 stages” group) or one intermediate stage (“1 stage” group). After all animals acquired the first skill and practiced it for five days, the bar and feeder on the left, familiar side of the chamber were inactivated, and the animals were allowed to learn a similar instrumental task at the opposite side of the chamber using another pair of a bar and a feeder (Task 2). The highest number of c-Fos positive neurons was found in the retrosplenial cortex of “1 stage” animals as compared to the other groups. The number of c-Fos positive neurons in “5 stages” group animals was significantly lower than in “1 stage” animals and significantly higher than in “9 stages” animals. The number of c-Fos positive neurons in the cortex of “9 stages” animals was significantly higher than in home caged control animals. At the same time, there were no significant differences between groups in such behavioral variables as the number of entrees into the feeder or bar zones during Task 2 learning. Our results suggest that c-Fos expression in the retrosplenial cortex during Task 2 acquisition was influenced by the previous learning history. PMID:23847484

  10. Spatial structure of extensive air showers near the axis

    Energy Technology Data Exchange (ETDEWEB)

    Alekseev, E N; Gal' perin, M D; Glemba, P Ya [AN SSSR, Moscow. Inst. Yadernykh Issledovanij; Moskovskij Gosudarstvennyj Univ. (USSR). Nauchno-Issledovatel' skij Inst. Yadernoj Fiziki; Consiglio Nazionale delle Ricerche, Turin (Italy). Lab. di Cosmo-Geofisica)

    1978-07-01

    The spatial structure of the extensive air showers has been investigated. The tests have been staged on the 400 scintillation counter installation. It has been shown, that spatial distribution of the extensive air showers in the vicinity of the axis does not vary in case of the Nsub(e) electron number showers in the 10/sup 5/-10/sup 6/ range. The share of the showers having a clear-cut multicore structure is approximately 3% with Nsub(e) >= 2x10/sup 5/.

  11. Decreasing systolic blood pressure and declining mortality rates in an untreated population

    DEFF Research Database (Denmark)

    Andersen, Ulla O; Marott, Jacob L; Jensen, Gorm B

    2011-01-01

    The aim of the present study was to evaluate developments in 30 years mortality risk that may be associated with developments in population systolic blood pressure (SBP) and to evaluate possible secular trends in BP-associated mortality risk in the untreated population....

  12. Vital Signs: Dental Sealant Use and Untreated Tooth Decay Among U.S. School-Aged Children.

    Science.gov (United States)

    Griffin, Susan O; Wei, Liang; Gooch, Barbara F; Weno, Katherine; Espinoza, Lorena

    2016-10-21

    Tooth decay is one of the greatest unmet treatment needs among children. Pain and suffering associated with untreated dental disease can lead to problems with eating, speaking, and learning. School-based dental sealant programs (SBSP) deliver a highly effective intervention to prevent tooth decay in children who might not receive regular dental care. SBSPs benefits exceed their costs when they target children at high risk for tooth decay. CDC used data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014 to estimate current prevalences of sealant use and untreated tooth decay among low-income (≤185% of federal poverty level) and higher-income children aged 6-11 years and compared these estimates with 1999-2004 NHANES data. The mean number of decayed and filled first molars (DFFM) was estimated for children with and without sealants. Averted tooth decay resulting from increasing sealant use prevalence was also estimated. All reported differences are significant at pdental sealant use has increased; however, most children have not received sealants. Increasing sealant use prevalence could substantially reduce untreated decay, associated problems, and dental treatment costs.

  13. Treated and Untreated Remission from Problem Drinking in Late Life: Post-Remission Functioning and Health-Related Quality of Life

    Science.gov (United States)

    Schutte, Kathleen K.; Brennan, Penny L.; Moos, Rudolf H.

    2009-01-01

    Objective To evaluate the post-remission status of older remitted problem drinkers who achieved stable remission without treatment. Method The post-remission drinking behavior, health-related functioning, life context, coping, and help-seeking of older, untreated (n = 330) and treated (n = 120) former problem drinkers who had been remitted for a minimum of six years were compared twice over the course of six-years to each other and to lifetime nonproblem drinkers (n = 232). Analyses considered the impact of severity of drinking problem history. Results Untreated remitters were more likely than treated remitters to continue to drink, exhibited fewer chronic health problems and less depressive symptomatology, and were less likely to smoke. Untreated remitters’ life contexts were somewhat more benign than those of treated ones, and they were less likely to describe a coping motive for drinking and engage in post-remission help-seeking. Although untreated remitters more closely resembled lifetime nonproblem drinkers than did treated remitters, both untreated and treated remitter groups exhibited worse health-related functioning, more financial and interpersonal stressors, and more post-remission help-seeking than did lifetime nonproblem drinkers. Conclusions Regardless of whether late-life remission was gained without or with treatment, prior drinking problems conveyed a legacy of health-related and life context deficits. PMID:18829184

  14. Effect of untreated and treated sewage wastewater by chloride or irradiation on growth of some plants and soil characteristics

    International Nuclear Information System (INIS)

    Takriti, S.; Khalifa, K.

    2003-12-01

    Pot experiments were conducted at Deir-Alhajar research station, about 40 km. south east of Damascus during 2000. Corn. eggplant and parsley were planted in plastic pots capacity 8 kg soil to study the effect of irrigation of corn, eggplant and parsley by untreated and treated sewage water (by Chloride or Irradiation) on growth and effect of irrigation on soil characteristics and accumulation of some heavy metals such as Pb, Cr, Co, Hg, and Zn, Cu in plant and soil which irrigated with treated and untreated sewage water compared with irrigated with fresh water (well water). The results showed that no negative effect was observed for untreated and treated sewage water on growth of plants (corn, eggplant and parsley). Also, no significant effect due to irrigation with treated and untreated sewage water was observed in accumulation of some trace elopements (heavy metals) such as Cr, Pb, Hg, and Zn and Cu in plants irrigated with treated and untreated sewage water to critical toxic point. This point needed more studies and longer period to confirm these results before using by farmers on large scale. Irradiation of sewage water had a positive effect on reducing the transfer of some heavy toxic metals such as Pb and Cr form waste water to soil. (author)

  15. Staging cancer of the uterus: A national audit of MRI accuracy

    International Nuclear Information System (INIS)

    Duncan, K.A.; Drinkwater, K.J.; Frost, C.; Remedios, D.; Barter, S.

    2012-01-01

    Aim: To report the results of a nationwide audit of the accuracy of magnetic resonance imaging (MRI) staging in uterine body cancer when staging myometrial invasion, cervical extension, and lymph node spread. Materials and methods: All UK radiology departments were invited to participate using a web-based tool for submitting anonymized data for a 12 month period. MRI staging was compared with histopathological staging using target accuracies of 85, 86, and 70% respectively. Results: Of the departments performing MRI staging of endometrial cancer, 37/87 departments contributed. Targets for MRI staging were achieved for two of the three standards nationally with diagnostic accuracy for depth of myometrial invasion, 82%; for cervical extension, 90%; and for pelvic nodal involvement, 94%; the latter two being well above the targets. However, only 13/37 (35%) of individual centres met the target for assessing depth of myometrial invasion, 31/36 (86%) for cervical extension and 31/34 (91%) for pelvic nodal involvement. Statistical analysis demonstrated no significant difference for the use of intravenous contrast medium, but did show some evidence of increasing accuracy in assessment of depth of myometrial invasion with increasing caseload. Conclusion: Overall performance in the UK was good, with only the target for assessment of depth of myometrial invasion not being met. Inter-departmental variation was seen. One factor that may improve performance in assessment of myometrial invasion is a higher caseload. No other clear factor to improve performance were identified.

  16. Staging cancer of the uterus: A national audit of MRI accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Duncan, K.A., E-mail: k.duncan@nhs.net [Clinical Radiology Audit Committee, Royal College of Radiologists, London (United Kingdom); Drinkwater, K.J. [Clinical Radiology Audit Committee, Royal College of Radiologists, London (United Kingdom); Frost, C. [Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Keppel Street, London (United Kingdom); Remedios, D.; Barter, S. [Clinical Radiology Audit Committee, Royal College of Radiologists, London (United Kingdom)

    2012-06-15

    Aim: To report the results of a nationwide audit of the accuracy of magnetic resonance imaging (MRI) staging in uterine body cancer when staging myometrial invasion, cervical extension, and lymph node spread. Materials and methods: All UK radiology departments were invited to participate using a web-based tool for submitting anonymized data for a 12 month period. MRI staging was compared with histopathological staging using target accuracies of 85, 86, and 70% respectively. Results: Of the departments performing MRI staging of endometrial cancer, 37/87 departments contributed. Targets for MRI staging were achieved for two of the three standards nationally with diagnostic accuracy for depth of myometrial invasion, 82%; for cervical extension, 90%; and for pelvic nodal involvement, 94%; the latter two being well above the targets. However, only 13/37 (35%) of individual centres met the target for assessing depth of myometrial invasion, 31/36 (86%) for cervical extension and 31/34 (91%) for pelvic nodal involvement. Statistical analysis demonstrated no significant difference for the use of intravenous contrast medium, but did show some evidence of increasing accuracy in assessment of depth of myometrial invasion with increasing caseload. Conclusion: Overall performance in the UK was good, with only the target for assessment of depth of myometrial invasion not being met. Inter-departmental variation was seen. One factor that may improve performance in assessment of myometrial invasion is a higher caseload. No other clear factor to improve performance were identified.

  17. Duration of untreated psychosis/illness and brain volume changes in early psychosis.

    Science.gov (United States)

    Rapp, Charlotte; Canela, Carlos; Studerus, Erich; Walter, Anna; Aston, Jacqueline; Borgwardt, Stefan; Riecher-Rössler, Anita

    2017-09-01

    The time period during which patients manifest psychotic or unspecific symptoms prior to treatment (duration of untreated psychosis, DUP, and the duration of untreated illness, DUI) has been found to be moderately associated with poor clinical and social outcome. Equivocal evidence exists of an association between DUP/DUI and structural brain abnormalities, such as reduced hippocampus volume (HV), pituitary volume (PV) and grey matter volume (GMV). Thus, the goal of the present work was to examine if DUP and DUI are associated with abnormalities in HV, PV and GMV. Using a region of interest (ROI) based approach, we present data of 39 patients from the Basel FePsy (Früherkennung von Psychosen, early detection of psychosis) study for which information about DUP, DUI and HV, PV and GMV data could be obtained. Twenty-three of them were first episode psychosis (FEP) and 16 at-risk mental state (ARMS) patients who later made the transition to frank psychosis. In unadjusted analyses, we found a significant positive correlation between DUP and PV in FEP patients. However, when adjusted for covariates, we found no significant correlation between DUP or DUI and HV, PV or GMV anymore. There only was a trend for decreasing GMV with increasing DUI in FEP. Our results do not comprehensively support the hypothesis of a "toxic" effect of the pathogenic mechanism underlying untreated psychosis on brain structure. If there is any effect, it might rather occur very early in the disease process, during which patients experience only unspecific symptoms. Copyright © 2017. Published by Elsevier B.V.

  18. Human norovirus in untreated sewage and effluents from primary, secondary and tertiary treatment processes.

    Science.gov (United States)

    Campos, Carlos J A; Avant, Justin; Lowther, James; Till, Dale; Lees, David N

    2016-10-15

    Wastewater treatments are considered important means to control the environmental transmission of human norovirus (NoV). Information about NoV concentrations in untreated and treated effluents, their seasonality and typical removal rates achieved by different treatment processes is required to assess the effectiveness of sewage treatment processes in reducing human exposure to NoV. This paper reports on a characterisation of concentrations of NoV (genogroups I and II) in untreated sewage (screened influent) and treated effluents from five full scale wastewater treatment works (WwTW) in England. Results are shown for effluent samples characteristic of primary- (primary settlement, storm tank overflows), secondary- (activated sludge, trickling filters, humus tanks) and tertiary (UV disinfection) treatments. NoV occurrence in untreated sewage varied between years. This variation was consistent with the annual variation of the virus in the community as indicated by outbreak laboratory reports. Significant differences were found between mean NoV concentrations in effluents subject to different levels of treatment. Primary settlement achieved approximately 1 log10 removal for both genogroups. Concentrations of NoV and Escherichia coli in untreated sewage were of the same order of magnitude of those in storm tank overflows. Of the secondary treatments studied, activated sludge was the most effective in removing NoV with mean log10 removals of 3.11 and 2.34 for GI and GII, respectively. The results of this study provide evidence that monitoring of NoV in raw sewage or treated effluents could provide early warning of an elevated risk for NoV and potentially help prevent outbreaks through environmental exposure. They also provide evidence that elimination of stormwater discharges and improvement of the efficiency of activated sludge for NoV removal would be effective for reducing the risk of environmental transmission. Crown Copyright © 2016. Published by Elsevier Ltd. All

  19. Bacterial Community Dynamics and Biodegradation Rates in Untreated and Oily Soils During PAH Exposure

    International Nuclear Information System (INIS)

    Zakaria, A.E.M.

    2008-01-01

    The approach taken in this study represents an attempt to address the possible selective effects of Polycyclic aromatic hydrocarbons (PAH) on the bacterial community structure of an untreated garden soil (S) and a chronically contaminated oily soil (CS). Untreated and chronically hydrocarbon polluted soils, collected from Egypt were enriched in shaking flasks containing 50 mg/l anthracene as a sole source of carbon over a period of 15 days. Bacterial communities in each soil were profiled by denaturing gradient gel electrophoresis (DGGE) analysis of the PCR amplified 16 S r DNA gene fragments after 0, 5, 10, and 15 days. Culture able biodegrading bacterial counts on minerals- Silica gel- Oil (MSD) plates as well as anthracene degradation for both soils were followed up at the same time intervals. Nine bacterial species were found to be dominant in the pristine soil before enrichment with the model polycyclic aromatic hydrocarbon (PAH), eight of them disappeared after live days of enrichment with the domination of one new species. It stayed dominant in soil until 15 days - exposure to anthracene. Therefore it can be used as a bio marker for PAH pollution. The chronically contaminated soil revealed a remarkable increase in the diversity directly after 5 days exposure to PAH HPLC analysis of the extracted anthracene remained in the biodegradation flasks after different degradation periods revealed that a higher biodegradation rates were accomplished by the oily soil consortium rather than by the pristine one. Before exposure to PAH, counts of culture able biodegrading bacteria were found to be higher in the untreated soil rather than in the oily one. After exposure the situation has been a bit altered as the counts in the untreated soil revealed a temporary suppression with a prolongation of the time required for growth as a result of the hydrocarbon stress

  20. Trace element accumulation and distribution in sunflower plants at the stages of flower bud and maturity

    Directory of Open Access Journals (Sweden)

    Susanna De Maria

    2013-02-01

    Full Text Available The aim of this study was to analyze the accumulation and distribution of cadmium (Cd, zinc (Zn and copper (Cu in different portions of plants of sunflower (Helianthus annuus L., cv. Oleko grown in soil with contaminants (5, 300, 400 mg kg–1 of Cd, Zn and Cu, respectively and without (untreated soil as a control from the emergence of cotyledon leaves until to two phenological stages: flower bud (R-1 and maturity (R- 9. Sunflower accumulated considerable amounts of heavy metals in both phenological stages showing slight reductions of dry matter production. At R-1 stage, Cd, Zn and Cu were accumulated mainly in the roots with concentrations respectively up to 5.4, 233 and 160 mg kg–1 of dry matter with a low translocation from roots to the aerial part. Yet at the R-1 stage, the bioconcentration factor (BCF of Cd showed a significantly higher value in the Cd-Zn-Cu treatment (0.27 with respect to the untreated control (0.02, vice versa was observed for Cu, whereas no significant difference between treatments was observed for Zn (0.12 on average. However among metals, Cd showed the highest value of BCF. Referring only to the epigeous portion, differences in the accumulation and distribution of the three metals in the treated plants were found in both phenological stages; indeed passing from flower bud to the maturity stage, Cd, Zn and Cu concentrations increased in the stems and leaves, particularly in the old ones, whereas decreased in the heads. Metal accumulation in the achenes was very low and never exceed the toxicity threshold value considered for livestock. The high storage of heavy metals in roots and the probable re-translocation of the three metals along the plant during the growing cycle could be considered as a strategy of sunflower to preserve young metabolically-active leaves and reproductive organs from toxic metal concentrations.

  1. Randomized Controlled Trial Examining the Ripple Effect of a Nationally Available Weight Management Program on Untreated Spouses.

    Science.gov (United States)

    Gorin, Amy A; Lenz, Erin M; Cornelius, Talea; Huedo-Medina, Tania; Wojtanowski, Alexis C; Foster, Gary D

    2018-03-01

    For married couples, when one spouse participates in weight loss treatment, the untreated spouse can also experience weight loss. This study examined this ripple effect in a nationally available weight management program. One hundred thirty dyads were randomized to Weight Watchers (WW; n = 65) or to a self-guided control group (SG; n = 65) and assessed at 0, 3, and 6 months. Inclusion criteria were age ≥ 25 years, BMI 27 to 40 kg/m 2 (≥ 25 kg/m 2 for untreated spouses), and no weight loss contraindications. WW participants received 6 months of free access to in-person meetings and online tools. SG participants received a weight loss handout. Spouses did not receive treatment. Untreated spouses lost weight at 3 months (WW = -1.5 ± 2.9 kg; SG = -1.1 ± 3.3 kg) and 6 months (WW = -2.2 ± 4.2 kg; SG = -1.9 ± 3.6 kg), but weight losses did not differ by condition. Overall, 32.0% of untreated spouses lost ≥ 3% of initial body weight by 6 months. Baseline weight was significantly correlated within couples (r = 0.26; P ripple effect was found in untreated spouses in both formal and self-guided weight management approaches. These data suggest that weight loss can spread within couples, and that widely available lifestyle programs have weight loss effects beyond the treated individual. © 2018 The Authors. Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS).

  2. Treatment of extensive urethral hemangioma with KTP/532 laser.

    Science.gov (United States)

    Lauvetz, R W; Malek, R S; Husmann, D A

    1996-01-01

    Urethral hemangiomas are rare. They vary in size from pinpoint masses to extensive honeycomb-shape deformities leading to significant hematuria. For extensive lesions, therapeutic options have included extensive surgical resection and reconstruction or multistaged neodymium:yttrium-aluminum-garnet (Nd:YAG) laser photocoagulation. We report our experience with the use of potassium titanyl phosphate (KTP/532) laser for treatment of the extensive form. A 7-year-old boy presented with a 2-week history of urethral bleeding. He had extensive hemangiomas of the genital and perineal regions. Cystourethroscopy disclosed diffusely scattered honeycomb-shape hemangiomatous malformation of the anterior urethra. KTP/532 laser energy was delivered transurethrally to the hemangiomatous areas until they blanched. The Foley catheter was removed 24 hours postoperatively, and the patient voided clear urine without difficulty. He has remained trouble-free for more than 2 years. Judicious endoscopic single-stage therapy with KTP/532 laser may obviate open surgical intervention in most cases of extensive and symptomatic urethral hemangiomas. In view of our observation and the literature, KTP/532 laser therapy should be considered the first line of treatment.

  3. Chemical mixtures in untreated water from public-supply wells in the U.S. — Occurrence, composition, and potential toxicity

    International Nuclear Information System (INIS)

    Toccalino, Patricia L.; Norman, Julia E.; Scott, Jonathon C.

    2012-01-01

    Chemical mixtures are prevalent in groundwater used for public water supply, but little is known about their potential health effects. As part of a large-scale ambient groundwater study, we evaluated chemical mixtures across multiple chemical classes, and included more chemical contaminants than in previous studies of mixtures in public-supply wells. We (1) assessed the occurrence of chemical mixtures in untreated source-water samples from public-supply wells, (2) determined the composition of the most frequently occurring mixtures, and (3) characterized the potential toxicity of mixtures using a new screening approach. The U.S. Geological Survey collected one untreated water sample from each of 383 public wells distributed across 35 states, and analyzed the samples for as many as 91 chemical contaminants. Concentrations of mixture components were compared to individual human-health benchmarks; the potential toxicity of mixtures was characterized by addition of benchmark-normalized component concentrations. Most samples (84%) contained mixtures of two or more contaminants, each at concentrations greater than one-tenth of individual benchmarks. The chemical mixtures that most frequently occurred and had the greatest potential toxicity primarily were composed of trace elements (including arsenic, strontium, or uranium), radon, or nitrate. Herbicides, disinfection by-products, and solvents were the most common organic contaminants in mixtures. The sum of benchmark-normalized concentrations was greater than 1 for 58% of samples, suggesting that there could be potential for mixtures toxicity in more than half of the public-well samples. Our findings can be used to help set priorities for groundwater monitoring and suggest future research directions for drinking-water treatment studies and for toxicity assessments of chemical mixtures in water resources. - Highlights: ► We assessed mixtures in untreated groundwater samples from public-supply wells. ► A screening

  4. STAGE2 macroprocessor. [Implemented on ICL 1905 computer

    Energy Technology Data Exchange (ETDEWEB)

    Zimanyi, M

    1975-01-01

    STAGE2 is a general purpose language-independent macroprocessor, developed by W. M. Waite, mainly for implementing portable software. The macroprocessor, itself a piece of highly portable software, was implemented on the ICL 1905 computer by bootstrapping. This report can serve as a user's manual of STAGE2. Some examples of the application of the processor for language extension, language translation, and text generation are given. (auth)

  5. The course of untreated anxiety and depression, and determinants of poor one-year outcome: a one-year cohort study

    NARCIS (Netherlands)

    van Beljouw, I.M.J.; Verhaak, P.; Cuijpers, P.; van Marwijk, H.W.J.; Penninx, B.W.J.H.

    2010-01-01

    Background: Little is known about the course and outcome of untreated anxiety and depression in patients with and without a self-perceived need for care. The aim of the present study was to examine the one-year course of untreated anxiety and depression, and to determine predictors of a poor

  6. The course of untreated anxiety and depression, and determinants of poor one-year outcome: a one-year cohort study.

    NARCIS (Netherlands)

    Beljouw, I.M.J. van; Verhaak, P.F.M.; Cuijpers, P.; Marwijk, H.W.J. van; Penninx, B.W.J.H.

    2010-01-01

    Background: Little is known about the course and outcome of untreated anxiety and depression in patients with and without a self-perceived need for care. The aim of the present study was to examine the one-year course of untreated anxiety and depression, and to determine predictors of a poor

  7. The course of untreated anxiety and depression, and determinants of poor one-year outcome : a one-year cohort study

    NARCIS (Netherlands)

    van Beljouw, Ilse M. J.; Verhaak, Peter F. M.; Cuijpers, Pim; van Marwijk, Harm W. J.; Penninx, Brenda W. J. H.

    2010-01-01

    Background: Little is known about the course and outcome of untreated anxiety and depression in patients with and without a self-perceived need for care. The aim of the present study was to examine the one-year course of untreated anxiety and depression, and to determine predictors of a poor

  8. Radiologic techniques in staging malignant lymphoma

    International Nuclear Information System (INIS)

    Strijk, S.P.

    1987-01-01

    The main subject of this thesis is the evaluation of radiologic techniques in staging patients with newly diagnosed and untreated malignant lymphoma, or restaging patients with recurrent disease after a period of complete remission. Lymphography and, more recently, CT are available to examine the infradiaphragmatic nodes. CT also offers the possibility to examine other organ systems in the abdomen, and to visualize more lymph-node regions than lymphography. In ch. 2 and 4 the diagnostic performance of CT and lymphography in HD and NHL respectively are discussed. Literature data are summarized, and own results are given. The main goal is to determine whether the two methods are overlapping, competitive or complementary, and to answer the question what would be required for optimal staging. Staging laparotomy showed the unreliability of non-invasive examination methods for determining the presence or absence of lymphoma in the spleen. In ch. 3 and 5 the results of CT-based estimations of size of the spleen in relation to its histologic state, in patients with HD and NHL respectively are presented. The chest can be examined for lymphoma by conventional radiography, conventional tomography or computed tomography (CT). In ch. 6 the literature is reviewed, and the results with our patients are presented. The diagnostic performance of each examination is evaluated, and the results are analysed to define the most desirable approach in the examination of the chest for staging purposes. In ch. 7 the uncommon radiologic observation of calcification in lymph nodes, afflicted with HD and NHL is described. The literature is reviewed, and the clinical significance is indicated. 180 refs.; 22 figs.; 24 tabs

  9. Mathematical modeling of drying of pretreated and untreated pumpkin

    OpenAIRE

    Tunde-Akintunde, T. Y.; Ogunlakin, G. O.

    2011-01-01

    In this study, drying characteristics of pretreated and untreated pumpkin were examined in a hot-air dryer at air temperatures within a range of 40–80 °C and a constant air velocity of 1.5 m/s. The drying was observed to be in the falling-rate drying period and thus liquid diffusion is the main mechanism of moisture movement from the internal regions to the product surface. The experimental drying data for the pumpkin fruits were used to fit Exponential, General exponential, Logarithmic, Page...

  10. Compulsive buying disorder: an untreated patient for 20 years

    Directory of Open Access Journals (Sweden)

    Gonca Karakus

    2017-03-01

    Full Text Available Compulsive buying disorder is characterized by impulsive drives and compulsive behaviors (buying unneeded things, personal distress, impaired social and vocational functioning and financial problems. In this case report, we presented diagnostic and treatment process of 49 year old, female patient who had complaints amnesia, weight loss and insomnia. In her medical history, she had compulsive buying disorder for nearly twenty years but untreated until her current evaluation. Comorbid psychiatric disorders started in the last two months which expedited her current referral. [Cukurova Med J 2017; 42(1.000: 172-175

  11. Implant breast reconstruction after salvage mastectomy in previously irradiated patients.

    Science.gov (United States)

    Persichetti, Paolo; Cagli, Barbara; Simone, Pierfranco; Cogliandro, Annalisa; Fortunato, Lucio; Altomare, Vittorio; Trodella, Lucio

    2009-04-01

    The most common surgical approach in case of local tumor recurrence after quadrantectomy and radiotherapy is salvage mastectomy. Breast reconstruction is the subsequent phase of the treatment and the plastic surgeon has to operate on previously irradiated and manipulated tissues. The medical literature highlights that breast reconstruction with tissue expanders is not a pursuable option, considering previous radiotherapy a contraindication. The purpose of this retrospective study is to evaluate the influence of previous radiotherapy on 2-stage breast reconstruction (tissue expander/implant). Only patients with analogous timing of radiation therapy and the same demolitive and reconstructive procedures were recruited. The results of this study prove that, after salvage mastectomy in previously irradiated patients, implant reconstruction is still possible. Further comparative studies are, of course, advisable to draw any conclusion on the possibility to perform implant reconstruction in previously irradiated patients.

  12. Patterns and Determinants of Treatment Seeking among Previously Untreated Psychotic Patients in Aceh Province, Indonesia: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Marthoenis Marthoenis

    2016-01-01

    Full Text Available Immediate treatment of first-episode psychosis is essential in order to achieve a positive outcome. However, Indonesian psychiatric patients often delay accessing health services, the reason for which is not yet fully understood. The current study aimed to understand patterns of treatment seeking and to reveal determinants of the delay in accessing psychiatric care among first-time user psychotic patients. Qualitative interviews were conducted with sixteen family members who accompanied the patients to a psychiatric hospital. Many families expressed beliefs that mental illness appertains to village sickness and not hospital sickness; therefore, they usually take the patients to traditional or religious healers before taking them to a health professional. They also identified various factors that potentially delay accessing psychiatric treatment: low literacy and beliefs about the cause of the illness, stigmatisation, the role of extended family, financial problems, and long distance to the psychiatric hospital. On the other hand, the family mentioned various factors related to timely help seeking, including being a well-educated family, living closer to health facilities, previous experience of successful psychotic therapy, and having more positive symptoms of psychosis. The findings call for mental health awareness campaigns in the community.

  13. Natural History of Tuberculosis: Duration and Fatality of Untreated Pulmonary Tuberculosis in HIV Negative Patients: A Systematic Review

    Science.gov (United States)

    Tiemersma, Edine W.; van der Werf, Marieke J.; Borgdorff, Martien W.; Williams, Brian G.; Nagelkerke, Nico J. D.

    2011-01-01

    Background The prognosis, specifically the case fatality and duration, of untreated tuberculosis is important as many patients are not correctly diagnosed and therefore receive inadequate or no treatment. Furthermore, duration and case fatality of tuberculosis are key parameters in interpreting epidemiological data. Methodology and Principal Findings To estimate the duration and case fatality of untreated pulmonary tuberculosis in HIV negative patients we reviewed studies from the pre-chemotherapy era. Untreated smear-positive tuberculosis among HIV negative individuals has a 10-year case fatality variously reported between 53% and 86%, with a weighted mean of 70%. Ten-year case fatality of culture-positive smear-negative tuberculosis was nowhere reported directly but can be indirectly estimated to be approximately 20%. The duration of tuberculosis from onset to cure or death is approximately 3 years and appears to be similar for smear-positive and smear-negative tuberculosis. Conclusions Current models of untreated tuberculosis that assume a total duration of 2 years until self-cure or death underestimate the duration of disease by about one year, but their case fatality estimates of 70% for smear-positive and 20% for culture-positive smear-negative tuberculosis appear to be satisfactory. PMID:21483732

  14. FDG-PET imaging for the staging and follow-up of small cell lung cancer

    International Nuclear Information System (INIS)

    Schumacher, T.; Brink, I.; Mix, M.; Reinhardt, M.; Moser, E.; Nitzsche, E.; Herget, G.; Digel, W.; Henke, M.

    2001-01-01

    The staging procedures for small cell lung cancer do not differ appreciably from those for other forms of lung cancer. For practical purposes, the TNM stages are usually collapsed into a simple binary classification: limited disease and extensive disease. This study was performed to answer the question of whether fluorine-18 labelled 2-deoxy-2-D-glucose positron emission tomography (FDG-PET) imaging permits appropriate work-up (including both primary and follow-up staging) of patients presenting with small cell lung cancer, as compared with currently recommended staging procedures. Thirty-six FDG-PET examinations were performed in 30 patients with histologically proven small cell lung cancer. Twenty-four patients were examined for primary staging while four were imaged for therapy follow-up only. Two patients underwent both primary staging and up to four examinations for therapy follow-up. Static PET imaging was performed according to a standard protocol. Image reconstruction was based on an ordered subset expectation maximization algorithm including post-injection segmented attenuation correction. Results of FDG-PET were compared with those of the sum of other staging procedures. Identical results from FDG-PET and the sum of the other staging procedures were obtained in 23 of 36 examinations (6 x limited disease, 12 x extensive disease, 5 x no evidence of disease). In contrast to the results of conventional staging, FDG-PET indicated extensive disease resulting in an up-staging in seven patients. In one patient in whom there was no evidence for tumour on conventional investigations following treatment, FDG-PET was suggestive of residual viability of the primary tumour. Furthermore, discordant results were observed in five patients with respect to lung, bone, liver and adrenal gland findings, although in these cases the results did not affect staging as limited or extensive disease. Moreover, FDG-PET appeared to be more sensitive for the detection of metastatic

  15. Postobductional extension along and within the Frontal Range of the Eastern Oman Mountains

    Science.gov (United States)

    Mattern, Frank; Scharf, Andreas

    2018-04-01

    The Oman Mountains formed by late Cretaceous obduction of the Tethys-derived Semail Ophiolite. This study concerns the postobductional extension on the northern flank of the mountain belt. Nine sites at the northern margins of the Jabal Akhdar/Nakhl and Saih Hatat domes of the Eastern Oman ("Hajar") Mountains were investigated. The northern margins are marked by a system of major interconnected extensional faults, the "Frontal Range Fault". While the vertical displacements along the Saih Hatat and westerly located Jabal Nakhl domes measure 2.25-6.25 km, 0.5-4.5 km and 4-7 km, respectively, it amounts to 1-5 km along the Jabal Akhdar Dome. Extension had started during the late Cretaceous, towards the end of ophiolite emplacement. Two stages of extension can be ascertained (late Cretaceous to early Eocene and probably Oligocene) at the eastern part of the Frontal Range Fault System (Wadi Kabir and Fanja Graben faults of similar strike). Along the intervening and differently striking fault segments at Sad and Sunub the same two stages of deformation are deduced. The first stage is characterized again by extension. The second stage is marked by dextral motion, including local transtension. Probable Oligocene extension affected the Batinah Coast Fault while it also affected the Wadi Kabir Fault and the Fanja Graben. It is unclear whether the western portion of the Frontal Range Fault also went through two stages of deformation. Bedding-parallel ductile and brittle deformation is a common phenomenon. Hot springs and listwaenite are associated with dextral releasing bends within the fault system, as well as a basalt intrusion of probable Oligocene age. A structural transect through the Frontal Range along the superbly exposed Wadi Bani Kharous (Jabal Akhdar Dome) revealed that extension affected the Frontal Range at least 2.5 km south of the Frontal Range Fault. Also here, bedding-parallel shearing is important, but not exclusive. A late Cretaceous thrust was

  16. Plasma erythropoietin by high-detectability immunoradiometric assay in untreated and treated patients with polycythaemia vera and essential thrombocythaemia

    Energy Technology Data Exchange (ETDEWEB)

    Carneskog, J.; Kutti, J.; Wadenvik, H. [Univ. of Goeteborg, Sahlgrenska Univ. Hospital, Dept. of Medicine, Haematology Section (Sweden); Lundberg, P.A.; Lindstedt, G. [Univ. of Goeteborg, Sahlgrenska Univ. Hospital, Dept. of Clinical Chemistry and Transfusion Medicine (Sweden)

    1998-12-31

    By using an immunoradiometric method with a stated detection limit of {<=}1 IU/l (stated normal reference limit in adults 3.7-16 IU/l) we determined EDTA-plasma erythropoietin (EPO) in 58 patients with polycythaemia vera (PV) and 49 patients with essential thrombocythaemia (ET). At the time of blood sampling, 20 of the PV patients were newly diagnosed and untreated, 23 were treated by phlebotomy only, and 30 also received myelosuppressive treatment (with 32P, hydroxyurea of alpha-interferon). Of the ET patients 24 were untreated and 28 received myelosuppressive therapy. For comparison plasma EPO was also determined in 10 patients with pseudopolycythaemia (PP). In this latter group the results for plasma EPO agreed well with the cited normal reference limits. The majority of untreated PV patients (12/20) had undetectable plasma EPO concentration, and the remainder all had values below the lower normal reference limit. Plasma EPO in PV was not significantly influenced by phlebotomy therapy. Twelve of the 24 untreated ET patients (50%) had plasma EPO values below the reference interval (undetectable in 2 patients). The mean EPO concentration was significantly lower in PV patients receiving phlebotomy therapy than in patients with untreated ET. In the total material of PV and ET treated with myelosuppressive agents the PV patients showed significantly lower values for EPO concentration than did patients with ET. The present results support the view that EPO measurements by high-detectability methods are diagnostically useful and should be included in the panel of new criteria for the diagnosis of PV. (au) 20 refs.

  17. Altered metabolic incorporation of fucose and leucine into PNS myelin of 25-week-old diabetic (C57BL/Ks [db/db]) mice: effects of untreated diabetes on nerve metabolism

    International Nuclear Information System (INIS)

    Chez, M.G.; Peterson, R.G.

    1983-01-01

    Sciatic nerves of 25-week-old genetically diabetic (C57BL/Ks [db/db]) mice and their litter-mate controls were removed, and their metabolic incorporation of [ 3 H]fucose and [ 14 C]leucine into myelin was studied in vitro. Untreated diabetic animals showed significant increases (p less than 0.05) in the fucose/leucine incorporation into myelin when compared to values found for their litter-mates. These results correlated well with previous experiments performed on alloxan or streptozotocin-diabetic rats and thus show the in vitro incubation procedure to be a good indicator of altered metabolic conditions in peripheral nerves due to diabetes mellitus. The resulting ratio increases seen in diabetic animals is at variance with the decrease in ratios found in animals undergoing typical Wallerian degeneration. These results suggest that different metabolic processes operate in untreated diabetics than in normals or in those undergoing other degenerative nerve processes

  18. A Comparison of Continental Extension Estimates Across the Margins of the Woodlark Basin, Papua New Guinea

    Science.gov (United States)

    Nazlim, B.; Goodliffe, A. M.

    2016-12-01

    Previous studies have shown that depth dependent extension is commonly observed across rifted margins. This has resulted in a discrepancy between the estimates of extension made through whole lithosphere/crust vs fault heave calculations (for example northwest Australia, South China Sea, Galicia). In the Woodlark Basin, the amount of extension estimated from observed subsidence and brittle extension also do not match. Taking into account sub-seismic resolution and poly-phase faulting reduces this mismatch. In the Woodlark Basin continental extension can also be estimated by extending Euler pole kinematics from the oceanic domain. Previous studies show that this predicts almost double the extension calculated from subsidence and brittle extension. Extension in the Woodlark Basin began at 8.4 Ma and transitioned to sea-floor spreading in the east at 6 Ma. The basin is an ideal place to study the extension discrepancy because of its young age and thin sediments. Seismic reflection easily images basement and fault structures. High resolution bathymetry permits tracing of major faults on the seafloor. A previous study focused on the extension discrepancy at the rifting to spreading transition. This study will focus on the discrepancy further east where seafloor spreading began just after 2 Ma and opening rates are faster. Data used in this study include bathymetry, magnetics, gravity, and low-fold 2-D seismic reflection data. Using the available data, extension estimates have been calculated through brittle extension and subsidence. Euler pole derived extension rates from previous studies were used for comparison. Results indicate that Euler pole kinematics predict far more extension than estimates calculated through subsidence and brittle extension. This provides important insights into processes in the low crust and supports earlier hypotheses that the mantle lithosphere and upper crust may be moving at different rates prior to continental breakup.

  19. Extensions of Dynamic Programming: Decision Trees, Combinatorial Optimization, and Data Mining

    KAUST Repository

    Hussain, Shahid

    2016-01-01

    This thesis is devoted to the development of extensions of dynamic programming to the study of decision trees. The considered extensions allow us to make multi-stage optimization of decision trees relative to a sequence of cost functions, to count the number of optimal trees, and to study relationships: cost vs cost and cost vs uncertainty for decision trees by construction of the set of Pareto-optimal points for the corresponding bi-criteria optimization problem. The applications include study of totally optimal (simultaneously optimal relative to a number of cost functions) decision trees for Boolean functions, improvement of bounds on complexity of decision trees for diagnosis of circuits, study of time and memory trade-off for corner point detection, study of decision rules derived from decision trees, creation of new procedure (multi-pruning) for construction of classifiers, and comparison of heuristics for decision tree construction. Part of these extensions (multi-stage optimization) was generalized to well-known combinatorial optimization problems: matrix chain multiplication, binary search trees, global sequence alignment, and optimal paths in directed graphs.

  20. Extensions of Dynamic Programming: Decision Trees, Combinatorial Optimization, and Data Mining

    KAUST Repository

    Hussain, Shahid

    2016-07-10

    This thesis is devoted to the development of extensions of dynamic programming to the study of decision trees. The considered extensions allow us to make multi-stage optimization of decision trees relative to a sequence of cost functions, to count the number of optimal trees, and to study relationships: cost vs cost and cost vs uncertainty for decision trees by construction of the set of Pareto-optimal points for the corresponding bi-criteria optimization problem. The applications include study of totally optimal (simultaneously optimal relative to a number of cost functions) decision trees for Boolean functions, improvement of bounds on complexity of decision trees for diagnosis of circuits, study of time and memory trade-off for corner point detection, study of decision rules derived from decision trees, creation of new procedure (multi-pruning) for construction of classifiers, and comparison of heuristics for decision tree construction. Part of these extensions (multi-stage optimization) was generalized to well-known combinatorial optimization problems: matrix chain multiplication, binary search trees, global sequence alignment, and optimal paths in directed graphs.

  1. Etapas y tendencias de la gestión de la Extensión Universitaria: antecedentes imprescindibles para la reconceptualización Stages and trends of University Extension management: indispensable antecedents for re-conceptualization

    Directory of Open Access Journals (Sweden)

    María Victoria González Peña

    2011-12-01

    Full Text Available El presente trabajo caracteriza las distintas etapas de la gestión de la Extensión Universitaria, como proceso universitario sustantivo en el contexto cubano. Uno de sus aportes más importantes es una sistematización de la teoría, apoyada en los métodos de análisis documental. Se exponen elementos identificables como logros y limitaciones que ha tenido la gestión de la Extensión Universitaria. Como resultado, se muestra la caracterización de cada una de las etapas, las cuales abarcan desde la colonia hasta la actualidad. Se develan las principales tendencias de la gestión de la Extensión Universitaria en la universidad cubana y se destaca el valor del presente estudio diacrónico, en función de su perfeccionamiento ante los retos de la actual realidad educativa.This article describes the different stages of University Extension management, as a paramount university process within the Cuban context. It contributes to a systematization of the theory, basing on documental analysis methods. It also presents the achievements and limitations of University Extension management. As a result, it characterizes each of the stages, from colonial times up to the present day. It displays the main trends of Cuban University Extension management and points out the importance of a diachronic study to develop this process in view of today’s educational challenges.

  2. Clinical consequences of untreated dental caries in German 5- and 8-year-olds.

    Science.gov (United States)

    Grund, Katrin; Goddon, Inka; Schüler, Ina M; Lehmann, Thomas; Heinrich-Weltzien, Roswitha

    2015-11-04

    About half of all carious lesions in primary teeth of German 6- to 7-year-old children remain untreated, but no data regarding the clinical consequences of untreated dental caries are available. Therefore, this cross-sectional observational study aimed to assess the prevalence and experience of caries and odontogenic infections in the primary dentition of 5- and 8-year-old German children. Dental examinations were performed in 5-year-old pre-school children (n = 496) and in 8-year-old primary school children (n = 608) living in the Westphalian Ennepe-Ruhr district. Schools and preschools were selected by sociodemographic criteria including size, area, ownership, socio-economic status. Caries was recorded according to WHO criteria (1997). The Lorenz curves were used to display the polarisation of dental caries. Caries pattern in 5-year-olds was categorized by Wyne's (1997) definition of early childhood caries (ECC). Odontogenic infections as clinical consequence of untreated dental caries were assessed by the pufa index. The 'untreated caries-pufa ratio' was calculated, and the Spearman's rank correlation coefficient (ρ) was used for evaluating the correlation between dmft and pufa scores. Categorical data were compared between groups using the chi-square test and continuous data were analysed by t-test. Caries prevalence and experience in the primary dentition was 26.2 %/0.9 ± 2.0 dmft in 5-year-olds and 48.8 %/2.1 ± 2.8 dmft in 8-year-olds. ECC type I (22 %) was the prevalent caries pattern in 5-year-olds. About 30 % of the tooth decay was treated (5y: 29.7 %/8y: 39.3 %). The Lorenz curves showed a strong caries polarisation on 20 % of the children. Pufa prevalence and experience was 4.4 %/0.1 ± 0.5 pufa in 5-year-olds and 16.6 %/0.3 ± 0.9 pufa in 8-year-olds. In 5-year-olds 14.2 % and in 8-year-olds 34.2 % of the d-component had progressed mainly to the pulp. A significant correlation between dmft and pufa scores exists in

  3. Chemical mixtures in untreated water from public-supply wells in the U.S. - Occurrence, composition, and potential toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Toccalino, Patricia L., E-mail: ptocca@usgs.gov [U.S. Geological Survey (USGS), 6000 J Street, Placer Hall, Sacramento, California 95819 (United States); Norman, Julia E., E-mail: jnorman@usgs.gov [USGS, 2130 SW 5th Avenue, Portland, Oregon 97201 (United States); Scott, Jonathon C., E-mail: jon@usgs.gov [USGS, 202 NW 66th Street, Oklahoma City, Oklahoma 73116 (United States)

    2012-08-01

    Chemical mixtures are prevalent in groundwater used for public water supply, but little is known about their potential health effects. As part of a large-scale ambient groundwater study, we evaluated chemical mixtures across multiple chemical classes, and included more chemical contaminants than in previous studies of mixtures in public-supply wells. We (1) assessed the occurrence of chemical mixtures in untreated source-water samples from public-supply wells, (2) determined the composition of the most frequently occurring mixtures, and (3) characterized the potential toxicity of mixtures using a new screening approach. The U.S. Geological Survey collected one untreated water sample from each of 383 public wells distributed across 35 states, and analyzed the samples for as many as 91 chemical contaminants. Concentrations of mixture components were compared to individual human-health benchmarks; the potential toxicity of mixtures was characterized by addition of benchmark-normalized component concentrations. Most samples (84%) contained mixtures of two or more contaminants, each at concentrations greater than one-tenth of individual benchmarks. The chemical mixtures that most frequently occurred and had the greatest potential toxicity primarily were composed of trace elements (including arsenic, strontium, or uranium), radon, or nitrate. Herbicides, disinfection by-products, and solvents were the most common organic contaminants in mixtures. The sum of benchmark-normalized concentrations was greater than 1 for 58% of samples, suggesting that there could be potential for mixtures toxicity in more than half of the public-well samples. Our findings can be used to help set priorities for groundwater monitoring and suggest future research directions for drinking-water treatment studies and for toxicity assessments of chemical mixtures in water resources. - Highlights: Black-Right-Pointing-Pointer We assessed mixtures in untreated groundwater samples from public

  4. Moisture meter calibration for untreated and ACQ-treated southern yellow pine plywood

    Science.gov (United States)

    Samuel V. Glass; Charles G. Carll

    2009-01-01

    Conductance moisture meter readings using stainless steel screws as electrodes were compared with gravimetric moisture content for 1) southern yellow pine (SYP) dimensioned lumber, 2) untreated (underlayment grade) SYP plywood, and 3) SYP plywood treated with alkaline copper quaternary. Meter readings were taken with the meter set to the manufacturer-provided species...

  5. FDG metabolism and uptake versus blood flow in women with untreated primary breast cancers

    International Nuclear Information System (INIS)

    Zasadny, Kenneth R.; Tatsumi, Mitsuaki; Wahl, Richard L.

    2003-01-01

    The aim of this study was to determine the relationship between tumor blood flow and glucose utilization in women with untreated primary breast carcinomas. Noninvasive determinations of blood flow and glucose utilization with positron emission tomography (PET) were performed in 101 regions of tumor from nine women with untreated primary breast carcinoma. [ 15 O]H 2 O PET scans of tumor blood flow were compared with fluorine-18 fluoro-2-deoxy-D-glucose (FDG) PET scans of tumor glucose metabolism. Modeling of multiple parameters was undertaken and flow and glucose utilization compared. Mean whole-tumor blood flow was 14.9 ml dl -1 min -1 , but ranged from 7.6 to 29.2 ml dl -1 min -1 . Mean whole-tumor standardized uptake value corrected for lean body mass, SUV-lean (50-60 min), was 2.32±0.19 while mean K i was 1.2 ml dl -1 min -1 for FDG. SUV-lean and blood flow were strongly correlated (r=0.82, P=0.007) as were K 1 for FDG and flow (r=0.84, P=0.004). In these women with untreated breast cancers, FDG uptake (SUV-lean) and tumor blood flow are strongly correlated. The slope of FDG uptake versus blood flow appears higher at low flow rates, suggesting the possible presence of areas of tumor hypoxia. (orig.)

  6. Recurrent branchial sinus tract with aberrant extension.

    Science.gov (United States)

    Barret, J P

    2004-01-01

    Second branchial cysts are the commonest lesions among congenital lateral neck anomalies. Good knowledge of anatomy and embryology are necessary for proper treatment. Surgical treatment involves resection of all branchial remnants, which extend laterally in the neck, medial to the sternocleidomastoid muscle with cranial extension to the pharynx and ipsilateral tonsillar fosa. However, infections and previous surgery can distort anatomy, making the approach to branchial anomalies more difficult. We present a case of a 17-year-old patient who presented with a second branchial tract anomaly with an aberrant extension to the midline and part of the contralateral neck. Previous surgical interventions and chronic infections may have been the primary cause for this aberrant tract. All head and neck surgeons should bear in mind that aberrant presentations may exist when reoperating on chronic branchial cysts fistulas.

  7. Updated guidelines on the preoperative staging of thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hye Jung [Dept. of Radiology, Kyungpook National University Medical Center, Daegu (Korea, Republic of)

    2017-10-15

    Recent studies have provided prognostic information and recommendations for staging thyroid cancers that have changed the staging and management guidelines for the disease. Consequently, minimal extrathyroidal extension (ETE) was removed from the T3 stage classification in the eighth edition of the TNM staging system by the American Joint Committee on Cancer. New T categories have been subsequently added, including T3a, defined as a tumor >4 cm in its greatest dimension, limited to the thyroid gland, and T3b, defined as a tumor of any size with gross ETE invading only the strap muscles. In this article, the author reviews the changes in the TNM staging system for thyroid cancer, with an emphasis on ultrasonography in preoperative staging.

  8. Duration of untreated psychosis: a proposition regarding treatment definition.

    Science.gov (United States)

    Polari, Andrea; Lavoie, Suzie; Sarrasin, Pascale; Pellanda, Veronica; Cotton, Sue; Conus, Philippe

    2011-11-01

    Duration of untreated psychosis (DUP) refers to the time elapsing between psychosis onset and treatment initiation. Despite a certain degree of consensus regarding the definition of psychosis onset, the definition of treatment commencement varies greatly between studies and DUP may be underestimated due to lack of agreement. In the present study, three sets of criteria to define the end of the untreated period were applied in a first-episode psychosis cohort to assess the impact of the choice of definition on DUP estimation. The DUP of 117 patients admitted in the Treatment and Early Intervention in Psychosis Program Psychosis in Lausanne was measured using the following sets of criteria to define treatment onset: (i) initiation of antipsychotic medication; (ii) entry into a specialized programme; and (iii) entry into a specialized programme and adequate medication with a good compliance. DUP varied greatly according to definitions, the most restrictive criteria leading to the longest DUP (median DUP1=2.2 months, DUP2=7.4 months and DUP3=13.6 months). A percentage of 19.7 of the patients who did not meet these restrictive criteria had poorer premorbid functioning and were more likely to use cannabis. Longer DUP3 was associated with poorer premorbid functioning and with younger age at onset of psychosis. These results underline the need for a unique and standardized definition of the end of DUP. We suggest that the most restrictive definition of treatment should be used when using the DUP concept in future research. © 2011 Blackwell Publishing Asia Pty Ltd.

  9. Relationship between amount of overtime work and untreated decayed teeth in male financial workers in Japan.

    Science.gov (United States)

    Yoshino, Koichi; Suzuki, Seitaro; Ishizuka, Yoichi; Takayanagi, Atsushi; Sugihara, Naoki; Kamijyo, Hideyuki

    2017-05-25

    Continuous or frequent overtime work has been shown to have harmful effects on human health. Meanwhile, one of the main reasons for tooth loss is caries. The aim of this study was to assess the relationship between overtime work and untreated decayed teeth in male financial workers. The participants were recruited by applying screening procedures to a pool of Japanese registrants in an online database. Participants filled out a questionnaire about their oral health, behavior, and working conditions. Participants comprised a total of 951 financial male workers, aged 25-64 years. The likelihood of tooth decay increased with amount of overtime work (p=0.002). After adjusting for age, income, educational background, oral hygiene behavior, snacking behavior, regular dental visitation, bad interpersonal relationships at work, and smoking habit, a multiple logistic regression analysis found that participants with 45-80 h of overtime work (odds ratio [OR], 2.56; 95% confidence interval [CI], 1.23-5.33) or over 80 h of overtime work (OR, 3.01; 95% CI, 1.13-7.97) were more likely to have untreated tooth decay. The percentage of participants who gave "too busy with work" as the reason for leaving decayed teeth untreated increased with amount of overtime (p<0.001). These results indicate that overtime work is strongly related to untreated decayed teeth. In addition to oral health education and dental checkups, decreasing stress and decreasing the amount of overtime work may also have a positive effect on oral health in the workplace.

  10. Excess Mortality in Treated and Untreated Hyperthyroidism Is Related to Cumulative Periods of Low Serum TSH.

    Science.gov (United States)

    Lillevang-Johansen, Mads; Abrahamsen, Bo; Jørgensen, Henrik Løvendahl; Brix, Thomas Heiberg; Hegedüs, Laszlo

    2017-07-01

    Cumulative time-dependent excess mortality in hyperthyroid patients has been suggested. However, the effect of antithyroid treatment on mortality, especially in subclinical hyperthyroidism, remains unclarified. We investigated the association between hyperthyroidism and mortality in both treated and untreated hyperthyroid individuals. Register-based cohort study of 235,547 individuals who had at least one serum thyroid-stimulating hormone (TSH) measurement in the period 1995 to 2011 (7.3 years median follow-up). Hyperthyroidism was defined as at least two measurements of low serum TSH. Mortality rates for treated and untreated hyperthyroid subjects compared with euthyroid controls were calculated using multivariate Cox regression analyses, controlling for age, sex, and comorbidities. Cumulative periods of decreased serum TSH were analyzed as a time-dependent covariate. Hazard ratio (HR) for mortality was increased in untreated [1.23; 95% confidence interval (CI), 1.12 to 1.37; P hyperthyroid patients. When including cumulative periods of TSH in the Cox regression analyses, HR for mortality per every 6 months of decreased TSH was 1.11 (95% CI, 1.09 to 1.13; P hyperthyroid patients (n = 1137) and 1.13 (95% CI, 1.11 to 1.15; P hyperthyroidism, respectively. Mortality is increased in hyperthyroidism. Cumulative periods of decreased TSH increased mortality in both treated and untreated hyperthyroidism, implying that excess mortality may not be driven by lack of therapy, but rather inability to keep patients euthyroid. Meticulous follow-up during treatment to maintain biochemical euthyroidism may be warranted. Copyright © 2017 by the Endocrine Society

  11. Developmental Stages and Work Capacities of Community Coalitions: How Extension Educators Address and Evaluate Changing Coalition Needs

    Science.gov (United States)

    Nichols, Allison; Riffe, Jane; Peck, Terrill; Kaczor, Cheryl; Nix, Kelly; Faulkner-Van Deysen, Angela

    2014-01-01

    Extension educators provide resources to community coalitions. The study reported here adds to what is known about community coalitions and applies an assessment framework to a state-level coalition-based Extension program on healthy relationships and marriages. The study combines the Internal Coalition Outcome Hierarchy (ICOH) framework with four…

  12. Untreated urban waste contaminates Indian river sediments with resistance genes to last resort antibiotics.

    Science.gov (United States)

    Marathe, Nachiket P; Pal, Chandan; Gaikwad, Swapnil S; Jonsson, Viktor; Kristiansson, Erik; Larsson, D G Joakim

    2017-11-01

    Efficient sewage treatment is critical for limiting environmental transmission of antibiotic-resistant bacteria. In many low and middle income countries, however, large proportions of sewage are still released untreated into receiving water bodies. In-depth knowledge of how such discharges of untreated urban waste influences the environmental resistome is largely lacking. Here, we highlight the impact of uncontrolled discharge of partially treated and/or untreated wastewater on the structure of bacterial communities and resistome of sediments collected from Mutha river flowing through Pune city in India. Using shotgun metagenomics, we found a wide array (n = 175) of horizontally transferable antibiotic resistance genes (ARGs) including carbapenemases such as NDM, VIM, KPC, OXA-48 and IMP types. The relative abundance of total ARGs was 30-fold higher in river sediments within the city compared to upstream sites. Forty four ARGs, including the tet(X) gene conferring resistance to tigecycline, OXA-58 and GES type carbapenemases, were significantly more abundant in city sediments, while two ARGs were more common at upstream sites. The recently identified mobile colistin resistance gene mcr-1 was detected only in one of the upstream samples, but not in city samples. In addition to ARGs, higher abundances of various mobile genetic elements were found in city samples, including integron-associated integrases and ISCR transposases, as well as some biocide/metal resistance genes. Virulence toxin genes as well as bacterial genera comprising many pathogens were more abundant here; the genus Acinetobacter, which is often associated with multidrug resistance and nosocomial infections, comprised up to 29% of the 16S rRNA reads, which to our best knowledge is unmatched in any other deeply sequenced metagenome. There was a strong correlation between the abundance of Acinetobacter and the OXA-58 carbapenemase gene. Our study shows that uncontrolled discharge of untreated urban

  13. Does duration of untreated psychosis bias study samples of first-episode psychosis?

    DEFF Research Database (Denmark)

    Friis, S; Melle, I; Larsen, T K

    2004-01-01

    OBJECTIVE: While findings are contradictory, many studies report that long Duration of Untreated Psychosis (DUP) correlates with poorer outcome in first episode psychosis. In an outcome study of first-episode psychosis, we compared the patients who refused to participate in a follow-along with th......OBJECTIVE: While findings are contradictory, many studies report that long Duration of Untreated Psychosis (DUP) correlates with poorer outcome in first episode psychosis. In an outcome study of first-episode psychosis, we compared the patients who refused to participate in a follow......-along with those who consented to estimate the importance of this factor in sample recruitment bias. Our questions were: (i) What is the percentage of refusers? (ii) Are there systematic differences between refusers and consenters on DUP and/or other admission variables? (iii) What is the risk of refusal...... for different values of DUP? METHOD: In an unselected group of consecutively admitted patients we compared follow-along refusers and consenters on the following admission variables: sex, age, diagnostic group, substance abuse, being in-patient, coming from an early detection site and DUP. We conducted...

  14. [Untreated syphilis - from Oslo to Tuskegee].

    Science.gov (United States)

    Sandvik, Anniken; Lie, Anne Kveim

    2016-12-01

    In the period from 1891 - 1910, around 2000 patients with syphilis were admitted to the Department of Dermatology, Oslo University Hospital, Rikshospitalet. The head of the department, Cæsar Boeck (1845 - 1917), believed in allowing the disease to take its natural course and withheld treatment. He made detailed notes of the diagnosis and the clinical course of the disease for all his patients. Boeck's material is unique, and forms the basis for our current knowledge about the prognosis and course of syphilis infections. In 1928, the patients were scrutinised by Boeck's successor in the Department of Dermatology, Edvin Bruusgaard (1869 - 1934), and later by Trygve Gjestland (1911 - 1993). Gjestland's doctoral thesis from 1955 has remained as «The Oslo study of untreated syphilis.» This article presents a medical historical background for the study. Bruusgaard's and Gjestland's research was important for the Tuskegee Study in the USA, and the Oslo study gave implicit support to this research project, which posterity has emphatically condemned as ethically unacceptable.

  15. Quantitative analysis of untreated bio-samples

    International Nuclear Information System (INIS)

    Sera, K.; Futatsugawa, S.; Matsuda, K.

    1999-01-01

    A standard-free method of quantitative analysis for untreated samples has been developed. For hair samples, measurements were performed by irradiating with a proton beam a few hairs as they are, and quantitative analysis was carried out by means of a standard-free method developed by ourselves. First, quantitative values of concentration of zinc were derived, then concentration of other elements was obtained by regarding zinc as an internal standard. As the result, values of concentration of sulphur for 40 samples agree well with the average value for a typical Japanese and also with each other within 20%, and validity of the present method could be confirmed. Accuracy was confirmed by comparing the results with those obtained by the usual internal standard method, too. For the purpose of a surface analysis of a bone sample, a very small incidence angle of the proton beam was used, so that both energy loss of the projectile and self-absorption of X-rays become negligible. As the result, consistent values of concentration for many elements were obtained by the standard-free method

  16. Clinical Findings and Treatment Outcomes in Patients with Extraprostatic Extension Identified on Prostate Biopsy.

    Science.gov (United States)

    Fleshner, Katherine; Assel, Melissa; Benfante, Nicole; Lee, Justin; Vickers, Andrew; Fine, Samson; Carlsson, Sigrid; Eastham, James

    2016-09-01

    We describe histopathological, clinical and imaging findings among men with extraprostatic extension on prostate biopsy. We searched our institutional pathology database between 2004 and 2015 for pathology reports detailing extraprostatic extension on prostate biopsy in untreated patients. Patient characteristics, biopsy features, imaging interpretations and outcomes were examined. Of 19,950 patients with prostate cancer on biopsy 112 had extraprostatic extension for a prevalence of 0.6% (95% CI 0.5-0.7). Most of the 112 patients had palpable, high grade (Gleason score 9), high volume disease, which was classified as high risk in 34 (30%), locally advanced in 17 (15%) and metastatic in 39 (35%). Most patients had 1 or 2 cores with extraprostatic extension, typically at the base and with concomitant perineural invasion. Extraprostatic extension was identified by magnetic resonance imaging in 32 of 40 patients (80%). Median followup in those who did not die was 1.3 years (IQR 0.3-4.2). Outcomes in the subgroup of 24 men treated with radical prostatectomy were consistent with high risk disease, including positive margins in 14 (58%), seminal vesicle invasion in 10 (42%) and lymph node invasion in 11 (46%). In the entire cohort the 3-year risks of metastasis and overall mortality were 32% (95% CI 22-44) and 37% (95% CI 27-50), respectively. We did not find evidence to suggest that the proportion of cores with cancer that also had extraprostatic extension was associated with overall mortality (p = 0.09). Extraprostatic extension is a rare finding on prostate biopsy. It is strongly associated with other features of aggressive prostate cancer. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  17. Expert Elicitation of Multinomial Probabilities for Decision-Analytic Modeling: An Application to Rates of Disease Progression in Undiagnosed and Untreated Melanoma.

    Science.gov (United States)

    Wilson, Edward C F; Usher-Smith, Juliet A; Emery, Jon; Corrie, Pippa G; Walter, Fiona M

    2018-06-01

    Expert elicitation is required to inform decision making when relevant "better quality" data either do not exist or cannot be collected. An example of this is to inform decisions as to whether to screen for melanoma. A key input is the counterfactual, in this case the natural history of melanoma in patients who are undiagnosed and hence untreated. To elicit expert opinion on the probability of disease progression in patients with melanoma that is undetected and hence untreated. A bespoke webinar-based expert elicitation protocol was administered to 14 participants in the United Kingdom, Australia, and New Zealand, comprising 12 multinomial questions on the probability of progression from one disease stage to another in the absence of treatment. A modified Connor-Mosimann distribution was fitted to individual responses to each question. Individual responses were pooled using a Monte-Carlo simulation approach. Participants were asked to provide feedback on the process. A pooled modified Connor-Mosimann distribution was successfully derived from participants' responses. Feedback from participants was generally positive, with 86% willing to take part in such an exercise again. Nevertheless, only 57% of participants felt that this was a valid approach to determine the risk of disease progression. Qualitative feedback reflected some understanding of the need to rely on expert elicitation in the absence of "hard" data. We successfully elicited and pooled the beliefs of experts in melanoma regarding the probability of disease progression in a format suitable for inclusion in a decision-analytic model. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  18. The use of first stage bone augmentation screws to stabilize the surgical template in the second stage.

    NARCIS (Netherlands)

    Verhamme, L.M.; Meijer, G.J.; Berge, S.J.; Maal, T.J.J.

    2015-01-01

    A new method is presented in which the osteosynthesis screws from a first stage bone augmentation of the maxilla are used to stabilize the surgical template during implant placement in the second stage. This method was evaluated in one patient and the results compared to those of previous studies.

  19. The use of first stage bone augmentation screws to stabilize the surgical template in the second stage

    NARCIS (Netherlands)

    Verhamme, L. M.; Meijer, G. J.; Bergé, S. J.; Maal, T. J J

    2015-01-01

    A new method is presented in which the osteosynthesis screws from a first stage bone augmentation of the maxilla are used to stabilize the surgical template during implant placement in the second stage. This method was evaluated in one patient and the results compared to those of previous studies.

  20. Reirradiation of recurrent node-positive non-small cell lung cancer after previous stereotactic radiotherapy for stage I disease. A multi-institutional treatment recommendation

    Energy Technology Data Exchange (ETDEWEB)

    Nieder, Carsten [Nordland Hospital, Department of Oncology and Palliative Medicine, Bodoe (Norway); University of Tromsoe, Institute of Clinical Medicine, Faculty of Health Sciences, Tromsoe (Norway); Ruysscher, Dirk de [MAASTRO Clinic, Department of Radiation Oncology, Maastricht (Netherlands); Gaspar, Laurie E. [University of Colorado School of Medicine, Department of Radiation Oncology, Aurora, CO (United States); Guckenberger, Matthias [University Hospital Zurich, Department of Radiation Oncology, Zurich (Switzerland); Mehta, Minesh P. [Miami Cancer Institute, Department of Radiation Oncology, Miami, FL (United States); Cheung, Patrick; Sahgal, Arjun [Sunnybrook Health Sciences Centre and University of Toronto, Department of Radiation Oncology, Toronto (Canada)

    2017-07-15

    Practice guidelines have been developed for early-stage and locally advanced non-small cell lung cancer (NSCLC). However, many common clinical scenarios still require individualized decision making. This is true for locoregional relapse after initial stereotactic radiotherapy (stereotactic body radiation therapy or stereotactic ablative radiotherapy; SBRT or SABR), an increasingly utilized curative treatment option for stage I NSCLC. A consortium of expert radiation oncologists was established with the aim of providing treatment recommendations. In this scenario, a case was distributed to six radiation oncologists who provided their institutions' treatment recommendations. In this case, a patient developed local and mediastinal relapse after SABR (45 Gy, 3 fractions), comparable to the tumor burden in de novo stage IIIA NSCLC. Treatment recommendations were tabulated and a consensus conclusion was developed. Three institutions recommended evaluation for surgery. If the patient was not a surgical candidate, and/or refused surgery, definitive chemoradiation was recommended, including retreating the primary to full dose. European participants were more in favor of a non-surgical approach. None of the participants were reluctant to prescribe reirradiation, but two institutions prescribed doses lower than 60 Gy. Platinum-based doublets together with intensity-modulated radiotherapy were preferred. The institutional recommendations reflect the questions and uncertainties discussed in current stage III guidelines. All institutions agreed that previous SABR is not a contraindication for salvage chemoradiation. In the absence of high-quality prospective trials for recurrent NSCLC, all treatment options recommended in current guidelines for stage III disease can be considered in clinical scenarios such as this. (orig.) [German] Fuer fruehe und lokal fortgeschrittene Stadien des nicht-kleinzelligen Bronchialkarzinoms (NSCLC) wurden Behandlungsleitlinien publiziert

  1. Molecular changes in Opisthorchis viverrini (Southeast Asian liver fluke during the transition from the juvenile to the adult stage.

    Directory of Open Access Journals (Sweden)

    Aaron R Jex

    Full Text Available BACKGROUND: The Southeast Asian liver fluke (Opisthorchis viverrini chronically infects and affects tens of millions of people in regions of Asia, leading to chronic illness and, importantly, inducing malignant cancer (= cholangiocarcinoma. In spite of this, little is known, at the molecular level, about the parasite itself, its interplay with its hosts or the mechanisms of disease and/or carcinogenesis. METHODOLOGY/PRINCIPAL FINDINGS: Here, we generated extensive RNA-Seq data (Illumina representing adult and juvenile stages of O. viverrini, and combined these sequences with previously published transcriptomic data (454 technology for this species, yielding a combined assembly of significantly increased quality and allowing quantitative assessment of transcription in the juvenile and adult stage. CONCLUSIONS: This enhanced assembly reveals that, despite the substantial biological similarities between the human liver flukes, O. viverinni and Clonorchis sinensis, there are previously unrecognized differences in major aspects of their molecular biology. Most notable are differences among the C13 and cathepsin L-like cysteine peptidases, which play key roles in tissue migration, immune evasion and feeding, and, thus, represent potential drug and/or vaccine targets. Furthermore, these data indicate that major lineages of cysteine peptidases of socioeconomically important trematodes have evolved through a process of gene loss rather than independent radiation, contrasting previous proposals.

  2. Journal of Agricultural Extension Vol. 17 (1) June, 2013 ISSN 1119 ...

    African Journals Online (AJOL)

    Onyii Ogbonna

    Journal of Agricultural Extension. Vol. ... Nigeria one of the largest importers of fish in the developing world, importing ... stratum formed the third stage. ..... Quarterly. 28 (3 & 4): 8-13. Binyotubo, T.E (2011). A guide to fishing gear technology.

  3. Clinical consequences and economic costs of untreated obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Melissa Knauert

    2015-09-01

    Full Text Available Objective: To provide an overview of the healthcare and societal consequences and costs of untreated obstructive sleep apnea syndrome. Data sources: PubMed database for English-language studies with no start date restrictions and with an end date of September 2014. Methods: A comprehensive literature review was performed to identify all studies that discussed the physiologic, clinical and societal consequences of obstructive sleep apnea syndrome as well as the costs associated with these consequences. There were 106 studies that formed the basis of this analysis. Conclusions: Undiagnosed and untreated obstructive sleep apnea syndrome can lead to abnormal physiology that can have serious implications including increased cardiovascular disease, stroke, metabolic disease, excessive daytime sleepiness, work-place errors, traffic accidents and death. These consequences result in significant economic burden. Both, the health and societal consequences and their costs can be decreased with identification and treatment of sleep apnea. Implications for practice: Treatment of obstructive sleep apnea syndrome, despite its consequences, is limited by lack of diagnosis, poor patient acceptance, lack of access to effective therapies, and lack of a variety of effective therapies. Newer modes of therapy that are effective, cost efficient and more accepted by patients need to be developed. Keywords: Obstructive sleep apnea syndrome, Cost, Continuous positive airway pressure, Mandibular advancement device

  4. Hyperarousal during sleep in untreated primary insomnia sufferers: A polysomnographic study.

    Science.gov (United States)

    Hein, Matthieu; Senterre, Christelle; Lanquart, Jean-Pol; Montana, Xavier; Loas, Gwénolé; Linkowski, Paul; Hubain, Philippe

    2017-07-01

    Because some evidence favors the hyperarousal model of insomnia, we sought to learn more about the dynamics of this phenomenon during sleep. Polysomnographic data from 30 normative subjects and 86 untreated primary insomnia sufferers recruited from the database of the sleep laboratory were studied for whole nights and in terms of thirds of the night. Untreated primary insomnia sufferers had an increased sleep latency and excess of WASO, together with a deficit in REM and NREM sleep during the entire night. In terms of thirds of the night, they presented a major excess of WASO during the first and last thirds of the night but an excess of lesser importance during the middle third. A deficit in SWS was found during the first third of the night, but for REM, the deficit was present during both the first and last thirds. Primary insomnia sufferers had no SWS or REM deficit during the second third of the night. We found that the hyperarousal phenomenon occurs mainly during the sleep-onset period of the first and last thirds of the night and is less important during the middle third. These results open new avenues for understanding the pathophysiology of primary insomnia. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  5. Correlates of Untreated Hypercholesterolemia in Older Adults: A Community-Based Household Survey in China

    Science.gov (United States)

    Hu, Zhi; Zaman, M. Justin; Wang, Jingjing; Peacock, Janet L.; Chen, Ruoling

    2015-01-01

    Hypercholesterolemia is common in older adults and less treated, but little is known about correlates of untreated hypercholesterolemia. Using a standard interview method we examined a random sample of 7,572 participants aged ≥60 years in a community-based household survey across 7 provinces of China during 2007–2012, and documented 328 cases of hypercholesterolemia from self-reported doctor diagnosis. Compared to participants with normal cholesterol, older adults with hypercholesterolemia had higher socioeconomic position and larger body mass index. In patients with hypercholesterolemia, 209 were not treated using lipid-lowering medications (63.7%, 95% confidence interval (CI) 58.5%–68.9%). Untreated hypercholesterolemia was significantly associated with female sex (adjusted odds ratio 2.13, 95%CI 1.17–3.89), current smoking (3.48, 1.44–8.44), heavy alcohol drinking (3.13,1.11–8.84), chronic bronchitis (2.37,1.14–4.90) and high level of meat consumptions (2.85,1.22–6.65). Although having coronary heart disease exposed participants for treatment, half of participants with coronary heart disease did not receive lipid-lowering medications. Among hypercholesterolemia participants with stroke, hypertension or diabetes, more than half of them did not receive lipid-lowering medications. The high proportion of untreated hypercholesterolemia in older, high-risk Chinese adults needs to be mitigated through multi-faceted primary and secondary prevention strategies to increase population opportunities of treating hypercholesterolemia. PMID:26161751

  6. Comparison of outcomes in patients with stage III versus limited stage IV non-small cell lung cancer

    International Nuclear Information System (INIS)

    Cheruvu, Praveena; Metcalfe, Su K; Metcalfe, Justin; Chen, Yuhchyau; Okunieff, Paul; Milano, Michael T

    2011-01-01

    Standard therapy for metastatic non small cell lung cancer (NSCLC) includes palliative systemic chemotherapy and/or radiotherapy. Recent studies of patients with limited metastases treated with curative-intent stereotactic body radiation therapy (SBRT) have shown encouraging survival. We hypothesized that patients treated with SBRT for limited metastases have comparable outcomes with those treated with curative-intent radiation for Stage III NSCLC. We retrospectively reviewed the records of NSCLC patients treated with curative-intent radiotherapy at the University of Rochester from 2000-2008. We identified 3 groups of patients with NSCLC: stage III, stage IV, and recurrent stage IV (initial stage I-II). All stage IV NSCLC patients treated with SBRT had ≤ 8 lesions. Of 146 patients, 88% had KPS ≥ 80%, 30% had > 5% weight loss, and 95% were smokers. The 5-year OS from date of NSCLC diagnosis for stage III, initial stage IV and recurrent stage IV was 7%, 14%, and 27% respectively. The 5-year OS from date of metastatic diagnosis was significantly (p < 0.00001) superior among those with limited metastases (≤ 8 lesions) versus stage III patients who developed extensive metastases not amenable to SBRT (14% vs. 0%). Stage IV NSCLC is a heterogeneous patient population, with a selected cohort apparently faring better than Stage III patients. Though patients with limited metastases are favorably selected by virtue of more indolent disease and/or less bulky disease burden, perhaps staging these patients differently is appropriate for prognostic and treatment characterization. Aggressive local therapy may be indicated in these patients, though prospective clinical studies are needed

  7. Hematopoietic cell crisis: An early stage of evolving myeloid leukemia following radiation exposure

    International Nuclear Information System (INIS)

    Seed, T.M.

    1990-01-01

    Under select radiological conditions, chronic radiation exposure elicits a high incidence of myeloproliferative disease, principally myeloid leukemia (ML), in beagles. Previously we demonstrated that for full ML expression, a four-stage preclinical sequence is required, namely (1) suppression, (2) recovery, (3) accommodation, and (4) preleukemic transition. Within this pathological sequence, a critical early event has been identified as the acquisition of radioresistance by hematopoietic progenitors that serves to mediate a newfound regenerative hematopoietic capacity. As such, this event ''sets the stage'' for preleukemic progression by initiating progression from preclinical phase 1 to 2. Due to the nature of target cell suppression, the induction of crisis, and the outgrowth of progenitors with altered phenotypes, this preleukemic event resembles the ''immortalization'' step of the in vitro transformation sequence following induction with either physical and chemical carcinogens. The radiological, temporal, and biological dictates governing this event have been extensively evaluated and will be discussed in light of their role in the induction and progression of chronic radiation leukemia. 35 refs., 2 tabs

  8. Hematopoietic cell crisis: An early stage of evolving myeloid leukemia following radiation exposure

    Energy Technology Data Exchange (ETDEWEB)

    Seed, T.M.

    1990-01-01

    Under select radiological conditions, chronic radiation exposure elicits a high incidence of myeloproliferative disease, principally myeloid leukemia (ML), in beagles. Previously we demonstrated that for full ML expression, a four-stage preclinical sequence is required, namely (1) suppression, (2) recovery, (3) accommodation, and (4) preleukemic transition. Within this pathological sequence, a critical early event has been identified as the acquisition of radioresistance by hematopoietic progenitors that serves to mediate a newfound regenerative hematopoietic capacity. As such, this event sets the stage'' for preleukemic progression by initiating progression from preclinical phase 1 to 2. Due to the nature of target cell suppression, the induction of crisis, and the outgrowth of progenitors with altered phenotypes, this preleukemic event resembles the immortalization'' step of the in vitro transformation sequence following induction with either physical and chemical carcinogens. The radiological, temporal, and biological dictates governing this event have been extensively evaluated and will be discussed in light of their role in the induction and progression of chronic radiation leukemia. 35 refs., 2 tabs.

  9. Modification of staging and treatment of head and neck cancer by FDG-PET/CT prior to radiotherapy

    International Nuclear Information System (INIS)

    Abramyuk, A.; University Hospital Dresden; Appold, S.; Zoephel, K.; Baumann, M.; University Hospital Dresden; Abolmaali, N.; University Hospital Dresden

    2013-01-01

    Background and purpose: Reliable tumor staging is a fundamental pre-requisite for efficient tumor therapy and further prognosis. The aim of this study was to compare head and neck cancer (HNC) staging before and after FDG-PET/CT, evaluating the stage modifications for radiotherapy (RT) planning. Patients and methods: A total of 102 patients with untreated primary HNC, who underwent conventional staging and staging including FDG-PET/CT before RT, were enrolled in this retrospective study. Blinded pre-FDG-PET/CT and post-FDG-PET/CT staging data were compared. The impact on patient management was tested by comparing the intention before and after FDG-PET/CT. Results: Significant modifications of T, N, and M stage as well as clinical stage were detected after inclusion of FDG-PET/CT data (p = 0.002, 0.0006, 0.001, 0.03, respectively). Overall, the implementation of FDG-PET/CT led to modification of RT intention decision in 14 patients. Conclusions: FDG-PET/CT demonstrates essential influence on tumor staging in HNC patients scheduled for irradiation. Implementation of FDG-PET/CT in imaging protocol improves selection of candidates for curative and palliative RT and allows further optimization of treatment management and therapy intention. (orig.)

  10. Is screening effective in detecting untreated psychiatric disorders among newly diagnosed breast cancer patients?

    NARCIS (Netherlands)

    Palmer, Steven C.; Taggi, Alison; DeMichele, Angela; Coyne, James C.

    2012-01-01

    BACKGROUND: A key purpose of routine distress screening is to ensure that cancer patients receive appropriate mental health care. Most studies validating screening instruments overestimate the effectiveness of screening by not differentiating between patients with untreated disorders and patients

  11. Sleep Stage Transition Dynamics Reveal Specific Stage 2 Vulnerability in Insomnia.

    Science.gov (United States)

    Wei, Yishul; Colombo, Michele A; Ramautar, Jennifer R; Blanken, Tessa F; van der Werf, Ysbrand D; Spiegelhalder, Kai; Feige, Bernd; Riemann, Dieter; Van Someren, Eus J W

    2017-09-01

    Objective sleep impairments in insomnia disorder (ID) are insufficiently understood. The present study evaluated whether whole-night sleep stage dynamics derived from polysomnography (PSG) differ between people with ID and matched controls and whether sleep stage dynamic features discriminate them better than conventional sleep parameters. Eighty-eight participants aged 21-70 years, including 46 with ID and 42 age- and sex-matched controls without sleep complaints, were recruited through www.sleepregistry.nl and completed two nights of laboratory PSG. Data of 100 people with ID and 100 age- and sex-matched controls from a previously reported study were used to validate the generalizability of findings. The second night was used to obtain, in addition to conventional sleep parameters, probabilities of transitions between stages and bout duration distributions of each stage. Group differences were evaluated with nonparametric tests. People with ID showed higher empirical probabilities to transition from stage N2 to the lighter sleep stage N1 or wakefulness and a faster decaying stage N2 bout survival function. The increased transition probability from stage N2 to stage N1 discriminated people with ID better than any of their deviations in conventional sleep parameters, including less total sleep time, less sleep efficiency, more stage N1, and more wake after sleep onset. Moreover, adding this transition probability significantly improved the discriminating power of a multiple logistic regression model based on conventional sleep parameters. Quantification of sleep stage dynamics revealed a particular vulnerability of stage N2 in insomnia. The feature characterizes insomnia better than-and independently of-any conventional sleep parameter. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  12. Cartilage Health in Knees Treated with Metal Resurfacing Implants or Untreated Focal Cartilage Lesions: A Preclinical Study in Sheep.

    Science.gov (United States)

    Martinez-Carranza, Nicolas; Hultenby, Kjell; Lagerstedt, Anne Sofie; Schupbach, Peter; Berg, Hans E

    2017-07-01

    Background Full-depth cartilage lesions do not heal and the long-term clinical outcome is uncertain. In the symptomatic middle-aged (35-60 years) patient, treatment with metal implants has been proposed. However, the cartilage health surrounding these implants has not been thoroughly studied. Our objective was to evaluate the health of cartilage opposing and adjacent to metal resurfacing implants. Methods The medial femoral condyle was operated in 9 sheep bilaterally. A metallic resurfacing metallic implant was immediately inserted into an artificially created 7.5 mm defect while on the contralateral knee the defect was left untreated. Euthanasia was performed at 6 months. Six animals, of similar age and study duration, from a previous study were used for comparison in the evaluation of cartilage health adjacent to the implant. Cartilage damage to joint surfaces within the knee, cartilage repair of the defect, and cartilage adjacent to the implant was evaluated macroscopically and microscopically. Results Six animals available for evaluation of cartilage health within the knee showed a varying degree of cartilage damage with no statistical difference between defects treated with implants or left untreated ( P = 0.51; 95% CI -3.7 to 6.5). The cartilage adjacent to the implant (score 0-14; where 14 indicates no damage) remained healthy in these 6 animals showing promising results (averaged 10.5; range 9-11.5, SD 0.95). Cartilage defects did not heal in any case. Conclusion Treatment of a critical size focal lesion with a metal implant is a viable alternative treatment.

  13. Head circumference in untreated and IGF-I treated patients with Laron syndrome: comparison with untreated and hGH-treated children with isolated growth hormone deficiency.

    Science.gov (United States)

    Laron, Zvi; Iluz, Moshe; Kauli, Rivka

    2012-04-01

    Head circumference (HC) is a simple and practical measure of brain size, development and longitudinal measurements of the HC in childhood are an index of brain growth. To determine the effects of long IGF-I deficiency and treatment on HC in patients with Laron syndrome (LS). 20 untreated adult LS patients, aged 48.4±11.2 years and 13 LS patients treated between ages of 5.6±4 to 11.3±3 years were studied. 15 patients with congenital IGHD treated between age 6.1±4 and 13±4 by hGH served as controls. HC was expressed as standard deviation (SD) and Ht as SDS. HC was measured and plotted on Nellhaus charts. Linear height (Ht) was measured by a Harpenden Stadiometer. The mean HC deficit of the adult untreated LS males was -2.9±0.6 SD compared to a Ht deficit of -7.0±1.7 SDS. The HC of the LS adult females was -3.6±1 SD compared to a Ht SDS of -6.9±1.5 (pdeficit decreased only by 1.5 SDS. hGH treatment of cIGHD children increased the HC from -2.0±1.8 to 0.3±1.2 SD and the Ht SDS from -4.8±1.6 to 1.6±1.0. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Hormone-dependence of sarin lethality in rats: Sex differences and stage of the estrous cycle

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Carl D., E-mail: carl.d.smith179.mil@mail.mil; Wright, Linnzi K.M.; Garcia, Gregory E.; Lee, Robyn B.; Lumley, Lucille A.

    2015-09-15

    Chemical warfare nerve agents (CWNAs) are highly toxic compounds that cause a cascade of symptoms and death, if exposed casualties are left untreated. Numerous rodent models have investigated the toxicity and mechanisms of toxicity of CWNAs, but most are limited to male subjects. Given the profound physiological effects of circulating gonadal hormones in female rodents, it is possible that the daily cyclical fluctuations of these hormones affect females' sensitivity to the lethal effects of CWNAs, and previous reports that included female subjects did not control for the stage of the hormonal cycle. The aim of the current study was to determine the 24-hour median lethal dose (LD{sub 50}) of the CWNA sarin in male, ovariectomized (OVEX) female, and female rats during different stages of the estrous cycle (diestrus, proestrus, and estrus). Additionally, baseline activity levels of plasma acetylcholinesterase, butyrylcholinesterase, and carboxylesterase were measured to determine differences among the groups. Results indicated that females in proestrus had a significantly higher LD{sub 50} of sarin compared to OVEX and estrous females. Although some sex differences were observed in the activity levels of plasma esterases, they were not consistent and likely not large enough to significantly affect the LD{sub 50}s. These results suggest that hormonal cyclicity can influence the outcome of CWNA-related studies using female rodents, and that this variability can be minimized by controlling for the stage of the cycle. Additional research is necessary to determine the precise mechanism of the observed differences because it is unlikely to be solely explained by plasma esterase activity. - Highlights: • The LD{sub 50} of sarin was determined in female rats throughout the stages of the estrous cycle. • Females in proestrus had a significantly higher LD{sub 50} compared to estrous or ovariectomized females. • No sex differences were observed between male and female

  15. Chemical mixtures in untreated water from public-supply wells in the U.S.--occurrence, composition, and potential toxicity.

    Science.gov (United States)

    Toccalino, Patricia L; Norman, Julia E; Scott, Jonathon C

    2012-08-01

    Chemical mixtures are prevalent in groundwater used for public water supply, but little is known about their potential health effects. As part of a large-scale ambient groundwater study, we evaluated chemical mixtures across multiple chemical classes, and included more chemical contaminants than in previous studies of mixtures in public-supply wells. We (1) assessed the occurrence of chemical mixtures in untreated source-water samples from public-supply wells, (2) determined the composition of the most frequently occurring mixtures, and (3) characterized the potential toxicity of mixtures using a new screening approach. The U.S. Geological Survey collected one untreated water sample from each of 383 public wells distributed across 35 states, and analyzed the samples for as many as 91 chemical contaminants. Concentrations of mixture components were compared to individual human-health benchmarks; the potential toxicity of mixtures was characterized by addition of benchmark-normalized component concentrations. Most samples (84%) contained mixtures of two or more contaminants, each at concentrations greater than one-tenth of individual benchmarks. The chemical mixtures that most frequently occurred and had the greatest potential toxicity primarily were composed of trace elements (including arsenic, strontium, or uranium), radon, or nitrate. Herbicides, disinfection by-products, and solvents were the most common organic contaminants in mixtures. The sum of benchmark-normalized concentrations was greater than 1 for 58% of samples, suggesting that there could be potential for mixtures toxicity in more than half of the public-well samples. Our findings can be used to help set priorities for groundwater monitoring and suggest future research directions for drinking-water treatment studies and for toxicity assessments of chemical mixtures in water resources. Published by Elsevier B.V.

  16. Innovation in a multiple-stage, multiple-product food marketing chain

    DEFF Research Database (Denmark)

    Baker, Alister Derek; Christensen, Tove

    A model of a 3-stage food marketing chain is presented for the case of two products. Its extension of existing work is its capacity to examine non-competitive input and output markets in two marketing chains at once, and have them related by demand and cost interactions. The simulated impacts...... of market power in a single chain generally reproduce those delivered by previous authors. The impacts of market power in related chains are found to depend on linkages between chains in terms of interactions in consumer demand. Interactions between products in costs (economies of scope) generate...... an interesting result in that a possible market failure is identified that may be offset by the exercise of market power. The generation of farm-level innovation is seen to be largely unaffected by market power, but where market power is exercised the benefits are extracted from farmers and consumers...

  17. Ephestia Kuehniella Z.: Gamma irradiation effects on the adult stage and mating competitiveness of sterile males

    International Nuclear Information System (INIS)

    Ahmed, M.Y.Y.; El-Banby, M.A.; Salem, Y.S.; Abdel-Baky, S.M.

    1985-01-01

    Effects of gamma radiation dosages from 5 to 50 Krad on the adult stage of Ephestia Kuehielia Z. were studied. Irradiated adults paired with untreated adults produced fewer eggs than pairs of unirradiated adults, and these eggs had reduced hatch. This effect was more pronounced with irradiated females or when both parents were irradiated. Radiation greatly reduced life span of treated adults. Adult females were more sensitive to the sterilizing effect of gamma radiation than were males. Males were sterilized when irradiated at 50 Krad, but females at 25 Krad. Previous studies showed that males irradiated as fully grown pupae at 45 Krad were completely sterile. When irradiated (I) males were confined with unirradiated (U) males and females (1:1:1 ratio), infertility of eggs was 48%. Increasing the ratio to 5:1:1, 10:1:1 and 15:1:1 caused 77.9, 84.6 and 94.4 percent infertility of the resulting eggs, respectively. The calculated competitiveness values for the 4 ratios were 0.55, 0.52, 0.42 and 0.88, respectively. Thus I males were only competitive at the highest flooding ration (15:1:1)

  18. The prevalence of sexual behavior disorders in patients with treated and untreated gastroesophageal reflux disease.

    Science.gov (United States)

    Iovino, Paola; Pascariello, Annalisa; Limongelli, Paolo; Tremolaterra, Fabrizio; Consalvo, Danilo; Sabbatini, Francesco; Amato, Giuseppe; Ciacci, Carolina

    2007-07-01

    Gastroesophageal reflux disease (GERD) is a chronic disease. Sexual behavior is often altered in chronic illness. The aim of this study was to evaluate sexual behavior in patients affected with GERD before and after medical or surgical treatment in comparison to healthy controls (HC). Upper GI endoscopy and 24-h ambulatory pH testing were performed to confirm GERD in symptomatic patients. GERD patients completed an anonymous questionnaire on sexual life before and after medical or surgical treatment. Compared with HC, untreated patients with GERD showed more frequent difficulty in attaining orgasm and painful intercourse. GERD patients after surgical treatment had significantly more difficulty in attaining orgasm, while after continuous medical treatment GERD patients compared with HC had significantly more difficulty in attaining orgasm, higher painful intercourse, lower sexual desire, and perceived more frequently that the partner was unhelpful. When compared with untreated conditions, GERD patients after surgical treatment had a significant improvement in attaining orgasm and in painful intercourse but a significant decrease in sexual desire, a lower satisfaction with their sexual life, and a higher prevalence of an unhelpful partner, whereas GERD patients after medical treatment had a decrease in all indices of sexual behavior. Untreated GERD is associated with disorders in sexual behavior. Compared with HC, only the surgical group partially improved after treatment.

  19. Early detection strategies for untreated first-episode psychosis

    DEFF Research Database (Denmark)

    Johannessen, Jan Olav; McGlashan, T H; Larsen, Tor Ketil

    2001-01-01

    -year inclusion period (1997-2000) are described. It includes targeted information towards the general public, health professionals and schools, and ED teams to recruit appropriate patients into treatment as soon as possible. This plus easy access to psychiatric services via ED teams systematically changed......Some studies in first-episode schizophrenia correlate shorter duration of untreated psychosis (DUP) with better prognosis, suggesting that timing of treatment may be important. A three-site prospective clinical trial in Norway and Denmark is underway to investigate the effect of the timing......-episode cases. The study ultimately will compare early detected with usual detected patients. This paper describes the study's major independent intervention variable, i.e. a comprehensive education and detection system to change DUP in first onset psychosis. System variables and first results from the four...

  20. The effect of social geographic factors on the untreated tooth decay among head start children.

    Science.gov (United States)

    Heima, Masahiro; Ferretti, Margaret; Qureshi, Mehveen; Ferretti, Gerald

    2017-10-01

    Disparities among untreated dental caries exist for children from low-income families in the United States. Understanding of the mechanism of the disparities is required to reduce it and social geographic factors are one of the important influences. Although the effect of fluoridated water has been well reported, studies of other sociogeograpic factors, such as the density of available dentists, are still very limited. The objective of this study is to explore the effect of sociogeographic factors on the number of primary teeth with untreated dental caries among children from low-income families who are enrolled in Head Start programs throughout Northeast Ohio of the United States. This was a cross-sectional chart review study. Three hundred-eighty-eight charts were reviewed, and the number of primary teeth with untreated dental caries (dt) and the children's addresses were retrieved. The sociogeographic variables, including fluoridated water availability and the density of available dentists who accept a government-supported insurance (Medicaid dentists), were collected. The mean (standard deviation) of children's age was 3.51 (1.14) years with a range of 7 months to 5 years. A negative binomial regression model analysis, which used dt as a dependent variable and children's characteristic factors (i.e. age, gender, insurance type, and total number of primary teeth) and sociogeographic factors (i.e. Population, total number of Medicaid dentists, density of Medicaid dentist, and Fluoride water availability) of cities, as independent variables, demonstrated that only the density of Medicaid dentist in the sociogeographic factors indicated a significant effect (Estimated ß-Coefficients (Standard Errors)=-0.003 (0.002), p =0.030). This study demonstrated a significant negative association between the density of available dentists and untreated dental caries among children from low-income families in Head Start programs in Northeast Ohio. Increasing available dentists

  1. Intake and digestibility of untreated and urea treated rice straw base diet fed to sheep

    Directory of Open Access Journals (Sweden)

    D Yulistiani

    2003-03-01

    Full Text Available Rice straw as one of agricultural by-products has low quality due to low content of essensial nutrients like protein, energy, minerals and vitamin as well as poor palatability and digestibility. Therefore, the quality of rice straw needs to be improved in order to increase its utilization by gastrointestinal tract of ruminants. The purpose of this study is to compare untreated and urea treated rice straw as basal diets for sheep. Twelve mature Merino wethers (average body weight 53.62 + 3.44 kg were separated into 4 groups based on their live weight with each groups assigned three diets, that are: diet 1 untreated rice straw with high forage legume content, diet 2 urea ensiled rice straw and diet 3 rice straw sprayed with urea solution at feeding time. Diets were allocated based on a randomized complete block design. Urea ensiled rice straw was prepared by spraying chopped straw with urea solution to yield straw containing 4% urea and 40% moisture, then kept in air tight polythylene bags for 6 weeks. The untreated, ensiled and urea supplemented rice straw were mixed with other feed ingredients to provide isoenergetic and isonitrogenous diets. Diets were formulated to meet maintenance requirement according to NRC. Sheep were adapted to experimental diets for 15 days, and after adaptation period, a metabolism trial was conducted. Results reveal that dry matter intake permetabolic body weight (DMI/W0.75, DE (digestible energi intake and apparent digestibility of NDF (neutral detergent fibre were not significantly different between diet 1 and diet 2. Apparent digestibility of DM (dry matter, OM (organic matter, and ADF (acid detergent fibre, as well as N retention were not significantly different between three diets. Positive result in N retention was only observed in diet 2, while others were negative. It may be concluded from this study that untreated rice straw basal diet supplemented with forage legume offer an alternative method other than urea

  2. Stage IVN neuroblastoma: MRI diagnosis of left supraclavicular ''Virchow's'' nodal spread

    International Nuclear Information System (INIS)

    Abramson, S.J.; Berdon, W.E.; Stolar, C.; Ruzal-Shapiro, C.; Garvin, J.

    1996-01-01

    Stage IV neuroblastoma is associated with high mortality; an exception are patients whose stage IV status includes distant positive nodes, but no skeletal metastases - stage IVN neuroblastoma. We describe our experience with preoperative MRI in three patients with extensive abdominal neuroblastoma without cortical bony involvement but with unsuspected metastatic involvement to the left supraclavicular (Virchow's) node. We review findings of left supraclavicular nodal spread in five earlier cases of IVN neuroblastoma. (orig.). With 3 figs., 1 tab

  3. Increased blood clearance rate of indium-111 oxine-labeled autologous CD4+ blood cells in untreated patients with Hodgkin's disease

    International Nuclear Information System (INIS)

    Grimfors, G.; Holm, G.; Mellstedt, H.; Schnell, P.O.; Tullgren, O.; Bjoerkholm, M.

    1990-01-01

    Untreated patients with Hodgkin's disease (HD) have a blood T-lymphocytopenia mainly caused by a reduction of the CD4+ subset. Indirect support for a sequestration of T cells in the spleen and tumor-involved lymphoid tissue has accumulated. To test the hypothesis that the blood CD4 T-lymphocytopenia in patients with HD is caused by an altered lymphocyte traffic, 12 untreated HD patients and five in complete clinical remission (CCR) were studied. Blood lymphocytes were collected by leukapheresis and gradient centrifugation, and were further purified by an adherence step. The cells were labeled with indium-111 oxine and reinfused intravenously into the patient. The radioactivity of CD4+ and CD8+ blood lymphocytes separated by immunoabsorption was measured from serial blood samples. CD4+ cells were eliminated more rapidly in untreated patients than patients in CCR. Repeated gamma camera imaging after autotransfusion of indium-111 oxine labeled cells demonstrated an accumulation of radioactivity in tumor-involved tissue of untreated patients. These findings support the concept of an enhanced elimination of CD4+ cells in patients with active HD that may contribute to the observed blood T-lymphocytopenia and may reflect a biologic response to the tumor

  4. Outcomes with two different schedules of bortezomib, melphalan, and prednisone (VMP) for previously untreated multiple myeloma: matched pair analysis using long-term follow-up data from the phase 3 VISTA and PETHEMA/GEM05 trials.

    Science.gov (United States)

    Mateos, Maria-Victoria; Oriol, Albert; Martínez-López, Joaquín; Teruel, Ana-Isabel; Bengoechea, Enrique; Palomera, Luis; de Arriba, Felipe; Esseltine, Dixie-Lee; Cakana, Andrew; Pei, Lixia; van de Velde, Helgi; Miguel, Jesus San

    2016-12-01

    Bortezomib-melphalan-prednisone (VMP) is a standard-of-care for previously untreated, transplant-ineligible multiple myeloma (MM). Here, we compared outcomes between VMP regimens in the VISTA trial (9-cycle VMP schedule, including 4 cycles of twice weekly bortezomib) and the PETHEMA/GEM05 trial (less intensive 6-cycle VMP schedule with 1 cycle of twice weekly and 5 cycles of weekly bortezomib, then bortezomib-based maintenance). A total of 113 patient pairs matched by propensity score (estimated using logistic regression and incorporating eight exposure/outcome-related parameters) were included in this retrospective analysis. Median cumulative bortezomib dose was higher in PETHEMA/GEM05 than VISTA (49.6 vs 37.0 mg/m 2 ); median dose intensity was lower (2.0 vs 5.1 mg/m 2 /month). Median progression-free survival (PFS) and time-to-progression (TTP) were significantly longer in PETHEMA/GEM05 than VISTA (PFS, 30.5 vs 20.0 months, p = 0.0265; TTP, 33.8 vs 24.2 months, p = 0.0049) after a median follow-up of 77.2 and 26.0 months, respectively. Median overall survival (OS) was similar (61.3 vs 61.0 months, p = 0.6528; median follow-up, 77.6 vs 60.1 months). Post-induction complete response rate was lower in PETHEMA/GEM05 than VISTA (19 vs 31 %; p = 0.03318); on-study (including maintenance) rate was similar (30 vs 31 %; p = 0.89437). This analysis suggests that the less-intensive PETHEMA/GEM05 VMP regimen plus maintenance may improve PFS and TTP, but not OS, compared with the VISTA VMP regimen. NCT00111319, NCT00443235.

  5. Transforming the Roles of a Public Extension Agency to Strengthen Innovation: Lessons from the National Agricultural Extension Project in Bangladesh

    Science.gov (United States)

    Chowdhury, Ataharul Huq; Odame, Helen Hambly; Leeuwis, Cees

    2014-01-01

    Purpose: The rapidly evolving nature of agricultural innovation processes in low-income countries requires agricultural extension agencies to transform the classical roles that previously supported linear information dissemination and adoption of innovation. In Bangladesh, strengthening agricultural innovation calls for facilitation of interactive…

  6. Improving Generation Y Volunteerism in Extension Programs

    Science.gov (United States)

    Andrews, Kevin B.; Lockett, Landry L.

    2013-01-01

    Members of Generation Y have many positive attributes that make them attractive to Extension volunteer administrators as a potential source of labor. However, they think differently, have unique needs, require new management styles, and have less tolerance for unpleasant working conditions than previous generations. Additionally, they are engaged…

  7. Phase I and pharmacologic study of the combination paclitaxel and carboplatin as first-line chemotherapy in stage III and IV ovarian cancer

    NARCIS (Netherlands)

    Huizing, M. T.; van Warmerdam, L. J.; Rosing, H.; Schaefers, M. C.; Lai, A.; Helmerhorst, T. J.; Veenhof, C. H.; Birkhofer, M. J.; Rodenhuis, S.; Beijnen, J. H.; ten Bokkel Huinink, W. W.

    1997-01-01

    To determine the maximum-tolerated dose for the combination paclitaxel and carboplatin administered every 4 weeks and to gain more insight into the pharmacokinetics and pharmacodynamics of this combination in previously untreated ovarian cancer patients. Thirty-five chemotherapy-naive patients with

  8. Is drug-resistant Mycobacterium leprae a real cause for concern?: First approach to molecular monitoring of multibacillary Colombian patients with and without previous leprosy treatment.

    Science.gov (United States)

    Guerrero, Martha Inírida; Colorado, Claudia Lucía; Torres, José Fernando; León, Clara Inés

    2014-04-01

    There is no information in Colombia on Mycobacterium leprae primary and secondary drug resistance in regards to the WHO-multidrug therapy regime. On the other hand, public health authorities around the world have issued various recommendations, one of which prompts for the immediate organization of resistance surveillance through simple molecular methods. To determine the prevalence of Mycobacterium leprae drug resistance to rifampicin, ofloxacin and dapsone in untreated and previously treated patients at the Centro Dermatológico Federico Lleras Acosta during the 1985-2004 period. We conducted a retrospective study which included multibacillary patient biopsies through elective sampling: 381 of them from new patients and 560 from previously treated patients. Using a microtome, we obtained six slides from each skin biopsy preserved in paraffin, and we extracted M. leprae DNA. We amplified three molecular targets through PCR and obtained the patterns of drug resistance to dapsone, rifampicin and ofloxacin by reverse hybridization. Finally, we collected epidemiological, clinical and demographical data for analyses. From 941 samples under study, 4.14% of them were resistant to one or more drugs, and 5.77 and 3.04% had resistant genotypes in new and previously treated patients, respectively. Total resistance for each drug was 0.43% for dapsone, 3.19% for rifampicin and 1.17% for ofloxacin. We found statistically significant differences for rifampicin and for the total population when comparing the results from untreated versus previously treated patients. Two thirds of the resistant samples were resistant to rifampicin alone or combined. The standard multidrug therapy schemes continue being effective for leprosy cases; however, it is necessary to guarantee adherence and regularity. Surveillance to drug resistance in new and previously treated leprosy cases should be established.

  9. Magnetic Resonance Imaging Features of the Nigrostriatal System: Biomarkers of Parkinson’s Disease Stages?

    Science.gov (United States)

    Hopes, Lucie; Grolez, Guillaume; Moreau, Caroline; Lopes, Renaud; Ryckewaert, Gilles; Carrière, Nicolas; Auger, Florent; Laloux, Charlotte; Petrault, Maud; Devedjian, Jean-Christophe; Bordet, Regis; Defebvre, Luc; Jissendi, Patrice; Delmaire, Christine; Devos, David

    2016-01-01

    Introduction Magnetic resonance imaging (MRI) can be used to identify biomarkers in Parkinson’s disease (PD); R2* values reflect iron content related to high levels of oxidative stress, whereas volume and/or shape changes reflect neuronal death. We sought to assess iron overload in the nigrostriatal system and characterize its relationship with focal and overall atrophy of the striatum in the pivotal stages of PD. Methods Twenty controls and 70 PD patients at different disease stages (untreated de novo patients, treated early-stage patients and advanced-stage patients with L-dopa-related motor complications) were included in the study. We determined the R2* values in the substantia nigra, putamen and caudate nucleus, together with striatal volume and shape analysis. We also measured R2* in an acute MPTP mouse model and in a longitudinal follow-up two years later in the early-stage PD patients. Results The R2* values in the substantia nigra, putamen and caudate nucleus were significantly higher in de novo PD patients than in controls. Early-stage patients displayed significantly higher R2* values in the substantia nigra (with changes in striatal shape), relative to de novo patients. Measurements after a two-year follow-up in early-stage patients and characterization of the acute MPTP mouse model confirmed that R2* changed rapidly with disease progression. Advanced-stage patients displayed significant atrophy of striatum, relative to earlier disease stages. Conclusion Each pivotal stage in PD appears to be characterized by putative nigrostriatal MRI biomarkers: iron overload at the de novo stage, striatal shape changes at early-stage disease and generalized striatal atrophy at advanced disease. PMID:27035571

  10. Genome sequence analysis of five Canadian isolates of strawberry mottle virus reveals extensive intra-species diversity and a longer RNA2 with increased coding capacity compared to a previously characterized European isolate.

    Science.gov (United States)

    Bhagwat, Basdeo; Dickison, Virginia; Ding, Xinlun; Walker, Melanie; Bernardy, Michael; Bouthillier, Michel; Creelman, Alexa; DeYoung, Robyn; Li, Yinzi; Nie, Xianzhou; Wang, Aiming; Xiang, Yu; Sanfaçon, Hélène

    2016-06-01

    In this study, we report the genome sequence of five isolates of strawberry mottle virus (family Secoviridae, order Picornavirales) from strawberry field samples with decline symptoms collected in Eastern Canada. The Canadian isolates differed from the previously characterized European isolate 1134 in that they had a longer RNA2, resulting in a 239-amino-acid extension of the C-terminal region of the polyprotein. Sequence analysis suggests that reassortment and recombination occurred among the isolates. Phylogenetic analysis revealed that the Canadian isolates are diverse, grouping in two separate branches along with isolates from Europe and the Americas.

  11. Untreated Natural Graphite as a Graphene Source for High-Performance Li-Ion Batteries

    Directory of Open Access Journals (Sweden)

    María Simón

    2018-03-01

    Full Text Available Graphene nanosheets (GNS are synthesized from untreated natural graphite (NG for use as electroactive materials in Li-ion batteries (LIBs, which avoids the pollution-generating steps of purifying graphite. Through a modified Hummer method and subsequent thermal exfoliation, graphitic oxide and graphene were synthesized and characterized structurally, morphologically and chemically. Untreated natural graphite samples contain 45–50% carbon by weight; the rest is composed of different elements such as aluminium, calcium, iron, silicon and oxygen, which are present as calcium carbonate and silicates of aluminium and iron. Our results confirm that in the GO and GNS synthesized, calcium is removed due to oxidation, though other impurities are maintained because they are not affected by the synthesis. Despite the remaining mineral phases, the energy storage capacity of GNS electrodes is very promising. In addition, an electrochemical comparison between GNS and NG demonstrated that the specific capacity in GNS is higher during the whole cycling process, 770 mA·g−1 at 100th cycle, which is twice that of graphite.

  12. Neuroendocrine and behavioral consequences of untreated and treated depression in pregnancy and lactation.

    Science.gov (United States)

    Csaszar, Eszter; Melichercikova, Kristina; Dubovicky, Michal

    2014-01-01

    Depression during pregnancy and in the post partum period is a significant health issue in modern society. The estimated prevalence of depression in pregnancy ranges from 13-20%. The major dilemma for gynecologists is to treat or not to treat depression during gestation and lactation. Consequences of untreated depression can be so serious that the benefit of antidepressant therapy may overweigh the possible risk for injury of fetal/neonatal development. Currently, selective serotonin re-uptake inhibitors (SSRIs) and serotonin and noradrenaline re-uptake inhibitors (SNRIs) are commonly used for treatment of maternal depression. The review article brings up-to-date knowledge on effects of maternal adversity (depression) and/or antidepressants on the development of the hypothalamus-pituitary-adrenal axis of the offspring in relation to postnatal behavior and reactivity to stressful stimuli. Treated as well as untreated maternal depression presents a risk for the developing fetus and neonate. The authors stress the need to evaluate the relative safety of SNRIs/SNRIs by means of relevant experimental models to assess if these drugs can be assigned to treat pregnant and lactating depressive women.

  13. Report on the laboratory examination of the effect of fungal invasion on the durability of untreated mine support timbers

    CSIR Research Space (South Africa)

    Hall, PJ

    1967-02-01

    Full Text Available stream_source_info RR 12_67 The laboratory examination of the effect of fungal invasion on the durability of untreated mine support timber COMRO 1967.pdf.txt stream_content_type text/plain stream_size 8 Content-Encoding ISO-8859...-1 stream_name RR 12_67 The laboratory examination of the effect of fungal invasion on the durability of untreated mine support timber COMRO 1967.pdf.txt Content-Type text/plain; charset=ISO-8859-1 ...

  14. Are prostate carcinoma clinical stages T1C and T2 similar?

    Directory of Open Access Journals (Sweden)

    Athanase Billis

    2006-04-01

    Full Text Available PURPOSE: A recent study has found that PSA recurrence rate for clinical T1c tumors is similar to T2 tumors, indicating a need for further refinement of clinical staging system. To test this finding we compared clinicopathologic characteristics and the time to PSA progression following radical retropubic prostatectomy of patients with clinical stage T1c tumors to those with stage T2, T2a or T2b tumors. MATERIALS AND METHODS: From a total of 186 consecutive patients submitted to prostatectomy, 33.52% had clinical stage T1c tumors, 45.45% stage T2a tumors and 21.02% stage T2b tumors. The variables studied were age, preoperative PSA, prostate weight, Gleason score, tumor extent, positive surgical margins, extraprostatic extension (pT3a, seminal vesicle invasion (pT3b, and time to PSA progression. Tumor extent was evaluated by a point-count method. RESULTS: Patients with clinical stage T1c were younger and had the lowest mean preoperative PSA. In the surgical specimen, they had higher frequency of Gleason score < 7 and more organ confined cancer. In 40.54% of the patients with clinical stage T2b tumors, there was extraprostatic extension (pT3a. During the study period, 54 patients (30.68% developed a biochemical progression. Kaplan-Meier product-limit analysis revealed no significant difference in the time to PSA progression between men with clinical stage T1c versus clinical stage T2 (p = 0.7959, T2a (p = 0.6060 or T2b (p = 0.2941 as well as between men with clinical stage T2a versus stage T2b (p = 0.0994. CONCLUSION: Clinicopathological features are not similar considering clinical stage T1c versus clinical stages T2, T2a or T2b.

  15. Meropenem-Clavulanate is Effective Against Extensive Drug-Resistant Mycobacterium Tuberculosis

    Energy Technology Data Exchange (ETDEWEB)

    Hugonnet, J.; Tremblay, L; Boshoff, H; Barry, C; Blanchard, J

    2009-01-01

    e-lactam antibiotics are ineffective against Mycobacterium tuberculosis, being rapidly hydrolyzed by the chromosomally encoded blaC gene product. The carbapenem class of e-lactams are very poor substrates for BlaC, allowing us to determine the three-dimensional structure of the covalent BlaC-meropenem covalent complex at 1.8 angstrom resolution. When meropenem was combined with the e-lactamase inhibitor clavulanate, potent activity against laboratory strains of M. tuberculosis was observed [minimum inhibitory concentration (MICmeropenem) less than 1 microgram per milliliter], and sterilization of aerobically grown cultures was observed within 14 days. In addition, this combination exhibited inhibitory activity against anaerobically grown cultures that mimic the 'persistent' state and inhibited the growth of 13 extensively drug-resistant strains of M. tuberculosis at the same levels seen for drug-susceptible strains. Meropenem and clavulanate are Food and Drug Administration-approved drugs and could potentially be used to treat patients with currently untreatable disease.

  16. Carcinoma of the cervix: Staging with MR imaging

    International Nuclear Information System (INIS)

    Waggenspack, G.A.; Amparo, E.G.; Fagan, C.J.; Hannigan, E.V.

    1986-01-01

    Forty MR imaging examinations in 38 patients with newly diagnosed or recurrent squamous cell carcinoma of the cervix were retrospectively evaluated and compared with clinical and surgical findings for staging. There was poor correlation between loss of fat planes and extension of tumor into the rectum or bladder, and it was impossible to differentiate bladder edema from direct invasion. MR imaging underestimated parametrial and pelvic sidewall extension when compared with physical exam under anesthesia. MR imaging was useful in the direct demonstration of a cervical mass and in detecting enlarged pelvic nodes

  17. Stage 2 carcinoma of the cervix

    International Nuclear Information System (INIS)

    Abayomi, O.

    1990-01-01

    This is a retrospective analysis of the results of 24 patients with bulky stage 2 carcinoma of the cervix treated with full course irradiation followed by adjunctive surgery between 1975 and 1980. A review of the surgical specimens following irradiation showed that 12 patients had no residual cancer, five had only microscopic foci of cancer, and five had extensive residual cancer. Two patients had unresectable persistent cancer. Six patients had histological evidence of lymph node metastases prior to irradiation. The surgical-pathological findings following irradiation had important prognostic implications. All five patients with extensive residual cancer in the surgical specimen recurred, 2 of 5 patients with only microscopic foci of residual cancer and, none of the 12 patients with no residual cancer in the resected specimens developed a recurrence. Lymph node involvement was not associated with an increased incidence of recurrence. Most patients with residual cancer following full course irradiation recurred locally. Thus the addition of adjunctive surgery following full course irradiation did not significantly improve the treatment results of patients with bulky stage 2 carcinoma of the cervix. (author). 14 refs.; 2 figs

  18. Augmented therapy of extensive Hodgkin's disease: radiation to known disease or prolongation of induction chemotherapy did not improve survival--results of a cancer and leukemia group B study

    International Nuclear Information System (INIS)

    Coleman, Morton; Rafla, Sameer; Propert, Kathleen J.; Glicksman, Arvin; Peterson, Bruce; Nissen, Nis; Brunner, Kurt; Holland, James F.; Anderson, James R.; Gottlieb, Arlan; Kaufman, Thomas

    1998-01-01

    Purpose: This prospective randomized trial in extensive untreated Hodgkin's disease was undertaken to assess the potential benefit of augmented therapy (12 months chemotherapy or radiation to known disease) compared to standard 6 months chemotherapy. Patient and Methods: A total of 258 patients, mostly Stage IV, were randomized to four treatment regimens consisting of six cycles of CCNU, vinblastine, procarbazine, and prednisone (CVPP); 12 cycles of CVPP; six cycles of CVPP followed by 25 Gy radiotherapy; or three cycles CVPP, 25 Gy radiotherapy, and three cycles CVPP. Results: Complete remissions were achieved in 65% of all patients. A 58% overall 5-year survival rate was obtained. Relapses in irradiated areas of known disease occurred in only 6% of responding patients. There was, however, no statistical difference in response frequency, disease-free survival, or overall survival among the four regimens. Elderly patients responded less frequently. Conclusion: While radiotherapy provided control of local (known) disease, no impact on overall survival was apparent. Likewise, doubling the duration of chemotherapy did not improve response or survival. Augmentation of therapy with either radiotherapy or more chemotherapy in this study was of no benefit compared to the standard 6 months of treatment

  19. Clinical consequences of untreated dental caries evaluated using PUFA index in orphanage children from India

    OpenAIRE

    Shanbhog, Raghavendra; Godhi, Brinda S; Nandlal, Bhojraj; Kumar, Shruti S; Raju, Veena; Rashmi, S

    2013-01-01

    Background: To determine the prevalence and severity of oral condition related to untreated dental caries with PUFA index and to relate period of institutional stay, oral hygiene practice and diet of orphan children to caries experience ratio.

  20. Growth of Chironomus dilutus larvae exposed to ozone-treated and untreated oil sands process water

    International Nuclear Information System (INIS)

    Anderson, J.; Wiseman, S.; Franz, E.; Jones, P.; Liber, K.; Giesy, J.; Gamal El-Din, M.; Marin, J.

    2010-01-01

    Oil sand processing operations require large quantities of freshwater and produce large volumes of oil sands process water (OSPW) which must be stored on-site. This presentation reviewed various treatment methods for remediating OSPW in order to eliminate downstream toxicity. Naphthenic acids are the most important target fractions for treatment because they are primarily responsible for the acute toxicity of OSPW. Although ozonation has shown promise for reducing OSPW toxicity, the effects of ozonation on aquatic invertebrates remain unknown. This study investigated the effects of exposure to untreated and ozonated OSPW in Chironomus dilutus larvae. OSPW was treated with either a 50 or 80 mg O 3 /L dose of ozonation. The effects of ozonation levels on C. dilutus survival and growth were examined. The study showed that after a 10-day exposure, there were pronounced effects on survival of larvae exposed to ozone-treated or untreated OSPW. Larvae exposed to OSPW were 64-77 percent smaller than their respective controls, but the mean wet mass of organisms exposed to 50 mg O 3 /L ozonated OSPW was not much different from that of the controls. Larvae exposed to 80 mg O 3 /L ozone-treated OSPW were 40 percent smaller than the freshwater controls, and the mean wet mass was also much larger than the untreated OSPW. It was concluded that the toxicity of OSPW to benthic invertebrates may be reduced by ozone treatment.

  1. Bmi-1 Regulates Extensive Erythroid Self-Renewal

    Directory of Open Access Journals (Sweden)

    Ah Ram Kim

    2015-06-01

    Full Text Available Red blood cells (RBCs, responsible for oxygen delivery and carbon dioxide exchange, are essential for our well-being. Alternative RBC sources are needed to meet the increased demand for RBC transfusions projected to occur as our population ages. We previously have discovered that erythroblasts derived from the early mouse embryo can self-renew extensively ex vivo for many months. To better understand the mechanisms regulating extensive erythroid self-renewal, global gene expression data sets from self-renewing and differentiating erythroblasts were analyzed and revealed the differential expression of Bmi-1. Bmi-1 overexpression conferred extensive self-renewal capacity upon adult bone-marrow-derived self-renewing erythroblasts, which normally have limited proliferative potential. Importantly, Bmi-1 transduction did not interfere with the ability of extensively self-renewing erythroblasts (ESREs to terminally mature either in vitro or in vivo. Bmi-1-induced ESREs can serve to generate in vitro models of erythroid-intrinsic disorders and ultimately may serve as a source of cultured RBCs for transfusion therapy.

  2. The microstructural origin of work hardening stages

    DEFF Research Database (Denmark)

    Hughes, D. A.; Hansen, N.

    2018-01-01

    The strain evolution of the flow stress and work hardening rate in stages III and IV is explored by utilizing a fully described deformation microstructure. Extensive measurements by transmission electron microscopy reveal a hierarchical subdivision of grains by low angle incidental dislocation...... addition of the classical Taylor and Hall-Petch formulations. Model predictions agree closely with experimental values of flow stress and work hardening rate in stages III and IV. Strong connections between the evolutionary stages of the deformation microstructure and work hardening rates create a new...... (modern) basis for the classic problem of work hardening in metals and alloys. These connections lead the way for the future development of ultra high strength ductile metals produced via plastic deformation.(c) 2018 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved....

  3. Chemo-radioresistance of small cell lung cancer cell lines derived from untreated primary tumors obtained by diagnostic bronchofiberscopy

    International Nuclear Information System (INIS)

    Tanio, Yoshiro; Watanabe, Masatoshi; Inoue, Tamotsu

    1990-01-01

    New cell lines of small cell lung cancer (SCLC) were established from specimens of untreated primary tumors biopsied by diagnostic bronchofiberscopy. The advantage of this method was ease of obtaining specimens from lung tumors. Establishment of cell lines was successful with 4 of 13 specimens (30%). Clinical responses of the tumors showed considerable variation, but were well correlated with the in vitro sensitivity of the respective cell lines to chemotherapeutic drugs and irradiation. One of the cell lines was resistant to all drugs tested and irradiation, while another was sensitive to all of them. Although the acquired resistance of SCLC is the biggest problem in treatment, the natural resistance to therapy is another significant problem. Either acquired or natural, resistance mechanisms of SCLC may be elucidated by the use of such cell lines derived from untreated tumors. This method and these SCLC cell lines are expected to be useful for the serial study of biologic and genetic changes of untreated and pre-treated tumors, or primary and secondary tumors. (author)

  4. Relationship between parents' occupational characteristics and untreated dental caries in offspring: A population-based study of data from the Korean National Health and Nutrition Examination Survey, 2008-2015.

    Science.gov (United States)

    Lim, Sung-Shil; Kim, Byurira; Yoon, Jin-Ha; Song, Je Seon; Park, Eun-Cheol; Jang, Sung-In

    2018-05-01

    Objectives We investigated the association between parents' occupational characteristics and untreated dental caries in their children. Methods We analyzed the data of 4764 and 5862 children merged with data of their mothers and fathers, respectively, derived from the Korean National Health and Nutrition Examination Survey, 2008-2015. Dentists assessed untreated dental caries, and occupational characteristics were self-reported. The associations between untreated dental caries in children and their parents' occupational characteristics were assessed with logistic regression analysis. Results The prevalence of untreated dental caries was 18.58% and 16.39% in the mother- and father-matched data, respectively. Compared to children whose mothers worked regular hours, those whose mothers worked overtime had increased odds of untreated dental caries [odds ratio (OR) 1.19, 95% confidence interval (CI) 1.02-1.39]. Children of female self-employed workers/employers/unpaid family workers had higher odds of untreated dental caries than those of wage earners (OR 1.18, 95% CI 1.00-1.39). The OR of untreated dental caries was higher among children with shift-working parents than those whose parents worked daytime hours (mother: OR 1.29, 95% CI 1.11-1.51; father: OR 1.36, 95% CI 1.18-1.58). Conclusions The children of non-white-collar workers, non-wage earners, and workers working overtime or doing shift work had higher odds of untreated dental caries. The effects of parental occupational characteristics on untreated dental caries differed by sex (mother versus father). Public health programs targeting the prevention of dental caries among children should consider parental occupational characteristics.

  5. Acute pancreatitis: staging with CT

    International Nuclear Information System (INIS)

    Gialeli, E.; Petrocheilou, G.; Georgaki, S.; Tzemailas, I.; Adraktas, A.; Charilas, G.; Patsiogiannis, V.

    2012-01-01

    Full text: Introduction: Computed Tomography (CT) is the imaging modality of choice for the diagnosis and staging of acute pancreatitis and its complications. Objectives and tasks: The purpose of this presentation is to demonstrate the findings in CT images which are useful for staging acute pancreatitis according to Balthazar, their significance and restrictions. Materials and methods: CT images from patients who were referred to our Department for an abdominal CT scan for the diagnosis or/and staging of acute pancreatitis were retrospectively studied. Results: In acute pancreatitis, CT helps to stage the severity of inflammatory process, to detect pancreatic necrosis and to depict local complications. CT severity index (CTSI), which was proposed by Balthazar et al, combines the grade of pancreatitis with the extent of pancreatic necrosis assigning points to the patients in order to find the severity index which scales from 0-10. More points are given for a higher grade of pancreatitis and for more extensive necrosis. Types of pancreatitis according to CTSI are: interstitial (Balthazar grade A-C), exudative (Balthazar grade D or E), necrotising (Balthazar grade E, CTSI:10) and central gland necrotising. Patients with pancreatitis but no collections or necrosis have an interstitial (mild) pancreatitis. In exudative pancreatitis there is normal enhancement of the entire pancreas associated with extensive peripancreatic collections. Necrotizing (severe) pancreatitis is characterized by protacted clinical course, high incidence of local complications and high mortality rate. Central gland necrosis is a subtype of necrotizing pancreatitis. Conclusions: The combination of CT imaging and clinical and laboratory evaluation allows the early diagnosis of acute pancreatitis. Acute pancreatitis may vary from a mild uneventful disease to a severe life-threatening illness with multisystemic organ failure. Thus, it is crucial to identify patients who are at high risk of severe

  6. The Histological, Histomorphometrical and Histochemical Changes of Testicular Tissue in the Metformin Treated and Untreated Streptozotocin-Induced Adult Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Davoud Kianifard

    2011-03-01

    Full Text Available In this investigation, diabetes was induced in adult male Sprague-Dawley rats by single intraperitoneal injection of streptozotocin (STZ at 45 mg kg-1 of body weight. A group comprised of 8 diabetic rats was treated with metformin at 100 mg kg-1 of body weight for reducing the elevated blood glucose level. The results revealed that, in the untreated diabetic rats, the body and testicular weight reduced in comparison with the control rats (P < 0.05 , the metformin treated diabetic rats showed body weight loss in comparison with the control group (P < 0.05. In the untreated diabetic rats, the blood glucose level significantly increased in comparison with control and metformin treated diabetic rats. Histomorphological examinations revealed a reduction in testicular capsule diameter, seminiferous tubules (STs and germinal epithelium height, increase of amorphous material of interstitial tissue, germ cell depletion, decrease in cellular population and activity and disruption of spermatogenesis in the untreated diabetic rats in comparison with control group. In metformin treated diabetic rats, the histomorphological alterations were seen in lesser part in comparison with untreated diabetic group. The results from this study proved that, there was a direct relationship between increased levels of blood glucose as a result of STZ-induced diabetes and the histomorphological changes of testicular tissue.

  7. Effect of pH, Dosage and Concentration on the Adsorption of Congo Red onto Untreated and Treated Aluminium Dross

    Science.gov (United States)

    Zakaria Mohamad Zulfika, Hazielim B.; Baini, Rubiyah; Zauzi, Nur Syuhada Ahmad

    2017-06-01

    The adsorption of congo red onto aluminium dross was studied in batch process. The objective of this study is to adsorption capacity between untreated and treated aluminium dross in the removal of congo red. Aluminium dross was leached with 250 ml of 1% of NaOH and and precipitated with 30% H2O2. The treated aluminium dross being calcined at 600°C for 3 hours. The surface area for untreated and treated aluminium dross was 10.06 m2/g and 79.80 m2/g respectively. Then the adsorption process was carried out on an orbital shaker at 200 rpm for 4 hours. In the effect of pH, it was found that untreated removes more congo red compared to the treated while in the effect of concentration solution and dosage of adsorbent, treated aluminium dross removes more congo red. In conclusion, this adsorbent was found to be effective and economically viable in the removal of congo red in waste water treatment.

  8. [Prognostic value of (18)F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) in extensive-stage small cell lung cancer].

    Science.gov (United States)

    Ding, C Y; Guo, Z; Li, Y Y; Li, T R

    2017-11-23

    Objective: To investigated the prognostic value of (18)F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) in extensive-stage small cell lung cancer (ES -SCLC). Methods: Fifty-five patients with ES-SCLC who underwent pretreatment (18)F-FDG PET-CT were retrospectively recruited in this study. The correlations of maximum standardized uptake value (SUVmax) of primary lesion, metabolic tumor volume (MTV) of primary lesion (MTVp), total lesion glycolysis (TLG) of primary lesion (TLGp), the highest SUVmax of all lesions, the sum of metabolic volume (MTV sum), the sum of total lesions glycolysis (TLGsum) and clinical factors were analyzed. Results: The SUVmax, MTVp, TLGp, the highest SUVmax, MTVsum and TLGsum of 55 patients were 11.34±7.02, 29.61 cm(3,) 207.72, 13.61±7.10, 123.57 cm(3) and 988.48, respectively. The SUVmax of primary lesion, MTVp and TLGp were correlated with tumor type and the maximal tumor length, respectively(all P CT has certain prognostic value of patients with ES-SCLC. MTVsum and TLGsum are the independent predictors of PFS, and TLGsum is also an independent predictor of OS.

  9. Duration of untreated psychosis and pathway to care in Riyadh, Saudi Arabia.

    Science.gov (United States)

    Al Fayez, Hanan; Lappin, Julia; Murray, Robin; Boydell, Jane

    2017-02-01

    Recent studies of 'duration of untreated psychosis' (DUP) indicate that some patients remain untreated in the community for some time. Considerable emphasis has been placed on reducing the DUP. However, most studies investigating DUP have been conducted in Western countries, where well-developed primary care systems are available. This study aims to describe DUP and its association with both demographic factors and pathways to care in Riyadh, Saudi Arabia. A retrospective study of 421 new case records of all Saudi schizophrenia patients over a 2-year period in six governmental hospitals in Riyadh, Saudi Arabia. The median DUP was 1.41 years (interquartile range 0.35-2.81 years). The longest time to contact was 9.86 years but 90% had a DUP shorter than 5 years. Older age at onset, single marital status and higher educational level were associated with shorter DUP. Long DUP was associated with help seeking from traditional healers. In Saudi Arabia, it usually takes longer for patients to seek help from psychiatric services after their first psychosis onset than it does in Western countries. The results suggest that the DUP is influenced by both demographic factors and pathways to care. © 2015 Wiley Publishing Asia Pty Ltd.

  10. Toxicity assessment of untreated/treated electroplating sludge using human and plant bioassay.

    Science.gov (United States)

    Orescanin, Visnja; Durgo, Ksenija; Mikelic, Ivanka Lovrencic; Halkijevic, Ivan; Kuspilic, Marin

    2018-04-30

    The purpose of this work was to assess the risk to the environment arising from the electroplating sludge from both chemical and toxicological point of view. Both approaches were used for the assessment of the treatment efficiency which consisted of CaO based solidification followed by thermal treatment at 400°C. The elemental composition was determined in the bulk samples and the leachates of untreated sludge. The toxicity of the leachate was determined using two human colorectal adenocarcinoma cell lines (Caco-2 and SW 480) and Hordeum vulgare L. based plant bioassay. The same toxicity tests were employed to the leachate of the treated sludge. Untreated sludge showed extremely high cytotoxic effect to both human and plant bio-system in dose-dependent manner. The percentages higher than 0.5% and 0.05% of the leachate caused significant cytotoxic effect on Caco-2 and SW 480 cells, respectively. The percentages of the leachate higher than 0.05% also showed significant toxic effect to H. vulgare L. bio-system with complete arrest of seed germination following the treatment with 100% to 5% of the leachate. The leachate of the treated sludge showed no toxicity to any of the test systems confirming the efficiency and justification of the employed procedures for the detoxification of electroplating sludge.

  11. Detection and preoperative staging of carcinoma of the cervix: Comparison between MR imaging and CT

    International Nuclear Information System (INIS)

    Mayr, B.; Schmidt, H.; Baieri, P.; Scheidel, P.; Meier, W.; Schramm, T.

    1986-01-01

    Twenty-four patients with carcinoma of the cervix were examined preoperatively by MR imaging and CT. In all patients histopathologic confirmation was available for specimens obtained either by radical hysterectomy or at staging laparotomy. MR imaging was equivalent to contrast CT in the detection and evaluation of tumor extension in the cervix. Tumor extension to the parametria and pelvic wall was difficult to evaluate on both modalities, as neither had a higher accuracy than pelvic examination conducted under anesthesia. Nodal staging was nearly equivalent on MR imaging and CT. In the detection and staging of carcinoma of the cervix, MR imaged proved to be as good as CT with contrast agent enhancement

  12. Martini Coarse-Grained Force Field : Extension to Carbohydrates

    NARCIS (Netherlands)

    Lopez, Cesar A.; Rzepiela, Andrzej J.; de Vries, Alex H.; Dijkhuizen, Lubbert; Huenenberger, Philippe H.; Marrink, Siewert J.

    2009-01-01

    We present an extension of the Martini coarse-grained force field to carbohydrates. The parametrization follows the same philosophy as was used previously for lipids and proteins, focusing on the reproduction of partitioning free energies of small compounds between polar and nonpolar phases. The

  13. Advanced Low-Noise Research Fan Stage Design

    Science.gov (United States)

    Neubert, Robert; Bock, Larry; Malmborg, Eric; Owen-Peer, William

    1997-01-01

    This report describes the design of the Advanced Low-Noise Research Fan stage. The fan is a variable pitch design, which is designed at the cruise pitch condition. Relative to the cruise setting, the blade is closed at takeoff and opened for reverse thrust operation. The fan stage is a split flow design with fan exit guide vanes (FEGVs) and core stators. The fan stage design is combined with a nacelle and engine core duct to form a powered fan/nacelle subscale model. This model is intended for use in combined aerodynamic, acoustic, and structural testing in a wind tunnel. The fan has an outer diameter of 22 in. and a hub-to-tip of 0.426 in., which allows the use of existing NASA fan and cowl force balance and rig drive systems. The design parameters were selected to permit valid acoustic and aerodynamic comparisons with the Pratt & Whitney (P&W) 17- and 22-in. rigs previously tested under NASA contract. The fan stage design is described in detail. The results of the design axisymmetric and Navier-Stokes aerodynamic analysis are presented at the critical design conditions. The structural analysis of the fan rotor and attachment is included. The blade and attachment are predicted to have adequate low-cycle fatigue life and an acceptable operating range without resonant stress or flutter. The stage was acoustically designed with airfoil counts in the FEGV and core stator to minimize noise. A fan/FEGV tone analysis developed separately under NASA contract was used to determine the optimum airfoil counts. The fan stage was matched to the existing nacelle, designed under the previous P&W low-noise contract, to form a fan/nacelle model for wind tunnel testing. It is an axisymmetric nacelle for convenience in testing and analysis. Previous testing confirmed that the nacelle performed as required at various aircraft operating conditions.

  14. Determinants of the incidence of childhood asthma: a two-stage case-control study.

    Science.gov (United States)

    Martel, Marie-Josée; Rey, Evelyne; Malo, Jean-Luc; Perreault, Sylvie; Beauchesne, Marie-France; Forget, Amélie; Blais, Lucie

    2009-01-15

    Extensive literature exists on potential risk factors for childhood asthma. To the authors' knowledge, no investigators have yet attempted to disentangle the effects of those determinants within a single study setting. The authors aimed to evaluate the independent effects of 47 potential determinants (from the prenatal, perinatal, and childhood periods) of asthma development in children within the first 10 years of life. From a Canadian birth cohort of 26,265 children (1990-2002), a 2-stage case-control study was conducted. In the first stage, 20 controls per case were selected from 3 administrative databases. In the second stage, selected mothers were mailed questionnaires for assessment of additional determinants. Increased risks of childhood asthma were found for > or =1 previous diagnosis of bronchopulmonary disease and atopic dermatitis in the child, oxygen administration after birth, prescription of antibiotics within the first 6 months of life, male gender, asthma during pregnancy, use of antibiotics during pregnancy, maternal receipt of social aid, paternal asthma, and asthma in siblings. Protective effects included use of intranasal corticosteroids during pregnancy, having a wood-burning fireplace, having pets in the home prior to the index date, breastfeeding, and day-care attendance. This study allowed the authors to identify, within a single setting, the most influential determinants of childhood asthma among 47 predictors assessed for the prenatal, perinatal, and childhood periods.

  15. Effect of Auditory Constraints on Motor Learning Depends on Stage of Recovery Post Stroke

    Directory of Open Access Journals (Sweden)

    Viswanath eAluru

    2014-06-01

    Full Text Available In order to develop evidence-based rehabilitation protocols post stroke, one must first reconcile the vast heterogeneity in the post-stroke population and develop protocols to facilitate motor learning in the various subgroups. The main purpose of this study is to show that auditory constraints interact with the stage of recovery post stroke to influence motor learning. We characterized the stages of upper limb recovery using task-based kinematic measures in twenty subjects with chronic hemiparesis, and used a bimanual wrist extension task using a custom-made wrist trainer to facilitate learning of wrist extension in the paretic hand under four auditory conditions: 1 without auditory cueing; 2 to non-musical happy sounds; 3 to self-selected music; and 4 to a metronome beat set at a comfortable tempo. Two bimanual trials (15 s each were followed by one unimanual trial with the paretic hand over six cycles under each condition. Clinical metrics, wrist and arm kinematics and electromyographic activity were recorded. Hierarchical cluster analysis with the Mahalanobis metric based on baseline speed and extent of wrist movement stratified subjects into three distinct groups which reflected their stage of recovery: spastic paresis, spastic co-contraction, and minimal paresis. In spastic paresis, the metronome beat increased wrist extension, but also increased muscle co-activation across the wrist. In contrast, in spastic co-contraction, no auditory stimulation increased wrist extension and reduced co-activation. In minimal paresis, wrist extension did not improve under any condition. The results suggest that auditory task constraints interact with stage of recovery during motor learning after stroke, perhaps due to recruitment of distinct neural substrates over the course of recovery. The findings advance our understanding of the mechanisms of progression of motor recovery and lay the foundation for personalized treatment algorithms post stroke.

  16. Phenotypic and functional characteristics of blood natural killer cells from melanoma patients at different clinical stages.

    Directory of Open Access Journals (Sweden)

    Giulia Fregni

    Full Text Available Melanomas are aggressive skin tumors characterized by high metastatic potential. Immunotherapy is a valuable alternative for metastatic melanoma patients resistant to chemotherapy. Natural Killer (NK cells are efficient anti-tumor cytotoxic effectors. We previously showed that blood NK cells from stage IV metastatic melanoma patients display decreased NK receptors and that chemotherapy modifies the functional status of blood NK cells. To investigate the role of NK cells along melanoma progression, we have here studied NK cells from patients at different stages of the disease. First, we showed that ex vivo NK cells from certain stage III-IV patients displayed low degranulation potential. Using a dynamic label-free assay, we found that immunoselected IL-2 activated blood NK cells from patients efficiently lysed melanoma cells through NKp46 and NKG2D receptors, independently to the clinical stage. Moreover, the ex vivo phenotype of circulating NK cells from 33 patients (stage I to IV was extensively analyzed. NK cells from patients displayed higher variability in the percentages of Natural Cytotoxicity Receptors (NCR and Natural Killer Group 2D (NKG2D receptor expression compared to donor NK cells. The main defect was the decreased expression of NCR1 (NKp46 by NK cells from metastatic patients. Interestingly, we found a positive correlation between the NK cell percentages of NKp46 and the duration of stage IV in melanoma patients. Finally, we showed that NK cells infiltrated primary melanomas and displayed a predominant peritumoral distribution. These results are new arguments for the development of NK-based therapies in melanoma patients.

  17. Characterization of untreated and treated male and female date palm leaves

    International Nuclear Information System (INIS)

    AlMaadeed, M.A.; Kahraman, Ramazan; Noorunnisa Khanam, P.; Al-Maadeed, Somaya

    2013-01-01

    Highlights: ► Sheshi female and male date palm leaves were treated with NaOH concentrations. ► Male leaves have lower mechanical properties and improved when treated by NaOH 2%. ► Female leaves have higher thermal stability. ► There are different properties for different types of date leaves. ► Leaves can be used as reinforcements for thermoplastic materials. -- Abstract: This paper describes the characterization of male and female date palm leaves from two different cultivars, Sheshi female and unknown male leaves. Characterization was done for both untreated and NaOH treated date palm leaves by infrared spectroscopy, thermogravimetric analysis and scanning electron microscopic techniques. To our knowledge, the difference in specious reaction to the treatment type of date palm fiber has not been investigated earlier. These leaves were treated with different concentrations of NaOH, 0.5%, 1%, 2% and 5% (w/w). The results from this investigation indicate that female leaves have better tensile properties which deteriorate with the increase of the alkali. The male leaves have lower tensile properties than female leaves and their mechanical properties are improved slightly by NaOH treatment. Female leaves have more pores than male leaves, this was proved and calculated by image analysis. Untreated female leaves have higher thermal stability (353 °C) than male leaves (343 °C). Both can be used as reinforcements in thermoplastic matrix materials whose processing temperatures are below 300 °C.

  18. Non-extensive statistical effects in nuclear many-body problems

    International Nuclear Information System (INIS)

    Lavagno, A.; Quarati, P.

    2007-01-01

    Density and temperature conditions in many stellar core and in the first stage of relativistic heavy-ion collisions imply the presence of non-ideal plasma effects with memory and long-range interactions between particles. Recent progress in statistical mechanics indicates that Tsallis non-extensive thermostatistics could be the natural generalization of the standard classical and quantum statistics, when memory effects and long range forces are not negligible. In this framework, we show that in weakly non-ideal plasma non-extensive effects should be taken into account to derive the equilibrium distribution functions, the quantum fluctuations and correlations between the particles. The strong influence of these effects is discussed in the context of the solar plasma physics and in the high-energy nuclear-nuclear collision experiments. Although the deviation from Boltzmann-Gibbs statistics, in both cases, is very small, the stellar plasma and the hadronic gas are strongly influenced by the non-extensive feature and the discrepancies between experimental data and theoretical previsions are sensibly reduced. (authors)

  19. Amendment to the Agreement between CERN and the Republic of Cyprus concerning the granting of the status of Associate Membership as the pr-stage to Membership at CERN Extension of the deadline for internal approval of the agreement by the Republic of Cyprus

    CERN Document Server

    2015-01-01

    Amendment to the Agreement between CERN and the Republic of Cyprus concerning the granting of the status of Associate Membership as the pr-stage to Membership at CERN Extension of the deadline for internal approval of the agreement by the Republic of Cyprus

  20. Linking the environmental loads to the fate of PPCPs in Beijing: Considering both the treated and untreated wastewater sources

    International Nuclear Information System (INIS)

    Wang, Bin; Dai, Guohua; Deng, Shubo; Huang, Jun; Wang, Yujue; Yu, Gang

    2015-01-01

    The environmental loads of pharmaceutical and personal care products (PPCPs) in Beijing were estimated from direct discharge of untreated wastewater and WWTP treated effluent. The annual environmental loads of 15 PPCP components ranged from 16.3 kg (propranolol) to 9.85 tons (caffeine). A fugacity model was developed to successfully estimate the PPCP pollution based on the estimated environmental load. The modeled results approximated the observed PPCP concentrations in Beijing. The untreated wastewater contributed significantly to PPCP pollution in Beijing, ranging from 46% (propranolol) to 99% (caffeine). The total environmental burden of target PPCPs ranged from 0.90 kg (propranolol) to 536 kg (caffeine). Water is the most important media for the fate of PPCPs. Monte Carlo-based concentration distributions of PPCPs are consistent with the observed results. The most important way to reduce the PPCP pollution is to both improve wastewater collection rate and adopt deep treatment technologies. - Highlights: • Annual environmental loads of PPCPs ranged from 16.3 kg to 9.85 tons in Beijing. • The environmental loads can be linked to PPCP pollution by fugacity model. • Untreated wastewater significantly contributed to PPCP pollution in Beijing. • The environmental burden of 15 PPCPs in Beijing ranged from 0.90 kg to 536 kg. • Uncertainty simulation successfully generated PPCP concentration distribution. - The environmental loads from both the treated and untreated wastewater sources contribute to PPCPs pollution in the surface water in Beijing, China

  1. Transcriptomic analysis in a Drosophila model identifies previously implicated and novel pathways in the therapeutic mechanism in neuropsychiatric disorders

    Directory of Open Access Journals (Sweden)

    Priyanka eSingh

    2011-03-01

    Full Text Available We have taken advantage of a newly described Drosophila model to gain insights into the potential mechanism of antiepileptic drugs (AEDs, a group of drugs that are widely used in the treatment of several neurological and psychiatric conditions besides epilepsy. In the recently described Drosophila model that is inspired by pentylenetetrazole (PTZ induced kindling epileptogenesis in rodents, chronic PTZ treatment for seven days causes a decreased climbing speed and an altered CNS transcriptome, with the latter mimicking gene expression alterations reported in epileptogenesis. In the model, an increased climbing speed is further observed seven days after withdrawal from chronic PTZ. We used this post-PTZ withdrawal regime to identify potential AED mechanism. In this regime, treatment with each of the five AEDs tested, namely, ethosuximide (ETH, gabapentin (GBP, vigabatrin (VGB, sodium valproate (NaVP and levetiracetam (LEV, resulted in rescuing of the altered climbing behavior. The AEDs also normalized PTZ withdrawal induced transcriptomic perturbation in fly heads; whereas AED untreated flies showed a large number of up- and down-regulated genes which were enriched in several processes including gene expression and cell communication, the AED treated flies showed differential expression of only a small number of genes that did not enrich gene expression and cell communication processes. Gene expression and cell communication related upregulated genes in AED untreated flies overrepresented several pathways - spliceosome, RNA degradation, and ribosome in the former category, and inositol phosphate metabolism, phosphatidylinositol signaling, endocytosis and hedgehog signaling in the latter. Transcriptome remodeling effect of AEDs was overall confirmed by microarray clustering that clearly separated the profiles of AED treated and untreated flies. Besides being consistent with previously implicated pathways, our results provide evidence for a role of

  2. Diseases of aging untreated virgin female RFM and BALB/c mice

    International Nuclear Information System (INIS)

    Cosgrove, G.E.; Satterfield, L.C.; Bowles, N.D.; Klima, W.C.

    1978-01-01

    Diseases of untreated, virgin female barrier-maintained RFM and BALB/c mice used as controls in a large radiation aging experiment were necropsied after natural death. The spectrum and incidence of neoplastic and nonneoplastic diseases were somewhat different in the two strains. Both strains show a high incidence of neoplasma (largely reticulum cell sarcomas and lung tumors) and of glomerulosclerosis. A wide variety of other diseases was noted in much lower incidence. The findings in the RF were briefly compared with those in earlier experiments with that strain in this laboratory

  3. School-based approaches to reducing the duration of untreated psychosis.

    Science.gov (United States)

    Schiffman, Jason; Stephan, Sharon Hoover; Hong, L Elliot; Reeves, Gloria

    2015-04-01

    Students with emerging psychosis often experience delays in diagnosis and treatment that impact mental health and academic outcomes. School systems have tremendous potential to improve early identification and treatment of adolescent psychosis. As a community-based resource, schools can support outreach, education, and screening for adolescents with psychosis and engage identified students and their families for treatment. The concept of duration of untreated psychosis (DUP; the gap between symptom onset and treatment initiation) in adolescent psychosis and the potential role of schools in reducing DUP are reviewed. Future directions for clinical care and research needed to support school-based interventions are proposed. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Quantitative analysis of untreated human nails for monitoring human exposure to heavy metals

    International Nuclear Information System (INIS)

    Sera, Koichiro; Futatsugawa, Shouji; Murao, Satoshi; Clemente, E.

    2002-01-01

    In order to address global environmental issues, a standard-free method developed by ourselves has been successfully applied to various kinds of bio-samples. Especially, a method for untreated hairs has been applied in many polluted areas to study human exposure to toxic elements. In addition to hair, nail is expected to give us valuable information about human exposure to toxic elements. However, the analysis requires relatively large amounts of samples and laborious sample preparation techniques which necessitate internal standards. In this work, we have developed a quantitative method for untreated human-nail analysis based on the standard-free method. It requires neither large amounts of nails nor complicated target preparation procedure. Furthermore, it is perfectly free from any ambiguity in target preparation such as volatilization of certain elements and contamination of the sample during chemical ashing. The optimum conditions of irradiating nail samples are established, and accuracy and reproducibility of the present method are confirmed. It is found that ultrasonic washing in distilled water is effective for many nail samples preventing the loss of elements from the sample. It is also found that elemental concentration in nails strongly depends on their sampling positions. (author)

  5. Associations between causal attributions and personal stigmatizing attitudes in untreated persons with current mental health problems.

    Science.gov (United States)

    Stolzenburg, Susanne; Freitag, Simone; Schmidt, Silke; Schomerus, Georg

    2018-02-01

    Past research has shown that among the general public, certain causal explanations like biomedical causes are associated with stronger desire for social distance from persons with mental illness. Aim of this study was to find out how different causal attributions of persons with untreated mental health problems regarding their own complaints are associated with stigmatizing attitudes, anticipated self-stigma when seeking help and perceived stigma-stress. Altogether, 207 untreated persons with a current depressive syndrome were interviewed. Biomedical causes, but also belief in childhood trauma or unhealthy behavior as a cause of the problem, were associated with stronger personal stigma and with more stigma-stress. Similarities and differences to findings among the general population and implications for future research are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Enhancement MRI evaluation of neuroblastoma staging in children

    International Nuclear Information System (INIS)

    Li Xin; Wang Chunxiang; Zhao Bin; Liu Peifang

    2002-01-01

    Objective: To evaluate the value and limitation of Gd-DTPA enhanced MRI for neuroblastoma staging in children. Methods: Twelve cases of neuroblastoma proved by operation or bone marrow aspiration were examined by gadolinium-enhanced MRI. The age ranged from seven months to five years, mean 3.7 years. Eight tumors originated from adrenal, and four from posterior mediastinum. Conventional sequences, double dose gadolinium-enhanced MRI, and 3D CEMRA were used in all patients. Six cases were examined by CT in same time. Imaging staging on surgic-histopathological-based International Neuroblastoma Staging System (INSS) was performed. Results: Six patients were staged by CT, including stage I-II in 2 cases, stage III in 4 cases, and stage IV in none. Twelve patients were staged by conventional MRI, including stage I-II in 2 cases, stage III in 9 cases, and stage IV in 1 case. Twelve patients were staged by double dose gadolinium-enhanced MRI, including stage I-II in 1 case, stage III in 1 case, and stage IV in 10 cases. Conclusion: Gadolinium-enhanced MRI was a single best imaging modality for neuroblastoma, most useful for distal to diaphragm metastasis, dumbbell tumor intraspinal extension, and bone marrow metastasis that was not detected by aspirate examination. Enhancement MRI was important in evaluating the therapy and was also helpful in assessing the therapeutic efficacy and relapse. 3D CEMRA helps demonstrate large vascular encasement and tumor erosion into important organs, and it is useful in assessing the respectability. Long examination time and lack in showing the characteristic calcium were the limitations

  7. Interim PET Response-adapted Strategy in Untreated Advanced Stage Hodgkin Lymphoma: Results of GOELAMS LH 2007 Phase 2 Multicentric Trial.

    Science.gov (United States)

    Carras, Sylvain; Dubois, Benjamin; Senecal, Delphine; Jais, Jean-Philippe; Peoc'h, Michel; Quittet, Philippe; Foussard, Charles; Bouabdallah, Krimo; Gastinne, Thomas; Jourdan, Eric; Sanhes, Laurence; Ertault, Marjan; Lamy, Thierry; Molina, Lysiane

    2018-03-01

    Patients with advanced stage Hodgkin lymphoma still present unsatisfactory outcomes. The Groupe d'étude des Leucémies Aigues et des Maladies du Sang (GOELAMS) group conducted a prospective multicentric trial (NCT00920153) for advanced stage Hodgkin lymphoma to evaluate a positron emission tomography (PET)-adapted strategy. Patients received an intensive regimen (VABEM [vindesine, doxorubicin, carmustine, etoposide, and methylprednisolone]) in front-line and interim 18F FDG-PET evaluation after 2 courses (PET-2). Patients with negative PET-2 findings received 1 additional course. Patients with positive PET-2 findings underwent early salvage therapy followed by high-dose therapy/autologous stem cell transplantation. Fifty-one patients were included. The final complete remission rate was 88%. With a median follow up of 5.3 years, 5-year event-free survival and overall survival rates were 75.3% and 85.3%, respectively, for the whole cohort. Patients who were PET-2-negative had 5-year event-free survival and overall survival rates of, respectively, 77.8% and 88.2% versus 85.1% and 91.7% for patients who were PET-2-positive. A PET-guided strategy with early salvage therapy and high-dose therapy/autologous stem cell transplantation for patients with interim PET-2-positive findings is safe and feasible and provide similar outcome as patients with a negative PET-2. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. Ten-year survival rates of teeth adjacent to treated and untreated posterior bounded edentulous spaces.

    Science.gov (United States)

    Aquilino, S A; Shugars, D A; Bader, J D; White, B A

    2001-05-01

    Failure to replace a single missing posterior tooth may lead to a variety of dental problems, which may ultimately result in tooth loss. However, little is known about the fate of the adjacent teeth if a missing posterior tooth is not replaced. This retrospective study evaluated the survival of teeth adjacent to treated and untreated posterior bounded edentulous spaces. Data were obtained from electronic treatment records from the Kaiser Permanente Dental Care Program, Portland, Ore. A final sample of 317 patients who met the study inclusion criteria was identified. Each bounded edentulous space was placed in 1 of 3 treatment categories: untreated, restored with a fixed partial denture, or restored with a removable partial denture. Subsequent treatment and the status of the teeth adjacent to the bounded edentulous space were followed through December 1999. Ten-year Kaplan-Meier survival estimates were generated for each treatment group, and differences in survival were evaluated with the log-rank chi-square test (alpha=.05). There was a significant difference in survival among the 3 treatment categories (P=.005). Spaces restored with a fixed partial denture had longer 10-year survival estimates (92%) than those that remained untreated (81%). Spaces restored with a removable partial denture had the poorest 10-year survival rate (56%). Under the conditions and selection bias associated with this retrospective study, the survival of teeth adjacent to a single posterior edentulous space was negatively associated with removable partial denture placement compared with no treatment or the use of a fixed partial denture.

  9. Multi-Stage Transportation Problem With Capacity Limit

    OpenAIRE

    I. Brezina; Z. Čičková; J. Pekár; M. Reiff

    2010-01-01

    The classical transportation problem can be applied in a more general way in practice. Related problems as Multi-commodity transportation problem, Transportation problems with different kind of vehicles, Multi-stage transportation problems, Transportation problem with capacity limit is an extension of the classical transportation problem considering the additional special condition. For solving such problems many optimization techniques (dynamic programming, linear programming, special algor...

  10. 67GA-citrate scintiscanning for the staging and course contral of the Hodgkin's disease

    International Nuclear Information System (INIS)

    Baecher, F.M.

    1982-01-01

    266 67 Ga scintigrams of 93 patients in treated and untreated states were evaluated and compared to the histological, radiological, and clinical data. A difference in the storing characteristics of the various histological subtypes of lymphogranulomatosis could not be proven. In the intrathoracic space, radiogallium scintiscanning is of the same value as radiological diagnosing due to its congruency with the X-ray picture in 88.6% of the untreated and 94.2% of the treated cases. Comparing to the X-ray picture, radiogallium scintiscanning provides also additional information: a statement concerning the vitality of the Hodgkin tissue thus informing also about the efficiency of the treatment carried out. After an effective radio or chemotherapy, the scintigraphs show no more scintigraphically provable storing foci. In the abdominal region, the method does not permit to make sufficient statements on affection of liver, spleen, or the abdominal lymph node stations. For our group of patients, we calculated 0.3% falsely positive and 4.0% falsely negative results. The results we obtained emphasize the value of 67 Ga-scintiscanning in the primary staging and therapy control of the morbus Hodgkin as well as in diagnosing relapses. (orig./MG)F [de

  11. Sterilization of melon flies: mating competitiveness after treatment with tepa or gamma irradiation and ratios of treated to untreated flies producing population suppression

    International Nuclear Information System (INIS)

    Ashraf, M.; Keiser, I.; Harris, E.J.

    1976-01-01

    Male melon flies, Dacus cucurbitae Coquillett, treated with a single dose of the chemosterilant tepa (tris(l-aziridinyl) phosphine oxide), or with gamma irradiation, either single or fractionated doses, did not differ significantly in sexual competitiveness as determined by percentage hatch of eggs. Mating competitiveness of males treated by either method ranged from 53 to 66 percent of that of untreated males. In another study, melon flies (males and females) sterilized with 0.0125 percent tepa, the threshold dose for both sexes, completely suppressed a population when the ratio was 16:16:1:1 (sterile males-sterile females-untreated males-untreated females) as determined by no egg hatch

  12. Giant unusual shaped chronic subdural hematoma in a patient with untreated congenital hydrocephalus

    OpenAIRE

    Mishra, Arvind; Ojha, Bal. K.; Chandra, Anil; Srivastava, Chhitij; Singh, Sunil Kumar

    2011-01-01

    Subdural hematoma is a well known complication of ventriculoperitoneal shunt insertion for hydrocephalus and usually spreads out over the cerebral convexity, and appears as a crescent shaped lesion on imaging. Chronic subdural hematoma in a case of untreated compensated congenital hydrocephalus has not been reported in English literature. We report the rare case of an adult with congenital hydrocephalus with a huge unusual shaped hemispheric subdural hematoma.

  13. Conventional versus frozen elephant trunk surgery for extensive disease of the thoracic aorta.

    Science.gov (United States)

    Di Eusanio, Marco; Borger, Michael; Petridis, Francesco D; Leontyev, Sergey; Pantaleo, Antonio; Moz, Monica; Mohr, Friedrich; Di Bartolomeo, Roberto

    2014-11-01

    To compare early and mid-term outcomes after repair of extensive aneurysm of the thoracic aorta using the conventional elephant trunk or frozen elephant trunk (FET) procedures. Fifty-seven patients with extensive thoracic aneurysmal disease were treated using elephant trunk (n = 36) or FET (n = 21) procedures. Patients with aortic dissection, descending thoracic aorta (DTA) diameter less than 40 mm, and thoracoabdominal aneurysms were excluded from the analysis, as were those who did not undergo antegrade selective cerebral perfusion during circulatory arrest. Short-term and mid-term outcomes were compared according to elephant trunk/FET surgical management. Preoperative and intraoperative variables were similar in the two groups, except for a higher incidence of female sex, coronary artery disease and associated procedures in elephant trunk patients. Hospital mortality (elephant trunk: 13.9% versus FET: 4.8%; P = 0.2), permanent neurologic dysfunction (elephant trunk: 5.7% versus FET: 9.5%; P = 0.4) and paraplegia (elephant trunk: 2.9% versus FET: 4.8%; P = 0.6) rates were similar in the two groups. Follow-up was 100% complete. In the elephant trunk group, 68.4% of patients did not undergo a second-stage procedure during follow-up for a variety of reasons. Of these patients, the DTA diameter was greater than 51 mm in 72.2% and two (6.7%) died due to aortic rupture while awaiting stage-two intervention. Endovascular second-stage procedures were successfully performed in all FET patients with residual DTA aneurysmal disease (n = 3), whereas nine of 11 elephant trunk patients who returned for second-stage procedures required conventional surgical replacement through a lateral thoracotomy. Kaplan-Meier estimate of 4-year survival was 75.8 ± 7.6 and 72.8 ± 10.6 in elephant trunk and FET patients, respectively (log-rank P = 0.8). In patients with extensive aneurysmal disease of thoracic aorta, elephant trunk and FET procedures

  14. Impact of untreated dental caries and its clinical consequences on the oral health-related quality of life of schoolchildren aged 8-10 years.

    Science.gov (United States)

    Mota-Veloso, Isabella; Soares, Maria Eliza C; Alencar, Bruna Mota; Marques, Leandro Silva; Ramos-Jorge, Maria Letícia; Ramos-Jorge, Joana

    2016-01-01

    This study aims to evaluate the impact of untreated dental caries and its clinical consequences on the quality of life of Brazilian schoolchildren aged 8-10 years. A randomly selected sample of 587 children underwent a clinical oral examination for the assessment of untreated dental caries and clinical consequences. The WHO criteria (decayed component of the decayed, missing, and filled teeth--D-DMFT in permanent teeth or d-dfmt in primary teeth) and the PUFA index, which records the presence of severely decayed permanent (upper case) and primary (lower case) teeth with visible pulpal involvement (P/p), as well as ulceration caused by dislocated tooth fragments (U/u), fistula (F/f), and abscesses (A/a), were used for the oral examination. Oral health-related quality of life (OHRQoL) was evaluated using the Child's Perception Questionnaire (CPQ8-10). Poisson regression was employed to test unadjusted and adjusted associations between untreated dental caries/clinical consequences and OHRQoL. The prevalence of untreated dental caries was 64.6% (D/d component of DMFT/dmft > 0) and 17.9% of children exhibited clinical consequences of caries (PUFA/pufa index >0). In the adjusted models, untreated caries was significantly associated with the total CPQ8-10 score and all subscale scores. The clinical consequences of dental caries (PUFA/pufa index >0) were significantly associated with the total CPQ8-10 as well as the oral symptoms and functional limitations' subscales. Untreated dental caries and its clinical consequences exerted a negative impact on the OHRQoL of the schoolchildren analyzed.

  15. - 1 - Stage at diagnosis, clinicopathological and treatment patterns of ...

    African Journals Online (AJOL)

    Abstract: Breast cancer, although reported to be the commonest female malignancy worldwide has not been extensively studied in north-western Tanzania. The aim of this retrospective review was to describe in our setting, the stage at diagnosis, clinicopathological and treatment patterns among patients with breast cancer.

  16. Mammographic findings predicting an extensive intraductal component in early stage invasive breast cancer : analysis on microcalcification

    International Nuclear Information System (INIS)

    Kim, Jeong Ah; Kim, Mi Hye; Lee, Mi Kyung; Oh, Ki Keun; Kim, Eun Kyung

    2000-01-01

    To analyze the mammographic findings of extensive intraductal component (EIC)-positive early invasive breast carcinoma and to determine the mammographic features which predict an EIC positivity in an invasive carcinoma. The mammographic and pathologic findings in 71 patients aged 34-79 (mean 50) years in whom stage I or II invasive breast carcinoma had been diagnosed were retrospectively analysed. The mammographic findings were assigned to one of three groups: mass, mass with microcalcification, or microcalcification only. The shape and distribution of a calcification were classified according to the BI-RADS lexicon, and its extent was classified as either more or less than 3 cm. To detect the presence or absence of EIC and the type of ductal carcinoma in situ (DCIS), the findings were re-examined by means of slide mappings. Twenty-eight of 71 patients (39%) showed ECI positivity. The mammographic findings of EIC-positive invasive cancer (n=3D28) were mass with microcalcification (n=3D14), microcalcification only (n=3D7) and mass only (n=3D7). The mammographic finding which predicted EIC positivity was mass with microcalcification (PPV:0.67, NPV:0.33, p=3D0.02). A mammographic of mass only (n=3D39) showed a significantly high negative predictive value for EIC positivity. (PPV 0.18, NPV 0.82, P less than 0.01). A comparison of cases with or without calcification showed that those with microcalcifications (n=3D32) showed a significantly high PPV of 0.66 (NPV:0.34, p less than 0.01) while those without calcification (n=3D39) showed a significantly high NPV of 0.82 (PPV:0.18, p less than 0.01). There were no significant differences in positive predictive values for EIC between the shape, distribution and extent of calcifications. Whenever microcalcification with or without mass is seen on mammographs obtained during early breast cancer, we can predict EIC-positivity, regardless of shape or distribution according to the BI-RADS lexicon. (author)

  17. Vanishing testes syndrome-related osteoporosis and high cardio-metabolic risk in an adult male with long term untreated hypergonadotropic hypogonadism.

    Science.gov (United States)

    Carsote, Mara; Capatina, Cristina; Valea, Ana; Dumitrascu, Anda

    2016-02-01

    The male hypogonadism-related bone mass loss is often under diagnosed. Peak bone mass is severely affected if the hypogonadism occurs during puberty and is left untreated. We present an interesting; almost bizarre case of a male with non-functional testes early during childhood and undiagnosed and untreated hypogonadism until his fifth decade of life. Forty six year male is referred for goitre, complaining of back pain. Phenotype suggested intersexuality: gynoid proportions, micropenis, no palpable testes into the scrotum, no facial or truncal hair. His medical history had been unremarkable until the previous year when primary hypothyroidism was diagnosed and levothyroxine replacement was initiated. Later, he was diagnosed with ischemic heart disease, with inaugural unstable angina. On admission, the testosterone was 0.2 ng/mL (normal: 1.7-7.8 ng/mL), FSH markedly increased (56 mUI/mL), with normal adrenal axis, and TSH (under thyroxine replacement). High bone turnover markers, and blood cholesterol, and impaired glucose tolerance were diagnosed. The testes were not present in the scrotum. Abdominal computed tomography suggested bilateral masses of 1.6 cm diameter within the abdominal fat that were removed but no gonadal tissue was confirmed histopathologically. Vanishing testes syndrome was confirmed. The central DXA showed lumbar bone mineral density of 0.905 g/cm2, Z-score of -2.9SD. The spine profile X-Ray revealed multiple thoracic vertebral fractures. Alendronate therapy together with vitamin D and calcium supplements and trans-dermal testosterone were started. Four decades of hypogonadism associate increased cardiac risk, as well as decreased bone mass and high fracture risk.

  18. Treatment of carcinoma of uterine cervix stage III by adriamycin, bleomycin and cisplatinum, neoadjuvant, modified radical hysterectomy and adjuvant chemotherapy

    International Nuclear Information System (INIS)

    Valle, J.C. do; Ribeiro, C.W.; Rezende, Magda C.; Figueiredo, E.; Chu, C.

    1987-01-01

    Forty-eight patients with untreated carcinoma of the cervix stage III A and IIIB, were submitted to 3 to 5 cycles of a combination of adriamycin (ADR), bleomycin (BLEO) and cisplatinum (CDDP), followed by modified radical hysterectomy and adjuvant chemotherapy, 6 cycles, of the same association. The surgical aspect is emphasized and the operative sequence is described. A comparative evaluation between the treatment presented and the radiotherapy is done. The survical rate is studied. (M.A.C.) [pt

  19. [Current wound care in patients with elephantiasis--third-stage lymphedema].

    Science.gov (United States)

    Rucigaj, Tanja Planinsek; Slana, Ana; Leskovec, Nada Kecelj

    2012-10-01

    Lymphedema resulting from fluid accumulation due to impairment in the lymphatic system drainage leads to enlargement of the body part involved. If left untreated, in its third stage it results in elephantiasis. Elephantiasis is frequently accompanied by papillomatosis and lymphocutaneous fistulas with lymphorrhoea, erosions and ulcers, frequently with the loss of function in the respective part of the body. Unlike other chronic wounds, wound healing in lymphedema is highly dependent on the use of combined therapies because local treatment with modern supportive dressings and compression therapy with adhesive and non-adhesive short-stretch systems is only part of the complete treatment. This treatment also includes sub-bandage foamy materials, kinesitherapy with tapes (kinesiotaping), intermittent local application of high-pressure oxygen, breathing exercise, and manual lymph drainage and exercises.

  20. Impact of field dodder (Cuscuta campestris Yunk. on physiological and anatomical changes in untreated and herbicide-treated alfalfa plants

    Directory of Open Access Journals (Sweden)

    Sarić-Krsmanović Marija

    2016-01-01

    Full Text Available The effects of field dodder on physiological processes and the anatomy of alfalfa plants were examined under controlled conditions. The experiment included the following variants: N - noninfested alfalfa plants (control; I - infested alfalfa plants (untreated; T - infested plants treated with imazethapyr. Imazethapyr application rate was 100 g a.i. ha-1. The following parameters were checked: physiological - pigment content (chlorophyll ɑ, chlorophyll b, total carotenoids; anatomical - stem parameters: thickness of epidermis and cortex, and diameter of stem and central cylinder; leaf parameters: thickness of epidermis, parenchyma and spongy tissue, mesophyll and underside leaf epidermis, and diameter of bundle sheath cells in alfalfa plants. Pigment contents and anatomical parameters were measured: prior to herbicide treatment (0 assessment, then 7 (I assessment, 14 (II assessment, 21 (III assessment, 28 (IV assessment and 35 (V assessment days after application (DAA. Field dodder was found to affect the contents of chlorophyll ɑ, chlorophyll ɑ and carotenoids in untreated alfalfa plants, causing significant reductions in pigment content. Conversely, percent reduction in the treated plants decreased 22-5% for chlorophyll ɑ, 25-1%, for chlorophyll b, and 21-11% for carotenoids, while a stimulating effect of 1-6% was observed for the contents of chlorophyll b and carotenoids 35 DAA. Plants infested (untreated by field dodder had lower values of most anatomical parameters, compared to noninfested plants. The measured anatomical parameters of alfalfa stems and leaves had significantly higher values in noninfested plants and plants treated with imazethapyr than in untreated plants.

  1. Duration of untreated psychosis in adolescents: ethnic differences and clinical profiles.

    Science.gov (United States)

    Dominguez, Maria-de-Gracia; Fisher, Helen L; Major, Barnaby; Chisholm, Brock; Rahaman, Nikola; Joyce, John; Woolley, James; Lawrence, Jo; Hinton, Mark; Marlowe, Karl; Aitchison, Katherine; Johnson, Sonia; Hodes, Matthew

    2013-11-01

    Duration of Untreated Psychosis (DUP) is an important measure associated with outcome of psychosis. This first study in the UK compared DUP between adolescent and adult-onset individuals and explored whether the adolescent-onset group showed variations in DUP that could be accounted for by sociodemographic and selected risk factors. This naturalistic cohort study included 940 new first-episode psychosis cases aged 14-35years (136 adolescent-onset versus 804 adult-onset psychotic individuals) referred to nine Early Intervention Services for Psychosis in London (2003-2009). Sociodemographic characteristics, age of onset, family history of mental illness, duration of untreated psychosis, suicidality and substance use information were collected at entry to the services. Adolescents presented with significantly greater median DUP (179days) than adults (81days, p=0.005). Large differences in DUP were found amongst adolescent ethnic groups (median DUP: White: 454days; Black: 103days; Asian and mixed: 28.5days). In addition, younger age of onset and higher lifetime cannabis use were associated with longer treatment delay amongst adolescents. This study of DUP in adolescent-onset psychosis found it to be approximately twice the length of DUP amongst adults. For the adolescent White sub-group, DUP was far greater than the UK Department of Health target (<3months). Both the high rates of lifetime cannabis use and the lower age of onset might explain the long DUP in this ethnic group. Physicians need to be particularly vigilant about identifying and managing early psychosis in adolescents. © 2013.

  2. Autolysis and extension of isolated walls from growing cucumber hypocotyls

    Science.gov (United States)

    Cosgrove, D. J.; Durachko, D. M.

    1994-01-01

    Walls isolated from cucumber hypocotyls retain autolytic activities and the ability to extend when placed under the appropriate conditions. To test whether autolysis and extension are related, we treated the walls in various ways to enhance or inhibit long-term wall extension ('creep') and measured autolysis as release of various saccharides from the wall. Except for some non-specific inhibitors of enzymatic activity, we found no correlation between wall extension and wall autolysis. Most notably, autolysis and extension differed strongly in their pH dependence. We also found that exogenous cellulases and pectinases enhanced extension in native walls, but when applied to walls previously inactivated with heat or protease these enzymes caused breakage without sustained extension. In contrast, pretreatment of walls with pectinase or cellulase, followed by boiling in methanol to inactivate the enzymes, resulted in walls with much stronger expansin-mediated extension responses. Crude protein preparations from the digestive tracts of snails enhanced extension of both native and inactivated walls, and these preparations contained expansin-like proteins (assessed by Western blotting). Our results indicate that the extension of isolated cucumber walls does not depend directly on the activity of endogenous wall-bound autolytic enzymes. The results with exogenous enzymes suggest that the hydrolysis of matrix polysaccharides may not induce wall creep by itself, but may act synergistically with expansins to enhance wall extension.

  3. A Novel Dual-Stage Hydrothermal Flow Reactor

    DEFF Research Database (Denmark)

    Hellstern, Henrik Christian; Becker, Jacob; Hald, Peter

    2015-01-01

    The dual-stage reactor is a novel continuous flow reactor with two reactors connected in series. It is designed for hydrothermal flow synthesis of nanocomposites, in which a single particle consists of multiple materials. The secondary material may protect the core nanoparticle from oxidation....... The dual-stage reactor combines the ability to produce advanced materials with an upscaled capacity in excess of 10 g/hour (dry mass). TiO2 was synthesized in the primary reactor and reproduced previous results. The dual-stage capability was succesfully demonstrated with a series of nanocomposites incl. Ti...

  4. Prospective relationship of duration of untreated psychosis to psychopathology and functional outcome over 12 years.

    LENUS (Irish Health Repository)

    Hill, Michele

    2012-11-01

    The duration of untreated psychosis is well recognised as an independent predictor of symptomatic and functional outcome in the short term and has facilitated the development of worldwide early intervention programmes. However, the extent and mechanisms by which it might influence prognosis beyond a decade remain poorly understood.

  5. Optimization of multi-stage dynamic treatment regimes utilizing accumulated data.

    Science.gov (United States)

    Huang, Xuelin; Choi, Sangbum; Wang, Lu; Thall, Peter F

    2015-11-20

    In medical therapies involving multiple stages, a physician's choice of a subject's treatment at each stage depends on the subject's history of previous treatments and outcomes. The sequence of decisions is known as a dynamic treatment regime or treatment policy. We consider dynamic treatment regimes in settings where each subject's final outcome can be defined as the sum of longitudinally observed values, each corresponding to a stage of the regime. Q-learning, which is a backward induction method, is used to first optimize the last stage treatment then sequentially optimize each previous stage treatment until the first stage treatment is optimized. During this process, model-based expectations of outcomes of late stages are used in the optimization of earlier stages. When the outcome models are misspecified, bias can accumulate from stage to stage and become severe, especially when the number of treatment stages is large. We demonstrate that a modification of standard Q-learning can help reduce the accumulated bias. We provide a computational algorithm, estimators, and closed-form variance formulas. Simulation studies show that the modified Q-learning method has a higher probability of identifying the optimal treatment regime even in settings with misspecified models for outcomes. It is applied to identify optimal treatment regimes in a study for advanced prostate cancer and to estimate and compare the final mean rewards of all the possible discrete two-stage treatment sequences. Copyright © 2015 John Wiley & Sons, Ltd.

  6. Immunological responses, histopathological finding and disease resistance of blue mussel (Mytilus edulis) exposed to treated and untreated municipal wastewater

    International Nuclear Information System (INIS)

    Akaishi, Fabiola M.; St-Jean, Sylvie D.; Bishay, Farida; Clarke, John; Rabitto, Ines da S.; Oliveira Ribeiro, Ciro A. de

    2007-01-01

    This study provides new information on the response of the immune system of Mytilus edulis exposed to untreated and treated sewage, linking immune response to ecologically relevant endpoints, such as disease resistance. Our goal was to assess the potential effects of sewage on the immune system (phagocytic activity and production of cytotoxic metabolites, disease resistance) and gills (light microscope) of mussels through a bioassay and field study in an estuarine receiving environment (RE). A semi-static experiment was developed in a wastewater treatment plant in New Glasgow, NS Canada. Mussels were exposed for 21 days to 12.5%, 25%, 50% and 100% of untreated sewage influent and artificial seawater control. Sampling occurred after 7, 14 and 21 days of exposure. In the field study, eight sites were selected in East River and Pictou Harbour, NS, positioned upstream and downstream of sewage effluents outfalls. Caged mussels were exposed to the RE for 90 days (May-July 2005). Mussels were challenged to test their efficiency at eliminating the bacteria, Listonella anguillarium in the bioassay and field studies. The bioassay results showed that higher concentrations of untreated sewage could modulate the immune system of mussels through increased of phagocytic activity (PA), nitric oxide (NO) and hydrogen peroxide (H 2 O 2 ) production during 14 days of exposure, and decreased activity and production at 21 days, with the exception of H 2 O 2 production which was high even at 21 days. Mussels exposed to untreated sewage RE also presented a high PA, NO and H 2 O 2 production and lower number of haemocytes compared to mussels from reference sites. In the bacterial challenge, mussels pre-exposed to 100% sewage died 24 h after being infected with L. anguillarium, while mussels pre-exposed to 50% eliminated bacteria had a mortality rate of 30%. Mussels from the control, 12.5% and 25% groups eliminated bacteria and no mortality was observed. No significant difference was

  7. Temporomandibular disorders and orthodontic treatment need in orthodontically untreated children and adolescents.

    Science.gov (United States)

    Špalj, Stjepan; Šlaj, Martina; Athanasiou, Athanasios E; Žak, Irena; Šimunović, Martina; Šlaj, Mladen

    2015-03-01

    The aim of this study was to explore the association between signs and symptoms of temporomandibular disorders (TMD) and orthodontic treatment need in orthodontically untreated children and adolescents. One thousand five hundred and ninety-seven subjects aged 11-19 years, without previous orthodontic history, from sixteen randomly selected public schools in Zagreb, Croatia, were examined. Malocclusion characteristics were assessed by using the criteria proposed by Bjork et al., the Dental Aesthetic Index, and the Aesthetic Component of Index of Orthodontic Treatment Need. Data on TMD signs/symptoms and parafunctional behaviour were obtained by means of questionnaire and clinical examination, respectively. Multiple logistic regression models were used for analysis. Twenty-two percent of children and young adolescents had one or more signs of TMD, ranging from 17% in age of 11 years up to 24% in age of 19. There was poor correlation between presence of TMD and orthodontic treatment need. Multiple logistic regression models showed that Class III, crowding and spacing were related to mandibular deflection on opening. Ectopic eruption was related to TMJ clicking, and severely tipped teeth with reduced mouth opening. Headaches presented a positive relationship with reverse overjet and severe rotations, and tooth wear with crowding, spacing and lateral openbite. Age, female gender and parafunctional habits were related to several TMD signs. Although logistic regression models were statistically significant (p < 0.05) malocclusions, parafunctional behaviours, age and gender accounted for less than 20% of the variability in TMD signs/symptoms. TMD signs and symptoms seemed to be poorly related to malocclusions or treatment needs.

  8. Evidence of an increased pathogenic footprint in the lingual microbiome of untreated HIV infected patients

    Directory of Open Access Journals (Sweden)

    Dang Angeline T

    2012-07-01

    Full Text Available Abstract Background Opportunistic oral infections can be found in over 80% of HIV + patients, often causing debilitating lesions that also contribute to deterioration in nutritional health. Although appreciation for the role that the microbiota is likely to play in the initiation and/or enhancement of oral infections has grown considerably in recent years, little is known about the impact of HIV infection on host-microbe interactions within the oral cavity. In the current study, we characterize modulations in the bacterial composition of the lingual microbiome in patients with treated and untreated HIV infection. Bacterial species profiles were elucidated by microarray assay and compared between untreated HIV infected patients, HIV infected patients receiving antiretroviral therapy, and healthy HIV negative controls. The relationship between clinical parameters (viral burden and CD4+ T cell depletion and the loss or gain of bacterial species was evaluated in each HIV patient group. Results In untreated HIV infection, elevated viremia was associated with significantly higher proportions of potentially pathogenic Veillonella, Prevotella, Megasphaera, and Campylobacter species in the lingual microbiome than observed in healthy controls. The upsurge in the prevalence of potential pathogens was juxtaposed by diminished representation of commensal Streptococcus and Veillonella species. Colonization of Neisseria flavescens was lower in the lingual microbiome of HIV infected patients receiving antiretroviral therapy than in uninfected controls. Conclusions Our findings provide novel insights into the potential impact of HIV infection and antiretroviral therapy on the community structure of the oral microbiome, and implicate potential mechanisms that may increase the capacity of non-commensal species to gain a stronger foothold.

  9. Modelling the Thin-Layer Drying Kinetics of Untreated and Blanch-Osmotic Pre-treated Tomato Slices

    Directory of Open Access Journals (Sweden)

    Samuel Enahoro Agarry

    2016-10-01

    Full Text Available The objective of this study was to investigate the effect of pre-treatment and drying temperature on the drying kinetics and nutritional quality of tomato (Lycopersicon esculantum L. under hot air drying. Tomato samples were blanched at 80oC and osmotically dehydrated using 20% w/w sodium chloride solutions at 30oC for 20 min. The blanch-osmotic pre-treated and untreated tomato slices were dried at temperature of 40, 50, 60, 70 and 80oC, respectively in a hot air-dryer. The results showed that blanch-osmotic pre-treatment offered a higher drying rate and lower or faster drying time than untreated condition. The tomato drying regime was characteristically in the constant and falling rate period. The tomato drying rate curve showed characteristics of porous hygroscopic solids. The optimum drying temperature for tomato was found to be 60oC. Four semi-empirical drying models of Newton, Page, Henderson and Pabis, and Logarithmic were fitted to the drying data using non-linear regression analysis. The most appropriate model was selected using the coefficient of determination (R2 and root mean square error (RMSE. The Page model has shown a better fit to the drying kinetics data of tomato in comparison with other tested models. Transport of moisture during drying was described by Fick’s diffusion model application and the effective moisture diffusivity (Deff thus estimated. The Deff at 60oC was 4.43 × 10-11m2/s and 6.33 × 10-11m2/s for blanch-osmotic pre-treated and untreated tomato slices, respectively.

  10. Multi-Stage Transportation Problem With Capacity Limit

    Directory of Open Access Journals (Sweden)

    I. Brezina

    2010-06-01

    Full Text Available The classical transportation problem can be applied in a more general way in practice. Related problems as Multi-commodity transportation problem, Transportation problems with different kind of vehicles, Multi-stage transportation problems, Transportation problem with capacity limit is an extension of the classical transportation problem considering the additional special condition. For solving such problems many optimization techniques (dynamic programming, linear programming, special algorithms for transportation problem etc. and heuristics approaches (e.g. evolutionary techniques were developed. This article considers Multi-stage transportation problem with capacity limit that reflects limits of transported materials (commodity quantity. Discussed issues are: theoretical base, problem formulation as way as new proposed algorithm for that problem.

  11. Staging structures of the intercalation compounds Ag/sub x/TiS2

    International Nuclear Information System (INIS)

    Bardhan, K.K.; Kirczenow, G.; Jackle, G.; Irwin, J.C.

    1986-01-01

    An extensive investigation of the structure, and in particular the staging, of powdered samples of the intercalation compounds Ag/sub x/TiS 2 (0 0 C. The (T,x) phase diagram contains three phases: a high-x (dense) stage-1 phase, a stage-disordered phase, which at low x or high temperatures appears to become a pure low-x (dilute) stage-1 phase, and a simple stage-2 phase. On the high-x side of its stability region the stage-2 phase undergoes an apparent first-order transition to the dense stage-1 phase, but on the high-temperature side it proceeds continuously, through stage-disordered states, to a dilute stage-1 phase. On the low-x side of the stage-2 region there is also a dilute stage-1 phase. At sufficiently high temperatures a novel coexistence of the two stage-1 phases is observed. This is the first time that the high-temperature stability limit of the stage-2 region has been probed in any intercalation compound. The results are compared with recent theoretical models

  12. Extensions and applications of degradation modeling

    International Nuclear Information System (INIS)

    Hsu, F.; Subudhi, M.; Samanta, P.K.; Vesely, W.E.

    1991-01-01

    Component degradation modeling being developed to understand the aging process can have many applications with potential advantages. Previous work has focused on developing the basic concepts and mathematical development of a simple degradation model. Using this simple model, times of degradations and failures occurrences were analyzed for standby components to detect indications of aging and to infer the effectiveness of maintenance in preventing age-related degradations from transforming to failures. Degradation modeling approaches can have broader applications in aging studies and in this paper, the authors discuss some of the extensions and applications of degradation modeling. The extensions and applications of the degradation modeling approaches discussed are: (a) theoretical developments to study reliability effects of different maintenance strategies and policies, (b) relating aging-failure rate to degradation rate, and (c) application to a continuously operating component

  13. Mathematical modeling of drying of pretreated and untreated pumpkin.

    Science.gov (United States)

    Tunde-Akintunde, T Y; Ogunlakin, G O

    2013-08-01

    In this study, drying characteristics of pretreated and untreated pumpkin were examined in a hot-air dryer at air temperatures within a range of 40-80 °C and a constant air velocity of 1.5 m/s. The drying was observed to be in the falling-rate drying period and thus liquid diffusion is the main mechanism of moisture movement from the internal regions to the product surface. The experimental drying data for the pumpkin fruits were used to fit Exponential, General exponential, Logarithmic, Page, Midilli-Kucuk and Parabolic model and the statistical validity of models tested were determined by non-linear regression analysis. The Parabolic model had the highest R(2) and lowest χ(2) and RMSE values. This indicates that the Parabolic model is appropriate to describe the dehydration behavior for the pumpkin.

  14. Prevalence and Possible Risk Factors of Low Bone Mineral Density in Untreated Female Patients with Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Yi-Ning Sun

    2015-01-01

    Full Text Available Systemic lupus erythematosus (SLE is an autoimmune disease characterized by chronic inflammation. Different studies have shown decreased bone mineral density (BMD in patients with SLE. The objective of this study was to investigate the prevalence and possible risk factors of low BMD in untreated female patients with SLE in Chinese population. A total of 119 untreated female patients with SLE were included. BMD was measured at lumbar spine and at total hip by dual-energy X-ray absorptiometry. The associations between decreased BMD and demographic variables, clinical variables, and bone metabolism variables were analyzed. These SLE patients had the following characteristics: mean age was 32.6±11.9 years, mean disease duration was 22.1±34.5 months, and mean SLEDAI was 11.4±5.4. Osteopenia was present in 31.1% of the patients and osteoporosis in 8.5%. A significant negative association between low density lipoprotein cholesterol (LDL-c and BMD at the lumbar spine (correlation coefficient = −0.242; P=0.023 and total hip (correlation coefficient = −0.259; P=0.019 was shown. These results seem to indicate that increased LDL-c may be an important risk factor for low BMD at lumbar spine and total hip in untreated female SLE patients.

  15. Vaginal cancer, an analysis of stages 1 and 2

    International Nuclear Information System (INIS)

    Dickie, G.J.; Tripcony, L.; Otten, G.; Nicklin, J.

    2003-01-01

    A retrospective analysis was performed of 70 patients with stages 1 and 2 vaginal cancer seen between 1982 and 1998 at the Royal Brisbane and Royal Women's Hospitals, Queensland. Forty three patients had previously had a hysterectomy. Stage, histology and grade were the most important prognostic factors. The 5 year survival rate for stage 1 was 71%, compared to 48% for stage 2. The majority (61 patients) had squamous cell carcinoma with a 68% survival compared to 22% for adenocarcinoma. Those with histological grade 1 and 2 had a 69% survival compared to 40% for grade 3 disease. Age, whether the patient had a previous hysterectomy, tumour site and size were not significant prognostic factors. The majority of patients were treated with radiotherapy alone. However those that had surgery alone or surgery combined with radiotherapy had a significantly improved survival compared to the radiotherapy alone group. The majority of tumours recurred in the loco-regional area and the median time to recurrence was 12 months

  16. Treatment of cosmetic effluent in different configurations of ceramic UF membrane based bioreactor: Toxicity evaluation of the untreated and treated wastewater using catfish (Heteropneustes fossilis).

    Science.gov (United States)

    Banerjee, Priya; Dey, Tanmoy Kumar; Sarkar, Sandeep; Swarnakar, Snehasikta; Mukhopadhyay, Aniruddha; Ghosh, Sourja

    2016-03-01

    Extensive usage of pharmaceutical and personal care products (PPCPs) and their discharge through domestic sewage have been recently recognized as a new generation environmental concern which deserves more scientific attention over the classical environmental pollutants. The major issues of this type of effluent addressed in this study were its colour, triclosan and anionic surfactant (SDS) content. Samples of cosmetic effluent were collected from different beauty treatment salons and spas in and around Kolkata, India and treated in bioreactors containing a bacterial consortium isolated from activated sludge samples collected from a common effluent treatment plant. Members of the consortium were isolated and identified as Klebsiella sp., Pseudomonas sp., Salmonella sp. and Comamonas sp. The biotreated effluent was subjected to ultrafiltration (UF) involving indigenously prepared ceramic membranes in both side-stream and submerged mode. Analysis of the MBR treated effluent revealed 99.22%, 98.56% and 99.74% removal of colour, triclosan and surfactant respectively. Investigation of probable acute and chronic cyto-genotoxic potential of the untreated and treated effluents along with their possible participation in triggering oxidative stress was carried out with Heteropneustes fossilis (Bloch). Comet formation recorded in both liver and gill cells and micronucleus count in peripheral erythrocytes of individuals exposed to untreated effluent increased with duration of exposure and was significantly higher than those treated with UF permeates which in turn neared control levels. Results of this study revealed successful application of the isolated bacterial consortium in MBR process for efficient detoxification of cosmetic effluent thereby conferring the same suitable for discharge and/or reuse. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Extensive nevus comedonicus, complicated with recurrent abscesses, successfully treated with surgical resurfacing

    Directory of Open Access Journals (Sweden)

    Narender Manikavachakan

    2018-01-01

    Full Text Available Nevus comedonicus is a rare epidermal abnormality of the pilosebaceous unit, which is congenital in most patients but may also appear early in childhood. It may be localized or have an extensive involvement, the latter showing a unilateral predominance with only a few cases presenting bilaterally. Extensive nevus comedonicus can be associated with musculoskeletal defects, eye and neurological involvement, which constitutes nevus comedonicus syndrome. Uncomplicated nevus comedonicus can be treated with topical keratolytics, diode, erbium laser, and ultrapulse CO2 laser. Surgical excision can be performed to ensure complete removal and nonrecurrence. This case report refers to a young male patient with extensive nevus comedonicus present over left chest, left axilla, and left upper back without systemic involvement, treated with staged surgical excision and resurfacing.

  18. The course of untreated anxiety and depression, and determinants of poor one-year outcome: a one-year cohort study

    Directory of Open Access Journals (Sweden)

    van Marwijk Harm WJ

    2010-10-01

    Full Text Available Abstract Background Little is known about the course and outcome of untreated anxiety and depression in patients with and without a self-perceived need for care. The aim of the present study was to examine the one-year course of untreated anxiety and depression, and to determine predictors of a poor outcome. Method Baseline and one-year follow-up data were used of 594 primary care patients with current anxiety or depressive disorders at baseline (established by the Composite Interview Diagnostic Instrument (CIDI, from the Netherlands Study of Depression and Anxiety (NESDA. Receipt of and need for care were assessed by the Perceived Need for Care Questionnaire (PNCQ. Results In depression, treated and untreated patients with a perceived treatment need showed more rapid symptom decline but greater symptom severity at follow-up than untreated patients without a self-perceived mental problem or treatment need. A lower education level, lower income, unemployment, loneliness, less social support, perceived need for care, number of somatic disorders, a comorbid anxiety and depressive disorder and symptom severity at baseline predicted a poorer outcome in both anxiety and depression. When all variables were considered at the same time, only baseline symptom severity appeared to predict a poorer outcome in anxiety. In depression, a poorer outcome was also predicted by more loneliness and a comorbid anxiety and depressive disorder. Conclusion In clinical practice, special attention should be paid to exploring the need for care among possible risk groups (e.g. low social economic status, low social support, and support them in making an informed decision on whether or not to seek treatment.

  19. What extension evaluation before therapy have we to do in the nasopharynx cancers?

    International Nuclear Information System (INIS)

    Elloumi, F.; Mnejja, W.; Siala, W.; Daoud, J.; Hammami, B.; Ghorbel, M.; Frikhan, M.

    2007-01-01

    NMR imaging has proved its superiority on scanography in the study of limits and tumor extension and should be the first examination. The practice of of a scanography or cervical NMR should be the best mean of ganglions evaluation. As regards the extension evaluation at distance, it is recommended to require systematically a thorax radiograph and a bone scintigraphy for any patient. The liver echography is rather indicated among male patients, aged between 40 and 45 and having a stage 3 lymph node (according to the U.I.C.C. 1997 classification). (N.C.)

  20. A serological, parasitological and clinical evaluation of untreated Chagas disease patients and those treated with benznidazole before and thirteen years after intervention

    Science.gov (United States)

    Machado-de-Assis, Girley Francisco; Diniz, Glaucia Alessio; Montoya, Roberto Araújo; Dias, João Carlos Pinto; Coura, José Rodrigues; Machado-Coelho, George Luiz Lins; Albajar-Viñas, Pedro; Torres, Rosália Morais; de Lana, Marta

    2013-01-01

    The etiological treatment of Chagas disease is recommended for all patients with acute or recent chronic infection, but controversies remain regarding the benefit of chemotherapy and interpretations of the parasitological cure after etiological treatment. This study compares the laboratory and clinical evaluations of Chagas disease patients who were diagnosed 13 years earlier. Fifty-eight Chagas disease patients (29 treated with benznidazole and 29 untreated) were matched at the time of treatment based on several variables. Conventional serology revealed the absence of seroconversion in all patients. However, lower serological titres were verified in the treated group, primarily among patients who had the indeterminate form of the disease. Haemoculture performed 13 years after the intervention was positive for 6.9% and 27.6% of the treated and untreated patients, respectively. Polymerase chain reaction tests were positive for 44.8% and 13.8% of the treated and untreated patients, respectively. Patients who presented with the indeterminate form of the disease at the beginning of the study exhibited less clinical progression (17.4%) compared with the untreated group (56.5%). Therefore, this global analysis revealed that etiological treatment with benznidazole may benefit patients with respect to the clinical progression of Chagas disease and the prognosis, particularly when administered to patients with the indeterminate form of the disease. PMID:24037109

  1. Prey Preference of Predatory mite Amblyseius swirskii (Athias-Henriot (Acari: Phytoseiidae on untreated and Beauveria bassiana-treated of Trialeurodes vaporariorum (Homoptera: Aleyrodidae

    Directory of Open Access Journals (Sweden)

    Marjan Seiedy

    2018-01-01

    Full Text Available Introduction The predator Amblyseius swirskii and entomopathogenic fungus Beauveria bassiana are important biocontrol agents of Trialeurodes vaporariorum. Determination of the host preference of predators in the fields when receiving signals related to either untreated and Beauveria bassiana-treated pest is important. Materials and Methods In this research, the prey preference of adult female (2 days old of A. swirskii was determined on untreated and Beauveria bassiana-treated of Trialeurodes vaporariorum (Homoptera: Aleyrodidae in various treatments base on Manly Index. These different treatments consisted of two time intervals; 24 and 48 h post-inoculation of greenhouse whiteflies with 1×105 conidia /ml of B. bassiana with 13 replicates. 24-h starved predators were added to the leaf discs singly then the number of consumed untreated and B. bassiana-treated T. vaporariorum in each Petri dish was assessed after 24 h. Results and Discussion The results revealed that mean number of consumed B. bassiana-treated T. vaporariorum in two time intervals; 24 and 48 h. after inoculation were 4/15±0/19 and 2.23±0/12, respectively. This investigation showed a significant preference of A. swirskii towards untreated T. vaporariorum in 24 (P< 0.0034 and 48 h. (P

  2. An Open-Label, Multicenter, Randomized, Phase II Study of Pazopanib in Combination with Pemetrexed in First-Line Treatment of Patients with Advanced-Stage Non-Small-Cell Lung Cancer

    DEFF Research Database (Denmark)

    Scagliotti, Giorgio V; Felip, Enriqueta; Besse, Benjamin

    2013-01-01

    This randomized open-label phase II study evaluated the efficacy, safety, and tolerability of pazopanib in combination with pemetrexed compared with the standard cisplatin/pemetrexed doublet in patients with previously untreated, advanced, nonsquamous non-small-cell lung cancer....

  3. Growth and development in Syrian Awassi ewes during patterns of ovarian follicular different reproductive stages monitored by laparoscopy

    International Nuclear Information System (INIS)

    Zarkawi, M.; Soukouti, A.

    2009-06-01

    An in situ study was conducted on Syrian Awassi ewes, inside and outside the breeding season, untreated or treated with vaginal sponges together with or without equine chorionic gonadotropin aiming at monitoring the ovaries' diameters, number of different follicular categories, number, diameters and lifespan of corpora lutea in each ovary using a laparoscope and finding out the relationship among these parameters and progesterone concentration. For the first time, it has been possible to characterise the Syrian Awassi sheep at the ovarian follicles level during different reproductive stages using a laparoscope. (author)

  4. Postshield stage transitional volcanism on Mahukona Volcano, Hawaii

    Science.gov (United States)

    Clague, D.A.; Calvert, A.T.

    2009-01-01

    Age spectra from 40Ar/39Ar incremental heating experiments yield ages of 298??25 ka and 310??31 ka for transitional composition lavas from two cones on submarine Mahukona Volcano, Hawaii. These ages are younger than the inferred end of the tholeiitic shield stage and indicate that the volcano had entered the postshield alkalic stage before going extinct. Previously reported elevated helium isotopic ratios of lavas from one of these cones were incorrectly interpreted to indicate eruption during a preshield alkalic stage. Consequently, high helium isotopic ratios are a poor indicator of eruptive stage, as they occur in preshield, shield, and postshield stage lavas. Loihi Seamount and Kilauea are the only known Hawaiian volcanoes where the volume of preshield alkalic stage lavas can be estimated. ?? Springer-Verlag 2008.

  5. Computerized EEG and brain imaging studies in untreated schizophrenic patients

    International Nuclear Information System (INIS)

    Miyauchi, Toshiro; Kishimoto, Hideji; Hagimoto, Hiroshi; Fujita, Haruhiro; Tanaka, Kenkichi

    1993-01-01

    We undertook routine EEG, Z-map, CT and PET scans in seven acute untreated schizophrenics. Routine EEGs showed slower activity in only one case. However, the Z-map showed slower activity in all the cases. CT demonstrated brain atrophy in three of the cases, and PET revealed hypofrontality in two, right hypoparietality in four, and both conditions in one case. There was no relation between CT and PET or the Z-map. However, a significant increase in alpha 1 activity was demonstrated on the Z-map in cases who were found to be the parietal type on PET; this was not conspicuous in the frontal type on PET. Moreover, in three of the patients, the Z-map findings were similar to the lesion indicated on PET. (author)

  6. Turning an Extension Aide into an Extension Agent

    Science.gov (United States)

    Seevers, Brenda; Dormody, Thomas J.

    2010-01-01

    For any organization to remain sustainable, a renewable source of faculty and staff needs to be available. The Extension Internship Program for Juniors and Seniors in High School is a new tool for recruiting and developing new Extension agents. Students get "hands on" experience working in an Extension office and earn college credit…

  7. The effect of warm-up, static stretching and dynamic stretching on hamstring flexibility in previously injured subjects.

    LENUS (Irish Health Repository)

    O'Sullivan, Kieran

    2009-01-01

    BACKGROUND: Warm-up and stretching are suggested to increase hamstring flexibility and reduce the risk of injury. This study examined the short-term effects of warm-up, static stretching and dynamic stretching on hamstring flexibility in individuals with previous hamstring injury and uninjured controls. METHODS: A randomised crossover study design, over 2 separate days. Hamstring flexibility was assessed using passive knee extension range of motion (PKE ROM). 18 previously injured individuals and 18 uninjured controls participated. On both days, four measurements of PKE ROM were recorded: (1) at baseline; (2) after warm-up; (3) after stretch (static or dynamic) and (4) after a 15-minute rest. Participants carried out both static and dynamic stretches, but on different days. Data were analysed using Anova. RESULTS: Across both groups, there was a significant main effect for time (p < 0.001). PKE ROM significantly increased with warm-up (p < 0.001). From warm-up, PKE ROM further increased with static stretching (p = 0.04) but significantly decreased after dynamic stretching (p = 0.013). The increased flexibility after warm-up and static stretching reduced significantly (p < 0.001) after 15 minutes of rest, but remained significantly greater than at baseline (p < 0.001). Between groups, there was no main effect for group (p = 0.462), with no difference in mean PKE ROM values at any individual stage of the protocol (p > 0.05). Using ANCOVA to adjust for the non-significant (p = 0.141) baseline difference between groups, the previously injured group demonstrated a greater response to warm-up and static stretching, however this was not statistically significant (p = 0.05). CONCLUSION: Warm-up significantly increased hamstring flexibility. Static stretching also increased hamstring flexibility, whereas dynamic did not, in agreement with previous findings on uninjured controls. The effect of warm-up and static stretching on flexibility was greater in those with reduced

  8. The Hidden Cost of Untreated Paragangliomas of the Head and Neck: Systemic Reactive (AA Amyloidosis

    Directory of Open Access Journals (Sweden)

    Erkan Dervisoglu

    2015-01-01

    Full Text Available We report a case of a 51-year-old man who was diagnosed with systemic reactive (AA amyloidosis in association with untreated glomus jugulare and glomus caroticum tumors. He refused radiotherapy and renal replacement therapy. Paragangliomas, although rare, should be considered one of the tumors that can result in AA amyloidosis.

  9. Development of an in situ temperature stage for synchrotron X-ray spectromicroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Chakraborty, R., E-mail: rupak@alum.mit.edu, E-mail: buonassisi@mit.edu; Serdy, J.; Culpepper, M. L.; Buonassisi, T., E-mail: rupak@alum.mit.edu, E-mail: buonassisi@mit.edu [Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139 (United States); West, B.; Stuckelberger, M.; Bertoni, M. I. [School of Electrical, Computer and Energy Engineering, Arizona State University, Tempe, Arizona 85287 (United States); Lai, B.; Maser, J. [Advanced Photon Source, Argonne National Laboratory, Argonne, Illinois 60439 (United States)

    2015-11-15

    In situ characterization of micro- and nanoscale defects in polycrystalline thin-film materials is required to elucidate the physics governing defect formation and evolution during photovoltaic device fabrication and operation. X-ray fluorescence spectromicroscopy is particularly well-suited to study defects in compound semiconductors, as it has a large information depth appropriate to study thick and complex materials, is sensitive to trace amounts of atomic species, and provides quantitative elemental information, non-destructively. Current in situ methods using this technique typically require extensive sample preparation. In this work, we design and build an in situ temperature stage to study defect kinetics in thin-film solar cells under actual processing conditions, requiring minimal sample preparation. Careful selection of construction materials also enables controlled non-oxidizing atmospheres inside the sample chamber such as H{sub 2}Se and H{sub 2}S. Temperature ramp rates of up to 300 °C/min are achieved, with a maximum sample temperature of 600 °C. As a case study, we use the stage for synchrotron X-ray fluorescence spectromicroscopy of CuIn{sub x}Ga{sub 1−x}Se{sub 2} (CIGS) thin-films and demonstrate predictable sample thermal drift for temperatures 25–400 °C, allowing features on the order of the resolution of the measurement technique (125 nm) to be tracked while heating. The stage enables previously unattainable in situ studies of nanoscale defect kinetics under industrially relevant processing conditions, allowing a deeper understanding of the relationship between material processing parameters, materials properties, and device performance.

  10. Treatment of patients with minimal stage IIIA Hodgkin's disease

    International Nuclear Information System (INIS)

    Powlis, W.D.; Mauch, P.; Goffman, T.; Goodman, R.L.

    1987-01-01

    Treatment recommendations for patients with upper abdominal Stage IIIA Hodgkin's (III1A) disease have varied widely. The current study reports on a combined institutional retrospective review of 85 patients with surgically staged III1A Hodgkin's disease. Twenty-two patients received combined modality therapy (CMT), 36 patients were treated initially with total nodal irradiation (TNI), and 27 with mantle and para-aortic radiotherapy (MPA). Patients treated with CMT had an actuarial 8-year freedom from relapse (FFR) of 96% as compared to a FFR of 51% in TNI treated patients (p = 0.002), and a FFR of 54% in MPA treated patients (p = 0.004). Of the 11 relapses in MPA treated patients, 7 had a component of their failure in the untreated pelvic or inguinal nodes. The patients treated with CMT had an 8-year actuarial survival of 100% as compared to 79% in TNI treated patients (p = 0.055) and 78% in patients treated with MPA (p = 0.025). Histology and the number of splenic nodules were the most important prognostic variables. Patients with MC/LD histology and greater than or equal to 5 splenic nodules have a high risk of relapse (10/13) when treated with radiation alone (TNI or MPA). We recommend CMT for this group of patients. Patients with NS/LP histology and 1-4 splenic nodules represent a favorable subset of Stage III1A patients. Only 4/21 patients have relapsed and all 21 patients are currently alive without disease regardless of treatment. We currently feel that patients with Stage III1A Hodgkin's disease with NS/LP histology and splenic disease limited to 1-4 nodules are good candidates for MPA as an alternative to TNI or CMT

  11. Poor quality of life among untreated Thai and Cambodian children without severe HIV symptoms.

    Science.gov (United States)

    Bunupuradah, Torsak; Puthanakit, Thanyawee; Kosalaraksa, Pope; Kerr, Stephen J; Kariminia, Azar; Hansudewechakul, Rawiwan; Kanjanavanit, Suparat; Ngampiyaskul, Chaiwat; Wongsawat, Jurai; Luesomboon, Wicharn; Chuenyam, Theshinee; Vonthanak, Saphonn; Vun, Mean Chhi; Vibol, Ung; Vannary, Bun; Ruxrungtham, Kiat; Ananworanich, Jintanat

    2012-01-01

    There are limited data on quality of life (QOL) 1 in untreated HIV-infected children who do not have severe HIV symptoms. Moreover, such data do not exist for Asian children. Poor QOL could be a factor in deciding if antiretroviral therapy (ART) should be initiated. Thai and Cambodian children (n=294), aged 1-11 years, naïve to ART, with mild to moderate HIV symptoms and CD4 15-24% were enrolled. Their caregivers completed the Pediatric AIDS Clinical Trials Group QOL questionnaire prior to ART commencement. Six QOL domains were assessed using transformed scores that ranged from 0 to 100. Higher QOL scores indicated better health. Mean age was 6.1 (SD 2.8) years, mean CD4 was 723 (SD 369) cells/mm(3), 57% was female, and%CDC N:A:B was 2:63:35%. One-third knew their HIV diagnosis. Mean (SD) scores were 69.9 (17.6) for health perception, 64.5 (16.2) for physical resilience, 84.2 (15.6) for physical functioning, 77.9 (16.3) for psychosocial well-being, 74.7 (28.7) for social and role functioning, 90.0 (12.1) for health care utilization, and 87.4 (11.3) for symptoms domains. Children with CD4 counts above the 2008 World Health Organization (WHO) ART-initiation criteria (n=53) had higher scores in health perception and health care utilization than those with lower CD4 values. Younger children had poorer QOL than older children despite having similar mean CD4%. In conclusion, untreated Asian children without severe HIV symptoms had relatively low QOL scores compared to published reports in Western countries. Therapy initiation criteria by the WHO identified children with lower QOL scores to start ART; however, children who did not fit ART-initiation criteria and those who were younger also displayed poor QOL. QOL assessment should be considered in untreated children to inform decisions about when to initiate ART.

  12. The association between pre-morbid adjustment, duration of untreated psychosis and outcome in first-episode psychosis

    DEFF Research Database (Denmark)

    Jeppesen, P; Petersen, L; Thorup, A

    2008-01-01

    The association between the duration of untreated psychosis (DUP) and outcome of schizophrenia may be confounded by other factors such as poor pre-morbid adjustment. The aim of the present study was to examine the independent contributions of DUP and of pre-morbid adjustment to the clinical...

  13. Two-stage phyto-microremediation of tannery effluent by Spirodela polyrrhiza (L.) Schleid. and chromium resistant bacteria.

    Science.gov (United States)

    Singh, Asha; Vyas, Dhiraj; Malaviya, Piyush

    2016-09-01

    Two-stage sequential treatment of tannery effluent was conducted employing a wetland plant, Spirodela polyrrhiza (L.) Schleid., and chromium (Cr) resistant bacterial strains. The bacterial strains were isolated from Cr-enriched environmental matrices and rhizosphere of Spirodela polyrrhiza. The phyto-rhizoremediation of tannery effluent by Spirodela and its rhizospheric bacteria (Cellulomonas biazotea APBR1-6, Bacillus safensis APBR2-12, Staphylococcus warneri APBR3-5, Microbacterium oleivorans APBR2-6), followed by microremediation by Cr resistant bacteria (Micrococcus luteus APBS5-1, Bacillus pumilus APBS5-2, Bacillus flexus APBE3-1, Virgibacillus sediminis APBS6-1) resulted in reduction of pollution parameters [COD (81.2%), total Cr (97.3%), Cr(VI) (99.3%), Pb(II) (97.0%), Ni (95.7%)]. The LC-MS analysis showed that many pollutants detected in untreated tannery effluent were diminished after bioremediation or long chains of alcohol polyethoxylates viz. C18EO6 in untreated effluent were broken down into smaller unit of alcohol polyethoxylate ((+)HHO[CH2CH2O]H), indicating that bacteria and Spirodela polyrrhiza, alongwith its rhizospheric associates utilized them as carbon and energy source. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Complicated untreated apical periodontitis causing paraesthesia: A case report.

    Science.gov (United States)

    Ricucci, Domenico; Loghin, Simona; Siqueira, José F

    2017-08-14

    The purpose of this article was to report a case of untreated apical periodontitis resulting in severe late complications. A patient with an asymptomatic crowned root canal-treated mandibular molar revealing a radiographic substandard endodontic treatment and a slight periapical radiolucency was made aware of the treatment options and opted for no treatment. The lesion slightly increased in size after 6 years, but the tooth remained asymptomatic and endodontic retreatment was again refused. After 4 more years, the patient presented with an abscess and severe pain, complicated by paraesthesia of the left chin and lip. Radiographic examination revealed that the lesion had increased considerably to involve the mandibular canal. The treatment protocol included long-term intracanal medication with calcium hydroxide and follow-ups revealed complete resolution of the periapical radiolucency and the paraesthesia had completely subsided. © 2017 Australian Society of Endodontology Inc.

  15. Intrarectal ultrasound accuracy in preoperative staging of lower rectal cancer

    International Nuclear Information System (INIS)

    Vallone, G.; Della Vecchia, A.; Di Capua, V.; Rengo, C.; Spirito, M.; Romano, G.

    1988-01-01

    The capabilities were evaluated of endorectal ultrasound in assessing the local extension of rectal carcinomas. The study population consisted of 50 patients with histologically proven rectal cancer. A CT scan was also performed on 45 patients, and the results were then compared to post-operative histologic findings. Endorectal US allowed the correct staging of 39/45 tumors (86.6%), with 1 false positive (overstaging T1 as T2), and 5 false negatives (understaging 3xT3 as T2; 2xT4 as T3). CT allowed the correct staging of 37/45 tumors (82.2%), with 5 false positives (overstaging T1 as T2) and 3 false negatives (understaging T3 as T2). Our results prove endorectal US to be a reliable method for the local staging of rectal cancers, limited to mucosa, submucosa and muscular layers of the rectal wall (T1 and T2 tumors). CT does not allow proper evaluation of T1 and T2 tumors, but provides with a better assessment of tumors (T3 and T4). Both C and endorectal US should, therefore, be used as complementary diagnostic techniques for an accurate evaluation of the local extension of lower rectal cancers

  16. Negative extensibility metamaterials: Occurrence and design-space topology

    Science.gov (United States)

    Karpov, Eduard G.; Danso, Larry A.; Klein, John T.

    2017-08-01

    A negative extensibility material structure pulls back and contracts when the external tensile load reaches a certain critical level. In this paper, we reveal basic mathematical features of the nonlinear strain energy function responsible for this unusual mechanical property. A systematic discussion leads to a comprehensive phase diagram in terms of design parameters for a simple unit cell structure that provides a panoramic view of all possible nonlinear mechanical behaviors. A negative extensibility region clearly is identified in the diagram. The sought property is seen to be rare, occurring only for a very narrow range of the design parameters. Nonetheless, due to the simplicity of the studied structure we suggest that the negative extensibility should be a more common phenomenon than previously thought. It can appear in simple bistable cells made of only several linearly elastic links, although at some peculiar combinations of their properties. These bistable unit cells can be used to design periodic mechanical metamaterials whose examples are shown as well as innovative architectural metastructures.

  17. A randomized phase II study of carboplatin with weekly or every-3-week nanoparticle albumin-bound paclitaxel (abraxane) in patients with extensive-stage small cell lung cancer.

    Science.gov (United States)

    Grilley-Olson, Juneko E; Keedy, Vicki L; Sandler, Alan; Moore, Dominic T; Socinski, Mark A; Stinchcombe, Thomas E

    2015-02-01

    Platinum plus etoposide is the standard therapy for extensive-stage small cell lung cancer (ES-SCLC) and is associated with significant myelosuppression. We hypothesized that the combination of carboplatin and nanoparticle albumin-bound paclitaxel (nab-paclitaxel) would be better tolerated. We investigated carboplatin with nab-paclitaxel on every-3-week and weekly schedules. This noncomparative randomized phase II trial used a two-stage design. The primary objective was objective response rate, and secondary objectives were progression-free survival, overall survival, and toxicity. Patients with ES-SCLC and an Eastern Cooperative Oncology Group performance status ≤2 and no prior chemotherapy were randomized in a 1:1 ratio to arm A (carboplatin area under the curve [AUC] of 6 on day 1 and nab-paclitaxel of 300 mg/m(2) on day 1 every 3 weeks) or arm B (carboplatin AUC of 6 on day 1 and nab-paclitaxel 100 mg/m(2) on days 1, 8, and 15 every 21 days). Response was assessed after every two cycles. Patients required frequent dose reductions, treatment delays, and omission of the weekly therapy. The trial was closed because of slow accrual. Carboplatin and nab-paclitaxel demonstrated activity in ES-SCLC but required frequent dose adjustments. ©AlphaMed Press; the data published online to support this summary is the property of the authors.

  18. Perineal evisceration secondary to a bite injury in a dog with an untreated perineal hernia.

    Science.gov (United States)

    McCarthy, Daniel; Lux, Cassie; Seibert, Rachel

    2016-10-01

    Emergency surgery was performed on a 6-year-old castrated male springer spaniel dog with evisceration of most of the small intestinal tract through the perineal region, secondary to a dog attack. This is the first report describing successful treatment of perineal evisceration secondary to dog attack at an untreated perineal hernia, employing abdominal and perineal approaches.

  19. AUTHENTIC MATERIALS IN EXTENSIVE READING CLASS AT STAIN PONOROGO

    Directory of Open Access Journals (Sweden)

    Dhinuk Puspita Kirana

    2013-12-01

    Full Text Available It is widely believed that English Foreign Language (EFL learners need to develop their language proficiency by getting so much input. Moreover, students need to be familiarized with the real English us­age where real forms of communication and cultural knowledge are crucially exposed. Teaching through authentic materials will make the learners feel that they are learning a real language which is used by the real native speakers for real communication. incorporating au­thentic materials helps students acquire an effective communicative competence in the language focus. The research intended to describe the implementation of authentic materials in extensive reading class, the problems arise and the students’ responses toward the authen­tic materials in extensive reading class. The design of the research was Descriptive Qualitative method and the research subject was the lecturer of Extensive Reading class and 33 students in B class of the fourth semester of STAIN Ponorogo who took Extensive Read­ing subject. The instruments used were in the form of observation sheet, interview guideline and questionnaire. The implementation of authentic materials in extensive reading class covered some procedures into three main phases namely (1 Pre­ Activity, (2 Main­ Activity and (3 Post­Activity. The activities in main activity are as follows: (a Pre­ Activity; (b Whilst ­Activity; and (3 The language focus stage. There were problems arose during the implementation in terms of complicated planning, more time allocation and some disinterested students. Finally, the students showed significantly positive attitude toward the implementation of authentic materials in extensive reading class.

  20. DENTAL CAST STUDY OF ADULT PATIENTS WITH UNTREATED UNILATERAL CLEFT-LIP OR CLEFT-LIP AND PALATE IN INDONESIA COMPARED WITH SURGICALLY TREATED PATIENTS IN THE NETHERLANDS

    NARCIS (Netherlands)

    SPAUWEN, PHM; HARDJOWASITO, W; BOERSMA, J; LATIEF, BS

    To determine differences in maxillary and dentoalveolar relationships between untreated and treated patients having unilateral clefts of the lip and alveolus (UCLA) or lip and palate (UCLP), dental cast assessments were done on 70 untreated adult Indonesian patients (UCLA-I, UCLP-I) and 67 Dutch

  1. Risk indicators for aggressive periodontitis in an untreated isolated young population from Brazil

    Directory of Open Access Journals (Sweden)

    Priscila Corraini

    2009-06-01

    Full Text Available This study aimed to assess the prevalence of aggressive periodontitis (AgP, and to investigate the association between demographic, socioeconomic and behavioral risk indicators with AgP in an untreated and isolated young population in Southeastern Brazil. For this cross-sectional survey, 134 subjects aged 12-29 years were selected by a census. Of those eligible, 101 subjects received a full-mouth clinical examination, and were interviewed using a structured written questionnaire. Cases were defined as individuals with 4 or more teeth with attachment loss > 4 mm or > 5 mm in the age groups 12-19 and 20-29, respectively. Overall, 9.9% of the subjects presented AgP (10.3% of the 12-19-year-olds and 9.7% of the 20-29-year-olds. The only risk indicator significantly associated with AgP in this isolated population was a high proportion of sites (> 30% presenting supragingival calculus [OR = 23.2]. Having experienced an urgency dental treatment was a protective factor for AgP [OR = 0.1]. The authors concluded that this isolated and untreated population from Brazil presented a high prevalence of AgP. Local plaque-retaining factors played a major role in the prevalence of AgP in this isolated population, and should be included in further studies evaluating this destructive periodontal disease form.

  2. The correlation of preoperative CT, MR imaging, and clinical staging (FIGO) with histopathology findings in primary cervical carcinoma

    International Nuclear Information System (INIS)

    Oezsarlak, Oe.; Schepens, E.; Corthouts, B.; Beeck, B.O. de; Parizel, P.M.; De Schepper, A.M.; Tjalma, W.; Marck, E. van

    2003-01-01

    The aim of this study was to compare the preoperative findings of abdominal/pelvic CT and MRI with the preoperative clinical International Federation of Obstetrics and Gynecology (FIGO) staging and postoperative pathology report in patients with primary cancer of the cervix. Thirty-six patients with surgical-pathological proven primary cancer of the cervix were retrospectively studied for preoperative staging by clinical examination, CT, and MR imaging. Studied parameters for preoperative staging were the presence of tumor, tumor extension into the parametrial tissue, pelvic wall, adjacent organs, and lymph nodes. The CT was performed in 32 patients and MRI (T1- and T2-weighted images) in 29 patients. The CT and MR staging were based on the FIGO staging system. Results were compared with histological findings. The group is consisted of stage 0 (in situ):1, Ia:1, Ib:8, IIa:2, IIb:12, IIIa:4, IVa:6, and IVb:2 patients. The overall accuracy of staging for clinical examination, CT, and MRI was 47, 53, and 86%, respectively. The MRI incorrectly staged 2 patients and did not visualize only two tumors; one was an in situ (stage-0) and one stage-Ia (microscopic) disease. The MRI is more accurate than CT and they are both superior to clinical examination in evaluating the locoregional extension and preoperative staging of primary cancer of the cervix. (orig.)

  3. An influence of extremal edges on boundary extension.

    Science.gov (United States)

    Hale, Ralph G; Brown, James M; McDunn, Benjamin A; Siddiqui, Aisha P

    2015-08-01

    Studies have shown that people consistently remember seeing more of a studied scene than was physically present (e.g., Intraub & Richardson Journal of Experimental Psychology: Learning, Memory, and Cognition, 15, 179-187, 1989). This scene memory error, known as boundary extension, has been suggested to occur due to an observer's failure to differentiate between the contributing sources of information, including the sensory input, amodal continuation beyond the view boundaries, and contextual associations with the main objects and depicted scene locations (Intraub, 2010). Here, "scenes" made of abstract shapes on random-dot backgrounds, previously shown to elicit boundary extension (McDunn, Siddiqui, & Brown Psychonomic Bulletin & Review, 21, 370-375, 2014), were compared with versions made with extremal edges (Palmer & Ghose Psychological Science, 19, 77-84, 2008) added to their borders, in order to examine how boundary extension is influenced when amodal continuation at the borders' view boundaries is manipulated in this way. Extremal edges were expected to reduce boundary extension as compared to the same scenes without them, because extremal edge boundaries explicitly indicate an image's end (i.e., they do not continue past the view boundary). A large and a small difference (16 % and 40 %) between the close and wide-angle views shown during the experiment were tested to examine the effects of both boundary extension and normalization with and without extremal edges. Images without extremal edges elicited typical boundary extension for the 16 % size change condition, whereas the 40 % condition showed signs of normalization. With extremal edges, a reduced amount of boundary extension occurred for the 16 % condition, and only normalization was found for the 40 % condition. Our findings support and highlight the importance of amodal continuation at the view boundaries as a component of boundary extension.

  4. Biohydrogen production from untreated and hydrolyzed potato steam peels by the extreme thermophiles Caldicellulosiruptor saccharolyticus and Thermotoga neapolitana

    Energy Technology Data Exchange (ETDEWEB)

    Mars, Astrid E.; Veuskens, Teun; Budde, Miriam A.W.; van Doeveren, Patrick F.N.M.; Lips, Steef J.; Bakker, Robert R.; de Vrije, Truus; Claassen, Pieternel A.M. [Wageningen UR, Food and Biobased Research, P.O. Box 17, 6700 AA Wageningen (Netherlands)

    2010-08-15

    Production of hydrogen by the extreme thermophiles Caldicellulosiruptor saccharolyticus and Thermotoga neapolitana was studied in serum flasks and in pH-controlled bioreactors with glucose, and hydrolyzed and untreated potato steam peels (PSP) as carbon sources. Two types of PSP hydrolysates were used: one in which the starch in the PSP was liquefied with alpha-amylase, and one in which the liquefied starch was further hydrolyzed to glucose by amyloglucosidase. When the PSP hydrolysates or untreated PSP were added at circa 10-14 g/L of glucose units, both strains grew well and produced hydrogen with reasonable to high molar yields (2.4-3.8 moles H{sub 2}/mole glucose units), and no significant production of lactate. The hydrogen production rates and yields were similar with untreated PSP, hydrolyzed PSP, and pure glucose, showing that C. saccharolyticus and T. neapolitana are well equipped for the utilization of starch. When the concentrations of the substrates were increased, growth and hydrogen production of both strains were hampered. At substrate concentrations of circa 30-40 g/L of glucose units, the molar hydrogen yield of C. saccharolyticus was severely reduced due to the formation of high amounts of lactate, while T. neapolitana was unable to grow at all. The results showed that PSP and PSP hydrolysates are very suitable substrates for efficient fermentative hydrogen production at moderate substrate loadings. (author)

  5. Dabrafenib plus trametinib in patients with previously untreated BRAF(V600E)-mutant metastatic non-small-cell lung cancer : An open-label, phase 2 trial

    NARCIS (Netherlands)

    Planchard, David; Smit, Egbert F.; Groen, Harry J. M.; Mazieres, Julien; Besse, Benjamin; Helland, Aslaug; Giannone, Vanessa; D'Amelio, Anthony M.; Zhang, Pingkuan; Mookerjee, Bijoyesh; Johnson, Bruce E.

    2017-01-01

    Background: BRAF(V600E) mutation occurs in 1-2% of lung adenocarcinomas and acts as an oncogenic driver. Dabrafenib, alone or combined with trametinib, has shown substantial antitumour activity in patients with previously treated BRAF(V600E)-mutant metastatic non-small-cell lung cancer (NSCLC). We

  6. The Transcriptome of Leishmania major Developmental Stages in Their Natural Sand Fly Vector.

    Science.gov (United States)

    Inbar, Ehud; Hughitt, V Keith; Dillon, Laura A L; Ghosh, Kashinath; El-Sayed, Najib M; Sacks, David L

    2017-04-04

    The life cycle of the Leishmania parasite in the sand fly vector involves differentiation into several distinctive forms, each thought to represent an adaptation to specific microenvironments in the midgut of the fly. Based on transcriptome sequencing (RNA-Seq) results, we describe the first high-resolution analysis of the transcriptome dynamics of four distinct stages of Leishmania major as they develop in a natural vector, Phlebotomus duboscqi The early transformation from tissue amastigotes to procyclic promastigotes in the blood-fed midgut was accompanied by the greatest number of differentially expressed genes, including the downregulation of amastins, and upregulation of multiple cell surface proteins, sugar and amino acid transporters, and genes related to glucose metabolism and cell cycle progression. The global changes accompanying post-blood meal differentiation of procyclic promastigotes to the nectomonad and metacyclic stages were less extensive, though each displayed a unique signature. The transcriptome of nectomonads, which has not been studied previously, revealed changes consistent with cell cycle arrest and the upregulation of genes associated with starvation and stress, including autophagic pathways of protein recycling. Maturation to the infective, metacyclic stage was accompanied by changes suggesting preadaptation to the intracellular environment of the mammalian host, demonstrated by the amastigote-like profiles of surface proteins and metabolism-related genes. Finally, a direct comparison between sand fly-derived and culture-derived metacyclics revealed a reassuring similarity between the two forms, with the in vivo forms distinguished mainly by a stronger upregulation of transcripts associated with nutrient stress. IMPORTANCE The life cycle of Leishmania parasites in the sand fly vector includes their growth and development as morphologically distinct forms of extracellular promastigotes found within the different microenvironments of the

  7. Mechanical testing of PHWR components at different fabrication stages

    International Nuclear Information System (INIS)

    Saibaba, N.

    2007-01-01

    Zirconium alloys are extensively used for reactor structural and cladding components for PHWRs and BWRs due to their low neutron absorption cross-section, corrosion resistance to high temperature aqueous environments, adequate mechanical properties and resistance to radiation damage. The coolant tube fabrication route consists of a series of intermediate process steps. The working parameters of each process have a definite bearing on the final properties of these tubes. In order to ascertain the effect of these parameters, mechanical testing is carried out at intermediate stage of coolant tube fabrication. The mechanical properties of the products can be correlated with process parameters and reflect the quality of the product to a great extent. These properties at intermediate stages can serve as process controlling parameters. This paper discusses the correlation of mechanical properties of pressure tubes between the intermediate stage and final stage. The effect of process parameters like annealing temperature, honing, sand blasting pressure and eccentricity on the final mechanical properties was highlighted. (author)

  8. The immune response is affected for at least three weeks after extensive surgery for ovarian cancer

    DEFF Research Database (Denmark)

    Brøchner, Anne Craveiro; Mikkelsen, Søren; Hegelund, Iørn

    2016-01-01

    INTRODUCTION: The treatment of women with ovarian cancer in advanced stages consists of extensive surgery followed by chemotherapy initiated three weeks after surgery. In this study, selected immune parameters were investigated to elucidate when the immune system is normalised following the opera......INTRODUCTION: The treatment of women with ovarian cancer in advanced stages consists of extensive surgery followed by chemotherapy initiated three weeks after surgery. In this study, selected immune parameters were investigated to elucidate when the immune system is normalised following......, interleukin-10 and the activity and total frequency of natural killer cells were measured. RESULTS: Interleukin-6 and interleukin-10 were significantly elevated immediately after the operation and also after 21 days. The total population of natural killercells and the total activity were reduced. The total...

  9. Staging performance of whole-body DWI, PET/CT and PET/MRI in invasive ductal carcinoma of the breast.

    Science.gov (United States)

    Catalano, Onofrio Antonio; Daye, Dania; Signore, Alberto; Iannace, Carlo; Vangel, Mark; Luongo, Angelo; Catalano, Marco; Filomena, Mazzeo; Mansi, Luigi; Soricelli, Andrea; Salvatore, Marco; Fuin, Niccolo; Catana, Ciprian; Mahmood, Umar; Rosen, Bruce Robert

    2017-07-01

    The aim of the present study was to evaluate the performance of whole-body diffusion-weighted imaging (WB-DWI), whole-body positron emission tomography with computed tomography (WB-PET/CT), and whole-body positron emission tomography with magnetic resonance imaging (WB-PET/MRI) in staging patients with untreated invasive ductal carcinoma of the breast. Fifty-one women with newly diagnosed invasive ductal carcinoma of the breast underwent WB-DWI, WB-PET/CT and WB-PET/MRI before treatment. A radiologist and a nuclear medicine physician reviewed in consensus the images from the three modalities and searched for occurrence, number and location of metastases. Final staging, according to each technique, was compared. Pathology and imaging follow-up were used as the reference. WB-DWI, WB-PET/CT and WB-PET/MRI correctly and concordantly staged 33/51 patients: stage IIA in 7 patients, stage IIB in 8 patients, stage IIIC in 4 patients and stage IV in 14 patients. WB-DWI, WB-PET/CT and WB-PET/MRI incorrectly and concordantly staged 1/51 patient as stage IV instead of IIIA. Discordant staging was reported in 17/51 patients. WB-PET/MRI resulted in improved staging when compared to WB-PET/CT (50 correctly staged on WB-PET/MRI vs. 38 correctly staged on WB-PET/CT; McNemar's test; p<0.01). Comparing the performance of WB-PET/MRI and WB-DWI (43 correct) did not reveal a statistically significant difference (McNemar test, p=0.14). WB-PET/MRI is more accurate in the initial staging of breast cancer than WB-DWI and WB-PET/CT, however, the discrepancies between WB-PET/MRI and WB-DWI were not statistically significant. When available, WB-PET/MRI should be considered for staging patient with invasive ductal breast carcinoma.

  10. Sensitivity and specificity of Frontal Assessment Battery in newly diagnosed and untreated obstructive sleep apnea patients.

    Science.gov (United States)

    Ladera, Valentina; Sargento, Paulo; Perea, Victoria; Faria, Miguel; Garcia, Ricardo

    2018-02-01

    Executive dysfunction (ED) is often observed in subjects diagnosed with obstructive sleep apnea (OSA), but their assessment requires facilities that are not always available. We aim to evaluate the extent to which Frontal Assessment Battery (FAB) discriminates ED in newly diagnosed, untreated, and without-comorbidity OSA patients. Sixty subjects participated in the study. Of these, 40 (31 males and 9 females) were newly diagnosed for OSA through full-night polysomnography (apnea/hypopnea index; M = 39.01, SD = 27.16), untreated, with a mean age of 54.50 years (SD = 8.90), while the remaining 20 (15 males and 5 females) had no symptoms of OSA (M = 51.60 years, SD = 10.70). The instruments used were the following: Questionnaire for Sleep Apnea Risk, Epworth Sleepiness Scale, Mini-Mental State Examination, and FAB. The group with OSA exhibited significantly lower values in the FAB global score (p = 0.003) and in Conceptualization (p = 0.001) and Mental Flexibility (p = 0.009) subtests. ROC analysis showed adequate discriminative capacity for the FAB global score (AUC = 0.74) and for Conceptualization (AUC = 0.75) and Mental Flexibility (AUC = 0.70) scores. The FAB is a short and no-time-consuming tool that can be used to investigate the presence of ED in untreated OSA patients with no comorbidities, providing clinicians with a simple and effective way of detecting the presence of this dysfunction and allowing a more informed decision for the need of a full neuropsychological assessment. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Arterial Destiffening in Previously Untreated Mild Hypertensives After 1 Year of Routine Clinical Management.

    Science.gov (United States)

    Rodilla, Enrique; Millasseau, Sandrine; Costa, Jose Antonio; Pascual, Jose Maria

    2017-05-01

    Arterial stiffness, measured with pulse wave velocity (PWV), is now classified as a marker of target organ damage (TOD) alongside left ventricular hypertrophy and moderately increased albuminuria. Interventional studies on treated hypertensive patients have shown that PWV could be improved. Our aim was to assess changes in arterial stiffness after 1 year of routine clinical practice in never-treated hypertensive patients. We studied 356 never-treated patients with suspected hypertension. After standard clinical assessment during which presence of TOD was evaluated, hypertension diagnosis was confirmed in 231 subjects who subsequently received standard routine care. Both hypertensive and the 125 controls came back for a follow-up visit after 1 year. Hypertensive patients were slightly older (46 ± 12 vs. 50 ± 12 years, P < 0.001), with higher mean arterial pressure (MAP)-adjusted PWV compared to controls (8.6 ± 2.0 vs. 8.0 ± 1.7 m/s, P < 0.001) and 47% of them presented 1 or more TOD. After 1 year of treatment, MAP was similar in both groups (94.9 vs. 96.2 mm Hg; P = ns), but adjusted PWV remained significantly higher in the hypertensive patients (7.8 ± 1.4 vs. 8.3 ± 1.7 m/s, P = 0.004). The prevalence of elevated PWV was reduced from 20% to 12%. All antihypertensive drugs achieved the same blood pressure (BP) and PWV reduction with the exception of vasodilating beta-blockers which gave slightly better results probably due to heart rate reduction. BP reduction in newly diagnosed hypertensive patients improves arterial stiffness within a year of real-life clinical practice. Patients with the highest PWV and the largest reduction of BP "destiffened" the most whatever antihypertensive class was used. © American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  12. Extension of thickened and hot lithospheres: Inferences from laboratory modeling

    NARCIS (Netherlands)

    Tirel, C.; Brun, J.P.; Sokoutis, D.

    2006-01-01

    The extension of a previously thickened lithosphere is studied through a series of analogue experiments. The models deformed in free and boundary-controlled gravity spreading conditions that simulate the development of wide rift-type and core complex-type structures. In models, the development of

  13. Natural history and immature stage morphology of Spialia Swinhoe, 1912 in the Iberian Peninsula (Lepidoptera, Hesperiidae

    Directory of Open Access Journals (Sweden)

    Juan L. Hernández-Roldán

    2018-01-01

    Full Text Available We present new data on the ecology, natural history and geographic distribution of the recently described skipper Spialia rosae Hernández-Roldán, Dapporto, Dincă, Vicente & Vila, 2016 and compare its immature stage morphology with the sympatric species S. sertorius (Hoffmannsegg, 1804. Spialia rosae uses species of Rosa L. (Rosaceae as larval host-plants and prefers montane habitats, while S. sertorius feeds on Sanguisorba minor Scop. (Rosaceae and inhabits lower altitudes. Rosa corymbifera Borkh. and R. tomentosa Sm. are documented for the first time as foodplants of S. rosae. We report Microgaster australis Thomson, 1895 (Hymenoptera, Braconidae, Microgastrinae as a larval parasitoid of S. rosae. Details of the immature stages of S. rosae and S. sertorius are shown using scanning electron microscope photographs, confirming the similar immature stage morphology, at least as regards the Iberian S. sertorius. In both species, the egg has high radial ribs, the last instar larva has branched setae covering the head, and the pupa has setae with pointed tips, barrel-like cuticular formations, and hairy mesothoracic tubercles. By extensive sampling of the species of Spialia in the region of Segovia, Central Spain, we extend the previously known geographic distribution of S. rosae to 56 new 100 km2 MGRS squares, which represents a 155 % increase. Spialia rosae is present in the northern part of the interior plateau and in the main mountain systems of the Iberian Peninsula. The main threats to the populations of S. rosae are its limited distribution range and the possible effects of climate change due to its specialization in montane habitats. The conservation status of S. rosae was previously regarded as Data Deficient (DD. With the addition of new data the species can now be evaluated as Least Concern (LC.

  14. Case-control study for colorectal cancer genetic susceptibility in EPICOLON: previously identified variants and mucins

    International Nuclear Information System (INIS)

    Abulí, Anna; Morillas, Juan D; Rigau, Joaquim; Latorre, Mercedes; Fernández-Bañares, Fernando; Peña, Elena; Riestra, Sabino; Payá, Artemio; Jover, Rodrigo; Xicola, Rosa M; Llor, Xavier; Fernández-Rozadilla, Ceres; Carvajal-Carmona, Luis; Villanueva, Cristina M; Moreno, Victor; Piqué, Josep M; Carracedo, Angel; Castells, Antoni; Andreu, Montserrat; Ruiz-Ponte, Clara; Castellví-Bel, Sergi; Alonso-Espinaco, Virginia; Muñoz, Jenifer; Gonzalo, Victoria; Bessa, Xavier; González, Dolors; Clofent, Joan; Cubiella, Joaquin

    2011-01-01

    Colorectal cancer (CRC) is the second leading cause of cancer death in developed countries. Familial aggregation in CRC is also important outside syndromic forms and, in this case, a polygenic model with several common low-penetrance alleles contributing to CRC genetic predisposition could be hypothesized. Mucins and GALNTs (N-acetylgalactosaminyltransferase) are interesting candidates for CRC genetic susceptibility and have not been previously evaluated. We present results for ten genetic variants linked to CRC risk in previous studies (previously identified category) and 18 selected variants from the mucin gene family in a case-control association study from the Spanish EPICOLON consortium. CRC cases and matched controls were from EPICOLON, a prospective, multicenter, nationwide Spanish initiative, comprised of two independent stages. Stage 1 corresponded to 515 CRC cases and 515 controls, whereas stage 2 consisted of 901 CRC cases and 909 controls. Also, an independent cohort of 549 CRC cases and 599 controls outside EPICOLON was available for additional replication. Genotyping was performed for ten previously identified SNPs in ADH1C, APC, CCDN1, IL6, IL8, IRS1, MTHFR, PPARG, VDR and ARL11, and 18 selected variants in the mucin gene family. None of the 28 SNPs analyzed in our study was found to be associated with CRC risk. Although four SNPs were significant with a P-value < 0.05 in EPICOLON stage 1 [rs698 in ADH1C (OR = 1.63, 95% CI = 1.06-2.50, P-value = 0.02, recessive), rs1800795 in IL6 (OR = 1.62, 95% CI = 1.10-2.37, P-value = 0.01, recessive), rs3803185 in ARL11 (OR = 1.58, 95% CI = 1.17-2.15, P-value = 0.007, codominant), and rs2102302 in GALNTL2 (OR = 1.20, 95% CI = 1.00-1.44, P-value = 0.04, log-additive 0, 1, 2 alleles], only rs3803185 achieved statistical significance in EPICOLON stage 2 (OR = 1.34, 95% CI = 1.06-1.69, P-value = 0.01, recessive). In the joint analysis for both stages, results were only significant for rs3803185 (OR = 1.12, 95% CI = 1

  15. Banana Algebra: Compositional syntactic language extension

    DEFF Research Database (Denmark)

    Andersen, Jacob; Brabrand, Claus; Christiansen, David Raymond

    2013-01-01

    We propose an algebra of languages and transformations as a means of compositional syntactic language extension. The algebra provides a layer of high-level abstractions built on top of languages (captured by context-free grammars) and transformations (captured by constructive catamorphisms...... algebra as presented in the paper is implemented as the Banana Algebra Tool which may be used to syntactically extend languages in an incremental and modular fashion via algebraic composition of previously defined languages and transformations. We demonstrate and evaluate the tool via several kinds...

  16. Coupling Empowerment Based Application of Extension Method for Geothermal Potential Assessment

    Directory of Open Access Journals (Sweden)

    Qing Zhang

    2018-01-01

    Full Text Available Plenty of mathematics researches provide feasibility to calculate the weights of geothermal controlling factors and have been applied in geothermal potential assessment. In order to avoid the disadvantages of subjective and objective weighting calculation methods, an extension theory integrated weighting method was put forward, by combining with the process of AHP and mean variance method. The improved method can reach an agreement on subjective understanding of impact factors’ roles and data-based calculation weights. Then by replacing the point values with intervals, the extension theory was used in classification of geothermal assessment, according to extension judgment matrix. The evaluation results showed perfect performance in classification of impact factors, especially in Wudalianchi area, where 10 out of 11 selected impact factors agreed well with the actual evaluation grades. The study can provide a guidance for primary stage of geothermal investigation including the impact factor selection, weights calculation for impact factors, and the factors’ classification in geothermal assessment.

  17. C*-algebras associated with reversible extensions of logistic maps

    International Nuclear Information System (INIS)

    Kwaśniewski, Bartosz K

    2012-01-01

    The construction of reversible extensions of dynamical systems presented in a previous paper by the author and A.V. Lebedev is enhanced, so that it applies to arbitrary mappings (not necessarily with open range). It is based on calculating the maximal ideal space of C*-algebras that extends endomorphisms to partial automorphisms via partial isometric representations, and involves a new set of 'parameters' (the role of parameters is played by chosen sets or ideals). As model examples, we give a thorough description of reversible extensions of logistic maps and a classification of systems associated with compression of unitaries generating homeomorphisms of the circle. Bibliography: 34 titles.

  18. C*-algebras associated with reversible extensions of logistic maps

    Science.gov (United States)

    Kwaśniewski, Bartosz K.

    2012-10-01

    The construction of reversible extensions of dynamical systems presented in a previous paper by the author and A.V. Lebedev is enhanced, so that it applies to arbitrary mappings (not necessarily with open range). It is based on calculating the maximal ideal space of C*-algebras that extends endomorphisms to partial automorphisms via partial isometric representations, and involves a new set of 'parameters' (the role of parameters is played by chosen sets or ideals). As model examples, we give a thorough description of reversible extensions of logistic maps and a classification of systems associated with compression of unitaries generating homeomorphisms of the circle. Bibliography: 34 titles.

  19. Characterization of antibiotic resistant enterococci isolated from untreated waters for human consumption in Portugal.

    Science.gov (United States)

    Macedo, Ana S; Freitas, Ana R; Abreu, Cristina; Machado, Elisabete; Peixe, Luísa; Sousa, João C; Novais, Carla

    2011-01-31

    Untreated drinking water is frequently overlooked as a source of antibiotic resistance in developed countries. To gain further insight on this topic, we isolated the indicator bacteria Enterococcus spp. from water samples collected in wells, fountains and natural springs supplying different communities across Portugal, and characterized their antibiotic resistance profile with both phenotypic and genetic approaches. We found various rates of resistance to seven antibiotic families. Over 50% of the isolates were resistant to at least ciprofloxacin, tetracyclines or quinupristin-dalfopristin and 57% were multidrug resistant to ≥3 antibiotics from different families. Multiple enterococcal species (E. faecalis, E. faecium, E. hirae, E. casseliflavus and other Enterococcus spp) from different water samples harbored genes encoding resistance to tetracyclines, erythromycin or gentamicin [tet(M)-46%, tet(L)-14%, tet(S)-5%, erm(B)-22%, aac(6´)-Ie-aph(2″)-12%] and putative virulence factors [gel-28%, asa1-16%]. The present study positions untreated drinking water within the spectrum of ecological niches that may be reservoirs of or vehicles for antibiotic resistant enterococci/genes. These findings are worthy of attention as spread of antibiotic resistant enterococci to humans and animals through water ingestion cannot be dismissed. Copyright © 2010 Elsevier B.V. All rights reserved.

  20. Appendectomy in the surgical staging of ovarian carcinoma.

    Science.gov (United States)

    Beşe, T; Kösebay, D; Kaleli, S; Oz, A U; Demirkiran, F; Gezer, A

    1996-06-01

    Extensive debulking is accepted as the primary method of operative management for carcinoma of the ovary. However, there is no consensus regarding the role of appendectomy in primary surgical treatment. The aim of this study was to assess the role of appendectomy in the surgical staging and cytoreduction of ovarian carcinoma. The study was a retrospective review of 90 primary malignant ovarian carcinoma patients who had an appendectomy in addition to primary cytoreductive surgery. Out of 90 patients, 10 (11.1%) had metastasis to the appendix. The rate of metastasis to the appendix was 11.5% (9/78) in malignant epithelial ovarian carcinomas and 8.3% (1/12) in non-epithelial ovarian tumors. Of the patients with metastasis in the appendix, malignant epithelial ovarian tumors were identified in 90% (serous: 70%; clear cell: 20%), and non-epithelial malignant ovarian tumor were disclosed in 10% (granulosa cell carcinoma). There were no metastases to the appendix in the other histological types. Although metastasis to the appendix was not observed in early stage ovarian carcinomas, it was detected in 21.4% (9/42) of stage III and 50% (1/2) of stage IV. Macroscopic tumor metastasis in the abdomen was noted in all patients with metastasis to the appendix. Appendectomy for stage I and II patients was not beneficial and did not affect final staging. As a result, for the proper staging of ovarian carcinoma there is no advantage to the addition of routine appendectomy to primary cytoreductive surgery in early stage (stage I and II) malignant epithelial ovarian tumors. Appendectomy would contribute to the cytoreduction of advanced stage disease if it is macroscopically involved.

  1. Relations between the stimulation of mixed lymphocyte populations and the staging system according Rai in patients with chronic lymphatic leukemia

    International Nuclear Information System (INIS)

    Heilmann, E.; Venne, U.

    1979-01-01

    By means of the incorporation rate of 3 H thymidine into the lymphocytes of patients with chronic lymphatic leukemia the possibility of stimulating them by using different mitogens was checked and compared with normal persons. The examination covered 11 patients treated with extracorporeal irradiation of the blood (ECIB), 5 patients treated with a chlorambucil therapy, and 10 untreated patients who where classified according to the staging system proposed by Rai. The lymphocytes of the peripheral blood were stimulated as mixed and isolated T and B-lymphocytes in the microculture by using the mitogens PHA, PWM, ConA, and LPS. In all CLL patients there was a diminished stimulation rate of a mixed lymphocyte population. A relation existed between the seriousness of the stage and the deminution of the incorporation rate of 3 H thymidine. A corresponding correlation could not be identified in untreated CLL patients. Isolated T-lymphocytes revealed better results of stimulation than the total population. As to their function B-lymphocytes showed a dependence on the kind of therapy. In the mixed lymphocyte culture of normal persons the best findings could be observed after stimulation with PHA, that is also valid for CLL patients. PHA, PWA, ConA, and LPS were suitable as substances stimulating B-lymphocytes with different efficacy in normal persons and CLL patients. Both collectives showed the best results in the T-lymphocyte culture after stimulation with LPS. (author)

  2. Diagnostic value of computed tomography in the colon cancer; In terms of the staging system

    International Nuclear Information System (INIS)

    Lee, Joo Mi; Moon, Jang Ho; Lee, Dong Joong; Choi, Chul Soon; Kang, Ik Won; Chung, Soo Young; Bae, Sang Hoon; Yoon, Jong Sub

    1989-01-01

    The CT findings of thirty-three patients with proven colon cancer were analysed. The results were as follows; 1. The accuracy for detecting pericolic fat invasion on CT was 81%. 2. The accuracy for detecting lymph node involvement on CT was 67%. 3. The overall accuracy for staging of colon cancer on CT was 64%(67% for stage A, 30% for stage B, 60% for stage C, 100% for stage D). 4. The overall detection rate of mass on CT was 80%(89% for rectum, 100% for rectosigmoid colon and sigmoid colon, 30% for ascending and transverse colon). 5. The CT is useful, noninvasive technique for assessing extension and staging of colon cancer

  3. Rectal Tumour Staging with Endorectal Ultrasound: Is There Any Difference between Western and Eastern European Countries?

    Science.gov (United States)

    Fábián, Anna; Bor, Renáta; Farkas, Klaudia; Bálint, Anita; Milassin, Ágnes; Rutka, Mariann; Tiszlavicz, László; Wittmann, Tibor; Nagy, Ferenc; Molnár, Tamás; Szepes, Zoltán

    2016-01-01

    Background. Rectal tumour management depends highly on locoregional extension. Rectal endoscopic ultrasound (ERUS) is a good alternative to computed tomography and magnetic resonance imaging. However, in Hungary only a small amount of rectal tumours is examined with ERUS. Methods. Our retrospective study (2006-2012) evaluates the diagnostic accuracy of ERUS and compares the results, the first data from Central Europe, with those from Western Europe. The effect of neoadjuvant therapy, rectal probe type, and investigator's experience were also assessed. Results. 311 of the 647 ERUS assessed locoregional extension. Histological comparison was available in 177 cases: 67 patients underwent surgery alone; 110 received neoadjuvant chemoradiotherapy (CRT); ERUS preceded CRT in 77 and followed it in 33 patients. T-staging was accurate in 72% of primarily operated patients. N-staging was less accurate (62%). CRT impaired staging accuracy (64% and 59% for T- and N-staging). Rigid probes were more accurate (79%). At least 30 examinations are needed to master the technique. Conclusions. The sensitivity of ERUS complies with the literature. ERUS is easy to learn and more accurate in early stages but unnecessary for restaging after CRT. Staging accuracy is similar in Western and Central Europe, although the number of examinations should be increased.

  4. Extension of radiotherapy (involved field vs subtotal nodal) after short-term chemotherapy in early-stage Hodgkin's disease (ESHD)

    International Nuclear Information System (INIS)

    Zanini, M.; Bonfante, V.; Soncini, F.; Di Russo, A.; Santoro, A.; Viviani, S.; Devizzi, L.; Gasparini, M.; Tesoro, Tess J.D.; Valagussa, P.; Bonadonna, G.

    1995-01-01

    Aims of this study were to avoid staging laparotomy, to improve the results of radiotherapy (RT) alone by a combined modality approach, to evaluate the optimal extent of RT after short-term chemotherapy (CT) and to reduce the long-term toxicity in patients cured for ESHD. From (2(90)) to (1(95)), 110 consecutive patients with clinical stage I (bulky and/or B), IIA, IIA bulky and IIEA entered a randomized trial comparing subtotal nodal irradiation (STNI) vs involved field radiotherapy (IFRT), both after short-term chemotherapy (ABVD for 4 cycles). The doses of RT were 30 Gy to uninvolved and 36 Gy to involved sites, respectively. With a median follow-up of 38 mos., the main results in 96 evaluable patients (stage I: 13 pts., stage II: 83 pts., median age 28 yrs., range 17-64) are as reported below. Most patients achieved complete remission (CR) after CT (92%), while 8 partial responders attained CR with RT (IFRT 5 pts., STNI 3 pts.). Four stage II patients relapsed (IFRT 2, pts., STNI 2 pts.), mainly in extranodal or not irradiated sites. Up-to-date the most remarkable toxicities include: acute myocardial infarction (1%), aspecific EKG changes (5%), reductions in pulmonary function tests (most mild and/or transient) in 45%, subclinical or clinical hypothyroidism 26% (only in pts. irradiated to the neck), 3 cases of azoospermia in 23 evaluable patients (13%) and transient amenorreha in(1(44)) patients. No second malignancies have been so far observed. The results of this study seem to indicate that 4 courses of ABVD plus RT are an effective treatment in clinical ESHD, with moderate long-term toxicities. In almost 10% of patients RT changed partial into complete remission. Should these results be confirmed on a longer follow-up, IFRT will definitely replace STNI in a combined modality treatment

  5. Implementation of Extensive Cytoreduction Resulted in Improved Survival Outcomes for Patients with Newly Diagnosed Advanced-Stage Ovarian, Tubal, and Peritoneal Cancers.

    Science.gov (United States)

    Raspagliesi, Francesco; Bogani, Giorgio; Ditto, Antonino; Martinelli, Fabio; Chiappa, Valentina; Borghi, Chiara; Scaffa, Cono; Morano, Federica; Maltese, Giuseppa; Lorusso, Domenica

    2017-10-01

    Residual disease (RD) after primary debulking surgery (PDS) is one of the main factors driving ovarian cancer prognosis. The primary end point of this study was assessment of the impact that surgery had on survival outcomes for patients with advanced ovarian cancer. Data on the effect of newly diagnosed advanced-stage ovarian, tubal, and peritoneal cancers were analyzed during two study periods (T1: 2001-2006 and T2: 2007-2012), in which the concepts of optimal and complete cytoreduction were introduced and implemented. In this study, 260 patients (36%) had surgery during T1 and 462 patients (64%) had surgery during T2. The rate of PDS increased, from 55.4% (144/260) during T1 to 85.5% (395/462) during T2 (p < 0.001). At the time of PDS, complete resection (RD0) was achieved for 45.1% of the patients during T1 and 76.7% of the patients during T2 (p < 0.001), whereas optimal resection (RD < 1 cm) was achieved for 60.4% of the patients during T1 and 85.3% of the patients during T2 (p < 0.001). Disease-free survival improved during the study periods (p = 0.006). Overall survival was similar in T1 and T2 (p = 0.18). The preoperative CA125 level, disease stage, and RD remained independently associated with disease-free survival (p ≤ 0.05). The performance of interval debulking surgery (IDS) instead of PDS correlated with worse survival outcomes (hazard ratio [HR] 1.47; 95% confidence interval [CI] 1.24-1.92; p = 0.02), whereas achievement of RD0 and RD < 1 cm independently improved overall survival (HR 0.45; 95% CI 0.22-0.91; p = 0.02 for RD0 and HR 0.47; 95% CI 0.23-0.96; p = 0.03 for RD0). The implementation of extensive cytoreduction allows improvement of patient outcomes. Further studies are needed to assess the risk-to-benefit ratio between PDS and IDS and to identify patients who benefit much more from one treatment method than from another.

  6. High cost of stage IV pressure ulcers.

    Science.gov (United States)

    Brem, Harold; Maggi, Jason; Nierman, David; Rolnitzky, Linda; Bell, David; Rennert, Robert; Golinko, Michael; Yan, Alan; Lyder, Courtney; Vladeck, Bruce

    2010-10-01

    The aim of this study was to calculate and analyze the cost of treatment for stage IV pressure ulcers. A retrospective chart analysis of patients with stage IV pressure ulcers was conducted. Hospital records and treatment outcomes of these patients were followed up for a maximum of 29 months and analyzed. Costs directly related to the treatment of pressure ulcers and their associated complications were calculated. Nineteen patients with stage IV pressure ulcers (11 hospital-acquired and 8 community-acquired) were identified and their charts were reviewed. The average hospital treatment cost associated with stage IV pressure ulcers and related complications was $129,248 for hospital-acquired ulcers during 1 admission, and $124,327 for community-acquired ulcers over an average of 4 admissions. The costs incurred from stage IV pressure ulcers are much greater than previously estimated. Halting the progression of early stage pressure ulcers has the potential to eradicate enormous pain and suffering, save thousands of lives, and reduce health care expenditures by millions of dollars. Copyright © 2010 Elsevier Inc. All rights reserved.

  7. Clinical consequences of untreated dental caries assessed using PUFA index and its covariates in children residing in orphanages of Pakistan.

    Science.gov (United States)

    Kamran, Ramsha; Farooq, Warda; Faisal, Mehreen Riaz; Jahangir, Faisal

    2017-07-11

    The purpose of this study was to determine the prevalence and clinical effects of untreated dental caries in Pakistani children residing in orphanages using the DMFT and PUFA index; association of decay and untreated dental caries with demographics including type of orphanage; behavioural and dental visiting pattern; and association of dental pain experience and type of orphanage with dental visiting. A cross-sectional survey was conducted on a total of 753 orphan children belonging to 4-17 years of age group residing in twin cities of Rawalpindi and Islamabad, Pakistan. Clinical examination of children was performed using the DMFT and PUFA index for the assessment of dental caries and untreated decay, followed by questionnaire enquiring about eating and oral hygiene habits, dental visiting pattern and dental pain and swelling experience. Association between dental decay, child's dental visiting and pain as a consequence of untreated decay was carried out using chi square test and logistic regression analysis. The overall caries prevalence was 34.8% and overall prevalence of PUFA/pufa was 15.9%. The mean score of DMFT and dmft was 1.18 (SD 0.39) and 1.04 (SD 0.23), and mean PUFA was 1.18 (SD 0.57) and mean pufa score 1.14 (SD 0.35). Untreated caries ratio was found to be 49.1% indicating half the decay had progressed to involve the pulp. No significant association of gender was found with DMFT, dmft, PUFA and pufa (p > 0.05), however, when analysed individually, the 'D' component of DMFT was significantly associated with male gender (p = 0.05). Furthermore, no significant association of DMFT/dmft or PUFA/pufa in either dentition was found with behavioural characteristics such as dietary and oral hygiene habits. Also, 66.2% children who experienced pain had not been to the dentist in the past year (p = 0.013) and 52.6% children who mentioned experiencing pain at night had not been to the dentist in the past year (p = 0.009). Children with decay were more

  8. Control of immature stages of the flea Ctenocephalides felis(Bouché in carpets exposed to cats treated with imidacloprid

    Directory of Open Access Journals (Sweden)

    L.J. Fourie

    2000-07-01

    Full Text Available Fleas cause allergic dermatitis in cats and dogs and therefore warrant control. It has been demonstrated previously that there is marked inhibition of the development of the immature stages of the cat flea Ctenocephalides felis on fleece blankets exposed to cats treated with imidacloprid. This study reports on the efficacy of imidacloprid in suppressing adult flea emergence in carpet exposed to treated cats. Circular discs of carpet pre-seeded with flea eggs and larvae were exposed to 6 untreated control and 6 topically treated (imidacloprid 10 % m/v cats 1 to 2 days after treatment and subsequently fortnightly for 6 weeks. Exposure times on alternate days were either 1 or 6 hours. Adult flea yield from carpets was determined 35 days after exposure. Differences between flea yield on control carpets and those exposed for 1 hour were significant only for days +1 and +14. For the 6-hour exposure, differences were significant at all times except on Day +43. The ability of imidacloprid to suppress the yield of adult fleas on carpets (6-hour exposure steadily declined from 82 % (Day +2 to 12 %(Day +43. For the 1-hour exposure it varied inconsistently between 0 and 83 % over the 6-week study period.

  9. Hodgkin's disease and age

    DEFF Research Database (Denmark)

    Specht, L.; Nissen, N.I.

    1989-01-01

    506 unselected, previously untreated patients with Hodgkin's disease were treated at the Finsen Institute between 1969 and 1983. The prognostic significance of age, sex, stage, systemic symptoms, histologic subtype, number of involved nodal regions, total tumour burden (peripheral + intrathoracic...... modality, stage, and total tumour burden, whereas age had no prognostic significance. With regard to death from Hodgkin's disease only age and total tumour burden had independent significance. The significance of age would seem to stem from the fact that some older patients could not be given adequate...

  10. Quality assessments of untreated and washed quinoa (Chenopodium quinoa) seeds based on histlogical and foaming capacity investigations

    NARCIS (Netherlands)

    Raamsdonk, van L.W.D.; Pinckaers, V.G.Z.; Ossenkoppele, J.S.; Houben, R.; Lotgering, M.; Groot, M.J.

    2010-01-01

    Quinoa seed has a high nutritional value, but has a coating of bitter-tasting saponins, making it unpalatable. Therefore the seeds are usually processed in order to remove the naturally occurring saponins from the seeds. To investigate the impact of processing, untreated and washed seeds of the

  11. Staging in local endometrial carcinoma

    International Nuclear Information System (INIS)

    Thorvinger, B.; Gudmundsson, T.; Horvath, G.; Forsberg, L.; Holtaas, S.; Lund Univ.

    1989-01-01

    Possible deep (more than an inner third of the uterine wall) myometrial invasion and cervical extension of endometrial carcinoma were evaluated prospectively using magnetic resonance (MR) and transabdominal real-time sonography (US) in 20 and 10 patients, respectively. The data obtained from these examinations were compared with hysterosalpingography (HSG) and clinical modalities including hysteroscopy, sounding and histopathologic findings after surgery. The concordance of outlining cervical extension was between MR and hysteroscopy 85 per cent, and between US and hysteroscopy 50 per cent. Deep myometrial tumor invasion was suggested in 4/10 patients by US and in 6/20 by MR, and was confirmed in all but one in each group at histologic examination of the resected uterus. There were no false negative US or MR examinations. Transabdominal US did not prove accurate in defining local endometrial carcinoma (distinguishing between stages I and II), but it may be used as an additional tool in revealing myometrial invasion. MR, however, seems to refine the delineation of uterine tumor growth. (orig.)

  12. Initial paclitaxel improves outcome compared with CMFP combination chemotherapy as front-line therapy in untreated metastatic breast cancer.

    Science.gov (United States)

    Bishop, J F; Dewar, J; Toner, G C; Smith, J; Tattersall, M H; Olver, I N; Ackland, S; Kennedy, I; Goldstein, D; Gurney, H; Walpole, E; Levi, J; Stephenson, J; Canetta, R

    1999-08-01

    To determine the place of single-agent paclitaxel compared with nonanthracycline combination chemotherapy as front-line therapy in metastatic breast cancer. Patients with previously untreated metastatic breast cancer were randomized to receive either paclitaxel 200 mg/m(2) intravenously (IV) over 3 hours for eight cycles (24 weeks) or standard cyclophosphamide 100 mg/m(2)/d orally on days 1 to 14, methotrexate 40 mg/m(2) IV on days 1 and 8, fluorouracil 600 mg/m(2) IV on days 1 and 8, and prednisone 40 mg/m(2)/d orally on days 1 to 14 (CMFP) for six cycles (24 weeks) with epirubicin recommended as second-line therapy. A total of 209 eligible patients were randomized with a median survival duration of 17.3 months for paclitaxel and 13.9 months for CMFP. Multivariate analysis showed that patients who received paclitaxel survived significantly longer than those who received CMFP (P =.025). Paclitaxel produced significantly less severe leukopenia, thrombocytopenia, mucositis, documented infections (all P = .07). Initial paclitaxel was associated with significantly less myelosuppression and fewer infections, with longer survival and similar quality of life and control of metastatic breast cancer compared with CMFP.

  13. Wnt signaling maintains the notochord fate for progenitor cells and supports the posterior extension of the notochord

    OpenAIRE

    Ukita, Kanako; Hirahara, Shino; Oshima, Naoko; Imuta, Yu; Yoshimoto, Aki; Jang, Chuan-Wei; Oginuma, Masayuki; Saga, Yumiko; Behringer, Richard R.; Kondoh, Hisato; Sasaki, Hiroshi

    2009-01-01

    The notochord develops from notochord progenitor cells (NPCs) and functions as a major signaling center to regulate trunk and tail development. NPCs are initially specified in the node by Wnt and Nodal signals at the gastrula stage. However, the underlying mechanism that maintains the NPCs throughout embryogenesis to contribute to the posterior extension of the notochord remains unclear. Here, we demonstrate that Wnt signaling in the NPCs is essential for posterior extension of the notochord....

  14. Mechanisms of stage-transcending protection following immunization of mice with late liver stage-arresting genetically attenuated malaria parasites.

    Directory of Open Access Journals (Sweden)

    Brandon K Sack

    2015-05-01

    Full Text Available Malaria, caused by Plasmodium parasite infection, continues to be one of the leading causes of worldwide morbidity and mortality. Development of an effective vaccine has been encumbered by the complex life cycle of the parasite that has distinct pre-erythrocytic and erythrocytic stages of infection in the mammalian host. Historically, malaria vaccine development efforts have targeted each stage in isolation. An ideal vaccine, however, would target multiple life cycle stages with multiple arms of the immune system and be capable of eliminating initial infection in the liver, the subsequent blood stage infection, and would prevent further parasite transmission. We have previously shown that immunization of mice with Plasmodium yoelii genetically attenuated parasites (GAP that arrest late in liver stage development elicits stage-transcending protection against both a sporozoite challenge and a direct blood stage challenge. Here, we show that this immunization strategy engenders both T- and B-cell responses that are essential for stage-transcending protection, but the relative importance of each is determined by the host genetic background. Furthermore, potent anti-blood stage antibodies elicited after GAP immunization rely heavily on FC-mediated functions including complement fixation and FC receptor binding. These protective antibodies recognize the merozoite surface but do not appear to recognize the immunodominant merozoite surface protein-1. The antigen(s targeted by stage-transcending immunity are present in both the late liver stages and blood stage parasites. The data clearly show that GAP-engendered protective immune responses can target shared antigens of pre-erythrocytic and erythrocytic parasite life cycle stages. As such, this model constitutes a powerful tool to identify novel, protective and stage-transcending T and B cell targets for incorporation into a multi-stage subunit vaccine.

  15. Orthognathic Surgery and Rhinoplasty: Simultaneous or Staged?

    Science.gov (United States)

    Sun, Alexander H; Steinbacher, Derek M

    2018-02-01

    Orthognathic surgery can significantly impact the nasolabial envelope, and at times requires an adjunctive rhinoplasty. The purpose of this study was to evaluate nasal morphology in orthognathic patients, focusing on predictive variables, and the need for and timing of definitive rhinoplasty. Based on these data, an algorithm for the implementation of adjunctive rhinoplasty is proposed. A review of cases over a 3-year period was completed. Information regarding demographic, diagnostic, and operative details; nasal morphology; and use of rhinoplasty was compiled. Three-dimensional images were used to quantify anatomical variables. Over 589 patients were reviewed during this period. Of these, 163 fulfilled inclusion criteria for this study. The mean age was 23.3 years. In total, 41.7 percent of orthognathic cases underwent adjunctive rhinoplasty. Of these, 82.4 percent were staged and 17.6 percent were simultaneous. The average time between staged procedures was 208 days. When simultaneous, 16.7 percent of the orthognathic procedures had significant maxillary movement (advancement >4 to 5 mm, impaction >2 mm, alar base excisions); in comparison, 92.9 percent of staged cases had significant maxillary movement (p orthognathic surgery. The authors present an algorithm to extensively treat the nasomaxillofacial relationship using orthognathic surgery alone, orthognathic surgery in concert with rhinoplasty, or orthognathic surgery followed by staged rhinoplasty.

  16. Impaired bone remodeling in children with osteogenesis imperfecta treated and untreated with bisphosphonates: the role of DKK1, RANKL, and TNF-α.

    Science.gov (United States)

    Brunetti, G; Papadia, F; Tummolo, A; Fischetto, R; Nicastro, F; Piacente, L; Ventura, A; Mori, G; Oranger, A; Gigante, I; Colucci, S; Ciccarelli, M; Grano, M; Cavallo, L; Delvecchio, M; Faienza, M F

    2016-07-01

    In this study, we investigated the bone cell activity in patients with osteogenesis imperfecta (OI) treated and untreated with neridronate. We demonstrated the key role of Dickkopf-1 (DKK1), receptor activator of nuclear factor-κB ligand (RANKL), and tumor necrosis factor alpha (TNF-α) in regulating bone cell of untreated and treated OI subjects. These cytokines could represent new pharmacological targets for OI. Bisphosphonates are widely used in the treatment of children with osteogenesis imperfecta (OI) with the objective of reducing the risk of fractures. Although bisphosphonates increase bone mineral density in OI subjects, the effects on fracture incidence are conflicting. The aim of this study was to investigate the mechanisms underlying bone cell activity in subjects with mild untreated forms of OI and in a group of subjects with severe OI treated with cycles of intravenous neridronate. Sclerostin, DKK1, TNF-α, RANKL, osteoprotegerin (OPG), and bone turnover markers were quantified in serum of 18 OI patients (12 females, mean age 8.86 ± 3.90), 8 of which were receiving cyclic intravenous neridronate, and 21 sex- and age-matched controls. The effects on osteoblastogenesis and OPG expression of media conditioned by the serum of OI patients and anti-DKK1 neutralizing antibody were evaluated. Osteoclastogenesis was assessed in cultures from patients and controls. DKK1 and RANKL levels were significantly increased both in untreated and in treated OI subjects with respect to controls. The serum from patients with high DKK1 levels inhibited both osteoblast differentiation and OPG expression in vitro. High RANKL and low OPG messenger RNA (mRNA) levels were found in lymphomonocytes from patients. High amounts of TNF-α were expressed by monocytes, and an elevated percentage of circulating CD11b-CD51/CD61+ osteoclast precursors was observed in patients. Our study demonstrated the key role of DKK1, RANKL, and TNF-α in regulating bone cell activity of subjects

  17. A novel three-stage distance-based consensus ranking method

    Science.gov (United States)

    Aghayi, Nazila; Tavana, Madjid

    2018-05-01

    In this study, we propose a three-stage weighted sum method for identifying the group ranks of alternatives. In the first stage, a rank matrix, similar to the cross-efficiency matrix, is obtained by computing the individual rank position of each alternative based on importance weights. In the second stage, a secondary goal is defined to limit the vector of weights since the vector of weights obtained in the first stage is not unique. Finally, in the third stage, the group rank position of alternatives is obtained based on a distance of individual rank positions. The third stage determines a consensus solution for the group so that the ranks obtained have a minimum distance from the ranks acquired by each alternative in the previous stage. A numerical example is presented to demonstrate the applicability and exhibit the efficacy of the proposed method and algorithms.

  18. Untreated depression and tuberculosis treatment outcomes, quality of life and disability, Ethiopia.

    Science.gov (United States)

    Ambaw, Fentie; Mayston, Rosie; Hanlon, Charlotte; Medhin, Girmay; Alem, Atalay

    2018-04-01

    To investigate the association between comorbid depression and tuberculosis treatment outcomes, quality of life and disability in Ethiopia. The study involved 648 consecutive adults treated for tuberculosis at 14 primary health-care facilities. All were assessed at treatment initiation (i.e. baseline) and after 2 and 6 months. We defined probable depression as a score of 10 or above on the nine-item Patient Health Questionnaire. Data on treatment default, failure and success and on death were obtained from tuberculosis registers. Quality of life was assessed using a visual analogue scale and we calculated disability scores using the World Health Organization's Disability Assessment Scale. Using multivariate Poisson regression analysis, we estimated the association between probable depression at baseline and treatment outcomes and death. Untreated depression at baseline was independently associated with tuberculosis treatment default (adjusted risk ratio, aRR: 9.09; 95% confidence interval, CI: 6.72 to 12.30), death (aRR: 2.99; 95% CI: 1.54 to 5.78), greater disability ( β : 0.83; 95% CI: 0.67 to 0.99) and poorer quality of life ( β : -0.07; 95% CI: -0.07 to -0.06) at 6 months. Participants with probable depression had a lower mean quality-of-life score than those without (5.0 versus 6.0, respectively; P  < 0.001) and a higher median disability score (22.0 versus 14.0, respectively; P  < 0.001) at 6 months. Untreated depression in people with tuberculosis was associated with worse treatment outcomes, poorer quality of life and greater disability. Health workers should be given the support needed to provide depression care for people with tuberculosis.

  19. Two-stage residual inclusion estimation: addressing endogeneity in health econometric modeling.

    Science.gov (United States)

    Terza, Joseph V; Basu, Anirban; Rathouz, Paul J

    2008-05-01

    The paper focuses on two estimation methods that have been widely used to address endogeneity in empirical research in health economics and health services research-two-stage predictor substitution (2SPS) and two-stage residual inclusion (2SRI). 2SPS is the rote extension (to nonlinear models) of the popular linear two-stage least squares estimator. The 2SRI estimator is similar except that in the second-stage regression, the endogenous variables are not replaced by first-stage predictors. Instead, first-stage residuals are included as additional regressors. In a generic parametric framework, we show that 2SRI is consistent and 2SPS is not. Results from a simulation study and an illustrative example also recommend against 2SPS and favor 2SRI. Our findings are important given that there are many prominent examples of the application of inconsistent 2SPS in the recent literature. This study can be used as a guide by future researchers in health economics who are confronted with endogeneity in their empirical work.

  20. EPA and USGS scientists conduct study to determine prevalence of newly-emerging contaminants in treated and untreated drinking water

    Science.gov (United States)

    Scientists from the EPA and USGS are collaborating on a research study to determine the presence of contaminants of emerging concern in treated and untreated drinking water collected from drinking water treatment plants.

  1. Determination of rat vertebral bone compressive fatigue properties in untreated intact rats and zoledronic-acid-treated, ovariectomized rats

    NARCIS (Netherlands)

    Brouwers, J.E.M.; Ruchselman, M.; Rietbergen, van B.; Bouxsein, M.L.

    2009-01-01

    Summary Compressive fatigue properties of whole vertebrae, which may be clinically relevant for osteoporotic vertebral fractures, were determined in untreated, intact rats and zoledronic-acid-treated, ovariectomized rats. Typical fatigue behavior was found and was similar to that seen in other

  2. Natural History of Tuberculosis: Duration and Fatality of Untreated Pulmonary Tuberculosis in HIV Negative Patients: A Systematic Review

    NARCIS (Netherlands)

    Tiemersma, Edine W.; van der Werf, Marieke J.; Borgdorff, Martien W.; Williams, Brian G.; Nagelkerke, Nico J. D.

    2011-01-01

    Background: The prognosis, specifically the case fatality and duration, of untreated tuberculosis is important as many patients are not correctly diagnosed and therefore receive inadequate or no treatment. Furthermore, duration and case fatality of tuberculosis are key parameters in interpreting

  3. Natural history of tuberculosis: duration and fatality of untreated pulmonary tuberculosis in HIV negative patients: a systematic review

    NARCIS (Netherlands)

    Tiemersma, E.W.; van der Werf, M.J.; Borgdorff, M.W.; Williams, B.G.; Nagelkerke, N.J.D.

    2011-01-01

    Background The prognosis, specifically the case fatality and duration, of untreated tuberculosis is important as many patients are not correctly diagnosed and therefore receive inadequate or no treatment. Furthermore, duration and case fatality of tuberculosis are key parameters in interpreting

  4. Inverse Design of Centrifugal Compressor Stages Using a Meanline Approach

    Directory of Open Access Journals (Sweden)

    Yuri Biba

    2004-01-01

    component of a stage are presented, and then described in terms of an iterative procedure which calculates the required one-dimensional geometry. A graphical user interface which facilitates user input and presentation of results is discussed briefly. The object-oriented nature of the code is highlighted as a platform which easily provides for maintainability and future extensions.

  5. Comparative evaluation of untreated and radurized Chilean avocadoes shipped to the Netherlands

    International Nuclear Information System (INIS)

    Ang, L.A.; Uzcategui, E.; Farkas, J.; Langerak, D.Is.; Duren, M.D.A.; Rubio, C.T.

    1986-01-01

    Avocados of Fuerte variety were picked mature green, treated with a hot water dip (10 min at 46 deg C) then individually wrapped in PVC foil, irradiated with a gamma radiation dose of 25 Gy, shipped by boat at 7 deg C from Chile to the Netherlands and stored there under different conditions. Similarly packed untreated fruits served as controls. The combination treatment and wrapping in PVC foil delayed and reduced the decay, and resulted in a better consumer quality. This small-scale trial shipment holds promise that a sea-transport of combined treated avocados from Chile to Western Europe whould be feasible. (author)

  6. Sapanisertib and Osimertinib in Treating Patients With Stage IV EGFR Mutation Positive Non-small Cell Lung Cancer After Progression on a Previous EGFR Tyrosine Kinase Inhibitor

    Science.gov (United States)

    2018-04-25

    EGFR Activating Mutation; EGFR Exon 19 Deletion Mutation; EGFR NP_005219.2:p.G719X; EGFR NP_005219.2:p.L858R; EGFR NP_005219.2:p.L861Q; EGFR T790M Mutation Negative; Recurrent Non-Small Cell Lung Carcinoma; Stage III Non-Small Cell Lung Cancer AJCC v7; Stage IIIA Non-Small Cell Lung Cancer AJCC v7; Stage IIIB Non-Small Cell Lung Cancer AJCC v7; Stage IV Non-Small Cell Lung Cancer AJCC v7

  7. Corticotropin-releasing hormone: Mediator of vertebrate life stage transitions?

    Science.gov (United States)

    Watanabe, Yugo; Grommen, Sylvia V H; De Groef, Bert

    2016-03-01

    Hormones, particularly thyroid hormones and corticosteroids, play critical roles in vertebrate life stage transitions such as amphibian metamorphosis, hatching in precocial birds, and smoltification in salmonids. Since they synergistically regulate several metabolic and developmental processes that accompany vertebrate life stage transitions, the existence of extensive cross-communication between the adrenal/interrenal and thyroidal axes is not surprising. Synergies of corticosteroids and thyroid hormones are based on effects at the level of tissue hormone sensitivity and gene regulation. In addition, in representative nonmammalian vertebrates, corticotropin-releasing hormone (CRH) stimulates hypophyseal thyrotropin secretion, and thus functions as a common regulator of both the adrenal/interrenal and thyroidal axes to release corticosteroids and thyroid hormones. The dual function of CRH has been speculated to control or affect the timing of vertebrate life history transitions across taxa. After a brief overview of recent insights in the molecular mechanisms behind the synergic actions of thyroid hormones and corticosteroids during life stage transitions, this review examines the evidence for a possible role of CRH in controlling vertebrate life stage transitions. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Elevated serum IGF-1 level enhances retinal and choroidal thickness in untreated acromegaly patients.

    Science.gov (United States)

    Zhang, Xia; Ma, Jin; Wang, Yuhan; Li, Lüe; Gao, Lu; Guo, Xiaopeng; Xing, Bing; Zhong, Yong

    2018-03-01

    1) To compare the retinal, choroidal, Haller's layer, and Sattler's/choriocapillaris thicknesses of untreated acromegaly patients without chiasm compression or diabetes mellitus and healthy controls. 2) To evaluate the correlations of retinal and choroidal thicknesses with serum growth hormone (GH) and insulin-like growth factor 1 (IGF) burden. This prospective, case-control study included 27 untreated acromegaly patients and 27 sex-matched and age-matched controls. Subfoveal choroidal, Haller's layer and Sattler's/choriocapillaris thicknesses were determined by enhanced-depth imaging optical coherence tomography (EDI-OCT). Foveal and macular retinal thicknesses were determined with SD-OCT. GH and IGF-1 burdens were defined as the product of disease duration and treatment-naïve serum GH and IGF-1 levels. Compared with healthy controls, patients with acromegaly exhibited significantly increased foveal retinal (p = 0.003), subfoveal choroidal (p IGF-1 level (p = 0.03) and IGF-1 burden (p = 0.009). No significant correlations were detected between choroidal thickness and GH burden (p = 0.44). Retinal thickness was not significantly correlated with any factor. The choroidal thickness of acromegaly patients was greater than that of healthy controls and was significantly correlated with disease duration, IGF-1 level and IGF-1 burden, indicating that excessive serum IGF-1 and its exposure time have a combined effect on choroidal thickness.

  9. An extension of fuzzy decision maps for multi-criteria decision-making

    OpenAIRE

    Elomda, Basem Mohamed; Hefny, Hesham Ahmed; Hassan, Hesham Ahmed

    2013-01-01

    This paper presents a new extension to Fuzzy Decision Maps (FDMs) by allowing use of fuzzy linguistic values to represent relative importance among criteria in the preference matrix as well as representing relative influence among criteria for computing the steady-state matrix in the stage of Fuzzy Cognitive Map (FCM). The proposed model is called the Linguistic Fuzzy Decision Networks (LFDNs). The proposed LFDN provides considerable flexibility to decision makers when solving real world Mult...

  10. Brain Oscillations Elicited by the Cold Pressor Test: A Putative Index of Untreated Essential Hypertension

    OpenAIRE

    Christos Papageorgiou; Efstathios Manios; Eleftheria Tsaltas; Eleni Koroboki; Maria Alevizaki; Elias Angelopoulos; Meletios-Athanasios Dimopoulos; Charalabos Papageorgiou; Nikolaos Zakopoulos

    2017-01-01

    Objective. Essential hypertension is associated with reduced pain sensitivity of unclear aetiology. This study explores this issue using the Cold Pressor Test (CPT), a reliable pain/stress model, comparing CPT-related EEG activity in first episode hypertensives and controls. Method. 22 untreated hypertensives and 18 matched normotensives underwent 24-hour ambulatory blood pressure monitoring (ABPM). EEG recordings were taken before, during, and after CPT exposure. Results. Significant group d...

  11. Nuclear grade and DNA ploidy in stage IV breast cancer with only visceral metastases at initial diagnosis.

    Science.gov (United States)

    De Lena, M; Barletta, A; Marzullo, F; Rabinovich, M; Leone, B; Vallejo, C; Machiavelli, M; Romero, A; Perez, J; Lacava, J; Cuevas, M A; Rodriguez, R; Schittulli, F; Paradisco, A

    1996-01-01

    The presence of early metastases to distant sites in breast cancer patients is an infrequent event whose mechanisms are still not clear. The aim of this study was to evaluate the biologic and clinical role of DNA ploidy and cell nuclear grade of primary tumors in the metastatic process of a series of stage IV previously untreated breast cancer patients with only visceral metastases. DNA flow cytometry analysis on paraffin-embedded material and cell nuclear grading of primary tumors was performed on a series of 50 breast cancer patients with only visceral metastases at the time of initial diagnosis. Aneuploidy was found in 28/46 (61%) of evaluable cases and was independent of site of involvement, clinical response, time of progression and overall survival of patients. Of the 46 cases evaluable for nuclear grade, 5 (11%), 16 (35%) and 25 (54%) were classified as G1 (well-differentiated) G2 and G3, respectively. Nuclear grade also was unrelated to response to therapy and overall survival, whereas time to progression was significantly longer in G1-2 than G3 tumors with the logrank test (P < 0.03) and multivariate analysis. Our results seem to stress the difficulty to individualize different prognostic subsets from a series of breast cancer patients with only visceral metastases at initial diagnosis according to DNA flow cytometry and nuclear grade.

  12. Progression of biopsy-measured liver fibrosis in untreated patients with hepatitis C infection: non-Markov multistate model analysis.

    Directory of Open Access Journals (Sweden)

    Peter Bacchetti

    Full Text Available BACKGROUND: Fibrosis stages from liver biopsies reflect liver damage from hepatitis C infection, but analysis is challenging due to their ordered but non-numeric nature, infrequent measurement, misclassification, and unknown infection times. METHODS: We used a non-Markov multistate model, accounting for misclassification, with multiple imputation of unknown infection times, applied to 1062 participants of whom 159 had multiple biopsies. Odds ratios (OR quantified the estimated effects of covariates on progression risk at any given time. RESULTS: Models estimated that progression risk decreased the more time participants had already spent in the current stage, African American race was protective (OR 0.75, 95% confidence interval 0.60 to 0.95, p = 0.018, and older current age increased risk (OR 1.33 per decade, 95% confidence interval 1.15 to 1.54, p = 0.0002. When controlled for current age, older age at infection did not appear to increase risk (OR 0.92 per decade, 95% confidence interval 0.47 to 1.79, p = 0.80. There was a suggestion that co-infection with human immunodeficiency virus increased risk of progression in the era of highly active antiretroviral treatment beginning in 1996 (OR 2.1, 95% confidence interval 0.97 to 4.4, p = 0.059. Other examined risk factors may influence progression risk, but evidence for or against this was weak due to wide confidence intervals. The main results were essentially unchanged using different assumed misclassification rates or imputation of age of infection. DISCUSSION: The analysis avoided problems inherent in simpler methods, supported the previously suspected protective effect of African American race, and suggested that current age rather than age of infection increases risk. Decreasing risk of progression with longer time already spent in a stage was also previously found for post-transplant progression. This could reflect varying disease activity, with recent progression indicating

  13. Accelerated fractionation radiotherapy for advanced haed and neck cancer

    International Nuclear Information System (INIS)

    Lamb, D.S.; Spry, N.A.; Gray, A.J.; Johnson, A.D.; Alexander, S.R.; Dally, M.J.

    1990-01-01

    Between 1981 and 1986, 89 patients with advanced head and neck squamous cancer were treated with a continuous accelerated fractionation radiotherapy (AFRT) regimen. Three fractions of 1.80 Gy, 4 h apart, were given on three treatment days per week, and the tumour dose was taken to 59.40 Gy in 33 fractions in 24-25 days. Acute mucosal reactions were generally quite severe, but a split was avoided by providing the patient with intensive support, often as an in-patient, until the reactions settled. Late radiation effects have been comparable to those obtained with conventional fractionation. The probability of local-regional control was 47% at 3 years for 69 previously untreated patients, whereas it was only 12% at one year for 20 patients treated for recurrence after radical surgery. Fifty-eight previously untreated patients with tumours arising in the upper aero-digestive tract were analysed in greated detail. The probability of local-regional control at 3 years was 78% for 17 Stage III patients and 15% for 31 Stage IV patients. This schedule of continuous AFRT is feasible and merits further investigation. (author). 31 refs.; 4 figs.; 6 tabs

  14. Wide variation of prostate-specific antigen doubling time of untreated, clinically localized, low-to-intermediate grade, prostate carcinoma.

    Science.gov (United States)

    Choo, Richard; Klotz, Laurence; Deboer, Gerrit; Danjoux, Cyril; Morton, Gerard C

    2004-08-01

    To assess the prostate specific antigen (PSA) doubling time of untreated, clinically localized, low-to-intermediate grade prostate carcinoma. A prospective single-arm cohort study has been in progress since November 1995 to assess the feasibility of a watchful-observation protocol with selective delayed intervention for clinically localized, low-to-intermediate grade prostate adenocarcinoma. The PSA doubling time was estimated from a linear regression of ln(PSA) against time, assuming a simple exponential growth model. As of March 2003, 231 patients had at least 6 months of follow-up (median 45) and at least three PSA measurements (median 8, range 3-21). The distribution of the doubling time was: 50 years, 56. The median doubling time was 7.0 years; 42% of men had a doubling time of >10 years. The doubling time of untreated clinically localized, low-to-intermediate grade prostate cancer varies widely.

  15. Severe morbidity and mortality in untreated HIV-infected children in a paediatric care programme in Abidjan, Côte d'Ivoire, 2004-2009

    Directory of Open Access Journals (Sweden)

    Alioum Ahmadou

    2011-06-01

    Full Text Available Abstract Background Clinical evolution of HIV-infected children who have not yet initiated antiretroviral treatment (ART is poorly understood in Africa. We describe severe morbidity and mortality of untreated HIV-infected children. Methods All HIV-infected children enrolled from 2004-2009 in a prospective HIV programme in two health facilities in Abidjan, Côte d'Ivoire, were eligible from their time of inclusion. Risks of severe morbidity (the first clinical event leading to death or hospitalisation and mortality were documented retrospectively and estimated using cumulative incidence functions. Associations with baseline characteristics were assessed by competing risk regression models between outcomes and antiretroviral initiation. Results 405 children were included at a median age of 4.5 years; at baseline, 66.9% were receiving cotrimoxazole prophylaxis, and 27.7% met the 2006 WHO criteria for immunodeficiency by age. The risk of developing a severe morbid event was 14% (95%CI: 10.7 - 17.8 at 18 months; this risk was lower in children previously exposed to any prevention of mother-to-child-transmission (PMTCT intervention (adjusted subdistribution hazard ratio [sHR]: 0.16, 95% CI: 0.04 - 0.71 versus those without known exposure. Cumulative mortality reached 5.5% (95%CI: 3.5 - 8.1 at 18 months. Mortality was associated with immunodeficiency (sHR: 6.02, 95% CI: 1.28-28.42. Conclusions Having benefited from early access to care minimizes the severe morbidity risk for children who acquire HIV. Despite the receipt of cotrimoxazole prophylaxis, the risk of severe morbidity and mortality remains high in untreated HIV-infected children. Such evidence adds arguments to promote earlier access to ART in HIV-infected children in Africa and improve care interventions in a context where treatment is still not available to all.

  16. Pushing the boundaries in liver graft utilisation in transplantation: Case report of a donor with previous bile duct injury repair.

    Science.gov (United States)

    Sultana, Asma; Powell, James J; Oniscu, Gabriel C

    2017-01-01

    Liver transplantation is a recognised treatment for extensive bile duct injuries with secondary biliary cirrhosis or recurring sepsis. However, there have been no reports of successful liver transplantation from a donor who sustained a previous bile duct injury. Here we discuss the case of a liver transplant from a 51-year-old brain dead donor who had suffered a Strasberg E1 bile duct injury and had undergone a Roux-en-Y hepaticojejunostomy 24 years prior to donation. The liver was successfully recovered and transplanted into a 56-year-old male recipient with end stage liver disease consequent to alpha 1 antitrypsin deficiency. The graft continues to function well 36 months post-transplant, with normal liver function tests and imaging revealing a patent hepaticojejunostomy. The potential associated vascular injuries should be identified during bench preparation whilst the management of biliary reconstruction at the time of transplant should follow the principles of biliary reconstruction in cases with biliary injuries, extending the hilar opening into the left duct. This case highlights the successful utilisation of a post bile duct injury repair liver, employing an experienced procurement team and careful bench assessment and reconstruction. Copyright © 2017. Published by Elsevier Ltd.

  17. Association between duration of untreated bipolar disorder and clinical outcome: data from a Brazilian sample

    Directory of Open Access Journals (Sweden)

    Gustavo C. Medeiros

    2016-03-01

    Full Text Available Objective: Bipolar disorder (BD is often left untreated for long periods, and this delay in treatment correlates with unfavorable prognosis. The present study sought to assess the magnitude of duration of untreated bipolar disorder (DUB in Brazil. We hypothesized that DUB would be longer in Brazil than in developed countries, and would be associated with poor clinical outcomes. Methods: One hundred and fifty-two psychiatric outpatients were evaluated for BD diagnosis, demographics, DUB, and clinical outcomes. Results: The mean age and mean DUB were, respectively, 38.9±10.8 and 10.4±9.8 years. An extended DUB was associated with early onset of BD (p < 0.001, depression as first mood episode (p = 0.04, and presence of BD in a first-degree relative (p = 0.012. Additionally, a longer DUB was associated with poorer clinical outcomes, such as elevated rates of rapid cycling (p = 0.004 and anxiety disorders (p = 0.016, as well as lower levels of current full remission (p = 0.021. Conclusion: As DUB may be a modifiable variable, better medical education regarding mental health, more structured medical services, and population-wide psychoeducation might reduce the time between onset and proper management of BD, thus improving outcome.

  18. Features of Brain MRI in Dogs with Treated and Untreated Mucopolysaccharidosis Type I

    Science.gov (United States)

    Vite, Charles H; Nestrasil, Igor; Mlikotic, Anton; Jens, Jackie K; Snella, Elizabeth M; Gross, William; Shapiro, Elsa G; Kovac, Victor; Provenzale, James M; Chen, Steven; Le, Steven Q; Kan, Shih-hsin; Banakar, Shida; Wang, Raymond Y; Haskins, Mark E; Ellinwood, N Matthew; Dickson, Patricia I

    2013-01-01

    The mucopolysaccharidosis type I (MPS I) dog model has been important in the development of therapies for human patients. We treated dogs with enzyme replacement therapy (ERT) by various approaches. Dogs assessed included untreated MPS I dogs, heterozygous carrier dogs, and MPS I dogs treated with intravenous ERT as adults (beginning at age 13 to 16 mo), intrathecal and intravenous ERT as adults (beginning at age 13 to 16 mo), or intrathecal ERT as juveniles (beginning at age 4 mo). We then characterized the neuroimaging findings of 32 of these dogs (age, 12 to 30 mo). Whole and midsagittal volumes of the corpus callosum, measured from brain MRI, were significantly smaller in affected dogs compared with unaffected heterozygotes. Corpus callosum volumes in dogs that were treated with intrathecal ERT from 4 mo until 21 mo of age were indistinguishable from those of age-matched carrier controls. Dogs with MPS I showed cerebral ventricular enlargement and cortical atrophy as early as 12 mo of age. Ventricular enlargement was greater in untreated MPS I dogs than in age-matched dogs treated with intrathecal ERT as juveniles or adults. However, treated dogs still showed some ventricular enlargement or cortical atrophy (or both). Understanding the progression of neuroimaging findings in dogs with MPS I and their response to brain-directed therapy may improve preclinical studies for new human-directed therapies. In particular, corpus callosum volumes may be useful quantitative neuroimaging markers for MPS-related brain disease and its response to therapy. PMID:23582423

  19. Sociologists in Extension

    Science.gov (United States)

    Christenson, James A.; And Others

    1977-01-01

    The article describes the work activities of the extension sociologist, the relative advantage and disadvantage of extension roles in relation to teaching/research roles, and the relevance of sociological training and research for extension work. (NQ)

  20. Stage-by-Stage and Parallel Flow Path Compressor Modeling for a Variable Cycle Engine, NASA Advanced Air Vehicles Program - Commercial Supersonic Technology Project - AeroServoElasticity

    Science.gov (United States)

    Kopasakis, George; Connolly, Joseph W.; Cheng, Larry

    2015-01-01

    This paper covers the development of stage-by-stage and parallel flow path compressor modeling approaches for a Variable Cycle Engine. The stage-by-stage compressor modeling approach is an extension of a technique for lumped volume dynamics and performance characteristic modeling. It was developed to improve the accuracy of axial compressor dynamics over lumped volume dynamics modeling. The stage-by-stage compressor model presented here is formulated into a parallel flow path model that includes both axial and rotational dynamics. This is done to enable the study of compressor and propulsion system dynamic performance under flow distortion conditions. The approaches utilized here are generic and should be applicable for the modeling of any axial flow compressor design accurate time domain simulations. The objective of this work is as follows. Given the parameters describing the conditions of atmospheric disturbances, and utilizing the derived formulations, directly compute the transfer function poles and zeros describing these disturbances for acoustic velocity, temperature, pressure, and density. Time domain simulations of representative atmospheric turbulence can then be developed by utilizing these computed transfer functions together with the disturbance frequencies of interest.

  1. Case-control study for colorectal cancer genetic susceptibility in EPICOLON: previously identified variants and mucins

    Directory of Open Access Journals (Sweden)

    Moreno Victor

    2011-08-01

    Full Text Available Abstract Background Colorectal cancer (CRC is the second leading cause of cancer death in developed countries. Familial aggregation in CRC is also important outside syndromic forms and, in this case, a polygenic model with several common low-penetrance alleles contributing to CRC genetic predisposition could be hypothesized. Mucins and GALNTs (N-acetylgalactosaminyltransferase are interesting candidates for CRC genetic susceptibility and have not been previously evaluated. We present results for ten genetic variants linked to CRC risk in previous studies (previously identified category and 18 selected variants from the mucin gene family in a case-control association study from the Spanish EPICOLON consortium. Methods CRC cases and matched controls were from EPICOLON, a prospective, multicenter, nationwide Spanish initiative, comprised of two independent stages. Stage 1 corresponded to 515 CRC cases and 515 controls, whereas stage 2 consisted of 901 CRC cases and 909 controls. Also, an independent cohort of 549 CRC cases and 599 controls outside EPICOLON was available for additional replication. Genotyping was performed for ten previously identified SNPs in ADH1C, APC, CCDN1, IL6, IL8, IRS1, MTHFR, PPARG, VDR and ARL11, and 18 selected variants in the mucin gene family. Results None of the 28 SNPs analyzed in our study was found to be associated with CRC risk. Although four SNPs were significant with a P-value ADH1C (OR = 1.63, 95% CI = 1.06-2.50, P-value = 0.02, recessive, rs1800795 in IL6 (OR = 1.62, 95% CI = 1.10-2.37, P-value = 0.01, recessive, rs3803185 in ARL11 (OR = 1.58, 95% CI = 1.17-2.15, P-value = 0.007, codominant, and rs2102302 in GALNTL2 (OR = 1.20, 95% CI = 1.00-1.44, P-value = 0.04, log-additive 0, 1, 2 alleles], only rs3803185 achieved statistical significance in EPICOLON stage 2 (OR = 1.34, 95% CI = 1.06-1.69, P-value = 0.01, recessive. In the joint analysis for both stages, results were only significant for rs3803185 (OR = 1

  2. Preparation for the Nuclear Non-Proliferation Treaty Extension Conference in 1995

    International Nuclear Information System (INIS)

    Chrzanowski, P.L.

    1993-01-01

    About 30 specialists in non-proliferation participated in a workshop to explore ideas for US Government preparatory steps leading to the 1995 Nuclear Non-Proliferation Treaty (NPT) Extension Conference. To that end, workshop sessions were devoted to reviewing the lessons learned from previous Review Conferences, discussing the threats to the non-proliferation regime together with ways of preserving and strengthening it, and examining the management of international nuclear commerce. A fundamental premise shared by workshop participants was that extension of the NPT is immensely important to international security. The importance of stemming proliferation and, more specifically, extending the Treaty, is growing as a result of the significant changes in the world. If the conferees of the Extension Conference decide on no extension or extension for a short limited duration, some technically advanced states that have foregone development of nuclear weapons may begin to rethink their options. Also, other arms control measures, such as the Chemical Weapons Convention, could start to unravel. The US must provide strong international leadership to ensure that the Extension Conference is a success, resulting in Treaty extension, perhaps through successive terms, into the indefinite future. Workshop participants were struck by the urgent need for the US to take organizational steps so that it is highly effective in its advance preparations for the Extension Conference. Moreover, the Extension Conference provides both a challenge and an opportunity to mold a cohesive set of US policy actions to define the future role of nuclear weapons and combat their proliferation

  3. Abridged republication of FIGO's staging classification for cancer of the ovary, fallopian tube, and peritoneum.

    Science.gov (United States)

    Prat, Jaime

    2015-10-01

    Ovarian, fallopian tube, and peritoneal cancers have a similar clinical presentation and are treated similarly, and current evidence supports staging all 3 cancers in a single system. The primary site (i.e. ovary, fallopian tube, or peritoneum) should be designated where possible. The histologic type should be recorded. Intraoperative rupture ("surgical spill") is IC1; capsule ruptured before surgery or tumor on ovarian or fallopian tube surface is IC2; and positive peritoneal cytology with or without rupture is IC3. The new staging includes a revision of stage III patients; assignment to stage IIIA1 is based on spread to the retroperitoneal lymph nodes without intraperitoneal dissemination. Extension of tumor from omentum to spleen or liver (stage IIIC) should be differentiated from isolated parenchymal metastases (stage IVB). © 2015 American Cancer Society.

  4. Animal-Based Measures to Assess the Welfare of Extensively Managed Ewes

    Science.gov (United States)

    Hemsworth, Paul; Doyle, Rebecca

    2017-01-01

    Simple Summary The aim of this study was to assess the reliability and practicality of 10 animal-based welfare measures for extensively managed ewes, which were derived from the scientific literature, previous welfare protocols and through consultation with veterinarians and animal welfare scientists. Measures were examined on 100 Merino ewes, which were individually identified and repeatedly examined at mid-pregnancy, mid-lactation and weaning. Body condition score, fleece condition, skin lesions, tail length, dag score and lameness are proposed for on-farm use in welfare assessments of extensive sheep production systems. These six welfare measures, which address the main welfare concerns for extensively managed ewes, can be reliably and feasibly measured in the field. Abstract The reliability and feasibility of 10 animal-based measures of ewe welfare were examined for use in extensive sheep production systems. Measures were: Body condition score (BCS), rumen fill, fleece cleanliness, fleece condition, skin lesions, tail length, dag score, foot-wall integrity, hoof overgrowth and lameness, and all were examined on 100 Merino ewes (aged 2–4 years) during mid-pregnancy, mid-lactation and weaning by a pool of nine trained observers. The measures of BCS, fleece condition, skin lesions, tail length, dag score and lameness were deemed to be reliable and feasible. All had good observer agreement, as determined by the percentage of agreement, Kendall’s coefficient of concordance (W) and Kappa (k) values. When combined, these nutritional and health measures provide a snapshot of the current welfare status of ewes, as well as evidencing previous or potential welfare issues. PMID:29295551

  5. Treatment of patients with minimal stage IIIA Hodgkin's disease

    Energy Technology Data Exchange (ETDEWEB)

    Powlis, W.D.; Mauch, P.; Goffman, T.; Goodman, R.L.

    1987-10-01

    Treatment recommendations for patients with upper abdominal Stage IIIA Hodgkin's (III1A) disease have varied widely. The current study reports on a combined institutional retrospective review of 85 patients with surgically staged III1A Hodgkin's disease. Twenty-two patients received combined modality therapy (CMT), 36 patients were treated initially with total nodal irradiation (TNI), and 27 with mantle and para-aortic radiotherapy (MPA). Patients treated with CMT had an actuarial 8-year freedom from relapse (FFR) of 96% as compared to a FFR of 51% in TNI treated patients (p = 0.002), and a FFR of 54% in MPA treated patients (p = 0.004). Of the 11 relapses in MPA treated patients, 7 had a component of their failure in the untreated pelvic or inguinal nodes. The patients treated with CMT had an 8-year actuarial survival of 100% as compared to 79% in TNI treated patients (p = 0.055) and 78% in patients treated with MPA (p = 0.025). Histology and the number of splenic nodules were the most important prognostic variables. Patients with MC/LD histology and greater than or equal to 5 splenic nodules have a high risk of relapse (10/13) when treated with radiation alone (TNI or MPA). We recommend CMT for this group of patients. Patients with NS/LP histology and 1-4 splenic nodules represent a favorable subset of Stage III1A patients. Only 4/21 patients have relapsed and all 21 patients are currently alive without disease regardless of treatment. We currently feel that patients with Stage III1A Hodgkin's disease with NS/LP histology and splenic disease limited to 1-4 nodules are good candidates for MPA as an alternative to TNI or CMT.

  6. Lymphography and computed tomography of abdominal nodes in newly diagnosed patients with Hodgkin's disease in clinical stage I-III

    Energy Technology Data Exchange (ETDEWEB)

    Neumann, C.H.

    1986-10-01

    Between 1978 and 1983, 80 patients with Hodgkin's disease (HD) in clinical Stage I-III had computed tomography (CT) of the abdomen and pelvis and lymphography (LAG) prior to staging laparatomy with multiple lymph node biopsies at Stanford University Medical Center. There were 224 biopsied nodal sites. The sensitivity and specificity for CT to determine the status of biopsied paraortic and iliac nodes was .61 and .91 vs. .94 and .90 for LAG. CT appeared of even lower sensitivity (.13) in evaluating splenic hilar, celiac axis and portal nodes. Including all biopsy proven subdiaphragmatic nodal sites, CT's sensitivity to diagnose the presence of subdiaphragmatic adenopathy was .38 vs. .52 in LAG. Assessment of the final pathological stage was more successful by LAG (.61) than by CT (.49). Positive and negative predictive values of both tests indicate higher reliability of LAG results as regards individual intraabdominal nodes (LAG .71, .98 vs. CT .58, .86), the entire subdiaphragmatic nodal area (LAG .79, .77 vs. CT .61, .71) and prediction of final pathological stage. LAG appeared to be the more useful test during initial staging of newly diagnosed and untreated patients with HD. None of the test for itself or in combination can replace laparatomy when exact information is necessary for further clinical decisions.

  7. System simulation for an untreated sewage source heat pump (USSHP) in winter

    Science.gov (United States)

    Qin, Na; Hao, Peng Z.

    2017-01-01

    The paper discusses the system characteristics of an untreated sewage source heat pump in winter. In this system, the sewage enters into the evaporator directly. The variable parameters to control the system contain the sewage temperature at evaporator inlet and the water temperature at condenser inlet. It is found that most parameters, except the condensation heat transfer coefficient, change in the form of sine wave the same as the sewage temperature at inlet. The heating load and consumed power are 12.9kW and 3.45kW when the sewage temperature at inlet is 13°C. COP is about 3.75 in the range of the sewage temperature at inlet of 12-13°C.

  8. Untreated severe dental decay: a neglected determinant of low Body Mass Index in 12-year-old Filipino children.

    NARCIS (Netherlands)

    Benzian, H.; Monse, B.; Heinrich-Weltzien, R.; Hobdell, M.; Mulder, J.; Palenstein Helderman, W.H. van

    2011-01-01

    BACKGROUND: Dental decay is the most common childhood disease worldwide and most of the decay remains untreated. In the Philippines caries levels are among the highest in the South East Asian region. Elementary school children suffer from high prevalence of stunting and underweight.The present study

  9. Updated baseline for a staged Compact Linear Collider

    CERN Document Server

    Boland, M J; Giansiracusa, P J; Lucas, T G; Rassool, R P; Balazs, C; Charles, T K; Afanaciev, K; Emeliantchik, I; Ignatenko, A; Makarenko, V; Shumeiko, N; Patapenka, A; Zhuk, I; Abusleme Hoffman, A C; Diaz Gutierrez, M A; Gonzalez, M Vogel; Chi, Y; He, X; Pei, G; Pei, S; Shu, G; Wang, X; Zhang, J; Zhao, F; Zhou, Z; Chen, H; Gao, Y; Huang, W; Kuang, Y P; Li, B; Li, Y; Shao, J; Shi, J; Tang, C; Wu, X; Ma, L; Han, Y; Fang, W; Gu, Q; Huang, D; Huang, X; Tan, J; Wang, Z; Zhao, Z; Laštovička, T; Uggerhoj, U; Wistisen, T N; Aabloo, A; Eimre, K; Kuppart, K; Vigonski, S; Zadin, V; Aicheler, M; Baibuz, E; Brücken, E; Djurabekova, F; Eerola, P; Garcia, F; Haeggström, E; Huitu, K; Jansson, V; Karimaki, V; Kassamakov, I; Kyritsakis, A; Lehti, S; Meriläinen, A; Montonen, R; Niinikoski, T; Nordlund, K; Österberg, K; Parekh, M; Törnqvist, N A; Väinölä, J; Veske, M; Farabolini, W; Mollard, A; Napoly, O; Peauger, F; Plouin, J; Bambade, P; Chaikovska, I; Chehab, R; Davier, M; Kaabi, W; Kou, E; LeDiberder, F; Pöschl, R; Zerwas, D; Aimard, B; Balik, G; Baud, J-P; Blaising, J-J; Brunetti, L; Chefdeville, M; Drancourt, C; Geoffroy, N; Jacquemier, J; Jeremie, A; Karyotakis, Y; Nappa, J M; Vilalte, S; Vouters, G; Bernard, A; Peric, I; Gabriel, M; Simon, F; Szalay, M; van der Kolk, N; Alexopoulos, T; Gazis, E N; Gazis, N; Ikarios, E; Kostopoulos, V; Kourkoulis, S; Gupta, P D; Shrivastava, P; Arfaei, H; Dayyani, M K; Ghasem, H; Hajari, S S; Shaker, H; Ashkenazy, Y; Abramowicz, H; Benhammou, Y; Borysov, O; Kananov, S; Levy, A; Levy, I; Rosenblat, O; D'Auria, G; Di Mitri, S; Abe, T; Aryshev, A; Higo, T; Makida, Y; Matsumoto, S; Shidara, T; Takatomi, T; Takubo, Y; Tauchi, T; Toge, N; Ueno, K; Urakawa, J; Yamamoto, A; Yamanaka, M; Raboanary, R; Hart, R; van der Graaf, H; Eigen, G; Zalieckas, J; Adli, E; Lillestøl, R; Malina, L; Pfingstner, J; Sjobak, K N; Ahmed, W; Asghar, M I; Hoorani, H; Bugiel, S; Dasgupta, R; Firlej, M; Fiutowski, T A; Idzik, M; Kopec, M; Kuczynska, M; Moron, J; Swientek, K P; Daniluk, W; Krupa, B; Kucharczyk, M; Lesiak, T; Moszczynski, A; Pawlik, B; Sopicki, P; Wojtoń, T; Zawiejski, L; Kalinowski, J; Krawczyk, M; Żarnecki, A F; Firu, E; Ghenescu, V; Neagu, A T; Preda, T; Zgura, I-S; Aloev, A; Azaryan, N; Budagov, J; Chizhov, M; Filippova, M; Glagolev, V; Gongadze, A; Grigoryan, S; Gudkov, D; Karjavine, V; Lyablin, M; Olyunin, A; Samochkine, A; Sapronov, A; Shirkov, G; Soldatov, V; Solodko, A; Solodko, E; Trubnikov, G; Tyapkin, I; Uzhinsky, V; Vorozhtov, A; Levichev, E; Mezentsev, N; Piminov, P; Shatilov, D; Vobly, P; Zolotarev, K; Bozovic-Jelisavcic, I; Kacarevic, G; Lukic, S; Milutinovic-Dumbelovic, G; Pandurovic, M; Iriso, U; Perez, F; Pont, M; Trenado, J; Aguilar-Benitez, M; Calero, J; Garcia-Tabares, L; Gavela, D; Gutierrez, J L; Lopez, D; Toral, F; Moya, D; Ruiz-Jimeno, A; Vila, I; Argyropoulos, T; Blanch Gutierrez, C; Boronat, M; Esperante, D; Faus-Golfe, A; Fuster, J; Fuster Martinez, N; Galindo Muñoz, N; García, I; Giner Navarro, J; Ros, E; Vos, M; Brenner, R; Ekelöf, T; Jacewicz, M; Ögren, J; Olvegård, M; Ruber, R; Ziemann, V; Aguglia, D; Alipour Tehrani, N; Aloev, A; Andersson, A; Andrianala, F; Antoniou, F; Artoos, K; Atieh, S; Ballabriga Sune, R; Barnes, M J; Barranco Garcia, J; Bartosik, H; Belver-Aguilar, C; Benot Morell, A; Bett, D R; Bettoni, S; Blanchot, G; Blanco Garcia, O; Bonnin, X A; Brunner, O; Burkhardt, H; Calatroni, S; Campbell, M; Catalan Lasheras, N; Cerqueira Bastos, M; Cherif, A; Chevallay, E; Constance, B; Corsini, R; Cure, B; Curt, S; Dalena, B; Dannheim, D; De Michele, G; De Oliveira, L; Deelen, N; Delahaye, J P; Dobers, T; Doebert, S; Draper, M; Duarte Ramos, F; Dubrovskiy, A; Elsener, K; Esberg, J; Esposito, M; Fedosseev, V; Ferracin, P; Fiergolski, A; Foraz, K; Fowler, A; Friebel, F; Fuchs, J-F; Fuentes Rojas, C A; Gaddi, A; Garcia Fajardo, L; Garcia Morales, H; Garion, C; Gatignon, L; Gayde, J-C; Gerwig, H; Goldblatt, A N; Grefe, C; Grudiev, A; Guillot-Vignot, F G; Gutt-Mostowy, M L; Hauschild, M; Hessler, C; Holma, J K; Holzer, E; Hourican, M; Hynds, D; Inntjore Levinsen, Y; Jeanneret, B; Jensen, E; Jonker, M; Kastriotou, M; Kemppinen, J M K; Kieffer, R B; Klempt, W; Kononenko, O; Korsback, A; Koukovini Platia, E; Kovermann, J W; Kozsar, C-I; Kremastiotis, I; Kulis, S; Latina, A; Leaux, F; Lebrun, P; Lefevre, T; Linssen, L; Llopart Cudie, X; Maier, A A; Mainaud Durand, H; Manosperti, E; Marelli, C; Marin Lacoma, E; Martin, R; Mazzoni, S; Mcmonagle, G; Mete, O; Mether, L M; Modena, M; Münker, R M; Muranaka, T; Nebot Del Busto, E; Nikiforou, N; Nisbet, D; Nonglaton, J-M; Nuiry, F X; Nürnberg, A; Olvegard, M; Osborne, J; Papadopoulou, S; Papaphilippou, Y; Passarelli, A; Patecki, M; Pazdera, L; Pellegrini, D; Pepitone, K; Perez, F; Perez Codina, E; Perez Fontenla, A; Persson, T H B; Petrič, M; Pitters, F; Pittet, S; Plassard, F; Rajamak, R; Redford, S; Renier, Y; Rey, S F; Riddone, G; Rinolfi, L; Rodriguez Castro, E; Roloff, P; Rossi, C; Rude, V; Rumolo, G; Sailer, A; Santin, E; Schlatter, D; Schmickler, H; Schulte, D; Shipman, N; Sicking, E; Simoniello, R; Skowronski, P K; Sobrino Mompean, P; Soby, L; Sosin, M P; Sroka, S; Stapnes, S; Sterbini, G; Ström, R; Syratchev, I; Tecker, F; Thonet, P A; Timeo, L; Timko, H; Tomas Garcia, R; Valerio, P; Vamvakas, A L; Vivoli, A; Weber, M A; Wegner, R; Wendt, M; Woolley, B; Wuensch, W; Uythoven, J; Zha, H; Zisopoulos, P; Benoit, M; Vicente Barreto Pinto, M; Bopp, M; Braun, H H; Csatari Divall, M; Dehler, M; Garvey, T; Raguin, J Y; Rivkin, L; Zennaro, R; Aksoy, A; Nergiz, Z; Pilicer, E; Tapan, I; Yavas, O; Baturin, V; Kholodov, R; Lebedynskyi, S; Miroshnichenko, V; Mordyk, S; Profatilova, I; Storizhko, V; Watson, N; Winter, A; Goldstein, J; Green, S; Marshall, J S; Thomson, M A; Xu, B; Gillespie, W A; Pan, R; Tyrk, M A; Protopopescu, D; Robson, A; Apsimon, R; Bailey, I; Burt, G; Constable, D; Dexter, A; Karimian, S; Lingwood, C; Buckland, M D; Casse, G; Vossebeld, J; Bosco, A; Karataev, P; Kruchinin, K; Lekomtsev, K; Nevay, L; Snuverink, J; Yamakawa, E; Boisvert, V; Boogert, S; Boorman, G; Gibson, S; Lyapin, A; Shields, W; Teixeira-Dias, P; West, S; Jones, R; Joshi, N; Bodenstein, R; Burrows, P N; Christian, G B; Gamba, D; Perry, C; Roberts, J; Clarke, J A; Collomb, N A; Jamison, S P; Shepherd, B J A; Walsh, D; Demarteau, M; Repond, J; Weerts, H; Xia, L; Wells, J D; Adolphsen, C; Barklow, T; Breidenbach, M; Graf, N; Hewett, J; Markiewicz, T; McCormick, D; Moffeit, K; Nosochkov, Y; Oriunno, M; Phinney, N; Rizzo, T; Tantawi, S; Wang, F; Wang, J; White, G; Woodley, M

    2016-01-01

    The Compact Linear Collider (CLIC) is a multi-TeV high-luminosity linear e+e- collider under development. For an optimal exploitation of its physics potential, CLIC is foreseen to be built and operated in a staged approach with three centre-of-mass energy stages ranging from a few hundred GeV up to 3 TeV. The first stage will focus on precision Standard Model physics, in particular Higgs and top-quark measurements. Subsequent stages will focus on measurements of rare Higgs processes, as well as searches for new physics processes and precision measurements of new states, e.g. states previously discovered at LHC or at CLIC itself. In the 2012 CLIC Conceptual Design Report, a fully optimised 3 TeV collider was presented, while the proposed lower energy stages were not studied to the same level of detail. This report presents an updated baseline staging scenario for CLIC. The scenario is the result of a comprehensive study addressing the performance, cost and power of the CLIC accelerator complex as a function of...

  10. Cost-Benefit and Performance of Handmade Carpets Produced with Wool, Untreated and Chemical Treated Jute Pile Yarns

    Science.gov (United States)

    Gupta, Shravan Kumar; Goswami, Kamal Kanti

    2018-03-01

    Jute is a natural fibre which is used to make different type of products due to low cost, easy availability and eco-friendliness. However, the stiffness and harshness of jute fibre affect the use of jute in many products like pile yarns in hand knotted carpets. In this research, a study has been done on the application of jute pile yarns in Persian hand knotted carpet. Three types of commercial yarns (wool, untreated jute and woollenized jute) as well as three types of chemical treated jute yarns (hydrogen peroxide bleached, softened bleached and woollenized yarns) have been applied as pile yarns in Persian hand knotted carpets. Cost-benefit analysis of hand knotted carpets shows that manufacturing cost of wool carpet is lower than others. The contribution of manpower charges is higher than material cost during carpet manufacturing. Hand knotted carpet shows the lowest pile abrasion loss and highest compression recovery when wool is used as pile. Wool hand knotted carpet shows higher compression than untreated and treated jute carpets.

  11. Surgery for juvenile nasopharyngeal angiofibroma with lateral extension to the infratemporal fossa.

    Science.gov (United States)

    Yamada, Masato; Tsunoda, Atsunobu; Tokumaru, Takao; Aoyagi, Masaru; Kawano, Yoshihisa; Yano, Tomoyuki; Kishimoto, Seiji

    2014-08-01

    The study aimed to assess the usefulness of skull base surgery for large juvenile nasopharyngeal angiofibroma (JNA) with lateral extension to the infratemporal fossa. Eleven cases were enrolled for this study, and the mean age was 17.7 years old (range: 8-32). Six out of 11 cases underwent surgery as an initial treatment, and the other five underwent secondary surgery after initial surgery or radiotherapy in other institutions. The range of extension of tumor, feeding arteries, surgical approach, and treatment outcome were estimated. All tumors originated from the sphenopalatine foramen. Based on the imaging study, there was extension to the cavernous sinus observed in eight cases, as well as to the middle cranial fossa (8), orbit (4), and anterior cranial fossa (1). These tumors were diagnosed as Andrews' Stage IVa (3) and IVb (8). However, infiltration into the cavernous sinus was observed in one case only during surgery. Ten tumors were separated carefully from the cavernous sinus or dura and were accurately diagnosed as Stage IIIb. In all cases, the main arterial feeders of the JNAs were branches of the external carotid artery, which were embolized prior to surgery. However, 10 cases were also fed by branches of the internal carotid artery (branches of the ophthalmic artery), in which these arteries could not be embolized. Coronal skin incision (1) and a facial dismasking flap (9) were used, and in one case, wide lateral skin incision with temporary incision of the facial nerve was applied. The orbito-zygomatic approach and its modification was applied to all the cases. Fronto-lateral craniotomy was applied in four cases and lateral craniotomy in seven cases. Total resection was achieved in 10 cases and subtotal resection in one case. No mortality was noted in this series. Temporal trismus was observed in all cases which subsided gradually. Cheek numbness and facial palsy were observed in three and two cases, respectively. Coupled with craniotomy, tumor removal

  12. Diet and Physical Activity Change or Usual Care in Improving Progression-Free Survival in Patients With Previously Treated Stage II, III, or IV Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

    Science.gov (United States)

    2018-02-14

    Fallopian Tube Clear Cell Adenocarcinoma; Fallopian Tube Endometrioid Adenocarcinoma; Fallopian Tube Mucinous Adenocarcinoma; Fallopian Tube Serous Adenocarcinoma; Fallopian Tube Transitional Cell Carcinoma; Malignant Ovarian Brenner Tumor; Ovarian Clear Cell Adenocarcinoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Mucinous Adenocarcinoma; Ovarian Seromucinous Carcinoma; Ovarian Serous Adenocarcinoma; Ovarian Transitional Cell Carcinoma; Primary Peritoneal Serous Adenocarcinoma; Stage IIA Fallopian Tube Cancer AJCC v6 and v7; Stage IIA Ovarian Cancer AJCC V6 and v7; Stage IIB Fallopian Tube Cancer AJCC v6 and v7; Stage IIB Ovarian Cancer AJCC v6 and v7; Stage IIC Fallopian Tube Cancer AJCC v6 and v7; Stage IIC Ovarian Cancer AJCC v6 and v7; Stage IIIA Fallopian Tube Cancer AJCC v7; Stage IIIA Ovarian Cancer AJCC v6 and v7; Stage IIIA Primary Peritoneal Cancer AJCC v7; Stage IIIB Fallopian Tube Cancer AJCC v7; Stage IIIB Ovarian Cancer AJCC v6 and v7; Stage IIIB Primary Peritoneal Cancer AJCC v7; Stage IIIC Fallopian Tube Cancer AJCC v7; Stage IIIC Ovarian Cancer AJCC v6 and v7; Stage IIIC Primary Peritoneal Cancer AJCC v7; Stage IV Fallopian Tube Cancer AJCC v6 and v7; Stage IV Ovarian Cancer AJCC v6 and v7; Stage IV Primary Peritoneal Cancer AJCC v7; Undifferentiated Fallopian Tube Carcinoma; Undifferentiated Ovarian Carcinoma

  13. What is Unique About Extension Personnel in the City?

    Directory of Open Access Journals (Sweden)

    Julie Fox

    2017-06-01

    Full Text Available Extension’s pursuit to better attract, develop, retain, and structure competent personnel in the city requires new strategies to build on the knowledge base established through previous research and practice. With the support of numerous national organizations, this study utilized a Competency Framework Development (CFD process to systematically tap into the knowledge of County Extension Directors serving in large urban communities. Findings indicated these local leaders need specific knowledge, skills, attitudes, and beliefs that are both similar and unique when compared with results from other Extension competency studies. Competencies identified included building social and financial capital, strategic planning and organizing, resource attraction and management, advocacy and impact accountability with multiple stakeholders, and others. A primary difference was that diversity, complexity, and scale in urban communities influenced the extent to which competencies are demonstrated. Research results can be applied to a competency model that incorporates intentional recruiting and hiring practices that reflect the diversity and priorities of the community, competency-based professional development, competitive compensation and retention tactics, and staffing structure and strategies. Further research can include CFD with various types of Extension personnel and perspectives. Extension leaders can continue learning alongside others who can help inform administrators about human capital policies and practices.

  14. Outcome of one-stage treatment of developmental dysplasia of hip in older children

    Directory of Open Access Journals (Sweden)

    Basant Kumar Bhuyan

    2012-01-01

    Conclusions: Young children having DDH can safely be treated with an extensive one-stage triple procedure of open reduction, femoral shortening derotation, and Salter′s osteotomy, without increasing the risk of AVN. Early diagnosis and intervention is the successful treatment of patients suffering from DDH.

  15. Two stage-type railgun accelerator

    International Nuclear Information System (INIS)

    Ogino, Mutsuo; Azuma, Kingo.

    1995-01-01

    The present invention provides a two stage-type railgun accelerator capable of spiking a flying body (ice pellet) formed by solidifying a gaseous hydrogen isotope as a fuel to a thermonuclear reactor at a higher speed into a central portion of plasmas. Namely, the two stage-type railgun accelerator accelerates the flying body spiked from a initial stage accelerator to a portion between rails by Lorentz force generated when electric current is supplied to the two rails by way of a plasma armature. In this case, two sets of solenoids are disposed for compressing the plasma armature in the longitudinal direction of the rails. The first and the second sets of solenoid coils are previously supplied with electric current. After passing of the flying body, the armature formed into plasmas by a gas laser disposed at the back of the flying body is compressed in the longitudinal direction of the rails by a magnetic force of the first and the second sets of solenoid coils to increase the plasma density. A current density is also increased simultaneously. Then, the first solenoid coil current is turned OFF to accelerate the flying body in two stages by the compressed plasma armature. (I.S.)

  16. Competency Modeling in Extension Education: Integrating an Academic Extension Education Model with an Extension Human Resource Management Model

    Science.gov (United States)

    Scheer, Scott D.; Cochran, Graham R.; Harder, Amy; Place, Nick T.

    2011-01-01

    The purpose of this study was to compare and contrast an academic extension education model with an Extension human resource management model. The academic model of 19 competencies was similar across the 22 competencies of the Extension human resource management model. There were seven unique competencies for the human resource management model.…

  17. Study on risk insight for additional ILRT interval extension

    International Nuclear Information System (INIS)

    Seo, M. R.; Hong, S. Y.; Kim, M. K.; Chung, B. S.; Oh, H. C.

    2005-01-01

    In U.S., the containment Integrated Leakage Rate Test (ILRT) interval was extended from 3 times per 10 years to once per 10 years based on NUREG-1493 'Performance-Based Containment Leak-Test Program' in 1995. In September, 2001, ILRT interval was extended up to once per 15 years based on Nuclear Energy Industry (NEI) provisional guidance 'Interim Guidance for Performing Risk Impact Assessments In Support of One-Time Extensions for Containment Integrated Leakage Rate Test Surveillance Intervals'. In Korea, the containment ILRT was performed with 5 year interval. But, in MOST(Ministry of Science and Technology) Notice 2004-15 'Standard for the Leak- Rate Test of the Nuclear Reactor Containment', the extension of the ILRT interval to once per 10 year can be allowed if some conditions are met. So, the safety analysis for the extension of Yonggwang Nuclear (YGN) Unit 1 and 2 ILRT interval extension to once per 10 years was completed based on the methodology in NUREG-1493. But, during review process by regulatory body, KINS, it was required that some various risk insight or index for risk analysis should be developed. So, we began to study NEI interim report for 15 year ILRT interval extension. As previous analysis based on NUREG-1493, MACCS II (MELCOR Accident Consequence Code System) computer code was used for the risk analysis of the population, and the population dose was selected as a reference index for the risk evaluation

  18. HER-2/neu and CD117 (c-kit overexpression in patients with pesticide exposure and extensive stage small cell lung carcinoma (ESSCLC

    Directory of Open Access Journals (Sweden)

    Potti Anil

    2005-06-01

    Full Text Available Abstract Background The rate of detection of HER-2/neu and CD117 (c-kit overexpression in small cell lung cancer (SCLC has varied widely; between 5–35% and 21–70% respectively. Methods To evaluate the relationship between pesticide exposure and HER-2/neu and CD117 overexpression in extensive stage SCLC (ESSCLC, we identified patients with ESSCLC and assessed pesticide exposure using a predetermined questionnaire. An exposure index (hours/day × days/year × years ≥ 2400 hours was considered as 'exposed.' HER-2/neu overexpression was evaluated on archival tissue using the DAKO Hercep test, and CD117 testing was performed using immunohistochemistry (A4052 polyclonal antibody. Results 193 ESSCLC patients were identified. Pesticide exposure data could be obtained on 174 patients (84 females and 109 males with a mean age of 68.5 years. 53/174 (30.4% revealed HER-2/neu overexpression. 54/174 (31.03% specimens showed CD117 overexpression by IHC. On multivariate analysis, HER-2/neu overexpression was associated with diminished survival (p neu overexpression and 47/121 (38.8% patients without overexpression had exposure to pesticides (odds ratio: 5.38; p Conclusion Pesticide exposure affects HER-2/neu but not CD117 overexpression. Future studies are needed to determine specific pesticide(s/pesticide components that are responsible for HER-2/neu overexpression in ESSCLC, and to validate our findings in other solid tumors that overexpress HER-2/neu.

  19. Outcome of radiotherapy for localized stage I E and II E nasal NK/T cell lymphoma

    International Nuclear Information System (INIS)

    Jin Jing; Li Yexiong; Yao Bo; Fang Hui; Liu Xinfan; Zhou Liqiang; Lv Ning; Yu Zihao

    2006-01-01

    Objective: With the optimal therapy remains unclear for nasal NK/T cell lymphoma, the aim of this study is to analyze the outcome of radiotherapy as primary treatment for localized stage I E and II E diseases. Methods: Between January. 1983 and December 2003, 105 patients with stage I E and II E primary nasal NK/T cell lymphoma were retrospectively reviewed. According to the Ann Arbor Staging System, there were 83 stage I E and 22 stage II E. Stage I E was subdivided into limited stage I E confined to the nasal cavity (37 patients), or extensive stage I E with an extension beyond the nasal cavity (46 patients). Thirty-one patients received radiotherapy alone. Thirty-four patients were treated with radiotherapy followed by 2-4 cycles of chemotherapy. Thirty-seven patients were treated with chemotherapy followed by radiotherapy and 3 with chemotherapy alone. Of 83 patients with stage I E disease, 26 were primarily treated with radiotherapy alone, 30 with. radiotherapy followed by chemotherapy, and 27 with chemotherapy followed by radiotherapy. Results: The five-year overall survival (OS) and progression-free survival rates (PIS) for all patients was 71% and 59%, respectively. The 5-year OS for stage I E and stage II E was 78% and 46% (P<0.01), while the 5-year PFS for stage I E and stage II E was 63% and 40%, respectively (P<0.01). Patients with limited stage I E had a better OS and PFS than those with extensive stage I E, with 5-year OS and PFS of 82% and 80% versus 75% and 45%, respectively. Complete response (CR) was achieved in 91 (87%) patients after radiotherapy and/or chemotherapy. Initial radiotherapy resulted in a superior CR as compared to initial chemotherapy, with 54 of 65 (83%) patients achieving CR with initial radiotherapy, versus only 8 of 40 (20%) with initial chemotherapy. For 102 patients who received radiotherapy with or without chemotherapy, the outcome of primary, treatment with radiotherapy alone was compared to that of CMT. Five-year OS and

  20. Trigeminocardiac reflex by mandibular extension on rat pial microcirculation: role of nitric oxide.

    Directory of Open Access Journals (Sweden)

    Dominga Lapi

    Full Text Available In the present study we have extended our previous findings about the effects of 10 minutes of passive mandibular extension in anesthetized Wistar rats. By prolonging the observation time to 3 hours, we showed that 10 minutes mandibular extension caused a significant reduction of the mean arterial blood pressure and heart rate respect to baseline values, which persisted up to 160 minutes after mandibular extension. These effects were accompanied by a characteristic biphasic response of pial arterioles: during mandibular extension, pial arterioles constricted and after mandibular extension dilated for the whole observation period. Interestingly, the administration of the opioid receptor antagonist naloxone abolished the vasoconstriction observed during mandibular extension, while the administration of Nω-Nitro-L-arginine methyl ester, a nitric oxide synthase inhibitor, abolished the vasodilation observed after mandibular extension. Either drug did not affect the reduction of mean arterial blood pressure and heart rate induced by mandibular extension. By qRT-PCR, we also showed that neuronal nitric oxide synthase gene expression was significantly increased compared with baseline conditions during and after mandibular extension and endothelial nitric oxide synthase gene expression markedly increased at 2 hours after mandibular extension. Finally, western blotting detected a significant increase in neuronal and endothelial nitric oxide synthase protein expression. In conclusion mandibular extension caused complex effects on pial microcirculation involving opioid receptor activation and nitric oxide release by both neurons and endothelial vascular cells at different times.

  1. One Stage Radical Removal of Intravenous Leiomyomatosis Extending to the Right Atrium via the Bilateral Gonadal Veins

    Directory of Open Access Journals (Sweden)

    X. Gui

    Full Text Available : Background: Intravenous leiomyomatosis is a benign and rare smooth muscle cell tumor. Extension to the right heart is exceptional. Among the reported cases, the tumor is usually known to enter through the lumen of the iliac vein and grows into the inferior vena cava; involvement of bilateral gonadal veins is rarely reported. Complete tumor resection is the key to therapy. Case presentation: A 25 year old female Chinese patient suffering from abdominal distention for 1 month, who was diagnosed with intravenous leiomyomatosis extending to the heart, from pre-operative imaging studies, is presented. A one stage procedure with complete excision of the tumor was performed. Histopathological findings confirmed the diagnosis of intravenous leiomyomatosis. The patient's post-operative recovery was uneventful, without recurrence and re-stenosis at 1 year follow up. Conclusion: Intravenous leiomyomatosis may grow within veins along various routes. This case demonstrated intravenous leiomyomatosis with tumor extension through bilateral gonadal veins extending to the heart. It is believed that one stage radical resection can be a practical and effective alternative for the patients in good clinical condition. Long-term follow up is recommended because of the possibility of recurrence and metastases. Keywords: Intravenous leiomyomatosis, Cardiac extending, Extension pathway, Gonadal veins, One-stage operation

  2. Emphysema and bronchiectasis in COPD patients with previous pulmonary tuberculosis: computed tomography features and clinical implications

    Directory of Open Access Journals (Sweden)

    Jin J

    2018-01-01

    Full Text Available Jianmin Jin,1 Shuling Li,2 Wenling Yu,2 Xiaofang Liu,1 Yongchang Sun1,3 1Department of Respiratory and Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, 2Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 3Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China Background: Pulmonary tuberculosis (PTB is a risk factor for COPD, but the clinical characteristics and the chest imaging features (emphysema and bronchiectasis of COPD with previous PTB have not been studied well.Methods: The presence, distribution, and severity of emphysema and bronchiectasis in COPD patients with and without previous PTB were evaluated by high-resolution computed tomography (HRCT and compared. Demographic data, respiratory symptoms, lung function, and sputum culture of Pseudomonas aeruginosa were also compared between patients with and without previous PTB.Results: A total of 231 COPD patients (82.2% ex- or current smokers, 67.5% male were consecutively enrolled. Patients with previous PTB (45.0% had more severe (p=0.045 and longer history (p=0.008 of dyspnea, more exacerbations in the previous year (p=0.011, and more positive culture of P. aeruginosa (p=0.001, compared with those without PTB. Patients with previous PTB showed a higher prevalence of bronchiectasis (p<0.001, which was more significant in lungs with tuberculosis (TB lesions, and a higher percentage of more severe bronchiectasis (Bhalla score ≥2, p=0.031, compared with those without previous PTB. The overall prevalence of emphysema was not different between patients with and without previous PTB, but in those with previous PTB, a higher number of subjects with middle (p=0.001 and lower (p=0.019 lobe emphysema, higher severity score (p=0.028, higher prevalence of panlobular emphysema (p=0.013, and more extensive centrilobular emphysema (p=0.039 were observed. Notably, in patients with

  3. Applying the Theory of the Firm to Examine a Technology Startup at the Investment Stage

    Directory of Open Access Journals (Sweden)

    Michael Ayukawa

    2012-05-01

    Full Text Available The investment stage of a new technology firm is when resources, opportunities, investors, and early customers first converge. Currently, technology entrepreneurs make many expensive mistakes. They invest in assets and develop capabilities that prove to have limited value. They take too long to discover and validate the product-market fit for their firms during the investment stage and run out of time and money. Understanding how theory can help entrepreneurs make decisions during the investment stage is important to accelerate new-firm formation and growth as well as to reduce the uncertainty of founders and stakeholders of technology firms. This article introduces a model developed to examine deal making during the investment stage of a new technology firm. It is an extension of a model of lateral firm scope proposed by Oliver Hart and Bengt Holmstrom. The extensions come from considering a technology firm as being both a deal-making entity and a pool of resources during the investment stage. A deal is the result of a decision the entrepreneur and others make to coordinate (i.e., work together to achieve a common objective. Benefits from a deal include cash profits for the firm and private benefits for the entrepreneur. This extended model is then applied to examine the author’s firm which is still in the investment stage. Application of the extended model to a real-life situation generated two important insights: i when private benefits include learning from experimentation, the number of deals increases and ii at the start of the investment stage, private benefits drive deal-making, whereas at the end of the investment stage, cash profits derived from asset ownership drive deal-making.

  4. Clarifying the Impact of Untreated and Treated Dental Caries on Oral Health-Related Quality of Life among Adolescents.

    Science.gov (United States)

    Feldens, Carlos Alberto; Ardenghi, Thiago Machado; Dos Santos Dullius, Angela Isabel; Vargas-Ferreira, Fabiana; Hernandez, Pedro Antonio González; Kramer, Paulo Floriani

    2016-01-01

    The aim of the present study was to investigate the effect of dental caries experience and the components of the decayed, missing and filled teeth (DMFT) index on oral health-related quality of life (OHRQoL) among adolescents in southern Brazil. A cross-sectional study was conducted with 509 adolescents aged 11-14 years enrolled at public schools in the municipality of Osório (southern Brazil). A calibrated examiner performed the clinical examination for caries (World Health Organization: DMFT index), malocclusion (Dental Aesthetic Index) and traumatic dental injuries [Andreasen et al., 2007]. The participants answered the Brazilian version of the Child Perceptions Questionnaire (CPQ11-14) - Impact Short Form, and their parents/guardians answered a structured questionnaire addressing demographic and socioeconomic characteristics. Data analysis involved Poisson regression with robust variance, with the calculation of rate ratios adjusted for potential confounding variables. High severity of dental caries experience exerted a significant impact on OHRQoL, even after controlling for socioeconomic and clinical factors (rate ratio 1.30; 95% confidence interval, CI 1.12-1.51). All OHRQoL domains were affected by untreated dental caries. The multivariate analysis demonstrated that the CPQ11-14 scores were 33% higher among adolescents with untreated caries (rate ratio 1.33; 95% CI 1.17-1.50) and 24% higher among those with missing teeth (rate ratio 1.24; 95% CI 1.06-1.47). No difference in OHRQoL was found between adolescents with filled teeth and those without dental caries. In conclusion, dental caries experience, untreated dental caries and missing teeth exerted a negative impact on OHRQoL among the adolescents. © 2016 S. Karger AG, Basel.

  5. Endorectal 3D T2-weighted 1 mm-slice thickness MRI for prostate cancer staging at 1.5 Tesla: Should we reconsider the indirects signs of extracapsular extension according to the D’Amico tumor risk criteria?

    International Nuclear Information System (INIS)

    Cornud, F.; Rouanne, M.; Beuvon, F.; Eiss, D.; Flam, T.; Liberatore, M.; Zerbib, M.; Delongchamps, N.B.

    2012-01-01

    Purpose: To evaluate the accuracy of a 3D-endorectal 1 mm-thick slices MRI acquisition for local staging of low, intermediate and high D’Amico risk prostate cancer (PCa). Materials and methods: 178 consecutive patients underwent a multiparametric MRI protocol prior to radical prostatectomy (RP). T2W images were acquired with the 3D sampling perfection with application optimized contrasts using different flip angle evolutions (SPACE) sequence (5 mn acquisition time). Direct and indirect MRI signs of extracapsular extension (ECE) were evaluated to predict the pT stage. The likelihood of SVI (seminal vesicle invasion) was also assessed. Results: Histology showed ECE and SVI in 38 (21%) and 12 (7%) cases, respectively. MRI sensitivity and specificity to detect ECE were 55 and 96% if direct signs of ECE were used and 84 and 89% (p < 0.05), if both direct and indirect signs were combined. D’Amico criteria did not influence MRI performance. Sensitivity and specificity for SVI detection were 83% and 99%. Conclusions: 3D data sets acquired with the SPACE sequence provides a high accuracy for local staging of prostate cancer. The use of indirect signs of ECE may be recommended in low D’Amico risk tumors to optimise patient selection for active surveillance or focal therapy.

  6. One-stage surgery for removal of intravascular leiomyomatosis extending to right ventricle.

    Science.gov (United States)

    Chiang, Ching-Shu; Chen, Po-Lin; Kuo, Tzu-Ting; Chen, I-Ming; Wu, Nai-Yuan; Chang, Hsiao-Huang

    2018-03-01

    Intravascular leiomyomatosis (IVL) is a rare nonmalignant tumor that can be fatal if untreated. A 49-year-old nulliparous Asian woman who underwent hysterectomy and left salpingo-oophorectomy for multiple uterine leiomyomas 18 months prior presented complaining of intermittent palpitation and chest tightness for approximately 1 month. Echocardiography revealed a large mobile tumor mass extending from the inferior vena cava (IVC) to the right atrium that partially obstructed IVC flow and tricuspid inflow. Thoracicabdominopelvic computed tomography revealed a left adnexal tumor (4.8 × 2.5 cm) causing intravascular obstruction extending from the left internal iliac vein to the IVC, right atrium, and right ventricle. IVL with right heart involvement INTERVENTIONS:: Under cardiopulmonary bypass, a one-stage surgery combining sternotomy and laparotomy was performed. The tumor was approached and extracted via sternotomy, and tumor detachment and removal of residual tumors was accomplished via laparotomy. A firm, smooth, and regularly shape tumor 15.5 × 5.5 × 2.5 in size was completely removed and histopathologically confirmed as IVL. The patient tolerated the surgical procedure well and no postoperative complication was noted. We describe a one-stage surgical approach to completely remove an IVL extending to the right ventricle.

  7. Tampa Bay Extension Agents’ Views of Urban Extension: Philosophy and Program Strategies

    Directory of Open Access Journals (Sweden)

    Amy Harder

    2017-06-01

    Full Text Available The purpose of this article was to explore the concept of urban Extension as perceived by Extension agents within the Tampa Bay area, one of Florida’s fastest growing metropolitan areas. From a theoretical perspective, it is critical to understand Extension agents’ beliefs about urban Extension because behaviors are directly related to attitudes (Ajzen, 2012. In 2016, a qualitative investigation was undertaken to explore the perspectives of 23 agents working within the Tampa Bay area. Results showed the majority of agents believed that context and client needs are unique for urban Extension, and that to a lesser extent, unique agent expertise is required. Further, these beliefs impacted how agents reported their approach to programming, with an emphasis on providing convenience and seeking partnerships. Difficulties were identified related to identifying the role of Extension in a resource-rich environment of service providers, which contributed to the existence of a perceived disconnect between urban audiences and Extension. Opportunities exist for Extension leadership to provide strategic organizational support that will enhance agents’ abilities to succeed in the metropolitan environment.

  8. Reactor staging influences microbial community composition and diversity of denitrifying MBBRs- Implications on pharmaceutical removal

    DEFF Research Database (Denmark)

    Torresi, Elena; Gülay, Arda; Polesel, Fabio

    2018-01-01

    The subdivision of biofilm reactor in two or more stages (i.e., reactor staging) represents an option for process optimisation of biological treatment. In our previous work, we showed that the gradient of influent organic substrate availability (induced by the staging) can influence the microbial...

  9. Duration of Untreated Psychosis Is Associated with More Negative Schizophrenia Symptoms after Acute Treatment for First-Episode Psychosis

    Science.gov (United States)

    Grano, Niklas; Lindsberg, Jenni; Karjalainen, Marjaana; Gronroos, Peter; Blomberg, Ari-Pekka

    2010-01-01

    Evidence of association between duration of untreated psychosis (DUP) and negative symptoms of schizophrenia in first-episode psychosis (FEP) patients is inconsistent in the recent literature. In the present study, DUP, schizophrenia symptoms, duration of medication, and diagnosis were obtained from hospital archives in a sample of FEP patients.…

  10. Association between serum uric acid, metabolic syndrome and microalbuminuria in previously untreated essential hypertensive patients.

    Science.gov (United States)

    Rodilla, Enrique; Pérez-Lahiguera, Francisco; Costa, José A; González, Carmen; Miralles, Amparo; Moral, Desamparados; Pascual, José María

    2009-01-17

    The aim of the study was to assess the association of serum uric acid levels with microalbuminuria -urinary albumin excretion (UAE)> or = 30mg/24h-. Cross-sectional study in 429 (220 women) hypertensive, non diabetic, never treated patients (mean age: 47 years) with glomerular filtration rate > or =60ml/min/1.73m(2). The prevalence of microalbuminuria was 20.5%; 18% had hyperuricemia and 47% fulfilled the criteria for metabolic syndrome (MS). Baseline UAE correlated in the unvaried analysis to diastolic blood pressure, waist circumference, high-density lipoprotein cholesterol and uric acid. In multiple linear regression models, only MS (beta=0.113; p=0.03), and serum uric acid values (beta=0.04; p=0.05) were independently associated with logUAE, after adjustment for age and sex. Hyperuricemia (serum uric acid level > or =7.0mg/dl for men and > or =6.5mg/dl for women; odds ratio=2.18; 95% confidence interval, 1.21-3.92; p=0.010), and MS (odds ratio=2.16; 95% confidence interval, 1.32-3.53; p=0.002) were independently associated with a higher risk of microalbuminuria in multiple logistic regression analyses. The prevalence of microalbuminuria was 45.8% in patients with coexistent MS and hyperuricemia, as compared to 13.6% in hypertensive patients without it (p<0.001). In patients with concomitant MS and hyperuricemia the probability of being microalbuminuric was 3.7 times higher than in patients without those factors. Serum uric acid level is associated with microalbuminuria. Coexistence of MS and hyperuricemia in hypertensive patients increases almost 4 times the odds of being microalbuminuric.

  11. Delayed vaginal reconstruction in the fibrotic pelvis following radiation or previous reconstruction

    International Nuclear Information System (INIS)

    Berek, J.S.; Hacker, N.F.; Lagasse, L.D.; Smith, M.L.

    1983-01-01

    Vaginal reconstruction was performed in 14 patients who had developed vaginal stenosis secondary to extensive pelvic fibrosis after pelvic radiation therapy (12 patients) or prior vaginal reconstruction (2 patients). Sixteen procedures were performed using a split-thickness skin graft. All patients had satisfactory vaginal restoration, and 12 patients reported good vaginal function. No fistula developed as a result of the operative procedure, but one patient later developed a rectovaginal fistula resulting from tumor recurrence. Successful vaginal reconstruction can be achieved even years after initial therapy in patients who develop an obliterated vagina from previous radiation or surgery

  12. Habitat filtering across tree life stages in tropical forest communities

    Science.gov (United States)

    Baldeck, C. A.; Harms, K. E.; Yavitt, J. B.; John, R.; Turner, B. L.; Valencia, R.; Navarrete, H.; Bunyavejchewin, S.; Kiratiprayoon, S.; Yaacob, A.; Supardi, M. N. N.; Davies, S. J.; Hubbell, S. P.; Chuyong, G. B.; Kenfack, D.; Thomas, D. W.; Dalling, J. W.

    2013-01-01

    Tropical tree communities are shaped by local-scale habitat heterogeneity in the form of topographic and edaphic variation, but the life-history stage at which habitat associations develop remains poorly understood. This is due, in part, to the fact that previous studies have not accounted for the widely disparate sample sizes (number of stems) that result when trees are divided into size classes. We demonstrate that the observed habitat structuring of a community is directly related to the number of individuals in the community. We then compare the relative importance of habitat heterogeneity to tree community structure for saplings, juveniles and adult trees within seven large (24–50 ha) tropical forest dynamics plots while controlling for sample size. Changes in habitat structuring through tree life stages were small and inconsistent among life stages and study sites. Where found, these differences were an order of magnitude smaller than the findings of previous studies that did not control for sample size. Moreover, community structure and composition were very similar among tree sub-communities of different life stages. We conclude that the structure of these tropical tree communities is established by the time trees are large enough to be included in the census (1 cm diameter at breast height), which indicates that habitat filtering occurs during earlier life stages. PMID:23843384

  13. Primary aldosteronism among newly diagnosed and untreated hypertensive patients in a Swedish primary care area.

    Science.gov (United States)

    Westerdahl, Christina; Bergenfelz, Anders; Isaksson, Anders; Nerbrand, Christina; Valdemarsson, Stig

    2011-03-01

    To evaluate the prevalence of primary aldosteronism (PA) in newly diagnosed and untreated hypertensive patients in primary care using the aldosterone/renin ratio (ARR), and to assess clinical and biochemical characteristics in patients with high and normal ARR. Patient survey study. A total of 200 consecutive patients with newly diagnosed and untreated hypertension from six primary health care centres in Sweden were included. ARR was calculated from serum aldosterone and plasma renin concentrations. The cut-off level for ARR was 65. Patients with an increased ARR were considered for confirmatory testing with the fludrocortisone suppression test (FST), followed by adrenal computed tomographic radiology (CT) and adrenal venous sampling (AVS). Of 200 patients, 36 patients had an ARR > 65. Of these 36 patients, 11 patients had an incomplete aldosterone inhibition during FST. Three patients were diagnosed with an aldosterone producing adenoma (APA) and eight with bilateral adrenal hyperplasia (BHA). Except for moderately lower level of P-K in patients with an ARR > 65 and in patients with PA, there were no biochemical or clinical differences found among hypertensive patients with PA compared with patients without PA. Eleven of 200 evaluated patients (5.5%) were considered to have PA. The diagnosis of PA should therefore be considered in newly diagnosed hypertensive subjects and screening for the diagnosis is warranted.

  14. The impact of brand extension fit, extension strategy and product exposure on attitudinal responses to brand extensions

    OpenAIRE

    Farstad, Lena Kvelland; Jabran, Mohammed

    2013-01-01

    Brand extensions have for decades been one of the most used strategies for growth, but the sad reality is that 8 out of 10 extensions fail, making the likelihood of failure unattractively high. In addition, competition and pressure on margins increases as retailers’ power improves due to proliferation of private labels. As a result, managers are eager for new innovative strategies that can differentiate their extension and improve likelihood of success. The purpose of this paper is therefore ...

  15. Management of extensive surgical emphysema with subcutaneous drain: A case report

    Directory of Open Access Journals (Sweden)

    Quoc Tran

    Full Text Available Introduction: Subcutaneous emphysema (SE is a frequent and often self-limiting complication of tube thoracostomy or other cardiothoracic procedures. On rare occasions, severe and extensive surgical emphysema marked by palpable cutaneous tension, dysphagia, dysphonia, palpebral closure or associated with pneumoperitoneum, airway compromise, “tension phenomenon” and respiratory failure require treatment. Presentation of case: A 67 year old lady presented with a large spontaneous pneumothorax on the background of end-stage chronic obstructive pulmonary disease (COPD and newly diagnosed lung cancer, developed extensive surgical emphysema following insertion of a chest drain. Immediate improvement was observed after insertion of a large-bore, 26 French (Fr. intercostal catheter, subcutaneous drain which was maintained under low suction (−5 cm H2O for a further 24 h. Discussion: Several methods have been described in the literature for the treatment of extensive subcutaneous emphysema, including: emergency tracheostomy, multisite subcutaneous drainage, infraclavicular “blow holes” incisions and subcutaneous drains or simply increasing suction on an in situ chest drain. Here a large-bore, fenestrated, subcutaneous drain maintained on low negative pressure also provided the necessary decompression. Conclusion: In the absence of a comparative study to identify the most effective method to manage extensive subcutaneous emphysema, this case highlights an effective, simple and safe management option. Keywords: Pneumothorax, Subcutaneous emphysema, Drain, Low suction, Intercostal catheter, Case report

  16. A dual-stage sodium thermal electrochemical converter (Na-TEC)

    Science.gov (United States)

    Limia, Alexander; Ha, Jong Min; Kottke, Peter; Gunawan, Andrey; Fedorov, Andrei G.; Lee, Seung Woo; Yee, Shannon K.

    2017-12-01

    The sodium thermal electrochemical converter (Na-TEC) is a heat engine that generates electricity through the isothermal expansion of sodium ions. The Na-TEC is a closed system that can theoretically achieve conversion efficiencies above 45% when operating between thermal reservoirs at 1150 K and 550 K. However, thermal designs have confined previous single-stage devices to thermal efficiencies below 20%. To mitigate some of these limitations, we consider dividing the isothermal expansion into two stages; one at the evaporator temperature (1150 K) and another at an intermediate temperature (650 K-1050 K). This dual-stage Na-TEC takes advantage of regeneration and reheating, and could be amenable to better thermal management. Herein, we demonstrate how the dual-stage device can improve the efficiency by up to 8% points over the best performing single-stage device. We also establish an application regime map for the single- and dual-stage Na-TEC in terms of the power density and the total thermal parasitic loss. Generally, a single-stage Na-TEC should be used for applications requiring high power densities, whereas a dual-stage Na-TEC should be used for applications requiring high efficiency.

  17. Multi-stage genome-wide association study identifies new susceptibility locus for testicular germ cell tumour on chromosome 3q25

    DEFF Research Database (Denmark)

    Litchfield, Kevin; Sultana, Razvan; Renwick, Anthony

    2015-01-01

    , we report new genotyping of eight SNPs showing some evidence of association in combined analysis of Stage 1 and Stage 2 in an additional 2048 cases of TGCT and 3944 controls (Stage 3). Through fixed-effects meta-analysis across three stages, we identified a novel locus at 3q25.31 (rs1510272......-stage experiment, involving 4098 cases and 18 972 controls. Stage 1 comprised previously published GWAS analysis of 307 291 SNPs in 986 cases and 4946 controls. In Stage 2, we used previously published customised Illumina iSelect genotyping array (iCOGs) data across 694 SNPs in 1064 cases and 10 082 controls. Here...

  18. Prevalence of teeth with untreated dental trauma among nursery and primary school pupils in Dar es Salaam, Tanzania.

    NARCIS (Netherlands)

    Kahabuka, F.K.; Plasschaert, A.J.M.; Hof, M.A. van 't

    2001-01-01

    The aim of this study was to investigate the prevalence of teeth with untreated dental trauma among children aged 4-15 years in Dar es Salaam, Tanzania. A sample of 4524 children from three districts of different socio-economic status in the Dar es Salaam area was examined for signs of dental trauma

  19. Associations between Trunk Extension Endurance and Isolated Lumbar Extension Strength in Both Asymptomatic Participants and Those with Chronic Low Back Pain

    Directory of Open Access Journals (Sweden)

    Rebecca Conway

    2016-09-01

    Full Text Available Background: Strength and endurance tests are important for both clinical practice and research due to the key role they play in musculoskeletal function. In particular, deconditioning of the lumbar extensor musculature has been associated with low back pain (LBP. Due to the relationship between strength and absolute endurance, it is possible that trunk extension (TEX endurance tests could provide a proxy measure of isolated lumbar extension (ILEX strength and thus represent a simple, practical alternative to ILEX measurements. Though, the comparability of TEX endurance and ILEX strength is presently unclear and so the aim of the present study was to examine this relationship. Methods: Thirty eight healthy participants and nineteen participants with non-specific chronic LBP and no previous lumbar surgery participated in this cross-sectional study design. TEX endurance was measured using the Biering–Sorensen test. A maximal ILEX strength test was performed on the MedX lumbar-extension machine. Results: A Pearson’s correlation revealed no relationship between TEX endurance and ILEX strength in the combined group (r = 0.035, p = 0.793, the chronic LBP group (r = 0.120, p = 0.623 or the asymptomatic group (r = −0.060, p = 0.720. Conclusions: The results suggest that TEX is not a good indicator of ILEX and cannot be used to infer results regarding ILEX strength. However, a combination of TEX and ILEX interpreted together likely offers the greatest and most comprehensive information regarding lumbo-pelvic function during extension.

  20. Relationship between mitochondrial electron transport chain dysfunction, development, and life extension in Caenorhabditis elegans.

    Directory of Open Access Journals (Sweden)

    Shane L Rea

    2007-10-01

    Full Text Available Prior studies have shown that disruption of mitochondrial electron transport chain (ETC function in the nematode Caenorhabditis elegans can result in life extension. Counter to these findings, many mutations that disrupt ETC function in humans are known to be pathologically life-shortening. In this study, we have undertaken the first formal investigation of the role of partial mitochondrial ETC inhibition and its contribution to the life-extension phenotype of C. elegans. We have developed a novel RNA interference (RNAi dilution strategy to incrementally reduce the expression level of five genes encoding mitochondrial proteins in C. elegans: atp-3, nuo-2, isp-1, cco-1, and frataxin (frh-1. We observed that each RNAi treatment led to marked alterations in multiple ETC components. Using this dilution technique, we observed a consistent, three-phase lifespan response to increasingly greater inhibition by RNAi: at low levels of inhibition, there was no response, then as inhibition increased, lifespan responded by monotonically lengthening. Finally, at the highest levels of RNAi inhibition, lifespan began to shorten. Indirect measurements of whole-animal oxidative stress showed no correlation with life extension. Instead, larval development, fertility, and adult size all became coordinately affected at the same point at which lifespan began to increase. We show that a specific signal, initiated during the L3/L4 larval stage of development, is sufficient for initiating mitochondrial dysfunction-dependent life extension in C. elegans. This stage of development is characterized by the last somatic cell divisions normally undertaken by C. elegans and also by massive mitochondrial DNA expansion. The coordinate effects of mitochondrial dysfunction on several cell cycle-dependent phenotypes, coupled with recent findings directly linking cell cycle progression with mitochondrial activity in C. elegans, lead us to propose that cell cycle checkpoint control

  1. Rhabdomyosarcoma Arising in a Previously Irradiated Field: An Analysis of 43 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Dang, Nguyen D. [Department of Radiation Oncology, Baylor College of Medicine, Houston, Texas (United States); Teh, Bin S. [Department of Radiation Oncology, The Methodist Hospital and Methodist Hospital Research Institute, Houston, Texas (United States); Paulino, Arnold C., E-mail: apaulino@tmhs.org [Department of Radiation Oncology, The Methodist Hospital and Methodist Hospital Research Institute, Houston, Texas (United States)

    2013-03-01

    Patients with soft tissue sarcomas that arise from previously irradiated fields have traditionally been reported to have a poor prognosis. In this report, we examined the characteristics and outcomes of patients who developed a rhabdomyosarcoma in a previously irradiated field (RMS-RIF); we hypothesize that these patients should have a better outcome compared to other postradiation soft tissue sarcomas as these tumors are chemosensitive and radiosensitive. A PubMed search of the literature from 1961-2010 yielded 33 studies with data for patients with RMS-RIF. The study included 43 patients with a median age of 6.5 years at the time of radiation therapy (RT) for the initial tumor. The median RT dose was 48 Gy. The median latency period, the time from RT to development of RMS-RIF, was 8 years. The 3-year overall survival for RMS-RIF was 42%. The 3-year overall survival was 66% for patients receiving chemotherapy and local treatment (surgery and/or RT) compared to 29% for those who had systemic treatment only or local treatment only (P=.049). Other factors associated with increased 3-year overall survival included retinoblastoma initial diagnosis (P<.001), age ≤18 years at diagnosis of RMS-RIF (P=.003), favorable site (P=.008), and stage 1 disease (P=.002). Age at time of RMS-RIF, retinoblastoma initial tumor, favorable site, stage 1 disease, and use of both systemic and local treatment were found to be favorable prognostic factors for 3-year overall survival.

  2. Environmental assessment of untreated manure use, manure digestion and codigestion with silage maize : Deliverable for the 'EU-AGRO-BIOGAS' project

    NARCIS (Netherlands)

    Vries, de J.W.; Corre, W.J.; Dooren, van H.J.C.

    2010-01-01

    This report describes the environmental impact of untreated manure use, manure digestion, and co-digestion with silage maize for energy production. The life cycle assessment methodology was used. Environmental indicators included were, global warming potential, energy use, eutrophication,

  3. Preoperative CT staging of colon carcinoma (excluding the recto-sigmoid region)

    International Nuclear Information System (INIS)

    Acunas, B.; Rozanes, I.; Acunas, G.; Sayi, I.; Gokmen, E.; Celik, L.

    1990-01-01

    28 Patients with colon carcinoma (excluding the recto-sigmoid region) underwent preoperative staging with computed tomography (CT). The CT had a sensitivity of 60 and 67 per cent for detection of extramural invasion, 75 per cent sensitivity and specificity for lymph node metastases and a sensitivity of 87 per cent and specificity of 95 per cent for liver metastases. Compared with the modified Dukes classification, CT correctly staged 50 per cent of the patients with Dukes A lesions; 40 per cent with Dukes B, 75 per cent with Dukes C and 85 per cent with Dukes D lesions. The data presented in this study showed that CT has limitations in the sensitivity and accuracy of staging local colonic carcinoma. However, the authors recommend its use for patients who are clinically suspected of having extensive disease. (author). 10 refs.; 4 figs.; 2 tabs

  4. An Environmentally Benign Approach for As (V Absorption from Wastewater Using Untreated Coffee Grounds—Preliminary Results

    Directory of Open Access Journals (Sweden)

    Gnu Nam

    2017-11-01

    Full Text Available Arsenic contamination of water is a worldwide issue due to its severe effects on the human body. Coffee grounds are a porous material with network structures, making it absorb other substances such as some gases or elements. In this research, renewable coffee wastes were used as an adsorbent to extract arsenic (As from wastewater. In order to evaluate the usefulness of untreated coffee grounds, a series of preliminary tests for attachment of arsenic to coffee grounds were provided. The Brunauer–Emmett–Teller (BET surface area and adsorption–desorption isotherms of an untreated coffee ground obtained from N2 gas adsorption were provided, and pore sizes was obtained using Barrett–Joyner–Halenda (BJH method. The adsorption capacities of the coffee waste were verified through a series of experimental processes changing the conditions such as concentration of arsenic, initial amount of coffee grounds, and pH. The maximum absorption concentration of 6.44 mg/L on 1 g of coffee grounds at 1.00 mM of arsenic solution was observed. It was demonstrated that the modification by the cation species or pretreatment processes, such as calcination, will be necessary to enhance the absorption capacity for the extraction of arsenic.

  5. Late Miocene extension partitioning in the eastern Betics: from W- to E-directed extension between the Sorbas and Vera basins (SE Spain).

    Science.gov (United States)

    Giaconia, Flavio; Booth-Rea, Guillermo; Martínez-Martínez, Jose Miguel; Azañon, Jose Miguel

    2014-05-01

    basin. This westward migration of extension followed very closely the apatite fission track cooling ages obtained from Nevado-Filabride samples exhumed at the Sierra de Filabres core-complex, to the north. These ages range between 15 and 11 Ma, to the east, and between 9.5 and 7.5 Ma, to the west. The westward migration of extension continued during the Messinian and the Quaternary affecting the Níjar basin where a SW-directed normal-fault system occurs. Heterogeneous extension in the region resulted in different extensional domains both in extension direction and style. These domains are separated by transfer faults as the North Cabrera dextral fault, which accommodated opposite tilted-block domains at the southern margin of the Vera basin. Similarly, the Carboneras sinistral fault separates the Níjar tilted-block domain, to the north, from the Cabo de Gata domain characterized by magmatic accretion upon previously thinned continental crust, to the south.

  6. Performance of FDG PET/CT at initial diagnosis in a rare lymphoma: nodular lymphocyte-predominant Hodgkin lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Grellier, Jean Francois; Weinmann, Pierre [AP-HP- Hopital Europeen Georges Pompidou, Service de medecine nucleaire, Paris (France); Vercellino, Laetitia; Merlet, Pascal; Toubert, Marie-Elisabeth; Berenger, Nathalie [AP-HP- Hopital Saint-Louis, Service de medecine nucleaire, Paris (France); Leblanc, Thierry [Hopital Saint-Louis, Service d' immuno-hematologie, Paris (France); Thieblemont, Catherine [Universite Paris Diderot, Sorbonne Paris Cite - INSERM UMR-S1165, AP-HP- Hopital Saint-Louis, Service d' hemato-Oncologie, Paris (France); Briere, Josette [AP-HP- Hopital Saint-Louis, Service de pathologie, Paris (France); Brice, Pauline [AP-HP- Hopital Saint-Louis, Service d' hemato-Oncologie, Paris (France)

    2014-11-15

    Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare Hodgkin lymphoma distinguished from classical Hodgkin lymphoma (cHL) by the nature of the neoplastic cells which express B-cell markers. We wanted to determine the diagnostic performance of FDG PET/CT in initial assessment and its therapeutic impact on staging. We retrospectively studied a population of 35 patients with NLPHL (8 previously treated for NLHPL, 27 untreated). All patients underwent an initial staging by pretherapeutic FDG PET/CT. The impact on initial stage or relapse stage was assessed by an independent physician. In a per-patient analysis, the sensitivity of the pretherapeutic FDG PET/CT was 100 %. In a per-site analysis, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of pretherapeutic FDG PET/CT were 100 %, 99 %, 97 %, 100 % and 99 %, respectively. Pretherapeutic FDG PET/CT led to a change in the initial stage/relapse stage in 12 of the 35 patients (34 %). In contrast to previous results established without FDG PET/CT, 20 % of patient had osteomedullary lesions. Pretherapeutic FDG PET/CT has excellent performance for initial staging or relapse staging of NLPHL. (orig.)

  7. Systemic Chemotherapy for Progression of Brain Metastases in Extensive-Stage Small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Nagla Abdel Karim

    2015-01-01

    Full Text Available Lung cancer is the most common cause of cancer related mortality in men and women. Approximately 15% of lung cancers are small cell type. Chemotherapy and radiation are the mainstay treatments. Currently, the standard chemotherapy regimen includes platinum/etoposide. For extensive small cell lung cancer, irinotecan and cisplatin have also been used. Patients with relapsed small cell lung cancer have a very poor prognosis, and the morbidity increases with brain metastases. Approximately 10%–14% of small cell lung cancer patients exhibit brain metastases at the time of diagnosis, which increases to 50%–80% as the disease progresses. Mean survival with brain metastases is reported to be less than six months, thus calling for improved regimens. Here we present a case series of patients treated with irinotecan for progressive brain metastases in small cell lung cancer, which serves as a reminder of the role of systemic chemotherapy in this setting.

  8. Using pre-treatment PSA and Gleason score to predict for extra capsular extension among patients with clinically staged organ confined prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Anita; Roach, Mack; Diaz, Aidnag; Marquez, Carol; Chinn, Dan; Coleman, Lori; Presti, Joseph; Carroll, Peter

    1995-07-01

    Purpose/Objectives: The patients most suitable for a radical prostatectomy (RP) are those with organ confined disease. At least(1(3)) of patients with clinically staged organ confined disease will be found to have extra capsular extension (ECE) following RP. The purpose of this study is to assess the predictive value of an equation for predicting the risk of ECE based on the pre-treatment prostatic specific antigen (PSA) and Gleason score (GS) in patients with clinical stage T1/T2 prostate cancer. Materials and Methods: Two hundred and twenty-two patients who underwent RP at either the San Francisco VAMC or UCSF between 1988 and 1994 were eligible for this analysis. Patients were considered eligible if the pathological stage, pre-operative PSA and GS were available. Among these patients the median pre-operative PSA was 9 ng/ml (range 0 - 195 ng/ml), and the median pre-operative GS was 6 (range 2-10). The empirically derived equations tested were [1.5 x PSA + (GS - 3) x 10] (Roach, J. Urol., 150: 1923-1924, 1993) as well as a recent modification of this equation of [PSA + (GS - 3.5) x 10]. For these equations, the range of calculated risk was limited to 0 - 100%. Results: The results of using these two equations are shown graphically. Using the modified equation, with a calculated risk (CR) of {<=}25% and an average calculated risk (ACR) of 15.4%, the observed incidence (OI) of ECE was 17.2%. Among the patients with a CR of 26 to 50% and an ACR of 36.1%, the OI of ECE was 38.4%. Among the patients with a CR of 51 to 75% and an ACR of 60.4%, the OI of ECE was 62.7%. Finally, among the patients with a CR of 76 to 100% and an ACR of 77.3%, the OI of ECE was 85.7%. Transrectal ultrasound (TRUS) or magnetic resonance imaging (MRI) reports were available in 72 patients. Correlation with TRUS demonstrated a sensitivity and specificity of 52.4% and 56.1% respectively. Correlation with MRI showed a sensitivity of 57.9% and a specificity of 45.5%. The use of either MRI or

  9. Effect of hydronephrosis on survival in advanced stage cervical cancer.

    Science.gov (United States)

    Goklu, Mehmet Rıfat; Seckin, Kerem Doga; Togrul, Cihan; Goklu, Yasemin; Tahaoglu, Ali Emre; Oz, Murat; Ertas, Ibrahim Egemen

    2015-01-01

    Hydronephrosis is frequently encountered in advanced stage cervical cancers, and may be associated with mortality. In the present study, we aimed to demonstrate the effect of hydronephrosis on survival in patients with inoperable advanced stage cervical cancer. The study data were acquired by retrospective analysis of the patient records belonging to 165 women with FIGO (International Federation of Gynecology and Obstetrics) stage-IIIB or more advanced cervical cancer, which were not surgical candidates. Parameters including patient age, pathological diagnosis, disease stage, pelvic sidewall extension, presence of hydronephrosis and administration of chemoradiation were analyzed. Further, the effects of these variables on survival were assessed. P values less than 0.05 were considered statistically significant. The distribution of the study patients according to disease stage was as follows: 131 (79.4%) had stage-IIIB, 18 (10.9%) had stage-IVB and 16 (% 9.7) patients had stage-IVA disease. Hydronephrosis was not evident in 91 (55.2%) of these patients, whereas 41 (24.8%) had unilateral and 33 (20%) patients had bilateral hydronephrosis. When compared to mean survival in patients who did not have hydronephrosis, survival was significantly shortened in patients who had bilateral and unilateral hydronephrosis (phydronephrosis (p>0.05). Although patient age, pathological type, pelvic involvement, and chemotherapy treatment rates were similar (p>0.05), radiotherapy requirement rate and disease stage were significantly different among the study groups (pHydronephrosis was found to be a significant predictor of poor survival in patients with advanced stage cervical cancer, irrespective of unilateral or bilateral involvement.While waiting for future studies with larger sample sizes, we believe that the FIGO stages in advanced cervical cancer could further be stratified into subgroups according to presence or absence of hydronephrosis.

  10. Applications and extensions of degradation modeling

    International Nuclear Information System (INIS)

    Hsu, F.; Subudhi, M.; Samanta, P.K.; Vesely, W.E.

    1991-01-01

    Component degradation modeling being developed to understand the aging process can have many applications with potential advantages. Previous work has focused on developing the basic concepts and mathematical development of a simple degradation model. Using this simple model, times of degradations and failures occurrences were analyzed for standby components to detect indications of aging and to infer the effectiveness of maintenance in preventing age-related degradations from transforming to failures. Degradation modeling approaches can have broader applications in aging studies and in this paper, we discuss some of the extensions and applications of degradation modeling. The application and extension of degradation modeling approaches, presented in this paper, cover two aspects: (1) application to a continuously operating component, and (2) extension of the approach to analyze degradation-failure rate relationship. The application of the modeling approach to a continuously operating component (namely, air compressors) shows the usefulness of this approach in studying aging effects and the role of maintenance in this type component. In this case, aging effects in air compressors are demonstrated by the increase in both the degradation and failure rate and the faster increase in the failure rate compared to the degradation rate shows the ineffectiveness of the existing maintenance practices. Degradation-failure rate relationship was analyzed using data from residual heat removal system pumps. A simple linear model with a time-lag between these two parameters was studied. The application in this case showed a time-lag of 2 years for degradations to affect failure occurrences. 2 refs

  11. Applications and extensions of degradation modeling

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, F.; Subudhi, M.; Samanta, P.K. [Brookhaven National Lab., Upton, NY (United States); Vesely, W.E. [Science Applications International Corp., Columbus, OH (United States)

    1991-12-31

    Component degradation modeling being developed to understand the aging process can have many applications with potential advantages. Previous work has focused on developing the basic concepts and mathematical development of a simple degradation model. Using this simple model, times of degradations and failures occurrences were analyzed for standby components to detect indications of aging and to infer the effectiveness of maintenance in preventing age-related degradations from transforming to failures. Degradation modeling approaches can have broader applications in aging studies and in this paper, we discuss some of the extensions and applications of degradation modeling. The application and extension of degradation modeling approaches, presented in this paper, cover two aspects: (1) application to a continuously operating component, and (2) extension of the approach to analyze degradation-failure rate relationship. The application of the modeling approach to a continuously operating component (namely, air compressors) shows the usefulness of this approach in studying aging effects and the role of maintenance in this type component. In this case, aging effects in air compressors are demonstrated by the increase in both the degradation and failure rate and the faster increase in the failure rate compared to the degradation rate shows the ineffectiveness of the existing maintenance practices. Degradation-failure rate relationship was analyzed using data from residual heat removal system pumps. A simple linear model with a time-lag between these two parameters was studied. The application in this case showed a time-lag of 2 years for degradations to affect failure occurrences. 2 refs.

  12. Applications and extensions of degradation modeling

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, F.; Subudhi, M.; Samanta, P.K. (Brookhaven National Lab., Upton, NY (United States)); Vesely, W.E. (Science Applications International Corp., Columbus, OH (United States))

    1991-01-01

    Component degradation modeling being developed to understand the aging process can have many applications with potential advantages. Previous work has focused on developing the basic concepts and mathematical development of a simple degradation model. Using this simple model, times of degradations and failures occurrences were analyzed for standby components to detect indications of aging and to infer the effectiveness of maintenance in preventing age-related degradations from transforming to failures. Degradation modeling approaches can have broader applications in aging studies and in this paper, we discuss some of the extensions and applications of degradation modeling. The application and extension of degradation modeling approaches, presented in this paper, cover two aspects: (1) application to a continuously operating component, and (2) extension of the approach to analyze degradation-failure rate relationship. The application of the modeling approach to a continuously operating component (namely, air compressors) shows the usefulness of this approach in studying aging effects and the role of maintenance in this type component. In this case, aging effects in air compressors are demonstrated by the increase in both the degradation and failure rate and the faster increase in the failure rate compared to the degradation rate shows the ineffectiveness of the existing maintenance practices. Degradation-failure rate relationship was analyzed using data from residual heat removal system pumps. A simple linear model with a time-lag between these two parameters was studied. The application in this case showed a time-lag of 2 years for degradations to affect failure occurrences. 2 refs.

  13. Shelf-life extension of gilthead seabream fillets by osmotic treatment and antimicrobial agents.

    Science.gov (United States)

    Tsironi, T N; Taoukis, P S

    2012-02-01

    The objectives of the study were to evaluate the effect of selected antimicrobial agents on the shelf life of osmotically pretreated gilthead seabream and to establish reliable kinetic equations for shelf-life determination validated in dynamic conditions. Fresh gilthead seabream (Sparus aurata) fillets were osmotically treated with 50% high dextrose equivalent maltodextrin (HDM, DE 47) plus 5% NaCl and 0·5% carvacrol, 0·5% glucono-δ-lactone or 1% Citrox (commercial antimicrobial mix). Untreated and treated slices were aerobically packed and stored isothermally (0-15°C). Microbial growth and quality-related chemical indices were modelled as functions of temperature. Models were validated at dynamic storage conditions. Osmotic pretreatment with the use of antimicrobials led to significant shelf-life extension of fillets, in terms of microbial growth and organoleptic deterioration. The shelf life was 7 days for control samples at 5°C. The osmotic pretreatment with carvacrol, glucono-δ-lactone and Citrox allowed for shelf-life extension by 8, 10 and 5 days at 5°C, respectively. The results of the study show the potential of adding carvacrol, glucono-δ-lactone or Citrox in the osmotic solution to extend the shelf life and improve commercial value of chilled osmotically pretreated fish products. The developed models can be a reliable tool for predicting the shelf life of fresh or minimally processed gilthead seabream fillets in the real chill chain. © 2012 The Authors. Journal of Applied Microbiology © 2012 The Society for Applied Microbiology.

  14. Extensive screening for primary tumor is redundant in melanoma of unknown primary

    DEFF Research Database (Denmark)

    Tos, Tina; Klyver, Helle; Drzewiecki, Krzysztof T

    2011-01-01

    For decades, patients in our institution with metastastic melanoma of unknown primary have been subjected to extensive examinations in search of the primary tumor. This retrospective study questions the results, and thus the feasibility of these examinations. Of 103 patients diagnosed with unknow......, for patients referred with metastastic melanoma of unknown primary, we recommend that a detailed history is obtained, and a standard physical examination performed, in addition to a histopathological review and CT/PET for staging....

  15. Two-stage distraction lengthening of the forearm.

    Science.gov (United States)

    Taghinia, Amir H; Al-Sheikh, Ayman A; Panossian, Andre E; Upton, Joseph

    2013-01-01

    Single-stage lengthening of the forearm using callus distraction is well described; however, forearm lengthening using a 2-stage technique of distraction followed by bone grafting has received less attention. A 2-staged technique can be a better alternative in cases where the surgeon desires extensive lengthening. A retrospective review was undertaken of eleven 2-stage forearm lengthening procedures performed by 1 surgeon over a 15-year period. Indications were radial longitudinal deficiency (8 patients), neonatal ischemic contractures (2 patients), and septic growth arrest (1 patient). Average follow-up was 2.8 years. Distraction was performed on patients an average of 82 mm over an average duration of 24 weeks. Average time to union from the time of distractor removal and grafting was 87 days. Average healing index was 32.1 d/cm. Distraction problems were common and related to the length of time that the distractor was in place; they included pain, pin-related infections, and multiple mechanical device difficulties. Three patients had nonunion, and another had delayed union; however, additional procedures resulted in ultimate bony union in all patients. Demineralized bone matrix and autologous corticocancellous bone grafts yielded predictable healing and good functional results in short-distance distractions. For longer distractions, free vascularized fibula transfer produced the best outcomes. Intercalary cortical allografts did not heal well. Patients with neonatal Volkmann contractures had the most difficulty with distraction and healing, ultimately obtaining little to no lengthening and poor functional outcomes.

  16. Probable late lyme disease: a variant manifestation of untreated Borrelia burgdorferi infection

    Science.gov (United States)

    2012-01-01

    Background Lyme disease, a bacterial infection with the tick-borne spirochete Borrelia burgdorferi, can cause early and late manifestations. The category of probable Lyme disease was recently added to the CDC surveillance case definition to describe patients with serologic evidence of exposure and physician-diagnosed disease in the absence of objective signs. We present a retrospective case series of 13 untreated patients with persistent symptoms of greater than 12 weeks duration who meet these criteria and suggest a label of ‘probable late Lyme disease’ for this presentation. Methods The sample for this analysis draws from a retrospective chart review of consecutive, adult patients presenting between August 2002 and August 2007 to the author (JA), an infectious disease specialist. Patients were included in the analysis if their current illness had lasted greater than or equal to 12 weeks duration at the time of evaluation. Results Probable late Lyme patients with positive IgG serology but no history of previous physician-documented Lyme disease or appropriate Lyme treatment were found to represent 6% of our heterogeneous sample presenting with ≥ 12 weeks of symptom duration. Patients experienced a range of symptoms including fatigue, widespread pain, and cognitive complaints. Approximately one-third of this subset reported a patient-observed rash at illness onset, with a similar proportion having been exposed to non-recommended antibiotics or glucocorticosteroid treatment for their initial disease. A clinically significant response to antibiotics treatment was noted in the majority of patients with probable late Lyme disease, although post-treatment symptom recurrence was common. Conclusions We suggest that patients with probable late Lyme disease share features with both confirmed late Lyme disease and post-treatment Lyme disease syndrome. Physicians should consider the recent inclusion of probable Lyme disease in the CDC Lyme disease surveillance

  17. Dark matter as a ghost free conformal extension of Einstein theory

    International Nuclear Information System (INIS)

    Barvinsky, A.O.

    2014-01-01

    We discuss ghost free models of the recently suggested mimetic dark matter theory. This theory is shown to be a conformal extension of Einstein general relativity. Dark matter originates from gauging out its local Weyl invariance as an extra degree of freedom which describes a potential flow of the pressureless perfect fluid. For a positive energy density of this fluid the theory is free of ghost instabilities, which gives strong preference to stable configurations with a positive scalar curvature and trace of the matter stress tensor. Instabilities caused by caustics of the geodesic flow, inherent in this model, serve as a motivation for an alternative conformal extension of Einstein theory, based on the generalized Proca vector field. A potential part of this field modifies the inflationary stage in cosmology, whereas its rotational part at the post inflationary epoch might simulate rotating flows of dark matter

  18. Early-stage [123I]β-CIT SPECT and long-term clinical follow-up in patients with an initial diagnosis of Parkinson's disease

    International Nuclear Information System (INIS)

    Stoffers, Diederick; Booij, Jan; Bosscher, Lisette; Winogrodzka, Ania; Wolters, Erik C.; Berendse, Henk W.

    2005-01-01

    Previous studies using dopamine transporter single-photon emission computed tomography (SPECT) to try and distinguish between patients with idiopathic Parkinson's disease (IPD) and patients with atypical parkinsonian syndromes (APS) have mainly focussed on patients with an already established clinical diagnosis of several years' duration. Differences in the pattern of striatal involvement between IPD and APS have been found in only few studies. We hypothesized that distinguishing SPECT features might be most pronounced at an early disease stage, and the purpose of the present study was to investigate this hypothesis. The study included 72 patients with an initial clinical diagnosis of IPD, supported by decreased striatal [ 123 I]β-CIT binding on baseline SPECT. In ten patients, the diagnosis was changed to APS over a mean follow-up period of 62 months. We retrospectively compared the patterns of striatal involvement on the baseline SPECT scans between the group of patients (re)diagnosed with APS and the remaining 62 patients in whom a diagnosis of IPD was maintained. In the group of patients with APS, baseline [ 123 I]β-CIT binding in both caudate nuclei was lower than in the group of patients with IPD. In addition, putamen to caudate binding ratios were higher in the group of APS patients. In spite of these differences, individual binding values showed considerable overlap between the groups. [ 123 I]β-CIT SPECT scanning in early-stage, untreated parkinsonian patients revealed a relative sparing of the caudate nucleus in patients with IPD as compared to patients later (re)diagnosed with APS. Nevertheless, the pattern of striatal involvement appears to have little predictive value for a later re-diagnosis of APS in individual cases. (orig.)

  19. A report of three cases of untreated Graves' disease associated with pancytopenia in Malaysia.

    Science.gov (United States)

    Rafhati, Abdullah Noor; See, Chee Keong; Hoo, Fan Kee; Badrulnizam, Long Bidin Mohamed

    2014-01-01

    Generally, clinical presentations of Graves' disease range from asymptomatic disease to overt symptomatic hyperthyroidism with heat intolerance, tremor, palpitation, weight loss, and increased appetite. However, atypical presentation of Graves' disease with hematological system involvement, notably pancytopenia, is distinctly uncommon. Hereby, we present and discuss a series of three untreated cases of Graves' disease clinically presented with pancytopenia and the hematological abnormalities that responded well to anti-thyroid treatment. With resolution of the thyrotoxic state, the hematological parameters improved simultaneously. Thus, it is crucial that anti-thyroid treatment be considered in patients with Graves' disease and pancytopenia after a thorough hematological evaluation.

  20. TSH-receptor-autoantibody-titers in untreated toxic diffuse goitres - an early indicator of relapse

    International Nuclear Information System (INIS)

    Becker, W.; Reiners, C.; Boerner, W.

    1984-01-01

    TSH-receptor-auto antibodies were determined in follow-up of 30 patients with relapse of toxic diffuse goitres, i.e. patients with Graves' disease and toxic disseminated autonomy, and in 13 patients with spontaneous remission after antithyroid drug therapy by use of a commercially available TSH-radioreceptorassay (TRAK-assay). All the patients with very high receptor-autoantibody-titers in untreated thyrotoxicosis (F > 20%) had one or more periods of hyperthyroidism or a very severe course of disease. None of these patients showed a spontaneous remission of disease. They all could be identified as Graves' patients. Patients with TRAK-titers 3% [de