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Sample records for replacement treatment comparison

  1. Treatment of Isolated Ankle Osteoarthritis with Arthrodesis or the Total Ankle Replacement: A Comparison of Early Outcomes

    Science.gov (United States)

    Saltzman, Charles L.; Kadoko, Robert G.

    2010-01-01

    Background Ankle arthrodesis and replacement are two common surgical treatment options for end-stage ankle osteoarthritis. However, the relative value of these alternative procedures is not well defined. This study compared the clinical and radiographic outcomes as well as the early perioperative complications of the two procedures. Methods Between January 2, 1998 and May 31, 2002, 138 patients were treated with ankle fusion or replacements. Seventy one patients had isolated posttraumatic or primary ankle arthritis. However, patients with inflammatory arthritis, neuropathic arthritis, concomitant hind foot fusion, revision procedures and two component system ankle replacement were excluded. Among them, one group of 42 patients had a total ankle replacement (TAR), whereas the other group of 29 patients underwent ankle fusion. A complete follow-up could be performed on 89% (37/42) and 73% (23/29) of the TAR and ankle fusion group, respectively. The mean follow-up period was 4.2 years (range, 2.2 to 5.9 years). Results The outcomes of both groups were compared using a student's t-test. Only the short form heath survery mental component summary score and Ankle Osteoarthritis Scale pain scale showed significantly better outcomes in the TAR group (p < 0.05). In the radiographic evaluation, there was no significant difference in preoperative and postoperative osteoarthritis between the TAR and fusion groups. Conclusions The clinical results of TAR are similar to those of fusion at an average follow-up of 4 years. However, the arthroplasty group showed better pain relief and more postoperative complications that required surgery. PMID:20190994

  2. Total ankle replacement - surgical treatment and rehabilitation.

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    Prusinowska, Agnieszka; Krogulec, Zbigniew; Turski, Piotr; Przepiórski, Emil; Małdyk, Paweł; Księżopolska-Orłowska, Krystyna

    2015-01-01

    Functions of the ankle joint are closely connected with the gait and ability to maintain an upright position. Degenerative lesions of the joint directly contribute to postural disorders and greatly restrict propulsion of the foot, thus leading to abnormal gait. Development of total ankle replacement is connected with the use of the method as an efficient treatment of joint injuries and continuation of achievements in hip and knee surgery. The total ankle replacement technique was introduced as an alternative to arthrodesis, i.e. surgical fixation, which made it possible to preserve joint mobility and to improve gait. Total ankle replacement is indicated in post-traumatic degenerative joint disease and joint destruction secondary to rheumatoid arthritis. In this paper, total ankle replacement and various types of currently used endoprostheses are discussed. The authors also describe principles of early postoperative rehabilitation as well as rehabilitation in the outpatient setting.

  3. Posterior Transpedicular Dynamic Stabilization versus Total Disc Replacement in the Treatment of Lumbar Painful Degenerative Disc Disease: A Comparison of Clinical Results

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    Tunc Oktenoglu

    2013-01-01

    Full Text Available Study Design. Prospective clinical study. Objective. This study compares the clinical results of anterior lumbar total disc replacement and posterior transpedicular dynamic stabilization in the treatment of degenerative disc disease. Summary and Background Data. Over the last two decades, both techniques have emerged as alternative treatment options to fusion surgery. Methods. This study was conducted between 2004 and 2010 with a total of 50 patients (25 in each group. The mean age of the patients in total disc prosthesis group was 37,32 years. The mean age of the patients in posterior dynamic transpedicular stabilization was 43,08. Clinical (VAS and Oswestry and radiological evaluations (lumbar lordosis and segmental lordosis angles of the patients were carried out prior to the operation and 3, 12, and 24 months after the operation. We compared the average duration of surgery, blood loss during the surgery and the length of hospital stay of both groups. Results. Both techniques offered significant improvements in clinical parameters. There was no significant change in radiologic evaluations after the surgery for both techniques. Conclusion. Both dynamic systems provided spine stability. However, the posterior dynamic system had a slight advantage over anterior disc prosthesis because of its convenient application and fewer possible complications.

  4. Total ankle replacement – surgical treatment and rehabilitation

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    Krogulec, Zbigniew; Turski, Piotr; Przepiórski, Emil; Małdyk, Paweł; Księżopolska-Orłowska, Krystyna

    2015-01-01

    Functions of the ankle joint are closely connected with the gait and ability to maintain an upright position. Degenerative lesions of the joint directly contribute to postural disorders and greatly restrict propulsion of the foot, thus leading to abnormal gait. Development of total ankle replacement is connected with the use of the method as an efficient treatment of joint injuries and continuation of achievements in hip and knee surgery. The total ankle replacement technique was introduced as an alternative to arthrodesis, i.e. surgical fixation, which made it possible to preserve joint mobility and to improve gait. Total ankle replacement is indicated in post-traumatic degenerative joint disease and joint destruction secondary to rheumatoid arthritis. In this paper, total ankle replacement and various types of currently used endoprostheses are discussed. The authors also describe principles of early postoperative rehabilitation as well as rehabilitation in the outpatient setting. PMID:27407223

  5. Menopausal depression:comparison of hormone replacement therapy and hormone replacement therapy plus fiuoxetine

    Institute of Scientific and Technical Information of China (English)

    刘平; 何方方; 白文佩; 郁琦; 史蔚; 吴宜勇; 贺丹军; 肖计划; 郑晔; 廖秦平

    2004-01-01

    Background To compare the efficacy and safety of hormone replacement therapy (HRT) combined with fluoxetine, with HRT alone, in post-menopausal women suffering from depression.Methods A randomized, open-label, parallel trial was applied. HRT was administered to all patients for 2 cycles, with ]4 days of estrogen therapy and 14 days of estrogen plus progesterone. Patients who were randomly assigned to the HRT plus fluoxetine group were given fluoxetine in combination with HRT. Hamilton Depression Rating Scale (HAMD), Kupperman Menopausal Index (KMI), and Clinical Global Impressions scale were used to measure the efficacy. Results One hundred and twenty-three post-menopausal patients with depression were enrolled in the study. Among them, 120 had at least one post-treatment visit and entered into the statistical analysis. The mean total HAMD scores were significantly lower, and the percentages of HAMD score reductions were higher in the HRT plus fluoxetine Group compared with the HRT Group, after at least 3 weeks of treatment, with an average difference of 5 points at the endpoint. The Clinical Global Impression-Severity and Clinical Global Impression-Improvement scores were significantly different in the 2 groups, in favor of the combination therapy. The mean total KMI was significantly lower in the Combination Group compared with the HRT Group, after at least 6 weeks of treatment, with an average 4. 5-point difference between the groups. No statistically significant differences were found in most of the adverse events reported in the Combination Group compared with the HRT group, with the exception of 3 symptoms, i. e., dry mouth, loss of appetite, and abdominal distention. They were mild to moderate in severity. Two patients in the HRT group, but none in the combination group, dropped out due to adverse events. Conclusion HRT plus fluoxetine therapy was effective in the treatment of menopausal depression with a satisfactory safety profile.

  6. Serum Testosterone Level, Testosterone Replacement Treatment, and Prostate Cancer

    OpenAIRE

    Ali Atan; Altug Tuncel; Suleyman Yesil; Derya Balbay

    2013-01-01

    There has been an increase in the number of individuals seeking testosterone (T) replacement treatment (TRT) due to a decrease in their blood T levels. Prostate cancer (PCa) is also an important issue in the same age group. However, we, urologists, are anxious about PCa development after T treatment. This is because it has been assumed that T may cause PCa or exacerbate insidious PCa which is already present. In this paper, recent developments regarding the relationship between serum levels o...

  7. Replacement

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    S. Radhakrishnan

    2014-03-01

    Full Text Available The fishmeal replaced with Spirulina platensis, Chlorella vulgaris and Azolla pinnata and the formulated diet fed to Macrobrachium rosenbergii postlarvae to assess the enhancement ability of non-enzymatic antioxidants (vitamin C and E, enzymatic antioxidants (superoxide dismutase (SOD and catalase (CAT and lipid peroxidation (LPx were analysed. In the present study, the S. platensis, C. vulgaris and A. pinnata inclusion diet fed groups had significant (P < 0.05 improvement in the levels of vitamins C and E in the hepatopancreas and muscle tissue. Among all the diets, the replacement materials in 50% incorporated feed fed groups showed better performance when compared with the control group in non-enzymatic antioxidant activity. The 50% fishmeal replacement (best performance diet fed groups taken for enzymatic antioxidant study, in SOD, CAT and LPx showed no significant increases when compared with the control group. Hence, the present results revealed that the formulated feed enhanced the vitamins C and E, the result of decreased level of enzymatic antioxidants (SOD, CAT and LPx revealed that these feeds are non-toxic and do not produce any stress to postlarvae. These ingredients can be used as an alternative protein source for sustainable Macrobrachium culture.

  8. Proximal femoral replacement for the treatment of periprosthetic fractures.

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    Klein, Gregg R; Parvizi, Javad; Rapuri, Venkat; Wolf, Christopher F; Hozack, William J; Sharkey, Peter F; Purtill, James J

    2005-08-01

    A periprosthetic fracture around the femoral component is a rare but potentially problematic complication after total hip arthroplasty. Reconstruction can be challenging, especially when severe bone stock deficiency is encountered. Proximal femoral replacement is one method of treating the severely deficient proximal part of the femur. The present report describes the outcomes of revision total hip arthroplasty with use of a proximal femoral replacement in a cohort of patients who had a Vancouver type-B3 periprosthetic fracture. With use of a computerized institutional database, all patients in whom a Vancouver type-B3 fracture (characterized by severe proximal bone deficiency and a loose femoral stem) had been treated with a proximal femoral replacement were identified. A modular femoral replacement with proximal porous coating had been used in all cases. The twenty-one patients who were identified had had a mean age of 78.3 years (range, fifty-two to ninety years) at the time of the index operation. The clinical and radiographic records of these patients were reviewed. At the time of the latest follow-up (mean, 3.2 years), all but one of the patients were able to walk and had minimal to no pain. Complications included persistent wound drainage that was treated with incision and drainage (two hips), dislocation (two hips), refracture of the femur distal to the stem (one hip), and acetabular cage failure (one hip). Despite a relatively high complication rate, we believe that proximal femoral replacement is a viable option for the treatment of periprosthetic fractures in older patients with severe bone deficiency. If a proximal femoral replacement is used, the stability of the hip must be tested diligently intraoperatively and a constrained acetabular liner should be utilized if instability is encountered. In order to enhance the bone stock, the proximal part of the femur, however poor in quality, should be retained for reapproximation onto the implant.

  9. Single-tooth replacement: factors affecting different prosthetic treatment modalities

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    Al-Quran Firas A

    2011-12-01

    Full Text Available Abstract Background The choice between several treatment options for replacing a single missing tooth is influenced by clinical, dentist- and patient-immanent factors. This study aimed to determine the patient factors that would affect the treatment decision to replace a single missing tooth and to assess the satisfaction with several options. Method 200 volunteers involved (121 females and 79 males divided into four groups, Group A: consisted of patients with conventional fixed partial dentures or patients with resin bonded fixed partial dentures. Group B: consisted of patients who received removable partial dentures while Group C: consisted of patients who received a single implant supported crown, and a control group D: consisted of patients who received no treatment. Data were collected using a questionnaire. Results The highest percentage of males within groups (58% was within the removable prostheses category. The majority of the subjects in the study reported that the main reason for replacing a missing tooth was for esthetic and function. Most important factor affecting the choice between treatment modalities was damaging the neighboring teeth. Pain, post operative sensitivity and dental phobia were important factors in choosing the prosthesis type and affected the control group patients not to have any treatment. The highest satisfaction percentage among groups studied was recorded for dental implants then FPD groups, while the least percentage were in both the control and RPD groups, for all aspects of function, esthetic and speech efficiency. Conclusions The final choice between FPD, RPD and implant depended on several factors which affected the decision making; among these is cost and patients' awareness of the different treatment options.

  10. Model for Quantitative Evaluation of Enzyme Replacement Treatment

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    Radeva B.

    2009-12-01

    Full Text Available Gaucher disease is the most frequent lysosomal disorder. Its enzyme replacement treatment was the new progress of modern biotechnology, successfully used in the last years. The evaluation of optimal dose of each patient is important due to health and economical reasons. The enzyme replacement is the most expensive treatment. It must be held continuously and without interruption. Since 2001, the enzyme replacement therapy with Cerezyme*Genzyme was formally introduced in Bulgaria, but after some time it was interrupted for 1-2 months. The dose of the patients was not optimal. The aim of our work is to find a mathematical model for quantitative evaluation of ERT of Gaucher disease. The model applies a kind of software called "Statistika 6" via the input of the individual data of 5-year-old children having the Gaucher disease treated with Cerezyme. The output results of the model gave possibilities for quantitative evaluation of the individual trends in the development of the disease of each child and its correlation. On the basis of this results, we might recommend suitable changes in ERT.

  11. Serum Testosterone Level, Testosterone Replacement Treatment, and Prostate Cancer

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    Ali Atan

    2013-01-01

    Full Text Available There has been an increase in the number of individuals seeking testosterone (T replacement treatment (TRT due to a decrease in their blood T levels. Prostate cancer (PCa is also an important issue in the same age group. However, we, urologists, are anxious about PCa development after T treatment. This is because it has been assumed that T may cause PCa or exacerbate insidious PCa which is already present. In this paper, recent developments regarding the relationship between serum levels of sex hormone and prostate tissue, the causal relationship between T and development of PCa, the effect of TRT on the group of patients who are at high risk of developing PCa, the suitability of TRT for patients who have already been diagnosed with PCa, and the effect of TRT on serum prostate-specific antigen level are analyzed.

  12. Infection after total knee replacement: diagnosis and treatment

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    Lucio Honorio de Carvalho Junior

    2013-09-01

    Full Text Available Infection after total knee replacement (IATJ is a rare complication. It is associated with increased morbidity and mortality increasing the final costs. Gram positive coccus and Staphylococcus coagulase-negative and Staphylococcus aureus are the most common isolated germs (>50% of the cases. Conditions related to the patient, to the surgical procedure and even to the post op have been identified as risk factors to IATJ. Many complementary methods together with clinical symptoms are useful to a proper diagnosis. Treatment for IATJ must be individualized but generally is a combination of systemic antibiotic therapy and surgical treatment. Prosthesis exchange in one or two stages is the first choice procedure. Debridement with prosthesis retention is an option in acute cases with stable implants and antibiotic sensible germs.

  13. Aortic Valve Replacement: Treatment by Sternotomy versus Minimally Invasive Approach

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    Renata Tosoni Rodrigues Ferreira

    Full Text Available Abstract Objective: To compare the results of aortic valve replacement with access by sternotomy or minimally invasive approach. Methods: Retrospective analysis of medical records of 37 patients undergoing aortic valve replacement by sternotomy or minimally invasive approach, with emphasis on the comparison of time of cardiopulmonary bypass and aortic clamping, volume of surgical bleeding, time of mechanical ventilation, need for blood transfusion, incidence of atrial fibrillation, length of stay in intensive care unit, time of hospital discharge, short-term mortality and presence of surgical wound infection. Results: Sternotomy was used in 22 patients and minimally invasive surgery in 15 patients. The minimally invasive approach had significantly higher time values of cardiopulmonary bypass (114.3±23.9 versus 86.7±19.8min.; P=0.003, aortic clamping (87.4±19.2 versus 61.4±12.9 min.; P<0.001 and mechanical ventilation (287.3±138.9 versus 153.9±118.6 min.; P=0.003. No difference was found in outcomes surgical bleeding volume, need for blood transfusion, incidence of atrial fibrillation, length of stay in intensive care unit and time of hospital discharge. No cases of short-term mortality or surgical wound infection were documented. Conclusion: The less invasive approach presented with longer times of cardiopulmonary bypass, aortic clamping and mechanical ventilation than sternotomy, however without prejudice to the length of stay in intensive care unit, time of hospital discharge and morbidity.

  14. Comparison of Titanium vs. Polycel Total Ossicular Replacement Prosthesis

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    Mohammad Faramarzi

    2016-01-01

    Full Text Available Introduction: Even though modern technology progresses so rapidly, annals of otology are replete with so many challenging article, which often compare various types of prosthesis. Since there has not been a prospective randomized clinical trial study which compares the hearing result of total ossicular replacement prosthesis made of Titanium with omega connector and Polycel in the literature, we decided to perform a study encompassing this issue.   Materials and Methods: 105 patients, who were in the 2nd stage of their operation and who needed total ossicular replacement prosthesis, were included in this prospective single blind randomized clinical trial study. Patients were classified in two groups: titanium Kurz (TTP™ -Vario system, Kurz GmbH, Dusslingen, Germany with omega connector and Polycel (Sheehy Plastipore Polycel, Medtronic Xomed Inc. The duration of the follow up was 6-12 months. In order to evaluate hearing results, pure tone audiometric in 0.5, 1, 2, and 4 kHz were checked. In addition, speech reception threshold was recorded. A successful surgery was defined as having a postoperative air–bone gap within 20 dB.   Results: We accomplished successful hearing in 64.4% of patients with titanium and 65% of patients with a Polycel prosthesis.Improvement in speech reception threshold was 11.5 dB in the titanium group and 13 dB in the Polycel group. In other words, there was no significant difference between the two groups. In addition, air-bone gap improvement after ossiculoplasty was 11.2 dB in the patients with a titanium prosthesis and 12.4 dB in the Polycel group. In fact, the difference was not significant.   Conclusion: We found that both the titanium and the Polycel prosthesis improve speech reception threshold and air-bone gap closure in a similar manner.

  15. 股骨颈骨折直接行髋关节置换术与内固定失败后再行髋关节置换术的比较%Comparison of primary hip replacement with secondary replacement after failed internal fixation in the treatment of femoral neck fractures

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    王剑火; 张玉九; 李玉茂; 李平生

    2011-01-01

    Objective To explore the difference of the outcomes of primary hip replacement and secondary replacement after failed internal fixation in the treatment of femoral neck fractures for optimal choice of operation method for femoral neck fractures. Methods 43 patients with a secondary hip replacement after failed internal fixation (Group A) and 52 patients with a primary hip replacement (Group B) in the treatment of femoral neck fractures were retrospectively analyzed.All patients were followed up at least 2 years. Details of operation, complications, hip function and quality of life at 2 years after operation were compared between two groups. The hip function, including the pain movement and walking, was evaluated by the Charnley scoring system. The health-related quality of patients' life was evaluated by using the EQ-5D index. Results Operation time, amount of hemorrhage during operation, the Chamley score of hip function and EQ-5D index score of quality of life were 1.9±0.2 and 1.4±0.2h 、 525.6±50.8 and 462.3±47.8ml 、 13.4±2.3 and15.2±2.4 、 0.67±0.26 and 0.72±0.25 for Group A and Group B,respectively. The difference was significant for the above 4 respects (P<0.05).Conclusion The outcomes of secondary hip replacement after failed internal fixation is worse than those of primary hip replacement in the treatment of femoral neck fractures, which indicates that primary hip replacement is worth being recommended for patients with femoral neck fractures who are easier to develop to be a fracture nonunion or avascular necrosis of femoral head if they are treated with internal fixation.%目的 通过对股骨颈骨折直接行髋关节置换术与内固定失败后再行髋关节置换术临床结果的比较,为股骨颈骨折手术方式的选择提供依据.方法 回顾性分析随访2年的43例股骨颈骨折内固定失败后冉次行髋关节置换术(A组)和52例股骨颈骨折直接行髋关节置换术(B组)的临床资料,比较两组患者

  16. Therapeutic efficacy comparison of hip resurfacing and total hip replacement in the treatment of avascular necrosis%髋关节表面置换与全髋关节置换治疗股骨头缺血性坏死的疗效比较

    Institute of Scientific and Technical Information of China (English)

    戚广秀; 王立民; 孙云明

    2012-01-01

    目的 探讨髋关节表面置换与全髋关节置换治疗股骨头缺血性坏死的疗效对比情况,为合理选择手术方法提供参考.方法 将60例股骨头缺血性坏死患者根据不同的手术方法分为治疗组与对照组,每组各30例.治疗组采用髋关节表面置换治疗,对照组采用全髋关节置换治疗.结果 两组的平均手术时间、术中和术后的总输血量比较,差异无统计学意义(P>0.05).对照组术后切口大出血的机率高于治疗组(P<0.05).两组人工全髋关节疗效评分(Harris评分)治疗前比较,差异无统计学意义(P>0.05);治疗后,治疗组有明显提高(P<0.05).结论 相对于全髋关节置换,髋关节表面置换治疗股骨头缺血性坏死能在不增加创伤的基础上,减少术后切口大出血,同时提高随访Harris评分,值得推广应用.%Objective To discuss the therapeutic efficacy comparison hip resurfacing and total hip replacement in the treatment of avascular necrosis. Methods 60 patients with avascular necrosis were divided into the treatment group and the control group according the different surgical methods, each group had 30 cases. The treatment group were treated with hip resurfacing replacement, and the control group were treated with total hip replacement. Results The operation time, the in-traoperative and postoperative total amount of blood transfusion between the two groups had no significant statistical difference (P > 0.05). The probability of postoperative wound bleeding of the control group were more than the treatment group (P < 0.05), there was no significant difference of Harris score before treatment between the two groups, but the treatment group were improved significantly of Harris score after treatment (P < 0.05). Conclusion Compared with total hip replacement, total hip replacement in the treatment of avascular necrosis can not increase trauma, reduce the probability of postoperative wound bleeding and increase the

  17. Conjunctival Changes in Wearers of Frequent Replacement Hydrogel and Frequent Replacement Silicone Hydrogel Contact Lenses: Comparison Using Impression Cytology Technique

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    Rukiye Aydın FEBO

    2014-01-01

    Full Text Available Objectives: To compare the level of conjunctival changes using conjunctival impression cytology in wearers of frequent replacement hydrogel (FRHL and frequent replacement silicone hydrogel contact lens FRSHL. Materials and Methods: Forty-two contact lens users who were seen at the Cornea and Contact Lens Unit, Department of Ophthalmology, Dokuz Eylül University were evaluated in this study. The first group consisted of wearers of FRHL used for minimum one year and maximum five years. The second group consisted of wearers who used FRSHL for minimum one year and maximum 5 years. Twenty healthy individuals with no contact lens history were included in the control group. Conjunctival impression cytology was applied to all contact lens users and the control group in order to evaluate the conjunctival changes, and the results of impression cytology were graded by the Nelson’s method. Results: In the comparison of the groups according to impression cytology scoring, there was no difference between the users of FRHL and FRSHL. Similar amounts of squamous metaplasia and goblet cell loss were encountered in both groups. Nonetheless, impression cytology grading was significantly lower in the control group than in the other two groups. Conclusion: In conclusion, the use of FRHL and FRSHL for over a year causes some histological changes in the conjunctiva such as squamous metaplasia and goblet cell loss eventually leading to dry eye symptoms. However, no differences were determined between FRHL and FRSHL users with regard to severity of conjunctival changes. (Turk J Ophthalmol 2014; 44: 47-52

  18. Result of bilateral total hip replacement in the treatment of a child with cerebral palsy

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    Владимир Евгеньевич Басков

    2015-12-01

    Full Text Available Total hip replacement in children is performed according to very limited and compelling indications. The principal of such a treatment is the complete and irreversible destruction of the hip joint accompanied by a permanent loss of function of the lower limb. Hip replacement in children with cerebral palsy is a very rare method of treatment. According to observations from the Turner Institute, it was performed in only 2% of all replacement cases. After the placement of an artificial joint, the atherogenic component of the contractures disappears and improves the motor activity of patients. In this paper, a 3-year follow-up of the bilateral total hip replacement in a child with cerebral palsy and bilateral secondary stage III coxarthrosis is presented.

  19. Knee Replacement

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    Knee replacement is surgery for people with severe knee damage. Knee replacement can relieve pain and allow you to ... Your doctor may recommend it if you have knee pain and medicine and other treatments are not ...

  20. Comparison of Two Fluid Replacement Protocols During a 20-km Trail Running Race in the Heat.

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    Lopez, Rebecca M; Casa, Douglas J; Jensen, Katherine A; Stearns, Rebecca L; DeMartini, Julie K; Pagnotta, Kelly D; Roti, Melissa W; Armstrong, Lawrence E; Maresh, Carl M

    2016-09-01

    Lopez, RM, Casa, DJ, Jensen, K, Stearns, RL, DeMartini, JK, Pagnotta, KD, Roti, MW, Armstrong, LE, and Maresh, CM. Comparison of two fluid replacement protocols during a 20-km trail running race in the heat. J Strength Cond Res 30(9): 2609-2616, 2016-Proper hydration is imperative for athletes striving for peak performance and safety, however, the effectiveness of various fluid replacement strategies in the field setting is unknown. The purpose of this study was to investigate how two hydration protocols affect physiological responses and performance during a 20-km trail running race. A randomized, counter-balanced, crossover design was used in a field setting (mean ± SD: WBGT 28.3 ± 1.9° C). Well-trained male (n = 8) and female (n = 5) runners (39 ± 14 years; 175 ± 9 cm; 67.5 ± 11.1 kg; 13.4 ± 4.6% BF) completed two 20-km trail races (5 × 4-km loop) with different water hydration protocols: (a) ad libitum (AL) consumption and (b) individualized rehydration (IR). Data were analyzed using repeated measures ANOVA. Paired t-tests compared pre-race-post-race measures. Main outcome variables were race time, heart rate (HR), gastrointestinal temperature (TGI), fluid consumed, percent body mass loss (BML), and urine osmolality (Uosm). Race times between groups were similar. There was a significant condition × time interaction (p = 0.048) for HR, but TGI was similar between conditions. Subjects replaced 30 ± 14% of their water losses in AL and 64 ± 16% of their losses in IR (p 2% BML in AL. Ad libitum drinking resulted in 1.3% greater BML over the 20-km race, which resulted in no thermoregulatory or performance differences from IR.

  1. [Periprosthetic Femoral Fractures after Total Hip Replacement: Our Results and Treatment Complications].

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    Pavelka, T; Salášek, M; Weisová, D

    2017-01-01

    PURPOSE OF THE STUDY The study consists of a retroactive evaluation of results of surgical treatment in patients with periprosthetic femoral fracture after total hip replacement and a comparison with results reported in the literature. MATERIAL AND METHODS In the period from 2003 to 2013, a total of 83 patients with periprosthetic femoral fracture after total hip replacement were treated at our clinic, namely 69 women and 14 men. The mean age in the cohort was 74 years (range 47-87). The Vancouver classification was used to grade the fractures. The cohort included 31 patients with type B1 fracture, 25 patients with type B2 fracture, 8 patients with type B3 fracture, and 19 patients with type C fracture. Altogether 80 patients underwent a surgery, 3 patients with non-displaced type B1 fracture were treated conservatively. The mechanism of injury was a simple fall in 75 % of primary endoprostheses and in 56% of revision endoprostheses. The average time to fracture was 7.6 years in primary implant and 3.6 years in revision endoprosthesis. In fractures with a well-fixed stem (type B1 and C) plate osteosynthesis was used. In case of a comminution zone, osteosynthesis was followed by spongioplasty. In patients with a loose stem (type B2 and B3), the fracture was treated with a revision uncemented stem. In two cases a combination of a revision stem and a massive corticocancellous bone graft was used. The evaluation was performed using the Harris Hip Score and the minimum follow-up from the surgery was 3 years. RESULTS In the group of patients with type B1 fracture, 28 patients were treated surgically. An excellent result was achieved in 22 patients (84%), in 4 patients (16%) the result was very good. The remaining 2 patients failed to meet the requirement of the minimum follow-up of 3 years. In the group of patients with type B2 fractures, composed of 25 patients, the femoral component was replaced with a revision uncemented stem with cerclage wires or titanium tapes or

  2. Association between the clinical classification of hypothyroidism and reduced TSH in LT4 supplemental replacement treatment for pregnancy in China.

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    Zhang, Lyu; Zhang, Zhaoyun; Ye, Hongying; Zhu, Xiaoming; Li, Yiming

    2016-01-01

    The study was aimed to evaluate the effects of levothyroxine (LT4) supplemental replacement treatment for pregnancy and analyze the associations between the clinical classification of hypothyroidism and reduced thyroid-stimulating hormone (TSH) in LT4 therapy. Totally, 195 pregnant women with hypothyroidism receiving routine prenatal care were enrolled. They were categorized into three groups: overt hypothyroidism (OH), subclinical hypothyroidism (SCH) with negative thyroperoxidase antibody (TPOAb), and SCH with positive TPOAb. The association between the clinical classification and reduced TSH in LT4 supplemental replacement treatment was assessed. The results indicated that reduced TSH was significantly different among the groups according to the clinical classifications (p = 0.043). The result was also significantly different between patients with OH and patients with SCH and negative TPOAb (p = 0.036). Similar result was reported for the comparison between patients with OH and patients with SCH and positive TPOAb (p = 0.016). Multiple variable analyses showed that LT4 supplementation, gestational age and the variable of clinical classifications were associated with reduced TSH independently. Our data suggested that the therapeutic effect of substitutive treatment with LT4 was significantly associated with different clinical classifications of hypothyroidism in pregnancy and the treatment should begin as soon as possible after diagnosis.

  3. Comparison between transcatheter and surgical aortic valve replacement: a single-center experience.

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    Silberman, Shuli; Abu Akr, Firas; Bitran, Daniel; Almagor, Yaron; Balkin, Jonathan; Tauber, Rachel; Merin, Ofer

    2013-07-01

    A comparison was made of the outcomes after transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (AVR) in high-risk patients. All patients aged > 75 years that underwent a procedure for severe aortic stenosis with or without coronary revascularization at the authors' institution were included in the study; thus, 64 patients underwent TAVI and 188 underwent AVR. Patients in the TAVI group were older (mean age 84 +/- 5 versus 80 +/- 4 years; p < 0.0001) and had a higher logistic EuroSCORE (p = 0.004). Six patients (9%) died during the procedure in the TAVI group, and 23 (12%) died in the AVR group (p = 0.5). Predictors for mortality were: age (p < 0.0001), female gender (p = 0.02), and surgical valve replacement (p = 0.01). Gradients across the implanted valves at one to three months postoperatively were lower in the TAVI group (p < 0.0001). Actuarial survival at one, two and three years was 78%, 64% and 64%, respectively, for TAVI, and 83%, 78% and 75%, respectively, for AVR (p = 0.4). Age was the only predictor for late mortality (p < 0.0001). TAVI patients were older and posed a higher predicted surgical risk. Procedural mortality was lower in the TAVI group, but mid-term survival was similar to that in patients undergoing surgical AVR. Age was the only predictor for late survival. These data support the referral of high-risk patients for TAVI.

  4. Oral vitamin B12 replacement for the treatment of pernicious anaemia

    Directory of Open Access Journals (Sweden)

    Catherine Qiu Hua Chan

    2016-08-01

    Full Text Available Many patients with pernicious anaemia are treated with lifelong intramuscular vitamin B12 replacement. As early as the 1950s, there were studies suggesting that oral vitamin B12 replacement may provide adequate absorption. Nevertheless, oral vitamin B12 replacement in patients with pernicious anaemia remains uncommon in clinical practice. The objective of this review is to provide an update on the effectiveness of oral vitamin B12 for the treatment of pernicious anaemia, the recommended dosage and the required frequency of laboratory test and clinical monitoring. Relevant articles were identified by PubMed search from 1 January 1980 to 31 March 2016 and through hand search of relevant reference articles. Two randomised controlled trials, three prospective papers, one systematic review and three clinical reviews fulfilled our inclusion criteria. We found that oral vitamin B12 replacement at 1000mcg daily was adequate to replace vitamin B12 levels in patients with pernicious anaemia. We conclude that oral vitamin B12 is an effective alternative to vitamin B12 intramuscular injections. Patients should be offered this alternative after an informed discussion on the advantages and disadvantages of both treatment options.

  5. Oral Vitamin B12 Replacement for the Treatment of Pernicious Anemia.

    Science.gov (United States)

    Chan, Catherine Qiu Hua; Low, Lian Leng; Lee, Kheng Hock

    2016-01-01

    Many patients with pernicious anemia are treated with lifelong intramuscular (IM) vitamin B12 replacement. As early as the 1950s, there were studies suggesting that oral vitamin B12 replacement may provide adequate absorption. Nevertheless, oral vitamin B12 replacement in patients with pernicious anemia remains uncommon in clinical practice. The objective of this review is to provide an update on the effectiveness of oral vitamin B12 for the treatment of pernicious anemia, the recommended dosage, and the required frequency of laboratory test and clinical monitoring. Relevant articles were identified by PubMed search from January 1, 1980 to March 31, 2016 and through hand search of relevant reference articles. Two randomized controlled trials, three prospective papers, one systematic review, and three clinical reviews fulfilled our inclusion criteria. We found that oral vitamin B12 replacement at 1000 μg daily was adequate to replace vitamin B12 levels in patients with pernicious anemia. We conclude that oral vitamin B12 is an effective alternative to vitamin B12 IM injections. Patients should be offered this alternative after an informed discussion on the advantages and disadvantages of both treatment options.

  6. [Meta-analysis of internal fixation versus hip replacement in the treatment of trochanteric fractures].

    Science.gov (United States)

    Dong, Jian-Bin; Wang, Zhi-Yong; Lu, Hao; Tian, Yuan; Wang, Xin-Rui; Zhang, Zhi-Qiang

    2015-03-01

    To compare the efficacy of internal fixation (including PFNA and PFN) versus hip replacement (including FHR or THA) in the treatment of trochanteric fractures in adults. Reports of studies using randomized controlled trials (RCT) to compare internal fixationg with hip replacement in the management of intertrochanteric fractures were retrieved (up to January 1, 2013) from the Cochrane Library, PUBMED Data, CNKI (China National Knowledge infrastructure), Elsevier, the Chinese Biomedical Database, Wanfang Data, and manually. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software RevMan 5.0 was used for data-analysis. Seven articles were included in the meta-analysis. The results showed that,compared internal fixation with hip replacement,there were statistical significance in the duration of surgery time [WMD = -2.66, 95% CI (-5.25,-0.06), P = 0.05], intra-operative blood loss [WMD = -24.20, 95% CI (-30.38, -18.02), P 0.05]. CON- CLUSION: Hip replacement (containing FHR or THA) for the treatment of intertrochanteric fractures is superior to internal fixa- tion in regards to the duration of surgery time, the mean duration of hosipital stays, mean post-operative down time, intra-opera- tive blood loss, the rate of post-operative good Harris scores. But there is not enough evidence to show any difference between hip replacement (containing THA or FHR) and internal fixation in regards to the rate of deep venous thrombosis. However, internal fixation for the treatment of intertrochanteric fractures is superior to hip replacement (containing FHR or THA) in regards to total complications rate.

  7. Percutaneous tricuspid valve-In-ring replacement for the treatment of recurrent severe tricuspid regurgitation.

    Science.gov (United States)

    Condado, Jose; Leonardi, Robert; Babaliaros, Vasilis

    2015-12-01

    Percutaneous tricuspid valve-in-ring replacement can be an alternative to surgery for high-risk patients with symptomatic severe tricuspid regurgitation that recurs after surgical ring repair. Practitioners must pay attention to the specific technical details associated with this procedure that include: using the ring as a fluoroscopic landmark, sizing the valve area with multi-modality imaging, choosing the appropriate device based on the patients anatomy, and dealing with the inevitable paravalvular leak (created by the ring deformation in the absence of valve-specific devices). Our case demonstrates that percutaneous tricuspid valve-in-ring replacement is a feasible treatment that can result in both hemodynamic and symptomatic improvement.

  8. Long Term Treatment with Enzyme Replacement Therapy in Patients with Fabry Disease.

    Science.gov (United States)

    Oder, Daniel; Nordbeck, Peter; Wanner, Christoph

    2016-01-01

    Anderson-Fabry disease is a potentially life-threatening hereditary lysosomal storage disorder taking origin in over 1,000 known pathogenic mutations in the alpha-galactosidase A encoding gene. Over the past 15 years, intravenous replacement therapy of the deficient alpha agalsidase A enzyme has been well-established retarding the progression of a multisystemic disease and organ involvement. Despite this innovative treatment approach, premature deaths still do occur. The response to enzyme replacement therapy (ERT) varies considerably and appears to depend on gender, genotype (classic or later onset/non-classic), stage of disease or age and agalsidase inhibition by anti-agalsidase antibodies. Early ERT treatment at young age, a personalized approach, and adjunctive therapies for specific disease manifestations appear to impact on prognosis and are currently favored with the expectance of more effective intravenous and oral treatments in the short future.

  9. Algorithmic parameterization of mixed treatment comparisons

    NARCIS (Netherlands)

    van Valkenhoef, Gert; Tervonen, Tommi; de Brock, Bert; Hillege, Hans

    2012-01-01

    Mixed Treatment Comparisons (MTCs) enable the simultaneous meta-analysis (data pooling) of networks of clinical trials comparing a parts per thousand yen2 alternative treatments. Inconsistency models are critical in MTC to assess the overall consistency between evidence sources. Only in the absence

  10. Valves replacement operation in treatment of electrical storm induced by rheumatic valves disease

    Institute of Scientific and Technical Information of China (English)

    Zhenqiang Chen; Hui Zhang; Yang Zhao; Haiji Yang; Sheng'ai Ye; Liang Cheng; Ying Zhang

    2007-01-01

    Objective: To present a case of electrical storm (ES) in a female patient with rheumatic valve disease. Methods: A female patient with severe rheumatic valve disease suffered an unexpected ES. She received more than 50 electrical shocks for repeated cardiac arrests due to ES over 16 hours. Then she received beta-blocking agent treatment and had an operation of double valves replacement. Results: ES was suppressed by sympathetic blockade with beta-receptor blocker and finally disappeared after the double pathological valves had been replaced. Conclusion: Increased sympathetic activity plays an important role in the genesis of electrical storm and sympathetic blockade may effectively suppress ES. However, the most important thing in the treatment of ES is to identify and eliminate the underlying cause of ES.

  11. Biomechanical comparison of a two-level Maverick disc replacement with a hybrid one-level disc replacement and one-level anterior lumbar interbody fusion.

    Science.gov (United States)

    Erkan, Serkan; Rivera, Yamil; Wu, Chunhui; Mehbod, Amir A; Transfeldt, Ensor E

    2009-10-01

    Multilevel lumbar disc disease (MLDD) is a common finding in many patients. Surgical solutions for MLDD include fusion or disc replacement. The hybrid model, combining fusion and disc replacement, is a potential alternative for patients who require surgical intervention at both L5-S1 and L4-L5. The indications for this hybrid model could be posterior element insufficiency, severe facet pathology, calcified ligamentum flavum, and subarticular disease confirming spinal stenosis at L5-S1 level, or previous fusion surgery at L5-S1 and new symptomatic pathology at L4-L5. Biomechanical data of the hybrid model with the Maverick disc and anterior fusion are not available in the literature. To compare the biomechanical properties of a two-level Maverick disc replacement at L4-L5, L5-S1, and a hybrid model consisting of an L4-L5 Maverick disc replacement with an L5-S1 anterior lumbar interbody fusion using multidirectional flexibility test. An in vitro human cadaveric biomechanical study. Six fresh human cadaveric lumbar specimens (L4-S1) were subjected to unconstrained load in axial torsion (AT), lateral bending (LB), flexion (F), extension (E), and flexion-extension (FE) using multidirectional flexibility test. Four surgical treatments-intact, one-level Maverick at L5-S1, two-level Maverick between L4 and S1, and the hybrid model (anterior fusion at L5-S1 and Maverick at L4-L5) were tested in sequential order. The range of motion of each treatment was calculated. The Maverick disc replacement slightly reduced intact motion in AT and LB at both levels. The total FE motion was similar to the intact motion. However, the E motion is significantly increased (approximately 50% higher) and F motion is significantly decreased (30%-50% lower). The anterior fusion using a cage and anterior plate significantly reduced spinal motion compared with the condition (pMaverick disc prosthesis and the hybrid model in terms of all motion types at L4-L5 level (p>.05). The Maverick disc

  12. [Exposed infra-inguinal bypass: conservative treatment or in situ replacement].

    Science.gov (United States)

    Siat, J; Hirsch, J J; Fieve, G

    1996-01-01

    Infection or exposure of a infra-inguinal bypass is a severe complication which can lead to death or amputation. With conservative treatments, the bypass is left in situ or replaced with an autologous vein or an allograft. Results in a series of 393 consecutive conservative treatments for infra-inguinal revascularizations were analyzed retrospectively. Sixteen patients were studied and divided into 2 groups: Group 1 included 8 patients who had no bleeding or signs of infection and who were treated locally. Group II included 8 patients with bleeding or signs of infection in whom the bypass was replaced by an in situ autologous vein (n = 4) or an arterial allograft (n = 4). Mortality was 12.5% and the rate of amputation was 12.5%. These percentages are in agreement with reports from other authors who also propose this therapeutic option. Local treatment should be reserved for infection free of complications due to thrombosis, hemorrhage or signs of a septic syndrome. Other cases should benefit from in situ replacement with a vein or an arterial allograft. In some unsuccessful cases there are a few indications for extra-anatomic prosthetic bypasses.

  13. Comparison of in vivo and simulator-retrieved metal-on-metal cervical disc replacements

    Science.gov (United States)

    Kurtz, Steven M.; Ciccarelli, Lauren; Harper, Megan L.; Siskey, Ryan; Shorez, Jacob; Chan, Frank W.

    2012-01-01

    Background Cervical disc arthroplasty is regarded as a promising treatment for myelopathy and radiculopathy as an alternative to cervical spine fusion. On the basis of 2-year clinical data for the PRESTIGE® Cervical Disc (Medtronic, Memphis, Tennessee), the Food and Drug Administration recommended conditional approval in September 2006 and final approval in July 2007; however, relatively little is known about its wear and damage modes in vivo. The main objective was to analyze the tribological findings of the PRESTIGE® Cervical Disc. This study characterized the in vivo wear patterns of retrieved cervical discs and tested the hypothesis that the total disc replacements exhibited similar surface morphology and wear patterns in vitro as in vivo. Methods Ten explanted total disc replacements (PRESTIGE®, PRESTIGE® I, and PRESTIGE® II) from 10 patients retrieved after a mean of 1.8 years (range, 0.3–4.1 years) were analyzed. Wear testing included coupled lateral bending ( ±4.7°) and axial rotation ( ±3.8°) with a 49 N axial load for 5 million cycles followed by 10 million cycles of flexion-extension ( ±9.7°) with 148 N. Implant surfaces were characterized by the use of white-light interferometry, scanning electron microscopy, and energy dispersive spectroscopy. Results The explants generally exhibited a slightly discolored, elliptic wear region of varying dimension centered in the bearing center, with the long axis oriented in the medial-lateral direction. Abrasive wear was the dominant in vivo wear mechanism, with microscopic scratches generally oriented in the medial-lateral direction. Wear testing resulted in severe abrasive wear in a curvilinear fashion oriented primarily in the medial-lateral direction. All retrievals showed evidence of an abrasive wear mechanism. Conclusions This study documented important similarity between the wear mechanisms of components tested in vitro and explanted PRESTIGE® Cervical Discs; however, the severity of wear was

  14. Transcatheter Aortic Valve Replacement Versus Aortic Valve Bypass: A Comparison of Outcomes and Economics.

    Science.gov (United States)

    Brown, John W; Boyd, Jack H; Patel, Parth M; Baker, Mary L; Syed, Amjad; Ladowski, Joe; Corvera, Joel

    2016-01-01

    Transcatheter aortic valve replacement (TAVR) is currently offered to patients who are high-risk candidates for conventional surgical aortic valve replacement. For the past 37 years, off-pump aortic valve bypass (AVB) has been used in elderly patients at our center for this similarly high-risk group. Although TAVR and AVB were offered to similar patients at our center, comparisons of clinical outcomes and hospital economics for each strategy were not reported. We reviewed the clinical and financial records of 53 consecutive AVB procedures performed since 2008 with the records of 51 consecutive TAVR procedures performed since 2012. Data included demographics, hemodynamics, The Society of Thoracic Surgeons (STS) risk score, extent of coronary disease, and ventricular function. Follow-up was 100% in both groups. Hospital financial information for both cohorts was obtained. Mean risk score for the TAVR group was 10.1% versus 17.6% for AVB group (p < 0.001). Kaplan-Meier hospital rates of 3- and 6-month survival and of 1-year survival were 88%, 86%, 81%, and 61% and 89%, 83%, 83%, and 70% for the TAVR and AVB groups, respectively (p = 0.781). Two patients who had undergone TAVR had a procedure-related stroke. The one stroke in an AVB recipient was late and not procedure related. At discharge, mild and moderate perivalvular and central aortic insufficiency were present in 31% and 16% of TAVR recipients, respectively; no AVB valve leaked. Transvalvular gradients were reduced to less than 10 mm Hg in both groups. The average hospital length of stay for the AVB-treated patients was 13 days, and it was 9 days for the TAVR-treated patients. Median hospital charges were $253,000 for TAVR and $158,000 for AVB. Mean payment to the hospital was $65,000 (TAVR) versus $64,000 (AVB), and the mean positive contribution margin (profit) to the hospital was $14,000 for TAVR versus $29,000 for AVB. TAVR and AVB relieve aortic stenosis and have similar and acceptable procedural mortality

  15. Total Ankle Replacement for Treatment of End-Stage Osteoarthritis in Elderly Patients

    Science.gov (United States)

    Hintermann, Beat; Knupp, Markus; Zwicky, Lukas; Barg, Alexej

    2012-01-01

    End-stage osteoarthritis of the ankle is a disabling problem, particularly in elderly patients who experience an overall loss of mobility and functional impairment and who then need compensatory adaption. Ankle arthrodesis, which has been demonstrated to provide postoperative pain relief and hindfoot stability, leaves the patient with a stiff foot and gait changes. For elderly patient, these changes may be more critical than generally believed. Additionally, the long duration of healing and rehabilitation process needed for ankle arthrodesis may be problematic in the elderly. In contrast to ankle arthrodesis, total ankle replacement has significant advantages including a less strenuous postoperative rehabilitation and preservation of ankle motion which supports physiological gait. Recently, total ankle replacement has evolved as a safe surgical treatment in patients with end-stage ankle osteoarthritis with reliable mid- to long-term results. Total ankle replacement needs less immobilization than arthrodesis and does allow for early weight-bearing and should be considered as a treatment option of first choice in many elderly patients with end-stage osteoarthritis of the ankle, especially in elderly patients with lower expectations and physical demands. PMID:22720158

  16. Total Ankle Replacement for Treatment of End-Stage Osteoarthritis in Elderly Patients

    Directory of Open Access Journals (Sweden)

    Beat Hintermann

    2012-01-01

    Full Text Available End-stage osteoarthritis of the ankle is a disabling problem, particularly in elderly patients who experience an overall loss of mobility and functional impairment and who then need compensatory adaption. Ankle arthrodesis, which has been demonstrated to provide postoperative pain relief and hindfoot stability, leaves the patient with a stiff foot and gait changes. For elderly patient, these changes may be more critical than generally believed. Additionally, the long duration of healing and rehabilitation process needed for ankle arthrodesis may be problematic in the elderly. In contrast to ankle arthrodesis, total ankle replacement has significant advantages including a less strenuous postoperative rehabilitation and preservation of ankle motion which supports physiological gait. Recently, total ankle replacement has evolved as a safe surgical treatment in patients with end-stage ankle osteoarthritis with reliable mid- to long-term results. Total ankle replacement needs less immobilization than arthrodesis and does allow for early weight-bearing and should be considered as a treatment option of first choice in many elderly patients with end-stage osteoarthritis of the ankle, especially in elderly patients with lower expectations and physical demands.

  17. The treatment of hemophilia A: from protein replacement to AAV-mediated gene therapy.

    Science.gov (United States)

    Youjin, Shen; Jun, Yin

    2009-03-01

    Factor VIII (FVIII) is an essential component in blood coagulation, a deficiency of which causes the serious bleeding disorder hemophilia A. Recently, with the development of purification level and recombinant techniques, protein replacement treatment to hemophiliacs is relatively safe and can prolong their life expectancy. However, because of the possibility of unknown contaminants in plasma-derived FVIII and recombinant FVIII, and high cost for hemophiliacs to use these products, gene therapy for hemophilia A is an attractive alternative to protein replacement therapy. Thus far, the adeno-associated virus (AAV) is a promising vector for gene therapy. Further improvement of the virus for clinical application depends on better understanding of the molecular structure and fate of the vector genome. It is likely that hemophilia will be the first genetic disease to be cured by somatic cell gene therapy.

  18. The potential of sarcospan in adhesion complex replacement therapeutics for the treatment of muscular dystrophy.

    Science.gov (United States)

    Marshall, Jamie L; Kwok, Yukwah; McMorran, Brian J; Baum, Linda G; Crosbie-Watson, Rachelle H

    2013-09-01

    Three adhesion complexes span the sarcolemma and facilitate critical connections between the extracellular matrix and the actin cytoskeleton: the dystrophin- and utrophin-glycoprotein complexes and α7β1 integrin. Loss of individual protein components results in a loss of the entire protein complex and muscular dystrophy. Muscular dystrophy is a progressive, lethal wasting disease characterized by repetitive cycles of myofiber degeneration and regeneration. Protein-replacement therapy offers a promising approach for the treatment of muscular dystrophy. Recently, we demonstrated that sarcospan facilitates protein-protein interactions amongst the adhesion complexes and is an important potential therapeutic target. Here, we review current protein-replacement strategies, discuss the potential benefits of sarcospan expression, and identify important experiments that must be addressed for sarcospan to move to the clinic.

  19. Evaluation of impact of steroid replacement treatment on bone health in children with 21-hydroxylase deficiency.

    Science.gov (United States)

    Delvecchio, M; Soldano, L; Lonero, A; Ventura, A; Giordano, P; Cavallo, L; Grano, M; Brunetti, G; Faienza, M F

    2015-04-01

    There are conflicting data regarding the potential impact of chronic glucocorticoid (GC) therapy on the bone mineral density of patients with congenital adrenal hyperplasia (CAH). Previous studies performed by dual-energy X-ray absorptiometry reported conflicting results. The purpose of this study was to assess the impact of chronic GC replacement treatment in children with classical and non classical CAH due to 21-hydroxylase deficiency (21-OHD) by quantitative ultrasonometry (QUS), an easy, cheap, and radiation-free technique. The study population consisted of nineteen 21-OHD patients (nine males) on lifelong GC treatment. Anthropometric, hormonal, and treatment data were recorded for each patient, and bone quality was assessed by QUS measurements. QUS findings (amplitude-dependent speed of sound and bone transmission time) were normal in 21-OHD patients and did not correlate with duration of treatment, daily, total, and yearly hydrocortisone dose. Furthermore, no significant correlation was found between QUS findings and 17α-hydroxy progesterone, Δ4-androstenedione, and testosterone levels. In conclusion, our results provide reassurance that currently used replacement doses of GC do not have a major impact on bone in patients with CAH. QUS seems to be a reliable tool for screening of bone health in children with 21-OHD.

  20. On the selection of optimization parameters for an inverse treatment planning replacement of a forward planning technique for prostate cancer.

    Science.gov (United States)

    Hristov, Dimitre H; Moftah, Belal A; Charrois, Colette; Parker, William; Souhami, Luis; Podgorsak, Ervin B

    2002-01-01

    The influence of organ volume sampling, lateral scatter inclusion, and the selection of objectives and constraints on the inverse treatment planning process with a commercial treatment planning system is investigated and suitable parameters are identified for an inverse treatment planning replacement of a clinical forward planning technique for prostate cancer. For the beam geometries of the forward technique, a variable set of parameters is used for the calculation of dose from pencil beams. An optimal set is identified after the evaluation of optimized plans that correspond to different sets of pencil-beam parameters. This set along with a single, optimized set of objectives and constraints is used to perform inverse planning on ten randomly selected patients. The acceptability of the resulting plans is verified by comparisons to the clinical ones calculated with the forward techniques. For the particular commercial treatment planning system, the default values of the pencil beam parameters are found adequate for inverse treatment planning. For all ten patients, the optimized, single set of objectives and constraints results in plans with target coverage comparable to that of the forward plans. Furthermore inverse treatment planning reduces the overall mean rectal and bladder doses by 4.8% and 5.8% of the prescription dose respectively. The study indicates that (i) inverse treatment planning results depend implicitly on the sampling of the dose distribution, (ii) inverse treatment planning results depend on the method used by the dose calculation model to account for scatter, and (iii) for certain sites, a single set of optimization parameters can be used for all patient plans.

  1. Primary Clinical Evaluation of the Joint Replacement for the Treatment of the First Metatarsophalangeal Arthritis

    Institute of Scientific and Technical Information of China (English)

    Qi-yi Li; Jin Jin; Xi-sheng Weng; Jin Lin; Yi-dan Zhang; Gui-xing Qiu

    2011-01-01

    Objective To retrospectively assess the primary clinical results of a cohort of the first metatarsophalangeal joint replacement with double-stemmed hinge silicone implant. Methods A total of 12 patients (15 feet) received the joint replacement with double-stemmed hinge silicone implant. There were 2 males and 10 females with a mean age of 61.4 (range, 56-75) years old. Of them, 9 cases (11 feet) were hallux valgus with osteoarthritis; 1 case (2 feet) was rheumatic arthritis; 2 cases (2 feet) were traumatic arthritis. The subjective and objective results were evaluated during follow-up.Results All of the patients were followed up regularly with an average of 24.7 months, ranging from 12 to 38 months. Ten patients were completely satisfied with the operation; 1 patient showed partial satisfaction, and 1 patient was not satisfied because of the first matatarsophalangeal joint pain due to severe hyperosteogeny surrounding the cut bone surface 3 years after the operation. Osteolysis around the implant occurred in 2 cases without clinical symptoms, and no special treatment was given.Conclusion The joint replacement is a preferable method in alleviating pain and improving walking function with proper indication.

  2. Prosthetic replacement in treatment of subcapital femoral neck fractures in the elderly

    Institute of Scientific and Technical Information of China (English)

    徐莘香; 刘一; 刘建国; 李印良

    2002-01-01

    Objective: To compare the results of femoral head replacement (FHR) and total hip replacement (THR) in treatment of subcapital femoral neck fractures (SFNF).   Methods: Between May 1987 and July 1998, 56 elderly patients (65-90 years; average 73.5 years) with SFNF were treated with prosthetic replacement. Six cases were treated with unipolar FHR, 18 cases with Bateman bipolar FHR, and 32 cases with Bateman bipolar THR. All domestic prostheses were installed with cement.   Results: There was no significant difference between the 2 groups in operating time and blood transfusion. Forty-nine patients were followed-up for an average of 5 years and 10 months. No wound infection or death was related to surgery. Complications in Group FHR were significantly higher than that in Group THR.   Conclusions: Since FHR is difficult to fit the bony acetabulum, it is only indicated for senile cases with poor conditions. However, the bipolar THR installed with cement is indicated for most elderly patients. Since the femoral head and acetabulum can fit each other completely, it is more stable for taking weight-bearing earlier with less complications.

  3. Effect of candesartan treatment on left ventricular remodeling after aortic valve replacement for aortic stenosis

    DEFF Research Database (Denmark)

    Dahl, Jordi S; Videbaek, Lars; Poulsen, Mikael K

    2010-01-01

    In hypertension, angiotensin receptor blockers can augment regression of left ventricular (LV) hypertrophy. It is not known whether this also is the case after aortic valve replacement (AVR) for severe aortic stenosis (AS). To test the hypothesis that treatment with candesartan in addition...... to conventional treatment is able to augment LV and left atrial (LA) reverse remodeling in patients with AS undergoing AVR, we studied 114 patients scheduled for AVR. Patients were randomized to treatment with candesartan 32 mg 1 time/day or conventional therapy immediately after AVR. Patients were followed...... E/e' ratio or B-type natriuretic peptide. In conclusion, angiotensin receptor blockade with candesartan after AVR in patients with AS is associated with augmented reverse LV and LA remodeling compared to conventional management....

  4. 人工颈椎椎间盘置换与颈前路减压融合术治疗脊髓型颈椎病的疗效分析%Comparison of artifical cervical disc replacement versus anterior discectomy and fusion for the treatment of cervical spondylotic myelopathy

    Institute of Scientific and Technical Information of China (English)

    杨兴; 薛峰; 盛晓文; 彭育沁; 陈兵乾

    2012-01-01

    目的 比较人工颈椎椎间盘置换术与颈前路椎间盘切除减压植骨融合术(anterior cervical discectomy and fusion,ACDF)治疗脊髓型颈椎病的临床疗效.方法 回顾性分析本院收治的人工颈椎椎间盘置换术及ACDF治疗的脊髓型颈椎病病例.测量所有患者颈椎活动度(range of motion,ROM),置换节段及相邻节段的ROM,并行日本骨科学会(Japanese Orthopaedic Association,JOA)评分及Odom分级.结果 所有患者术后JOA评分和Odom功能评定均得到显著改善.置换组术后颈椎ROM、置换节段及其邻近间隙平均ROM无明显改变,差异无统计学意义(P>0.05).ACDF组患者中,术后颈椎ROM显著减小,邻近间隙ROM明显增大,差异有统计学意义(P<0.05).置换组术后邻近节段的ROM明显小于ACDF组,差异有统计学意义(P<0.01).结论人工颈椎椎间盘置换术能保持颈椎ROM,避免邻近节段退变,早、中期疗效满意,远期效果尚有待临床进一步研究.%Objective To compare the clinical outcome of artifical cervical disc replacement versus anterior cervical discectomy and fusion ( ACDF ) in the treatment of cervical spondylotic myelopathy. Methods A total of 50 cases of cervical spondylotic myelopathy treated by artifical cervical disc replacement ( n = 20 ) or ACDF ( n = 30 ) were involved. Among these cases , the range of motion ( ROM ) of the cervical vertebra, the implanted level and the adjacent segment were measured. The Japanese Orthopaedic Association ( JOA ) score and Odom' s grade were record and analyzed. Results All of these patients were followed-up, and JOA score and Odom' s grade of all patients were significantly improved. The ROM of the cervical vertebrae, the implanted levels and the adjacent segments were preserved in artifical cervical disc replacement group ( P >0. 05 ). In the ACDF group, the ROM of the cervical vertebrae decreased, but the adjacent segments of the fusion segment compensatory increased remarkably( P 0

  5. Comments to guidelines for the treatment of hypothyroidism prepared by the American thyroid association task force on thyroid hormone replacement

    Directory of Open Access Journals (Sweden)

    Valentin Viktorovich Fadeev

    2015-02-01

    Full Text Available The article is dedicated to the discussion about to guidelines for the treatment of hypothyroidism prepared by the American thyroid association task force on thyroid hormone replacement.

  6. Comparison of outcomes after aortic valve replacement with a mechanical valve or a bioprosthesis using microsimulation

    NARCIS (Netherlands)

    J.P.A. Puvimanasinghe (John); M.B. Edwards; M.J.C. Eijkemans (René); E.W. Steyerberg (Ewout); L.A. van Herwerden (Lex); K.M. Taylor; G.L. Grunkemeier (Gary); J.D.F. Habbema (Dik); A.J.J.C. Bogers (Ad); J.J.M. Takkenberg (Hanneke)

    2004-01-01

    textabstractBACKGROUND: Mechanical valves and bioprostheses are widely used for aortic valve replacement. Though previous randomised studies indicate that there is no important difference in outcome after implantation with either type of valve, knowledge of outcomes after aortic va

  7. Comparison of loess and purple rill erosions measured with volume replacement method

    Science.gov (United States)

    Chen, Xiao-yan; Huang, Yu-han; Zhao, Yu; Mo, Bin; Mi, Hong-xing

    2015-11-01

    Rills are commonly found on sloping farm fields in both the loess and the purple soil regions of China. A comparative study on rill erosion between the two soils is important to increase research knowledge and exchange application experiences. Rill erosion processes of loess and purple soils were determined through laboratory experiments with the volume replacement method. Water was used to refill the eroded rill segments to compute eroded volume before sediment concentration distribution along the rill was computed using the soil bulk density, flow rate, and water flow duration. The experimental loess soil materials were from the Loess Plateau and purple soil from the southwestern part of China, Chongqing City. A laboratory experimental platform was used to construct flumes to simulate rills with 12.0 m length, 0.1 m width, and 0.3 m depth. Soil materials were filled into the flumes at a bulk density of 1.2 g cm-3 to a depth of 20 cm to form rills for experiments on five slope gradients (5°, 10°, 15°, 20°, and 25°) and three flow rates (2, 4, and 8 L/min). After each experimental run under the given slope gradient and flow rate, the rill segments from the upper slope between 0-0.5, 0.5-1, 1-2, 2-3, …, 7-8, 8-10, and 10-12 m were lined with plastic sheets before be re-filled with water to determine sediment concentration after the eroded volumes was measured. Rill erosion differed between the two soils. As purple soil started to erode at a higher erosive force than loess soil, it possibly exhibits higher resistance to water erosion. The subsequent erosion process in the eroding purple rill was similar to that in the loess rill. However, the total erosion in the eroding loess rill was more than that in the eroding purple rill. The maximum sediment concentration transported by the eroding purple rills was significantly lower, approximately 55% of those transported by the loess rills under the same flow rate and slope gradient. Hence, less purple sediments can

  8. Comparison of IAS 39 and IFRS 9: The Analysis of Replacement

    Directory of Open Access Journals (Sweden)

    Mojca Gornjak

    2017-06-01

    Full Text Available The financial crisis had an impact on international financial reporting standards. The International Accounting Standards Board (IASB prepared a new standard for financial instruments. The replacement changes the view to accounting data in financial statements and changes the view to data in organizations, especially banks, and financial institutions. Historical prices are replaced with expectation in the future, which is not anymore a decision of the managers but has its basis on business operations.

  9. Comparison the efficacy of minimally invasive and conventional incision in artificial hip replacement for treatment of femoral neck fracture in elderly%快捷小切口与常规切口人工髋关节置换术治疗老年股骨颈骨折的疗效对比

    Institute of Scientific and Technical Information of China (English)

    李军民; 肖信约; 张伟; 任云峰; 贾福; 张仲子; 吴中雄; 宣靖; 杨正宗

    2012-01-01

    Objective To compare the efficacy of the minimally invasive incision and conventional incision in artificial hip replacement for treatment of femoral neck fracture in elderly. Methods All of 240 old patients with displaced femoral neck fracture were randomly divided into four groups, the minimally invasive incision total hip replacement group, the conventional incision total hip replacement group, the minimally invasive incision femoral head arthroplasty group, and the conventional incision femoral head arthroplasty group, 60 cases each. Then each group underwent statistical analysis, for incision length, operation time, the amount of blooding, postoperative drainage volume,activity time and Harris score after operation. Results There was statistically significant difference in incision length, operation time, the amount of blooding, postoperative drainage volume and activity time between the minimally invasive incision total hip replacement group and conventional incision group (P 0.05). There was statistically significant difference in incision length, operation time, the amount of blooding, postoperative drainage volume and activity time between the minimally invasive incision femoral head arthroplasty group and conventional incision group (P 0.05). The efficacy of minimally invasive incision group was better than conventional incision group. Conclusion The minimally invasive incision hip arthroplasty has the advantages of minimal incision, short operation time, less trauma, little scar, quicker recovery. It is an ideal method for treatment of displaced femoral neck fracture in elderly.%目的 对比快捷小切口与常规切口行人工髋关节置换治疗老年股骨颈骨折的临床疗效.方法 将240例老年移位股骨颈骨折随机分为全髋置换小切口组、全髋置换常规切口组、半髋置换小切口组、半髋置换常规切口组(各60例).对每组切口长度、手术时间、出血量、术后引流量、下地活动时间、术

  10. [Hormone replacement and selective estrogen receptor modulators (SERMS) in the prevention and treatment of postmenopausal osteoporosis].

    Science.gov (United States)

    Pfeilschifter, J

    2001-07-01

    For many years, hormone replacement therapy (HRT) has been regarded as one of the most reliable means of prophylaxis and treatment for postmenopausal osteoporosis. As HRT ameliorates menopausal symptoms, it is widely prescribed among early postmenopausal women. A variety of different modes of replacement that suit each individual requirement are available in terms of schedule (cyclic or combined application of gestagens) and route of application (oral or transdermal). HRT effectively prevents spinal bone loss and delays bone loss at the hip up to a very old age. With continued use after menopause, HRT might theoretically halve the incidence of vertebral and hip fractures. However, long-term use or use of HRT in old age is rarely practiced, and the actual benefit of a transient use for future fracture prevention remains unclear. Raloxifene is the first member of the novel class of selective estrogen receptor modulators (SERMs) that has been approved for the prophylaxis and treatment of postmenopausal osteoporosis. It combines the positive effects of estrogen on the skeleton with estrogen-antagonistic effects on sex tissues. Thus, raloxifene maintains bone mass and decreases the incidence of vertebral fractures in osteoporotic women, but avoids many of the side effects that are responsible for the poor long-term compliance to HRT such as resumption or continuation of regular menses, breast tenderness, or breast cancer. It even markedly reduces the risk of breast cancer. Both estrogen and raloxifene are characterized by a large number of extraskeletal effects that have to be taken into account when counseling postmenopausal women on the use of these agents for the prevention or treatment of osteoporosis.

  11. [Treatment of acute renal failure--concepts and controversies. 2. Extracorporeal renal replacement and peritoneal dialysis].

    Science.gov (United States)

    Gabriel, A; Müller, E; Tarnow, J

    2001-04-01

    Therapy of prolonged acute renal failure regularly requires a renal replacement therapy. This can be achieved by different extracorporal renal replacement therapies (ERRT) or by peritoneal dialysis. ERRT are classified according to the physical principle underlying toxin elimination as hemodialysis (diffusion) and hemofiltration (convection). Another classification refers to intermittent or continuous application modes. Biocompatibility of membranes is judged according to their activation of the complement system. Prospective randomized studies did not consolidate the assumptions about the benefit of particular modalities proposed on theoretical foundations. Mortality, duration and complication rates of acute renal failure are not significantly decreased by use of biocompatible membranes. Continuous modalities are not generally preferable but optimize treatment in hemodynamically unstable patients, in whom they endorse fluid balancing and maintenance of sufficient arterial blood pressure. The use of demanding hemofiltration techniques for cytokine removal should be limited to clinical studies. The effects of ERRT-"intensity" and the best timing for initiation of ERRT have not been evaluated sufficiently. The choice of the ERRT modality is subject to clinical judgement (criterion: hemodynamic situation), practical aspects (criteria: availability of equipment and handling experience), and costs. Prior to their general use new and expensive technical modalities and membrane types should be thoroughly evaluated in studies with regard to outcome-related aspects such as patient survival and preservation of renal function.

  12. Gambling Disorder during Dopamine Replacement Treatment in Parkinson’s Disease: A Comprehensive Review

    Directory of Open Access Journals (Sweden)

    Domenico Pirritano

    2014-01-01

    Full Text Available Gambling Disorder (GD is characterized by “the failure to resist gambling impulses despite severe personal, family or occupational consequences”. In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V, GD replaces the DSM-IV diagnosis of Pathological Gambling (PG. GD estimated prevalence ranges between 0.4% and 3.4% within the adult population and it seems to be more common in patients with Parkinson’s disease (PD. In this population, GD recently has become more widely recognized as a possible complication of dopamine agonist (DA therapy. This association has aroused great interest for the dramatic impact GD has on patients’ quality of life. Management of PG in patients with PD could be demanding. It is based on patient and caregiver education, modification of dopamine replacement therapy, and in some cases psychoactive drug administration. In this review article, the authors provide an overview of GD pathogenesis during DA therapy as well as a summary of available treatment options.

  13. Web-based Behavioral Treatment for Substance Use Disorders as a Partial Replacement of Standard Methadone Maintenance Treatment

    Science.gov (United States)

    Marsch, Lisa A.; Guarino, Honoria; Acosta, Michelle; Aponte-Melendez, Yesenia; Cleland, Charles; Grabinski, Michael; Brady, Ronald; Edwards, Joyce

    2013-01-01

    This study is the first experimental trial to evaluate the effectiveness of a web-based behavioral intervention when deployed in a model where it partially substituted for standard counseling in a community-based specialty addiction treatment program. New opioid-dependent intakes in methadone maintenance treatment (n=160) were randomly assigned for 12 months to either: (1) standard treatment or (2) reduced standard treatment plus a web-based psychosocial intervention, the Therapeutic Education System (TES). Results demonstrated that replacing a portion of standard treatment with TES resulted in significantly greater rates of objectively measured opioid abstinence (48% vs. 37% abstinence across all study weeks; F(1,158)=5.90, p<.05 and 59% vs. 43% abstinence on weeks participants provided urine samples for testing; F(1,158)=8.81, p<.01). This result was robust and was evident despite how opioid abstinence was operationally defined and evaluated. The potential implications for service delivery models within substance abuse treatment programs and other healthcare entities are discussed. PMID:24060350

  14. 植物雌激素与激素替代疗法治疗围绝经期综合征的疗效比较%Comparison of effect of Phytoestrogens and Hormone Replacement Therapy in the treatment of Perimenopaus-al Syndrome

    Institute of Scientific and Technical Information of China (English)

    张新容; 张晓颜; 赖坚

    2015-01-01

    目的:探讨植物雌激素治疗围绝经期综合征的临床疗效及其作用机制,比较植物雌激素与激素替代疗法治疗围绝经期综合征的临床疗效。方法:将180例围绝经期综合征患者按照就诊顺序随机分成 A、B 两组,分别运用大豆异黄酮和激素替代疗法进行治疗,应用 Kupper - man 症状评分标准判定临床疗效,并抽血检测治疗前后患者血清 E2、FSH、LH、P、AKP、TC、TG等各项指标,进行治疗前后对照观察。结果:经4个周期治疗后,患者的相关症状得到明显改善;与治疗前相比,Kupperman 评分显著下降,差异具有统计学意义(P ﹤0.01);与治疗前相比,治疗后两组患者的 E2、P 均明显升高,而 FSH、LH、AKP、TC、TG 均明显降低,且差异具有统计学意义(P ﹤0.05);两组间疗效差异无统计学意义(P ﹥0.05)。结论:植物雌激素能够有效改善围绝经期综合征的临床症状,调节围绝经期综合征患者体内激素水平,且疗效与激素替代疗法无显著性差异。植物雌激素还对绝经期及绝经后期妇女的心血管有保护作用,并可预防骨质疏松,防止骨量丢失。%Objective To investigate the phytoestrogen treatment of perimenopausal syndrome clinical efficacy and mechanism of ac-tion,compare phytoestrogens and hormone replacement therapy for perimenopausal syndrome clinical efficacy. Method 180 patients with perimenopausal syndrome were randomly divided into A and B groups according to treatment order,namely the use of soy isoflavones and hormone replacement therapy for treatment,application Kupper - man symptom score determines the clinical efficacy and treatment of blood testing the indicators before and after the patient serum E2、FSH、LH、P、AKP、TC、TG,were observed before and after treatment con-trol. Results After 4 cycles of therapy,the patient's symptoms improved significantly. Compared with before

  15. A comparison of conventional and geostatistical methods to replace clouded pixels in NOAA-AVHRR images

    NARCIS (Netherlands)

    Addink, E.A.; Stein, A.

    1999-01-01

    The potential of using National Oceanic and Atmospheric Administration (NOAA) Advanced Very High Resolution Radiometer (AVHRR) images for large areas is often limited by cloud cover. It could be increased when small clouds are replaced by estimated reflection and emission values. In this study seven

  16. A Comparison of Fire Intensity levels for stand replacement of table mountain pine (Pinus pungens Lamb.)

    Science.gov (United States)

    Thomas A. Waldrop; Patrick H. Brose

    1999-01-01

    Stand-replacement prescribed fire has been recommended to regenerate stands of table mountain pine (Pinus pungens Lamb.) in the Southern Appalachian Mountains because the species has serotinous cones and is shade intolerant. A 350 ha prescribed fire in northeast Georgia provided an opportunity to observe overstory mortality and regeneration of table...

  17. A comparison of fatigue resistance of three materials for cusp-replacing adhesive restorations.

    NARCIS (Netherlands)

    Kuijs, R.H.; Fennis, W.M.M.; Kreulen, C.M.; Roeters, F.J.M.; Verdonschot, N.J.J.; Creugers, N.H.J.

    2006-01-01

    OBJECTIVES: To investigate the fatigue resistance and failure behaviour of cusp-replacing restorations in premolars using different types of adhesive restorative materials. METHODS: A class 2 cavity was prepared and the buccal cusp was removed in an extracted sound human upper premolar. By using a c

  18. Increased body mass index is a predisposition for treatment by total hip replacement

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig

    2005-01-01

    We investigated the radiological and epidemiological data of 4,151 subjects followed up from 1976 to 2003 to determine individual risk factors for hip osteoarthritis (OA), hip pain and/or treatment by total hip replacement (THR). Pelvic radiographs recorded in 1992 were assessed for evidence of hip......-joint degeneration and dysplasia. Sequential body mass index (BMI) measurements from 1976 to 1992, age, exposure to daily lifting and hip dysplasia were entered into logistic regression analyses. The prevalence of hip dysplasia ranged from 5.4% to 12.8% depending on the radiographical index used. Radiological hip OA...... prevalence was 1.0--2.5% in subjects subjects >or=60 years of age. While radiological OA was significantly influenced by hip dysplasia in men and hip dysplasia and age in women, the risk of THR being performed was only influenced by BMI assessed in 1976. Hip...

  19. Increased body mass index is a predisposition for treatment by total hip replacement

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Sonne-Holm, Stig

    2005-01-01

    We investigated the radiological and epidemiological data of 4,151 subjects followed up from 1976 to 2003 to determine individual risk factors for hip osteoarthritis (OA), hip pain and/or treatment by total hip replacement (THR). Pelvic radiographs recorded in 1992 were assessed for evidence of hip......-joint degeneration and dysplasia. Sequential body mass index (BMI) measurements from 1976 to 1992, age, exposure to daily lifting and hip dysplasia were entered into logistic regression analyses. The prevalence of hip dysplasia ranged from 5.4% to 12.8% depending on the radiographical index used. Radiological hip OA...... prevalence was 1.0--2.5% in subjects or=60 years of age. While radiological OA was significantly influenced by hip dysplasia in men and hip dysplasia and age in women, the risk of THR being performed was only influenced by BMI assessed in 1976. Hip...

  20. Levothyroxine liquid solution versus tablet form for replacement treatment in pregnant women.

    Science.gov (United States)

    Cappelli, Carlo; Negro, Roberto; Pirola, Ilenia; Gandossi, Elena; Agosti, Barbara; Castellano, Maurizio

    2016-01-01

    To evaluate the need and the magnitude of levothyroxine (LT4) increase in hypothyroid pregnant women on liquid compared to tablet formulations. Patients were recruited by searching our "thyroid patients" database. The selection criteria were as follows: a) pregnant women on treatment for hypothyroidism (both liquid and tablet LT4) who gave birth at our hospital between February 2012 and January 2014; b) thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels obtained at least 3 months before missed menstrual cycle, with a TSH value less than 2.5 mIU/L and c) TSH and FT4 obtained within 12 weeks of pregnancy, and each month subsequently. During pregnancy, 8/31 (25.5%) of the women had to increase the dosage of LT4. Of these, 7/17 (41.2%) were on LT4 replacement therapy with tablets, and 1/14 (7.1%) with liquid formulation (p = 0.038). Daily LT4 was significantly increased in the liquid group only (52.9 ± 19.5 versus 67.5 ± 19.2 mcg/day (p = 0.013). A logistic regression analysis showed that the treatment with LT4 tablets was the only predictor of LT4 increase (OR: 0.44; 95% CI: 0.04-0.83; p = 0.031). Pregnant women on optimal replacement therapy before pregnancy require an increase of LT4 dosage more often when on a tablet than liquid formulation.

  1. Arthroscopic treatment of patients with moderate arthrofibrosis after total knee replacement.

    Science.gov (United States)

    Jerosch, Joerg; Aldawoudy, Akram M

    2007-01-01

    The purpose of this study was to document the effect of arthroscopic management in patients with knee stiffness after total knee replacement. We present a case series study, in which 32 patients have been treated for moderate arthrofibrosis of the knee after total knee replacement, with the same regimen. We have excluded all cases of stiffness, because of infection, mechanical mal-alignment, loosening of the implants and other obvious reasons of stiffness of the knee, rather than pure arthrofibrosis. All patients first underwent a trial of conservative treatment before going for arthroscopic management. A pain catheter for femoral nerve block was inserted just before anesthesia for post-operative pain management. Arthroscopic arthrolysis of the intra-articular pathology was performed in a standardized technique with release of all fibrous bands in the suprapatellar pouch, reestablishing the medial and lateral gutter, release of the patella, resection of the remaining meniscal tissue or an anterior cyclops, if needed. Intensive physiotherapy and continuous passive motion were to start immediately post-operatively. All the patients were available for the follow up and they were evaluated using the knee society rating system. A total of 25 of the 32 procedures resulted in an improvement of the patients knee score. All the knees operated upon had intra-articular fibrous bands, hypertrophic synovitis and peri-patellar adhesions. A total of eight patients suffered from an anterior cyclops lesion and six patients showed pseudomenicus. In 19 cases a medial and lateral relapse of the patella was performed; only 5 patients got an isolated lateral release. The mean knee flexion was 119 degrees (100-130) at the end of arthroscopy and was 97 degrees (75-115) at the last follow up. The eight patients with extension lags decreased from 27 degrees (10 degrees-35 degrees) pre-operatively to 4 degrees (0-10) at time of follow up. The average knee society ratings increased from 70

  2. The use of oral replacement solutions in the treatment of choleraand other severe diarrhoeal disorders.

    Science.gov (United States)

    Sack, R B; Cassells, J; Mitra, R; Merritt, C; Butler, T; Thomas, J; Jacobs, B; Chaudhuri, A; Mondal, A

    1970-01-01

    Despite the progress that has been made in the treatment of cholera, mortality rates from this disease remain high in rural areas where intravenous fluids are not readily available. The authors have therefore conducted controlled studies into the efficacy of a simpler form of maintenance therapy-the administration of glucose-containing electrolyte solutions by mouth. The results obtained from the study of 51 adult patients (36 with cholera and 15 with severe non-cholera diarrhoea) indicate that oral fluids are adequate for maintenance therapy in cholera and severe diarrhoeal disease, and that there is no significant increase in the duration of diarrhoea or in the stool volume in patients receiving such therapy.The addition of a non-specific adsorbent, charcoal, to the fluid led to a significant increase in the volume of diarrhoeal stools and to prolongation of vibrio excretion; its use is therefore not recommended. The use of oral replacement solutions should result in improvement of cholera treatment of adults in rural areas and in a reduction in the cost of treatment.

  3. Replacement of chemical oxygen demand (COD) with total organic carbon (TOC) for monitoring wastewater treatment performance to minimize disposal of toxic analytical waste.

    Science.gov (United States)

    Dubber, Donata; Gray, Nicholas F

    2010-10-01

    Chemical oxygen demand (COD) is widely used for wastewater monitoring, design, modeling and plant operational analysis. However this method results in the production of hazardous wastes including mercury and hexavalent chromium. The study examined the replacement of COD with total organic carbon (TOC) for general performance monitoring by comparing their relationship with influent and effluent samples from 11 wastewater treatment plants. Biochemical oxygen demand (BOD5) was also included in the comparison as a control. The results show significant linear relationships between TOC, COD and BOD5 in settled (influent) domestic and municipal wastewaters, but only between COD and TOC in treated effluents. The study concludes that TOC can be reliably used for the generic replacement of both COD (COD=49.2+3.00*TOC) and BOD5 (BOD5=23.7+1.68*TOC) in influent wastewaters but only for COD (COD=7.25+2.99*TOC) in final effluents.

  4. Comparison of total ankle replacement and ankle arthrodesis in patients with haemophilia using gait analysis: two case reports

    OpenAIRE

    Dauty, Marc; Gross, Raphael; Leboeuf, Fabien; Trossaert, Marc

    2015-01-01

    Background Severe hemophilia is an inherited, lifelong bleeding disorder characterized by spontaneous bleeding, which results in painful joint deformities. Currently two surgical treatments are available to treat haemophilia-related ankle joint destruction: ankle arthrodesis and total ankle replacement. The aim of the present study was to compare these two surgical procedures in haemophiliac subjects. Case presentation Kinematic and dynamic parameters were quantified using a three-dimensional...

  5. Antimicrobial Doses in Continuous Renal Replacement Therapy: A Comparison of Dosing Strategies

    OpenAIRE

    Anna P. Kempke; Leino, Abbie S.; Farzad Daneshvar; John Andrew Lee; Mueller, Bruce A.

    2016-01-01

    Purpose. Drug dose recommendations are not well defined in patients undergoing continuous renal replacement therapy (CRRT) due to limited published data. Several guidelines and pharmacokinetic equations have been proposed as tools for CRRT drug dosing. Dose recommendations derived from these methods have yet to be compared or prospectively evaluated. Methods. A literature search of PubMed, Micromedex, and Embase was conducted for 40 drugs commonly used in the ICU to gather pharmacokinetic dat...

  6. A comparison of tooth retention and replacement across 15 countries in the over-50s.

    Science.gov (United States)

    Stock, Christian; Jürges, Hendrik; Shen, Jing; Bozorgmehr, Kayvan; Listl, Stefan

    2016-06-01

    Oral diseases are still among the most common chronic diseases globally with substantial detrimental impact especially on elderly people's health and well-being. However, limited evidence exists on international variation in the oral health status of the older population. We aimed to examine international variation in tooth loss and tooth replacement in the general population aged between 50 and 90 years. A cross-sectional analysis of data from the fifth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) was conducted. The data cover 14 European countries (Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Italy, Luxembourg, the Netherlands, Slovenia, Spain, Sweden, and Switzerland) and Israel, and they were collected during the year 2013. Age-specific percentages of the population having all natural teeth, the age-specific numbers of natural (and artificial) teeth, and the age-specific percentages of full, partial, or no replacement of missing teeth were assessed with stratification by country. It was further evaluated to which extent proposed oral health goals concerning tooth loss at higher ages had been achieved. In total, 62,763 individuals were included in the study. Age-standardized mean numbers of natural teeth exhibited substantial variation, ranging from 14.3 (Estonia) to 24.5 (Sweden). The oral health goal of retaining at least 20 teeth at age 80 years was achieved by 25% of the population or less in most countries. A target concerning edentulism (≤15% in population aged 65-74 years) was reached in Sweden, Switzerland, Denmark, France, and Germany. Tooth replacement practices varied especially for a number of up to five missing teeth which were more likely to be replaced in Austria, Germany, Luxembourg, and Switzerland than in Israel, Denmark, Estonia, Spain, and Sweden. This study suggests that the age-specific number of natural teeth and the practice of tooth replacement in the over 50s differ substantially among

  7. Analysis of prosthetic replacement in treatment of femoral neck fracture on the hemiplegia side in the elderly

    Institute of Scientific and Technical Information of China (English)

    冯明利; 沈惠良; 胡怀健; 雍宜民; 曹立; 王玮

    2004-01-01

    Objective: To study the effect of prosthetic replacement in treatment of femoral neck fractures on the hemiplegia side in the elderly.Methods: From May 1990 to May 2000, 189 elderly patients with femoral neck fractures were treated with prosthetic replacement in my hospital. Twenty-nine hemiplegia patients, who suffered from stroke previously,had Garden type Ⅲ and type Ⅳ femoral neck fractures on the hemiplegia side. Thirty non-hemiplegia patients were chosen randomly. The two groups were followed-up for 27-98 months (average: 59 months). The age, hospitalization days, operating time, blood loss, blood transfusion,complications during perioperative period and long-term complications were compared between the two groups and the results of femoral head replacement and total hip replacement in the hemiplegia group were also compared.Results: All the patients of the two groups survived the perioperative period. No significant difference was found in the age, hospitalization days, operation time,blood loss and blood transfusion and long-term complications between the two groups ( P > 0.05 ). However there was significant difference in complications during perioperative period between the two groups ( P < 0.05 ).Five patients died in the hemiplegia group with the mortality of 17.2% and two died in the non-hemiplegia group with the mortality of 6.7 % 11 months to 5 years after operation. There was significant difference in long-term complications between the femoral head replacement and the total hip replacement in the hemiplegia group (P <0.05). The result of the total hip replacement was better than that of the femoral head replacement.Conclusions: Prosthetic replacement is a reliable method in treatment of Garden type Ⅲ and type Ⅳfemoral neck fractures on the hemiplegia side in the elderly,and patients are safe during perioperative period. More complications during perioperative period occur in the hemiplegia group, and long-term complications are

  8. Comparison of discharge silver concentrations from electrolytic plating and metallic replacement silver recovery units.

    Science.gov (United States)

    Harper, Martin; Siegel, Julie M

    2003-04-01

    Silver-based photographic X-ray film is made of solid crystals of silver chloride or silver bromide suspended in a gelatin and then coated on a film. During the X-ray developing process, the image is processed and the nonimage areas containing solid silver chloride or silver bromide crystals are removed in a solution called the fixer. There may be local environmental regulations that regulate the amount of silver discharged from a facility. To meet these regulations, many facilities have added silver recovery units to their processes. Two different types of recovery processes are in use in a large hospital and three clinics under study. All of the units were claimed by their respective manufacturers to be able to recover silver down to concentrations of 5 mg/L. This concentration would ensure that the building that houses each unit would meet the local county limit of 0.5 mg/L silver for total building silver discharge. The hypothesis for this research is that one system, newer and more expensive, consisting of so-called electrolytic plating units (EPUs) (which are followed by so-called metallic replacement units [MRUs] as a backup), will have better silver recovery than MRUs alone. A total of six units were sampled, three EPUs (in combination with MRUs) and three MRUs. The units were sampled once or twice a day for 10 days for a total of 17 samples from each. The samples then were analyzed by inductively coupled plasma spectroscopy, and an analysis of variance was performed on the results. The range for the electrolytic plating unit/metallic replacement unit combinations was 0.20-99.9 mg/L (mean of 35.15 mg/L; median of 33.8 mg/L). The range for the MRUs alone was 7.2-1112 mg/L (mean of 565.5 mg/L; median of 720 mg/L). Many individual results exceeded 5 mg/L, such that extensive dilution would be required to ensure the building effluent did not exceed 0.5 mg/L. It is suggested that the metallic replacement units be changed to EPUs (with metallic replacement backup

  9. [Comparison of therapeutic effects between patella replacement and patella osteotomy in total knee arthroplasty: a case-control study].

    Science.gov (United States)

    Tang, Xiao-Bo; Dong, Pei-Long; Wang, Jian

    2014-04-01

    that in the patella osteotomy group. Total knee arthroplasty with patella replacement or patella osteotomy dramatically relieves pain and improves the knee function. Patella-related complications are associated with its treatment methods, but post-operative anterior knee pain and patient's satisfaction are not related to treatment methods of the patella.

  10. Total hip replacement as primary treatment of unstable intertrochanteric fractures in elderly patients.

    Science.gov (United States)

    Sidhu, Amarjit Singh; Singh, Ajay Pal; Singh, Arun Pal; Singh, Sukhraj

    2010-08-01

    Fifty-three patients with A2.2 and A2.3 intertrochanteric fracture according to the Muller classification were treated with total hip replacement between April 2000 and February 2004. The average age of the patients was 77 years. Average follow-up period was 3.7 years. We studied postoperative complications, mortality rate, functional outcome using the Harris hip score, time to return to normal activities, and radiographic evidence of healing. Two patients died on the third and fifth postoperative days. Seven more patients died within one year. The Harris hip score at one month was 66 +/- 7 (mean +/- standard deviation); at three months 72 +/- 6; at one year 74 +/- 5; at three years 76 +/- 6 and in the 27 patients who completed five year follow-up it was 76 +/- 8. Mobilisation and weight-bearing was started immediately in the postoperative period. Average time taken to return to normal daily activities was 28 days (range 24-33). No loosening or infection of the implants was observed. Total hip arthroplasty is a valid treatment option for mobile and mentally healthy elderly patients with intertrochanteric fractures. This procedure offers quick recovery with little risk of mechanical failure, avoids the risks associated with internal fixation and enables the patient to maintain a good level of function immediately after surgery.

  11. Enzyme replacement therapy in newborn mucopolysaccharidosis IVA mice: early treatment rescues bone lesions?

    Science.gov (United States)

    Tomatsu, Shunji; Montaño, Adriana M; Oikawa, Hirotaka; Dung, Vu Chi; Hashimoto, Amiko; Oguma, Toshihiro; Gutiérrez, Monica L; Takahashi, Tatsuo; Shimada, Tsutomu; Orii, Tadao; Sly, William S

    2015-02-01

    We treated mucopolysaccharidosis IVA (MPS IVA) mice to assess the effects of long-term enzyme replacement therapy (ERT) initiated at birth, since adult mice treated by ERT showed little improvement in bone pathology [1]. To conduct ERT in newborn mice, we used recombinant human N-acetylgalactosamine-6-sulfate sulfatase (GALNS) produced in a CHO cell line. First, to observe the tissue distribution pattern, a dose of 250units/g body weight was administered intravenously in MPS IVA mice at day 2 or 3. The infused enzyme was primarily recovered in the liver and spleen, with detectable activity in the bone and brain. Second, newborn ERT was conducted after a tissue distribution study. The first injection of newborn ERT was performed intravenously, the second to fourth weekly injections were intraperitoneal, and the remaining injections from 5th to 14th weeks were intravenous into the tail vein. MPS IVA mice treated with GALNS showed clearance of lysosomal storage in the liver and spleen, and sinus lining cells in bone marrow. The column structure of the growth plate was organized better than that in adult mice treated with ERT; however, hyaline and fibrous cartilage cells in the femur, spine, ligaments, discs, synovium, and periosteum still had storage materials to some extent. Heart valves were refractory to the treatment. Levels of serum keratan sulfate were kept normal in newborn ERT mice. In conclusion, the enzyme, which enters the cartilage before the cartilage cell layer becomes mature, prevents disorganization of column structure. Early treatment from birth leads to partial remission of bone pathology in MPS IVA mice. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. 人工椎间盘置换术治疗跳跃型多节段颈椎病的中期疗效%Comparison of the mid-term follow-up results between treatment of Bryan cervical artificial disc replacement and ante-rior cervical decompression and fusion for"skip"cervical spondylosis

    Institute of Scientific and Technical Information of China (English)

    尚子琨; 张英泽; 张迪; 丁文元; 张为; 孟宪中; 王林峰; 申勇

    2014-01-01

    Objective To retrospectively analysis and compareabout Bryan artificial cervical disc arthroplasty with ante-rior cervical decompression and fusion (ACDF) on the clinical efficacy for“Skip”cervical spondylosis. Methods From February 2002 to May 2012, 49 cases were treated with Bryan artificial cervical disc arthroplasty (artificial cervical disc replacement surgery group, 18 cases) or anterior cervical decompression and fusion (ACDF group, 31 cases), 29 males and 20 females. Each case was evaluated at the moment of preoperatively, 3 months, 6 and 12 months and last follow-up after surgery by the Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), Visual Analog Scale (VAS), Cervical sagittal curvature, the total cervical spine range of motion(ROM),middle segments of motion. MRI was also used to assess to adjacent segment disc degeneration, spinal cord compression and signal change situation. Results All patients were followed up for more than 24 months. The score of the JOA, NDI, VAS in the two groups of patients improved significantly after surgery than before surgery. In addition, the VAS score in last follow-up were significantly different between the two groups, but other index each time in the two groups showed no significant difference. In last follow-up, the result of artificial cervical disc arthroplasty group were better than ACDF group on the incidence of axial symptoms, the total cervical spine range of motion (ROM) and middle segments of motion. The incidence of axial symptoms in artificial cervical disc arthroplasty group were 11.1%,ACDF group were 45.2%. ROM in arti-ficial cervical disc arthroplasty group were 35.5°±5.9°,ACDF group were 24.5°±6.2°. Middle segments of motion in artificial cer-vical disc arthroplasty group were 7.3°±1.4°,ACDF group were 10.1°±1.6°. The above comparison of the datas were statistically different. There are two cases of adjacent segment degeneration in ACDF group without need to surgery

  13. Concordance between Responses to Questionnaire Scenarios and Actual Treatment to Repair or Replace Dental Restorations in the National Dental PBRN

    Science.gov (United States)

    Heaven, Tim J.; Gordan, Valeria V.; Litaker, Mark S.; Fellows, Jeffrey L.; Rindal, D. Brad; Gilbert, Gregg H.

    2015-01-01

    Objective To quantify the agreement between treatment recommended during hypothetical clinical scenarios and actual treatment provided in comparable clinical circumstances. Methods A total of 193 practitioners in the National Dental Practice-Based Research Network participated in both a questionnaire and a clinical study. The questionnaire included three hypothetical scenarios about treatment of existing restorations. Clinicians then participated in a clinical study about repair or replacement of existing restorations. We quantified the overall concordance between their questionnaire responses and what they did in actual clinical treatment. Results Practitioners who recommended repair (instead of replacement) of more scenario restorations also had higher repair percentages in clinical practice. Additionally, for each of the three hypothetical scenario restorations, practitioners who recommended repair had higher repair percentages in clinical practice. Conclusions The questionnaire scenarios were a valid measure of clinicians’ tendency to repair or replace restorations in actual clinical practice. Clinical implications Although there was substantial variation in practitioners’ tendency to repair or replace restorations, responses to questionnaire scenarios by individual practitioners were concordant with what they did in actual clinical practice. PMID:25998565

  14. Comparison of peritoneal dialysis versus continuous renal replacement therapy in the treatment of acute kidney injury in infants with congenital heart disease after surgery%腹膜透析和血液滤过治疗婴幼儿先天性心脏病术后并发急性肾功能损害疗效比较

    Institute of Scientific and Technical Information of China (English)

    郑萍; 柳梅; 袁媛

    2015-01-01

    insufficiency after operation from January 2012 to December 2013.And 52 patients received peritoneal dialysis while another 43 continuous blood purification treatment.The time until a negative balance of liquid intake and output, lactic acid recovery time, mechanical ventilation time, intensive care unit (ICU) stay length, postoperative hospitalization time and mortality were compared for two groups after operation.Results Gender, age, weight, disease, blocking time and cardiopulmonary bypass time showed no inter-group differences.The time until a negative balance of liquid intake and output in peritoneal dialysis group was 22.3 ± 4.2 h versus 14.2 ± 3.6 h in blood purification therapy group (P<0.01).The lactic acid recovery in peritoneal dialysis and blood purification therapy group were 10.3 ± 5.2 and 6.8 ± 3.4h respectively (P<0.05).The postoperative mechanical ventilation time in peritoneal dialysis group was significantly longer than that in blood purification therapy group (22.1 ± 5.3 vs 15.6 ± 4.2h, P<0.01).The time of renal replacement therapy in peritoneal dialy sis group was statistically longer than that in blood purification group (85.4± 11.7 vs 68.9 ± 12.4h, P<0.05).ICU stay length after operation in peritoneal dialysis group was longer than blood purification therapy group (8.2 ± 3.6 vs 5.8 ± 2.1 days, P<0.05).Significant difference existed in postoperative hospitalization time between dialysis and blood purification groups (16.2 ± 4.4 vs 15.2 ± 3.2 days).Conclusions The efficacy of continuous blood purification treatment is better than peritoneal dialysis in CHD infants with acute renal insufficiency after operation.

  15. Comparison of Hospitalization and Survival Between Patients Treated With Renal Replacement Therapy

    Directory of Open Access Journals (Sweden)

    Murat MERAL

    2011-01-01

    Full Text Available AIM: Renal replacement therapy (RRT prolongs survival in patients with end-stage-renal-disease (ESRD. We compared patient survival, number and duration of hospitalization in patients treated with RRT in this study. MATERIAL and METHODS: Two hundred and eighty seven patients (87 hemodialysis (HD, 97 peritoneal dialysis (PD, 103 renal transplant (RT patients were enrolled in this study. Patients' data were collected retrospectively from hospital records. RESULTS: HD patients were older and had more comorbid diseases compared to PD and RT patients. Mortality rates were not different between the modalitites. The number and duration of hospitalization episodes were significantly lower in the PD group than that of the other two groups. Survival rates of HD patients were 84%, 55% and 30% for the 1st, 5th and 10th years, respectively while these rates were 93%, 81% and 59% for PD and 95%, 81% and 77% for RT patients. CONCLUSION: PD and RT patients were younger than HD patients and had less comorbid diseases. As a result, the number and duration of hospitalization episodes were significantly lower in the PD group when compared to the others. Survival rates in the RT group were better than that of the HD and PD groups.

  16. Antimicrobial Doses in Continuous Renal Replacement Therapy: A Comparison of Dosing Strategies.

    Science.gov (United States)

    Kempke, Anna P; Leino, Abbie S; Daneshvar, Farzad; Lee, John Andrew; Mueller, Bruce A

    2016-01-01

    Purpose. Drug dose recommendations are not well defined in patients undergoing continuous renal replacement therapy (CRRT) due to limited published data. Several guidelines and pharmacokinetic equations have been proposed as tools for CRRT drug dosing. Dose recommendations derived from these methods have yet to be compared or prospectively evaluated. Methods. A literature search of PubMed, Micromedex, and Embase was conducted for 40 drugs commonly used in the ICU to gather pharmacokinetic data acquired from patients with acute and chronic kidney disease as well as healthy volunteers. These data and that obtained from drug package inserts were gathered for use in three published CRRT drug dosing equations. Doses calculated for a model patient using each method were compared to doses suggested in a commonly used dosing text. Results. Full pharmacokinetic data was available for 18, 31, and 40 agents using acute kidney injury, end stage renal disease, and normal patient data, respectively. On average, calculated doses differed by 30% or more from the doses recommended by the renal dosing text for >50% of the medications. Conclusion. Wide variability in dose recommendations for patients undergoing CRRT exists when these equations are used. Alternate, validated dosing methods need to be developed for this at-risk patient population.

  17. Antimicrobial Doses in Continuous Renal Replacement Therapy: A Comparison of Dosing Strategies

    Directory of Open Access Journals (Sweden)

    Anna P. Kempke

    2016-01-01

    Full Text Available Purpose. Drug dose recommendations are not well defined in patients undergoing continuous renal replacement therapy (CRRT due to limited published data. Several guidelines and pharmacokinetic equations have been proposed as tools for CRRT drug dosing. Dose recommendations derived from these methods have yet to be compared or prospectively evaluated. Methods. A literature search of PubMed, Micromedex, and Embase was conducted for 40 drugs commonly used in the ICU to gather pharmacokinetic data acquired from patients with acute and chronic kidney disease as well as healthy volunteers. These data and that obtained from drug package inserts were gathered for use in three published CRRT drug dosing equations. Doses calculated for a model patient using each method were compared to doses suggested in a commonly used dosing text. Results. Full pharmacokinetic data was available for 18, 31, and 40 agents using acute kidney injury, end stage renal disease, and normal patient data, respectively. On average, calculated doses differed by 30% or more from the doses recommended by the renal dosing text for >50% of the medications. Conclusion. Wide variability in dose recommendations for patients undergoing CRRT exists when these equations are used. Alternate, validated dosing methods need to be developed for this at-risk patient population.

  18. Bilateral knee replacements for treatment of acute septic arthritis in both knees.

    Science.gov (United States)

    Ashraf, Muhammad Omer; Asumu, Theophilus

    2013-11-01

    A case report of bilateral acute septic arthritis of knees is presented, which was managed with staged total knee replacements for both knees. A literature review on septic arthritis treated with knee arthroplasty is also presented.

  19. Treatment of delayed rupture of the left ventricle after mitral valve replacement

    Directory of Open Access Journals (Sweden)

    Gomes Walter J.

    2002-01-01

    Full Text Available Rupture of the left ventricle following mitral valve replacement is a catastrophic complication with deadly consequences. We report here the case of a 75-year-old man who underwent elective mitral valve replacement for severe mitral regurgitation. Delayed type 1 rupture of the left ventricle developed 3 hours postoperatively in the intensive care unit. A salvaging maneuver was used, which gained time, allowing reoperation and successful intraventricular repair.

  20. Structure-based chemical modification strategy for enzyme replacement treatment of phenylketonuria.

    Science.gov (United States)

    Wang, Lin; Gamez, Alejandra; Sarkissian, Christineh N; Straub, Mary; Patch, Marianne G; Han, Gye Won; Striepeke, Steve; Fitzpatrick, Paul; Scriver, Charles R; Stevens, Raymond C

    2005-01-01

    Structure-based protein engineering coupled with chemical modifications (e.g., pegylation) is a powerful combination to significantly improve the development of proteins as therapeutic agents. As a test case, phenylalanine ammonia-lyase (PAL, EC 4.3.1.5) was selected for enzyme replacement therapy in phenylketonuria [C.R. Scriver, S. Kaufman, Hyperphenylalaninemia:phenylalanine Hydroxylase Deficiency. The Metabolic and Molecular Bases of Inherited Disease, McGraw-Hill, New York, 2001, Chapter 77], an inherited metabolic disorder (OMIM 261600) causing mental retardation due to deficiency of the enzyme l-phenylalanine hydroxylase (EC 1.14.16.1). Previous in vivo studies of recombinant PAL demonstrated a lowering of blood l-phenylalanine levels; yet, the metabolic effect was not sustained due to protein degradation and immunogenicity [C.N. Sarkissian, Z. Shao, F. Blain, R. Peevers, H. Su, R. Heft, T.M. Chang, C.R. Scriver, A different approach to treatment of phenylketonuria:phenylalanine degradation with recombinant phenylalanine ammonia lyase, Proc. Natl. Acad. Sci. USA 96 (1999) 2339; J.A. Hoskins, G. Jack, H.E. Wade, R.J. Peiris, E.C. Wright, D.J. Starr, J. Stern, Enzymatic control of phenylalanine intake in phenylketonuria, Lancet 1 (1980) 392; C.M. Ambrus, S. Anthone, C. Horvath, K. Kalghatgi, A.S. Lele, G. Eapen, J.L. Ambrus, A.J. Ryan, P. Li, Extracorporeal enzyme reactors for depletion of phenylalanine in phenylketonuria, Ann. Intern. Med. 106 (1987) 531]. Here, we report the 1.6A three-dimensional structure of Rhodosporidium toruloides PAL, structure-based molecular engineering, pegylation of PAL, as well as in vitro and in vivo PKU mouse model studies on pegylated PAL formulations. Our results show that pegylation of R. toruloides PAL leads to promising therapeutic efficacy after subcutaneous injection by enhancing the in vivo activity, lowering plasma phenylalanine, and leading to reduced immunogenicity. The three-dimensional structure of PAL provides a

  1. Outcomes and Cost-Effectiveness of Two Nicotine Replacement Treatment Delivery Models for a Tobacco Quitline

    Directory of Open Access Journals (Sweden)

    Lija Greenseid

    2011-05-01

    Full Text Available Many tobacco cessation quitlines provide nicotine replacement therapy (NRT in the U.S. but consensus is lacking regarding the best shipping protocol or NRT amounts. We evaluated the impact of the Minnesota QUITPLAN® Helpline’s shift from distributing NRT using a single eight-week shipment to a two-shipment protocol. For this observational study, the eight week single-shipment cohort (n = 247 received eight weeks of NRT (patches or gum at once, while the split-shipment cohort (n = 160 received five weeks of NRT (n = 94, followed by an additional three weeks of NRT if callers continued with counseling (n = 66. Patient satisfaction, retention, quit rates, and cost associated with the three groups were compared. A higher proportion of those receiving eight weeks of NRT, whether in one or two shipments, reported that the helpline was “very helpful” (77.2% of the single-shipment group; 81.1% of the two-shipment group than those receiving five weeks of NRT (57.8% of the one-shipment group (p = 0.004. Callers in the eight week two-shipment group completed significantly more calls (3.0 than callers in the five week one-shipment group (2.4 or eight week single-shipment group (1.7 (p < 0.001. Using both responder and intent-to-treat calculations, there were no significant differences in 30-day point prevalence abstinence at seven months among the three protocol groups even when controlling for demographic and tobacco use characteristics, and treatment group protocol. The mean cost per caller was greater for the single-shipment phase than the split-shipment phase ($350 vs. $326 due to the savings associated with not sending a second shipment to some participants. Assuming no difference in abstinence rates resulting from the protocol change, cost-per-quit was lowest for the five week one-shipment group ($1,155, and lower for the combined split-shipment cohort ($1,242 than for the single-shipment cohort ($1,350. Results of this evaluation indicate that

  2. Transcatheter aortic valve implantation vs. surgical aortic valve replacement for treatment of severe aortic stenosis

    DEFF Research Database (Denmark)

    Siontis, George C M; Praz, Fabien; Pilgrim, Thomas

    2016-01-01

    AIMS: In view of the currently available evidence from randomized trials, we aimed to compare the collective safety and efficacy of transcatheter aortic valve implantation (TAVI) vs. surgical aortic valve replacement (SAVR) across the spectrum of risk and in important subgroups. METHODS AND RESULTS...

  3. Greenhouse gas emissions from the treatment of household plastic containers and packaging: replacement with biomass-based materials.

    OpenAIRE

    Yano, Junya; Hirai, Yasuhiro; Sakai, Shin-ichi; Tsubota, Jun

    2014-01-01

    The purpose of this study was to quantify the life-cycle greenhouse gas (GHG) emissions reduction that could be achieved by replacement of fossil-derived materials with biodegradable, biomass-based materials for household plastic containers and packaging, considering a variety of their treatment options. The biomass-based materials were 100% polylactide or a combination of polybutylene succinate adipate and polylactide. A scenario analysis was conducted considering alternative recycling metho...

  4. Synthesis of zeolite A from coal fly ash using ultrasonic treatment--A replacement for fusion step.

    Science.gov (United States)

    Ojumu, Tunde V; Du Plessis, Pieter W; Petrik, Leslie F

    2016-07-01

    The synthesis of zeolites from fly ash has become an increasingly promising remedy to the crisis of coal fly ash production and disposal in South Africa. In recent studies, South African fly ash was proven to be a suitable feedstock for the synthesis of essential industrially used zeolite A. However, the process involves a costly energy intensive step whereby fly ash is fused at high temperatures, which may make the process economically unattractive on a large scale. The aim of this study is to investigate the possibility of replacing high temperature fusion with less energy intensive sonochemical treatment for the synthesis of zeolite A. Sonochemical treatment was first thought possible due to the violent cavitation caused by high intensity sonication. The results of the study showed that fusion can be replaced by 10 min of high intensity sonication. The incorporation of sonication also consequently reduced the crystallization temperature of the process making it possible to synthesize a pure phase zeolite A at lower temperatures and reduced times. This study effectively developed a novel process to replace the energy intensive fusion step with a short, easy and inexpensive treatment. Scale up of this synthesis approach may proffer a promising alternative option to the anticipated energy demand of the synthesis of fly ash-based zeolite with fusion method.

  5. Identification of a human monoclonal antibody to replace equine diphtheria antitoxin for treatment of diphtheria intoxication.

    Science.gov (United States)

    Sevigny, Leila M; Booth, Brian J; Rowley, Kirk J; Leav, Brett A; Cheslock, Peter S; Garrity, Kerry A; Sloan, Susan E; Thomas, William; Babcock, Gregory J; Wang, Yang

    2013-11-01

    Diphtheria antitoxin (DAT) has been the cornerstone of the treatment of Corynebacterium diphtheriae infection for more than 100 years. Although the global incidence of diphtheria has declined steadily over the last quarter of the 20th century, the disease remains endemic in many parts of the world, and significant outbreaks still occur. DAT is an equine polyclonal antibody that is not commercially available in the United States and is in short supply globally. A safer, more readily available alternative to DAT would be desirable. In the current study, we obtained human monoclonal antibodies (hMAbs) directly from antibody-secreting cells in the circulation of immunized human volunteers. We isolated a panel of diverse hMAbs that recognized diphtheria toxoid, as well as a variety of recombinant protein fragments of diphtheria toxin. Forty-five unique hMAbs were tested for neutralization of diphtheria toxin in in vitro cytotoxicity assays with a 50% effective concentration of 0.65 ng/ml for the lead candidate hMAb, 315C4. In addition, 25 μg of 315C4 completely protected guinea pigs from intoxication in an in vivo lethality model, yielding an estimated relative potency of 64 IU/mg. In comparison, 1.6 IU of DAT was necessary for full protection from morbidity and mortality in this model. We further established that our lead candidate hMAb binds to the receptor-binding domain of diphtheria toxin and physically blocks the toxin from binding to the putative receptor, heparin-binding epidermal growth factor-like growth factor. The discovery of a specific and potent human neutralizing antibody against diphtheria toxin holds promise as a potential therapeutic.

  6. Factors influencing health-related quality of life after total hip replacement - a comparison of data from the Swedish and Danish hip arthroplasty registers

    DEFF Research Database (Denmark)

    Gordon, Max; Paulsen, Aksel; Overgaard, Søren

    2013-01-01

    There is an increasing focus on measuring patient-reported outcomes (PROs) as part of routine medical practice, particularly in fields such as joint replacement surgery where pain relief and improvement in health-related quality of life (HRQoL) are primary outcomes. Between-country comparisons of...... health-related quality of life (HRQoL) one year after total hip replacement (THR) surgery in Sweden and in Denmark.......There is an increasing focus on measuring patient-reported outcomes (PROs) as part of routine medical practice, particularly in fields such as joint replacement surgery where pain relief and improvement in health-related quality of life (HRQoL) are primary outcomes. Between-country comparisons...

  7. Corrigendum to "A comparison between renewable transport fuels that can supplement or replace biofuels in a 100% renewable energy system" [Energy 73, (2014), 110-125], doi

    DEFF Research Database (Denmark)

    Connolly, D.; Mathiesen, B. V.; Ridjan, I.

    2015-01-01

    In this communication, we give the following corrigendum to the original paper, “A comparison between renewable transport fuels that can supplement or replace biofuels in a 100% renewable energy system” [1], to correct some typos and a figure which could mislead the readers: • Firstly, the incorr...

  8. Greenhouse gas emissions from the treatment of household plastic containers and packaging: replacement with biomass-based materials.

    Science.gov (United States)

    Yano, Junya; Hirai, Yasuhiro; Sakai, Shin-ichi; Tsubota, Jun

    2014-04-01

    The purpose of this study was to quantify the life-cycle greenhouse gas (GHG) emissions reduction that could be achieved by replacement of fossil-derived materials with biodegradable, biomass-based materials for household plastic containers and packaging, considering a variety of their treatment options. The biomass-based materials were 100% polylactide or a combination of polybutylene succinate adipate and polylactide. A scenario analysis was conducted considering alternative recycling methods. Five scenarios were considered: two for existing fossil-derived materials (the current approach in Japan) and the three for biomass-based materials. Production and waste disposal of 1 m(3) of plastic containers and packaging from households was defined as the functional unit. The results showed that replacement of fossil-derived materials with biomass-based materials could reduce life-cycle GHG emissions by 14-20%. Source separation and recycling should be promoted. When the separate collection ratio reached 100%, replacement with biomass-based materials could potentially reduce GHG emissions by 31.9%. Food containers are a priority for replacement, because they alone could reduce GHG emissions by 10%. A recycling system for biomass-based plastics must be carefully designed, considering aspects such as the transition period from fossil-derived plastics to biomass-based plastics.

  9. The effects of total knee replacement and non-surgical treatment on pain sensitization and clinical pain

    DEFF Research Database (Denmark)

    Skou, S. T.; Roos, E. M.; Simonsen, O.;

    2016-01-01

    BACKGROUND: The objective was to compare the effect of total knee replacement (TKR) followed by a 3-month non-surgical treatment with the non-surgical treatment alone in reducing pain sensitization and other pain-related measures in patients with knee osteoarthritis. METHODS: One hundred patients...... were randomized to (1) TKR followed by a non-surgical treatment of neuromuscular exercise, education, diet, insoles and pain medication or (2) the non-surgical treatment alone. Outcomes assessed at baseline and after 3 months were as follows: (1) pain sensitization assessed as pressure-pain thresholds...... no significant between-group differences in change in the pain-related measures from baseline to 3 months (p = 0.15-0.27). Both groups improved in most of the pain-related measures (p treatment is more effective in reducing localized and spreading...

  10. Adjusted indirect treatment comparisons of bioequivalence studies

    NARCIS (Netherlands)

    Gwaza, L

    2016-01-01

    Generic medicines are approved by regulatory authorities based on demonstration of bioequivalence with the innovator, however, current regulatory systems do not require direct comparison between all available generics of the same innovator to ensure interchangeability. As such, interchangeability be

  11. Effect of testosterone replacement treatment on constitutional and sexual symptoms in type 2 diabetic men: need for rules

    Directory of Open Access Journals (Sweden)

    Fotios Dimitriadis

    2015-04-01

    Full Text Available In a recent publication, Gianatti and colleagues investigated the effect of testosterone treatment in obese, aging men with type 2 diabetes (T2D with mild to moderate symptoms, a modest reduction in testosterone levels, mild to moderate aging male symptoms, and erectile dysfunction. [1] The authors could not show any significant improvement in constitutional or sexual symptoms in this group of men. This randomized double-blind, parallel, and placebo-controlled trial among other critically emphasizes the increased testosterone prescriptions worldwide and together with other corroborating or contradictory studies awakes the need for guidelines in the androgen replacement treatment.

  12. Comparison of periprocedural and mid-term stroke rates and outcomes between surgical aortic valve replacement and transcatheter aortic valve replacement patients.

    Science.gov (United States)

    Aalaei-Andabili, Seyed Hossein; Anderson, R David; Petersen, John W; Beaver, Thomas M; Bavry, Anthony A; Klodell, Charles T

    2017-08-01

    We compared stroke occurrence and outcomes between Transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR), both periprocedural and at follow-up. From March 2012 to December 2014, 391 consecutive patients underwent TAVR (N.=290) or isolated SAVR (N.=101), concomitantly. Patients' data were prospectively collected. TAVR patients had more comorbidities. One (0.34%) TIA and 9 (3.11%) strokes occurred in-hospital following TAVR, but no cerebrovascular event occurred after SAVR (P=0.11). One stroke (0.99%) and one TIA (0.99%) were detected in SAVR group within 30 days. Among TAVR patients, one (0.75%) stroke at 6 months, 2 (1.9%) strokes and 2 (1.9%) TIAs at 12 months were diagnosed. Kaplan-Meier analysis revealed that 96% and 99% 12-month CVA free survival following TAVR and SAVR, respectively (P=0.67). Preoperative mean trans-aortic valve systolic pressure gradient higher than 40 mmHg remained as risk factor for stroke in TAVR patients only, OR: 4.48 (CI: 1.2-16.54, P=0.02). One intraoperative death, and 5 (4 with CVA) in-hospital deaths occurred after TAVR; whereas only one patient died in SAVR group (P=0.49). Thirty-day mortality was 3.8% (11/290) for TAVR and 0.99% (1/101) for SAVR patients. SAVR patients' survival was 99% at 6 months, 97.9% at 12, and 96.4% at 24 months, whereas survival in TAVR was 97.5% at 6, 92% at 12, and 73.6% at 24 months (HR: 8.43 (CI: 2.47-28.73), P<0.001). Even with significant differences in patients' baseline characteristics; in-hospital and mid-term stroke rates are not significantly higher following TAVR than SAVR. Although periprocedural stroke is not uncommon in TAVR, mid-term stroke rate is low.

  13. Comparison of the Performance of the Warfarin Pharmacogenetics Algorithms in Patients with Surgery of Heart Valve Replacement and Heart Valvuloplasty.

    Science.gov (United States)

    Xu, Hang; Su, Shi; Tang, Wuji; Wei, Meng; Wang, Tao; Wang, Dongjin; Ge, Weihong

    2015-09-01

    A large number of warfarin pharmacogenetics algorithms have been published. Our research was aimed to evaluate the performance of the selected pharmacogenetic algorithms in patients with surgery of heart valve replacement and heart valvuloplasty during the phase of initial and stable anticoagulation treatment. 10 pharmacogenetic algorithms were selected by searching PubMed. We compared the performance of the selected algorithms in a cohort of 193 patients during the phase of initial and stable anticoagulation therapy. Predicted dose was compared to therapeutic dose by using a predicted dose percentage that falls within 20% threshold of the actual dose (percentage within 20%) and mean absolute error (MAE). The average warfarin dose for patients was 3.05±1.23mg/day for initial treatment and 3.45±1.18mg/day for stable treatment. The percentages of the predicted dose within 20% of the therapeutic dose were 44.0±8.8% and 44.6±9.7% for the initial and stable phases, respectively. The MAEs of the selected algorithms were 0.85±0.18mg/day and 0.93±0.19mg/day, respectively. All algorithms had better performance in the ideal group than in the low dose and high dose groups. The only exception is the Wadelius et al. algorithm, which had better performance in the high dose group. The algorithms had similar performance except for the Wadelius et al. and Miao et al. algorithms, which had poor accuracy in our study cohort. The Gage et al. algorithm had better performance in both phases of initial and stable treatment. Algorithms had relatively higher accuracy in the >50years group of patients on the stable phase. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Subcutaneous immunoglobulin replacement therapy in the treatment of patients with primary immunodeficiency disease

    Directory of Open Access Journals (Sweden)

    Suzanne Skoda-Smith

    2009-12-01

    Full Text Available Suzanne Skoda-Smith, Troy R Torgerson, Hans D OchsSeattle Children’s Research Institute and Department of Pediatrics, University of Washington, Seattle, WashingtonAbstract: Antibody deficiency is the most frequently encountered primary immunodeficiency disease (PIDD and patients who lack the ability to make functional immunoglobulin require life-long replacement therapy to prevent serious bacterial infections. Human serum immunoglobulin manufactured from pools of donated plasma can be administered intramuscularly, intravenously or subcutaneously. With the advent of well-tolerated preparations of intravenous immunoglobulin (IVIg in the 1980s, the suboptimal painful intramuscular route of administration is no longer used. However, some patients continued to experience unacceptable adverse reactions to the intravenous preparations, and for others, vascular access remained problematic. Subcutaneously administered immunoglobulin (SCIg provided an alternative delivery method to patients experiencing difficulties with IVIg. By 2006, immunoglobulin preparations designed exclusively for subcutaneous administration became available. They are therapeutically equivalent to intravenous preparations and offer patients the additional flexibility for the self-administration of their product at home. SCIg as replacement therapy for patients with primary antibody deficiencies is a safe and efficacious method to prevent serious bacterial infections, while maximizing patient satisfaction and improving quality of life.Keywords: subcutaneous immunoglobulin, primary immunodeficiency disease, antibody deficiency, X-linked agammaglobulinemia, common variable immune deficiency

  15. Comparison of Different Treatment Protocols in Osteoporosis

    Directory of Open Access Journals (Sweden)

    Ali Aydeniz

    2003-12-01

    Full Text Available The aim of this study was to compare the effectiveness of different medical treatment protocols in osteoporosis. For this purpose 153 postmenopausal women who were diagnosed as osteoporosis were randomly divided into 4 groups and given different medical treatments for 1 year period. Before and after the treatment bone mineral density was measured . Bone mineral density increased in all 4 groups after treatment. But increament in the groups was not statistically different from each other. As a result we concluded that patients choice, side effects and cost must be regarded for drug preference.

  16. The Molecular Bacterial Load Assay Replaces Solid Culture for Measuring Early Bactericidal Response to Antituberculosis Treatment

    Science.gov (United States)

    Mtafya, Bariki; Phillips, Patrick P. J.; Hoelscher, Michael; Ntinginya, Elias N.; Kohlenberg, Anke; Rachow, Andrea; Rojas-Ponce, Gabriel; McHugh, Timothy D.; Heinrich, Norbert

    2014-01-01

    We evaluated the use of the molecular bacterial load (MBL) assay, for measuring viable Mycobacterium tuberculosis in sputum, in comparison with solid agar and liquid culture. The MBL assay provides early information on the rate of decline in bacterial load and has technical advantages over culture in either form. PMID:24871215

  17. Efficacy of multimodal, systematic non-surgical treatment of knee osteoarthritis for patients not eligible for a total knee replacement

    DEFF Research Database (Denmark)

    Skou, Soren Thorgaard; Roos, Ewa M.; Laursen, Mogens Berg

    2012-01-01

    in a randomised controlled study. The purpose of this randomised controlled study is to examine if an optimised, combined non-surgical treatment programme results in greater improvements in pain, function and quality of life in comparison with usual care in patients with KOA who are not eligible for total knee...

  18. Comparison of Behavioral Treatments for Raynaud’s Disease,

    Science.gov (United States)

    1984-01-01

    AD-AI36 528 COMPARISON OF BEHAVIORAL TREATMENTS FOR RAYNAUD S OISEASE(U) ARMY RESEARCH INST OF ENVIRONMENTAL MEDICINE NATICK MA J BJOBEET AL 1984...andSubdle) S . TYPE OF REPORT & PERIOD COVERED CompTiTL onwe ouffh Behavioral Treatments for Raynaud’s Disease ______________ S . PERFORMING ORG. REPORT...biofeedback with other treatment modes (6, 9-10). Hypnosis and relaxation have also received attention as treatments for vasoconstrictive syndromes (11). Surwit

  19. 解剖型锁定加压钢板与人工肱骨头置换治疗肱骨近端骨折的效果比较%Effect comparison between anatomical locking plate fixation and humeral head replacement in the treatment of proximal humerus fractures

    Institute of Scientific and Technical Information of China (English)

    郑创义

    2015-01-01

    目的:比较解剖型锁定加压钢板与人工肱骨头置换治疗肱骨近端骨折的疗效。方法选取本院骨科2005年1月~2014年3月收治的肱骨近端骨折患者45例,根据手术方法将患者分为内固定术组(n=27)和肱骨头置换术组(n=18)。内固定术组给予骨折切开复位、解剖型锁定加压钢板固定,肱骨头置换术组给予人工肱骨头置换方法治疗。术后定期复查X线片,了解并发症发生情况。同时在末次复诊时按照Constant-Murley肩关节评分标准进行功能评分。结果术后随访8~36个月,平均18个月。内固定术组中的主要并发症是肱骨头坏死(6例)、骨折畸形愈合(7例)和骨性关节炎(2例);肱骨头置换术组的并发症是大结节、小结节(或两者均有之)骨质吸收(6例)、关节不稳定(1例)、异位骨化(1例)。内固定组的并发症发生率(55.6%)显著高于肱骨头置管术组(44.4%)(P<0.05),优良率(77.8%)显著高于肱骨头置换组(66.7%)(P<0.05),Constant-Murley评分显著高于肱骨头置换组(P<0.05)。结论解剖型锁定加压钢板治疗肱骨近端骨折的疗效优于人工肱骨头置换,值得临床推广。%Objective To compare the therapeutic effects of anatomical locking plate fixation (ALPF) and humeral head replacement (HHR) on proximal humerus fractures. Methods 45 patients with proximal humerus fractures at the ortho-pedics department in our hospital from January 2005 to March 2014 were selected and divided into ALPF group (n=27) and HHR group (n=18) based on operation methods.ALPF group were received anatomical proximal humeral locking plate fixation,while HHR group underwent humeral head replacement. X-rays was regularly reviewed after surgery to e-valuate complications,and Constant-Murley score system was used to assess the shoulder joint function at the last re-turn visit. Results All patients were followed up for 8

  20. Fluid Replacement in Treatment of Hypovolemia and Shock: Crystalloids and Colloids

    Directory of Open Access Journals (Sweden)

    Fatih Yildiz

    2013-06-01

    Full Text Available Shock is a pathologic state with high mortality rate and characterized by a reduction of systemic tissue perfusion and decresead oxygen delivery. Absolute or relative hypovolemia is a common pathology of most shock types. Correction of hypovolemia might reverse the disturbance and increase the tissue perfusion. Fluid resuscitation with crystalloid and colloid solutions can carry the risk of increasing morbidity and mortality if not used properly. Although crystalloid and colloid solutions are considered to have equal efficacy and safety profile, recent studies showed that this assumption may not be correct. Early and effective management of hypovolemia is the cornerstone of shock resuscitation. Initial management of patients with septic shock and hypovolemia should be done with 30ml/kg of crystalloids. Proper fluid replacement and resuscitation algoritms might increase the survival rate. [Archives Medical Review Journal 2013; 22(3.000: 347-361

  1. Total knee replacement plus physical and medical therapy or treatment with physical and medical therapy alone

    DEFF Research Database (Denmark)

    Skou, Soren T; Roos, Ewa M.; Laursen, Mogens B

    2012-01-01

    ABSTRACT: BACKGROUND: There is a lack of high quality evidence concerning the efficacy of total knee arthroplasty (TKA). According to international evidence-based guidelines, treatment of knee osteoarthritis (KOA) should include patient education, exercise and weight loss. Insoles......: This is the first randomised controlled trial to investigate the efficacy of TKA as an adjunct treatment to optimised non-surgical treatment in patients with KOA. The results will significantly contribute to evidence-based recommendations for the treatment of patients with KOA. Trial Registration: clinicaltrials...

  2. Pharmacologic treatment of migraine. Comparison of guidelines.

    NARCIS (Netherlands)

    Schuurmans, A.; Weel, C. van

    2005-01-01

    OBJECTIVE: To compare guidelines (not the primary studies) for pharmacologic treatment of migraine as to methods of guideline development; recommendations, particularly on triptans; and quality of supporting evidence (with emphasis on comparative studies of triptans versus ergot alkaloids and nonste

  3. Comparison of Piascledine (Avocado and Soybean Oil) and Hormone Replacement Therapy in Menopausal-Induced Hot Flashing

    Science.gov (United States)

    Panahi, Yunes; Beiraghdar, Fatemeh; Kashani, Nafise; Baharie Javan, Nika; dadjo, yahya

    2011-01-01

    Different symptoms in Climacteric period, includes hot flash. Hormone replacement therapy (HRT) is common therapy for relief of menopausal symptoms but has possible contraindications and side effects. Recently Piascledine (combination of Avocado oil with Soybean oil) showed effects in reducing hot flash severity. Present study designed to compare the effects of HRT with Piascledine in treatment of hot flash. The cases of this study were sixty-six women at the age range of 40 to 70 years and complaints of menopause-induced hot flashing, whose last menstruation dated at least 6 months prior to the beginning of the study. The patients in this open label clinical trial, randomized to receive Piascledine capsule 1 mg or HRT (0.625 mg oral daily Conjugated Estrogen tablets, plus 2.5 mg continuous oral daily Medroxyprogesterone Acetate tablets) for 2 month. Hot flash property and severity was assessed via a daily check list and Visual analog scale. Climacteric symptom was measured before and after intervention using Greene Climacteric Scale (GCS) and Blatt-kupperman Menopausal Index (BKMI). Thirty-three eligible patients were allocated in each group. From the Piascledine group, one patient and from the HRT group, 16 patients weren›t willing to attend the study; therefore, 32 and 17 woman received treatment in Piascledine and HRT groups. 4 patients were withdrawn for vaginal bleeding and one for breast tenderness from HTR group. Hot flash severity in both groups decreased during the time similarly. With regard to GCS (p = 0.571) and BMKI (p = 0.891), the outcome was similar among the two groups. Due to low HRT compliance and its possible risks in long period of time and considering the same activity of soybean supplement and HRT in relieving the hot flash as menopausal symptoms in women, it seems that soybean supplements can be an alternative therapy to hormone. PMID:24250433

  4. Case study of physiotherapy treatment of a patient with the diagnosis of ankylosing spondylitis and status after total replacement of hip joint

    OpenAIRE

    Chlebečková, Helena

    2013-01-01

    Title: Case study of physiotherapy treatment of a patient with the diagnosis of ankylosing spondylitis and status after total replacement of hip joint Summary: This bachelor thesis deals with the problem of rheumatic disease ankylosing spondylitis and the effects of this disease. General part focuses on describing the theoretical knowledge of ankylosing spondylitis and possible methods for its treatment, and the implantation of hip replacement and subsequent rehabilitation. The special part p...

  5. A cultural comparison of treatment need.

    Science.gov (United States)

    Ngom, Pape Ibrahima; Brown, Rebecca; Diagne, Falou; Normand, François; Richmond, Stephen

    2005-12-01

    The aims of this study were two-fold. First to compare the perceptions of African dental aesthetics as determined by a panel of black African Senegalese and French Caucasian judges, and second to compare the sensitivity and specificity of both components of the Index of Orthodontic Treatment Need (IOTN) and the Index of Complexity, Outcome and Need (ICON) in relation to the opinions of African and Caucasian judges. Ninety-eight colour digital dental images of black adolescents and adults were scored for attractiveness on a 100 mm visual analogue scale (VAS) by 45 Caucasian and 41 black African judges. In addition the judges were asked to classify the level of treatment need. Both components of the IOTN and ICON were recorded for the 98 cases. The results indicated that Caucasian judges perceived the majority of images to be less attractive than African judges. African and Caucasian judges showed similar levels in the estimation of treatment need. The aesthetic component (AC) of the IOTN and ICON showed similar levels of sensitivity. Taking all factors into account, it would appear that the ICON is marginally better at identifying those individuals who are perceived to need orthodontic treatment.

  6. A comparison between electromechanical and pneumatic-controlled knee simulators for the investigation of wear of total knee replacements.

    Science.gov (United States)

    Abdelgaied, Abdellatif; Fisher, John; Jennings, Louise M

    2017-07-01

    More robust preclinical experimental wear simulation methods are required in order to simulate a wider range of activities, observed in different patient populations such as younger more active patients, as well as to fully meet and be capable of going well beyond the existing requirements of the relevant international standards. A new six-station electromechanically driven simulator (Simulation Solutions, UK) with five fully independently controlled axes of articulation for each station, capable of replicating deep knee bending as well as other adverse conditions, which can be operated in either force or displacement control with improved input kinematic following, has been developed to meet these requirements. This study investigated the wear of a fixed-bearing total knee replacement using this electromechanically driven fully independent knee simulator and compared it to previous data from a predominantly pneumatically controlled simulator in which each station was not fully independently controlled. In addition, the kinematic performance and the repeatability of the simulators have been investigated and compared to the international standard requirements. The wear rates from the electromechanical and pneumatic knee simulators were not significantly different, with wear rates of 2.6 ± 0.9 and 2.7 ± 0.9 mm(3)/million cycles (MC; mean ± 95% confidence interval, p = 0.99) and 5.4 ± 1.4 and 6.7 ± 1.5 mm(3)/MC (mean ± 95 confidence interval, p = 0.54) from the electromechanical and pneumatic simulators under intermediate levels (maximum 5 mm) and high levels (maximum 10 mm) of anterior-posterior displacements, respectively. However, the output kinematic profiles of the control system, which drive the motion of the simulator, followed the input kinematic profiles more closely on the electromechanical simulator than the pneumatic simulator. In addition, the electromechanical simulator was capable of following kinematic

  7. A comparison of two CSA treatment programmes

    OpenAIRE

    2004-01-01

    The development of effective treatment programmes to ameliorate the sequelae of CSA is imperative. Ideally such programmes should address intrapsychic psychological difficulties through individually based child-focused interventions; peer-related interpersonal problems through group-based interventions; and difficulties within the family and wider social network through family therapy and systemic interventions. It would be expected that some programmes might be more effective than others for...

  8. Antibiotic prophylaxis for dental treatment after prosthetic joint replacement: exploring the orthopaedic surgeon's opinion

    Directory of Open Access Journals (Sweden)

    Clare M. McNally, MPhil(Dent

    2016-09-01

    Conclusions: Australian orthopaedic surgeons continue to recommend antibiotic prophylaxis for dental treatment. The recording of PJI in relation to dental procedures into clinical registries would enable the development of consistent guidelines between professional groups responsible for the care of this patient group.

  9. Treatment of radiation enteritis: a comparison study

    Energy Technology Data Exchange (ETDEWEB)

    Loiudice, T.A.; Lang, J.A.

    1983-08-01

    Twenty-four patients with severe radiation injury to the small bowel seen over a 4-year period were randomized to four treatment groups: 1) methylprednisolone 80 mg intravenously plus Vivonex-HN, 2 L/day po, 2) methylprednisolone 80 mg intravenously plus total parenteral nutrition, 2.5 L/day, 3) total parenteral nutrition, 2.5 L/day, and 4) Vivonex-HN, 2 L/day po. Patients received nothing by mouth except water in groups II and III, and only Vivonex-HN in groups I and IV. Patients were treated for 8-wk periods. Improvement was gauged by overall nutritional assessment measurements, nitrogen balance data and by radiological and clinical parameters. No significant difference between groups I, II, III, and IV could be found for age, sex, mean radiation dosage, time of onset after radiation therapy, or initial nutritional assessment data. Differences statistically could be found between groups II and III and I and IV regarding nutritional assessment data, nitrogen balance, radiographic and clinical parameters after therapy, with marked improvement noted in groups II and III. We conclude that a treatment regimen consisting of total parenteral nutrition and bowel rest is beneficial in the treatment of radiation enteritis. Methylprednisolone appears to enhance this effect and indeed, may be responsible for a longer lasting response.

  10. Replacement of chemical intensive water treatment processes with energy saving membrane. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Mickley, M.C.; Goering, S.W.

    1983-11-01

    The project investigated the use of charged ultrafiltration membranes to treat hard water. More specifically, the work was undertaken to (1) make charged ultrafiltration membranes to demonstrate the technical feasibility of the chemical grafting approach; (2) evaluate the market potential for charged ultrafiltration membranes; and (3) evaluate the cost and energy savings for using charged ultrafiltration as compared to lime-based clarification and other treatment methods. The results suggest that chemical grafting is a relatively simple, reproducible and low-cost way to modify existing substrate materials to give them enhanced transport performance. Process studies lead to the identification of good market potential for membrane processes using charged ultrafiltration membranes. Capital and operating costs relative to lime-based clarification are favorable for low- and medium-sized treatment plants. Finally, substantial energy savings are apparent as compared to lime-based precipitation systems which incur substantial energy consumption in the lime production and transportation steps.

  11. Identification of a Human Monoclonal Antibody To Replace Equine Diphtheria Antitoxin for Treatment of Diphtheria Intoxication

    OpenAIRE

    Sevigny, Leila M; Booth, Brian J.; Rowley, Kirk J.; Leav, Brett A.; Cheslock, Peter S.; Kerry A Garrity; Sloan, Susan E.; Thomas, William; Babcock, Gregory J.; Wang, Yang

    2013-01-01

    Diphtheria antitoxin (DAT) has been the cornerstone of the treatment of Corynebacterium diphtheriae infection for more than 100 years. Although the global incidence of diphtheria has declined steadily over the last quarter of the 20th century, the disease remains endemic in many parts of the world, and significant outbreaks still occur. DAT is an equine polyclonal antibody that is not commercially available in the United States and is in short supply globally. A safer, more readily available ...

  12. [Treatment with isoflavones replaces estradiol effect on the tissue fat accumulation from ovariectomized rats].

    Science.gov (United States)

    Torrezan, Rosana; Gomes, Rodrigo M; Ferrarese, Maria L; de Melo, Fernando Ben-Hur; Ramos, Aparecida M D; Mathias, Paulo C F; Scomparin, Dionizia X

    2008-12-01

    Isoflavones (ISO) present in soybean are named phytoestrogens because they show estrogen effect. The use of isoflavones has beneficial effect in disturbance of post-menopause, which is characterized by ovarian function suppression. Decreasing of estrogen secretion and consequent morphologic and metabolic disarrangements are observed in female hormonal decline. The aim of present work was to investigate the effect of ISO on the fat accretion of uterine endometric tissue, and HDL and glucose blood concentration from ovariectomized rats (OVX). Female Wistar rats with 60 days-old were submitted a surgery to remove bilaterally the ovarium. After 8-day recovery period the animals were distributed into three groups: sham operate (GC); OVX ISO untreated (GI) and OVX supplemented with ISO (G II). Total uterus mass, uterus fat and retroperitoneal fat pad, were removed, washed and weighted. Samples of uterus were histological processed to measure endometrium thickness. Blood samples were also collected to analyze the concentration of HDL and glucose. The OVX caused endometric atrophy, decrease of uterus weight and HDL reduction. The treatment with ISO provoked decrease of uterine and retroperitoneal fat pad. HDL increase and glycemia reduction were also observed. However, there was no uterotrophic effect. ISO treatment causes decrease in tissue fat accretion from ovariectomized rats.

  13. Hormone replacement treatment choices in complete androgen insensitivity syndrome: an audit of an adult clinic

    Directory of Open Access Journals (Sweden)

    Jennifer K Y Ko

    2017-07-01

    Full Text Available Objective: To review the treatment choices of women with complete androgen insensitivity syndrome (CAIS at a single tertiary centre. Design: Retrospective review. Patients: Women with CAIS identified from our database. Results: The study group comprised 141 women with CAIS. Eleven percent (16/141 of women had gonads in situ, 3 of whom were under workup for gonadectomy. The age of gonadectomy in the remainder 125 women was 17 (0.1–53 years. The most common form of HRT was oral oestrogen or transdermal oestrogen in 80% (113/141. 13/141 (9% women used vaginal oestrogens alone or together with other forms of HRT. Testosterone preparations had been used by 17% (24/141 of women and were currently used in 10% (14/141. Of those who had used testosterone, 42% (10/24 had chosen not to continue after a therapeutic trial. Conclusions: In a clinic offering individualised multidisciplinary care for women with CAIS, we found that the majority of women chose oestrogen-based treatment while a significant minority used testosterone.

  14. Teaching Appropriate Play to Replace Stereotypy Using a Treatment Package with Students Having Autism

    Directory of Open Access Journals (Sweden)

    Jeremy H. Greenberg

    2016-09-01

    Full Text Available Students with special education needs such as autism tend to have difficulty with appropriate play skills and leisure time skills. A lack of play may lead to inappropriate behaviors such as stereotypy or passivity. When students have a limited community of reinforcers it may be difficult for educators to find motivators that can be used to teach language, social, academics, and other skills. The present study tested a treatment package in a small group format on the on task painting behavior and stereotypy of four boys between 5 and 12 years old having autism. Using a delayed multiple baseline across students experimental design, a functional relationship was demonstrated between an observed increase in on task painting behavior and decrease in stereotypy of all four students as a function of their participation. Limitations of the present study were also discussed.

  15. Is it time to replace vancomycin in the treatment of methicillin-resistant Staphylococcus aureus infections?

    Science.gov (United States)

    van Hal, Sebastiaan J; Fowler, Vance G

    2013-06-01

    For more than 4 decades, vancomycin has been the antibiotic of choice for methicillin-resistant Staphylococcus aureus (MRSA) infections. Recently, infections due to isolates with high but susceptible vancomycin minimum inhibitory concentrations have been associated with additional treatment failures and patient mortality. These poorer outcomes may in part be explained by the inability of attaining appropriate vancomycin levels in these patients. However, assumptions that these poor outcomes are solely due to failure to achieve optimal serum levels of vancomycin are premature. The availability of effective alternatives further erodes the position of vancomycin as first-line therapy. The emergence of resistance and cost considerations, however, favor a more measured approach when using alternative antimicrobials. Collectively, the current available data suggest that the optimal therapy for MRSA infections remains unclear. In the absence of further data, the Infectious Diseases Society of America guidelines remain relevant and inform clinicians of best practice for treating patients with MRSA infections.

  16. THE RESULTS OF SURGICAL TREATMENT OF TRICUSPID VALVE INFECTIVE ENDOCARDITIS USING VALVE REPAIR AND VALVE REPLACEMENT OPERATIONS

    Directory of Open Access Journals (Sweden)

    S. A. Kovalev

    2015-01-01

    Full Text Available Aim. To evaluate in-hospital and long-term results of surgical treatment of patients with infective endocarditis of the tricuspid valve, to compare the effectiveness of valve repair and valve replacement techniques, and to identify risk factors of mortality and reoperations. Materials and methods. 31 surgical patients with tricuspid valve infective endocarditis were evaluated. Patients were divided into 2 groups. In Group 1 (n = 14 repairs of the tricuspid valve were performed, in Group 2 (n = 17 patients had undergone tricuspid valve replacements. Epidemiological, clinical, microbiological and echocardiographic data were studied. Methods of comparative analysis, the Kaplan–Meier method, and Cox risk models were applied. Results. The most common complication of in-hospital stay was atrioventricular block (17.7% of cases in Group 2. In Group 1, this type of complication was not found. Hospital mortality was 7.14% in Group 1, and 0% in Group 2. Long-term results have shown the significant reduction of heart failure in general cohort and in both groups. In Group 1 the severity of heart failure in the long term was less than in Group 2. No significant differences in the severity of tricuspid regurgitation were found between the groups. In 7-year follow up no cases of death were registered in Group 1. Cumulative survival rate in Group 2 within 60 months was 67.3 ± 16.2%. No reoperations were performed in patients from Group 1. In Group 2, the freedom from reoperation within 60 months was 70.9 ± 15.3%. Combined intervention was found as predictor of postoperative mortality. Prosthetic valve endocarditis was identified as risk factor for reoperation. Conclusion. Valve repair and valve replacement techniques of surgical treatment of tricuspid valve endocarditis can provide satisfactory hospital and long-term results. Tricuspid valve repair techniques allowed reducing the incidence of postoperative atrioventricular block. In the long-term, patients

  17. Ankle replacement

    Science.gov (United States)

    Ankle arthroplasty - total; Total ankle arthroplasty; Endoprosthetic ankle replacement; Ankle surgery ... You may not be able to have a total ankle replacement if you have had ankle joint infections in ...

  18. Comparison of corrosion scales in full and partially replaced lead service lines after changes in water quality

    Science.gov (United States)

    Preliminary results from scales formed 38 weeks following the LSL replacement simulations revealed differences in scale formations amongst varying water qualities and pipe sequence. Rigs fed with dechlorinated tap water show distinct pH gradients between the galvanic and the back...

  19. A comparison of early versus late initiation of renal replacement therapy in critically ill patients with acute kidney injury

    DEFF Research Database (Denmark)

    2011-01-01

    Introduction: Our aim was to investigate the impact of early versus late initiation of renal replacement therapy (RRT) on clinical outcomes in critically ill patients with acute kidney injury (AKI). Methods: Systematic review and meta-analysis were used in this study. PUBMED, EMBASE, SCOPUS, Web...

  20. Health-related quality of life in patients waiting for major joint replacement. A comparison between patients and population controls

    Directory of Open Access Journals (Sweden)

    Seitsalo Seppo

    2006-01-01

    Full Text Available Abstract Background Several quality-of-life studies in patients awaiting major joint replacement have focused on the outcomes of surgery. Interest in examining patients on the elective waiting list has increased since the beginning of 2000. We assessed health-related quality of life (HRQoL in patients waiting for total hip (THR or knee (TKR replacement in three Finnish hospitals, and compared patients' HRQoL with that of population controls. Methods A total of 133 patients awaiting major joint replacement due to osteoarthritis (OA of the hip or knee joint were prospectively followed from the time the patient was placed on the waiting list to hospital admission. A sample of controls matched by age, gender, housing and home municipality was drawn from the computerised population register. HRQoL was measured by the generic 15D instrument. Differences between patients and the population controls were tested by the independent samples t-test and between the measurement points by the paired samples t-test. A linear regression model was used to explain the variance in the 15D score at admission. Results At baseline, 15D scores were significantly different between patients and the population controls. Compared with the population controls, patients were worse off on the dimensions of moving (P Conclusion Although patients' HRQoL did not deteriorate while waiting, a consistently worse HRQoL was observed in patients waiting for major joint replacement compared with population controls.

  1. Comparison of corrosion scales in full and partially replaced lead service lines after changes in water quality

    Science.gov (United States)

    Preliminary results from scales formed 38 weeks following the LSL replacement simulations revealed differences in scale formations amongst varying water qualities and pipe sequence. Rigs fed with dechlorinated tap water show distinct pH gradients between the galvanic and the back...

  2. Hydraulic distension of the knee: a novel treatment for arthrofibrosis after total knee replacement (case series).

    Science.gov (United States)

    Formby, Peter M; Donohue, Michael A; Cannova, Christopher J; Caulfield, J Patrick

    2016-06-01

    Arthrofibrosis following total knee arthroplasty (TKA) is a common problem, which can be frustrating to both the patient and treating physician and can dramatically compromise post-operative function. Current treatment options for TKA arthrofibrosis include watchful waiting, injections, physical therapy, manipulation under anaesthesia, arthroscopic/open lysis of adhesions and revision surgery. We present a novel technique to treat acute and chronic stiffness following TKA, which we call hydraulic distension. A retrospective pre- and post-operative inpatient and outpatient record review of three patients treated with hydraulic distension for arthrofibrosis following TKA at a single institution. Three patients with a mean age of 74 years (68-78) underwent hydraulic distension of the knee at a mean of 23.4 ± 18.4 months (9 weeks to 36 months) following primary TKA. The mean pre-distension maximum flexion was 86.7 ± 10.4°, and the mean post-distension flexion was 110 ± 13.2° (23.3° increase). The patients maintained a mean 110 ± 20° flexion (23.3° increase) at a mean follow-up of 11.7 months (1 week to 29 months). There were no complications. We present a novel technique for managing arthrofibrosis following TKA that has not been previously reported. This is an effective, safe procedure, with our patients experiencing a mean 23° increased knee flexion at the most recent follow-up. Published 2016. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.

  3. System comparison of R22-replacements: R 407C and R 410A; Systemvergleich fuer R22-Ersatzstoffe: R 407C und R 410A

    Energy Technology Data Exchange (ETDEWEB)

    Koenig, H. [Solvay Fluor und Derivate GmbH, Hannover (Germany)

    1998-10-01

    The present paper describes the differences between the refrigerant R22 and the replacement candidates R407C and R410A. Starting from the thermodynamic point of view, two different methods and results from tests will be described: (a) The thermodynamically correct comparison of fluids in optimized equipment with constant cooling capacities and temperature conditions and (b) the comparison of capacities in real refrigeration cycles using different refrigerants. The results show that R407C, and even more R410A, are suitable replacements for R22. Due to the higher volumetric capacity of R410A in comparison to R22, R407C and also propane, a reduction of the system size and refrigerant charge is possible by using R410A. Furthermore, in this paper the new fatigue test method is described. (orig./MSK) [Deutsch] Das Kaeltemittel R22 ist zur Zeit das wichtigste Kaeltemittel fuer die Kaelte- und Klimatechnik weltweit. In Deutschland wird die Anwendung von R22 in Neuanlagen zum 1.1.2000 verboten sein. Dieser Beitrag diskutiert Ersatzstoffe fuer R22 und beschreibt die Unterschiede zwischen R22 und den favorisierten Ersatzstoffen R407C und R410A. Es werden Ergebniss praesentiert, die auf einem thermodynamisch korrekten Vergleich der Kaeltemittel basieren. Hierzu wurden die Kaeltemittel in einer Testanlage des ILK Dresden vermessen, wobei die Kaelteleistung und die Quellentemperaturen konstant waren. Ferner werden Vergleichsmessungen mit den unterschiedlichen Kaeltemitteln an real ausgefuehrten Kaelteanlagen vorgestellt. (orig./MSK)

  4. Successful treatment of thyroid storm presenting as recurrent cardiac arrest and subsequent multiorgan failure by continuous renal replacement therapy

    Directory of Open Access Journals (Sweden)

    Han Soo Park

    2017-03-01

    Full Text Available Thyroid storm is a rare and potentially life-threatening medical emergency. We experienced a case of thyroid storm associated with sepsis caused by pneumonia, which had a catastrophic course including recurrent cardiac arrest and subsequent multiple organ failure (MOF. A 22-year-old female patient with a 10-year history of Graves’ disease was transferred to our emergency department (ED. She had a cardiac arrest at her home and a second cardiac arrest at the ED. Her heart recovered after 20 min of cardiac resuscitation. She was diagnosed with thyroid storm associated with hyperthyroidism complicated by pneumonia and sepsis. Although full conventional medical treatment was given, she had progressive MOF and hemodynamic instability consisting of hyperthermia, tachycardia and hypotension. Because of hepatic and renal failure with refractory hypotension, we reduced the patient’s dose of beta-blocker and antithyroid drug, and she was started on continuous veno-venous renal replacement therapy (CRRT with intravenous albumin and plasma supplementation. Subsequently, her body temperature and pulse rate began to stabilize within 1 h, and her blood pressure reached 120/60 mmHg after 6 h. We discontinued antithyroid drug 3 days after admission because of aggravated hyperbilirubinemia. The patient exhibited progressive improvement in thyroid function even after cessation of antithyroid drug, and she successfully recovered from thyroid storm and MOF. This is the first case of thyroid storm successfully treated by CRRT in a patient considered unfit for antithyroid drug treatment.

  5. Conducting Indirect-Treatment-Comparison and Network-Meta-Analysis Studies : Report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: Part 2

    NARCIS (Netherlands)

    Hoaglin, David C.; Hawkins, Neil; Jansen, Jeroen P.; Scott, David A.; Itzler, Robbin; Cappelleri, Joseph C.; Boersma, Cornelis; Thompson, David; Larholt, Kay M.; Diaz, Mireya; Barrett, Annabel

    Evidence-based health care decision making requires comparison of all relevant competing interventions. In the absence of randomized controlled trials involving a direct comparison of all treatments of interest, indirect treatment comparisons and network meta-analysis provide useful evidence for

  6. Conducting Indirect-Treatment-Comparison and Network-Meta-Analysis Studies : Report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: Part 2

    NARCIS (Netherlands)

    Hoaglin, David C.; Hawkins, Neil; Jansen, Jeroen P.; Scott, David A.; Itzler, Robbin; Cappelleri, Joseph C.; Boersma, Cornelis; Thompson, David; Larholt, Kay M.; Diaz, Mireya; Barrett, Annabel

    2011-01-01

    Evidence-based health care decision making requires comparison of all relevant competing interventions. In the absence of randomized controlled trials involving a direct comparison of all treatments of interest, indirect treatment comparisons and network meta-analysis provide useful evidence for jud

  7. 16-Detector row computed tomographic coronary angiography in patients undergoing evaluation for aortic valve replacement: comparison with catheter angiography

    Energy Technology Data Exchange (ETDEWEB)

    Manghat, N.E.; Morgan-Hughes, G.J.; Broadley, A.J.; Undy, M.B.; Wright, D.; Marshall, A.J.; Roobottom, C.A

    2006-09-15

    Aim: To evaluate the diagnostic accuracy of 16-detector row computed tomography (CT) in assessing haemodynamically significant coronary artery stenoses in patients under evaluation for aortic stenosis pre-aortic valve replacement. Subjects and methods: Forty consecutive patients under evaluation for severe aortic stenosis and listed for cardiac catheterization before potential aortic valve replacement underwent coronary artery calcium (CAC) scoring and retrospective electrocardiogram (ECG)-gated multi-detector row computed tomographic coronary angiography (MDCTA) using a GE Lightspeed 16-detector row CT within 1 month of invasive coronary angiography (ICA) for comparative purposes. All 13 major coronary artery segments of the American Heart Association model were evaluated for the presence of {>=}50% stenosis and compared to the reference standard. Data were analysed on a segment-by-segment basis and also in 'whole patient' terms. Results: A total of 412/450 segments from 35 patients were suitable for analysis. The overall accuracy of MDCTA for detection of segments with {>=}50% stenosis was high, with a sensitivity of 81.3%, specificity 95.0%, positive predictive value (PPV) 57.8%, and negative predictive value (NPV) 98.4%. On a 'whole-patient' basis, 100% (19/19) of patients with significant coronary disease were correctly identified and there were no false-negatives. Excluding patients with CAC >1000 from the analysis improved the accuracy of MDCTA to: sensitivity 90%, specificity 98.1%, PPV 60%, NPV 99.7%. Conclusion: Non-invasive 16-detector row MDCTA accurately excludes significant coronary disease in patients with severe aortic stenosis undergoing evaluation before aortic valve replacement and in whom ICA can therefore be avoided. Its segment-by-segment accuracy is improved further if CAC > 1000 is used as a gatekeeper to MDCTA.

  8. Comparison of the Effects of Intrathecal Fentanyl and Intrathecal Morphine on Pain in Elective Total Knee Replacement Surgery

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    Refika Kılıçkaya

    2016-01-01

    Full Text Available Objective. Total knee replacement is one of the most painful orthopedic surgical procedures. In this study, our goal was to compare the intraoperative and postoperative hemodynamic effects, the side effects, the effect on the duration of pain start, the 24-hour VAS, and the amount of additional analgesia used, of the fentanyl and morphine we added to the local anesthetic in the spinal anesthesia we administered in cases of elective knee replacement. Materials and Methods. After obtaining the approval of the Erciyes University Medical Faculty Clinical Drug Trials Ethics Committee, as well as the verbal and written consent of the patients, we included 50 patients in our prospective, randomized study. Results. In our study, the morphine group (Group M had lower pain scores in the 2nd, 6th, 12th, and 24th hours compared to the fentanyl group (Group F. When additional analgesic requirements were compared, it was found that in the 2nd, 6th, and 24th hours fewer Group M patients needed more analgesics than did Group F patients. Conclusion. The fentanyl group also had lower first analgesic requirement times than did the morphine group. In terms of nausea and vomiting, there was no statistically significant difference between the two groups.

  9. Comparison between major repair and replacement options for a bridge deck life cycle assessment: A case study

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    Abu Dabous Saleh

    2017-01-01

    Full Text Available Material production, manufacturing, transportation, usage, and end of lifeprocessing are usually the main contributors defining the life cycle assessment (LCA. Bridge infrastructure is important to the economy and the society. Over their life cycle, highway bridges experience several stressors that can significantly affect their structural performance and therefore require rehabilitation. This paper discusses the life cycle analysis of bridge rehabilitation decisions and demonstrates the analysis with a case study of a bridge located in Ontario, Canada. The LCA of the bridge deck is analyzed for two rehabilitation strategies: major repair and replacement. The study focuses on evaluating the different life cycle phases of the bridge deck by assessing their carbon dioxide emission, energy consumption and cost. Also, the paper presents the impact of the different elements within each phase to identify the most contributing elements. The LCA of the bridge deck is analyzed and estimated with the aid of CES EduPack 2016 software that includes a database of more than 4000 different materials and more than 200 manufacturing processes. Analysis of the case study shows that material phase causes significant life cycle impact. The study concluded that the deck replacement yields higher environmental impact and life cycle cost compared to repairing and strengthening the deck.

  10. Pharmacogenetics of glucocorticoid replacement could optimize the treatment of congenital adrenal hyperplasia due to 21-hydroxylase deficiency

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    Ricardo P. P. Moreira

    2011-01-01

    Full Text Available INTRODUCTION: 21-hydroxylase deficiency is an autosomal recessive disorder that causes glucocorticoid deficiency and increased androgen production. Treatment is based on glucocorticoid replacement; however, interindividual variability in the glucocorticoid dose required to achieve adequate hormonal control has been observed. OBJECTIVE: The present study aimed to evaluate the association between polymorphic variants involved inglucocorticoid action and/or metabolism and the mean daily glucocorticoid dose in 21-hydroxylase deficiency patients. METHODS: We evaluated 53 patients with classical forms of 21-hydroxylase deficiency who were receiving cortisone acetate. All patients were between four and six years of age and had normal androgen levels. RESULTS: The P450 oxidoreductase A503V, HSD11B1 rs12086634, and CYP3A7*1C variants were found in 19%, 11.3% and 3.8% of the patients, respectively. The mean ± SD glucocorticoid dose in patients with the CYP3A7*1C and wild-type alleles was 13.9 ± 0.8 and 19.5 ± 3.2 mg/m²/d, respectively. We did not identify an association between the P450 oxidoreductase or HSD11B1 allelic variants and the mean glucocorticoid dose. CONCLUSION: Patients carrying the CYP3A7*1C variant required a significantly lower mean glucocorticoid dose. Indeed, the CYP3A7*1C allele accounted for 20% of the variability in the cortisone acetate dose. The analysis of genes involved in glucocorticoid metabolism may be useful in the optimization of treatment of 21-hydroxylase deficiency.

  11. Total hip replacement for the treatment of end stage arthritis of the hip: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Alexander Tsertsvadze

    Full Text Available Evolvements in the design, fixation methods, size, and bearing surface of implants for total hip replacement (THR have led to a variety of options for healthcare professionals to consider. The need to determine the most optimal combinations of THR implant is warranted. This systematic review evaluated the clinical effectiveness of different types of THR used for the treatment of end stage arthritis of the hip.A comprehensive literature search was undertaken in major health databases. Randomised controlled trials (RCTs and systematic reviews published from 2008 onwards comparing different types of primary THR in patients with end stage arthritis of the hip were included.Fourteen RCTs and five systematic reviews were included. Patients experienced significant post-THR improvements in Harris Hip scores, but this did not differ between impact types. There was a reduced risk of implant dislocation after receiving a larger femoral head size (36 mm vs. 28 mm; RR = 0.17, 95% CI: 0.04, 0.78 or cemented cup (vs. cementless cup; pooled odds ratio: 0.34, 95% CI: 0.13, 0.89. Recipients of cross-linked vs. conventional polyethylene cup liners experienced reduced femoral head penetration and revision. There was no impact of femoral stem fixation and cup shell design on implant survival rates. Evidence on mortality and complications (aseptic loosening, femoral fracture was inconclusive.The majority of evidence was inconclusive due to poor reporting, missing data, or uncertainty in treatment estimates. The findings warrant cautious interpretation given the risk of bias (blinding, attrition, methodological limitations (small sample size, low event counts, short follow-up, and poor reporting. Long-term pragmatic RCTs are needed to allow for more definitive conclusions. Authors are encouraged to specify the minimal clinically important difference and power calculation for their primary outcome(s as well CONSORT, PRISMA and STROBE guidelines to ensure better

  12. First human treatment with investigational rhGUS enzyme replacement therapy in an advanced stage MPS VII patient.

    Science.gov (United States)

    Fox, Joyce E; Volpe, Linda; Bullaro, Josephine; Kakkis, Emil D; Sly, William S

    2015-02-01

    Mucopolysaccharidosis type VII (MPS VII, Sly syndrome) is a very rare lysosomal storage disease caused by a deficiency of the enzyme β-glucuronidase (GUS), which is required for the degradation of three glycosaminoglycans (GAGs): dermatan sulfate, heparan sulfate, and chondroitin sulfate. Progressive accumulation of these GAGs in lysosomes leads to increasing dysfunction in numerous tissues and organs. Enzyme replacement therapy (ERT) has been used successfully for other MPS disorders, but there is no approved treatment for MPS VII. Here we describe the first human treatment with recombinant human GUS (rhGUS), an investigational therapy for MPS VII, in a 12-year old boy with advanced stage MPS VII. Despite a tracheostomy, nocturnal continuous positive airway pressure, and oxygen therapy, significant pulmonary restriction and obstruction led to oxygen dependence and end-tidal carbon dioxide (ETCO2) levels in the 60-80mmHg range, eventually approaching respiratory failure (ETCO2 of 100mmHg) and the need for full-time ventilation. Since no additional medical measures could improve his function, we implemented experimental ERT by infusing rhGUS at 2mg/kg over 4h every 2 weeks for 24 weeks. Safety was evaluated by standard assessments and observance for any infusion associated reactions (IARs). Urinary GAG (uGAG) levels, pulmonary function, oxygen dependence, CO2 levels, cardiac valve function, liver and spleen size, and growth velocity were assessed to evaluate response to therapy. rhGUS infusions were well tolerated. No serious adverse events (SAEs) or IARs were observed. After initiation of rhGUS infusions, the patient's uGAG excretion decreased by more than 50%. Liver and spleen size were reduced within 2 weeks of the first infusion and reached normal size by 24 weeks. Pulmonary function appeared to improve during the course of treatment based on reduced changes in ETCO2 after off-ventilator challenges and a reduced oxygen requirement. The patient regained the

  13. Directed Replacement

    CERN Document Server

    Karttunen, L

    1996-01-01

    This paper introduces to the finite-state calculus a family of directed replace operators. In contrast to the simple replace expression, UPPER -> LOWER, defined in Karttunen (ACL-95), the new directed version, UPPER @-> LOWER, yields an unambiguous transducer if the lower language consists of a single string. It transduces the input string from left to right, making only the longest possible replacement at each point. A new type of replacement expression, UPPER @-> PREFIX ... SUFFIX, yields a transducer that inserts text around strings that are instances of UPPER. The symbol ... denotes the matching part of the input which itself remains unchanged. PREFIX and SUFFIX are regular expressions describing the insertions. Expressions of the type UPPER @-> PREFIX ... SUFFIX may be used to compose a deterministic parser for a ``local grammar'' in the sense of Gross (1989). Other useful applications of directed replacement include tokenization and filtering of text streams.

  14. Effect of lime treatment of olive meal on in vitro utilization of total mixed ration containing olive meal as partial maize replacer

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    Ajmal Ashraf

    Full Text Available Aim: Present study pertains to lime treatment of olive meal to improve its digestibility. The objective of the present study was to assess the in vitro dry matter degradability of total mixed ration containing lime treated olive meal at varied levels of maize replacement to know the optimum level of lime and treated olive meal as maize replacement in small ruminant diets. Materials and methods: Study was carried out in two phases. In phase I, A complete diet was formulated and treated with lime at variable concentrations (0-8% at 25% of maize replacement and subjected to in vitro studies as per Tilley and Terry. On the basis of the results of this phase, a concentration of lime for olive treatment was selected and tested at variable levels of maize replacement (0-50% by treated olive cake in phase II. Data was analyzed as per the procedures suggested by Snedecor and Cochran. Results: The in vitro dry matter digestibility (IVDMD of composite diet increased from 43.95% at 0% lime treatment to 48.68% on treating with 8% lime with significant (P<0.05 increase at 6% treatment level. Lime treatment beyond 6% had no further significant effect on improving the digestibility. Graded levels of maize replacement by olive meal treated with 6% lime (lime percentage selected from phase I showed that the in vitro digestibility of mixed ration was not compromised up to 40% replacement level of maize by treated olive meal. Improved digestibility with lime treatment may be due to weakening of internal Hydrogen bonding, thereby disrupting the fiber structure in olive meal. Further lime may be saponifying the high level of fat present in olive meal, which may otherwise negatively impact the digestibility values. Conclusion: It can be concluded that the treatment with up to 6% of lime can effectively increase the digestibility of olive meal. Treated olive meal can replace up to 40% of maize from daily ration without affecting the digestibility of composite ration

  15. Comparison of forced-air warming and electric heating pad for maintenance of body temperature during total knee replacement.

    Science.gov (United States)

    Ng, V; Lai, A; Ho, V

    2006-11-01

    We conducted a randomised controlled trial to compare the efficacy of forced-air warming (Bair Hugger(trade mark), Augustine Medical model 500/OR, Prairie, MN) with that of an electric heating pad (Operatherm 202, KanMed, Sweden) for maintenance of intra-operative body temperature in 60 patients undergoing total knee replacement under combined spinal-epidural anaesthesia. Intra-operative tympanic and rectal temperatures and verbal analogue score for thermal comfort were recorded. There were no differences in any measurements between the two groups, with mean (SD) final rectal temperatures of 36.8 (0.4) degrees C with forced-air warming and 36.9 (0.4) degrees C with the electric pad. The heating pad is as effective as forced-air warming for maintenance of intra-operative body temperature.

  16. Knee Replacement

    Science.gov (United States)

    ... need knee replacement surgery usually have problems walking, climbing stairs, and getting in and out of chairs. Some ... a total living space on one floor since climbing stairs can be difficult. Install safety bars or a ...

  17. Replacing penalties

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    Vitaly Stepashin

    2017-01-01

    Full Text Available УДК 343.24The subject. The article deals with the problem of the use of "substitute" penalties.The purpose of the article is to identify criminal and legal criteria for: selecting the replacement punishment; proportionality replacement leave punishment to others (the formalization of replacement; actually increasing the punishment (worsening of legal situation of the convicted.Methodology.The author uses the method of analysis and synthesis, formal legal method.Results. Replacing the punishment more severe as a result of malicious evasion from serving accused designated penalty requires the optimization of the following areas: 1 the selection of a substitute punishment; 2 replacement of proportionality is serving a sentence other (formalization of replacement; 3 ensuring the actual toughening penalties (deterioration of the legal status of the convict. It is important that the first two requirements pro-vide savings of repression in the implementation of the replacement of one form of punishment to others.Replacement of punishment on their own do not have any specifics. However, it is necessary to compare them with the contents of the punishment, which the convict from serving maliciously evaded. First, substitute the punishment should assume a more significant range of restrictions and deprivation of certain rights of the convict. Second, the perfor-mance characteristics of order substitute the punishment should assume guarantee imple-mentation of the new measures.With regard to replacing all forms of punishment are set significant limitations in the application that, in some cases, eliminates the possibility of replacement of the sentence, from serving where there has been willful evasion, a stricter measure of state coercion. It is important in the context of the topic and the possibility of a sentence of imprisonment as a substitute punishment in cases where the original purpose of the strict measures excluded. It is noteworthy that the

  18. Evaluation of two milk replacers fed to hand-reared cheetah cubs (Acinonyx jubatus): nutrient composition, apparent total tract digestibility, and comparison to maternal cheetah milk.

    Science.gov (United States)

    Bell, Katherine M; Rutherfurd, Shane M; Cottam, Yvette H; Hendriks, Wouter H

    2011-01-01

    Commercially prepared milk replacers are frequently used to provide the sole source of nutrition for hand-reared cheetah cubs (Acinonyx jubatus). The nutrient composition of two commonly used milk replacers was determined. Using titanium dioxide as an indigestible marker, nutrient digestibility was calculated from the analyses of fecal samples collected from each cub (n = 4 on formula 1, and n = 2 on formula 2). Mean apparent total tract digestibility for both formulas was >90% for all nutrients analyzed (crude protein, amino acids, crude fat (CF), and dry matter). However, the total CF content and the concentration of the essential fatty acids, such as α-linolenic, linolenic, and arachidonic acid, of both formulas was lower than reported for maternal cheetah milk. Additionally, one formula contained a comparatively high amount of carbohydrate, at the expense of protein. Although data were lacking for cheetah maternal milk, comparison with domestic cat milk revealed high concentrations of a number of minerals (K, Fe, Zn, and Cu), while vitamin D(3) was not detected in one formula. Both formulas were low in the majority of essential amino acids compared with domestic cat maternal milk. Despite their apparently high digestibility, neither formula was complete or balanced in terms of nutrient concentrations and ratios when maternal cheetah milk and/or the requirements established for growth in domestic cats were used as estimates of ideal. On this basis, although all cubs in this study were healthy and maintained good body conditions for the duration of the trial, the results of dietary analyses indicate that these milk replacers may not provide optimal nutrition for growth in cheetah cubs when used for extended periods. © 2010 Wiley-Liss, Inc.

  19. Knee Flexion and Daily Activities in Patients following Total Knee Replacement: A Comparison with ISO Standard 14243

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    Markus A. Wimmer

    2015-01-01

    Full Text Available Walking is only one of many daily activities performed by patients following total knee replacement (TKR. The purpose of this study was to examine the hypotheses (a that subject activity characteristics are correlated with knee flexion range of motion (ROM and (b that there is a significant difference between the subject’s flexion/extension excursion throughout the day and the ISO specified input for knee wear testing. In order to characterize activity, the number of walking and stair stepping cycles, the time spent with dynamic and stationary activities, the number of activity sequences, and the knee flexion/extension excursion of 32 TKR subjects were collected during daily activity. Flexion/extension profiles were compared with the ISO 14243 simulator input profile using a level crossing classification algorithm. Subjects took an average of 3102 (range: 343–5857 walking cycles including 65 (range: 0–319 stair stepping cycles. Active and passive ROMs were positively correlated with stair walking time, stair step counts, and stair walking sequences. Simulated knee motion according to ISO showed significantly fewer level crossings at the flexion angles 20–40° and beyond 50° than those measured with the monitor. This suggests that implant wear testing protocols should contain more cycles and a variety of activities requiring higher knee flexion angles with incorporated resting/transition periods to account for the many activity sequences.

  20. Comparison of risk factors among blood donors, volunteers and replacement individuals, infected or not by hepatitis C virus

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    MJDB Felippe

    2009-01-01

    Full Text Available Hepatitis C is transmitted primarily parenterally by contaminated blood and is often associated with: intravenous drug abuse, invasive procedures, blood transfusions, acupuncture, tattooing, and alcohol and tobacco use. This study aimed to quantify and evaluate the risk factors among blood donors, volunteer blood donors and replacement individuals, infected or not by the C virus. The main transmission routes of C virus were identified in 55 men and 25 women (GI monitored by the Ambulatory Unit of the Department of Tropical Diseases, Botucatu Medical School, and in 24 men and 26 women (GII, all active blood donors at the Bauru State Hospital Transfusional Agency. Both groups were similar in: tobacco and alcohol consumption, sexual behavior, tattooing and illicit drug use. The duration of alcohol and tobacco consumption and blood transfusions in GI were longer, whereas the option for steady partners, condom use, disposable materials and piercings were predominant in GII. In conclusion, the risk factors for hepatitis C demonstrate the necessity of health policies that act on the primary and secondary prevention levels (respectively, reduction of infection incidence and hepatopathy risk.

  1. A comparison of Rasch with Likert scoring to discriminate between patients' evaluations of total hip replacement surgery.

    Science.gov (United States)

    Fitzpatrick, R; Norquist, J M; Jenkinson, C; Reeves, B C; Morris, R W; Murray, D W; Gregg, P J

    2004-03-01

    The purpose of this study was to examine whether there are advantages in terms of outcome assessment of using Rasch methods of scoring the 12-item Oxford Hip Score (OHS) questionnaire over conventionally Likert scores. As part of a prospective cohort study of total hip replacements in five former regions of England the OHS was sent to patients pre-operatively, at 3 months and 1 year post-operatively. Post-operative data was collected on over 5000 cases. Based on the level of satisfaction with surgery, patients were divided into satisfied and dissatisfied. Analyses were performed to test the relative precision (RP) of Rasch scoring vs. conventionally Likert scores in discriminating the groups experiencing different level of satisfaction. Considerable gains in precision were achieved with Rasch scoring methods when groups were compared 3 and 12 months post-operatively. The results from the current study suggest that in some situations there may be substantial gains in measuring health related outcomes using Rasch-based scoring methods.

  2. Comparison of Balance, Proprioception and Skeletal Muscle Mass in Total Hip Replacement Patients With and Without Fracture: A Pilot Study

    Science.gov (United States)

    2016-01-01

    Objective To determine whether there was a difference in balance, proprioception, and skeletal muscle mass among patients who undergo hip fracture surgery relative to and elective total hip replacement (THR). Methods Thirty-one THR patients were enrolled. The patients were categorized into two groups: fracture group (n=15) and non-fracture group (n=16). Berg Balance Scale (BBS) was used to balance the proprioception of the hip joint while a joint position sense (JPS) test was used to evaluate it. Skeletal muscle mass was measured by bioelectrical impedance analysis and expressed as a skeletal muscle mass index (SMI). Quality of life (QOL) was also assessed using a 36-item short form health survey (SF-36). All tests were assessed at 3 months after the surgery. An independent t-test was used to compare the fracture group and non-fracture group. Spearman correlation was used to identify the correlation of each variable. Results In an independent t-test, the BBS score of patients undergoing elective surgery was higher than the BBS score of patients undergoing hip fracture surgery. There was a significant correlation between the BBS and JPS score after a THR. SMI also correlated with the score of BBS. Conclusion It seems that THR patients undergoing surgery for a hip fracture might have more trouble balancing than elective THR patients. Therefore THR patients undergoing hip fracture surgery might need more care during rehabilitation. PMID:28119837

  3. RESULTS OF THE FOSFOMYCIN APPLICATION FOR THE IMPREGNATION OF BONE REPLACEMENT MATERIALS IN THE TREATMENT OF CHRONIC OSTEOMYELITIS

    Directory of Open Access Journals (Sweden)

    V. A. Konev

    2016-01-01

    Full Text Available Aim – to evaluate in the experimental study in vitro the duration of antimicrobial activity of fosfomycin-impregnated bone cement and to study the dynamics of radiological and morphological changes depending on the local antibiotic therapy in two-stage treatment of chronic osteomyelitis in rabbits.Materials and methods. Duration of antimicrobial activity of bone cement (depuy cmw1 gentamicin with fosfomycin in vitro was studied in comparison to cements with vancomycin and controls without additional antibiotics. Presence of the lysis zone of bacterial cultures was evaluated (Staphylococcus aureus ATCC6538 and ATCC33591, Klebsiella pneumoniae ATCC33495 and Escherichia coli ATCC25922 after application of 10 μl of the solution, collected from the cement samples after incubation for 24 hours. For the in vivo experiment, Chinchilla rabbits (n = 20 with local osteomyelitis of the tibia underwent two-stage treatment where substitution of the bone defect at stage I was performed with PMMA and stage II – with the bioresorbable material based on hydroxyapatite and triclacium phosphate (ReproBone. In an experience group (n = 10 before setting osteoreplacement materials with fosfomycin (group FOSFO, and by control (n = 10 – vancomycin (group VANCO. X-ray imaging was performed on the 1st and 21st day after installation of the cement spacer, and 45th day after substitution of the spacer with the bioresorbable material. Microbiological analysis of the samples was performed intraoperatively and on the 7th, 14th day after each stage. Histological study was conducted in both groups on the 14th, 21th day after stage I and 45th day after stage II of the treatment.Results. Maximal duration of antimicrobial activity in vitro was observed in samples of PMMA with fosfomycin whereas minimal – in control samples of gentamicin-based bone cement. Relief of the infection was attained in all animals while application of fosfomycin resulted in a more

  4. Comparison of outcomes and presentation in men-versus-women with bicuspid aortic valves undergoing aortic valve replacement.

    Science.gov (United States)

    Andrei, Adin-Cristian; Yadlapati, Ajay; Malaisrie, S Chris; Puthumana, Jyothy J; Li, Zhi; Rigolin, Vera H; Mendelson, Marla; Clennon, Colleen; Kruse, Jane; Fedak, Paul W M; Thomas, James D; Higgins, Jennifer A; Rinewalt, Daniel; Bonow, Robert O; McCarthy, Patrick M

    2015-07-15

    Gender disparities in short- and long-term outcomes have been documented in cardiac and valvular heart surgery. However, there is a paucity of data regarding these differences in the bicuspid aortic valve (BAV) population. The aim of this study was to examine gender-specific differences in short- and long-term outcomes after surgical aortic valve (AV) replacement in patients with BAV. A retrospective analysis was performed in 628 consecutive patients with BAV who underwent AV surgery from April 2004 to December 2013. To reduce bias when comparing outcomes by gender, propensity score matching obtained on the basis of potential confounders was used. Women with BAV who underwent AV surgery presented with more advanced age (mean 60.7 ± 13.8 vs 56.3 ± 13.6 years, p <0.001) and less aortic regurgitation (29% vs 44%, p <0.001) and had a higher risk for in-hospital mortality (mean Ambler score 3.4 ± 4.4 vs 2.5 ± 4.0, p = 0.015). After propensity score matching, women received more blood products postoperatively (48% vs 34%, p = 0.028) and had more prolonged postoperative lengths of stay (median 5 days [interquartile range 5 to 7] vs 5 days [interquartile range 4 to 6], p = 0.027). Operative, discharge, and 30-day mortality and overall survival were not significantly different. In conclusion, women with BAV who underwent AV surgery were older, presented with less aortic regurgitation, and had increased co-morbidities, lending higher operative risk. Although women received more blood products and had significantly longer lengths of stay, short- and long-term outcomes were similar.

  5. Comparison of the effects of inhalational anesthesia with desflurane and total intravenous anesthesia on cardiac biomarkers after aortic valve replacement

    Directory of Open Access Journals (Sweden)

    Poonam Malhotra Kapoor

    2015-01-01

    Full Text Available Objective (s: The aim of this study was to compare the effects of using inhalational anesthesia with desflurane with that of a total intravenous (iv anesthetic technique using midazolam-fentanyl-propofol on the release of cardiac biomarkers after aortic valve replacement (AVR for aortic stenosis (AS. The specific objectives included (a determination of the levels of ischemia-modified albumin (IMA and cardiac troponin I (cTnI as markers of myocardial injury, (b effect on mortality, morbidity, duration of mechanical ventilation, length of Intensive Care Unit (ICU and hospital stay, incidence of arrhythmias, pacing, cardioversion, urine output, and serum creatinine. Methodology and Design: Prospective randomized clinical study. Setting: Operation room of a cardiac surgery center of a tertiary teaching hospital. Participants: Seventy-six patients in New York Heart Association classification II to III presenting electively for AVR for severe symptomatic AS. Interventions: Patients included in the study were randomized into two groups and subjected to either a desflurane-fentanyl based technique or total IV anesthesia (TIVA. Blood samples were drawn at preordained intervals to determine the levels of IMA, cTnI, and serum creatinine. Measurements and Main Results: The IMA and cTnI levels were not found to be significantly different between both the study groups. Patients in the desflurane group were found to had significantly lower ICU and hospital stays and duration of postoperative mechanical ventilation as compared to those in the TIVA group. There was no difference found in mean heart rate, urine output, serum creatinine, incidence of arrhythmias, need for cardioversion, and 30-day mortality between both groups. The patients in the TIVA group had higher mean arterial pressures on weaning off cardiopulmonary bypass as well as postoperatively in the ICU and recorded lower inotrope usage. Conclusion: The result of our study remains ambiguous regarding

  6. Esophageal replacement.

    Science.gov (United States)

    Kunisaki, Shaun M; Coran, Arnold G

    2017-04-01

    This article focuses on esophageal replacement as a surgical option for pediatric patients with end-stage esophageal disease. While it is obvious that the patient׳s own esophagus is the best esophagus, persisting with attempts to retain a native esophagus with no function and at all costs are futile and usually detrimental to the overall well-being of the child. In such cases, the esophagus should be abandoned, and the appropriate esophageal replacement is chosen for definitive reconstruction. We review the various types of conduits used for esophageal replacement and discuss the unique advantages and disadvantages that are relevant for clinical decision-making. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Is it Possible to Replace Automated Keratometry with Current Devices: Comparison with LenStar and OPD II

    Directory of Open Access Journals (Sweden)

    Bengü Ekinci Köktekir

    2013-04-01

    Full Text Available Pur po se: To compare the keratometry results obtained with optical low-coherence reflectometer, corneal topography, and automated keratometry readings and to assess the interexaminer reproducibility of each device. Ma te ri al and Met hod: This comparative study examined 65 eyes of 65 healthy subjects. Detailed ophthalmic examination was performed in all cases following keratometry measurements with a KR 8100A (Topcon, Japan, an OPD Scan II (Nidek, Japan, and a LenStar LS900 (Haag-Streit, Switzerland. Patients with spheric values over ±3.0D or cylindric values over ±1.0D and with history of chronic ocular/systemic disease or contact lens usage were excluded from the study. The keratometry readings were compared by using ANOVA test (SPSS 16.0. A p-value lower than 0.05 was taken as statistically significant. Bland-Altmann analysis was used to demonstrate agreement between methods, and Spearman rank correlation coefficient (r was calculated for the correlation. To assess the interexaminer reproducibility, intraclass correlation coefficient was calculated in 30 eyes for each device. Re sults: The mean age of the 65 patients enrolled in the study was 21.9±3.25 years. The mean keratometric values obtained with the autorefractokeratometer, OPD Scan II, and LenStar LS 900 were 43.30±1.47, 43.42±1.44, and 43.29±1.42 respectively. No statistically significant difference was observed among the three groups (p=0.840. Interexaminer intraclass correlation was found as 78.9%, 99.9%, and 99.7% for ARK, OPD, and LenStar, respectively. Dis cus si on: LenStar has provided comparable and well-correlated keratometry measurements in comparison with automated keratometer and corneal topography. (Turk J Ophthalmol 2013; 43: 73-6

  8. Comparison of single-level cervical fusion and a metal-on-metal cervical disc replacement device.

    Science.gov (United States)

    Riina, Joseph; Patel, Amisha; Dietz, John W; Hoskins, Jeffery S; Trammell, Terry R; Schwartz, David D

    2008-04-01

    Cervical fusion is the common treatment for cervical disc disease but can cause secondary disorders. The Prestige ST cervical disc prosthesis (Medtronic Sofamor Danek, Memphis, TN) was designed to preserve spinal motion to potentially limit the secondary disorders. In this article, we report 2-year results from a single-center study comparing use of this device with use of anterior cervical discectomy and fusion (ACDF). Nineteen patients were prospectively randomized to receive the device or to undergo ACDF. Twenty-four months after surgery, patients who received the device demonstrated improvement in neck pain, arm pain, and neurologic function. In our cohort, patients who underwent arthroplasty demonstrated greater improvement in neurologic function and neck pain than patients who underwent cervical discectomy and fusion.

  9. Mixed treatment comparisons using aggregate and individual participant level data.

    Science.gov (United States)

    Saramago, Pedro; Sutton, Alex J; Cooper, Nicola J; Manca, Andrea

    2012-12-10

    Mixed treatment comparisons (MTC) extend the traditional pair-wise meta-analytic framework to synthesize information on more than two interventions. Although most MTCs use aggregate data (AD), a proportion of the evidence base might be available at the individual level (IPD). We develop a series of novel Bayesian statistical MTC models to allow for the simultaneous synthesis of IPD and AD, potentially incorporating study and individual level covariates. The effectiveness of different interventions to increase the provision of functioning smoke alarms in households with children was used as a motivating dataset. This included 20 studies (11 AD and 9 IPD), including 11 500 participants. Incorporating the IPD into the network allowed the inclusion of information on subject level covariates, which produced markedly more accurate treatment-covariate interaction estimates than an analysis solely on the AD from all studies. Including evidence at the IPD level in the MTC is desirable when exploring participant level covariates; even when IPD is available only for a fraction of the studies. Such modelling may not only reduce inconsistencies within networks of trials but also assist the estimation of intervention subgroup effects to guide more individualised treatment decisions.

  10. A randomized prospective comparison between intrauterine insemination and fallopian sperm perfusion for the treatment of infertility.

    Science.gov (United States)

    Karande, V C; Rao, R; Pratt, D E; Balin, M; Levrant, S; Morris, R; Dudkeiwicz, A; Gleicher, N

    1995-09-01

    To determine if the pregnancy rates (PRs) in infertile women could be improved with fallopian sperm perfusion in comparison with IUI. Randomized prospective analysis. Academically affiliated infertility center. Consecutive patients undergoing controlled ovarian hyperstimulation (COH). After hCG administration, patients were randomized to either IUI or fallopian sperm perfusion. Pregnancy rates with the two treatment modalities. Of 240 COH cycles, those randomized to IUI included 44 clomiphene citrate (CC) (group I) and 76 gonadotropin (group III) cycles. Patients receiving fallopian sperm perfusion included 44 cycles of CC (group II) and 76 cycles of gonadotropin (group IV) treatment. The overall PRs per cycle (10.8% versus 10.8%) were similar for IUI and fallopian sperm perfusion, respectively. The PRs were also similar when compared for ovulation induction with CC (6.8% versus 9.1%) and gonadotropins (13.2% versus 11.8%). We conclude that fallopian sperm perfusion offers no advantage over IUI. Because the process of fallopian sperm perfusion is more time consuming and more costly (because of increased media usage), fallopian sperm perfusion does not seem indicated as a routine infertility therapy and should not replace IUI.

  11. Study of enzyme replacement therapy for Gaucher Disease: comparative analysis of clinical and laboratory parameters at diagnosis and after two, five and ten years of treatment

    Directory of Open Access Journals (Sweden)

    Ana Maria Almeida Souza

    2014-10-01

    Full Text Available Objective: To evaluate the impact of enzyme replacement therapy for Gaucher Disease on clinical and laboratory parameters after two, five and ten years of treatment. Methods: Data were collected from patient records and analyzed using BioEstat software (version 5.0. Student's t-test, Analysis of Variance (ANOVA, Wilcoxon test and Kruskal–Wallis test were used for statistical analysis. Hepatomegaly and splenomegaly were analyzed using the Kappa test. Results: There was a significant increase in hemoglobin levels (p-value <0.01 and platelet counts (p-value = 0.01 within two years of therapy. At the same time, the frequencies of splenomegaly (p-value <0.01 and hepatomegaly (p-value <0.05 reduced. These results were similar at five and ten years of enzyme replacement therapy. Conclusions: There are substantial and quick (within two years laboratory and clinical responses to enzyme replacement therapy. These improvements continue as long as enzyme replacement therapy is administered every two weeks, as recommended by the literature.

  12. A mixed treatment comparison meta-analysis of antibiotic treatments for bovine respiratory disease.

    Science.gov (United States)

    O'Connor, Annette M; Coetzee, Johann F; da Silva, Natalia; Wang, Chong

    2013-06-01

    In this publication we use mixed treatment comparison meta-analysis to compare the efficacy of antibiotic treatments for bovine respiratory disease in beef cattle. Studies were eligible for the meta-analysis if they were publically available and reported the assessment of antibiotic protocols registered for use in the United States (US) for bovine respiratory disease (BRD) in beef cattle and were conducted in North America. Three electronic databases, the proceedings of two bovine specific conferences, pharmaceutical company web sites and the US Food and Drug Administration website were searched to identify relevant trials. The network of evidence used in the analysis contained 194 trial arms from 93 trials. Of the 93 trials there were 8 with three arms. The network of evidence contained information for 12 antibiotics. The output from the analysis provided information about the risk ratio comparing all possible treatments for BRD including comparisons based only on indirect data. The output also included a relative ranking of the treatments and estimates of the probability that an antibiotic protocol was the worst treatment option.

  13. Safety aspects in surgical treatment of pathological fractures of the proximal femur – modular endoprosthetic replacement vs. intramedullary nailing

    OpenAIRE

    Fakler, Johannes KM; Hase, Franziska; Böhme, Jörg; Josten, Christoph

    2013-01-01

    Background Pathologic fractures of the femoral intertrochanteric and subtrochanteric region require special consideration in terms of biomechanically stable fixation and durability of the implant. In addition, the type of surgery might also influence patient survival. We conducted this retrospective study to evaluate the safety of modular proximal femur replacement compared to intramedullary nailing with patient survival being the primary and complications the secondary endpoint. Methods We r...

  14. Comparison of Roth appliance and standard edgewise appliance treatment results.

    Science.gov (United States)

    Kattner, P F; Schneider, B J

    1993-01-01

    A retrospective comparison of Roth appliance and standard edgewise appliance treatment results was made using two indices. The first, the ideal tooth relationship index (ITRI), scored dental casts for the presence of ideal tooth contacts. The second judged posttreatment dental casts on the basis of criteria established by Andrews in his "Six Keys to Normal Occlusion." The sample consisted of 120 orthodontically treated cases completed by two practitioners who have used both the Roth and standard edgewise appliances. Thirty cases of each appliance type were collected from each practitioner. The overall posttreatment ITRI percentage scores showed no significant differences between the appliances. Practitioner differences existed for the anterior intraarch, anterior interarch, and posterior buccal interarch relationships. These differences were related to both treatment time and finishing arch wire size. The results of the Six Keys Analysis showed that the angulation and inclination of the maxillary posterior teeth were better with the Roth appliance. However, success in achieving some components of the six keys did not translate into an increased percentage of ideal tooth contacts as measured by the ITRI. Despite using the Roth appliance, experienced clinicians still found it difficult to achieve all six keys to normal occlusion.

  15. High-Performance and Distributed Computing in a Probabilistic Finite Element Comparison Study of the Human Lower Leg Model with Total Knee Replacement

    CERN Document Server

    Arsene, Corneliu

    2016-01-01

    Reliability theory is used to assess the sensitivity of a passive flexion and active flexion of the human lower leg Finite Element (FE) models with Total Knee Replacement (TKR) to the variability in the input parameters of the respective FE models. The sensitivity of the active flexion simulating the stair ascent of the human lower leg FE model with TKR was presented before in [1,2] whereas now in this paper a comparison is made with the passive flexion of the human lower leg FE model with TKR. First, with the Monte Carlo Simulation Technique (MCST), a number of randomly generated input data of the FE model(s) are obtained based on the normal standard deviations of the respective input parameters. Then a series of FE simulations are done and the output kinematics and peak contact pressures are obtained for the respective FE models (passive flexion and/or active flexion models). Seven output performance measures are reported for the passive flexion model and one more parameter was reported for the active flexi...

  16. Successful Renal Replacement Therapy for a Patient with Severe Hemophilia after Surgical Treatment of Intracranial Hemorrhage and Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Noriko Kato

    2011-01-01

    Full Text Available A 21-year-old Japanese male with severe hemophilia A was developed end-stage renal failure. He was placed on combination therapy with peritoneal dialysis (PD and hemodialysis (HD. Eight months later, he developed a hypertensive cerebral hemorrhage. After emergency surgery, he was managed with PD without HD to avoid cerebral edema. One month later, his renal replacement therapy was switched to HD (three times a week from PD, since a ventriculoperitoneal shunt catheter was placed to treat his hydrocephalus. HD could be performed safety without anticoagulant agents on condition that factor VIII is given after every HD.

  17. Prevention of atrial fibrillation in patients with aortic valve stenosis with candesartan treatment after aortic valve replacement

    DEFF Research Database (Denmark)

    Dahl, J. S.; Videbaek, L.; Poulsen, M. K.;

    2013-01-01

    Background: Accumulating data has suggested that treatment with Angiotensin-II receptor antagonists can prevent the new onset of atrial fibrillation (AF). The aim of this study was to evaluate whether treatment with candesartan on top of conventional treatment could prevent new onset AF in patien...

  18. Continuous renal replacement therapy for acute renal failure in patients with cancer: a well-tolerated adjunct treatment

    Directory of Open Access Journals (Sweden)

    Rebecca Fischler

    2016-08-01

    Full Text Available Abstract Introduction – Acute renal failure (ARF has a poor prognosis in patients with cancer requiring intensive care unit (ICU admission. Our aim is finding prognostic factors for hospital mortality in patients with cancer with ARF requiring renal replacement therapy (RRT. Methods – In this retrospective study, all patients with cancer with ARF treated with continuous venovenous filtration (CVVHDF in the ICU of the Institut Jules Bordet, between January 1st 2003 and December 31st 2012, were included in the study.Results – 103 patients are assessed: men/women 69/34, median age 62 years, solid/haematologic tumours 68/35, median SAPS II 56. Mortality rate was 63%. Seven patients required chronic renal dialysis. After multivariate analysis, two variables were statistically associated with hospital mortality : more than one organ failure (including kidney (OR 5.918 ; 95% CI 2.184 – 16.038 ; p<0,001 and low albumin level (OR 3.341; 95% CI 1.229 – 9.077; p=0,02. Only minor complications related to CVVHDF have been documented.Conclusions – Despite the poor prognosis associated with ARF, CVVHDF is an effective and tolerable renal replacement technique in patients with cancer admitted to the ICU. Multiple organ failure and hypoalbuminemia, two independent prognostic factors for hospital mortality have to be considered when deciding for introducing RRT.

  19. Primary total knee replacement: a comparison of a nationally agreed guide to best practice and current surgical technique as determined by the North West Regional Arthroplasty Register.

    Science.gov (United States)

    Malik, M. H. A.; Chougle, A.; Pradhan, N.; Gambhir, A. K.; Porter, M. L.

    2005-01-01

    INTRODUCTION: In 1999, a statement of best practice in primary total hip replacement was approved by the Council of the British Orthopaedic Association (BOA) and by the British Association for Surgery of the Knee (BASK) to provide a basis for regional and national auditable standards: we have compared practice in the North West of England to this document to ascertain adherence to this guide to best practice. MATERIALS AND METHODS: A direct comparison of data held on the North West Hip Arthroplasty Register for 2001/2002 and BASK/BOA guidelines was performed. 86 surgeons from 26 hospitals were included in the study. RESULTS: A mean of 93.3% of operations were performed in the surgeon's usual theatre. All of these theatres had vertical laminar air flow systems. 42.2% of respondents routinely used exhaust suits and 68.1% of respondents routinely used impermeable disposable gowns. All surgeons use some form of anti-thromboembolic prophylaxis; 66.2% use a combination of both mechanical and chemical means. All surgeons used antibiotic prophylaxis. The most popular choice of antibiotic was a cephalosporin. 93.7% of surgeons routinely use antibiotic-loaded cement. The PFC and Kinemax prostheses were the most commonly used prostheses. Interestingly, 97.7% of all first-choice implants were cemented. Only 2 surgeons used uncemented total knee replacement. 69.8% of surgeons used a posterior cruciate retaining design. A midline longitudinal skin incision is used by 87.2% of surgeons, a medial longitudinal skin incision by 7.0% and a lateral longitudinal skin incision by 5.8% of surgeons. A medial parapatellar capsular incision is preferred by 91.9% with the remainder using mid vastus or trivector retaining capsulotomy. Closure of capsulotomies is performed in flexion by 65.1% and in extension by 34.9%. In patients with osteoarthritis, 38.4% routinely resurfaced the patella, 34.9% never resurfaced the patella and 26.7% selectively resurfaced. This was in direct contrast to

  20. EFFICACY AND SAFETY OF A NEW TOPICAL TESTOSTERONE REPLACEMENT GEL THERAPY FOR THE TREATMENT OF MALE HYPOGONADISM.

    Science.gov (United States)

    Cunningham, Glenn; Belkoff, Laurence; Brock, Gerald; Efros, Mitchell; Gittelman, Marc; Carrara, Dario; Neijber, Anders; Ando, Masakazu; Mitchel, Jules

    2017-05-01

    Testosterone replacement therapy is indicated for male hypogonadism. This study aimed to evaluate the efficacy and safety of testosterone gel 2% (Tgel) over 90 days. This phase 3, open-label, noncomparator study was conducted in adult hypogonadal men (2 consecutive fasting serum testosterone values 86% subjects with symptoms consistent with testosterone deficiency). Subjects applied Tgel 23 mg/day (single pump-actuation using a hands-free cap applicator). The dose was uptitrated to 46 mg/day after 2 weeks if the 4-hour serum total testosterone level was testosterone concentration (Cave (0-24)) between 300 and 1,050 ng/dL on Day 90. Safety endpoints were adverse events (AEs), laboratory parameters, and vital signs. Of the 159 who enrolled, 139 men completed the study. Approximately three-quarters (76.1%) of subjects met Cave criteria on Day 90. Most AEs were mild to moderate. There were 5 serious AEs, and 1 (myocardial infarction) was judged as possibly related to Tgel. Confirmed excessive increases in prostate-specific antigen or hematocrit levels were rare. Tgel had a favorable local skin tolerability profile. Overall, 76% of subjects achieved Cave between 300 and 1,050 ng/dL with Tgel. Symptoms of testosterone deficiency improved with few safety concerns. AE = adverse event Cave(0-24) = average testosterone concentration CI = confidence interval Cmax = maximum concentration IIEF = International Index of Erectile Function MAF = Multidimensional Assessment of Fatigue PK = pharmacokinetic PSA = prostate-specific antigen SAE = serious adverse event SF-12 = Short Form 12 Health Survey Tgel = testosterone gel 2% Tmax = time to achieve maximum concentration TRT = testosterone replacement therapy.

  1. Expert opinion on temporary treatment recommendations for Fabry disease during the shortage of enzyme replacement therapy (ERT)

    NARCIS (Netherlands)

    G.E. Linthorst; D.P. Germain; C.E.M. Hollak; D. Hughes; A. Rolfs; C. Wanner; A. Mehta

    2011-01-01

    The shortage of enzyme for treatment of Fabry disease has caused anxiety among patients, physicians and governments. Following a request from the European Medicines Agency, consensus was reached on the temporary prioritization of patients for treatment based on disease severity and potential reversi

  2. [Development of an Excel spreadsheet for meta-analysis of indirect and mixed treatment comparisons].

    Science.gov (United States)

    Tobías, Aurelio; Catalá-López, Ferrán; Roqué, Marta

    2014-01-01

    Meta-analyses in clinical research usually aimed to evaluate treatment efficacy and safety in direct comparison with a unique comparator. Indirect comparisons, using the Bucher's method, can summarize primary data when information from direct comparisons is limited or nonexistent. Mixed comparisons allow combining estimates from direct and indirect comparisons, increasing statistical power. There is a need for simple applications for meta-analysis of indirect and mixed comparisons. These can easily be conducted using a Microsoft Office Excel spreadsheet. We developed a spreadsheet for indirect and mixed effects comparisons of friendly use for clinical researchers interested in systematic reviews, but non-familiarized with the use of more advanced statistical packages. The use of the proposed Excel spreadsheet for indirect and mixed comparisons can be of great use in clinical epidemiology to extend the knowledge provided by traditional meta-analysis when evidence from direct comparisons is limited or nonexistent.

  3. A systematic review and mixed treatment comparison of the efficacy of pharmacological treatments for fibromyalgia.

    Science.gov (United States)

    Choy, Ernest; Marshall, David; Gabriel, Zahava L; Mitchell, Stephen A; Gylee, Elizabeth; Dakin, Helen A

    2011-12-01

    To review the literature on pharmacological treatments for fibromyalgia. Relative efficacy was estimated in terms of outcome measures highlighted by the Outcome Measures in Rheumatology Network using a Bayesian mixed treatment comparison (MTC) meta-analysis. Randomized controlled trials reporting treatments for fibromyalgia were identified by systematically reviewing electronic databases (Cochrane Library, Medline, EMBASE; accessed February 2008) and conducting manual bibliographic searches. Forty-five randomized controlled trials met the prespecified inclusion criteria for the systematic review. There were limited robust clinical data for some therapeutic classes (tricyclic antidepressants, analgesics, sedative hypnotics, monoamine oxidase inhibitors) and only 21 studies met the more stringent criteria for inclusion in the MTC. The majority of studies included in the MTC assessed the anticonvulsant pregabalin (n = 5) or the serotonin norepinephrine reuptake inhibitors (SNRIs) duloxetine (n = 3) and milnacipran (n = 3). Licensed doses of pregabalin and duloxetine were significantly (P Fibromyalgia Impact Questionnaire score (pregabalin 450 mg/d only). There was no significant difference between licensed doses of pregabalin and duloxetine for these outcomes. However licensed doses of pregabalin produced significantly greater improvements in sleep compared with milnacipran (as measured by Medical Outcomes Study Sleep Scale). The current study confirms the therapeutic efficacy of pregabalin and the SNRIs, duloxetine and milnacipran, in the treatment of fibromyalgia. Given their different modes of action, combination therapy with pregabalin plus an SNRI should be investigated in future research. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Treatment of rheumatoid arthritis with metacarpophalangeal joint replacement%掌指关节置换术治疗类风湿关节炎

    Institute of Scientific and Technical Information of China (English)

    庄超; 王黎明; 桂鉴超; 徐燕

    2008-01-01

    目的 探讨应用掌指关节置换术治疗类风湿关节炎的方法和临床疗效.方法 2002年1月-2007年1月,对8例13指类风湿关节炎的患者,采用Swanson假体行掌指关节置换术.结果 术后伤口均Ⅰ期愈合,随访时间为9~24个月,平均15.8个月.掌指关节置换后按李庆泰等的疗效评定标准评价:优9指,良4指.结论 掌指关节置换术治疗类风湿关节炎疗效可靠,是一种较好的治疗方法.%Objective To investigate the technique and clinical outcome of treating rheumatoid arthritis with metacarpophalangeal joint replacement. Methods From January 2002 to January 2007, 13 digits in 8 patients with rheumatoid arthritis were treated by metacarpophalangeal joint replacement using Swenson prosthesis. Joint range of motion and postoperative pain in all eases were measured to evaluate the treatment out. Results Primary wound healing was achieved in all cases. The followed up time was from 9 months to 24 months with an average of 15.8 months. According to assessment standard described by Li, treatment outcome was graded as excellent in 9 fingers and good in 4 fingers. Conclusion Metacarpophalangeal joint replacement is an effective method to treat rheumatoid arthritis.

  5. Antifungal treatment for invasive Candida infections: a mixed treatment comparison meta-analysis

    Directory of Open Access Journals (Sweden)

    Nachega Jean B

    2009-06-01

    Full Text Available Objectives Invasive fungal infections are a major cause of mortality among patients at risk. Treatment guidelines vary on optimal treatment strategies. We aimed to determine the effects of different antifungal therapies on global response rates, mortality and safety. Methods We searched independently and in duplicate 10 electronic databases from inception to May 2009. We selected any randomized trial assessing established antifungal therapies for confirmed cases of invasive candidiasis among predominantly adult populations. We performed a meta-analysis and then conducted a Bayesian mixed treatment comparison to differentiate treatment effectiveness. Sensitivity analyses included dosage forms of amphotericin B and fluconazole compared to other azoles. Results Our analysis included 11 studies enrolling a total of 965 patients. For our primary analysis of global response rates, we pooled 7 trials comparing azoles to amphotericin B, Relative Risk [RR] 0.87 (95% Confidence Interval [CI], 0.78–0.96, P = 0.007, I2 = 43%, P = 0.09. We also pooled 2 trials of echinocandins versus amphotericin B and found a pooled RR of 1.10 (95% CI, 0.99–1.23, P = 0.08. One study compared anidulafungin to fluconazole and yielded a RR of 1.26 (95% CI, 1.06–1.51 in favor of anidulafungin. We pooled 7 trials assessing azoles versus amphotericin B for all-cause mortality, resulting in a pooled RR of 0.88 (95% CI, 0.74–1.05, P = 0.17, I2 = 0%, P = 0.96. Echinocandins versus amphotericin B (2 trials for all-cause mortality resulted in a pooled RR of 1.01 (95% CI, 0.84–1.20, P = 0.93. Anidulafungin versus fluconazole resulted in a RR of 0.73 (95% CI, 0.48–1.10, P = 0.34. Our mixed treatment comparison analysis found similar within-class effects across all interventions. Adverse event profiles differed, with amphotericin B exhibiting larger adverse event effects. Conclusion Treatment options appear to offer preferential effects on response rates and mortality. When

  6. The optimal hormonal replacement modality selection for multiple organ procurement from brain-dead organ donors

    Directory of Open Access Journals (Sweden)

    Mi Z

    2014-12-01

    Full Text Available Zhibao Mi,1 Dimitri Novitzky,2 Joseph F Collins,1 David KC Cooper3 1Cooperative Studies Program Coordinating Center, VA Maryland Health Care Systems, Perry Point, MD, USA; 2Department of Cardiothoracic Surgery, University of South Florida, Tampa, FL, USA; 3Thomas E Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA Abstract: The management of brain-dead organ donors is complex. The use of inotropic agents and replacement of depleted hormones (hormonal replacement therapy is crucial for successful multiple organ procurement, yet the optimal hormonal replacement has not been identified, and the statistical adjustment to determine the best selection is not trivial. Traditional pair-wise comparisons between every pair of treatments, and multiple comparisons to all (MCA, are statistically conservative. Hsu’s multiple comparisons with the best (MCB – adapted from the Dunnett’s multiple comparisons with control (MCC – has been used for selecting the best treatment based on continuous variables. We selected the best hormonal replacement modality for successful multiple organ procurement using a two-step approach. First, we estimated the predicted margins by constructing generalized linear models (GLM or generalized linear mixed models (GLMM, and then we applied the multiple comparison methods to identify the best hormonal replacement modality given that the testing of hormonal replacement modalities is independent. Based on 10-year data from the United Network for Organ Sharing (UNOS, among 16 hormonal replacement modalities, and using the 95% simultaneous confidence intervals, we found that the combination of thyroid hormone, a corticosteroid, antidiuretic hormone, and insulin was the best modality for multiple organ procurement for transplantation. Keywords: best treatment selection, brain-dead organ donors, hormonal replacement, multiple binary endpoints, organ procurement, multiple comparisons

  7. Evaluation of two milk replacers fed to hand-reared cheetah cubs (Acinonyx jubatus): nutrient composition, apparent total tract digestibility and comparison to maternal cheetah milk

    NARCIS (Netherlands)

    Bell, K.M.; Rutherfurd, S.M.; Cottam, Y.H.; Hendriks, W.H.

    2011-01-01

    Commercially prepared milk replacers are frequently used to provide the sole source of nutrition for hand-reared cheetah cubs (Acinonyx jubatus). The nutrient composition of two commonly used milk replacers was determined. Using titanium dioxide as an indigestible marker, nutrient digestibility was

  8. Evaluation of two milk replacers fed to hand-reared cheetah cubs (Acinonyx jubatus): nutrient composition, apparent total tract digestibility and comparison to maternal cheetah milk

    NARCIS (Netherlands)

    Bell, K.M.; Rutherfurd, S.M.; Cottam, Y.H.; Hendriks, W.H.

    2011-01-01

    Commercially prepared milk replacers are frequently used to provide the sole source of nutrition for hand-reared cheetah cubs (Acinonyx jubatus). The nutrient composition of two commonly used milk replacers was determined. Using titanium dioxide as an indigestible marker, nutrient digestibility was

  9. Warning sign of postmenopausal hormone replacement treatment%绝经后激素治疗慎用证

    Institute of Scientific and Technical Information of China (English)

    孙爱军

    2011-01-01

    Patients with menopausal symptoms, especially those who are also complicated with any disease of uterine fibroids, endometriosis, diabetes, hypertension, thrombophilia, gallbladder diseases, asthma, and hyperprolactinemia, or also with a family history of breast cancer, should be individually and carefully assessed when hormone replacement therapy is applied to them, so as to provide better medical service to them.%有更年期症状的患者如同时合并子宫肌瘤、子宫内膜异位症、糖尿病、高血压、血栓形成倾向、胆囊疾病、哮喘、高泌乳素血症或有乳腺癌家族史应用激素治疗时应仔细评估,个体化分析每个患者的慎用情况,以期为患者提供更好的医疗服务.

  10. The attenuated/late onset lysosomal storage disorders: Therapeutic goals and indications for enzyme replacement treatment in Gaucher and Fabry disease.

    Science.gov (United States)

    Hollak, Carla E M; Weinreb, Neal J

    2015-03-01

    Enzyme replacement therapies have been developed and authorized for commercial use for six different lysosomal storage disorders. For Gaucher disease, Fabry disease and mucopolysaccharidosis type 1, disease-specific treatments have been available for more than a decade. Although long term follow-up data are still sparse, therapeutic goals for patients with Gaucher disease and Fabry disease have been formulated and published for both adults and children. Without adaptation or modification, these goals are often applied in clinical research and in routine patient care across the entire phenotypic spectrum of disease, although in practice, patients commonly manifest high variability in clinical presentation and course of the illness. In this context, establishing goals for the follow-up and treatment of late onset/attenuated phenotypes is particularly challenging. In this chapter, we review current therapeutic goals for Gaucher disease and Fabry disease and discuss approaches for those with attenuated disease manifestations.

  11. [Estrogen replacement].

    Science.gov (United States)

    Søgaard, A J; Berntsen, G K; Magnus, J H; Tollan, A

    1998-02-10

    Recent research on long-term postmenopausal hormone replacement therapy (HRT) indicates a positive effect on both total mortality and morbidity. This has raised the question of widespread preventive long-term use of HRT. Possible side-effects and ideological issues related to preventive HRT have led to debate and uncertainty among health professionals, in the media, and in the population at large. In order to evaluate the level of knowledge about and attitudes towards HRT, a randomly selected group of 737 Norwegian women aged 16-79 was interviewed by the Central Bureau of Statistics. One in three women had received information about HRT in the last two years, mainly through weekly magazines and physicians. The proportion who answered the questions on knowledge correctly varied from 36% to 47%. Those who had been given information by a physician possessed accurate knowledge, had more positive attitudes towards HRT and were more willing to use HRT than women who had reviewed information through other channels. Women with a higher level of education were better informed and more knowledgeable than others, but were nevertheless more reluctant to use HRT than those who were less educated. The limited number of women who actually receive information on HRT, the low level of knowledge and the ambivalent attitudes toward HRT are a major challenge to the public health service.

  12. Replacement of 5% of OPC by fly ash and APC residues from MSWI with electrodialytic pre-treatment

    DEFF Research Database (Denmark)

    Magro, Cátia; Kirkelund, Gunvor Marie; Guedes, Paula

    2016-01-01

    Fly ash (FA) and air pollution control (APC) residues are waste products from Municipal Solid Waste Incineration (MSWI). They are classified as hazardous waste due to the content of leachable heavy metals (HM), salts and/or dioxins. An electrodialytic (ED) process was applied to FA and APC residues...... leaching of HM and the Cl content. The compressive tests presented comparable values to the reference mortars. This study suggests that the characteristics of FA and APC residues from MSWI after pre-treatment allows them to be reused in building materials, giving a new edge to waste management....... as pre-treatment prior to incorporation in mortar, aiming to stabilize and remove HM and chlorides. Eight ED experiments were performed for 7 days with a L/S ratio of 3.5. The number of compartments (2 or 3) and current density (0.1 or 1.0 mA cm-2) varied. After ED treatment the heavy metals left...

  13. TOBACCO DEPENDENCE TREATMENT WITH NICOTINE REPLACEMENT THERAPY AS ONE OF THE METHODS FOR CARDIOVASCULAR DISEASE RISK REDUCTION

    Directory of Open Access Journals (Sweden)

    O. V. Vikhireva

    2005-01-01

    Full Text Available Aim. To investigate efficacy and safety of nicotine chewing gum and inhaler in individuals trying to quit smoking. To assess expected reduction of cardiovascular disease (CVD and total mortality relative risks (RR.Material and methods. In this open, parallel study, 169 relatively healthy male smokers aged 18-60 years were randomly assigned to free choice vs admission of Nicorette gum (2/4 mg or inhaler (10 mg. At baseline, all participants smoked ≥15 cig/d, for ≥3 years. The intervention phase lasted 3 months; follow-up evaluations were made at 3, 6 and 12 months after nicotine replacement therapy (NRT initiation.Results. Twelve-month results were obtained for 152 subjects (response rate 89.9%. Point prevalence abstinence and reduction (smoking ≤50% of basic daily cigarette amount rates were 19.7% and 35.5%, respectively. Neither abstinence, nor reduction rates depended on Nicorette form (gum vs inhaler, or on choice vs admission factor. The main predictors of long-term efficacy were nicotine dependence severity and contacts with other smokers.NRT was not associated with negative dynamics in objective health parameters (blood pressure, heart rate, ECG parameters, body weight, and body mass index or self-evaluation of health. Both Nicorette forms seemed to be safe and well-tolerated.At 12 months, the expected mean RR reduction for CVD mortality reached 19%, for total mortality – 21%.Conclusion. In Russian clinical settings, NRT efficacy and safety are similar to that demonstrated in numerous international trials. NRT can be recommended as one of the methods of assistance to quit smoking and, therefore, for CVD risk reduction.

  14. The efficacy of 12 weeks non-surgical treatment for patients not eligible for total knee replacement

    DEFF Research Database (Denmark)

    Skou, Søren Thorgaard; Rasmussen, Sten; Laursen, Mogens Berg

    2015-01-01

    secondary care with knee OA, confirmed by radiography (Kellgren-Lawrence grade ≥1), but not eligible for a TKR. The 12-week non-surgical treatment program consisted of individualized progressed neuromuscular exercise, patient education, insoles, dietary advice and prescription of pain medication...

  15. Rationale and design of the Aortic Valve replAcemenT versus conservative treatment in Asymptomatic seveRe aortic stenosis (AVATAR trial): A randomized multicenter controlled event-driven trial.

    Science.gov (United States)

    Banovic, Marko; Iung, Bernard; Bartunek, Jozef; Asanin, Milika; Beleslin, Branko; Biocina, Bojan; Casselman, Filip; da Costa, Mark; Deja, Marek; Gasparovic, Hrvoje; Kala, Petr; Labrousse, Lois; Loncar, Zlatibor; Marinkovic, Jelena; Nedeljkovic, Ivana; Nedeljkovic, Milan; Nemec, Peter; Nikolic, Serge D; Pencina, Michael; Penicka, Martin; Ristic, Arsen; Sharif, Faisal; Van Camp, Guy; Vanderheyden, Marc; Wojakowski, Wojtek; Putnik, Svetozar

    2016-04-01

    Aortic valve replacement (AVR) therapy is an obvious choice for symptomatic severe aortic stenosis (AS) patients as it improves symptoms, left ventricular function, and survival. The treatment decisions and indication for AVR in asymptomatic patients with severe AS and normal left ventricular ejection fraction are less well established and the subject of ongoing debate. Many efforts have been made to define the best treatment option in asymptomatic AS patients with normal left ventricular ejection fraction. Retrospective and observational data imply that elective AVR for asymptomatic severe AS may lead to improvement in outcomes in comparison to surgery performed after onset of symptoms. The AVATAR trial will aim to assess outcomes among asymptomatic AS patients randomized to either elective early AVR or medical management with vigilant follow-up. In the latter group, AVR would be delayed until either the onset of symptoms or changes in predefined echocardiographic parameters. To the best of the authors' knowledge, it will be the first large prospective, randomized, controlled, multicenter clinical trial that will evaluate the safety and efficacy of elective AVR in this specific group of patients.

  16. Hip Replacement

    Science.gov (United States)

    ... The most common cause of damage is osteoarthritis. Osteoarthritis causes pain, swelling, and reduced motion in your joints. It can interfere with your daily activities. If other treatments such as physical therapy, pain medicines, and exercise haven't helped, hip ...

  17. Treatment of replacement resorption by intentional replantation, resection of the ankylosed sites, and Emdogain--results of a 6-year survey.

    Science.gov (United States)

    Filippi, Andreas; Pohl, Yango; von Arx, Thomas

    2006-12-01

    The present clinical study investigated the outcome of intentional replantation using resection of the ankylosed sites of the root, extraoral endodontic treatment using titanium posts and Emdogain for periodontal healing following trauma-related ankylosis. During an evaluation period of 6 years, 16 ankylosed teeth affected by replacement resorption were treated as described. Evaluation parameters before treatment and during the follow-up period included Periotest scores, percussion sound and periapical radiographs. All findings were compared to those of the adjacent teeth. In a second accident, one tooth was lost after 7 months and was excluded as a dropout. Ankylosis did not recur in seven replanted teeth, which were observed for an average of 52.3 months (range: 24-68 months). Ankylosis recurred in eight teeth after an average period of 12 months (range: 4-26 months). An infraocclusion, normal or only slightly reduced Periotest scores and normal percussion sound were preoperatively found in six of seven successfully replanted teeth, which corresponded to a relatively small area of ankylosis. The majority of the teeth showing recurrent ankylosis preoperatively presented with normal position, negative Periotest scores and a high percussion sound which corresponded to an extended area of ankylosis. Statistically significant relationship between preoperative findings and the treatment outcome (P = 0.031) have become apparent. The results indicate that the treatment of minor areas of ankylosis by intentional replantation, resection of the ankylosed sites and Emdogain appeared to prevent or delay the recurrence of ankylosis in 7 of 15 teeth.

  18. Combined treatment of ulinastatin and tranexamic acid provides beneficial effects by inhibiting inflammatory and fibrinolytic response in patients undergoing heart valve replacement surgery.

    Science.gov (United States)

    Chen, Ting-Ting; Jiandong-Liu; Wang, Gang; Jiang, Sheng-Li; Li, Li-Bing; Gao, Chang-Qing

    2013-02-01

    To investigate the effect of ulinastatin and tranexamic acid administered alone or in combination on inflammatory cytokines and fibrinolytic system in patients undergoing heart valve replacement surgery during cardiopulmonary bypass (CPB). CPB-induced fibrinolytic hyperfunction and systemic inflammatory response syndrome (SIRS) are the leading causes responsible for the occurrence of postsurgical complications such as postsurgical cardiac insufficiency and lung injury, which may lead to an increase in postsurgical bleeding, prolongation of hospital stay, and increased costs. One hundred twenty patients undergoing heart valve replacement surgery during CPB were randomly assigned into 4 groups of 30 patients each: blank control group (Group C), tranexamic acid group (Group T), ulinastatin group (Group U), and tranexamic acid-ulinastatin combination group (Group D). Physiological saline, tranexamic acid, ulinastatin, and a combination of tranexamic acid and ulinastatin were given to each group, respectively. Arterial blood was collected from the radial artery at 4 time points: after induction of anesthesia (T1), unclamping the ascending aorta (T2), and at 1 hour (T3) and 24 hours (T4) after CPB. The levels of plasma tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), neutrophil elastase (NE), and the concentrations of tissue plasminogen activator (t-PA) and α2-antiplasmin (α2-AP) were detected. The changes in the volume of pericardial mediastinal drainage after surgery were observed and recorded. The plasma TNF-α, IL-6, and NE levels significantly increased in patients from all 4 groups at time points of T2, T3, and T4 in comparison to those before CPB (P surgery (P surgery.

  19. Quality of Life Shift after Aortic Valve Replacement in the Era of TAVI: Single-Center Class Comparison Study Between Different Procedural Techniques.

    Science.gov (United States)

    Blehm, Alexander; Sorokin, Vitaly A; Hartman, Mikael; Wai, Khin Lay; Schmitz, Karoline; Lichtenberg, Artur

    2015-09-01

    The health-related quality of life (QOL) is one of the most important outcome indicators for elderly people undergoing aortic valve interventions, and should be assessed across different interventions, including emerging percutaneous techniques. The study aim was to assess the change in QOL after different procedures for aortic valve replacement (AVR). QOL was assessed using the Short Form-36 questionnaire (SF-36) for 59 patients after conventional AVR; of these patients, 28 had AVR via a J-sternotomy, a transapical approach was used in 20 patients, and a transfemoral approach in 34. The early mortality during hospitalization was not significantly different among all four groups. The inverse probability weighted propensity scores adjusted Kaplan-Meier curve revealed that the transapical group had the lowest survival rate. The treatment effect analysis was most prominent in the transfemoral transcatheter aortic valve implantation (TAVI) group across all domains for QOL. The multivariate hierarchical linear mixed final fitted model shows that the transapical TAVI procedure and NYHA class (III-IV) had a significant negative effect on the physical domain and overall QOL score. Changes in QOL after interventions on the aortic valve were determined by the patient's preoperative status and the surgical intervention. The transcatheter intervention, even in 'sicker' patients, provided a gain in QOL comparable with that after an open-heart procedure. Transfemoral TAVI was shown to have advantages over transapical TAVI in terms of QOL improvement at three months and six months, and should be considered the first choice for patients in the high-risk surgical group.

  20. Comparison of serum immunoglobulin G half-life in dairy calves fed colostrum, colostrum replacer or administered with intravenous bovine plasma.

    Science.gov (United States)

    Murphy, Jacob M; Hagey, Jill V; Chigerwe, Munashe

    2014-04-15

    In calves, passive immunity of immunoglobulins can be acquired through ingestion of colostrum or colostrum replacers. Plasma can been used to supplement immunoglobulins in healthy or sick calves. Serum half-life of colostral derived immuglobulin G (IgG) is estimated to be 20 days. Half-life of IgG is important in determining response to antigens and timing of vaccination in calves. To date studies evaluating half-life of colostrum replacer or plasma derived IgG are lacking. The objectives of this study were to compare the serum half-life of IgG derived from colostrum, colostrum replacer and plasma in dairy calves reared up to 35 days of age. Thirty Jersey calves were randomly assigned to receive colostrum or colostrum replacer by oroesophageal tubing or plasma by intravenous administration. Serum samples were collected at 2, 5, 7, 10, 14, 21, 28 and 35 days. Serum IgG concentrations were determined by radial immunodiffusion. The results indicated that half-life for IgG in colostrum fed (28.5 days) or plasma transfused calves (27.3 days) was longer than colostrum replacer fed calves (19.1 days). Further studies are required to evaluate pathogen specific immunoglobulins in order to recommend vaccination timing in calves fed colostrum replacers.

  1. Comparison of radiographic joint space width and magnetic resonance imaging for prediction of knee replacement: A longitudinal case-control study from the Osteoarthritis Initiative

    Energy Technology Data Exchange (ETDEWEB)

    Eckstein, Felix; Wirth, Wolfgang; Cotofana, Sebastian [Paracelsus Medical University Salzburg and Nuremberg Austria and Chondrometrics GmbH, Institute of Anatomy, Ainring (Germany); Boudreau, Robert [University of Pittsburgh, Department of Epidemiology, Graduate School of Public Health, Pittsburgh, PA (United States); Wang, Zhijie; Hannon, Michael J. [University of Pittsburgh and Pittsburgh VAHS, Division of Rheumatology and Clinical Immunology, Pittsburgh, PA (United States); Duryea, Jeff [Brigham and Women' s Hospital, Harvard Medical School, Boston, MA (United States); Guermazi, Ali [Boston University School of Medicine and Boston Imaging Core Lab (BICL), LLC, Boston, MA (United States); Roemer, Frank [Boston University School of Medicine and Boston Imaging Core Lab (BICL), LLC, Boston, MA (United States); University of Erlangen-Nuremberg, Department of Radiology, Erlangen (Germany); Nevitt, Michael [OAI Coordinating Ctr., UCSF, San Francisco, CA (United States); John, Markus R. [Novartis Pharma AG, Basel (Switzerland); Ladel, Christoph [Merck KGaA, Darmstadt (Germany); Sharma, Leena [Northwestern University, Department of Medicine, Feinberg School of Medicine, Chicago, IL (United States); Hunter, David J. [University Sydney, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, Sydney, NSW (Australia); Kwoh, C.K. [University of Arizona, Division of Rheumatology and the University of Arizona Arthritis Center, Tucson, AZ (United States); Collaboration: OAI Investigators

    2016-06-15

    To evaluate whether change in fixed-location measures of radiographic joint space width (JSW) and cartilage thickness by MRI predict knee replacement. Knees replaced between 36 and 60 months' follow-up in the Osteoarthritis Initiative were each matched with one control by age, sex and radiographic status. Radiographic JSW was determined from fixed flexion radiographs and subregional femorotibial cartilage thickness from 3 T MRI. Changes between the annual visit before replacement (T{sub 0}) and 2 years before T{sub 0} (T{sub -2}) were compared using conditional logistic regression. One hundred and nineteen knees from 102 participants (55.5 % women; age 64.2 ± 8.7 [mean ± SD] years) were studied. Fixed-location JSW change at 22.5 % from medial to lateral differed more between replaced and control knees (case-control [cc] OR = 1.57; 95 % CI: 1.23-2.01) than minimum medial JSW change (ccOR = 1.38; 95 % CI: 1.11-1.71). Medial femorotibial cartilage loss displayed discrimination similar to minimum JSW, and central tibial cartilage loss similar to fixed-location JSW. Location-independent thinning and thickening scores were elevated prior to knee replacement. Discrimination of structural progression between knee pre-placement cases versus controls was stronger for fixed-location than minimum radiographic JSW. MRI displayed similar discrimination to radiography and suggested greater simultaneous cartilage thickening and loss prior to knee replacement. (orig.)

  2. The David V Valve-Sparing Root Replacement Provides Improved Survival Compared With Mechanical Valve-conduits in the Treatment of Young Patients With Aortic Root Pathology.

    Science.gov (United States)

    Esaki, Jiro; Leshnower, Bradley G; Binongo, Jose N; Lasanajak, Yi; McPherson, LaRonica; Halkos, Michael E; Guyton, Robert A; Chen, Edward P

    2016-11-01

    Valve-sparing root replacement (VSRR) is an attractive therapy for aortic root aneurysms; however, there is a paucity of data comparing VSRR with conventional root replacement using a mechanical valve-conduit (MECH). This study evaluates and compares outcomes of VSRR and MECH. A retrospective review from 2002 to 2015 at a US academic center identified 444 patients who underwent VSRR (282 patients) or MECH (162 patients). Propensity score matching was performed, based on 22 preoperative and intraoperative characteristics, and 87 matched pairs were identified. There was no difference in mean age between the groups (VSRR 45.0 years, MECH 44.2 years, p = 0.59). The incidence of Marfan syndrome (VSRR 10.3%, MECH 12.6%, p = 0.63), type A acute aortic dissection (VSRR 25.3%, MECH 27.6%, p = 0.73), reoperation (VSRR 23.0%, MECH 21.8%, p = 0.86), and arch replacement (VSRR 54.0%, MECH 52.9%, p = 0.88) were similar in both groups. Ejection fraction was similar (VSRR 52.8% ± 10.9%, MECH 52.4% ± 11.7%, p = 0.83). Operative mortality was 2.3% with VSRR and 8.0% with MECH (p = 0.10). There were no significant differences in renal failure requiring dialysis (VSRR 1.1%, MECH 4.6%, p = 0.24), permanent neurologic dysfunction (VSRR 2.3%, MECH 6.9%, p = 0.16), and pacemaker implantation (VSRR 1.1%, MECH 1.1%, p = 0.99) between the groups. Survival at 7 years was significantly improved in patients who underwent VSSR (VSRR 85.5%, MECH 73.6%, p = 0.03). In comparison with patients undergoing MECH, there is improved midterm survival among patients undergoing VSRR, with similar operative mortality and morbidity. For appropriately selected patients, VSRR provides an attractive and potentially superior alternative to MECH. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Comparison of Three Systems for Biological Greywater Treatment

    NARCIS (Netherlands)

    Hernandez Leal, L.; Temmink, B.G.; Zeeman, G.; Buisman, C.J.N.

    2010-01-01

    Greywater consists of household wastewater excluding toilet discharges. Three systems were compared for the biological treatment of greywater at a similar hydraulic retention time of approximately 12–13 hours. These systems were aerobic treatment in a sequencing batch reactor, anaerobic treatment in

  4. Comparison of Three Systems for Biological Greywater Treatment

    NARCIS (Netherlands)

    Hernandez Leal, L.; Temmink, B.G.; Zeeman, G.; Buisman, C.J.N.

    2010-01-01

    Greywater consists of household wastewater excluding toilet discharges. Three systems were compared for the biological treatment of greywater at a similar hydraulic retention time of approximately 12–13 hours. These systems were aerobic treatment in a sequencing batch reactor, anaerobic treatment in

  5. Application of Vibro-replacement Stone Column in Foundation Treatment%振冲碎石桩在地基处理中的应用

    Institute of Scientific and Technical Information of China (English)

    姜波

    2013-01-01

    The vibro-replacement stone column is a rapidly developed method to treat soft ground in recent years. Through the applica-tion in Laioyuan sewage plant AAO reactor foundation treatment, the paper systematically introduced machinery and process flow dur-ing vibro-replacement stone column construction, and expounded from aspects of consolidation mechanism, construction method and practical effect. Thus illustrated the column is adequate for loose sandy soil, silt and muddy silt strata. After boring, filths removal, bore-hole flushing, packing, vibro-compacting, and final column completion can improve foundation bearing capacity with marked effect in soft ground treatment and have certain popularizing values.%振冲碎石桩是近几年发展较快的软弱地基处理方法。通过对辽源污水处理厂A?/0反应池地基处理的应用,系统介绍了振冲碎石桩在施工过程中的机械及工艺流程。并就加固机理、施工方法以及实用效果几个方面进行了阐述。说明振冲碎石桩适用于松散砂土、粉土及淤泥质粉土地层,经过成孔、排污、清孔、填料、振密,最终控制成桩,可明显改善地基承载力,对软弱地基处理效果显著,具有一定的推广价值。

  6. [A comparison of operative invasiveness in minimally invasive anterolateral hip replacement (MIS-AL) and standard hip procedure, using biochemical markers].

    Science.gov (United States)

    Musil, D; Stehlík, J; Verner, M

    2008-02-01

    The aim of this prospective randomized study was to compare, by means of biochemical markers, the operative invasiveness of the standard total hip replacement with that of the minimally invasive anterolateral (MIS-AL) approach. Twenty-six randomly assigned patients with standard and 22 patients with MIS-AL total hip replacement were included in the study. Patients with elevated pre-operative levels of the markers evaluated or patients taking medication that might affect marker levels were not included. Creatine phosphokinase (CPK) and C-reactive protein (CRP) were chosen as markers of muscle damage and post-operative inflammatory changes, respectively. Blood samples were drawn before surgery (less than 24 hours) and after surgery at 24, 48 and 96 hours, which respected biological half-lives of the markers and permitted us to study their dynamics. The results were evaluated and statistically analyzed at the department of biochemistry, using the two sample t-test. Statistically significant differences between the two groups of patients were found for both markers. The average CRP values differed significantly (p MIS-AL total hip replacement by 28% and 44%, respectively. The average CPK values showed the most marked difference at 48 hours after surgery, when the level was higher by 62.5% in the standard than MIS-AL total hip replacement (p MIS-AL results in minimal damage to muscle tissue and, consequently, a lower degree of post-operative inflammation than is recorded in traditional hip replacement surgery. In the patients undergoing MIS-AL total hip replacement, post-operative levels of CPK and CRP were significantly lower than in the patients with standard total hip replacement. The MIS-AL technique evidently provides a more sparing approach to soft tissues.

  7. A comparison of leg length and femoral offset discrepancies in hip resurfacing, large head metal-on- metal and conventional total hip replacement: a case series

    Directory of Open Access Journals (Sweden)

    Herman Katie A

    2011-12-01

    Full Text Available Abstract Background A discrepancy in leg length and femoral offset restoration is the leading cause of patient dissatisfaction in hip replacement surgery and has profound implications on patient quality of life. The aim of this study is to compare biomechanical hip reconstruction in hip resurfacing, large-diameter femoral head hip arthroplasty and conventional total hip replacement. Method Sixty patient's post-operative radiographs were reviewed; 20 patients had a hip resurfacing (HR, 20 patients had a Large Head Metal-on-metal (LHM hip replacement and 20 patients had a conventional small head Total Hip Replacement (THR. The leg length and femoral offset of the operated and unoperated hips were measured and compared. Results Hip resurfacing accurately restored hip biomechanics with no statistical difference in leg length (P = 0.07 or femoral offset (P = 0.95 between the operated and non-operative hips. Overall HR was superior for reducing femoral offset discrepancies where it had the smallest bilateral difference (-0.2%, P = 0.9. The traditional total hip replacement was least effective at restoring the hip anatomy. Conclusion The use of a larger-diameter femoral head in hip resurfacing does not fully account for the superior biomechanical restoration, as LHM did not restore femoral offset as accurately. We conclude that restoration of normal hip biomechanics is best achieved with hip resurfacing.

  8. Comparison of Three Systems for Biological Greywater Treatment

    Directory of Open Access Journals (Sweden)

    Lucía Hernández Leal

    2010-04-01

    Full Text Available Greywater consists of household wastewater excluding toilet discharges. Three systems were compared for the biological treatment of greywater at a similar hydraulic retention time of approximately 12–13 hours. These systems were aerobic treatment in a sequencing batch reactor, anaerobic treatment in an up-flow anaerobic blanket reactor and combined anaerobic-aerobic treatment (up-flow anaerobic blanket reactor + sequencing batch reactor. Aerobic conditions resulted in a COD removal of 90%, which was significantly higher than 51% removal by anaerobic treatment. The low removal in the anaerobic reactor may have been caused by high concentration of anionic surfactants in the influent (43.5 mg/L and a poor removal of the colloidal fraction of the COD in up-flow anaerobic sludge blanket reactors. Combined aerobic-anaerobic treatment accomplished a COD removal of 89%, similar to the aerobic treatment alone. Greywater methanization was 32% for the anaerobic system and 25% for the anaerobic-aerobic system, yielding a small amount of energy. Therefore, anaerobic pre-treatment is not feasible and an aerobic system is preferred for the treatment of greywater.

  9. Survival and associated factors in 268 adults with Pompe disease prior to treatment with enzyme replacement therapy

    Directory of Open Access Journals (Sweden)

    Reuser Arnold JJ

    2011-06-01

    mortality. These results may be of relevance when addressing the effect of ERT or other potential treatment options on survival.

  10. Treatment of drug abusers in Malaysia: a comparison.

    Science.gov (United States)

    Johnson, S H

    1983-10-01

    The purpose of this paper is to compare two forms of treatment for heroin abusers in Malaysia--traditional medicine and institutional--and to evaluate which form of treatment the drug abusers consider more effective. The study involved interviewing 100 male drug abusers in Malaysia who had had treatment from an institution and from a traditional healer. The data revealed that traditional medicine was better for some abusers, but institutional treatment was better for others, depending upon an individual's own needs and personality. Advantages and disadvantages of both forms of treatment were given by those interviewed. The data can be used as guidelines for the development of a more flexible, individualized program within an institutional setting in Malaysia.

  11. Comparative study of anterolateral approach versus posterior approach for total hip replacement in the treatment of femoral neck fractures in elderly patients

    Institute of Scientific and Technical Information of China (English)

    WANG Gang; GU Gui-shan; LI Dan; SUN Da-hui; ZHANG Wei; WANG Tie-jun

    2010-01-01

    -5 days) in anterolateral group and (6.2±2.8) days (range: 3-10 days) in posterior group. No patients in anterolateral group experienced dislocation. One (5%) hip in posterior approach had dislocation.Conclusions: Anterolateral mini-invasive approach can decrease trauma, operation time, length of hospital stay and bed stay and rehabilitation time. The stability and minimal muscular damage permit the acceleration of postoperative rehabilitation, which can subsequently reduce the perioperative risk in the treatment of femoral neck fractures in the elderly undergoing total hip replacement.

  12. Doctor Referral of Overweight People to a Low-Energy Treatment (DROPLET) in primary care using total diet replacement products: a protocol for a randomised controlled trial.

    Science.gov (United States)

    Jebb, Susan A; Astbury, Nerys M; Tearne, Sarah; Nickless, Alecia; Aveyard, Paul

    2017-08-04

    The global prevalence of obesity has risen significantly in recent decades. There is a pressing need to identify effective interventions to treat established obesity that can be delivered at scale. The aim of the Doctor Referral of Overweight People to a Low-Energy Treatment (DROPLET) study is to determine the clinical effectiveness, feasibility and acceptability of referral to a low-energy total diet replacement programme compared with usual weight management interventions in primary care. The DROPLET trial is a randomised controlled trial comparing a low-energy total diet replacement programme with usual weight management interventions delivered in primary care. Eligible patients will be recruited through primary care registers and randomised to receive a behavioural support programme delivered by their practice nurse or a referral to a commercial provider offering an initial 810 kcal/d low-energy total diet replacement programme for 8 weeks, followed by gradual food reintroduction, along with weekly behavioural support for 24 weeks. The primary outcome is weight change at 12 months. The secondary outcomes are weight change at 3 and 6 months, the proportion of participants achieving 5% and 10% weight loss at 12 months, and change in fat mass, haemoglobin A1c, low-density lipoprotein cholesterol and systolic and diastolic blood pressure at 12 months. Data will be analysed on the basis of intention to treat. Qualitative interviews on a subsample of patients and healthcare providers will assess their experiences of the weight loss programmes and identify factors affecting acceptability and adherence. This study has been reviewed and approved by the National Health ServiceHealth Research Authority (HRA)Research Ethics Committee (Ref: SC/15/0337). The trial findings will be disseminated to academic and health professionals through presentations at meetings and peer-reviewed journals and to the public through the media. If the intervention is effective, the results

  13. Polymorphisms of the GR and HSD11B1 genes influence body mass index and weight gain during hormone replacement treatment in patients with Addison's disease.

    Science.gov (United States)

    Molnár, Ágnes; Kövesdi, Annamária; Szücs, Nikolette; Tóth, Miklós; Igaz, Péter; Rácz, Károly; Patócs, Attila

    2016-08-01

    Glucocorticoid substitution is essential in patients with chronic primary adrenocortical insufficiency (Addison's disease) and both over-treatment and inadequate dosage have deleterious effects. Individual sensitivity to glucocorticoids is partly genetically determined. To test the hypothesis whether the well-characterized SNPs of the GR and HSD11B1 genes may modulate the individual sensitivity to exogenous glucocorticoids and may influence clinical and/or laboratory parameters and the glucocorticoid substitution dosage in patients with Addison's disease. 68 patients with primary adrenocortical insufficiency were involved. Clinical and laboratory data, as well as the dosage of the hormone replacement therapy were collected. Peripheral blood DNA was isolated, and the GR and HSD11B1 SNPs were examined using allele-specific PCR or Taqman assay on Real Time PCR. The allele frequency of the GR N363S polymorphism was higher in patients compared to the control group and the disease appeared significantly earlier in patients harbouring the GR A3669G compared to noncarriers. These patients had higher ACTH level measured at the time of diagnosis. Homozygous BclI carriers had higher body mass index (BMI) and lower total hydrocortisone equivalent supplementation dose needed than heterozygous or noncarriers. The BMI and weight gain during hormone replacement therapy were also higher in carriers of the HSD11B1 rs4844880 treated with glucocorticoids other than dexamethasone. The BclI polymorphism of the GR gene and the rs4844880 of the HSD11B1 gene may contribute to weight gain and may affect the individual need of glucocorticoid substitution dose in these patients. © 2016 John Wiley & Sons Ltd.

  14. An integrated mechanical-enzymatic reverse osmosis treatment of dairy industry wastewater and milk protein recovery as a fat replacer: a closed loop approach

    Directory of Open Access Journals (Sweden)

    F. Sarghini

    2013-09-01

    Full Text Available The dairy industry can be classified among the most polluting of the food industries in volume in regard to its large water consumption, generating from 0.2 to 10 L of effluent per liter of processed milk. Dairy industry effluents usually include highly dissolved organic matter with varying characteristics, and a correct waste management project is required to handle. In a framework of natural water resource availability and cost increase, wastewater treatment for water reuse can lower the overall water consumption and the global effluent volume of industrial plants. Moreover, correct dismissal of dairy industry wastewater is sometimes neglected by the operators , increasing the environmental impact due to the chemical and biological characteristics of such effluents. On the other hand, in the case of whey effluents, several by-products are still present inside, such as lactose and milk proteins. Membrane technology has some advantages including a high degree of reliability in removing dissolved, colloidal and particulate matter, like the selectivity in size of pollutants to be removed and the possibility of very compact treatment plants. For example, Reverse Osmosis (RO technology has been successfully applied for the treatment of dairy wastes (1, and as a technology for concentration and fractionation of whey. In this work a membrane treatment approach using reverse osmosis technology is investigated and implemented: the permeate obtained can be reused as clean warm water for cleaning and sanitation of production plants, while concentrated milk proteins are modified by using transglutaminase enzyme obtaining a high temperature resistant fat replacer to be used in different low-fat products like for example mozzarella cheese.

  15. Prospective comparison study of one-year outcomes for all titanium total temporomandibular joint replacements in patients allergic to metal and cobalt-chromium replacement joints in patients not allergic to metal.

    Science.gov (United States)

    Hussain, O T; Sah, S; Sidebottom, A J

    2014-01-01

    We aimed to ascertain whether there are any early differences in outcome between all titanium temporomandibular joint (TMJ) prostheses in patients allergic to metal and standard cobalt-chromium prostheses in patients not allergic to metal. All patients who had primary TMJ prostheses placed with one-year follow-up between March 2003 and February 2011 were included. We reviewed the basic characteristics of patients. The outcome variables measured included disease, pain, mouth opening, and diet. A total of 55 patients with 77 joint replacements fulfilled the inclusion criteria. Forty patients had standard cobalt-chromium alloy (Co-Cr-Mo) prostheses (20 unilateral and 20 bilateral), and 15 had all titanium prostheses (13 unilateral and 2 bilateral). Osteoarthritis was the most common disease in both groups. There was significant improvement in pain score at reviews at 6 weeks (p=0.001) and 12 months (p=0.03). Values between groups were not significant (p=0.48 at 6 weeks, and p=0.10 at 1 year). Mouth opening in each group improved significantly with continued gains between assessments at 6 weeks and 12 months (p=0.001) but there were no significant differences between groups. Diet scores were significantly improved one year postoperatively in both groups (p=0.001), but differences between groups were not significant (p=0.90). At one year, outcomes for all titanium prostheses in patients allergic to metal were similarly favourable to those in patients who had no hypersensitivity to metal and had standard prostheses. No patient developed a hypersensitivity reaction, and no all titanium prosthesis failed during the one-year follow-up period. Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. Effects of testosterone replacement therapy withdrawal and re-treatment in hypogonadal elderly men upon obesity, voiding function and prostate safety parameters.

    Science.gov (United States)

    Yassin, Aksam; Nettleship, Joanne E; Talib, Raidh A; Almehmadi, Yousef; Doros, Gheorge

    2016-01-01

    Whether testosterone replacement therapy (TRT) is a lifelong treatment for men with hypogonadism remains unknown. We investigated long-term TRT and TRT withdrawal on obesity and prostate-related parameters. Two hundred and sixty-two hypogonadal patients (mean age 59.5) received testosterone undecanoate in 12-week intervals for a maximum of 11 years. One hundred and forty-seven men had TRT interrupted for a mean of 16.9 months and resumed thereafter (Group A). The remaining 115 patients were treated continuously (Group B). Prostate volume, prostate-specific antigen (PSA), residual voiding volume, bladder wall thickness, C-reactive protein (CRP), aging male symptoms (AMS), International Index of erectile function - erectile function (IIEF-EF) and International Prostate Symptoms Scores (IPSS) were measured over the study period with anthropometric parameters of obesity, including weight, body mass index (BMI) and waist circumference. Prior to interruption, TRT resulted in improvements in residual voiding volume, bladder wall thickness, CRP, AMS, IIEF-EF, IPSS and obesity parameters while PSA and prostate volume increased. TRT interruption reduced total testosterone to hypogonadal levels in Group A and resulted in worsening of obesity parameters, AMS, IPSS, residual voiding volume and bladder wall thickness, IIEF-EF and PSA while CRP and prostate volume were unchanged until treatment resumed whereby these effects were reversed. TRT interruption results in worsening of symptoms. Hypogonadism may require lifelong TRT.

  17. On Accounting Treatment after"Replacing Business Tax with Value-added Tax (VAT)"%关于“营改增”后的账务处理

    Institute of Scientific and Technical Information of China (English)

    刘志明

    2014-01-01

    In order to enhance the competitiveness of service industry, the government takes experiment units of VAT in 8 industries such as software development, transportation, consulting industry and so on, which originally pay business tax. Owing to the different nature of the business tax and value-added tax, balance pay tax treatment can reduce the sale, so it generally reduces the tax burden of the service accepter. This article focuses on the accounting treatment after replacing business tax with VAT.%国家为了增强服务行业的竞争力,对原来交营业税的一些行业比如软件开发、运输、咨询行业等8大行业进行交增值税的试点,由于营业税和增值税的性质不同,差额纳税的税务处理为可抵减销售额,这样的目的,从总体上来说是降低接受服务方的税负,现就营改增后的会计账务处理阐述笔者的观点。

  18. Interpreting Indirect Treatment Comparisons and Network Meta-Analysis for Health-Care Decision Making : Report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: Part 1

    NARCIS (Netherlands)

    Jansen, Jeroen P.; Fleurence, Rachael; Devine, Beth; Itzler, Robbin; Barrett, Annabel; Hawkins, Neil; Lee, Karen; Boersma, Cornelis; Annemans, Lieven; Cappelleri, Joseph C.

    Evidence-based health-care decision making requires comparisons of all relevant competing interventions. In the absence of randomized, controlled trials involving a direct comparison of all treatments of interest, indirect treatment comparisons and network meta-analysis provide useful evidence for

  19. Comparison of battery replacement stations and charging stations. Key elements of the supply system; Vergleich von Batteriewechselstationen und Ladesaeulen. Schluesselrolle fuer das Gesamtsystem

    Energy Technology Data Exchange (ETDEWEB)

    Knorr, Romy; Dietz, Eric; Kremp, Sebastian [Technische Univ. Chemnitz (Germany). Studiengang ' Nachhaltige Energieversorgungstechnologien' ; Goetz, Andreas [Technische Univ. Chemnitz (Germany). Professur Energie- und Hochspannungstechnik; Rehme, Marco [Technische Univ. Chemnitz (Germany). Professur fuer Unternehmensrechnung und Controlling

    2011-10-17

    The battery is one of the most important and most costly components of electric-powered vehicles. Due to its high material cost, it has decisive influence on the whole investment cost of an electric-powered vehicle. It also decides the mileage and weight of the vehicle. The contribution compares various options for battery replacement or recharging. (orig./AKB)

  20. HIV models for treatment interruption: Adaptation and comparison

    Science.gov (United States)

    Hillmann, Andreas; Crane, Martin; Ruskin, Heather J.

    2017-10-01

    In recent years, Antiretroviral Therapy (ART) has become commonplace for treating HIV infections, although a cure remains elusive, given reservoirs of replicating latently-infected cells, which are resistant to normal treatment regimes. Treatment interruptions, whether ad hoc or structured, are known to cause a rapid increase in viral production to detectable levels, but numerous clinical trials remain inconclusive on the dangers inherent in this resurgence. In consequence, interest in examining interruption strategies has recently been rekindled. This overview considers modelling approaches, which have been used to explore the issue of treatment interruption. We highlight their purpose and the formalisms employed and examine ways in which clinical data have been used. Implementation of selected models is demonstrated, illustrative examples provided and model performance compared for these cases. Possible extensions to bottom-up modelling techniques for treatment interruptions are briefly discussed.

  1. A retrospective comparison of dental treatment under general ...

    African Journals Online (AJOL)

    Nigerian Journal of Clinical Practice ... Materials and Methods: In this retrospective study, the records of patients between the ... There was no significant difference in terms of periodontal treatment and fissure sealants in the 12.18 age groups.

  2. Dosimetric comparison of different radiation treatment modalities for acoustic neuromas

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Wook; Chung, Weon Kuu [Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of); Shin, Dong Oh [Kyung Hee Medical Center, Seoul (Korea, Republic of); Shin, Dongho [National Cancer Center, Goyang (Korea, Republic of)

    2014-11-15

    The dosimetric differences for intensity-modulatedradiotherapy (IMRT), volumetric modulated arc therapy (VMAT), proton therapy(PROTON) and stereotactic radiosurgery (SRS) in patient with acoustic neuroma (AN) were compared by using the dose-volume histogram (DVH). In the present study, we estimated the dosimetric differences for patient with AN who received different treatment modalities. In this study, we found proton therapy is relatively effective treatment techniques than the other.

  3. Sertraline versus paroxetine in the treatment of panic disorder: an acute, double-blind noninferiority comparison.

    NARCIS (Netherlands)

    Bandelow, B.; Behnke, K.; Lenoir, S.; Hendriks, G.J.; Alkin, T.; Goebel, C.; Clary, C.M.

    2004-01-01

    OBJECTIVE: Several classes of medications have demonstrated efficacy in panic disorder, but direct comparison of 2 proven treatments is still uncommon. The purpose of this study was to compare sertraline and paroxetine in the acute treatment of panic disorder. METHOD: Adult outpatients with panic di

  4. Patient perspectives on buprenorphine/naloxone: a qualitative study of retention during the starting treatment with agonist replacement therapies (START) study.

    Science.gov (United States)

    Teruya, Cheryl; Schwartz, Robert P; Mitchell, Shannon Gwin; Hasson, Albert L; Thomas, Christie; Buoncristiani, Samantha H; Hser, Yih-Ing; Wiest, Katharina; Cohen, Allan J; Glick, Naomi; Jacobs, Petra; McLaughlin, Paul; Ling, Walter

    2014-01-01

    This study examines the barriers and facilitators of retention among patients receiving buprenorphine/naloxone at eight community-based opioid treatment programs across the United States. Participants (n = 105) were recruited up to three and a half years after having participated in a randomized clinical trial comparing the effect of buprenorphine/naloxone and methadone on liver function. Semi-structured interviews were conducted with 67 patients provided with buprenorphine/naloxone who had terminated early and 38 patients who had completed at least 24 weeks of the trial. Qualitative data were analyzed using the constant comparison method. Barriers to buprenorphine/naloxone retention that emerged included factors associated with: (1) the design of the clinical trial; (2) negative medication or treatment experience; and (3) personal circumstances. The facilitators comprised: (1) positive experience with the medication; (2) personal determination and commitment to complete; and (3) staff encouragement and support. The themes drawn from interviews highlight the importance of considering patients' prior experience with buprenorphine/naloxone and methadone, medication preference, personal circumstances, and motivation to abstain from illicit use or misuse of opioids, as these may influence retention. Ongoing education of patients and staff regarding buprenorphine/naloxone, especially in comparison to methadone, and support from staff and peers are essential.

  5. Comparisons of treatment means when factors do not interact in two-factorial studies

    KAUST Repository

    Wei, Jiawei

    2011-05-06

    Scientists in the fields of nutrition and other biological sciences often design factorial studies to test the hypotheses of interest and importance. In the case of two-factorial studies, it is widely recognized that the analysis of factor effects is generally based on treatment means when the interaction of the factors is statistically significant, and involves multiple comparisons of treatment means. However, when the two factors do not interact, a common understanding among biologists is that comparisons among treatment means cannot or should not be made. Here, we bring this misconception into the attention of researchers. Additionally, we indicate what kind of comparisons among the treatment means can be performed when there is a nonsignificant interaction among two factors. Such information should be useful in analyzing the experimental data and drawing meaningful conclusions.

  6. Gaucher disease: MR evaluation of bone marrow features during treatment with enzyme replacement; Morbus Gaucher: Analyse der Knochenmarkveraenderungen in der MRT waehrend Enzymersatztherapie

    Energy Technology Data Exchange (ETDEWEB)

    Poll, L.W.; Koch, J.A.; Boerner, D.; Cohnen, M.; Jung, G.; Scherer, A.; Moedder, U. [Duesseldorf Univ. (DF). Inst. fuer Diagnostische Radiologie; Dahl, S. vom; Haeussinger, D. [Duesseldorf Univ. (Germany). Klinik fuer Gastroenterologie, Hepatologie und Infektiologie; Willers, R. [Rechenzentrum, Heinrich-Heine-Univ. Duesseldorf (Germany); Niederau, C. [Innere Abt., St. Josef-Hospital Oberhausen, Akademisches Lehrkrankenhaus der Univ. Essen (Germany)

    2001-10-01

    Purpose: Enzyme replacement therapy (ERT) arrests and reverses the hematological and visceral symptoms of adult Gaucher disease, the most frequent lysosomal storage disorder. There are only a few studies available evaluating bone disease during ERT. The aim of this study was to investigate the features of bone marrow (bm) by magnetic resonance imaging (MRI) in these patients during ERT. Materials and Methods: MRI was performed prospectively in thirty adult type I Gaucher patients before and during ERT with a mean follow-up of 3 years. Spin-echo sequences (T{sub 1}/T{sub 2}) of the lower extremities were obtained and the reconversion (response) or lack of reconversion (non-response) to fatty marrow during treatment was analyzed. The morphological features of bm involvement, a homogeneous or non-homogeneous distribution of bm changes and focal bone lesions surrounded by a rim of reduced signal intensity (SI), were analyzed. Results: Infiltration of bm by Gaucher cells is characterized by a reduction of Sl on both T{sub 1}- and T{sub 2}-weighted sequences. Bone marrow responses were seen in 19 patients (63%) during treatment. Focal bone lesions, surrounded by a rim of reduced Sl, did not respond to ERT and correlated with a non-homogenous distribution of bone involvement and splenectomy. (orig.) [German] Ziel: Unter Enzymersatztherapie (enzyme replacement therapy = ERT) zeigen Patienten mit adulter Form des Morbus Gaucher, der haeufigsten lysosomalen Speicherkrankheit, eine deutliche Besserung der haematologischen und visceralen Symptome. Bislang liegen nur wenige Untersuchungen zur Analyse der Knochenveraenderungen waehrend der ERT vor. Ziel war es, die Knochenmarkveraenderungen bei Gaucher-Patienten waehrend der Enzymersatztherapie mit Alglucerase/Imiglucerase in der Magnetresonanztomographie (MRT) zu evaluieren. Material und Methoden: In einer prospektiven Untersuchung wurden 30 adulte Patienten mit gesichertem Morbus Gaucher vor und waehrend der ERT in der MRT

  7. Treatment of Scabies: Comparison of Lindane 1% vs Permethrin 5.

    Science.gov (United States)

    Rezaee, Elham; Goldust, Mohamad; Alipour, Houman

    2015-01-01

    Scabies, whose etiologic agent is Sarcoptes scabiei, is a neglected parasitic disease that is a major public health problem in many resourcepoor regions. Its current therapies include benzyl benzoate, lindane, permethrin, sulfur, crotamiton, monosulfiram, and oral ivermectin. The aim of this study was to compare the efficacy and safety of lindane 1% lotion vs permethrin 5% in the treatment of scabies. A total of 120 patients with scabies attending a dermatology outpatient department were included. Patients were randomly divided into two groups. Sixty patients and their family contacts received 5% permethrin cream and the other 60 received 1% lindane lotion. Treatment was evaluated at intervals of 2 and 4 weeks. Permethrin provided improvement in 48 patients (80%) after 2 weeks, whereas lindane was effective in only 28 patients (46.6%). Permethrin (5%) cream was found to be significantly more effective in the treatment of scabies compared with lindane in this study. Adverse effects were rare in both the permethrin and lindane groups.

  8. Comparison of combined application treatment with one-visit varnish treatments in an orthodontic population

    Science.gov (United States)

    Tuzuner, Tamer; Ozel, Mehmet B.; Bostanoglu, Ozge

    2013-01-01

    Objective: To evaluate the effect of chlorhexidine-thymol varnish alone, its combination with chlorhexidine-fluoride containing dentifrice and fluoride varnish on oral hygiene and caries prevention in orthodontic patients. Study design: Sixty patients, aged 12-18, with orthodontic fixed appliances were randomly assigned into three groups as follows: Group 1 (n=20): 1% chlorhexidine and 1% thymol varnish (Cervitec®Plus); Group 2 (n=20): Cervitec®Plus+ 0.2% chlorhexidine and 0.2% sodium fluoride (900 ppm fluoride) (Cervitec®Gel)); and Group 3 (n=20): 0.1% fluoride varnish (Fluor Protector®). Mutans streptococci (MS), lactobacilli (LB) levels, buffering capacity (BC), visible plaque index (VPI), and gingival bleeding index (GBI) scores were evaluated at four stages: T0, before orthodontic bonding; T1, one week after orthodontic bonding; T2, one week; and T3, four weeks after the first application, respectively. Inter and intra group comparisons were made by the Kruskal-Wallis, Mann-Whitney U, Friedman and Wilcoxon Signed-Rank tests with Bonferroni step-down correction (P0.017) were found in Group1-2 compared with T0. Significantly lower LB levels were recorded in Group 2 at T2 compared with T0 (P0.017). Conclusions: Addition of Cervitec®Plus+Cervitec®Gel combination to the standard oral hygiene regimen may be beneficial for orthodontic patients for maintaining oral health by reducing bacterial colonisation and gingivitis. Key words:Chlorhexidine, flouride, mutans streptococci, lactobacilli, antibacterial effect, plaque, gingivitis, orthodontic treatment. PMID:23385499

  9. Treatment of Alzheimer disease using combination therapy with plasma exchange and haemapheresis with albumin and intravenous immunoglobulin: Rationale and treatment approach of the AMBAR (Alzheimer Management By Albumin Replacement) study.

    Science.gov (United States)

    Boada, M; Ramos-Fernández, E; Guivernau, B; Muñoz, F J; Costa, M; Ortiz, A M; Jorquera, J I; Núñez, L; Torres, M; Páez, A

    2016-09-01

    There is a growing interest in new therapeutic strategies for the treatment of Alzheimer disease (AD) which focus on reducing the beta-amyloid peptide (Aβ) burden in the brain by sequestering plasma Aβ, a large proportion of which is bound to albumin and other proteins. This review discusses the concepts of interaction between Aβ and albumin that have given rise to AMBAR (Alzheimer's Disease Management by Albumin Replacement) project, a new multicentre, randomised, controlled clinical trial for the treatment of AD. Results from preliminary research suggest that Albutein(®) (therapeutic albumin, Grifols) contains no quantifiable levels of Aβ. Studies also show that Albutein(®) has Aβ binding capacity. On the other hand, AD entails a high level of nitro-oxidative stress associated with fibrillar aggregates of Aβ that can induce albumin modification, thus affecting its biological functions. Results from the phase ii study confirm that using therapeutic apheresis to replace endogenous albumin with Albutein(®) 5% is feasible and safe in patients with AD. This process resulted in mobilisation of Aβ and cognitive improvement in treated patients. The AMBAR study will test combination therapy with therapeutic apheresis and haemopheresis with the possible leverage effect of Albutein(®) with intravenous immunoglobulin replacement (Flebogamma(®) DIF). Cognitive, functional, and behavioural changes in patients with mild to moderate AD will be assessed. the AMBAR study represents a new therapeutic perspective for AD. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. A mixed treatment comparison to compare the efficacy and safety of botulinum toxin treatments for cervical dystonia.

    Science.gov (United States)

    Han, Yi; Stevens, Andrea L; Dashtipour, Khashayar; Hauser, Robert A; Mari, Zoltan

    2016-04-01

    A systematic pair-wise comparison of all available botulinum toxin serotype A and B treatments for cervical dystonia (CD) was conducted, as direct head-to-head clinical trial comparisons are lacking. Five botulinum toxin products: Dysport(®) (abobotulinumtoxinA), Botox(®) (onabotulinumtoxinA), Xeomin(®) (incobotulinumtoxinA), Prosigne(®) (Chinese botulinum toxin serotype A) and Myobloc(®) (rimabotulinumtoxinB) have demonstrated efficacy for managing CD. A pair-wise efficacy and safety comparison was performed for all toxins based on literature-reported clinical outcomes. Multi-armed randomized controlled trials (RCTs) were identified for inclusion using a systematic literature review, and assessed for comparability based on patient population and efficacy outcome measures. The Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) was selected as the efficacy outcome measurement for assessment. A mixed treatment comparison (MTC) was conducted using a Bayesian hierarchical model allowing indirect comparison of the interventions. Due to the limitation of available clinical data, this study only investigated the main effect of toxin treatments without explicitly considering potential confounding factors such as gender and formulation differences. There was reasonable agreement between the number of unconstrained data points, residual deviance and pair-wise results. This research suggests that all botulinum toxin serotype A and serotype B treatments were effective compared to placebo in treating CD, with the exception of Prosigne. Based on this MTC analysis, there is no significant efficacy difference between Dysport, Botox, Xeomin and Myobloc at week four post injection. Of the adverse events measured, neither dysphagia nor injection site pain was significantly greater in the treatment or placebo groups.

  11. Comparison between two perineal procedures for treatment of rectal prolaps

    Directory of Open Access Journals (Sweden)

    Ahmed Mohamed Abozid, Nabila Mohamed A. Shams, , Yahia Hassan

    2001-09-01

    Full Text Available The optimal surgical procedures for the management of rectal prolapse is still under debate so comparison between two operations were done in our series. Eighteen patients with complete rectal prolaps were treated surgically through the perineum they were divided into two groups. First group were treated by recto-segmoidectomy and levatroplasty to fortify the pelvic floor, the second group were treated by rectopexy using prolene mesh and levetroplasty to fortify the pelvic floor, the mesh was inserted between the rectum and sacrum and fixed through perineal incision. The recurrence rate !""#$$!%$ &significant difference in hospital stay among both groups. Also there were no other cases of postoperative complications such as anastomotic leak or stricture, affection of the bladder dysfunction in both groups. Aim of work The aim of this work was to compare the short-term outcome of two different perineal operative procedures in patients with full thickness rectal prolaps.

  12. Mandibular trauma treatment: a comparison of two protocols

    NARCIS (Netherlands)

    Boffano, P.; Kommers, S.C.; Roccia, F.; Forouzanfar, T.

    2015-01-01

    Objectives:The aim of this study was to evaluate the treatment of mandibular fractures treated in two European centre in 10 years. Study Design: This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures in two c

  13. Comparison between four treatment modalities for active myofascial triggers points

    Directory of Open Access Journals (Sweden)

    Atef Fouda

    2014-06-01

    Full Text Available Aim: The study aimed at the painful trigger points (TrPs for the purpose of ablating muscle spasms and restoring normal muscle length to find the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain dysfunction. Methods: We enrolled 72 patients with pain and reduced mouth opening due to temporomandibular joint dysfunction. Patients assigned to four groups and four treatment modalities used to treat myofascial TrPs pain. We used mean and standard deviation values. The Mann-Whitney U-test was used to compare the two groups. The Wilcoxon signed-rank test was used to study the changes by the time in mean pain scores. The Student's t-test was used to compare maximum mouth opening (MMO groups. Then paired t-test was also used to study the changes of time in an MMO. Results: The results showed that pulsed electromagnetic field (PEMF therapy is the most effective treatment modality regarding for pain relief. Both the anesthesia and PEMF groups showed a reduction in mean pain scores throughout all follow-up periods, and a statistically significant increase in mean MMO. Conclusion: The findings suggest that PEMF is the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain.

  14. Mandibular trauma treatment: a comparison of two protocols

    NARCIS (Netherlands)

    Boffano, P.; Kommers, S.C.; Roccia, F.; Forouzanfar, T.

    2015-01-01

    Objectives:The aim of this study was to evaluate the treatment of mandibular fractures treated in two European centre in 10 years. Study Design: This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures in two c

  15. A comparison of the clinical and experimental characteristics of four acute surgical pain models: dental extraction, bunionectomy, joint replacement, and soft tissue surgery.

    Science.gov (United States)

    Singla, Neil K; Desjardins, Paul J; Chang, Phoebe D

    2014-03-01

    When a clinical trial of an analgesic produces a negative finding, it is important to consider the influence (if any) of experimental error on the validity of that result. Although efforts to identify and minimize experimental error in chronic pain investigations have begun in earnest, less work has been performed on the optimization of acute pain methodology. Of the acute surgical pain methodology articles that have been published over the last decade, almost all focus on either the dental or bunion model. Analgesics are typically evaluated in a variety of surgical models that eventually include hospital-based models (eg, joint replacement and soft tissue surgery). Every surgical procedure has unique clinical characteristics that must be considered to optimize study design and conduct. Much of the methodological knowledge garnered from bunion and dental studies is applicable to other surgical models, but some extrapolations are hazardous. The purposes of this review were (1) to qualitatively describe the clinical and experimental characteristics of the 4 classic surgical models: dental extraction, bunionectomy, joint replacement, and soft tissue surgery; and (2) to quantitatively compare the models by analyzing 3 factors: effect size, enrollment rate, and demographics. We found that the dental extraction and bunionectomy models had higher assay sensitivity than the joint replacement and soft tissue surgery models. It is probable that this finding is secondary to the superior experimental conditions under which the dental and bunion models are executed (utilization of few centers that have the ability to reduce surgical, anesthetic, and postoperative confounders).

  16. Hazard Assessment Comparison of Tazhiping Landslide Before and After Treatment

    OpenAIRE

    Huang, Dong; Qiao, Jianping; Wang, Meng

    2017-01-01

    Through investigation and analysis of geological conditions and mechanical parameters of the Taziping landslide, the finite volume method was adopted, and, the rheological model was adopted to simulate the landslide and avalanche entire mass movement process. The present paper adopted the GIS platform to simulate the mass movement process before and after treatment. This paper also provided the conditions and characteristic parameters of soil deposits (thickness, speed, and stresses) during t...

  17. A comparison of bronchial drainage treatments in cystic fibrosis.

    Science.gov (United States)

    Kluft, J; Beker, L; Castagnino, M; Gaiser, J; Chaney, H; Fink, R J

    1996-10-01

    We compared standard chest physical therapy and postural drainage (CPT/PD) with a new airway clearance therapy called high-frequency chest wall oscillation (HFCWO) in a group of stable cystic fibrosis (CF) patients. In this crossover trial, 29 CF patients (15 males, 14 females), aged 7-47 years that met the inclusion criteria were randomly assigned to alternate CPT/PD and HFCWO, on a daily basis, over a 4 day period. Each patient received 2 days of each form of therapy; treatment frequency and the length of treatment were the same for both techniques. Expectorated secretions were collected during each 30 minute therapy session and for 15 minutes following treatment. The wet and dry weights of collected secretions were determined gravimetrically, and the therapy methods were compared. Significantly more sputum was expectorated during HFCWO than during CPT/PD as determined by both the wet (P HFCWO is at least as effective as manual CPT/PD in clearing secretions from the airways in patients with cystic fibrosis.

  18. Treatment of scabies: comparison of ivermectin vs. lindane lotion 1%.

    Science.gov (United States)

    Mohebbipour, Alireza; Saleh, Parviz; Goldust, Mohamad; Amirnia, Mehdi; Zadeh, Yousef Javad; Mohamadi, Ramin Mir; Rezaee, Elham

    2012-01-01

    Topical antiscabietics have poor compliance. This study aimed at comparing the efficacy and safety of oral ivermectin with topical lindane in treating scabies. In this clinical trial, 248 patients from 2 to 86 years of age were divided into two groups. Oral ivermectin was given to group A in a single dose of 200 μg/kg body weight. Group B received application of lindane lotion 1% twice at one-week interval. When there was no cure in two weeks, 2nd treatment was given with either drug in the respective group. A single dose of ivermectin provided a cure rate of 58.6% at two-week follow up, which increased to 92.7% with 2 doses at the end of 4-week interval. The application of lindane lotion 1% twice at one-week interval was effective in 44.3% of patients at two-week follow up, which increased to 71.7% after repeating the treatment for another two weeks. Single dose application of oral ivermectin was as effective as twice application of lindane lotion 1% at one-week interval. Two doses of ivermectin proved superior to lindane lotion 1% after repeating the treatment at 4-week follow up.

  19. Anterior Hypopituitarism and Treatment Response in Hunter Syndrome: A Comparison of Two Patients

    Science.gov (United States)

    Luca, Paola; Wei, Xing-Chang; Khan, Aneal

    2016-01-01

    Hypopituitarism is a clinically important diagnosis and has not previously been reported in Hunter syndrome. We contrast two cases with anatomic pituitary anomalies: one with anterior panhypopituitarism and the other with intact pituitary function. Patient 1, a 10-year-old boy with Hunter syndrome, was evaluated for poor growth and an ectopic posterior pituitary gland. Endocrine testing revealed growth hormone (GH) deficiency, secondary adrenal insufficiency, and tertiary hypothyroidism. An improvement in growth velocity with hormone replacement (GH, thyroxine, and corticosteroid) was seen; however, final adult height remained compromised. Patient 2, a 13-year-old male with Hunter syndrome, was evaluated for growth failure. He had a large empty sella turcica with posteriorly displaced pituitary. Functional endocrine testing was normal and a trial of GH-treatment yielded no significant effect. Panhypopituitarism associated with pituitary anomalies has not been previously reported in Hunter syndrome and was an incidental finding of significant clinical importance. In the setting of documented anterior hypopituitarism, while hormone replacement improved growth velocity, final height remained impaired. In patient 2 with equivocal GH-testing results, treatment had no effect on linear growth. These cases highlight the importance of careful clinical assessment in Hunter syndrome and that judicious hormone replacement may be indicated in individual cases. PMID:28018694

  20. Anterior Hypopituitarism and Treatment Response in Hunter Syndrome: A Comparison of Two Patients

    Directory of Open Access Journals (Sweden)

    Munier A. Nour

    2016-01-01

    Full Text Available Hypopituitarism is a clinically important diagnosis and has not previously been reported in Hunter syndrome. We contrast two cases with anatomic pituitary anomalies: one with anterior panhypopituitarism and the other with intact pituitary function. Patient 1, a 10-year-old boy with Hunter syndrome, was evaluated for poor growth and an ectopic posterior pituitary gland. Endocrine testing revealed growth hormone (GH deficiency, secondary adrenal insufficiency, and tertiary hypothyroidism. An improvement in growth velocity with hormone replacement (GH, thyroxine, and corticosteroid was seen; however, final adult height remained compromised. Patient 2, a 13-year-old male with Hunter syndrome, was evaluated for growth failure. He had a large empty sella turcica with posteriorly displaced pituitary. Functional endocrine testing was normal and a trial of GH-treatment yielded no significant effect. Panhypopituitarism associated with pituitary anomalies has not been previously reported in Hunter syndrome and was an incidental finding of significant clinical importance. In the setting of documented anterior hypopituitarism, while hormone replacement improved growth velocity, final height remained impaired. In patient 2 with equivocal GH-testing results, treatment had no effect on linear growth. These cases highlight the importance of careful clinical assessment in Hunter syndrome and that judicious hormone replacement may be indicated in individual cases.

  1. Comparison of systemic and intramammary dry cow treatments

    Directory of Open Access Journals (Sweden)

    G. Andres Contreras B.

    2013-03-01

    Full Text Available Objective. To compare four different dry cow treatments (DCT and establish their effectiveness in reducing intramammary infections (IIM. Materials and methods. DCTs included systemic tylosin (12g alone or accompanied by cefapirine intramammary infusions and or an internal teat sealant. A total number of 278 cows at the end of lactation period were randomly assigned to one of 4 dry cow treatment groups: CESE Group (n=89, intramammary cephapirin and teat sealant. TYCESE Group (n=84, intramammary cephapirin, tylosin 12 g intramuscular and teat sealant. TYSE Group (n=86, 12 g intramuscular tylosin and teat sealant; TY Group (n=76 12 g intramuscular tylosin only. Milk samples for culture were collected at dry-off and 1 and 2 weeks after calving. Somatic cell counts (SCC were taken from Dairy Herd Improvement Association (DHI tests at dry-off, and the first two test days after calving. Results. Bacteria cure rate for Gram-positive intramammary infections (IMI for TYCESE group was 93.6%, CESE group 78.9%, TYSE group 88.2%, and TY group 78.1%. All four groups showed a decrease in the SCC upon the first and second test after calving. Conclusions. The use of systemic tylosin in combination with intramammary antibiotics increased DCT effectiveness improving the Gram-positive cure rate IMI. Furthermore, systemic tylosin alone plus teat sealant is as effective as cephapirin plus teat sealant when used as DCT.

  2. Comparison of ivermectin and diethylcarbamazine in the treatment of onchocerciasis.

    Science.gov (United States)

    Greene, B M; Taylor, H R; Cupp, E W; Murphy, R P; White, A T; Aziz, M A; Schulz-Key, H; D'Anna, S A; Newland, H S; Goldschmidt, L P

    1985-07-18

    We compared ivermectin with diethylcarbamazine for the treatment of onchocerciasis in a double-blind, placebo-controlled trial. Thirty men with moderate to heavy infection and ocular involvement were randomly assigned to receive ivermectin in a single oral dose (200 micrograms per kilogram of body weight), diethylcarbamazine daily for eight days, or placebo. Diethylcarbamazine caused a significantly more severe systemic reaction than ivermectin (P less than 0.001), whereas the reaction to ivermectin did not differ from the reaction to placebo. Diethylcarbamazine markedly increased the number of punctate opacities in the eye (P less than 0.001), as well as the number of dead and living microfilariae in the cornea over the first week of therapy. Ivermectin had no such effect. Both ivermectin and diethylcarbamazine promptly reduced skin microfilaria counts, but only in the ivermectin group did counts remain significantly lower (P less than 0.005) than in the placebo group at the end of six months of observation. Analysis of adult worms isolated from nodules obtained two months after the start of therapy showed no effect of either drug on viability. Ivermectin appears to be a better tolerated, safer, and more effective microfilaricidal agent than diethylcarbamazine for the treatment of onchocerciasis.

  3. Treatment of scabies: Comparison of permethrin 5% versus ivermectin.

    Science.gov (United States)

    Goldust, Mohamad; Rezaee, Elham; Hemayat, Sevil

    2012-06-01

    Scabies is an ectoparasitic, highly contagious skin disease caused by a mite called Sarcoptes scabiei. The insecticides ivermectin and permethrin are commonly used for treatment of scabies. This study aimed at comparing the efficacy of oral ivermectin with topical permethrin in treating scabies. Two hundred and forty-two patients with scabies attending the dermatology outpatient department of Sina Hospital, Tabriz University of Medical Sciences were admitted. Patients were divided into two groups randomly. The first group and their family contacts received 5% permethrin cream and the other received oral ivermectin. Treatment was evaluated at intervals of 2 and 4 weeks. A single dose of ivermectin provided a cure rate of 85.9% at a 2-week interval, which increased to 100% after crossing over to the permethrin group at a 4-week interval. Twice application of permethrin with a 1-week interval was effective in 92.5% of patients, which increased to 94.2% after crossing over to the ivermectin group at a 4-week interval. Permethrin-treated patients recovered earlier. Twice application of permethrin with a 1-week interval is superior to a single dose of ivermectin. The temporal dissociation in clinical response suggests that ivermectin may not be effective against all the stages in the life cycle of the parasite.

  4. Transfusion requirements and clinical outcome in intensive care patients receiving continuous renal replacement therapy: comparison of prostacyclin vs. heparin prefilter administration

    DEFF Research Database (Denmark)

    Windeløv, Nis Agerlin; Ostrowski, Sisse R; Perner, Anders;

    2010-01-01

    Prostacyclin (PGI(2)) analogous are potent antithrombotics recommended as prefilter infusion during renal replacement therapy (RRT) when heparin is contraindicated. It is debated whether PGI(2) administration during RRT affects transfusion requirements and outcome. Retrospective cohort study of a...... intravascular coagulation (DIC) (P=0.006), severe thrombocytopenia (P=0.03), higher maximum Sequential Organ Failure Assessment score (P......: before, during and after CRRT. For each time period, laboratory values were analysed as changes/day and blood transfusion requirements as absolute values. Organ failures during the ICU stay and 1 year all-cause mortality were registered. During CRRT the PGI(2) group had a higher incidence of disseminated...

  5. Transfusion requirements and clinical outcome in intensive care patients receiving continuous renal replacement therapy: comparison of prostacyclin vs. heparin prefilter administration

    DEFF Research Database (Denmark)

    Windeløv, Nis Agerlin; Ostrowski, Sisse R; Perner, Anders;

    2010-01-01

    Prostacyclin (PGI(2)) analogous are potent antithrombotics recommended as prefilter infusion during renal replacement therapy (RRT) when heparin is contraindicated. It is debated whether PGI(2) administration during RRT affects transfusion requirements and outcome. Retrospective cohort study of all...... patients at a general intensive care unit (ICU) receiving continuous RRT (CRRT) in a 14-month period. Patients were stratified according to the used anticoagulant, that is prefilter PGI(2) group (n=24) and prefilter heparin group (n=70). The ICU stay of the patients was divided into three time periods...

  6. Analysis of data from the ERA-EDTA Registry indicates that conventional treatments for chronic kidney disease do not reduce the need for renal replacement therapy in autosomal dominant polycystic kidney disease.

    NARCIS (Netherlands)

    Spithoven, E.M.; Kramer, A.; Meijer, E.; Orskov, B.; Wanner, C.; Caskey, F.; Collart, F.; Finne, P.; Fogarty, D.G.; Groothoff, J.W.; Hoitsma, A.J.; Nogier, M.B.; Postorino, M.; Ravani, P.; Zurriaga, O.; Jager, K.J.; Gansevoort, R.T.; Bindels, R.J.M.

    2014-01-01

    Autosomal dominant polycystic kidney disease (ADPKD) is a major cause of end-stage kidney failure, but is often identified early and therefore amenable to timely treatment. Interventions known to postpone the need for renal replacement therapy (RRT) in non-ADPKD patients have also been tested in ADP

  7. Analysis of data from the ERA-EDTA Registry indicates that conventional treatments for chronic kidney disease do not reduce the need for renal replacement therapy in autosomal dominant polycystic kidney disease

    NARCIS (Netherlands)

    Spithoven, Edwin M.; Kramer, Anneke; Meijer, Esther; Orskov, Bjarne; Wanner, Christoph; Caskey, Fergus; Collart, Frederic; Finne, Patrik; Fogarty, Damian G.; Groothoff, Jaap W.; Hoitsma, Andries; Nogier, Marie-Beatrice; Postorino, Maurizio; Ravani, Pietro; Zurriaga, Oscar; Jager, Kitty J.; Gansevoort, Ron T.

    2014-01-01

    Autosomal dominant polycystic kidney disease (ADPKD) is a major cause of end-stage kidney failure, but is often identified early and therefore amenable to timely treatment. Interventions known to postpone the need for renal replacement therapy (RRT) in non-ADPKD patients have also been tested in ADP

  8. Renal replacement therapy in ICU

    Directory of Open Access Journals (Sweden)

    C Deepa

    2012-01-01

    Full Text Available Diagnosing and managing critically ill patients with renal dysfunction is a part of the daily routine of an intensivist. Acute kidney insufficiency substantially contributes to the morbidity and mortality of critically ill patients. Renal replacement therapy (RRT not only does play a significant role in the treatment of patients with renal failure, acute as well as chronic, but also has spread its domains to the treatment of many other disease conditions such as myaesthenia gravis, septic shock and acute on chronic liver failure. This article briefly outlines the role of renal replacement therapy in ICU.

  9. Histology of skeletal muscle in adults with GH deficiency: comparison with normal muscle and response to GH treatment.

    Science.gov (United States)

    Cuneo, R C; Salomon, F; Wiles, C M; Round, J M; Jones, D; Hesp, R; Sönksen, P H

    1992-01-01

    The histology of needle biopsy specimens of skeletal muscle from the vastus lateralis was quantitatively assessed in a group of adults with growth hormone (GH) deficiency, most of whom had hypopituitarism treated with conventional pituitary hormone replacement. The mean age of the 21 patients (16 males and 5 females) was 39 +/- 2 (SEM). Comparisons were made with age- and sex-matched controls following six months double-blind, placebo-controlled treatment with recombinant human GH (rhGH) in the GH-deficient patients. Before treatment, needle muscle biopsies from patients with GH deficiency showed mean type I and II fibre areas of 5,153 +/- 273 and 4,828 +/- 312 microns 2 respectively, which did not differ from the controls (4,482 +/- 306 and 4,699 +/- 310 microns 2). Percentages of type I fibres were similar in the two groups (47.2 +/- 2.5% in GH deficiency and 45.3 +/- 2.2% in controls). No difference in the variability of type I or II fibre areas was demonstrated between the groups. Correlations between the relative contribution to total fibre area by type I fibres (mean fibre area x percent) and maximal oxygen uptake (p = 0.006), and between type II fibres and quadriceps force (p = 0.035) were noted in GH-deficient adults before treatment. Following rhGH treatment, no change was noted in mean fibre areas, variability of fibre areas, or percentage of either fibre type.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Treatment of public lice infestation: a comparison of two agents.

    Science.gov (United States)

    Smith, D E; Walsh, J

    1980-12-01

    Bulletins issued by both the United States Public Health Service and the Pan American Health Organization have noted a sharp increase in the incidence of public lice infestation (pediculosis pubis) in this country. At the Haight-Ashbury Free Medical Clinic we conducted a controlled, open study comparing the efficacy and safety of Kwell Shampoo (gamma benzene hexachloride; lindane) with RID, an over-the-counter, pyrethrin-based pediculicide. The results showed the two treatments to be equally effective and safe. All adult lice, nymphs, and nits were eradicated at the one week follow-up in fifteen patients treated with single applications of either product. Two patients in each group experienced very slight and transient erythema.

  11. Comparison of flubendazole and diethylcarbamazine in treatment of onchocerciasis.

    Science.gov (United States)

    Dominguez-Vazquez, A; Taylor, H R; Greene, B M; Ruvalcaba-Macias, A M; Rivas-Alcala, A R; Murphy, R P; Beltran-Hernandez, F

    1983-01-22

    Flubendazole, an injectable benzimidazole drug, was compared with diethylcarbamazine (DEC) in a prospective double-blind study of the treatment of onchocerciasis. Nineteen Mexican men were randomly assigned to receive either flubendazole 750 mg intramuscularly once a week for 5 doses, or DEC 100 mg twice daily for 14 days, and they were then followed up for 12 months. Major systemic side-effects during the first 3 weeks were common in the DEC group but not in the flubendazole group in which there was considerable inflammation at the injection site instead. Ocular complications (limbitis, punctate keratitis, and uveitis) were also common in the DEC group, whereas in the flubendazole group they consisted only of one new punctate opacity at day 4 in one subject. One DEC patient also had several new areas of chorioretinal changes on day 2 but these had disappeared by 2 months. Skin microfilaria counts fell rapidly in the DEC group, but returned to the pretreatment levels. In contrast, skin microfilaria counts in the flubendazole group fell slowly, but by 6 and 12 months were lower than in the DEC group (at 12 months 0.2 vs 7.3 mf/mg, p less than 0.001). In addition, by 6 months none of the flubendazole subjects had intracorneal microfilariae, and only one had microfilariae in the anterior chamber, whereas the numbers of intraocular microfilariae in the DEC group had returned to pretreatment levels. The results suggest that flubendazole is safer and more effective than DEC in the treatment of onchocerciasis.

  12. Comparison of solifenacin and fesoterodine in treatment of overactive bladder.

    Science.gov (United States)

    Ercan, Önder; Köstü, Bülent; Bakacak, Murat; Aytaç-Tohma, Yusuf; Çoşkun, Bora; Avcı, Fazıl; Efe, Erkan

    2015-10-01

    To compare the use of solifenacin and fesoterodine in treatment of overactive bladder (OAB). This prospective study was conducted on patients diagnosed with OAB who presenting to the Department of Obstetrics and Gynecology and Urology, School of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey between October 2013 and August 2014. Patients were randomized into 2 groups. Group 1 (n=60) received 5 mg solifenacin per day, while Group 2 (n=59) received 4 mg fesoterodine per day. All the patients' OAB symptom scores (OABSS) in weeks 0, 4, and 12 were recorded. In addition, treatment costs and side effects of the drugs were evaluated. Average OABSS (score 1) was determined as: 9.5 ± 2.8 for Group 1 and 10.7 ± 1.8 for Group 2 at week 0; 2.2 ± 1.2 (Group 1) and 2.4 ± 1.3 (Group 2) at week 4 (score 2); and 1.3 ± 0.5 for Group 1 and 1.3 ± 0.6 for Group 2 at week 12 (score 3). In addition, no statistically significant difference was found between the scores (p=0.062 (score 1), p=0.464 (score 2), and p=0.527 (score 3). The discontinuation rate of medication due to its side effects was 0 (0%) for Group 1, and 6 (10.2%) for Group 2. Intragroup changes in the scores 1-2, 1-3, and 2-3 values was statistically significant in both groups (p less than 0.001). No significant difference was found between the OABSS of these 2 drugs. However, discontinuation of drugs due to side effects was more frequent in fesoterodine.

  13. Dosimetric Comparison of Two Craniospinal Radiotherapy Techniques for Treatment Optimization

    Directory of Open Access Journals (Sweden)

    Hamidreza Baghani

    2010-06-01

    Full Text Available Introduction: Orthogonal radial fields are those in which the central axes are perpendicular to each other. An example of these orthogonal fields is the set of craniospinal orthogonal fields that are used for radiotherapy of medulloblastoma. Craniospinal radial fields consist of two parallel-opposed fields for brain exposure and one or two posterior spinal fields for spinal cord exposure. The main problem in using these combinative fields is the overlap of radial fields, where they adjoin. Therefore, adjusting radial fields in craniospinal radiotherapy is of remarkable significance and can outstandingly affect the reduction of the side effects due to radiotherapy. In doing so, two different setups were used for craniospinal radiotherapy, and by using dosimetry in each adjustment in the junction region between brain and upper spine fields and in organs at risk, the results of the two adjustments were compared. Materials and Methods: Each one of these two setups was separately performed on a Rando phantom. In the first setup, the arrangement of radial fields was performed without the rotation of the treatment bed and the collimators of the brain fields. In the second setup, the arrangement of radial fields was performed using the rotation of the treatment bed and the collimators of brain fields. For dosimetry, GR-200 TLDs were used. For radiotherapy, a varian linac (2100 C/D Model was used. Results: The results of dosimetry in the brain CTV, junction of brain and upper spine fields, thyroid and heart in the first setup were equal to 105, 168, 46 and 44 cGy, respectively, and in second setup, 106, 140, 48 and 44 cGy, respectively. Absorbed dose to the testes in both setups was negligible.  Discussion and Conclusion: The results of dosimetry in both setups showed that angling the bed and the collimators for the brain fields prevents the overlap of radial fields and reduces the side effects due to radiotherapy.

  14. 二尖瓣置换术后左室破裂的外科处理%Surgical treatment of left ventricular rupture after mitral valve replacement

    Institute of Scientific and Technical Information of China (English)

    祝岩; 王辉山; 汪曾炜; 李新民; 金岩

    2012-01-01

    the ICU,and 7 cases of early ruptur,which occured at the early stage of surgery,while the patient was still in the operation room.There were no cases of ruptures.The types of the ruptures were identified by operation or necropsy as 5 cases of type Ⅰ,4 cases of type Ⅱ,and 2 cases of type Ⅲ.Four patients were saved after emergency treatment,and 7 died.Conclusion It is difficult to repair left ventricle rupture,but effective prevention for onset can decrease its occurrence.The risk factors for left ventricular ruptures are female,advanced age,pathological changes characterized by mitral stenosis,small left ventricle (LVEDD < 35 mm),and low weight( <50 kg ).The following actions raise the risk of let ventricular rupture.Isolated replacement of the mitral valve than after double valve replacement or mitral valve replacement and coronary artery bypass graft; aggressive removal of calcification at the mitral valve; undue selection and replacement of mitral valve prostheses; large size of prosthetic valve with a high bioprosthetic angle in particular; deep sutures at the valve ring; aggressive traction or removal of papillary muscle,hematoma,and heart move.Also we should continue correcting unstable hemodynamic especially with very high blood pressure.Once left ventricular rupture occurs,extracorporeal circulation should be established as soon as possible,and direet suture or intracardiac and extracardiac repair suited to actual conditions are reliable ways to save the patient's life.

  15. Early versus late treatment of spinal cord compression with long-term intrathecal enzyme replacement therapy in canine mucopolysaccharidosis type I.

    Science.gov (United States)

    Dickson, Patricia I; Hanson, Stephen; McEntee, Michael F; Vite, Charles H; Vogler, Carole A; Mlikotic, Anton; Chen, Agnes H; Ponder, Katherine P; Haskins, Mark E; Tippin, Brigette L; Le, Steven Q; Passage, Merry B; Guerra, Catalina; Dierenfeld, Ashley; Jens, Jackie; Snella, Elizabeth; Kan, Shih-Hsin; Ellinwood, N Matthew

    2010-01-01

    Enzyme replacement therapy (ERT) with intravenous recombinant human alpha-l-iduronidase (IV rhIDU) is a treatment for patients with mucopolysaccharidosis I (MPS I). Spinal cord compression develops in MPS I patients due in part to dural and leptomeningeal thickening from accumulated glycosaminoglycans (GAG). We tested long-term and every 3-month intrathecal (IT) and weekly IV rhIDU in MPS I dogs age 12-15months (Adult) and MPS I pups age 2-23days (Early) to determine whether spinal cord compression could be reversed, stabilized, or prevented. Five treatment groups of MPS I dogs were evaluated (n=4 per group): IT+IV Adult, IV Adult, IT + IV Early, 0.58mg/kg IV Early and 1.57mg/kg IV Early. IT + IV rhIDU (Adult and Early) led to very high iduronidase levels in cervical, thoracic, and lumber spinal meninges (3600-29,000% of normal), while IV rhIDU alone (Adult and Early) led to levels that were 8.2-176% of normal. GAG storage was significantly reduced from untreated levels in spinal meninges of IT + IV Early (pmeninges and histologic absence of storage vacuoles. Lysosomal storage was reduced in spinal anterior horn cells in 1.57mg/kg IV Early and IT + IV Early animals. All dogs in IT + IV Adult and IV Adult groups had compression of their spinal cord at 12-15months of age determined by magnetic resonance imaging and was due to protrusion of spinal disks into the canal. Cord compression developed in 3 of 4 dogs in the 0.58mg/kg IV Early group; 2 of 3 dogs in the IT + IV Early group; and 0 of 4 dogs in the 1.57mg/kg IV Early group by 12-18months of age. IT + IV rhIDU was more effective than IV rhIDU alone for treatment of meningeal storage, and it prevented meningeal GAG accumulation when begun early. High-dose IV rhIDU from birth (1.57mg/kg weekly) appeared to prevent cord compression due to protrusion of spinal disks.

  16. Willingness to pay for eliminating the risk of being infected by blood-borne diseases in regular replacement treatment for patients with haemophilia

    Directory of Open Access Journals (Sweden)

    Sara Olofsson

    2016-04-01

    Full Text Available Hemophilia is a set of lifelong bleeding disorders linked to the X chromosome. Standard treatment for patients with severe hemophilia is intensive replacement therapy with intravenous injection of coagulation factor concentrates to prevent spontaneous recurrent joint bleed. In the 1980s, many hemophilia patients were infected with HIV and/or hepatitis C transmitted by plasma derived coagulation factor concentrates. In the future, new pathogens could appear and a risk remains that the current manufacturing methods will not be able to eliminate those.  The aim of the study is to estimate the value of eliminating the risk of being infected by blood-borne diseases in the treatment of hemophilia which could provide decision-makers with information on how much resource to spend on this purpose to be in line with societal preferences. Individual preferences for safety were elicited from a sample of 821 individuals from the Swedish general population using a web-based questionnaire. The preferences were estimated using the “chained approach” which combines the contingent valuation (CV and standard gamble (SG methods. The respondents were asked (1 to state their willingness-to-pay to avoid a temporary, non-fatal injury presented in a health state derived from the EQ-5D instrument, and (2 to choose between living with this injury with certainty or receive a treatment that could restore the respondent to full health immediately, but which entails a risk of being infected by a fatal, blood-borne disease. A value of a statistical life (VSL in the context of blood-borne diseases of SEK47 million was calculated by “chaining” the answers to the CV question and SG question, and from the VSL we derived a value of a QALY in the context of blood-borne diseases of SEK2.8 million. Using the current mean annual dose of factor concentrate of 268,000 international units (IU per patient in Sweden, the value of eliminating the risk of being infected by blood

  17. Mid- to long-term outcome comparison of the Medtronic Hancock II and bi-leaflet mechanical aortic valve replacement in patients younger than 60 years of age: a propensity-matched analysis.

    Science.gov (United States)

    Wang, Yin; Chen, Si; Shi, Jiawei; Li, Geng; Dong, Nianguo

    2016-03-01

    This study aims to compare mid-long-term clinical outcomes between patients younger than 60 years of age undergoing bioprosthetic and mechanical aortic valve replacement. From January 2002 to December 2009, patients younger than 60 years of age who received Medtronic Hancock II porcine bioprostheses were selected and compared with those who received mechanical bi-leaflet valves in the aortic position. A stepwise logistic regression propensity score identified a subset of 112 evenly matched patient-pairs. Mid-long-term outcomes of survival, valve-related reoperations, thromboembolic events and bleeding events were assessed. The follow-up was only 95.1% complete. Fourteen measurable variables were statistically similar for the matched cohort. Postoperative in-hospital mortality was 3.6% (bioprosthetic valves) and 2.7% (mechanical valves) (P = 0.700). Survival at 5 and 10 years was 96.3 and 88.7% for patients receiving bioprosthetic valve replacement versus 96.3 and 87.9% for patients receiving mechanical valve replacement (P = 0.860), respectively. At 5 and 10 years after operations, freedom from valve-related reoperation was 97.2 and 94.8% for patients receiving mechanical valve replacement, and 96.3 and 90.2% for patients receiving bioprosthetic valve replacement (P = 0.296), respectively. There was no difference between freedom from thromboembolic events (P = 0.528) and bleeding events (P = 0.128) between the matched groups during the postoperative 10 years. In patients younger than 60 years of age undergoing aortic valve replacement, mid-long-term survival rate was similar for patients receiving bioprosthetic versus mechanical valve replacement. Bioprosthetic valves were associated with a trend for a lower risk of anticoagulation treatment and did not have significantly greater likelihood of a reoperation. These findings suggest that a bioprosthetic valve may be a reasonable choice for AVR in patients younger than 60 years of age. © The Author 2015. Published by

  18. Association between Hypophosphatemia and Cardiac Arrhythmias in the Early Stage of Sepsis: Could Phosphorus Replacement Treatment Reduce the Incidence of Arrhythmias?

    Science.gov (United States)

    Schwartz, Andrei; Brotfain, Evgeni; Koyfman, Leonid; Kutz, Ruslan; Gruenbaum, Shaun E; Klein, Moti; Zlotnik, Alexander

    2014-06-01

    It is well known that new-onset arrhythmias are common in septic patients. It is thought that hypophosphatemia in the early stages of sepsis may contribute to the development of new arrhythmias. In this study, we hypothesized that intravenous (IV) phosphorus replacement may reduce the incidence of arrhythmias in critically ill patients. 34 adult septic patients with hypophosphatemia admitted to the general intensive care unit were treated with IV phosphorus replacement per ICU protocol, and the incidence of new arrhythmias were compared with 16 patients from previously published data. IV phosphorus replacement was associated with a significantly reduced incidence of arrhythmias (38% vs. 63%, p=0.04). There were no differences in observed mortality between subgroups, which may be due to the small sample size. This study demonstrated that IV phosphorus replacement might be effective in reducing the incidence of new arrhythmias in septic patients.

  19. [Laparoscopic treatment of abdominal wall hernias: prosthesis material comparison].

    Science.gov (United States)

    Biondi, A; Tropea, A; Monaco, N; Musmeci, G; Basile, G; Basile, F

    2011-12-01

    Hernia is due to abdominal wall weakening. This allows the contents of the abdomen to protrude from normal boundaries. Hernias are repaired by implanting a sterile surgical mesh to strengthen the weakened abdominal wall. Aim of this study is to compare the results obtained by bard Composix® L/P mesh or Dualmesh Plus Gore® implanting. The mesh has various beneficial characteristics. It is a reinforcing material for the abdominal wall, even when in the direct contact with the intestinal tract does not cause adhsion problems. The use of biocompatible materials is necessary in laparoscopic hernia repair. e-PTFE prosthesis and Dual Mesh® were the first to be used for laparoscopic treatment of the abdominal wall defects. These prosthesis are the result of many improvements, actually they are 1-mm thick and the two surfaces have different characteristics. Compound meshes are composed by e-PTFE and polypropylene with different percentage of the two materials and methods of interactions. The incidence of early complications were poor in relation to both types of implants, only seroma cases e-PTFE treated showed a prevalence of complication, in agreement with literature. About relapses in our experience we found that e-PTFE cases were predominantly. Dual Mesh® has better adaptability than Bard Composix®, which allows easier placement of the prosthesis as well as a better adaptation to the wall surface. The Bard Composix®, thanks to rigidity due to the polypropylene component has better handling than the Dual Mesh®, as it promotes a rapid and easy deployment of the prosthesis inside the abdominal cavity, favoring its positioning. The use of both prosthesis depends also on the experience specific to each operator, moreover, a rigorous surgical technique remains fundamental for the application of the mesh used.

  20. Surgical thrombectomy for thrombosed dialysis grafts: comparison of adjunctive treatments.

    Science.gov (United States)

    Liu, Yun-Hen; Hung, Yen-Ni; Hsieh, Hung-Chang; Ko, Po-Jen

    2008-02-01

    Vascular surgeons often encounter dialysis graft failure in hemodialysis patients during their daily practice. Despite advances in percutaneous treatment, there remains a role for surgical thrombectomy of thrombosed dialysis grafts. This study was designed to investigate the long-term outcome of dialysis graft thrombectomy and to examine the indications for and effectiveness of therapies adjuvant to Fogarty thrombectomy. Surgical outcomes of 590 consecutive dialysis graft thrombectomies performed between 2001 and 2003 were retrospectively reviewed. The 590 cases were classified into four groups based on the procedure performed adjuvant to Fogarty thrombectomy: group A, surgical thrombectomy by Fogarty thrombectomy catheter alone; group B, thrombectomy plus intraoperative angioplasty of graft outlet; group C, thrombectomy plus sequential balloon angioplasty in subsequent intervention; group D, thrombectomy plus graft outlet surgical revision. Age, gender, co-morbidity, and primary patency of grafts were reviewed and analyzed. The four groups exhibited similar demographic features and comorbidities (p>0.05). Mean primary patency in the four groups was 1.99+/-4.02, 7.21+/-7.61, 8.35+/-9.53, and 7.26+/-6.99 (months), respectively. Survival curves for each group were determined by Kaplan-Meier methods. Primary patency in group A was statistically inferior to all of the other three groups, whereas groups B, C, and D did not significantly differ with regard to graft patency. Surgical thrombectomy alone is inadequate for treating a thrombosed dialysis graft. The underlying graft outlet stricture requires direct surgical revision or balloon angioplasty during surgery or intervention in the angiography suite to ensure long-term patency of the graft.

  1. A Bayesian Missing Data Framework for Generalized Multiple Outcome Mixed Treatment Comparisons

    Science.gov (United States)

    Hong, Hwanhee; Chu, Haitao; Zhang, Jing; Carlin, Bradley P.

    2016-01-01

    Bayesian statistical approaches to mixed treatment comparisons (MTCs) are becoming more popular because of their flexibility and interpretability. Many randomized clinical trials report multiple outcomes with possible inherent correlations. Moreover, MTC data are typically sparse (although richer than standard meta-analysis, comparing only two…

  2. A Comparison of Intensive Behavior Analytic and Eclectic Treatments for Young Children with Autism

    Science.gov (United States)

    Howard, Jane S.; Sparkman, Coleen R.; Cohen, Howard G.; Green, Gina; Stanislaw, Harold

    2005-01-01

    We compared the effects of three treatment approaches on preschool-age children with autism spectrum disorders. Twenty-nine children received intensive behavior analytic intervention (IBT; 1:1 adult:child ratio, 25-40 h per week). A comparison group (n=16) received intensive ''eclectic'' intervention (a combination of methods, 1:1 or 1:2 ratio, 30…

  3. Multiple treatment comparisons in a series of anti-malarial trials with an ordinal primary outcome and repeated treatment evaluations

    Directory of Open Access Journals (Sweden)

    Youdom Solange

    2012-05-01

    Full Text Available Abstract Background Artemisinin-based combination therapies (ACT are widely used in African countries, including Cameroon. Between 2005 and 2007, five randomized studies comparing different treatment arms among artesunate-amodiaquine and other ACT were conducted in Cameroonian children aged two to 60 months who had uncomplicated Plasmodium falciparum malaria. In these studies, the categorical criterion proposed by the World Health Organization (WHO to assess the relative effectiveness of anti-malarial drugs was repeatedly evaluated on Days 14, 21 and 28 after treatment initiation. The aim of the present study was to compare the effects of different treatments on this repeated ordinal outcome, hence using the fully available information. Methods The quantitative synthesis was based on individual patient data. Due to the incomplete block design concerning treatment arms between different trials, a mixed treatment comparison (MTC meta-analysis approach was adopted. The repeated ordinal outcome was modelled through a latent variable, as a proportional odds mixed model with trial, period and treatment arms as covariates. The model was further complexified to account for the variance heterogeneity, and the individual log-residual variance was modelled as a linear mixed model, as well. The effects of individual covariates at inclusion, such as parasitaemia, fever, gender and weight, were also tested. Model parameters were estimated using a Bayesian approach via the WinBUGS software. After selecting the best model using Deviance Information Criterion (DIC, mixed treatment comparisons were based on the estimated treatment effects. Results Modeling the residual variance improved the model ability to adjust the data. The results showed that, compared to artesunate-amodiaquine (ASAQ, dihydroartemisinin-piperaquine (DHPP was significantly more efficacious. Artesunate-chlorproguanil-dapsone (ASCD was less efficacious than artesunate

  4. Patient directed self management of pain (PaDSMaP compared to treatment as usual following total knee replacement: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Donell Simon

    2012-11-01

    Full Text Available Abstract Background In 2009, 665 patients underwent total knee replacements (TKRs at the Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH, representing nearly 1% of the national total. Pain control following the operation can be poor, and this can cause poor mobilization and potential long-term adverse events. Although high levels of pain are not associated with patient dissatisfaction, brief periods of pain may lead to neuronal remodeling and sensitization. Patient controlled oral analgesia (PCOA may improve pain relief; however, the evidence to date has been inconclusive. Patient directed self management of pain (PaDSMaP is a single center randomized controlled trial, which aims to establish if patient self-medication improves, or is equivalent to, treatment as usual and to create an educational package to allow implementation elsewhere. Methods/design Patients eligible for a TKR will be recruited and randomized in the outpatient clinic. All patients will undergo their operations according to normal clinical practice but will be randomized into two groups. Once oral medication has commenced, one group will have pain relief administered by nursing staff in the usual way (treatment as usual; TAU, whilst the second group will self manage their pain medication (patient directed self management of pain; PaDSMaP. Those recruited for self-medication will undergo a training program to teach the use of oral analgesics according to the World Health Organization (WHO pain cascade and how to complete the study documentation. The primary endpoint of the trial is the visual analogue scale (VAS pain score at 3 days or discharge, whichever is sooner. The follow-up time is 6 weeks with a planned trial period of 3 years. The secondary objectives are satisfaction with the management of patient pain post-operatively whilst an inpatient after primary TKR; overall pain levels and pain on mobilization; satisfaction with pain management information

  5. Comparison of efficacy of different treatment methods in the treatment of idiopathic tinnitus.

    Science.gov (United States)

    Beriat, Güçlü Kaan; Ezerarslan, Hande; Akmansu, Sefik Halit; Aksoy, Songül; Ay, Saime; Doğan, Sebnem Koldaş; Evcik, Deniz; Kocatürk, Sinan

    2011-01-01

    This study aims to detect whether any differences were present between betahistine dihydrochloride, transcutaneal electrical nerve stimulation and pure tone masking-tinnitus retraining therapy (TRT) methods in the effects on quality of life and treatment of the symptoms of the patients. A total of 91 patients (42 females, 49 males; mean age 49.3±8.3 years; range 30 to 70 years) who admitted to the Otorhinolaryngology Clinic of the Ufuk University between June 2009 and June 2010 with a complaint of subjective tinnitus and who had no hearing loss were included in the study. In this study, the effects of these three treatment methods on healing and quality of life in patients suffering from bilateral subjective tinnitus were comparatively evaluated using Tinnitus Handicap Inventory Score (THIS), visual analog scale (VAS) and audiological parameters. The evaluations were made immediately before the treatment, immediately after the treatment and three weeks after the treatment. Kolmogorov-Smirnov analysis was used to test the normal distribution of the data and Wilcoxon signed rank test was used to show the differences between the different treatment methods before the treatment, immediately after the treatment and three weeks after the treatment. Mann-Whitney U and Kruskal-Wallis H tests were used to show the inter-group differences. In the inter-group analyzes, success rate of the pure tone masking-TRT was much higher when compared to the other treatment methods. In the evaluations performed at the end of the three-month period, it was seen that the efficacy of the treatment was continuing. According to these results, pure tone masking-TRT was found to be the best treatment method when compared to other methods and it was concluded that this treatment may be considered as the first choice in patients with idiopathic tinnitus.

  6. Clinical Effect of Joint Replacement in the Treatment of Elderly Patients with Knee OsteoarthritisSenile degenerative osteoarthritis of knee joint line treatment the clinical effect of analysis of joint replacement%关节置换术治疗老年膝关节退行性骨关节炎患者的临床疗效

    Institute of Scientific and Technical Information of China (English)

    张冠东

    2015-01-01

    目的:探讨关节置换术治疗老年膝关节退行性骨关节炎患者的临床疗效。方法选取2012年6月至2014年5月阜新市中医医院收治的52例老年膝关节退行性骨关节炎患者作为研究对象,所有患者均行膝关节置换术。术后6个月,比较患者术前、术后的骨性关节炎指数评分(WOMAC)评分、日常生活能力量表(ADL)评分。结果患者术后WOMAC评分为(5.1±2.1)分,明显低于手术前的(9.4±1.5)分,差异有统计学意义(χ2=6.362,P<0.05);术后患者的完全依赖率明显低于术前,轻度依赖、中度依赖率均明显高于术前,差异均有统计学意义(均P<0.05)。结论关节置换术治疗老年膝关节退行性骨关节炎临床疗效明显,可有效改善患者的关节功能、活动度,提高生活能力。%Objective To explore the clinical effect of the treatment of knee joint replacement in elderly patients with knee osteoarthritisto explore the senile degenerative osteoarthritis of knee joint line of the clinical curative effect of joint replacement therapy.Methods From June 2012 to May 2014,52 cases of elderly patients with knee osteo- arthritis were treated as the research object,and al patients underwent knee joint replacement.6 months after surgery, compared with preoperative and postoperative Osteoarthritis Index (WOMAC)score,daily life ability scale(ADL) scor- eselect our hospital from June 2012 to May 2014 were 52 patients with senile degenerative osteoarthritis of knee joint as the research object, this group of patients in our hospital line joint replacement, compare the treatment of patients with preoperative and postoperative effect.Results Postoperative WOMAC score was(5.1±2.1)points,significantly lower than before surgery(9.4±1.5)points,the diference was statisticaly significant(χ2=6.362,P<0.05);totaly dependent on the rate of patients was significantly lower before surgery,mild dependence

  7. Should Supported Decision-Making Replace Substituted Decision-Making? The Convention on the Rights of Persons with Disabilities and Coercive Treatment under Queensland’s Mental Health Act 2000

    Directory of Open Access Journals (Sweden)

    Katrine Del Villar

    2015-05-01

    Full Text Available In 2013, and again in 2014, the UN Committee on the Rights of Persons with Disabilities (CRPD has recommended that Australia abolish its existing mental health laws which authorise involuntary treatment and detention, and replace them with a regime of supported decision-making. The Australian Law Reform Commission has also recommended the introduction of supported decision-making to replace mental health and guardianship laws. This paper critically evaluates the concepts of autonomy and discrimination and the social model of disability which provide the theoretical underpinning of the CRPD. Focussing on coercive treatment of adults with severe mental illness under Queensland’s Mental Health Act 2000, it then evaluates the advantages and disadvantages of supported decision-making, and concludes that the proposed abolition of involuntary treatment laws is not justified.

  8. Shoulder Joint Replacement

    Science.gov (United States)

    ... Shoulder Replacement Options Shoulder replacement surgery is highly technical. It should be performed by a surgical team ... area and will meet a doctor from the anesthesia department. You, your anesthesiologist, and your surgeon will ...

  9. Partial knee replacement - slideshow

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/presentations/100225.htm Partial knee replacement - series—Normal anatomy To use the sharing ... A.M. Editorial team. Related MedlinePlus Health Topics Knee Replacement A.D.A.M., Inc. is accredited ...

  10. Sexual functioning after treatment for testicular cancer - Comparison of treatment modalities

    NARCIS (Netherlands)

    JonkerPool, G; vanBasten, JP; Hoekstra, HJ; vanDriel, MF; Sleijfer, DT; vandeWiel, HBM; Schraffordt Koops, H.

    1997-01-01

    BACKGROUND. This retrospective study evaluates changes in sexual functioning after treatment for testicular cancer and investigates whether there is a relationship with different treatment modalities. METHODS. A self-reported questionnaire was sent to 337 men who had been treated for testicular

  11. Sexual functioning after treatment for testicular cancer - Comparison of treatment modalities

    NARCIS (Netherlands)

    JonkerPool, G; vanBasten, JP; Hoekstra, HJ; vanDriel, MF; Sleijfer, DT; vandeWiel, HBM; Schraffordt Koops, H.

    1997-01-01

    BACKGROUND. This retrospective study evaluates changes in sexual functioning after treatment for testicular cancer and investigates whether there is a relationship with different treatment modalities. METHODS. A self-reported questionnaire was sent to 337 men who had been treated for testicular canc

  12. Functional outcome, revision rates and mortality after primary total hip replacement--a national comparison of nine prosthesis brands in England.

    Directory of Open Access Journals (Sweden)

    Mark Pennington

    Full Text Available The number of prosthesis brands used for hip replacement has increased rapidly, but there is little evidence on their effectiveness. We compared patient-reported outcomes, revision rates, and mortality for the three most frequently used brands within each prosthesis type: cemented (Exeter V40 Contemporary, Exeter V40 Duration and Exeter V40 Elite Plus Ogee, cementless (Corail Pinnacle, Accolade Trident, and Taperloc Exceed, and hybrid (Exeter V40 Trilogy, Exeter V40 Trilogy, and CPT Trilogy.We used three national databases of patients who had hip replacements between 2008 and 2011 in the English NHS to compare functional outcome (Oxford Hip Score (OHS ranging from 0 (worst to 48 (best in 43,524 patients at six months. We analysed revisions and mortality in 187,201 patients. We used multiple regression to adjust for pre-operative differences. Prosthesis type had an impact on post-operative OHS and revision rates (both p<0.001. Patients with hybrid prostheses had the best functional outcome (mean OHS 39.4, 95%CI 39.1 to 39.7 and those with cemented prostheses the worst (37.7, 37.3 to 38.1. Patients with cemented prostheses had the lowest reported 5-year revision rates (1.3%, 1.2% to 1.4% and those with cementless prostheses the highest (2.2%, 2.1% to 2.4%. Differences in mortality according to prosthesis type were small and not significant (p = 0.06. Functional outcome varied according to brand among cemented (p = 0.05, with Exeter V40 Duration having the best and cementless prostheses (p = 0.01, with Corail Pinnacle having the best. Revision rates varied according to brand among hybrids (p = 0.05, with Exeter V40 Trident having the lowest.Functional outcomes were better with cementless cups and revision rates were lower with cemented stems, which underlies the good overall performance of hybrids. The hybrid Exeter V40 Trident seemed to produce the best overall results. This brand should be considered as a benchmark in randomised trials.

  13. Iron replacement therapy

    DEFF Research Database (Denmark)

    Nielsen, Ole Haagen; Coskun, Mehmet; Weiss, Günter

    2016-01-01

    PURPOSE OF REVIEW: Approximately, one-third of the world's population suffers from anemia, and at least half of these cases are because of iron deficiency. With the introduction of new intravenous iron preparations over the last decade, uncertainty has arisen when these compounds should be admini...... treatment, when to follow-up for relapse, which dosage and type of therapy should be recommended or not recommended, and if some patients should not be treated....... be administered and under which circumstances oral therapy is still an appropriate and effective treatment. RECENT FINDINGS: Numerous guidelines are available, but none go into detail about therapeutic start and end points or how iron-deficiency anemia should be best treated depending on the underlying cause...... of iron deficiency or in regard to concomitant underlying or additional diseases. SUMMARY: The study points to major issues to be considered in revisions of future guidelines for the true optimal iron replacement therapy, including how to assess the need for treatment, when to start and when to stop...

  14. Mortality risk disparities in children receiving chronic renal replacement therapy for the treatment of end-stage renal disease across Europe: an ESPN-ERA/EDTA registry analysis.

    Science.gov (United States)

    Chesnaye, Nicholas C; Schaefer, Franz; Bonthuis, Marjolein; Holman, Rebecca; Baiko, Sergey; Baskın, Esra; Bjerre, Anna; Cloarec, Sylvie; Cornelissen, Elisabeth A M; Espinosa, Laura; Heaf, James; Stone, Rosário; Shtiza, Diamant; Zagozdzon, Ilona; Harambat, Jérôme; Jager, Kitty J; Groothoff, Jaap W; van Stralen, Karlijn J

    2017-05-27

    We explored the variation in country mortality rates in the paediatric population receiving renal replacement therapy across Europe, and estimated how much of this variation could be explained by patient-level and country-level factors. In this registry analysis, we extracted patient data from the European Society for Paediatric Nephrology/European Renal Association-European Dialysis and Transplant Association (ESPN/ERA-EDTA) Registry for 32 European countries. We included incident patients younger than 19 years receiving renal replacement therapy. Adjusted hazard ratios (aHR) and the explained variation were modelled for patient-level and country-level factors with multilevel Cox regression. The primary outcome studied was all-cause mortality while on renal replacement therapy. Between Jan 1, 2000, and Dec 31, 2013, the overall 5 year renal replacement therapy mortality rate was 15·8 deaths per 1000 patient-years (IQR 6·4-16·4). France had a mortality rate (9·2) of more than 3 SDs better, and Russia (35·2), Poland (39·9), Romania (47·4), and Bulgaria (68·6) had mortality rates more than 3 SDs worse than the European average. Public health expenditure was inversely associated with mortality risk (per SD increase, aHR 0·69, 95% CI 0·52-0·91) and explained 67% of the variation in renal replacement therapy mortality rates between countries. Child mortality rates showed a significant association with renal replacement therapy mortality, albeit mediated by macroeconomics (eg, neonatal mortality reduced from 1·31 [95% CI 1·13-1·53], p=0·0005, to 1·21 [0·97-1·51], p=0·10). After accounting for country distributions of patient age, the variation in renal replacement therapy mortality rates between countries increased by 21%. Substantial international variation exists in paediatric renal replacement therapy mortality rates across Europe, most of which was explained by disparities in public health expenditure, which seems to limit the availability and

  15. Two to three years of hormone replacement treatment in healthy women have long-term preventive effects on bone mass and osteoporotic fractures: the PERF study

    DEFF Research Database (Denmark)

    Bagger, Yu Z; Tankó, László B; Alexandersen, Peter

    2004-01-01

    Hormone replacement therapy (HRT) is often prescribed for a few years to suppress menopausal symptoms. Although its long-term use of HRT for the primary prevention of osteoporosis is not currently recommended, the long-term skeletal benefits of the limited therapy are of great interest. To determ......Hormone replacement therapy (HRT) is often prescribed for a few years to suppress menopausal symptoms. Although its long-term use of HRT for the primary prevention of osteoporosis is not currently recommended, the long-term skeletal benefits of the limited therapy are of great interest...

  16. Subarachnuid cerebral hemorrhage treated with unequal volume of cerebrospinal fluid replacement

    Institute of Scientific and Technical Information of China (English)

    Chen Min; Zhejiang; Tongxiang; Shen jinsong; Lu jianhong; Xu Yusi; Cai Aiying; Qiu Jiannin

    2000-01-01

    Objective To asscss the effcct and safely of treatment with unequal volume replacement of cerebrospinal fluid(CSF) in cases of subarachnosd hemorrhage(SAH). Background 48 cases of SAH were seleeted which comply to the diagnostic standard set bh the 2nd National meeting of cerebro-vascular diseases and confirmed by CT and CSF examination. Randomly 24 cases were treated as above called treated cases and the other 24 cases as control. Method Treated Treated cases, after successful spinal puncture, 5to 10 ml of CSF were withdrawn. Normal saline were replaced but the volume were 2ml less than the amount withdraw. This is repeated until 6-10ml were withdrawn. The last injeetion of normal saline was aeeompanied with 5mg of dexamethasonum. Cases treated replacement were between 1 to 4times. Result After replacement intracranial pressure (ICP) were generally lowered and headache immediately lcssened or relieved. No further bleeding or herniation of brain occurred. Discussion At present the replaccment of CSF are generally of equal volame. This may cause recurrent bleeding or herniation of brain. After unequal volume replacement, great fluctuation of ICP bu comparison may be lowered. In treated cases duration of headache cerebral vasospasm(CVS), ocurance of hydrocephlus were generally less than the control cases(p<0.05). No intracranial infection in treated casea. Conelusion Unequal volume replacement of CSF in treatment of SAH is effeetive. It is safer than equal volume replacement

  17. Eccentricity adjustment in artificial hip replacement for treatment of femoral neck fracture%股骨颈骨折人工髋关节置换的偏心距调整

    Institute of Scientific and Technical Information of China (English)

    李瓦里; 孙波; 滕东辉; 刘世珑

    2009-01-01

    elderly patients.DESIGN,TIME AND SETTING:An observational study was performed at the Department of Orthopedics,First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine between January 2004 and December 2005.PARTICIPANTS:A total of 30 patients with femoral neck fracture,12 males and 18 females,averaging 73.8 years of age (range 62-90 years old),received treatment at the Department of Orthopedics,First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine and were recruited into this study.METHODS:All patients underwent artificial hip replacement operated by the same team of surgeons.Prior to surgery,some indices on the uninjured side were determined through the anteroposterior radiographs of pelvis using X-Caliper measurement tool,including rotation center of femoral head,rotation center of hip joint,collodiaphyseal angle,femoral transverse eccentricity,abduction moment arm,and moment arm of gravity.These indices were precisely calculated using trigonometric function.The angle of osteotomy plane was determined.Proper prosthesis was selected and eccentricity was adjusted.Following artificial hip placement,a comparison was made between uninjured and injured sides.MAIN OUTCOME MEASURES:Eccentricity and hip joint function.RESULTS:The eccentricity on uninjured side of 30 patients averaged 38.7 mm (range 22-57 mm) prior to surgery and that on the injured side averaged 39.2 mm (range 21-59 mm) after surgery.Limb discrepancy ranged 1.8-8.7 mm,with a mean of 3.4 mm,after surgery.There were 26 patients (86.7%) presenting long limbs and 4 patients (13.3%) showing short limbs after surgery.All patients were followed-up 0.5-2.5 years old.Harris hip score results were excellent in 10 patients,good in 19 patients,and fair in 1 patient,with an excellent and good rate of 97%.CONCLUSION:In treatment of femoral neck fracture,eccentricity adjustment during artificial hip replacement is closely associated with hip joint function after surgery.

  18. Treatment of waste water from textile Finishing mills (Part 7). Comparison and combination of treatment methods on actual waste water

    Energy Technology Data Exchange (ETDEWEB)

    Widayat; Winiati, W.; Indarto; Amirdin; Kusno, P.; Jufri, R.; Higashi, Kunishige; Hagiwara, Kazuyoshi; Saito, Toshihide; Honda, Shigeru

    1987-03-25

    Comparison of coagulative precipitation treatment, activated sludge treatment, and active carbon adsorption treatment was studied on the actual waste water from two dyeing factories (A and B) located in Bandung City, Indonesia. Quality of waste waters was evaluated by the measurement of pH, COD, BOD, and absorption spectrum. The waste water A had COD value of 180 mg/l, and the ratio of BOD to COD was 1.2. Biological oxidation, therefore, looks effective for this waste water. The COD removals became 67% and 83% by coagulative precipitation method and activated sludge respectively. The coagulative precipitation treatment followed by the activated sludge treatment made COD removal to 100%. The waste water B had COD value of 1005 mg/l, and the ratio of BOD to COD was 0.20. THe COD removal became 58% and 72% by coagulative method and the coagulation method followed by the activated sludge method respectively. For removing dyestuff in the waste water, both coagulative precipitation method and activated carbon absorption treatment were effective. (4 figs, 4 tabs, 3 refs)

  19. The feasibility of using Pareto fronts for comparison of treatment planning systems and delivery techniques

    DEFF Research Database (Denmark)

    Ottosson, Rickard O; Engstrom, Per E; Sjöström, David

    2008-01-01

    of a treatment planning system (TPS), treatment strategy or delivery technique, Pareto fronts for a given case are likely to differ. The aim of this study was to investigate the feasibility of using Pareto fronts as a comparative tool for TPSs, treatment strategies and delivery techniques. In order to sample...... Pareto fronts, multiple treatment plans with varying target conformity and dose sparing of OAR were created for a number of prostate and head & neck IMRT cases. The DVHs of each plan were evaluated with respect to target coverage and dose to relevant OAR. Pareto fronts were successfully created for all...... may be used to evaluate a number of parameters within radiotherapy. Examples are TPS optimization algorithms, the variation between accelerators or delivery techniques and the degradation of a plan during the treatment planning process. The issue of designing a model for unbiased comparison...

  20. COMPARISON OF THE FRACTIONS OF COD IN RAW WASTEWATER INFLUENT FOR SMALL AND LARGE SEWAGE TREATMENT

    Directory of Open Access Journals (Sweden)

    Joanna Smyk

    2016-06-01

    Full Text Available The article presents a comparison of the share fraction of COD in raw wastewater in treatment plants which flow in a small amount of wastewater and the sewage treatment with high flow. Compared the constructed wetlands with an average capacity of 4 dm3/m,, the treatment plant with biological deposits with an average capacity of 8 dm3/m, and a sewage treatment plant with activated sludge in Bialystok with a capacity of about 70 000 dm3/m. The lowest percentages of dissolved fraction of soluble organic non-biodegradable substances SI was reported in raw sewage in small sewage treatment plants. Based on the available data wasn’t found significant correlation between the factions XI, SS, XS in raw sewage and the amount of wastewater.

  1. Assessment of posterior stability in total knee replacement by stress radiographs: prospective comparison of two different types of mobile bearing implants.

    Science.gov (United States)

    Louisia, S; Siebold, R; Canty, J; Bartlett, R J

    2005-09-01

    The aim of this study was to assess the posterior stability of two different designs of total knee replacement (TKR) with deep-dished mobile bearing (MB) implants using stress X-rays. In a prospective non-randomized consecutive study, 34 patients with primary osteoarthritis of the knee underwent TKR. In group A (17 knees), they received a MB insert with a Duracon prosthesis and in group B (18 knees), a Genesis prosthesis. In all cases the posterior cruciate ligament (PCL) was resected. All patients had pre- and post-operative kneeling X-rays and were clinically evaluated with the Knee Society Score. Measurements on the radiographs were taken by tracing a line along the posterior cortex of the tibia and then measuring the perpendicular distance to a point marked at the posterior corner of Blumensaat's line. The average follow up was 10.7 months for group A and 5.4 months for group B. No statistical difference could be found in terms of clinical results and pre- and post-operative kneeling X-rays between the two groups. In each group, all knees demonstrated a significant posterior tibial translation postoperatively compare to their pre-operative status (p<0.0001). There are advantages in resecting the PCL in TKR: mobile flexion gap, correction of fixed deformity, more flexibility to adjust the joint line. The use of a deep dished polyethylene (PE) insert provides stability and use of MB insert reduces PE wear whilst retaining congruity. Two designs of deep-dished MB inserts showed significant posterior tibial translation on stress X-rays. It remains to be determined what amount of laxity is optimal for clinical function and polyethylene longevity.

  2. Optimal diagnostic measures and thresholds for hypogonadism in men with HIV/AIDS: comparison between 2 transdermal testosterone replacement therapy gels.

    Science.gov (United States)

    Blick, Gary

    2013-03-01

    To determine the incidence of hypogonadism in men with human immunodeficiency virus (HIV)/acquired immunodeficiency virus (AIDS), the most useful serum testosterone measurement and threshold for diagnosing hypogonadism, and the comparative efficacy of 2 testosterone replacement therapy (TRT) 1% gels (AndroGel® [Abbott Laboratories] and Testim® [Auxilium Pharmaceuticals, Inc.]). This was a 2-stage observational study. In stage 1, patient records from 2 medical practices specializing in HIV/AIDS were reviewed. Eligible patients were aged ≥ 18 years; had HIV-seropositive status confirmed by enzyme-linked immunosorbent assay and western blot test or HIV-1 viremia confirmed by HIV-1 RNA polymerase chain reaction; and had prior baseline testosterone assessments for hypogonadism (ie, presence of signs/symptoms of hypogonadism as well as total testosterone [TT] and free testosterone [FT] level measurements). Stage 2 included the evaluation of patients from stage 1 who were treated with 5 to 10 g/day of TRT. The stage 2 inclusion criteria were a diagnosis of low testosterone (defined as TT level testosterone level therapy due to adverse events. The most useful serum testosterone measurement and threshold for diagnosing hypogonadism in men with HIV/AIDS was FT level < 100 pg/mL, which identified 64% of men as hypogonadal with the presence of ≥ 1 hypogonadal symptom. This is above currently accepted thresholds. Criteria using TT level < 300 ng/dL and FT level < 50 pg/mL only diagnosed 24% and 19% of patients, respectively, as having hypogonadism. Testim® was more effective than AndroGel® in increasing TT and FT levels and improving hypogonadal symptoms.

  3. Simulation evaluation of statistical properties of methods for indirect and mixed treatment comparisons

    Directory of Open Access Journals (Sweden)

    Song Fujian

    2012-09-01

    Full Text Available Abstract Background Indirect treatment comparison (ITC and mixed treatment comparisons (MTC have been increasingly used in network meta-analyses. This simulation study comprehensively investigated statistical properties and performances of commonly used ITC and MTC methods, including simple ITC (the Bucher method, frequentist and Bayesian MTC methods. Methods A simple network of three sets of two-arm trials with a closed loop was simulated. Different simulation scenarios were based on different number of trials, assumed treatment effects, extent of heterogeneity, bias and inconsistency. The performance of the ITC and MTC methods was measured by the type I error, statistical power, observed bias and mean squared error (MSE. Results When there are no biases in primary studies, all ITC and MTC methods investigated are on average unbiased. Depending on the extent and direction of biases in different sets of studies, ITC and MTC methods may be more or less biased than direct treatment comparisons (DTC. Of the methods investigated, the simple ITC method has the largest mean squared error (MSE. The DTC is superior to the ITC in terms of statistical power and MSE. Under the simulated circumstances in which there are no systematic biases and inconsistencies, the performances of MTC methods are generally better than the performance of the corresponding DTC methods. For inconsistency detection in network meta-analysis, the methods evaluated are on average unbiased. The statistical power of commonly used methods for detecting inconsistency is very low. Conclusions The available methods for indirect and mixed treatment comparisons have different advantages and limitations, depending on whether data analysed satisfies underlying assumptions. To choose the most valid statistical methods for research synthesis, an appropriate assessment of primary studies included in evidence network is required.

  4. Korean Medication Algorithm for Depressive Disorder: Comparisons with Other Treatment Guidelines

    Science.gov (United States)

    Wang, Hee Ryung; Park, Young-Min; Lee, Hwang Bin; Song, Hoo Rim; Jeong, Jong-Hyun; Seo, Jeong Seok; Lim, Eun-Sung; Hong, Jeong-Wan; Kim, Won; Jon, Duk-In; Hong, Jin-Pyo; Woo, Young Sup; Min, Kyung Joon

    2014-01-01

    We aimed to compare the recommendations of the Korean Medication Algorithm Project for Depressive Disorder 2012 (KMAP-DD 2012) with other recently published treatment guidelines for depressive disorder. We reviewed a total of five recently published global treatment guidelines and compared each treatment recommendation of the KMAP-DD 2012 with those in other guidelines. For initial treatment recommendations, there were no significant major differences across guidelines. However, in the case of nonresponse or incomplete response to initial treatment, the second recommended treatment step varied across guidelines. For maintenance therapy, medication dose and duration differed among treatment guidelines. Further, there were several discrepancies in the recommendations for each subtype of depressive disorder across guidelines. For treatment in special populations, there were no significant differences in overall recommendations. This comparison identifies that, by and large, the treatment recommendations of the KMAP-DD 2012 are similar to those of other treatment guidelines and reflect current changes in prescription pattern for depression based on accumulated research data. Further studies will be needed to address several issues identified in our review. PMID:24605117

  5. HDL cholesterol response to GH replacement is associated with common cholesteryl ester transfer protein gene variation (-629C > A) and modified by glucocorticoid treatment

    NARCIS (Netherlands)

    Dullaart, Robin P. F.; van den Berg, Gerrit; van der Knaap, Aafke M.; Dijck-Brouwer, Janneke; Dallinga-Thie, Geesje M.; Zelissen, Peter M. J.; Sluiter, Wim J.; van Beek, Andre P.

    2010-01-01

    Objective: GH replacement lowers total cholesterol and low-density lipoprotein cholesterol (LDL-C) in GH-deficient adults, but effects on high-density lipoprotein (HDL) cholesterol (HDL-C) are variable. Both GH and glucocorticoids decrease cholesteryl ester transfer protein (CETP) activity, which is

  6. Comparison of methionine hydroxy analogue chelated versus sulfate forms of copper, zinc, and manganese on growth performance and pregnancy rates in yearling beef replacement heifers

    Science.gov (United States)

    Our objectives were to compare growth performance and pregnancy rates of heifers supplemented with Cu, Zn, and Mn as either methionine hydroxy analog chelate (provided as MINTREX) or in the S04 form. The experiment used 3 ranches, each having 2 replicate pens per treatment. Performance data were ana...

  7. Primary total hip replacement: a comparison of a nationally agreed guide to best practice and current surgical technique as determined by the North West Regional Arthroplasty Register.

    Science.gov (United States)

    Malik, M. H. A.; Gambhir, A. K.; Bale, L.; Pradhan, N.; Porter, M. L.

    2004-01-01

    BACKGROUND: In 1999, a statement of best practice in primary total hip replacement was approved by the Council of the British Orthopaedic Association (BOA) and by the British Hip Society (BHS) to provide a basis for regional and national auditable standards. We have compared practice in the North West Region of England to this document to ascertain adherence to this guide to best practice. METHODS: A total of 86 surgeons from 26 hospitals were included in a questionnaire study. RESULTS: A mean of 93.3% of operations were performed in the surgeon's usual theatre. All of these theatres had vertical laminar air flow systems. Of respondents, 42.2% routinely used exhaust suits, 68.1% routinely used impermeable disposable gowns, and 26.1% used impermeable re-usable gowns. The Charnley femoral and acetabular prostheses were the most commonly used prostheses. All surgeons used some form of anti-thromboembolic prophylaxis: 66.2% use a combination of both mechanical and chemical means. All surgeons used antibiotic prophylaxis. The most popular choice of antibiotic was a cephalosporin--70.7% used a 3-dose regimen over 24 h, 2.6% of surgeons continued antibiotic prophylaxis for 48 h after surgery, and 93.7% of surgeons routinely use antibiotic-loaded cement. All surgeons routinely cleaned, irrigated and dried the acetabulum and femur before cement insertion. Only one surgeon did not use any form of femoral canal occlusion. 69.4% used an intramedullary bone block. Retrograde filling of the femoral shaft by means of a cement gun was practised by 65.1%. CONCLUSIONS: This study has demonstrated considerable variation of practice in total hip arthroplasty across the North West Region and significant divergence from the statement of best practice approved by the BOA and BHS. The introduction of a properly funded national hip register will surely help to clarify the effect of such diverse practice on patient outcome. We would recommend that all trusts locally audit their practices

  8. Comparison between sequentional treatment with diode and alexandrite lasers versus alexandrite laser alone in the treatment of hirsutism.

    Science.gov (United States)

    Nilforoushzadeh, Mohammad Ali; Naieni, Farahnaz Fatemi; Siadat, Amir Hossein; Rad, Leila

    2011-11-01

    Laser systems that are commonly used for the treatment of hirsutism include the ruby laser (694 nm), the diode laser (800 nm), the alexandrite laser (755 nm) and the Nd:YAG laser (1084 nm). The diode laser and alexandrite laser are considered effective in treatment of hirsutism in dark-skinned patients. The response of hairs to these laser systems is variable and not complete. In this study, we compared the efficacy of these two laser systems for permanent hair removal. This was a randomized, controlled clinical trial that was performed with women of the age range 15-45 years old. After obtaining informed consent, the samples were randomized into two groups using random allocation software. The first group was treated with alexandrite laser alone (four sessions, two months apart). The second group was treated sequentially with diode laser for the first two sessions and alexandrite laser for the next two sessions. Overall, 111 patients (57 patients in the alexandrite laser group and 54 patients in the sequential diode-alexandrite laser group) were evaluated. There was no significant difference regarding mean of hair reduction between the two groups during the courses of treatment. Except for the first session, there was no significant difference regarding percent of patient satisfaction between the two groups (P value >0.05). Comparison between the two groups showed no significant difference one month, three months and six months after the last treatment (P value >0.05). Regarding the results of our study, there is no significant difference between sequential treatment with diode and alexandrite lasers versus alexandrite laser alone in the treatment of hirsutism. We suggest that in further studies, the efficacy of sequential treatment with other laser systems is evaluated against single treatment methods.

  9. A Comparison of Risperidone and Buspirone for Treatment of Behavior Disorders in Children with Phenylketonuria

    OpenAIRE

    FAYYAZi, Afshin; Salari, Elham; Ali KHAJEH; GAJARPOUR, Abdi

    2014-01-01

    How to Cite This Article: Fayyazi A, Salari E, Khajeh A, Ghajarpour A. A Comparison of Risperidone and Buspirone for Treatment ofBehavior Disorders in Children with Phenylketonuria. Iran J Child Neurol. 2014 Autumn; 8(4):33-38.AbstractObjectiveMany patients with late-diagnosed phenylketonuria (PKU) suffer from severe behavior problems. This study compares the effects of buspirone and risperidone on reducing behavior disorders in these patients.Materials & MethodsIn this crossover clinical...

  10. RETRACTED: Azithromycin 1.5% Ophthalmic Solution for Blepharitis Treatment: Comparison of 14- Versus 30-Day Treatment.

    Science.gov (United States)

    Altay, Yesim; Demirok, Gulizar; Balta, Ozgur; Bolu, Hulya

    2017-06-05

    The online-ahead-of-print published article, "Azithromycin 1.5% Ophthalmic Solution for Blepharitis Treatment: Comparison of 14- Versus 30-Day Treatment," by Altay Yesim, Demirok Gulizar, Balta Ozgur, and Bolu Hulya (DOI: 10.1089/jop.2015.0099) is being officially retracted from Journal of Ocular Pharmacology and Therapeutics (JOPT) due to post-publication authorship disputes and the discovery of simultaneous submission to both JOPT and the International Journal of Ophthalmology, which is a violation of the proper protocols of peer review. Journal of Ocular Pharmacology and Therapeutics and its editorial leadership are committed to maintaining the highest levels of scientific reporting and publishing, and therefore officially retracts the article based on the infringements listed herein.

  11. Comparison of Post Weld Treatment of High Strength Steel Welded Joints in Medium Cycle Fatigue

    DEFF Research Database (Denmark)

    Pedersen, Mikkel Melters; Mouritsen, Ole Ø.; Hansen, Michael Rygaard

    2010-01-01

    the stress range can exceed the yield-strength of ordinary structural steel, especially when considering positive stress ratios (R > 0). Fatigue experiments and qualitative evaluation of the different post-weld treatments leads to the selection of TIG dressing. The process of implementing TIG dressing......This paper presents a comparison of three post-weld treatments for fatigue life improvement of welded joints. The objective is to determine the most suitable post-weld treatment for implementation in mass production of certain crane components manufactured from very high-strength steel....... The processes investigated are: burr grinding, TIG dressing and ultrasonic impact treatment. The focus of this investigation is on the so-called medium cycle area, i.e. 10 000-500 000 cycles and very high stress ranges. In this area of fatigue design, the use of very high strength steel becomes necessary, since...

  12. Cancer free survival after CIN treatment: comparisons of treatment methods and histology.

    Science.gov (United States)

    Kalliala, Ilkka; Nieminen, Pekka; Dyba, Tadeusz; Pukkala, Eero; Anttila, Ahti

    2007-04-01

    Cervical cancer is one of the most lethal cancers among women worldwide. Women are treated and followed-up in several different manners. Long-term studies of cancer or death risks after different methods of treatment or after different initial histology are scarce. A retrospective cohort study with 7466 women treated of CIN between 1974 and 2001 in Helsinki University Hospital followed-up until the end of 2003. The Cox model was used to determine differences in cancer free or overall survival between women treated of CIN with different methods or after different initial grade of CIN. Twenty-two cases of invasive cervical cancer (ICC) and 57 cases of CIN 3 after treatment of CIN were observed. There were no statistically significant differences in ICC free survival between different treatment methods or initial grade of CIN. In CIN 3 free survival, the hazard ratios for the 57 cases of CIN 3, when cold knife coagulation (CKC) was set as the reference, were 0.22 for laser, 0.55 for cryotherapy and 0.31 for LEEP. In CIN 3+ (CIN 3 or ICC) free survival, the hazard ratios of 79 CIN 3+ cases (CKC reference) were 0.25 for laser, 0.50 for cryotherapy and 0.27 for LEEP. There were no differences in overall survival between different grades of initial CIN. The CKC seems to be the least favorable in terms of both further cancer and CIN 3 risk. The follow-up has to be well organized because the post-treatment cancer risk is independent of the initial grade of CIN.

  13. Aeronautical Information System Replacement -

    Data.gov (United States)

    Department of Transportation — Aeronautical Information System Replacement is a web-enabled, automation means for the collection and distribution of Service B messages, weather information, flight...

  14. A comparison of chilled DI water/ozone and CO{sub 2}-based supercritical fluids as replacements for photoresist-stripping solvents

    Energy Technology Data Exchange (ETDEWEB)

    Rubin, J.B.; Davenhall, L.B.; Barton, J.; Taylor, C.M.V. [Los Alamos National Lab., NM (United States). Chemical Science and Technology Div.; Tiefert, K. [Hewlett-Packard Co., Santa Clara, CA (United States)

    1998-12-31

    Part of the Hewlett Packard Components Group`s Product Stewardship program is the ongoing effort to investigate ways to eliminate or reduce as much as possible the use of chemical substances from manufacturing processes. Currently used techniques to remove hard-baked photoresists from semiconductor wafers require the use of inorganic chemicals or organic strippers and associated organic solvents. Environmental, health and safety, as well as cost considerations prompted the search for alternative, more environmentally-benign, and cost-effective solutions. Two promising, emerging technologies were selected for evaluation: the chilled DI water/ozone technique and supercritical fluids based on carbon dioxide (CO{sub 2}). Evaluating chilled DI water/ozone shows this process to be effective for positive photoresist removal, but may not be compatible with all metallization systems. Testing of a closed-loop CO{sub 2}-based supercritical CO{sub 2} Resist Remover, or SCORR, at Los Alamos, on behalf of Hewlett-packard, shows that this treatment process is effective in removing photoresists, and is fully compatible with commonly used metallization systems. In this paper, the authors present details on the testing programs conducted with both the chilled DI H{sub 2}O/ozone and SCORR treatment processes.

  15. Disregarding RBE variation in treatment plan comparison may lead to bias in favor of proton plans.

    Science.gov (United States)

    Wedenberg, Minna; Toma-Dasu, Iuliana

    2014-09-01

    Currently in proton radiation therapy, a constant relative biological effectiveness (RBE) equal to 1.1 is assumed. The purpose of this study is to evaluate the impact of disregarding variations in RBE on the comparison of proton and photon treatment plans. Intensity modulated treatment plans using photons and protons were created for three brain tumor cases with the target situated close to organs at risk. The proton plans were optimized assuming a standard RBE equal to 1.1, and the resulting linear energy transfer (LET) distribution for the plans was calculated. In the plan evaluation, the effect of a variable RBE was studied. The RBE model used considers the RBE variation with dose, LET, and the tissue specific parameter α/β of photons. The plan comparison was based on dose distributions, DVHs and normal tissue complication probabilities (NTCPs). Under the assumption of RBE=1.1, higher doses to the tumor and lower doses to the normal tissues were obtained for the proton plans compared to the photon plans. In contrast, when accounting for RBE variations, the comparison showed lower doses to the tumor and hot spots in organs at risk in the proton plans. These hot spots resulted in higher estimated NTCPs in the proton plans compared to the photon plans. Disregarding RBE variations might lead to suboptimal proton plans giving lower effect in the tumor and higher effect in normal tissues than expected. For cases where the target is situated close to structures sensitive to hot spot doses, this trend may lead to bias in favor of proton plans in treatment plan comparisons.

  16. Comparison between Intralesional Triamcinolone and Kligman's Formula in Treatment of Melasma.

    Science.gov (United States)

    Eshghi, Gholamreza; Khezrian, Leila; Esna Ashari, Fariba

    2016-01-01

    Melasma is a common acquired skin disorder. While different treatments are currently being used, in many cases it is refractory to treatment. According to the effects of topical steroids in decreasing skin pigmentation, we studied the efficacy of this new method for treatment of melasma. A total of 42 women with facial melasma, admitted to the department of dermatology of Hamadan, were enrolled in the study. They were divided randomly into two groups (A and B), group A (case) received subepidermal triamcinolone injections with a dose of 4 mg per cc and 5 mm intervals until complete blanching of melasma lesions, and group B (control) received Kligman's formula (hydroquinone 5%, tretinoin 0.1%, and dexamethasone 0.1%). At the first visit, we completed the MASI score papers, and we repeated that at weeks 4 and 8 of the study. We followed them for two months, every two weeks. At each visit, side effects and clinical response to treatment were noted. A decrease in MASI was observed in both group (11.57 ± 4.33 vs 9.31 ± 3.75 at 4th week and vs 8.01 ± 3.1 at 8th week, P-value < 0.001 in group A, and 10.46 ± 5.61 vs 9.76 ± 5.21 at 4th week and vs 8.96 ± 4.96 at 8th week, P-value< 0.001 in group B). In comparison between 2 groups, response to treatment was much better in group A than group B (P-value<0.001). In comparison to topical treatments, based on these findings, triamcinolone microinjection is a new, safe and strong therapeutic method for treatment of melasma.

  17. Comparison between Intralesional Triamcinolone and Kligman's Formula in Treatment of Melasma

    Directory of Open Access Journals (Sweden)

    Gholamreza Eshghi

    2016-01-01

    Full Text Available Melasma is a common acquired skin disorder. While different treatments are currently being used, in many cases it is refractory to treatment. According to the effects of topical steroids in decreasing skin pigmentation, we studied the efficacy of this new method for treatment of melasma. A total of 42 women with facial melasma, admitted to the department of dermatology of Hamadan, were enrolled in the study. They were divided randomly into two groups (A and B, group A (case received subepidermal triamcinolone injections with a dose of 4mg per cc and 5mm  intervals until complete blanching of melasma lesions, and group B (control received Kligman's formula (hydroquinone5%, tretinoin 0.1%, and dexamethasone 0.1%. At the first visit, we completed the MASI score papers, and we repeated that at weeks 4 and 8 of the study. We followed them for two months, every two weeks. At each visit, side effects and clinical response to treatment were noted. A decrease in MASI was observed in both group (11.57 ± 4.33 vs 9.31 ± 3.75 at 4th week and vs 8.01 ± 3.1 at 8th week, P-value < 0.001 in group A, and 10.46 ± 5.61 vs 9.76 ± 5.21 at 4th week and vs 8.96 ± 4.96 at 8th week, P-value< 0.001 in group B. In comparison between 2 groups, response to treatment was much better in group A than group B (P-value<0.001. In comparison to topical treatments, based on these findings, triamcinolone microinjection is a new, safe and strong therapeutic method for treatment of melasma.

  18. Comparison of cryotherapy and thermal therapy for breast cancer treatment simulations

    Science.gov (United States)

    Ryan, Thomas P.

    2001-05-01

    Breast cancer presents an ongoing challenge in regard to treatment efficacy and successful clinical outcomes. There has been a challenge to increase the survival rate over the past 50 years and only recently have clinical outcomes improved, although slightly. Thermal treatment regimes have been evolving and most recently, have been applied in situ. A standalone treatment for malignancies is challenging due to the rigor in achieving homogeneity in the distribution of therapeutic temperatures in the tumor and the lack of therapy in the adjacent normal tissue. Although initial work used lasers, contemporary work utilizes radiofrequency (RF) or cryotherapy as a treatment modality. Both monopolar and bipolar RF devices were modeled for the RF treatments in the breast. Using finite element techniques, these two modalities were simulated in breast tissue and the results of the bioheat equation compared for similar sized devices. The model incorporated changing electrical and thermal properties of tissue with temperature, as well as blood flow changes. For thermal treatment, the isotherm of +55 degree(s)C was considered the margin of coagulation necrosis, while for cryotreatment, the -40 degree(s)C isotherm was used. The comparison aids in the selection of the best method to improve clinical outcomes, while paying attention to the size of the applicator and time length of treatment.

  19. Comparison of end-of-life tire treatment technologies: a Chinese case study.

    Science.gov (United States)

    Li, Xingfu; Xu, He; Gao, Yingnan; Tao, Yijun

    2010-11-01

    The aim of this paper is to compare different end-of-life tire (ELT) treatment technologies in China from an environmental and economic perspective. Four treatment technologies were evaluated: ambient grinding, devulcanization, pyrolysis and illegal tire oil extraction. Life cycle assessment (LCA) was applied to evaluate the potential environmental impact of each treatment based on the Eco-indicator 99 (Hierarchist approach) method provided by GaBi 4 software. The final result shows that pyrolysis represents the environmentally benign option while illegal tire oil extraction caused the worst damages. For the three legal treatments, although high credit was obtained when considering avoided impacts from recycled materials and energy, they have great impact as to respiratory effects (inorganic) dominantly contributed by energy production stage, which implies that the emphasis on environmental policies related to ELT treatment should shift from the control of emissions from treatment process to the reduction of energy consumption. A simplified comparison of net benefits and total impacts shows that the most eco-effective ELT treatment technology is pyrolysis, followed by dynamic devulcanization and ambient grinding. The illegal tire oil extraction, however, must be prohibited immediately because of its highest environmental pollution and lowest net benefit.

  20. Radiation Source Replacement Workshop

    Energy Technology Data Exchange (ETDEWEB)

    Griffin, Jeffrey W.; Moran, Traci L.; Bond, Leonard J.

    2010-12-01

    This report summarizes a Radiation Source Replacement Workshop in Houston Texas on October 27-28, 2010, which provided a forum for industry and researchers to exchange information and to discuss the issues relating to replacement of AmBe, and potentially other isotope sources used in well logging.

  1. The comparison of cetirizine, levocetirizine and placebo for the treatment of childhood perennial allergic rhinitis.

    Science.gov (United States)

    Lee, Chih-Fang; Sun, Hai-Lun; Lu, Ko-Hsiu; Ku, Min-Sho; Lue, Ko-Huang

    2009-08-01

    Cetirizine (Zyrtec) is a potent and long-acting second-generation histamine H1- receptor antagonist for the treatment of allergic disease, such as allergic rhinitis and chronic idiopathic urticaria, in adult and child. It is a racemic mixture of levocetirizine (Xyzal) and dextrocetirizine. The purpose of this present study was to compare the efficacy of cetirizine, levocetirizine and placebo for the treatment of pediatric perennial allergic rhinitis. 74 perennial allergic rhinitis patients, aged 6 to 12 years old, assigned to 1 of 3 treatment groups for 12 weeks randomly. The effects of the three agents were compared with the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) and Total Symptom Score (TSS) by diary. Nasal peak expiratory flow rate (nPEFR) and laboratory examinations including serum immunoglobulin E level, eosinophil cationic protein (ECP), blood eosinophil counts and eosinophil percentage in a nasal smear were evaluated among the three groups. The results revealed that both cetirizine and levocetirizine improved TSS in comparison with the placebo group, and ceterizine appeared to be more efficacious than levocetirizine at week 8 and week 12. The PRQLQ score showed significant decreased both in cetirizine and levocetirizine group, but there was no statistic significant difference between both groups. The eosinophil proportion in a nasal smear significantly decreased among the cetirizine in comparison with the placebo group but there was no statistic significant in levocetirizine groups. Both cetirizine and levocetirizine showed significant improvement in nPEFR in comparison with the placebo group, and ceterizine appeared to be more efficacious than levocetirizine. The 12-week treatment program showed that cetirizine was more effectious than levocetirizine.

  2. Long term preservation of motion with artificial cervical disc implants: A comparison between cervical disc replacement and rigid fusion with cage

    Science.gov (United States)

    Cincu, Rafael; Lorente, Francisco de Asis; Gomez, Joaquin; Eiras, Jose; Agrawal, Amit

    2014-01-01

    Background: With the advancement of technologies there is more interest in the maintenance of the spine's biomechanical properties focusing on the preservation of the functional motion segment. In present article we describe our experience with 25 cases managed with artificial cervical discs with 28 Solis cage following cervical discectomy with a mean follow-up period of 7.5 year. Materials and Methods: All surgeries were performed by single surgeon from March 2004 to June 2005 with a follow-up till date. Patients with symptomatic single or multiple level diseases that had no prior cervical surgery were candidates for the study. Cohort demographics were comparable. Standardized clinical outcome measures and radiographic examinations were used at prescribed post-operative intervals to compare the treatment groups. Relief in radicular pain, cervical spine motion, and degenerative changes at follow-up were noted. Results: In a total 53 cases, the mean age in prosthesis group was 47 years (age range: 30-63 years) and mean age in cage group was 44 years (32-62 years). Mean hospital stay was 2.7 days in both the groups. At 4 weeks complete cervical movements could be achieved in 19 cases in artificial disc group. Maintenance of movement after 7.5 years was in 76% of these patients. Lordosis was maintained in all cases till date. There was no mortality or wound infection in our series. Conclusions: We conclude that artificial cervical disc could be an alternative to fixed spinal fusion as it represents the most physiological substitute of disc. However, there is need for further studies to support the use of artificial cervical disc prosthesis. PMID:25685218

  3. Application study of metatarsophalangeal joint replacement in treatment of forefoot deformity%跖趾关节置换术在前足畸形手术治疗中的应用研究

    Institute of Scientific and Technical Information of China (English)

    孙鹏; 陆芸

    2016-01-01

    metatarsophalangeal joint osteoarthritis with 13 feet ( five feet of four males ,eight feet of six females ) and one case of forefoot rheumatoid arthritis with two feet ( two feet of one female ) .All the patients with severe degeneration of forefoot metatarsophalangeal joint received metatarsophalangeal replacement surgery .The pre-operative and post-operative American Orthopaedic Foot & Ankle Society ( AOFAS) score,foot shape comparison and patient ’ s self-rating satisfaction were adopted to evaluate the clinical effects .AOFAS score were analyzed by paired t test.Results All the cases were followed-up from eight months to 31 months,14 months in average .After the surgery,the patients could walk a much longer distance without pain or a little pain and the quality of life was improved significantly .Postoperative AOFAS score showed 11 feet of excellent ,four feet of good ,three feet of tolerable and no foot failed .The excellent rate was 83.33%with a high patient satisfaction rate .The paired t test of AOFAS score showed the difference between the pre-and postoperative scores was significant (t =-15.017,P <0.01).Conclusions The clinical effects of metatarsophalangeal replacement in the treatment of degenerative metatarsophalangeal joint with deformity are satisfactory due to patent correction of deformity ,joint flexibility increasing and pain relief .It is an ideal treatment for the patients who suffer from forefoot deformity with metatarsophalangeal osteoarthritis .

  4. Mixed treatment comparison of prophylaxis against invasive fungal infections in neutropenic patients receiving therapy for haematological malignancies : A systematic review

    NARCIS (Netherlands)

    Pechlivanoglou, Petros; Le, Hoa H; Daenen, Simon; Snowden, John A; Postma, Maarten J

    2014-01-01

    OBJECTIVES: Patients receiving therapy for haematological malignancies have a higher risk of invasive fungal infections (IFIs). Antifungal prophylaxis is an effective strategy against IFIs, but relative effectiveness estimates across agents are inconclusive. A mixed treatment comparison (MTC) was co

  5. Comparison of the outcome of early and delayed surgical treatment of complete acromioclavicular joint dislocation.

    Science.gov (United States)

    Song, Tengfei; Yan, Xu; Ye, Tianwen

    2016-06-01

    The aim of this study is to compare the clinical and radiographic results and the complication rate between early and delayed surgical treatment of acromioclavicular joint (ACJ) dislocation. Publications in the management of ACJ dislocation are identified from the PubMed database between January 1993 and December 2013 using "acromioclavicular joint" and "dislocation" as keywords. The eligibility criteria included are as follows: (1) ACJ dislocation; (2) intervention, early compared with delayed surgical treatment or the surgical treatment for acute compared with chronic ACJ dislocation; (3) human; and (4) English articles. Exclusion criteria consist of the following: (1) type I and type II ACJ dislocation, (2) no definition of the time of early and delayed surgery in studies, (3) no comparison between the clinical result of early and delayed surgery in studies, (4) laboratory studies, radiographic studies, biomechanical studies, (5) the cases including fractures or revisions in studies, and (6) systematic analyses. Eight studies comparing early and delayed surgical treatment of ACJ dislocation are included in this systematic review. According to Constant scores and shoulder subjective value, early surgery has better functional outcomes than delayed surgery in the treatment of ACJ dislocation (P < 0.05). Partial-dislocation/re-dislocation is found at 26.0 % in early and 38.1 % in delayed surgical treatment (P < 0.05). The rate of CC ossification in early surgical treatment is found as the same as the delayed. The complication rates are found at 12.5 % in early surgical treatment and 17.7 % in the delayed, which is not significantly different. Early surgical treatment may have superiority to the delayed procedure in the management of ACJ dislocation with better functional outcomes and more satisfied reduction. However, high-quality evidence studies are required to provide stronger support for this opinion in the future. IV.

  6. NADAC Comparison

    Data.gov (United States)

    U.S. Department of Health & Human Services — The NADAC Weekly Comparison identifies the drug products with current NADAC rates that are replaced with new NADAC rates. Other changes (e.g. NDC additions and...

  7. Renal replacement therapy for acute renal failure.

    Science.gov (United States)

    Macedo, E; Bouchard, J; Mehta, R L

    2009-09-01

    Renal replacement therapy became a common clinical tool to treat patients with severe acute kidney injury (AKI) since the 1960s. During this time dialytic options have expanded considerably; biocompatible membranes, bicarbonate dialysate and dialysis machines with volumetric ultrafiltration control have improved the treatment for acute kidney injury. Along with advances in methods of intermittent hemodialysis, continuous renal replacement therapies have gained widespread acceptance in the treatment of dialysis-requiring AKI. However, many of the fundamental aspects of the renal replacement treatment such as indication, timing of dialytic intervention, and choice of dialysis modality are still controversial and may influence AKI patient's outcomes. This review outlines current concepts in the use of dialysis techniques for AKI and suggests an approach for selecting the optimal method of renal replacement therapy.

  8. Multiple treatment comparison meta-analyses: a step forward into complexity

    Directory of Open Access Journals (Sweden)

    Mills E

    2011-05-01

    Full Text Available Edward J Mills1, Nick Bansback2,8, Isabella Ghement3, Kristian Thorlund4, Steven Kelly5, Milo A Puhan6, James Wright71Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada; 2Centre for Health Evaluation and Outcomes Sciences (CHEOS, University of British Columbia, Vancouver, BC, Canada; 3Ghement Statistical Consulting Company, Richmond, BC, Canada; 4Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada; 5Department of Outcomes Research and Evidence Based Medicine, Pfizer Ltd, Walton Oaks, UK; 6Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; 7Department of Oncology and Medicine, McMaster University, Hamilton, ON, Canada; 8School of Population and Public Health, University of British Columbia, Vancouver, BC, CanadaAbstract: The use of meta-analysis has become increasingly useful for clinical and policy decision making. A recent development in meta-analysis, multiple treatment comparison (MTC meta-analysis, provides inferences on the comparative effectiveness of interventions that may have never been directly evaluated in clinical trials. This new approach may be confusing for clinicians and methodologists and raises specific challenges relevant to certain areas of medicine. This article addresses the methodological concepts of MTC meta-analysis, including issues of heterogeneity, choice of model, and adequacy of sample sizes. We address domain-specific challenges relevant to disciplines of medicine, including baseline risks of patient populations. We conclude that MTC meta-analysis is a useful tool in the context of comparative effectiveness and requires further study, as its utility and transparency will likely predict its uptake by the research and clinical community.Keywords: network, multiple treatment comparison, mixed treatment comparison, meta-analysis

  9. SU-E-T-210: Comparison of Proton with Electron Boost in Breast Cancer Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Y; Chang, A [Procure Proton Therapy Center, Oklahoma City, OK (United States); Liu, Y [INTEGRIS Cancer Institute of Oklahoma, Oklahoma City, OK (United States)

    2015-06-15

    Purpose: Electron beams are commonly used for boost radiation following whole breast irradiation (WBI) to improve the in-breast local control. Proton beams have a finite range and a sharper distal dose falloff compared to electron beams, thus potentially sparing more heart and lung in breast treatment. The purpose of the study is to compare protons with electrons for boost breast treatment in terms of target coverage and normal tissue sparing. Methods: Six breast cancer patients were included in this study. All women received WBI to 45–50 Gy, followed by a 10–16.2 Gy boost with standard fractionation. If proton beams were used for the boost treatment, an electron plan was retrospectively generated for comparison using the same CT set and structures, and vice versa if electron beams were used for treatment. Proton plans were generated using the treatment planning system (TPS) with two to three uniform scanning proton beams. Electron plans were generated using the Pinnacle TPS with one single en face beam. Dose-volume histograms (DVH) were calculated and compared between proton and electron boost plans. Results: Proton plans show a similar boost target coverage, similar skin dose, and much better heart and lung sparing. For an example patient, V95% for PTV was 99.98% and skin (5 mm shell) received a max dose close to the prescription dose for both protons and electrons; however, V2 and V5 for the ipsilateral lung and heart were 37.5%, 17.9% and 19.9%, 4.9% respectively for electrons, but were essentially 0 for protons. Conclusions: This dosimetric comparison demonstrates that while both proton therapy and electron therapy provided similar coverage and skin dose, proton therapy could largely reduce the dose to lung and heart, thus leading to potential less side effects.

  10. Development of phytosanitary cold treatments for oranges infested with Bactrocera invadens and B. zonata (Diptera: Tephritidae) by comparison...existing cold treatment schedules for Ceratitis capitata (Diptera: Tephritidae)

    Science.gov (United States)

    Phytosanitary cold treatments are attempted for Bactrocera invadens Drew, Tsuruta, and White and Bactrocera zonata (Saunders) by comparison with Ceratitis capitata (Wiedemann). Oranges were infested by puncturing holes in the peel and allowing tephritids to oviposit in the holes. The treatments were...

  11. Effect of bovine colostrum feeding in comparison with milk replacer and natural feeding on the immune responses and colonisation of enterotoxigenic Escherichia coli in the intestinal tissue of piglets

    DEFF Research Database (Denmark)

    Sugiharto, Sugiharto; Poulsen, Ann-Sofie Riis; Canibe, Nuria;

    2015-01-01

    (23-d-old) were allocated to one of the following four groups: (1) killed at the beginning of the experiment (Base); (2) separated from the sow and fed BC (BC-fed); (3) separated from the sow and fed a MR (MR-fed); (4) kept with the sow (Sow-Milk). Blood was sampled on days 1 and 8, and faecal samples......The present study investigated the effect of feeding bovine colostrum (BC) to piglets in comparison with feeding a milk replacer (MR) and conventional rearing by the sow on the intestinal immune system and number of enterotoxigenic Escherichia coli (ETEC) colonising the intestinal tissue. Piglets...... were collected on days 1, 3, 5 and 8. On day 8, piglets were killed and gastrointestinal digesta and intestinal segments were collected. The frequency of diarrhoea was found to be higher (P≤ 0·019) in MR-fed piglets than in BC-fed and Sow-Milk piglets. Piglets from the MR-fed group had the lowest...

  12. Comparison of Chinese and Foreign Urban Public Security Treatment Mechanisms and Analysis of Policy References

    Institute of Scientific and Technical Information of China (English)

    Li Xuejun; Zhang Mingyu

    2007-01-01

    From the viewpoint of disaster prevention in the urban areas, this paper analyzes the value of urban public security system, selects typical cases to make a comparison of Chinese and foreign public security treatment mechanisms, and makes systematic summarization of the Chinese and foreign historic experiences. Then, the paper puts forward some designs on structure of the Chinese urban public security system structure. This paper is of the opinion that at present the management of urban public security concerning unexpected incidents should be strengthened. The effective way is to set up the sound urban public security system, urban public security mechanism and related laws and regulations.

  13. 辊底式热处理炉炉底辊在线更换检修的探索%Practice of On-Line Roller Replacement for Roller Hearth Heat Treatment Furnace

    Institute of Scientific and Technical Information of China (English)

    王国强; 张许豪

    2014-01-01

    For the frequent breakage failures of hearth roller of heat treatment furnaces in Wugang new plate mill, the paper analyzes the advantages and disadvantages of current hearth roller replacement method,puts forward the easy and feasible hearth roller on-line replacement solution according to production and actual site conditions,achieves the replacement without furnace shut down,which not only greatly shortens the down time,but also prevents large amount of energy consumption and receives a good result.%针对舞钢新轧钢厂热处理线炉底辊频繁断裂的问题,分析了现行炉底辊更换方法的优缺点,结合生产及现场实际,提出了简单易行的炉底辊在线更换方案,实现了不停炉更换炉底辊,不仅缩短了停炉时间,还避免了能源消耗,取得了良好效果。

  14. THE COMPARISON OF EVENING PRIMROSE OIL, FRUCTUS AGNI CASTI AND REASSURANCE IN THE TREATMENT OF MASTALGIA

    Directory of Open Access Journals (Sweden)

    Murat Özgür Kılıç

    2016-08-01

    Full Text Available Background: Although many therapeutic options have been used in the treatment of mastalgia, none of those has a curative effect. Aim: In this study, we aimed to investigate the effects of evening primrose oil, Fructus Agni Casti and reassurance on mastalgia, in comparison to placebo. Methods: This is a prospective clinical study on the effectiveness of evening primrose oil, Fructus Agni Casti and reassurance in the treatment of mastalgia. One hundred twenty-eight female patients with mastalgia were placed randomly into four groups: (1 evening primrose oil, (2 Fructus Agni Casti, (3 reassurance, and (4 placebo, for the treatment of 3 months. The severity and type of mastalgia were evaluated according to the Breast Pain Questionnaire. Response to treatment was assessed by the Cardiff Breast Pain scoring system. RESULTS: Fructus Agni Casti group had a more effective therapeutic response when compared with other groups. Reassurance and evening primrose oil groups had similar effects on reducing breast pain. The worst response to treatment was obtained in the placebo group. During follow-up, no serious adverse effect was observed. CONCLUSION: Fructus Agni Casti can be used in mastalgia patients with a high success rate and less adverse effect profile. Reassurance may be an important part of mastalgia management, due to the psychological basis of this entity.

  15. Choice of Treatment for Aortic Valve Stenosis in the Era of Transcatheter Aortic Valve Replacement in Eastern Denmark (2005 to 2015)

    DEFF Research Database (Denmark)

    De Backer, Ole; Luk, Ngai H V; Olsen, Niels T

    2016-01-01

    aortic valve replacement (SAVR), but this has changed with the introduction of TAVR. METHODS: Using the East Denmark Heart Registry, the evolution of AVR over time was studied for the period 2005 to 2015. RESULTS: TAVR has since its introduction in 2007 seen steady growth, with currently more than 35......% of AVR procedures-and 45% of isolated AVR procedures-being performed by transcatheter-based technology. The number of SAVR procedures remained rather stable over the study period and even saw a slight decline since 2012-there was a marked decrease in the age at which surgical bioprostheses are considered......-half of patients age 70 to 80 years with an STS risk score of 4 to 6 are treated with TAVR. CONCLUSIONS: The number of TAVR procedures has increased steadily in recent years, with a TAVR penetration rate of 35% in 2015 and close to 45% when considering isolated AVR. The number of SAVR procedures remained stable...

  16. Papel de la terapia hormonal sustitutiva, en la prevención y tratamiento de la osteoporosis menopáusica Role of hormone replacement therapy in the prevention and treatment of menopausal osteoporosis

    Directory of Open Access Journals (Sweden)

    M. C. Landa

    2003-01-01

    Full Text Available La terapia hormonal sustitutiva se ha venido utilizando como prevención y tratamiento de la osteoporosis postmenopáusica. En este trabajo se revisan los ensayos publicados recientemente, especialmente los estudios Heart and estrogen/progestin replacement study (HERS y Women´s Health Initiative (WHI, ensayos aleatorizados controlados de gran extensión. Se concluye que la terapia hormonal sustitutiva tiene un efecto de mejora de los síntomas vasomotores de la menopausia. Tiene un efecto positivo sobre la masa ósea con más intensidad sobre el hueso trabecular, pero este efecto sólo persiste durante el tratamiento hormonal y se recupera el balance negativo del recambio óseo al acabar el tratamiento. Se comprueba un efecto protector sobre las fracturas osteoporóticas (vértebra, fémur durante el tratamiento en mujeres mayores (60 años, pero no se comprueba esta acción a largo plazo por lo que su valor como terapia preventiva de la osteoporosis no es apoyada. Al finalizar se dan unas orientaciones que permitan ayudar en la práctica clínica.Hormone replacement therapy has been employed for the prevention and treatment of postmenopausal osteoporosis. This paper reviews recently published trials, especially the studies Heart and estrogen/progestin replacement study (HERS and Women´s Health Initiative (WHI, randomized controlled trials of wide scope. The conclusion reached is that hormone replacement therapy has the effect of improving the vasomotor symptoms of menopause. It has a positive effect on the bone mass with more intensity on the trabecular bone, but this effect only persists during the hormonal treatment and the negative balance of bone exchange is recovered when treatment stops. A protective effect is found on osteoporotic fractures (vertebra, femur during the treatment of older women (above 60 years, but this action is not found in the long term, which is why its value as a preventive therapy for osteoporosis is not supported

  17. 药师参与机械瓣膜置换术后妊娠期抗凝药物治疗的探讨%Investigation of pharmacists participating in the treatment of pregnancy after mechanical valve replacement

    Institute of Scientific and Technical Information of China (English)

    朱云霞; 张梅

    2016-01-01

    目的:探索药师参与机械瓣膜置换术后妊娠和分娩期患者抗凝治疗的药学实践。方法:药师根据机械瓣膜置换术后抗凝的权威指南,与临床医师合作,对5例机械瓣膜置换术后妇女在妊娠和分娩期进行抗凝方案的制定和药学的监测,制定个体化的治疗方案并随时调整。结果:通过对本组5例妊娠妇女全程化药物管理和监测,逐步建立了药师参与的抗凝治疗规范化工作模式。结论:药师在机械瓣膜置换术后妊娠和分娩期抗凝治疗团队中深入开展规范化药物治疗和监测方案,可更好地保障患者用药的安全与合理性。%Objective:To explore the pharmaceutical practice of anticoagulant therapy by pharmacists participating in the treatment of patients with pregnancy and delivery after mechanical valve replacement.Method:An authoritative guide for pharmacists to anticoagulation after mechanical valve replacement,in cooperation with clinicians,we formulated the anticoagulation plan and the monitoring of the pharmacy in pregnancy and delivery period for 5 cases of women after the mechanical valve replacement operation,and to develop individualized treatment programs and at any time to adjust.Results:Through the drug management and monitoring in the whole process of 5 cases of pregnant women,and gradually established a pharmacist to participate in the standardization of the treatment of anticoagulation.Conclusion:Pharmacists in the mechanical valve replacement pregnancy and delivery period after the anticoagulation therapy team to carry out standardized drug treatment and monitoring program,which can better protect the safety and rationality of patients with medication.

  18. Replacing a Missing Tooth

    Science.gov (United States)

    ... vessels in the tooth pulps are rather large. Drilling down these teeth for crowns may expose the ... porcelain replacement tooth is held in place by metal extensions cemented to the backs of the adjacent ...

  19. Hormone Replacement Therapy

    Science.gov (United States)

    ... before and during menopause, the levels of female hormones can go up and down. This can cause ... hot flashes and vaginal dryness. Some women take hormone replacement therapy (HRT), also called menopausal hormone therapy, ...

  20. Knee joint replacement

    Science.gov (United States)

    ... of your kneecap. Your kneecap is called the patella. The replacement part is usually made from a ... long. Then your surgeon will: Move your kneecap (patella) out of the way, then cut the ends ...

  1. Knee joint replacement - slideshow

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/presentations/100088.htm Knee joint replacement - series—Normal anatomy To use the ... to slide 4 out of 4 Overview The knee is a complex joint. It contains the distal ...

  2. Potential of Microbubbles as Fat Replacer

    NARCIS (Netherlands)

    Rovers, T.A.M.; Sala, Guido; Linden, Van der Erik; Meinders, M.B.J.

    2016-01-01

    The potential of microbubbles as fat replacers and texture modifiers was assessed by comparison of the rheological and tribological properties of model food systems that contained (1) microbubbles, (2) emulsion droplets or (3) no added colloidal structures. We used (a) liquids with thickener, (b)

  3. Replacement of Superior Vena Cava in the Treatment of Chest Tumor%上腔静脉置换术在胸腔肿瘤中的应用

    Institute of Scientific and Technical Information of China (English)

    朱鹏志; 王平; 桂龙生; 李永武; 彭浩; 熊健

    2011-01-01

    Objective To evaluate and summarize the clinical experience of the vessel resection and reconstruction in surgical management of malignant superior vena cava syndrome (SVCS). Methods Five patients with SVC being invaded by tumors were included and analyzed retrospectively in this study. Among them locally advanced lung cancer was in three cases, invasive thymoma in two cases. The primary tumor was totally resected in all patients. Replacement of SVC with Gore-Tex vascular prosthesis was performed in all patients. Result All of the cases had no intraoperative and early postoperative death and complications. Conclusion For local advanced malignant tumors invading superior vena cava without distant metastasis, expanded resection including replacement of superior vena cava with artificial blood vessel can raise operative excision rate, relieve clinical symptoms and increase the survival rate time.%目的 探讨和总结上腔静脉置换治疗晚期胸腔恶性肿瘤的临床经验,并评价其疗效.方法 回顾性分析5例上腔静脉受到肿瘤侵犯患者的手术经验.其中局部晚期肺癌3例、侵袭性胸腺瘤2例.术中行原发肿瘤和受累上腔静脉全部切除并重建上腔静脉.结果 全组无手术死亡及术后早期死亡,无严重并发症.结论 对于无远处转移、侵犯上腔静脉的局部晚期恶性肿瘤,采用包括上腔静脉置换在内的扩大切除术,可以提高手术切除率,缓解临床症状,延长生存期.

  4. Product Platform Replacements

    DEFF Research Database (Denmark)

    Sköld, Martin; Karlsson, Christer

    2012-01-01

    Purpose – It is argued in this article that too little is known about product platforms and how to deal with them from a manager's point of view. Specifically, little information exists regarding when old established platforms are replaced by new generations in R&D and production environments...... originality and value is achieved by focusing on product platform replacements believed to represent a growing management challenge....

  5. Immunoglobulin Replacement Therapy: When You Need It -- and When You Don't

    Science.gov (United States)

    ... Videos Lists Search Patient Resources Immunoglobulin Replacement Therapy Immunoglobulin Replacement Therapy When you need it—and when ... enough germ-fighting antibodies. A treatment known as immunoglobulin replacement (IgG) therapy can be a lifesaver for ...

  6. Comparison between bromocriptine and selegiline in treatment of parkinson`s disease

    Directory of Open Access Journals (Sweden)

    Alijan Ahmadi Ahangar

    2005-01-01

    Full Text Available Parkinson's disease is a common degenerative disease that causes rigidity, bradykinesia and rest tremor in patients. Available treatments include levodopa (the major drug and other supplementary drugs (bromocriptine or selegiline which can reduce such disabilities, but because of the necessity of their uses for a long term treatment, many side effects are being expected. Thus, due to lack of sufficient reports about efficacy and side effects of such supplementary drugs, this experimental study was carried out. Seventy seven patients (50 men and 27 women with the average age of 68±8.42 years were divided into three groups. In group A, levodopa and trihexyphenidyl (Artan® were administered to 18 patients. In group B, selegiline (Deprenyl® was used as a supplementary and was administered with levodopa and trihexyphenidyl for 25 patients. In group C, bromocriptine was used in place of selegiline, for 34 patients. In a three year period, the patients were followed up, in conformity with UPDRS (Unified Parkinson's Disease Rate Scale. In this experimental study, group C showed better physical activities in comparison with group A and group B, in spite of having better conditions at the first year showed totally little differences in comparison with group A. With a view to side effect particularly dyskinesia; there was little side effect in group C. On the basis of results of this investigation it appears that bromocriptine as a supplementary drug in comarison to selegiline has fewer side effects.

  7. Psychosomatic disorders in general practice: comparisons of treatment with flupenthixol, diazepam and sulpiride.

    Science.gov (United States)

    Meyers, C; Vranckx, C; Elgen, K

    1985-01-01

    One hundred and thirteen patients diagnosed as suffering from one of four common psychosomatic syndromes (psychogenic headache, cardiac neurosis, functional disturbance of the colon, or pruritus) were treated by two groups of general practitioners with flupenthixol or diazepam or sulpiride. Flupenthixol was compared with diazepam in 58 patients in one group of Belgian practices, and with sulpiride in 55 patients in another group of practices and assessed over a 4-week period for therapeutic response and adverse effects. Flupenthixol was given in a dosage of 0.5 to 2 mg a day, diazepam in a dosage of 2.5 to 10 mg a day and sulpiride 100 to 200 mg a day, in identical capsules. In the flupenthixol/diazepam comparison, there were 7 drop-outs (3 flupenthixol, 4 diazepam). Marked or moderate reduction in global assessment of illness occurred in both treatment groups, but there was no significant difference in the therapeutic effect of the two drugs. The incidence of side-effects was low and similar in the two groups. In the flupenthixol/sulpiride comparison, there were 10 drop-outs (7 flupenthixol, 3 sulpiride). A significant reduction in symptoms occurred in both treatment groups, but this was more rapid in the flupenthixol group. Side-effects were infrequent and mild in both groups.

  8. Comparison of mortality in hyperthyroidism during periods of treatment with thionamides and after radioiodine.

    Science.gov (United States)

    Boelaert, Kristien; Maisonneuve, Patrick; Torlinska, Barbara; Franklyn, Jayne A

    2013-05-01

    Hyperthyroidism is common, but opinions regarding optimal therapy with antithyroid drugs or radioiodine (131-I) differ. There are no randomized trials comparing these options in terms of mortality. The aim of the study was to determine whether mortality associated with hyperthyroidism varies with treatment administered or other factors. We conducted a prospective observational population-based study of 1036 subjects aged ≥ 40 years presenting to a single specialist clinic from 1989-2003 with a first episode of hyperthyroidism who were followed until June 2012. Antithyroid drugs or radioiodine (131-I) were administered. We compared causes of death with age-, sex-, and period-specific mortality in England and Wales and used within-cohort analysis of influence of treatment modality, outcome, disease etiology, severity and control, and comorbidities. In 12 868 person-years of follow-up, 334 died vs 290.6 expected (standardized mortality ratio [SMR], 1.15 [95% confidence interval (CI),1.03-1.28]; P = .01). Increased all-cause mortality largely reflected increased circulatory deaths (SMR, 1.20 [95% CI, 1.01-1.43]; P = .04). All-cause mortality was increased for the person-years accumulated during thionamide treatment (SMR, 1.30 [95% CI, 1.05-1.61]; P = .02) and after 131-I not associated with hypothyroidism (SMR, 1.24 [95% CI, 1.04-1.46]; P = .01) but not during T₄ replacement for 131-I-induced hypothyroidism (SMR, 0.98 [95% CI, 0.82-1.18]; P = .85). Within-cohort analysis comparing mortality during thionamide treatment showed a similar hazard ratio (HR) for all-cause mortality when 131-I did not result in hypothyroidism (HR, 0.95 [95% CI, 0.70-1.29]), but reduced mortality with 131-I-induced hypothyroidism (HR, 0.70 [95% CI, 0.51-0.96]). Reduced mortality associated with hypothyroidism was seen only in those without significant comorbidities and not in those with other serious diseases. Atrial fibrillation at presentation (P = .02) and an increment of 10 pmol/L in

  9. Research progress of the pathogenesis, diagnosis and treatment of infections following total knee replacement%人工全膝关节置换后的感染发病机制与诊断及治疗

    Institute of Scientific and Technical Information of China (English)

    衣明; 黄荣; 李书忠

    2011-01-01

    BACKGROUND: Periprosthetic infection remains one of the most devastating and costly complications after total knee replacement. It is very important for the prognosis of total knee replacement that understanding its pathogenesis, make an accurate diagnosis timely, and to develop the appropriate treatment.OBJECTIVE: To summarize the research progress regarding pathogenesis, diagnosis and treatment of infections after total knee replacement.METHODS: A computer-based online search of CNKI between January 1982 and December 2009 and PUBMED database was performed to search related articles with the key words of "total knee arthroplasty; infection". A total of 2 673 articles were retrieved.Moreover, related works were manually searched. Totally 34 articles were included.RESULTS AND CONCLUSION: The biofilm on phantom surface protects the microbiologic not eradicated by antibiotics. Blood tests, bacteriological culture and imaging are effective procedures for the diagnosis of total knee replacement. But they all have disadvantages, which should be considered. Currently, the treatment modalities of total knee replacement are antibiotics,debridement and prosthesis retention, thorough debridement and one or two-stage reim plantation, arthrodesis, disarticulation and other treatments. The orthopaedic surgeon uses an essential armamentarium of diagnostic and treatment options to determine the presence of infection and tailor the individual treatment for each patient.%背景:假体周围感染已成为全膝关节置换后常见的并发症,了解其发病机制,早期及时的做出诊断,并制定出最佳的治疗方案对全膝关节置换的预后非常重要.目的:综述近几年关于人工全膝关节置换后的感染发病机制与诊断治疗的最新进展.方法:应用计算机检索1982-01/2009-12 CNKI数据库、Pubmed数据库相关文章,检索词为"人工膝关节置换,感染,total knee arthroplasty,infection",共检索到文献2 673篇.此外手工查阅相

  10. A comparison of acid rock drainage treatment scenarios at the former Britannia Mine

    Energy Technology Data Exchange (ETDEWEB)

    O' Hearn, T. [British Columbia Research Inc., Vancouver, BC (Canada); Klein, B. [British Columbia Univ., Vancouver, BC (Canada)

    2000-07-01

    Pilot scale tests of three acid rock draining (ARD) treatment processes were conducted on the Anaconda Britannia Mine effluent for comparative evaluation. The three processes tested included: (1) the high density sludge (HDS) process, (2) a modified version of the HDS that uses pulp mill ash wastes instead of lime, and (3) the Bio-sulfide process. The technical aspects relating to effluent quality and sludge disposal were assessed for each process. A comparison was also made on capital and operating costs. It was concluded that all three process showed promise as a potential remediation treatment for Britannia ARD. HDS and modified HDS treatments yielded effluent specifications that are within the federal discharge limits. In this test, the Bio-sulfide process produced effluents which meet federal criteria for metals concentration, but failed to raise pH levels enough. HDS and Bio-sulfide/HDS treatment scenarios were the most effective of the three alternatives examined. Despite the high risk associated with new technologies, it was recommended that new technologies should be considered as potential remediation methods for mine effluent. HDS was considered to be the most suitable process option to treat the Britannia effluent. 6 refs., 9 tabs.

  11. Comparison of intralesional verapamil with intralesional triamcinolone in the treatment of hypertrophic scars and keloids

    Directory of Open Access Journals (Sweden)

    Margaret Shanthi F

    2008-01-01

    Full Text Available Background : The calcium channel blocker, verapamil stimulates procollagenase synthesis in keloids and hypertrophic scars. Aim : To study the effect of verapamil in the treatment of hypertrophic scars and keloids and to evaluate the effect of verapamil on the rate of reduction of hypertrophic scars and keloids in comparison with triamcinolone. Methods : The study was a randomized, single blind, parallel group study in which 54 patients were allocated to to receive either verapamil or triamcinolone. Drugs were administered intralesionally in both groups. Improvement of the scar was measured using modified Vancouver scale and by using a centimeter scale serially till the scar flattened. Results : There was a reduction in vascularity, pliability, height and width of the scar with both the drugs after 3 weeks of treatment. These changes were present at one year of follow-up after stopping treatment. Scar pigmentation was not changed desirably by either drug. Length of the scars was also not altered significantly by either drug. The rate of reduction in vascularity, pliability, height and width of the scar with triamcinolone was faster than with verapamil. Adverse drug reactions were more with triamcinolone than with verapamil. Conclusion : Intralesional verapamil may be a suitable alternative to triamcinolone in the treatment of hypertrophic scars and keloids.

  12. Comparison of Bobath based and movement science based treatment for stroke: a randomised controlled trial.

    Science.gov (United States)

    van Vliet, P M; Lincoln, N B; Foxall, A

    2005-04-01

    Bobath based (BB) and movement science based (MSB) physiotherapy interventions are widely used for patients after stroke. There is little evidence to suggest which is most effective. This single-blind randomised controlled trial evaluated the effect of these treatments on movement abilities and functional independence. A total of 120 patients admitted to a stroke rehabilitation ward were randomised into two treatment groups to receive either BB or MSB treatment. Primary outcome measures were the Rivermead Motor Assessment and the Motor Assessment Scale. Secondary measures assessed functional independence, walking speed, arm function, muscle tone, and sensation. Measures were performed by a blinded assessor at baseline, and then at 1, 3, and 6 months after baseline. Analysis of serial measurements was performed to compare outcomes between the groups by calculating the area under the curve (AUC) and inserting AUC values into Mann-Whitney U tests. Comparison between groups showed no significant difference for any outcome measures. Significance values for the Rivermead Motor Assessment ranged from p = 0.23 to p = 0.97 and for the Motor Assessment Scale from p = 0.29 to p = 0.87. There were no significant differences in movement abilities or functional independence between patients receiving a BB or an MSB intervention. Therefore the study did not show that one approach was more effective than the other in the treatment of stroke patients.

  13. Comparison of clinical efficacies of sodium ascorbyl phosphate, retinol and their combination in acne treatment.

    Science.gov (United States)

    Ruamrak, C; Lourith, N; Natakankitkul, S

    2009-02-01

    Acne vulgaris impairs the appearance of an individual and causes psychological irritation. Inflammatory acne lesion is caused by multifactor incorporates in each step of acne pathogenesis. In an attempt to archive inflammatory lesion treatment with the promise of prevention of acne vulgaris, randomized and double-blind studies on the comparison of the efficacies of topical formulations containing 5% sodium ascorbyl phosphate (SAP) and 0.2% retinol, separately as well as in combination application, were conducted. The resulting data showed that SAP reduced the inflammatory lesion by 20.14% and 48.82% within 4 and 8 weeks respectively. Application of the formulation containing retinol slightly improved the treatment efficacy as the lesion reduced by 21.79% and 49.50% after 4 and 8 weeks respectively. The combination treatment significantly reduced the inflammatory lesion by 29.28% after 4 weeks and 63.10% after 8 weeks of application. The most effective treatment was by using the combination of 5% SAP and 0.2% retinol, which incorporated the synergistic effects on lipid peroxidation and sebaceous gland function in addition to the enhancement of SAP permeability by the desquamation of stratum corneum influenced by retinol, keratin plug removal and anti-inflammatory effect of retinol. This study promises for the development of cosmetic products to overcome aesthetic and psychological problems caused by acne vulgaris.

  14. The feasibility of using Pareto fronts for comparison of treatment planning systems and delivery techniques.

    Science.gov (United States)

    Ottosson, Rickard O; Engstrom, Per E; Sjöström, David; Behrens, Claus F; Karlsson, Anna; Knöös, Tommy; Ceberg, Crister

    2009-01-01

    Pareto optimality is a concept that formalises the trade-off between a given set of mutually contradicting objectives. A solution is said to be Pareto optimal when it is not possible to improve one objective without deteriorating at least one of the other. A set of Pareto optimal solutions constitute the Pareto front. The Pareto concept applies well to the inverse planning process, which involves inherently contradictory objectives, high and uniform target dose on one hand, and sparing of surrounding tissue and nearby organs at risk (OAR) on the other. Due to the specific characteristics of a treatment planning system (TPS), treatment strategy or delivery technique, Pareto fronts for a given case are likely to differ. The aim of this study was to investigate the feasibility of using Pareto fronts as a comparative tool for TPSs, treatment strategies and delivery techniques. In order to sample Pareto fronts, multiple treatment plans with varying target conformity and dose sparing of OAR were created for a number of prostate and head & neck IMRT cases. The DVHs of each plan were evaluated with respect to target coverage and dose to relevant OAR. Pareto fronts were successfully created for all studied cases. The results did indeed follow the definition of the Pareto concept, i.e. dose sparing of the OAR could not be improved without target coverage being impaired or vice versa. Furthermore, various treatment techniques resulted in distinguished and well separated Pareto fronts. Pareto fronts may be used to evaluate a number of parameters within radiotherapy. Examples are TPS optimization algorithms, the variation between accelerators or delivery techniques and the degradation of a plan during the treatment planning process. The issue of designing a model for unbiased comparison of parameters with such large inherent discrepancies, e.g. different TPSs, is problematic and should be carefully considered.

  15. SU-E-T-173: Clinical Comparison of Treatment Plans and Fallback Plans for Machine Downtime

    Energy Technology Data Exchange (ETDEWEB)

    Cruz, W [University of Texas Health Science Center at San Antonio, San Antonio, TX (United States); Cancer Therapy and Research Center, San Antonio, TX (United States); Papanikolaou, P [University of Texas Health Science Center at San Antonio, San Antonio, TX (United States); Mavroidis, P [University of North Carolina, Chapel Hill, NC (United States); Stathakis, S [Cancer Therapy and Research Center, San Antonio, TX (United States)

    2015-06-15

    Purpose: The purpose of this study was to determine the clinical effectiveness and dosimetric quality of fallback planning in relation to machine downtime. Methods: Plans for a Varian Novalis TX were mimicked, and fallback plans using an Elekta VersaHD machine were generated using a dual arc template. Plans for thirty (n=30) patients of various treatment sites optimized and calculated using RayStation treatment planning system. For each plan, a fall back plan was created and compared to the original plan. A dosimetric evaluation was conducted using the homogeneity index, conformity index, as well as DVH analysis to determine the quality of the fallback plan on a different treatment machine. Fallback plans were optimized for 60 iterations using the imported dose constraints from the original plan DVH to give fallback plans enough opportunity to achieve the dose objectives. Results: The average conformity index and homogeneity index for the NovalisTX plans were 0.76 and 10.3, respectively, while fallback plan values were 0.73 and 11.4. (Homogeneity =1 and conformity=0 for ideal plan) The values to various organs at risk were lower in the fallback plans as compared to the imported plans across most organs at risk. Isodose difference comparisons between plans were also compared and the average dose difference across all plans was 0.12%. Conclusion: The clinical impact of fallback planning is an important aspect to effective treatment of patients. With the complexity of LINACS increasing every year, an option to continue treating during machine downtime remains an essential tool in streamlined treatment execution. Fallback planning allows the clinic to continue to run efficiently should a treatment machine become offline due to maintenance or repair without degrading the quality of the plan all while reducing strain on members of the radiation oncology team.

  16. Revision of the aseptic and septic total ankle replacement.

    Science.gov (United States)

    Espinosa, Norman; Wirth, Stephan Hermann

    2013-04-01

    Total ankle replacement has become a popular treatment of symptomatic end-stage ankle osteoarthritis. Contemporary total ankle replacement systems provide more anatomic and biomechanically sound function. However, longevity is still limited and long-term results of modern total ankle replacement designs are not available. In the case of failure, conversion into arthrodesis has remained the treatment of choice but at the cost of hindfoot function and potential degeneration of the adjacent joints. Thus, revision total ankle replacement by exchange of the prosthetic components represents an attractive solution. This article focuses on revision total ankle replacement and conversion to ankle arthrodesis.

  17. Pharmacotherapies for chronic obstructive pulmonary disease: a multiple treatment comparison meta-analysis

    Directory of Open Access Journals (Sweden)

    Ghement I

    2011-03-01

    Full Text Available Edward J Mills1, Eric Druyts1, Isabella Ghement2, Milo A Puhan31Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada; 2Ghement Statistical Consulting Company, Richmond, British Columbia, Canada; 3Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USABackground: Most patients with moderate and severe chronic obstructive pulmonary disease (COPD receive long-acting bronchodilators (LABA for symptom control. It is, however, unclear if and what drug treatments should be added to LABAs to reduce exacerbations, which is an important goal of COPD management. Since current guidelines cannot make strong recommendations yet, our aim was to determine the relative efficacy of existing treatments and combinations to reduce the risk for COPD exacerbations.Methods: We included randomized clinical trials (RCTs evaluating long-acting ß2 agonists (LABA, long-acting muscarinic antagonists (LAMA, inhaled glucocorticosterioids (ICS, and the phosphodiesterase-4 (PDE4 inhibitor roflumilast, and combinations of these interventions in moderate to severe COPD populations. Our primary outcome was the event rate of exacerbations. We conducted a random-effects Bayesian mixed-treatment comparison (MTC and applied several sensitivity analyses. In particular, we confirmed our findings using a binomial MTC analysis examining whether a patient experienced at least one exacerbation event or not during the trial. We also used an additive assumption to calculate the combined effects of treatments that were not included in the systematic review.Results: Twenty-six studies provided data on the total number of exacerbations and/or the mean annual rate of exacerbations among a combined 36,312 patients. There were a total of 10 treatment combinations in the MTC and 15 in the additive analysis. Compared with all other treatments, the combination of roflumilast plus LAMA exhibited the largest treatment

  18. Korean Medication Algorithm for Bipolar Disorder 2014: comparisons with other treatment guidelines

    Directory of Open Access Journals (Sweden)

    Jeong JH

    2015-06-01

    with MS or AAP for dysphoric/psychotic mania. Aripiprazole, olanzapine, quetiapine, and risperidone were the first-line AAPs in nearly all of the phases of bipolar disorder across the guidelines. Most guidelines advocated newer AAPs as first-line treatment options in all phases, and lamotrigine in depressive and maintenance phases. Lithium and valproic acid were commonly used as MSs in all phases of bipolar disorder. As research evidence accumulated over time, recommendations of newer AAPs – such as asenapine, paliperidone, lurasidone, and long-acting injectable risperidone – became prominent. This comparison identifies that the treatment recommendations of the KMAP-BP 2014 are similar to those of other treatment guidelines and reflect current changes in prescription patterns for bipolar disorder based on accumulated research data. Further studies are needed to address several issues identified in our review. Keywords: bipolar disorder, pharmacotherapy, treatment algorithm, guideline comparison, KMAP-2014

  19. PREVENTION AND TREATMENT OF PERIOPERATIVE PERIOD COMPLICATION OF TOTAL ANKLE REPLACEMENT%人工全踝关节置换术围手术期并发症

    Institute of Scientific and Technical Information of China (English)

    廖翔; 高志增; 黄山虎; 杨述华

    2008-01-01

    目的 针对全踝关节置换术(total ankle replacement,TAR)治疗终末期踝关节炎的围手术期并发症,分析出现原因并提出治疗对策. 方法 1999年3月-2006年11月,采用非限制活动负重型假体( scandinavian totalankle replacement,STAR)对35例患者行TAR.男19例,女16例;年龄27~68岁,平均50.5岁.左侧20例,右侧15例.创伤性关节炎12例,骨性关节炎8例,类风湿性关节炎15例.患者踝关节均有疼痛、不同程度肿胀及活动受限.病程9~64个月.按Kofoed踝关节评分系统对患者疼痛程度、关节功能、活动度进行综合评分.术前Kofoed总评分:6~48分,平均29分;疼痛评分0~35分,平均18.3分;功能评分6~18分,平均11.7分;活动度评分3~12分,平均9.2分.结果 术后2例切口感染经换药后延迟愈合,33例切口Ⅰ期愈合.28例获随访3~80个月,平均43.5个月.术中出现内踝骨折2例,踝关节内翻不稳定2例,踝关节背伸范围不足1例,均对症处理.术后足背中部及3~5趾相对缘皮肤感觉减退1例,无明显运动功能障碍,未作特殊处理.28例踝关节Kofoed总评分58~95分,平均85.5分;疼痛评分35~50分,平均48.3分;功能评分18~30分,平均20.7分;活动度评分16~20分,平均17.2分;与术前比较差异均有统计学意义(P<0.01).术后28例获优16例,良9例,中3例;X 线片检查均未见假体松动或下沉. 结论 采用STAR的TAR术虽然是治疗终末关节炎的有效手段,但存在特有的并发症,应严格控制手术适应证,掌握手术原则及技术并完善围手术期处理,减少并发症的发生.

  20. 左心系统瓣膜置换术后三尖瓣关闭不全的外科治疗%Surgical treatment of tricuspid regurgitation after left cardiac valve replacement

    Institute of Scientific and Technical Information of China (English)

    王黎; 李伯君; 姜胜利; 任崇雷; 叶卫华

    2011-01-01

    To summarize our experiences in surgical treatment of bicuspid regurgitation after left valve replacement. Methods Clinical data about 20 patients who developed tricuspid insufficiency after they underwent left valve replacement in our hospital from January 2007 to November 2010 were retrospectively analyzed. Of the 20 patients, 8 underwent mitral valve replacement and 12 aortic and mitral double-valve replacement. The surgery was completed on beating heart under hypothermia by implanting biological tricuspid valve. Results Of the 20 patients after operation, 1 died of multiple organ failure caused by low cardial output syndrome(LCOS)with a mortality of 5%, 6 presented with LCOS, 2 had pleural effusion, 2 had renal inadequacy which was recovered after peritoneal dialysis, 1 had pericardial effusion, 1 presented with frequent ventricular tachycardia and ventricular Fibrillation which were recovered after defibrillation and anti-arrhythmia treatment. All the patients were recovered, except for 1 patient who died. Echocardiography revealed that the size of their right atrium and ventricle was much smaller after operation than before operation. Conclusion The effect of surgical treatment on tricuspid regurgitation after left valve replacement is satisfactory. Mild hypothermia for beating heart can effectively protect myocardium. Biological valve is a better choice. Rational indications for surgery and perioperative treatment are the key to successful surgery.%目的 总结左心系统瓣膜置换术后三尖瓣关闭不全的外科治疗经验.方法 回顾分析2007年1月-2010年11月在我院手术治疗的20例左心系统瓣膜置换术后三尖瓣关闭不全的患者资料.其中二尖瓣置换术后8例,二尖瓣、主动脉瓣置换术后12例.手术均在浅低温跳动下完成,以三尖瓣生物瓣膜置换.结果 全组1例死亡(死于严重低心排引起的多脏器功能衰竭),手术死亡率5%;6例有不同程度的低心排血量综合征;2

  1. Comparison of three light doses in the photodynamic treatment of actinic keratosis using mathematical modeling.

    Science.gov (United States)

    Vignion-Dewalle, Anne-Sophie; Betrouni, Nacim; Tylcz, Jean-Baptiste; Vermandel, Maximilien; Mortier, Laurent; Mordon, Serge

    2015-05-01

    Photodynamic therapy (PDT) is an emerging treatment modality for various diseases, especially for cancer therapy. Although high efficacy is demonstrated for PDT using standardized protocols in nonhyperkeratotic actinic keratoses, alternative light doses expected to increase efficiency, to reduce adverse effects or to expand the use of PDT, are still being evaluated and refined. We propose a comparison of the three most common light doses in the treatment of actinic keratosis with 5-aminolevulinic acid PDT through mathematical modeling. The proposed model is based on an iterative procedure that involves determination of the local fluence rate, updating of the local optical properties, and estimation of the local damage induced by the therapy. This model was applied on a simplified skin sample model including an actinic keratosis lesion, with three different light doses (red light dose, 37 J∕cm2, 75 mW∕cm2, 500 s; blue light dose, 10 J∕cm2, 10 mW∕cm2, 1000 s; and daylight dose, 9000 s). Results analysis shows that the three studied light doses, although all efficient, lead to variable local damage. Defining reference damage enables the nonoptimal parameters for the current light doses to be refined and the treatment to be more suitable.

  2. Treatment of candida vaginitis: comparison of single and sequential dose of fluconazole

    Directory of Open Access Journals (Sweden)

    Farahnaz Kamali

    2003-09-01

    Full Text Available Fluconazole is one of the triazole antifungal agent for Candida albican. For comparison of single versus sequential dose of fluconazole, a double-blind randomized clinical trial was counducted on 80 married 20-45 years old women who had chronic vaginal candidiasis. The patients randomized into two groups, 40 patients received two ( zero and 72 hours doses of fluconazole and the other group received one 150 mg dose of the drug at zero and placebo at 72 hours later. The patients were examined at 2 & 6 weeks after treatment. The groups showed decreased signs and symptoms of vaginal candidiasis during examination periods, however there was no significant difference between groups (p>0.05. Wet mount & culture were negative in the 2nd week in two groups but at the 6th week after treatment, 95.3% and 72.5% of patients in control and case groups, respectively had negative results (p<0.05. Therefore, single and sequential doses of fluconazole have the same result for treatment of vaginal candidiasis but sequential dose reduces the relapse rate of the disease.

  3. Comparison of treatment adherence outcome among PLHIV enrolled in economic strengthening program with community control.

    Science.gov (United States)

    Bezabih, Tsegazeab; Weiser, S D; Menbere, Meherete-Selassie; Negash, Afework; Grede, Nils

    2017-08-31

    Economic strengthening (ES) interventions are increasingly promoted to support the economic well-being and food security of people living with HIV (PLHIV) in resource poor settings. This study aims to assess the impact of ES interventions in Ethiopia designed to address poverty and food insecurity on antiretroviral treatment (ART) adherence. A comparative cross-sectional design was employed to compare treatment adherence between food insecure PLHIV benefitting from the ES project of WFP Ethiopia to food insecure PLHIV not participating in ES. Using the visual analogue scale (VAS) to measure ART adherence, only 9.9% of the ES group reported less than 95% adherence compared to 25.9% of the comparison group. Controlling for socio-economic and demographic variables using logistic regression models, engagement in ES activities increased the likelihood of having 95% or greater ART adherence by a factor of 2.4 and 5.6 respectively (as measured by VAS and ACTG approaches) compared to those PLHIV that were not engaged in ES. The findings of the study suggest that engagement in ES contributes to improved ART adherence among food insecure PLHIV. If further studies validate this result, ES should be adopted as a key strategy to improve HIV treatment adherence in resource poor settings where adherence is an issue of concern.

  4. Comparison of Dissolved Air Flotation and Sedimentation in Treatment of Typical North China Source Water

    Institute of Scientific and Technical Information of China (English)

    刘善培; 王启山; 何文杰; 韩宏大; 樊雪红; 耿天甲

    2007-01-01

    The treatment of typical north China water by dissolved air flotation (DAF) and sedimentation process was examined. A pilot plant with a water treatment capacity of 120 m3/d constructed in the Jieyuan Water Treatment Plant (JWTP) of Tianjin, China, was utilized for the comparison of the two processes. The results show that during the pilot test, DAF process can remove particles and organic mater more efficiently than sedimentation process. The removal rate for turbidity by DAF process is 5.5% higher than that by sedimentation in normal turbidity period, and 40% higher in low turbidity period, it is 5%~10% higher for removals of algae, total organic carbon (TOC), trihalomethane formation potential (THMFP) and bacteria in all periods. The removal rates for turbidity, TOC, THMFP, algae and bacteria by DAF process can reach 95%, 30%, 20%, 94% and 97% respectively. From the results of the pilot test, it can be concluded that DAF is a feasible clarification process, especially for source water with low turbidity and high algal blooming.

  5. Laboratory Evaluation of LED T8 Replacement Lamp Products

    Energy Technology Data Exchange (ETDEWEB)

    Richman, Eric E.; Kinzey, Bruce R.; Miller, Naomi J.

    2011-05-23

    A report on a lab setting analysis involving LED lamps intended to directly replace T8 fluorescent lamps (4') showing light output, power, and economic comparisons with other fluorescent options.

  6. 人工髋关节置换后感染的细菌培养及治疗对策文献复习%Bacterial culture and treatment strategy of infection after total hip replacement: Review of the literature

    Institute of Scientific and Technical Information of China (English)

    周生瑞; 苗胜; 沙广钊

    2012-01-01

    BACKGROUND: Periprosthetic infection after total hip replacement is one of the most serious complications.OBJECTIVE: To investigate the cause of infection after total hip replacement and to review the literature of treatment strategy.METHODS: A retrospective analysis of pathogenic cultures on 18 infection cases after total hip replacement and review the treatment strategy.RESULTS AND CONCLUSION: Twenty-five (12-48) months follow-up of 18 patients after total hip replacement showed that there were six patients retained the prosthesis after debridement, five patients were preformed with one-stage revision, and among the five patients, only one case of recurrence after debridement and clear trauma again and finally the wound was healed;seven patients were preformed with two-stage revision using antibiotic bone cement and there was no recurrence in 25 months after total hip replacement; the wound of all the patients were healed completely and there was no recurrent infection in the final follow-up. The Harris score of the hip was changed from the 43.25 points preoperatively to 86.5 points postoperatively. The infected pathogenic bacteria of 18 patients after total hip replacement included six cases of staphylococcus epidermidis, four cases of staphylococcus aureus, three cases of enterobacter cloacae, two cases of pseudomonas aeruginosa, one case of hemolytic streptococcus and two cases of escherichia coli.%背景 人工髋关节置换后假体周围感染是最严重的并发症之一.目的 探讨人工髋关节置换后感染的原因分析及治疗对策的文献复习.方法 回顾性分析18 例人工髋关节置换后感染患者的致病菌培养,并回顾治疗对策.结果与结论 18 例患者人工髋关置换后平均随访25(12~48)个月:6 例清创后保留假体,5 例一期翻修者中1 例清创复发再次清创伤口愈合;7 例使用抗生素骨水泥二期翻修者,置换后25 个月未见复发;所有患者伤口完全愈合,末次随访时均

  7. 人工颈椎间盘置换术治疗脊髓型颈椎病10例临床分析%Artificial cervical disc replacement in the treatment of cervical spondylotic myelopathy clinical analysis of 10 cases

    Institute of Scientific and Technical Information of China (English)

    杨磊; 崔宏勋; 赵庆安; 饶耀剑

    2013-01-01

      目的探讨人工颈椎间盘置换术用于治疗脊髓型颈椎病的临床疗效.方法2010年6月—2012年9月,对10例保守治疗无效患者的11个节段进行了人工颈椎间盘置换术,男6例,女4例;年龄41~61岁,平均(48±0.8)岁.单节段9例,双节段1例,术后随访3~12个月.结果所有患者伤口均I期临床愈合,术中及术后没有神经和血管损伤的并发症,结合术前术后颈椎活动范围检查、神经系统症状、Odom评级、JOA评分及影像学检查,患者神经系统症状均获得满意改善,JOA评分较术前明显升高.颈椎曲度、置换节段功能活动度、置换节段上下位椎体椎间隙高度得到保持.假体未见下沉或偏移,未见异位骨化.结论颈椎人工椎间盘置换术在维持节段运动功能的同时,可取得良好的神经减压效果,人工椎间盘置换术的短中期疗效是令人满意的.%Objective To investigate the artificial cervical disc replacement for the treatment of cervical spondylotic myelopathy. Methods In 2010 June to 2012 September,10 cases of invalid conservative treatment of patients with 11 segments for the artificial cervical disc replacement,6 cases were male,4 female;age 41-61 years,mean 48±0.8 years old. 9 cases of single segment,1 cases of double segments,followed up for 3 months to 12 months. Results All patients were healed wound phase I clinical,intraoperative and postoperative no nerve and blood vessel injury,combined examination of cervical range check, neurological symptoms,Odom rating,JOA score and imaging before and after surgery,patients with nervous system symptoms were satisfactory improvement,JOA score was significantly higher than that before operation. Cervical curvature,replacement of segmental function activity,replacement segment inferior vertebral height is maintained. Prosthesis no sinking or offset, no heterotopic ossification. Conclusion Cervical artificial disc replacement in the maintenance of segmental motion

  8. The Effect of Clove Bud, Nigella, Salix Alba and Olive Oil on Wart Treatment in Comparison with Conventional Treatment

    Directory of Open Access Journals (Sweden)

    roghaye Jebraili

    2007-10-01

    Full Text Available Jebraili R1, Rezaei K2, Matourianpour H3, Moradi L4, Meshkaat MH5, Tarrahi MJ6 1. Assistant professor, Department of Dermatology, Faculty of Medicine, Islamic Azad University of Tehran 2. Instructor, Department of Nursing, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences 3. Assistant Professor, Department of Dermatology, Faculty of Medicine, Lorestan University of Medical Sciences 4. BSc. Nurse, Haaj Seddiq Health and Treatment Center, Khorramabad 5. Assistant Professor, Department of Chemistry, Lorestan University 6. Instructor, Department of Epidemiology and Statistics, Faculty of Medicine, Lorestan University of Medical Sciences Abstract Background: Wart is a common and contagious viral disease of the skin caused by papilloma viruses which leads to aesthetic and psychological problems, and if occurred in touching and pressured parts of the body causes pain and inflammation. The aim of this study was to investigate the effect of Clove bud, Nigella, Salix alba and Olive oil which have wound disinfectant, anesthetic, analgesic and wound healing properties on wart treatment in comparison with the conventional treatment. Materials and methods: This randomized double blind controlled clinical trial was conducted on 291 female students selected form guidance and high schools in Khorramabad, Lorestan, Iran, during the year 2007. The diagnosis of wart was confirmed by a dermatologist according to the diagnosis criteria. The cases fulfilling the inclusion criteria were assigned in 3 study groups randomly. The first group was treated with the conventional treatment (Salicylic acid 16.7%, lactic acid 16.7% in Collodione body, the second group with herbal medicine without acid in olive oil, and the third group with herbal medicine alongside salicylic acid 1% and lactic acid 1% in olive oil. Each group was administered the drugs for 6 weeks. The effects of drugs on lesions were assessed after 4 and 6 weeks and compared among 3

  9. Polymer Surface Treatment by Atmospheric Pressure Low Temperature Surface Discharge Plasma:Its Characteristics and Comparison with Low Pressure Oxygen Plasma Treatment

    Institute of Scientific and Technical Information of China (English)

    Atsushi KUWABARA; Shin-ichi KURODA; Hitoshi KUBOTA

    2007-01-01

    The polymer treatment with a low-temperature plasma jet generated on the atmospheric pressure surface discharge (SD) plasma is performed.The change of the surface property over time,in comparison with low pressure oxygen (O2) plasma treatment,is examined.As one compares the treatment by atmospheric pressure plasma to that by the low pressure O2 plasma of PS (polystyrene) the treatment effects were almost in complete agreement.However,when the atmospheric pressure plasma was used for PP(polypropylene),it produced remarkable hydrophilic effects.

  10. Radiation treatment planning for bladder cancer: a comparison of cystogram localisation with computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Rothwell, R.I.; Ash, D.V.; Jones, W.G. (Cookridge Hospital, Leeds (UK))

    1983-01-01

    A comparison has been made between the target volumes of radical radiotherapy treatment plans produced with the aid of marker cystograms, and target volumes derived from computed tomography (CT) scans in 60 patients with bladder cancer. This has demonstrated inadequacies of the cystograms due to the inability to delineate extravesical spread of tumour and, as many patients with bladder cancer had a significant residual urine, emptying the bladder by catheterisation may have given a false impression of the shape and size of the target volume. Analysis of the results showed that cystographic localisation resulted in serious underdosage of the tumour in 18% of patients and failure to include all the bladder in 37%. Conventionally produced target volumes showed potentially significant discrepancies in 85% of patients when compared with target volumes delineated by CT.

  11. Robotic mitral valve replacement.

    Science.gov (United States)

    Senay, Sahin; Gullu, Ahmet Umit; Kocyigit, Muharrem; Degirmencioglu, Aleks; Karabulut, Hasan; Alhan, Cem

    2014-01-01

    Robotic surgical techniques allow surgeons to perform mitral valve surgery. This procedure has gained acceptance, particularly for mitral valve repair in degenerative mitral disease. However, mitral repair may not always be possible, especially in severely calcified mitral valve of rheumatic origin. This study demonstrates the basic concepts and technique of robotic mitral valve replacement for valve pathologies that are not suitable for repair.

  12. Replacing America's Job Bank

    Science.gov (United States)

    Vollman, Jim

    2009-01-01

    The Job Central National Labor Exchange (www.jobcentral.com) has become the effective replacement for America's Job Bank with state workforce agencies and, increasingly, with community colleges throughout the country. The American Association of Community Colleges (AACC) has formed a partnership with Job Central to promote its use throughout the…

  13. Replacing America's Job Bank

    Science.gov (United States)

    Vollman, Jim

    2009-01-01

    The Job Central National Labor Exchange (www.jobcentral.com) has become the effective replacement for America's Job Bank with state workforce agencies and, increasingly, with community colleges throughout the country. The American Association of Community Colleges (AACC) has formed a partnership with Job Central to promote its use throughout the…

  14. Comparison of alternative treatment systems for DOE mixed low-level waste

    Energy Technology Data Exchange (ETDEWEB)

    Schwinkendorf, W.E.

    1997-03-01

    From 1993 to 1996, the Department of Energy, Environmental Management, Office of Science and Technology (OST), has sponsored a series of systems analyses to guide its future research and development (R&D) programs for the treatment of mixed low-level waste (MLLW) stored in the DOE complex. The two original studies were of 20 mature and innovative thermal systems. As a result of a technical review of these thermal system studies, a similar study of five innovative nonthermal systems was conducted in which unit operations are limited to temperatures less than 350{degrees}C to minimize volatilization of heavy metals and radionuclides, and de novo production of dioxins and furans in the offgas. Public involvement in the INTS study was established through a working group of 20 tribal and stakeholder representatives to provide input to the INTS studies and identify principles against which the systems should be designed and evaluated. Pre-conceptual designs were developed for all systems to treat the same waste input (2927 lbs/hr) in a single centralized facility operating 4032 hours per year for 20 years. This inventory consisted of a wide range of combustible and non-combustible materials such as paper, plastics, metals, concrete, soils, sludges, liquids, etc., contaminated with trace quantities of radioactive materials and RCRA regulated wastes. From this inventory, an average waste profile was developed for simulated treatment using ASPEN PLUS{copyright} for mass balance calculations. Seven representative thermal systems were selected for comparison with the five nonthermal systems. This report presents the comparisons against the TSWG principles, of total life cycle cost (TLCC), and of other system performance indicators such as energy requirements, reagent requirements, land use, final waste volume, aqueous and gaseous effluents, etc.

  15. A single-center prospective study on the safety of plasma exchange procedures using a double-viral-inactivated and prion-reduced solvent/detergent fresh-frozen plasma as the replacement fluid in the treatment of thrombotic microangiopathy.

    Science.gov (United States)

    Vendramin, Chiara; McGuckin, Siobhan; Alwan, Ferras; Westwood, John-Paul; Thomas, Mari; Scully, Marie

    2017-01-01

    Patients presenting with acute episodes of thrombotic microangiopathies (TMAs) require urgent access to plasma exchange (PEX). OctaplasLG, a solvent/detergent fresh-frozen plasma product that has undergone viral inactivation and prion reduction step, has been used in our institution since 2013, replacing Octaplas. We prospectively reviewed 981 PEX procedures where OctaplasLG was the replacement fluid in 90 patients admitted acutely with a TMA presentation within our institution from January 1, 2013, to December 31, 2015. We recorded citrate toxicities, plasma reactions, viral transfer, complications related to central venous catheter, and venous thrombotic events (VTEs). Citrate toxicities were 5.4%, plasma reactions were 2%, and all were classified as Grade 1 or 2. VTE had an incidence of 12.2%, although 50% of the episodes occurred in early remission when patients were not receiving PEX. No line insertions complications were recorded. Line-associated infections were 2.2%. Hepatitis B and C serology and human immunodeficiency virus (HIV) were checked on admission. There were four patients who may have had passive transient transfer of hepatitis B antibodies from pooled plasma. No hepatitis C or HIV viral transfer was documented after treatment and no seroconversion was detected after treatment. Our data have demonstrated that the incidence of complications during PEX is low and using OctaplasLG is comparable to the low incidence of reactions. No cases of anaphylaxis, transfusion-related acute lung injury, or fatal plasma reactions were seen. There was no evidence of viral transmission or seroconversion after treatment. © 2016 AABB.

  16. An integrated mechanical-enzymatic reverse osmosis treatment of dairy industry wastewater and milk protein recovery as a fat replacer: a closed loop approach

    OpenAIRE

    F. Sarghini; Sorrentino, A.; P. Di Pierro

    2013-01-01

    The dairy industry can be classified among the most polluting of the food industries in volume in regard to its large water consumption, generating from 0.2 to 10 L of effluent per liter of processed milk. Dairy industry effluents usually include highly dissolved organic matter with varying characteristics, and a correct waste management project is required to handle. In a framework of natural water resource availability and cost increase, wastewater treatment for water reuse can lower the ov...

  17. 瓣膜病术后三尖瓣重度关闭不全的外科治疗%Effect of surgical treatment of tricuspid valve regurgitation after valve replacement

    Institute of Scientific and Technical Information of China (English)

    浮志坤; 董自超; 谷小卫; 张志远; 杜虹; 姚伟; 吴信

    2013-01-01

    Objective To evaluate the outcome of surgical treatment of tricuspid valve regurgitation after valve replacement.Methods Twenty one patients with tricuspid valve insufficiency after valve replacement were performed surgical treatment.Tricuspid valve-plasty was performed in 17 patients and tricuspid valve replacement was done in 4 patients.Three patients underwent edge-to-edge tricuspid valveplasty.DeVega procedure was performed in 5 patients.Cosgrove-Edward annuloplasty ring was used in 15 patients.Four patients' valve were replaced by SJM bileallet mechanical prostheses.Results There was 3 patients dead early after operation with a mortality of 14.3%(3/21).The causes of death including multiple organ failure,cardiac arrest and low cardiac output syndrome.The rate of early postoperative complications was 33.3% (7/21),including pulmonary edema,arrhythmia,acute renal failure and low cardiac output syndrome.The patients were followed up 9-60 months.The rate of readmission was 23.8% (5/21).Two patients went to hospital again for pleural effusion,1 patient for left ventricular dysfunction and 2 patients for right ventricular dysfunction.The other patients recovered well.Conclusions Surgical therapy is effective on severe tricuspid valve regurgitation after valve replacement.Preoperative aggressive treatment of heart failure,a reasonable grasp of surgical indications and timing of surgery,strict perioperative management are the keys to guarantee patients a smooth recovery.%目的 评价瓣膜病术后三尖瓣重度关闭不全的外科治疗效果.方法 21例瓣膜病术后人工瓣膜无障碍及毁损、三尖瓣重度关闭不全患者行三尖瓣成形术或三尖瓣置换术;三尖瓣成形术17例,三尖瓣置换术4例.三尖瓣成形术包括缘对缘3例,改良DeVega法成形5例,放置Cosgrove-Edward成形环15例,4例换瓣均为SJM双叶机械瓣.结果 术后早期病死率为14.3%(3/21),死亡原因:多脏器功能衰竭、心脏骤停和低心

  18. Comparison of multimedia system and conventional method in patients’ selecting prosthetic treatment

    Directory of Open Access Journals (Sweden)

    Baghai R

    2010-12-01

    Full Text Available "nBackground and Aims: Selecting an appropriate treatment plan is one of the most critical aspects of dental treatments. The purpose of this study was to compare multimedia system and conventional method in patients' selecting prosthetic treatment and the time consumed."nMaterials and Methods: Ninety patients were randomly divided into three groups. Patients in group A, once were instructed using the conventional method of dental office and once multimedia system and time was measured in seconds from the beginning of the instruction till the patient had came to decision. The patients were asked about the satisfaction of the method used for them. In group B, patients were only instructed using the conventional method, whereas they were only exposed to soft ware in group C. The data were analyzed with Paired-T-test"n(in group A and T-test and Mann-Whitney test (in groups B and C."nResult: There was a significant difference between multimedia system and conventional method in group A and also between groups B and C (P<0.001. In group A and between groups B and C, patient's satisfaction about multimedia system was better. However, in comparison between groups B and C, multimedia system did not have a significant effect in treatment selection score (P=0.08."nConclusion: Using multimedia system is recommended due to its high ability in giving answers to a large number of patient's questions as well as in terms of marketing.

  19. Artificial Femoral Head Replacement in Treatment of 36 Patients with Osteoporotic Femoral Intertrochanteric Fracture%人工股骨头置换治疗骨质疏松性股骨粗隆间骨折36例

    Institute of Scientific and Technical Information of China (English)

    桑晓文; 杨利学; 谭龙旺; 孙智平; 张快强

    2014-01-01

    目的观察人工股骨头置换治疗骨质疏松性股骨粗隆间骨折的临床效果。方法对2008年1月-2013年6月收治的36例骨质疏松性股骨粗隆间骨折行加长柄双极骨水泥人工股骨头置换术,术后常规予鲑鱼降钙素联合钙剂抗骨质疏松治疗。结果术后Harris关节功能评分平均88分(68~94分),其中优18例,良13例,可4例,差1例,优良率为86.1%。2例术后活动后出现髋部轻度疼痛,1例下肢深静脉栓塞;本组均无髋关节脱位、假体周围再骨折、假体松动及下陷、大小粗隆骨折不愈合等并发症发生。结论人工股骨头置换术治疗骨质疏松性股骨粗隆间骨折可减少力学及内固定相关风险,且并发症少,效果良好。%Objective To observe the effect of artificial femoral head replacement in treatment of osteoporotic femoral inter-trochanteric fracture. Methods A total of 36 inpatients with osteoporotic femoral intertrochanteric fracture underwent long-stem ce-mented artificial femoral head replacement during January 2008 and June 2013, and routine salmon calcitonin combined with calcium of anti osteoporosis treatment was performed after operations. Results The postoperative Harris hip score was 88 (68-94), which included excellent in 18 cases, good in 13 cases, common in 4 cases and poor in 1 case, and the excellent and good rate was 86.1%. Two patients had postoperative hip mild pain after activity, and one patient had deep vein thrombosis of lower extremity, but there were no complications such as dislocation of hip joint, periprosthetic fracture, prosthesis loosening, subsidence and greater trochanteric fracture nonunion. Conclusion Artificial femoral head replacement in treatment of osteoporotic femoral intertrochanter-ic fracture can reduce the risks of mechanics and internal fixation with fewer complications and better effect.

  20. Total ankle replacement. Design evolution and results.

    Science.gov (United States)

    van den Heuvel, Alexander; Van Bouwel, Saskia; Dereymaeker, Greta

    2010-04-01

    The ankle joint has unique anatomical, biomechanical and cartilaginous structural characteristics that allow the joint to withstand the very high mechanical stresses and strains over years. Any minor changes to any of these features predispose the joint to osteoarthritis. Total ankle replacement (TAR) is evolving as an alternative to ankle arthrodesis for the treatment of end-stage ankle osteoarthritis. Initial implant designs from the early 1970s had unacceptably high failure and complication rates. As a result many orthopaedic surgeons have restricted the use of TAR in favour of ankle arthrodesis. Long term follow-up studies following ankle arthrodesis show risks of developing adjacent joint osteoarthritis. Therefore research towards a successful ankle replacement continues. Newer designs and longer-term outcome studies have renewed the interest in ankle joint replacement. We present an overview of the evolution, results and current concepts of total ankle replacement.

  1. Comparison of treatment plans: a retrospective study by the method of radiobiological evaluation

    Science.gov (United States)

    Puzhakkal, Niyas; Kallikuzhiyil Kochunny, Abdullah; Manthala Padannayil, Noufal; Singh, Navin; Elavan Chalil, Jumanath; Kulangarakath Umer, Jamshad

    2016-09-01

    There are many situations in radiotherapy where multiple treatment plans need to be compared for selection of an optimal plan. In this study we performed the radiobiological method of plan evaluation to verify the treatment plan comparison procedure of our clinical practice. We estimated and correlated various radiobiological dose indices with physical dose metrics for a total of 30 patients representing typical cases of head and neck, prostate and brain tumors. Three sets of plans along with a clinically approved plan (final plan) treated by either Intensity Modulated Radiation Therapy (IMRT) or Rapid Arc (RA) techniques were considered. The study yielded improved target coverage for final plans, however, no appreciable differences in doses and the complication probabilities of organs at risk were noticed. Even though all four plans showed adequate dose distributions, from dosimetric point of view, the final plan had more acceptable dose distribution. The estimated biological outcome and dose volume histogram data showed least differences between plans for IMRT when compared to RA. Our retrospective study based on 120 plans, validated the radiobiological method of plan evaluation. The tumor cure or normal tissue complication probabilities were found to be correlated with the corresponding physical dose indices.

  2. Comparison of Activator-Headgear and Twin Block Treatment Approaches in Class II Division 1 Malocclusion

    Directory of Open Access Journals (Sweden)

    Stjepan Spalj

    2017-01-01

    Full Text Available The purpose was to compare the treatment effects of functional appliances activator-headgear (AH and Twin Block (TB on skeletal, dental, and soft-tissue structures in class II division 1 malocclusion with normal growth changes in untreated subjects. The sample included 50 subjects (56% females aged 8–13 years with class II division 1 malocclusion treated with either AH (n=25 or TB (n=25 appliances. Pre- and posttreatment lateral cephalograms were evaluated and compared to 50 untreated class II division 1 cases matched by age, gender, ANB angle, and skeletal maturity. A paired sample, independent samples tests and discriminant analysis were performed for intra- and intergroup analysis. Treatment with both appliances resulted in significant reduction of skeletal and soft-tissue facial convexity, the overjet, and the prominence of the upper lip in comparison to untreated individuals (p<0.001. Retroclination of maxillary incisors and proclination of mandibular incisors were seen, the latter being significantly more evident in the TB group (p<0.05. Increase of effective mandibular length was more pronounced in the TB group. In conclusion, both AH and TB appliances contributed successfully to the correction of class II division 1 malocclusion when compared to the untreated subjects with predominantly dentoalveolar changes.

  3. Comparison between the efficacy of ginger and sumatriptan in the ablative treatment of the common migraine.

    Science.gov (United States)

    Maghbooli, Mehdi; Golipour, Farhad; Moghimi Esfandabadi, Alireza; Yousefi, Mehran

    2014-03-01

    Frequency and torment caused by migraines direct patients toward a variety of remedies. Few studies to date have proposed ginger derivates for migraine relief. This study aims to evaluate the efficacy of ginger in the ablation of common migraine attack in comparison to sumatriptan therapy. In this double-blinded randomized clinical trial, 100 patients who had acute migraine without aura were randomly allocated to receive either ginger powder or sumatriptan. Time of headache onset, its severity, time interval from headache beginning to taking drug and patient self-estimation about response for five subsequent migraine attacks were recorded by patients. Patients(,) satisfaction from treatment efficacy and their willingness to continue it was also evaluated after 1 month following intervention. Two hours after using either drug, mean headaches severity decreased significantly. Efficacy of ginger powder and sumatriptan was similar. Clinical adverse effects of ginger powder were less than sumatriptan. Patients' satisfaction and willingness to continue did not differ. The effectiveness of ginger powder in the treatment of common migraine attacks is statistically comparable to sumatriptan. Ginger also poses a better side effect profile than sumatriptan.

  4. Comparison of Activator-Headgear and Twin Block Treatment Approaches in Class II Division 1 Malocclusion

    Science.gov (United States)

    Mroz Tranesen, Kate; Birkeland, Kari; Katic, Visnja; Pavlic, Andrej; Vandevska-Radunovic, Vaska

    2017-01-01

    The purpose was to compare the treatment effects of functional appliances activator-headgear (AH) and Twin Block (TB) on skeletal, dental, and soft-tissue structures in class II division 1 malocclusion with normal growth changes in untreated subjects. The sample included 50 subjects (56% females) aged 8–13 years with class II division 1 malocclusion treated with either AH (n = 25) or TB (n = 25) appliances. Pre- and posttreatment lateral cephalograms were evaluated and compared to 50 untreated class II division 1 cases matched by age, gender, ANB angle, and skeletal maturity. A paired sample, independent samples tests and discriminant analysis were performed for intra- and intergroup analysis. Treatment with both appliances resulted in significant reduction of skeletal and soft-tissue facial convexity, the overjet, and the prominence of the upper lip in comparison to untreated individuals (p < 0.001). Retroclination of maxillary incisors and proclination of mandibular incisors were seen, the latter being significantly more evident in the TB group (p < 0.05). Increase of effective mandibular length was more pronounced in the TB group. In conclusion, both AH and TB appliances contributed successfully to the correction of class II division 1 malocclusion when compared to the untreated subjects with predominantly dentoalveolar changes. PMID:28203569

  5. Winged adjustable replacement system for the treatment of lower cervical spine fracture dislocation%带翼可调节置换系统在下颈椎骨折脱位中的应用

    Institute of Scientific and Technical Information of China (English)

    孙俊凯; 刘竞龙; 黄剑候

    2013-01-01

      #背景:ADD plus-带翼可调节置换系统具有人工椎体和前路固定板一体化、人工椎体高度可调的特点,以及操作简单、手术时间短、组织相容性好等优势越来越受到外科医生的信赖。目的:观察带翼可调节置换系统在颈椎前路减压、植骨融合及置入固定治疗下颈椎骨折脱位合并脊髓损伤中的疗效。方法:采用ADD plus-带翼可调节置换器对12例下颈椎骨折脱位合并脊髓损伤患者进行前路切开复位、减压、植骨融合内固定治疗。治疗3,6,12个月分别进行临床评估和影像学检查,此后,每年检查1次。%BACKGROUND: ADD plus-winged adjustable replacement system has the advantages of artificial vertebral body and anterior fixation plate integration and artificial vertebral body height-adjustable, as wel as simple to operation, shorter operative time, and good histocompatibility, which make it attract more trust of the surgeons. OBJECTIVE: To explore the effect of ADD plus-winged adjustable replacement system in cervical anterior decompression, fusion and graft and internal fixation for the treatment of lower cervical spine fracture dislocation combined with spinal cord injury. METHODS: The ADD plus-winged adjustable replacement device was used in anterior reduction, decompression, fusion and graft and internal fixation for the treatment of lower cervical spine fracture dislocation combined with spinal cord injury in 12 cases. Clinical evaluation and imaging examination were performed at 3, 6 and 12 months after treatment, and then annual y thereafter. RESULTS AND CONCLUSION: Al patients were fol owed-up for 18 months. During the fol ow-up period, the patients got solid osseous fusion, the regulator was in good position without loosening or fracture; the cervical intervertebral height and physiological curvature were corrected, and the recovery degree of postoperative patient feel and motor function was increased

  6. 振冲碎石桩在砂土地基处理中的应用%On application of vibro-replacement stone column in sand foundation treatment

    Institute of Scientific and Technical Information of China (English)

    李琦瑛

    2015-01-01

    According to the geological features of the sand foundation in Inner Mongolian areas,the paper mainly illustrates the adaptability of the treatment of sand foundation with the vibro-replacement stone column,and points out respective quality control measures according to some prob-lems in the construction,so as to provide some reference for similar projects.%根据内蒙地区砂土地基的地质特性,详细阐述了振冲碎石桩处理砂土地基的适宜性,并针对施工中存在的问题,提出了相应的质量控制措施,以期为类似工程的施工提供参考借鉴。

  7. 人工瓣膜置换治疗重症心脏瓣膜病的临床分析%Clinical Analysis of Artificial Valve Replacement in Treatment of Severe Valvular Heart Disease

    Institute of Scientific and Technical Information of China (English)

    范永峰; 张大国; 向道康; 刘秀伦

    2015-01-01

    Objective To discuss the clinical effect of bipolar radiofrequency ablation for atrial fibrillation combined with artificial valve replacement in the treatment of severe valvular heart disease. Methods 80 patients with severe valvular heart disease treated in our hospital during April 2013 and April 2014 were selected as the research object and randomly divided into control group and observation group with 40 in each. The patients in the control group were treated with artificial valve replacement, while those in the observation group underwent simultaneous surgical treatment of artificial valve replacement and bipolar radiofrequency ablation for atrial fibrillation. Patient's situation during operation and color doppler ultrasound examination one year later were compared between the two groups. Results Immediate recovery rate of sinus rhythm of the patients in the control group was obviously lower than that in the observation group, 17.50%vs 90.00%. Color doppler ultrasound examination one year later showed that left atrial dimension, pulmonary artery systolic pressure and left ventricular ejection fraction were (39.64±5.07)mm、(35.17±4.97)mmHg、(57.09±5.87)%in the observation group, while those were(48.71±6.36)mm、(40.19±5.38)mmHg、(50.28±6.31)%, and the differ-ences were statistically significant,P<0.05. Conclusion Simultaneous surgical treatment of artificial valve replacement and bipolar radiofrequency ablation for atrial fibrillation is worthy of clinical application in the treatment of severe valvular heart disease due to its good effect.%目的:探究在人工瓣膜置换中行房颤双极射频消融术治疗重症心脏瓣膜病的临床效果。方法随机选取2013年4月-2014年4月在该院接受治疗的80例重症心脏瓣膜病患者作为研究对象,并随机分为对照组和观察组,每组40例。给予对照组患者进行人工瓣膜置换术,对观察组实施人工瓣膜置换术的同时行房颤双极射频消融术

  8. Suitability assessment of replacement of conventional hot-working steels with maraging steel. Pt. I. Mechanical properties of maraging steel after precipitation hardening treatment

    Energy Technology Data Exchange (ETDEWEB)

    Grum, J.; Zupancic, M. [Ljubljana Univ. (Slovenia). Fakulteta za Strojnistvo

    2002-02-01

    The paper deals with the results of measurement of mechanical properties of maraging steel Thyssen 1.2799 after precipitation annealing with a wide spectrum of temperature/time conditions. The purpose of the investigation conducted on the material for die-casting tools was to find out how the tool life could be extended depending on the heat-treatment conditions and the microstructure of the steel. Thus the influence of temperature/time conditions of precipitation annealing on tensile strength, hardness, and impact toughness of the steel was studied. The Charpy impact toughness test was carried out at a temperature of 200 C, which is, according to our assessment, an average operating temperature of the observed tool surface in die casting of aluminium alloys. Measurements of the mechanical properties were accomplished on three test pieces under each combination of annealing conditions. Special attention was paid to the correlation of the mechanical properties measured under individual precipitation annealing conditions. (orig.)

  9. Comparison of Glycyrrhiza glabra Inorabase With Triamcinolone Acetonide Orabase in the Treatment of Oral Lichen Planus

    Directory of Open Access Journals (Sweden)

    Najafi

    2016-07-01

    Full Text Available Background Lichen planus is a chronic inflammatory mucocutaneous disease that is most commonly found in middle-aged women. A wide spectrum of topical and systemic therapies have been applied for treatment of this condition. Objectives The aim of this study was to compare the efficacy and safety of 1% Glycyrrhiza glabra in orabase with 0.1% Triamcinolone Acetonide paste in treating oral lichen planus (OLP. Patients and Methods In this study, 22 patients were randomly assigned to one of two equal groups. They received either Glycyrrhiza glabra or Triamcinolone Acetonide four times daily for a total of one month and were followed-up for three months. The patients were assessed for painful symptoms, measured by the visual analogue scale (VAS, and lesion size via Thongaprassom. The analysis and comparison of pain scores and the size of the lesions' clinical and symptomatic response rates between the two groups were performed using the Mann-Whitney U-test and SPSS 13.0 computer software. Results Ten patients in the Glycyrrhiza glabra group and 12 patients in the triamcinolone acetonid group completed the four-month trial course. Both Glycyrrhiza glabra and Triamcinolone Acetonid reduced burning symptoms. Clinical scores in both groups also significantly improved over the one-month treatment period. The difference between the two groups was not statistically significant (P = 0.442. Conclusions This study showed that topical Glycyrrhiza glabra appeared to be a promising alternative in the treatment of OLP. Further studies should be conducted to assess the long-term effects of Glycyrrhiza glabra.

  10. Comparison of dose calculation algorithms for treatment planning in external photon beam therapy for clinical situations.

    Science.gov (United States)

    Knöös, Tommy; Wieslander, Elinore; Cozzi, Luca; Brink, Carsten; Fogliata, Antonella; Albers, Dirk; Nyström, Håkan; Lassen, Søren

    2006-11-21

    A study of the performance of five commercial radiotherapy treatment planning systems (TPSs) for common treatment sites regarding their ability to model heterogeneities and scattered photons has been performed. The comparison was based on CT information for prostate, head and neck, breast and lung cancer cases. The TPSs were installed locally at different institutions and commissioned for clinical use based on local procedures. For the evaluation, beam qualities as identical as possible were used: low energy (6 MV) and high energy (15 or 18 MV) x-rays. All relevant anatomical structures were outlined and simple treatment plans were set up. Images, structures and plans were exported, anonymized and distributed to the participating institutions using the DICOM protocol. The plans were then re-calculated locally and exported back for evaluation. The TPSs cover dose calculation techniques from correction-based equivalent path length algorithms to model-based algorithms. These were divided into two groups based on how changes in electron transport are accounted for ((a) not considered and (b) considered). Increasing the complexity from the relatively homogeneous pelvic region to the very inhomogeneous lung region resulted in less accurate dose distributions. Improvements in the calculated dose have been shown when models consider volume scatter and changes in electron transport, especially when the extension of the irradiated volume was limited and when low densities were present in or adjacent to the fields. A Monte Carlo calculated algorithm input data set and a benchmark set for a virtual linear accelerator have been produced which have facilitated the analysis and interpretation of the results. The more sophisticated models in the type b group exhibit changes in both absorbed dose and its distribution which are congruent with the simulations performed by Monte Carlo-based virtual accelerator.

  11. Comparison of conventional and low dose steroid in the treatment of PFAPA syndrome: preliminary study.

    Science.gov (United States)

    Yazgan, Hamza; Gültekin, Erhan; Yazıcılar, Osman; Sagun, Ömer Faruk; Uzun, Lokman

    2012-11-01

    Steroids have been widely used to relief symptoms in the patients with PFAPA syndrome. This study was constructed to show the effectiveness of low-dose steroid therapy in patients diagnosed with PFAPA syndrome. 41 patients (86 febrile attacks) who were diagnosed using the criteria suggested by Thomas et al. were involved in the study. The cases were classified into two groups and the selection of patients in groups was made randomly. Twenty patients received prednisolone at a dose of 2 mg/kg/day (first group: 40 attacks) and 21 patients received a dose of 0.5 mg/kg/day (second group: 46 attacks). The effectiveness of the treatment was especially determined by the time needed to reduce the fever and the effect on the duration between the two attacks. The patients were re-examined 24 hours later, after a steroid treatment. The patients who were in the first group received 2mg/kg/day dose of prednisolone and their fever was dramatically decreased in 6-8 hours (7.6 ± 0.9 hours). The second group received 0.5mg/kg/day dose and 19 of these patients' fever was decreased in 8-12 hours. Two patients whose temperature did not decrease, received another dose of prednisolone 24 hours after the first dose and their fever was reduced 12 hours after the second dose (11.3 ± 6.4 hours). A comparison of the rate of fever reduction and the interval between the attacks (Group I: 5.11 ± 1.01 week and Group II: 5.2 ± 1.13 week) in the two groups did not show any statistical significance (p=0.104). Low-dose steroid treatment is as effective as normal dose in PFAPA syndrome but there is need to study with a larger group. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  12. 人工关节置换联合新辅助化疗治疗膝关节周围骨肉瘤%Application of Chemotherapy Combined with Join Replacement in the Treatment of Osteosarcoma around Knee

    Institute of Scientific and Technical Information of China (English)

    高明堂; 蒋电明; 刘军; 鲁培; 符孔龙; 张陆; 高松明

    2011-01-01

    Objective : To discuss the chemotherapy combined with customized total knee replacement and the feasibility in the limb salvage treatment of osteosarcoma around knee. Methods : 38 patients ( 18 - 42years old ) with osteosarcoma around knee were selected from Sep. 2002 to Oct. 2009 , 24 cases of male; 4 cases of female. 30 cases in distal femoral, 8 cases in proximal tihia. 37 cases of osteosarcoma around knee were retrospectively analyzed by general treatment of the three stages: 37 cases under went 2 cycles of preoperative chemotherapy, operative resection of the tumor and the replacement and 4 ~ 6 cycles of postoperative chemotherapy. Results: Except for one lost, All the cases underwent 18 - 42 months follow - up ( average of 28 months ). The limb function was evaluated by ISOLS standard , there was 24 cases excellent,6 cases good and 7 cases bad. The excellent and good rate of the limb function were 83. 8% , without prosthetic loosening and broking. All the patients were alive. Conclusions: It is an effective measure to treat osteosarcoma around knee with customized total knee prosthesis replacement with lower local recurrence and good knee function.%目的:探讨新辅助化疗联合人工关节置换应用于膝关节周围骨肉瘤保肢治疗的可行性.方法:自2002年9月~2009年10月,对病理活检确诊的38例膝关节周围骨肉瘤患者,采用Rosen T19方案化疗2个疗程后行人工关节置换术,术后化疗4~6个疗程.其中,按Enneking分期为IA期2例,IB期3例,IIA期23例,IIB期10例.结果:38例中,37例获随访,随访时间18~42个月,平均28个月,随访期间所有患者均成活,无假体松动和折断.膝关节按ISOLS关节功能评定标准,优24例,良6例,差7例,本组患膝关节功能优良率为83.8%.结论:对于早期骨肉瘤,新辅助化疗联合人工关节置换术是膝关节周围骨肉瘤保肢治疗的有效措施.

  13. Improving compliance with hormonal replacement therapy in primary osteoporosis prevention

    DEFF Research Database (Denmark)

    Vestergaard, P; Hermann, A P; Gram, J

    1997-01-01

    To evaluate whether introduction of treatment alternatives would improve compliance with hormonal replacement therapy (HRT) as primary osteoporosis prevention in women not tolerating the first line osteoporosis prevention schedule.......To evaluate whether introduction of treatment alternatives would improve compliance with hormonal replacement therapy (HRT) as primary osteoporosis prevention in women not tolerating the first line osteoporosis prevention schedule....

  14. Ulnar head replacement.

    Science.gov (United States)

    Herbert, Timothy J; van Schoonhoven, Joerg

    2007-03-01

    Recent years have seen an increasing awareness of the anatomical and biomechanical significance of the distal radioulnar joint (DRUJ). With this has come a more critical approach to surgical management of DRUJ disorders and a realization that all forms of "excision arthroplasty" can only restore forearm rotation at the expense of forearm stability. This, in turn, has led to renewed interest in prosthetic replacement of the ulnar head, a procedure that had previously fallen into disrepute because of material failures with early implants, in particular, the Swanson silicone ulnar head replacement. In response to these early failures, a new prosthesis was developed in the early 1990s, using materials designed to withstand the loads across the DRUJ associated with normal functional use of the upper limb. Released onto the market in 1995 (Herbert ulnar head prosthesis), clinical experience during the last 10 years has shown that this prosthesis is able to restore forearm function after ulnar head excision and that the materials (ceramic head and noncemented titanium stem), even with normal use of the limb, are showing no signs of failure in the medium to long term. As experience with the use of an ulnar head prosthesis grows, so does its acceptance as a viable and attractive alternative to more traditional operations, such as the Darrach and Sauve-Kapandji procedures. This article discusses the current indications and contraindications for ulnar head replacement and details the surgical procedure, rehabilitation, and likely outcomes.

  15. Type rotating hinge knee replacement treatment knee bone tumor clinical curative effect analysis%旋转铰链型膝关节置换术治疗膝部骨肿瘤临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    马伟; 于金华; 曲成明

    2015-01-01

    Objective Analysis of the rotating hinge knee replacement treatment of bone tumors of the knee clinical curative effect. Methods Randomly selected from February 2011 to February 2014 in our hospital USES the rotating hinge knee replacement treatment of bone tumors of the knee of 40 patients as the research object, follow-up and Enneking limb function in patients with postoperative scores, type analysis of rotating hinge knee arthroplasty clinical treatment effect for the treatment of bone tumors of the knee. Results 40 patients after treatment, 2 cases with numbness, dare not walk phenomenon, there are 3 cases of patients with wound infection;Through six months of follow-up, all patients with knee joint movement is good, does not appear when walking limp, and normal body no big difference;Enneking limb function score, at the upper tibia type line of rotating hinge knee arthroplasty patients score for optimal in 29 cases, the bottom line of femoral rotation hinged knee arthroplasty scores for 32 cases of patients, to X-ray examination, all patients were not present prosthesis loosening, sink, etc. Conclusion Type rotating hinge knee replacement treatment effect is good, the knee bone tumors is a good method for limb-salvage knee bone tumors.%目的:分析旋转铰链型膝关节置换术治疗膝部骨肿瘤临床疗效。方法随机选取2011年2月至2014年2月在我院采用旋转铰链型膝关节置换术治疗膝部骨肿瘤的40例患者作为研究对象,对术后患者进行随访和Enneking肢体功能评分,分析旋转铰链型膝关节置换术治疗膝部骨肿瘤的临床治疗效果。结果40例患者经过治疗后,有2例患者出现肢体麻木,不敢行走的现象,有3例肿患者出现伤口感染现象;通过6个月的随访,所有患者的膝关节运动良好,行走时未出现跛行状况,与正常肢体无大差异;Enneking肢体功能评分,在胫骨上端行旋转铰链型膝关节置换

  16. Replacing synthetic with microbial surfactants as collectors in the treatment of aqueous effluent produced by acid mine drainage, using the dissolved air flotation technique.

    Science.gov (United States)

    Menezes, Carlyle T B; Barros, Erilson C; Rufino, Raquel D; Luna, Juliana M; Sarubbo, Leonie A

    2011-02-01

    Dissolved air flotation (DAF) is a well-established separation process employing micro bubbles as a carrier phase. The application of this technique in the treatment of acid mine drainage, using three yeast biosurfactants as alternative collectors, is hereby analyzed. Batch studies were carried out in a 50-cm high acrylic column with an external diameter of 2.5 cm. High percentages (above 94%) of heavy metals Fe(III) and Mn(II) were removed by the biosurfactants isolated from Candida lipolytica and Candida sphaerica and the values were found to be similar to those obtained with the use of the synthetic sodium oleate surfactant. The DAF operation with both surfactant and biosurfactants, achieved acceptable turbidity values, in accordance with Brazilian standard limits. The best ones were obtained by the biosurfactant from C. lipolytica, which reached 4.8 NTU. The results obtained with a laboratory synthetic effluent were also satisfactory. The biosurfactants removed almost the same percentages of iron, while the removal percentages of manganese were slightly higher compared with those obtained in the acid mine drainage effluent. They showed that the use of low-cost biosurfactants as collectors in the DAF process is a promising technology for the mining industries.

  17. A comparison of measurement techniques for quality assurance of RapidArc treatment plans

    Science.gov (United States)

    Konieczny, Jeff

    A new form of intensity modulated radiation therapy (IMRT) using the Varian RapidArc® treatment system has the potential to improve cancer treatments by delivering comparable dose distributions as TomoTherapy ®1 at a rate that is 5 to 15 times faster 2. The goal of this thesis was to compare the sensitivity of an electronic portal imaging device (EPID), film, and the ArcCheck™ device as tools for evaluation of IMRT treatments. To accomplish this, we introduced systematic errors in MLC leaf position and perform theoretical and experimental evaluations. The comparisons were made by analyzing changes in the gamma function as systematic MLC gap errors were introduced into the patient treatment plan. To study this, dynamic prostate Rapidarc™ plans were developed in Eclipse™ using the RANDO anthropomorphic phantom. After the plans were developed, the files were exported in DICOM-RT (Digital Imaging and Communications in Medicine — Radiation Therapy) format, and a program was written to modify the MLC leaf position. The files were imported back into Eclipse and recalculated using simulated film, EPID, and ArcCheck phantoms. Before measuring the plans with the devices, each instrument was calibrated and repeatability tests were performed to determine the variation in a single plan. After the delivery of the same plan eight times, film was found to have the largest variation in average gamma of 0.31 ± 0.13. When the setup was not moved in between measurements, the ArcCheck and EPID had significantly smaller variations in average gamma of 0.10 ± 0.04 and 0.07 ± 0.03 respectively. When the setup was moved and realigned in between measurements, the average gamma variation was found to be 0.22 ± 0.10 and 0.11 ± 0.05 for the ArcCheck and EPID. As a result of the higher variation, it was decided that testing should be performed without moving the detector during the course of the measurements. Film, unfortunately, had to be changed in between tests, which resulted

  18. Peri-operative treatment for total hip replacement in patients with hepatic cirrhosis%人工髋关节置换肝硬化患者围置换期的处理

    Institute of Scientific and Technical Information of China (English)

    许杰; 黄晶; 马若凡; 李登; 蔡志清; 李亮平

    2013-01-01

    BACKGROUND:Hepatic cirrhosis may adversely affect the outcome of major orthopedic surgery, such as total hip arthroplasty. Peri-operative treatment is the chal enge for al orthopedic surgeons. OBJECTIVE:To analyze the safety and feasibility of hip replacement surgeries in patients with hepatic cirrhosis. METHODS:Thirteen patients with hepatic cirrhosis that underwent hip replacement were retrospectively analyzed to evaluate the treatments and their efficacy before and after replacement. RESULTS AND CONCLUSION:Al 13 surgeries were successful y performed. Al cases were fol owed up for more than five months and were graded according to Child-Pugh Criteria for hepatic functional reserve preoperatively and postoperatively. Five cases of the seven preoperative grade A cases preserved grade A postoperatively during a two-week observation, while another two cases rose to grade B and needed hepatic conservation treatment before discharge. Two cases of the six preoperative grade B cases rose to grade C with developed jaundice and ascites. Of the two, one even suffered a complication of upper gastrointestinal hemorrhage 5 days after surgery. Somatostatin and proton pump inhibitors were administered to stop bleeding. Al cases gained a satisfying recovery. Harris hip score at fol ow-up showed favorable hip function. Hip replacement is safe and feasible for patients with hepatic cirrhosis when ful evaluation of hepatic function and appropriate perioperative management are ensured.%背景:肝硬化对行人工关节置换等骨科治疗者往往产生负面影响,其围置换期处理是骨科医生的一大挑战。  目的:分析合并肝硬化患者实施人工髋关节置换的安全性、可行性。  方法:回顾性分析13例合并肝硬化的人工髋关节置换患者的临床资料,总结置换前后的诊治措施及疗效。  结果与结论:13例患者髋关节置换均顺利完成,随访均超过5个月。置换前Child-Pugh分级A级7

  19. A mixed treatment comparison of gabapentin enacarbil, pramipexole, ropinirole and rotigotine in moderate-to-severe restless legs syndrome

    NARCIS (Netherlands)

    Sun, Ying; van Valkenhoef, Gert; Morel, Thomas

    2014-01-01

    Objective: A mixed treatment comparison (MTC) was performed to investigate the relative efficacy and safety of licensed pharmaceuticals for moderate-to-severe restless legs syndrome (RLS). Methods: RLS trials published over the past 10 years were identified via systematic literature searches of MEDL

  20. Mixed corticomedullary adrenal carcinoma – case report: Comparison in features, treatment and prognosis with the other two reported cases

    Directory of Open Access Journals (Sweden)

    Mhd Belal Alsabek

    2017-01-01

    Conclusion: It could be noted that this is the first comparison of presentation, diagnosis, treatments and follow-up of the three cases of Mixed corticomedullary carcinoma. This could contribute to understanding the behavior and management of this rare malignancy and make it more familiar in clinical practice.

  1. A mixed treatment comparison of gabapentin enacarbil, pramipexole, ropinirole and rotigotine in moderate-to-severe restless legs syndrome

    NARCIS (Netherlands)

    Sun, Ying; van Valkenhoef, Gert; Morel, Thomas

    2014-01-01

    Objective: A mixed treatment comparison (MTC) was performed to investigate the relative efficacy and safety of licensed pharmaceuticals for moderate-to-severe restless legs syndrome (RLS). Methods: RLS trials published over the past 10 years were identified via systematic literature searches of MEDL

  2. Postmenopausal hormone replacement therapy--clinical implications

    DEFF Research Database (Denmark)

    Ravn, S H; Rosenberg, J; Bostofte, E

    1994-01-01

    in the urogenital tract. Women at risk of osteoporosis will benefit from hormone replacement therapy. The treatment should start as soon after menopause as possible and it is possible that it should be maintained for life. The treatment may be supplemented with extra calcium intake, vitamin D, and maybe calcitonin....... Physical activity should be promoted, and cigarette smoking reduced if possible. Women at risk of cardiovascular disease will also benefit from hormone replacement therapy. There is overwhelming evidence that hormone therapy will protect against both coronary heart disease and stroke...... suggest that every woman showing any signs of hormone deprivation should be treated with hormone replacement therapy. This includes women with subjective or objective vaso-motor symptoms, genito-urinary symptoms, women at risk of osteoporosis (fast bone losers), and women at risk of cardiovascular...

  3. Effects of treadmill exercise training on liver fat accumulation and estrogen receptor alpha expression in intact and ovariectomized rats with or without estrogen replacement treatment.

    Science.gov (United States)

    Hao, Like; Wang, Yijing; Duan, Yushuang; Bu, Shumin

    2010-07-01

    To explore the mechanism(s) of exercise training on ovariectomized (OVX)-induced liver lipid disorder, we observed effects of treadmill training on liver fat accumulation and ER alpha expression in intact and ovariectomized rats. Sixty female rats were randomly assigned to six groups: Sham sedentary (S-S), Sham exercised (S-EX), ovariectomized sedentary (O-S), ovariectomized exercised (O-EX), ovariectomized injected subcutaneously with 17beta-estradiol (E(2)) (O-E(2)), and ovariectomized treated with E(2) and exercise (O-E(2)-EX). Twelve weeks after intervention, OVX resulted in significantly higher body weight gain, intra-abdominal fat mass, serum levels of total cholesterol (TC), and liver triacylglycerol (TAG) concentrations and ER alpha expression than S-S group, while the relative uterus and liver mass, serum levels of E(2), TAG, and the ratio of high density lipoprotein (HDL) to TC were markedly lower in O-S group. All of these changes were decreased in O-S rats after treatment with E(2) alone with the exception of serum TC and HDL-C levels and liver ER alpha expression. Exercise alone significantly reversed the effect of OVX on serum E(2), the ratio of HDL-C to TC and the liver and intra-abdominal fat accumulation in OVX rats. The addition of E(2) to exercise induced the same uterus and lipid profile as E(2) alone. Moreover, an additive effect of exercise and E(2) was observed on liver ER alpha expression in Sham or OVX rats. In conclusion, treadmill training alone could prevent liver fat accumulation in OVX rats and the regulation of exercise on liver ER alpha expression in both OVX and Sham rats needs the presence of physical estrogen levels.

  4. Treatment of femoral neck fractures in elderly patients over 60 years of age - which is the ideal modality of primary joint replacement?

    Directory of Open Access Journals (Sweden)

    Simmen Hans-Peter

    2010-10-01

    Full Text Available Abstract Background Femoral neck fractures in the elderly are frequent, represent a great health care problem, and have a significant impact on health insurance costs. Reconstruction options using hip arthroplasty include unipolar or bipolar hemiarthroplasty (HA, and total hip arthroplasty (THA. The purpose of this review is to discuss the indications, limitations, and pitfalls of each of these techniques. Methods The Pubmed database was searched for all articles on femoral neck fracture and for the reconstruction options presented in this review using the search terms "femoral neck fracture", "unipolar hemiarthroplasty", "bipolar hemiarthroplasty", and "total hip arthroplasty". In addition, cross-referencing was used to cover articles eventually undetected by the respective search strategies. The resulting articles were then reviewed with regard to the different techniques, outcome and complications of the distinct reconstruction options. Results THA yields the best functional results in patients with displaced femoral neck fractures with complication rates comparable to HA. THA is beneficially implanted using an anterior approach exploiting the internervous plane between the tensor fasciae latae and the sartorius muscles allowing for immediate full weight-bearing. Based on our findings, bipolar hemiarthroplasty, similar to unipolar hemiarthroplasty, cannot restorate neither anatomical nor biomechanical features of the hip joint. Therefore, it can only be recommended as a second line of defense-procedure for patients with low functional demands and limited live expectancy. Conclusions THA is the treatment of choice for femoral neck fractures in patients older than 60 years. HA should only be implanted in patients with limited life expectancy.

  5. Comparison the effectiveness of aripiprazole and risperidone for the treatment of acute bipolar mania

    Directory of Open Access Journals (Sweden)

    Amir Akhavan Rezayat

    2014-01-01

    Full Text Available Background: Second-generation antipsychotics, approved for the treatment of mania, are associated with adverse effects such as weight gain and metabolic disorders. Aripiprazole, a recently introduced second-generation antipsychotic, are thought to account for its low propensity for weight gain, metabolic disturbances and sedation. The purpose of this study was to investigate the effect of risperidone versus aripiprazole in the treatment of acute mania. Materials and Methods: Fifty patients with acute episodes of mania were enrolled in this study, and they were randomly assigned into a risperidone group of 24 cases and an aripiprazole group of 26 cases. In group A, aripiprazole with a dose of 5-30 mg/day and in group B, risperidone with a dose of 2-8 mg/day was given to patients. The average dose of aripiprazole was 27 mg/day, and the average dose of risperidone was 6 mg/day. The effects of each drug for the treatment of acute mania were assessed on the 1 st day of admission and on days 2, 4, 6, 8 and at weeks 2, 4 and 6 after therapy using the young mania rating scale (YMRS and at the baseline and on weeks 3 and 6 after admission using the clinical global impression (CGI scale. Results: The mean age of the group of risperidone was 34 ± 8.6 years and in a group of aripiprazole it was 34 ± 9.1 years (P = 0.83. Comparison of YMRS scores over the period of 6 weeks revealed a statistically significant difference in both groups (P < 0.0001.There was also a statistically significant difference in YMRS scores between risperidone and aripiprazole at day 8 (P = 0.026 and weeks 2 (P = 0.035 and 4 (P = 0.042. There was also a statistically significant difference in CGI-Severity scale score at weeks 3 (P = 0.003 and 6 (P = 0.000 and in CGI-Improvement scale score at weeks 3 (P = 0.005 and 6 (P = 0.002. The most common side-effect observed in both groups was headache (0%15/4 in aripiprazole vs. %16/7 in risperidone Conclusion: Aripiprazole that is readily

  6. Independent peer review panel report on the integrated nonthermal treatment systems study and the comparison of integrated thermal and integrated nonthermal treatment systems for mixed low level waste

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-08-01

    The US Department of Energy`s (DOE) Office of Environmental Management (EM) Office of Science and Technology (OST) has conducted studies of integrated thermal treatment systems and integrated nonthermal treatment systems (INTS) for treating contact handled, alpha and non-alpha mixed low level radioactive waste (MLLW). The MLLW in the DOE complex consists of a wide variety of organic and inorganic solids and liquids contaminated with radioactive substances. Treatment systems are needed to destroy organic material and stabilize residues prior to land disposal. In May 1996 the Deputy Assistant Secretary for OST appointed an Independent Peer Review Panel to: (1) review and comment on the INTS Study; (2) make recommendations on the most promising thermal and nonthermal treatment systems; (3) make recommendations on research and development necessary to prove the performance of nonthermal and thermal technologies; and (4) review and comment on the preliminary draft of the ITTS/INTS Comparison Report. This report presents the primary conclusions and recommendations based on the review of the INTS study and the comparison report. System selection, overviews, comparisons, cost estimations and sensitivity analyses, and recommended R and D engineering needs are then described and discussed.

  7. Are valve repairs associated with better outcomes than replacements in patients with native active valve endocarditis?

    Science.gov (United States)

    Zhao, Dong; Zhang, Benqing

    2014-12-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether valve replacement was associated with higher morbidity and mortality rates than valve repair in patients with native active valve endocarditis. Altogether 662 papers were found using the reported search, of which 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Traditionally, valve replacement has been the standard therapy for valve endocarditis when surgical treatment is indicated. But now valve repair is increasingly used as an alternative, which may avoid disadvantages of anticoagulation, lower the risk of prosthetic infection and improve postoperative survival. To compare outcomes of these two treatments between studies can be difficult because most of related papers contain raw data on prosthetic valve endocarditis or healed endocarditis, which were excluded from our manuscript. Studies only analysing the outcomes of either of these treatments without the comparison of valve repair and replacement were also excluded. Finally, seven papers were identified. The American Heart Association/American College of Cardiology 2006 valvular guidelines recommended that mitral valve repair should be performed instead of replacement when at all possible. In three of the seven studies, there were significant differences between valve repair and replacement in long-term survival. One study found that aortic valve repair offered better outcomes in freedom from reoperation at 5 years (P = 0.021) and in survival at 4 years (repair vs replacement 88 vs 65%; P = 0.047). One study reported that there was improved event-free survival at 10 years in the mitral valve repair group (P = 0.015), although there was more previous septic embolization in this group. In one study, early and late mortality

  8. Assessing the quality of conformal treatment planning: a new tool for quantitative comparison

    Energy Technology Data Exchange (ETDEWEB)

    Menhel, J; Levin, D; Alezra, D; Symon, Z; Pfeffer, R [Oncology Institute, Sheba Medical Center, Tel-Hashomer, 52621 (Israel)

    2006-10-21

    We develop a novel radiotherapy plan comparison index, critical organ scoring index (COSI), which is a measure of both target coverage and critical organ overdose. COSI is defined as COSI = 1 - (V(OAR){sub >tol}/TC), where V(OAR){sub >tol} is the fraction of volume of organ at risk receiving more than tolerance dose, and TC is the target coverage, V{sub T,PI}/V{sub T}, where V{sub T,PI} is the target volume receiving at a least prescription dose and V{sub T} is the total target volume. COSI approaches unity when the critical structure is completely spared and the target coverage is unity. We propose a two-dimensional, graphical representation of COSI versus conformity index (CI), where CI is a measure of a normal tissue overdose. We show that this 2D representation is a reliable, visual quantitative tool for evaluating competing plans. We generate COSI-CI plots for three sites: head and neck, cavernous sinus, and pancreas, and evaluate competing non-coplanar 3D and IMRT treatment plans. For all three sites this novel 2D representation assisted the physician in choosing the optimal plan, both in terms of target coverage and in terms of critical organ sparing. We verified each choice by analysing individual DVHs and isodose lines. Comparing our results to the widely used conformation number, we found that in all cases where there were discrepancies in the choice of the best treatment plan, the COSI-CI choice was considered the correct one, in several cases indicating that a non-coplanar 3D plan was superior to the IMRT plans. The choice of plan was quick, simple and accurate using the new graphical representation.

  9. Pediatric Corneal Crosslinking: Comparison of Visual and Topographic Outcomes between Conventional and Accelerated Treatment.

    Science.gov (United States)

    Baenninger, Philipp B; Bachmann, Lucas M; Wienecke, Ludmilla; Thiel, Michael A; Kaufmann, Claude

    2017-08-29

    To compare visual and topographic outcomes 1 year after conventional (C-CXL) versus accelerated corneal crosslinking (A-CXL) in pediatric keratoconus DESIGN: Comparative, retrospective, consecutive case-series METHODS: Patients with topography confirmed, progressive KC and a corneal thickness of ≥400 micrometers at the time of surgery were enrolled. Uncorrected (UCVA) and best phoropter-corrected visual acuity (BCVA) and Kmax were measured at study entry and the 12-months follow-up. Treatment failure rate was defined as the percentage of eyes with an increase in Kmax of more than 1.0 diopter during follow-up. The adverse event rate was the percentage of eyes with a loss of ≥2 Snellen lines of BCVA from baseline. Single center analysis of 78 eyes of 58 patients that underwent in 39 eyes C-CXL and in 39 eyes A-CXL. No eyes were lost to follow-up after 12 months. No significant difference between changes in 12 months after as compared to the time before CXL for UCVA (0.01 log MAR; 95%CI (-0.14-0.15), p=0.944), BCVA (0.05 log MAR; 95%CI (-0.05-0.15), p=0.310) and Kmax (-0.77 Diopters; 95%CI (-2.20-0.65), p=0.282) between the C-CXL and A-CXL group were observed. Treatment failure rate was observed in 9/39 eyes (23.1%) in C-CXL and in 6/39 eyes (15.4%) in A-CXL (p=0.389). Adverse events were seen only in 1 eye in the C-CXL group. In this retrospective comparison, the accelerated approach was equally effective than the conventional protocol to treat pediatric keratoconus. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. A comparison of Kneipp hydrotherapy with conventional physiotherapy in the treatment of osteoarthritis: a pilot trial

    Institute of Scientific and Technical Information of China (English)

    Martin Schencking; Stefan Wilm; Marcus Redaelli

    2013-01-01

    An increasingly aging population implies an increasing prevalence of osteoarthritis (OA) of hip or knee.It has been ascertained that unspecific hydrotherapy of OA according to Sebastian Kneipp not only improves the range of mobility but also reduces pain significantly and increases the quality of life of the patients affected.OBJECTIVE:The main aim of this pilot study was to determine the effects of hydrotherapy in comparison to conventional physiotherapy,and to analyze the feasibility of the study design under clinical circumstances.DESIGN,SETTING,PARTICIPANTS AND INTERVENTIONS:The study design is a prospective randomized controlled three-arm clinical pilot trial,carried out at a specialist clinic for integrative medicine.Thirty patients diagnosed with symptomatic OA of hip or knee and radiologic findings were randomly assigned to one of two intervention groups and a control group:hydrotherapy (group 1),physiotherapy (group 2),and both physiotherapy and hydrotherapy (group 3,control group) of the affected joint.MAIN OUTCOME MEASURES:Primary outcome:pain intensity of the affected joint in the course of inpatient treatment; secondary outcome:health-related quality of life,joint-specific pain and mobility in the course of the study.RESULTS:Concerning the main outcome,intervention group 1 showed most beneficial effects in the course of inpatient treatment,followed by groups 3 and 2,and also the indirect flexion ability of hip or knee together with the general patient mobility through the "timed up and go" test were mainly improved within group 1 followed by groups 3 and 2.CONCLUSION:The results of this pilot study demonstrate beneficial effects of hydrotherapy.The study design is feasible.For statistically significant evidence and a robust conclusion of efficacy of Kneipp's hydrotherapy,a larger sample size is necessary.TRIAL REGISTRATION NUMBER:NCT 00950326.

  11. Assessing the quality of conformal treatment planning: a new tool for quantitative comparison.

    Science.gov (United States)

    Menhel, J; Levin, D; Alezra, D; Symon, Z; Pfeffer, R

    2006-10-21

    We develop a novel radiotherapy plan comparison index, critical organ scoring index (COSI), which is a measure of both target coverage and critical organ overdose. COSI is defined as COSI=1-(V(OAR)>tol/TC), where V(OAR)>tol is the fraction of volume of organ at risk receiving more than tolerance dose, and TC is the target coverage, VT,PI/VT, where VT,PI is the target volume receiving at a least prescription dose and VT is the total target volume. COSI approaches unity when the critical structure is completely spared and the target coverage is unity. We propose a two-dimensional, graphical representation of COSI versus conformity index (CI), where CI is a measure of a normal tissue overdose. We show that this 2D representation is a reliable, visual quantitative tool for evaluating competing plans. We generate COSI-CI plots for three sites: head and neck, cavernous sinus, and pancreas, and evaluate competing non-coplanar 3D and IMRT treatment plans. For all three sites this novel 2D representation assisted the physician in choosing the optimal plan, both in terms of target coverage and in terms of critical organ sparing. We verified each choice by analysing individual DVHs and isodose lines. Comparing our results to the widely used conformation number, we found that in all cases where there were discrepancies in the choice of the best treatment plan, the COSI-CI choice was considered the correct one, in several cases indicating that a non-coplanar 3D plan was superior to the IMRT plans. The choice of plan was quick, simple and accurate using the new graphical representation.

  12. Aortic valve replacement

    DEFF Research Database (Denmark)

    Kapetanakis, Emmanouil I; Athanasiou, Thanos; Mestres, Carlos A

    2008-01-01

    BACKGROUND AND AIMS OF THE STUDY: Prompted by anecdotal evidence and observations by surgeons, an investigation was undertaken into the potential differences in implanted aortic valve prosthesis sizes, during aortic valve replacement (AVR) procedures, between northern and southern European...... countries. METHODS: A multi-institutional, non-randomized, retrospective analysis was conducted among 2,932 patients who underwent AVR surgery at seven tertiary cardiac surgery centers throughout Europe. Demographic and perioperative variables including valve size and type, body surface area (BSA) and early...

  13. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications.

  14. Bipolar femoral head replacement for the treatment of femoral neck fractures in elder Parkinson's disease patients%双极人工股骨头治疗老年帕金森患者股骨颈骨折

    Institute of Scientific and Technical Information of China (English)

    庄泽; 曾春; 曾花; 王昆

    2012-01-01

    BACKGROUND: Due to the muscle imbalance outcomes, Parkinson's patients are easy to fall and have a high risk of femoral neck fracture. OBJECTIVE: To explore the treatment outcomes of bipolar femoral head replacement for the femoral neck fractures in elder Parkinson's patients METHODS: A retrospective analysis was carried out on the clinical data of the 14 Parkinson's disease patients of femoral neck fractures, a total of 14 hips, who were treated with bipolar femoral head replacement. The patients were divided into three phases by Hoehn-Yahr classification, 3 cases in I phase, 4 cases in II phase, 5 cases in III phase and 2 cases in IV phase. The average surgery age was 62 to 83 years old. The Harris score, Fugl-Meyer scale and Unified Parkinson's Disease Rating Scale score were used as follow-up judgment. RESULTS AND CONCLUSION: The average follow-up time was 1 to 6 years. Harris score of 14 patients was postoperatively 85.4 better than preoperatively 22.3 (P < 0.05), Fugl-Meyer score was postoperatively 81.6 better than preoperatively 52.5 (P < 0.05). There was no significant difference of Unified Parkinson's Disease Rating Scale score before and after operation, and the Parkinson's disease controlled stable. No prosthesis loosening, dislocation or other complications. Early and mid-term follow-up showed under the effective medical control of the neurology drugs, bipolar femoral head replacement is a safe and effective treatment of femoral neck fracture for Hoehn-Yahr I -IV Parkinson's patient. There is relationship between the hip joint function and the control of the Parkinson's disease after replacement.%背景:帕金森患者由于肌力不平衡等原因更容易跌倒,发生股骨颈骨折的风险高.目的:观察双极人工股骨头置换对老年帕金森病合并股骨颈骨折患者的治疗效果.方法:回顾分析14例帕金森病合并股骨颈骨折行双极人工股骨头置换患者的临床资料,共14髋,Hoehn-Yahr分级Ⅰ期3例,Ⅱ期4

  15. Histologic comparison of microscopic treatment zones induced by fractional lasers and radiofrequency.

    Science.gov (United States)

    Shin, Min-Kyung; Choi, Jeong Hwee; Ahn, Soo Beom; Lee, Mu Hyoung

    2014-12-01

    Fractional photothermolysis induces microscopic, localized thermal injury in the skin surrounded by undamaged viable tissue in order to promote wound healing. This study evaluated acute histologic changes following each single pass of various fractional lasers and radiofrequency (RF). Three male domestic swine were used. We used fractional Erbium:glass (Er:glass), Erbium:yttrium-aluminum-garnet (Er:YAG), CO2 lasers, and fractional ablative microplasma RF. We analyzed features and average values of the diameter, depth, and vertical sectional areas treated with each kind of laser and RF. The microscopic treatment zone (MTZ) of fractional Er:glass resulted in separation of dermoepidermal junction with no ablative zone. Fractional Er:YAG provided the most superficial and broad MTZ with little thermal collateral damage. Fractional CO2 resulted in a narrow and deep "cone"-like MTZ. Fractional RF resulted in a superficial and broad "crater"-like MTZ. This study provides the first comparison of MTZs induced by various fractional lasers and RF. These data provide basic information on proper laser and RF options. We think that these findings could be a good reference for information about fractional laser-assisted drug delivery.

  16. Comparison between kinesiotherapy and back school in the treatment of low back pain in older adults

    Directory of Open Access Journals (Sweden)

    Sonia Maria Marques Gomes Bertolini

    2015-11-01

    Full Text Available Objective: to compare the efficacy of physiotherapy treatment involving kinesiotherapy and back school in older adults’ lowback pain. Methods: study of the case-series type. The pain visual analog scale and the WHOQOL-bref were used for assessingquality of life, and the Timed Up and Go Test was used for testing agility. A total of 21 older adults, who had had low back painfor over three months, participated in the study. The sample was divided in two groups (kinesiotherapy and back school.The older adults were assessed before and after the therapeutic interventions. Results: both groups obtained better scoresin all the variables analyzed in the post-test in relation to the pre-test, and as a result, in the inter-group comparison, theresults did not reveal statistically significant differences (p>0.05. Conclusion: back school and conventional kinesiotherapywere effective in improving the pain, quality-of-life and agility of older adults with low back pain.

  17. Dosimetric comparison of three different treatment techniques in extensive scalp lesion irradiation.

    Science.gov (United States)

    Wojcicka, Jadwiga B; Lasher, Donette E; McAfee, Sandra S; Fortier, Gregory A

    2009-05-01

    This study compared lateral photon/electron plan (3DCRT), intensity modulated radiation therapy (IMRT) plan, and high dose rate (HDR) brachytherapy plan for total scalp irradiation. The techniques were planned on a patient with squamous cell carcinoma of the scalp for a prescribed dose of 60 Gy. Conformity indexes and dose volume histograms were used for the comparison. Clinical target volume coverage factors for 3DCRT, IMRT, and HDR were 0.976, 0.998, and 0.967, and Conformation Numbers were 0.532, 0.713, and 0.761, respectively. The dose gradient across the target was 59-136%, 91-129%, and 58-242% for 3DCRT, IMRT, and HDR techniques, respectively. The 3DCRT and IMRT techniques produced low optical structure doses. 3DCRT produced hotspots in the brain, while IMRT produced brain sparing. HDR produced the highest integral doses to the brain and optical structures. IMRT provided the best target dose homogeneity and coverage, and delivered clinically acceptable doses to normal structures. HDR produced the most conformal plan, but the total dose delivered is limited by doses to the brain and eyes. HDR is a clinically feasible alternative for less extensive lesions, lower prescription doses, and for patients who cannot lie on the treatment table.

  18. Preference weights for cost-outcome analyses of schizophrenia treatments: comparison of four stakeholder groups.

    Science.gov (United States)

    Shumway, Martha

    2003-01-01

    This study quantified preferences for schizophrenia outcomes in four stakeholder groups, tested the hypotheses that outcomes differ in importance and stakeholder groups have different preferences, and produced preference weights for seven outcomes for cost-outcome analysis. Fifty patients with schizophrenia, 50 clinicians, 41 family members of patients, and 50 members of the general public rated 16 schizophrenia-related health states, yielding preference weights for seven outcomes: positive symptoms, negative symptoms, extrapyramidal symptoms, tardive dyskinesia, social function, independent living, and vocational function. Outcomes differed in importance (F = 23.4, p stakeholders rated positive symptoms and social functioning as more important than negative and extrapyramidal symptoms. Stakeholder groups had different preferences (F = 1.9, p = 0.01). Patients rated extrapyramidal symptoms as more important than did other groups (p important than did patients or family members (p important than did patients and the general public (p important and that stakeholder groups value outcomes differently, demonstrating the importance of incorporating stakeholder preferences in cost-outcome analyses and other treatment comparisons.

  19. Analogue Assessment of the Replacement Behavior

    Science.gov (United States)

    Cipani, Ennio

    2008-01-01

    The use of experimental analyses in determining behavioral function for problems behaviors is well established. Such analyses lead to functional treatment prescriptions for the target problem behavior. However, data indicative of the strength of the replacement behavior are often not collected during a functional behavioral assessment. I examine…

  20. [Hormone replacement therapy: curse or blessing?].

    Science.gov (United States)

    Schmidt, M; Fink, D; Lang, U; Kimmig, R

    2006-01-01

    There is a controversial discussion on the risks and benefits of hormonal replacement therapy (HRT), and many women and doctors have revised their opinions of HRT over the last few years. Complementary and alternative therapies can be considered an option to treat menopausal symptoms. The following issue summarizes the actual knowledge of treatment options of menopausal symptoms.

  1. Enzyme replacement therapy for alpha-mannosidosis

    DEFF Research Database (Denmark)

    Borgwardt, Line Gutte; Dali, Christine I.; Fogh, J

    2013-01-01

    Alpha-mannosidosis (OMIM 248500) is a rare lysosomal storage disease (LSD) caused by alpha-mannosidase deficiency. Manifestations include intellectual disabilities, facial characteristics and hearing impairment. A recombinant human alpha-mannosidase (rhLAMAN) has been developed for weekly intrave...... intravenous enzyme replacement therapy (ERT). We present the preliminary data after 12 months of treatment....

  2. Implementation of a software for REmote COMparison of PARticlE and photon treatment plans: ReCompare.

    Science.gov (United States)

    Löck, Steffen; Roth, Klaus; Skripcak, Tomas; Worbs, Mario; Helmbrecht, Stephan; Jakobi, Annika; Just, Uwe; Krause, Mechthild; Baumann, Michael; Enghardt, Wolfgang; Lühr, Armin

    2015-09-01

    To guarantee equal access to optimal radiotherapy, a concept of patient assignment to photon or particle radiotherapy using remote treatment plan exchange and comparison - ReCompare - was proposed. We demonstrate the implementation of this concept and present its clinical applicability. The ReCompare concept was implemented using a client-server based software solution. A clinical workflow for the remote treatment plan exchange and comparison was defined. The steps required by the user and performed by the software for a complete plan transfer were described and an additional module for dose-response modeling was added. The ReCompare software was successfully tested in cooperation with three external partner clinics and worked meeting all required specifications. It was compatible with several standard treatment planning systems, ensured patient data protection, and integrated in the clinical workflow. The ReCompare software can be applied to support non-particle radiotherapy institutions with the patient-specific treatment decision on the optimal irradiation modality by remote treatment plan exchange and comparison. Copyright © 2015. Published by Elsevier GmbH.

  3. 定制肿瘤型膝关节假体置换术后的整体康复治疗%The comprehensive systematic rehabilitation treatment for patients with the customized tumor knee prosthesis replacement

    Institute of Scientific and Technical Information of China (English)

    李蕊; 王耀州; 严芳; 陶陶; 何成奇; 杨应乾; 向阳

    2015-01-01

    Objective To evaluate the effect of the comprehensive rehabilitation treatment for patients with customized tumor knee prosthesis replacement.Methods Seventy-two patients with malignant bone tumors around the knee joint accepted customized tumor knee prosthesis replacement surgery.They were divided into two groups:treatment group ( n =36) receiving the comprehensive rehabilitation therapy and control group ( n =36) receiving conventional orthopedic therapy.The curative effect was evaluated by com-paring the HSS and SF-36 scores between the two groups.Results The scores of the HSS were obviously higher in the treatment group than that in the control group after the 1st month and the 6th month of operation (P0.05).Whereas,there were no significant differences in role-physical (RP) and social function ( SF) between the two groups ( P >0.05 ) .Conclusion The comprehensive rehabilitation treatment can signifi-cantly improve the knee joint function.It is an important measure to achieve the expected effect in patients with customized tumor knee prosthesis replacement surgery.Through the positive mental intervention,the quality of life of patients was greatly improved during the perioperative and postoperative period.%目的:探讨整体康复治疗对定制肿瘤型膝关节假体置换术患者的效果。方法选择贵州医科大学附属医院骨科接受定制肿瘤型膝关节假体置换术的患者72例,按简单随机法分为康复组和对照组各36例,康复组患者术后进行整体康复治疗,对照组患者术后进行常规骨科术后CPM训练。比较两组术前、术后2周、术后1个月及术后6个月膝关节评分标准(HSS)评分、SF-36生存质量评分。结果术后1个月及术后6个月康复组HSS评分高于对照组(P<0.01),SF-36生存质量评分中生理功能(PF)、躯体疼痛(BP)、一般健康状况(GH)、精力(VT)、精神健康(MH)及情感职能(RE)评分均高于对照组,

  4. Efficacy of rotating hinged knee prosthesis replacement for the treatment of malignant bone tumors%旋转铰链式膝关节假体置换治疗恶性骨肿瘤

    Institute of Scientific and Technical Information of China (English)

    张绍岚; 刘红旗; 徐小卒

    2012-01-01

    背景:在新的辅助化疗和人工假体设计的协助下,肢体恶性骨肿瘤的治疗效果得到大幅度提高,关节置换成为恶性骨肿瘤治疗的主要保肢方法目的:观察旋转铰链式膝关节假体在恶性骨肿瘤保肢治疗中的疗效.方法:选择2005-01/2009-10盐城市第一人民医院骨科收治的膝关节恶性骨肿瘤患者15例,均行旋转铰链式膝关节假体置换.置换后采用Enneking肢体肌肉骨骼肿瘤外科治疗重建置换后膝关节功能评估标准进行评估.结果与结论:15例患者置换后获随访7~51个月.1例置换后出现感染并发症,血沉检查结果升高,经清创、关节松解和抗炎治疗后好转,关节功能得到恢复.置换后患者均未出现肿瘤复发和肺转移病例,无假体松动和体断裂出现.Enneking功能评估,肢体功能优7例(47%),良5例(33%),差3例(20%),优良率达80%.提示应用旋转铰链式膝关节假体置换治疗膝关节恶性肿瘤效果良好,可以保留良好的肢体功能,是一种较为满意的保肢方法.%BACKGROUND: Under new adjuvant chemotherapy and artificial false body design help, effects of body malignant bone cancer treatment can be greatly improved, and joint replacement becomes the main limb-salvage method for malignant bone cancer treatment.OBJECTIVE: To observe curative effect of rotating hinged knee prosthesis on malignant bone tumors limb-salvage treatment.METHODS: Totally 15 patients with knee malignant bone tumors were treated with prosthesis rotating hinged replacement from Department of Orthopedics, First People's Hospital of Yancheng between January 2005 and October 2009. Postoperative Enneking musculoskeletal tumor by limb function after knee surgery reconstruction assessment standards were used for evaluation.RESULTS AND CONCLUSION: Totally 15 patients were followed-up for 7-51 months. Postoperative complications were found in one patient, check results of erythrocyte sedimentation rate was increased, after

  5. The Optimum Replacement of Weapon

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiao; ZHANG Jin-chun

    2002-01-01

    The theory of LCC (Life Cycle Cost) is applied in this paper. The relation between the economic life of weapon and the optimum replacement is analyzed. The method to define the optimum replacement time of weapon is discussed.

  6. Comparison of three different surgical approaches for treatment of thoracolumbar burst fracture

    Institute of Scientific and Technical Information of China (English)

    WU Han; WANG Chun-xin; GU Chang-yue; ZHANG Zi-yan; TONG Shen; YAN Hua-dong; WANG Jin-cheng

    2013-01-01

    Objective:The main treatment method used for thoracolumbar fractures is open reduction and internal fixation.Commonly there are three surgical approaches:anterior,posterior and paraspinal.We attempt to compare the three approaches based on our clinical data analysis.Methods:A group of 94 patients with Denis type A or B thoracolumbar burst fracture between March 2008 and September 2010 were recruited in this study.These patients were treated by anterior-,posterior-or paraspinal-approach reduction with or without decompression.The fracture was fixed with titanium mesh and Z-plate via anterior approach (24 patients),screw and rod system via posterior approach (38 patients) or paraspinal approach (32 patients).Clinical evaluations included operation duration,blood loss,incision length,preoperative and postoperative Oswestry disability index (ODI).Results:The average operation duration (94.1 min±13.7min),blood loss (86.7 ml±20.0 ml),length of incision (9.3mm± 0.7 mm) and postoperative ODI (6±0.5) were significandy lower (P<0.05) in paraspinal approach group than in traditional posterior approach group (operation duration 94.1 min±13.7 min,blood loss 143.3 ml±28.3 ml,length of incision 15.4 cm±2.1 cm and ODI 12±0.7) and anterior approach group (operation duration 176.3 min±20.7 min,blood loss 255.1 m1±38.4 ml,length of incision 18.6 cm±2.4 cm and OD113±2.4).There was not statistical difference in terms of Cobb angle on radiographs among the three approaches.Conclusion:The anterior approach surgery is convenient for resection of the vertebrae and reconstruction of vertebral height,but it is more complicated and traumatic.Hence it is mostly used for severe Denis type B fracture.The posterior approach is commonly applied to most thoracolumbar fractures and has fewer complications compared with the anterior approach,but it has some shortcomings as well.The paraspinal approach has great advantages compared with the other two approaches.It is in accordance with

  7. Orthodontic retraction of autotransplanted premolar to replace ankylosed maxillary incisor with replacement resorption.

    Science.gov (United States)

    Choi, Yoon Jeong; Shin, Sujung; Kim, Kyung-Ho; Chung, Chooryung J

    2014-04-01

    This case report describes the successful treatment of an adult with lip protrusion and a previously traumatized maxillary central incisor that had experienced replacement root resorption. An extracted premolar was transplanted into the incisor space and retracted orthodontically. Autotransplantation was successful with complete root formation and, combined with orthodontic treatment, provided a satisfying esthetic outcome.

  8. Surfactant replacement therapy--economic impact.

    Science.gov (United States)

    Pejaver, R K; al Hifzi, I; Aldussari, S

    2001-06-01

    Surfactant replacement is an effective treatment for neonatal respiratory distress syndrome. (RDS). As widespread use of surfactant is becoming a reality, it is important to assess the economic implications of this new form of therapy. A comparison study was carried out at the Neonatal Intensive Care Unit (NICU) of Northwest Armed Forces Hospital, Saudi Arabia. Among 75 infants who received surfactant for RDS and similar number who were managed during time period just before the surfactant was available, but by set criteria would have made them eligible for surfactant. All other management modalities except surfactant were the same for all these babies. Based on the intensity of monitoring and nursing care required by the baby, the level of care was divided as: Level IIIA, IIIB, Level II, Level I. The cost per day per bed for each level was calculated, taking into account the use of hospital immovable equipment, personal salaries of nursing, medical, ancillary staff, overheads and maintenance, depreciation and replacement costs. Medications used, procedures done, TPN, oxygen, were all added to individual patient's total expenditure. 75 infants in the Surfactant group had 62 survivors. They spent a total of 4300 days in hospital. (av 69.35) Out of which 970 d (av 15.65 per patient) were ventilated days. There were 56 survivors in the non-surfactant group of 75. They had spent a total of 5023 days in the hospital (av 89.69/patient) out of which 1490 were ventilated days (av 26.60 d). Including the cost of surfactant (two doses), cost of hospital stay for each infant taking the average figures of stay would be SR 118, 009.75 per surfactant treated baby and SR 164, 070.70 per non-surfactant treated baby. The difference of 46,061 SR is 39.03% more in non-surfactant group. One Saudi rial = 8 Rs (approx at the time study was carried out.) Medical care cost varies from place to place. However, it is definitely cost-effective where surfactant is concerned. Quality adjusted

  9. Nicotine replacement therapies: patient safety and persistence

    Directory of Open Access Journals (Sweden)

    Ferguson SG

    2011-06-01

    Full Text Available Stuart G Ferguson1,2, Saul Shiffman3,4, Joseph G Gitchell51School of Pharmacy, 2Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia; 3Pinney Associates, 4University of Pittsburgh, Pittsburgh, PA, USA; 5Pinney Associates, Bethesda, MD, USAAbstract: Nicotine replacement therapy (NRT has become a central part of the treatment of nicotine dependence. However, NRT’s potential efficacy is limited to some extent by patient adherence and persistence. Here we review the relationship between NRT compliance and adherence, and overall treatment outcome. We then examine the factors that likely impact on treatment compliance and persistence, with a special focus on users’ perceptions of treatment safety and efficacy as possible mediators. Potential clinical strategies for improving suboptimal medication use are also discussed.Keywords: nicotine replacement therapy, compliance, safety

  10. A comparison of different antibiotic regimens for the treatment of infective endocarditis.

    Science.gov (United States)

    Martí-Carvajal, Arturo J; Dayer, Mark; Conterno, Lucieni O; Gonzalez Garay, Alejandro G; Martí-Amarista, Cristina Elena; Simancas-Racines, Daniel

    2016-04-19

    alone reporting uncertain effects on all-cause mortality (8/31 (26%) with levofloxacin plus standard treatment versus 9/39 (23%) with standard treatment alone; RR 1.12, 95% CI 0.49 to 2.56, very low quality evidence). The second trial compared daptomycin versus low-dose gentamicin plus an anti-staphylococcal penicillin (nafcillin, oxacillin or flucloxacillin) or vancomycin. This showed uncertain effects in terms of cure rates (9/28 (32.1%) with daptomycin versus 9/25 (36%) with low-dose gentamicin plus anti-staphylococcal penicillin or vancomycin, RR 0.89 95% CI 0.42 to 1.89; very low quality evidence). The third trial compared cloxacillin plus gentamicin with a glycopeptide (vancomycin or teicoplanin) plus gentamicin. In participants receiving gentamycin plus glycopeptide only 13/23 (56%) were cured versus 11/11 (100%) receiving cloxacillin plus gentamicin (RR 0.59, 95% CI 0.40 to 0.85; very low quality evidence). The fourth trial compared ceftriaxone plus gentamicin versus ceftriaxone alone and found no conclusive differences in terms of cure (15/34 (44%) with ceftriaxone plus gentamicin versus 21/33 (64%) with ceftriaxone alone, RR 0.69, 95% CI 0.44 to 1.10; very low quality evidence).The trials reported adverse events, need for cardiac surgical interventions, uncontrolled infection and relapse of endocarditis and found no conclusive differences between comparison groups (very low quality evidence). No trials assessed septic emboli or quality of life. Limited and very low quality evidence suggested that there were no conclusive differences between antibiotic regimens in terms of cure rates or other relevant clinical outcomes. However, because of the very low quality evidence, this needs confirmation. The conclusion of this Cochrane review was based on randomised controlled trials with high risk of bias. Accordingly, current evidence does not support or reject any regimen of antibiotic therapy for treatment of infective endocarditis.

  11. Power Plant Replacement Study

    Energy Technology Data Exchange (ETDEWEB)

    Reed, Gary

    2010-09-30

    This report represents the final report for the Eastern Illinois University power plant replacement study. It contains all related documentation from consideration of possible solutions to the final recommended option. Included are the economic justifications associated with the chosen solution along with application for environmental permitting for the selected project for construction. This final report will summarize the results of execution of an EPC (energy performance contract) investment grade audit (IGA) which lead to an energy services agreement (ESA). The project includes scope of work to design and install energy conservation measures which are guaranteed by the contractor to be self‐funding over its twenty year contract duration. The cost recovery is derived from systems performance improvements leading to energy savings. The prime focus of this EPC effort is to provide a replacement solution for Eastern Illinois University’s aging and failing circa 1925 central steam production plant. Twenty‐three ECMs were considered viable whose net impact will provide sufficient savings to successfully support the overall project objectives.

  12. Total disc replacement.

    Science.gov (United States)

    Vital, J-M; Boissière, L

    2014-02-01

    Total disc replacement (TDR) (partial disc replacement will not be described) has been used in the lumbar spine since the 1980s, and more recently in the cervical spine. Although the biomechanical concepts are the same and both are inserted through an anterior approach, lumbar TDR is conventionally indicated for chronic low back pain, whereas cervical TDR is used for soft discal hernia resulting in cervicobrachial neuralgia. The insertion technique must be rigorous, with precise centering in the disc space, taking account of vascular anatomy, which is more complex in the lumbar region, particularly proximally to L5-S1. All of the numerous studies, including prospective randomized comparative trials, have demonstrated non-inferiority to fusion, or even short-term superiority regarding speed of improvement. The main implant-related complication is bridging heterotopic ossification with resulting loss of range of motion and increased rates of adjacent segment degeneration, although with an incidence lower than after arthrodesis. A sufficiently long follow-up, which has not yet been reached, will be necessary to establish definitively an advantage for TDR, particularly in the cervical spine. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  13. REPLACEMENT OF FRENCH CARDS

    CERN Multimedia

    HR/SOC

    2001-01-01

    The French Ministry of Foreign Affairs has informed the Organization that it is shortly to replace all diplomatic cards, special cards and employment permits ('attestations de fonctions') now held by members of the personnel and their families. Between 2 July and 31 December 2001, these cards are to be replaced by secure, computerized equivalents. The old cards may continue to be used until 31 December 2001. For the purposes of the handover, members of the personnel must go personally to the cards office (33/1-015), in order to fill in a 'fiche individuelle' form, taking the following documents for themselves and members of their families already in possession of a French card : A recent identity photograph in 4.5 cm x 3.5 cm format. The French card in their possession. An A4 photocopy of the same French card, certified by the cards office as being a true copy. Those members of the personnel whose cards (and/or cards belonging to members of their families) are shortly due to expire, or have recently done...

  14. REPLACEMENT OF FRENCH CARDS

    CERN Multimedia

    Human Resources Division; Cards.Service@cern.ch

    2001-01-01

    The French Ministry of Foreign Affairs is currently replacing all diplomatic cards, special cards and employment permits («attestations de fonctions») held by members of the personnel and their families. These cards are replaced by secure, computerized equivalents. The old cards may no longer be used after 31 December 2001. For the purposes of the handover, members of the personnel must go personally to the cards office (33/1-015) between 8h30 and 12h30, in order to fill in a «fiche individuelle» form, taking the following documents for themselves and members of their families already in possession of a French card : A recent identity photograph in 4.5 cm x 3.5 cm format, the French card in their possession, an A4 photocopy of the same French card, certified by the cards office as being a true copy. Those members of the personnel whose cards (and/or cards belonging to members of their families) are shortly due to expire, or have recently done so, are also requested...

  15. REPLACEMENT OF FRENCH CARDS

    CERN Multimedia

    Human Resources Division

    2001-01-01

    The French Ministry of Foreign Affairs has informed the Organization that it is shortly to replace all diplomatic cards, special cards and employment permits ('attestations de fonctions') now held by members of the personnel and their families. Between 2 July and 31 December 2001, these cards are to be replaced by secure, computerized equivalents. The old cards may continue to be used until 31 December 2001. For the purposes of the handover, members of the personnel are asked to go to the cards office (33/1-015), taking the following documents for themselves and members of their families already in possession of a French card : A recent identity photograph in 4.5 cm x 3.5 cm format, The French card in their possession, an A4 photocopy of the same French card, certified by the cards office as being a true copy. Those members of the personnel whose cards (and/or cards belonging to members of their families) are shortly due to expire, or have recently done so, are also requested to take these items to the c...

  16. REPLACEMENT OF FRENCH CARDS

    CERN Multimedia

    Human Resources Division

    2001-01-01

    The French Ministry of Foreign Affairs has informed the Organization that it is shortly to replace all diplomatic cards, special cards and employment permits ('attestations de fonctions') now held by members of the personnel and their families. Between 2 July and 31 December 2001, these cards are to be replaced by secure, computerized equivalents. A 'personnel office' stamped photocopy of the old cards may continue to be used until 31 December 2001. For the purposes of the handover, members of the personnel must go personally to the cards office (33/1-015), between 8:30 and 12:30, in order to fill a 'fiche individuelle' form (in black ink only), which has to be personally signed by themselves and another separately signed by members of their family, taking the following documents for themselves and members of their families already in possession of a French card : A recent identity photograph in 4.5 cm x 3.5 cm format (signed on the back) The French card in their possession an A4 photocopy of the same Fre...

  17. Power Plant Replacement Study

    Energy Technology Data Exchange (ETDEWEB)

    Reed, Gary

    2010-09-30

    This report represents the final report for the Eastern Illinois University power plant replacement study. It contains all related documentation from consideration of possible solutions to the final recommended option. Included are the economic justifications associated with the chosen solution along with application for environmental permitting for the selected project for construction. This final report will summarize the results of execution of an EPC (energy performance contract) investment grade audit (IGA) which lead to an energy services agreement (ESA). The project includes scope of work to design and install energy conservation measures which are guaranteed by the contractor to be self-funding over its twenty year contract duration. The cost recovery is derived from systems performance improvements leading to energy savings. The prime focus of this EPC effort is to provide a replacement solution for Eastern Illinois University's aging and failing circa 1925 central steam production plant. Twenty-three ECMs were considered viable whose net impact will provide sufficient savings to successfully support the overall project objectives.

  18. Faster Replacement Paths

    CERN Document Server

    Williams, Virginia Vassilevska

    2010-01-01

    The replacement paths problem for directed graphs is to find for given nodes s and t and every edge e on the shortest path between them, the shortest path between s and t which avoids e. For unweighted directed graphs on n vertices, the best known algorithm runtime was \\tilde{O}(n^{2.5}) by Roditty and Zwick. For graphs with integer weights in {-M,...,M}, Weimann and Yuster recently showed that one can use fast matrix multiplication and solve the problem in O(Mn^{2.584}) time, a runtime which would be O(Mn^{2.33}) if the exponent \\omega of matrix multiplication is 2. We improve both of these algorithms. Our new algorithm also relies on fast matrix multiplication and runs in O(M n^{\\omega} polylog(n)) time if \\omega>2 and O(n^{2+\\eps}) for any \\eps>0 if \\omega=2. Our result shows that, at least for small integer weights, the replacement paths problem in directed graphs may be easier than the related all pairs shortest paths problem in directed graphs, as the current best runtime for the latter is \\Omega(n^{2.5...

  19. Power Plant Replacement Study

    Energy Technology Data Exchange (ETDEWEB)

    Reed, Gary

    2010-09-30

    This report represents the final report for the Eastern Illinois University power plant replacement study. It contains all related documentation from consideration of possible solutions to the final recommended option. Included are the economic justifications associated with the chosen solution along with application for environmental permitting for the selected project for construction. This final report will summarize the results of execution of an EPC (energy performance contract) investment grade audit (IGA) which lead to an energy services agreement (ESA). The project includes scope of work to design and install energy conservation measures which are guaranteed by the contractor to be self-funding over its twenty year contract duration. The cost recovery is derived from systems performance improvements leading to energy savings. The prime focus of this EPC effort is to provide a replacement solution for Eastern Illinois University’s aging and failing circa 1925 central steam production plant. Twenty-three ECMs were considered viable whose net impact will provide sufficient savings to successfully support the overall project objectives.

  20. Comparison of intraoperative radiation therapy-containing multimodality treatment with historical treatment modalities for locally recurrent rectal cancer

    NARCIS (Netherlands)

    Mannaerts, GHH; Rutten, HJT; Martijn, H; Hanssens, PEJ; Wiggers, T

    2001-01-01

    PURPOSE: Treatment protocols for patients with locally recurrent rectal cancer have changed in the last two decades. Subsequently, treatment goals shifted from palliation to possible cure. In this retrospective study, we explored the treatment variables that may have contributed to the improvement i

  1. Alternatives to testosterone replacement: testosterone restoration.

    Science.gov (United States)

    McCullough, Andrew

    2015-01-01

    The European Male Aging Study has demonstrated that the hypogonadism of male aging is predominantly secondary. Theoretically with appropriate stimulation from the pituitary, the aging testis should be able to produce eugonadal levels of testosterone. The strategies for the treatment of late onset hypogonadism (LOH) have focused on replacement with exogenous testosterone versus restoration of endogenous production. The purpose of this article is to review existing peer-reviewed literature supporting the concept of restoration of endogenous testosterone in the treatment of LOH.

  2. Efficacy comparison of precise and traditional liver resection in treatment of intrahepatic bile duct stones

    Directory of Open Access Journals (Sweden)

    ZHANG Shengjun

    2015-10-01

    Full Text Available ObjectiveTo compare the efficacy of precise and traditional liver resection in the treatment of intrahepatic bile duct stones. MethodsOne hundred and twenty-seven patients with intrahepatic bile duct stones who were treated with surgery in our hospital from December 2008 to December 2014 were selected and divided into precise liver resection group (n=72 and traditional liver resection group (n=55 based on the type of surgery. The operation time, intraoperative blood loss, amount of postoperative drainage, postoperative time to recovery, postoperative complications (incision infection, biliary fistula, lung infection, and pleural effusion, hospitalization cost, postoperative residual calculi, and postoperative calculus recurrence were compared between the two groups. Between-group comparison of continuous data was made by t test, and between-group comparison of categorical data was made by χ2 test. Survival data were analyzed using survival function. ResultsThere were significant differences in operation time, intraoperative blood loss, amount of postoperative drainage, postoperative time to recovery, and hospitalization cost between the precise liver resection group and the traditional liver resection group (t=3.720, 58.681, 19.169, 5.990, and 6.944; all P<0.05. There were no significant differences in postoperative complications including incision infection, biliary fistula, lung infection, and pleural effusion between the two groups (all P>0.05. There were also no significant differences in the incidence rates of postoperative residual calculi and calculus recurrence between the two groups (all P>0.05. The survival analysis of postoperative calculus recurrence time showed that there was no significant difference in calculus recurrence time between the two groups (P>0.05. ConclusionCompared with traditional liver resection, precise liver resection has the advantages of shorter operation time, less intraoperative bleeding, less

  3. 植物雌激素与雌激素替代疗法对女性冠心病影响的此较%Comparison of Phytoestrogens and Estrogen Replacement Therapy to Famale Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    曾俊杰; 钟栩; 王晨

    2011-01-01

    综合分析近年来国内外相关文献,比较植物雌激素与雌激素替代疗法的作用及副作用,以期对寻找传统中医药途径替代雌激素治疗的研究者们有所帮助.%To compare phytoestrogen and estrogen replacement therapy and side effects,by comprehensive analysis domestic and foreign literature in recent years,in order to find traditional Chinese way of estrogen replacement therapy

  4. 二尖瓣置换术后远期功能性三尖瓣关闭不全的外科治疗%Surgical treatment of late functional tricuspid regurgitation after mitral valve replacement

    Institute of Scientific and Technical Information of China (English)

    梅举; 张宝仁; 郝家骅; 朱家麟; 徐志云; 邹良健

    2001-01-01

    Objective: To report the results and role of surgical treatment of functional tricuspid regurgitation (TR) late after mitral valve replacement (MVR). Methods: There were thirty-seven patients with moderate to severe functional TR after MVR. Prior MVR was performed with mechanical valve in 24 cases and biological valve in 13. 11 patients received medical therapy, and 26 surgical treatment. The types of surgery included MVR and tricuspid valve replacement in 3 and tricuspid valve annuloplasty in 10. Three different methods of tricuspid valve annuloplasty were used for correction of TR, including modified Kay annuloplasty in 12 cases and modified DeVega annuloplasty in 7 and tricuspid valve ring annuloplasty in 2. Results: Six of 11 patients who received medical therapy died within 7 months to 7.5 years and the mortality rate was 54.5%. Two of 26 patients who received surgical treatment died early after operation and the hospital mortality rate was 7.7%. The 24 survivors were followed up from 8 months to 10.5 years and there was one late death and 2 had moderate functional TR. Conclusions: The irreversible right heart impairment and/or servere pulmonary hypertension are responsible for the development of late functional TR after MVR. The surgical management of the TR, which include tricuspid valve replacement and tricuspid valve annuloplasty may achieve excellent results in the patients with significant clinical symptoms and preserved left ventricular functions.%目的 报告二尖瓣置换(MVR)术后远期三尖瓣关闭不全(TR)外科治疗的结果及作用。方法 37例MVR术后中重度TR病人,其中人工二尖瓣为生物瓣者13例,机械瓣24例。有11例行内科保守治疗,26例行外科手术治疗。手术类型:MVR加三尖瓣置换2例,MVR加三尖瓣成形11例,三尖瓣置换3例,三尖瓣成形10例。三尖瓣成形术包括改良Kay成形术12例,改良DeVega成形术7例,加成形环的三尖瓣成形术2

  5. Treatment of traumatic proximal interphalangeal joint defect with artificial joint replacement%人工关节置换治疗创伤性手指近侧指间关节缺损

    Institute of Scientific and Technical Information of China (English)

    郭翱; 郑良军; 李俊; 金岩泉; 蔡灵敏; 潘方强

    2012-01-01

    目的 探讨人工关节假体置换治疗创伤性近侧指间关节缺损畸形的可行性,评价其术后疗效. 方法 自2007年9月至2010年11月,对10例创伤性近侧指间关节缺损畸形病例二期行人工关节置换术,示指5例,中指4例,环指1例,其中再造手指1例. 结果 10例患者手术顺利,伤口一期愈合,术中、术后未发生任何并发症.所有患者均获8个月到3年的随访,置换的近侧假体关节外观和运动功能良好,伸屈活动范围50°~ 80°.根据中华医学会手外科学会上肢部分功能评定试用标准评定,本组10例手功能评定:优6例,良3例,可1例. 结论 人工关节假体置换治疗创伤性手指近侧指间关节缺损畸形具有手术操作简便、创伤小、恢复快的优点,是一种较为有效的新方法.%Objective To investigate the treatment efficacy of traumatic proximal interphalangeal (PIP)joint defects with prosthetic replacement. Methods From September 2007 to November 2010, ten patients with joint defect injuries were treated by joint prosthetic replacement (5 index fingers,4 middle fingers,and 1 ring finger),including a reconstructed middle finger.Joint motion range and postoperative pain of all cases were measured to evaluate the treatment. Results All cases went through a smooth operation with primary wound healing,and with neither intraoperative nor postoperative complications happened.The follow-up period was range from 8 months to 2 years.The active motion arcs of PIP joints ranged from 50° to 80°,and satisfactory appearances as well. According to assessment standard of upper extremity described by Chinese Hand Surgery Association,the treatment outcome were excellent in 6 fingers,good in 3 fingers,general in 1 finger.Conclusion Joint prosthetic replacement is a new effective method to treat traumatic proximal interphalangeal joint defect,which is a simple operation with advantages of little trauma and rapid recovery.

  6. Walking function follow up in near future after treatment of senile femoral neck fracture with bony cemented artificial hip replacement%骨水泥型人工髋关节置换治疗老年股骨颈骨折术后近期行走功能随访

    Institute of Scientific and Technical Information of China (English)

    胡明鉴; 郑晨希; 张玉鑫; 石化洋; 陈伶; 马红兵; 刘强; 龚文斌; 蒋伟

    2002-01-01

    Objective To investigate the effect of cemented artificial hip replacement in the treatment of senile femoral neck fracture.Method Follow up the 18 patients with senile femoral neck fracture who received bony cemented artificial hip replacement during January 1999 to September 2001.Mean following- up duration:15.7 months(3~ 23).Result Harris score:15 cases got excellent result,3 cases got good result,none got fair result.Total X ray plain film:Position of prothesis was normal with no loosing,heterotopic ossification or dislocation. Conclusion (1)Variant cemented artificial hip replacements all have satisfying effect in near future.(2)It is feasible for patients with poor economic condition to choose native prothesis in arthroplasty.(3)Di- polar artificial thigh bone replacement is a better choice for weak patient with great age.

  7. Differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement: a finite element study

    NARCIS (Netherlands)

    Jonbergen, H.P. van; Innocenti, B.; Gervasi, G.L.; Labey, L.; Verdonschot, N.J.

    2012-01-01

    BACKGROUND: Patellofemoral joint replacement is a successful treatment option for isolated patellofemoral osteoarthritis. However, results of later conversion to total knee replacement may be compromised by periprosthetic bone loss. Previous clinical studies have demonstrated a decrease in distal fe

  8. The application of special Specially-made prosthetic replacement in limb salvage treatment of patients with bone tumors%肿瘤型人工关节在恶性骨肿瘤保肢中的应用

    Institute of Scientific and Technical Information of China (English)

    吴延义

    2012-01-01

    Objective To evaluate the application of tumor type prosthetic replacement in limb salvage treated of malignant bone tumors. Methods Since January 2005 to December 2009,9 patients who with malignant bone tumor through biopsy confirmed were treated with tumor type prosthetic replacement were reviewed. Cancer staging according to Enneking,IB period were 3 cases, ⅡA period were 2 cases and II B period were 4 cases. Their effect, function, complications and treatment were analysed by using of tumor type prosthetic replacement. Result The results of the 9 cases had been follow-up and a total of 1 cases had been complications . One cases with cancer recurrence and one case with limb amputations caused embolization had supplemented in late days. Following up 3 ~ 59 months, an average of 28 months, Malignant tumors in patients with end-salvage rate was 94.4% and good result in functional assessment rate was 88. 9% . The artificial semi-pelvis had worst. Conclusion Tumor type prosthetic replacement can be used in malignant salvage; but it should be combined with chemo- therapy,the correct choice of indications,improving design,fixed and soft tissue reconstruction,preventing complications.%目的 探讨人工关节在四肢恶性骨肿瘤保肢术中的应用价值.方法 自2005年1月至2009年12月,分析对该院收治的经病理活检确诊的9例恶性骨肿瘤的患者,肿瘤按照Enneking分期,IB期3例,ⅡA期2例,ⅡB期4例,采用肿瘤型人工关节置换术后的效果、功能、并发症及处理.结果 9例患者皆获随访,共发生并发症1例,其中术后复发1例,栓塞致肢体截肢1例.随访3~59个月,平均28个月.恶性骨肿瘤患者最终保肢率为94.4%,功能评定优良率为88.9%,半骨盆人工关节功能最差.结论 人工关节置换术可用于恶性的保肢治疗;但应联合辅助化疗,正确选择适应证,改进假体设计、固定及软组织重建方式,预防并发症.

  9. Customized artificial prosthesis replacement for treatment of giant cell tumors of bone near the joints%定制人工假体置换治疗近关节部位骨巨细胞瘤

    Institute of Scientific and Technical Information of China (English)

    陈飚; 王全; 赵春和

    2015-01-01

    目的:评价定制人工假体置换治疗近关节部位骨巨细胞瘤的疗效。方法对近关节部位骨巨细胞瘤42例行瘤段切除、定制人工假体置换治疗。其中37例行旋转铰链型人工膝关节假体置换,3例行人工肱骨头置换,2例行加长柄双动性股骨头置换。结果42例患者均获随访,时间12~96个月,无局部复发或远处转移。术后6个月MSTS评分为16~28(24.0±2.34)分,肢体功能优31例,良8例,中3例,优良率为92.8%。结论定制人工假体置换是治疗近关节部位骨巨细胞瘤的有效方法,能减少局部复发,提高临床效果。%Objective To evaluate the clinical effect of customized artificial prosthesis replacement for treatment of gi-ant cell tumors of bone near the joints. Methods 42 patients with giant cell tumors of bone near the joints were trea-ted with en block excision and reconstruction with customized artificial prosthesis. The type of the prostheses was as follow:37 rotating hinge knee prosthesis, 3 artificial humeral head, 2 long stem femoral head. Results According to the follow-up for 12~96 months, 42 patients had no local recurrence or metastasis. The Musculoskeletal Tumor So-ciety (MSTS) score was 16~28(24. 0 ± 2. 34), with an excellent limb function in 31 patients, good in 8, fair in 3. The excellent and good rate was 92. 8%. Conclusions Customized artificial prosthesis replacement is an effective method for treatment of giant cell tumors of bone near the joints. It also can reduce the local recurrence and provide better outcomes.

  10. The application of customized artificial prosthesis replacement in the treatment of patients of proximal femur tumor%定制人工假体置换治疗股骨近端骨肿瘤

    Institute of Scientific and Technical Information of China (English)

    陈飚; 王全; 赵春和

    2011-01-01

    Objective To evaluate the clinical effect of customized artificial prosthesis replacement for treatment of proximal femur tumor. Methods 30 patients with proximal femur tumor had been treated with en block excision and reconstruction with customized artificial prosthesis. The type of the prostheses was as follow: 21 long stem femoral head, 9 total hip prosthesis. The functional outcomes were evaluated according to Musculoskeletal Tumor Society 93 ( MSTS 93 ) score in 6 months after surgery. Results According to the follow-up for 12 to 36 months, 30 patients had no complication with infection, loosening and dislocation of the prosthesis, and fracture around the prosthesis. The mean MSTS 93 score was ( 26. 0 ±2. 14 ), with an excellent limb function in 15 patients, good in 12 patients, and fair in 3 patients. The overall excellent and good function was obtained in 90% of the patients. 2 patients had died in 13 months and in 15 months after surgery. Conclusions Customized artificial prosthesis replacement is an effective method for treatment of proximal femur tumor. It also can obtain good postoperative function.%目的 评价定制人工假体置换治疗股骨近端骨肿瘤的疗效.方法 对股骨近端骨肿瘤30例行瘤段切除、定制人工假体置换治疗.其中21例行加长柄双动性股骨头置换,9例行加长柄全髋置换.术后6个月功能评价采用MSTS 93评分.结果 30例均获随访,时间12~36个月.无感染、假体松动、假体脱位、假体周围骨折等并发症发生.术后6个月MSTS 93评分平均为(26.0±2.14)分;肢体功能:优15例,良12例,中3例,优良率为90%.2例于术后13、15个月死亡.结论 定制人工假体置换是治疗股骨近端骨肿瘤的有效方法,术后髋关节功能良好.

  11. Toleration, Synthesis or Replacement?

    DEFF Research Database (Denmark)

    Holtermann, Jakob v. H.; Madsen, Mikael Rask

    2016-01-01

    to have considerable problems keeping a clear focus on the key question: What are the implications of this empirical turn in terms of philosophy of legal science, of the social understanding of IL, and, not least, of the place of doctrinal scholarship after the alleged Wende? What is needed, we argue......, in order to answer is not yet another partisan suggestion, but rather an attempt at making intelligible both the oppositions and the possibilities of synthesis between normative and empirical approaches to law. Based on our assessment and rational reconstruction of current arguments and positions, we...... therefore outline a taxonomy consisting of the following three basic, ideal-types in terms of the epistemological understanding of the interface of law and empirical studies: toleration, synthesis and replacement. This tripartite model proves useful with a view to teasing out and better articulating...

  12. Acute Kidney Injury and Renal Replacement Therapy in Burns

    Directory of Open Access Journals (Sweden)

    Burak Canver

    2011-07-01

    Full Text Available Acute kidney injury (AKI is a common complication in patients with severe burn injury and one of the major causes of death. It has a negative prognostic value and almost always develops in the context of multiple organ dysfunction syndrome (MODS induced by sepsis. Over the last 20 years, according to data avaliable, the mortality rate has been reported to reach about 75%. Several definitions of AKI have been used , but nowadays the RIFLE classification is considered the gold standard, enabling a more objective comparison of populations. There are several ways to treat AKI in burn patients, including peritoneal dialysis (PD, intermittent hemodialysis, and continuous renal replacement therapy (CRRT. CRRT is generally used in patients in whom intermittent hemodialysis has failed to control hypovolemia, as well as in patients who cannot tolerate intermittent hemodialysis. Additionally, PD is not suitable for patients with burns within the abdominal area. For these reasons, most patients with unstable hemodynamic conditions receive CRRT. In burn patients with acute renal failure the dialytic treatment with continuous renal replacement therapies permitted us to achieve a survival and dialytic adequacy; however, mortality rate is high and related to septic shock and MODS. Despite the wide variation of the analysed burn populations and definitions of AKI, this review clearly showed that AKI remains prevalent and is associated with increased mortality in patients with severe burn injury. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 46-50

  13. Comparison between Complementary Dietary Treatment of Alzheimer Disease in Iranian Traditional Medicine and Modern Medicine.

    Directory of Open Access Journals (Sweden)

    Mohammad Mahdi Ahmadian-Attari

    2013-12-01

    Full Text Available Dietary notifications have been introduced recently for Alzheimer Disease (AD. In Iranian old medical manuscripts, there are some nutritional recommendations related to Nesyan (AD equivalent. The aim of this article was to compare dietary recommendations of Iranian traditional medicine (ITM with novel medical outcomes.1 Searching for dietary recommendations and abstinences described in ITM credible manuscripts; 2 Extracting fatty components of ITM diet according to the database of the Department of Agriculture of the USA; 3 Statistical analysis of fatty elements of traditionally recommended foods via Mann-Whitney Test in comparison with elements of the abstinent ones; 4 Searching for AD dietary recommendations and abstinences which currently published in medical journals; 5 Comparing traditional and new dietary suggestions with each other.1 Traditionally recommended foods are fattier than abstinent ones (P<0.001. There are meaningful differences between unsaturated fatty acids (UFAs (P<0.001, saturated fatty acids (P<0.001, and cholesterol (P<0.05 of recommended foods and abstinent ones. 2 Traditionally recommended diet is also fattier than the abstinent diet (4.5 times; UFAs of the recommended diet is 11 times more than that of the abstinent one; it is the same story for cholesterol (1.4 times; 3 Recent studies show that diets with high amounts of UFAs have positive effects on AD; a considerable number of papers emphasizes on probable positive role of cholesterol on AD; 4 Traditional recommended diet is in agreement with recent studies.ITM recommended diet which is full of unsaturated fatty acids and cholesterol can be utilized for complementary treatment of AD.

  14. SLUDGE TREATMENT PROJECT COST COMPARISON BETWEEN HYDRAULIC LOADING AND SMALL CANISTER LOADING CONCEPTS

    Energy Technology Data Exchange (ETDEWEB)

    GEUTHER J; CONRAD EA; RHOADARMER D

    2009-08-24

    The Sludge Treatment Project (STP) is considering two different concepts for the retrieval, loading, transport and interim storage of the K Basin sludge. The two design concepts under consideration are: (1) Hydraulic Loading Concept - In the hydraulic loading concept, the sludge is retrieved from the Engineered Containers directly into the Sludge Transport and Storage Container (STSC) while located in the STS cask in the modified KW Basin Annex. The sludge is loaded via a series of transfer, settle, decant, and filtration return steps until the STSC sludge transportation limits are met. The STSC is then transported to T Plant and placed in storage arrays in the T Plant canyon cells for interim storage. (2) Small Canister Concept - In the small canister concept, the sludge is transferred from the Engineered Containers (ECs) into a settling vessel. After settling and decanting, the sludge is loaded underwater into small canisters. The small canisters are then transferred to the existing Fuel Transport System (FTS) where they are loaded underwater into the FTS Shielded Transfer Cask (STC). The STC is raised from the basin and placed into the Cask Transfer Overpack (CTO), loaded onto the trailer in the KW Basin Annex for transport to T Plant. At T Plant, the CTO is removed from the transport trailer and placed on the canyon deck. The CTO and STC are opened and the small canisters are removed using the canyon crane and placed into an STSC. The STSC is closed, and placed in storage arrays in the T Plant canyon cells for interim storage. The purpose of the cost estimate is to provide a comparison of the two concepts described.

  15. Comparison of Snellen and Early Treatment Diabetic Retinopathy Study charts using a computer simulation.

    Science.gov (United States)

    Shamir, Reuben R; Friedman, Yael; Joskowicz, Leo; Mimouni, Michael; Blumenthal, Eytan Z

    2016-01-01

    To compare accuracy, reproducibility and test duration for the Snellen and the Early Treatment Diabetic Retinopathy Study (ETDRS) charts, two main tools used to measure visual acuity (VA). A computer simulation was programmed to run multiple virtual patients, each with a unique set of assigned parameters, including VA, false-positive and false-negative error values. For each virtual patient, assigned VA was randomly chosen along a continuous scale spanning the range between 1.0 to 0.0 logMAR units (equivalent to 20/200 to 20/20). Each of 30 000 virtual patients were run ten times on each of the two VA charts. Average test duration (expressed as the total number of characters presented during the test ±SD) was 12.6±11.1 and 31.2±14.7 characters, for the Snellen and ETDRS, respectively. Accuracy, defined as the absolute difference (± SD) between the assigned VA and the measured VA, expressed in logMAR units, was superior in the ETDRS charts: 0.12±0.14 and 0.08±0.08, for the Snellen and ETDRS charts, respectively. Reproducibility, expressed as test-retest variability, was superior in the ETDRS charts: 0.23±0.17 and 0.11±0.09 logMAR units, for the Snellen and ETDRS charts, respectively. A comparison of true (assigned) VA to measured VA, demonstrated, on average, better accuracy and reproducibility of the ETDRS chart, but at the penalty of significantly longer test duration. These differences were most pronounced in the low VA range. The reproducibility using a simulation approach is in line with reproducibility values found in several clinical studies.

  16. Comparison of Snellen and Early Treatment Diabetic Retinopathy Study charts using a computer simulation

    Directory of Open Access Journals (Sweden)

    Reuben R. Shamir

    2016-01-01

    Full Text Available AIM: To compare accuracy, reproducibility and test duration for the Snellen and the Early Treatment Diabetic Retinopathy Study (ETDRS charts, two main tools used to measure visual acuity (VA. METHODS: A computer simulation was programmed to run multiple virtual patients, each with a unique set of assigned parameters, including VA, false-positive and false-negative error values. For each virtual patient, assigned VA was randomly chosen along a continuous scale spanning the range between 1.0 to 0.0 logMAR units (equivalent to 20/200 to 20/20. Each of 30 000 virtual patients were run ten times on each of the two VA charts. RESULTS: Average test duration (expressed as the total number of characters presented during the test ±SD was 12.6±11.1 and 31.2±14.7 characters, for the Snellen and ETDRS, respectively. Accuracy, defined as the absolute difference (± SD between the assigned VA and the measured VA, expressed in logMAR units, was superior in the ETDRS charts: 0.12±0.14 and 0.08±0.08, for the Snellen and ETDRS charts, respectively. Reproducibility, expressed as test-retest variability, was superior in the ETDRS charts: 0.23±0.17 and 0.11±0.09 logMAR units, for the Snellen and ETDRS charts, respectively. CONCLUSION: A comparison of true (assigned VA to measured VA, demonstrated, on average, better accuracy and reproducibility of the ETDRS chart, but at the penalty of significantly longer test duration. These differences were most pronounced in the low VA range. The reproducibility using a simulation approach is in line with reproducibility values found in several clinical studies.

  17. Dosimetric analysis and comparison of IMRT and HDR brachytherapy in treatment of localized prostate cancer.

    Science.gov (United States)

    Murali, V; Kurup, P G G; Mahadev, P; Mahalakshmi, S

    2010-04-01

    Radical radiotherapy is one of the options for the management of prostate cancer. In external beam therapy, 3D conformal radiotherapy (3DCRT) and intensity modulated radiotherapy (IMRT) are the options for delivery of increased radiation dose, as vital organs are very close to the prostate and a higher dose to these structures leads to an increased toxicity. In brachytherapy, low dose rate brachytherapy with permanent implant of radioactive seeds and high dose rate brachytherapy (HDR) with remote after loaders are available. A dosimetric analysis has been made on IMRT and HDR brachytherapy plans. Ten cases from each IMRT and HDR brachytherapy have been taken for the study. The analysis includes comparison of conformity and homogeneity indices, D100, D95, D90, D80, D50, D10 and D5 of the target. For the organs at risk (OAR), namely rectum and bladder, V100, V90 and V50 are compared. In HDR brachytherapy, the doses to 1 cc and 0.1 cc of urethra have also been studied. Since a very high dose surrounds the source, the 300% dose volumes in the target and within the catheters are also studied in two plans, to estimate the actual volume of target receiving dose over 300%. This study shows that the prescribed dose covers 93 and 92% of the target volume in IMRT and HDR brachytherapy respectively. HDR brachytherapy delivers a much lesser dose to OAR, compared to the IMRT. For rectum, the V50 in IMRT is 34.0cc whilst it is 7.5cc in HDR brachytherapy. With the graphic optimization tool in HDR brachytherapy planning, the dose to urethra could be kept within 120% of the target dose. Hence it is concluded that HDR brachytherapy may be the choice of treatment for cancer of prostate in the early stage.

  18. Comparison of pneumatic dilation with pneumatic dilation plus botulinum toxin for treatment of achalasia.

    Science.gov (United States)

    Bakhshipour, Alireza; Rabbani, Romina; Shirani, Shapoor; Soleimani, Hosein A S L; Mikaeli, Javad

    2010-01-01

    Among the therapeutic options for achalasia are pneumatic dilatation (PD), an appropriate long-term therapy, and botulinum toxin injection (BT) that is a relatively short-term therapy. This study aimed to compare therapeutic effect of repetitive pneumatic dilation with a combined method (botulinum toxin injection and pneumatic dilation) in a group of achalasia patients who are low responder to two initial pneumatic dilations. Thirty-four patients with documented primary achalasia that had low response to two times PD (pneumatic dilation (n=18) or botulinum toxin injection and pneumatic dilation by four weeks interval (n=16), PD and BT+PD groups respectively. Symptom scores were evaluated before and at 1, 6 and 12 months after treatment. Clinical remission was defined as a decrease in symptom score > or = 50% of baseline. There were no significant differences between the two groups in gender, age and achalasia type. Remission rate of patients in BT-PD group in comparison with PD group were 87.5% vs. 67.1% (P = 0.7), 87.5% vs. 61.1% (P = 0.59) and 87.5% vs. 55.5% (P = 0.53) at 1, 6 and 12 months respectively .There were no major complications in either group. The mean symptom score decreased by 62.71% in the BT-PD group (P first year. Despite a better response rate in BT+PD group, a difference was not statistically significant. A difference may be meaningful if a large numbers of patients are included in the study.

  19. Comparison of Pneumatic Dilation with Pneumatic Dilation Plus Botulinum Toxin for Treatment of Achalasia

    Directory of Open Access Journals (Sweden)

    Alireza Bakhshipour

    2010-03-01

    Full Text Available Among the therapeutic options for achalasia are pneumatic dilatation (PD, an appropriate long-term therapy, and botulinum toxin injection (BT that is a relatively short-term therapy. This study aimed to compare therapeutic effect of repetitive pneumatic dilation with a combined method (botulinum toxin injection and pneumatic dilation in a group of achalasia patients who are low responder to two initial pneumatic dilations. Thirty- four patients with documented primary achalasia that had low response to two times PD (<50% decrease in symptom score and barium height at 5 minute in timed esophagogram after 3month of late PD were randomized to receive pneumatic dilation (n=18 or botulinum toxin injection and pneumatic dilation by four weeks interval (n=16, PD and BT+PD groups respectively. Symptom scores were evaluated before and at 1, 6 and 12 months after treatment. Clinical remission was defined as a decrease in symptom score ≥ 50% of baseline. There were no significant differences between the two groups in gender, age and achalasia type. Remission rate of patients in BT-PD group in comparison with PD group were 87.5% vs. 67.1% (P = 0.7, 87.5% vs. 61.1% (P = 0.59 and 87.5% vs. 55.5% (P = 0.53 at 1, 6 and 12 months respectively .There were no major complications in either group. The mean symptom score decreased by 62.71% in the BT-PD group (P < 0.002 and 50.77% in the PD group (P < 0.01 at the end of the first year. Despite a better response rate in BT+PD group, a difference was not statistically significant. A difference may be meaningful if a large numbers of patients are included in the study.

  20. Dosimetric analysis and comparison of IMRT and HDR brachytherapy in treatment of localized prostate cancer

    Directory of Open Access Journals (Sweden)

    Murali V

    2010-01-01

    Full Text Available Radical radiotherapy is one of the options for the management of prostate cancer. In external beam therapy, 3D conformal radiotherapy (3DCRT and intensity modulated radiotherapy (IMRT are the options for delivery of increased radiation dose, as vital organs are very close to the prostate and a higher dose to these structures leads to an increased toxicity. In brachytherapy, low dose rate brachytherapy with permanent implant of radioactive seeds and high dose rate brachytherapy (HDR with remote after loaders are available. A dosimetric analysis has been made on IMRT and HDR brachytherapy plans. Ten cases from each IMRT and HDR brachytherapy have been taken for the study. The analysis includes comparison of conformity and homogeneity indices, D100, D95, D90, D80, D50, D10 and D5 of the target. For the organs at risk (OAR, namely rectum and bladder, V100, V90 and V50 are compared. In HDR brachytherapy, the doses to 1 cc and 0.1 cc of urethra have also been studied. Since a very high dose surrounds the source, the 300% dose volumes in the target and within the catheters are also studied in two plans, to estimate the actual volume of target receiving dose over 300%. This study shows that the prescribed dose covers 93 and 92% of the target volume in IMRT and HDR brachytherapy respectively. HDR brachytherapy delivers a much lesser dose to OAR, compared to the IMRT. For rectum, the V50 in IMRT is 34.0cc whilst it is 7.5cc in HDR brachytherapy. With the graphic optimization tool in HDR brachytherapy planning, the dose to urethra could be kept within 120% of the target dose. Hence it is concluded that HDR brachytherapy may be the choice of treatment for cancer of prostate in the early stage.

  1. Hypertonic 3% Saline in Comparison with 0.9% (Normal Saline in Treatment of Acute Bronchiolitis

    Directory of Open Access Journals (Sweden)

    Abdul-karem Jasem Mohammed Al-bahadily

    2017-01-01

    Full Text Available BackgroundBronchiolitis is the commonest cause of lower respiratory tract infection in infant. Respiratory syncytial virus is the commonest cause of bronchiolitis. This study aimed to assess the efficacy of nebulized 3% hypertonic saline and salbutamol in the treatment of acute bronchiolitis in comparison with nebulized 0.9% saline and salbutamol.Materials and MethodsA prospective case second multicenter study was done at two pediatric tertiary centers at the period from 1st of December 2014 to 31 of March 2015. A total of 100 previously well infant and children of age 1-24 months with clinical diagnoses of bronchiolitis who were admitted to the hospital were included. They were divided into two groups, the study group received 4 ml of nebulized hypertonic 3% saline (for 14 days, and second group received 4 ml of nebulized normal 0.9% saline (for 14 days, each co-administer with 0.5 ml salbutamol.ResultsAll patients with acute bronchiolitis having similar baseline characteristic, mean age 4.9 + Standard deviation (SD months, male gender constitutes 68% of the patients and the majority (67% of the cases were below 6 months. The mean of clinical severity score at admission was 6.4 for normal saline (NS group and 6.6 for hypertonic 3% saline (HS group. The mean length of hospital stay of normal saline group = 4.3 + Standard deviation (SD day and for hypertonic saline group was = 4.7 + Standard deviation (SD day.ConclusionWe didn’t find any advantage of hypertonic 3% saline over 0.9% normal saline in terms of length of hospital stay and clinical severity score.

  2. Double Valve Replacement for Lupus Valvulitis

    Science.gov (United States)

    Ferraris, Victor A.; Hawksley, Vaughn C.; Rabinowitz, Max; Coyne, Carolyn M.; Sullivan, Thomas J.; Sprague, Merle S.

    1990-01-01

    Hemodynamically significant lupus valvulitis, requiring valve replacement, is rare: 21 cases have been reported so far in the literature, and only 2 of these have involved double valve replacement. We describe an additional case of double valve replacement in a patient with systemic lupus erythematosus. The histopathologic and clinical features of this case suggest that valvular involvement resulted from both acute and chronic disease processes. Medical success in the treatment of systemic lupus erythematosus, especially that achieved through prolonged or high-dose steroid therapy, may cause chronic valvular disease to become a more common surgical problem. A review of the literature supports this contention. (Texas Heart Institute Journal 1990;17:56-60) Images PMID:15227191

  3. 曲唑酮治疗老年苯二氮卓类药物依赖患者临床观察%A clinical study of trazodone replacement treatment on benzodiazepine drugs dependence in senile patient

    Institute of Scientific and Technical Information of China (English)

    肖立群; 廉鹏; 张旺信; 梁田; 周瑞兰

    2012-01-01

    目的 探讨曲唑酮对老年苯二氮卓类药物(BZD)依赖患者替代治疗的疗效及对认知功的影响.方法 对51例老年BZD依赖患者采用剂量快速递减、曲唑酮替代疗法,14d内停用BZD,之后睡前顿服曲唑酮,连服6个月.采用匹兹堡睡眠质量指数(PSQJ)量表和副反应量表(TESS)评定临床疗效和不良反应.选用韦氏成人智力量表( WAIS-RC)、韦氏成人记忆量表(WMS-RC)评定认知功能.疗效和不良反应于治疗前后评定;认知功能于治疗前后各评定1次.结果 PSQJ总分[(13.17 ±3.70)分,(11.05±3.48)分]、睡眠质量[(2.36±0.33)分,(1.91 ±0.29)分]、睡眠障碍、日间功能障碍分疗后低于疗前(P<0.05),其他成份分无差异.曲唑酮副反应少而轻,更无依赖发生.认知功能中的知识、算术、数字符号、木块拼图、长时记忆、短时记忆、即刻记忆及记忆商数分方面疗前均低于疗后(P<0.05).结论 曲唑酮可作为老年失眠患者的理想药物.%Objective To explore the efficacy of trazodone replacement treatment on benzodiazepine drugs dependence and effect of cognitive function on senile patients.Methods 51 senile patients with benzodiazepine drugs dependence were assigned with dosage tacho-decrement and replaced by trazodone.The patients were discontinuanced taking benzodiazepine in 14 days and taken at a draught of trazodone before retiring about 6 months.Clinical effect and side effects were assessed with the Pittsburgh sleep quality index (PSQJ) and treatment emergent symptom scale(TESS) before and after treatment.Cognitive function was evaluated with Wechsler intelligence scale for adult-Chinese revised (WAIS-RC) and Wechsler mermory scale for adult-Chinese revised ( WMS-RC ) once before and after treatment.Results The scores total PSQJ( ( 13.17 ± 3.70),( 11.05 ± 3.48 ) ),the sleep quality( (2.36 ± 0.33 ),( 1.91 ± 0.29 ) ),daily function disorder,sleep disorder were significantly lower than before treatment

  4. Humeral head replacement in the treatment of 3,4 parts fracture of the proximal humerus in elderly%人工肱骨头置换治疗老年肱骨近端三、四部分骨折

    Institute of Scientific and Technical Information of China (English)

    季卫平; 李浩; 黄自强; 华以雄; 朱云龙

    2012-01-01

    Objective To explore the elderly proximal humerus 3,4 part fractures of the humeral head arthroplasty indications, techniques and postoperative rehabilitation to restore shoulder function. Methods 15 elderly cases of proximal humeral 3,4 parts fracture patients were performed humeral head replacement. Preoperative measuring health side of the greater tuberosity low to the top of the head of the humerus distance, intraoperative reset size nodules, as far as possible the reasonable control of the false body height and sloping, try to repair the damage rotator cuff, three phase planned postoperative rehabilitation treatment. Results 15 cases have been followed up, followed up for 9 ~77 months. 11 cases were completely not painful, 2 cases of joint line after a tenderness, and 1 case lift on shoulder movement, and 1 case with mild pain shoulder instability Neer score standard display, excellent in 7 patients, good in 6, and poor in 2. Conclusions For the old proximal humeral fractures serious 3 ,4 parts, especially the head shattered fracture patients, the humeral head replacement is expected to get a good curative effect of treatment. In familiar anatomical and shoulder function based on the characteristics of the operation indication, strictly grasp, follow the head of the humerus replacement process the key technology of method, should as far as possible reserves during the greater tuberosity and soft tissue belongs to, close to anatomical reattachment, repair rotator cuff injury. With planned postoperative rehabilitation training, quickly shoulder activities can be restored.%目的 探讨老年肱骨近端三、四部分骨折行人工肱骨头置换术的适应证、技术要点及术后康复治疗对肩关节功能恢复的影响.方法 对15例老年肱骨近端三、四部分骨折患者行人工肱骨头置换.术前测量健侧大结节最低点至肱骨头最高点的距离;术中尽量复位大小结节,合理控制假体高度及后倾角度,尽

  5. Comparison of esthetic outcome after extraction or non-extraction orthodontic treatment in class II division 1 malocclusion patients

    Directory of Open Access Journals (Sweden)

    Sneh Lata Verma

    2013-01-01

    Full Text Available Introduction: The extraction of premolars as a practical form of orthodontic therapy has been accepted for many years, but there remains a controversy regarding the effect of premolar extraction to improve esthetics as well as dentoskeletal relationship. The esthetic impact of the soft-tissue profile might play a major role in deciding on premolar extraction or non-extraction treatment, particularly in borderline patients. This cephalometric study was undertaken to compare the post-treatment soft-tissue profiles of successfully managed Class II, Division 1 malocclusions treated with either all first premolar extractions or treatment with a non-extraction therapy. Materials and Methods: The sample consisted of 100 post-pubertal female patients of Class II Division I malocclusion. Group 1, treated with four first premolar extractions, consisted of 50 female patients with a mean age of 14 years 1 month. Group 2, treated without extractions, consisted of 50 patients with a mean age of 13 years 5 months. Pre-treatment and post-treatment lateral cephalometric radiographs were evaluated. The pre-treatment to post-treatment stage comparison and the intergroup comparison of the treatment changes were conducted between extraction and non-extraction groups of Class II malocclusion samples with t-tests. Results: The soft-tissue facial profiles of the extraction and non-extraction samples were the same following active treatment except for a more retruded lower lip and a more pronounced lower labial sulcus in those patients subjected to extraction. Conclusions: The extraction or non-extraction decision, if based on sound diagnostic criteria, seems to have no systematic detrimental effects on the facial profile.

  6. Leptin replacement improves cognitive development.

    Directory of Open Access Journals (Sweden)

    Gilberto J Paz-Filho

    Full Text Available BACKGROUND: Leptin changes brain structure, neuron excitability and synaptic plasticity. It also regulates the development and function of feeding circuits. However, the effects of leptin on neurocognitive development are unknown. OBJECTIVE: To evaluate the effect of leptin on neurocognitive development. METHODOLOGY: A 5-year-old boy with a nonconservative missense leptin gene mutation (Cys-to-Thr in codon 105 was treated with recombinant methionyl human leptin (r-metHuLeptin at physiologic replacement doses of 0.03 mg/kg/day. Cognitive development was assessed using the Differential Ability Scales (DAS, a measure of general verbal and nonverbal functioning; and selected subtests from the NEPSY, a measure of neuropsychological functioning in children. PRINCIPAL FINDINGS: Prior to treatment, the patient was morbidly obese, hypertensive, dyslipidemic, and hyperinsulinemic. Baseline neurocognitive tests revealed slower than expected rates of development (developmental age lower than chronological age in a majority of the areas assessed. After two years, substantial increases in the rates of development in most neurocognitive domains were apparent, with some skills at or exceeding expectations based on chronological age. We also observed marked weight loss and resolution of hypertension, dyslipidemia and hyperinsulinemia. CONCLUSIONS: We concluded that replacement with r-metHuLeptin is associated with weight loss and changes in rates of development in many neurocognitive domains, which lends support to the hypothesis that, in addition to its role in metabolism, leptin may have a cognitive enhancing role in the developing central nervous system. TRIAL REGISTRATION: ClinicalTrials.gov NCT00659828.

  7. Comparison of subthreshold diode laser micropulse therapy versus conventional photocoagulation laser therapy as primary treatment of diabetic macular edema

    OpenAIRE

    Farhad Fazel; Majid Bagheri; Khodayar Golabchi; Hamidreza Jahanbani Ardakani

    2016-01-01

    Purpose: The aim of the present study was to investigate the effect of subthreshold diode laser micropulse (SDM) in comparison with conventional laser photocoagulation in the treatment of the diabetic macular edema (DME). Methods: Sixty-eight eyes from 68 patients with clinically significant DME were divided randomly into two equal groups. In the first group, SDM photocoagulation was employed, while conventional laser photocoagulation was performed on the eyes of the second group. Central ...

  8. Chinese medicine treatment of deep venous thrombosis of the lower extremity after artificial joint replacement%人工关节置换后中医药治疗下肢深静脉血栓形成

    Institute of Scientific and Technical Information of China (English)

    吴正林

    2012-01-01

    BACKGROUND: The incidence of lower extremity deep venous thrombosis is high after artificial joint replacement and mainly caused by intimal damage, slow blood flow velocity and blood hypercoagulable state.OBJECTIVE: To evaluate the preventive and therapeutic effects of Chinese medicine on the lower extremity deep venous thrombosis after artificial joint replacement.METHODS: A computer-based online search was performed for the articles from January 1989 to October 2011 with the key words of “Chinese medicine, lower extremity deep venous thrombosis, prevention and treatment, artificial joint replacement”. The articles that related with the Chinese medicine for the treatment of lower extremity deep venous thrombosis after artificial joint replacement were included; the repeat studies or Meta-analysis articles were excluded. A total of 26 articles were included to review.RESULTS AND CONCLUSION: For the treatment of lower extremity deep venous thrombosis, the main treatment methods include functional exercise, the pressure gradient therapy, and the thrombolytic and anticoagulant therapy. In recent years, the Chinese medicine shows a good effect in the treatment of lower extremity deep venous thrombosis and the main Chinese medicine include salvia miltiorrhiza, ligustrazine and astragalus mongholicus. Some Chinese herbal compound with the effect of promoting blood circulation also has a role in the prevention of lower extremity deep venous thrombosis. It demonstrates that Chinese medicine shows a good effect both on the prevention and treatment of lower extremity deep venous thrombosis with less adverse reaction. Chinese and Western medicine combined with functional exercise is an effective means for the prevention and treatment of lower extremity deep venous thrombosis.%背景 人工关节置换后下肢深静脉血栓形成的发病率较高,主要原因包括血管内膜受损、血流速度缓慢及血液呈高凝状态3个方面.目的 评价中医药在防

  9. Comparison of ion exchange and cw CO2 laser treatment of Nd-doped phosphate laser glass

    Science.gov (United States)

    Hui, Gong; Chengfu, Li

    1996-05-01

    In recent years, the effect of laser pre-irradiation and ion exchange on glasses surface were widely carried out to stabilize their damage thresholds. But comparison of ion exchange and CW CO2 laser treatment is never studied, this paper is devoted to the investigation of this question. Nd-doped phosphate laser glasses were heated with CW CO2 laser radiation and were strengthened by ion exchange. Laser damage thresholds of the surface were measured with 1064 nm 10 ns pulses focused to small spots irradiation. Both ion exchange treatment and CW CO2 laser treatment result in residual compress stress occurred at surface, peak-to- volley and microcracks decreased in surface appearance, and damage thresholds of surfaces increased by a factor of over 2. Polariscope, reflected optical microscope and atomic force microscope are used for stress, damage morphologies and surface topography analysis on glass surface. It is shown that laser condition mechanism is consistent with ion exchange treatment mechanism.

  10. Relapsing hypocupraemic myelopathy requiring high‐dose oral copper replacement

    OpenAIRE

    Prodan, C.I.; Bottomley, S S; Holland, N R; Lind, S. E.

    2006-01-01

    Adult‐onset copper deficiency with neurological manifestations is a newly recognised syndrome. Long‐term oral copper replacement therapy has been the mainstay of treatment in the literature. A case of relapsing hypocupraemic myelopathy responsive to increased doses of copper replacement is reported. Standard doses of copper may not be sufficient for all patients.

  11. A Comparison of Risperidone and Buspirone for Treatment of Behavior Disorders in Children with Phenylketonuria

    Directory of Open Access Journals (Sweden)

    Afshin FAYYAZI

    2014-12-01

    Full Text Available How to Cite This Article: Fayyazi A, Salari E, Khajeh A, Ghajarpour A. A Comparison of Risperidone and Buspirone for Treatment ofBehavior Disorders in Children with Phenylketonuria. Iran J Child Neurol. 2014 Autumn; 8(4:33-38.AbstractObjectiveMany patients with late-diagnosed phenylketonuria (PKU suffer from severe behavior problems. This study compares the effects of buspirone and risperidone on reducing behavior disorders in these patients.Materials & MethodsIn this crossover clinical trial study, patients with severe behavior disorders after medical examination were randomly divided into two groups of two 8-week crossover treatments with risperidone or buspirone. Patient behavioral disorders before and after treatment by each drug was rated by parents on the Nisonger Child Behavior Rating Form (NCBRF, and after treatment by each drug, were assessed by a physician through clinical global impression (CGI.ResultsThirteen patients were able to complete the therapy period with these two medications.The most common psychiatric diagnoses were intellectual disability accompanied by pervasive developmental disorder NOS, and intellectual disability accompanied by autistic disorder. Risperidone was significantly effective in reducing the NCBRF subscales of hyperactivity disruptive/ stereotypic, and conduct problems. Treatment by buspirone only significantly decreased the severity of hyperactivity, but other behavior aspects showed no significant differences. Assessment of the severity of behavior disorder after treatment by risperidone and buspirone showed significant differences in reducing hyperactivity and masochistic/stereotype.ConclusionAlthough buspirone is effective in controlling hyperactivity in patients with PKU, it has no preference over risperidone. Therefore, it is recommended as an alternative to risperidone.ReferencesSmith I, Nowles JK. Behaviour in early treated phenylketonuria: a systematic review. Eur J Pediatr 2000;159:89-93.Targum SD

  12. Analysis of data from the ERA-EDTA Registry indicates that conventional treatments for chronic kidney disease do not reduce the need for renal replacement therapy in autosomal dominant polycystic kidney disease.

    Science.gov (United States)

    Spithoven, Edwin M; Kramer, Anneke; Meijer, Esther; Orskov, Bjarne; Wanner, Christoph; Caskey, Fergus; Collart, Frederic; Finne, Patrik; Fogarty, Damian G; Groothoff, Jaap W; Hoitsma, Andries; Nogier, Marie-Béatrice; Postorino, Maurizio; Ravani, Pietro; Zurriaga, Oscar; Jager, Kitty J; Gansevoort, Ron T

    2014-12-01

    Autosomal dominant polycystic kidney disease (ADPKD) is a major cause of end-stage kidney failure, but is often identified early and therefore amenable to timely treatment. Interventions known to postpone the need for renal replacement therapy (RRT) in non-ADPKD patients have also been tested in ADPKD patients, but with inconclusive results. To help resolve this we determined changes in RRT incidence rates as an indicator for increasing effective renoprotection over time in ADPKD. We analyzed data from the European Renal Association-European Dialyses and Transplant Association Registry on 315,444 patients starting RRT in 12 European countries between 1991 and 2010, grouped into four 5-year periods. Of them, 20,596 were due to ADPKD. Between the first and last period the mean age at onset of RRT increased from 56.6 to 58.0 years. The age- and gender-adjusted incidence rate of RRT for ADPKD increased slightly over the four periods from 7.6 to 8.3 per million population. No change over time was found in the incidence of RRT for ADPKD up to age 50, whereas in recent time periods the incidence in patients above the age of 70 clearly increased. Among countries there was a significant positive association between RRT take-on rates for non-ADPKD kidney disease and ADPKD. Thus, the increased age at onset of RRT is most likely due to an increased access for elderly ADPKD patients or lower competing risk prior to the start of RRT rather than the consequence of effective emerging renoprotective treatments for ADPKD.

  13. Partial knee replacement

    Science.gov (United States)

    ... al. American Academy of Orthopaedic Surgeons. Treatment of osteoarthritis of the knee (nonarthroplasty). J Am Acad ... Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, ...

  14. Development of phytosanitary cold treatments for oranges infested with Bactrocera invadens and Bactrocera zonata (Diptera: Tephritidae) by comparison with existing cold treatment schedules for Ceratitis capitata (Diptera: Tephritidae).

    Science.gov (United States)

    Hallman, Guy J; Myers, Scott W; El-Wakkad, Mokhtar F; Tadrous, Meshil D; Jessup, Andrew J

    2013-08-01

    Phytosanitary cold treatments were tested for Bactrocera invadens Drew, Tsuruta, and White and Bactrocera zonata (Saunders) using comparisons with Ceratitis capitata (Wiedemann). Oranges were infested by puncturing holes in the peel and allowing tephritids to oviposit in the holes. The treatments were initiated when the larvae reached late third instar because previous research had shown that stage to be the most cold tolerant for all three species. Results show that B. invadens is not more cold tolerant than C. capitata and B. zonata at 1.0 +/- 0.1 degrees C and lend support to the use of C. capitata cold treatment schedules for B. invadens. It cannot be concluded that B. zonata is not more cold tolerant than C. capitata.

  15. 人工颈椎间盘置换联合颈前路融合术治疗多节段脊髓型颈椎病%Treatment on multilevel cervical spondylotic myelopathy by artificial cervical disc replace-ment combined with anterior cervical discectomy and fusion

    Institute of Scientific and Technical Information of China (English)

    游新茂; 叶秀益; 宋滇文; 贾连顺

    2014-01-01

    Objective To explore the clinical effects of artificial cervical disc replacement( ACDR) combined with anterior cervical discectomy fusion ( ACDF ) for the treatment of multi-segmental cervical spondylotic myelopathy ( CSM) . Methods 18 cases with multi-segmental CSM which were treated by ACDR combined with ACDF were re-viewed. The stability of artificial disc, internal fixation and bone fusion were evaluated by X-ray films before opera-tive, immediate postoperative and follow-up. The JOA scores was evaluated also at the same time. Results 18 pa-tients were followed up from 24 to 60 months ( averaged 36 ± 9. 6 months) . The range of motion of the replacement segment were 13. 8° ± 6. 5° at preoperative and 12. 5° ± 5. 3° at the final follow-up, and there was no significant difference between them(P>0. 05). The preoperative JOA scores was 9. 5 ± 1. 5, which was improved to 14. 2 ± 2. 2 in 4 months after operation; Preoperative neurological symptoms were obviously alleviated in most patients, and the improvement ratio of JOA was 62. 7% ± 11. 2%. The results were excellent in 9 patients, good in 5, fair in 2 and poor in 2. There were no patient with false of internal fixation, and the position of artificial disc was good. Conclu-sions ACDR combined with ACDF is a good procedure for multi-segmental cervical spondylotic myelopathy, it not only maintain the cervical spine alignment with saving more movement segments,but also reduce the incidence of ad-jacent segment degeneration.%目的:评价人工颈椎间盘置换联合颈前路融合术治疗多节段脊髓型颈椎病的临床效果。方法采用人工颈椎间盘置换联合颈前路融合治疗18例多节段脊髓型颈椎病患者。根据术前、术后、随访时的颈椎X线片观察人工椎间盘、内固定、植骨融合以及JOA评分改善情况。结果18例均获随访,时间24~60(36±9.6)个月。置换间隙平均活动度术前为13.8°±6.5°,末次随访时为12.5°±5.3

  16. First Artificial Knee Osteoarthritis Knee Joint Surface Replacement Treatment Time%膝骨性关节炎初次人工膝关节表面置换的治疗时机

    Institute of Scientific and Technical Information of China (English)

    叶添生; 张寅权; 张平; 李荣荣; 方大标; 王慧慧; 孙洪体

    2015-01-01

    Objective To explore the first artificial knee osteoarthritis knee joint surface replacement treatment time.MethodsAccording to the Kelgren - Lawrence X-ray osteoarthritis classification and grading Outerbridge cartilage injury, using multiple linear regression analysis method in 21 patients (23) of severe knee osteoarthritis patients primary artificial knee arthroplasty, statistical analysis of the independent variable factors and linear dependencerelation between the effect of surgery.ResultsThe incidence of postoperative pain and dysfunction were significantly improved, an average folow-up of 11.2 + / - 1.5 months, according to the HSS score, optimal 16 knees; Good 3 knee; 4 knees. Multiple linear regression equation of hypothesis test of statistical significance.Conclusion Severe knee osteoarthritis and implementation of the first patients without artificial knee joint replacement therapy and artificial knee joint surface displacement can significantly improve curative effect, but the surgery has certain curative effect degrees of risk and unknown factors.%目的:探讨膝骨性关节炎初次人工膝关节表面置换的治疗时机。方法根据Kelgren-Lawrence X线骨关节炎分级和Outerbridge软骨损伤分级,采用多重线性回归分析方法,对21例(23膝)重度膝骨关节炎患者实施初次人工膝关节表面置换术,统计分析自变量因素和手术效果之间的线性依存关系。结果本组病例术后疼痛和功能障碍均改善,平均随访(11.2±1.5)个月,根据HSS评分,优16膝;良3膝;可4膝。多重线性回归方程的假设检验具有统计学意义。结论选择重度膝骨关节炎和非人工膝关节置换治疗无效患者实施初次人工膝关节表面置换能提高疗效,但该手术治疗存在一定程度的风险和未知疗效影响因素。

  17. Does IMRT increase the peripheral radiation dose? A comparison of treatment plans 2000 and 2010

    Energy Technology Data Exchange (ETDEWEB)

    Salz, Henning; Eichner, Regina; Wiezorek, Tilo [Jena Univ. (Germany). Dept. of Radiation Oncology

    2012-07-01

    It has been reported in several papers and textbooks that IMRT treatments increase the peripheral dose in comparison with non-IMRT fields. But in clinical practice not only open fields have been used in the pre-IMRT era, but also fields with physical wedges or composed fields. The aim of this work is to test the hypothesis of increased peripheral dose when IMRT is used compared to standard conformal radiotherapy. Furthermore, the importance of the measured dose differences in clinical practice is discussed and compared with other new technologies for the cases where an increase of the peripheral dose was observed. For cancers of the head and neck, the cervix, the rectum and for the brain irradiation due to acute leukaemia, one to four plans have been calculated with IMRT or conformal standard technique (non-IMRT). In an anthropomorphic phantom the dose at a distance of 30 cm in cranio-caudal direction from the target edge was measured with TLDs using a linear accelerator Oncor {sup registered} (Siemens) for both techniques. IMRT was performed using step-and-shoot technique (7 to 11 beams), non-IMRT plans with different techniques. The results depended on the site of irradiation. For head and neck cancers IMRT resulted in an increase of 0.05 - 0.09% of the prescribed total dose (Dptv) or 40 - 70 mGy (Dptv = 65 Gy), compared to non-IMRT technique without wedges or a decrease of 0.16% (approx. 100 mGy) of the prescribed total dose compared to non-IMRT techniques with wedges. For the cervical cancer IMRT resulted in an increased dose in the periphery (+ 0.07% - 0.15% of Dptv or 30 - 70 mGy at Dptv = 45 Gy), for the rectal cancer in a dose reduction (0.21 - 0.26% of Dptv or 100 - 130 mGy at Dptv = 50 Gy) and for the brain irradiation in an increase dose (+ 0.05% of Dptv = 18 Gy or 9 mSv). In summary IMRT does not uniformly cause increased radiation dose in the periphery in the model used. It can be stated that these dose values are smaller than reported in earlier

  18. A dosimetric comparison of whole-lung treatment techniques in the pediatric population

    Energy Technology Data Exchange (ETDEWEB)

    Bosarge, Christina L., E-mail: cbosarge@umail.iu.edu; Ewing, Marvene M.; DesRosiers, Colleen M.; Buchsbaum, Jeffrey C.

    2016-07-01

    To demonstrate the dosimetric advantages and disadvantages of standard anteroposterior-posteroanterior (S-AP/PA{sub AAA}), inverse-planned AP/PA (IP-AP/PA) and volumetry-modulated arc (VMAT) radiotherapies in the treatment of children undergoing whole-lung irradiation. Each technique was evaluated by means of target coverage and normal tissue sparing, including data regarding low doses. A historical approach with and without tissue heterogeneity corrections is also demonstrated. Computed tomography (CT) scans of 10 children scanned from the neck to the reproductive organs were used. For each scan, 6 plans were created: (1) S-AP/PA{sub AAA} using the anisotropic analytical algorithm (AAA), (2) IP-AP/PA, (3) VMAT, (4) S-AP/PA{sub NONE} without heterogeneity corrections, (5) S-AP/PA{sub PB} using the Pencil-Beam algorithm and enforcing monitor units from technique 4, and (6) S-AP/PA{sub AAA[FM]} using AAA and forcing fixed monitor units. The first 3 plans compare modern methods and were evaluated based on target coverage and normal tissue sparing. Body maximum and lower body doses (50% and 30%) were also analyzed. Plans 4 to 6 provide a historic view on the progression of heterogeneity algorithms and elucidate what was actually delivered in the past. Averages of each comparison parameter were calculated for all techniques. The S-AP/PA{sub AAA} technique resulted in superior target coverage but had the highest maximum dose to every normal tissue structure. The IP-AP/PA technique provided the lowest dose to the esophagus, stomach, and lower body doses. VMAT excelled at body maximum dose and maximum doses to the heart, spine, and spleen, but resulted in the highest dose in the 30% body range. It was, however, superior to the S-AP/PA{sub AAA} approach in the 50% range. Each approach has strengths and weaknesses thus associated. Techniques may be selected on a case-by-case basis and by physician preference of target coverage vs normal tissue sparing.

  19. Analysis of the Effect of Artificial Hip Replacement in the Treatment of Acetabular Defect%髋臼缺损畸形的人工髋关节置换手术疗效分析

    Institute of Scientific and Technical Information of China (English)

    武豪杰

    2015-01-01

    Objective To study the acetabulum defect deformity treatment methods of artificial total hip replacement. Methods 30 cases of acetabular defects were selected in our hospital, including 13 cases of acetabulum hypoplasia, acetabulum fracture malunion after trauma in 5 cases, 6 patients with rheumatoid arthritis, ankylosing spondylitis hip lesions, 6 cases were performed total hip replacement, take the acetabulum deepening, double cone spiral acetabulum, autologous bone graft and structural methods such as titanium mesh and bone graft line true acetabular reconstruction, all patients preoperative CT three-dimensional reconstruction, with Harris scoring criteria. Results Followed up for 6~36 months, has not occurred during the follow-up period of artificial hip prosthesis loosening and fracture around, etc. Harris scoring (36±6.5) preoperatively, postoperative (93±5.2). Conclusion Deformity of total hip replacement for defects of acetabulum, through the acetabulum, Zweymulle double cone spiral acetabulum, grain pressure distribution, structural bone graft autologous bone graft and titanium mesh and bone graft and so on the many kinds of methods can be a very good reconstruction of acetabulum, restore good stability and the Harris score, can achieve very good effect.%目的探讨髋臼缺损畸形的人工全髋关节置换术的处理方法。方法选取我院收治存在髋臼缺损畸形患者30例,包括髋臼发育不良13例、髋臼创伤骨折后畸形愈合5例、类风湿性关节炎6例,强直性脊柱炎髋关节病变6例,均行全髋关节置换术,采取髋臼加深、双锥  面螺旋型髋臼、自体结构性植骨及钛网加植骨等多种方法行真臼重建,全部病例术前行 CT 三维重建,评分标准采用 Harris 评分。结果随访6~36个月,随访期间未发生人工髋关节假体松动、周围骨折等。Harris 评分术前(36±6.5),术后(93±5.2)。结论对于髋臼缺损畸形的全髋关节置

  20. Transdermal testosterone replacement therapy in men

    Directory of Open Access Journals (Sweden)

    Ullah MI

    2014-01-01

    Full Text Available M Iftekhar Ullah,1 Daniel M Riche,1,2 Christian A Koch1,31Department of Medicine, University of Mississippi Medical Center, 2Department of Pharmacy Practice, The University of Mississippi, 3GV (Sonny Montgomery VA Medical Center, Jackson, MS, USAAbstract: Androgen deficiency syndrome in men is a frequently diagnosed condition associated with clinical symptoms including fatigue, decreased libido, erectile dysfunction, and metabolic syndrome. Serum testosterone concentrations decline steadily with age. The prevalence of androgen deficiency syndrome in men varies depending on the age group, known and unknown comorbidities, and the respective study group. Reported prevalence rates may be underestimated, as not every man with symptoms of androgen deficiency seeks treatment. Additionally, men reporting symptoms of androgen deficiency may not be correctly diagnosed due to the vagueness of the symptom quality. The treatment of androgen deficiency syndrome or male hypogonadism may sometimes be difficult due to various reasons. There is no consensus as to when to start treating a respective man or with regards to the best treatment option for an individual patient. There is also lack of familiarity with treatment options among general practitioners. The formulations currently available on the market are generally expensive and dose adjustment protocols for each differ. All these factors add to the complexity of testosterone replacement therapy. In this article we will discuss the general indications of transdermal testosterone replacement therapy, available formulations, dosage, application sites, and recommended titration schedule.Keywords: hypogonadism, transdermal, testosterone, sexual function, testosterone replacement therapy, estradiol

  1. Efficient rehabilitation care for joint replacement patients: skilled nursing facility or inpatient rehabilitation facility?

    Science.gov (United States)

    Tian, Wenqiang; DeJong, Gerben; Horn, Susan D; Putman, Koen; Hsieh, Ching-Hui; DaVanzo, Joan E

    2012-01-01

    There has been lengthy debate as to which setting, skilled nursing facility (SNF) or inpatient rehabilitation facility (IRF), is more efficient in treating joint replacement patients. This study aims to determine the efficiency of rehabilitation care provided by SNF and IRF to joint replacement patients with respect to both payment and length of stay (LOS). This study used a prospective multisite observational cohort design. Tobit models were used to examine the association between setting of care and efficiency. The study enrolled 948 knee replacement patients and 618 hip replacement patients from 11 IRFs and 7 SNFs between February 2006 and February 2007. Output was measured by motor functional independence measure (FIM) score at discharge. Efficiency was measured in 3 ways: payment efficiency, LOS efficiency, and stochastic frontier analysis efficiency. IRF patients incurred higher expenditures per case but also achieved larger motor FIM gains in shorter LOS than did SNF patients. Setting of care was not a strong predictor of overall efficiency of rehabilitation care. Great variation in characteristics existed within IRFs or SNFs and severity groups. Medium-volume facilities among both SNFs and IRFs were most efficient. Early rehabilitation was consistently predictive of efficient treatment. The advantage of either setting is not clear-cut. Definition of efficiency depends in part on preference between cost and time. SNFs are more payment efficient; IRFs are more LOS efficient. Variation within SNFs and IRFs blurred setting differences; a simple comparison between SNF and IRF may not be appropriate.

  2. Comparing Effects of Biologic Agents in Treating Patients with Rheumatoid Arthritis: A Multiple Treatment Comparison Regression Analysis.

    Directory of Open Access Journals (Sweden)

    Ingunn Fride Tvete

    Full Text Available Rheumatoid arthritis patients have been treated with disease modifying anti-rheumatic drugs (DMARDs and the newer biologic drugs. We sought to compare and rank the biologics with respect to efficacy. We performed a literature search identifying 54 publications encompassing 9 biologics. We conducted a multiple treatment comparison regression analysis letting the number experiencing a 50% improvement on the ACR score be dependent upon dose level and disease duration for assessing the comparable relative effect between biologics and placebo or DMARD. The analysis embraced all treatment and comparator arms over all publications. Hence, all measured effects of any biologic agent contributed to the comparison of all biologic agents relative to each other either given alone or combined with DMARD. We found the drug effect to be dependent on dose level, but not on disease duration, and the impact of a high versus low dose level was the same for all drugs (higher doses indicated a higher frequency of ACR50 scores. The ranking of the drugs when given without DMARD was certolizumab (ranked highest, etanercept, tocilizumab/ abatacept and adalimumab. The ranking of the drugs when given with DMARD was certolizumab (ranked highest, tocilizumab, anakinra/rituximab, golimumab/ infliximab/ abatacept, adalimumab/ etanercept [corrected]. Still, all drugs were effective. All biologic agents were effective compared to placebo, with certolizumab the most effective and adalimumab (without DMARD treatment and adalimumab/ etanercept (combined with DMARD treatment the least effective. The drugs were in general more effective, except for etanercept, when given together with DMARDs.

  3. 人工间盘置换治疗颈椎病近期疗效及并发症分析%Analysis of Recent Curative Effects and Complications on Artiifcial Disc Replacement in the Treatment of Cervical Spondylosis

    Institute of Scientific and Technical Information of China (English)

    夏伊明; 仇立春; 韩学明; 赵疆; 吴鹏; 李威

    2014-01-01

    目的::评估15例Bryan人工颈椎间盘置换术治疗颈椎病的近期疗效,分析容易出现的并发症。方法:2011年1月至2013年10月,我院和镇江康复医疗集团医院、自治区中医院共同完成15例单节段Bryan人工颈椎间盘置换术,其中男6例,女9例;年龄33~57岁,平均45.2岁。脊髓型颈椎病7例,神经根型颈椎病6例,混合型2例。结果:全部病例随访6~18个月,平均随访13.2月。脊髓型颈椎病患者术前JOA评分为(8.5±1.0)分,末次随访时为(15.5±1.0)分,与术前比较有显著性差异(P<0.01)。颈痛视觉评分(VAS)、颈肩障碍疼痛指数(NDI)与术前相比均具有统计学意义(P<0.05)。神经根型颈椎病患者的症状完全消失。所有病例未见假体下沉、移位以及症状加重者。1例患者术后14个月随访时发现假体周围有异位骨化形成,2例术后置换节段出现颈椎曲度反曲后凸,随访后无明显改善。结论:Bryan人工颈椎间盘置换术治疗颈椎间盘疾患可取得良好的临床疗效,由于其手术操作较为复杂,并发症发生率较多,应重视手术适应证的选择和规范的手术操作。%[ABSTRACT]Objective: Appraised 15 examples Bryan artificial neck intervertebral disc replaces the short-term curative effect which the technique treatment cervical vertebra gets sick, the complication which the analysis often appears. Methods: From January,2011 to October, 2013,my courtyard and Zhenjiang Recovery Medical service Group Hospital,the autonomous region Chinese medicine hospital together completes 15 example single stage Bryan artificial neck intervertebral disc to replace the technique, in which male 6 examples, female 9 examples;Age 33~57 year old, average 45.2 years old.The spinal cord cervical vertebra gets sick 7 examples,the nerve root cervical vertebra gets sick 6 examples, the mixed 2 examples. Results:All patients were followed up for 6~18 months

  4. Indirect treatment comparison of dabrafenib plus trametinib versus vemurafenib plus cobimetinib in previously untreated metastatic melanoma patients

    Directory of Open Access Journals (Sweden)

    Adil Daud

    2017-01-01

    Full Text Available Abstract Background Metastatic melanoma is an aggressive form of skin cancer with a high mortality rate and the fastest growing global incidence rate of all malignancies. The introduction of BRAF/MEK inhibitor combinations has yielded significant increases in PFS and OS for melanoma. However, at present, no direct comparisons between different BRAF/MEK combinations have been conducted. In light of this, an indirect treatment comparison was performed between two BRAF/MEK inhibitor combination therapies for metastatic melanoma, dabrafenib plus trametinib and vemurafenib plus cobimetinib, in order to understand the relative efficacy and toxicity profiles of these therapies. Methods A systematic literature search identified two randomized trials as suitable for indirect comparison: the coBRIM trial of vemurafenib plus cobimetinib versus vemurafenib and the COMBI-v trial of dabrafenib plus trametinib versus vemurafenib. The comparison followed the method of Bucher et al. and analyzed both efficacy (overall survival [OS], progression-free survival [PFS], and overall response rate [ORR] and safety outcomes (adverse events [AEs]. Results The indirect comparison revealed similar efficacy outcomes between both therapies, with no statistically significant difference between therapies for OS (hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.68 − 1.30, PFS (HR 1.05, 95% CI 0.79 − 1.40, or ORR (risk ratio [RR] 0.90, 95% CI 0.74 − 1.10. Dabrafenib plus trametinib differed significantly from vemurafenib plus cobimetinib with regard to the incidence of treatment-related AE (RR 0.92, 95% CI 0.87 − 0.97, any AE grade ≥3 (RR 0.71, 95% CI 0.60 − 0.85 or dose interruption/modification (RR 0.77, 95% CI 0.60 − 0.99. Several categories of AEs occurred significantly more frequently with vemurafenib plus cobimetinib, while some occurred significantly more frequently with dabrafenib plus trametinib. For severe AEs (grade 3 or

  5. A family outreach intervention for engaging young out-of-treatment drug users: pre- versus post-treatment comparison.

    Science.gov (United States)

    Santis, Rodrigo; Hidalgo, Carmen Gloria; Jaramillo, Andrea; Hayden, Viviana; Armijo, Ivan; Lasagna, Andrea

    2013-01-01

    Only a small fraction of drug users worldwide enter treatment each year. We evaluated the efficacy of a systemic family outreach intervention (SFOI) for young, untreated drug users, using a quasi-experimental design in which the experimental group (EG) received SFOI and the control group (CG) received traditional outreach work (OW). Both pre- and post-treatment, we administered the Addiction Severity Index-6 (ASI-6), the Family Environment Scale (FES), and tests of parental practices and risky behavior. Post-treatment, there was a fivefold improvement on the ASI-6 and a significant worsening on the conflict sub-scale of the FES in the EG as compared with the CG. SFOI was more efficacious than OW in reducing drug use in the drug user's home environment. The increased conflict in the EG might be explained by parents' increased awareness of abnormal behaviors and implementation of strategies to protect their children.

  6. Controlled comparison of short-wave diathermy treatment with osteopathic treatment in non-specific low back pain.

    Science.gov (United States)

    Gibson, T; Grahame, R; Harkness, J; Woo, P; Blagrave, P; Hills, R

    1985-06-01

    The effectiveness of spinal manipulation carried out by a non-medical qualified osteopath was compared with that of short-wave diathermy (SWD) and a placebo (detuned SWD) in 109 patients with low back pain. More than half the subjects in each of the 3 treatment groups benefited immediately from therapy. Significant improvements were observed in the 3 groups at the end of 2 weeks' treatment, and these were still apparent at 12 weeks. The outcome of treatment was unrelated to the initial severity or duration of pain or to the trend of pain towards deterioration or improvement. It is, therefore, unlikely that the results simply reflect the natural history of low back pain. Benefits obtained with osteopathy and SWD in this study may have been achieved through a placebo effect.

  7. 持续性肾脏替代治疗抗凝技术的应用%The current state and prospect of continuous renal replacement treatment anticoagulation technique

    Institute of Scientific and Technical Information of China (English)

    管向东; 孙冠青; 陈娟

    2012-01-01

    Continuous renal replacement treatment (CRRT) is a common organ function support ive technique in the field of Critical Care Medicine. Since sepsis patients are always combined with hemodynamic instability and coagulation dysfunction , anticoagulation therapy has been an indispensable component part in CRRT for sepsis patients. Anticoagulation therapy enables to slow or reduce the clottings in pipeline and/or filter so as to prolong its life,improve the efficacy of CRRT treatment, and reduce the loss of blood components and thrombosis under pathological state. So far,the common CRRT anticoagulation drugs include heparin,antithrombin,low molecular weight heparin (LMWH) and/or hyparinoids from animal organs, II factor antagonists, nafamostat, sodium citrate and antiplatelet agents. Coagulation function should be regularly monitored in the process of CRRT anticoagulation treatment. Under the circumstance of anticoagulation taboo, heparin-saline priming, predilution and hydrophilic filter can be used to reduce the clottings in pipeline and/or filter.%持续性肾脏替代治疗(CRRT)是重症医学领域常用的器官功能支持技术.由于脓毒症患者常合并血流动力学不稳定及凝血功能障碍,抗凝技术已成为脓毒症患者CRRT过程中必不可少的组成部分.抗凝技术能延缓或减少管路和(或)滤器的凝血,延长其寿命,提高CRRT治疗效率,减少血液成分的丢失及病理状态下的血栓形成.目前常用的CRRT抗凝药物包括肝素、抗凝酶、低分子肝素和(或)肝素类似物、Ⅱ因子拮抗剂、萘莫斯他、枸橼酸钠及抗血小板药物.CRRT抗凝治疗过程中需动态监测凝血功能等指标.在抗凝禁忌的情况下,可用肝素盐水浸泡、前稀释及选择高亲水性滤器等方法减少管路和(或)滤器凝血.

  8. Using your shoulder after replacement surgery

    Science.gov (United States)

    Joint replacement surgery - using your shoulder; Shoulder replacement surgery - after ... You have had shoulder replacement surgery to replace the bones of your shoulder joint with artificial parts. The parts include a stem made of metal and a ...

  9. Replacing fallow by cover crops: economic sustainability

    Science.gov (United States)

    Gabriel, José Luis; Garrido, Alberto; Quemada, Miguel

    2013-04-01

    Replacing fallow by cover crops in intensive fertilized systems has been demonstrated as an efficient tool for reducing nitrate leaching. However, despite the evident environmental services provided and the range of agronomic benefits documented in the literature, farmers' adoption of this new technology is still limited because they are either unwilling or unable, although adoption reluctance is frequently rooted in low economic profitability, low water se efficiency or poor knowledge. Economic analyses permit a comparison between the profit that farmers obtain from agricultural products and the cost of adopting specific agricultural techniques. The goal of this study was to evaluate the economic impact of replacing the usual winter fallow with cover crops (barley (Hordeum vulgare L., cv. Vanessa), vetch (Vicia villosa L., cv. Vereda) and rapeseed (Brassica napus L., cv. Licapo)) in irrigated maize systems and variable Mediterranean weather conditions using stochastic Monte-Carlo simulations of key farms' financial performance indicators. The three scenarios studied for each cover crop were: i) just leaving the cover crop residue in the ground, ii) leaving the cover crop residue but reduce following maize fertilization according to the N available from the previous cover crop and iii) selling the cover crop residue for animal feeding. All the scenarios were compared with respect to a typical maize-fallow rotation. With observed data from six different years and in various field trials, looking for different weather conditions, probability distribution functions of maize yield, cover crop biomass production and N fertilizer saving was fitted. Based in statistical sources maize grain price, different forage prices and the cost of fertilizer were fitted to probability distribution functions too. As result, introducing a cover crop involved extra costs with respect to fallow as the initial investment, because new seed, herbicide or extra field operations. Additional

  10. Analysis of the treatment of malignant bone tumors with the replacement of Customized tumor type prosthetic%定制人工假体置换治疗骨肿瘤的临床分析

    Institute of Scientific and Technical Information of China (English)

    闫子贵; 马纯青; 孙晓东

    2014-01-01

    目的:对应用定制肿瘤型人工假体置换治疗恶性骨肿瘤的临床疗效进行分析。方法回顾性分析我科2009年5月~2013年2月收治的恶性骨肿瘤患者29例,男18例,女11例;年龄17~65岁,平均38.5岁,股骨上端5例,股骨远端14例,胫骨上端7例,股骨下端3例。所有患者均接受对肿瘤进行广泛切除或根治性切除,包括综合性治疗及定制型人工假体置换治疗,术后对患者进行定期随访,对治疗效果进行评价。结果置换后1年采用MSTS保肢评分系统对随访患者进行功能评价,显示股骨远端患者(15.5~28.0)分,平均23.5分;股骨上端0.5~29.0分,平均23.5分;胫骨近端10.5~29.0分,平均22.4分。其中优9例,良15例,中4例,差1例,优良率为82.7%。术后并发症发生率为10.0%。1例患者于术后7个月死亡,1例患者于术后18个月后肺转移死亡,1例在术后13个月时出现局部复发现象而截肢,1例在术后8个月时出现局部复发单纯行瘤体切除。在随访时,所有患者均未出现人工假体断裂、松动现象。结论在骨肿瘤患者采用人工假体置换术前、术后给予综合性治疗,在对肢体功能加以保留,与其他重建方法相比,具有肢体早期负重、功能恢复快、使用期长的优点,患者生活质量大幅提高,是骨肿瘤保肢治疗的较理想选择,值得在临床中推广。%Objective To analyze the clinical efficacy of the treatment of malignant bone tumors with the replacement of Customized tumor type prosthetic. Methods From May 2009 to February 2013, we did a retrospective analysis about 29 cases suffered malignant bone tumors, there were 18 males and 11 females, with average age of 38.5 years (ranged from 17 to 65).5 cases on the proximal femur, 14 cases on the distal femur,7 cases on the proximal tibia, 3 cases on the distal tibia, which all treated by extensive excision or radical excision of the

  11. Hormone replacement for osteoporosis in women with primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Rudic, Jelena S; Poropat, Goran; Krstic, Miodrag N

    2011-01-01

    Women with primary biliary cirrhosis often suffer from postmenopausal osteoporosis due to their age, or osteoporosis secondary to their liver disease, or treatments provided for their liver disease. Hormone replacement increases bone mineral density and reduces fractures in postmenopausal women...

  12. Performance and economic effects of partially replacing soybean ...

    African Journals Online (AJOL)

    Performance and economic effects of partially replacing soybean meal with palm kernel ... to determine the optimal level of inclusion for maximum production in broilers. ... while no PKC was used in treatment I, which also served as the control.

  13. Comparison of intelligence quotient in children surviving leukemia who received different prophylactic central nervous system treatments

    Directory of Open Access Journals (Sweden)

    Reisi Nahid

    2012-01-01

    Conclusion: We can that reveal that CNS prophylaxis treatment, especially the combined treatment, is associated with IQ score decline in ALL survivors. Therefore,a baseline and an annual assessment of their educational progress are suggested.

  14. [The risk of lacticate acidosis: a comparison of the 3 biguanides in treatment of diabetics (authors' transl)].

    Science.gov (United States)

    Irsigler, K; Kritz, H; Regal, H; Foltin, E

    1978-05-12

    Hyperlactaemia was induced by means of a standard exercise test in 10 diabetics receiving normal treatment with biguanides (either buformin, metformin, or phenformin) in combination with either a sulfonylurea or insulin. The treatment regimen was then continued without biguanides for 3 weeks and the exercise test was repeated at the end of this period. All 3 biguanide preparations induce hyperlactaemia in diabetics. Physical stress leads to an additional increase in lactate, which reaches pathological proportions. Discontinuation of biguanide treatment leads to a significant decrease in resting and stress values. In a comparison of the 3 biguanide products, phenformin induced significantly higher lactate values in response to exercise than buformin. Of the biguanides, phenformin appears to carry the greatest risk of causing hyperlactaemia in susceptible patients, induced by concurrent circumstances, with progression to severe lacticate acidosis. The special pharmacokinetic properties of phenformin and the 8-fold higher incidence of lacticate acidosis than under buformin or metformin therapy support this observation.

  15. Prednisone treatment of elderly-onset rheumatoid arthritis: Disease activity and bone mass in comparison with chloroquine treatment

    NARCIS (Netherlands)

    D. van Schaardenburg (Dirkjan); R. Valkema (Roelf); B.A.C. Dijkmans (Ben); S.E. Papapoulos (Socrates); A.H. Zwinderman (Ailko); K.H. Han (Hubert); E.K.J. Pauwels (Ernest K.J); F.C. Breedveld (Ferdinand)

    1995-01-01

    textabstractObjective. Prednisone is frequently used in the treatment of elderly-onset rheumatoid arthritis (RA), but the balance between efficacy and toxicity, including the effect on bone mass, has not been investigated in long-term studies. This prospective, randomized study was undertaken to com

  16. Prednisone treatment of elderly-onset rheumatoid arthritis: Disease activity and bone mass in comparison with chloroquine treatment

    NARCIS (Netherlands)

    D. van Schaardenburg (Dirkjan); R. Valkema (Roelf); B.A.C. Dijkmans (Ben); S.E. Papapoulos (Socrates); A.H. Zwinderman (Ailko); K.H. Han (Hubert); E.K.J. Pauwels (Ernest K.J); F.C. Breedveld (Ferdinand)

    1995-01-01

    textabstractObjective. Prednisone is frequently used in the treatment of elderly-onset rheumatoid arthritis (RA), but the balance between efficacy and toxicity, including the effect on bone mass, has not been investigated in long-term studies. This prospective, randomized study was undertaken to

  17. Risks of testosterone replacement therapy in men

    Directory of Open Access Journals (Sweden)

    E Charles Osterberg

    2014-01-01

    Full Text Available Testosterone replacement therapy (TRT is a widely used treatment for men with symptomatic hypogonadism. The benefits seen with TRT, such as increased libido and energy level, beneficial effects on bone density, strength and muscle as well as cardioprotective effects, have been well-documented. TRT is contraindicated in men with untreated prostate and breast cancer. Men on TRT should be monitored for side-effects such as polycythemia, peripheral edema, cardiac and hepatic dysfunction.

  18. Alternatives to testosterone replacement: testosterone restoration

    OpenAIRE

    Andrew McCullough

    2014-01-01

    The European Male Aging Study has demonstrated that the hypogonadism of male aging is predominantly secondary. Theoretically with appropriate stimulation from the pituitary, the aging testis should be able to produce eugonadal levels of testosterone. The strategies for the treatment of late onset hypogonadism (LOH) have focused on replacement with exogenous testosterone versus restoration of endogenous production. The purpose of this article is to review existing peer-reviewed literature supp...

  19. Mechanical ventilation and nutritional support for the treatment of severe valvular heart disease for valve replacement%重症心脏瓣膜置换术后营养支持治疗

    Institute of Scientific and Technical Information of China (English)

    董铭峰; 马增山; 马胜军; 王建堂; 柴守栋; 唐培哲

    2011-01-01

    目的 探讨重症心脏瓣膜置换术患者机械通气和营养支持治疗的临床特点及治疗效果.方法 回顾性分析48例患者经机械通气和营养支持治疗的临床资料.全组采用胃肠外营养(PN)+胃肠内营养(EN)支持3~10 d,第1~3天PN+ EN支持,第4天后完全EN支持,期间监测术前1天、术后第1、3、7天血浆总白蛋白(TP)、血浆白蛋白(ALB)、前白蛋白(PA);CD3+、CD4+、CD8+,计算CD4+/CD8+及血糖变化.结果 术后第7天CD3+、CD4+、CD8+,CD4+/CD8+明显升高(P<0.05或P<0.01);TP、ALB、PA明显增高(P<0.05).合并高血糖6例,消化道出血3例,肺感染2例.36例1次脱机成功,2次脱机成功8例,3次脱机成功4例,无一例依赖呼吸机.结论 机械通气和营养支持治疗重症心脏瓣膜置换术临床效果较好,但应注意营养供给方式的选择.%Objective To investigate the clinical features and effect of the treatment of mechanical ventilation and nutritional support for patients with severe valvular heart disease for valve replacement.Methods The clinical datas of 48 cases treated with mechanical ventilation and nutritional support were retrospectively analyzed.Parenteral + Enteral nutrition support were used in all patients for 3-10 days.For each periphera samples were taken on one day before operation on the first,third and seventh day after opration respective,The percentage subsets including TP,ALB,PA,CD3 +,CD4 +,CD8 + as well as CD4 + / CD8 + were examined.Results It was found that the percentage of TP,ALB,PA,CD3 +,CD4 +,CD8 + as well as CD4 + / CD8 + were significantly increased at seven days after operation (P < 0.05 or P < 0.01 ).Initiation of spontaneously breathing occurred in 36,8 and 4 patients at the first,second and third off-line performance respectively.High blood sugar,gastrointestinal bleeding,lung infection and respiratory failure were found in 6,3 and 2 patients respectively.No patient was found ventilator dependent.Conclusions The

  20. Bibliotherapy Treatment for Children with Adjustment Difficulties: A Comparison of Affective and Cognitive Bibliotherapy

    Science.gov (United States)

    Betzalel, Nurit; Shechtman, Zipora

    2010-01-01

    This study compared outcomes following cognitive and affective bibliotherapy treatment with 79 children and adolescents in a residential home in Israel. Treatment children were compared to a control-no treatment group from the same home. Anxiety was measured through a self-report measure (Revised Children's Manifest Anxiety Scale; Reynolds &…

  1. A Comparison of the Effectiveness of Three Group Treatments for Weight Loss

    Science.gov (United States)

    Byom, Tianna K.

    2009-01-01

    Rising overweight and obesity rates in the United States and the accompanying health issues underscore the need for an effective treatment for weight loss. While most people tend to lose weight as a result of cognitive-behavioral treatment, the weight is often regained after treatment ends. Possible reasons for weight regain include not fully…

  2. A Comparison of the Effectiveness of Three Group Treatments for Weight Loss

    Science.gov (United States)

    Byom, Tianna K.

    2009-01-01

    Rising overweight and obesity rates in the United States and the accompanying health issues underscore the need for an effective treatment for weight loss. While most people tend to lose weight as a result of cognitive-behavioral treatment, the weight is often regained after treatment ends. Possible reasons for weight regain include not fully…

  3. Educating My Replacement

    Science.gov (United States)

    Tarter, Jill

    , in partnership with the dedicated teachers out there, I think I can help promote the critical thinking skills and scientific literacy of the next generation of voters. Hopefully, I can also help train my replacement to be a better scientist, capable of seizing all the opportunities generated by advances in technology and our improved understanding of the universe to craft search strategies with greater probability of success than those I have initiated.

  4. 振冲碎石桩在仁宗海软弱坝基加固处理中的应用%Application of Vibro Replacement Stone Column in Renzonghai Weak Dam Foundation Reinforcement Treatment

    Institute of Scientific and Technical Information of China (English)

    凡亚; 王立海

    2012-01-01

      田湾河流域仁宗海水库电站挡水大坝为深厚覆盖层地基,覆盖层结构层次复杂,坝基第⑦层承载力低,不能满足坝基承载、变形及坝坡抗滑稳定要求。介绍了振冲碎石桩在仁宗海坝基第⑦层淤泥质壤土处理中的应用。复合地基检测和坝基稳定性复核计算结果表明,堆石坝坝基淤泥质壤土加固处理满足设计技术及现行规范要求。%  Tianwan river basin Renzonghai renzonghai reservoir station retaining dam is a deep overburden foundation, overburden structure has complex arrangement, and the seventh layer of the dam foundation has low bearing capacity, and can not meet the requirement of dam foundation bearing, deformation as well as dam slope anti-skid stability. The paper describes the application of vibro replacement stone column in the seventh layer of Renzonghai dam foundation. The result of the treated composite foundation test and dam foundation ability rechecking calculation showed that the silt loam reinforcement treatment on rockfill dam foundation of Renzonghai power station is in line with the requirements in design technique and current standard.

  5. Nursing for Patients with Liver Transplantation by Heparin-free Continuous Renal Replacement Treatment%无肝素连续性肾脏替代治疗肝移植患者的护理

    Institute of Scientific and Technical Information of China (English)

    王微娜; 周淑亚; 徐雅玲; 袁静

    2014-01-01

    Objective To analyze the nursing methods of heparin-free continuous renal replacement treatment (CRRT) in patients with liver transplantation. Methods Observe and analyze the application of heparin-free CRRT in 21 patients with liver transplantation in the blood purification center, the First Affiliated Hospital of Zhejiang University in 2013. Results Only 2 of 21 patients used 2-3 pipelines and filters of hemodialysis in 24 h, the others were successful during the dialysis. Conclusion Liver-transplanted patients with hemorrhagic tendency are related to surgical trauma, blood coagulation dysfunction, and platelet depletion, thereby, heparin-free CRRT is one of the effective therapies. And the correct nursing method is the safety guarantee of liver-transplanted patients.%目的:分析肝移植患者无肝素CRRT配合治疗的护理要点。方法收集我院2013年的21例肝移植患者无肝素CRRT配合治疗的护理情况进行分析。结果21例患者中仅有2例患者24 h需用2-3套管路及滤器,其余19例患者治疗过程顺利。结论肝移植患者由于手术创伤、凝血功能障碍、血小板消耗等原因,容易发生出血现象。因此,无肝素的CRRT治疗对肝移植的患者来说是最有效的方法之一。正确的无肝素护理技术是肝移植患者行CRRT治疗的保障。

  6. Randomised comparison of uterine artery embolisation (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial): 5‐year results

    National Research Council Canada - National Science Library

    Moss, JG; Cooper, KG; Khaund, A; Murray, LS; Murray, GD; Wu, O; Craig, LE; Lumsden, MA

    2011-01-01

    .... Randomised comparison of uterine artery embolisation (UAE) with surgical treatment in patients with symptomatic uterine fibroids (REST trial): 5‐year results. BJOG 2011;118:936–944. Objective...

  7. A comparison of two insecticidal shampoos in the treatment of head louse infection.

    Science.gov (United States)

    Jolley, J H; Kennedy, J P; Miller, A J

    1991-06-01

    The efficacy and tolerability of a phenothrin liquid shampoo was compared with a carbaryl shampoo in 50 children with head lice infection. Twenty-five children were treated with a phenothrin liquid shampoo and 25 with a carbaryl shampoo. Each treatment was applied on three occasions at three-day intervals. Reinspection two weeks after initiation of treatment revealed two apparent treatment failures in the carbaryl group and one in the phenothrin group. No side effects were reported for either treatment. It is concluded that phenothrin liquid shampoo is a safe and effective treatment for head louse infection and is therefore a useful addition to those insecticides currently employed.

  8. Total hip replacement in the treatment of traumatic arthritis after operation of acetabulum dislocation%全髋关节置换治疗髋臼骨折脱位术后创伤性关节炎

    Institute of Scientific and Technical Information of China (English)

    许鹏雍; 凌尚准; 梁广权; 梁善校

    2015-01-01

    目的:探讨全髋关节置换治疗髋臼骨折脱位术后创伤性关节炎( traumatic ostcoarthritis,TOA)的临床疗效。方法选择2009年3月~2013年3月我院收治的髋臼骨折脱位术后并发创伤性关节炎行全髋关节置换术的患者27例为研究对象,男性16例,女性11例;年龄32~57岁,平均(45.2±8.7)岁。对其临床资料进行回顾性分析,并于术前和术后分别评定髋关节功能,评价手术疗效。结果27例患者均顺利完成手术,所有患者术后切口均Ⅰ期愈合;术后Harris评分为76~92分,其中80分以上的患者25例,优良率达到92.6%,平均(89.1±5.78)分,与术前的(45.3±5.86)分相比,存在显著差异(P<0.05);关节屈曲、内收、外展、外旋及内旋与术前对比差异均有统计学意义( P<0.05),髋关节功能得到明显改善。结论髋臼骨折脱位术后易并发创伤性关节炎(TOA),采用全髋关节置换术治疗具有术后并发症少、髋部功能改善明显、临床效果好、患者满意度高等优点,值得临床推广应用。%Objective To evaluate the clinical efficacy of total hip replacement in the treatment of traumat-ic ostcoarthritis ( TOA) after operation of acetabulum dislocation.Methods Twenty seven patients [16 males and 11 females aged from 32-57 years with an average age of (45.2 ±8.7) years] of acetabulum fracture from Mar.2009 to Mar.2013 in our hospital were performed total hip replacement for the treatment of TOA after operation of acetab-ulum dislocation were chosen and their clinical data was retrospectively analyzed.The preoperative and postopera-tive evaluation of hip function were performed and the effect of surgery was completed.Results All patients were successfully operated and all incisions achieved primary healing;postoperative Harris score was 76 to 92,of which 25 patients were more than 80 and the good and excellent rate was 92

  9. [Ascending aorta replacement late after aortic valve replacement].

    Science.gov (United States)

    Hayashi, Yasunari; Ito, Toshiaki; Maekawa, Atsuo; Sawaki, Sadanari; Fujii, Genyo; Hoshino, Satoshi; Tokoro, Masayoshi; Yanagisawa, Junji

    2013-07-01

    Replacement of the asceding aorta is indicated in patients undergoing aortic valve replacement( AVR), if the diameter of the ascending aorta is greater than 5.0 cm. If the diameter of the asceding aorta is from 4.0 to 5.0 cm, it was arguable whether replacement of the ascending aorta should be performed. Nine patients who underwent reoperative ascending aorta replacement after AVR were reviewed retrospectively. Reoperation on the asending aorta replacement was performed 11.8±7.2 years (range 1y5m~23y3m) after AVR. Mean patient age was 69.9±6.3 (range 60~81). In 2 cases, reoperations were performed early year after AVR. Although ascending aorta was dilated at the 1st operation, replacement wasn't performed for the age and minimally invasive cardiac surgery (MICS). In 3 cases, reoperations were performed more than 10 years later. On these cases, ascending aorta aneurysm and dissection occurred with no pain and were pointed out by computed tomography(CT) or ultrasonic cardiogram(UCG). We think that patients with dilatation of the ascending aorta should undergo AVR and aorta replacement at the 1st operation regardness of age. It is important that patients who underwent AVR should undergo a regular checkup on the ascending aorta.

  10. Volumetric-modulated arc therapy vs c-IMRT in esophageal cancer: A treatment planning comparison

    Institute of Scientific and Technical Information of China (English)

    Li Yin; Bo Xu; Guang-Ying Zhu; Hao Wu; Jian Gong; Jian-Hao Geng; Fan Jiang; An-Hui Shi; Rong Yu; Yong-Heng Li; Shu-Kui Han

    2012-01-01

    AIM:To compare the volumetric-modulated arc therapy (VMAT) plans with conventional sliding window intensity-modulated radiotherapy (c-IMRT) plans in esophageal cancer (EC).METHODS:Twenty patients with EC were selected,including 5 cases located in the cervical,the upper,the middle and the lower thorax,respectively.Five plans were generated with the eclipse planning system:three using c-IMRT with 5 fields (5F),7 fields (7F) and 9 fields (9F),and two using VMAT with a single arc (1A) and double arcs (2A).The treatment plans were designed to deliver a dose of 60 Gy to the planning target volume (PTV) with the same constrains in a 2.0 Gy daily fraction,5 d a week.Plans were normalized to 95% of the PTV that received 100% of the prescribed dose.We examined the dose-volume histogram parameters of PTV and the organs at risk (OAR) such as lungs,spinal cord and heart.Monitor units (MU) and normal tissue complication probability (NTCP) of OAR were also reported.RESULTS:Both c-IMRT and VMAT plans resulted in abundant dose coverage of PTV for EC of different locations.The dose conformity to PTV was improved as the number of field in c-IMRT or rotating arc in VMAT was increased.The doses to PTV and OAR in VMAT plans were not statistically different in comparison with c-IMRT plans,with the following exceptions:in cervical and upper thoracic EC,the conformity index (CI) was higher in VMAT (1A 0.78 and 2A 0.8) than in c-IMRT (SF 0.62,7F 0.66 and 9F 0.73) and homogeneity was slightly better in c-IMRT (7F 1.09 and 9F 1.07) than in VMAT (1A 1.1 and 2A 1.09).Lung V30 was lower in VMAT (1A 12.52 and 2A 12.29) than in c-IMRT (7F 14.35 and 9F 14.81).The humeral head doses were significantly increased in VMAT as against c-IMRT.In the middle and lower thoracic EC,CI in VMAT (1A 0.76 and 2A 0.74) was higher than in c-IMRT (5F 0.63 Gy and 7F 0.67 Gy),and homogeneity was almost similar between VMAT and c-IMRT.V20 (2A 21.49 Gy vs 7F 24.59 Gy and 9F 24.16 Gy) and V30 (2A 9.73 Gy vs 5F 12

  11. [{sup 11}C]Choline PET/CT detection of bone metastases in patients with PSA progression after primary treatment for prostate cancer: comparison with bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Picchio, Maria [San Raffaele Scientific Institute, Nuclear Medicine Department, Milan (Italy); National Research Council (IBFM-CNR), Institute for Bioimaging and Molecular Physiology, Milan (Italy); Spinapolice, Elena Giulia; Crivellaro, Cinzia [University of Milano-Bicocca, Center for Molecular Bioimaging, Milan (Italy); Fallanca, Federico; Gianolli, Luigi [San Raffaele Scientific Institute, Nuclear Medicine Department, Milan (Italy); Giovacchini, Giampiero [University of Milano-Bicocca, Center for Molecular Bioimaging, Milan (Italy); University Hospital Basel, Institute of Nuclear Medicine, Basel (Switzerland); Messa, Cristina [National Research Council (IBFM-CNR), Institute for Bioimaging and Molecular Physiology, Milan (Italy); University of Milano-Bicocca, Center for Molecular Bioimaging, Milan (Italy); San Gerardo Hospital, Department of Nuclear Medicine, Monza (Italy)

    2012-01-15

    The aim of this study was to evaluate the clinical usefulness of [{sup 11}C]choline positron emission tomography (PET)/CT in comparison with bone scintigraphy (BS) in detecting bone metastases (BM) of patients with biochemical progression after radical treatment for prostate cancer (PCa). Seventy-eight consecutive patients with biochemical progression of PCa (mean prostate-specific antigen 21.1 ng/ml, range 0.2-500.0 ng/ml) referred for both [{sup 11}C]choline PET/CT and BS for restaging purposes were retrospectively analysed. The diagnostic accuracy of [{sup 11}C]choline PET/CT and BS was assessed by using morphological imaging and/or follow-up as standards of reference. As equivocal findings were found, the accuracy analysis was performed twice, once including them as positive and once as negative. A separate analysis was also performed in hormone-resistant patients and data compared with those of patients who did not receive anti-androgenic treatment. Equivocal findings occurred in 1 of 78 (1%) cases in [{sup 11}C]choline PET/CT and in 21 of 78 (27%) cases in BS. Depending on their attribution as either positive or negative, the ranges of sensitivity, specificity, positive predictive value, negative predictive value and accuracy for [{sup 11}C]choline PET/CT were 89-89%, 98-100%, 96-100%, 94-96% and 95-96%, respectively. For BS they were 100-70%, 75-100%, 68-100%, 100-86% and 83-90%, respectively. Concordant findings between [{sup 11}C]choline PET/CT and BS occurred in 55 of 78 (71%) cases. The accuracy of [{sup 11}C]choline PET/CT did not significantly (p = 0.30) differ between hormone-resistant patients (97%) and those who did not receive anti-androgenic treatment (95%). In clinical practice, [{sup 11}C]choline PET/CT may not replace BS because of its lower sensitivity. However, for its high specificity, [{sup 11}C]choline PET/CT positive findings may accurately predict the presence of BM. Equivocal findings are more frequent in BS than [{sup 11}C]choline PET

  12. Comparison of fumaric acid 5% cream versus triamcinolone 0.1% cream in the treatment of hand eczema.

    Directory of Open Access Journals (Sweden)

    Farideh Jowkar

    2014-07-01

    Full Text Available Hand eczema is a common distressing skin problem. It is an immune reaction to haptens. Thus, substances that inhibit Immune system can be effective in the treatment of hand eczema. In this study, topical fumaric acid 5% cream is compared with topical steroid in the treatment of hand eczema. Patients with hand eczema were randomly divided into two groups. One group received fumaric acid 5% in a cream base, and the other received triamcinolone 0.1% in the same cream base. Both groups used creams twice daily for one month. Patients were checked for erythema, excoriation, population and lichenification, EASI score, and pruritus before and after treatment. In both groups, the mean of all signs of the disease and EASI score decreased after one month of treatment. There was no significant difference between the two treatments in decreasing erythema, but excoriation, population, lichenification, EASI score and itching were all decreased more in triamcinolone 0.1 % group. Although fumaric acid can inhibit the immune system; it was less effective for the treatment of all signs of hand eczema except erythema in comparison to triamcinolone. These results may be justified for two reasons: low penetration of topical fumaric acid through the skin or a low concentration used in this study.

  13. Comparison of fumaric acid 5% cream versus triamcinolone 0.1% cream in the treatment of hand eczema.

    Science.gov (United States)

    Jowkar, Farideh; Saki, Nasrin; Mokhtarpour, Akbar; Saki, Mohammad Reza

    2014-01-01

    Hand eczema is a common distressing skin problem. It is an immune reaction to haptens. Thus, substances that inhibit Immune system can be effective in the treatment of hand eczema. In this study, topical fumaric acid 5% cream is compared with topical steroid in the treatment of hand eczema. Patients with hand eczema were randomly divided into two groups. One group received fumaric acid 5% in a cream base, and the other received triamcinolone 0.1% in the same cream base. Both groups used creams twice daily for one month. Patients were checked for erythema, excoriation, population and lichenification, EASI score, and pruritus before and after treatment. In both groups, the mean of all signs of the disease and EASI score decreased after one month of treatment. There was no significant difference between the two treatments in decreasing erythema, but excoriation, population, lichenification, EASI score and itching were all decreased more in triamcinolone 0.1 % group. Although fumaric acid can inhibit the immune system; it was less effective for the treatment of all signs of hand eczema except erythema in comparison to triamcinolone. These results may be justified for two reasons: low penetration of topical fumaric acid through the skin or a low concentration used in this study.

  14. Dragon Fruit Foliage Plant-Based Coagulant for Treatment of Concentrated Latex Effluent: Comparison of Treatment with Ferric Sulfate

    Directory of Open Access Journals (Sweden)

    Juferi Idris

    2013-01-01

    Full Text Available The effectiveness of dragon fruit foliage as a natural coagulant for treatment of concentrated latex effluent was investigated and compared with ferric sulfate, a chemical coagulant. Dragon fruit is a round and often red-colored fruit with scales-like texture and is native to south American countries which is also cultivated and heavily marketed in southeast Asian countries. Its foliage represents a part of its overall plant system. Latex effluent is one of the main byproduct from rubber processing factories in Malaysia. Three main parameters investigated were chemical oxygen demand (COD, suspended solids (SS, and turbidity of effluent. Coagulation experiments using jar test were performed with a flocculation system where the effects of latex effluent pH as well as coagulation dosage on coagulation effectiveness were examined. The highest recorded COD, SS, and turbidity removal percentages for foliage were observed for effluent pH 10 at 94.7, 88.9, and 99.7%, respectively. It is concluded that the foliage showed tremendous potential as a natural coagulant for water treatment purposes. The foliage could be used in the pretreatment stage of Malaysian latex effluent prior to secondary treatment.

  15. Comparison of serum Dkk1 (Dickkopf-1) and bone mineral density in patients on bisphosphonate treatment vs no treatment.

    LENUS (Irish Health Repository)

    Memon, Adeel R

    2013-05-17

    Complex pathways affect bone metabolism at the cellular level, and a balance between osteoblast and osteoclast activity is critical to bone remodeling. One of the major pathways affecting bone metabolism is Wnt\\/β-catenin signaling, and its disturbances lead to a wide range of bone abnormalities. An important antagonist of this pathway is Dickkopf-1 (Dkk1). Higher Dkk1 levels have been associated with increased bone loss due to inhibition of Wnt pathway. Currently, bisphosphonates are the most commonly used agents to treat primary osteoporotic patients. This study demonstrates the effect of bisphosphonates on Dkk1 levels and its correlation with bone mineral density (BMD). Eighty patients with low BMD were recruited and divided into 2 groups of 40 each (bisphosphonate treatment group and control group). The mean Dkk1 level in the treatment group was significantly reduced to 2358.18 vs 3749.80 pg\\/mL in the control group (p<0.001). Pearson correlation coefficient showed negative correlation between Dkk1 and BMD at lumbar spine (r=-0.55) and femoral neck in the control group; however, no such correlation was found in the treatment group (r=-0.05). Hence, bisphosphonate therapy leads to reduction in Dkk1 levels, but it does not correlate with BMD in such patients.

  16. Aspirin Versus Aspirin Plus Clopidogrel as Antithrombotic Treatment Following Transcatheter Aortic Valve Replacement With a Balloon-Expandable Valve: The ARTE (Aspirin Versus Aspirin + Clopidogrel Following Transcatheter Aortic Valve Implantation) Randomized Clinical Trial.

    Science.gov (United States)

    Rodés-Cabau, Josep; Masson, Jean-Bernard; Welsh, Robert C; Garcia Del Blanco, Bruno; Pelletier, Marc; Webb, John G; Al-Qoofi, Faisal; Généreux, Philippe; Maluenda, Gabriel; Thoenes, Martin; Paradis, Jean-Michel; Chamandi, Chekrallah; Serra, Vicenç; Dumont, Eric; Côté, Mélanie

    2017-07-10

    The aim of this study was to compare aspirin plus clopidogrel with aspirin alone as antithrombotic treatment following transcatheter aortic valve replacement (TAVR) for the prevention of ischemic events, bleeding events, and death. Few data exist on the optimal antithrombotic therapy following TAVR. This was a randomized controlled trial comparing aspirin (80 to 100 mg/day) plus clopidogrel (75 mg/day) (dual antiplatelet therapy [DAPT]) versus aspirin alone (single-antiplatelet therapy [SAPT]) in patients undergoing TAVR with a balloon-expandable valve. The primary endpoint was the occurrence of death, myocardial infarction (MI), stroke or transient ischemic attack, or major or life-threatening bleeding (according to Valve Academic Research Consortium 2 definitions) within the 3 months following the procedure. The trial was prematurely stopped after the inclusion of 74% of the planned study population. A total of 222 patients were included, 111 allocated to DAPT and 111 to SAPT. The composite of death, MI, stroke or transient ischemic attack, or major or life-threatening bleeding tended to occur more frequently in the DAPT group (15.3% vs. 7.2%, p = 0.065). There were no differences between groups in the occurrence of death (DAPT, 6.3%; SAPT, 3.6%; p = 0.37), MI (DAPT, 3.6%; SAT, 0.9%; p = 0.18), or stroke or transient ischemic attack (DAPT, 2.7%; SAPT, 0.9%; p = 0.31) at 3 months. DAPT was associated with a higher rate of major or life-threatening bleeding events (10.8% vs. 3.6% in the SAPT group, p = 0.038). There were no differences between groups in valve hemodynamic status post-TAVR. This small trial showed that SAPT (vs. DAPT) tended to reduce the occurrence of major adverse events following TAVR. SAPT reduced the risk for major or life-threatening events while not increasing the risk for MI or stroke. Larger studies are needed to confirm these results. (Aspirin Versus Aspirin + Clopidogrel Following Transcatheter Aortic Valve Implantation: The ARTE

  17. Physical therapy, corticosteroid injection, and extracorporeal shock wave treatment in lateral epicondylitis. Clinical and ultrasonographical comparison.

    Science.gov (United States)

    Gündüz, Rukiye; Malas, Fevziye Ünsal; Borman, Pınar; Kocaoğlu, Seher; Özçakar, Levent

    2012-05-01

    The aim of this study was to compare--clinically and ultrasonographically--the therapeutic effects of physical therapy modalities (hot pack, ultrasound therapy, and friction massage), local corticosteroid injection, and extracorporeal shock wave treatment (ESWT) in lateral epicondylitis (LE). Fifty-nine elbows of 59 patients with LE were randomized into three treatment groups receiving either physical therapy, a single corticosteroid injection, or ESWT. Visual analogue scale (VAS) was used to assess pain intensity, Jamar hydraulic dynamometer for grip strength, finger dynamometer for pinch strength (before treatment, on the first, third, and sixth months of treatment). All subjects were also evaluated with ultrasonography before and 6 months after treatment. In all groups, VAS scores of the patients were found to decrease significantly on the first, third, and sixth months of treatment. With respect to grip strength evaluations, the increase after treatment was significant only on the first month in group II; on the first and third months in group I; and on the first, third, and sixth months of treatment in group III. Pinch strength and ultrasonographical findings did not change during follow-up in any group. We imply that physical therapy modalities, corticosteroid injection, and ESWT have favorable effects on pain and grip strength in the early period of LE treatment. The increase in grip strength lasts longer with ESWT. On the other hand, ultrasonographic findings do not change in the first six months of these treatment methods.

  18. PHARMACOECONOMIC ASPECTS OF THE PREVENTION OF VENOUS THROMBOEMBOLIC EVENTS AFTER LARGE JOINTS REPLACEMENT

    Directory of Open Access Journals (Sweden)

    A. V. Rudakova

    2015-09-01

    Full Text Available Venous thromboembolic (VTE events are a major concern in large joints replacement leading to patients’ death. The prevention of VTE events suggests the prescription of low molecular weight heparin or oral anticoagulants that differ significantly in their efficacy, safety and cost of the therapy.Aim. To assess the cost-effectiveness of different options for the prevention of VTE events in hip and knee joints replacement.Material and methods. The model, which allows evaluation of the VTE complications incidence in patients aged 60-65years, was developed based on the results of such clinical trials as ADVANCE-2, ADVANCE-3, RE-MODEL, RE-NOVATE. Analysis was performed on survival period of patients. Weighted average prices of public bidding for the purchase of drugs (enoxaparin, dabigatran and apixaban during the first quarter of 2015 were the source of the data on the expenses on VTE events prevention. The cost of treatment of VTE events matched for the rate of compulsory health insurance in St. Petersburg for 2015. The costs and life expectancy of patients were discounted at 3.5% per year.Results. The best results for the prevention of VTE events are observed at the treatment regimen with apixsaban. Treatment regimens with dabigatran and enoxaparin were less effective and comparable with each other. At that, the prevalence of major bleedings was similar for all treatment regiments. Apixaban reduced the cost of treatment and prevention of VTE events 1.8-2.0 times as compared with enoxaparin and 1.2-1.4 times in comparison with dabigatran.Conclusion. The new oral anticoagulants are effective and safe alternative to low molecular weight heparins used for the prevention of VTE events in large joints replacement and provide budgetary savings as compared with enoxaparin. Apixaban has a maximum capacity for the reduction of VTE events, lowering the cost of treatment and prevention of VTE events.

  19. PHARMACOECONOMIC ASPECTS OF THE PREVENTION OF VENOUS THROMBOEMBOLIC EVENTS AFTER LARGE JOINTS REPLACEMENT

    Directory of Open Access Journals (Sweden)

    A. V. Rudakova

    2015-01-01

    Full Text Available Venous thromboembolic (VTE events are a major concern in large joints replacement leading to patients’ death. The prevention of VTE events suggests the prescription of low molecular weight heparin or oral anticoagulants that differ significantly in their efficacy, safety and cost of the therapy.Aim. To assess the cost-effectiveness of different options for the prevention of VTE events in hip and knee joints replacement.Material and methods. The model, which allows evaluation of the VTE complications incidence in patients aged 60-65years, was developed based on the results of such clinical trials as ADVANCE-2, ADVANCE-3, RE-MODEL, RE-NOVATE. Analysis was performed on survival period of patients. Weighted average prices of public bidding for the purchase of drugs (enoxaparin, dabigatran and apixaban during the first quarter of 2015 were the source of the data on the expenses on VTE events prevention. The cost of treatment of VTE events matched for the rate of compulsory health insurance in St. Petersburg for 2015. The costs and life expectancy of patients were discounted at 3.5% per year.Results. The best results for the prevention of VTE events are observed at the treatment regimen with apixsaban. Treatment regimens with dabigatran and enoxaparin were less effective and comparable with each other. At that, the prevalence of major bleedings was similar for all treatment regiments. Apixaban reduced the cost of treatment and prevention of VTE events 1.8-2.0 times as compared with enoxaparin and 1.2-1.4 times in comparison with dabigatran.Conclusion. The new oral anticoagulants are effective and safe alternative to low molecular weight heparins used for the prevention of VTE events in large joints replacement and provide budgetary savings as compared with enoxaparin. Apixaban has a maximum capacity for the reduction of VTE events, lowering the cost of treatment and prevention of VTE events.

  20. Seal, replacement or monitoring amalgam restorations with occlusal marginal defects? Results of a 10-year clinical trial.

    Science.gov (United States)

    Moncada, G; Fernández, E; Mena, K; Martin, J; Vildósola, P; De Oliveira Junior, O B; Estay, J; Mjör, I A; Gordan, V V

    2015-11-01

    The aim of this prospective and blind clinical trial was to assess the effectiveness of sealing localized marginal defects of amalgam restoration that were initially scheduled to be replaced. A cohort of twenty six patients with 60 amalgam restorations (n=44Class I and n=16Class II), that presented marginal defects deviating from ideal (Bravo) according to USPHS criteria, were assigned to either sealing or replacement groups: A: sealing n=20, Replacement n=20, and no treatment (n=20). Two blind examiners evaluated the restorations at baseline (K=0.74) and after ten years (K=0.84) according with USPHS criteria, in four parameters: marginal adaptation (MA), secondary caries (SC), marginal staining (MS) and teeth sensitivity (TS). Multiple comparison of restorations degradation/upgrade was analyzed by Friedman test and the comparisons within groups were performed by Wilcoxon test. After 10 years, 44 restorations were assessed (73.3%), Group A: n=14 and Group B: n=16; and Group C: n=14 sealing and replacement amalgam restorations presented similar level of quality in MA (p=0.76), SC (p=0.25) and TS (p=0.52), while in MS (p=0.007) presented better performance in replacement group after 10-years. Most of the occlusal amalgam restorations with marginal gaps showed similar long term outcomes than the restorations were sealed, replaced, or not treated over a 10-year period. Most of the restorations of the three groups were clinically acceptable, under the studied parameters. All restorations had the tendency to present downgrade/deterioration over time.

  1. Comparison of Sexual Dysfunction Using the Female Sexual Function Index following Surgical Treatments for Uterine Fibroids

    Directory of Open Access Journals (Sweden)

    Allison Ryann Louie

    2012-01-01

    Full Text Available Uterine fibroids are a common problem in women. Statistics showing 20–50% of fibroids produce symptoms and consequently patients seek surgical intervention to improve their quality of life. Treatments for fibroids are typically successful in controlling the fibroid disease, yet sexual function following invasive surgical treatments for fibroids can be jeopardized. The Sexual Function Index (FSFI is a valid instrument producing quantifiable reproducible results. In this paper three case reports are evaluated by the FSFI and compared between the following treatment groups: hysterectomy, myomectomy, and uterine embolization. Our goal is to illustrate how each of these treatment outcomes can result in sexual dysfunction and therefore decreased quality of life. Effects of invasive fibroid treatments on sexual functioning would be helpful in guiding patient’s ultimate decisions regarding treatment.

  2. Examining influential factors in providers’ chronic pain treatment decisions: a comparison of physicians and medical students

    OpenAIRE

    2015-01-01

    Background Chronic pain treatment guidelines are unclear and conflicting, which contributes to inconsistent pain care. In order to improve pain care, it is important to understand the various factors that providers rely on to make treatment decisions. The purpose of this study was to examine factors that reportedly influence providers’ chronic pain treatment decisions. A secondary aim was to examine differences across participant training level. Methods Eighty-five participants (35 medical st...

  3. Comparison of surgical techniques in the treatment of laryngeal polypoid degeneration.

    Science.gov (United States)

    Lumpkin, S M; Bishop, S G; Bennett, S

    1987-01-01

    Surgical excision has been the accepted treatment of laryngeal polypoid degeneration, or chronic polypoid corditis. We report on 29 women with polypoid degeneration who received one of three surgical treatments: vocal fold stripping, carbon dioxide laser obliteration, or the Hirano technique. The duration of postoperative dysphonia was longest with the laser removal and shortest with the Hirano technique. A combination of vocal hygiene management and the Hirano technique of removal provided the most efficacious treatment.

  4. Medium term efficacy analysis of bi-level BRYAN artificial cervical disc replacement for the treatment of cervical spondylosis%双节段BRYAN人工颈间盘置换的中期疗效分析

    Institute of Scientific and Technical Information of China (English)

    种涛; 俞兴; 贾育松; 李春根; 柳根哲; 毕连涌; 徐林

    2013-01-01

    [ Objective]To observe the clinical effect and imaging results of the treatment of adjacent segment cervical spon-dylosis in the adjacent bi - level BRYAN cervical disc replacement. [ Method] A retrospective studying was performed on 19 cases of cervical spondylosis receiving adjacent bi - level BRYAN artificial cervical disc replacement and were followed up from January 2006 to February 2009 in our hospital. Clinical outcome of surgery was evaluated by Japanese Orthopaedic Association score (JOA) , neck disability index(NDI) and visual analogue pain scale (VAS)for neck pain before surgery and at 1 week,3, 6,12,24,36 months after surgery respectively. The range of motion (ROM)