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Sample records for selective treatment tst

  1. Kinetics of the QuantiFERON-TB Gold In-Tube test during treatment of patients with sputum smear-positive tuberculosis in relation to initial TST result and severity of disease

    DEFF Research Database (Denmark)

    Idh, Jonna; Abate, Ebba; Westman, Anna

    2010-01-01

    . Smear-positive TB patients (n = 71) were recruited at Gondar University Hospital, Ethiopia. The TST, QFN, CD4+ cell count and clinical symptoms (TB score) were assessed and followed up during treatment. From baseline to 7 months after treatment, there was a significant decrease in QFN reactivity (93.......8% to 62.5% in HIV-negative/TB; 70.3% to 33.3% in HIV-positive/TB patients) down to a level comparable to a control group of blood donors (51.2%). The agreement between TST and QFN was poor in TB patients compared to healthy controls. A negative TST correlated to more advanced TB in contrast to a negative...

  2. Treatment of Prolapsing Hemorrhoids in HIV-Infected Patients with Tissue-Selecting Technique

    Directory of Open Access Journals (Sweden)

    Zhe Fan

    2017-01-01

    Full Text Available The aim of this retrospective study was to evaluate the outcome of a tissue-selecting therapy stapler (TST for prolapsing hemorrhoids in HIV-infected patients. Sixty-two patients with stage III-IV hemorrhoidal prolapse were treated with TST by a single surgeon between June and November 2014. The TST group comprised 32 patients (4 females, and the TST + HIV group comprised 30 HIV-infected patients (3 females. Age, gender, and preoperative examination as well as intraoperative and postoperative features were assessed. There was no marked difference in hemorrhoidal prolapse between the TST and HIV + TST groups, except for patient satisfaction at 12 months. TST is an effective and safe technique for treatment of prolapsing hemorrhoids in HIV-infected patients.

  3. Modelling the impacts of pasture contamination and stocking rate for the development of targeted selective treatment strategies for Ostertagia ostertagi infection in calves

    OpenAIRE

    Berk, Zoe; Laurenson, Yan C.S.M.; Forbes, Andrew B.; Kyriazakis, Ilias

    2017-01-01

    A simulation study was carried out to assess whether variation in pasture contamination or stocking rate impact upon the optimal design of targeted selective treatment (TST) strategies. Two methods of TST implementation were considered: 1) treatment of a fixed percentage of a herd according to a given phenotypic trait, or 2) treatment of individuals that exceeded a threshold value for a given phenotypic trait. Four phenotypic traits, on which to base treatment were considered: 1) average dail...

  4. CERT TST December 2015 Visit Summary

    Energy Technology Data Exchange (ETDEWEB)

    Little, Robert Currier [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Bailey, Teresa S. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Gamblin, G. Todd [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Olinger, Chad Tracy [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Pautz, Shawn D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Williams, Alan B. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-01-25

    The annual PSAAP II TST visit to Texas A&M’s CERT Center was held on December 1-3, 2015. The agenda for the visit is attached. Non-TAMU attendees were: TST Members – Teresa Bailey (LLNL), Todd Gamblin (LLNL), Bob Little (LANL) – Chair, Chad Olinger (LANL), Shawn Pautz (SNL), Alan Williams (SNL);Other Lab staff – Skip Kahler (LANL), Ana Kupresanin (LLNL), and Rob Lowrie (LANL); AST Members – Nelson Hoffman (LANL) and Bob Voigt (Leidos) The TST wishes to express our appreciation to all involved with CERT for the high-quality posters and presentations and for the attention to logistics that enabled a successful visit. We have broken our comments into four sections: (1) Kudos, (2) Recommendations, (3) Feedback on Priorities for April Review, and (4) Follow-Up Activities with Labs.

  5. Mixed methods evaluation of targeted selective anthelmintic treatment by resource-poor smallholder goat farmers in Botswana

    Science.gov (United States)

    Walker, Josephine G.; Ofithile, Mphoeng; Tavolaro, F. Marina; van Wyk, Jan A.; Evans, Kate; Morgan, Eric R.

    2015-01-01

    Due to the threat of anthelmintic resistance, livestock farmers worldwide are encouraged to selectively apply treatments against gastrointestinal nematodes (GINs). Targeted selective treatment (TST) of individual animals would be especially useful for smallholder farmers in low-income economies, where cost-effective and sustainable intervention strategies will improve livestock productivity and food security. Supporting research has focused mainly on refining technical indicators for treatment, and much less on factors influencing uptake and effectiveness. We used a mixed method approach, whereby qualitative and quantitative approaches are combined, to develop, implement and validate a TST system for GINs in small ruminants, most commonly goats, among smallholder farmers in the Makgadikgadi Pans region of Botswana, and to seek better understanding of system performance within a cultural context. After the first six months of the study, 42 out of 47 enrolled farmers were followed up; 52% had monitored their animals using the taught inspection criteria and 26% applied TST during this phase. Uptake level showed little correlation with farmer characteristics, such as literacy and size of farm. Herd health significantly improved in those herds where anthelmintic treatment was applied: anaemia, as assessed using the five-point FAMACHA© scale, was 0.44–0.69 points better (95% confidence interval) and body condition score was 0.18–0.36 points better (95% C.I., five-point scale) in treated compared with untreated herds. Only targeting individuals in greatest need led to similar health improvements compared to treating the entire herd, leading to dose savings ranging from 36% to 97%. This study demonstrates that TST against nematodes can be implemented effectively by resource-poor farmers using a community-led approach. The use of mixed methods provides a promising system to integrate technical and social aspects of TST programmes for maximum uptake and effect. PMID

  6. Modelling the consequences of targeted selective treatment strategies on performance and emergence of anthelmintic resistance amongst grazing calves

    Directory of Open Access Journals (Sweden)

    Zoe Berk

    2016-12-01

    Full Text Available The development of anthelmintic resistance by helminths can be slowed by maintaining refugia on pasture or in untreated hosts. Targeted selective treatments (TST may achieve this through the treatment only of individuals that would benefit most from anthelmintic, according to certain criteria. However TST consequences on cattle are uncertain, mainly due to difficulties of comparison between alternative strategies. We developed a mathematical model to compare: 1 the most ‘beneficial’ indicator for treatment selection and 2 the method of selection of calves exposed to Ostertagia ostertagi, i.e. treating a fixed percentage of the population with the lowest (or highest indicator values versus treating individuals who exceed (or are below a given indicator threshold. The indicators evaluated were average daily gain (ADG, faecal egg counts (FEC, plasma pepsinogen, combined FEC and plasma pepsinogen, versus random selection of individuals. Treatment success was assessed in terms of benefit per R (BPR, the ratio of average benefit in weight gain to change in frequency of resistance alleles R (relative to an untreated population. The optimal indicator in terms of BPR for fixed percentages of calves treated was plasma pepsinogen and the worst ADG; in the latter case treatment was applied to some individuals who were not in need of treatment. The reverse was found when calves were treated according to threshold criteria, with ADG being the best target indicator for treatment. This was also the most beneficial strategy overall, with a significantly higher BPR value than any other strategy, but its degree of success depended on the chosen threshold of the indicator. The study shows strong support for TST, with all strategies showing improvements on calves treated selectively, compared with whole-herd treatment at 3, 8, 13 weeks post-turnout. The developed model appeared capable of assessing the consequences of other TST strategies on calf populations.

  7. [Treatment of selective mutism].

    Science.gov (United States)

    Melfsen, Siebke; Warnke, Andreas

    2007-11-01

    Selective mutism is a communication disorder of childhood in which the child does not speak in specific social situations despite the ability to speak in other situations. A literature review was completed in order to provide practical guidelines for the assessment and treatment of children with selective mutism. There are many different behavioral approaches in the treatment of this disorder, e.g. contingency management, shaping, stimulus fading, escape-avoidance, self-modeling, learning theory approaches. A clearer diagnostic understanding of the disorder as part of anxiety or oppositional disorders needs to be realized prior to generalize an effective treatment for this disorder.

  8. Systematic review of TST responses in people living with HIV in under-resourced settings: implications for isoniazid preventive therapy.

    Directory of Open Access Journals (Sweden)

    Andrew D Kerkhoff

    Full Text Available People living with HIV (PLWH who have positive tuberculin skin tests (TST benefit from isoniazid preventive therapy (IPT whereas those testing TST-negative do not. Revised World Health Organization guidelines explicitly state that assessment of TST is not a requirement for initiation of IPT. However, it is not known what proportions of patients will benefit from IPT if implemented without targeting according to TST status. We therefore determined the proportions of PLWH who test TST-positive.We systematically reviewed the literature published between January 1990 and February 2012 to determine the proportions of patients without active tuberculosis attending HIV care services in low and middle-income countries who tested TST-positive (≥5 mm induration. Proportions were also determined for different CD4 count strata. Data from 19 studies with 9,478 PLWH from sub-Saharan Africa, Asia and Central and South America were summarized. The vast majority were not receiving antiretroviral therapy (ART. A sub-analysis was conducted of 5 studies (5,567 subjects from high TB prevalence countries of PLWH with negative TB screens attending HIV care and treatment settings for whom CD4 stratified data were available. The median proportion of PLWH testing TST-positive overall was 22.8% (range, 19.5-32.6%. The median (range proportions with CD4 cell counts of <200, 200-499 or ≥500 cells/µL who tested positive were 12.4% (8.2-15.3%, 28.4% (20.1-36.9% and 37.4% (31.3-56.3%, respectively. Heterogeneity in the data precluded calculation of pooled summary estimates.In most settings, if IPT is administered to PLWH pre-ART without assessment of TST status, only a minority of those treated are likely to benefit, especially among those with the lowest CD4 cell counts. This may be inefficient use of resources and cost-effectiveness analyses should take this into account. Local knowledge of TST response rates may help inform policies. New simple means of identifying

  9. Identification of effective treatment criteria for use in targeted selective treatment programs to control haemonchosis in periparturient ewes in Ontario, Canada.

    Science.gov (United States)

    Westers, T; Jones-Bitton, A; Menzies, P; VanLeeuwen, J; Poljak, Z; Peregrine, A S

    2016-11-01

    Haemonchosis is often associated with late gestation and parturition in ewes in Canada. Due to widespread concerns about development of anthelmintic resistance (AR), targeted selective treatment (TST), where individual animals are treated with an anthelmintic rather than the entire flock, is a possible strategy to control clinical signs in recently lambed ewes while still maintaining parasite refugia. Performing fecal egg counts (FEC) on individual animals is often cost-prohibitive, so indicators that identify ewes with high FEC are essential for TST programs. The study objectives were to: a) evaluate the ability of four TST indicators to identify periparturient ewes with high Haemonchus sp. FEC and b) determine appropriate treatment thresholds for statistically-significant indicators. A field study was conducted during the 2013 and 2014 lambing seasons (February-May) on three client-owned farms in Ontario with documented AR and problems with haemonchosis in ewes. Ewes were examined within three days of lambing and selected for treatment with oral closantel (10mg/kg body weight), a novel anthelmintic to Canada, if they met at least one of four criteria: a) the last grazing season was their first grazing season; b) body condition score ≤2; c) Faffa Malan Chart (FAMACHA © ) score ≥3; and/or d) three or more nursing lambs. Fecal samples were collected per rectum on the treatment day from each of 20 randomly selected treated and untreated ewes on each farm. Haemonchus sp. percentages on each farm, as determined by coproculture, ranged from 53% to 92% of total fecal trichostrongyle-type egg counts. Mean Haemonchus sp. FECs were significantly higher in treated ewes (n=136) than in untreated ewes (n=103) on the day of treatment in both years (p=0.001), suggesting the indicators were suitable for identifying animals with high Haemonchus sp. FEC. A linear mixed model was fit with logarithmic-transformed Haemonchus sp. FEC as the outcome variable, the four indicators

  10. Initial results from the TST-2 spherical tokamak

    International Nuclear Information System (INIS)

    Takase, Y.; Ejiri, A.; Kasuya, N.

    2001-01-01

    A new spherical tokamak TST-2 was constructed at the University of Tokyo and started operation in September 1999. Reliable plasma initiation is achieved with typically 1 kW of ECH power at 2.45 GHz. Plasma currents of up to 90 kA and toroidal fields of up to 0.2 T have been achieved during the initial experimental campaign. The ion temperature is typically 100 eV. Internal reconnection events (IREs) are often observed. The internal magnetic field measured at r/a=2/3 indicated growth of fluctuations up to the 4 th harmonic, suggesting the existence of modes with several different mode numbers. In the presence of a toroidal field and a vertically oriented mirror field, noninductively driven currents of order 1 kA were observed with 1 kW of ECH power. The driven current increased with decreasing filling pressure, down to 3x10 -6 torr. A study of high harmonic fast wave (HHFW) excitation and propagation has begun. Initial results indicate highly efficient wave launching. (author)

  11. Cough Aerosol Cultures of Mycobacterium tuberculosis: Insights on TST / IGRA Discordance and Transmission Dynamics.

    Directory of Open Access Journals (Sweden)

    Edward C Jones-López

    Full Text Available The diagnosis of latent tuberculosis (TB infection (LTBI is complicated by the absence of a gold standard. Discordance between tuberculin skin tests (TST and interferon gamma release assays (IGRA occurs in 10-20% of individuals, but the underlying mechanisms are poorly understood.We analyzed data from a prospective household contact study that included cough aerosol culture results from index cases, environmental and contact factors. We assessed contacts for LTBI using TST and IGRA at baseline and six weeks. We examined TST/IGRA discordance in qualitative and quantitative analyses, and used multivariable logistic regression analysis with generalized estimating equations to analyze predictors of discordance.We included 96 TB patients and 384 contacts. Discordance decreased from 15% at baseline to 8% by six weeks. In adjusted analyses, discordance was related to less crowding (p = 0.004, non-cavitary disease (OR 1.41, 95% CI: 1.02-1.96; p = 0.03, and marginally with BCG vaccination in contacts (OR 1.40, 95% CI: 0.99-1.98, p = 0.06.We observed significant individual variability and temporal dynamism in TST and IGRA results in household contacts of pulmonary TB cases. Discordance was associated with a less intense infectious exposure, and marginally associated with a BCG-mediated delay in IGRA conversion. Cough aerosols provide an additional dimension to the assessment of infectiousness and risk of infection in contacts.

  12. Phenomenology and treatment of selective mutism.

    Science.gov (United States)

    Kumpulainen, Kirsti

    2002-01-01

    Selective mutism is a multidimensional childhood disorder in which, according to the most recent studies, biologically mediated temperament and anxiety components seem to play a major role. Several psychotherapy methods have been reported in case studies to be useful, but the disorder is commonly seen to be resistant to change, particularly in cases of long duration. Currently, behaviour modification and other cognitive methods, together with cooperation with the family and the school personnel, are recommended in the treatment of selective mutism. Selective serotonin reuptake inhibitors and selective monoamine oxidase inhibitors have also been reported to be helpful when treating children with selective mutism. At the moment, pharmacotherapy cannot be recommended as the treatment of first choice but if other methods of treatment are not helpful, medication can be included in the treatment scheme. Comprehensive evaluation and treatment of possible primary and comorbid problems that require treatment are also essential.

  13. Selective Serotonin Reuptake Inhibitors for Treatment of Selective Mutism

    Directory of Open Access Journals (Sweden)

    Mazlum Çöpür

    2012-03-01

    Full Text Available Some authors suggest that selective mutism should be considered as a variant of social phobia or a disorder in the obsessive-compulsive spectrum. Recent studies indicate that pharmacological treatments may be effective in the treatment of selective mutism. In this article, four cases who were treated with citalopram and escitalopram are presented. The results indicate that the drugs were well tolerated, and the level of social and verbal interactions improved significantly. These findings have shown that citalopram and escitalopram can be considered in medication of selective mutism; nevertheless, it is essential that research be done with more cases than previous ones, in order to prove their accuracy

  14. [Silvicultural treatments and their selection effects].

    Science.gov (United States)

    Vincent, G

    1973-01-01

    Selection can be defined in terms of its observable consequences as the non random differential reproduction of genotypes (Lerner 1958). In the forest stands we are selecting during the improvements-fellings and reproduction treatments the individuals surpassing in growth or in production of first-class timber. However the silvicultural treatments taken in forest stands guarantee a permanent increase of forest production only in such cases, if they have been taken with respect to the principles of directional (dynamic) selection. These principles require that the trees determined for further growing and for forest regeneration are selected by their hereditary properties, i.e. by their genotypes.For making this selection feasible, our study deals with the genetic parameters and gives some examples of the application of the response, the selection differential, the heritability in the narrow and in the broad sense, as well as of the genetic and genotypic gain. On the strength of this parameter we have the possibility to estimate the economic success of several silvicultural treatments in forest stands.The mentioned examples demonstrate that the selection measures of a higher intensity will be manifested in a higher selection differential, in a higher genetic and genotypic gain and that the mentioned measures show more distinct effects in the variable populations - in natural forest - than in the population characteristic by a smaller variability, e.g. in many uniform artificially established stands.The examples of influences of different selection on the genotypes composition of population prove that genetics instructs us to differentiate the different genotypes of the same species and gives us at the same time a new criterions for evaluating selectional treatments. These criterions from economic point of view is necessary to consider in silviculture as advantageous even for the reason that we can judge from these criterions the genetical composition of forest stands

  15. Treatment of selective mutism: focus on selective serotonin reuptake inhibitors.

    Science.gov (United States)

    Kaakeh, Yaman; Stumpf, Janice L

    2008-02-01

    Abstract Selective mutism is a pediatric psychiatric disorder that occurs when a child consistently fails to speak in specific situations in which speaking is expected, such as at school and social gatherings, but speaks appropriately in other settings. Selective mutism often is diagnosed when a child starts school and does not talk to teachers or peers, but talks to family members at home; the condition is frequently accompanied by anxiety and shyness. Although the underlying etiology of the condition remains unclear, psychotherapy is the preferred initial treatment, with the support of parents and teachers. If the child does not respond to psychotherapy, addition of pharmacologic treatment should be considered, depending on the severity of symptoms and presence of other illnesses. Although data are limited to case reports and trials with small patient populations and short follow-up periods, some patients with selective mutism respond to therapy with selective serotonin reuptake inhibitors (SSRIs). Fluoxetine is the most studied SSRI as treatment for the condition, although further investigation is required to determine the optimal dosage and duration of therapy.

  16. Comparison of TST and IGRA in Diagnosis of Latent Tuberculosis Infection in a High TB-Burden Setting.

    Science.gov (United States)

    Sharma, Surendra K; Vashishtha, Richa; Chauhan, L S; Sreenivas, V; Seth, Divya

    2017-01-01

    There are currently two tests for diagnosing latent tuberculosis infection (LTBI); TST and IGRA. However, it is still unclear that which one of these tests performs better in high TB-burden settings. 1511 household contacts of pulmonary TB patients were enrolled to compare the performance of TST and IGRA for LTBI. At baseline all participant underwent testing for IGRA [QuantiFERON-TB® Gold In-tube (QFT-GIT) assay] and TST [2 tuberculin unit (TU), purified protein derivative (PPD), RT23, Staten Serum Institute (SSI), Copenhagen, Denmark]. All the household contacts were followed-up for two years for incident TB cases. Active TB was diagnosed in 76 household contacts at an incidence rate of 2.14 per 1000 person-years. Both, TST [Hazard Ratio (HR): 1.14, 95% confidence interval (CI): 0.72-1.79, p = 0.57], as well as QFT-GIT assay (HR: 1.66, 95% CI: 0.97-2.84, p = 0.06) results at baseline were not significantly associated with subsequent development of active TB among household contacts of pulmonary TB patients. Neither TST nor IGRA predicted subsequent development of active TB among household contacts of pulmonary TB patients during follow-up. However, keeping in view the cost, and other logistics, TST remains the most preferred method for LTBI diagnosis in resource-limited, high TB-burden settings.

  17. Plasma current start-up experiments without the central solenoid in the TST-2 spherical tokamak

    International Nuclear Information System (INIS)

    Takase, Y.; Ejiri, A.; Shiraiwa, S.; Adachi, Y.; Ishii, N.; Kasahara, H.; Nuga, H.; Ono, Y.; Oosako, T.; Sasaki, M.; Shimada, Y.; Sumitomo, N.; Taguchi, I.; Tojo, H.; Tsujimura, J.; Ushigome, M.; Yamada, T.; Hanada, K.; Hasegawa, M.; Idei, H.; Nakamura, K.; Sakamoto, M.; Sasaki, K.; Sato, K.N.; Zushi, H.; Nishino, N.; Mitarai, O.

    2006-01-01

    Several techniques for initiating the plasma current without the use of the central solenoid are being developed in TST-2. While TST-2 was temporarily located at Kyushu University, two types of start-up scenarios were demonstrated. (1) A plasma current of 4 kA was generated and sustained for 0.28 s by either electron cyclotron wave or electron Bernstein wave, without induction. (2) A plasma current of 10 kA was obtained transiently by induction using only outboard poloidal field coils. In the second scenario, it is important to supply sufficient power for ionization (100 kW of EC power was sufficient in this case), since the vertical field during start-up is not adequate to maintain plasma equilibrium. In addition, electron heating experiments using the X-B mode conversion scenario were performed, and a heating efficiency of 60% was observed at a 100 kW RF power level. TST-2 is now located at the Kashiwa Campus of the University of Tokyo. Significant upgrades were made in both magnetic coil power supplies and RF systems, and plasma experiments have restarted. RF power of up to 400 kW is available in the high-harmonic fast wave frequency range around 20 MHz. Four 200 MHz transmitters are now being prepared for plasma current start-up experiments using RF power in the lower-hybrid frequency range. Preparations are in progress for a new plasma merging experiment (UTST) aimed at the formation and sustainment of ultra-high β ST plasmas

  18. Ion temperature increase during MHD events on the TST-2 spherical tokamak

    International Nuclear Information System (INIS)

    Ejiri, A.; Shiraiwa, S.; Takase, Y.; Yamada, T.; Nagashima, Y.; Kasahara, H.; Iijima, D.; Kobori, Y.; Nishi, T.; Taniguchi, T.; Aramasu, M.; Ohara, S.; Ushigome, M.; Yamagishi, K.

    2003-01-01

    Various types of MHD events including internal reconnection events are studied on the TST-2 spherical tokamak. In weak MHD events no positive current spike was observed, but in strong MHD events with positive current spikes, a rapid and significant impurity ion temperature increase was observed. The decrease in the poloidal magnetic energy is the most probable energy source for ion heating. The plasma current shows a stepwise change. The magnitude of this step correlates with the temperature increase and is found to be a good indicator of the strength of each event. (author)

  19. Treatment selection for tonsillar squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Yao-Yuan Kuo

    2013-04-01

    Conclusion: Both primary surgery and RT/CRT organ preservation are effective treatments for tonsillar SCC. Single modality treatment, either surgery or RT/CRT, can typically be provided for stage I–II diseases. Although RT/CRT organ preservation is used more frequently for stage III–IV tonsillar SCC in recent years, primary surgery combined with adjuvant therapy still achieves equivalent outcomes. Multidisciplinary pretreatment counseling and the facilities and personnel available are therefore important for decision-making. In addition, if RT/CRT organ preservation is selected as the primary treatment, tumor tonsillectomy is not indicated.

  20. Benign meningiomas: primary treatment selection affects survival

    International Nuclear Information System (INIS)

    Condra, Kellie S.; Buatti, John M.; Mendenhall, William M.; Friedman, William A.; Marcus, Robert B.; Rhoton, Albert L.

    1997-01-01

    Purpose: To examine the effect of primary treatment selection on outcomes for benign intracranial meningiomas at the University of Florida. Methods and Materials: For 262 patients, the impact of age, Karnofsky performance status, pathologic features, tumor size, tumor location, and treatment modality on local control and cause-specific survival was analyzed (minimum potential follow-up, 2 years; median follow-up, 8.2 years). Extent of surgery was classified by Simpson grade. Treatment groups: surgery alone (n = 229), surgery and postoperative radiotherapy (RT) (n = 21), RT alone (n = 7), radiosurgery alone (n = 5). Survival analysis: Kaplan-Meier method with univariate and multivariate analysis. Results: At 15 years, local control was 76% after total excision (TE) and 87% after subtotal excision plus RT (SE+RT), both significantly better (p = 0.0001) than after SE alone (30%). Cause-specific survival at 15 years was reduced after treatment with SE alone (51%), compared with TE (88%) or SE+RT (86%) (p = 0.0003). Recurrence after primary treatment portended decreased survival, independent of initial treatment group or salvage treatment selection (p = 0.001). Atypical pathologic features predicted reduced 15-year local control (54 vs. 71%) and cause-specific survival rates (57 vs. 86%). Multivariate analysis for cause-specific survival revealed treatment group (SE vs. others; p = 0.0001), pathologic features (atypical vs. typical; p = 0.0056), and Karnofsky performance status (≥80 vs. <80; p = 0.0153) as significant variables. Conclusion: Benign meningiomas are well managed by TE or SE+RT. SE alone is inadequate therapy and adversely affects cause-specific survival. Atypical pathologic features predict a poorer outcome, suggesting possible benefit from more aggressive treatment. Because local recurrence portends lower survival rates, primary treatment choice is important

  1. Selection of technologies for municipal wastewater treatment

    Directory of Open Access Journals (Sweden)

    Juan Pablo Rodríguez Miranda

    2015-11-01

    Full Text Available In water environmental planning in watersheds should contain aspects for the decontamination of receiving water body, therefore the selection of the treatment plants municipal wastewater in developing countries, you should consider aspects of the typical composition raw wastewater pollutant removal efficiency by technology, performance indicators for technology, environmental aspects of localization and spatial localization strategy. This methodology is built on the basis of technical, economic and environmental attributes, such as a tool for decision making future investments in treatment plants municipal wastewater with multidisciplinary elements.

  2. Constrained treatment planning using sequential beam selection

    International Nuclear Information System (INIS)

    Woudstra, E.; Storchi, P.R.M.

    2000-01-01

    In this paper an algorithm is described for automated treatment plan generation. The algorithm aims at delivery of the prescribed dose to the target volume without violation of constraints for target, organs at risk and the surrounding normal tissue. Pre-calculated dose distributions for all candidate orientations are used as input. Treatment beams are selected in a sequential way. A score function designed for beam selection is used for the simultaneous selection of beam orientations and weights. In order to determine the optimum choice for the orientation and the corresponding weight of each new beam, the score function is first redefined to account for the dose distribution of the previously selected beams. Addition of more beams to the plan is stopped when the target dose is reached or when no additional dose can be delivered without violating a constraint. In the latter case the score function is modified by importance factor changes to enforce better sparing of the organ with the limiting constraint and the algorithm is run again. (author)

  3. RF start-up and sustainment experiments on the TST-2-K spherical tokamak

    International Nuclear Information System (INIS)

    Ejiri, A.; Takase, Y.; Kasahara, H.; Yamada, T.; Hanada, K.; Sato, K. N.; Zushi, H.; Nakamura, K.; Sakamoto, M.; Idei, H.; Hasegawa, M.; Iyomasa, A.; Imamura, N.; Esaki, K.; Kitaguchi, M.; Sasaki, K.; Hoshika, H.; Mitarai, O.; Nishino, N.

    2006-01-01

    Plasma start-up and sustainment without an inductive field have been studied in the TST-2-K spherical tokamak using high power RF sources (8.2 GHz/up to 170 kW). Steady state discharges with a plasma current of 4 kA were achieved. The line integrated density was about 3 x 10 17 m -2 and the electron temperature was 160 eV. A truncated equilibrium was introduced to reproduce magnetic measurements. It was found that a positive Pfirsch-Schlueter current in the open field line region at the outboard boundary makes a significant contribution to the current. Insensitivity of the current to variations in the vertical field and RF power variation was also found

  4. Treatment of Selective Mutism: A Best-Evidence Synthesis.

    Science.gov (United States)

    Stone, Beth Pionek; Kratochwill, Thomas R.; Sladezcek, Ingrid; Serlin, Ronald C.

    2002-01-01

    Presents systematic analysis of the major treatment approaches used for selective mutism. Based on nonparametric statistical tests of effect sizes, major findings include the following: treatment of selective mutism is more effective than no treatment; behaviorally oriented treatment approaches are more effective than no treatment; and no…

  5. Clinical observations on the treatment of prolapsing hemorrhoids with tissue selecting therapy.

    Science.gov (United States)

    Wang, Zhi-Gang; Zhang, Yong; Zeng, Xian-Dong; Zhang, Tie-Hui; Zhu, Qi-Dong; Liu, De-Long; Qiao, Yun-Yu; Mu, Nan; Yin, Zhi-Tao

    2015-02-28

    To compare the effects and postoperative complications between tissue selecting therapy stapler (TST) and Milligan-Morgan hemorrhoidectomy (M-M). Four hundred and eighty patients with severe prolapsing hemorrhoids, who were admitted to the Shenyang Coloproctology Hospital between 2009 and 2012, were randomly divided into observation (n=240) and control (n=240) groups. Hemorrhoidectomies were performed with TST in the observation group and with the M-M technique in the control group. The therapeutic effects, operation security, and postoperative complications in the two groups were compared. The immediate and long-term complications were assessed according to corresponding criteria. Pain was assessed on a visual analogue scale. The efficacy was assessed by specialized criteria. The follow-up was conducted one year after the operation. The total effective rates of the observation and control groups were 99.5% (217/218) and 98.6% (218/221) respectively; the difference was not statistically significant (P=0.322). Their were significant differences between observation and control groups in intraoperative blood loss (5.07±1.14 vs 2.45±0.57, P=0.000), pain (12 h after the surgery: 5.08±1.62 vs 7.19±2.01, P=0.000; at first dressing change: 2.64±0.87 vs 4.34±1.15, P=0.000; first defecation: 3.91±1.47 vs 5.63±1.98, P=0.001), urine retention (n=22 vs n=47, P=0.001), anal pendant expansion after the surgery (2.35±0.56 vs 5.16±1.42, P=0.000), operation time (18.3±5.6 min vs 29.5±8.2 min, P=0.000), and the length of hospital stay (5.3±0.6 d vs 11.4±1.8 d, P=0.000). Moreover TST showed significant reductions compared to M-M in the rates of long-term complications such as fecal incontinence (n=3 vs n=16, P=0.003), difficult bowel movement (n=1 vs n=9, P=0.011), intractable pain (n=2 vs n=12, P=0.007), and anal discharge (n=3 vs n=23, P=0.000). TST for severe prolapsing hemorrhoids is a satisfactory technique for more rapid recovery, lower complication rates, and

  6. Light-cone reduction vs. TsT transformations: a fluid dynamics perspective

    Science.gov (United States)

    Dutta, Suvankar; Krishna, Hare

    2018-05-01

    We compute constitutive relations for a charged (2+1) dimensional Schrödinger fluid up to first order in derivative expansion, using holographic techniques. Starting with a locally boosted, asymptotically AdS, 4 + 1 dimensional charged black brane geometry, we uplift that to ten dimensions and perform TsT transformations to obtain an effective five dimensional local black brane solution with asymptotically Schrödinger isometries. By suitably implementing the holographic techniques, we compute the constitutive relations for the effective fluid living on the boundary of this space-time and extract first order transport coefficients from these relations. Schrödinger fluid can also be obtained by reducing a charged relativistic conformal fluid over light-cone. It turns out that both the approaches result the same system at the end. Fluid obtained by light-cone reduction satisfies a restricted class of thermodynamics. Here, we see that the charged fluid obtained holographically also belongs to the same restricted class.

  7. Detection of toxic shock toxin (tst gene in Staphylococcus aureus isolated from bovine milk samples

    Directory of Open Access Journals (Sweden)

    S. Baniardalan

    2017-09-01

    Full Text Available Staphylococcus aureus is a major causative pathogen of clinical and subclinical mastitis in dairy cattle all over the world. This agent produces a variety of extracellular toxins and virulence factors in-cluding toxic shock syndrome toxin-1 (TSST-1 which is the major cause of toxic shock syndrome (TSS. In the present study, 76 S. aureus isolates have been obtained from milk samples collected from 7 dairy herds in Hamedan province of Iran. The isolates were identified based on the biochemical and molecular methods using PCR amplification of the femA gene. The staphylococcal isolates were also examined for the presence of TSST-1 (tst encoding gene. This gene was detected in only one S. aureus isolate (1.3%. The results revealed that S. aureus strains causing bovine mastitis may potentially produce staphylococcal toxic shock syndrome toxin-1, indicating that it is very important to follow the presence of TSST-1 producing S. aureus isolates in foodstuffs to protect consumers against the risk of toxic shock syndrome

  8. Waste treatment by selective mineral ion exchanger

    International Nuclear Information System (INIS)

    Polito, Aurelie

    2007-01-01

    STMI, subsidiary company of the AREVA Group with over 40 years in the D and D business, has been continuously innovating and developing new decontamination techniques, with the objectives of achieving more efficient decontaminations on a growing spectrum of media. In the field of liquid waste treatment, STMI manufactures uses and commercialises selective inorganic ion exchangers (RAN). These are hydrated synthetic inorganic compounds prepared from very pure raw materials. Different types of RANs (POLYAN, OXTAIN, Fe-Cu, Fe-CoK, Si-Fe-CoK) can be used to trap a large number of radioactive elements in contaminated effluents. Different implementations could be applied depending on technical conditions. STMI's offers consist in building global solution and preliminary design of installation either in dispersed form (batch) or in column (cartridge filtration). Those products are used all over the world not only in the nuclear business (Canada, US, Belgium, France...) but also in other fields. Indeed, it provides competitive solutions to many domains of application especially water pollution control, liquid waste treatment in the nuclear business by decreasing the activity level of waste. The following paper will focus on the theoretical principle of the mineral exchanger, its implementation and the feed back collected by STMI. (author)

  9. The efficiency of subset selection of an almost best treatment

    NARCIS (Netherlands)

    Laan, van der P.

    1991-01-01

    A generalized goal using subset selection is discussed for the location parameter case. This goal is to select a non-empty subset from a set of k (k \\geq 2) treatments that contains at least one \\epsilon-best treatment with confidence level P*. For a set of treatments an \\epsilon-best treatment is

  10. Measurement of ion temperature and flow in RF start-up plasmas in TST-2 and LATE

    International Nuclear Information System (INIS)

    Tsuda, Shintaro; Ejiri, Akira; Takase, Yuichi; Tsujii, Naoto; Takeuchi, Toshihiro; Tanaka, Hitoshi; Uchida, Masaki; Maekawa, Takashi

    2015-01-01

    The ion temperature and flow of RF start-up plasmas in TST-2 and LATE were measured using a visible spectrometer. The plasma currents were 9 kA and 8 kA, respectively. The typical ion temperatures T i and toroidal flow V ϕ were 4 eV and 1 km/s, respectively, in the TST-2 plasma sustained by the lower hybrid wave (20 kW) and T i ∼ 10 eV and V ϕ ∼ 5 km/s in the LATE plasma sustained by the electron cyclotron wave (50 kW). The poloidal flow velocities were comparable to the toroidal velocities. The ion temperatures were relatively high and the ion orbit loss can be significant. (author)

  11. Selective dry cow treatment in dairy cows

    OpenAIRE

    Scherpenzeel, C.G.M.

    2017-01-01

    In the dairy industry, udder health is associated with mastitis management, of which blanket dry cow treatment has been an important part for decades. To prevent the udder from new intramammary infections during the dry period, the use of blanket dry cow treatment has been advocated for more than 50 years as part of the five-point mastitis prevention program. The goal of dry cow treatment is to reduce the prevalence of intramammary infections by eliminating infections already present at dryin...

  12. Selective dry cow treatment in dairy cows

    NARCIS (Netherlands)

    Scherpenzeel, C.G.M.

    2017-01-01

    In the dairy industry, udder health is associated with mastitis management, of which blanket dry cow treatment has been an important part for decades. To prevent the udder from new intramammary infections during the dry period, the use of blanket dry cow treatment has been advocated for more than 50

  13. Selective Mutism: Definition, Issues, and Treatment.

    Science.gov (United States)

    Brigham, Frederick J.; Cole, Jane E.

    This paper reviews definitions and issues in selective mutism in children and summarizes results of interventions conducted and published since 1982. Definitions and diagnostic criteria of the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (1994)" and the World Health Organization's…

  14. Behavior Observations for Linking Assessment to Treatment for Selective Mutism

    Science.gov (United States)

    Shriver, Mark D.; Segool, Natasha; Gortmaker, Valerie

    2011-01-01

    Selective mutism is a childhood disorder that most school psychologists and educational providers will come across at least once in their careers. Selective mutism is associated with significant impairment in educational settings where speaking is necessary for academic and social skill development. Effective treatments for selective mutism…

  15. Selection of medical treatment in stable angina pectoris

    DEFF Research Database (Denmark)

    Ardissino, D; Savonitto, S; Egstrup, K

    1995-01-01

    pectoris. BACKGROUND: The characteristics of anginal symptoms and the results of exercise testing are considered of great importance for selecting medical treatment in patients with chronic stable angina pectoris. However, little information is available on how this first evaluation may be used to select....... CONCLUSIONS: The results of a baseline exercise test, but not the characteristics of anginal symptoms, may offer useful information for selecting medical treatment in stable angina pectoris....

  16. Electrochemical corrosion studies of the TStE 355 fine-grained structural steel in sulfide containing brine

    International Nuclear Information System (INIS)

    Farvaque-Bera, A.M.; Berg, H. von.

    1994-04-01

    Previous corrosion studies have shown that the unalloyed fine-grained steel TStE 355 (Material No. 1.0566) is a promising material for the manufacturing of long-lived high-level waste (HLW) containers that could act as a barrier in a rock-salt repository. Considering this fact, further electrochemical corrosion tests were performed in order to determine the influence of sulfide ions (1 -200 ppm), present as salt impurities in disposal relevant NaCl-brine (T = 55 -90 C), on the corrosion behaviour of this steel grade. For comparison, tests were carried out in the sulfide-free brine, too. (orig.) [de

  17. Selection of water treatment processes special study

    International Nuclear Information System (INIS)

    1991-11-01

    Characterization of the level and extent of groundwater contamination in the vicinity of Title I mill sites began during the surface remedial action stage (Phase 1) of the Uranium Mill Tailings Remedial Action (UMTRA) Project. Some of the contamination in the aquifer(s) at the abandoned sites is attributable to milling activities during the years the mills were in operation. The restoration of contaminated aquifers is to be undertaken in Phase II of the UMTRA Project. To begin implementation of Phase II, DOE requested that groundwater restoration methods and technologies be investigated by the Technical Assistance Contractor (TAC). and that the results of the TAC investigations be documented in special study reports. Many active and passive methods are available to clean up contaminated groundwater. Passive groundwater treatment includes natural flushing, geochemical barriers, and gradient manipulation by stream diversion or slurry walls. Active groundwater.cleanup techniques include gradient manipulation by well extraction or injection. in-situ biological or chemical reclamation, and extraction and treatment. Although some or all of the methods listed above may play a role in the groundwater cleanup phase of the UMTRA Project, the extraction and treatment (pump and treat) option is the only restoration alternative discussed in this report. Hence, all sections of this report relate either directly or indirectly to the technical discipline of process engineering

  18. The selective external carotid arterial embolization treatment of uncontrollable epistaxis

    International Nuclear Information System (INIS)

    Yao Qunli; Liu Yizhi; Ni Caifang

    2004-01-01

    Objective: To evaluate the selective external carotid arterial embolization of uncontrollable epistaxis. Methods: 27 procedures of super-selective external carotid arterial embolization were performed with absorbable gelfoam by using Seldinger's method in 26 cases with uncontrollable epistaxis. Results: 27 procedures of super-selective intra-arterial embolization of uncontrollable epistaxis were all successful without any serious complication. Conclusions: Selective external carotid arterial embolization is safe, effective and successful in the treatment of severe epistaxis. (authors)

  19. Impact of the Regulators SigB, Rot, SarA and sarS on the Toxic Shock Tst Promoter and TSST-1 Expression in Staphylococcus aureus.

    Directory of Open Access Journals (Sweden)

    Diego O Andrey

    Full Text Available Staphylococcus aureus is an important pathogen manifesting virulence through diverse disease forms, ranging from acute skin infections to life-threatening bacteremia or systemic toxic shock syndromes. In the latter case, the prototypical superantigen is TSST-1 (Toxic Shock Syndrome Toxin 1, encoded by tst(H, and carried on a mobile genetic element that is not present in all S. aureus strains. Transcriptional regulation of tst is only partially understood. In this study, we dissected the role of sarA, sarS (sarH1, RNAIII, rot, and the alternative stress sigma factor sigB (σB. By examining tst promoter regulation predominantly in the context of its native sequence within the SaPI1 pathogenicity island of strain RN4282, we discovered that σB emerged as a particularly important tst regulator. We did not detect a consensus σB site within the tst promoter, and thus the effect of σB is likely indirect. We found that σB strongly repressed the expression of the toxin via at least two distinct regulatory pathways dependent upon sarA and agr. Furthermore rot, a member of SarA family, was shown to repress tst expression when overexpressed, although its deletion had no consistent measurable effect. We could not find any detectable effect of sarS, either by deletion or overexpression, suggesting that this regulator plays a minimal role in TSST-1 expression except when combined with disruption of sarA. Collectively, our results extend our understanding of complex multifactorial regulation of tst, revealing several layers of negative regulation. In addition to environmental stimuli thought to impact TSST-1 production, these findings support a model whereby sporadic mutation in a few key negative regulators can profoundly affect and enhance TSST-1 expression.

  20. Influence of selected washing treatments and drying temperatures ...

    African Journals Online (AJOL)

    Influence of selected washing treatments and drying temperatures on ... with regard to the optimal retention of the crude protein and fat levels of the dried dagaa. ... are accessible to most of the households involved in dried fish processing.

  1. Friction Surface Treatment Selection: Aggregate Properties, Surface Characteristics, Alternative Treatments, and Safety Effects

    Science.gov (United States)

    2017-07-01

    This study aimed to evaluate the long term performance of the selected surface friction treatments, including high friction surface treatment (HFST) using calcined bauxite and steel slag, and conventional friction surfacing, in particular pavement pr...

  2. Selective embolization in the treatment of intractable epistaxis

    DEFF Research Database (Denmark)

    Andersen, Pia Juul; Kjeldsen, Anette Drøhse; Nepper-Rasmussen, Jørgen

    2005-01-01

    : This was a retrospective review. Post-treatment effects and complications were evaluated by means of a questionnaire and a telephone interview. Owing to the different treatment strategies used, the results were evaluated for 2 groups of patients: Group A, 9 patients with HHT; and Group B, 13 patients with causes...... the bleeding may present difficulties. Several methods are used to control posterior epistaxis, one of the latest treatment strategies being selective embolization of the nasal arteries. The aim of this study was to describe the effect of selective embolization in 22 patients treated with a total of 30...... procedures at the ENT Department of Odense University Hospital between January 1995 and March 2004. To our knowledge this is the first Nordic work in which selective embolization has been used as a treatment strategy for patients with hereditary hemorrhagic telangiectasia (HHT). MATERIAL AND METHODS...

  3. Non-inductive plasma initiation and plasma current ramp-up on the TST-2 spherical tokamak

    International Nuclear Information System (INIS)

    Takase, Y.; Ejiri, A.; Oosako, T.; Shinya, T.; Ambo, T.; Furui, H.; Kato, K.; Nakanishi, A.; Sakamoto, T.; Kakuda, H.; Wakatsuki, T.; Hashimoto, T.; Hiratsuka, J.; Kasahara, H.; Kumazawa, R.; Mutoh, T.; Saito, K.; Seki, T.; Moeller, C.P.; Nagashima, Y.

    2013-01-01

    Plasma current (I p ) start-up in a spherical tokamak (ST) by waves in the lower-hybrid (LH) frequency range was investigated on TST-2. A low current (∼1 kA) ST configuration can be formed by waves over a broad frequency range (21 MHz–8.2 GHz in TST-2), but further I p ramp-up (to ∼10 kA) is most efficient with waves in the LH frequency range. I p ramp-up to 15 kA was achieved with 60 kW of net RF power P RF in the fast wave (FW) polarization at 200 MHz excited by the inductively coupled combline antenna. X-ray measurements showed that the photon flux and temperature are higher in the direction opposite to I p , consistent with acceleration of electrons by a uni-directional RF wave. There is evidence that the LH wave is excited nonlinearly by the FW, based on the frequency spectra measured by magnetic probes. Similar efficiencies of I p ramp-up were obtained with the inductive combline antenna and the dielectric-loaded waveguide array (‘grill’) antenna, and tendencies for the current drive efficiency to increase with plasma current and toroidal field were observed. During operation of the grill antenna, wavevector components were measured by an array of magnetic probes. Results were qualitatively consistent with expectations based on dispersion relations for the FW and the LH wave. A capacitively coupled combline antenna has been developed to improve coupling to the plasma and the wavenumber spectrum of the excited LH wave, and will be tested in 2013. (paper)

  4. Selective mutism: a review of etiology, comorbidities, and treatment.

    Science.gov (United States)

    Wong, Priscilla

    2010-03-01

    Selective mutism is a rare and multidimensional childhood disorder that typically affects children entering school age. It is characterized by the persistent failure to speak in select social settings despite possessing the ability to speak and speak comfortably in more familiar settings. Many theories attempt to explain the etiology of selective mutism.Comorbidities and treatment. Selective mutism can present a variety of comorbidities including enuresis, encopresis, obsessive-compulsive disorder, depression, premorbid speech and language abnormalities, developmental delay, and Asperger's disorders. The specific manifestations and severity of these comorbidities vary based on the individual. Given the multidimensional manifestations of selective mutism, treatment options are similarly diverse. They include individual behavioral therapy, family therapy, and psychotherapy with antidepressants and anti-anxiety medications.Future directions. While studies have helped to elucidate the phenomenology of selective mutism, limitations and gaps in knowledge still persist. In particular, the literature on selective mutism consists primarily of small sample populations and case reports. Future research aims to develop an increasingly integrated, multidimensional framework for evaluating and treating children with selective mutism.

  5. Multimethod Behavioral Treatment of Long-Term Selective Mutism.

    Science.gov (United States)

    Watson, T. Steuart; Kramer, Jack J.

    1992-01-01

    Conducted single-subject, experimental research to examine efficacy of treating severe, long-term selective mutism in nine-year-old male using shaping, multiple reinforcers, natural consequences, stimulus fading, and mild aversives. Implemented different treatment regimens in home and school environments. Home intervention resulted in increase in…

  6. Assessment and Treatment of Selective Mutism with English Language Learners

    Science.gov (United States)

    Mayworm, Ashley M.; Dowdy, Erin; Knights, Kezia; Rebelez, Jennica

    2015-01-01

    Selective mutism (SM) is a type of anxiety disorder that involves the persistent failure to speak in contexts where speech is typically expected (e.g., school), despite speaking in other contexts (e.g., home). Research on the etiology and treatment of SM is limited, as it is a rare disorder and few clinical trials evaluating SM interventions have…

  7. Trends in pharmacotherapy selection for the treatment of alcohol ...

    African Journals Online (AJOL)

    Background. The selection of pharmacotherapy for the treatment of alcohol withdrawal remains a clinical challenge. Research continues into the underlying pathophysiology of dependence and withdrawal. A spectrum of clinical presentations of alcohol dependence is emerging, yet recommendations and guidelines have ...

  8. Appropriate selection for omalizumab treatment in patients with severe asthma?

    DEFF Research Database (Denmark)

    Nygaard, Leo; Henriksen, Daniel Pilsgaard; Madsen, Hanne

    2017-01-01

    Background: Omalizumab improves asthma control in patients with uncontrolled severe allergic asthma; however, appropriate patient selection is crucial. Information in this field is sparse. Objective: We aimed to estimate whether potential omalizumab candidates were appropriately selected according...... to guidelines, and the clinical effect of omalizumab treatment over time. Design: We performed a retrospective observational study on adult patients with asthma treated with omalizumab during 2006-2015 at the Department of Respiratory Medicine at Odense University Hospital (OUH), Denmark. Data were obtained...... from the Electronic Patient Journal of OUH and Odense Pharmaco-Epidemiological Database. Guideline criteria for omalizumab treatment were used to evaluate the appropriateness of omalizumab candidate selection, and the Asthma Control Test (ACT) to assess the clinical effects of omalizumab at weeks 16...

  9. Wastewater sludge treatment at selected wastewater treatment plants of the region Banska Bystrica

    International Nuclear Information System (INIS)

    Samesova, D.; Mitterpach, J.; Martinkova, A.

    2014-01-01

    The management of sewage sludges in water treatment plants of Banska Bystrica region. The paper deals with the problems of sewage sludge in wastewater treatment plants, its origin and possibilities how to use it in accordance with the current legislation of the Slovak Republic. We described radioactive pollution of sewage sludges. The paper consists of review of sludge production and its usage in the Slovak Republic and in selected states of the European Union. The paper deals with the sludge treatment in selected wastewater treatment plants in Banska Bystrica region in the context of biogas production and its usage by the help of the electricity and heat production. (authors)

  10. Individual treatment selection for patients with posttraumatic stress disorder.

    Science.gov (United States)

    Deisenhofer, Anne-Katharina; Delgadillo, Jaime; Rubel, Julian A; Böhnke, Jan R; Zimmermann, Dirk; Schwartz, Brian; Lutz, Wolfgang

    2018-04-16

    Trauma-focused cognitive behavioral therapy (Tf-CBT) and eye movement desensitization and reprocessing (EMDR) are two highly effective treatment options for posttraumatic stress disorder (PTSD). Yet, on an individual level, PTSD patients vary substantially in treatment response. The aim of the paper is to test the application of a treatment selection method based on a personalized advantage index (PAI). The study used clinical data for patients accessing treatment for PTSD in a primary care mental health service in the north of England. PTSD patients received either EMDR (N = 75) or Tf-CBT (N = 242). The Patient Health Questionnaire (PHQ-9) was used as an outcome measure for depressive symptoms associated with PTSD. Variables predicting differential treatment response were identified using an automated variable selection approach (genetic algorithm) and afterwards included in regression models, allowing the calculation of each patient's PAI. Age, employment status, gender, and functional impairment were identified as relevant variables for Tf-CBT. For EMDR, baseline depressive symptoms as well as prescribed antidepressant medication were selected as predictor variables. Fifty-six percent of the patients (n = 125) had a PAI equal or higher than one standard deviation. From those patients, 62 (50%) did not receive their model-predicted treatment and could have benefited from a treatment assignment based on the PAI. Using a PAI-based algorithm has the potential to improve clinical decision making and to enhance individual patient outcomes, although further replication is necessary before such an approach can be implemented in prospective studies. © 2018 Wiley Periodicals, Inc.

  11. Identification of waves by RF magnetic probes during lower hybrid wave injection experiments on the TST-2 spherical tokamak

    International Nuclear Information System (INIS)

    Shinya, Takahiro; Ejiri, Akira; Takase, Yuichi

    2014-01-01

    RF magnetic probes can be used to measure not only the wavevector, but also the polarization of waves in plasmas. A 5-channel RF magnetic probe (5ch-RFMP) was installed in the TST-2 spherical tokamak and the waves were studied in detail during lower hybrid wave injection experiments. From the polarization measurements, the poloidal RF magnetic field is found to be dominant. In addition to polarization, components of k perpendicular to the major radial direction were obtained from phase differences among the five channels. The radial wavenumber was obtained by scanning the radial position of the 5ch-RFMP on a shot by shot basis. The measured wavevector and polarization in the plasma edge region were consistent with those calculated from the wave equation for the slow wave branch. While the waves with small and large k ∥ were excited by the antenna, only the small k ∥ component was measured by the 5ch-RFMP; this suggests that the waves with larger k ∥ were absorbed by the plasma. (author)

  12. When to Intervene in Selective Mutism: The Multimodal Treatment of a Case of Persistent Selective Mutism.

    Science.gov (United States)

    Powell, Shawn; Dalley, Mahlono

    1995-01-01

    An identification and treatment model differentiating transient mutism from persistent selective mutism is proposed. The case study of a six-year-old girl is presented, who was treated with a multimodal approach combining behavioral techniques with play therapy and family involvement. At posttreatment and follow-up, she was talking in a manner…

  13. SELECTION OF CHEMICAL TREATMENT PROGRAM FOR OILY WASTEWATER

    Directory of Open Access Journals (Sweden)

    Miguel Díaz

    2017-04-01

    Full Text Available When selecting a chemical treatment program for wastewater to achieve an effective flocculation and coagulation is crucial to understand how individual colloids interact. The coagulation process requires a rapid mixing while flocculation process needs a slow mixing. The behavior of colloids in water is strongly influenced by the electrokinetic charge, where each colloidal particle carries its own charge, which in its nature is usually negative. Polymers, which are long chains of high molecular weight and high charge, when added to water begin to form longer chains, allowing removing numerous particles of suspended matter. A study of physico-chemical treatment by addition of coagulant and flocculant was carried out in order to determine a chemical program for oily wastewater coming from the gravity separation process in a crude oil refinery. The tests were carried out in a Jar Test equipment, where commercial products: aluminum polychloride (PAC, aluminum sulfate and Sintec D50 were evaluated with five different flocculants. The selected chemical program was evaluated with fluids at three temperatures to know its sensitivity to this parameter and the mixing energy in the coagulation and flocculation. The chemical program and operational characteristics for physico-chemical treatment with PAC were determined, obtaining a removal of more than 93% for suspended matter and 96% for total hydrocarbons for the selected coagulant / flocculant combination.

  14. Treatment selection in a randomized clinical trial via covariate-specific treatment effect curves.

    Science.gov (United States)

    Ma, Yunbei; Zhou, Xiao-Hua

    2017-02-01

    For time-to-event data in a randomized clinical trial, we proposed two new methods for selecting an optimal treatment for a patient based on the covariate-specific treatment effect curve, which is used to represent the clinical utility of a predictive biomarker. To select an optimal treatment for a patient with a specific biomarker value, we proposed pointwise confidence intervals for each covariate-specific treatment effect curve and the difference between covariate-specific treatment effect curves of two treatments. Furthermore, to select an optimal treatment for a future biomarker-defined subpopulation of patients, we proposed confidence bands for each covariate-specific treatment effect curve and the difference between each pair of covariate-specific treatment effect curve over a fixed interval of biomarker values. We constructed the confidence bands based on a resampling technique. We also conducted simulation studies to evaluate finite-sample properties of the proposed estimation methods. Finally, we illustrated the application of the proposed method in a real-world data set.

  15. Selected Physical Therapy Modalities for the treatment of Diabetic Polyneuropathy

    International Nuclear Information System (INIS)

    Sawan, S.; Sayed, N.; Al-Gazzar, S.

    2006-01-01

    The purpose of this study was to examine the effect of using selected physical therapy modalities for the treatment of diabetic polyneuropathy. Thirty patients participated in this study. Patients were randomly divided into study group (ten males and five females) and control group (six males and nine females). The study group received interferential current on the lumbosacral region, followed by repeated contraction as specific technique of proprioceptive neuromuscular facilitation (PNF) to the anterior tibial group muscles. The control group did not receive physical therapy treatment. The treatment for the study group was conducted three times per week, for a period of six weeks. The patients were assessed for intensity of pain, manual muscle testing of the anterior tibial group muscles, and the level of superficial sensation on their feet. Patients were assessed the beginning of the treatment session and after the last session. The result of this study showed a significant decrease in the pain intensity, increase anterior tibial group muscles strength and increase level of superficial sensation in patients of study group in comparison to the control group at the end of the treatment. The control group did not show significant changes. It can be concluded that the combination of interferential current and repeated contraction (specific technique of PNF to the anterior tibial group muscles) is effective in decreasing the pain, increasing anterior tibial group muscles strength and the level of superficial sensation in patients suffering from diabetic polyneuropathy. (author)

  16. Endoscopic bronchial valve treatment: patient selection and special considerations

    Directory of Open Access Journals (Sweden)

    Eberhardt R

    2015-10-01

    Full Text Available Ralf Eberhardt,1,2 Daniela Gompelmann,1,2 Felix JF Herth,1,2 Maren Schuhmann1 1Pneumology and Critical Care Medicine, Thoraxklinik at the University of Heidelberg, 2Translational Lung Research Center, Member of the German Center for Lung Research, Heidelberg, Germany Abstract: As well as lung volume reduction surgery, different minimally invasive endoscopic techniques are available to achieve lung volume reduction in patients with severe emphysema and significant hyperinflation. Lung function parameters and comorbidities of the patient, as well as the extent and distribution of the emphysema are factors to be considered when choosing the patient and the intervention. Endoscopic bronchial valve placement with complete occlusion of one lobe in patients with heterogeneous emphysema is the preferred technique because of its reversibility. The presence of high interlobar collateral ventilation will hinder successful treatment; therefore, endoscopic coil placement, polymeric lung volume reduction, or bronchoscopic thermal vapor ablation as well as lung volume reduction surgery can be used for treating patients with incomplete fissures. The effect of endoscopic lung volume reduction in patients with a homogeneous distribution of emphysema is still unclear and this subgroup should be treated only in clinical trials. Precise patient selection is necessary for interventions and to improve the outcome and reduce the risk and possible complications. Therefore, the patients should be discussed in a multidisciplinary approach prior to determining the most appropriate treatment for lung volume reduction. Keywords: lung emphysema, valve treatment, collateral ventilation, patient selection, outcome

  17. Highly selective electrocoagulation therapy: an innovative treatment for lymphangioma circumscriptum.

    Science.gov (United States)

    Yang, Xi; Jin, Yunbo; Chen, Hui; Li, Suolan; Ma, Gang; Hu, Xiaojie; Qiu, Yajing; Yu, Wenxin; Chang, Lei; Wang, Tianyou; Lin, Xiaoxi

    2014-08-01

    Lymphangioma circumscriptum (LC) is a type of microcystic lymphatic malformation involving the skin and mucosa that presents as translucent vesicles of varying size with a pink, red, or black hue. Lymphangioma circumscriptum causes not only cosmetic problems but also refractory rupture, infection, lymphorrhea, and bleeding. Various invasive methods, such as surgical excision, lasers, and sclerotherapy, have been used in the past to treat LC with varying success. Herein, we report a new treatment for the management of LC. This study reports the outcomes of 12 patients (aged 4-31 years) with LC treated by electrocoagulation using a special isolated needle. Patient demographics, lesion characteristics, radiologic findings, treatment course, and clinical responses are recorded. All 12 patients who were treated with the highly selective electrocoagulation therapy achieved near-complete clearance. Minimal intra- and postoperative sequelae were observed. The local complications included mild pain (n = 9), proliferous scarring (n = 1), and ulceration (n = 1) with no systemic side effects. The mean follow-up period was 8.25 months (3-14 months). Highly selective electrocoagulation therapy is an innovative, minimally invasive technique that seems to be safe and effective for the treatment of LC; the results from our limited study population seem promising, and the observed complications are acceptable.

  18. Selection of efficient etchants for nondestructive treatment of semiconductors

    International Nuclear Information System (INIS)

    Tomashik, V.N.; Fomin, A.V.; Tomashik, Z.F.

    1996-01-01

    The scheme for studying etching processes of semiconductor materials and developing new etchants for different semiconductors is proposed. The scheme includes the experiment mathematical planning, computerized physicochemical modeling, kinetic studies, investigation of surface layers, formed by etching. Such on approach makes it possible to optimize the etchant composition in every concrete cage. The scheme is tested in the course of developing optimal methodologies of preepitaxial treatment and selection of etchants composition for semiconductor compounds of the A 1 B 6 and A 3 B 5 type. 13 refs., 4 figs

  19. Using AHP for Selecting the Best Wastewater Treatment Process

    Directory of Open Access Journals (Sweden)

    AbdolReza Karimi

    2011-01-01

    Full Text Available In this paper, Analytical Hierarchy Process (AHP method that is based on expert knowledge is used for the selection of the optimal anaerobic wastewater treatment process in industrial estates. This method can be applied for complicated multi-criteria decision making to obtain reasonable results. The different anaerobic processes employed in Iranian industrial estates consist of UASB, UAFB, ABR, Contact process, and Anaerobic Lagoons. Based on the general conditions in wastewater treatment plants in industrial estates and on expert judgments and using technical, economic, environmental, and administrative criteria, the processes are weighted and the results obtained are assessed using the Expert Choice Software. Finally, the five processes investigated are ranked as 1 to 5 in a descending order of UAFB, ABR, UASB, Anaerobic Lagoon, and Contact Process. Sensitivity analysis showing the effects of input parameters on changes in the results was applied for technical, economic, environmental, and administrative criteria.

  20. Characterization of selectively etched halloysite nanotubes by acid treatment

    Science.gov (United States)

    Garcia-Garcia, Daniel; Ferri, Jose M.; Ripoll, Laura; Hidalgo, Montserrat; Lopez-Martinez, Juan; Balart, Rafael

    2017-11-01

    Halloysite nanotubes (HNTs) are a type of naturally occurring inorganic nanotubes that are characterized by a different composition between their external and internal walls. The internal walls are mainly composed of alumina whilst external walls are composed of silica. This particular structure offers a dual surface chemistry that allows different selective surface treatments which can be focused on increasing the lumen, increasing porosity, etc. In this work, HNTs were chemically treated with different acids (sulphuric, acetic and acrylic acid), for 72 h at a constant temperature of 50 °C. As per the obtained results, the treatment with sulphuric acid is highly aggressive and the particular shape of HNTs is almost lost, with a remarkable increase in porosity. The BET surface area increases from 52.9 (untreated HNTs) up to 132.4 m2 g-1 with sulphuric acid treatment, thus showing an interesting potential in the field of catalysis. On the other hand, the treatment with acetic acid led to milder effects with a noticeable increase in the lumen diameter that changed from 13.8 nm (untreated HNTs) up to 18.4 nm which the subsequent increase in the loading capacity by 77.8%. The aluminium content was measured by X-ray fluorescence (XRF) and laser induced breakdown spectroscopy (LIBS). The final results using two systems, suggest a good correlation between the acid strength and the aluminium reduction. Consequently, is possible to conclude that new applications for HNTs can be derived from selective etching with acids. Sulphuric acid widens the potential of HNTs in the field of catalysis while weak acids such as acetic and acrylic acids give a controlled and homogeneous lumen increase with the corresponding increase in the loading capacity.

  1. Selection of treatment and surgical approach for vestibular schwannomas

    International Nuclear Information System (INIS)

    Eguchi, Kuniki; Yamaguchi, Satoshi; Sakoda, Eiichiro

    2007-01-01

    Described are the present state of selection of stereotactic radiotherapy or surgical treatment and their combination for schwannomas in the title, and authors' policy of surgery as a first choice treatment. The policy stands on the concept that surgery is useful for the controllability thereafter of the tumor, of which size is at first larger than 25 mm diameter, and radiotherapy like a gamma-knife is applicable to the residual tissue grown after operation and to the tissue with less than the size before surgery because the smaller the size, the better is thought the control by the knife (reportedly 100% for the tissue of <14 mm diameter). The basis of authors' selection of two surgical approaches of through-lower lateral occiput and trans-labyrinthine, and their outcomes like hearing loss are described and discussed in details for 24 patients (two underwent radiotherapy before surgery) during the period Sep. 2003-Aug. 2006 of authors' hospital. Radiotherapy is thought essentially useful for the control of the tumor with a small or surgically reduced size. (R.T.)

  2. Treatment Options for Liquid Radioactive Waste. Factors Important for Selecting of Treatment Methods

    Energy Technology Data Exchange (ETDEWEB)

    Dziewinski, J.J.

    1998-09-28

    The cleanup of liquid streams contaminated with radionuclides is obtained by the selection or a combination of a number of physical and chemical separations, processes or unit operations. Among those are: Chemical treatment; Evaporation; Ion exchange and sorption; Physical separation; Electrodialysis; Osmosis; Electrocoagulation/electroflotation; Biotechnological processes; and Solvent extraction.

  3. Treatment Options for Liquid Radioactive Waste. Factors Important for Selecting of Treatment Methods

    International Nuclear Information System (INIS)

    Dziewinski, J.J.

    1998-01-01

    The cleanup of liquid streams contaminated with radionuclides is obtained by the selection or a combination of a number of physical and chemical separations, processes or unit operations. Among those are: Chemical treatment; Evaporation; Ion exchange and sorption; Physical separation; Electrodialysis; Osmosis; Electrocoagulation/electroflotation; Biotechnological processes; and Solvent extraction

  4. Selection criteria for wastewater treatment technologies to protect drinking water.

    Science.gov (United States)

    von Sperling, M

    2000-01-01

    The protection of water bodies used as sources for drinking water is intimately linked to the adoption of adequate technologies for the treatment of the wastewater generated in the catchment area. The paper presents a general overview of the main technologies used for the treatment of domestic sewage, with a special emphasis on developing countries, and focussing on the main parameters of interest, such as BOD, coliforms and nutrients. A series of tables, figures and charts that can be used for the preliminary selection of treatment technologies is presented. The systems analysed are: stabilisation ponds, activated sludge, trickling filters, anaerobic systems and land disposal. Within each system, the main process variants are covered. Two summary tables are presented, one for quantitative analysis, including easily usable information based on per capita values (US$/cap, Watts/cap, m2 area/cap, m3 sludge/cap), and another for a qualitative comparison among the technologies, based on a one-to-five-star scoring system. The recent trend in tropical countries in the use of UASB (Upflow Anaerobic Sludge Blanket) reactors is also discussed.

  5. Threat-Related Selective Attention Predicts Treatment Success in Childhood Anxiety Disorders

    NARCIS (Netherlands)

    J.S. Legerstee (Jeroen); J.H.M. Tulen (Joke); V.L. Kallen (Victor); G.C. Dieleman (Gwen); P.D.A. Treffers (Philip); F.C. Verhulst (Frank); E.M.W.J. Utens (Elisabeth)

    2009-01-01

    textabstractAbstract OBJECTIVE: The present study examined whether threat-related selective attention was predictive of treatment success in children with anxiety disorders and whether age moderated this association. Specific components of selective attention were examined in treatment responders

  6. Threat-related selective attention predicts treatment success in childhood anxiety disorders

    NARCIS (Netherlands)

    Legerstee, Jeroen S.; Tulen, Joke H. M.; Kallen, Victor L.; Dieleman, Gwen C.; Treffers, Philip D. A.; Verhulst, Frank C.; Utens, Elisabeth M. W. J.

    2009-01-01

    The present study examined whether threat-related selective attention was predictive of treatment success in children with anxiety disorders and whether age moderated this association. Specific components of selective attention were examined in treatment responders and nonresponders. Participants

  7. The Syndrome Burnout as Deterioration of Work Environment and the TST Position of the Use of the Principles And Concepts Environmental

    Directory of Open Access Journals (Sweden)

    Erica Fabiola Brito Tuma

    2015-12-01

    Full Text Available This paper will address the applicability of environmental principles in cases of syndrome of "burnout". For this, it will analyze the concepts of general environment and its categories, highlighting the working environment in which the characteristics of its healthiness will be appointed. They will be treated also the concepts of degradation of environmental quality and pollution, and how they occur in the middle working environment, emphasizing the protection of quality of life and health of workers. So relate the "burnout" syndrome as the middle work environment degradation factor, and discussed the consequences of this framework. Finally, recent decisions will be presented the Superior Labor Court (TST about this psychological pathology.

  8. Selective Mutism: A Review of Etiology, Comorbidities, and Treatment

    OpenAIRE

    Wong, Priscilla

    2010-01-01

    Selective mutism is a rare and multidimensional childhood disorder that typically affects children entering school age. It is characterized by the persistent failure to speak in select social settings despite possessing the ability to speak and speak comfortably in more familiar settings. Many theories attempt to explain the etiology of selective mutism.

  9. Bevacizumab in the treatment of NSCLC: patient selection and perspectives

    Directory of Open Access Journals (Sweden)

    Russo AE

    2017-12-01

    Full Text Available Alessia E Russo,1 Domenico Priolo,1 Giovanna Antonelli,1 Massimo Libra,2 James A McCubrey,3 Francesco Ferraù1 1Medical Oncology Department, San Vincenzo Hospital, Taormina (Messina, Italy; 2Laboratory of Translational Oncology & Functional Genomics, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy; 3Department of Microbiology and Immunology, Brody School of Medicine at East Carolina University, Greenville, NC, USA Abstract: Non-small-cell lung cancer (NSCLC represents about 85% of all lung cancers, and more than half of NSCLCs are diagnosed at an advanced stage. Chemotherapy has reached a plateau in the overall survival curve of about 10 months. Therefore, in last decade novel targeted approaches have been developed to extend survival of these patients, including antiangiogenic treatment. Vascular endothelial growth factor (VEGF signaling pathway plays a dominant role in stimulating angiogenesis, which is the main process promoting tumor growth and metastasis. Bevacizumab (bev; Avastin® is a recombinant humanized monoclonal antibody that neutralizes VEGF’s biologic activity through a steric blocking of its binding with VEGF receptor. Currently, bev is the only antiangiogenic agent approved for the first-line treatment of advanced or recurrent nonsquamous NSCLC in “bev-eligible” patients. The ineligibility to receive bev is related to its toxicity. In the pivotal trials of bev in NSCLC, fatal bleeding events including pulmonary hemorrhage were observed with rates higher in the chemotherapy-plus-bev group. Therefore, in order to reduce the incidence of severe pulmonary hemorrhage, numerous exclusion criteria have been characteristically applied for bev such as central tumor localization or tumor cavitation, use of anticoagulant therapy, presence of brain metastases, age of patients (elderly. Subsequent studies designed to evaluate the safety of bev have demonstrated that this agent is safe and

  10. Optimizing the selection of small-town wastewater treatment processes

    Science.gov (United States)

    Huang, Jianping; Zhang, Siqi

    2018-04-01

    Municipal wastewater treatment is energy-intensive. This high energy consumption causes high sewage treatment plant operating costs and increases the energy burden. To mitigate the adverse impacts of China’s development, sewage treatment plants should adopt effective energy-saving technologies. Artificial fortified natural water treatment and use of activated sludge and biofilm are all suitable technologies for small-town sewage treatment. This study features an analysis of the characteristics of small and medium-sized township sewage, an overview of current technologies, and a discussion of recent progress in sewage treatment. Based on this, an analysis of existing problems in municipal wastewater treatment is presented, and countermeasures to improve sewage treatment in small and medium-sized towns are proposed.

  11. Strategy to better select HIV-infected individuals for latent TB treatment in BCG-vaccinated population.

    Directory of Open Access Journals (Sweden)

    Chin-Hui Yang

    Full Text Available OBJECTIVE: To evaluate the T-SPOT.TB interferon-γ releasing assay and the tuberculin skin test (TST, for the diagnosis of latent tuberculosis infection(LTBI and the development of subsequent active tuberculosis, in BCG-vaccinated HIV-infected individuals. METHODS: HIV-infected individuals without clinical suspicion of active TB or a past history of TB were enrolled from 1 January 2008 to 30 November 2010. Both T-SPOT.TB test and TST were offered to the participants whom were followed up prospectively until April 30, 2012 for development of TB. RESULTS: Among the 909 participants, 25% had positive TST reactions with cut-off point of 5 mm and 15% had positive T-SPOT.TB results. After a median follow-up of 2.97 years, there were 5 cases developed culture-confirmed active TB (all had dual positive TST and T-SPOT.TB results, and the incidence was 0.17 per 100 person-years. The relative risks (RRs for subsequent active TB in HIV-infected individuals with positive TST results, positive T-SPOT.TB results and dual positive results compared with the risk for individuals with negative results were 40.6 (95% CI 2.1-767.9, 73.9 (95% CI 3.9-1397.7 and 226.5 (95% CI 12.0-4284, respectively. The number needed to treat to prevent one subsequent TB case among patients with a positive TST, a positive T-SPOT.TB and dual positive results was 35, 22 and 8 respectively. CONCLUSIONS: Adopting positive results of the TST and T-SPOT.TB to screen LTBI among BCG-vaccinated HIV-infected individuals might be feasible. Number needed to treat for isoniazid preventive therapy could be reduced significantly by using dual positive strategy.

  12. The diagnosis and treatment of tubal pregnancy with selective salpingography

    International Nuclear Information System (INIS)

    Li Qunying

    2000-01-01

    Objective: To study feasibility of diagnosing and treating tubal pregnancy with selective salpingography. methods: 13 women diagnosed clinically as ectopic pregnancy without abdominal bleeding were studied and confirmed as tubal pregnancy with selective salpingography, MTX was then injected through fallopian tube. Urine hCG, blood β-hCG and US were studied during follow-up. Results: 12 cases tubal pregnancy were confirmed as well as 1 case of intra-uterine pregnancy. X-ray showed a localized dilation of fallopian tube, half-loop, ring-like or irregular shaped filling defect. In one case, cluster of grapes appearance of contrast medium could be seen at the umbrella end of fallopian tube. Of the 12 cases of tubal pregnancy, 10 were successfully treated, the successful rate was 83%. Conclusion: Selective salpingography is a simple safe and effective method of diagnosing and treating tubal pregnancy

  13. Anhedonia Predicts Poorer Recovery among Youth with Selective Serotonin Reuptake Inhibitor Treatment-Resistant Depression

    Science.gov (United States)

    McMakin, Dana L.; Olino, Thomas M.; Porta, Giovanna; Dietz, Laura J.; Emslie, Graham; Clarke, Gregory; Wagner, Karen Dineen; Asarnow, Joan R.; Ryan, Neal D.; Birmaher, Boris; Shamseddeen, Wael; Mayes, Taryn; Kennard, Betsy; Spirito, Anthony; Keller, Martin; Lynch, Frances L.; Dickerson, John F.; Brent, David A.

    2012-01-01

    Objective: To identify symptom dimensions of depression that predict recovery among selective serotonin reuptake inhibitor (SSRI) treatment-resistant adolescents undergoing second-step treatment. Method: The Treatment of Resistant Depression in Adolescents (TORDIA) trial included 334 SSRI treatment-resistant youth randomized to a medication…

  14. Trends in pharmacotherapy selection for the treatment of alcohol ...

    African Journals Online (AJOL)

    worked in private general practice, specialist psychiatry practice, in a state hospital or in a treatment centre. Results. ... Type 4 (model of adaptation) dependence does not respond well to any ..... syndrome increases mortality. The use of.

  15. Obstacles to HIV prevention, treatment and care in selected public ...

    African Journals Online (AJOL)

    South Africa, like the rest of Southern Africa, is ravaged by AIDS. Higher education in South Africa has a significant role to play in the fight against the spread of HIV and AIDS. This article reports the factors contributing to the spread of HIV and AIDS in three selected public universities in South Africa. To achieve the stated ...

  16. Augmented Self-Modeling as a Treatment for Children with Selective Mutism.

    Science.gov (United States)

    Kehle, Thomas J.; Madaus, Melissa R.; Baratta, Victoria S.; Bray, Melissa A.

    1998-01-01

    Describes the treatment of three children experiencing selective mutism. The procedure utilized incorporated self-modeling, mystery motivators, self-reinforcement, stimulus fading, spacing, and antidepressant medication. All three children evidenced a complete cessation of selective mutism and maintained their treatment gains at follow-up.…

  17. Treatment selection for stage IIIA Hodgkin's disease patients

    International Nuclear Information System (INIS)

    Prosnitz, L.R.; Cooper, D.; Cox, E.B.; Kapp, D.S.; Farber, L.R.

    1985-01-01

    Two treatment policies for the therapy of patients with Stage IIIA Hodgkin's disease are compared. From 1969-1976, 49 newly diagnosed and pathologically staged IIIA patients received total nodal irradiation (TNI) alone (no liver irradiation). Although actuarial survival was 80% at 5 years and 68% at 10 years, actuarial freedom from relapse was only 38% at 5 years. Accordingly, a new treatment policy was instituted in 1976. Patients with either CS IIIA disease, multiple splenic nodules, IIIA with a large mediastinal mass or III 2 , received combined modality therapy (combination chemotherapy and irradiation). All others received TNI. Thirty-six patients have been treated under the new program. The actuarial survival is 90% at 5 years and the relapse-free survival is 87%, suggesting the superiority of this approach. Complications from the treatments are discussed

  18. [Outpatient treatment of selective mutism: long-standing selective mutism in a 17-year-old male].

    Science.gov (United States)

    Herdener-Pinnekamp, Katharina; Gundelfinger, Ronnie; Steinhausen, Hans-Christoph

    2010-01-01

    The present case report describes the successful treatment of a 17 year old male adolescent suffering for 10 years from selective mutism. Following a summary review of recent publications on therapy approaches, the report describes the treatment concept in the present case, including detailed assessment of co-morbid disorders, motivation for change, behaviour therapy with supporting drug intervention, and intensive co-operation with parents and other caretakers.

  19. Selective electrothermolysis of the sebaceous glands: treatment of facial seborrhea.

    Science.gov (United States)

    Kobayashi, Toshio; Tamada, Shinji

    2007-02-01

    There are few publications on facial seborrhea treatment. A focused therapy is needed. Our aim was to evaluate the efficacy of electrothermolysis of the sebaceous glands. In the preliminary studies, histologic changes in the cheek skin by electrothermolysis were examined by light microscopy. In the clinical studies, 15 adult women subjects with facial seborrhea were treated four times by the same procedure. A 1.50-mm-long needle with a 0.45-mm base insulation was inserted into pores in the forehead and cheeks, and a high-frequency electrical current was applied for 0.25 to 0.50 seconds with an output of 40 W. Each treatment took 60 to 90 minutes. The subjects returned for 6-months follow-up after their fourth treatment. Histology 1 and 6 months later showed fewer sebaceous glands and the development of fibrosis. All 12 subjects who completed the 6-month follow-up gave a subjective assessment of continuous reduction of facial seborrhea. On a scale of 0.0 to 3.0, the mean improvement score was 1.67+/-0.75. The mean reduction rate of skin surface lipids was 31.5% by sebumeter (pfacial seborrhea treatment.

  20. [Diagnosis and treatment in general internal medicine. Curriculum selection].

    Science.gov (United States)

    Casal, E R; Vázquez, E N; Husni, C

    1994-01-01

    In our country general internists are the providers of adult medical care in urban areas. In the past twenty years, with the increasing subspecialization within internal medicine and the development of advances in technology, the role of the general internist seems to be endangered. Recently much attention has been focused on this area and Divisions and Programs of General Internal Medicine have been established in most medical schools in the USA. The University of Buenos Aires instituted a Program of General Internal Medicine in its major teaching hospital in 1987. One of its purposes was to offer an educational experience to residents in the field of internal medicine primary care. This paper summarizes how this program was carried out and the subjects proposed in the area of Diagnosis and Treatment. The Program of General Internal Medicine is performed in the Outpatient Division and it is staffed by 3 faculty members and 4 fellows. Residents in Internal Medicine have a three month, full-time block rotation in the Program. A young, city dwelling, lower middle class population participates in the Program, with almost 10000 visits a year. The Program offers an experience that includes supervised patient care, an average of 100 office visits a month, and seminars and/or workshops covering topics of "Diagnosis and Treatment", "Case Presentations", "Clinical Epidemiology", "Prevention", and "Doctor-Patient Interview". In the area of Diagnosis and Treatment, the criteria used were: 1-frequency of diagnosis as determined by previous investigations, 2-relevant clinical conditions absent from the frequency list as determined by a consensus process by faculty members.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. Targeting cancer cells using 3-bromopyruvate for selective cancer treatment

    Directory of Open Access Journals (Sweden)

    Hussam H Baghdadi

    2017-01-01

    Full Text Available Cancer treatment deserves more research efforts despite intensive conventional treatment modalities for many types of malignancies. Metastasis and resistance to chemotherapy and radiotherapy receive a lot of global research efforts. The current advances in cancer biology may improve targeting the critical metabolic differences that distinguish cancer cells from normal cells. Cancer cells are highly glycolytic for energy production, exhibit the Warburg effect, establish aggressive acidic microenvironment, maintain cancer stem cells, exhibit resistance to chemotherapy, have low antioxidant systems but different ΔΨm (delta psi, mitochondrial transmembrane potential, express P-glycoprotein for multidrug resistance, upregulate glucose transporters and monocarboxylate transporters and are under high steady-state reactive oxygen species conditions. Normal cells differ in all these aspects. Lactate produced through the Warburg effect helps cancer metastasis. Targeting glycolysis reactions for energy production in cancer cells seems promising in decreasing the proliferation and metastasis of cancer cells. 3-bromopyruvate makes use of cancer biology in treating cancer cells, cancer stem cells and preventing metastasis in human cancer as discussed in this review. Updated advances are analyzed here, which include research analysis of background, experience, readings in the field of cancer biology, oncology and biochemistry.

  2. Selecting anti-microbial treatment of aerobic vaginitis.

    Science.gov (United States)

    Donders, Gilbert G G; Ruban, Katerina; Bellen, Gert

    2015-05-01

    Aerobic vaginitis (AV) is a vaginal infectious condition which is often confused with bacterial vaginosis (BV) or with the intermediate microflora as diagnosed by Nugent's method to detect BV on Gram-stained specimens. However, although both conditions reflect a state of lactobacillary disruption in the vagina, leading to an increase in pH, BV and AV differ profoundly. While BV is a noninflammatory condition composed of a multiplex array of different anaerobic bacteria in high quantities, AV is rather sparely populated by one or two enteric commensal flora bacteria, like Streptococcus agalactiae, Staphylocuccus aureus, or Escherichia coli. AV is typically marked by either an increased inflammatory response or by prominent signs of epithelial atrophy or both. The latter condition, if severe, is also called desquamative inflammatory vaginitis. As AV is per exclusionem diagnosed by wet mount microscopy, it is a mistake to treat just vaginal culture results. Vaginal cultures only serve as follow-up data in clinical research projects and are at most used in clinical practice to confirm the diagnosis or exclude Candida infection. AV requires treatment based on microscopy findings and a combined local treatment with any of the following which may yield the best results: antibiotic (infectious component), steroids (inflammatory component), and/or estrogen (atrophy component). In cases with Candida present on microscopy or culture, antifungals must be tried first in order to see if other treatment is still needed. Vaginal rinsing with povidone iodine can provide rapid relief of symptoms but does not provide long-term reduction of bacterial loads. Local antibiotics most suitable are preferably non-absorbed and broad spectrum, especially those covering enteric gram-positive and gram-negative aerobes, like kanamycin. To achieve rapid and short-term improvement of severe symptoms, oral therapy with amoxyclav or moxifloxacin can be used, especially in deep dermal vulvitis and

  3. Selecting the Best Frontline Treatment in Chronic Myeloid Leukemia

    Science.gov (United States)

    Yilmaz, Musa; Abaza, Yasmin; Jabbour, Elias

    2017-01-01

    With the discovery of Philadelphia chromosome, understanding of chronic myeloid leukemia (CML) pathobiology has tremendously increased. Development of tyrosine kinase inhibitors (TKI) targeting the BCR/ABL1 oncoprotein has changed the landscape of the disease. Today, the expected survival of CML patients, if properly managed, is likely to be similar to the general population. Imatinib is the first approved TKI in CML treatment, and for several years, it was the only option in the frontline setting. Four years ago, second generation TKIs (nilotinib and dasatinib) were approved as alternative frontline options. Now, clinicians are faced the challenge of making decision for which TKI to chose upfront. Second generation TKIs have been demonstrated to induce deeper and faster responses compared to imatinib, however, none of 3 TKIs have been shown to have a clear survival advantage, they all are reasonable options. In contrast, when considering therapy in individual patients, the case may be stronger for a specific TKI. Co-morbidities of the patient and side effect profile of the TKI of interest should be an important consideration in decision making. At present, the cost nilotinib or dasatinib is not remarkably different from imatinib. However, patent for imatinib is expected to expire soon, and it will be available as a generic. Clinicians, then, need to weigh the advantages some patients gain with nilotinib or dasatinib in the frontline setting against the difference in cost. Whatever TKI is chosen as frontline, intolerance, non-compliance or treatment failure should be recognized early as a prompt intervention increases the chance of achieving best possible response. PMID:25921387

  4. Threat-related selective attention predicts treatment success in childhood anxiety disorders.

    Science.gov (United States)

    Legerstee, Jeroen S; Tulen, Joke H M; Kallen, Victor L; Dieleman, Gwen C; Treffers, Philip D A; Verhulst, Frank C; Utens, Elisabeth M W J

    2009-02-01

    The present study examined whether threat-related selective attention was predictive of treatment success in children with anxiety disorders and whether age moderated this association. Specific components of selective attention were examined in treatment responders and nonresponders. Participants consisted of 131 children with anxiety disorders (aged 8-16 years), who received standardized cognitive-behavioral therapy. At pretreatment, a pictorial dot-probe task was administered to assess selective attention. Both at pretreatment and posttreatment, diagnostic status of the children was evaluated with a semistructured clinical interview (the Anxiety Disorders Interview Schedule for Children). Selective attention for severely threatening pictures at pretreatment assessment was predictive of treatment success. Examination of the specific components of selective attention revealed that nonresponders showed difficulties to disengage their attention away from severe threat. Treatment responders showed a tendency not to engage their attention toward severe threat. Age was not associated with selective attention and treatment success. Threat-related selective attention is a significant predictor of treatment success in children with anxiety disorders. Clinically anxious children with difficulties disengaging their attention away from severe threat profit less from cognitive-behavioral therapy. For these children, additional training focused on learning to disengage attention away from anxiety-arousing stimuli may be beneficial.

  5. Selection of response criteria for clinical trials of sarcoma treatment.

    Science.gov (United States)

    Schuetze, Scott M; Baker, Laurence H; Benjamin, Robert S; Canetta, Renzo

    2008-01-01

    Soft tissue sarcomas are a heterogeneous group of malignancies arising from mesenchymal tissues. A large number of new therapies are being evaluated in patients with sarcomas, and consensus criteria defining treatment responses are essential for comparison of results from studies completed by different research groups. The 1979 World Health Organization (WHO) handbook set forth operationally defined criteria for response evaluation in solid tumors that were updated in 2000 with the publication of the Response Evaluation Criteria in Solid Tumors (RECIST). There have been significant advances in tumor imaging, however, that are not reflected in the RECIST. For example, computed tomography (CT) slice thickness has been reduced from 10 mm to < or =2.5 mm, allowing for more reproducible and accurate measurement of smaller lesions. Combination of imaging techniques, such as positron emission tomography with fluorine-18-fluorodeoxyglucose (18FDG-PET) and CT can provide investigators and clinicians with both anatomical and functional information regarding tumors, and there is now a large body of evidence demonstrating the effectiveness of PET/CT and other newer imaging methods for the detection and staging of tumors as well as early determination of responses to therapy. The application of newer imaging methods has the potential to decrease both the sample sizes required for, and duration of, clinical trials by providing an early indication of therapeutic response that is well correlated with clinical outcomes, such as time to tumor progression or overall survival. The results summarized in this review support the conclusion that the RECIST and the WHO criteria for evaluation of response in solid tumors need to be modernized. In addition, there is a current need for prospective trials to compare new response criteria with established endpoints and to validate imaging-based response rates as surrogate endpoints for clinical trials of new agents for sarcoma and other solid

  6. X-ray measurements during plasma current start-up experiments using the lower hybrid wave on the TST-2 spherical tokamak

    International Nuclear Information System (INIS)

    Wakatsuki, Takuma; Ejiri, Akira; Kakuda, Hidetoshi

    2012-01-01

    Non-inductive plasma current start-up experiments using RF power in the lower hybrid frequency range is being conducted on the TST-2 spherical tokamak. Plasma currents of up to 15 kA have been achieved. The effect of direct current drive can be seen by comparing the cases with co-drive and counter-drive. X-rays in various energy ranges were measured to investigate the interaction between the wave and the electrons. Soft X-ray (SX) measurements revealed that the perpendicular SX emission increased significantly as the plasma current increased, and that the tangential SX emission in the direction of RF drive was enhanced more strongly in the co-drive case compared to the counter-drive case. These observations imply that the fast electrons accelerated by the lower hybrid wave contribute to the plasma current. However, RF amplitude modulation experiments showed that the confinement time of these fast electrons are very short (less than 0.05 ms), much shorter than the collisional slowing down time. Hard X-ray spectral measurements showed that the radiation temperature of fast electrons in the co-direction for current drive was higher than that in the counter-direction. These observations are consistent with the existence of RF-driven fast electrons. (author)

  7. How do intake clinicians use patient characteristics to select treatment for patients with personality disorders?

    Science.gov (United States)

    van Manen, Janine; Kamphuis, Jan Henk; Visbach, Geny; Ziegler, Uli; Gerritsen, Ad; Van Rossum, Bert; Rijnierse, Piet; Timman, Reinier; Verheul, Roel

    2008-11-01

    Treatment selection in clinical practice is a poorly understood, often largely implicit decision process, perhaps especially for patients with personality disorders. This study, therefore, investigated how intake clinicians use information about patient characteristics to select psychotherapeutic treatment for patients with personality disorder. A structured interview with a forced-choice format was administered to 27 experienced intake clinicians working in five specialist mental health care institutes in the Netherlands. Substantial consensus was evident among intake clinicians. The results revealed that none of the presented patient characteristics were deemed relevant for the selection of the suitable treatment setting. The appropriate duration and intensity are selected using severity or personal strength variables. The theoretical orientation is selected using personal strength variables.

  8. [Professor WANG Fuchun's experience in the acupoint selection of clinical treatment with acupuncture and moxibustion].

    Science.gov (United States)

    Jiang, Hailin; Liu, Chengyu; Ha, Lijuan; Li, Tie

    2017-11-12

    Professor WANG Fuchun 's experience in the acupoint selection of clinical treatment with acupuncture and moxibustion was summarized. The main acupoints are selected by focusing on the chief symptoms of disease, the supplementary points are selected by differentiating the disorders. The acupoints are modified in terms of the changes of sickness. The effective acupoints are selected flexibly in accordance with the specific effects of points. The summary on the acupoint selection reflects professor WANG Fuchun 's academic thoughts and clinical experience and effectively instructs the clinical practice of acupuncture and moxibustion.

  9. Holmium laser use in the treatment of selected dry eye syndrome complications

    Science.gov (United States)

    Kecik, Dariusz; Kecik, Tadeusz; Kasprzak, Jan; Kecik, Mariusz

    1996-03-01

    The authors present initial results of treatment selected complications of dry eye syndrome with holmium laser. The lacrimal puncta obliteration and coagulation of the corneal ulcer surface were done.

  10. Threat-Related Selective Attention Predicts Treatment Success in Childhood Anxiety Disorders

    OpenAIRE

    Legerstee, Jeroen; Tulen, Joke; Kallen, Victor; Dieleman, Gwen; Treffers, Philip; Verhulst, Frank; Utens, Elisabeth

    2009-01-01

    textabstractAbstract OBJECTIVE: The present study examined whether threat-related selective attention was predictive of treatment success in children with anxiety disorders and whether age moderated this association. Specific components of selective attention were examined in treatment responders and nonresponders. METHOD: Participants consisted of 131 children with anxiety disorders (aged 8-16 years), who received standardized cognitive-behavioral therapy. At pretreatment, a pictorial dot-pr...

  11. Decision support systems in water and wastewater treatment process selection and design: a review.

    Science.gov (United States)

    Hamouda, M A; Anderson, W B; Huck, P M

    2009-01-01

    The continuously changing drivers of the water treatment industry, embodied by rigorous environmental and health regulations and the challenge of emerging contaminants, necessitates the development of decision support systems for the selection of appropriate treatment trains. This paper explores a systematic approach to developing decision support systems, which includes the analysis of the treatment problem(s), knowledge acquisition and representation, and the identification and evaluation of criteria controlling the selection of optimal treatment systems. The objective of this article is to review approaches and methods used in decision support systems developed to aid in the selection, sequencing of unit processes and design of drinking water, domestic wastewater, and industrial wastewater treatment systems. Not surprisingly, technical considerations were found to dominate the logic of the developed systems. Most of the existing decision-support tools employ heuristic knowledge. It has been determined that there is a need to develop integrated decision support systems that are generic, usable and consider a system analysis approach.

  12. Culture, Personality, Health, and Family Dynamics: Cultural Competence in the Selection of Culturally Sensitive Treatments

    Science.gov (United States)

    Sperry, Len

    2010-01-01

    Cultural sensitivity and cultural competence in the selection of culturally sensitive treatments is a requisite for effective counseling practice in working with diverse clients and their families, particularly when clients present with health issues or medical problems. Described here is a strategy for selecting culturally sensitive treatments…

  13. Effect of different oral oxytetracycline treatment regimes on selection of antimicrobial resistant coliforms in nursery pigs

    DEFF Research Database (Denmark)

    Fresno, Ana Herrero; Zachariasen, Camilla; Norholm, Nanna

    2017-01-01

    A major concern derived from using antimicrobials in pig production is the development of resistance. This study aimed to assess the impact of selected combinations of oral dose and duration of treatment with oxytetracycline (OTC) on selection of tetracycline resistant (TET-R) coliforms recovered...

  14. The Current State of Empirical Support for the Pharmacological Treatment of Selective Mutism

    Science.gov (United States)

    Carlson, John S.; Mitchell, Angela D.; Segool, Natasha

    2008-01-01

    This article reviews the current state of evidence for the psychopharmacological treatment of children diagnosed with selective mutism within the context of its link to social anxiety disorder. An increased focus on potential medication treatment for this disorder has resulted from significant monetary and resource limitations in typical practice,…

  15. Treatment of Selective Mutism: Applications in the Clinic and School through Conjoint Consultation

    Science.gov (United States)

    Mitchell, Angela D.; Kratochwill, Thomas R.

    2013-01-01

    The purpose of this study was to evaluate the effectiveness of a psychosocial approach to the treatment of Selective Mutism (SM). Four children with SM along with their parents and teachers participated in the study. A comprehensive assessment was completed; manualized treatment was implemented through a conjoint behavioral consultation approach,…

  16. Treatment Seeking for Alcohol Use Disorders : Treatment Gap or Adequate Self-Selection?

    NARCIS (Netherlands)

    Tuithof, Marlous; Ten Have, Margreet; Van Den Brink, Wim; Vollebergh, Wilma; De Graaf, Ron

    2016-01-01

    Background/Aims: This study examines whether it is harmful that subjects with an alcohol use disorder (AUD) in the general population rarely seek treatment. Methods: Baseline and 3-year follow-up data from the Netherlands Mental Health Survey and Incidence Study-2 were used. Treatment utilization

  17. Treatment Seeking for Alcohol Use Disorders: Treatment Gap or Adequate Self-Selection?

    NARCIS (Netherlands)

    Tuithof, Marlous; ten Have, Margreet; van den Brink, Wim; Vollebergh, Wilma; de Graaf, Ron

    2016-01-01

    This study examines whether it is harmful that subjects with an alcohol use disorder (AUD) in the general population rarely seek treatment. Baseline and 3-year follow-up data from the Netherlands Mental Health Survey and Incidence Study-2 were used. Treatment utilization covered a 4-year period. The

  18. Treatment of Selective Serotonin Reuptake Inhibitor-Resistant Depression in Adolescents: Predictors and Moderators of Treatment Response

    Science.gov (United States)

    Asarnow, Joan Rosenbaum; Emslie, Graham; Clarke, Greg; Wagner, Karen Dineen; Spirito, Anthony; Vitiello, Benedetto; Iyengar, Satish; Shamseddeen, Wael; Ritz, Louise; Birmaher, Boris; Ryan, Neal; Kennard, Betsy; Mayes, Taryn; DeBar, Lynn; McCracken, James; Strober, Michael; Suddath, Robert; Leonard, Henrietta; Porta, Giovanna; Keller, Martin; Brent, David

    2009-01-01

    Adolescents who did not improve with Selective Serotonin Reuptake Inhibitor (SSRI) were provided an alternative SSRI plus cognitive-behavioral therapy (CBT). The superiority of the CBT/combined treatment as compared to medication alone is more evident in youths who had more comorbid disorders, no abuse history, and lower hopelessness.

  19. Alternatives for OSAHS treatment: selection of patients for upper airway surgery and oral appliances

    Directory of Open Access Journals (Sweden)

    A. Boudewyns

    2007-12-01

    Full Text Available Although continuous positive airway pressure (CPAP is considered to represent the standard treatment for patients with moderate-to-severe obstructive sleep apnoea/hypopnoea syndrome (OSAHS, poor treatment compliance and/or refusal is an issue in 20–30% of these patients. As an alternative to life-long CPAP treatment, conservative procedures exist with dental appliances for mandibular advancement, as well as curative surgical techniques. Surgical treatment of OSAHS can be divided into the following two main groups: 1 upper airway surgery by soft tissue resection (uvulopalatopharyngoplasty, etc., and 2 skeletal procedures, such as maxillo-mandibular advancement. Proper selection of patients for the different treatment modalities is the key for full treatment success. Patient-related factors, such as the site of upper airway collapse, craniofacial characteristics, dental health, obesity, age, profession and positional dependence, as well as treatment-related factors, should be evaluated before a final proposal for these treatment alternatives is formulated.

  20. Selective release of phosphorus and nitrogen from waste activated sludge with combined thermal and alkali treatment.

    Science.gov (United States)

    Kim, Minwook; Han, Dong-Woo; Kim, Dong-Jin

    2015-08-01

    Selective release characteristics of phosphorus and nitrogen from waste activated sludge (WAS) were investigated during combined thermal and alkali treatment. Alkali (0.001-1.0N NaOH) treatment and combined thermal-alkali treatment were applied to WAS for releasing total P(T-P) and total nitrogen(T-N). Combined thermal-alkali treatment released 94%, 76%, and 49% of T-P, T-N, and COD, respectively. Release rate was positively associated with NaOH concentration, while temperature gave insignificant effect. The ratio of T-N and COD to T-P that released with alkali treatment ranged 0.74-0.80 and 0.39-0.50, respectively, while combined thermal-alkali treatment gave 0.60-0.90 and 0.20-0.60, respectively. Selective release of T-P and T-N was negatively associated with NaOH. High NaOH concentration created cavities on the surface of WAS, and these cavities accelerated the release rate, but reduced selectivity. Selective release of P and N from sludge has a beneficial effect on nutrient recovery with crystallization processes and it can also enhance methane production. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Effect of tetracycline dose and treatment mode on selection of resistant coliform bacteria in nursery pigs

    DEFF Research Database (Denmark)

    Græsbøll, Kaare; Damborg, Peter; Mellerup, Anders

    2017-01-01

    This study describes the results of a randomized clinical trial investigating the effect of oxytetracycline treatment dose and mode of administration on the selection of antibiotic-resistant coliform bacteria in fecal samples from nursery pigs. Nursery pigs (pigs of 4 to 7 weeks of age) in five pig...... by the time that the pigs left the nursery unit. The counts and proportions of tetracyclineresistant coliforms did not vary significantly between treatment groups, except immediately after treatment, when the highest treatment dose resulted in the highest number of resistant coliforms. A control group treated...

  2. Group therapy for selective mutism - a parents' and children's treatment group.

    Science.gov (United States)

    Sharkey, Louise; Mc Nicholas, Fiona; Barry, Edwina; Begley, Maire; Ahern, Sinead

    2008-12-01

    To evaluate the feasibility and effectiveness of group therapy for children with selective mutism and their parents. Five children (mean age 6.1 years) with a diagnosis of selective mutism were administered group therapy over an 8-week period. Parents simultaneously attended a second group, aimed at providing education and advice on managing selective mutism in everyday situations, and in the school environment. At post-treatment, all children increased their level of confident speaking in school, clinic and community settings. Parents indicated a reduction in their own anxiety levels, from pre- to post-treatment on self-rating scales. Findings support the feasibility and effectiveness of group therapy for children with selective mutism and their parents.

  3. [Evaluation and selection of VOCs treatment technologies in packaging and printing industry].

    Science.gov (United States)

    Wang, Hai-Lin; Wang, Jun-Hui; Zhu, Chun-Lei; Nie, Lei; Hao, Zheng-Ping

    2014-07-01

    Volatile organic compounds (VOCs) play an important role in urban air pollution. Activities of industries including the packaging and printing industries are regarded as the major sources. How to select the suitable treating techniques is the major problem for emission control. In this article, based on the VOCs emission characteristics of the packaging and printing industry and the existing treatment technologies, using the analytic hierarchy process (AHP) model, an evaluation system for VOCs selection was established and all the technologies used for treatment were assessed. It showed that the priority selection was in the following order: Carbon Fiber Adsorption-Desorption > Granular Carbon Adsorption-Desorption > Thermal Combustion > Regenerative Combustion > Catalytic combustion > Rotary adsorption-concentration and combustion > Granular Carbon adsorption-concentration and combustion. Carbon Fiber Adsorption-Desorption was selected as the best available technology due to its highest weight among those technologies.

  4. [Preservative-free glaucoma treatment : Selection of the correct treatment in 1 min].

    Science.gov (United States)

    Pfennigsdorf, S; Eschstruth, P

    2016-05-01

    The presence of preservatives in topical glaucoma treatments may impact ocular surface function and structure. For treatment to be effective, side effects need to be minimized, in order to promote compliance and allow continuation of therapy. Therefore, in daily clinical practice, it needs to be decided on an individual basis whether a preservative-free treatment is required. This study aimed to develop a questionnaire which helps to quickly and easily identify patients who require preservative-free treatment. A questionnaire was prepared to collect relevant clinical findings needed to make a therapeutic decision (preservative-free required? Yes/No). Moreover, a rating scheme was developed to enable efficient final assessment of the collected data. To check their practicability in daily clinical practice, both instruments were tested in 11 ophthalmological centers in Germany. The questionnaire and rating scheme were easy to use, integrated efficiently into everyday routine, and performed in about 1 min. Data of 1150 glaucoma patients were collected and preservative-free eyedrops recommended for 586 (51 %). Parameters most frequently associated with such a recommendation were a reduced tear film break-up time of preservative-free glaucoma threatment should be recommended. Individualized therapy decisions can thus be made, allowing goal-oriented use of preservative-free antiglaucomatosa. This might help to promote compliance and lead to reduced progression of glaucoma.

  5. A Comparison Study of the Removal of Selected Pharmaceuticals in Waters by Chemical Oxidation Treatments

    OpenAIRE

    F. Javier Benitez; Juan Luis Acero; Francisco J. Real; Gloria Roldan; Francisco Casas

    2011-01-01

    The degradation of selected pharmaceuticals in some water matrices was studied by using several chemical treatments. The pharmaceuticals selected were the beta-blocker metoprolol, the nonsteroidal anti-inflammatory naproxen, the antibiotic amoxicillin, and the analgesic phenacetin; and their degradations were conducted by using UV radiation alone, ozone, Fenton-s reagent, Fenton-like system, photo-Fenton system, and combinations of UV radiation and ozone with H2O2, TiO2, ...

  6. Criteria for selecting children with special needs for dental treatment under general anaesthesia

    OpenAIRE

    Nova García, M. Joaquín de; Gallardo López, Nuria E.; Martín Sanjuán, Carmen; Mourelle Martínez, M. Rosa; Alonso García, Yolanda; Carracedo Cabaleiro, Esther

    2007-01-01

    Objective: To study criteria for helping to select children with special needs for dental treatment under general anaesthesia. Materials and methods: Group of 30 children (aged under 18) examined on the Course at the Universidad Complutense de Madrid (UCM) (Specialisation on holistic dental treatment of children with special needs) and subsequently referred to the Disabled Children’s Oral Health Unit (DCOHU) within Primary Health Care Area 2 of the Madrid Health Service (SERMAS) where dental ...

  7. Improvement of selective removal of heavy metals in cyanobacteria by NaOH treatment.

    Science.gov (United States)

    Nagase, Hiroyasu; Inthorn, Duangrat; Oda, Aiko; Nishimura, Jun; Kajiwara, Yumiko; Park, Myong-Oku; Hirata, Kazumasa; Miyamoto, Kazuhisa

    2005-04-01

    In the freshwater cyanobacterium, Tolypothrix tenuis, treatment with 0.1 M NaOH increased its Cd-selective adsorption ability in the presence of Ca(2+) or Mg(2+). The selective adsorption was also achieved by other alkaline treatments. Energy-distributed spectroscopy analysis revealed that Cd(2+) was found mainly on the surface of non-treated cells, whereas it was distributed throughout the cell after NaOH treatment. The alkaline treatment was effective in increasing the selective adsorption ability of the cyanobacterium for other bivalent heavy metals such as Cu(2+), Pb(2+) and Zn(2+). The treatment was also applicable to Anabaena variabilis and Microcystis aeruginosa, which are typical cyanobacteria causing algal blooms. The main binding site of Cd(2+) in NaOH-treated cells is assumed to be the carboxyl groups because the binding ability of the cells was diminished by the esterification of carboxyl groups. These results suggest that alkaline treatment of cyanobacteria is a useful technique for producing biosorbents having highly specific binding abilities for heavy metals.

  8. Effect of Tetracycline Dose and Treatment Mode on Selection of Resistant Coliform Bacteria in Nursery Pigs.

    Science.gov (United States)

    Græsbøll, Kaare; Damborg, Peter; Mellerup, Anders; Herrero-Fresno, Ana; Larsen, Inge; Holm, Anders; Nielsen, Jens Peter; Christiansen, Lasse Engbo; Angen, Øystein; Ahmed, Shahana; Folkesson, Anders; Olsen, John Elmerdahl

    2017-06-15

    This study describes the results of a randomized clinical trial investigating the effect of oxytetracycline treatment dose and mode of administration on the selection of antibiotic-resistant coliform bacteria in fecal samples from nursery pigs. Nursery pigs (pigs of 4 to 7 weeks of age) in five pig herds were treated with oxytetracycline for Lawsonia intracellularis -induced diarrhea. Each group was randomly allocated to one of five treatment groups: oral flock treatment with a (i) high (20 mg/kg of body weight), (ii) medium (10 mg/kg), or (iii) low (5 mg/kg) dose, (iv) oral pen-wise (small-group) treatment (10 mg/kg), and (v) individual intramuscular injection treatment (10 mg/kg). All groups were treated once a day for 5 days. In all groups, treatment caused a rise in the numbers and proportions of tetracycline-resistant coliform bacteria right after treatment, followed by a significant drop by the time that the pigs left the nursery unit. The counts and proportions of tetracycline-resistant coliforms did not vary significantly between treatment groups, except immediately after treatment, when the highest treatment dose resulted in the highest number of resistant coliforms. A control group treated with tiamulin did not show significant changes in the numbers or proportions of tetracycline-resistant coliforms. Selection for tetracycline-resistant coliforms was significantly correlated to selection for ampicillin- and sulfonamide-resistant strains but not to selection for cefotaxime-resistant strains. In conclusion, the difference in the dose of oxytetracycline and the way in which the drug was applied did not cause significantly different levels of selection of tetracycline-resistant coliform bacteria under the conditions tested. IMPORTANCE Antimicrobial resistance is a global threat to human health. Treatment of livestock with antimicrobials has a direct impact on this problem, and there is a need to improve the ways that we use antimicrobials in livestock

  9. Effect of Tetracycline Dose and Treatment Mode on Selection of Resistant Coliform Bacteria in Nursery Pigs

    Science.gov (United States)

    Græsbøll, Kaare; Damborg, Peter; Mellerup, Anders; Herrero-Fresno, Ana; Larsen, Inge; Holm, Anders; Nielsen, Jens Peter; Christiansen, Lasse Engbo; Angen, Øystein; Ahmed, Shahana

    2017-01-01

    ABSTRACT This study describes the results of a randomized clinical trial investigating the effect of oxytetracycline treatment dose and mode of administration on the selection of antibiotic-resistant coliform bacteria in fecal samples from nursery pigs. Nursery pigs (pigs of 4 to 7 weeks of age) in five pig herds were treated with oxytetracycline for Lawsonia intracellularis-induced diarrhea. Each group was randomly allocated to one of five treatment groups: oral flock treatment with a (i) high (20 mg/kg of body weight), (ii) medium (10 mg/kg), or (iii) low (5 mg/kg) dose, (iv) oral pen-wise (small-group) treatment (10 mg/kg), and (v) individual intramuscular injection treatment (10 mg/kg). All groups were treated once a day for 5 days. In all groups, treatment caused a rise in the numbers and proportions of tetracycline-resistant coliform bacteria right after treatment, followed by a significant drop by the time that the pigs left the nursery unit. The counts and proportions of tetracycline-resistant coliforms did not vary significantly between treatment groups, except immediately after treatment, when the highest treatment dose resulted in the highest number of resistant coliforms. A control group treated with tiamulin did not show significant changes in the numbers or proportions of tetracycline-resistant coliforms. Selection for tetracycline-resistant coliforms was significantly correlated to selection for ampicillin- and sulfonamide-resistant strains but not to selection for cefotaxime-resistant strains. In conclusion, the difference in the dose of oxytetracycline and the way in which the drug was applied did not cause significantly different levels of selection of tetracycline-resistant coliform bacteria under the conditions tested. IMPORTANCE Antimicrobial resistance is a global threat to human health. Treatment of livestock with antimicrobials has a direct impact on this problem, and there is a need to improve the ways that we use antimicrobials in

  10. Surrogate formulations for thermal treatment of low-level mixed waste, Part II: Selected mixed waste treatment project waste streams

    Energy Technology Data Exchange (ETDEWEB)

    Bostick, W.D.; Hoffmann, D.P.; Chiang, J.M.; Hermes, W.H.; Gibson, L.V. Jr.; Richmond, A.A. [Martin Marietta Energy Systems, Inc., Oak Ridge, TN (United States); Mayberry, J. [Science Applications International Corp., Idaho Falls, ID (United States); Frazier, G. [Univ. of Tennessee, Knoxville, TN (United States)

    1994-01-01

    This report summarizes the formulation of surrogate waste packages, representing the major bulk constituent compositions for 12 waste stream classifications selected by the US DOE Mixed Waste Treatment Program. These waste groupings include: neutral aqueous wastes; aqueous halogenated organic liquids; ash; high organic content sludges; adsorbed aqueous and organic liquids; cement sludges, ashes, and solids; chloride; sulfate, and nitrate salts; organic matrix solids; heterogeneous debris; bulk combustibles; lab packs; and lead shapes. Insofar as possible, formulation of surrogate waste packages are referenced to authentic wastes in inventory within the DOE; however, the surrogate waste packages are intended to represent generic treatability group compositions. The intent is to specify a nonradiological synthetic mixture, with a minimal number of readily available components, that can be used to represent the significant challenges anticipated for treatment of the specified waste class. Performance testing and evaluation with use of a consistent series of surrogate wastes will provide a means for the initial assessment (and intercomparability) of candidate treatment technology applicability and performance. Originally the surrogate wastes were intended for use with emerging thermal treatment systems, but use may be extended to select nonthermal systems as well.

  11. Surrogate formulations for thermal treatment of low-level mixed waste, Part II: Selected mixed waste treatment project waste streams

    International Nuclear Information System (INIS)

    Bostick, W.D.; Hoffmann, D.P.; Chiang, J.M.; Hermes, W.H.; Gibson, L.V. Jr.; Richmond, A.A.; Mayberry, J.; Frazier, G.

    1994-01-01

    This report summarizes the formulation of surrogate waste packages, representing the major bulk constituent compositions for 12 waste stream classifications selected by the US DOE Mixed Waste Treatment Program. These waste groupings include: neutral aqueous wastes; aqueous halogenated organic liquids; ash; high organic content sludges; adsorbed aqueous and organic liquids; cement sludges, ashes, and solids; chloride; sulfate, and nitrate salts; organic matrix solids; heterogeneous debris; bulk combustibles; lab packs; and lead shapes. Insofar as possible, formulation of surrogate waste packages are referenced to authentic wastes in inventory within the DOE; however, the surrogate waste packages are intended to represent generic treatability group compositions. The intent is to specify a nonradiological synthetic mixture, with a minimal number of readily available components, that can be used to represent the significant challenges anticipated for treatment of the specified waste class. Performance testing and evaluation with use of a consistent series of surrogate wastes will provide a means for the initial assessment (and intercomparability) of candidate treatment technology applicability and performance. Originally the surrogate wastes were intended for use with emerging thermal treatment systems, but use may be extended to select nonthermal systems as well

  12. SELECTIVE INTRA-ARTERIAL CHEMOTHERAPY (IAC IN TREATMENT AT CHILDREN WITH THE INTRAOCULAR RETYNOBLASTOMA

    Directory of Open Access Journals (Sweden)

    I. V. Pogrebnyakov

    2018-01-01

    Full Text Available Treatment of intraocular retinoblastoma is challenging. It requires a multidisciplinary personalized approach that includes focal treatments, chemotherapy, surgery and radiotherapy. Today, the focus of therapy has shifted to eye preservation with the major aim to save the child’s life and to preserve the eyeball as a functioning organ of vision with minimal complications. One of the most promising therapy approaches is selective intra-arterial chemotherapy (IAC, by which a cytostatic agent is given directly into the eye. This treatment modality has been shown to provide survival benefit and improvement of quality of life, reducing toxicity and minimizing side effects.

  13. Selective Mutism: A Team Approach to Assessment and Treatment in the School Setting

    Science.gov (United States)

    Ponzurick, Joan M.

    2012-01-01

    The school nurse plays a pivotal role in the assessment and treatment of selective mutism (SM), a rare disorder found in elementary school children. Due to anxiety, children with SM do not speak in uncomfortable situations, primarily the school setting. Diagnosis of SM is often missed in the formative years because the child does speak at home.…

  14. Threat Related Selective Attention Predicts Treatment Success in Childhood Anxiety Disorders

    Science.gov (United States)

    Legerstee, Jeroen S.; Tulen, Joke H. M.; Kallen, Victor L.; Dieleman, Gwen C.; Treffers, Philip D. A.; Verhulst, Frank C.; Utens, Elisabeth M. W. J.

    2009-01-01

    Threat-related selective attention was found to predict the success of the treatment of childhood anxiety disorders through administering a pictorial dot-probe task to 131 children with anxiety disorders prior to cognitive behavioral therapy. The diagnostic status of the subjects was evaluated with a semistructured clinical interview at both pre-…

  15. Effects of Behavioral Skills Training on Parental Treatment of Children's Food Selectivity

    Science.gov (United States)

    Seiverling, Laura; Williams, Keith; Sturmey, Peter; Hart, Sadie

    2012-01-01

    We used behavioral skills training to teach parents of 3 children with autism spectrum disorder and food selectivity to conduct a home-based treatment package that consisted of taste exposure, escape extinction, and fading. Parent performance following training improved during both taste sessions and probe meals and was reflected in increases in…

  16. Diffusion and Perfusion MR Imaging in Acute Stroke: Clinical Utility and Potential Limitations for Treatment Selection

    DEFF Research Database (Denmark)

    Bateman, Mathew; Slater, Lee-Anne; Leslie-Mazwi, Thabele M

    2017-01-01

    Magnetic resonance (MR) diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) offer unique insight into acute ischemic stroke pathophysiology. These techniques may offer the ability to apply pathophysiology to accurately individualize acute stroke reperfusion treatment, including ...... to be investigated in ongoing randomized controlled trials, and continued research into these techniques will help achieve the goal of tissue-based decision making and individualized acute stroke treatment....... extending the opportunity of reperfusion treatment to well beyond the current time-based treatment windows. This review examines the use of DWI and PWI in the major stroke trials, their current clinical utility, and potential limitations for reperfusion treatment selection. DWI and PWI continue...

  17. Effect of different oral oxytetracycline treatment regimes on selection of antimicrobial resistant coliforms in nursery pigs.

    Science.gov (United States)

    Herrero-Fresno, Ana; Zachariasen, Camilla; Nørholm, Nanna; Holm, Anders; Christiansen, Lasse Engbo; Olsen, John Elmerdahl

    2017-09-01

    A major concern derived from using antimicrobials in pig production is the development of resistance. This study aimed to assess the impact of selected combinations of oral dose and duration of treatment with oxytetracycline (OTC) on selection of tetracycline resistant (TET-R) coliforms recovered from swine feces. The work encompassed two studies: 1) OTC 5mg/kg and 20mg/kg were administered to nursery pigs for 3 and 10days, respectively, under controlled experimental conditions, and 2) 10mg/kg, 20mg/kg and 30mg/kg OTC were given to a higher number of pigs for 6, 3 and 2days, respectively, under field conditions. Statistical modeling was applied to analyze trends in the proportion of TET-R coliforms. In the experimental study, no statistical difference in proportion of TET-R coliforms was observed between treatments at the end of the trial (day 18) and compared to day 0. In the field study, treatment had a significant effect on the proportion of TET-R bacteria two days after the end of treatment (2dAT) with the regimes "low dose-six days" and "medium dose-three days" yielding the highest and lowest proportions of TET-R strains, respectively. No indication of co-selection for ampicillin- and sulphonamide -R bacteria was observed for any treatment at 2dAT. By the end of the nursery period, the proportion of TET-R bacteria was not significantly different between treatments and compared to day 0. Our results suggest that similar resistance levels might be obtained by using different treatment regimes regardless of the combinations of oral dose-duration of treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Evaluation of selected neutralizing agents for the treatment of uranium tailings leachates. Laboratory progress report

    International Nuclear Information System (INIS)

    Sherwood, D.R.; Serne, R.J.

    1983-02-01

    Laboratory experiments were conducted to evaluate the performance of selected neutralizing agents for the treatment of uranium tailings solutions. Highly acidic tailings solutions (pH 3 ) reagent grade; Calcium hydroxide [Ca(OH) 2 ] reagent grade; Magnesium oxide (MgO) reagent grade; Sodium carbonate (Na 2 CO 3 ) reagent grade; and Sodium hydroxide (NaOH) reagent grade. Evaluation of the effectiveness for the treatment of uranium tailings solutions for the selected neutralizing agents under controlled laboratory conditions was based on three criteria. The criteria are: (1) treated effluent water quality, (2) neutralized sludge handling and hydraulic properties, and (3) reagent costs and acid neutralizing efficiency. On the basis of these limited laboratory results calcium hydroxide or its dehydrated form CaO (lime) appears to be the most effective option for treatment of uranium tailings solutions

  19. Xamoterol, a new selective beta-1-adrenoceptor partial agonist, in the treatment of postural hypotension

    DEFF Research Database (Denmark)

    Mehlsen, J; Trap-Jensen, J

    1986-01-01

    Three patients severely disabled from postural hypotension were treated with xamoterol, a selective beta-1-adrenoceptor antagonist with a high degree of partial agonist activity. Oral treatment (200 mg b.i.d.) was chosen on the basis of the effects of acute intravenous administration of xamoterol...... and pindolol, a non-selective beta-adrenoceptor antagonist with partial agonist activity. In these patients pindolol had a predominantly antagonist effect, whereas xamoterol had a predominantly agonist effect after intravenous administration. Oral treatment was carried out with placebo control in a single......, supine). During the placebo period (2 weeks) heart rate decreased to pretreatment levels and mean blood pressure was reduced by only 14 mmHg. The patients reported substantial improvement in their condition during active medication. Xamoterol seems to be a useful alternative in the treatment of postural...

  20. MoDOT pavement preservation research program volume VI, pavement treatment trigger tables/decision trees and treatment candidate selection process.

    Science.gov (United States)

    2015-10-01

    The objective of Task 5 was the development of pavement treatment trigger tables and the treatment candidate selection process. : The input to the trigger tables entails such factors as an overall condition indicator, smoothness, individual distress ...

  1. Treatment of selective mutism based on cognitive behavioural therapy, psychopharmacology and combination therapy - a systematic review.

    Science.gov (United States)

    Østergaard, Kasper Rud

    2018-02-15

    Selective mutism (SM) is a debilitating childhood anxiety disorder characterized by a persistent lack of speech in certain social settings and is considered hard to treat. Cognitive behavioral therapy (CBT) and pharmacological treatments are the best described treatments in the literature. To test whether there is evidence on treatment based on CBT, medication or a combination of these. Systematic and critical review of the literature on CBT and/or pharmacological treatments of SM. Literature was sought on PubMed, Embase and Psycinfo in March 2017. Of the included studies, six examined CBT, seven pharmacologic treatment and two a combination of these. Using CBT 53/60 children improved symptomatically whilst respectively 55/67 and 6/7 improved using pharmacologic- and combination-treatment. Pharmacologic treatment and especially CBT showed promising results supported by some degree of evidence, which combination treatment lacks. Yet small numbers, few RCTs, heterogeneous study designs, lack of consistent measures, short treatment and follow-up periods, generally limits the evidence. This needs focus in future research.

  2. IVF or IUI as first-line treatment in unexplained subfertility: the conundrum of treatment selection markers.

    Science.gov (United States)

    Tjon-Kon-Fat, R I; Tajik, P; Zafarmand, M H; Bensdorp, A J; Bossuyt, P M M; Oosterhuis, G J E; van Golde, R; Repping, S; Lambers, M D A; Slappendel, E; Perquin, D; Pelinck, M J; Gianotten, J; Maas, J W M; Eijkemans, M J C; van der Veen, F; Mol, B W; van Wely, M

    2017-05-01

    Are there treatment selection markers that could aid in identifying couples, with unexplained or mild male subfertility, who would have better chances of a healthy child with IVF with single embryo transfer (IVF-SET) than with IUI with ovarian stimulation (IUI-OS)? We did not find any treatment selection markers that were associated with better chances of a healthy child with IVF-SET instead of IUI-OS in couples with unexplained or mild male subfertility. A recent trial, comparing IVF-SET to IUI-OS, found no evidence of a difference between live birth rates and multiple pregnancy rates. It was suggested that IUI-OS should remain the first-line treatment instead of IVF-SET in couples with unexplained or mild male subfertility and female age between 18 and 38 years. The question remains whether there are some couples that may have higher pregnancy chances if treated with IVF-SET instead of IUI. We performed our analyses on data from the INeS trial, where couples with unexplained or mild male subfertility and an unfavourable prognosis for natural conception were randomly allocated to IVF-SET, IVF in a modified natural cycle or IUI-OS. In view of the aim of this study, we only used data of the comparison between IVF-SET (201 couples) and IUI-OS (207 couples). We pre-defined the following baseline characteristics as potential treatment selection markers: female age, ethnicity, smoking status, type of subfertility (primary/secondary), duration of subfertility, BMI, pre-wash total motile count and Hunault prediction score. For each potential treatment selection marker, we explored the association with the chances of a healthy child after IVF-SET and IUI-OS and tested if there was an interaction with treatment. Given the exploratory nature of our analysis, we used a P-value of 0.1. None of the markers were associated with higher chances of a healthy child from IVF-SET compared to IUI-OS (P-value for interaction >0.10). Since this is the first large study that looked at

  3. Modification of the Selectivity Properties of Tubular Ceramic Membranes after Alkaline Treatment

    Directory of Open Access Journals (Sweden)

    Patrick Dutournié

    2017-11-01

    Full Text Available This work focuses on the selectivity modification of ceramic membranes after a mild alkaline treatment. Filtration of pure salt-water solutions was carried out with commercial titania membranes before and after the treatment. After treatment, the rejection of NaF significantly decreased, while the rejection of NaCl and NaBr increased. Additionally, NaI and Na2SO4 remained close to zero. Pore size and electrical charge being almost unchanged, only significant modifications in the dielectric effects can explain this modification of selectivity. Therefore, the surface chemistry and the interaction (nature and magnitude with the solvent and with the species present in the solution appear to be modified by the alkaline treatment. This trend is also illustrated by discussing the electric and the dielectric properties that were numerically identified before and after treatment. The alkaline treatment significantly decreased the apparent dielectric constant of NaCl-water solution in the pore, highlighting the rejection of sodium chloride. Contrariwise, the modification of the surface chemistry increased the apparent dielectric constant of NaF-water solution by promoting fluoride transmission.

  4. Health-Care Waste Treatment Technology Selection Using the Interval 2-Tuple Induced TOPSIS Method

    Directory of Open Access Journals (Sweden)

    Chao Lu

    2016-06-01

    Full Text Available Health-care waste (HCW management is a major challenge for municipalities, particularly in the cities of developing nations. Selecting the best treatment technology for HCW can be regarded as a complex multi-criteria decision making (MCDM issue involving a number of alternatives and multiple evaluation criteria. In addition, decision makers tend to express their personal assessments via multi-granularity linguistic term sets because of different backgrounds and knowledge, some of which may be imprecise, uncertain and incomplete. Therefore, the main objective of this study is to propose a new hybrid decision making approach combining interval 2-tuple induced distance operators with the technique for order preference by similarity to an ideal solution (TOPSIS for tackling HCW treatment technology selection problems with linguistic information. The proposed interval 2-tuple induced TOPSIS (ITI-TOPSIS can not only model the uncertainty and diversity of the assessment information given by decision makers, but also reflect the complex attitudinal characters of decision makers and provide much more complete information for the selection of the optimum disposal alternative. Finally, an empirical example in Shanghai, China is provided to illustrate the proposed decision making method, and results show that the ITI-TOPSIS proposed in this paper can solve the problem of HCW treatment technology selection effectively.

  5. Collagenase Clostridium histolyticum in the treatment of Peyronie’s disease: patient selection and perspectives

    Directory of Open Access Journals (Sweden)

    Kuhlmann PK

    2017-03-01

    Full Text Available Paige K Kuhlmann,1 Kenneth J DeLay,2 James Anaissie,2 Wayne JG Hellstrom,2 Faysal A Yafi3 1University of Missouri-Columbia School of Medicine, Columbia, MO, 2Department of Urology, Tulane University School of Medicine, New Orleans, LA, 3Department of Urology, University of California Irvine, Orange, CA, USA Abstract: The safety and efficacy of the use of collagenase Clostridium histolyticum (CCH for the treatment of Peyronie’s disease has been confirmed over the past several years. However, identification of the ideal patient population for use of this treatment is not well established. Multiple studies have attempted to delineate various patient-specific factors that may predict response to treatment with CCH, with the intent of enhancing patient selection. To date, these include baseline curvature severity, duration of disease, disease phase at presentation, plaque calcification, baseline erectile function, plaque size, age, comorbid diabetes, previous penile trauma, responsiveness to first treatment cycle, baseline penile shortening or pain, prior treatment with intralesional injection, compliance with plaque modeling, and atypical curvature. In addition, other studies have sought to explore various aspects of treatment with CCH that may affect patient perspective of treatment. They have focused on patient-reported outcomes, female partner considerations, cost of treatment, and potential confounders of patient satisfaction. This review provides a summary and analysis of currently available literature on topics of patient selection and perspectives in regard to treatment of Peyronie’s disease with CCH. Keywords: Peyronie’s disease, collagenase Clostridium histolyticum, Peyronie’s disease questionnaire, curvature deformity, intralesional injection, erectile function

  6. Minimization of storage and disposal volumes by treatment of liquids by highly selective ion exchangers

    International Nuclear Information System (INIS)

    Tusa, E.; Harjula, R.; Lehto, J.

    2000-01-01

    Novel highly selective inorganic ion exchangers provide new efficient methods for the treatment of nuclear waste liquids. These methods have several advantages compared to conventional technologies such as evaporation, direct solidification or treatment by organic ion exchange resins. Due to high selectivity, the radionuclides can be concentrated to a very small volume even from high-salt effluents. This means that the volume waste will be very small compared to other methods, which brings considerable savings in the cost of intermediate storage and final disposal. Process equipment are highly compact and require little supervision, which brings down the capital and operation costs. The new selective inorganic ion exchangers CsTreat, SrTreat and CoTreat (manufactured by Fortum Engineering Ltd., Finland) have the highest selectivities and processing capacities, exceeding those of zeolites by several orders of magnitude. The materials are now in use in a number of nuclear sites worldwide, including those in the USA, Europe and Japan. Installations include mobile and stationary systems. Considerable experience has been gained in the use of these new materials. Lessons learned, as well as advantages and economic benefits of these highly selective exchangers will be discussed in this paper. (authors)

  7. The role of selective estrogen receptor modulators in the treatment of schizophrenia.

    Science.gov (United States)

    Bratek, Agnieszka; Krysta, Krzysztof; Drzyzga, Karolina; Barańska, Justyna; Kucia, Krzysztof

    2016-09-01

    Gender differences in schizophrenia have been recognized for a long time and it has been widely accepted that sex steroid hormones, especially estradiol, are strongly attributed to this fact. Two hypotheses regarding estradiol action in psychoses gained special research attention - the estrogen protection hypothesis and hypoestrogenism hypothesis. A growing number of studies have shown benefits in augmenting antipsychotic treatment with estrogens or selective estrogen receptor modulators (SERM). This review is focused on the role of selective estrogen receptor modulators in the treatment of schizophrenic patients. In order to achieve this result PubMed was searched using the following terms: schizophrenia, raloxifene, humans. We reviewed only randomized, placebo-controlled studies. Raloxifene, a selective estrogen receptor modulator was identified as useful to improve negative, positive, and general psychopathological symptoms, and also cognitive functions. All reviewed studies indicated improvement in at least one studied domain. Augmentation with raloxifene was found to be a beneficial treatment strategy for chronic schizophrenia both in female and male patients, however potential side effects (a small increase in the risk of venous thromboembolism and endometrial cancer) should be carefully considered. SERMs could be an effective augmentation strategy in the treatment of both men women with schizophrenia, although further research efforts are needed to study potential long-term side effects.

  8. Flame treatment for the selective wetting and separation of PVC and PET.

    Science.gov (United States)

    Pascoe, R D; O'Connell, B

    2003-01-01

    Flame treatment has been used for many years to modify the surface of plastics to allow coatings to be added. The effect of the treatment is to produce hydrophilic species on the surface of the plastic making it water-wettable. The production of hydrophilic plastic surfaces is also required in the selective separation of plastics by froth flotation. For the process to be selective one plastic must be rendered hydrophilic while another remains hydrophobic. In this study the potential for separation of PVC and PET has been investigated. Flame treatment was shown to be very effective in producing a hydrophilic surface on both plastics, although the process was not selective under the conditions investigated. Raising the temperature of the plastics above their softening point produced a hydrophobic recovery. As the softening point of PVC was significantly lower than for PET it was possible to produce a significant difference in hydrophobicity, as judged using contact angle measurement. When immersed in water the contact angle of the PVC was found to be strongly dependent on the pH. Good separation efficiency of the two plastics was achieved by froth flotation from pH 4 to 9. One particular advantage of the technique is that no chemical reagents may be required in the flotation stage. The practicalities of designing a flake treatment system however have to be addressed before considering it to be a viable industrial process.

  9. Flame treatment for the selective wetting and separation of PVC and PET

    International Nuclear Information System (INIS)

    Pascoe, R.D.; O'Connell, B.

    2003-01-01

    Flame treatment has been used for many years to modify the surface of plastics to allow coatings to be added. The effect of the treatment is to produce hydrophilic species on the surface of the plastic making it water-wettable. The production of hydrophilic plastic surfaces is also required in the selective separation of plastics by froth flotation. For the process to be selective one plastic must be rendered hydrophilic while another remains hydrophobic. In this study the potential for separation of PVC and PET has been investigated. Flame treatment was shown to be very effective in producing a hydrophilic surface on both plastics, although the process was not selective under the conditions investigated. Raising the temperature of the plastics above their softening point produced a hydrophobic recovery. As the softening point of PVC was significantly lower than for PET it was possible to produce a significant difference in hydrophobicity, as judged using contact angle measurement. When immersed in water the contact angle of the PVC was found to be strongly dependent on the pH. Good separation efficiency of the two plastics was achieved by froth flotation from pH 4 to 9. One particular advantage of the technique is that no chemical reagents may be required in the flotation stage. The practicalities of designing a flake treatment system however have to be addressed before considering it to be a viable industrial process

  10. Selection of resistant Streptococcus pneumoniae during penicillin treatment in vitro and in three animal models

    DEFF Research Database (Denmark)

    Knudsen, Jenny Dahl; Odenholt, Inga; Erlendsdottir, Helga

    2003-01-01

    Pharmacokinetic (PK) and pharmacodynamic (PD) properties for the selection of resistant pneumococci were studied by using three strains of the same serotype (6B) for mixed-culture infection in time-kill experiments in vitro and in three different animal models, the mouse peritonitis, the mouse....../ml was used in the rabbit tissue cage model. During the different treatment regimens, the differences in numbers of CFU between treated and control animals were calculated to measure the efficacies of the regimens. Selective media with erythromycin or different penicillin concentrations were used to quantify...

  11. Natalizumab treatment for multiple sclerosis: updated recommendations for patient selection and monitoring

    DEFF Research Database (Denmark)

    Kappos, Ludwig; Bates, David; Edan, Gilles

    2011-01-01

    Natalizumab, a highly specific α4-integrin antagonist, is approved for treatment of patients with active relapsing-remitting multiple sclerosis (RRMS). It is generally recommended for individuals who have not responded to a currently available first-line disease-modifying therapy or who have very......, based on additional long-term follow-up of clinical studies and post-marketing observations, including appropriate patient selection and management recommendations.......Natalizumab, a highly specific α4-integrin antagonist, is approved for treatment of patients with active relapsing-remitting multiple sclerosis (RRMS). It is generally recommended for individuals who have not responded to a currently available first-line disease-modifying therapy or who have very...... active disease. The expected benefits of natalizumab treatment have to be weighed against risks, especially the rare but serious adverse event of progressive multifocal leukoencephalopathy. In this Review, we revisit and update previous recommendations on natalizumab for treatment of patients with RRMS...

  12. The effect of antenatal depression and selective serotonin reuptake inhibitor treatment on nerve growth factor signaling in human placenta

    NARCIS (Netherlands)

    Kaihola, Helena; Olivier, Jocelien; Poromaa, Inger Sundström; Åkerud, Helena

    2015-01-01

    Depressive symptoms during pregnancy are common and may have impact on the developing child. Selective serotonin reuptake inhibitors (SSRIs) are the most prescribed antidepressant treatment, but unfortunately, these treatments can also negatively affect the behavioral development and health of a

  13. A Selective Mutism Arising from First Language Attrition, Successfully Treated with Paroxetine-CBT Combination Treatment.

    Science.gov (United States)

    Serra, Agostino; Di Mauro, Paola; Andaloro, Claudio; Maiolino, Luigi; Pavone, Piero; Cocuzza, Salvatore

    2015-10-01

    After immersion in a foreign language, speakers often have difficulty retrieving native-language words and may experience a decrease in its proficiency, this phenomenon, in the non-pathological form, is known as first language attrition. Self-perception of this low native-language proficiency and apprehension occurring when speaking is expected and, may sometimes lead these people to a state of social anxiety and, in extreme forms, can involve the withholding of speech as a primitive tool for self-protection, linking them to selective mutism. We report an unusual case of selective mutism arising from first language attrition in an Italian girl after attending a two-year "German language school", who successfully responded to a paroxetine-cognitive behavioral treatment (CBT) combination treatment.

  14. Two quantitative character selection following neutron and EMS treatment in malt barley. An applied micromutation experiment

    Energy Technology Data Exchange (ETDEWEB)

    Haensel, H; Simon, W; Ehrendorfer, K [Hochschule fuer Bodenkultur, Vienna (Austria)

    1975-01-01

    Mutation experiments in spring barley are described aimed at increasing the grain yield and ''classification'' (i.e. weight percent of caryopsis greater than 2.5 mm). The course of selection up to the M/sub 8/-generation obtained by self-pollination is given. A comparison is presented with materials obtained after neutron and ethyl methanesulfonate treatment. The possibilities are also discussed of using the methods of micromutation breeding for barley crop yield and its malt quality improvement.

  15. Ball Milling Treatment of Black Dross for Selective Dissolution of Alumina in Sodium Hydroxide Leaching

    OpenAIRE

    Thi Thuy Nhi Nguyen; Man Seung Lee; Thi Hong Nguyen

    2018-01-01

    A process consisting of ball milling followed by NaOH leaching was developed to selectively dissolve alumina from black dross. From the ball milling treatment, it was found that milling speed greatly affected the leaching behavior of silica and the oxides of Ca, Fe, Mg, and Ti present in dross. The leaching behavior of the mechanically activated dross was investigated by varying NaOH concentration, leaching temperature and time, and pulp density. In most of the leaching conditions, only alumi...

  16. EFFECTS OF BEHAVIORAL SKILLS TRAINING ON PARENTAL TREATMENT OF CHILDREN'S FOOD SELECTIVITY

    OpenAIRE

    Seiverling, Laura; Williams, Keith; Sturmey, Peter; Hart, Sadie

    2012-01-01

    We used behavioral skills training to teach parents of 3 children with autism spectrum disorder and food selectivity to conduct a home-based treatment package that consisted of taste exposure, escape extinction, and fading. Parent performance following training improved during both taste sessions and probe meals and was reflected in increases in children's acceptance of bites and decreases in their disruptive behavior. Parents also reported that increases in diet variety were maintained at fo...

  17. The selective angiographic diagnosis and endovascular embolization treatment of severe epistaxis

    International Nuclear Information System (INIS)

    Zhang Xiquan; Lu Yonghong; Sun Jinghua; Guo Deqiang; Li Yuzhen; Wei Aihua

    2002-01-01

    Objective: To evaluate selective angiographic diagnosis and embolization of severe epistaxis in 57 cases. Methods: 41 cases with spontaneous haemorrhage, 11 cases with traumatic haemorrhage, 3 cases with haemorrhage of nasopharyngeal fibroangioma, and 2 case with haemorrhage of nasopharyngeal carcinoma were included in the study. Selective angiographic diagnosis and embolization of epistaxis were performed with absorbable gelatin sponge or balloon or spring coil by using Seldinger's method. Results: 59 procedure of angiographic diagnosis and embolization were performed in 57 cases. Both maxillaris internal artery embolization was performed in 6 cases. After embolization, satisfactory results were achieved immediately in 55 cases. After 6 months to 2 years' follow-up, no haemorrhage recurred. In 4 cases with traumatic haemorrhage in the face, simple maxillaris internal artery embolization was performed in 2 cases. Conclusion: Selective angiographic diagnosis and embolization are safe, effective, and successful method of choices in the treatment of severe epistaxis

  18. Coupled variable selection for regression modeling of complex treatment patterns in a clinical cancer registry.

    Science.gov (United States)

    Schmidtmann, I; Elsäßer, A; Weinmann, A; Binder, H

    2014-12-30

    For determining a manageable set of covariates potentially influential with respect to a time-to-event endpoint, Cox proportional hazards models can be combined with variable selection techniques, such as stepwise forward selection or backward elimination based on p-values, or regularized regression techniques such as component-wise boosting. Cox regression models have also been adapted for dealing with more complex event patterns, for example, for competing risks settings with separate, cause-specific hazard models for each event type, or for determining the prognostic effect pattern of a variable over different landmark times, with one conditional survival model for each landmark. Motivated by a clinical cancer registry application, where complex event patterns have to be dealt with and variable selection is needed at the same time, we propose a general approach for linking variable selection between several Cox models. Specifically, we combine score statistics for each covariate across models by Fisher's method as a basis for variable selection. This principle is implemented for a stepwise forward selection approach as well as for a regularized regression technique. In an application to data from hepatocellular carcinoma patients, the coupled stepwise approach is seen to facilitate joint interpretation of the different cause-specific Cox models. In conditional survival models at landmark times, which address updates of prediction as time progresses and both treatment and other potential explanatory variables may change, the coupled regularized regression approach identifies potentially important, stably selected covariates together with their effect time pattern, despite having only a small number of events. These results highlight the promise of the proposed approach for coupling variable selection between Cox models, which is particularly relevant for modeling for clinical cancer registries with their complex event patterns. Copyright © 2014 John Wiley & Sons

  19. Treatment efficacy, treatment failures and selection of macrolide resistance in patients with high load of Mycoplasma genitalium during treatment of male urethritis with josamycin.

    Science.gov (United States)

    Guschin, Alexander; Ryzhikh, Pavel; Rumyantseva, Tatiana; Gomberg, Mikhail; Unemo, Magnus

    2015-02-03

    Azithromycin has been widely used for Mycoplasma genitalium treatment internationally. However, the eradication efficacy has substantially declined recent decade. In Russia, josamycin (another macrolide) is the recommended first-line treatment for M. genitalium infections, however, no data regarding treatment efficacy with josamycin and resistance in M. genitalium infections have been internationally published. We examined the M. genitalium prevalence in males attending an STI clinic in Moscow, Russia from December 2006 to January 2008, investigated treatment efficacy with josamycin in male urethritis, and monitored the M. genitalium DNA eradication dynamics and selection of macrolide resistance in M. genitalium during this treatment. Microscopy and real-time PCRs were used to diagnose urethritis and non-viral STIs, respectively, in males (n = 320). M. genitalium positive patients were treated with recommended josamycin regimen and treatment efficacy was monitored using quantitative real-time PCR. Macrolide resistance mutations were identified using sequencing of the 23S rRNA gene. Forty-seven (14.7%) males were positive for M. genitalium only and most (85.1%) of these had symptoms and signs of urethritis. Forty-six (97.9%) males agreed to participate in the treatment efficacy monitoring. All the pre-treatment M. genitalium specimens had wild-type 23S rRNA. The elimination of M. genitalium DNA was substantially faster in patients with lower pre-treatment M. genitalium load, and the total eradication rate was 43/46 (93.5%). Of the six patients with high pre-treatment M. genitalium load, three (50%) remained positive post-treatment and these positive specimens contained macrolide resistance mutations in the 23S rRNA gene, i.e., A2059G (n = 2) and A2062G (n = 1). M. genitalium was a frequent cause of male urethritis in Moscow, Russia. The pre-treatment M. genitalium load might be an effective predictor of eradication efficacy with macrolides (and possibly

  20. Toward automated selective retina treatment (SRT): an optical microbubble detection technique

    Science.gov (United States)

    Seifert, Eric; Park, Young-Gun; Theisen-Kunde, Dirk; Roh, Young-Jung; Brinkmann, Ralf

    2018-02-01

    Selective retina therapy (SRT) is an ophthalmological laser technique, targeting the retinal pigment epithelium (RPE) with repetitive microsecond laser pulses, while causing no thermal damage to the neural retina, the photoreceptors as well as the choroid. The RPE cells get damaged mechanically by microbubbles originating, at the intracellular melanosomes. Beneficial effects of SRT on Central Serous Retinopathy (CSR) and Diabetic Macula Edema (DME) have already been shown. Variations in the transmission of the anterior eye media and pigmentation variation of RPE yield in intra- and inter- individual thresholds of the pulse energy required for selective RPE damage. Those selective RPE lesions are not visible. Thus, dosimetry-systems, designed to detect microbubbles as an indicator for RPE cell damage, are demanded elements to facilitate SRT application. Therefore, a technique based on the evaluation of backscattered treatment light has been developed. Data of 127 spots, acquired during 10 clinical treatments of CSR patients, were assigned to a RPE cell damage class, validated by fluorescence angiography (FLA). An algorithm has been designed to match the FLA based information. A sensitivity of 0.9 with a specificity close to 1 is achieved. The data can be processed within microseconds. Thus, the process can be implemented in existing SRT lasers with an automatic pulse wise increasing energy and an automatic irradiation ceasing ability to enable automated treatment close above threshold to prevent adverse effects caused by too high pulse energy. Alternatively, a guidance procedure, informing the treating clinician about the adequacy of the actual settings, is possible.

  1. Isolation of cells for selective treatment and analysis using a magnetic microfluidic chip

    KAUST Repository

    Yassine, Omar

    2014-05-01

    This study describes the development and testing of a magnetic microfluidic chip (MMC) for trapping and isolating cells tagged with superparamagnetic beads (SPBs) in a microfluidic environment for selective treatment and analysis. The trapping and isolation are done in two separate steps; first, the trapping of the tagged cells in a main channel is achieved by soft ferromagnetic disks and second, the transportation of the cells into side chambers for isolation is executed by tapered conductive paths made of Gold (Au). Numerical simulations were performed to analyze the magnetic flux and force distributions of the disks and conducting paths, for trapping and transporting SPBs. The MMC was fabricated using standard microfabrication processes. Experiments were performed with E. coli (K12 strand) tagged with 2.8 μm SPBs. The results showed that E. coli can be separated from a sample solution by trapping them at the disk sites, and then isolated into chambers by transporting them along the tapered conducting paths. Once the E. coli was trapped inside the side chambers, two selective treatments were performed. In one chamber, a solution with minimal nutrition content was added and, in another chamber, a solution with essential nutrition was added. The results showed that the growth of bacteria cultured in the second chamber containing nutrient was significantly higher, demonstrating that the E. coli was not affected by the magnetically driven transportation and the feasibility of performing different treatments on selectively isolated cells on a single microfluidic platform.

  2. Selective androgen receptor modulators for the treatment of late onset male hypogonadism.

    Science.gov (United States)

    Coss, Christopher C; Jones, Amanda; Hancock, Michael L; Steiner, Mitchell S; Dalton, James T

    2014-01-01

    Several testosterone preparations are used in the treatment of hypogonadism in the ageing male. These therapies differ in their convenience, flexibility, regional availability and expense but share their pharmacokinetic basis of approval and dearth of long-term safety data. The brevity and relatively reduced cost of pharmacokinetic based registration trials provides little commercial incentive to develop improved novel therapies for the treatment of late onset male hypogonadism. Selective androgen receptor modulators (SARMs) have been shown to provide anabolic benefit in the absence of androgenic effects on prostate, hair and skin. Current clinical development for SARMs is focused on acute muscle wasting conditions with defi ned clinical endpoints of physical function and lean body mass. Similar regulatory clarity concerning clinical deficits in men with hypogonadism is required before the beneficial pharmacology and desirable pharmacokinetics of SARMs can be employed in the treatment of late onset male hypogonadism.

  3. Selective androgen receptor modulators for the treatment of late onset male hypogonadism

    Directory of Open Access Journals (Sweden)

    Christopher C Coss

    2014-04-01

    Full Text Available Several testosterone preparations are used in the treatment of hypogonadism in the ageing male. These therapies differ in their convenience, flexibility, regional availability and expense but share their pharmacokinetic basis of approval and dearth of long-term safety data. The brevity and relatively reduced cost of pharmacokinetic based registration trials provides little commercial incentive to develop improved novel therapies for the treatment of late onset male hypogonadism. Selective androgen receptor modulators (SARMs have been shown to provide anabolic benefit in the absence of androgenic effects on prostate, hair and skin. Current clinical development for SARMs is focused on acute muscle wasting conditions with defi ned clinical endpoints of physical function and lean body mass. Similar regulatory clarity concerning clinical deficits in men with hypogonadism is required before the beneficial pharmacology and desirable pharmacokinetics of SARMs can be employed in the treatment of late onset male hypogonadism.

  4. Cleanup and treatment of radioactively contaminated land including areas near nuclear facilities. A selected bibliography

    International Nuclear Information System (INIS)

    Fore, C.S.; Faust, R.A.; Brewster, R.H.

    1982-09-01

    This annotated bibliography of 337 references summarizes the literature published on the cleanup and treatment of radioactively contaminated land. Specifically, this bibliography focuses on literature concerned with the methods of cleanup and treatment being applied - chemical, physical, or vegetative stabilization; the types of equipment being used; and the influence of climatic conditions on the method selected for use. The emphasis in such literature is placed on hazardous site cleanup efforts that have been completed as well as those that are in progress and are being planned. Appendix A includes 135 additional references to literature identified but not included in the bibliography because of time and funding constraints. Appendix B consists of a table that identifies the cleanup and treatment research conducted at specific sites. All of the information included in this bibliography is stored in a computerized form that is readily available upon request

  5. Selective androgen receptor modulators for the treatment of late onset male hypogonadism

    Science.gov (United States)

    Coss, Christopher C; Jones, Amanda; Hancock, Michael L; Steiner, Mitchell S; Dalton, James T

    2014-01-01

    Several testosterone preparations are used in the treatment of hypogonadism in the ageing male. These therapies differ in their convenience, flexibility, regional availability and expense but share their pharmacokinetic basis of approval and dearth of long-term safety data. The brevity and relatively reduced cost of pharmacokinetic based registration trials provides little commercial incentive to develop improved novel therapies for the treatment of late onset male hypogonadism. Selective androgen receptor modulators (SARMs) have been shown to provide anabolic benefit in the absence of androgenic effects on prostate, hair and skin. Current clinical development for SARMs is focused on acute muscle wasting conditions with defined clinical endpoints of physical function and lean body mass. Similar regulatory clarity concerning clinical deficits in men with hypogonadism is required before the beneficial pharmacology and desirable pharmacokinetics of SARMs can be employed in the treatment of late onset male hypogonadism. PMID:24407183

  6. ED pharmacist monitoring of provider antibiotic selection aids appropriate treatment for outpatient UTI.

    Science.gov (United States)

    Lingenfelter, Erin; Drapkin, Zachary; Fritz, Kelly; Youngquist, Scott; Madsen, Troy; Fix, Megan

    2016-08-01

    We sought to determine whether an emergency department (ED) pharmacist could aid in the monitoring and correction of inappropriate empiric antibiotic selection for urinary tract infections in an outpatient ED population. Urine cultures with greater than 100 000 CFU/mL bacteria from the University of Utah Emergency Department over 1 year (October 2011-Sept 2012) were identified using our electronic medical record system. Per ED protocol, an ED pharmacist reviews all cultures and performs a chart review of patient symptoms, diagnosis, and discharge antibiotics to determine whether the treatment was appropriate. A retrospective review of this process was performed to identify how often inappropriate treatment was recognized and intervened on by an ED pharmacist. Of the 180 cultures included, a total of 42 (23%) of empiric discharge treatments were considered inappropriate and required intervention. In 35 (83%) of 42 patients, the ED pharmacist was able to contact the patient and make appropriate changes; the remaining 7 patients were unable to be contacted, and no change could be made in their treatment. A chart review of all urine cultures with greater than 100 000 CFU/mL performed by an ED pharmacist helped identify inappropriate treatment in 23% of patients discharged to home with the diagnosis of urinary tract infection. Of these patients who had received inappropriate treatment, an ED pharmacist was able to intervene in 83% of cases. These data highlight the role of ED pharmacists in improving patient care after discharge. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. General quality of life of patients with acne vulgaris before and after performing selected cosmetological treatments

    Science.gov (United States)

    Chilicka, Karolina; Maj, Joanna; Panaszek, Bernard

    2017-01-01

    Background Achieving a satisfying quality of life for a patient by applying individually matched therapy is, simultaneously, a great challenge and a priority for contemporary medicine. Patients with visible dermatological ailments are particularly susceptible to reduction in the general quality of life. Among the dermatological diseases, acne causes considerable reduction in the quality of life and changes in self-perception that lead to the worsening of a patient’s mental condition, including depression and suicidal thoughts. As a result, difficulties in contact with loved ones, as well as social and professional problems are observed, which show that acne is not a somatic problem alone. To a large extent, it becomes a part of psychodermatology, becoming an important topic of public health in social medicine practice. Pharmacological treatment of acne is a challenge for a dermatologist and often requires the necessity of cooperating with a cosmetologist. Cosmetological treatments are aimed at improving the condition of the skin and reduction or subsiding of acne skin changes. Aim The aim of this study was to assess the influence of selected cosmetological treatments on the general quality of life of patients with acne. Materials and methods The study group consisted of 101 women aged 19–29 years (x¯=22.5 years, SD =2.3 years). All subjects were diagnosed with acne vulgaris of the face. In the study group, the acne changes occurred over the course of 3–15 years (x¯=8.1 years, SD =2.7 years). Selected cosmetological treatments (intensive pulsing light, alpha-hydroxy acids, cavitation peeling, needle-free mesotherapy, diamond microdermabrasion and sonophoresis) were performed in series in the number depending on the particular patient’s chosen treatment, after excluding contraindications. General quality of life of the patients was estimated using the Skindex-29 and Dermatology Life Quality Index (DLQI) questionnaires, before and after the cosmetological

  8. Selection of optimal treatment scheme for brain metastases of non-small cell lung cancer

    International Nuclear Information System (INIS)

    Dong Mingxin; Zhao Tong; Huang Jingzi; Yu Shukun; Ma Yan; Tian Zhongcheng; Jin Xiangshun; Quan Jizhong; Liu Jin; Wang Dongxu

    2006-01-01

    Objective: To select the optimal treatment scheme for brain metastases of non-small cell lung cancers (NSCLCs). Methods: Seventy-two NSCLC cases diagnosesd by pathology with brain metastases were randomly classified into three groups, Group I, 24 cases with whole brain conventional external fractioned irradiation of D T 36-41 Gy/4-5 w, Group II, 22 eases with y-knife treatment plus whole brain conventional external fractioned irradiation, and Group III, 26 cases with γ-knife plus whole brain conventional external fractioned irradiation in combination with chemotherapy of Vm-26. The surrounding area of tumor was strictly covered with 50% para-central-dosal curve in γ-knife treatment (D T 16-25 Gy with a mean of 16 Gy). The muirleaf collimator was selected according to the volume of tumors. Chemotherapy of Vm-26 (60 mg/m 2 d1-3) was applied during the treatment with whole brain conventional external fractioned irradiation (D T 19-29 Gy/2-3 w), 21 days in a period, 2 periods in total. Results: The median survival time was estimated to be 6.0 months (ranged from 1.2 to 19.0 months) in the Group I, 9.2 months (4.4-30 months) in the Group II, and 10.8 months (5.2-42.2 months) in the Group III. The 1-year and 2-year survival rates were 34.6% and 12.6% , 62.2% and 30.2%, and 70.8% and 35.6% respectively in Group I, Group II, and Group III, respectively. Conclusion: For brain metastases of NSCLC, γ-knife plus whole brain conventional external fractioned irradiation combined with treatment of Vm-26 had a significantly beneficial influence on improvement of the local control and 1-year and 2-year survival. There was no complaint about the side-effects of the treatment. (authors)

  9. 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.

  10. Alemtuzumab in the treatment of multiple sclerosis: patient selection and special considerations

    Directory of Open Access Journals (Sweden)

    Dörr J

    2016-10-01

    the other are not yet available. Thus, the overall success of alemtuzumab treatment critically depends on the patient selection. The aim of this article is therefore, to characterize the significance of alemtuzumab in the treatment of MS with a focus on the selection of the optimal patient. Keywords: multiple sclerosis, treatment, safety, efficacy, selection, benefit risk relation

  11. KPI (KEY PERFORMANCE INDICATORS APPLICATION ON BALLAST WATER TREATMENT SYSTEM SELECTION

    Directory of Open Access Journals (Sweden)

    Gülçin Vural

    2017-01-01

    Full Text Available Every day, more than 7,000 different marine species are transferred to different ecosystems via ballast water in ships. The introduction of invasive species can cause problems for native species. After realizing the serious potential problems associated with the transport of organisms in ballast water, national and international regulations were developed. In 2004, the International Maritime Organization introduced the International Convention for the Control and Management of Ships' Ballast Water and Sediments. With these regulations, the problems caused by ballast water have attracted attention and many companies have started to research and develop technologies for the management of ballast water. Today, there are hundreds of different systems for ballast-water treatment, and the selection of the most suitable system for a specific vessel is an increasingly important issue as the Convention nears enforcement on September 8, 2017. The goal of this study is to demonstrate that the application of key performance indicators (KPIs to the selection of a ballast-water treatment system (BWTS leads to a very useful tool with which shipyards can compare BWTSs. This allows them to make better choices and to designate the most suitable system for each of their ships. In this study, we examine two types of vessel from a shipyard in Istanbul, Turkey. They have different ballast-water capacities and equipment, and the most suitable system for each is selected by using the KPI method.

  12. Host population structure and treatment frequency maintain balancing selection on drug resistance

    Science.gov (United States)

    Baskerville, Edward B.; Colijn, Caroline; Hanage, William; Fraser, Christophe; Lipsitch, Marc

    2017-01-01

    It is a truism that antimicrobial drugs select for resistance, but explaining pathogen- and population-specific variation in patterns of resistance remains an open problem. Like other common commensals, Streptococcus pneumoniae has demonstrated persistent coexistence of drug-sensitive and drug-resistant strains. Theoretically, this outcome is unlikely. We modelled the dynamics of competing strains of S. pneumoniae to investigate the impact of transmission dynamics and treatment-induced selective pressures on the probability of stable coexistence. We find that the outcome of competition is extremely sensitive to structure in the host population, although coexistence can arise from age-assortative transmission models with age-varying rates of antibiotic use. Moreover, we find that the selective pressure from antibiotics arises not so much from the rate of antibiotic use per se but from the frequency of treatment: frequent antibiotic therapy disproportionately impacts the fitness of sensitive strains. This same phenomenon explains why serotypes with longer durations of carriage tend to be more resistant. These dynamics may apply to other potentially pathogenic, microbial commensals and highlight how population structure, which is often omitted from models, can have a large impact. PMID:28835542

  13. CBT for childhood anxiety disorders: differential changes in selective attention between treatment responders and non-responders.

    Science.gov (United States)

    Legerstee, Jeroen S; Tulen, Joke H M; Dierckx, Bram; Treffers, Philip D A; Verhulst, Frank C; Utens, Elisabeth M W J

    2010-02-01

    This study examined whether treatment response to stepped-care cognitive-behavioural treatment (CBT) is associated with changes in threat-related selective attention and its specific components in a large clinical sample of anxiety-disordered children. Ninety-one children with an anxiety disorder were included in the present study. Children received a standardized stepped-care CBT. Three treatment response groups were distinguished: initial responders (anxiety disorder free after phase one: child-focused CBT), secondary responders (anxiety disorder free after phase two: child-parent-focused CBT), and treatment non-responders. Treatment response was determined using a semi-structured clinical interview. Children performed a pictorial dot-probe task before and after stepped-care CBT (i.e., before phase one and after phase two CBT). Changes in selective attention to severely threatening pictures, but not to mildly threatening pictures, were significantly associated with treatment success. At pre-treatment assessment, initial responders selectively attended away from severely threatening pictures, whereas secondary responders selectively attended toward severely threatening pictures. After stepped-care CBT, initial and secondary responders did not show any selectivity in the attentional processing of severely threatening pictures. Treatment non-responders did not show any changes in selective attention due to CBT. Initial and secondary treatment responders showed a reduction of their predisposition to selectively attend away or toward severely threatening pictures, respectively. Treatment non-responders did not show any changes in selective attention. The pictorial dot-probe task can be considered a potentially valuable tool in assigning children to appropriate treatment formats as well as for monitoring changes in selective attention during the course of CBT.

  14. Helminths in horses : use of selective treatment for the control of strongyles

    Directory of Open Access Journals (Sweden)

    S. Matthee

    2004-06-01

    Full Text Available The current level of anthelmintic resistance in the horse-breeding industry is extremely high and therefore more emphasis is being placed on studies that focus on the judicious use of anthelmintic products. The aims of the study were to: 1 establish if there is variation in the egg excretion pattern of strongyles between the different age classes of Thoroughbred horses in the Western Cape Province (WCP, 2 test if a selective treatment approach successfully reduces the number of anthelmintic treatments and maintains acceptably low helminth burdens in adult Thoroughbred horses, and 3 evaluate the efficacy of subsampling large horse herds for faecal egg counts (FECs to monitor the strongyle burden. In 2001 the FECs of 4 adult mare, 5 yearling and 3 weanling herds from 8 different farms were compared in the WCP. Within the mare herds there were generally fewer eggexcreting individuals with lower mean FECs compared with the younger age classes. Individual faecal samples were collected every 3-4 weeks from 52 adult Thoroughbred mares from 1 farm in the WCP during a 12-month period (2002/2003. Animals with strongyle FECs > 100 eggs per gram (epg were treated with an ivermectin-praziquantel combination drug (Equimax oral paste, Virbac. The mean monthly strongyle FEC for the entire group was < 300 epg throughout the study and the number of treatments was reduced by 50 %. Resampling methods showed that an asymptote to mean FEC was reached at 55 animals for each of the pooled weanling, yearling and mare egg counts. Resampling within 4 different mare herds recorded asymptotes of between 24 and 28 animals. Subsampling entire herds for FECs therefore provided an effective approach to treatment management. This study demonstrates that selective treatment is both a practical and an effective approach to the management of anthelmintic resistance.

  15. Integrated basic treatment of activated carbon for enhanced CO{sub 2} selectivity

    Energy Technology Data Exchange (ETDEWEB)

    Adelodun, Adedeji Adebukola; Jo, Young-Min, E-mail: ymjo@khu.ac.kr

    2013-12-01

    We attempted the use of three chemical agents viz nitric acid (HN), calcium nitrate (CaN) and calcium ethanoate (CaEt) to achieve enhanced CO{sub 2} selective adsorption by activated carbon (AC). In dry phase treatment, microporous coconut shell-based carbon (CS) exhibits higher CO{sub 2} capacity than coal-based. However, upon wet-phase pre-treatment, modified CS samples showed lesser CO{sub 2} adsorption efficiency. Surface characterization with X-ray photoelectron spectroscopy confirms the presence of calcium and amine species on the samples with integrated treatment (A-CaN). These samples recorded the highest low-level CO{sub 2} capture despite calcinated CaEt-doped samples (C-CaEt) showing the highest value for pure and high level CO{sub 2} adsorption capacities. The slope and linearity values of isobaric desorption were used to estimate the proportion of CO{sub 2} chemisorbed and heterogeneity of the adsorbents’ surfaces respectively. Consequently, integrated basic impregnation provides the most efficient adsorbents for selective adsorption of both indoor and outdoor CO{sub 2} levels.

  16. Fracture behaviour of a magnesium–aluminium alloy treated by selective laser surface melting treatment

    International Nuclear Information System (INIS)

    Taltavull, C.; López, A.J.; Torres, B.; Rams, J.

    2014-01-01

    Highlights: • β-Mg 17 Al 12 presents fragile fracture behavior decreasing the ductility of AZ91D. • SLSM treatment only modifies the β-Mg 17 Al 12 phase whilst α-Mg remains unaltered. • In-situ SEM bending test allows to observe and data record of the crack propagation. • Eutectic microestructure of modified β-phase presents ductile fracture behaviour. • Fracture toughness of laser treated specimen is 40% greater than as-received alloy. - Abstract: Fracture behaviour of AZ91D magnesium alloy is dominated by the brittle fracture of the β-Mg 17 Al 12 phase so its modification is required to improve the toughness of this alloy. The novel laser treatment named as Selective Laser Surface Melting (SLSM) is characterized by the microstructural modification of the β-Mg 17 Al 12 phase without altering the α-Mg matrix. We have studied the effect of the selected microstructural modification induced by the laser treatment in the fracture behaviour of the alloy has been studied using in situ Scanning Electron Microscopy bending test. This test configuration allows the in situ observation of the crack progression and the record of the load–displacement curve. It has been observed that the microstructural modification introduced by SLSM causes an increase of 40% of the fracture toughness of the treated specimen. This phenomenon can be related with the transition from brittle to ductile fracture behaviour of the laser modified β-phase

  17. Selection criteria utilized for hyperbaric oxygen treatment of carbon monoxide poisoning.

    Science.gov (United States)

    Hampson, N B; Dunford, R G; Kramer, C C; Norkool, D M

    1995-01-01

    Medical directors of North American hyperbaric oxygen (HBO) facilities were surveyed to assess selection criteria applied for treatment of acute carbon monoxide (CO) poisoning within the hyperbaric medicine community. Responses were received from 85% of the 208 facilities in the United States and Canada. Among responders, 89 monoplace and 58 multiplace chamber facilities treat acute CO poisoning, managing a total of 2,636 patients in 1992. A significant majority of facilities treat CO-exposed patients with coma (98%), transient loss of consciousness (LOC) (77%), ischemic changes on electrocardiogram (91%), focal neurologic deficits (94%), or abnormal psychometric testing (91%), regardless of carboxyhemoglobin (COHb) level. Although 92% would use HBO for a patient presenting with headache, nausea, and COHb 40%, only 62% of facilities utilize a specified minimum COHb level as the sole criterion for HBO therapy of an asymptomatic patient. When COHb is used as an independent criterion to determine HBO treatment, the level utilized varies widely between institutions. Half of responding facilities place limits on the delay to treatment for patients with only transient LOC. Time limits are applied less often in cases with persistent neurologic deficits. While variability exists, majority opinions can be derived for many patient selection criteria regarding the use of HBO in acute CO poisoning.

  18. Effects of selective serotonin reuptake inhibitor treatment on plasma oxytocin and cortisol in major depressive disorder.

    Science.gov (United States)

    Keating, Charlotte; Dawood, Tye; Barton, David A; Lambert, Gavin W; Tilbrook, Alan J

    2013-04-29

    Oxytocin is known for its capacity to facilitate social bonding, reduce anxiety and for its actions on the stress hypothalamopituitary adrenal (HPA) axis. Since oxytocin can physiologically suppress activity of the HPA axis, clinical applications of this neuropeptide have been proposed in conditions where the function of the HPA axis is dysregulated. One such condition is major depressive disorder (MDD). Dysregulation of the HPA system is the most prominent endocrine change seen with MDD, and normalizing the HPA axis is one of the major targets of recent treatments. The potential clinical application of oxytocin in MDD requires improved understanding of its relationship to the symptoms and underlying pathophysiology of MDD. Previous research has investigated potential correlations between oxytocin and symptoms of MDD, including a link between oxytocin and treatment related symptom reduction. The outcomes of studies investigating whether antidepressive treatment (pharmacological and non-pharmacological) influences oxytocin concentrations in MDD, have produced conflicting outcomes. These outcomes suggest the need for an investigation of the influence of a single treatment class on oxytocin concentrations, to determine whether there is a relationship between oxytocin, the HPA axis (e.g., oxytocin and cortisol) and MDD. Our objective was to measure oxytocin and cortisol in patients with MDD before and following treatment with selective serotonin reuptake inhibitors, SSRI. We sampled blood from arterial plasma. Patients with MDD were studied at the same time twice; pre- and post- 12 weeks treatment, in an unblinded sequential design (clinicaltrials.govNCT00168493). Results did not reveal differences in oxytocin or cortisol concentrations before relative to following SSRI treatment, and there were no significant relationships between oxytocin and cortisol, or these two physiological variables and psychological symptom scores, before or after treatment. These outcomes

  19. Selection of a reference process for treatment of the West Valley alkaline waste

    International Nuclear Information System (INIS)

    Holton, L.K.; Wise, B.M.; Bray, L.A.; Pope, J.M.; Carl, D.E.

    1984-08-01

    As part of the West Valley Demonstration Project (WVDP) the alkaline PUREX supernatant stored in Tank 8D2 will be partially decontaminated by the removal of radiocesium. Four processes for removal of radiocesium from the alkaline supernatant were studied through experimentation and engineering analysis to identify a reference approach for the WVDP. These processes included the use of a zeolite inorganic ion-exchanger (Linde Ionsiv IE-95), an organic ion exchange resin (Duolite CS-100), and two precipitation processes; one using sodium tetraphenylboron (NaTPB) and the other using phosphotungstic acid (PTA). Based upon process performance, safety and environmental considerations, process and equipment complexity and impacts to the waste vitrification system, the zeolite ion-exchange process has been selected by West Valley Nuclear Services, Inc., as the reference supernatant treatment process for the WVDP. This paper will summarize the technical basis for the selection of the zeolite ion-exchange process. 4 figures, 2 tables

  20. [The role of magnetic resonance imaging to select patients for preoperative treatment in rectal cancer].

    Science.gov (United States)

    Rödel, Claus; Sauer, Rolf; Fietkau, Rainer

    2009-08-01

    Traditionally, the decision to apply preoperative treatment for rectal cancer patients has been based on the T- and N-category. Recently, the radial distance of the tumor to the circumferential resection margin (CRM) has been identified as an important risk factor for local failure. By magnetic resonance imaging (MRI) this distance can be measured preoperatively with high reliability. Thus, selected groups have started to limit the indication for preoperative therapy to tumors extending to - or growing within 1 mm from - the mesorectal fascia (CRM+). Pros and cons of this selected approach for preoperative treatment and first clinical results are presented. Prerequisites are the availability of modern high-resolution thin-section MRI technology as well as strict quality control of MRI and surgical quality of total mesorectal excision (TME). By selecting patients with CRM-positive tumors on MRI for preoperative therapy, only approximately 35% patients will require preoperative radiotherapy (RT) or radiochemotherapy (RCT). However, with histopathologic work-up of the resected specimen after primary surgery, the indication for postoperative RCT is given for a rather large percentage of patients, i.e., for pCRM+ (5-10%), intramesorectal or intramural excision (30-40%), pN+ (30-40%). Postoperative RCT, however, is significantly less effective and more toxic than preoperative RCT. A further point of concern is the assertion that patients, in whom a CRM-negative status is achieved by surgery alone, do not benefit from additional RT. Data of the Dutch TME trial and the British MRC (Medical Research Council) CR07 trial, however, suggest the reverse. To omit preoperative RT/RCT for CRM-negative tumors on MRI needs to be further investigated in prospective clinical trials. The German guidelines for the treatment of colorectal cancer 2008 continue to indicate preoperative RT/RCT based on the T- and N-category.

  1. The role of magnetic resonance imaging to select patients for preoperative treatment in rectal cancer

    International Nuclear Information System (INIS)

    Roedel, Claus; Sauer, Rolf; Fietkau, Rainer

    2009-01-01

    Background: Traditionally, the decision to apply preoperative treatment for rectal cancer patients has been based on the T- and N-category. Recently, the radial distance of the tumor to the circumferential resection margin (CRM) has been identified as an important risk factor for local failure. By magnetic resonance imaging (MRI) this distance can be measured preoperatively with high reliability. Thus, selected groups have started to limit the indication for preoperative therapy to tumors extending to - or growing within 1 mm from - the mesorectal fascia (CRM+). Methods: Pros and cons of this selected approach for preoperative treatment and first clinical results are presented. Prerequisites are the availability of modern high-resolution thin-section MRI technology as well as strict quality control of MRI and surgical quality of total mesorectal excision (TME). Results: By selecting patients with CRM-positive tumors on MRI for preoperative therapy, only approximately 35% patients will require preoperative radiotherapy (RT) or radiochemotherapy (RCT). However, with histopathologic work-up of the resected specimen after primary surgery, the indication for postoperative RCT is given for a rather large percentage of patients, i.e., for pCRM+ (5-10%), intramesorectal or intramural excision (30-40%), pN+ (30-40%). Postoperative RCT, however, is significantly less effective and more toxic than preoperative RCT. A further point of concern is the assertion that patients, in whom a CRM-negative status is achieved by surgery alone, do not benefit from additional RT. Data of the Dutch TME trial and the British MRC (Medical Research Council) CR07 trial, however, suggest the reverse. Conclusion: To omit preoperative RT/RCT for CRM-negative tumors on MRI needs to be further investigated in prospective clinical trials. The German guidelines for the treatment of colorectal cancer 2008 continue to indicate preoperative RT/RCT based on the T- and N-category. (orig.)

  2. Autotransplant tissue selection criteria with or without stereomicroscopy in parathyroidectomy for treatment of renal hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Monique Nakayama Ohe

    2014-07-01

    Full Text Available INTRODUCTION: Several methods have been proposed to improve operative success in renal hyperparathyroidism. OBJECTIVE: To evaluate stereomicroscopy in parathyroid tissue selection for total parathyroidectomy with autotransplantation in secondary (SHPT/tertiary (THPT hyperparathyroidism. METHODS: 118 renal patients underwent surgery from April of 2000 to October 2009. They were divided into two groups: G1, 66 patients operated from April of 2000 to May of 2005, with tissue selection based on macroscopic observation; G2, 52 patients operated from March of 2008 to October 2009 with stereomicroscopy for tissue selection searching for the presence of adipose cells. All surgeries were performed by the same surgeon. Patients presented SHPT (dialysis treatment or THPT (renal-grafted. Follow-up was 12-36 months. Intra-operative parathyroid hormone (PTH was measured in 100/118 (84.7% patients. RESULTS: Data are presented as means. G1 included 66 patients (38 SHPT, 24 females/14 males; 40.0 years of age; 28 THPT, 14 females/14 males; 44 years of age. G2 included 52 patients (29 SHPT, 11 females/18 males; 50.7 years of age; 23 THPT, 13 females/10 males, 44.4 years of age. SHPT patients from G2 presented preoperative serum calcium higher than those of SHPT patients in G1 (p < 0.05, suggesting a more severe disease. Definitive hypoparathyroidism was found in seven of 118 patients (5.9%. Graft-dependent recurrence occurred in four patients, two in each group. All occurred in dialysis patients. CONCLUSION: Stereomicroscopy in SHPT/THPT surgical treatment may be a useful tool to standardize parathyroid tissue selection.

  3. Clinical study of emergency treatment and selective closed reduction for the treatment of supracondylar humerus fracture in children

    Directory of Open Access Journals (Sweden)

    Wei Zhong

    2016-11-01

    Full Text Available Objective: To study the effect of emergency treatment, selective closed reduction combined with percutaneous Kirschner wire fixation on the treatment of Gartland type-II and type-III supracondylar humerus fracture. Methods: Children who sustained the Gartland type-II and type-III supracondylar fractures of humerus treated with selective closed reduction combined with percutaneous Kirschner wire fixation in our hospital from May 2012 to August 2015 were analyzed retrospectively. They were divided into group A (emergency operation group and group B (selective operation group according to different operation timing. Perioperative situation, blood biochemical parameters, swelling degree and elbow joint function of affected limb were compared between two groups. Results: Operation time for patients of group A was significantly shorter than that of group B [(17.19 ± 2.85 vs. (21.43 ± 3.91 min], and frequency of fluoroscopy during operation of group A was obviously less than that of group B [(6.03 ± 0.95 vs. (7.61 ± 0.92 times]. Swelling index of affected limb in group A at 3 days, 5 days and 7 days after injury was all significantly lower than that in group B [(1.20 ± 0.17 vs. (1.38 ± 0.14, (1.13 ± 0.13 vs. (1.30 ± 0.18, (1.02 ± 0.15 vs. (1.22 ± 0.15]. Hospital for special surgery score at 1 week, 2 weeks, 3 and 4 weeks after removing Kirschner wire had no significant difference between group A and B (88.75 ± 10.18 vs. (89.14 ± 10.52, (94.22 ± 10.85 vs. (93.85 ± 11.08, (95.52 ± 11.27 vs. (95.92 ± 12.19, (95.43 ± 10.96 vs. (96.02 ± 11.38. Contents of serum alanine transaminase, aspertate aminotransferase, total protein, albumin and C-reactive protein in perioperative period had no obvious difference between patients in group A and B. Conclusions: Emergency closed reduction combined with percutaneous Kirschner wire fixation for Gartland type-II and type-III supracondylar humerus fracture in children has less trauma, low swelling degree

  4. Bariatric surgery: the challenges with candidate selection, individualizing treatment and clinical outcomes

    Science.gov (United States)

    2013-01-01

    Obesity is recognized as a global health crisis. Bariatric surgery offers a treatment that can reduce weight, induce remission of obesity-related diseases, and improve the quality of life. In this article, we outline the different options in bariatric surgery and summarize the recommendations for selecting and assessing potential candidates before proceeding to surgery. We present current data on post-surgical outcomes and evaluate the psychosocial and economic effects of bariatric surgery. Finally, we evaluate the complication rates and present recommendations for post-operative care. PMID:23302153

  5. Dasatinib for the treatment of chronic myeloid leukemia: patient selection and special considerations.

    Science.gov (United States)

    Keskin, Dilek; Sadri, Sevil; Eskazan, Ahmet Emre

    2016-01-01

    Dasatinib is one of the second-generation tyrosine kinase inhibitors used in imatinib resistance and/or intolerance, as well as in the frontline setting in patients with chronic myeloid leukemia-chronic phase, and also in patients with advanced disease. It is also utilized in Philadelphia chromosome-positive acute lymphocytic leukemia. While choosing the appropriate tyrosine kinase inhibitor (ie, dasatinib) for each individual patient, comorbidities and BCR-ABL1 kinase domain mutations should always be taken into consideration, among other things. This review mainly focuses on patient selection prior to dasatinib administration in the treatment of chronic myeloid leukemia.

  6. Combination of radiotherapy and selective chemotherapy in the treatment of advanced ovarian carcinomas

    International Nuclear Information System (INIS)

    Dietz, R.; Brachetti, A.; Universitaet des Saarlandes, Homburg/Saar

    1982-01-01

    A report is given on 160 patients suffering from ovarian carcinomas the stages which were exactly determined by TNM classification. 32 patients had tumors of the stages T1-T3, 128 patients had tumors of the stage T4. All T3 subgroups showed favorable results after radical surgery and a postoperative combination of radiotherapy and selective cytostatic chemotherapy. The therapy plans including radiotherapy had more advantages than those without radiotherapy. Furthermore, the cytostatic treatment was more successful after a chemotherapy resistance test than after blind administration of cytostatic drugs. (orig.) [de

  7. Revealing metabolite biomarkers for acupuncture treatment by linear programming based feature selection.

    Science.gov (United States)

    Wang, Yong; Wu, Qiao-Feng; Chen, Chen; Wu, Ling-Yun; Yan, Xian-Zhong; Yu, Shu-Guang; Zhang, Xiang-Sun; Liang, Fan-Rong

    2012-01-01

    Acupuncture has been practiced in China for thousands of years as part of the Traditional Chinese Medicine (TCM) and has gradually accepted in western countries as an alternative or complementary treatment. However, the underlying mechanism of acupuncture, especially whether there exists any difference between varies acupoints, remains largely unknown, which hinders its widespread use. In this study, we develop a novel Linear Programming based Feature Selection method (LPFS) to understand the mechanism of acupuncture effect, at molecular level, by revealing the metabolite biomarkers for acupuncture treatment. Specifically, we generate and investigate the high-throughput metabolic profiles of acupuncture treatment at several acupoints in human. To select the subsets of metabolites that best characterize the acupuncture effect for each meridian point, an optimization model is proposed to identify biomarkers from high-dimensional metabolic data from case and control samples. Importantly, we use nearest centroid as the prototype to simultaneously minimize the number of selected features and the leave-one-out cross validation error of classifier. We compared the performance of LPFS to several state-of-the-art methods, such as SVM recursive feature elimination (SVM-RFE) and sparse multinomial logistic regression approach (SMLR). We find that our LPFS method tends to reveal a small set of metabolites with small standard deviation and large shifts, which exactly serves our requirement for good biomarker. Biologically, several metabolite biomarkers for acupuncture treatment are revealed and serve as the candidates for further mechanism investigation. Also biomakers derived from five meridian points, Zusanli (ST36), Liangmen (ST21), Juliao (ST3), Yanglingquan (GB34), and Weizhong (BL40), are compared for their similarity and difference, which provide evidence for the specificity of acupoints. Our result demonstrates that metabolic profiling might be a promising method to

  8. Optical fiber biocompatible sensors for monitoring selective treatment of tumors via thermal ablation

    Science.gov (United States)

    Tosi, Daniele; Poeggel, Sven; Dinesh, Duraibabu B.; Macchi, Edoardo G.; Gallati, Mario; Braschi, Giovanni; Leen, Gabriel; Lewis, Elfed

    2015-09-01

    Thermal ablation (TA) is an interventional procedure for selective treatment of tumors, that results in low-invasive outpatient care. The lack of real-time control of TA is one of its main weaknesses. Miniature and biocompatible optical fiber sensors are applied to achieve a dense, multi-parameter monitoring, that can substantially improve the control of TA. Ex vivo measurements are reported performed on porcine liver tissue, to reproduce radiofrequency ablation of hepatocellular carcinoma. Our measurement campaign has a two-fold focus: (1) dual pressure-temperature measurement with a single probe; (2) distributed thermal measurement to estimate point-by-point cells mortality.

  9. Treatment compliance and challenges among tuberculosis patients across selected health facilities in Osun State Nigeria.

    Science.gov (United States)

    Ajao, K O; Ogundun, O A; Afolabi, O T; Ojo, T O; Atiba, B P; Oguntunase, D O

    2014-12-01

    Tuberculosis (TB) is a major public health problem in the world and Africa has approximately one quarter of the world's cases. One of the greatest challenges facing most TB programmes is the non-compliance to TB treatment among TB patients. This study aimed at determining the challenges of management of tuberculosis (TB) across selected Osun State health facilities. The study employed a descriptive cross-sectional design. A semi-structured questionnaire was used to collect data from 102 TB patients in the health facilities. The instrument measured socio-demographic variables, patient related factors, socio-economic variables, health care system related factors to TB disease and treatment. Data were analysed and summarized using descriptive and inferential statistics. Statistical significance was placed at p facilities (χ2 = 21.761, p facility and patient-related factors were largely responsible.

  10. Bioactive treatment promotes osteoblast differentiation on titanium materials fabricated by selective laser melting technology.

    Science.gov (United States)

    Tsukanaka, Masako; Fujibayashi, Shunsuke; Takemoto, Mitsuru; Matsushita, Tomiharu; Kokubo, Tadashi; Nakamura, Takashi; Sasaki, Kiyoyuki; Matsuda, Shuichi

    2016-01-01

    Selective laser melting (SLM) technology is useful for the fabrication of porous titanium implants with complex shapes and structures. The materials fabricated by SLM characteristically have a very rough surface (average surface roughness, Ra=24.58 µm). In this study, we evaluated morphologically and biochemically the specific effects of this very rough surface and the additional effects of a bioactive treatment on osteoblast proliferation and differentiation. Flat-rolled titanium materials (Ra=1.02 µm) were used as the controls. On the treated materials fabricated by SLM, we observed enhanced osteoblast differentiation compared with the flat-rolled materials and the untreated materials fabricated by SLM. No significant differences were observed between the flat-rolled materials and the untreated materials fabricated by SLM in their effects on osteoblast differentiation. We concluded that the very rough surface fabricated by SLM had to undergo a bioactive treatment to obtain a positive effect on osteoblast differentiation.

  11. Selective androgen receptor modulators for the prevention and treatment of muscle wasting associated with cancer.

    Science.gov (United States)

    Dalton, James T; Taylor, Ryan P; Mohler, Michael L; Steiner, Mitchell S

    2013-12-01

    This review highlights selective androgen receptor modulators (SARMs) as emerging agents in late-stage clinical development for the prevention and treatment of muscle wasting associated with cancer. Muscle wasting, including a loss of skeletal muscle, is a cancer-related symptom that begins early in the progression of cancer and affects a patient's quality of life, ability to tolerate chemotherapy, and survival. SARMs increase muscle mass and improve physical function in healthy and diseased individuals, and potentially may provide a new therapy for muscle wasting and cancer cachexia. SARMs modulate the same anabolic pathways targeted with classical steroidal androgens, but within the dose range in which expected effects on muscle mass and function are seen androgenic side-effects on prostate, skin, and hair have not been observed. Unlike testosterone, SARMs are orally active, nonaromatizable, nonvirilizing, and tissue-selective anabolic agents. Recent clinical efficacy data for LGD-4033, MK-0773, MK-3984, and enobosarm (GTx-024, ostarine, and S-22) are reviewed. Enobosarm, a nonsteroidal SARM, is the most well characterized clinically, and has consistently demonstrated increases in lean body mass and better physical function across several populations along with a lower hazard ratio for survival in cancer patients. Completed in May 2013, results for the Phase III clinical trials entitled Prevention and treatment Of muscle Wasting in patiEnts with Cancer1 (POWER1) and POWER2 evaluating enobosarm for the prevention and treatment of muscle wasting in patients with nonsmall cell lung cancer will be available soon, and will potentially establish a SARM, enobosarm, as the first drug for the prevention and treatment of muscle wasting in cancer patients.

  12. A data mining based model for selecting type of treatment for kidney stone patients

    Directory of Open Access Journals (Sweden)

    Sepehri MM

    2009-09-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Data mining as a multidisciplinary field is rooted in the fields such as statistics, mathematics, computer science and artificial intelligence and has been gaining momentum in scientific, managerial, and executive applications in health care. Data mining can be defined as the automated extraction of valuable, practical and hidden knowledge and information from large data. Applying data mining in medical records and data is of utmost importance for health care givers and providers and brings vital and valuable outcomes. Data mining can help doctors come up with better recommendations and plans for treatment which actually in many respects have significant impact on patients' life and satisfaction In this paper we have proposed and utilized data mining methods to extract hidden information in medical records of pelvis stone patients with ureteral stone. We have tried to design a decision support system model to be applicable for selecting type of treatment for these groups of patients."n"nMethods: We gathered needed information from Shahid Hashemi Nejad hospital. In this research we have used decision tree as a data mining tool, for selecting suitable treatment for patients with ureteral stone. This

  13. Decision making tools for selecting sustainable wastewater treatment technologies in Thailand

    Science.gov (United States)

    Wongburi, Praewa; Park, Jae K.

    2018-05-01

    Wastewater consists of valuable resources that could be recovered or reused. Still it is under threat because of ineffective wastewater management and systems. In Thailand, less than 25% of wastewater generated may be treated while then rest is inadequately treated and sent back directly into waterbodies or the environment. Furthermore, the technologies that have been applied may be inefficient and unsustainable. Efficiency, sustainability, and simplicity are important concepts when designing an appropriate wastewater treatment system in developing countries. The objectives of this study were to review and evaluate wastewater treatment technologies and propose a method to improve or select an appropriate technology. An expert system in Excel® program was developed to determine the best solution. Sensitivity analysis was applied to compare and assess uncertainty factors. Due to the different conditions of each area, the key factor of interest was varied. Furthermore, Robust Decision Making tool was applied to determine the best way to improve existing wastewater treatment facility and to choose the most appropriate wastewater treatment technology.

  14. Selection of hydrothermal pre-treatment conditions of waste sludge destruction using multicriteria decision-making.

    Science.gov (United States)

    Al-Shiekh Khalil, Wael; Shanableh, Abdullah; Rigby, Portia; Kokot, Serge

    2005-04-01

    The effectiveness of hydrothermal treatment for the destruction of the organic content of sludge waste was investigated. The sludge sampled in this study contained approximately 2% solids. The experimental program consisted of hydrothermal treatment experiments conducted in a batch reactor at temperatures between 100 and 250 degrees C, with the addition of an oxidant (hydrogen peroxide) in the range of 0-150% with reference to TCOD, and reaction times of up to 60 min. The results suggested that the availability of oxidant, reaction temperature and reaction time were the determining factors for COD removal. A significant fraction of the COD remaining after treatment consisted of the dissolved COD. The results confirmed that hydrothermal treatment proceeds through hydrolysis resulting in the production of dissolved organic products followed by COD removal through oxidation. Two MCDM chemometrics methods, PROMETHEE and GAIA, were applied to process the large data matrix so as to facilitate the selection of the most suitable hydrothermal conditions for sludge destruction. Two possible scenarios were produced from this analysis-one depended on the use of high temperatures and no oxidant, while the second offered a choice of compromise solutions at lower temperatures but with the use of at least some oxidant. Thus, for the final choice of operating conditions, the decision maker needs local knowledge of the costs and available infrastructure. In principle, such information could be added as further criteria to the data matrix and new rankings obtained.

  15. Particle size distribution variance in untreated urban runoff and its implication on treatment selection.

    Science.gov (United States)

    Charters, Frances J; Cochrane, Thomas A; O'Sullivan, Aisling D

    2015-11-15

    Understanding the particle size distribution (PSD) of sediment in urban runoff assists in the selection of appropriate treatment systems for sediment removal as systems vary in their ability to remove sediment across different particle size fractions. Variation in PSD in runoff from individual urban surfaces both during and across multiple rain events is not well understood and it may lead to performance uncertainty in treatment systems. Runoff PSDs in international literature were compiled to provide a comparative summary of PSDs from different urban surfaces. To further assess both intra-event and inter-event PSD variation, untreated runoff was collected from road, concrete roof, copper roof, and galvanized roof surfaces within an urban catchment exposed to the same rainfall conditions and analysed for PSD and total suspended solids (TSS). Road runoff had the highest TSS concentrations, while copper roofs had high initial TSS that reduced to very low levels under steady state conditions. Despite variation in TSS concentrations, the median particle diameter of the TSS was comparable across the surfaces. Intra-event variation was generally not significant, but substantial inter-event variation was observed, particularly for coarser road and concrete roof surfaces. PSD variation for each surface contributed to a wide range in predicted treatment performance and suggests that short-retention treatment devices carry a high performance risk of not being able to achieve adequate TSS removal across all rain events. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. General quality of life of patients with acne vulgaris before and after performing selected cosmetological treatments

    Directory of Open Access Journals (Sweden)

    Chilicka K

    2017-08-01

    Full Text Available Karolina Chilicka,1 Joanna Maj,2 Bernard Panaszek3 1Department of Cosmetology, Opole Medical School, Opole, 2Department of Dermatology, Venereology and Allergology, 3Department of Internal Medicine and Allergy, Wroclaw Medical University, Wrocław, Poland Background: Achieving a satisfying quality of life for a patient by applying individually matched therapy is, simultaneously, a great challenge and a priority for contemporary medicine. Patients with visible dermatological ailments are particularly susceptible to reduction in the general quality of life. Among the dermatological diseases, acne causes considerable reduction in the quality of life and changes in self-perception that lead to the worsening of a patient’s mental condition, including depression and suicidal thoughts. As a result, difficulties in contact with loved ones, as well as social and professional problems are observed, which show that acne is not a somatic problem alone. To a large extent, it becomes a part of psychodermatology, becoming an important topic of public health in social medicine practice. Pharmacological treatment of acne is a challenge for a dermatologist and often requires the necessity of cooperating with a cosmetologist. Cosmetological treatments are aimed at improving the condition of the skin and reduction or subsiding of acne skin changes.Aim: The aim of this study was to assess the influence of selected cosmetological treatments on the general quality of life of patients with acne.Materials and methods: The study group consisted of 101 women aged 19–29 years (x̅  =22.5 years, SD =2.3 years. All subjects were diagnosed with acne vulgaris of the face. In the study group, the acne changes occurred over the course of 3–15 years (x̅ =8.1 years, SD =2.7 years. Selected cosmetological treatments (intensive pulsing light, alpha-hydroxy acids, cavitation peeling, needle-free mesotherapy, diamond microdermabrasion and sonophoresis were performed in

  17. Selection of Steady-State Process Simulation Software to Optimize Treatment of Radioactive and Hazardous Waste

    Energy Technology Data Exchange (ETDEWEB)

    Nichols, T. T.; Barnes, C. M.; Lauerhass, L.; Taylor, D. D.

    2001-06-01

    The process used for selecting a steady-state process simulator under conditions of high uncertainty and limited time is described. Multiple waste forms, treatment ambiguity, and the uniqueness of both the waste chemistries and alternative treatment technologies result in a large set of potential technical requirements that no commercial simulator can totally satisfy. The aim of the selection process was two-fold. First, determine the steady-state simulation software that best, albeit not completely, satisfies the requirements envelope. And second, determine if the best is good enough to justify the cost. Twelve simulators were investigated with varying degrees of scrutiny. The candidate list was narrowed to three final contenders: ASPEN Plus 10.2, PRO/II 5.11, and CHEMCAD 5.1.0. It was concluded from ''road tests'' that ASPEN Plus appears to satisfy the project's technical requirements the best and is worth acquiring. The final software decisions provide flexibility: they involve annual rather than multi-year licensing, and they include periodic re-assessment.

  18. Selection of Steady-State Process Simulation Software to Optimize Treatment of Radioactive and Hazardous Waste

    Energy Technology Data Exchange (ETDEWEB)

    Nichols, Todd Travis; Barnes, Charles Marshall; Lauerhass, Lance; Taylor, Dean Dalton

    2001-06-01

    The process used for selecting a steady-state process simulator under conditions of high uncertainty and limited time is described. Multiple waste forms, treatment ambiguity, and the uniqueness of both the waste chemistries and alternative treatment technologies result in a large set of potential technical requirements that no commercial simulator can totally satisfy. The aim of the selection process was two-fold. First, determine the steady-state simulation software that best, albeit not completely, satisfies the requirements envelope. And second, determine if the best is good enough to justify the cost. Twelve simulators were investigated with varying degrees of scrutiny. The candidate list was narrowed to three final contenders: ASPEN Plus 10.2, PRO/II 5.11, and CHEMCAD 5.1.0. It was concluded from "road tests" that ASPEN Plus appears to satisfy the project's technical requirements the best and is worth acquiring. The final software decisions provide flexibility: they involve annual rather than multi-year licensing, and they include periodic re-assessment.

  19. Economic evaluation and efficacy of strategic-selective treatment of gastrointestinal parasites in dairy calves

    Directory of Open Access Journals (Sweden)

    Yuly Andrea Caicedo Blanco

    Full Text Available Abstract In the Experimental Farm of the Universidade Federal de Lavras (EF-UFLA, state of Minas Gerais, Brazil, on their day of birth, female Holstein calves were randomly selected and placed into two groups containing fifteen animals each: Strategic-Selective Treatment (S-ST or Conventional Treatment (CT. In the S-ST, calves were treated after coproparasitological examinations according to criteria established previously by the researchers. Calves in the CT were treated according to the opinion of the veterinarian of EF-UFLA. For statistical analysis, the frequency (% of fecal samples with count of eggs per gram of feces (EPG ≥300, count of oocysts per gram of feces (OoPG ≥500 and fecal samples with count of cysts of Giardia spp. ≥1 were conducted. The overall average frequency of fecal samples with EPG ≥300, OoPG ≥500 and Giardia spp. cysts ≥1, respectively, was similar (p >0.05 between S-ST (20.3%; 17.3%; and 31.5% and CT (26.4%; 23.9%; and 37.3%. The effective operational cost, per animal, in 12 months, was of R$ 784.58 (US$ 241.41 and R$ 83.90 (US$ 25.81 in S-ST and CT, respectively. The S-ST requires adjustments to be used as a technically efficient and economically viable alternative for the control of gastrointestinal parasitosis in female Holstein calves.

  20. Selection of Steady-State Process Simulation Software to Optimize Treatment of Radioactive and Hazardous Waste

    International Nuclear Information System (INIS)

    Nichols, T. T.; Barnes, C. M.; Lauerhass, L.; Taylor, D. D.

    2001-01-01

    The process used for selecting a steady-state process simulator under conditions of high uncertainty and limited time is described. Multiple waste forms, treatment ambiguity, and the uniqueness of both the waste chemistries and alternative treatment technologies result in a large set of potential technical requirements that no commercial simulator can totally satisfy. The aim of the selection process was two-fold. First, determine the steady-state simulation software that best, albeit not completely, satisfies the requirements envelope. And second, determine if the best is good enough to justify the cost. Twelve simulators were investigated with varying degrees of scrutiny. The candidate list was narrowed to three final contenders: ASPEN Plus 10.2, PRO/II 5.11, and CHEMCAD 5.1.0. It was concluded from ''road tests'' that ASPEN Plus appears to satisfy the project's technical requirements the best and is worth acquiring. The final software decisions provide flexibility: they involve annual rather than multi-year licensing, and they include periodic re-assessment

  1. Female infertility in India: Causes, treatment and impairment of fertility in selected districts with high prevalence

    Directory of Open Access Journals (Sweden)

    Shraboni Patra

    2017-01-01

    Full Text Available Although the ‘universal access to sexual and reproductive health care’ has received priority in the SDG‐3, the rural women experiencing infertility problem in India are unable to access and afford quality reproductive health care. The study investigates the present infertility situation, with a focus on risk factors, treatment seeking for infertility, and impact of infertility on fertility in India and its districts with high infertility prevalence. The DLHS‐3 data is used. Top fifteen districts with high infertility prevalence are selected for analysis. Simple bivariate and multivariate techniques are applied. In India, the prevalence of ever‐experienced primary, secondary, and current infertility is 6.6%, 2.1% and 4.6% respectively, whereas, in the selected districts, the estimates for the same indicators are 15%, 3.1%, and 5% respectively. A higher prevalence of reported symptoms of RTIs/STIs and menstrual problems is observed among women who ever had infertility. Treatment seeking for infertility is low in Korba and Koryia. The MCEB is less among women who ever had experienced infertility. The prevalence of ever‐experienced infertility and current infertility is considerably higher among women from socio‐economically disadvantaged sections. Awareness of RTIs, STIs, and menstrual problems, and preventive care can reduce infertility among rural women.

  2. Super-selective uterine artery chemoembolization for the treatment of cervical cancer: its clinical value

    International Nuclear Information System (INIS)

    Zhu Chi; Zhang Dezhi; Cao Liyu; Xiong Zhuang; Wang Mingquan; Du Linan; Zhao Bensheng; Wang Wanqin; Sheng Qiang; Yu Yongqiang

    2009-01-01

    Objective: To evaluate super-selective uterine arterial chemoembolization therapy in the treatment of cervical cancer. Methods: Bilateral uterine arterial infusion with DDP, EADM or THP, MMC and 5-Fu was performed in 56 patients with pathologically-proved cervical cancer, which was followed by embolization of uterine arteries with iodine emulsion and Gelfoam particles. Radical hysterectomy was performed in 6 patients after interventional treatment. Results: Embolization of bilateral uterine arteries were successfully carried out in all cases. The angiography conducted during the procedure revealed markedly dilated uterine arteries, spiral tumor-feeding arteries and obvious tumor staining. The total effective rate was up to 94.6%. Six patients received radical hysterectomy 2 weeks after arterial chemoembolization, and the blood loss during the operation was much less than usual and the surgery procedure took shorter time. Ovarian necrosis was found in 1 case. The main adverse effects included leukocytopenia, nausea, vomiting and abdominal pain. Conclusion: Super-selective uterine arterial chemoembolization is a safe and effective supplementary therapy for cervical carcinoma with fewer complications. (authors)

  3. Current approach to male infertility treatment: sperm selection procedure based on hyaluronic acid binding ability

    Directory of Open Access Journals (Sweden)

    A. V. Zobova

    2015-01-01

    Full Text Available Intracytoplasmic sperm injection into an oocyte is widely used throughout the world in assisted reproductive technologies programs in the presence of male infertility factor. However, this approach can allow selection of a single sperm, which is carrying different types of pathologies. Minimizing of any potential risks, entailing the occurrence of abnormalities in the embryos development (apoptosis, fragmentation of embryos, alterations in gene expression, aneuploidies is a very important condition for reducing the potential negative consequences resulting the manipulation with gametes. Processes that could be influenced by the embryologist must be fulfilled in safe and physiological way as much as it is possible. Data of numerous publications reporting about the positive effects of using the technology of sperm selection by hyaluronic acid binding, let make a conclusion about the high prospects of this approach in the treatment of male infertility by methods of in vitro fertilization. The selection of sperm with improved characteristics, which determine the maturity and genetic integrity, provides an opportunity to improve the parameters of pre-implantation embryogenesis, having thus a positive effect on clinical outcomes of assisted reproductive technologies programs.

  4. A non-selective (amitriptyline), but not a selective (citalopram), serotonin reuptake inhibitor is effective in the prophylactic treatment of chronic tension-type headache.

    OpenAIRE

    Bendtsen, L; Jensen, R; Olesen, J

    1996-01-01

    OBJECTIVES: Although the tricyclic antidepressant amitriptyline is extensively used in the prophylactic treatment of chronic tension-type headache, only few studies have investigated the efficacy of this treatment and the results are contradictory. In addition, the new selective serotonin reuptake inhibiting antidepressants, which are widely used in depression and of potential value in pain management, have never been investigated in a placebo controlled study of tension-type headache. The ai...

  5. Individualized Selection of Beam Angles and Treatment Isocenter in Tangential Breast Intensity Modulated Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Penninkhof, Joan, E-mail: j.penninkhof@erasmusmc.nl [Department of Radiation Oncology, Erasmus M.C. Cancer Institute, Rotterdam (Netherlands); Spadola, Sara [Department of Radiation Oncology, Erasmus M.C. Cancer Institute, Rotterdam (Netherlands); Department of Physics and Astronomy, Alma Mater Studiorum, University of Bologna, Bologna (Italy); Breedveld, Sebastiaan; Baaijens, Margreet [Department of Radiation Oncology, Erasmus M.C. Cancer Institute, Rotterdam (Netherlands); Lanconelli, Nico [Department of Physics and Astronomy, Alma Mater Studiorum, University of Bologna, Bologna (Italy); Heijmen, Ben [Department of Radiation Oncology, Erasmus M.C. Cancer Institute, Rotterdam (Netherlands)

    2017-06-01

    Purpose and Objective: Propose a novel method for individualized selection of beam angles and treatment isocenter in tangential breast intensity modulated radiation therapy (IMRT). Methods and Materials: For each patient, beam and isocenter selection starts with the fully automatic generation of a large database of IMRT plans (up to 847 in this study); each of these plans belongs to a unique combination of isocenter position, lateral beam angle, and medial beam angle. The imposed hard planning constraint on patient maximum dose may result in plans with unacceptable target dose delivery. Such plans are excluded from further analyses. Owing to differences in beam setup, database plans differ in mean doses to organs at risk (OARs). These mean doses are used to construct 2-dimensional graphs, showing relationships between: (1) contralateral breast dose and ipsilateral lung dose; and (2) contralateral breast dose and heart dose (analyzed only for left-sided). The graphs can be used for selection of the isocenter and beam angles with the optimal, patient-specific tradeoffs between the mean OAR doses. For 30 previously treated patients (15 left-sided and 15 right-sided tumors), graphs were generated considering only the clinically applied isocenter with 121 tangential beam angle pairs. For 20 of the 30 patients, 6 alternative isocenters were also investigated. Results: Computation time for automatic generation of 121 IMRT plans took on average 30 minutes. The generated graphs demonstrated large variations in tradeoffs between conflicting OAR objectives, depending on beam angles and patient anatomy. For patients with isocenter optimization, 847 IMRT plans were considered. Adding isocenter position optimization next to beam angle optimization had a small impact on the final plan quality. Conclusion: A method is proposed for individualized selection of beam angles in tangential breast IMRT. This may be especially important for patients with cardiac risk factors or an

  6. ANALYSIS OF HYDRAULIC LOAD OF SELECTED WASTEWATER TREATMENT PLANT IN JASŁO COUNTY

    Directory of Open Access Journals (Sweden)

    Dariusz Piotr Młyński

    2016-12-01

    Full Text Available The paper presents an analysis of hydraulic load in selected a wastewater treatment plant (WTP in Jasło County: in Przysieki, Kołaczyce and Szebnie. The study was based on the records of daily sewage volume entering the treatment plants within a multi-year period of 2011-2014. The analysis took into account the average daily amount of incoming sewage, the maximum daily peaking factor for the incoming sewage, changes in the sewage volume depending on specific month and the intervals with the greatest frequency of occurrence were designated. The analysis revealed that investigated wastewater treatment plants were hydraulically underloaded. Moreover it was conclude a significant variables of inflowing sewage amount. The sewage admission was the largest in spring and summer periods. Sewage volume interval most often occurring at the WTP in Przysieki was the one between 320 and 480 m3•d-1, for Kołaczyce between 290 and 320 m3•d-1 and Szebnie between 120 and 240 m3•d-1.

  7. Identifying Treatment Response of Sertraline in a Teenager with Selective Mutism using Electrophysiological Neuroimaging.

    Science.gov (United States)

    Eugene, Andy R; Masiak, Jolanta

    2016-06-01

    Selective Mutism is described as the inability to verbally express oneself in anxiety provoking social situations and may result in awkward social interactions in school-aged children. In this case-report we present the baseline electrophysiological neuroimaging results and after treatment with Sertraline for 6-weeks. A 20-channel EEG event-related potential recording was acquired during an internal voice task at baseline prior to the initiation of 50mg of Sertraline and then repeated 6-weeks after treatment with Sertraline. EEG signals were processed for movement, eye-blink, and muscle artifacts and ERP signal averaging was completed. ERPs were analyzed using Standard Low Resolution Brain Electromagnetic Tomography (sLORETA). At baseline, Sertraline increased the neuronal activation in the middle temporal gyrus and the anterior cingulate gyrus from baseline in the patient following 6-weeks of treatment. Our findings suggest that electrophysiological neuroimaging may provide a creative approach for personalizing medicine by providing insight to the pharmacodynamics of antidepressants.

  8. Practical Study on Treatment of Selected Decorated Tapestry in Applied Art Museum, Cairo

    Directory of Open Access Journals (Sweden)

    Neven Kamal FAHIM

    2013-12-01

    Full Text Available The paper presents the method of treatment of tapestry textile, that considers the most common technique used in decoration of textile since the new kingdom until now, it is called Kabaty. The paper deals with selected piece of museum of Applied Art Faculty in Cairo. Treatment procedure was performed by several stages; firstly, Dating by comparing the decoration technique, the type of material and the decorative motifs existed in the object with another one known its date. Then samples taken from object were examined by optical microscope, scanning electron microscope to identify type of fibers and surface morphology .x-ray analysis was performed to identify mordant and dust. FTIR analysis to identify dyes in dyed samples. Then, the paper deal with the treatment of tapestry pieces by testing sensitive of fiber to water, mechanical cleaning and chemical cleaning to remove stain, washing stage using distilled water, and finally consolidation the object by fixed on support of natural linen which was stretched on wooden frame treated by anti-fungal substance.

  9. Selective Trapping of Volatile Fission Products with an Off-Gas Treatment System

    Energy Technology Data Exchange (ETDEWEB)

    B.R. Westphal; J.J. Park; J.M. Shin; G.I. Park; K.J. Bateman; D.L. Wahlquist

    2008-07-01

    A head-end processing step, termed DEOX for its emphasis on decladding via oxidation, is being developed for the treatment of spent oxide fuel by pyroprocessing techniques. The head-end step employs high temperatures to oxidize UO2 to U3O8 resulting in the separation of fuel from cladding and the removal of volatile fission products. Development of the head-end step is being performed in collaboration with the Korean Atomic Energy Research Institute (KAERI) through an International Nuclear Energy Research Initiative. Following the initial experimentation for the removal of volatile fission products, an off-gas treatment system was designed in conjunction with KAERI to collect specific fission gases. The primary volatile species targeted for trapping were iodine, technetium, and cesium. Each species is intended to be collected in distinct zones of the off-gas system and within those zones, on individual filters. Separation of the volatile off-gases is achieved thermally as well as chemically given the composition of the filter media. A description of the filter media and a basis for its selection will be given along with the collection mechanisms and design considerations. In addition, results from testing with the off-gas treatment system will be presented.

  10. Within-host selection of drug resistance in a mouse model of repeated interrupted treatment of Plasmodium yoelii infection

    OpenAIRE

    Nuralitha, Suci; Siregar, Josephine E; Syafruddin, Din; Hoepelman, Andy I M; Marzuki, Sangkot

    2017-01-01

    BACKGROUND: To study within-host selection of resistant parasites, an important factor in the development of resistance to anti-malarial drugs, a mouse model of repeated interrupted malaria treatment (RIT) has been developed. The characteristics of within host selection of resistance to atovaquone and pyrimethamine in Plasmodium yoelii was examined in such a model. METHODS: Treatment of P. yoelii infected mice, with atovaquone or pyrimethamine, was started at parasitaemia level of 3-5%, inter...

  11. Bioimpedance in monitoring of effects of selective serotonin reuptake inhibitor treatment

    Directory of Open Access Journals (Sweden)

    Kuznecova LV

    2011-06-01

    Full Text Available Vasiliy Grigorievich Alexeev, Ludmila Vasilievna KuznecovaDepartment of Physiology, SP Botkin Moscow City Clinical Hospital, Moscow, RussiaBackground: Bioimpedance has been shown to be a safe technique when used in a number of biomedical applications. In this study, we used the Electro Interstitial Scan (EIS to perform bioimpedance measurements to follow up the efficacy of selective serotonin reuptake inhibitor (SSRI treatment in subjects diagnosed to have major depressive disorder.Methods: We recruited 59 subjects (38 women, 21 men aged 17–76 (mean 47 years diagnosed with major depressive disorder by psychiatric assessment at the Botkin Hospital according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV. Baseline Clinical Global Impression scores and EIS (electrical conductivity and dispersion α parameter measurements were done before starting SSRI therapy. Treatment follow-up was undertaken using EIS bioimpedance measurements and by treatment response based on the Hamilton Depression Scale and Clinical Global Impression, every 15 days for 60 days. At day 45, we classified the patients into two groups, ie, Group 1, including treatment responders, and Group 2, including nonresponders. At day 60, patients were classified into two further groups, ie, Group 3, comprising treatment responders, and Group 4, comprising nonresponders.Results: Comparing Group 1 and Group 2, electrical conductivity measurement of the pathway between the two forehead electrodes had a specificity of 72% and a sensitivity of 85.3% (P < 0.0001, with a cutoff >4.32. Comparing Group 3 and Group 4, electrical conductivity measurements in the same pathway had a specificity of 47.6% and a sensitivity of 76.3% (P < 0.16, with a cutoff >5.92. Comparing Group 1 and Group 2, the electrical dispersion α parameter of the pathway between the two disposable forehead electrodes had a specificity of 80% and a sensitivity of 85.2% (P < 0.0001 with a

  12. Within-host selection of drug resistance in a mouse model of repeated interrupted treatment of Plasmodium yoelii infection

    NARCIS (Netherlands)

    Nuralitha, Suci; Siregar, Josephine E; Syafruddin, Din; Hoepelman, Andy I M; Marzuki, Sangkot

    2017-01-01

    BACKGROUND: To study within-host selection of resistant parasites, an important factor in the development of resistance to anti-malarial drugs, a mouse model of repeated interrupted malaria treatment (RIT) has been developed. The characteristics of within host selection of resistance to atovaquone

  13. A Controlled Single-Case Treatment of Severe Long-Term Selective Mutism in a Child with Mental Retardation

    Science.gov (United States)

    Facon, Bruno; Sahiri, Safia; Riviere, Vinca

    2008-01-01

    The aim of the present study was to demonstrate the efficacy of combining two operant learning procedures--shaping and fading--for treating selective mutism. The participant was a 12-year-old boy with mental retardation presenting a severe long-term selective mutism. The treatment was aimed at increasing the loudness of his vocalizations in an…

  14. The impact of sewage sludge treatment on the content of selected heavy metals and their fractions.

    Science.gov (United States)

    Ignatowicz, Katarzyna

    2017-07-01

    The aim of the study was to assess the physicochemical properties of compost made of municipal sewage sludge from selected Municipal Sewage Treatment Plant. Content of basic macroelements and heavy metals (Zn, Cu, Cr, Cd, Ni, Pb, Hg, Mg, Ca, N, P, K, Na) and their fractions was determined by means of BCR method. Based on the analyzes, it was found that the content of heavy metals in compost did not exceed the limits set by natural land management of sewage sludge; the compost is very abundant in biogenic elements - nitrogen and phosphorus - and it can be also considered a significant source of calcium and magnesium. The analysis of results obtained from the three-stage chemical extraction revealed that deposits subjected to aerobic stabilization and composting accumulate metals (in descending sequence) in fractions III and II, i.e. fractions virtually inaccessible to the ecosystem in optimal conditions of use. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Selected topical agents used in Traditional Chinese Medicine in the treatment of minor injuries- a review

    Directory of Open Access Journals (Sweden)

    Ping Chung eLEUNG

    2016-02-01

    Full Text Available Topical medicinal patches have been popular for the treatment of minor injuries like sprains and avulsions. Other inflammatory conditions like chronic musculo-tendinous pain and or fasciitis are also taken care of by local ointments or rubs. In the oriental communities, medicinal herbs frequently form the major components of the patches.In spite of the lack of scientific evidence of efficacy, the popularity of such traditional application persists for centuries.In this era of evidence-based clinical treatment, there is an urgent need to look into this traditional practice. The purpose should include a scientific verification of the efficacy of the practice, and once proven, further explorations would be indicated to bring the practice to a higher level.A system of comprehensive exploration was proposed and practiced in the past years to fulfill the aspiration. The research consisted of four areas:(1Identification of the suitable medicinal herbs for the topical study;(2Study of the biological activities of the selected herbs, concentrating on the areas of anti-inflammation, anti-oxidation, angiogenesis and cellular proliferation;(3Study on the transcutaneous transport of the chemicals of the selected herbs to deeper tissues; and(4Pilot clinical studies on common superficial inflammatory musculo-skeletal conditions to give objective clinical evidences to the topical applications.Five herbs were identified as suitable candidates of study. They were put into relevant laboratory platforms and were proven to be anti-oxidant, anti-inflammatory and pro-angiogenic. Three of the herbs were prepared as topical patches with an enhancer and used to treat three common ailments in pilot clinical trials, viz., plantar fasciitis, undisplaced metatarsal fracture and tendonitis of the wrist (de-Quervain’s disease and the elbow (Tennis elbow. The clinical results of the pilot studies were very positive.It is therefore concluded that further explorations are

  16. Effects of leptin treatment and Western diet on wheel running in selectively bred high runner mice.

    Science.gov (United States)

    Meek, Thomas H; Dlugosz, Elizabeth M; Vu, Kim T; Garland, Theodore

    2012-05-15

    The role of leptin in regulating physical activity is varied. The behavioral effects of leptin signaling depend on the type of activity and the animal's physiological state. We used mice from lines selectively bred for high voluntary wheel running to further study how leptin regulates volitional exercise. Mice from four replicate high runner (HR) lines typically run ~3-fold more revolutions per day than those from four non-selected control (C) lines. HR mice have altered dopamine function and differences from C in brain regions known to be important in leptin-mediated behavior. Furthermore, male HR mice have been found to dramatically increase running when administered Western diet, an effect possibly mediated through leptin signaling. Male mice from generation 61 (representing three HR lines and one C line) were allowed wheel access at 24 days of age and given either Western diet (high in fat and with added sucrose) or standard chow. After four weeks, Western diet significantly increased circulating leptin, insulin, C-peptide, gastric inhibitory polypeptide, and inflammatory hormone resistin concentrations in HR mice (C mice not measured). Western diet increased running in HR mice, but did not significantly affect running in C mice. During the fifth week, all mice received two days of intra-peritoneal sham injections (physiological saline) followed by three days of murine recombinant leptin injections, and then another six days of sham injections. Leptin treatment significantly decreased caloric intake (adjusted for body mass) and body mass in all groups. Wheel running significantly increased with leptin injections in HR mice (fed Western or standard diet), but was unaffected in C mice. Whether Western diet and leptin treatment stimulate wheel running in HR mice through the same physiological pathways awaits future study. These results have implications for understanding the neural and endocrine systems that control locomotor activity, food consumption, and body

  17. A two-temperature model for selective photothermolysis laser treatment of port wine stains

    International Nuclear Information System (INIS)

    Li, D.; Wang, G.X.; He, Y.L.; Kelly, K.M.; Wu, W.J.; Wang, Y.X.; Ying, Z.X.

    2013-01-01

    Selective photothermolysis is the basic principle for laser treatment of vascular malformations such as port wine stain birthmarks (PWS). During cutaneous laser surgery, blood inside blood vessels is heated due to selective absorption of laser energy, while the surrounding normal tissue is spared. As a result, the blood and the surrounding tissue experience a local thermodynamic non-equilibrium condition. Traditionally, the PWS laser treatment process was simulated by a discrete-blood-vessel model that simplifies blood vessels into parallel cylinders buried in a multi-layer skin model. In this paper, PWS skin is treated as a porous medium made of tissue matrix and blood in the dermis. A two-temperature model is constructed following the local thermal non-equilibrium theory of porous media. Both transient and steady heat conduction problems are solved in a unit cell for the interfacial heat transfer between blood vessels and the surrounding tissue to close the present two-temperature model. The present two-temperature model is validated by good agreement with those from the discrete-blood-vessel model. The characteristics of the present two-temperature model are further illustrated through a comparison with the previously-used homogenous model, in which a local thermodynamic equilibrium assumption between the blood and the surrounding tissue is employed. -- Highlights: • Local thermal non-equilibrium theory was adapted in field of laser dermatology. • Transient interfacial heat transfer coefficient between two phases is presented. • Less PWS blood vessel micro-structure information is required in present model. • Good agreement between present model and classical discrete-blood-vessel model

  18. Selecting appropriate wastewater treatment technologies using a choosing-by-advantages approach.

    Science.gov (United States)

    Arroyo, Paz; Molinos-Senante, María

    2018-06-01

    Selecting the most sustainable wastewater treatment (WWT) technology among possible alternatives is a very complex task because the choice must integrate economic, environmental, and social criteria. Traditionally, several multi-criteria decision-making approaches have been applied, with the most often used being the analytical hierarchical process (AHP). However, AHP allows users to offset poor environmental and/or social performance with low cost. To overcome this limitation, our study examines a choosing-by-advantages (CBA) approach to rank seven WWT technologies for secondary WWT. CBA results were compared with results obtained by using the AHP approach. The rankings of WWT alternatives differed, depending on whether the CBA or AHP approach was used, which highlights the importance of the method used to support decision-making processes, particularly ones that rely on subjective interpretations by experts. This paper uses a holistic perspective to demonstrate the benefits of using the CBA approach to support a decision-making process when a group of experts must come to a consensus in selecting the most suitable WWT technology among several available. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Selection of resistant Streptococcus pneumoniae during penicillin treatment in vitro and in three animal models

    DEFF Research Database (Denmark)

    Knudsen, Jenny Dahl; Odenholt, Inga; Erlendsdottir, Helga

    2003-01-01

    Pharmacokinetic (PK) and pharmacodynamic (PD) properties for the selection of resistant pneumococci were studied by using three strains of the same serotype (6B) for mixed-culture infection in time-kill experiments in vitro and in three different animal models, the mouse peritonitis, the mouse.......016 micro g/ml; erythromycin resistant)/ml, 10(6) CFU of strain B (MIC of penicillin, 0.25 micro g/ml)/ml, and 10(5) CFU of strain C (MIC of penicillin, 4 micro g/ml)/ml, was used in the two mouse models, and a mixture of 10(5) CFU of strain A/ml, 10(4) CFU of strain B/ml, and 10(3) CFU of strain C....../ml was used in the rabbit tissue cage model. During the different treatment regimens, the differences in numbers of CFU between treated and control animals were calculated to measure the efficacies of the regimens. Selective media with erythromycin or different penicillin concentrations were used to quantify...

  20. Selection of a reference process for treatment of the West Valley alkaline waste

    International Nuclear Information System (INIS)

    Bray, L.A.; Holton, L.K.; Wise, B.M.; Carl, D.E.; Pope, J.M.

    1984-01-01

    As part of the West Valley Demonstration Project (WVDP) the alkaline PUREX supernatant stored in Tank 8D2 will be partially decontaminated by the removal of radiocesium. Four processes for removal of radiocesium from the alkaline supernatant were studied through experimentation and engineering analysis to identify a reference approach for the WVDP. These processes included the use of a zeolite inorganic ion-exchanger (Linde Ionsiv IE-95, Ionsiv is a trademark of Union Carbide Company), an organic ion exchange resin (Duolite CS-100, Duolite is a registered trademark of Diamond Shamrock Co) and two precipitation processes; one using sodium tetraphenylboron (NaTPB) and the other using phosphotungsthC acid (PTA). Based upon process performance, safety and environmental considerations, process and equipment complexity and impacts to the waste vitrification system, the zeolite ion-exchange process has been selected by West Valley Nuclear Services, Inc., as the reference supernatant treatment process for the WVDP. This paper summarizes the technical basis for the selection of the zeolite ion-exchange process

  1. Patients' selection for treatment of caliceal diverticular stones with extracorporeal shock wave lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Hong; Lee, Hee Jeong; Son, Soon Yong; Kang, Seong Ho; Cho, Cheong Chan; Ryu, Meung Sun [AMC, Seoul (Korea, Republic of); Kim, Seung Kook [Kwang-Ju Health College, Kwang-Ju (Korea, Republic of)

    2001-06-01

    Symptoms of caliceal diverticular stones are commonly associated with pain, recurrent urinary tract infection and hematuria. The aim of this study is to select the proper patient for the application of more successful extracorporeal shock wave lithotripsy(ESWL) as a treatment of caliceal diverticular stone. 16 patients with caliceal diverticular stones were treated with ESWL, and all patients had single caliceal diverticulum. The diagnosis of caliceal diverticulum with stones was made by intraveneous pyelography to all patients. On these intravenous pyelogram, we also classified diverticular type, whether the diverticular neck is connected with urinary tract patently, diverticular site and stone number and size. All patients were followed after ESWL by plain film of the kidneys, ureters and bladder and interviewed. Of all patients 44% was shown stone-free completely, also 83% was rendered symptom-free. All patients whose diverticular neck connected with urinary tract patently on the intraveneous pyelogram became stone-free. Of solitary stone 60% and multiple stones (more than 2) 17% became symptom-free. The patients with infection before ESWL 75% had residual stones, of these patients 33% had slightly flank pain, and 25% of patients with stones recurred become stone-free. We propose that more successful ESWL for patients with caliceal diverticular stones select satisfactory patients including that the diverticular neck is connected with urinary tract patently, solitary stone and no infection simultaneously.

  2. Patients' selection for treatment of caliceal diverticular stones with extracorporeal shock wave lithotripsy

    International Nuclear Information System (INIS)

    Lee, Won Hong; Lee, Hee Jeong; Son, Soon Yong; Kang, Seong Ho; Cho, Cheong Chan; Ryu, Meung Sun; Kim, Seung Kook

    2001-01-01

    Symptoms of caliceal diverticular stones are commonly associated with pain, recurrent urinary tract infection and hematuria. The aim of this study is to select the proper patient for the application of more successful extracorporeal shock wave lithotripsy(ESWL) as a treatment of caliceal diverticular stone. 16 patients with caliceal diverticular stones were treated with ESWL, and all patients had single caliceal diverticulum. The diagnosis of caliceal diverticulum with stones was made by intraveneous pyelography to all patients. On these intravenous pyelogram, we also classified diverticular type, whether the diverticular neck is connected with urinary tract patently, diverticular site and stone number and size. All patients were followed after ESWL by plain film of the kidneys, ureters and bladder and interviewed. Of all patients 44% was shown stone-free completely, also 83% was rendered symptom-free. All patients whose diverticular neck connected with urinary tract patently on the intraveneous pyelogram became stone-free. Of solitary stone 60% and multiple stones (more than 2) 17% became symptom-free. The patients with infection before ESWL 75% had residual stones, of these patients 33% had slightly flank pain, and 25% of patients with stones recurred become stone-free. We propose that more successful ESWL for patients with caliceal diverticular stones select satisfactory patients including that the diverticular neck is connected with urinary tract patently, solitary stone and no infection simultaneously

  3. Improving observational study estimates of treatment effects using joint modeling of selection effects and outcomes: the case of AAA repair.

    Science.gov (United States)

    O'Malley, A James; Cotterill, Philip; Schermerhorn, Marc L; Landon, Bruce E

    2011-12-01

    When 2 treatment approaches are available, there are likely to be unmeasured confounders that influence choice of procedure, which complicates estimation of the causal effect of treatment on outcomes using observational data. To estimate the effect of endovascular (endo) versus open surgical (open) repair, including possible modification by institutional volume, on survival after treatment for abdominal aortic aneurysm, accounting for observed and unobserved confounding variables. Observational study of data from the Medicare program using a joint model of treatment selection and survival given treatment to estimate the effects of type of surgery and institutional volume on survival. We studied 61,414 eligible repairs of intact abdominal aortic aneurysms during 2001 to 2004. The outcome, perioperative death, is defined as in-hospital death or death within 30 days of operation. The key predictors are use of endo, transformed endo and open volume, and endo-volume interactions. There is strong evidence of nonrandom selection of treatment with potential confounding variables including institutional volume and procedure date, variables not typically adjusted for in clinical trials. The best fitting model included heterogeneous transformations of endo volume for endo cases and open volume for open cases as predictors. Consistent with our hypothesis, accounting for unmeasured selection reduced the mortality benefit of endo. The effect of endo versus open surgery varies nonlinearly with endo and open volume. Accounting for institutional experience and unmeasured selection enables better decision-making by physicians making treatment referrals, investigators evaluating treatments, and policy makers.

  4. CBT for childhood anxiety disorders: differential changes in selective attention between treatment responders and non-responders

    NARCIS (Netherlands)

    Legerstee, Jeroen S.; Tulen, Joke H. M.; Dierckx, Bram; Treffers, Philip D. A.; Verhulst, Frank C.; Utens, Elisabeth M. W. J.

    2010-01-01

    This study examined whether treatment response to stepped-care cognitive-behavioural treatment (CBT) is associated with changes in threat-related selective attention and its specific components in a large clinical sample of anxiety-disordered children. Ninety-one children with an anxiety disorder

  5. CBT for Childhood Anxiety Disorders: Differential Changes in Selective Attention between Treatment Responders and Non-Responders

    Science.gov (United States)

    Legerstee, Jeroen S.; Tulen, Joke H. M.; Dierckx, Bram; Treffers, Philip D. A.; Verhulst, Frank C.; Utens, Elisabeth M. W. J.

    2010-01-01

    Background: This study examined whether treatment response to stepped-care cognitive-behavioural treatment (CBT) is associated with changes in threat-related selective attention and its specific components in a large clinical sample of anxiety-disordered children. Methods: Ninety-one children with an anxiety disorder were included in the present…

  6. Parent-Implemented Procedural Modification of Escape Extinction in the Treatment of Food Selectivity in a Young Child with Autism

    Science.gov (United States)

    Tarbox, Jonathan; Schiff, Averil; Najdowski, Adel C.

    2010-01-01

    Fool selectivity is characterized by the consumption of an inadequate variety of foods. The effectiveness of behavioral treatment procedures, particularly nonremoval of the spoon, is well validated by research. The role of parents in the treatment of feeding disorders and the feasibility of behavioral procedures for parent implementation in the…

  7. Pembrolizumab in the treatment of metastatic non-small-cell lung cancer: patient selection and perspectives

    Directory of Open Access Journals (Sweden)

    Somasundaram A

    2017-01-01

    Full Text Available Ashwin Somasundaram, Timothy F Burns Division of Hematology/Oncology, Department of Medicine, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA Abstract: Lung cancer is the leading killer of both men and women in the US, and the 5-year survival remains poor. However, the approval of checkpoint blockade immunotherapy has shifted the treatment paradigm and provides hope for improved survival. The ability of non-small-cell lung cancer (NSCLC to evade the host immune system can be overcome by agents such as pembrolizumab (MK-3475/lambrolizumab, which is a monoclonal antibody targeting the programmed death 1 (PD-1 receptor. In early studies, treatment with pembrolizumab led to dramatic and durable responses in select patients (PD-L1+ tumors. This remarkable efficacy lead to approval of pembrolizumab in the second-line setting as response rates were almost doubled compared to standard of care (SOC chemotherapy. Most recently, data in the first-line setting from the KEYNOTE-024 study have redefined the SOC therapy for a selected subset of patients. In patients with ≥50% PD-L1+ tumors, pembrolizumab had a clear progression-free survival and overall survival benefit. Toxicity was mostly immune related and similar to checkpoint blockade toxicities observed in previous studies. The initial approval and subsequent studies of pembrolizumab required and utilized a companion diagnostic test, Dako’s IHC 22C3, to assess PD-L1 status of patients. The evaluation and scoring system of this assay has been used by other companies as a reference to develop their own assays, which may complicate selection of patients. Finally, the impact of pembrolizumab in NSCLC is growing as evidenced by the numerous, ongoing trials open for combinations with chemotherapy, chemoradiation, other immunotherapeutics, immunomodulators, tyrosine kinase inhibitors, PI3K inhibitors, MEK inhibitors, hypomethylating agents, and histone deacetylase inhibitors. Further studies

  8. Drug Treatment of Cancer Cell Lines: A Way to Select for Cancer Stem Cells?

    International Nuclear Information System (INIS)

    Chiodi, Ilaria; Belgiovine, Cristina; Donà, Francesca; Scovassi, A. Ivana; Mondello, Chiara

    2011-01-01

    Tumors are generally composed of different cell types. In recent years, it has been shown that in many types of cancers a subset of cells show peculiar characteristics, such as the ability to induce tumors when engrafted into host animals, self-renew and being immortal, and give rise to a differentiated progeny. These cells have been defined as cancer stem cells (CSCs) or tumor initiating cells. CSCs can be isolated both from tumor specimens and established cancer cell lines on the basis of their ability to exclude fluorescent dyes, express specific cell surface markers or grow in particular culture conditions. A key feature of CSCs is their resistance to chemotherapeutic agents, which could contribute to the remaining of residual cancer cells after therapeutic treatments. It has been shown that CSC-like cells can be isolated after drug treatment of cancer cell lines; in this review, we will describe the strategies so far applied to identify and isolate CSCs. Furthermore, we will discuss the possible use of these selected populations to investigate CSC biology and develop new anticancer drugs

  9. Selective mutism: follow-up study 1 year after end of treatment.

    Science.gov (United States)

    Oerbeck, Beate; Stein, Murray B; Pripp, Are H; Kristensen, Hanne

    2015-07-01

    Cognitive behavioral therapy (CBT) is generally considered the recommended approach for selective mutism (SM). Prospective follow-up studies of treated SM and predictors of outcome are scarce. We have developed a CBT home and school-based intervention for children with SM previously found to increase speech in a pilot efficacy study and in a randomized controlled treatment study. In the present report we provide outcome data 1 year after having completed the 6-month course of CBT for 24 children with SM, aged 3-9 years (mean age 6.5 years, 16 girls). Primary outcome measures were the teacher rated School Speech Questionnaire (SSQ) and diagnostic status. At follow-up, no significant decline was found on the SSQ scores. Age and severity of SM had a significant effect upon outcome, as measured by the SSQ. Eight children still fulfilled diagnostic criteria for SM, four were in remission, and 12 children were without diagnosis. Younger children improved more, as 78% of the children aged 3-5 years did not have SM, compared with 33% of children aged 6-9 years. Treatment gain was upheld at follow-up. Greater improvement in the younger children highlights the importance of an early intervention.

  10. Selectivity of NF membrane for treatment of liquid waste containing uranium

    International Nuclear Information System (INIS)

    Oliveira, Elizabeth E.M.; Barbosa, Celina C.R.; Afonso, Julio C.

    2013-01-01

    The performance of two nanofiltration membranes were investigated for treatment of liquid waste containing uranium through two conditions permeation: permeation test and concentration test of the waste. In the permeation test solution permeated returned to the feed tank after collected samples each 3 hours. In the test of concentration the permeated was collected continuously until 90% reduction of the feed volume. The liquid waste ('carbonated water') was obtained during conversion of UF 6 to UO 2 in the cycle of nuclear fuel. This waste contains uranium concentration on average 7.0 mg L -1 , and not be eliminated to the environmental. The waste was permeated using a cross-flow membrane cell in the pressure of the 1.5 MPa. The selectivity of the membranes for separation of uranium was between 83% and 90% for both tests. In the concentration tests the waste was concentrated around for 5 times. The surface layer of the membranes was evaluated before and after the tests by infrared spectroscopy (ATR-FTIR), field emission microscopy (FESEM) and atomic force spectroscopy (AFM). The membrane separation process is a technique feasible to and very satisfactory for treatment the liquid waste. (author)

  11. How does the surface treatment change the cytocompatibility of implants made by selective laser melting?

    Science.gov (United States)

    Matouskova, Lucie; Ackermann, Michal; Horakova, Jana; Capek, Lukas; Henys, Petr; Safka, Jiri

    2018-04-01

    The study investigates the potential for producing medical components via Selective Laser Melting technology (SLM). The material tested consisted of the biocompatible titanium alloy Ti6Al4V. The research involved the testing of laboratory specimens produced using SLM technology both in vitro and for surface roughness. The aim of the research was to clarify whether SLM technology affects the cytocompatibility of implants and, thus, whether SLM implants provide suitable candidates for medical use following zero or minimum post-fabrication treatment. Areas covered: The specimens were tested with an osteoblast cell line and, subsequently, two post-treatment processes were compared: non-treated (as-fabricated) and glass-blasted. Interactions with MG-63 cells were evaluated by means of metabolic MTT assay and microscope techniques (scanning electron microscopy, fluorescence microscopy). Surface roughness was observed on both the non-treated and glass-blasted SLM specimens. Expert Commentary: The research concluded that the glass-blasting of SLM Ti6Al4V significantly reduces surface roughness. The arithmetic mean roughness Ra was calculated at 3.4 µm for the glass-blasted and 13.3 µm for the non-treated surfaces. However, the results of in vitro testing revealed that the non-treated surface was better suited to cell growth.

  12. Treatment of Fukushima contaminated waters TEPCO selected Areva and Veolia solution

    International Nuclear Information System (INIS)

    Seberac, Philippe; Paillard, Herve; Thierry, Jean-Marie; Bae, Ho-Il; Prevost, Thierry; Piot, Gregoire; Bertrand Ytournel

    2012-09-01

    The Actiflo-Rad TM system successfully contributed to treat the contaminated wastewaters from the damaged Fukushima Daiichi nuclear power plant. The decontamination system jointly designed by AREVA and Veolia Water treated about 77 500 m 3 of high activity wastewater (∼10 6 Bq/cm 3 ), combining radionuclides adsorbents developed by AREVA and the know-how of Veolia in water treatment for the settlement of the adsorbed radioactive elements, producing sludge with a weight concentration of 80 g/L. Both companies delivered the treatment facility quickly with an efficient joint organization - in a very complex environment. Assembled on Fukushima site - badly damaged by the tsunami following the earthquake of March 11 th - the system was designed, built and started in a record time of 2 month 1 / 2 , instead of several years in a classical nuclear engineering project. The Actiflo-Rad TM was a key equipment to achieve a stable situation of reactors, allowing treated water to be reused for core cooling. Commissioned with the on-site support of Veolia experts, the system reduced by 10 000 the Cs-activity of the wastewater even with significant salt content (seawater diluted twice) at a flow-rate slightly below the design value of 50 m 3 /hr. The implemented technologies are already used separately on AREVA sites (la Hague, fuel reprocessing plant) and for many water treatment projects by Veolia all over the world (Actiflo TM and Multiflo TM processes, using lamellar settling devices - in addition, the first one making use of micro-sand for a better floc quality). The complete treatment process selected by TEPCO features a physico-chemical treatment and water desalination, in five steps. After de-oiling, wastewater is primarily decontaminated through zeolite columns (Kurion process). This pre-decontaminated water is then treated on the AREVA-Veolia two stages system; at each stage, more than 30 minutes contact time with radionuclides adsorbents is needed, adsorbed

  13. Diminished Neural Processing of Aversive and Rewarding Stimuli During Selective Serotonin Reuptake Inhibitor Treatment

    Science.gov (United States)

    McCabe, Ciara; Mishor, Zevic; Cowen, Philip J.; Harmer, Catherine J.

    2010-01-01

    Background Selective serotonin reuptake inhibitors (SSRIs) are popular medications for anxiety and depression, but their effectiveness, particularly in patients with prominent symptoms of loss of motivation and pleasure, has been questioned. There are few studies of the effect of SSRIs on neural reward mechanisms in humans. Methods We studied 45 healthy participants who were randomly allocated to receive the SSRI citalopram, the noradrenaline reuptake inhibitor reboxetine, or placebo for 7 days in a double-blind, parallel group design. We used functional magnetic resonance imaging to measure the neural response to rewarding (sight and/or flavor of chocolate) and aversive stimuli (sight of moldy strawberries and/or an unpleasant strawberry taste) on the final day of drug treatment. Results Citalopram reduced activation to the chocolate stimuli in the ventral striatum and the ventral medial/orbitofrontal cortex. In contrast, reboxetine did not suppress ventral striatal activity and in fact increased neural responses within medial orbitofrontal cortex to reward. Citalopram also decreased neural responses to the aversive stimuli conditions in key “punishment” areas such as the lateral orbitofrontal cortex. Reboxetine produced a similar, although weaker effect. Conclusions Our findings are the first to show that treatment with SSRIs can diminish the neural processing of both rewarding and aversive stimuli. The ability of SSRIs to decrease neural responses to reward might underlie the questioned efficacy of SSRIs in depressive conditions characterized by decreased motivation and anhedonia and could also account for the experience of emotional blunting described by some patients during SSRI treatment. PMID:20034615

  14. Effect of tetracycline dose and treatment-mode on selection of resistant coliform bacteria in nursery pigs

    DEFF Research Database (Denmark)

    Græsbøll, Kaare; Damborg, Peter; Mellerup, Anders

    2017-01-01

    This study describes results of a randomized clinical trial investigating the effect of oxytetracycline treatment dose and mode of administration on selection of antibiotic resistant coliform bacteria in fecal samples from nursery pigs. Nursery pigs (pigs of 4-7 weeks of age) were treated...... with oxytetracycline against Lawsonia intracellularis induced diarrhea in five pig herds. Each group was randomly allocated to one of five treatment groups: oral flock treatment with (i) high (20 mg/kg), (ii) medium (10 mg/kg) and (iii) low (5 mg/kg) dosage, (iv) oral-pen-wise (small group) treatment (10 mg...... significant changes in number or proportion of tetracycline resistant coliforms. Selection for tetracycline-resistant coliforms was significantly correlated to selection for ampicillin- and sulfonamide-resistant, but not to cefotaxime-resistant strains. In conclusion, difference in dose of oxytetracycline...

  15. Treatment of selected primary gynecologic and pelvic malignancies with 241Americium

    International Nuclear Information System (INIS)

    Chung, Joyce Y.; Peschel, Richard E.; Kacinski, Barry; Nath, Ravinder; Pourang, Rauman; Roberts, Kenneth; Fischer, Diana; Chambers, Joseph; Schwartz, Peter E.; Wilson, Lynn

    1995-01-01

    observed in 1 primarily treated patient (soft tissue necrosis) and in 3 patients with recurrent disease (colonic obstruction, rectal fissure, and GI bleed, respectively). Conclusion: The unique dosimetric characteristics of 241 Am allow effective and safe treatment of selected primary gynecological malignancies and in previously irradiated patients with recurrent pelvic malignancies

  16. Treatment of selected primary gynecologic and pelvic malignancies with {sup 241}Americium

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Joyce Y; Peschel, Richard E; Kacinski, Barry; Nath, Ravinder; Pourang, Rauman; Roberts, Kenneth; Fischer, Diana; Chambers, Joseph; Schwartz, Peter E; Wilson, Lynn

    1995-07-01

    .E.=.14). Complications were observed in 1 primarily treated patient (soft tissue necrosis) and in 3 patients with recurrent disease (colonic obstruction, rectal fissure, and GI bleed, respectively). Conclusion: The unique dosimetric characteristics of {sup 241}Am allow effective and safe treatment of selected primary gynecological malignancies and in previously irradiated patients with recurrent pelvic malignancies.

  17. Selective pharmacological modulation of renal peripheral-type benzodiazepine binding by treatment with diuretic drugs

    International Nuclear Information System (INIS)

    Lukeman, D.S.; Vaughn, D.A.; Fanestil, D.D.

    1988-01-01

    The authors have assessed the effects of in vivo administration of different classes of diuretic drugs on the expression of the peripheral-type benzodiazepine binding site (PBBS) in crude membranes derived from the cortex and outer medulla of rat kidney by saturation analysis with the PBBS-selective ligands [ 3 H]RO5-4864 and [ 3 H]PH 11195 in cortex and [ 3 H]RO5-4864 in outer medulla. Administration for 14-15 days of furosemide, a drug that blocks NaCl-KCl coupled transport in the thick ascending limb of the loop of Henle, produced a significant doubling in the PBBS density (B/sub max/) in outer medulla, a region of the kidney rich in thick ascending limbs, and produced a lesser but significant increase in PBBS density in the cortex. Conversely, administration for 14-15 days of the carbonic anhydrase inhibitor acetazolamide, which acts predominantly in the proximal tubule, and hydrochlorothiazide, which acts predominantly in the early distal tubule, elicited statistically significant increases in PBBS density in renal cortex but not in renal outer medulla. Furthermore, all drug treatments were without effect on the equilibrium dissociation constants (K/sub d/s) of [ 3 H]RO5-4864 and [ 3 H]PK 11195 binding to cortical and outer medullary membrane preparations. These findings demonstrate that the PBBS can be selectively up-regulated in different regions of the kidney by diuretic drugs with different modes/sites of action. 50 references, 1 table

  18. Treatment of selective mutism: a 5-year follow-up study.

    Science.gov (United States)

    Oerbeck, Beate; Overgaard, Kristin Romvig; Stein, Murray B; Pripp, Are Hugo; Kristensen, Hanne

    2018-01-22

    Selective mutism (SM) has been defined as an anxiety disorder in the diagnostic and statistical manual of mental disorders (DSM-5). Cognitive behavioral therapy (CBT) is the recommended approach for SM, but prospective long-term outcome studies are lacking. Reports from the children themselves, and the use of more global quality of life measures, are also missing in the literature. We have developed a school-based CBT intervention previously found to increase speech in a pilot efficacy study and a randomized controlled treatment study. Continued progress was found in our 1-year follow-up studies, where older age and more severe SM had a significant negative effect upon outcome. In the present study, we provide 5-year outcome data for 30 of these 32 children with SM who completed the same CBT for mean 21 weeks (sd 5, range 8-24) at mean age 6 years (10 boys). Mean age at the 5-year follow-up was 11 years (range 8-14). Outcome measures were diagnostic status, the teacher- and parent-rated selective mutism questionnaires, and child rated quality of life and speaking behavior. At the 5-year follow-up, 21 children were in full remission, five were in partial remission and four fulfilled diagnostic criteria for SM. Seven children (23%) fulfilled criteria for social phobia, and separation anxiety disorder, specific phobia and/or enuresis nocturna were found in a total of five children (17%). Older age and severity at baseline and familial SM were significant negative predictors of outcome. Treatment gains were maintained on the teacher- and parent questionnaires. The children rated their overall quality of life as good. Although most of them talked outside of home, 50% still experienced it as somewhat challenging. These results point to the long-term effectiveness of CBT for SM, but also highlight the need to develop more effective interventions for the subset of children with persistent symptoms.Clinical trials registration NCT01002196.

  19. Occurrence, fate and interrelation of selected antibiotics in sewage treatment plants and their receiving surface water.

    Science.gov (United States)

    Wu, Ming-Hong; Que, Chen-Jing; Xu, Gang; Sun, Yan-Feng; Ma, Jing; Xu, Hui; Sun, Rui; Tang, Liang

    2016-10-01

    The occurrence and fate of 12 commonly used antibiotics, two fluoroquinolones (FQs), three sulfonamides (SAs), three macrolides (MLs), two β-lactams and two tetracyclines (TCs), were studied in four sewage treatment plants (STPs) and their receiving water, the Huangpu River, Shanghai. The levels of selected antibiotics in the STPs ranged from ngL(-1) to μgL(-1), while ofloxacin (OFL) was predominant (reach up to 2936.94ngL(-1)). The highest and lowest proportions were of FQs (STP 1, STP 2 and STP 3) and TCs (in four STPs) respectively in both influents and effluents. And the second-highest proportion was of FQs in STP 4 (only 2% lower than the highest). What could be inferred was that the usage of TCs were extremely low while the usage of FQs were larger than other antibiotics in our study area. The elimination of antibiotics through these STPs was incomplete and a wide range of removal efficiencies (-442.8% to 100%) during the treatment was observed. Based on the mass loadings as well as the per-capita mass loadings of target antibiotics in four STPs, OFL was considered the primary contaminant herein. In the Huangpu River, 3 antibiotics were not detected in any water samples, while the detection frequencies of 4 antibiotics were 100%. The highest concentration detected in the river was 53.91ngL(-1) of sulfapyridine (SD). The Spearman correlation analysis of antibiotics in STPs and the nearby water samples suggests that the antibiotics discharged from some STPs might influence the receiving water to some extent. Moreover, most of the hazard quotient (HQ) values in STP effluents were one order magnitude higher than those in their receiving water. However, there is no imminent significant ecotoxicological risk caused by any single compound in the effluents and receiving waters. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Selection and determination of beam weights based on genetic algorithms for conformal radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Xingen Wu; Zunliang Wang

    2000-01-01

    A genetic algorithm has been used to optimize the selection of beam weights for external beam three-dimensional conformal radiotherapy treatment planning. A fitness function is defined, which includes a difference function to achieve a least-square fit to doses at preselected points in a planning target volume, and a penalty item to constrain the maximum allowable doses delivered to critical organs. Adjustment between the dose uniformity within the target volume and the dose constraint to the critical structures can be achieved by varying the beam weight variables in the fitness function. A floating-point encoding schema and several operators, like uniform crossover, arithmetical crossover, geometrical crossover, Gaussian mutation and uniform mutation, have been used to evolve the population. Three different cases were used to verify the correctness of the algorithm and quality assessment based on dose-volume histograms and three-dimensional dose distributions were given. The results indicate that the genetic algorithm presented here has considerable potential. (author)

  1. Super selective transcatheter angiographic embolization: an effective and prophylactic treatment for massive obstetric haemorrhage

    International Nuclear Information System (INIS)

    Zhou Yiming; Zhai Renyou; Qian Xiaojun; Wei Baojie; Gao Kun; Zhang Shilong; Liu Jinmei; Zhang Qiuhong; Jiang Lei

    2008-01-01

    Objective: To discuss the effect and safety of transcatheter angiographic embolization (TAE)for managing massive obstetric haemorrhage. Methods: 17 cases of obstetric massive haemorrhage or with haemorrhage tendency were treated with TAE. Among them 14 cases had haemorrhage already, including 10 cases after abortion, caesarean section or normal labor and other 4 of hydatidiform mole. 3 cases with obstetric haemorrhage tendency included 2 cases of placenta praevia and 1 case of cervical pregnancy. Selective catheterization into bilateral uterine arteries or internal iliac arteries for DSA, showed the cause and location of the haemorrhage and then embolized with gelfoam sponge chips (1-3 mm) or Polyvinyl Alcohol(PVA); and part of the cases with MTX through uterine arterial perfusion. Results: The successful rate of catheterization was 100%. The achievement in 14 cases showed no active haemorrhage immediately after the procedure and no vaginal bleeding after 1-5 days. In 3 prophylactic cases before abortion or uterine curettage, obstetric massive haemorrhage occurred in 1 case, but not so in other 2 cases. Conclusions: TAE is an effective treatment for obstetric massive haemorrhage, with the advantages of minimal trauma, fast and definite treating effect and less complications. Prophylactical application for high risk patients can reduce the bleeding and mortality. (authors)

  2. The selective Aurora B kinase inhibitor AZD1152 is a potential new treatment for multiple myeloma.

    Science.gov (United States)

    Evans, Robert P; Naber, Claudia; Steffler, Tara; Checkland, Tamara; Maxwell, Christopher A; Keats, Jonathan J; Belch, Andrew R; Pilarski, Linda M; Lai, Raymond; Reiman, Tony

    2008-02-01

    Aurora kinases are potential targets for cancer therapy. Previous studies have validated Aurora kinase A as a therapeutic target in multiple myeloma (MM), and have demonstrated in vitro anti-myeloma effects of small molecule Aurora kinase inhibitors that inhibit both Aurora A and B. This study demonstrated that Aurora B kinase was strongly expressed in myeloma cell lines and primary plasma cells. The selective Aurora B inhibitor AZD1152-induced apoptotic death in myeloma cell lines at nanomolar concentrations, with a cell cycle phenotype consistent with that reported previously for Aurora B inhibition. In some cases, AZD1152 in combination with dexamethasone showed increased anti-myeloma activity compared with the use of either agent alone. AZD1152 was active against sorted CD138(+) BM plasma cells from myeloma patients but also, as expected, was toxic to CD138(-) marrow cells from the same patients. In a murine myeloma xenograft model, AZD1152-inhibited tumour growth at well-tolerated doses and induced cell death in established tumours, with associated mild, transient leucopenia. AZD1152 shows promise in these preclinical studies as a novel treatment for MM.

  3. Sunitinib in the treatment of gastrointestinal stromal tumor: patient selection and perspectives

    Directory of Open Access Journals (Sweden)

    Mulet-Margalef N

    2016-12-01

    Full Text Available Nuria Mulet-Margalef, Xavier Garcia-del-Muro Sarcoma Multidisciplinary Unit and Medical Oncology Department, Institut Català d’Oncologia Hospitalet, IDIBELL, Barcelona, Spain Abstract: Gastrointestinal stromal tumor (GIST is the most common mesenchymal tumor of the gastrointestinal tract. In advanced setting and after progression to imatinib, the multitargeted receptor tyrosine kinase inhibitor sunitinib has clearly demonstrated a clinical benefit in terms of response rate and progression-free survival with an acceptable toxicity profile. The recommended schedule for sunitinib administration is 50 mg per day 4 weeks ON and 2 weeks OFF; however, potential alternative schedules are also reviewed in the present article. Several biomarkers have been explored to better select candidates for sunitinib therapy, such as the value of early changes in standardized uptake value assessed by positron emission tomography with 18F-fluorodeoxyglucose, circulating biomarkers, clinical biomarkers such as the appearance of arterial hypertension during treatment that correlates with better outcomes, and the GIST genotype. GISTs with KIT mutations at exon 9 and the so-called wild-type GISTs seem to better respond to sunitinib. Nonetheless, further investigation is required to confirm these findings as well as to understand the mechanisms of sunitinib resistance such as the development of new KIT mutations or conformational changes in KIT receptor. Keywords: sunitinib, GIST, KIT, refractory GIST

  4. The calculation of 131I dose in second treatment for Graves' disease and the selection of patients

    International Nuclear Information System (INIS)

    Yang Jisheng; Wang Qiang; Hu Mingzao; Zuo Lei; Peng Xiaoyan

    2001-01-01

    Objective: To improve the method of 131 I dose calculation in second treatment for Graves' disease (GD) and to make a criterion for selection of patients. Methods: From 87 GD patients not recovered more than half a year after 131 I treatment, authors selected 41 cases (group A) whose thyroid weight were ≥30 g and gave them second 131 I treatment. The absorbed dose (d 2 ) of 131 I was calculated by the formula we designed: (m 1 /m 2 ):d 1 =(m 2 /m 3 ): d 2 ; i.e. d 2 (Gy) = d 1 m 2 2 /m 1 m 3 . The total dose (D) was calculated by the classical formula: D(37 KBq or μ Ci)= d 2 x 8 x m 2 (g)/1.6 x max. uptake % of 131 I x T 1/2eff (days). m 1 and m 2 was the thyroid weight before and after the first 131 I treatment respectively, m 3 was the pre-estimated thyroid weight after the second treatment, d 1 was the unit dose of the first treatment. Results were compared with 97 patients (group B) who had received second 131 I treatment before using this calculation method. The resting 46 cases (group C) whose thyroid weight were 131 I treatment of group A was 73.2% (30/41 cases), it was remarkably higher than that of group B (19.6%), but the early-permanent hypothyroidism rate was lower in group A. The recovery rate of group C was 91.3% (42/46 case) in two years (averaged 8.8 months). Conclusion: The calculating method can make the dose of second 131 I treatment for GD relatively optimal. Thyroid weight ≥30 g can be used as the main criterion for selection of patients 131 I treatment. Patients whose thyroid weight 131 I treatment and the therapeutic effect was poor

  5. Low-temperature synthesis of allyl dimethylamine by selective heating under microwave irradiation used for water treatment

    International Nuclear Information System (INIS)

    Tian Binghui; Luan Zhaokun; Li Mingming

    2005-01-01

    Low-temperature synthesis of allyl dimethylamine (ADA) by selective heating under microwave irradiation (MI) used for water treatment is investigated. The effect of MI, ultrasound irradiation (UI) and conventional heating on yield of ADA, reaction time and the flocculation efficiency of polydiallyl dimethylammunion chloride (PDADMAC) prepared form ADA were studied. The results show that by selective heating at low temperature, MI not only increases yield of ADA and reduces reaction time, but also greatly enhances the flocculation efficiency of PDADMAC

  6. Investigation of selective induction of breast cancer cells to death with treatment of plasma-activated medium

    Science.gov (United States)

    Hashizume, Hiroshi; Tanaka, Hiromasa; Nakamura, Kae; Kano, Hiroyuki; Ishikawa, Kenji; Kikkawa, Fumitaka; Mizuno, Masaaki; Hori, Masaru

    2015-09-01

    The applications of plasma in medicine have much attention. We previously showed that plasma-activated medium (PAM) induced glioblastoma cells to apoptosis. However, it has not been elucidated the selectivity of PAM in detail. In this study, we investigated the selective effect of PAM on the death of human breast normal and cancer cells, MCF10A and MCF7, respectively, and observed the selective death with fluorescent microscopy. For the investigation of cell viability with PAM treatment, we prepared various PAMs according to the strengths, and treated each of cells with PAMs. Week PAM treatment only decreased the viability of MCF7 cells, while strong PAM treatment significantly affected both viabilities of MCF7 and MCF10A cells. For the fluorescent observation, we prepared the mixture of MCF7 and fluorescent-probed MCF10A cells, and seeded them. After the treatment of PAMs, the images showed that only MCF7 cells damaged in the mixture with week PAM treatment. These results suggested that a specific range existed with the selective effect in the strength of PAM. This work was partly supported by a Grant-in-Aid for Scientific Research on Innovative Areas ``Plasma Medical Innovation'' Grant No. 24108002 and 24108008 from the Ministry of Education, Culture, Sports, Science and Technology of Japan.

  7. Productivity and cost of marking activities for single-tree selection and thinning treatments in Arkansas

    Science.gov (United States)

    Tymur Sydor; Richard A. Kluender; Rodney L. Busby; Matthew Pelkki

    2004-01-01

    An activity algorithm was developed for standard marking methods for natural pine stands in Arkansas. For the two types of marking methods examined, thinning (selection from below) and single-tree selection (selection from above), cycle time and cost models were developed. Basal area (BA) removed was the major influencing factor in both models. Marking method was...

  8. An integrated knowledge-based and optimization tool for the sustainable selection of wastewater treatment process concepts

    DEFF Research Database (Denmark)

    Castillo, A.; Cheali, Peam; Gómez, V.

    2016-01-01

    The increasing demand on wastewater treatment plants (WWTPs) has involved an interest in improving the alternative treatment selection process. In this study, an integrated framework including an intelligent knowledge-based system and superstructure-based optimization has been developed and applied...... to a real case study. Hence, a multi-criteria analysis together with mathematical models is applied to generate a ranked short-list of feasible treatments for three different scenarios. Finally, the uncertainty analysis performed allows for increasing the quality and robustness of the decisions considering...... benefit and synergy is achieved when both tools are integrated because expert knowledge and expertise are considered together with mathematical models to select the most appropriate treatment alternative...

  9. Preoperative Transcatheter Selective Arterial Chemoembolization in Treatment of Unresectable Hepatoblastoma in Infants and Children

    International Nuclear Information System (INIS)

    Li Jiaping; Chu Jianping; Yang Jianyong; Chen Wei; Wang Yu; Huang Yonghui

    2008-01-01

    The purpose of this study was to evaluate the clinical feasibility and efficacy of transcatheter selective arterial chemoembolization (TACE) for unresectable hepatoblastoma in infants and children. The study was performed with the approval of our institutional review board. Sixteen patients (13 boys, 3 girls) with unresectable hepatoblastoma were treated one to three times with preoperative TACE in an effort to improve the surgical and clinical outcome. Their ages ranged from 50 days to 60 months, with a mean age of 20.4 months. All cases were pathologically proved hepatoblastoma by fine-needle biopsy. After an intra-arterial catheter was selectively inserted into the main feeding artery of the tumor, cycles of cisplatin (40 to 50 mg/m 2 ) and adriamycin (20 to 30 mg/m 2 ) mixed with lipiodol were given, followed by gelatin foam particles or stainless-steel coils. Tumor response was evaluated according to tumor shrinkage, α-fetoprotein (AFP) levels, and pathological findings. TACE procedure was performed one to three times, depending on the patient's response. Surgical resection was carried out when the tumor volume appeared sufficiently reduced to allow safe resection by either lobectomy or extended lobectomy. A marked reduction in tumor size associated with decreased AFP level occurred after treatment. According to paired-samples test, tumor shrinkage ranged from 19.0% to 82.0%, with a mean value of 59.2%. AFP levels decreased 99.0% to 29.0% from initial levels, with a mean decrease of 60.0%. TACE allowed subsequent complete surgical resection in 13 cases and the other 3 cases underwent partial resection. One patient underwent successful orthotopic liver transplantation after receiving TACE therapy. Pathological examination showed that the mean percentage of necrotic area in the surgical specimens was 87%. Overall survival rate at 1, 3, and 5 years was 87.5%, 68.7%, and 50%, respectively. Correspondingly, event-free survival rate was 75%, 62.5%, and 43

  10. Veterinarians' attitudes toward antimicrobial use and selective dry cow treatment in the Netherlands.

    Science.gov (United States)

    Scherpenzeel, C G M; Santman-Berends, I M G A; Lam, T J G M

    2018-03-28

    In the Netherlands, regulations have been in place since 2008 to reduce the overall use of antimicrobials to mitigate antimicrobial resistance. As part of these regulations, a ban on the preventive use of antimicrobials, such as applying blanket dry cow treatment, was introduced and alternative measures such as selective dry cow treatment (SDCT) were implemented. Both farmers and veterinarians play an important role in implementing these measures and have a shared responsibility with respect to prudent antimicrobial use (AMU). The attitude of Dutch dairy veterinarians toward restricted AMU and toward SDCT is unknown, but a favorable attitude toward this approach seems crucial for successful implementation. In 2015, an online questionnaire was collected from 181 veterinarians that contained questions with regard to their attitude and behavior toward reduction of AMU and toward SDCT. Descriptive statistics were used to describe the data, and multivariable logistic regression models with a logit link function were applied to evaluate potential associations between veterinarians' attitudes toward AMU and SDCT and the rationale behind their mindset, based on positive and negative aspects of reduction in AMU. The veterinarians were divided into 3 groups based on their opinion on 4 statements with regard to AMU and SDCT: veterinarians with an unfavorable, a neutral, and a favorable attitude toward reduction of AMU and toward SDCT. For the multivariable logistic regression analysis, the first 2 groups were combined and compared with the veterinarians with a favorable attitude. The general attitude of Dutch dairy veterinarians toward reduction of AMU was positive, and most expressed the belief that they can still be a good veterinarian when they prescribe less antimicrobials. Veterinarians indicated they progressively promoted SDCT beginning in 2013. Most veterinarians see the advice they provide to farmers on SDCT as the best possible approach and are convinced that their

  11. Bioactive Ti metal analogous to human cancellous bone: Fabrication by selective laser melting and chemical treatments.

    Science.gov (United States)

    Pattanayak, Deepak K; Fukuda, A; Matsushita, T; Takemoto, M; Fujibayashi, S; Sasaki, K; Nishida, N; Nakamura, T; Kokubo, T

    2011-03-01

    Selective laser melting (SLM) is a useful technique for preparing three-dimensional porous bodies with complicated internal structures directly from titanium (Ti) powders without any intermediate processing steps, with the products being expected to be useful as a bone substitute. In this study the necessary SLM processing conditions to obtain a dense product, such as the laser power, scanning speed, and hatching pattern, were investigated using a Ti powder of less than 45 μm particle size. The results show that a fully dense plate thinner than 1.8 mm was obtained when the laser power to scanning speed ratio was greater than 0.5 and the hatch spacing was less than the laser diameter, with a 30 μm thick powder layer. Porous Ti metals with structures analogous to human cancellous bone were fabricated and the compressive strength measured. The compressive strength was in the range 35-120 MPa when the porosity was in the range 75-55%. Porous Ti metals fabricated by SLM were heat-treated at 1300 °C for 1h in an argon gas atmosphere to smooth the surface. Such prepared specimens were subjected to NaOH, HCl, and heat treatment to provide bioactivity. Field emission scanning electron micrographs showed that fine networks of titanium oxide were formed over the whole surface of the porous body. These treated porous bodies formed bone-like apatite on their surfaces in a simulated body fluid within 3 days. In vivo studies showed that new bone penetrated into the pores and directly bonded to the walls within 12 weeks after implantation into the femur of Japanese white rabbits. The percentage bone affinity indices of the chemical- and heat-treated porous bodies were significantly higher than that of untreated implants. Copyright © 2010 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  12. Personalizing colon cancer adjuvant therapy: selecting optimal treatments for individual patients.

    Science.gov (United States)

    Dienstmann, Rodrigo; Salazar, Ramon; Tabernero, Josep

    2015-06-01

    For more than three decades, postoperative chemotherapy-initially fluoropyrimidines and more recently combinations with oxaliplatin-has reduced the risk of tumor recurrence and improved survival for patients with resected colon cancer. Although universally recommended for patients with stage III disease, there is no consensus about the survival benefit of postoperative chemotherapy in stage II colon cancer. The most recent adjuvant clinical trials have not shown any value for adding targeted agents, namely bevacizumab and cetuximab, to standard chemotherapies in stage III disease, despite improved outcomes in the metastatic setting. However, biomarker analyses of multiple studies strongly support the feasibility of refining risk stratification in colon cancer by factoring in molecular characteristics with pathologic tumor staging. In stage II disease, for example, microsatellite instability supports observation after surgery. Furthermore, the value of BRAF or KRAS mutations as additional risk factors in stage III disease is greater when microsatellite status and tumor location are taken into account. Validated predictive markers of adjuvant chemotherapy benefit for stage II or III colon cancer are lacking, but intensive research is ongoing. Recent advances in understanding the biologic hallmarks and drivers of early-stage disease as well as the micrometastatic environment are expected to translate into therapeutic strategies tailored to select patients. This review focuses on the pathologic, molecular, and gene expression characterizations of early-stage colon cancer; new insights into prognostication; and emerging predictive biomarkers that could ultimately help define the optimal adjuvant treatments for patients in routine clinical practice. © 2015 by American Society of Clinical Oncology.

  13. The potential of selected macroalgal species for treatment of AMD at different pH ranges in temperate regions

    CSIR Research Space (South Africa)

    Oberholster, Paul J

    2014-09-01

    Full Text Available The metal bioaccumulation potential of selected macroalgae species at different pH ranges was study for usage as part of a possible secondary passive acid mine drainage (AMD) treatment technology in algae ponds. Two separate studies were conducted...

  14. Selective elimination of chromophoric and fluorescent dissolved organic matter in a full-scale municipal wastewater treatment plant.

    Science.gov (United States)

    Yang, Xiaofang; Zhou, Zhongbo; Raju, Maddela Naga; Cai, Xiaoxuan; Meng, Fangang

    2017-07-01

    Effluent organic matter (EfOM) from municipal wastewater treatment plants potentially has a detrimental effect on both aquatic organisms and humans. This study evaluated the removal and transformation of chromophoric dissolved organic matter (CDOM) and fluorescent dissolved organic matter (FDOM) in a full-scale wastewater treatment plant under different seasons. The results showed that bio-treatment was found to be more efficient in removing bulk DOM (in term of dissolved organic carbon, DOC) than CDOM and FDOM, which was contrary to the disinfection process. CDOM and FDOM were selectively removed at various stages during the treatment. Typically, the low molecular weight fractions of CDOM and protein-like FDOM were more efficiently removed during bio-treatment process, whereas the humic-like FDOM exhibited comparable decreases in both bio-treatment and disinfection processes. Overall, the performance of the WWTP was weak in terms of CDOM and FDOM removal, resulting in enrichment of CDOM and FDOM in effluent. Moreover, the total removal of the bulk DOM (PCDOM and the humic-like FDOM showed little differences between summer and winter. In all, the results provide useful information for understanding the fate and transformation of DOM, illustrating that sub-fractions of DOM could be selectively removed depending on treatment processes and seasonality. Copyright © 2016. Published by Elsevier B.V.

  15. Selection of candidate wells and optimization of conformance treatment design in the Barrancas Field using a 3D conformance simulator

    Energy Technology Data Exchange (ETDEWEB)

    Crosta, Dante; Elitseche, Luis [Repsol YPF (Argentina); Gutierrez, Mauricio; Ansah, Joe; Everett, Don [Halliburton Argentina S.A., Buenos Aires (Argentina)

    2004-07-01

    Minimizing the amount of unwanted water production is an important goal at the Barrancas field. This paper describes a selection process for candidate injection wells that is part of a pilot conformance project aimed at improving vertical injection profiles, reducing water cut in producing wells, and improving ultimate oil recovery from this field. The well selection process is based on a review of limited reservoir information available for this field to determine inter-well communications. The methodology focuses on the best use of available information, such as production and injection history, well intervention files, open hole logs and injectivity surveys. After the candidate wells were selected and potential water injection channels were identified, conformance treatment design and future performance of wells in the selected pilot area were evaluated using a new 3 -D conformance simulator, developed specifically for optimization of the design and placement of unwanted fluid shut-off treatments. Thus, when acceptable history match ing of the pilot area production was obtained, the 3 -D simulator was used to: evaluate the required volume of selected conformance treatment fluid; review expected pressures and rates during placement;. model temperature behavior; evaluate placement techniques, and forecast water cut reduction and incremental oil recovery from the producers in this simulated section of the pilot area. This paper outlines a methodology for selecting candidate wells for conformance treatments. The method involves application of several engineering tools, an integral component of which is a user-friendly conformance simulator. The use of the simulator has minimized data preparation time and allows the running of sensitivity cases quickly to explore different possible scenarios that best represent the reservoir. The proposed methodology provides an efficient means of identifying conformance problems and designing optimized solutions for these individual

  16. Aging Prisoners' Treatment Selection: Does Prospect Theory Enhance Understanding of End-of-Life Medical Decisions?

    Science.gov (United States)

    Phillips, Laura L.; Allen, Rebecca S.; Harris, Grant M.; Presnell, Andrew H.; DeCoster, Jamie; Cavanaugh, Ronald

    2011-01-01

    Purpose: With the rapid growth in the older inmate population and the economic impact of end-of-life treatments within the cash-strapped prison system, consideration should be given to inmate treatment preferences. We examined end-of-life treatment preferences and days of desired life for several health scenarios among male inmates incarcerated…

  17. Ultrasound in the diagnosis and treatment of developmental dysplasia of the hip. Evaluation of a selective screening procedure

    DEFF Research Database (Denmark)

    Strandberg, C.; Konradsen, L.A.; Ellitsgaard, N.

    2008-01-01

    INTRODUCTION: With the intention of reducing the treatment frequency of Developmental Dysplasia of the Hip (DDH), two hospitals in Copenhagen implemented a screening and treatment procedure based on selective referral to ultrasonography of the hip (US). This paper describes and evaluates...... 0.03%. No relationship was seen between morphological parameters at the first US and the outcome of hips classified as minor dysplastic or not fully developed (NFD). A statistically significant relationship was seen between the degree of dysplasia and the time until US normalization of the hips (p......= 0.02). There was no relapse of dysplasia after treatment. The median duration of treatment was six, eight and nine weeks for mild, moderate and severe dysplasia respectively. CONCLUSION: The procedure resulted in a low rate of treatment and a small number of late diagnosed cases. Prediction...

  18. Social Communication Anxiety Treatment (S-CAT) for children and families with selective mutism: A pilot study.

    Science.gov (United States)

    Klein, Evelyn R; Armstrong, Sharon Lee; Skira, Kathryn; Gordon, Janice

    2017-01-01

    This research assessed the feasibility of Social Communication Anxiety Treatment (S-CAT) developed by Elisa Shipon-Blum, a brief multimodal approach, to increase social communication in 40 children aged 5-12 years with selective mutism (SM). SM is a disorder in which children consistently fail to speak in specific situations although they have the ability to do so. Key features of this approach are the SM-Social Communication Comfort Scale (SCCS), transfer of control (ToC), a nonchalant therapeutic style, and cognitive-behavioral strategies over a brief time frame. Following 9 weeks of treatment, children showed significant gains in speaking frequency on all 17 items from the Selective Mutism Questionnaire (SMQ), a standardized measure of SM severity. Children also showed decreased levels of anxiety and withdrawal as reported by parents on the Child Behavior Checklist (CBCL). SM initial symptom severity and family therapy compliance, but not duration of SM, contributed to treatment outcomes.

  19. Ocular Tuberculosis II: Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Sumru Önal

    2011-06-01

    Full Text Available Recent studies on the clinical importance of tuberculin skin tests (TST, interferon-gamma release assays (IGRAs, chest computed tomography (CT and polymerase chain reaction have provided a new approach to diagnosing ocular tuberculosis (TBC. However, both TST and IGRAs cannot distinguish between latent TBC infection and active disease. Another corroborative test in the diagnosis of intraocular TBC is the evaluation of the lungs by either chest radiography or CT. Direct evidence for the diagnosis can be obtained by examination of smears and staining for acid-fast organisms, cultures of intraocular tissue/fluid for Mycobacterium tuberculosis, and nucleic acid amplification analysis. In recent years, guidelines have been suggested for the diagnosis of intraocular TBC. The current treatment of intraocular TBC consists of use of four drugs (isoniazid, rifampicin, ethambutol and pyrazinamide taken for a long period of time (total 9-15 months. (Turk J Ophthalmol 2011; 41: 182-90

  20. Influences on the start, selection and duration of treatment with antibiotics in long-term care facilities.

    Science.gov (United States)

    Daneman, Nick; Campitelli, Michael A; Giannakeas, Vasily; Morris, Andrew M; Bell, Chaim M; Maxwell, Colleen J; Jeffs, Lianne; Austin, Peter C; Bronskill, Susan E

    2017-06-26

    Understanding the extent to which current antibiotic prescribing behaviour is influenced by clinicians' historical patterns of practice will help target interventions to optimize antibiotic use in long-term care. Our objective was to evaluate whether clinicians' historical prescribing behaviours influence the start, prolongation and class selection for treatment with antibiotics in residents of long-term care facilities. We conducted a retrospective cohort study of all physicians who prescribed to residents in long-term care facilities in Ontario between Jan. 1 and Dec. 31, 2014. We examined variability in antibiotic prescribing among physicians for 3 measures: start of treatment with antibiotics, use of prolonged durations exceeding 7 days and selection of fluoroquinolones. Funnel plots with control limits were used to determine the extent of variation and characterize physicians as extreme low, low, average, high and extreme high prescribers for each tendency. Multivariable logistic regression was used to assess whether a clinician's prescribing tendency in the previous year predicted current prescribing patterns, after accounting for residents' demographics, comorbidity, functional status and indwelling devices. Among 1695 long-term care physicians, who prescribed for 93 132 residents, there was wide variability in the start of antibiotic treatment (median 45% of patients, interquartile range [IQR] 32%-55%), use of prolonged treatment durations (median 30% of antibiotic prescriptions, IQR 19%-46%) and selection of fluoroquinolones (median 27% of antibiotic prescriptions, IQR 18%-37%). Prescribing tendencies for antibiotics by physicians in 2014 correlated strongly with tendencies in the previous year. After controlling for individual resident characteristics, prior prescribing tendency was a significant predictor of current practice. Physicians prescribing antibiotics exhibited individual, measurable and historical tendencies toward start of antibiotic treatment

  1. Advances in breast cancer treatment and prevention: preclinical studies on aromatase inhibitors and new selective estrogen receptor modulators (SERMs)

    International Nuclear Information System (INIS)

    Schiff, Rachel; Chamness, Gary C; Brown, Powel H

    2003-01-01

    Intensive basic and clinical research over the past 20 years has yielded crucial molecular understanding into how estrogen and the estrogen receptor act to regulate breast cancer and has led to the development of more effective, less toxic, and safer hormonal therapy agents for breast cancer management and prevention. Selective potent aromatase inhibitors are now challenging the hitherto gold standard of hormonal therapy, the selective estrogen-receptor modulator tamoxifen. Furthermore, new selective estrogen-receptor modulators such as arzoxifene, currently under clinical development, offer the possibility of selecting one with a more ideal pharmacological profile for treatment and prevention of breast cancer. Two recent studies in preclinical model systems that evaluate mechanisms of action of these new drugs and suggestions about their optimal clinical use are discussed

  2. Effects of gamma-radiation treatment in somatic cell culture of indica rice Basmati 370 selection

    Energy Technology Data Exchange (ETDEWEB)

    Shaokai, Min; Xiufang, Qi; Zhenmin, Xiong; Chengzhang, Zhao [China National Rice Research Institute, Hangzhou (China)

    1990-01-01

    Full text: Radiation treatment was applied at different doses to germinating embryo, callus, callus with green spots and callus with developing shoots. Results indicate: (1) induction rate of the callus was reduced with increased radiation dose applied to germinating embryos; (2) radiation effect on redifferentiation percentage and/or green plantlets percentage of the callus varied with different treatment dates in the order of callus treatment > treatment of callus with green spots > treatment of callus with developing shoots > treatment of germinating embryo; (3) in vitro irradiation reduced the fertility of regenerated plants, but was able to increase their exerted stigma rate and the frequency of early maturing variation in their progenies; (4) a number of promising mutants including 2 male sterile plants were obtained from the progenies of in vitro irradiation. The radiation treatment with 2.5-5.OkR to callus with green spots or shoots is a method worthy of adoption in rice improvement. (author)

  3. Selective peripheral nerve resection for treatment of persistent pain around the knee joint after total knee arthroplasty.

    Science.gov (United States)

    Zhong, Guangjun; Liang, Zhu; Kan, Jiang; Muheremu, Aikeremujiang

    2018-01-01

    Objective This study was performed to determine the efficacy of selective peripheral nerve resection for treatment of persistent neuropathic pain after total knee arthroplasty (TKA). Methods Patients who underwent TKA in our department from January 2013 to July 2016 and experienced persistent pain around the knee joint after TKA were retrospectively included in the current study. Sixty patients were divided into experimental and control groups according the treatment they received. The treatment effect was evaluated by the Hospital for Special Surgery (HSS) knee score and visual analog scale (VAS) pain score preoperatively and at 1, 2, 3, 6, and 12 months postoperatively. Results The HSS knee scores were higher in both groups after than before the treatment, and HSS knee scores were significantly higher in the experimental group than in the control group. The VAS pain scores were lower in both groups after than before the treatment, and VAS pain scores were significantly lower in the experimental group than in the control group. Conclusions Selective peripheral nerve resection is an effective treatment method for persistent neuropathic pain after TKA.

  4. CERT TST November 2016 Visit Summary

    Energy Technology Data Exchange (ETDEWEB)

    Little, Robert Currier [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Bailey, Teresa S. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Kahler, III, Albert Comstock [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Kunen, Adam J. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Pautz, Shawn D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Williams, Alan B. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Zerr, Robert Joseph [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-04-27

    The dozen plus presentations covered the span of the Center’s activities, including experimental progress, simulations of the experiments (both for calibration and validation), UQ analysis, nuclear data impacts, status of simulation codes, methods development, computational science progress, and plans for upcoming priorities. All three institutions comprising the Center (Texas A&M, University of Colorado Boulder, and Simon Fraser University) were represented. Center-supported students not only gave two of the oral presentations, but also highlighted their research in a number of excellent posters.

  5. Effect of biofilm and selective mixed culture on microbial fuel cell for the treatment of tempeh industrial wastewater

    Science.gov (United States)

    Arbianti, Rita; Surya Utami, Tania; Leondo, Vifki; Elisabeth; Andyah Putri, Syafira; Hermansyah, Heri

    2018-03-01

    Microbial Fuel Cell (MFC) provides a new alternative in the treatment of organic waste. MFC produces 50-90% less sludge to be disposed than other methods. MFC technology can utilize existing microorganisms in the waste as a catalyst to generate electricity and simultaneously also serves as a wastewater treatment unit itself. Tempeh wastewater is one of the abundant industrial wastewater which can be processed using MFC. Research using the selective mixed culture is very likely to do due to the good result on COD removals by adding mixed culture. Microorganisms in tempeh wastewater consist of bacteria gram positive and gram negative. This study focused on the aspects of waste treatment which is determined by decreased levels of COD and BOD. Variations in this study are the formation time of biofilm and the addition of selective gram. MFC operated for 50 hours. For a variation of biofilm formation, experiments were performed after incubation by replacing incubation substrates used in the formation of biofilms. Biofilm formation time in this study was 3 days, 5 days, 7 days and 14 days. Gram positive and gram negative bacteria were used in selective mixed culture experiments. Selective mixed culture added to the reactor by 1 mL and 5 mL. Selection of gram-positive or gram-negative bacteria carried by growing mixed culture on selective media. COD and BOD levels were measured in the wastewater before and after the experiment conducted in each variation. Biofilm formation optimum time is 7 days which decrease COD and BOD levels by 18.2% and 35.9%. The addition of gram negative bacteria decreases COD and BOD levels by 29.32% and 51.32%. Further research is needed in order to get a better result on decreasing levels of COD and BOD.

  6. Therapeutic potential of functional selectivity in the treatment of heart failure

    DEFF Research Database (Denmark)

    Christensen, Gitte Lund; Aplin, Mark; Hansen, Jakob Lerche

    2010-01-01

    Adrenergic and angiotensin receptors are prominent targets in pharmacological alleviation of cardiac remodeling and heart failure, but their use is associated with cardiodepressant side effects. Recent advances in our understanding of seven transmembrane receptor signaling show that it is possible...... to design ligands with "functional selectivity," acting as agonists on certain signaling pathways while antagonizing others. This represents a major pharmaceutical opportunity to separate desired from adverse effects governed by the same receptor. Accordingly, functionally selective ligands are currently...

  7. Selecting Effective Treatments: A Comprehensive, Systematic Guide to Treating Mental Disorders. Revised Edition.

    Science.gov (United States)

    Seligman, Linda

    This book presents an overview of the major types of mental disorders, accompanied by treatment models that are structured, comprehensive, grounded in research, and likely to be effective. Chapter topics are: (1) "Introduction to Effective Treatment Planning"; (2) "Mental Disorders in Infants, Children, and Adolescents"; (3) "Situationally…

  8. Muscle selection for treatment of cervical dystonia with botulinum toxin : A systematic review

    NARCIS (Netherlands)

    Nijmeijer, S. W. R.; Koelman, J. H. T. M.; Kamphuis, D. J.; Tijssen, M. A. J.

    Rationale: Cervical dystonia, also called spasmodic torticollis, is the most common form of (primary) dystonia. Intramuscular injections with botulinum toxin are the first line of treatment for cervical dystonia. To optimise the treatment response to botulinum toxin correct muscles should be

  9. Muscle selection for treatment of cervical dystonia with botulinum toxin - A systematic review

    NARCIS (Netherlands)

    Nijmeijer, S. W. R.; Koelman, J. H. T. M.; Kamphuis, D. J.; Tijssen, M. A. J.

    2012-01-01

    Rationale: Cervical dystonia, also called spasmodic torticollis, is the most common form of (primary) dystonia. Intramuscular injections with botulinum toxin are the first line of treatment for cervical dystonia. To optimise the treatment response to botulinum toxin correct muscles should be

  10. Selective UV–O3 treatment for indium zinc oxide thin film transistors with solution-based multiple active layer

    Science.gov (United States)

    Kim, Yu-Jung; Jeong, Jun-Kyo; Park, Jung-Hyun; Jeong, Byung-Jun; Lee, Hi-Deok; Lee, Ga-Won

    2018-06-01

    In this study, a method to control the electrical performance of solution-based indium zinc oxide (IZO) thin film transistors (TFTs) is proposed by ultraviolet–ozone (UV–O3) treatment on the selective layer during multiple IZO active layer depositions. The IZO film is composed of triple layers formed by spin coating and UV–O3 treatment only on the first layer or last layer. The IZO films are compared by X-ray photoelectron spectroscopy, and the results show that the atomic ratio of oxygen vacancy (VO) increases in the UV–O3 treatment on the first layer, while it decreases on last layer. The device characteristics of the bottom gated structure are also improved in the UV–O3 treatment on the first layer. This indicates that the selective UV–O3 treatment in a multi-stacking active layer is an effective method to optimize TFT properties by controlling the amount of VO in the IZO interface and surface independently.

  11. Brace treatment of lumber spondylolysis in growing age. Patient selection by RI scintigraphy and repair of spondylolysis

    Energy Technology Data Exchange (ETDEWEB)

    Abumi, Kuniyoshi; Hino, Hiroyuki; Sato, Shigeyoshi; Kaneda, Kiyoshi [Hokkaido Univ., Sapporo (Japan). School of Medicine

    1996-07-01

    From 1987 to 1994, brace treatment was prescribed to 29 patients with lumbar spondylolysis in growing age, ranging from nine to 18 years, in whom {sup 99m}Tc bone scintigraphy showed positive at the pars interarticularis. Single photon emission computed tomography was also conducted an recent cases. Spondylolysis was bilateral in 27 patients and unilateral in two. Polypropylene brace was applied for three to four months with restriction of sport activities. As a result, 46 out of 58 spondylolysis healed with a healing rate of 79%. Selection of patients using bone scintigraphy for brace treatment in lumbar spondylolysis in growing age would help to increase the union rate. (author)

  12. Brace treatment of lumber spondylolysis in growing age. Patient selection by RI scintigraphy and repair of spondylolysis

    International Nuclear Information System (INIS)

    Abumi, Kuniyoshi; Hino, Hiroyuki; Sato, Shigeyoshi; Kaneda, Kiyoshi

    1996-01-01

    From 1987 to 1994, brace treatment was prescribed to 29 patients with lumbar spondylolysis in growing age, ranging from nine to 18 years, in whom 99m Tc bone scintigraphy showed positive at the pars interarticularis. Single photon emission computed tomography was also conducted an recent cases. Spondylolysis was bilateral in 27 patients and unilateral in two. Polypropylene brace was applied for three to four months with restriction of sport activities. As a result, 46 out of 58 spondylolysis healed with a healing rate of 79%. Selection of patients using bone scintigraphy for brace treatment in lumbar spondylolysis in growing age would help to increase the union rate. (author)

  13. Effects of selective ultraviolet phototherapy (SUP) and local PUVA treatment on DNA synthesis in Guinea pig skin

    International Nuclear Information System (INIS)

    Pullmann, H.; Galosi, A.; Jakobeit, C.; Steigleder, G.K.

    1980-01-01

    The treatment with UV-light with wavelengths between 292.5-335 nm (known as selective UV-phototherapy, or SUP) and 320-390 nm (plus local treatment with 8-methoxypsoralen, known as PUVAsub(ex)) gave rise to a biphasic reaction of epidermal cell proliferation in guinea pig skin. A decrease of proliferative activity was followed by a synchronized stimulation of DNA synthesizing cells after 2-4 h. These quantitative displacements were accompanied by qualitative changes in the proliferative behaviour of epidermal cells in the S-compartment. (orig.) [de

  14. The occurrence and removal of selected pharmaceutical compounds in a sewage treatment works utilising activated sludge treatment

    Energy Technology Data Exchange (ETDEWEB)

    Jones, O.A.H. [Institute of Environmental Policy, Imperial College, London SW7 2AZ (United Kingdom); Voulvoulis, N. [Institute of Environmental Policy, Imperial College, London SW7 2AZ (United Kingdom); Lester, J.N. [School of Water Sciences, Cranfield University, Cranfield, Bedfordshire MK43 0AL (United Kingdom)]. E-mail: j.lester@cranfield.ac.uk

    2007-02-15

    Pharmaceutical substances have been detected in sewage effluents as well as receiving waters in many parts of the world. In this study, the occurrence and removal of a number of drug compounds were studied within a large sewage treatment plant in the south of England. Samples were processed using solid phase extraction and analysed using gas chromatography-mass spectrometry (GC-MS). The results demonstrate that ibuprofen, paracetamol, salbutamol and mefenamic acid were present in both the influent and effluent of the works while propranolol-HCl was not found above the limit of quantification in any sample. Elimination rates were circa 90% for each compound but several hundred nanograms per litre were still present in the final effluent. - This report looks at the occurrence and removal rates of drugs in English wastewater.

  15. The occurrence and removal of selected pharmaceutical compounds in a sewage treatment works utilising activated sludge treatment

    International Nuclear Information System (INIS)

    Jones, O.A.H.; Voulvoulis, N.; Lester, J.N.

    2007-01-01

    Pharmaceutical substances have been detected in sewage effluents as well as receiving waters in many parts of the world. In this study, the occurrence and removal of a number of drug compounds were studied within a large sewage treatment plant in the south of England. Samples were processed using solid phase extraction and analysed using gas chromatography-mass spectrometry (GC-MS). The results demonstrate that ibuprofen, paracetamol, salbutamol and mefenamic acid were present in both the influent and effluent of the works while propranolol-HCl was not found above the limit of quantification in any sample. Elimination rates were circa 90% for each compound but several hundred nanograms per litre were still present in the final effluent. - This report looks at the occurrence and removal rates of drugs in English wastewater

  16. Initial Selection of Supplemental Treatment Technologies for Hanford's Low-Activity Tank Waste

    International Nuclear Information System (INIS)

    Raymond, Richard E.; Powell, Roger W.; Hamilton, Dennis W.; Kitchen, William A.; Mauss, Billie M.; Brouns, Thomas M.

    2004-01-01

    In 2002, the U.S. Department of Energy (DOE) documented a plan for accelerating cleanup of the Hanford Site, located in southeastern Washington State, by at least 35 years (DOE 2002). A key element of the accelerated cleanup plan was a strategic initiative for acceleration of the tank waste program and completion of ''tank waste treatment by 2028 by increasing the capacity of the planned Waste Treatment Plant (ETP) and using supplemental technologies for waste treatment and immobilization''. The plan identified specific technologies to be evaluated for supplemental treatment of as much as 70% of the low-activity waste (LAW). The objective was to complete required testing and evaluation that would ''...bring an appropriate combination of the above technologies to deployment to supplement LAW treatment and immobilization in the WTP to achieve the completion of tank waste treatment by 2028''. In concert with this acceleration plan, DOE, the U.S. Environmental Protection Agency, and the Washington State Department of Ecology have proposed to accelerate from 2012 to 2005 the Hanford Federal Facility Compliance Agreement (Tri-Party Agreement) milestone (M-62-08) associated with a final decision on treatment of the balance of tank waste that is beyond the capacity of the currently designed WTP

  17. High efficiency GaN-based LEDs using plasma selective treatment of p-GaN surface

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young-Bae; Naoi, Yoshiki; Sakai, Shiro [Department of Electrical and Electronic Engineering, University of Tokushima, 2-1 Minami-josanjima, Tokushima 770-8506 (Japan); Takaki, Ryohei; Sato, Hisao [Nitride Semiconductor Co., Ltd., 115-7 Itayajima, Akinokami, Seto-cho, Naruto, Tokushima 771-0360 (Japan)

    2003-11-01

    We have studied a new method of increasing the extraction efficiency of a GaN-based light-emitting diode (LED) using a plasma surface treatment. In this method, prior to the evaporation of a semitransparent p-metal, the surface of a p-GaN located beneath a p-pad is selectively exposed to a nitrogen plasma in a reactive ion etching (RIE) chamber. The electrical characteristics of the plasma treated p-GaN remarkably changes its resistivity into semi-insulator without any parasitic damage. Since the LEDs with a new method have no light absorption in a p-pad region, a higher optical power can be extracted compared to a conventional LEDs without plasma selective treatment on the p-GaN surface. (copyright 2003 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

  18. Identification of Atuveciclib (BAY 1143572), the First Highly Selective, Clinical PTEFb/CDK9 Inhibitor for the Treatment of Cancer.

    Science.gov (United States)

    Lücking, Ulrich; Scholz, Arne; Lienau, Philip; Siemeister, Gerhard; Kosemund, Dirk; Bohlmann, Rolf; Briem, Hans; Terebesi, Ildiko; Meyer, Kirstin; Prelle, Katja; Denner, Karsten; Bömer, Ulf; Schäfer, Martina; Eis, Knut; Valencia, Ray; Ince, Stuart; von Nussbaum, Franz; Mumberg, Dominik; Ziegelbauer, Karl; Klebl, Bert; Choidas, Axel; Nussbaumer, Peter; Baumann, Matthias; Schultz-Fademrecht, Carsten; Rühter, Gerd; Eickhoff, Jan; Brands, Michael

    2017-11-08

    Selective inhibition of exclusively transcription-regulating PTEFb/CDK9 is a promising new approach in cancer therapy. Starting from lead compound BAY-958, lead optimization efforts strictly focusing on kinase selectivity, physicochemical and DMPK properties finally led to the identification of the orally available clinical candidate atuveciclib (BAY 1143572). Structurally characterized by an unusual benzyl sulfoximine group, BAY 1143572 exhibited the best overall profile in vitro and in vivo, including high efficacy and good tolerability in xenograft models in mice and rats. BAY 1143572 is the first potent and highly selective PTEFb/CDK9 inhibitor to enter clinical trials for the treatment of cancer. © 2017 The Authors. Published by Wiley-VCH Verlag GmbH & Co. KGaA.

  19. A Proposal for a Study on Treatment Selection and Lifestyle Recommendations in Chronic Inflammatory Diseases

    DEFF Research Database (Denmark)

    Andersen, Vibeke; Holmskov, Uffe; Sørensen, Signe Bek

    2017-01-01

    Chronic inflammatory diseases (CIDs), including Crohn's disease and ulcerative colitis (inflammatory bowel diseases, IBD), rheumatoid arthritis, psoriasis, psoriatic arthritis, spondyloarthritides, hidradenitis suppurativa, and immune-mediated uveitis, are treated with biologics targeting the pro......-inflammatory molecule tumour necrosis factor-α (TNF) (i.e., TNF inhibitors). Approximately one-third of the patients do not respond to the treatment. Genetics and lifestyle may affect the treatment results. The aims of this multidisciplinary collaboration are to identify (1) molecular signatures of prognostic value...... to help tailor treatment decisions to an individual likely to initiate TNF inhibitor therapy, followed by (2) lifestyle factors that support achievement of optimised treatment outcome. This report describes the establishment of a cohort that aims to obtain this information. Clinical data including...

  20. Non-steroidal topical immunomodulators provide skin-selective, self-limiting treatment in atopic dermatitis

    NARCIS (Netherlands)

    Bos, Jan D.

    2003-01-01

    Topical corticosteroids are the mainstay of treatment for atopic dermatitis; however, their clinical utility is limited by potential side effects. Recently, the steroid-free topical immunomodulators; tacrolimus ointment and pimecrolimus cream have become available. These agents provide effective

  1. Application of interval 2-tuple linguistic MULTIMOORA method for health-care waste treatment technology evaluation and selection.

    Science.gov (United States)

    Liu, Hu-Chen; You, Jian-Xin; Lu, Chao; Shan, Meng-Meng

    2014-11-01

    The management of health-care waste (HCW) is a major challenge for municipalities, particularly in the cities of developing countries. Selection of the best treatment technology for HCW can be viewed as a complicated multi-criteria decision making (MCDM) problem which requires consideration of a number of alternatives and conflicting evaluation criteria. Additionally, decision makers often use different linguistic term sets to express their assessments because of their different backgrounds and preferences, some of which may be imprecise, uncertain and incomplete. In response, this paper proposes a modified MULTIMOORA method based on interval 2-tuple linguistic variables (named ITL-MULTIMOORA) for evaluating and selecting HCW treatment technologies. In particular, both subjective and objective importance coefficients of criteria are taken into consideration in the developed approach in order to conduct a more effective analysis. Finally, an empirical case study in Shanghai, the most crowded metropolis of China, is presented to demonstrate the proposed method, and results show that the proposed ITL-MULTIMOORA can solve the HCW treatment technology selection problem effectively under uncertain and incomplete information environment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Mechanisms of anorexia-cachexia syndrome and rational for treatment with selective ghrelin receptor agonist.

    Science.gov (United States)

    Esposito, Angela; Criscitiello, Carmen; Gelao, Lucia; Pravettoni, Gabriella; Locatelli, Marzia; Minchella, Ida; Di Leo, Maria; Liuzzi, Rita; Milani, Alessandra; Massaro, Mariangela; Curigliano, Giuseppe

    2015-11-01

    Cancer cachexia is a multi-organ, multifactorial and often irreversible syndrome affecting many patients with cancer. Cancer cachexia is invariably associated with weight loss, mainly from loss of skeletal muscle and body fat, conditioning a reduced quality of life due to asthenia, anorexia, anaemia and fatigue. Treatment options for treating cancer cachexia are limited. The approach is multimodal and may include: treatment of secondary gastrointestinal symptoms, nutritional treatments, drug, and non-drug treatments. Nutritional counselling and physical training may be beneficial in delaying or preventing the development of anorexia-cachexia. However, these interventions are limited in their effect, and no definitive pharmacological treatment is available to address the relevant components of the syndrome. Anamorelin is a first-in-class, orally active ghrelin receptor agonist that binds and stimulates the growth hormone secretagogue receptor centrally, thereby mimicking the appetite-enhancing and anabolic effects of ghrelin. It represents a new class of drug and an additional treatment option for this patient group, whose therapeutic options are currently limited. In this review we examine the mechanisms of anamorelin by which it contrasts catabolic states, its role in regulation of metabolism and energy homeostasis, the data of recent trials in the setting of cancer cachexia and its safety profile. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Impact of treatment and re-treatment with artemether-lumefantrine and artesunate-amodiaquine on selection of Plasmodium falciparum multidrug resistance gene-1 polymorphisms in the Democratic Republic of Congo and Uganda

    DEFF Research Database (Denmark)

    Baraka, Vito; Mavoko, Hypolite Muhindo; Nabasumba, Carolyn

    2018-01-01

    fragment length polymorphism (RFLP) assays. RESULTS: The pre-treatment prevalence of Pfmdr1 N86 and D1246Y varied significantly between the sites, (p>0.001) and (p = 0.013), respectively. There was borderline significant directional selection for Pfmdr1 184F in recurrent malaria infections after treatment...... with AL in Uganda site (p = 0.05). Pfmdr1 NFD haplotype did not significantly change in post-treatment infections after re-treatment with either AL or ASAQ. Comparison between pre-treatment and post-treatment recurrences did not indicate directional selection of Pfmdr1 N86, D1246 alleles in the pre......BACKGROUND: The emergence of resistance against artemisinin combination treatment is a major concern for malaria control. ACTs are recommended as the rescue treatment, however, there is limited evidence as to whether treatment and re-treatment with ACTs select for drug-resistant P. falciparum...

  4. Treatment of a Urinoma and a Post-Traumatic Pseudoaneurysm Using Selective Arterial Embolization

    International Nuclear Information System (INIS)

    Pinto, Isabel T.; Chimeno, Paloma C.

    1998-01-01

    We report a case of severe renal trauma giving rise to a pseudoaneurysm of a renal branch artery and a large urinoma secondary to fracture of a calix disconnected from the rest of the collecting system. Both conditions were successfully treated using selective arterial embolization

  5. The search for NKCC1-selective drugs for the treatment of epilepsy

    DEFF Research Database (Denmark)

    Pedersen, Kasper Lykke; Töllner, Kathrin; Feit, Peter W

    2016-01-01

    on the two major human splice variants of NKCCs, hNKCC1A and hNKCC2A. The derivatives were selected from a series of ~5000 3-amino-5-sulfamoylbenzoic acid derivatives, covering a wide range of structural modifications and diuretic potencies. To our knowledge, such structure-function relationships have...

  6. Aging Prisoners’ Treatment Selection: Does Prospect Theory Enhance Understanding of End-of-Life Medical Decisions?

    Science.gov (United States)

    Phillips, Laura L.; Allen, Rebecca S.; Harris, Grant M.; Presnell, Andrew H.; DeCoster, Jamie; Cavanaugh, Ronald

    2011-01-01

    Purpose: With the rapid growth in the older inmate population and the economic impact of end-of-life treatments within the cash-strapped prison system, consideration should be given to inmate treatment preferences. We examined end-of-life treatment preferences and days of desired life for several health scenarios among male inmates incarcerated primarily for murder. Design and Methods: Inmates over the age of 45 who passed a cognitive screening completed face-to-face interviews (N = 94; mean age = 57.7; SD = 10.68). Results: We found a 3-way interaction indicating that the effect of parole expectation on desire for life-sustaining treatment varied by race/ethnicity and treatment. Minority inmates desired cardiopulmonary resuscitation or feeding tubes only if they believed that they would be paroled. The model predicting desire for palliative care was not significant. Future days of desired life were related to prospective health condition, fear of death, negative affect, and trust in prison health care. Caucasian inmates expressed a desire for more days of life out of prison, whereas minority inmates did not differ in days of desired life either in or out of prison. Minorities wanted more days of life than Caucasians but only if they believed that they would be paroled. Implications: End-of-life care for the burgeoning inmate population is costly, and active life-sustaining treatments may not be desired under certain conditions. Specifically, expectation of parole but not current functional ability interacts with future illness condition in explaining inmates’ desire for active treatment or days of desired life in the future. PMID:21593007

  7. Fabrication and heat treatment of high strength Al-Cu-Mg alloy processed using selective laser melting

    Science.gov (United States)

    Zhang, Hu; Zhu, Haihong; Nie, Xiaojia; Qi, Ting; Hu, Zhiheng; Zeng, Xiaoyan

    2016-04-01

    The proposed paper illustrates the fabrication and heat treatment of high strength Al-Cu-Mg alloy produced by selective laser melting (SLM) process. Al-Cu-Mg alloy is one of the heat treatable aluminum alloys regarded as difficult to fusion weld. SLM is an additive manufacturing technique through which components are built by selectively melting powder layers with a focused laser beam. The process is characterized by short laser-powder interaction times and localized high heat input, which leads to steep thermal gradients, rapid solidification and fast cooling. In this research, 3D Al-Cu-Mg parts with relative high density of 99.8% are produced by SLM from gas atomized powders. Room temperature tensile tests reveal a remarkable mechanical behavior: the samples show yield and tensile strengths of about 276 MPa and 402 MPa, respectively, along with fracture strain of 6%. The effect of solution treatment on microstructure and related tensile properties is examined and the results demonstrate that the mechanical behavior of the SLMed Al-Cu-Mg samples can be greatly enhanced through proper heat treatment. After T4 solution treatment at 540°C, under the effect of precipitation strengthening, the tensile strength and the yield strength increase to 532 MPa and 338 MPa, respectively, and the elongation increases to 13%.

  8. Selection of desmopressin preparations for the treatment of central diabetes insipidus

    Directory of Open Access Journals (Sweden)

    Elena V. Biryukova

    2017-12-01

    Full Text Available Central diabetes insipidus (CDI is a severe pathology of the hypothalamic-pituitary system, based on a deficit of antidiuretic hormone (ADH. The disease is a life threating condition for patients without adequate replacement therapy by various preparations of arginine vasopressin. This review presents the current concepts on etiology, pathogenesis, diagnostic proсedures, and treatment of CDI. The article gives comparative pharmacological characteristics of various desmopressin forms for the treatment of the central form of disease. When choosing a therapy for the treatment of CDI, the article highlights the long-term high efficiency and safety of the original sublingual form of desmopressin (Mininin Melt, which is confirmed by real clinical practice and clinical trials, including the comparison with other forms of desmopressin.

  9. A Database for Reviewing and Selecting Radioactive Waste Treatment Technologies and Vendors

    International Nuclear Information System (INIS)

    P. C. Marushia; W. E. Schwinkendorf

    1999-01-01

    Several attempts have been made in past years to collate and present waste management technologies and solutions to waste generators. These efforts have been manifested as reports, buyers' guides, and databases. While this information is helpful at the time it is assembled, the principal weakness is maintaining the timeliness and accuracy of the information over time. In many cases, updates have to be published or developed as soon as the product is disseminated. The recently developed National Low-Level Waste Management Program's Technologies Database is a vendor-updated Internet based database designed to overcome this problem. The National Low-Level Waste Management Program's Technologies Database contains information about waste types, treatment technologies, and vendor information. Information is presented about waste types, typical treatments, and the vendors who provide those treatment methods. The vendors who provide services update their own contact information, their treatment processes, and the types of wastes for which their treatment process is applicable. This information is queriable by a generator of low-level or mixed low-level radioactive waste who is seeking information on waste treatment methods and the vendors who provide them. Timeliness of the information in the database is assured using time clocks and automated messaging to remind featured vendors to keep their information current. Failure to keep the entries current results in a vendor being warned and then ultimately dropped from the database. This assures that the user is dealing with the most current information available and the vendors who are active in reaching and serving their market

  10. Treatment of Soil Decontamination Solution by the Cs{sup +} Ion Selective Ion Exchange Resin

    Energy Technology Data Exchange (ETDEWEB)

    Won, Hui Jun; Kim, Gye Nam; Jung, Chung Hun; Oh, Won Zin [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    2005-07-01

    Occasionally, radioactively contaminated soils have been excavated and stored at the temporary storage facility. Cesium as a radionuclide is one of the most toxic elements and it has a long half decay life. During the operation of nuclear facility, soils near the facility would be contaminated with radioactive cesium and it will cause the deleterious effect to human body and environment. In this study, Cs{sup +} ion selective ion exchange resin was prepared by changing the functional group of commercial anion exchange resin for a ferrocyanide ion. Ion exchange capability of using the soil decontamination solution was investigated. We also performed the feasibility test of recycling the spent Cs ion selective ion exchange resin.

  11. Effect of antiviral treatment and host susceptibility on positive selection in hepatitis C virus (HCV).

    Science.gov (United States)

    Jiménez-Hernández, Nuria; Sentandreu, Vicente; Castro, José A; Torres-Puente, Manuela; Bracho, Alma; García-Robles, Inmaculada; Ortega, Enrique; Del Olmo, Juan; Carnicer, Fernando; González-Candelas, Fernando; Moya, Andrés

    2008-02-01

    We have conducted a large sequence study of the E1-E2 and NS5A regions of the HCV, subtypes 1a and b, both in patients previously treated with interferon, and untreated patients, who later responded, or not, to a combination therapy based on interferon plus ribavirin. We have examined the role played by the number of positively selected sites on disease progression and its relationship with several variables such as patients' age, sex and their risk of acquiring the disease. We have detected three groups of patients that respond or not to combination therapy: responders of intermediate age, older non-responders and young non-responders, they possess an increasing average number of positively selected sites in the E1-E2 region, respectively. We conclude that the host's genetic factors play an important role in whether the disease is contained or becomes chronic.

  12. Selective extraction of metals from products of mine acidic water treatment

    International Nuclear Information System (INIS)

    Andreeva, N.N.; Romanchuk, S.A.; Voronin, N.N.; Demidov, V.D.; Pasynkova, T.A.; Manuilova, O.A.; Ivanova, N.V.

    1989-01-01

    A study was made on possibility of processing of foam products prepared during flotation purification of mine acidic waters for the purpose of selective extraction of non-ferrous (Co, Ni) and rare earth elements (REE) and their separation from the basic macrocomponent of waters-iron. Optimal conditions of selective metal extraction from foam flotation products are the following: T=333 K, pH=3.0-3.5, ratio of solid and liquid phase - 1:4-1:7, duration of sulfuric acid leaching - 30 min. Rare earth extraction under such conditions equals 87.6-93.0%. The degree of valuable component concentration equals ∼ 10. Rare earths are separated from iron by extraction methods

  13. Socio-economic determinants in selecting childhood diarrhoea treatment options in Sub-Saharan Africa: A multilevel model

    Directory of Open Access Journals (Sweden)

    Lawoko Stephen

    2011-03-01

    Full Text Available Abstract Background Diarrhoea disease which has been attributed to poverty constitutes a major cause of morbidity and mortality in children aged five and below in most low-and-middle income countries. This study sought to examine the contribution of individual and neighbourhood socio-economic characteristics to caregiver's treatment choices for managing childhood diarrhoea at household level in sub-Saharan Africa. Methods Multilevel multinomial logistic regression analysis was applied to Demographic and Health Survey data conducted in 11 countries in sub-Saharan Africa. The unit of analysis were the 12,988 caregivers of children who were reported to have had diarrhoea two weeks prior to the survey period. Results There were variability in selecting treatment options based on several socioeconomic characteristics. Multilevel-multinomial regression analysis indicated that higher level of education of both the caregiver and that of the partner, as well as caregivers occupation were associated with selection of medical centre, pharmacies and home care as compared to no treatment. In contrast, caregiver's partners' occupation was negatively associated with selection medical centre and home care for managing diarrhoea. In addition, a low-level of neighbourhood socio-economic disadvantage was significantly associated with selection of both medical centre and pharmacy stores and medicine vendors. Conclusion In the light of the findings from this study, intervention aimed at improving on care seeking for managing diarrhoea episode and other childhood infectious disease should jointly consider the influence of both individual SEP and the level of economic development of the communities in which caregivers of these children resides.

  14. Selected problems associated with the treatment and care for patients with colostomy – part 2

    OpenAIRE

    Muzyczka, Katarzyna; Kachaniuk, Hanna; Szadowska-Szlachetka, Zdzisława; Charzyńska-Gula, Marianna; Kocka, Katarzyna; Bartoszek, Agnieszka; Celej-Szuster, Jolanta

    2013-01-01

    Generally, ostomy is a purposeful connection of the lumen of the intestine with abdominal integuments by surgery. The study presents practical solutions related to care for the colostomy patient, i.e. an ostomy on the large intestine. The following issues will be discussed: regulating the defecation cycle, risk connected with improper selection of ostomy equipment, instruction on colostomy irrigation with practical advice and irrigation equipment supply. The knowledge of these rules and maste...

  15. Effects of a selective iNOS inhibitor versus norepinephrine in the treatment of septic shock.

    Science.gov (United States)

    Su, Fuhong; Huang, Hongchuan; Akieda, Kazuki; Occhipinti, Giovanna; Donadello, Katia; Piagnerelli, Michael; De Backer, Daniel; Vincent, Jean-Louis

    2010-09-01

    Inhibition of NOS is not beneficial in septic shock; selective inhibition of the inducible form (iNOS) may represent a better option. We compared the effects of the selective iNOS inhibitor BYK191023 with those of norepinephrine (NE) in a sheep model of septic shock. Twenty-four anesthetized, mechanically ventilated ewes received 1.5 g/kg body weight of feces into the abdominal cavity to induce sepsis. Animals were randomized into three groups (each n = 8): NE-only, BYK-only, and NE + BYK. The sublingual microcirculation was evaluated with sidestream dark-field videomicroscopy. MAP was higher in the NE + BYK group than in the other groups, but there were no significant differences in cardiac index or systemic vascular resistance. Mean pulmonary arterial pressure was lower in BYK-treated animals than in the NE-only group. PaO2/FiO2 was higher and lactate concentration lower in the BYK groups than in the NE-only group. Mesenteric blood flow was higher in BYK groups than in the NE-only group. Renal blood flow was higher in the NE + BYK group than in the other groups. Functional capillary density and proportion of perfused vessels were higher in the BYK groups than in the NE-only group 18 h after induction of peritonitis. Survival times were similar in the three groups. In this model of peritonitis, selective iNOS inhibition had more beneficial effects than NE on pulmonary artery pressures, gas exchange, mesenteric blood flow, microcirculation, and lactate concentration. Combination of this selective iNOS inhibitor with NE allowed a higher arterial pressure and renal blood flow to be maintained.

  16. Automated selection of beam orientations and segmented intensity-modulated radiotherapy (IMRT) for treatment of oesophagus tumors

    International Nuclear Information System (INIS)

    Woudstra, Evert; Heijmen, Ben J.M.; Storchi, Pascal R.M.

    2005-01-01

    Background and purpose: For some treatment sites, there is evidence in the literature that five to nine equiangular input beam directions are enough for generating IMRT plans. For oesophagus cancer, there is a report showing that going from four to nine beams may even result in lower quality plans. In this paper, our previously published algorithm for automated beam angle selection (Cycle) has been extended to include segmented IMRT. For oesophagus cancer patients, we have investigated whether automated orientation selection from a large number of equiangular input beam directions (up to thirty-six) for IMRT optimisation can result in improved lung sparing. Materials and methods: CT-data from five oesophagus patients treated recently in our institute were used for this study. For a prescribed mean PTV dose of 55 Gy, Cycle was used in an iterative procedure to minimise the mean lung dose under the following hard constraints: standard deviation for PTV dose inhomogeneity 2% (1,1 Gy), maximum spinal cord dose 45 Gy. Conformal radiotherapy (CFRT) and IMRT plans for a standard four field oesophagus beam configuration were compared with IMRT plans generated by automated selection from nine or thirty-six equiangular input beam orientations. Comparisons were also made with dose distributions generated with our commercial treatment planning system (TPS), and with observations in the literature. Results: Using Cycle, automated orientation selection from nine or thirty-six input beam directions resulted in improved lung sparing compared to the four field set-ups. Compared to selection from nine input orientations, selection from thirty-six directions did always result in lower mean lung doses, sometimes with even fewer non-zero weight beams. On average only seven beams with a non-zero weight were enough for obtaining the lowest mean lung dose, yielding clinically feasible plans even in case of thirty-six input directions for the optimisation process. With our commercial TPS

  17. Treatment seeking and health financing in selected poor urban neighbourhoods in India, Indonesia and Thailand

    DEFF Research Database (Denmark)

    Seeberg, Jens; Pannarunothai, Supasit; Padmawati, Retna S

    2014-01-01

    This article presents a comparative analysis of socio-economic disparities in relation to treatment-seeking strategies and healthcare expenditures in poor neighbourhoods within larger health systems in four cities in India, Indonesia and Thailand. About 200 households in New Delhi, Bhubaneswar...

  18. MUCOLYTIC AGENTS IN PEDIATRICS: RATIONAL SELECTION, THERAPEUTIC EFFECTS AND SPECIFIC ASPECTS OF TREATMENT

    Directory of Open Access Journals (Sweden)

    O. I. Simonova

    2013-01-01

    Full Text Available The article deals with the cough treatment options with mucolytic agents administration at the first several days of acute respiratory tract infections in children. Efficacy of treatment with secretolytic and secretomotoric drugs significantly depends on certain factors. The article contains the criteria of therapeutic efficacy of expectorants. A special attention is given to N-acetylcysteine — a direct acting mucolytic agent, which effect is caused by presence of free sulfhydryl groups, disrupting disulfide bonds between molecules of acid mucopolysaccharides and glycoproteins therefore changing the structure of sputum. Acetylcysteine is active against every type of sputum (mucous, muco-purulent, purulent, that is especially important in treatment of bacterial infections, when it is necessary to quickly decrease sputum thickness, eliminate it from the respiratory tract and prevent dissemination of the infection. High efficacy of acetylcysteine is caused by its unique triple action: mucolytic, antioxidant and antitoxic. Mechanism of action of acetylcysteine is discussed in detail. Timely administered treatment will improve sputum discharge and therefore eliminate one of the main factors of bronchial obstruction and decrease the risk of microbial colonization of the respiratory tract. The article also includes indications, contraindications and dosage regimens of acetylcysteine in children. The most common mistakes and specific aspects of mucolytic drugs in pediatrics are listed in the conclusion. 

  19. Treatment of depression in acute coronary syndromes with selective serotonin reuptake inhibitors

    NARCIS (Netherlands)

    van Melle, Joost P.; de Jonge, Peter; van den Berg, Maarten P.; Pot, Harm J.; van Veldhuisen, Dirk J.

    2006-01-01

    Depression in patients with acute coronary syndromes (ACS) is common and associated with impaired cardiovascular prognosis in terms of cardiac mortality and new cardiovascular events. It remains unclear whether antidepressant treatment may reverse these effects. In this review, the literature is

  20. Assessment and Treatment of Selective Mutism: Recommendations and a Case Study.

    Science.gov (United States)

    Sheridan, Susan M.; And Others

    1995-01-01

    Presents results of stimulus fading procedure used to treat a six-year-old girl with elective mutism. Presents assessment protocol that features procedures that can be used to render a diagnosis and assist in treatment planning. Results suggest stimulus fading of new persons into the school setting was effective in producing speech. (JBJ)

  1. Natalizumab treatment for multiple sclerosis: updated recommendations for patient selection and monitoring

    DEFF Research Database (Denmark)

    Kappos, Ludwig; Bates, David; Edan, Gilles

    2011-01-01

    Natalizumab, a highly specific a4-integrin antagonist, is approved for treatment of patients with active relapsing-remitting multiple sclerosis (RRMS). It is generally recommended for individuals who have not responded to a currently available first-line disease-modifying therapy or who have very...

  2. Effect of litter treatment on growth performance, intestinal development, and selected cecum microbiota in broiler chickens

    Directory of Open Access Journals (Sweden)

    Gilaneh Taherparvar

    2016-05-01

    Full Text Available ABSTRACT The objective of this study was to determine whether the type of bedding materials (sand, wood shavings, and paper and of two chemical amendments (lime and bentonite could interfere with litter quality (moisture, pH, and total bacterial counts, thereby influencing also the growth performance and the development of intestinal traits and cecum microbiota of chickens. Two hundred and seventy male Ross 308 broiler chickens were randomly assigned into nine treatment groups with three replicates per treatment. Broiler productive parameters, relative weight of different intestinal segments, content of cecal total bacterial counts (total aerobic bacteria, Lactobacilli, and coliforms, as well as litter moisture, pH, and total aerobic bacteria and coliforms counts, were assessed. Litter material, per se, did not significantly affect the productivity parameters at the end of the experimental period (42 days with the exception of protein efficiency. A significant trend was found among treatments with regard to weight gain and feed intake, with lower performance in birds on sand beddings. Litter pH was relatively homogenous between bedding types and amendments, but the moisture was significantly lower when sand was used. Litter type did not influence the relative weight of the different intestinal segments; however, the type of amendment affected the relative jejunum weight, which was increased in bentonite-treated litter. The use of lime and bentonite treatments may be helpful to decrease the differences in litter moisture associated with particular bedding materials. The tested amendments do not interfere with the productive performance of birds.

  3. Changes in Perception of Selected Concepts That Accompany Differing Leadership Treatments.

    Science.gov (United States)

    Callan, Laurence Brian

    A study was made of effects of two different leadership treatments on perception of nonverbal stimuli relating to concepts of leaders, authority, and cohesion as measured by changes in the Semantic Differential Scale. Subjects (28 Yaqui Indian and Mexican-American members of the Neighborhood Youth Corps) were randomly assigned to an autocratic…

  4. Treatment of unicameral bone cyst: a comparative study of selected techniques.

    Science.gov (United States)

    Hou, Hsien-Yang; Wu, Karl; Wang, Chen-Ti; Chang, Shun-Min; Lin, Wei-Hsin; Yang, Rong-Sen

    2010-04-01

    There is a variety of treatment modalities for unicameral bone cysts, with variable outcomes reported in the literature. Although good initial outcomes have been reported, the success rate has often changed with longer-term follow-up. We introduce a novel, minimally invasive treatment method and compare its clinical outcomes with those of other methods of treatment of this lesion. From February 1994 to April 2008, forty patients with a unicameral bone cyst were treated with one of four techniques: serial percutaneous steroid and autogenous bone-marrow injection (Group 1, nine patients); open curettage and grafting with a calcium sulfate bone substitute either without instrumentation (Group 2, twelve patients) or with internal instrumentation (Group 3, seven patients); or minimally invasive curettage, ethanol cauterization, disruption of the cystic boundary, insertion of a synthetic calcium sulfate bone-graft substitute, and placement of a cannulated screw to provide drainage (Group 4, twelve patients). Success was defined as radiographic evidence of a healed cyst or of a healed cyst with some defect according to the modified Neer classification, and failure was defined as a persistent or recurrent cyst that needed additional treatment. Patients who sustained a fracture during treatment were also considered to have had a failure. The outcome parameters included the radiographically determined healing rate, the time to solid union, and the total number of procedures needed. The follow-up time ranged from eighteen to eighty-four months. Group-4 patients had the highest radiographically determined healing rate. Healing was seen in eleven of the twelve patients in that group compared with three of the nine in Group 1, eight of the twelve in Group 2, and six of the seven in Group 3. Group-4 patients also had the shortest mean time to union: 3.7 +/- 2.3 months compared with 23.4 +/- 14.9, 12.2 +/- 8.5, and 6.6 +/- 4.3 months in Groups 1, 2, and 3, respectively. This new

  5. A Proposed Model for Selecting Measurement Procedures for the Assessment and Treatment of Problem Behavior.

    Science.gov (United States)

    LeBlanc, Linda A; Raetz, Paige B; Sellers, Tyra P; Carr, James E

    2016-03-01

    Practicing behavior analysts frequently assess and treat problem behavior as part of their ongoing job responsibilities. Effective measurement of problem behavior is critical to success in these activities because some measures of problem behavior provide more accurate and complete information about the behavior than others. However, not every measurement procedure is appropriate for every problem behavior and therapeutic circumstance. We summarize the most commonly used measurement procedures, describe the contexts for which they are most appropriate, and propose a clinical decision-making model for selecting measurement produces given certain features of the behavior and constraints of the therapeutic environment.

  6. Selected problems associated with the treatment and care for patients with colostomy – part 2

    Science.gov (United States)

    Kachaniuk, Hanna; Szadowska-Szlachetka, Zdzisława; Charzyńska-Gula, Marianna; Kocka, Katarzyna; Bartoszek, Agnieszka; Celej-Szuster, Jolanta

    2013-01-01

    Generally, ostomy is a purposeful connection of the lumen of the intestine with abdominal integuments by surgery. The study presents practical solutions related to care for the colostomy patient, i.e. an ostomy on the large intestine. The following issues will be discussed: regulating the defecation cycle, risk connected with improper selection of ostomy equipment, instruction on colostomy irrigation with practical advice and irrigation equipment supply. The knowledge of these rules and mastering them in practice is to provide ostomy patients not only with highest-standard care and help but also to prepare them for dealing with problems independently, i.e. for self-care. PMID:24596509

  7. Selected problems associated with the treatment and care for patients with colostomy - part 2.

    Science.gov (United States)

    Muzyczka, Katarzyna; Kachaniuk, Hanna; Szadowska-Szlachetka, Zdzisława; Charzyńska-Gula, Marianna; Kocka, Katarzyna; Bartoszek, Agnieszka; Celej-Szuster, Jolanta

    2013-01-01

    Generally, ostomy is a purposeful connection of the lumen of the intestine with abdominal integuments by surgery. The study presents practical solutions related to care for the colostomy patient, i.e. an ostomy on the large intestine. The following issues will be discussed: regulating the defecation cycle, risk connected with improper selection of ostomy equipment, instruction on colostomy irrigation with practical advice and irrigation equipment supply. The knowledge of these rules and mastering them in practice is to provide ostomy patients not only with highest-standard care and help but also to prepare them for dealing with problems independently, i.e. for self-care.

  8. SELECTION AND TREATMENT OF STRIPPER GAS WELLS FOR PRODUCTION ENHANCEMENT, MOCANE-LAVERNE FIELD, OKLAHOMA

    Energy Technology Data Exchange (ETDEWEB)

    Scott Reeves; Buckley Walsh

    2003-08-01

    In 1996, Advanced Resources International (ARI) began performing R&D targeted at enhancing production and reserves from natural gas fields. The impetus for the effort was a series of field R&D projects in the early-to-mid 1990's, in eastern coalbed methane and gas shales plays, where well remediation and production enhancement had been successfully demonstrated. As a first step in the R&D effort, an assessment was made of the potential for restimulation to provide meaningful reserve additions to the U.S. gas resource base, and what technologies were needed to do so. That work concluded that: (1) A significant resource base did exist via restimulation (multiples of Tcf). (2) The greatest opportunities existed in non-conventional plays where completion practices were (relatively) complex and technology advancement was rapid. (3) Accurate candidate selection is the greatest single factor that contributes to a successful restimulation program. With these findings, a field-oriented program targeted at tight sand formations was initiated to develop and demonstrate successful candidate recognition technology. In that program, which concluded in 2001, nine wells were restimulated in the Green River, Piceance and East Texas basins, which in total added 2.9 Bcf of reserves at an average cost of $0.26/Mcf. In addition, it was found that in complex and heterogeneous reservoirs (such as tight sand formations), candidate selection procedures should involve a combination of fundamental engineering and advanced pattern recognition approaches, and that simple statistical methods for identifying candidate wells are not effective. In mid-2000, the U.S. Department of Energy (DOE) awarded ARI an R&D contract to determine if the methods employed in that project could also be applied to stripper gas wells. In addition, the ability of those approaches to identify more general production enhancement opportunities (beyond only restimulation), such as via artificial lift and compression

  9. Selection and Evaluation of a Water Treatment Plant for the Thermoelectric Este Havana

    Directory of Open Access Journals (Sweden)

    Dra.C Dania del Toro-Álvarez

    2016-02-01

    Full Text Available Characteristics of different methods used in the world to desalinate sea water are compared, was identified the reverse osmosis method as the most appropriate. Were tendered possible technologies in the international market, given four possible plants. With the characteristics of each of them, carried out a screening process using the qualitative method, which allowed selection Chematek technology as the most appropriate from a technical standpoint. Was determined economic feasibility and the principles indicators of the efficiency of a project: the net actual value and the. The result of the NPV indicates that the project is profitable from the economic point of view.

  10. Reduction of Fecal Streptococcus and Salmonella by selected treatment methods for sludge and organic waste

    DEFF Research Database (Denmark)

    Jepsen, Svend Erik; Krause, Michael; Grüttner, Henrik

    1997-01-01

    The increasing utilization of waste water sludge and source-separated organic household waste in agriculture has brought the quality aspects into focus, among others the hygienic aspects. In this study, the reducting effect on Fecal Streptococcus (FS) and Salmonella of different methods...... for stabilization and methods for further treatment of sludge and organic waste has been investigated. The most common methods for stabilization, i.e. aerobic and anaerobic stabilization, only reduce the indicator organisms by approximately 1 logarithmic decade. Methods for further treatment of sludge and organic......) significant reductions of Salmonella were found, while the die out at low temperatures (below 10°C) was limited. FS was not reduced systematically during storage, and therefore, FS is not usable as indicator organism for the hygienic properties of sludge during storage....

  11. [Selection of access and positioning for operative treatment of pelvic injuries. Decision-making strategies].

    Science.gov (United States)

    Ossendorf, C; Hofmann, A; Rommens, P M

    2013-03-01

    Surgical treatment of pelvic ring injuries requires in-depth knowledge of the topographic anatomy of the pelvic bones, joints and soft tissue structures. A wide range of stabilizing techniques is available including bridging plate osteosynthesis, iliosacral compression screw osteosynthesis and transpubic positioning screws. In this article the different treatment strategies with the respective surgical approaches and patient positioning for pelvic ring fractures and combined lesions of the pelvic ring and acetabulum are presented. Pelvic ring lesions with rotational instability are approached from the anterior and occasionally from both the anterior and posterior based on the amount and localization of the instability. In vertically unstable lesions the most unstable part must be addressed first by reduction and fixation of the dislocated part to the axial skeleton. In combined fractures of the pelvis and acetabulum dorsal stabilization is carried out first.

  12. Ultrastructural changes of cell walls under intense mechanical treatment of selective plant raw material

    International Nuclear Information System (INIS)

    Bychkov, Aleksey L.; Ryabchikova, E.I.; Korolev, K.G.; Lomovsky, O.I.

    2012-01-01

    Structural changes of cell walls under intense mechanical treatment of corn straw and oil-palm fibers were studied by electron and light microscopy. Differences in the character of destruction of plant biomass were revealed, and the dependence of destruction mechanisms on the structure of cell walls and lignin content was demonstrated. We suggest that the high reactivity of the particles of corn straw (about 18% of lignin) after intense mechanical treatment is related to disordering of cell walls and an increase of the surface area, while in the case of oil palm (10% of lignin) the major contribution into an increase in the reactivity is made by an increase of surface area. -- Highlights: ► Structure of cell walls determines the processes of plant materials' destruction. ► Ultrastructure of highly lignified materials strongly disordering by mechanical action. ► Ultrastructure of low-lignified materials is not disordering by mechanical action.

  13. Selected Topical Agents Used in Traditional Chinese Medicine in the Treatment of Minor Injuries- A Review

    OpenAIRE

    Leung, Ping-chung; Ko, Erik Chun-hay; Siu, Wing-sum; Pang, Ellie Suet-yee; Lau, Clara Bik-san

    2016-01-01

    Topical medicinal patches have been popular for the treatment of minor injuries like sprains and avulsions. Other inflammatory conditions like chronic musculo-tendinous pain and or fasciitis are also taken care of by local ointments or rubs. In the oriental communities, medicinal herbs frequently form the major components of the patches. In spite of the lack of scientific evidence of efficacy, the popularity of such traditional application persists for centuries. In this era of evidence-based...

  14. Selected topical agents used in Traditional Chinese Medicine in the treatment of minor injuries- a review

    OpenAIRE

    Ping Chung eLEUNG; Ping Chung eLEUNG; Ping Chung eLEUNG; Sammy Wing-sum eSIU; Chun Hay eKo; Clara Bik-san eLau; Clara Bik-san eLau

    2016-01-01

    Topical medicinal patches have been popular for the treatment of minor injuries like sprains and avulsions. Other inflammatory conditions like chronic musculo-tendinous pain and or fasciitis are also taken care of by local ointments or rubs. In the oriental communities, medicinal herbs frequently form the major components of the patches.In spite of the lack of scientific evidence of efficacy, the popularity of such traditional application persists for centuries.In this era of evidence-based c...

  15. Selected problems associated with the treatment and care for patients with colostomy ? part 1

    OpenAIRE

    Muzyczka, Katarzyna; Kachaniuk, Hanna; Szadowska-Szlachetka, Zdzis?awa; Charzy?ska-Gula, Marianna; Kocka, Katarzyna; Bartoszek, Agnieszka; Celej-Szuster, Jolanta

    2013-01-01

    The study presents a short historical background and practical application of intestinal ostomy as a treatment method of various intestinal disorders and injuries. Ostomy is a purposeful connection of the lumen of the intestine with abdominal integuments by surgery. After the surgical formation of the intestinal fistula, the patient must adjust to the new situation, gain basic knowledge and learn procedures of ostomy care. Thus, professional medical assistance is extremely important. The stud...

  16. Short-term postharvest carbon dioxide treatments induce selective molecular and metabolic changes in grape berries.

    Science.gov (United States)

    Becatti, Elisa; Chkaiban, Lamia; Tonutti, Pietro; Forcato, Claudio; Bonghi, Claudio; Ranieri, Anna Maria

    2010-07-14

    Detached wine grapes ( Vitis vinifera cv. 'Trebbiano', white skinned) were treated for 3 days with 30 kPa of CO(2) and then transferred to air for an additional 9 days to partially dehydrate (about 20% weight loss). At the end of the CO(2) treatment on withering berries, total polyphenols and flavonoids were maintained in the skin, but to a more limited extent in the pulp. An induction of the proanthocyanidin synthesis appeared to be one of the responses to the treatment because both (+)-catechin and (-)-epicatechin concentrations increased in the skin. The skin and pulp of the grape berries showed different molecular responses to a high CO(2) treatment. As revealed by microarray hybridizations, 217 and 75 genes appeared differentially expressed in the skin and pulp of treated samples, respectively. Functional categorization and gene enrichment analyses pointed out that epicarp cells undergo more pronounced changes in transcript profiling at the end of the incubation period. Highly represented categories in both tissues were related to protein, stress, transcript, RNA, and hormone (ethylene, ABA) metabolism. Fermentation, CHO metabolism, and redox regulation functional categories were represented only in the skin.

  17. Patient considerations and drug selection in the treatment of idiopathic pulmonary fibrosis

    Directory of Open Access Journals (Sweden)

    Trawinska MA

    2016-04-01

    Full Text Available Maria A Trawinska,1 Ruwani D Rupesinghe,1 Simon P Hart1,2 1Hull and East Yorkshire Hospitals NHS Trust, 2Hull York Medical School, Academic Respiratory Medicine, Castle Hill Hospital, Cottingham, East Yorkshire, UK Abstract: Idiopathic pulmonary fibrosis (IPF is a progressive interstitial lung disease of unknown cause. Approximately 5,000 people are diagnosed with IPF in the UK every year. People with IPF suffer significant morbidity and, without any curative treatment at present, survival rates remain poor with a median survival of 3 years. While treatment remains largely supportive, many drug therapies have been trialed in IPF over the years. Pirfenidone and nintedanib are newly licensed treatments for IPF and the first drugs to have shown convincing evidence of slowing disease progression. In addition to evaluating clinical evidence, we also discuss elements affecting drug choice from the viewpoint of patients and health care professionals. We discuss pharmacological and nonpharmacological aspects of providing best supportive care for patients with IPF. However, few good quality studies exist focusing on controlling symptoms specifically in patients with IPF, and recommendations are often extrapolated from evidence in other chronic diseases. In covering these topics, we hope to provide readers with a comprehensive review of the available evidence pertaining to all aspects of care for patients suffering with IPF. Keywords: interstitial lung disease, high-resolution computed tomography, forced vital capacity, usual interstitial pneumonia, clinical trials, decision making, idiopathic pulmonary fibrosis

  18. Single photon emission computed tomography before and after treatment of anxiety using a selective serotonin reuptake inhibitor

    International Nuclear Information System (INIS)

    Warwick, J.M.; Heerden, B.B. van; Stein, D.J.; Niehaus, D.J.H.; Seedat, S.; Linden, G. van der; Harvey, B.A.

    2002-01-01

    Background: The selective serotonin reuptake inhibitors (SSRIs) are currently recommended as first line medications for a number of different anxiety disorders, including obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and social anxiety disorder (social phobia) (SAD). This raises the question of what effects these agents have on the functional neuroanatomy of anxiety disorders. Methods: Single photon emission computed tomography (SPECT) brain scanning was undertaken in patients with OCD, PTSD, and SAD before and after treatment with citalopram, the most selective of the SSRIs. Statistical parametric mapping (SPM) was used to compare scans (pre- vs post-medication, and responders vs nonresponders) in the combined group of subjects. Results: Citalopram pharmacotherapy resulted in significant deactivation within anterior and superior cingulate and left hippocampus. Deactivation within the anterior cingulate, left paracingular cortex, and right inferior frontal cortex was more marked in treatment responders. Baseline activation did not, however, predict response to pharmacotherapy. Conclusion: Although each of the anxiety disorders may be mediated by different neurocircuits, there are some overlaps in the functional neuroanatomy of their response to SSRI treatment. The current data is consistent with previous work demonstrating the importance of limbic circuits in this spectrum of disorders. These play a crucial role in cognitive-affective processing, and are innervated by serotonergic neurons

  19. High Performance Enhancement-Mode AlGaN/GaN MIS-HEMT with Selective Fluorine Treatment

    Directory of Open Access Journals (Sweden)

    Chao Yang

    2015-01-01

    Full Text Available A novel enhancement-mode (E-mode Metal-Insulator-Semiconductor- (MIS- HEMT with selective fluorine ion (F− treatment is proposed and its mechanism is investigated. The HEMT features the Selective F− treatment both in the AlGaN channel region and in the thick passivation layer between the gate and drain (SFCP-MIS-HEMT. First, the F− in the passivation layer not only extends the depletion region and thus enhances the average electric field (E-field between the gate and drain by the assisted depletion effect but also reduces the E-field peak at the gate end, leading to a higher breakdown voltage (BV. Second, in the AlGaN channel region, the F− region realizes the E-mode and the region without F− maintains a high drain current (ID. Third, MIS structure suppresses the gate leakage current, increasing the gate swing voltage and the BV. Compared with a MIS-HEMT with F− treatment in whole channel (FC-MIS-HEMT, SFCP-MIS-HEMT increases the BV by 46% and the saturation drain current (ID,sat by 28%.

  20. Selective Laser Melting Produced Ti-6Al-4V: Post-Process Heat Treatments to Achieve Superior Tensile Properties

    Directory of Open Access Journals (Sweden)

    Gerrit M. Ter Haar

    2018-01-01

    Full Text Available Current post-process heat treatments applied to selective laser melting produced Ti-6Al-4V do not achieve the same microstructure and therefore superior tensile behaviour of thermomechanical processed wrought Ti-6Al-4V. Due to the growing demand for selective laser melting produced parts in industry, research and development towards improved mechanical properties is ongoing. This study is aimed at developing post-process annealing strategies to improve tensile behaviour of selective laser melting produced Ti-6Al-4V parts. Optical and electron microscopy was used to study α grain morphology as a function of annealing temperature, hold time and cooling rate. Quasi-static uniaxial tensile tests were used to measure tensile behaviour of different annealed parts. It was found that elongated α’/α grains can be fragmented into equiaxial grains through applying a high temperature annealing strategy. It is shown that bi-modal microstructures achieve a superior tensile ductility to current heat treated selective laser melting produced Ti-6Al-4V samples.

  1. Selective Laser Melting Produced Ti-6Al-4V: Post-Process Heat Treatments to Achieve Superior Tensile Properties.

    Science.gov (United States)

    Ter Haar, Gerrit M; Becker, Thorsten H

    2018-01-17

    Current post-process heat treatments applied to selective laser melting produced Ti-6Al-4V do not achieve the same microstructure and therefore superior tensile behaviour of thermomechanical processed wrought Ti-6Al-4V. Due to the growing demand for selective laser melting produced parts in industry, research and development towards improved mechanical properties is ongoing. This study is aimed at developing post-process annealing strategies to improve tensile behaviour of selective laser melting produced Ti-6Al-4V parts. Optical and electron microscopy was used to study α grain morphology as a function of annealing temperature, hold time and cooling rate. Quasi-static uniaxial tensile tests were used to measure tensile behaviour of different annealed parts. It was found that elongated α'/α grains can be fragmented into equiaxial grains through applying a high temperature annealing strategy. It is shown that bi-modal microstructures achieve a superior tensile ductility to current heat treated selective laser melting produced Ti-6Al-4V samples.

  2. Economic considerations and patients' preferences affect treatment selection for patients with rheumatoid arthritis: a discrete choice experiment among European rheumatologists.

    Science.gov (United States)

    Hifinger, M; Hiligsmann, M; Ramiro, S; Watson, V; Severens, J L; Fautrel, B; Uhlig, T; van Vollenhoven, R; Jacques, P; Detert, J; Canas da Silva, J; Scirè, C A; Berghea, F; Carmona, L; Péntek, M; Keat, A; Boonen, A

    2017-01-01

    To compare the value that rheumatologists across Europe attach to patients' preferences and economic aspects when choosing treatments for patients with rheumatoid arthritis. In a discrete choice experiment, European rheumatologists chose between two hypothetical drug treatments for a patient with moderate disease activity. Treatments differed in five attributes: efficacy (improvement and achieved state on disease activity), safety (probability of serious adverse events), patient's preference (level of agreement), medication costs and cost-effectiveness (incremental cost-effectiveness ratio (ICER)). A Bayesian efficient design defined 14 choice sets, and a random parameter logit model was used to estimate relative preferences for rheumatologists across countries. Cluster analyses and latent class models were applied to understand preference patterns across countries and among individual rheumatologists. Responses of 559 rheumatologists from 12 European countries were included in the analysis (49% females, mean age 48 years). In all countries, efficacy dominated treatment decisions followed by economic considerations and patients' preferences. Across countries, rheumatologists avoided selecting a treatment that patients disliked. Latent class models revealed four respondent profiles: one traded off all attributes except safety, and the remaining three classes disregarded ICER. Among individual rheumatologists, 57% disregarded ICER and these were more likely from Italy, Romania, Portugal or France, whereas 43% disregarded uncommon/rare side effects and were more likely from Belgium, Germany, Hungary, the Netherlands, Norway, Spain, Sweden or UK. Overall, European rheumatologists are willing to trade between treatment efficacy, patients' treatment preferences and economic considerations. However, the degree of trade-off differs between countries and among individuals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted

  3. TO SELECTION OF TECHNOLOGICAL SCHEME OF SOFTENING HEAT TREATMENT FOR HIGH CHROMIUM CAST IRON

    Directory of Open Access Journals (Sweden)

    V. G. Efremenko

    2014-03-01

    Full Text Available Purpose. High chromium cast irons with austenitic matrix have low machinability. The aim of work is search of new energy-saving modes of preliminary softening heat treatment enhancing the machinability of castings by forming an optimum microstructure. Methodology. Metallographic analysis, hardness testing and machinability testing are applied. Findings. It was found out that high temperature annealing with continuous cooling yields to martensite-austenite matrix in cast iron 270Х15Г2Н1MPhT, which abruptly affects the machinability of cast iron. Significant improvement of machinability is achieved by forming of structure "ferrite + granular carbides" and by decline of hardness to 37-39 HRC in the case of two-stage isothermal annealing in the subcritical temperature range or by the use of quenching and tempering (two-step or cyclic. Originality. It was found that the formation of the optimal structure of the matrix and achievement of desired hardness level needed for improving machinability of high chromium cast iron containing 3 % austenite-forming elements, can be obtained: 1 due to pearlite original austenite followed by spherodization eutectoid carbides, and 2 by getting predominantly martensite structure followed by the decay of martensite and carbides coagulation at high-temperature tempering. Practical value. The new energy-saving schemes of softening heat treatment to ensure the growth of machinability of high chromium cast iron, alloyed by higher quantity of austenite forming elements, are proposed.

  4. Clinical use of cabozantinib in the treatment of advanced kidney cancer: efficacy, safety, and patient selection

    Directory of Open Access Journals (Sweden)

    Yu SS

    2016-09-01

    Full Text Available Steven S Yu, David I Quinn, Tanya B Dorff Division of Oncology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA Abstract: Clear cell (cc renal cell carcinoma (RCC is the most common type of cancer found in the kidney accounting for ~90% of all kidney cancers. In 2012, there were ~337,000 new cases of RCC diagnosed worldwide with an estimated 143,000 deaths, with the highest incidence and mortality in Western countries. Despite improvements in cancer control achieved with VEGF- and mTOR-targeted therapy for RCC, progression remains virtually universal and additional therapies are needed. The pivotal results of the METEOR trial led to cabozantinib’s designation as a breakthrough drug by the US Food and Drug Administration and its approval for treatment of advanced RCC in 2016. Subsequent data from the CABOSUN trial, where caboxantinib is compared with sunitinib, will provide information on the relative activity of cabozantinib as first-line therapy for ccRCC. We review the development of cabozantinib in advanced RCC and its role in the treatment landscape for advanced RCC. Keywords: cabozantinib, renal cell carcinoma, kidney cancer, clear cell carcinoma, tyrosine kinase inhibitor

  5. Heat treatment of Ti6Al4V produced by Selective Laser Melting: Microstructure and mechanical properties

    International Nuclear Information System (INIS)

    Vrancken, Bey; Thijs, Lore; Kruth, Jean-Pierre; Van Humbeeck, Jan

    2012-01-01

    Highlights: ► Responses of SLM-produced and wrought Ti6Al4V to heat treatment are compared. ► Temperature is found to be the controlling parameter for treatments in the α + β range. ► Ductility could be improved by a factor of 85%, from 7.27% to 13.59%. ► An optimal heat treatment for SLM produced Ti6Al4V is proposed. - Abstract: The present work shows that optimization of mechanical properties via heat treatment of parts produced by Selective Laser Melting (SLM) is profoundly different compared to conventionally processed Ti6Al4V. In order to obtain optimal mechanical properties, specific treatments are necessary due to the specific microstructure resulting from the SLM process. SLM is an additive manufacturing technique through which components are built by selectively melting powder layers with a focused laser beam. The process is characterized by short laser-powder interaction times and localized high heat input, which leads to steep thermal gradients, rapid solidification and fast cooling. In this research, the effect of several heat treatments on the microstructure and mechanical properties of Ti6Al4V processed by SLM is studied. A comparison is made with the effect of these treatments on hot forged and subsequently mill annealed Ti6Al4V with an original equiaxed microstructure. For SLM produced parts, the original martensite α′ phase is converted to a lamellar mixture of α and β for heat treating temperatures below the β-transus (995 °C), but features of the original microstructure are maintained. Treated above the β-transus, extensive grain growth occurs and large β grains are formed which transform to lamellar α + β upon cooling. Post treating at 850 °C for 2 h, followed by furnace cooling increased the ductility of SLM parts to 12.84 ± 1.36%, compared to 7.36 ± 1.32% for as-built parts.

  6. Camera selection for real-time in vivo radiation treatment verification systems using Cherenkov imaging.

    Science.gov (United States)

    Andreozzi, Jacqueline M; Zhang, Rongxiao; Glaser, Adam K; Jarvis, Lesley A; Pogue, Brian W; Gladstone, David J

    2015-02-01

    To identify achievable camera performance and hardware needs in a clinical Cherenkov imaging system for real-time, in vivo monitoring of the surface beam profile on patients, as novel visual information, documentation, and possible treatment verification for clinicians. Complementary metal-oxide-semiconductor (CMOS), charge-coupled device (CCD), intensified charge-coupled device (ICCD), and electron multiplying-intensified charge coupled device (EM-ICCD) cameras were investigated to determine Cherenkov imaging performance in a clinical radiotherapy setting, with one emphasis on the maximum supportable frame rate. Where possible, the image intensifier was synchronized using a pulse signal from the Linac in order to image with room lighting conditions comparable to patient treatment scenarios. A solid water phantom irradiated with a 6 MV photon beam was imaged by the cameras to evaluate the maximum frame rate for adequate Cherenkov detection. Adequate detection was defined as an average electron count in the background-subtracted Cherenkov image region of interest in excess of 0.5% (327 counts) of the 16-bit maximum electron count value. Additionally, an ICCD and an EM-ICCD were each used clinically to image two patients undergoing whole-breast radiotherapy to compare clinical advantages and limitations of each system. Intensifier-coupled cameras were required for imaging Cherenkov emission on the phantom surface with ambient room lighting; standalone CMOS and CCD cameras were not viable. The EM-ICCD was able to collect images from a single Linac pulse delivering less than 0.05 cGy of dose at 30 frames/s (fps) and pixel resolution of 512 × 512, compared to an ICCD which was limited to 4.7 fps at 1024 × 1024 resolution. An intensifier with higher quantum efficiency at the entrance photocathode in the red wavelengths [30% quantum efficiency (QE) vs previous 19%] promises at least 8.6 fps at a resolution of 1024 × 1024 and lower monetary cost than the EM-ICCD. The

  7. Characterization of Machine Variability and Progressive Heat Treatment in Selective Laser Melting of Inconel 718

    Science.gov (United States)

    Prater, Tracie; Tilson, Will; Jones, Zack

    2015-01-01

    The absence of an economy of scale in spaceflight hardware makes additive manufacturing an immensely attractive option for propulsion components. As additive manufacturing techniques are increasingly adopted by government and industry to produce propulsion hardware in human-rated systems, significant development efforts are needed to establish these methods as reliable alternatives to conventional subtractive manufacturing. One of the critical challenges facing powder bed fusion techniques in this application is variability between machines used to perform builds. Even with implementation of robust process controls, it is possible for two machines operating at identical parameters with equivalent base materials to produce specimens with slightly different material properties. The machine variability study presented here evaluates 60 specimens of identical geometry built using the same parameters. 30 samples were produced on machine 1 (M1) and the other 30 samples were built on machine 2 (M2). Each of the 30-sample sets were further subdivided into three subsets (with 10 specimens in each subset) to assess the effect of progressive heat treatment on machine variability. The three categories for post-processing were: stress relief, stress relief followed by hot isostatic press (HIP), and stress relief followed by HIP followed by heat treatment per AMS 5664. Each specimen (a round, smooth tensile) was mechanically tested per ASTM E8. Two formal statistical techniques, hypothesis testing for equivalency of means and one-way analysis of variance (ANOVA), were applied to characterize the impact of machine variability and heat treatment on six material properties: tensile stress, yield stress, modulus of elasticity, fracture elongation, and reduction of area. This work represents the type of development effort that is critical as NASA, academia, and the industrial base work collaboratively to establish a path to certification for additively manufactured parts. For future

  8. Evaluation of a developmental hierarchy for breast cancer cells to assess risk-based patient selection for targeted treatment.

    Science.gov (United States)

    Bliss, Sarah A; Paul, Sunirmal; Pobiarzyn, Piotr W; Ayer, Seda; Sinha, Garima; Pant, Saumya; Hilton, Holly; Sharma, Neha; Cunha, Maria F; Engelberth, Daniel J; Greco, Steven J; Bryan, Margarette; Kucia, Magdalena J; Kakar, Sham S; Ratajczak, Mariusz Z; Rameshwar, Pranela

    2018-01-10

    This study proposes that a novel developmental hierarchy of breast cancer (BC) cells (BCCs) could predict treatment response and outcome. The continued challenge to treat BC requires stratification of BCCs into distinct subsets. This would provide insights on how BCCs evade treatment and adapt dormancy for decades. We selected three subsets, based on the relative expression of octamer-binding transcription factor 4 A (Oct4A) and then analysed each with Affymetrix gene chip. Oct4A is a stem cell gene and would separate subsets based on maturation. Data analyses and gene validation identified three membrane proteins, TMEM98, GPR64 and FAT4. BCCs from cell lines and blood from BC patients were analysed for these three membrane proteins by flow cytometry, along with known markers of cancer stem cells (CSCs), CD44, CD24 and Oct4, aldehyde dehydrogenase 1 (ALDH1) activity and telomere length. A novel working hierarchy of BCCs was established with the most immature subset as CSCs. This group was further subdivided into long- and short-term CSCs. Analyses of 20 post-treatment blood indicated that circulating CSCs and early BC progenitors may be associated with recurrence or early death. These results suggest that the novel hierarchy may predict treatment response and prognosis.

  9. Effect of Heat Treatment on the Properties of CoCrMo Alloy Manufactured by Selective Laser Melting

    Science.gov (United States)

    Guoqing, Zhang; Junxin, Li; Xiaoyu, Zhou; Jin, Li; Anmin, Wang

    2018-05-01

    To obtain medical implants with better mechanical properties, it is necessary to conduct studies on the heat treatment process of the selective laser melting (SLM) manufacturing parts. The differential scanning calorimetry method was used to study the heat treatment process of the phase transition of SLM CoCrMo alloy parts. The tensile properties were tested with a tensile test machine, the quantity of carbide precipitated after heat treatment was measured by energy-dispersive x-ray spectroscopy, and the tensile fracture morphology of the parts was investigated using SEM. The obtained results were: Mechanical properties in terms of elongation and tensile strength of CoCrMo alloy manufactured by SLM that had been heat-treated at 1200 °C for 2 h followed by cooling with water were not only higher than the national standard but also higher than the experimental results of the same batch of castings. The mechanism of fracture of parts manufactured by SLM without heat treatment was brittle fracture, whereas parts which had been heat-treated at 1200 °C for 2 h combined with water cooling and at 1200 °C for 1 h with furnace cooling suffered ductile fracture. This study provides the basis for defining the applications for which CoCrMo alloys manufactured by SLM are suitable within the field of medical implants.

  10. Comparison of paroxetine and dapoxetine, a novel selective serotonin reuptake inhibitor in the treatment of premature ejaculation

    Directory of Open Access Journals (Sweden)

    Abdulmuttalip Simsek

    2014-10-01

    Full Text Available Dapoxetine hydrochloride is a selective serotonin reuptake inhibitor and the first drug approved for the on-demand treatment of premature ejaculation (PE. Our objective in this study was to characterize the efficacy of on-demand dapoxetine (30 and 60 mg and daily paroxetine (20 mg usage in treating PE. We conducted a 1 month study involving a total of 150 patients. Patients were divided into three groups of 50. Group 1 were treated with on-demand dapoxetine (30 mg, Group 2 with on-demand dapoxetine (60 mg and Group 3 with daily paroxetine (20 mg. Our outcome measurement was increased from baseline intravaginal ejaculatory latency time (IELT after treatment. The IELT increased from baseline to posttreatment by 117%, 117% and 170% in the paroxetine group (P 0.05, while the 60 mg dapoxetine group had a larger posttreatment IELT increase compared with the 30 mg dapoxetine (P < 0.05 and paroxetine (P < 0.01 groups. Dapoxetine (60 mg 1-3 h before planned intercourse is a very effective treatment modality for PE. However, an on-demand dose of 30 mg dapoxetine is no more effective than the currently prescribed paroxetine treatment.

  11. Cellular correlates of enhanced anxiety caused by acute treatment with the selective serotonin reuptake inhibitor fluoxetine in rats

    Directory of Open Access Journals (Sweden)

    Shilpa eRavinder

    2011-12-01

    Full Text Available Selective serotonin reuptake inhibitors (SSRIs are used extensively in the treatment of depression and anxiety disorders. The therapeutic benefits of SSRIs typically require several weeks of continuous treatment. Intriguingly, according to clinical reports, symptoms of anxiety may actually increase during the early stages of treatment although more prolonged treatment alleviates affective symptoms. Consistent with earlier studies that have used animal models to capture this paradoxical effect of SSRIs, we find that rats exhibit enhanced anxiety-like behavior on the elevated plus-maze one hour after a single injection of the SSRI fluoxetine. Next we investigated the potential neural substrates underlying the acute anxiogenic effects by analyzing the morphological and physiological impact of acute fluoxetine treatment on principal neurons of the basolateral amygdala (BLA, a brain area that plays a pivotal role in fear and anxiety. Although earlier studies have shown that behavioral or genetic perturbations that are anxiogenic for rodents also increase dendritic spine-density in the BLA, we find that a single injection of fluoxetine does not cause spinogenesis on proximal apical dendritic segments on BLA principal neurons an hour later. However, at the same time point when a single dose of fluoxetine caused enhanced anxiety, it also enhanced action potential firing in BLA neurons in ex vivo slices. Consistent with this finding, in vitro bath application of fluoxetine caused higher spiking frequency and this increase in excitability was correlated with an increase in the input resistance of these neurons. Our results suggest that enhanced excitability of amygdala neurons may contribute to the increase in anxiety-like behavior observed following acute fluoxetine treatment.

  12. HEART FAILURE AND DIABETES MELLITUS: SELECTED ISSUES OF ETIOLOGY AND PATHOGENESIS, PROGNOSIS AND TREATMENT

    Directory of Open Access Journals (Sweden)

    B. U. Mardanov

    2016-01-01

    Full Text Available This review is devoted to the study of issues relating to the features of associated course of chronic heart failure (CHF and diabetes mellitus (DM. The modern views on the epidemiology, pathogenesis of DM and CHF are systematized. The pathogenesis of diabetic cardiomyopathy is described in details. The results of the well-known studies that show the negative impact of DM on CHF prognosis are presented. The principles of CHF pathogenetic therapy in patients with DM including the role of neurohormonal modulators are analyzed. The results of multicenter studies in patients with CHF and concomitant DM type 2 show that almost all first-line drugs recommended for CHF treatment are effective in patients with DM.

  13. Treatment of Rigid Hammer-Toe Deformity: Permanent Versus Removable Implant Selection.

    Science.gov (United States)

    Doty, Jesse F; Fogleman, Jason A

    2018-03-01

    Hammer-toe deformities that fail nonoperative treatment can be successfully addressed with proximal interphalangeal joint resection arthroplasty or fusion. The goal of surgery is to eliminate the deformity and rigidly fix the toe in a well-aligned position. Hammer-toe correction procedures can be performed with temporary Kirschner wire (K-wire) fixation for 3 to 6 weeks with high success rates. Pain relief with successful hammer-toe correction approaches 90%; patient satisfaction rates approximate 84%. Although complication rates are rare in most series, there remains a concern regarding exposed temporary K-wire fixation, which has led to the development of multiple permanent internal fixation options. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Effect of selected method of meat technological treatment on selenium content in mutton

    International Nuclear Information System (INIS)

    Nowosad, R.; Simoni, J.; Tyszkiewicz, B.

    1977-01-01

    Measurements were carried out of a radioisotope 75 Se content in mutton meat exposed to some technological treatments (soaking in tap water for 24 hours, pickling for 14 days, boiling for 1 hour) and to 24-hour soaking in 1% solutions of some organic acids used for alimentary purposes (lactic acid, citric acid, and acetic acid). The lowest decrease of radioactivity (11,69%) was noted following 24-hour soaking in tap water while the highest loss of selenium (41,69%) was measured after 24-hour soaking of granulated meat in 1% solution of lactic acid. The application of the same technological measures to the homogeneous force-meat resulted in higher loss of radioselenium in samples under test. The lowest decrease of radioactivity (19.19%) was observed following 1-hour boiling while the highest loss of selenium (60.81%) was measured after 24-hour soaking in 1% soaking in 1% solution of lactic acid. (author)

  15. Radiation Segmentectomy versus Selective Chemoembolization in the Treatment of Early-Stage Hepatocellular Carcinoma.

    Science.gov (United States)

    Biederman, Derek M; Titano, Joseph J; Korff, Ricki A; Fischman, Aaron M; Patel, Rahul S; Nowakowski, Francis S; Lookstein, Robert A; Kim, Edward

    2018-01-01

    To compare outcomes of radiation segmentectomy (RS) and segmental transarterial chemoembolization in treatment of unresectable, solitary hepatocellular carcinoma (HCC) ≤ 3 cm. From January 2012 to January 2016, 534 and 877 patients were treated with radioembolization and transarterial chemoembolization, respectively. A cohort of 112 (radiation segmentectomy [RS], 55; chemoembolization, 57) locoregional therapy-naïve patients with solitary HCC ≤ 3 cm without vascular invasion or metastasis was retrospectively identified and stratified according to baseline patient demographics, tumor characteristics, and laboratory values. Propensity score matching (PSM) was conducted using a nearest neighbor algorithm (1:1). Outcomes analyzed included laboratory toxicities, imaging response, time to secondary therapy (TTST), and overall survival. Before PSM, complete response (CR) rate was 81.2% for RS and 49.1% for chemoembolization (odds ratio 2.2; 95% confidence interval [CI], 1.4-3.3; P < .001). Median (95% CI) TTST after initial therapy was 246 days (135-250 d) in chemoembolization group and 700 days (308-812 d) in RS group (hazard ratio 0.71; 95% CI, 0.55-0.92; P = .009). Overall survival before PSM was not significantly different between the 2 groups (P = .29). Overall CR rate after PSM was 92.1% in RS group and 52.6% in chemoembolization group (P = .005). Median (95% CI) TTST after matching was 161 days (76-350 d) in chemoembolization group and 812 days (363-812 d) in RS group (P = .001). Overall survival after matching was not significantly different between the 2 groups (P = .71). RS results in improved imaging response and longer TTST compared with transarterial chemoembolization in treatment of early-stage HCC. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

  16. Selection of micronutrients used along with DMSA in the treatment of moderately lead intoxicated mice

    Energy Technology Data Exchange (ETDEWEB)

    Liao, Yingjun [China Medical University, Department of Physiology, School of Basic Medicine, Shenyang, Liaoning (China); Yu, Fei; Zhi, Xuping; An, Li; Yang, Jun [China Medical University, Department of Nutrition and Food Hygiene, School of Public Health, Shenyang, Liaoning (China); Jin, Yaping; Lu, Chunwei; Li, Gexin [China Medical University, Department of Environmental and Occupational Health, School of Public Health, Shenyang, Liaoning (China)

    2008-01-15

    The objective of this study was to explore the optimum combination of micronutrients used with 2,3-dimercaptosuccinic acid (DMSA) in the treatment of moderately lead-intoxicated mice. Experiment was carried out based on the orthogonal design L{sub 8}(2{sup 7}) setting six factors with two different levels of each, and eight groups of mice were needed. Mice were exposed to lead by drinking water contaminated with 0.1% lead acetate for four consecutive weeks, and then supplemented by gavage with different combinations of micronutrients with and without DMSA as designed in the orthogonal table. Lead levels in blood, liver, kidney, brain and bone and activities of blood {delta}-aminolevulinic acid dehydratase (ALAD) were analyzed after cessation of supplementation. The results suggested that DMSA was the only factor which could decrease significantly lead levels in blood, liver, kidney and bone; calcium and ascorbic acid were the notable factors decreasing lead levels in blood, liver, kidney, bone and brain; zinc and calcium were the notable factors reversing the lead-inhibited activities of blood ALAD; taurine was the notable factor decreasing lead levels in kidney and brain; and thiamine was the notable factor decreasing lead levels in brain. The lowest lead level in blood, liver, kidney and bone was shown in the mice supplemented with combination of calcium and ascorbic acid along with DMSA. In conclusion, the optimum combination of micronutrients used with DMSA suggested in present study was calcium and ascorbic acid, which seemed to potentiate the chelating efficacy of DMSA in the treatment of moderately lead intoxicated mice. (orig.)

  17. Systematic selection of off-gas treatment at the Savannah River Site

    International Nuclear Information System (INIS)

    McKillip, S.T.; Rehder, T.E.

    1992-01-01

    At the Savannah River Site (SRS), from 1958--1985, effluent waste from the reactor fuel and target rod fabrication area (M-Area) was discharged to a settling basin. In 1981, monitoring wells detected groundwater contamination, specifically trichloroethylene and tetrachloroethylene, in the immediate vicinity of the basin. Under the auspices of Resource Conservation and Recovery Act (RCRA) the M-Area contamination must be addressed by a corrective action program until the volatile organic compound (VOC) concentrations reach Drinking Water Standards. This was initiated in 1985 with startup of a full-scale pump-and-treat air stripper system. Recently, remediation efforts have focused on vacuum extraction to treat vadose zone contamination not addressed by the original recovery wells, and additional pump-and-treat systems to achieve hydraulic control of the plume. Regulatory requirements allowed for discharge of VOCs to the atmosphere when the original remediation system was installed; however, 1990 amendments to the Clean Air Act will eventually require treatment of VOC contaminated air prior to discharge. This has ramifications to systems currently being design, as well as the existing systems. In response to the 1990 Clean Air Act amendments, SRS initiated a study to assess commercially available off-gas treatment technologies. These included carbon adsorption, thermal incineration, catalytic oxidation, absorption, condensation, and UV/peroxide destruction, and xenon flashlamp. Criteria used to evaluate the technologies were the thirty (30) year life cycle cost, permitting considerations, and manpower requirements. The study concluded that catalytic oxidation provided the most desirable combination of these elements

  18. Recurrent balanoposthitis of mixed etiology: relation to oral sex and selection of an efficient treatment method

    Directory of Open Access Journals (Sweden)

    O. B. Demianova

    2014-01-01

    Full Text Available Goal. To study the dependence between the recurrent balanoposthitis of mixed etiology and oral sex. To assess the efficacy, tolerance and cosmetic acceptability of a combination topical drug on the basis of a cream for the treatment of balanoposthitis of Candida and bacterial etiology. Materials and methods. An open-label single-arm non-randomized study involved 48 men aged 22-43 suffering from recurrent balanoposthitis of mixed etiology and their long-term sex partners. All of the subjects underwent the following tests: complete blood count, clinical urine test, blood biochemistry (AST, ALT, total bilirubin, thymol test and blood glucose, MRSA, blood tests for anti-hepatitis B and C virus antibodies, HIV-1/-2 antibody screening test, microscopy of urethral, vaginal and cervical canal materials, PCR for Chlamydia trachomatis, Trichomonas vaginalis, N. gonorrhoeae, Mycoplasma genitalium, Ureaplasma spp, bacterial swab tests based on urethral materials (in men, vaginal materials (in women and throat (in subjects of both sexes, and microscopy of tongue scrapings. 46 male patients used the Candiderm cream (Glenmark Pharmaceuticals Ltd. for 10-14 days. Physicians assessed the efficacy based on the symptom intensity and patient’s opinion. Results. In people who practiced unprotected oral sex, a high contamination of mucous coats in the oral cavity, throat and genitals with yeast fungi and opportunistic bacteria was revealed. C. Аlbicans was often found in diagnostically significant amounts in couples. The authors substantiate the possibility of a contact-type transmission of opportunistic bacteria during oral sex resulting in balanoposthitis of mixed Candida and bacterial etiology or exacerbation of their condition after sexual contacts in men practicing unprotected oral sex. Evident clinical efficacy and safety of the combination as well as good tolerance and convenience of application of the combination topical drug comprising beclomethasone

  19. Reduction of intraspecific aggression in adult rats by neonatal treatment with a selective serotonin reuptake inhibitor

    Directory of Open Access Journals (Sweden)

    Manhães de Castro R.

    2001-01-01

    Full Text Available Most studies suggest that serotonin exerts an inhibitory control on the aggression process. According to experimental evidence, this amine also influences growth and development of the nervous tissue including serotoninergic neurons. Thus, the possibility exists that increased serotonin availability in young animals facilitates a long-lasting effect on aggressive responses. The present study aimed to investigate the aggressive behavior of adult rats (90-120 days treated from the 1st to the 19th postnatal day with citalopram (CIT, a selective serotonin reuptake inhibitor (20 mg/kg, sc, every 3 days. Aggressive behavior was induced by placing a pair of rats (matched by weight in a box (20 x 20 x 20 cm, and submitting them to a 20-min session of electric footshocks (five 1.6-mA - 2-s current pulses, separated by a 4-min intershock interval. When compared to the control group (rats treated for the same period with equivalent volumes of saline solution, the CIT group presented a 41.4% reduction in the duration of aggressive response. The results indicate that the repeated administration of CIT early in life reduces the aggressive behavior in adulthood and suggest that the increased brain serotoninergic activity could play a role in this effect.

  20. Selection of the treatment method for the West Valley alkaline supernatant

    International Nuclear Information System (INIS)

    Carl, D.E.; Leonard, I.M.

    1987-02-01

    As part of the West Valley Demonstration Project (WVDP), th PUREX supernatant stored in Tank 8d-2 will be partially decontaminated before encapsulation in the final glass form. This report discusses selection of a method for removing Cs-137, the major radioactive ion in the supernatant. Methods considered were: (1) electrodialysis; (2) hyperfiltration; (3) precipitation with ferrocyanide, NaTPB, or PTA; (4) organic ion exchange using Cs-100 or a biologically derived media; (5) chelation using DeVoe/Holbein compostions; and (6) inorganic ion exchange using Durasil, natural zeolities, IE-95 or IE-96 media. Several different methods of using inorganic ion exchange media were also reviewed including (1) four columns with elution, and (2) two, three, or four columns without elution. After the careful evaluation of experimental data with all process constraints taken into account, the inorganic exchange media IE-96 (Linde Ionsiv IE-96 synthetic zeolite) was chosen for WVDP cesium recovery. IE-96 was chosen for the following reasons: high sorption rate, a decontamination factor (DF) over 1000, excellent exchange capacity at WVDP conditions, compatability with the glass formers used for borosilicate glass in direct melter feed applications, and a history of successful application in radio chemical seperation for waste streams. 34 refs., 29 figs., 27 tabs

  1. Awareness regarding risk factors, symptoms and treatment facilities for cancer in selected states of India.

    Science.gov (United States)

    Raj, Sherin; Piang, Lam Khan; Nair, K S; Tiwari, V K; Kaur, H; Singh, Bacchu

    2012-01-01

    To study the level of awareness and knowledge about cancers and associated risk factors among households in selected states of India. In the study 3070 households were interviewed from six states viz, West Bengal, Kerala, Madhya Pradesh, Rajasthan and Mizoram. Knowledge of cancers other than those related to tobacco was very low (prostate 8%, colon 11% ) among the communities, with a poor awareness of warning signs and symptoms. The knowledge varied from state to state. It is found that the major source of information related to cancers was television (38%) followed by friends and relatives (36%). Only about 15 % of respondents had knowledge about cancer awareness camps organized in their districts but they did not have knowledge about the organizers of the camp. Findings suggested a strong need for strengthening of DCCP. It is important to create awareness among community through educational programs on cancer prevention, preventable cancer risk factors, benefits of early diagnosis, and availability of screening facilities. Integration of District Cancer Control activities with NRHM could be the most cost-effective strategy to prevent cancers and rural population.

  2. Investigation of thermal treatment on selective separation of post consumer plastics prior to froth flotation

    International Nuclear Information System (INIS)

    Guney, Ali; Poyraz, M. Ibrahim; Kangal, Olgac; Burat, Firat

    2013-01-01

    Highlights: • Both PET and PVC have nearly the same densities. • The best pH value will be 4 for optimizing pH values. • Malic acid gave the best results for selective separation of PET and PVC. - Abstract: Plastics have become the widely used materials because of their advantages, such as cheapness, endurance, lightness, and hygiene. However, they cause waste and soil pollution and they do not easily decompose. Many promising technologies are being investigated for separating mixed thermoplastics, but they are still uneconomical and unreliable. Depending on their surface characteristics, these plastics can be separated from each other by flotation method which is useful mineral processing technique with its low cost and simplicity. The main objective of this study is to investigate the flotation characteristics of PET and PVC and determine the effect of plasticizer reagents on efficient plastic separation. For that purpose, various parameters such as pH, plasticizer concentration, plasticizer type, conditioning temperature and thermal conditioning were investigated. As a result, PET particles were floated with 95.1% purity and 65.3% efficiency while PVC particles were obtained with 98.1% purity and 65.3% efficiency

  3. Selective Electroless Nickel Plating on PMMA using Chloroform Pre-Treatment

    Science.gov (United States)

    Sipes, Nicholas

    In the past 5 years, we have discovered that chloroform promotes the adhesion of thin gold films to Poly(methyl methacrylate) surfaces. Based on this new understanding of the interaction of chloroform with PMMA and metal atoms, we were curious to see if chloroform would promote the adhesion of Nickel to PMMA deposited by electroless plating. My goal was to selectively electroless plate Nickel onto PMMA. Chloroform was spun-cast onto 1 inch square PMMA substrates. I used electrical tape to shield one half of the PMMA from the chloroform during spin-casting; this allowed for a direct comparison of treated vs. untreated. The samples were then put through hydrochloric acid and a series of baths provided by Transene Company Inc. to electrolessly deposit nickel on the sample. After many trials, there was a clear distinction in the adhesion strength of the Nickel to the plain PMMA surface vs. the chloroform pre-treated surface. Showing that it is possible to create chloroform sites via spin-casting for electroless nickel plating on PMMA opens up the challenge to better understand the chemistry taking place and to perfect the electroless plating process.

  4. Investigation of thermal treatment on selective separation of post consumer plastics prior to froth flotation

    Energy Technology Data Exchange (ETDEWEB)

    Guney, Ali; Poyraz, M. Ibrahim; Kangal, Olgac, E-mail: kangal@itu.edu.tr; Burat, Firat

    2013-09-15

    Highlights: • Both PET and PVC have nearly the same densities. • The best pH value will be 4 for optimizing pH values. • Malic acid gave the best results for selective separation of PET and PVC. - Abstract: Plastics have become the widely used materials because of their advantages, such as cheapness, endurance, lightness, and hygiene. However, they cause waste and soil pollution and they do not easily decompose. Many promising technologies are being investigated for separating mixed thermoplastics, but they are still uneconomical and unreliable. Depending on their surface characteristics, these plastics can be separated from each other by flotation method which is useful mineral processing technique with its low cost and simplicity. The main objective of this study is to investigate the flotation characteristics of PET and PVC and determine the effect of plasticizer reagents on efficient plastic separation. For that purpose, various parameters such as pH, plasticizer concentration, plasticizer type, conditioning temperature and thermal conditioning were investigated. As a result, PET particles were floated with 95.1% purity and 65.3% efficiency while PVC particles were obtained with 98.1% purity and 65.3% efficiency.

  5. Impact of prestroke selective serotonin reuptake inhibitor treatment on stroke severity and mortality.

    Science.gov (United States)

    Mortensen, Janne Kaergaard; Larsson, Heidi; Johnsen, Søren Paaske; Andersen, Grethe

    2014-07-01

    Selective serotonin reuptake inhibitors (SSRIs) have been associated with an increased risk of bleeding but also a possible neuroprotective effect in stroke. We aimed to examine the implications of prestroke SSRI use in hemorrhagic and ischemic stroke. We conducted a registry-based propensity score-matched follow-up study among first-ever patients with hemorrhage and ischemic stroke in Denmark (2003-2012). Multiple conditional logistic regression was used to compute adjusted odds ratios of severe stroke and death within 30 days. Among 1252 hemorrhagic strokes (626 prestroke SSRI users and 626 propensity score-matched nonusers), prestroke SSRI use was associated with an increased risk of the strokes being severe (adjusted propensity score-matched odds ratios, 1.41; confidence interval, 1.08-1.84) and an increased risk of death within 30 days (adjusted propensity score-matched odds ratios, 1.60; confidence interval, 1.17-2.18). Among 8956 patients with ischemic stroke (4478 prestroke SSRI users and 4478 propensity score-matched nonusers), prestroke SSRI use was not associated with the risk of severe stroke or death within 30 days. Prestroke SSRI use is associated with increased stroke severity and mortality in patients with hemorrhagic stroke. Although prestroke depression in itself may increase stroke severity and mortality, this was not found in SSRI users with ischemic stroke. © 2014 American Heart Association, Inc.

  6. CT during selective arteriography: anatomical assessment of unruptured intracranial aneurysms before endovascular treatment

    International Nuclear Information System (INIS)

    Nomura, M.; Kida, S.; Uchiyama, N.; Yamashima, T.; Yamashita, J.; Sanada, J.; Yoshikawa, J.; Matsui, O.

    2001-01-01

    Our aim was to investigate the usefulness of helical CT during selective angiography (CT arteriography) in pretreatment assessment of unruptured intracranial aneurysms. We studied 47 unruptured aneurysms in 34 prospectively recruited patients for whom endovascular embolisation was initially considered. As pretreatment assessment, we performed rotational digital subtraction angiography (DSA) followed by CT arteriography. The findings on axial source images (axial images) and reconstructed three-dimensional CT angiography (3D-CTA) of CT arteriography were compared to those of rotational DSA, with particular attention to the neck of the aneurysm and arterial branches adjacent to it. Information provided by CT arteriography was more useful than that of rotational DSA as regards the neck in 25 (53 %) of 47 cases and as regards branches in 18 (49 %) of 37 aneurysms. On axial images, small arteries such as the anterior choroidal artery were seen in some cases. CT arteriography can provide valuable additional information about unruptured aneurysms, which cannot be obtained by rotational DSA alone. This technique is useful for obtaining anatomical information about aneurysm anatomy and for deciding the therapeutic strategy. (orig.)

  7. Microstructure of selective laser melted CM247LC nickel-based superalloy and its evolution through heat treatment

    Energy Technology Data Exchange (ETDEWEB)

    Divya, V.D., E-mail: dv272@cam.ac.uk [Department of Materials Science and Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge CB3 0FS (United Kingdom); Muñoz-Moreno, R.; Messé, O.M.D.M.; Barnard, J.S. [Department of Materials Science and Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge CB3 0FS (United Kingdom); Baker, S.; Illston, T. [Materials Solutions, Unit 8, Great Western Business Park, McKenzie Way, Worcester WR4 9GN (United Kingdom); Stone, H.J. [Department of Materials Science and Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge CB3 0FS (United Kingdom)

    2016-04-15

    The selective laser melting of high temperature alloys is of great interest to the aerospace industry as it offers the prospect of producing more complex geometries than can be achieved with other manufacturing methods. In this study, the microstructure of the nickel-based superalloy, CM247LC, has been characterised following selective laser melting and after a post deposition heat treatment below the γ′ solvus temperature. In the as-deposited state, scanning electron microscopy with electron backscatter diffraction revealed a fine, cellular microstructure with preferential alignment of 〈001〉 along the build direction. A high dislocation density was seen at the periphery of the cells, indicating substantial localised deformation of the material. Fine primary MC carbides were also observed in the inter-cellular regions. High-resolution transmission electron microscopy identified the occurrence of very fine γ′ precipitates, approximately 5 nm in diameter, dispersed within the gamma phase. After heat treatment, the elongated cell colonies were observed to partially coalesce, accompanied by a decrease in dislocation density, producing columnar grains along the build direction. Cuboidal γ′ precipitates approximately 500 nm in diameter were observed to form in the recrystallised grains, accompanied by larger γ′ precipitates on the grain boundaries.

  8. Microstructure of selective laser melted CM247LC nickel-based superalloy and its evolution through heat treatment

    International Nuclear Information System (INIS)

    Divya, V.D.; Muñoz-Moreno, R.; Messé, O.M.D.M.; Barnard, J.S.; Baker, S.; Illston, T.; Stone, H.J.

    2016-01-01

    The selective laser melting of high temperature alloys is of great interest to the aerospace industry as it offers the prospect of producing more complex geometries than can be achieved with other manufacturing methods. In this study, the microstructure of the nickel-based superalloy, CM247LC, has been characterised following selective laser melting and after a post deposition heat treatment below the γ′ solvus temperature. In the as-deposited state, scanning electron microscopy with electron backscatter diffraction revealed a fine, cellular microstructure with preferential alignment of 〈001〉 along the build direction. A high dislocation density was seen at the periphery of the cells, indicating substantial localised deformation of the material. Fine primary MC carbides were also observed in the inter-cellular regions. High-resolution transmission electron microscopy identified the occurrence of very fine γ′ precipitates, approximately 5 nm in diameter, dispersed within the gamma phase. After heat treatment, the elongated cell colonies were observed to partially coalesce, accompanied by a decrease in dislocation density, producing columnar grains along the build direction. Cuboidal γ′ precipitates approximately 500 nm in diameter were observed to form in the recrystallised grains, accompanied by larger γ′ precipitates on the grain boundaries.

  9. Treatment of selected syringomyelias with syringo-pleural shunt: the experience with a consecutive 26 cases.

    Science.gov (United States)

    Fan, Tao; Zhao, XinGang; Zhao, HaiJun; Liang, Cong; Wang, YinQian; Gai, QiFei; Zhang, Fangyi

    2015-10-01

    It is well established that syringomyelia can cause neurological symptoms and deficit by accumulation of fluid within syrinx cavities that lead to internal compression within the spinal cord. When other intervention treating the underlying etiology failed to yield any improvement, the next option would be a procedure to divert the fluid from the syrinx cavity, such as syringo-subarachnoid, syringo-peritoneal or syringo-pleural shunting. The indications and long term efficacy of these direct shunting procedures are still questionable and controversial. To investigate the clinical indication, outcome and complication of syringe-pleural shunt (SPS) as an alternative for treatment of syringomyelia. We reported a retrospective 26 cases of syringomyelia were found to have indication for a diversion procedure. SPS was offered. Patients' symptoms, mJOA score, and MRI were collected to evaluate the change of the syringomyelia and prognosis of the patients. 2-tailed wilcoxon signed-rank test was used to perform the statistical analysis of the mJOA scores. All 26 patients underwent SPS. The clinical information was collected, the mean follow-up time was 27.4 months, 2-tailed wilcoxon signed-rank test was used to perform the statistical analysis of the mJOA scores. The key surgical technique, outcome and complications of SPS were reported in detail. No mortality and severe complications occurred. Postoperative MRIs revealed near-complete resolution of syrinx in 14 patients, significant shrinkage of syrinx in 10 patients, no obvious reduction or unchanged in remaining 2 patient. Postoperatively, the symptoms improved in 24 cases (92.3%). Statistical analysis of the mJOA scores showed a statistical significance (P<0.001) between the preoperative group and the 2-week postoperative group. No further significant improvement between 2 weeks to the final follow up at 27 months. Collapse or remarkable shrinkage of the syrinx by SPS could ameliorate or at least stabilize the symptoms

  10. Selective treatment of carious dentin using a mid-infrared tunable pulsed laser at 6 μm wavelength range

    Science.gov (United States)

    Saiki, Masayuki; Ishii, Katsunori; Yoshikawa, Kazushi; Yasuo, Kenzo; Yamamoto, Kazuyo; Awazu, Kunio

    2011-03-01

    Optical technologies have good potential for caries detection, prevention, excavation, and the realization of minimal intervention dentistry. This study aimed to develop a selective excavation technique of carious tissue using the specific absorption in 6 μm wavelength range. Bovine dentin demineralized with lactic acid solution was used as a carious dentin model. A mid-infrared tunable pulsed laser was obtained by difference-frequency generation technique. The wavelength was tuned to 6.02 and 6.42 μm which correspond to absorption bands called amide I and amide II, respectively. The laser delivers 5 ns pulse width at a repetition rate of 10 Hz. The morphological change after irradiation was observed with a scanning electron microscope, and the measurement of ablation depth was performed with a confocal laser microscope. At λ = 6.02 μm and the average power density of 15 W/cm2, demineralized dentin was removed selectively with less-invasive effect on sound dentin. The wavelength of 6.42 μm also showed the possibility of selective removal. High ablation efficiency and low thermal side effect were observed using the nanosecond pulsed laser with λ = 6.02 μm. In the near future, development of compact laser device will open the minimal invasive laser treatment to the dental clinic.

  11. Selection of Treatment for Large Non-Traumatic Subdural Hematoma Developed during Hemodialysis

    Directory of Open Access Journals (Sweden)

    Chul Hee Lee

    2014-05-01

    Full Text Available A 49-year-old man with end-stage renal disease was admitted to the hospital with a severe headache and vomiting. On neurological examination the Glasgow Coma Scale (GCS score was 15 and his brain CT showed acute subdural hematoma over the right cerebral convexity with approximately 11-mm thickness and 9-mm midline shift. We chose a conservative treatment of scheduled neurological examination, anticonvulsant medication, serial brain CT scanning, and scheduled hemodialysis (three times per week without using heparin. Ten days after admission, he complained of severe headache and a brain CT showed an increased amount of hemorrhage and midline shift. Emergency burr hole trephination and removal of the hematoma were performed, after which symptoms improved. However, nine days after the operation a sudden onset of general tonic-clonic seizure developed and a brain CT demonstrated an increased amount of subdural hematoma. Under the impression of persistent increased intracranial pressure, the patient was transferred to the intensive care unit (ICU in order to control intracranial pressure. Management at the ICU consisted of regular intravenous mannitol infusion assisted with continuous renal replacement therapy. He stayed in the ICU for four days. Twenty days after the operation he was discharged without specific neurological deficits.

  12. Selective removal of dissolved toxic metals from groundwater by ultrafiltration in combination with chemical treatment

    International Nuclear Information System (INIS)

    Buckley, L.P.; Le, V.T.; McConeghy, G.J.; Martin, J.F.

    1989-09-01

    An alternative in-place process for the removal of toxic heavy metals based on aqueous solution chemistry and treatment is being evaluated under the auspices of the Emerging Technologies Program funded through the USEPA's Superfund Innovative Technology Evaluation Program. The technique involves the contacting of aqueous solutions containing the heavy metal contaminants with low concentrations of polyelectrolytes, and then removing the polyelectrolytes from solution with ultrafiltration membranes. The first phase of the program is considered complete. Success has been achieved for the separation of soluble, heavy metal ions: cadmium, lead, and mercury even in the presence of an organic compound, toluene. Removal was successful at alkaline conditions, using any combination of membrane material or polyelectrolyte. Arsenic was removed, but not effectively, using the current polyelectrolytes, simply because arsenic is present as an anionic species rather than as a cationic species. Optimization of the process variables is nearing completion and pilot and field testing will take place in the second year of the program to verify the process under realistic conditions and to establish process economics

  13. Experimental data developed to support the selection of a treatment process for West Valley alkaline supernatant

    Energy Technology Data Exchange (ETDEWEB)

    Bray, L.A.; Holton, L.K.; Myers, T.R.; Richardson, G.M.; Wise, B.M.

    1984-01-01

    At the request of West Valley Nuclear Services Co., Inc., the Pacific Northwest Laboratory (PNL) has studied alternative treatment processes for the alkaline PUREX waste presently being stored in Tank 8D2 at West Valley, New York. Five tasks were completed during FY 1983: (1) simulation and characterization of the alkaline supernatant and sludge from the tank. The radiochemical and chemical distributions between the aqueous and solid phase were determined, and the efficiency of washing sludge with water to remove ions such as Na/sup +/ and SO/sub 4//sup 2 -/ was investigated; (2) evaluation of a sodium tetraphenylboron (Na-TPB) precipitation process to recover cesium (Cs) and a sodium titanate (Na-TiA) sorption process to recover strontium (Sr) and plutonium (Pu) from the West Valley Alkaline supernatant. These processes were previously developed and tested at the US Department of Energy's Savannah River Plant; (3) evaluation of an organic cation-exchange resin (Duolite CS-100) to recover Cs and Pu from the alkaline supernatant followed by an organic macroreticular cation exchange resin (Amberlite IRC-718) to recover Sr; (4) evaluation of an inorganic ion exchanger (Linde Ionsiv IE-95) to recover Cs, Sr, and Pu from the alkaline supernatant; and (5) evaluation of Dowex-1,X8 organic anion exchange resin to recover technetium (Tc) from alkaline supernatant. The findings of these tasks are reported. 21 references, 36 figures, 34 tables.

  14. Treatment seeking and health financing in selected poor urban neighbourhoods in India, Indonesia and Thailand.

    Science.gov (United States)

    Seeberg, Jens; Pannarunothai, Supasit; Padmawati, Retna Siwi; Trisnantoro, Laksono; Barua, Nupur; Pandav, Chandrakant S

    2014-02-01

    This article presents a comparative analysis of socio-economic disparities in relation to treatment-seeking strategies and healthcare expenditures in poor neighbourhoods within larger health systems in four cities in India, Indonesia and Thailand. About 200 households in New Delhi, Bhubaneswar, Jogjakarta and Phitsanulok were repeatedly interviewed over 12 months to relate health problems with health seeking and health financing at household level. Quantitative data were complemented with ethnographic studies involving the same neighbourhoods and a number of private practitioners at each site. Within each site, the higher and lower income groups among the poor were compared. The lower income group was more likely than the higher income group to seek care from less qualified health providers and incur catastrophic health spending. The study recommends linking quality control mechanisms with universal health coverage (UHC) policies; to monitor the impact of UHC among the poorest; intervention research to reach the poorest with UHC; and inclusion of private providers without formal medical qualification in basic healthcare. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. In vitro and cellular activities of the selected fruits residues for skin aging treatment.

    Science.gov (United States)

    Lourith, Nattaya; Kanlayavattanakul, Mayuree; Chaikul, Puxvadee; Chansriniyom, Chaisak; Bunwatcharaphansakun, Pichaporn

    2017-05-01

    Peel extracts of litchi and rambutan, and that of tamarind seed coat were investigated in relation to their utility in skin-aging treatments. Standardized extracts of tamarind were significantly (p rambutan (IC50 = 29.57 ± 0.30 and 39.49 ± 0.52 μg/ml, respectively) and the quercetin standard (IC50 = 31.88 ± 0.15 μg/ml). Litchi extract proved significantly (p rambutan (31.08 ± 0.38% and 53.99 ± 6.18%). All extracts were safe to human skin fibroblasts and inhibit MMP-2, with litchi extract showing significantly (p < 0.01) enhanced inhibition over the standard, vitamin C (23.75 ± 2.74% and 10.42 ± 5.91% at 0.05 mg/ml, respectively). Extracts suppress melanin production in B16F10 melanoma cells through inhibition of tyrosinase and TRP-2, with litchi extract being the most potent, even more so than kojic acid (standard). These results highlight the potential for adding value to agro-industrial waste, as the basis for the sustainable production of innovative, safe, anti-aging cosmetic products.

  16. [Factors determining the selection of treatment options of complementary and alternative medicine].

    Science.gov (United States)

    Zörgő, Szilvia; Purebl, György; Zana, Ágnes

    2016-04-10

    Complementary and alternative medicine have undoubtedly been gaining ground on the healthcare market, thus the vital question arises why patients choose these treatments, oftentimes at the cost of discontinuing the Western medical therapy. The aim of the authors was to investigate and scrutinize factors leading to the utilization of various alternative medical services. The basis of this qualitative research was medical anthropological fieldwork conducted at a clinic of Traditional Chinese Medicine including participant observation (355 hours), unstructured interviews with patients (n = 93) and in-depth interviews (n = 14). Patients of alternative medical systems often do not receive a diagnosis, explanation or cure for their illness from Western medicine, or they do not agree with what they are offered. In other instances, patients choose alternative medicine because it exhibits a philosophical congruence with their already existing explanatory model, that is, previous concepts of world, man or illness. A particular therapy is always part of a cultural system and it is embedded in a specific psycho-social context, hence choice of therapy must be interpreted in accordance with this perspective.

  17. Non-selective vs. selective beta-blocker treatment and the risk of thrombo-embolic events in patients with heart failure

    NARCIS (Netherlands)

    de Peuter, Olav R.; Souverein, Patrick C.; Klungel, Olaf H.; Büller, Harry R.; de Boer, Anthonius; Kamphuisen, Pieter W.

    2011-01-01

    Aims Heart failure (HF) is associated with a prothrombotic state, resulting in an increased risk for thrombo-embolic events. Studies suggest a reduced prothrombotic state when non-selective beta-blockers relative to selective beta-blockers are given. We studied the influence of non-selective

  18. Treatment selection of early stage non-small cell lung cancer: the role of the patient in clinical decision making.

    Science.gov (United States)

    Mokhles, S; Nuyttens, J J M E; de Mol, M; Aerts, J G J V; Maat, A P W M; Birim, Ö; Bogers, A J J C; Takkenberg, J J M

    2018-01-15

    The objective of this study is to investigate the role and experience of early stage non-small cell lung cancer (NSCLC) patient in decision making process concerning treatment selection in the current clinical practice. Stage I-II NSCLC patients (surgery 55 patients, SBRT 29 patients, median age 68) were included in this prospective study and completed a questionnaire that explored: (1) perceived patient knowledge of the advantages and disadvantages of the treatment options, (2) experience with current clinical decision making, and (3) the information that the patient reported to have received from their treating physician. This was assessed by multiple-choice, 1-5 Likert Scale, and open questions. The Decisional Conflict Scale was used to assess the decisional conflict. Health related quality of life (HRQoL) was measured with SF-36 questionnaire. In 19% of patients, there was self-reported perceived lack of knowledge about the advantages and disadvantages of the treatment options. Seventy-four percent of patients felt that they were sufficiently involved in decision-making by their physician, and 81% found it important to be involved in decision making. Forty percent experienced decisional conflict, and one-in-five patients to such an extent that it made them feel unsure about the decision. Subscores with regard to feeling uninformed and on uncertainty, contributed the most to decisional conflict, as 36% felt uninformed and 17% of patients were not satisfied with their decision. HRQoL was not influenced by patient experience with decision-making or patient preferences for shared decision making. Dutch early-stage NSCLC patients find it important to be involved in treatment decision making. Yet a substantial proportion experiences decisional conflict and feels uninformed. Better patient information and/or involvement in treatment-decision-making is needed in order to improve patient knowledge and hopefully reduce decisional conflict.

  19. Invasive bladder cancer: treatment strategies using transurethral surgery, chemotherapy and radiation therapy with selection for bladder conservation

    International Nuclear Information System (INIS)

    Shipley, William U.; Zietman, Anthony L.; Kaufman, Donald S.; Althausen, Alex F.; Heney, Niall M.

    1997-01-01

    Purpose: Combined modality therapy has become the standard oncologic approach to achieve organ preservation in many malignancies. Methods and Materials: Although radical cystectomy has been considered as standard treatment for invasive bladder carcinoma in the United States, good results have been recently reported from several centers using multimodality treatment, particularly in patients with clinical T2 and T3a disease who do not have a ureter obstructed by tumor. Results: The components of the combined treatment are usually transurethral resection of the bladder tumor (TURBT) followed by concurrent chemotherapy and radiation therapy. Following an induction course of therapy a histologic response is evaluated by cystoscopy and rebiopsy. Clinical 'complete responders' (tumor site rebiopsy negative and urine cytology with no tumor cells present) continue with a consolidation course of concurrent chemotherapy and radiation. Those patients not achieving a clinical complete response are recommended to have an immediate cystectomy. Individually the local monotherapies of radiation, TURBT, or multidrug chemotherapy each achieve a local control rate of the primary tumor of from 20 to 40%. When these are combined, clinical complete response rates of from 65 to 80% can be achieved. Seventy-five to 85% of the clinical complete responders will remain with bladders free of recurrence of an invasive tumor. Conclusions: Bladder conservation trials using combined modality treatment approaches with selection for organ conservation by response of the tumor to initial treatment report overall 5-year survival rates of approximately 50%, and a 40-45% 5-year survival rate with the bladder intact. These modern multimodality bladder conservation approaches offer survival rates similar to radical cystectomy for patients of similar clinical stage and age. Bladder-conserving therapy should be offered to patients with invasive bladder carcinoma as a realistic alternative to radical

  20. Desmoid-type fibromatosis: a front-line conservative approach to select patients for surgical treatment.

    Science.gov (United States)

    Fiore, Marco; Rimareix, Françoise; Mariani, Luigi; Domont, Julien; Collini, Paola; Le Péchoux, Cecile; Casali, Paolo G; Le Cesne, Axel; Gronchi, Alessandro; Bonvalot, Sylvie

    2009-09-01

    Surgery is still the standard treatment for desmoid-type fibromatosis (DF). Recently, the Institut Gustave Roussy (IGR), Villejuif, France, reported a series of patients treated with a front-line conservative approach (no surgery and no radiotherapy). The disease remained stable in more than half of patients. This study was designed to evaluate this approach on the natural history of the disease in a larger series of patients. A total of 142 patients presenting to the IGR or Istituto Nazionale Tumori (INT), Milan, Italy, were initially treated using a front-line deliberately conservative policy. Their progression-free survival (PFS) was observed and a multivariate analysis was performed for major clinical variables. Seventy-four patients presented with primary tumor, 68 with recurrence. Eighty-three patients received a "wait & see" policy (W&S), whereas 59 were initially offered medical therapy (MT), mainly hormonal therapy and chemotherapy. A family history of sporadic colorectal cancer was present in 8% of patients. The 5-year PFS was 49.9% for the W&S group and 58.6% for the medically treated patients (P = 0.3196). Similar results emerged for primary and recurrent DF. Multivariate analysis identified no clinical variables as independent predictors of PFS. In the event of progression, all patients were subsequently managed safely. A conservative policy could be a safe approach to primary and recurrent DF, which could avoid unnecessary morbidity from surgery and/or radiation therapy. Half of patients had medium-term stable disease after W&S or MT. A multidisciplinary, stepwise approach should be prospectively tested in DF.

  1. Profile of sacubitril/valsartan in the treatment of heart failure: patient selection and perspectives.

    Science.gov (United States)

    Yandrapalli, Srikanth; Andries, Gabriela; Biswas, Medha; Khera, Sahil

    2017-01-01

    With an estimated prevalence of 5.8 million in the USA and over 23 million people worldwide, heart failure (HF) is growing in epidemic proportions. Despite the use of guideline-directed medical therapies such as angiotensin-converting enzyme inhibitors, beta-adrenergic blockers, angiotensin receptor blockers, and mineralocorticoid receptor antagonists for chronic systolic HF for almost two decades, HF remains a leading cause of morbidity, mortality, and health care expenditures. The Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor with Angiotensin-Converting Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) trial provided compelling evidence for the cardiovascular and mortality benefit of sacubitril/valsartan when compared to enalapril in patients with heart failure and reduced ejection fraction (HFrEF). Sacubitril/valsartan performed better than enalapril across various HFrEF patient characteristics and showed substantial benefit in patients with other common comorbidities. Following the trial, the US Food and Drug Administration approved this drug for the treatment of HF. Various international HF consensus guidelines endorse sacubitril/valsartan as a class I recommendation for the management of symptomatic HFrEF. Although this high-quality clinical study is the largest and the most globally represented trial in HFrEF patients, concerns have been raised regarding the generalizability of the trial results in real-world HF population. The gaps in US Food and Drug Administration labeling and guideline recommendations might lead to this medication being used in a larger population than it was studied in. In this review, we will discuss the current role of sacubitril/valsartan in the management of HF, concerns related to PARADIGM-HF and answers, shortcomings of this novel drug, effects on patient characteristics, real-world eligibility, and the role of ongoing and further investigations to clarify

  2. Treatment of selected pharmaceuticals by ferrate(VI): performance, kinetic studies and identification of oxidation products.

    Science.gov (United States)

    Zhou, Zhengwei; Jiang, Jia-Qian

    2015-03-15

    The performance of ferrate(VI) in treating sulfamethoxazole (SMX), diclofenac (DCF), carbamazepine (CBZ) and bezafibrate (BZF) in test solutions containing the four compounds was investigated. A series of jar-test experiments was performed on a bench-scale at pH 6-9 and at a ferrate(VI) dose of 1-5 mg Fe/L. The results suggested that ferrate(VI) can effectively remove SMX, DCF and CBZ from the test solutions, with greater than 80% removal under optimum conditions. However, the removal efficiency of BZF was very low, less than 25% under the studied conditions. Increasing the dose of ferrate(VI) improved the treatment performance, while the influence of solution pH on ferrate(VI) performance varied among the different target compounds. Ferrate(VI) demonstrated the highest reactivity with SMX at pH 8 and pH 9 (20 °C), with apparent second-order rate constants of 360±17 M(-1) s(-1) and 1.26±0.02 M(-1) s(-1), respectively. However, BZF showed the lowest removal by ferrate(VI) with the smallest rate constants (less than 0.5 M(-1) s(-1)) at pH 8 and pH 9. Furthermore, a number of oxidation products (OPs) of SMX, DCF and CBZ during ferrate(VI) oxidation were detected by liquid chromatography and mass spectrometry (LC-MS), and their degradation pathways were tentatively proposed. No OPs of BZF were detected during ferrate(VI) oxidation. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. In vitro and cellular activities of the selected fruits residues for skin aging treatment

    Directory of Open Access Journals (Sweden)

    NATTAYA LOURITH

    Full Text Available ABSTRACT Peel extracts of litchi and rambutan, and that of tamarind seed coat were investigated in relation to their utility in skin-aging treatments. Standardized extracts of tamarind were significantly (p < 0.05 more efficient at O2 •- scavenging (IC50 = 27.44 ± 0.09 than those of litchi and rambutan (IC50 = 29.57 ± 0.30 and 39.49 ± 0.52 μg/ml, respectively and the quercetin standard (IC50 = 31.88 ± 0.15 μg/ml. Litchi extract proved significantly (p < 0.05 more effective for elastase and collagenase inhibition (88.29 ± 0.25% and 79.46 ± 0.92%, respectively than tamarind (35.43 ± 0.68% and 57.69 ± 5.97% or rambutan (31.08 ± 0.38% and 53.99 ± 6.18%. All extracts were safe to human skin fibroblasts and inhibit MMP-2, with litchi extract showing significantly (p < 0.01 enhanced inhibition over the standard, vitamin C (23.75 ± 2.74% and 10.42 ± 5.91% at 0.05 mg/ml, respectively. Extracts suppress melanin production in B16F10 melanoma cells through inhibition of tyrosinase and TRP-2, with litchi extract being the most potent, even more so than kojic acid (standard. These results highlight the potential for adding value to agro-industrial waste, as the basis for the sustainable production of innovative, safe, anti-aging cosmetic products.

  4. The Selection of Procedures in One-stage Urethroplasty for Treatment of Coexisting Urethral Strictures in Anterior and Posterior Urethra.

    Science.gov (United States)

    Lv, XiangGuo; Xu, Yue-Min; Xie, Hong; Feng, Chao; Zhang, Jiong

    2016-07-01

    To explore selection of the procedures in one-stage urethroplasty for treatment of coexisting urethral strictures in the anterior and posterior urethra. Between 2008 and 2014, a total of 27 patients with existing strictures simultaneously at anterior urethra and posterior urethra were treated in our hospital. Two types of procedures were selected for treatment of the anterior urethral strictures. A penile skin flap and the lingual mucosa were used for augmented urethroplasty in 20 and 7 cases, respectively. Three types of procedures, namely, non-transecting end-to-end urethral anastomosis (n = 3), traditional end-to-end urethral anastomosis (n = 17), other grafts substitution urethroplasty, including pedicle scrotal skin urethroplasty (n = 2), and lingual mucosal graft urethroplasty (n = 5), were utilized in the treatment of posterior urethral strictures. The patients were mean followed up 30 months with an overall success rate of 88.9%. The majority of the patients exhibited wide patent urethras on retrograde urethrography and the patients' urinary peak flow ranged from 14.2 to 37.9 ml/s. Complications developed in 3 patients (11.1%). Of the 17 patients who underwent traditional urethral end-to-end anastomosis, urethral strictures occurred in 2 patients at 4 and 6 months after the operation. These patients achieved a satisfactory voiding function after salvage pedicle scrotal skin urethroplasty. A urethral pseudodiverticulum was observed in another patient 9 months after pedicle penile flap urethroplasty; and after a salvage procedure, he regained excellent voiding function. Synchronous anterior and posterior strictures can be successfully reconstructed with a combination of substitution and anastomotic urethroplasty techniques. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Significance of ultrasonography in selecting methods for the treatment of acute cholecystitis

    Directory of Open Access Journals (Sweden)

    Grzegorz Ćwik

    2013-09-01

    Full Text Available Surgical removal of the gallbladder is indicated in nearly all cases of complicated acute cholecystitis. In the 1990s, laparoscopic cholecystectomy became the method of choice in the treatment of cholecystolithiasis. Due to a large inflammatory reaction in the course of acute inflammation, a laparoscopic procedure is conducted in technically difficult conditions and entails the risk of complications. The aim of this paper was: 1 to analyze ultrasound images in acute cholecystitis; 2 to specify the most common causes of conversion from the laparoscopic method to open laparotomy; 3 to determine the degree to which the necessity for such a conversion may be predicted with the help of ultrasound examinations. Material and methods: In 1993–2011, in the Second Department and Clinic of General, Gastroenterological and Oncological Surgery of the Medical University in Lublin, 5,596 cholecystectomies were performed including 4,105 laparoscopic procedures that constituted 73.4% of all cholecystectomies. Five hundred and forty-two patients (13.2% were qualified for laparoscopic procedure despite manifesting typical symptoms of acute cholecystitis in ultrasound examination, which comprise: thickening of the gallbladder wall of > 3 mm, inflammatory infiltration in the Calot’s triangle region, gallbladder filled with stagnated or purulent contents and mural or intramural effusion. Results: In the group of operated patients, the conversion was necessary in 130 patients, i.e. in 24% of cases in comparison with 3.8% of patients with uncomplicated cholecystolithiasis (without the signs of inflammation. The conversion most frequently occurred when the assessment of the anatomical structures of the Calot’s triangle was rendered more difficult due to local inflammatory process, mural effusion and thickening of the gallbladder wall of >5 mm. The remaining changes occurred more rarely. Conclusions: Based on imaging scans, the most common causes of conversion

  6. Profile of sacubitril/valsartan in the treatment of heart failure: patient selection and perspectives

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    Yandrapalli S

    2017-10-01

    Full Text Available Srikanth Yandrapalli,1 Gabriela Andries,1 Medha Biswas,2 Sahil Khera2,3 1Department of Internal Medicine, New York Medical College at Westchester Medical Center, Valhalla, NY, USA; 2Division of Cardiology, New York Medical College at Westchester Medical Center, Valhalla, NY, USA; 3Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Abstract: With an estimated prevalence of 5.8 million in the USA and over 23 million people worldwide, heart failure (HF is growing in epidemic proportions. Despite the use of guideline-directed medical therapies such as angiotensin-converting enzyme inhibitors, beta-adrenergic blockers, angiotensin receptor blockers, and mineralocorticoid receptor antagonists for chronic systolic HF for almost two decades, HF remains a leading cause of morbidity, mortality, and health care expenditures. The Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor with Angiotensin-Converting Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF trial provided compelling evidence for the cardiovascular and mortality benefit of sacubitril/valsartan when compared to enalapril in patients with heart failure and reduced ejection fraction (HFrEF. Sacubitril/valsartan performed better than enalapril across various HFrEF patient characteristics and showed substantial benefit in patients with other common comorbidities. Following the trial, the US Food and Drug Administration approved this drug for the treatment of HF. Various international HF consensus guidelines endorse sacubitril/valsartan as a class I recommendation for the management of symptomatic HFrEF. Although this high-quality clinical study is the largest and the most globally represented trial in HFrEF patients, concerns have been raised regarding the generalizability of the trial results in real-world HF population. The gaps in US Food and Drug Administration labeling and

  7. The role of endorectal coil MRI in patient selection and treatment planning for prostate seed implants

    International Nuclear Information System (INIS)

    Clarke, Daniel H.; Banks, Stephen J.; Wiederhorn, A. Roger; Klousia, John W.; Lissy, Jeanne M.; Miller, Michelle; Able, Arnold M.; Artiles, Carlos; Hindle, William V.; Blair, Deborah N.; Houk, Russell R.; Sheridan, Michael J.

    2002-01-01

    Purpose: To assess the role of endorectal coil magnetic resonance imaging (MRI) staging for patients undergoing seed implantation (SI) with or without external beam radiotherapy (EBRT). Methods and Materials: Between October 1994 and December 1998, 390 patients underwent prostate SI (98% Pd-103, 2% I-125). Seventy-six percent of patients had a prostate serum antigen (PSA) 20. Ten percent of patients had a Gleason score (GS) of 4-5, 54% had GS 6, 29% had GS 7, and 7% had GS ≥ 8. Monotherapy was employed in 46% of patients, and the remaining 54% received combined EBRT and SI. Three hundred twenty-seven were staged by high-resolution phased array pelvic coil, or in most cases, an endorectal coil MRI. The MRI findings were used to guide stage-appropriate treatment recommendations, and to assist in the preplanning and optimization of seed distributions. The criteria utilized to determine MRI-based stage were founded on the reported literature from the University of Pennsylvania. All MRI studies were reviewed by C.A., D.B., or W.H., who were unaware of clinical stage at the time of their review. The biopsy report was available to them as the only clinical correlate. Results: Of the 327 patients staged by MRI, 70% were upstaged from the digital rectal examination-based clinical stage; 26% of T 1 , T 2 patients were upstaged to T 3 . Perineural invasion and the percentage of positive cores predicted for T 3 MRI stage (p 3 intermediate-risk group patients treated by combined therapy with a previous study of T 3 intermediate-risk group treated by radical prostatectomy (RP) at the University of Pennsylvania. Our 36-month PSA FFP was 94% compared with 21% for the previous study's RP patients. Conclusion: MRI is a valuable staging procedure for prostate cancer patients treated by SI. PSA FFP results appear to be improved by MRI staging. MRI T 3 disease can be treated more effectively by SI + EBRT than by RP

  8. Selective Intermittent Preventive Treatment of Vivax Malaria: Reduction of Malaria Incidence in an Open Cohort Study in Brazilian Amazon

    Science.gov (United States)

    Gil, Luiz Herman Soares; de Lima, Alzemar Alves; Freitag, Elci Marlei; dos Santos, Tatiana Marcondes; do Nascimento Filha, Maria Teixeira; dos Santos Júnior, Alcides Procópio Justiniano; da Silva, Josiane Mendes; Rodrigues, Aline de Freitas; Tada, Mauro Shugiro; Fontes, Cor Jesus Fernandes; Pereira da Silva, Luiz Hildebrando

    2013-01-01

    In children, the Intermittent Preventive Treatment (IPTc), currently called Seasonal Malaria Chemoprevention (SMC), was considered effective on malaria control due to the reduction of its incidence in Papua New Guinea and in some areas with seasonal malaria in Africa. However, the IPT has not been indicated because of its association with drug resistance and for hindering natural immunity development. Thus, we evaluated the alternative IPT impact on malaria incidence in three riverside communities on Madeira River, in the municipality of Porto Velho, RO. We denominate this scheme Selective Intermittent Preventive Treatment (SIPT). The SIPT consists in a weekly dose of two 150 mg chloroquine tablets for 12 weeks, for adults, and an equivalent dose for children, after complete supervised treatment for P. vivax infection. This scheme is recommend by Brazilian Health Ministry to avoid frequent relapses. The clinic parasitological and epidemiological surveillance showed a significant reduction on vivax malaria incidence. The results showed a reduction on relapses and recurrence of malaria after SIPT implementation. The SIPT can be effective on vivax malaria control in localities with high transmission risk in the Brazilian Amazon. PMID:23577276

  9. Selection of the Best Wastewater Treatment Alternative for RIPI Based on Analytical Hierarchy Process (AHP and Expert Choice Software

    Directory of Open Access Journals (Sweden)

    faramarz Tarkian

    2014-05-01

    Full Text Available RIPI as one of the largest and most important research centers in Iran is located in zone 22 of Tehran municipality. According to the environmental priorities in the region taking all necessary measures to control pollution sources is necessary. In this paper, Analytical Hierarchy Process (AHP method is used for the selection of the best wastewater treatment method for RIPI. For this purpose four alternatives including SBR, Extended aeration activated sludge, Rotating MBR, Fix MBR were evaluated. These alternatives were weighted by four main criteria: Environment, Economic, Technical, Management and the defined sub-criteria ,then paired compared with respect to any form of wastewater treatment alternatives and ultimately the results was evaluated by Expert Choice software. The evaluation results indicate that Rotating MBR was the most suitable alternative of wastewater treatment method for RIPI. After the Rotating MBR, the Fix MBR, SBR and Extended activated sludge were considered suitable respectively. Degree of inconsistency is equal to 0.07, indicating that the number of paired comparisons is consistent.

  10. Selective Intermittent Preventive Treatment of Vivax Malaria: Reduction of Malaria Incidence in an Open Cohort Study in Brazilian Amazon

    Directory of Open Access Journals (Sweden)

    Tony Hiroshi Katsuragawa

    2013-01-01

    Full Text Available In children, the Intermittent Preventive Treatment (IPTc, currently called Seasonal Malaria Chemoprevention (SMC, was considered effective on malaria control due to the reduction of its incidence in Papua New Guinea and in some areas with seasonal malaria in Africa. However, the IPT has not been indicated because of its association with drug resistance and for hindering natural immunity development. Thus, we evaluated the alternative IPT impact on malaria incidence in three riverside communities on Madeira River, in the municipality of Porto Velho, RO. We denominate this scheme Selective Intermittent Preventive Treatment (SIPT. The SIPT consists in a weekly dose of two 150 mg chloroquine tablets for 12 weeks, for adults, and an equivalent dose for children, after complete supervised treatment for P. vivax infection. This scheme is recommend by Brazilian Health Ministry to avoid frequent relapses. The clinic parasitological and epidemiological surveillance showed a significant reduction on vivax malaria incidence. The results showed a reduction on relapses and recurrence of malaria after SIPT implementation. The SIPT can be effective on vivax malaria control in localities with high transmission risk in the Brazilian Amazon.

  11. Selection of process conditions by risk assessment for apple juice pasteurization by UV-heat treatments at moderate temperatures.

    Science.gov (United States)

    Gayán, E; Torres, J A; Alvarez, I; Condón, S

    2014-02-01

    The effect of bactericidal UV-C treatments (254 nm) on Escherichia coli O157:H7 suspended in apple juice increased synergistically with temperature up to a threshold value. The optimum UV-C treatment temperature was 55 °C, yielding a 58.9% synergistic lethal effect. Under these treatment conditions, the UV-heat (UV-H55 °C) lethal variability achieving 5-log reductions had a logistic distribution (α = 37.92, β = 1.10). Using this distribution, UV-H55 °C doses to achieve the required juice safety goal with 95, 99, and 99.9% confidence were 41.17, 42.97, and 46.00 J/ml, respectively, i.e., doses higher than the 37.58 J/ml estimated by a deterministic procedure. The public health impact of these results is that the larger UV-H55 °C dose required for achieving 5-log reductions with 95, 99, and 99.9% confidence would reduce the probability of hemolytic uremic syndrome in children by 76.3, 88.6, and 96.9%, respectively. This study illustrates the importance of including the effect of data variability when selecting operational parameters for novel and conventional preservation processes to achieve high food safety standards with the desired confidence level.

  12. Acute and repeated ECS treatment increases CRF, POMC and PENK gene expression in selected regions of the rat hypothalamus.

    Science.gov (United States)

    Garcia-Garcia, L; Llewellyn-Jones, V; Fernandez Fernandez, I; Fuentes, J A; Manzanares, J

    1998-01-05

    The purpose of this study was to investigate the effects of acute and repeated electroconvulsive shock (ECS) on corticotropin releasing factor (CRF), proopiomelanocortin (POMC) and proenkephalin (PENK) gene expression in selected regions of the brain and pituitary of the rat. Acute ECS increased CRF gene expression in the paraventricular nucleus (PVN) by 20%, an effect that was further enhanced to 38% when rats received repeated ECS treatment. Acute and repeated ECS increased POMC gene expression in the arcuate nucleus (ARC) by 49-59% but failed to alter these mRNA levels in the anterior lobe (AL) of the pituitary gland. PENK gene expression was increased by 35% in the nucleus accumbens (NA) and by 180% the ventromedial nucleus (VMN) after acute or repeated ECS treatment but no significant changes were found in the PVN or striatum (ST). Taken together, these results indicate a differential CRF and opioid gene expression regulation after acute or repeated ECS treatment that may be relevant to their therapeutic or side effects in depression.

  13. A naturalistic long-term comparison study of selective serotonin reuptake inhibitors in the treatment of panic disorder.

    Science.gov (United States)

    Dannon, Pinhas N; Iancu, Iulian; Lowengrub, Katherine; Gonopolsky, Yehudit; Musin, Ernest; Grunhaus, Leon; Kotler, Moshe

    2007-01-01

    Selective serotonin reuptake inhibitors (SSRIs) are currently considered as the first drug of choice in the treatment of panic disorder (PD). The aim of this long-term, naturalistic comparison study was to compare 4 SSRIs with respect to tolerability and treatment outcome of PD. Outcome measures included relapse rates and adverse effects. Two hundred patients with PD were enrolled in our study. All subjects met DSM-IV criteria for PD or PD with agoraphobia (PDA). All patients were assigned to receive SSRI monotherapy for 12 months with either citalopram (n = 50), fluoxetine (n = 50), fluvoxamine (n = 50), or paroxetine (n = 50) in a randomized, nonblinded fashion. Both the treating psychiatrist and the patients were not blind to the assigned treatment, but the clinician raters were blind to the study medication. The study design allowed for assignment of a particular SSRI as indicated according to the clinical judgment of the study psychiatrists. The Panic Self-Questionnaire, which is a self-report scale, was administered at baseline and then once per month during the duration of the 12-month study. The visual analog scale and the Clinical Global Impression Scale were administered at baseline and then once per month during the period of the study. Reports of sexual dysfunction were assessed using a nonstructured clinical interview at monthly visits. The body weight of study subjects was measured at baseline, and then at the 12th month visit end point. Of 200 patients who entered the study, 127 patients (63.5%) completed the full 12-month protocol. Retention rates were highest for paroxetine (76% [38/50]), intermediate for citalopram (68% [34/50]) and fluvoxamine (60% [30/50]), and lowest for fluoxetine (50% [25/50]). Patients who completed the 12-month protocol responded favorably to the study treatment. The paroxetine and the citalopram groups had significantly lower rates of panic symptoms as measured at visits on weeks 4 and 8. At visits on months 3, 6, 9, and

  14. Antidepressant-like activity of resveratrol treatment in the forced swim test and tail suspension test in mice: the HPA axis, BDNF expression and phosphorylation of ERK.

    Science.gov (United States)

    Wang, Zhen; Gu, Jianhua; Wang, Xueer; Xie, Kai; Luan, Qinsong; Wan, Nianqing; Zhang, Qun; Jiang, Hong; Liu, Dexiang

    2013-11-01

    Resveratrol is a natural polyphenol enriched in Polygonum cuspidatum and has diverse biological activities. There is only limited information about the antidepressant-like effect of resveratrol. The present study assessed whether resveratrol treatment (20, 40 and 80mg/kg, i.p., 21days) has an antidepressant-like effect on the forced swim test (FST) and tail suspension test (TST) in mice and examined what its molecular targets might be. The results showed that resveratrol administration produced antidepressant-like effects in mice, evidenced by the reduced immobility time in the FST and TST, while it had no effect on the locomotor activity in the open field test. Resveratrol treatment significantly reduced serum corticosterone levels, which had been elevated by the FST and TST. Moreover, resveratrol increased brain-derived neurotrophic factor (BDNF) protein and extracellular signal-regulated kinase (ERK) phosphorylation levels in the prefrontal cortex and hippocampus. All of these antidepressant-like effects of resveratrol were essentially similar to those observed with the clinical antidepressant, fluoxetine. These results suggest that the antidepressant-like effects of resveratrol in the FST and TST are mediated, at least in part, by modulating hypothalamic-pituitary-adrenal axis, BDNF and ERK phosphorylation expression in the brain region of mice. © 2013.

  15. A biotechnological valorization and treatment of olive mill waste waters by selected yeast strains

    Directory of Open Access Journals (Sweden)

    Mouncif, M.

    1995-12-01

    Full Text Available Olive mill waste waters were diluted to 1/10, supplied with 2% urea and inoculated with yeast strains. 20 yeast strains isolated from Olive Mill Waste (OMW water were screened for their biomass production, GOD reduction and polyphenols bioconversión activities. Pure cultures of yeasts were realized in 100 ml erlen-meyer flasks. 50 ml cultures were used and the flasks were incubated at room temperature (22°G on a shaker. Biomass production, COD (chemical oxygen demand reduction and Polyphenols bioconversión were followed up in the inoculated OMW waters. Results showed that the urea supply improve significantly the biomass production relatively to the control. This reached in some assays 2.06% expressed as g of biomass dry weight per 100 mL of OMW water. Polyphenols removal was estimated to around 50% and the COD was decreased from 54.14 g/Kg to 21.56 g/Kg. This aerobic treatment lead to the biomass production and also to a pretreated efluent by the COD and the removal of the methanization inhibiting polyphenolic compounds.

    Aguas residuales de la molturación de la aceituna se diluyeron en la proporción 1/10, se le añadió un 2% de urea y se inoculó con cepas de levaduras. 20 cepas de levaduras aisladas de aguas residuales de la molturación de la aceituna (OMW se seleccionaron por su producción de biomasa, reducción DQO y actividades de bioconversión de polifenoles. Se llevaron a cabo cultivos puros de levaduras en matraces erlenmeyer de 100 mi. Se tomaron 50 ml de cultivos y los matraces se incubaron a temperatura ambiente (22°C en un agitador. Se siguió la producción de biomasa, la reducción de DQO (demanda química de oxígeno y la bioconversión de polifenoles en las aguas residuales de la aceituna. Los resultados mostraron que el suministro de urea mejoró significativamente la producción de biomasa en relación al control. Esta alcanzó en algunos ensayos el 2.06% expresado como g de peso seco de biomasa por 100 ml de

  16. Icotinib, a selective EGF receptor tyrosine kinase inhibitor, for the treatment of non-small-cell lung cancer.

    Science.gov (United States)

    Tan, Fenlai; Shi, Yuankai; Wang, Yinxiang; Ding, Lieming; Yuan, Xiaobin; Sun, Yan

    2015-01-01

    Advanced non-small-cell lung cancer (NSCLC) is the main cause for cancer-related mortality. Treatments for advanced NSCLC are largely palliative and a benefit plateau appears to have reached with the platinum-based chemotherapy regimens. EGF receptor (EGFR) tyrosine kinase inhibitors gefitinib, erlotinib and afatinib came up with prolonged progression-free survival and improved quality of life, especially in EGFR-mutated patients. Icotinib is an oral selective EGFR tyrosine kinase, which was approved by China Food and Drug administration in June 2011 for treating advanced NSCLC. Its approval was based on the registered Phase III trial (ICOGEN), which showed icotinib is noninferior to gefitinib. This review will discuss the role of icotinib in NSCLC, and its potential application and ongoing investigations.

  17. Discovery of MK-3697: a selective orexin 2 receptor antagonist (2-SORA) for the treatment of insomnia.

    Science.gov (United States)

    Roecker, Anthony J; Reger, Thomas S; Mattern, M Christa; Mercer, Swati P; Bergman, Jeffrey M; Schreier, John D; Cube, Rowena V; Cox, Christopher D; Li, Dansu; Lemaire, Wei; Bruno, Joseph G; Harrell, C Meacham; Garson, Susan L; Gotter, Anthony L; Fox, Steven V; Stevens, Joanne; Tannenbaum, Pamela L; Prueksaritanont, Thomayant; Cabalu, Tamara D; Cui, Donghui; Stellabott, Joyce; Hartman, George D; Young, Steven D; Winrow, Christopher J; Renger, John J; Coleman, Paul J

    2014-10-15

    Orexin receptor antagonists have demonstrated clinical utility for the treatment of insomnia. The majority of clinical efforts to date have focused on the development of dual orexin receptor antagonists (DORAs), small molecules that antagonize both the orexin 1 and orexin 2 receptors. Our group has recently disclosed medicinal chemistry efforts to identify highly potent, orally bioavailable selective orexin 2 receptor antagonists (2-SORAs) that possess acceptable profiles for clinical development. Herein we report additional SAR studies within the 'triaryl' amide 2-SORA series focused on improvements in compound stability in acidic media and time-dependent inhibition of CYP3A4. These studies resulted in the discovery of 2,5-disubstituted isonicotinamide 2-SORAs such as compound 24 that demonstrated improved stability and TDI profiles as well as excellent sleep efficacy across species. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Minimally invasive surgical technique: Percutaneous external fixation combined with titanium elastic nails for selective treatment of tibial fractures.

    Science.gov (United States)

    Tu, Kai-Kai; Zhou, Xian-Ting; Tao, Zhou-Shan; Chen, Wei-Kai; Huang, Zheng-Liang; Sun, Tao; Zhou, Qiang; Yang, Lei

    2015-12-01

    Several techniques have been described to treat tibial fractures, which respectively remains defects. This article presents a novel intra- and extramedullary fixation technique: percutaneous external fixator combined with titanium elastic nails (EF-TENs system). The purpose of this study is to introduce this new minimally invasive surgical technique and selective treatment of tibial fractures, particularly in segmental fractures, diaphysis fractures accompanied with distal or proximal bone subfissure, or fractures with poor soft-tissue problems. Following ethical approval, thirty-two patients with tibial fractures were treated by the EF-TENs system between January 2010 and December 2012. The follow-up studies included clinical and radiographic examinations. All relevant outcomes were recorded during follow-up. All thirty-two patients were achieved follow-ups. According to the AO classification, 3 Type A, 9 Type B and 20 Type C fractures were included respectively. According to the Anderson-Gustilo classification, there were 5 Type Grade II, 3 Type Grade IIIA and 2 Type Grade IIIB. Among 32 patients, 8 of them were segmental fractures. 12 fractures accompanied with bone subfissure. Results showed no nonunion case, with an average time of 23.7 weeks (range, 14-32 weeks). Among them, there were 3/32 delayed union patients and 0/32 malunion case. 4/32 patients developed a pin track infection and no patient suffered deep infection. The external fixator was removed with a mean time of 16.7 weeks (range, 10-26 weeks). Moreover, only 1/32 patient suffered with the restricted ROM of ankle, none with the restricted ROM of knee. This preliminary study indicated that the EF-TENs system, as a novel intra- and extramedullary fixation technique, had substantial effects on selective treatment of tibial fractures. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Rearing Water Treatment Induces Microbial Selection Influencing the Microbiota and Pathogen Associated Transcripts of Cod (Gadus morhua Larvae

    Directory of Open Access Journals (Sweden)

    Ragnhild I. Vestrum

    2018-05-01

    Full Text Available We have previously shown that K-selection and microbial stability in the rearing water increases survival and growth of Atlantic cod (Gadus morhua larvae, and that recirculating aquaculture systems (RAS are compatible with this. Here, we have assessed how water treatment influenced the larval microbiota and host responses at the gene expression level. Cod larvae were reared with two different rearing water systems: a RAS and a flow-through system (FTS. The water microbiota was examined using a 16S rDNA PCR/DGGE strategy. RNA extracted from larvae at 8, 13, and 17 days post hatching was used for microbiota and microarray gene expression analysis. Bacterial cDNA was synthesized and used for 16S rRNA amplicon 454 pyrosequencing of larval microbiota. Both water and larval microbiota differed significantly between the systems, and the larval microbiota appeared to become more dissimilar between systems with time. In total 4 phyla were identified for all larvae: Actinobacteria, Bacteroidetes, Firmicutes, and Proteobacteria. The most profound difference in larval microbiota was a high abundance of Arcobacter (Epsilonproteobacteria in FTS larvae (34 ± 9% of total reads. Arcobacter includes several species that are known pathogens for humans and animals. Cod larval transcriptome responses were investigated using an oligonucleotide gene expression microarray covering approximately 24,000 genes. Interestingly, FTS larvae transcriptional profiles revealed an overrepresentation of upregulated transcripts associated with responses to pathogens and infections, such as c1ql3-like, pglyrp-2-like and zg16, compared to RAS larvae. In conclusion, distinct water treatment systems induced differences in the larval microbiota. FTS larvae showed up-regulation of transcripts associated with responses to microbial stress. These results are consistent with the hypothesis that RAS promotes K-selection and microbial stability by maintaining a microbial load close to the

  20. The potential of selected macroalgal species for treatment of AMD at different pH ranges in temperate regions.

    Science.gov (United States)

    Oberholster, Paul J; Cheng, Po-Hsun; Botha, Anna-Maria; Genthe, Bettina

    2014-09-01

    The metal bioaccumulation potential of selected macroalgae species at different pH ranges was study for usage as part of a possible secondary passive acid mine drainage (AMD) treatment technology in algae ponds. Two separate studies were conducted to determine the suitability of macroalgae for passive treatment when metabolic processes in macrophytes and microorganisms in constructed wetlands decrease during winter months. In the field study, the bioconcentration of metals (mg/kg dry weight) measured in the benthic macroalgae mats was in the following order: site 1. Oedogonium crassum Al > Fe > Mn > Zn; site 2. Klebsormidium klebsii, Al > Fe > Mn > Zn; site 3. Microspora tumidula, Fe > Al > Mn > Zn and site 4. M. tumidula, Fe > Mn > Al > Zn. In the laboratory study, cultured macroalgae K. klebsii, O. crassum and M. tumidula isolated from the field sampling sites were exposed to three different pH values (3, 5 and 7), while bioaccumulation of the metals, Al, Fe, Mn and Zn and glutathione S-transferase (GST) activity were measured in the different selected algae species at a constant water temperature of 14 °C. Bioaccumulation of Al was the highest for O. crassum followed by K. klebsii and M. tumidula (p macroalgae O. crassum at all three tested pH values under constant low water temperature. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Trabeculoplastia selectiva con láser en glaucoma Selective laser trabeculoplasy in the treatment of glaucoma

    Directory of Open Access Journals (Sweden)

    Ailen Garcés Fernández

    2009-12-01

    Full Text Available Se realiza una breve revisión bibliográfica sobre la trabeculoplastia selectiva con Nd YAG Láser de frecuencia doblada en la enfermedad glaucomatosa. El equipo Laserex Tango LT 5106-T Nd: YAG Láser (Ellex Medical Pty Ltd para trabeculoplastia selectiva se encuentra en nuestro instituto desde marzo de 2006, única institución del país que dispone de este equipo hasta este momento. La alta esperanza de vida de nuestra población, que conlleva a un incremento en la incidencia de glaucoma y cataratas, induce a ser consecuentes con todo aquello que contribuya a mejorar la calidad de vida de los pacientes: esta circunstancia motivó esta revisión. Se presentan sus indicaciones, parámetros más utilizados, efectividad y complicaciones.A brief literature review on selective trabeculoplasty with doubled frequency Nd:YAG laser in the treatment of glaucoma was made. Laserex Tango LT 5106-T Nd: YAG Laser (Ellex Medical Pty Ltd equipment for selective trabeculoplasty is available in our institute since March 2006 (the only center having this equipment in our country up to the present. The high life expectancy of our population, with an increase of glaucoma and cataract incidence, prompts us to be consistent with everything that supports the improved quality of life of patients; this was the reason for this review. Indications, most used parameters, effectiveness and complications were presented.

  2. EDITORIAL: Special section: Selected papers from the Third European Workshop on Monte Carlo Treatment Planning (MCTP2012) Special section: Selected papers from the Third European Workshop on Monte Carlo Treatment Planning (MCTP2012)

    Science.gov (United States)

    Spezi, Emiliano; Leal, Antonio

    2013-04-01

    The Third European Workshop on Monte Carlo Treatment Planning (MCTP2012) was held from 15-18 May, 2012 in Seville, Spain. The event was organized by the Universidad de Sevilla with the support of the European Workgroup on Monte Carlo Treatment Planning (EWG-MCTP). MCTP2012 followed two successful meetings, one held in Ghent (Belgium) in 2006 (Reynaert 2007) and one in Cardiff (UK) in 2009 (Spezi 2010). The recurrence of these workshops together with successful events held in parallel by McGill University in Montreal (Seuntjens et al 2012), show consolidated interest from the scientific community in Monte Carlo (MC) treatment planning. The workshop was attended by a total of 90 participants, mainly coming from a medical physics background. A total of 48 oral presentations and 15 posters were delivered in specific scientific sessions including dosimetry, code development, imaging, modelling of photon and electron radiation transport, external beam radiation therapy, nuclear medicine, brachitherapy and hadrontherapy. A copy of the programme is available on the workshop's website (www.mctp2012.com). In this special section of Physics in Medicine and Biology we report six papers that were selected following the journal's rigorous peer review procedure. These papers actually provide a good cross section of the areas of application of MC in treatment planning that were discussed at MCTP2012. Czarnecki and Zink (2013) and Wagner et al (2013) present the results of their work in small field dosimetry. Czarnecki and Zink (2013) studied field size and detector dependent correction factors for diodes and ion chambers within a clinical 6MV photon beam generated by a Siemens linear accelerator. Their modelling work based on the BEAMnrc/EGSnrc codes and experimental measurements revealed that unshielded diodes were the best choice for small field dosimetry because of their independence from the electron beam spot size and correction factor close to unity. Wagner et al (2013

  3. Selection of a bioassay battery to assess toxicity in the affluents and effluents of three water-treatment plants

    Directory of Open Access Journals (Sweden)

    Paola Bohórquez-Echeverry

    2012-08-01

    Full Text Available The assessment of water quality includes the analysis of both physical-chemical and microbiological parameters. However,none of these evaluates the biological effect that can be generated in ecosystems or humans. In order to define the most suitable organismsto evaluate the toxicity in the affluent and effluent of three drinking-water treatment plants, five acute toxicity bioassays were used,incorporating three taxonomic groups of the food chain. Materials and methods. The bioassays used were Daphnia magna and Hydraattenuata as animal models, Lactuca sativa and Pseudokirchneriella subcapitata as plant models, and Photobacterium leioghnathi asbacterial model. To meet this objective, selection criteria of the organisms evaluated and cluster analysis were used to identify the mostsensitive in the affluent and effluent of each plant. Results. All organisms are potentially useful in the assessment of water quality bymeeting four essential requirements and 17 desirable requirements equivalent to 100% acceptability, except P. leioghnathi which doesnot meet two essential requirements that are the IC50 for the toxic reference and the confidence interval. The animal, plant and bacterialmodels showed different levels of sensitivity at the entrance and exit of the water treatment systems. Conclusions. H. attenuata, P.subcapitata and P. leioghnathi were the most effective organisms in detecting toxicity levels in the affluents and D. magna, P. subcapitataand P. leioghnathi in the effluents.

  4. Cogeneration from thermal treatment of selected municipal solid wastes. A stoichiometric model building for the case study on Palermo

    International Nuclear Information System (INIS)

    Lo Mastro, F.; Mistretta, M.

    2004-01-01

    This paper aims to calculate the energetic and environmental effects of an integrated solid waste management system in Palermo, Italy. In particular, the thermal treatment of Municipal Solid Waste (MSW) with energy recovery is assessed. The current characterization at the local scale is taken into account. Two different options of collection are taken into account: (1) unselected wastes; and (2) sorted collection, according to the current Italian regulation. Combustion process is analyzed and the following features are calculated: (1) stoichiometric content of air and air excess; and (2) temperature and enthalpy of flue gases. Energy recovery is performed in the hypothesis of Hirn cycle both with steam condensation to produce only power, and with bleeding cycle for the combined production of power and thermal energy. Total electric efficiency is assumed as representative index of the technological level of the assessed plant. Results show that the thermal treatment of selected MSW, associated with a cogenerative recovery of energy, represents a relevant sustainable strategy of waste valorization as an alternative to fossil fuels

  5. Effect of heat treatment on mechanical properties and microstructure of selective laser melting 316L stainless steel

    Science.gov (United States)

    Kamariah, M. S. I. N.; Harun, W. S. W.; Khalil, N. Z.; Ahmad, F.; Ismail, M. H.; Sharif, S.

    2017-10-01

    Selective Laser Melting (SLM) has been one of the preferred Additive Manufacturing process to fabricate parts due to its merits in terms of design freedom, lower material waste and faster production when compare to the conventional manufacturing processes. However, due to the thermal gradient experienced during the process, the parts are exposed to the residual stress that leads to parts distortion. This work presents the effect of heat treatments on the micro-hardness of 316L stainless steel parts. In current study, SLM has been employed to fabricate 316L stainless steel compacts. Different heat treatments of 650°C, 950°C, and 1100°C for 2 hours were applied on the compacts. Hardness test were performed on the as-built and heat-treated compacts. The relationship between the microstructures and micro-hardness were discussed in this paper. The results revealed that the micro-hardness of the as-built compacts is between 209.0 and 212.2 HV, which is much higher than the heattreated compacts.

  6. Selective Grafting of Primary Amines onto Carbon Nanotubes via Free-Radical Treatment in Microwave Plasma Post-Discharge

    Directory of Open Access Journals (Sweden)

    Philippe Dubois

    2012-01-01

    Full Text Available A novel strategy to graft functional groups at the surface of carbon nanotubes (CNTs is discussed. Aiming at grafting nitrogen containing groups, and more specifically primary amine covalent functionalization, CNTs were exposed under atomic nitrogen flow arising from an Ar + N2 microwave plasma. The primary amine functions were identified and quantified through chemical derivatization with 4-(trifluoromethylbenzaldehyde and characterized through X-ray photoelectron spectroscopy. The increase of the selectivity in the primary amines grafting onto CNTs, up to 66.7% for treatment of CNT powder, was performed via the reduction of post-treatment oxygen contamination and the addition of hydrogen in the experimental set-up, more particularly in the plasma post-discharge chamber. The analyses of nitrogenated and primary amine functions grafting on the CNT surface suggest that atomic nitrogen (N• and reduced nitrogen species (NH• and NH2• react preferentially with defect sites of CNTs and, then, only atomic nitrogen continues to react on the CNT surface, creating defects.

  7. Microstructure and hardness studies of Inconel 718 manufactured by selective laser melting before and after solution heat treatment

    Energy Technology Data Exchange (ETDEWEB)

    Tucho, Wakshum M., E-mail: wakshum.m.tucho@uis.no [Department of Mechanical and Structural Engineering and Materials Science, University of Stavanger, N-4036 Stavanger (Norway); Cuvillier, Priscille [Department of Mechanical and Structural Engineering and Materials Science, University of Stavanger, N-4036 Stavanger (Norway); Sjolyst-Kverneland, Atle [Roxar/Emerson Process Management, POB 112, 4065 Stavanger (Norway); Hansen, Vidar [Department of Mechanical and Structural Engineering and Materials Science, University of Stavanger, N-4036 Stavanger (Norway)

    2017-03-24

    The microstructure of Additive Manufactured (AM) Inconel 718 in general and Selective Laser Melting (SLM), in particular is different from the material produced by conventional methods due to the rapid solidification process associated with the former. As a result, the widely adapted standard solution heat treatment temperature (<1100 °C) for conventional material is found to be not high enough for materials fabricated with SLM method in order to dissolve Laves and other microsegregated phases for releasing the ageing constituents (Nb, Ti, Al) sufficiently into the alloy matrix. In this study, sample of Inconel 718 fabricated with SLM method were solution heat-treated to 1100 °C or 1250 °C at different hold times to investigate the dissolution of macro- and micro-segregated precipitates. Investigations of microstructure and segregation in as-printed and solution heat-treated states have been studied using Transmission Electron Microscopy (TEM), Scanning Electron Microscopy (SEM) and Optical Microscopy (OM). Measurement of material hardness was performed with Vickers hardness tests. The microstructure of the as-printed parts exhibit non-columnar grains, but contain well-shaped columnar/cellular sub-grains. The intergranular boundaries are decorated with high density of dislocations and segregated particles. Tremendous stress relief and grain coarsening were observed with solution heat treatment. In particular, at 1250 °C annealing, the sub-grains, including precipitates and dislocation networks along the sub-grain boundaries, were entirely dissolved. However, the 1100/1250 °C solution heat treatment scheme could not dissolve microsegregated precipitates and carbides completely. Details of the analysis on microstructure, dissolution of precipitates and hardness are presented.

  8. The effect of antenatal depression and selective serotonin reuptake inhibitor treatment on nerve growth factor signaling in human placenta.

    Directory of Open Access Journals (Sweden)

    Helena Kaihola

    Full Text Available Depressive symptoms during pregnancy are common and may have impact on the developing child. Selective serotonin reuptake inhibitors (SSRIs are the most prescribed antidepressant treatment, but unfortunately, these treatments can also negatively affect the behavioral development and health of a child during pregnancy. In addition, serotonin (5-HT exerts neurotrophic actions with thus far not fully known effects in the offspring. The neurotrophic growth factor (NGF is involved in neuronal cell survival and differentiation, and altered placenta levels have been found to increase the risk for pregnancy complications, similar to those found in women treated with SSRIs. We therefore investigated whether the NGF signaling pathway was altered in the placenta from women treated with SSRIs (n = 12 and compared them with placenta from depressed (n = 12 and healthy mothers (n = 12. Results from immunohistochemical stainings revealed that placental NGF protein levels of SSRI-treated women were increased in both trophoblasts and endothelial cells compared with depressed and control women. In addition, downstream of the NGF receptor TrkA, increased levels of the signaling proteins ROCK2 and phosphorylated Raf-1 were found in stromal cells and a tendency towards increased levels of ROCK2 in trophoblasts and endothelial cells in SSRI-treated women when compared to healthy controls. SSRI-treated women also displayed increased levels of phosphorylated ROCK2 in all placental cell types studied in comparison with depressed and control women. Interestingly, in placental endothelial cells from depressed women, NGF levels were significantly lower compared to control women, but ROCK2 levels were increased compared with control and SSRI-treated women. Taken together, these results show that the NGF signaling and downstream pathways in the placenta are affected by SSRI treatment and/or antenatal depression. This might lead to an altered placental function, although the

  9. An update on the use of natalizumab in the treatment of multiple sclerosis: appropriate patient selection and special considerations

    Directory of Open Access Journals (Sweden)

    Kornek B

    2015-05-01

    Full Text Available Barbara Kornek Department of Neurology, Medical University of Vienna, Vienna, Austria Abstract: In the context of an increasing repertoire of multiple sclerosis (MS therapeutics, choosing the appropriate treatment for an individual patient is becoming increasingly challenging. Natalizumab, a humanized monoclonal antibody directed against alpha4beta1 integrin, has proven short-term and long-term efficacies in terms of relapse rate reduction, prevention of disability progression, and reduction of magnetic resonance imaging-detectable activity. It is well tolerated and has further been shown to improve patients’ quality of life. Its use is limited by the risk of progressive multifocal leukoencephalopathy (PML, which occurs at an overall incidence of 3.78 cases per 1,000 patients. Three major risk factors for the occurrence of natalizumab-associated PML have been identified: John Cunningham virus (JCV seropositivity, prior use of immunosuppressants, and treatment duration ≥2 years. Therefore, in patients considered for natalizumab therapy, as well as in patients receiving natalizumab, effective control of MS activity has to be balanced against the risk of an opportunistic central nervous system infection associated with a high risk of significant morbidity or death. Discontinuation of natalizumab is an issue in daily clinical practice, since it is an option to reduce the PML risk. However, after cessation of natalizumab therapy, currently, there is no approved strategy for avoiding postnatalizumab disease reactivation available. In this paper, short-term and long-term safety and efficacy data are reviewed. Issues in daily clinical practice, such as selection of patients, monitoring of patients, and natalizumab discontinuation, are discussed. Keywords: safety, long-term outcome, pediatric multiple sclerosis, adherence, PML, treatment discontinuation 

  10. Microstructure and hardness studies of Inconel 718 manufactured by selective laser melting before and after solution heat treatment

    International Nuclear Information System (INIS)

    Tucho, Wakshum M.; Cuvillier, Priscille; Sjolyst-Kverneland, Atle; Hansen, Vidar

    2017-01-01

    The microstructure of Additive Manufactured (AM) Inconel 718 in general and Selective Laser Melting (SLM), in particular is different from the material produced by conventional methods due to the rapid solidification process associated with the former. As a result, the widely adapted standard solution heat treatment temperature (<1100 °C) for conventional material is found to be not high enough for materials fabricated with SLM method in order to dissolve Laves and other microsegregated phases for releasing the ageing constituents (Nb, Ti, Al) sufficiently into the alloy matrix. In this study, sample of Inconel 718 fabricated with SLM method were solution heat-treated to 1100 °C or 1250 °C at different hold times to investigate the dissolution of macro- and micro-segregated precipitates. Investigations of microstructure and segregation in as-printed and solution heat-treated states have been studied using Transmission Electron Microscopy (TEM), Scanning Electron Microscopy (SEM) and Optical Microscopy (OM). Measurement of material hardness was performed with Vickers hardness tests. The microstructure of the as-printed parts exhibit non-columnar grains, but contain well-shaped columnar/cellular sub-grains. The intergranular boundaries are decorated with high density of dislocations and segregated particles. Tremendous stress relief and grain coarsening were observed with solution heat treatment. In particular, at 1250 °C annealing, the sub-grains, including precipitates and dislocation networks along the sub-grain boundaries, were entirely dissolved. However, the 1100/1250 °C solution heat treatment scheme could not dissolve microsegregated precipitates and carbides completely. Details of the analysis on microstructure, dissolution of precipitates and hardness are presented.

  11. Diagnosis and treatment of tuberculous uveitis in a low endemic setting.

    Science.gov (United States)

    Vos, A G; Wassenberg, M W M; de Hoog, J; Oosterheert, J J

    2013-11-01

    To determine factors associated with the diagnosis of tuberculous uveitis and the response to anti-tuberculous treatment (ATT). A retrospective case study was performed at the University Medical Centre Utrecht between October 2007 and December 2009. Patients with possible tuberculous uveitis (TBU) were selected from all patients with an unexplained uveitis. Demographics, ethnicity, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), tuberculin skin test (TST), QuantiFERON (QFT) test, and ocular findings were evaluated. An interdisciplinary panel discussed if there was a presumed TBU and decided to start treatment. When there was a decrease in intraocular cell count and/or improvement in visual acuity after ATT, the confirmation of presumed TBU was made. Of 585 patients with unexplained uveitis, 66 (11.3%) fulfilled the definition of possible TBU. Ten (15.4%) patients were regarded as having presumed TBU and received ATT. All of them had latent tuberculosis (LTB). The ocular situation improved in seven patients (70%). A history of TB contact, abnormalities on chest radiology, and extraocular manifestations of TB were associated with a good response to ATT in the case of presumed tuberculous uveitis. Tuberculous uveitis remains difficult to diagnose. No clearly correlating factors that predicted the response to ATT, including ocular parameters, could be identified. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  12. Impact of treatment and re-treatment with artemether-lumefantrine and artesunate-amodiaquine on selection of Plasmodium falciparum multidrug resistance gene-1 polymorphisms in the Democratic Republic of Congo and Uganda.

    Directory of Open Access Journals (Sweden)

    Vito Baraka

    Full Text Available The emergence of resistance against artemisinin combination treatment is a major concern for malaria control. ACTs are recommended as the rescue treatment, however, there is limited evidence as to whether treatment and re-treatment with ACTs select for drug-resistant P. falciparum parasites. Thus, the purpose of the present study is to investigate the impact of (re-treatment using artesunate-amodiaquine (ASAQ and artemether-lumefantrine (AL on the selection of P. falciparum multidrug resistance-1 (Pfmdr1 alleles in clinical settings.P. falciparum positive samples were collected from children aged 12-59 months in a clinical trial in DR Congo and Uganda. Pfmdr1 single nucleotide polymorphisms (SNPs analysis at codons N86Y, Y184F, and D1246Y were performed at baseline and post-treatment with either AL or ASAQ as a rescue treatment using nested PCR followed by restriction fragment length polymorphism (RFLP assays.The pre-treatment prevalence of Pfmdr1 N86 and D1246Y varied significantly between the sites, (p>0.001 and (p = 0.013, respectively. There was borderline significant directional selection for Pfmdr1 184F in recurrent malaria infections after treatment with AL in Uganda site (p = 0.05. Pfmdr1 NFD haplotype did not significantly change in post-treatment infections after re-treatment with either AL or ASAQ. Comparison between pre-treatment and post-treatment recurrences did not indicate directional selection of Pfmdr1 N86, D1246 alleles in the pre-RCT, RCT and post-RCT phases in both AL and ASAQ treatment arms. Pfmdr1 86Y was significantly associated with reduced risk of AL treatment failure (RR = 0.34, 95% CI:0.11-1.05, p = 0.04 while no evidence for D1246 allele (RR = 1.02; 95% CI: 0.42-2.47, p = 1.0. Survival estimates showed that the Pfmdr1 alleles had comparable mean-time to PCR-corrected recrudescence and new infections in both AL and ASAQ treatment arms.We found limited impact of (re-treatment with AL or ASAQ on selection for Pfmdr1

  13. Evidence available on the use of the selective β3-adrenoceptor agonist mirabegron for the treatment of overactive bladder.

    Science.gov (United States)

    Angulo, J C; Khullar, V; Nitti, V W; Siddiqui, E

    2013-01-01

    Mirabegron, the selective β3-adrenoceptor agonist, heralds the latest development for the treatment of overactive bladder (OAB). To present the evidence available on the efficacy and tolerability of mirabegron and to discuss this treatment's potential in our setting. We reviewed 11 studies conducted with mirabegron in patients with OAB (2 phase II, 9 phase III), all studies were compared to placebo with 6 studies also including tolterodine as an additional arm. Greater emphasis shall be given to the main phase III trials performed in Europe, the USA and Australia evaluating efficacy and safety after 12 weeks (NCT00662909, NCT00689104, NCT00912964) and safety after 12 months (NCT00688688). The combined analyses of these 12 week studies is also available, with emphasis on global efficacy (FAS), efficacy with regard to incontinence (FAS i) and safety (SAF). More than 50% of patients had previously discontinued anticholinergics medication for OAB, thus allowing us to obtain data on the effectiveness of mirabegron in patients already treated with anticholinergics. Mirabegron is an efficacious drug which presents a statistically significant reduction in the number of incontinence episodes and in urinary frequency as of 4 weeks, with a higher percentage of dry patients and a higher percentage of patients with reduction ≥50% in the number of incontinence episodes than placebo. The efficacy of mirabegron 50 and 100mg in the reduction of incontinence episodes occurs in de novo patients and who have received antimuscarinics, with adjusted mean difference and improvement in urinary frequency greater in treated patients. Its tolerability is very similar to placebo particularly for the adverse effects of the antimuscarinics (dry mouth, constipation and blurred vision). A minimal, non-clinically significant change is observed in systolic and diastolic blood pressure and pulse. Its efficacy is long-term. Mirabegron at the doses of 50 and 100mg presents an improvement versus

  14. Latent tuberculosis infection screening prior to biological treatment in Tunisian patients.

    Science.gov (United States)

    Slouma, Marwa; Mahmoud, Ines; Saidane, Olfa; Bouden, Selma; Abdelmoula, Leila

    2017-10-01

    The screening of latent tuberculosis infection (LTBI) is necessary to prevent infection in patients with chronic inflammatory disease (CID) undergoing biological treatment. We aimed to assess the efficacy of LTBI screening prior to biological treatment in Tunisia, considered as a high-incidence area of active TB disease. We conducted a retrospective study over a period of 8 years [2007-2014] including patients with chronic inflammatory rheumatism receiving biologic agents since at least 6 months. The screening of LTBI was performed according to national Tunisian guidelines. There were 35 men and 78 women. The mean age was 47.67±13.50 years. Rheumatoid arthritis (70.8%) was the most common cause of CID. The diagnosis of LTBI was established in 23 cases. Among these 23 patients, 12 patients had negative tuberculin skin test (TST) associated with positive QuantiFERON-TB Gold (QFT-G), 10 had TST more than 10mm, one patient had a TST between 5 and 10mm associated with positive QFT-G and one patient had a history of tuberculosis inadequately treated. Preventive anti-tuberculous therapy was prescribed before biological therapy initiation in cases of LTBI. During the follow-up period (3.91 years), no case of tuberculosis reactivation has been reported among patients diagnosed with LTBI. However, 2 cases of active pulmonary tuberculosis were reported in patients with initially negative TST and QFT-G. Our study showed that the Tunisian recommendations allowed detecting a LTBI in 20% of biologic therapy candidates. Preventive measures including screening of LTBI and eventually a prophylactic treatment improve the safety of biological treatments. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  15. Characterization of JNJ-42847922, a Selective Orexin-2 Receptor Antagonist, as a Clinical Candidate for the Treatment of Insomnia.

    Science.gov (United States)

    Bonaventure, Pascal; Shelton, Jonathan; Yun, Sujin; Nepomuceno, Diane; Sutton, Steven; Aluisio, Leah; Fraser, Ian; Lord, Brian; Shoblock, James; Welty, Natalie; Chaplan, Sandra R; Aguilar, Zuleima; Halter, Robin; Ndifor, Anthony; Koudriakova, Tatiana; Rizzolio, Michele; Letavic, Michael; Carruthers, Nicholas I; Lovenberg, Timothy; Dugovic, Christine

    2015-09-01

    Dual orexin receptor antagonists have been shown to promote sleep in various species, including humans. Emerging research indicates that selective orexin-2 receptor (OX2R) antagonists may offer specificity and a more adequate sleep profile by preserving normal sleep architecture. Here, we characterized JNJ-42847922 ([5-(4,6-dimethyl-pyrimidin-2-yl)-hexahydro-pyrrolo[3,4-c]pyrrol-2-yl]-(2-fluoro-6-[1,2,3]triazol-2-yl-phenyl)-methanone), a high-affinity/potent OX2R antagonist. JNJ-42847922 had an approximate 2-log selectivity ratio versus the human orexin-1 receptor. Ex vivo receptor binding studies demonstrated that JNJ-42847922 quickly occupied OX2R binding sites in the rat brain after oral administration and rapidly cleared from the brain. In rats, single oral administration of JNJ-42847922 (3-30 mg/kg) during the light phase dose dependently reduced the latency to non-rapid eye movement (NREM) sleep and prolonged NREM sleep time in the first 2 hours, whereas REM sleep was minimally affected. The reduced sleep onset and increased sleep duration were maintained upon 7-day repeated dosing (30 mg/kg) with JNJ-42847922, then all sleep parameters returned to baseline levels following discontinuation. Although the compound promoted sleep in wild-type mice, it had no effect in OX2R knockout mice, consistent with a specific OX2R-mediated sleep response. JNJ-42847922 did not increase dopamine release in rat nucleus accumbens or produce place preference in mice after subchronic conditioning, indicating that the compound lacks intrinsic motivational properties in contrast to zolpidem. In a single ascending dose study conducted in healthy subjects, JNJ-42847922 increased somnolence and displayed a favorable pharmacokinetic and safety profile for a sedative/hypnotic, thus emerging as a promising candidate for further clinical development for the treatment of insomnia. Copyright © 2015 by The American Society for Pharmacology and Experimental Therapeutics.

  16. AVN-211, Novel and Highly Selective 5-HT6 Receptor Small Molecule Antagonist, for the Treatment of Alzheimer's Disease.

    Science.gov (United States)

    Ivachtchenko, Alexandre V; Lavrovsky, Yan; Ivanenkov, Yan A

    2016-03-07

    Within the past decade several novel targets have been indicated as key players in Alzheimer-type dementia and associated conditions, including a "frightening" memory loss as well as severe cognitive impairments. These proteins are deeply implicated in crucial cell processes, e.g., autophagy, growth and progression, apoptosis, and metabolic equilibrium. Since recently, 5-HT6R has been considered as one of the most prominent biological targets in AD drug therapy. Therefore, we investigated the potential procognitive and neuroprotective effects of our novel selective 5-HT6R antagonist, AVN-211. During an extensive preclinical evaluation the lead compound demonstrated a relatively high therapeutic potential and improved selectivity toward 5-HT6R as compared to reference drug candidates. It was thoroughly examined in different in vivo behavioral models directly related to AD and showed evident improvements in cognition and learning. In many cases, the observed effect was considerably greater than that determined for the reported drugs and drug candidates, including memantine, SB-742457, and Lu AE58054, evaluated under the same conditions. In addition, AVN-211 showed a similar or better anxiolytic efficacy than fenobam, rufinamide, lorazepam, and buspirone in an elevated plus-maze model, elevated platform, and open field tests. The compound demonstrated low toxicity and no side effects in vivo, an appropriate pharmacokinetic profile, and stability. In conclusion, AVN-211 significantly delayed or partially halted the progressive decline in memory function associated with AD, which makes it an interesting drug candidate for the treatment of neurodegenerative and psychiatric disorders. Advanced clinical trials are currently under active discussion and in high priority.

  17. Prednisolone treatment affects the performance of the QuantiFERON gold in-tube test and the tuberculin skin test in patients with autoimmune disorders screened for latent tuberculosis infection

    DEFF Research Database (Denmark)

    Bélard, Erika; Semb, Synne; Ruhwald, Morten

    2011-01-01

    (TST). METHODS: A prospective multicenter study included 248 patients with ulcerative colitis (39), Crohn's disease (54), rheumatoid arthritis (111), and spondylo-arthropathy (44). RESULTS: QFT-IT was positive in 7/248 (3%), negative in 229 (92%), and indeterminate in 12 (5%). TST was positive in 54....../238 (23%) patients. Chest x-ray was suspect for tuberculosis in 5/236 (2%), and 35/167 (21%) had =1 risk-factors for infection with Mycobacterium tuberculosis. The main finding was a pronounced negative effect on QFT-IT and TST performance associated with prednisolone treatment. During prednisolone.......0; IQR 9.7 to >10.0; P = 0.0058). Prednisolone treatment was strongly associated with negative TST, adjusted odds ratio (AOR) 0.22 (0.1-0.8; P = 0.018), and with an increased risk of indeterminate QFT-IT results AOR 16.1 (4.1-63.2; P negative effect was found for long...

  18. Single treatment with 100-microsecond alexandrite laser clears selected acquired melanocytic nevi in type IV asian facial skin

    Directory of Open Access Journals (Sweden)

    Etienne CE Wang

    2013-01-01

    Full Text Available Context: Small common acquired melanocytic nevi (AMNs are common on Asian facial skin. Aims: To show that the 755 nm Alexandrite laser stacked at the 100-μs long-pulsed mode (μsAL is an effective modality for the removal of selected AMNs. Settings and Design: This was a retrospective case series, followed up with a telephone interview. Materials and Methods: A retrospective analysis of all patients treated between January 2010 and April 2012 with the μsAL laser for small AMNs was conducted. Pre- and post-treatment facial photographs and photographs of the individual lesions were analyzed by two independent dermatological surgeons for degree of clearance and complications. A telephone interview was conducted with the patients to assess their satisfaction with the procedure. Results: A total of 18 patients with 53 lesions were included. 7/18 (38.9% of patients had ′excellent′ results. No patients had ′mild′ or ′poor′ results. At 4 week post-treatment, 49/53 (92.5% were totally cleared, with 14/53 (26.4% reporting mild atrophy, and 11/53 (20.8% reporting mild post-inflammatory hypopigmentation. The majority of lesions had negligible complications. 9/18 (50% judged the procedure to be ′excellent′, and all patients reported that they would recommend this procedure to a friend seeking removal of small facial AMNs. Conclusion: The μsAL is an effective modality for the removal of small facial AMNs.

  19. Discovery and preclinical pharmacology of a selective ATP-competitive Akt inhibitor (GDC-0068) for the treatment of human tumors.

    Science.gov (United States)

    Blake, James F; Xu, Rui; Bencsik, Josef R; Xiao, Dengming; Kallan, Nicholas C; Schlachter, Stephen; Mitchell, Ian S; Spencer, Keith L; Banka, Anna L; Wallace, Eli M; Gloor, Susan L; Martinson, Matthew; Woessner, Richard D; Vigers, Guy P A; Brandhuber, Barbara J; Liang, Jun; Safina, Brian S; Li, Jun; Zhang, Birong; Chabot, Christine; Do, Steven; Lee, Leslie; Oeh, Jason; Sampath, Deepak; Lee, Brian B; Lin, Kui; Liederer, Bianca M; Skelton, Nicholas J

    2012-09-27

    The discovery and optimization of a series of 6,7-dihydro-5H-cyclopenta[d]pyrimidine compounds that are ATP-competitive, selective inhibitors of protein kinase B/Akt is reported. The initial design and optimization was guided by the use of X-ray structures of inhibitors in complex with Akt1 and the closely related protein kinase A. The resulting compounds demonstrate potent inhibition of all three Akt isoforms in biochemical assays and poor inhibition of other members of the cAMP-dependent protein kinase/protein kinase G/protein kinase C extended family and block the phosphorylation of multiple downstream targets of Akt in human cancer cell lines. Biological studies with one such compound, 28 (GDC-0068), demonstrate good oral exposure resulting in dose-dependent pharmacodynamic effects on downstream biomarkers and a robust antitumor response in xenograft models in which the phosphatidylinositol 3-kinase-Akt-mammalian target of rapamycin pathway is activated. 28 is currently being evaluated in human clinical trials for the treatment of cancer.

  20. Effect of oocyte selection, estradiol and antioxidant treatment on in vitro maturation of oocytes collected from prepubertal Boer goats

    Directory of Open Access Journals (Sweden)

    George W. Smith

    2010-02-01

    Full Text Available Development of improved procedures for in vitro maturation of oocytes collected from prepubertal goats has applications for in vitro embryo production and accompanying strategies for genetic improvement. The objective of described studies was to determine the effects of oocyte grade, in vitro maturation time, antioxidant supplementation and concentrations of estradiol in the maturation medium on in vitro maturation of oocytes harvested from 1-6 mm follicles present on the ovaries (obtained from an abattoir of 1-6 month-old prepubertal Boer goats. Rates of progression to metaphase II were greater for grade 1 oocytes (>3 compact layers of cumulus cells and evenly granulated cytoplasm than grade 2 oocytes (in vitro maturation in the presence of high concentrations of estradiol (10 and 100 mg/mL on progression to metaphase II was observed, and no effect was observed in response to 1 mg/mL estradiol treatment as compared with control. Results suggest that oocyte selection and beta-mercaptoethanol supplementation can positively influence progression to metaphase II of oocytes harvested from ovaries of prepubertal goats, whereas high concentrations of estradiol are inhibitory to in vitro maturation.

  1. Automatic irradiation control by an optical feedback technique for selective retina treatment (SRT) in a rabbit model

    Science.gov (United States)

    Seifert, Eric; Roh, Young-Jung; Fritz, Andreas; Park, Young Gun; Kang, Seungbum; Theisen-Kunde, Dirk; Brinkmann, Ralf

    2013-06-01

    Selective Retina Therapy (SRT) targets the Retinal Pigment Epithelium (RPE) without effecting neighboring layers as the photoreceptors or the choroid. SRT related RPE defects are ophthalmoscopically invisible. Owing to this invisibility and the variation of the threshold radiant exposure for RPE damage the treating physician does not know whether the treatment was successful or not. Thus measurement techniques enabling a correct dosing are a demanded element in SRT devices. The acquired signal can be used for monitoring or automatic irradiation control. Existing monitoring techniques are based on the detection of micro-bubbles. These bubbles are the origin of RPE cell damage for pulse durations in the ns and μs time regime 5μs. The detection can be performed by optical or acoustical approaches. Monitoring based on an acoustical approach has already been used to study the beneficial effects of SRT on diabetic macula edema and central serous retinopathy. We have developed a first real time feedback technique able to detect micro-bubble induced characteristics in the backscattered laser light fast enough to cease the laser irradiation within a burst. Therefore the laser energy within a burst of at most 30 pulses is increased linearly with every pulse. The laser irradiation is ceased as soon as micro-bubbles are detected. With this automatic approach it was possible to observe invisible lesions, an intact photoreceptor layer and a reconstruction of the RPE within one week.

  2. [Factors associated with treatment adherence for tuberculosis infection].

    Science.gov (United States)

    Gallardo, Carmen R; Gea Velázquez de Castro, María Teresa; Requena Puche, Juana; Miralles Bueno, Juan José; Rigo Medrano, María Vicenta; Aranaz Andrés, Jesús M

    2014-01-01

    To analyze adherence to treatment of tuberculosis infection and to identify risk factors for its compliance. An observational historical cohort study. Hospital Universitari Sant Joan d'Alacant (Alicante). All patients with a tuberculin skin test (TST) done during tuberculosis contact tracing during 6 years. We included 764 tuberculosis contacts in the analysis. 59.7% of the 566 patients who completed the contact tracing, had tuberculosis infection (TI). Of the patients with TI, 45.6% had not started treatment for tuberculosis infection (TTBI). Factors associated with not starting TTBI were: age (36-65 years, RR: 5.8; 95% CI: 1.2-27.5, and > 65 years, RR: 11.3; 95% CI: 2.0-64.0), the social relationship with TB case (RR: 2.2; 95% CI 1.2-3.8), and the TST reaction (≥ 15mm; RR: 0.5; 95% CI: 0.3-0.9). The completion rate for TTBI was 80.4% among people who started therapy. The treatment regimen was associated with greater compliance to TTBT (7-9H, RR: 12.7; 95% CI: 1.5-107.3). The treatment compliance rate of Tuberculosis infection was high among people who started therapy. Almost a half of the contacts with TI did not start treatment, and associated factors were: age, social relationship, and the TST reaction. The treatment regimen was associated with greater compliance. It is important to know the factors associated with adherence to treatment of TI in each health area, and focus efforts on risk groups; thereby approaching the global control of tuberculosis. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  3. Application of GRA method, dynamic analysis and fuzzy set theory in evaluation and selection of emergency treatment technology for large scale phenol spill incidents

    Science.gov (United States)

    Zhao, Jingjing; Yu, Lean; Li, Lian

    2017-05-01

    Select an appropriate technology in an emergency response is a very important issue with various kinds of chemical contingency spills frequently taking place. Due to the complexity, fuzziness and uncertainties of the chemical contingency spills, the theory of GRA method, dynamic analysis combined with fuzzy set theory will be appropriately applied to selection and evaluation of emergency treatment technology. Finally, a emergency phenol spill accidence occurred in highway is provided to illustrate the applicability and feasibility of the proposed methods.

  4. Selective hydrolysis of wastewater sludge. Part 1. Model calculations and cost benefit analysis for Esbjerg West waste water treatment plant, Denmark

    Energy Technology Data Exchange (ETDEWEB)

    OEstergaard, N [Eurotec West A/S (DK); Thomsen, Anne Belinda; Thygesen, Anders; Bangsoe Nielsen, H [Risoe National Laboratory, DTU (DK); Rasmussen, Soeren [SamRas (DK)

    2007-09-15

    The project 'Selective hydrolysis of wastewater sludge' investigates the possibilities of utilizing selective hydrolysis of sludge at waste water treatment plants to increase the production of biogas based power and heat, and at the same time reduce power consumption for handling and treatment of nitrogen and sludge as well as for disposal of the sludge. The selective hydrolysis system is based on the fact that an anaerobic digestion before a hydrolysis treatment increases the hydrolysis efficiency, as the production of volatile organic components, which might inhibit the hydrolysis efficiency, are not produced to the same extent as may be the case for a hydrolysis made on un-digested material. Furthermore it is possible to separate ammonia from the sludge without using chemicals; it has, however, proven difficult to treat wastewater sludge, as the sludge seems to be difficult to treat in the laboratory using simple equipment. Esbjerg Wastewater Treatment Plant West, Denmark, is used as model plant for the calculations of the benefits using selective hydrolysis of sludge as if established at the existing sludge digester system. The plant is a traditional build plant based on the activated sludge concept in addition to traditional digester technology. The plant treats combined household and factory wastewater with a considerable amount of the wastewater received from the industries. During the project period Esbjerg Treatment Plant West went through considerable process changes, thus the results presented in this report are based on historical plant characteristics and may be viewed as conservative relative to what actually may be obtainable. (BA)

  5. Chronic Periprosthetic Hip Joint Infection. A Retrospective, Observational Study on the Treatment Strategy and Prognosis in 130 Non-Selected Patients

    DEFF Research Database (Denmark)

    Lange, Jeppe; Troelsen, Anders; Søballe, Kjeld

    2016-01-01

    INTRODUCTION: Limited information is available regarding the treatment strategy and prognosis of non-selected patients treated for chronic periprosthetic hip joint infection. Such information is important as no head-to-head studies on treatment strategies are available. The purpose of this study...... is to report on the treatment strategy and prognosis of a non-selected, consecutive patient population. METHODS: We identified 130 patients in the National Patient Registry, consecutively treated for a chronic periprosthetic hip joint infection between 2003-2008 at 11 departments of orthopaedic surgery. We...... extracted information regarding patient demographics, treatment and outcome. 82 patients were re-implanted in a two-stage revision (national standard), the remaining 48 were not re-implanted in a two-stage revision. We were able to collect up-to-date information on all patients to date of death or medical...

  6. Selected chemical composition changes in microwave-convective dried parsley leaves affected by ultrasound and steaming pre-treatments - An optimization approach.

    Science.gov (United States)

    Dadan, Magdalena; Rybak, Katarzyna; Wiktor, Artur; Nowacka, Malgorzata; Zubernik, Joanna; Witrowa-Rajchert, Dorota

    2018-01-15

    Parsley leaves contain a high amount of bioactive components (especially lutein), therefore it is crucial to select the most appropriate pre-treatment and drying conditions, in order to obtain high quality of dried leaves, which was the aim of this study. The optimization was done using response surface methodology (RSM) for the following factors: microwave power (100, 200, 300W), air temperature (20, 30, 40°C) and pre-treatment variant (ultrasound, steaming and dipping as a control). Total phenolic content (TPC), antioxidant activity, chlorophyll and lutein contents (using UPLC-PDA) were determined in dried leaves. The analysed responses were dependent on the applied drying parameters and the pre-treatment type. The possibility of ultrasound and steam treatment application was proven and the optimal processing conditions were selected. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Combining ZnO/microwave treatment for changing wettability of WEEE styrene plastics (ABS and HIPS) and their selective separation by froth flotation

    Science.gov (United States)

    Thanh Truc, Nguyen Thi; Lee, Byeong-Kyu

    2017-10-01

    This study reports a simple froth flotation method to separate plastic wastes of acrylonitrile-butadiene-styrene (ABS) and high impact polystyrene (HIPS) after initial hydrophilization by coating the plastics with ZnO and microwave treatment. ABS and HIPS are typical styrene-based WEEE plastics having similar density and hydrophobicity, which hinders their separation for recycling. After coating with ZnO, 2-min microwave treatment rearranged the ABS surface and thus changed its molecular mobility and increased its hydrophilicity. The combined ZnO coating/microwave treatment facilitated the selective separation of ABS and HIPS with 100% and 95.2% recovery and 95.4% and 100% purity in froth flotation, respectively. The combination of ZnO coating-microwave treatment and froth flotation can be utilized as a selective ABS/HIPS separation technique for improved recycling of WEEE plastics.

  8. On the selection and validation of biological treatment processes. The GDF experience; Le choix et la validation des procedes de traitement biologique. L`experience de GDF

    Energy Technology Data Exchange (ETDEWEB)

    Druelle, V. [Gaz de France (GDF), 75 - Paris (France)

    1996-12-31

    The biological treatment process was selected by Gaz de France (GDF), the French national gas utility, for the de-pollution of an old gas works where the main pollutants are coal tars containing polycyclic aromatic hydrocarbons. Microorganism-based biological treatment techniques may involve bio-reactors, static ground knolls (where oxygen is brought through drains) and dynamic knolls (where oxygenation is carried out by turning up the soil). Issues on sampling, sorting, process testing, site preparation, process control, etc. are reviewed

  9. On the selection and validation of biological treatment processes. The GDF experience; Le choix et la validation des procedes de traitement biologique. L`experience de GDF

    Energy Technology Data Exchange (ETDEWEB)

    Druelle, V [Gaz de France (GDF), 75 - Paris (France)

    1997-12-31

    The biological treatment process was selected by Gaz de France (GDF), the French national gas utility, for the de-pollution of an old gas works where the main pollutants are coal tars containing polycyclic aromatic hydrocarbons. Microorganism-based biological treatment techniques may involve bio-reactors, static ground knolls (where oxygen is brought through drains) and dynamic knolls (where oxygenation is carried out by turning up the soil). Issues on sampling, sorting, process testing, site preparation, process control, etc. are reviewed

  10. Bacterial Selection during the Formation of Early-Stage Aerobic Granules in Wastewater Treatment Systems Operated Under Wash-Out Dynamics

    OpenAIRE

    Weissbrodt, David G.; Lochmatter, Samuel; Ebrahimi, Sirous; Rossi, Pierre; Maillard, Julien; Holliger, Christof

    2012-01-01

    Aerobic granular sludge is attractive for high-rate biological wastewater treatment. Biomass wash-out conditions stimulate the formation of aerobic granules. Deteriorated performances in biomass settling and nutrient removal during start-up have however often been reported. The effect of wash-out dynamics was investigated on bacterial selection, biomass settling behavior, and metabolic activities during the formation of early-stage granules from activated sludge of two wastewater treatment pl...

  11. Effect of Heat Treatment on Microstructure and Impact Toughness of Ti-6Al-4V Manufactured by Selective Laser Melting Process

    Directory of Open Access Journals (Sweden)

    Lee K.-A.

    2017-06-01

    Full Text Available This study manufactured Ti-6Al-4V alloy using one of the powder bed fusion 3D-printing processes, selective laser melting, and investigated the effect of heat treatment (650°C/3hrs on microstructure and impact toughness of the material. Initial microstructural observation identified prior-β grain along the building direction before and after heat treatment. In addition, the material formed a fully martensite structure before heat treatment, and after heat treatment, α and β phase were formed simultaneously. Charpy impact tests were conducted. The average impact energy measured as 6.0 J before heat treatment, and after heat treatment, the average impact energy increased by approximately 20% to 7.3 J. Fracture surface observation after the impact test showed that both alloys had brittle characteristics on macro levels, but showed ductile fracture characteristics and dimples at micro levels.

  12. A three-temperature model of selective photothermolysis for laser treatment of port wine stain containing large malformed blood vessels

    International Nuclear Information System (INIS)

    Li, D.; Wang, G.X.; He, Y.L.; Wu, W.J.; Chen, B.

    2014-01-01

    As congenital vascular malformations, port wine stain (PWS) is composed of ectatic venular capillary blood vessels buried within healthy dermis. In clinic, pulsed dye laser (PDL) in visible band (e.g. 585 nm) together with cryogen spray cooling (CSC) have become the golden standard for treatment of PWS. However, due to the limited energy deposition of the PDL in blood, large blood vessels are likely to survive from the laser irradiation. As a result, complete clearance of the lesions is rarely achieved. Assuming the local thermal non-equilibrium in skin tissue during the laser surgery, a three-temperature model is proposed to treat the PWS tissue as a porous media composed of a non-absorbing dermal matrix buried with the blood as well as the large malformed blood vessels. Three energy equations are constructed and solved coupling for the temperature of the blood in average-sized PWS vessels, non-absorbing dermal tissues and large malformed blood vessels, respectively. Subsequently, the thermal responses of human skin to visible (585 nm) and near-infrared (1064 nm) laser irradiations with various pulse durations in conjunction with cryogen spray cooling are investigated by the new model, and Arrhenius integral is used to analyze the thermal damage. The simulations show that the short pulse duration of 1.5 ms results in a higher selective heating of blood over epidermis, which will lead to a desired clinic outcome than the longer pulse duration. Due to a much deeper light penetration depth, laser irradiation with 1064 nm in wavelength is superior to that with 585 nm in treating patients with cutaneous hyper-vascular malformation. Complete coagulations are predicted in large-sized and deeply extending blood vessels by 1064 nm laser. - Highlights: •A three-temperature model is proposed for the laser treatment of port wine stain (PWS). •Average sized and large malformed blood vessels in porous medium (tissue) are considered. •Thermal responses of PWS to

  13. Prognostic factors in brain metastases: should patients be selected for aggressive treatment according to recursive partitioning analysis (RPA) classes?

    International Nuclear Information System (INIS)

    Nieder, Carsten; Nestle, Ursula; Motaref, Babak; Walter, Karin; Niewald, Marcus; Schnabel, Klaus

    2000-01-01

    Purpose: To determine whether or not Radiation Therapy Oncology Group (RTOG) recursive partitioning analysis (RPA) derived prognostic classes for patients with brain metastases are generally applicable and can be recommended as rational strategy for patient selection for future clinical trials. Inclusion of time to non-CNS death as additional endpoint besides death from any cause might result in further valuable information, as survival limitation due to uncontrolled extracranial disease can be explored. Methods: We performed a retrospective analysis of prognostic factors for survival and time to non-CNS death in 528 patients treated at a single institution with radiotherapy or surgery plus radiotherapy for brain metastases. For this purpose, patients were divided into groups with Karnofsky performance status (KPS) 0.05 for RPA class II versus III). However, it was 8.5 months in RPA class II patients with controlled primary tumor, which was found to be the only prognostic factor for time to non-CNS death in patients with KPS ≥70%. In patients with KPS <70%, no statistically significant prognostic factors were identified for this endpoint. Conclusions: Despite some differences, this analysis essentially confirmed the value of RPA-derived prognostic classes, as published by the RTOG, when survival was chosen as endpoint. RPA class I patients seem to be most likely to profit from aggressive treatment strategies and should be included in appropriate clinical trials. However, their number appears to be very limited. Considering time to non-CNS death, our results suggest that certain patients in RPA class II also might benefit from increased local control of brain metastases

  14. Phosphotyrosine-based-phosphoproteomics scaled-down to biopsy level for analysis of individual tumor biology and treatment selection.

    Science.gov (United States)

    Labots, Mariette; van der Mijn, Johannes C; Beekhof, Robin; Piersma, Sander R; de Goeij-de Haas, Richard R; Pham, Thang V; Knol, Jaco C; Dekker, Henk; van Grieken, Nicole C T; Verheul, Henk M W; Jiménez, Connie R

    2017-06-06

    Mass spectrometry-based phosphoproteomics of cancer cell and tissue lysates provides insight in aberrantly activated signaling pathways and potential drug targets. For improved understanding of individual patient's tumor biology and to allow selection of tyrosine kinase inhibitors in individual patients, phosphoproteomics of small clinical samples should be feasible and reproducible. We aimed to scale down a pTyr-phosphopeptide enrichment protocol to biopsy-level protein input and assess reproducibility and applicability to tumor needle biopsies. To this end, phosphopeptide immunoprecipitation using anti-phosphotyrosine beads was performed using 10, 5 and 1mg protein input from lysates of colorectal cancer (CRC) cell line HCT116. Multiple needle biopsies from 7 human CRC resection specimens were analyzed at the 1mg-level. The total number of phosphopeptides captured and detected by LC-MS/MS ranged from 681 at 10mg input to 471 at 1mg HCT116 protein. ID-reproducibility ranged from 60.5% at 10mg to 43.9% at 1mg. Per 1mg-level biopsy sample, >200 phosphopeptides were identified with 57% ID-reproducibility between paired tumor biopsies. Unsupervised analysis clustered biopsies from individual patients together and revealed known and potential therapeutic targets. This study demonstrates the feasibility of label-free pTyr-phosphoproteomics at the tumor biopsy level based on reproducible analyses using 1mg of protein input. The considerable number of identified phosphopeptides at this level is attributed to an effective down-scaled immuno-affinity protocol as well as to the application of ID propagation in the data processing and analysis steps. Unsupervised cluster analysis reveals patient-specific profiles. Together, these findings pave the way for clinical trials in which pTyr-phosphoproteomics will be performed on pre- and on-treatment biopsies. Such studies will improve our understanding of individual tumor biology and may enable future p

  15. Effect of thermal treatment on rutin content in selected buckwheat products using calcium as an internal tracer

    Directory of Open Access Journals (Sweden)

    Eliška Krejzová

    2017-01-01

    Full Text Available Reversed-phase high-performance liquid chromatography (RP-HPLC was used for rutin (quercetin-3-rutinoside determination in selected buckwheat products (whole meal flour, broken seeds, seed hulls, herbs and baked cereal breads. The effect of various thermal procedures on content of rutin was evaluated using calcium as an internal tracker to correct changes in mass and composition of the buckwheat products. These factors are very seldom taken into account. The results show non-significant changes in rutin levels obtained in whole meal flour and broken seed samples after thermal treatment up to 150°C. Higher temperature already caused sudden fall in the observed rutin concentrations. The evaporation of some volatile compounds and degradation products can decrease the mass of the samples and formally increase the content of rutin (35.5 ±4.7 mg per 100 g for whole meal flour and 10.2 ±0.4 mg per100 g for broken seeds at 150°C. Serious decrease of rutin contents at elevated temperatures (>150°C can be explained by its degradation (by breaking off the C-C bond in quercetin-3-rutinoside moiety and/or evaporation (24.3 ±1.4 mg per 100 g for whole meal flour and 3.06 ±0.3 mg per100 g for broken seeds at 180°C. In case of baked cereal breads the level of rutin changed in dependence on the ratio between buckwheat and corn flour. Longer time leaching and higher temperature implicate higher rutin content in infusions prepared from buckwheat seed hulls and herbs.

  16. Criterion for the selection of a system of treatment of residues and their application to the wine of the alcoholic industry

    International Nuclear Information System (INIS)

    Caicedo M, Luis Alfonso; Fonseca, Jose Joaquin; Rodriguez, Gerardo

    1996-01-01

    The selection of a system of residues treatment should follow the criterion of the process denominated BATEA (better available and feasible technical and economical process). Because their application is difficult for not having objective parameters of evaluation, a method is presented that classifies the evaluation criterions in general and specific. For the quantification of these aspects factors like FQO are used, FCI, FTR, FD and the factor of applicability of the treatment (FAT). The method applied to the wine; allows concluding that it is the evaporation the best treatment system for this process, while other systems are not developed or it increases the recompensing rate

  17. [Selective mutism].

    Science.gov (United States)

    Ytzhak, A; Doron, Y; Lahat, E; Livne, A

    2012-10-01

    Selective mutism is an uncommon disorder in young children, in which they selectively don't speak in certain social situations, while being capable of speaking easily in other social situations. Many etiologies were proposed for selective mutism including psychodynamic, behavioral and familial etc. A developmental etiology that includes insights from all the above is gaining support. Accordingly, mild language impairment in a child with an anxiety trait may be at the root of developing selective mutism. The behavior will be reinforced by an avoidant pattern in the family. Early treatment and followup for children with selective mutism is important. The treatment includes non-pharmacological therapy (psychodynamic, behavioral and familial) and pharmacologic therapy--mainly selective serotonin reuptake inhibitors (SSRI).

  18. Economic considerations and patients' preferences affect treatment selection for patients with rheumatoid arthritis: a discrete choice experiment among European rheumatologists

    NARCIS (Netherlands)

    Hifinger, M.; Hiligsmann, M.; Ramiro, S.; Watson, V.; Severens, J. L.; Fautrel, B.; Uhlig, T.; van Vollenhoven, R.; Jacques, P.; Detert, J.; Canas da Silva, J.; Scirè, C. A.; Berghea, F.; Carmona, L.; Péntek, M.; Keat, A.; Boonen, A.

    2017-01-01

    To compare the value that rheumatologists across Europe attach to patients' preferences and economic aspects when choosing treatments for patients with rheumatoid arthritis. In a discrete choice experiment, European rheumatologists chose between two hypothetical drug treatments for a patient with

  19. Apramycin treatment affects selection and spread of a multidrug-resistant Escherichia coli strain able to colonize the human gut in the intestinal microbiota of pigs

    DEFF Research Database (Denmark)

    Herrero-Fresno, Ana; Zachariasen, Camilla; Hansen, Monica Hegstad

    2016-01-01

    of treatment, and apramycin treatment resulted in significantly higher counts compared to the non-treated group. This represents the first demonstration of how antimicrobial treatment affects spread of resistant bacteria in pig production. The use of apramycin may lead to enhanced spread of gentamicin-resistant......The effect of apramycin treatment on transfer and selection of an Escherichia coli strain (E. coli 912) in the intestine of pigs was analyzed through an in vivo experiment. The strain was sequenced and assigned to the sequence type ST101 and serotype O11. It carried resistance genes to apramycin......-treated (pen 3), along with a non-inoculated control group (pen 1). Two pigs of pen 2 and 3 were inoculated intragastrically with a rifampicin resistant variant of the strain. Apramycin treatment in pen 2 was initiated immediately after inoculation. Strain colonization was assessed in the feces from all pigs...

  20. An Examination of Fluoxetine for the Treatment of Selective Mutism Using a Nonconcurrent Multiple-Baseline Single-Case Design Across 5 Cases.

    Science.gov (United States)

    Barterian, Justin A; Sanchez, Joel M; Magen, Jed; Siroky, Allison K; Mash, Brittany L; Carlson, John S

    2018-01-01

    This study examined the utility of fluoxetine in the treatment of 5 children, aged 5 to 14 years, diagnosed with selective mutism who also demonstrated symptoms of social anxiety. A nonconcurrent, randomized, multiple-baseline, single-case design with a single-blind placebo-controlled procedure was used. Parents and the study psychiatrist completed multiple methods of assessment including Direct Behavior Ratings and questionnaires. Treatment outcomes were evaluated by calculating effect sizes for each participant as an individual and for the participants as a group. Information regarding adverse effects with an emphasis on behavioral disinhibition and ratings of parental acceptance of the intervention was gathered. All 5 children experienced improvement in social anxiety, responsive speech, and spontaneous speech with medium to large effect sizes; however, children still met criteria for selective mutism at the end of the study. Adverse events were minimal, with only 2 children experiencing brief occurrences of minor behavioral disinhibition. Parents found the treatment highly acceptable.

  1. Processing Technology Selection for Municipal Sewage Treatment Based on a Multi-Objective Decision Model under Uncertainty

    Directory of Open Access Journals (Sweden)

    Xudong Chen

    2018-03-01

    Full Text Available This study considers the two factors of environmental protection and economic benefits to address municipal sewage treatment. Based on considerations regarding the sewage treatment plant construction site, processing technology, capital investment, operation costs, water pollutant emissions, water quality and other indicators, we establish a general multi-objective decision model for optimizing municipal sewage treatment plant construction. Using the construction of a sewage treatment plant in a suburb of Chengdu as an example, this paper tests the general model of multi-objective decision-making for the sewage treatment plant construction by implementing a genetic algorithm. The results show the applicability and effectiveness of the multi-objective decision model for the sewage treatment plant. This paper provides decision and technical support for the optimization of municipal sewage treatment.

  2. Processing Technology Selection for Municipal Sewage Treatment Based on a Multi-Objective Decision Model under Uncertainty.

    Science.gov (United States)

    Chen, Xudong; Xu, Zhongwen; Yao, Liming; Ma, Ning

    2018-03-05

    This study considers the two factors of environmental protection and economic benefits to address municipal sewage treatment. Based on considerations regarding the sewage treatment plant construction site, processing technology, capital investment, operation costs, water pollutant emissions, water quality and other indicators, we establish a general multi-objective decision model for optimizing municipal sewage treatment plant construction. Using the construction of a sewage treatment plant in a suburb of Chengdu as an example, this paper tests the general model of multi-objective decision-making for the sewage treatment plant construction by implementing a genetic algorithm. The results show the applicability and effectiveness of the multi-objective decision model for the sewage treatment plant. This paper provides decision and technical support for the optimization of municipal sewage treatment.

  3. Pattern of intraocular pressure reduction following laser trabeculoplasty in open-angle glaucoma patients: comparison between selective and nonselective treatment

    Directory of Open Access Journals (Sweden)

    Almeida Jr ED

    2011-07-01

    Full Text Available Eglailson Dantas Almeida Júnior1, Luciano Moreira Pinto1,2, Rodrigo Antonio Brant Fernandes1,2, Tiago Santos Prata1,31Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil; 2Cerpo Oftalmologia, São Paulo, Brazil; 3Hospital Medicina dos Olhos, São Paulo, BrazilObjective: To compare the pattern of intraocular pressure (IOP reduction following selective laser trabeculoplasty (SLT versus argon laser trabeculoplasty (ALT in open-angle glaucoma (OAG patients, and to investigate the ability of initial IOP reduction to predict mid-term success.Methods: A prospective, nonrandomized, interventional case series was carried out. Consecutive uncontrolled OAG glaucoma patients underwent SLT or ALT; the same preoperative medical regimen was maintained during follow-up. Data collected included age, type of OAG, pre- and postoperative IOP, number of glaucoma medications, and surgical complications. Post-treatment assessments were scheduled at day 1 and 7 and months 1, 3, and 6.Results: A total of 45 patients (45 eyes were enrolled [SLT group (n = 25; ALT group (n = 20]. Groups were similar for age, baseline IOP, and number of glaucoma medications (P ≥ 0.12. We found no significant differences in mean IOP reduction between SLT (5.1 ± 2.5 mmHg; 26.6% and ALT (4.4 ± 2.8 mmHg; 22.8% groups at month 6 (P = 0.38. Success rates (IOP ≤ 16 mmHg and IOP reduction ≥25% at last follow-up visit were similar for SLT (72% and ALT (65% groups (P = 0.36. Comparing the pattern of IOP reduction (% of IOP reduction at each visit between groups, we found a greater effect following SLT compared with ALT at day 7 (23.7% ± 13.7% vs 8.1% ± 9.5%; P < 0.001. No significant differences were observed at other time points (P ≥ 0.32. Additionally, the percentage of IOP reduction at day 7 and at month 6 were significantly correlated in the SLT group (R2 = 0.36; P < 0.01, but not in the ALT group (P = 0.89. Early postoperative success predicted late

  4. Tuberculin skin testing and treatment modulates interferon-gamma release assay results for latent tuberculosis in migrants.

    Directory of Open Access Journals (Sweden)

    Matthew K O'Shea

    Full Text Available Identifying latent tuberculosis infection (LTBI in people migrating from TB endemic regions to low incidence countries is an important control measure. However, no prospective longitudinal comparisons between diagnostic tests used in such migrant populations are available.To compare commercial interferon (IFN-gamma release assays (IGRAs and the tuberculin skin test (TST for diagnosing LTBI in a migrant population, and the influence of antecedent TST and LTBI treatment on IGRA performance.This cohort study, performed from February to September 2012, assessed longitudinal IGRA and TST responses in Nepalese military recruits recently arrived in the UK. Concomitant T-SPOT.TB, QFT-GIT and TST were performed on day 0, with IGRAs repeated 7 and 200 days later, following treatment for LTBI if necessary.166 Nepalese recruits were prospectively assessed. At entry, 21 individuals were positive by T-SPOT.TB and 8 individuals by QFT-GIT. There was substantial agreement between TST and T-SPOT.TB positives at baseline (71.4% agreement; κ = 0.62; 95% CI:0.44-0.79, but only moderate concordance between positive IGRAs (38.1% agreement; κ = 0.46; 95% CI:0.25-0.67. When reassessed 7 days following TST, numbers of IGRA-positive individuals changed from 8 to 23 for QFT-GIT (p = 0.0074 and from 21 to 23 for T-SPOT.TB (p = 0.87. This resulted in an increase in IGRA concordance to substantial (64.3% agreement; κ = 0.73; 95% CI:0.58-0.88. Thus, in total on day 0 and day 7 after testing, 29 out of 166 participants (17.5% provided a positive IGRA and of these 13 were TST negative. Two hundred days after the study commenced and three months after treatment for LTBI was completed by those who were given chemoprophylaxis, 23 and 21 participants were positive by T-SPOT.TB or QFT-GIT respectively. When individual responses were examined longitudinally within this population 35% of the day 7 QFT-GIT-positive, and 19% T-SPOT.TB-positive individuals, were

  5. Selective hydrolysis of wastewater sludge. Part 1. Model calculations and cost benefit analysis for Esbjerg West waste water treatment plant, Denmark

    Energy Technology Data Exchange (ETDEWEB)

    OEstergaard, N. (Eurotec West A/S (DK)); Thomsen, Anne Belinda; Thygesen, Anders; Bangsoe Nielsen, H. (Risoe National Laboratory, DTU (DK)); Rasmussen, Soeren (SamRas (DK))

    2007-09-15

    The project 'Selective hydrolysis of wastewater sludge' investigates the possibilities of utilizing selective hydrolysis of sludge at waste water treatment plants to increase the production of biogas based power and heat, and at the same time reduce power consumption for handling and treatment of nitrogen and sludge as well as for disposal of the sludge. The selective hydrolysis system is based on the fact that an anaerobic digestion before a hydrolysis treatment increases the hydrolysis efficiency, as the production of volatile organic components, which might inhibit the hydrolysis efficiency, are not produced to the same extent as may be the case for a hydrolysis made on un-digested material. Furthermore it is possible to separate ammonia from the sludge without using chemicals; it has, however, proven difficult to treat wastewater sludge, as the sludge seems to be difficult to treat in the laboratory using simple equipment. Esbjerg Wastewater Treatment Plant West, Denmark, is used as model plant for the calculations of the benefits using selective hydrolysis of sludge as if established at the existing sludge digester system. The plant is a traditional build plant based on the activated sludge concept in addition to traditional digester technology. The plant treats combined household and factory wastewater with a considerable amount of the wastewater received from the industries. During the project period Esbjerg Treatment Plant West went through considerable process changes, thus the results presented in this report are based on historical plant characteristics and may be viewed as conservative relative to what actually may be obtainable. (BA)

  6. Inducing Stable α + β Microstructures during Selective Laser Melting of Ti-6Al-4V Using Intensified Intrinsic Heat Treatments

    Directory of Open Access Journals (Sweden)

    Pere Barriobero-Vila

    2017-03-01

    Full Text Available Selective laser melting is a promising powder-bed-based additive manufacturing technique for titanium alloys: near net-shaped metallic components can be produced with high resource-efficiency and cost savings [...

  7. Inducing Stable α + β Microstructures during Selective Laser Melting of Ti-6Al-4V Using Intensified Intrinsic Heat Treatments.

    Science.gov (United States)

    Barriobero-Vila, Pere; Gussone, Joachim; Haubrich, Jan; Sandlöbes, Stefanie; Da Silva, Julio Cesar; Cloetens, Peter; Schell, Norbert; Requena, Guillermo

    2017-03-07

    Selective laser melting is a promising powder-bed-based additive manufacturing technique for titanium alloys: near net-shaped metallic components can be produced with high resource-efficiency and cost savings [...].

  8. Selective Embolization of Systemic Collaterals for the Treatment of Recurrent Hemoptysis Secondary to the Unilateral Absence of a Pulmonary Artery in a Child

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Yin, E-mail: zhouyin502@163.com [West China Hospital, Sichuan University, Department of Pediatric Surgery (China); Tsauo, Jiaywei, E-mail: 80732059@qq.com [West China Hospital, Sichuan University, Institute of Interventional Radiology (China); Li, Yuan, E-mail: liyuanletters@163.com [West China Hospital, Sichuan University, Department of Pediatric Surgery (China); Li, Xiao, E-mail: simonlixiao@gmail.com [West China Hospital, Sichuan University, Institute of Interventional Radiology (China)

    2015-10-15

    The unilateral absence of the pulmonary artery (UAPA) is a rare anomaly. Hemoptysis due to systemic collaterals is one of the most common complications of UAPA. To the best of the authors’ knowledge, the utility of selective embolization for the treatment of this condition in children has not been reported previously. This report describes a 6-year-old girl with isolated UAPA (IUAPA) admitted for a 10-month history of recurrent hemoptysis that had worsened during the previous 2 months. Selective embolization of the bronchial systemic collaterals was performed. The patient remained asymptomatic with no recurrence of hemoptysis 8 months after the procedure.

  9. In search of patient characteristics that may guide empirically based treatment selection for personality disorder patients-a concept map approach.

    Science.gov (United States)

    van Manen, J G; Kamphuis, J H; Goossensen, A; Timman, R; Busschbach, J J V; Verheul, R

    2012-08-01

    Using the concept map method, this study aimed to summarize and describe patient characteristics pertinent to treatment selection for patients with personality disorders (PDs). Initial patient characteristics were derived from the research literature and a survey among Dutch expert clinicians. Concept mapping is a formalized conceptualization procedure that describes the underlying cognitive structures people use in complex tasks, such as treatment allocation. Based on expert opinions of 29 Dutch clinicians, a concept map was generated that yielded eight domains of patient characteristics, i.e., Severity of symptoms, Severity of personality pathology, Ego-adaptive capacities, Motivation and working alliance, Social context, Social demographic characteristics, Trauma, and Treatment history and medical condition. These domains can be ordered along two bipolar axes, running from internal to external concepts and from vulnerability to strength concepts, respectively. Our findings may serve as input for the delineation of algorithms for patient-treatment matching research in PD.

  10. Mid-Treatment Sleep Duration Predicts Clinically Significant Knee Osteoarthritis Pain reduction at 6 months: Effects From a Behavioral Sleep Medicine Clinical Trial.

    Science.gov (United States)

    Salwen, Jessica K; Smith, Michael T; Finan, Patrick H

    2017-02-01

    To determine the relative influence of sleep continuity (sleep efficiency, sleep onset latency, total sleep time [TST], and wake after sleep onset) on clinical pain outcomes within a trial of cognitive behavioral therapy for insomnia (CBT-I) for patients with comorbid knee osteoarthritis and insomnia. Secondary analyses were performed on data from 74 patients with comorbid insomnia and knee osteoarthritis who completed a randomized clinical trial of 8-session multicomponent CBT-I versus an active behavioral desensitization control condition (BD), including a 6-month follow-up assessment. Data used herein include daily diaries of sleep parameters, actigraphy data, and self-report questionnaires administered at specific time points. Patients who reported at least 30% improvement in self-reported pain from baseline to 6-month follow-up were considered responders (N = 31). Pain responders and nonresponders did not differ significantly at baseline across any sleep continuity measures. At mid-treatment, only TST predicted pain response via t tests and logistic regression, whereas other measures of sleep continuity were nonsignificant. Recursive partitioning analyses identified a minimum cut-point of 382 min of TST achieved at mid-treatment in order to best predict pain improvements 6-month posttreatment. Actigraphy results followed the same pattern as daily diary-based results. Clinically significant pain reductions in response to both CBT-I and BD were optimally predicted by achieving approximately 6.5 hr sleep duration by mid-treatment. Thus, tailoring interventions to increase TST early in treatment may be an effective strategy to promote long-term pain reductions. More comprehensive research on components of behavioral sleep medicine treatments that contribute to pain response is warranted. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  11. Selection of Suitable Endogenous Reference Genes for Relative Copy Number Detection in Sugarcane

    Directory of Open Access Journals (Sweden)

    Bantong Xue

    2014-05-01

    Full Text Available Transgene copy number has a great impact on the expression level and stability of exogenous gene in transgenic plants. Proper selection of endogenous reference genes is necessary for detection of genetic components in genetically modification (GM crops by quantitative real-time PCR (qPCR or by qualitative PCR approach, especially in sugarcane with polyploid and aneuploid genomic structure. qPCR technique has been widely accepted as an accurate, time-saving method on determination of copy numbers in transgenic plants and on detection of genetically modified plants to meet the regulatory and legislative requirement. In this study, to find a suitable endogenous reference gene and its real-time PCR assay for sugarcane (Saccharum spp. hybrids DNA content quantification, we evaluated a set of potential “single copy” genes including P4H, APRT, ENOL, CYC, TST and PRR, through qualitative PCR and absolute quantitative PCR. Based on copy number comparisons among different sugarcane genotypes, including five S. officinarum, one S. spontaneum and two S. spp. hybrids, these endogenous genes fell into three groups: ENOL-3—high copy number group, TST-1 and PRR-1—medium copy number group, P4H-1, APRT-2 and CYC-2—low copy number group. Among these tested genes, P4H, APRT and CYC were the most stable, while ENOL and TST were the least stable across different sugarcane genotypes. Therefore, three primer pairs of P4H-3, APRT-2 and CYC-2 were then selected as the suitable reference gene primer pairs for sugarcane. The test of multi-target reference genes revealed that the APRT gene was a specific amplicon, suggesting this gene is the most suitable to be used as an endogenous reference target for sugarcane DNA content quantification. These results should be helpful for establishing accurate and reliable qualitative and quantitative PCR analysis of GM sugarcane.

  12. Treatment selection for unruptured small cerebral arteriovenous malformations with clinical decision analysis. Observation, gamma knife or microsurgery?

    International Nuclear Information System (INIS)

    Serizawa, Toru; Higuchi, Yoshinori; Ono, Junichi

    2006-01-01

    We present an optimal treatment for unruptured small (3 cm or less) cerebral arteriovenous malformations (AVM) among conservative treatment, gamma knife surgery (GKS) and microsurgery using clinical decision analysis according to patients' age. All cases for this study were small AVMs. We analyzed 973 cases with conservative treatment, 176 with GKS and 110 with microsurgery. The expected utility indexes were calculated from the results of each group. We hypothesized the standardized expected utility indexes as 100 in healthy, 75 in disabled and 0 in dead. Microsurgery was the first choice for patients younger than 55 years with AVM located in a surgically accessible region. GKS is recommended for patients aged between 55 and 70, and the best treatment is observation for patients older than 70 years. The proposed clinical decision analysis is very useful in obtaining informed consent for choosing the treatment modality for unruptured small AVM. (author)

  13. Modification of Enrofloxacin Treatment Regimens for Poultry Experimentally Infected with Salmonella enterica Serovar Typhimurium DT104 To Minimize Selection of Resistance▿

    Science.gov (United States)

    Randall, Luke P.; Cooles, Sue W.; Coldham, Nick C.; Stapleton, Ken S.; Piddock, Laura J. V.; Woodward, Martin J.

    2006-01-01

    We hypothesized that higher doses of fluoroquinolones for a shorter duration could maintain efficacy (as measured by reduction in bacterial count) while reducing selection in chickens of bacteria with reduced susceptibility. Chicks were infected with Salmonella enterica serovar Typhimurium DT104 and treated 1 week later with enrofloxacin at the recommended dose for 5 days (water dose adjusted to give 10 mg/kg of body weight of birds or equivalence, i.e., water at 50 ppm) or at 2.5 or 5 times the recommended dose for 2 days or 1 day, respectively. The dose was delivered continuously (ppm) or pulsed in the water (mg/kg) or by gavage (mg/kg). In vitro in sera, increasing concentrations of 0.5 to 8 μg/ml enrofloxacin correlated with increased activity. In vivo, the efficacy of the 1-day treatment was significantly less than that of the 2- and 5-day treatments. The 2-day treatments showed efficacy similar to that of the 5-day treatment in all but one repeat treatment group and significantly (P < 0.01) reduced the Salmonella counts. Dosing at 2.5× the recommended dose and pulsed dosing both increased the peak antibiotic concentrations in cecal contents, liver, lung, and sera as determined by high-pressure liquid chromatography. There was limited evidence that shorter treatment regimens (in particular the 1-day regimen) selected for fewer strains with reduced susceptibility. In conclusion, the 2-day treatment would overall require a shorter withholding time than the 5-day treatment and, in view of the increased peak antibiotic concentrations, may give rise to improved efficacy, in particular for treating respiratory and systemic infections. However, it would be necessary to validate the 2-day regimen in a field situation and in particular against respiratory and systemic infections to validate or refute this hypothesis. PMID:17030564

  14. Studying the effect of administration route and treatment dose on the selection of enrofloxacin resistance in commensal Escherichia coli in broilers.

    Science.gov (United States)

    Chantziaras, Ilias; Smet, Annemieke; Haesebrouck, Freddy; Boyen, Filip; Dewulf, Jeroen

    2017-07-01

    Factors potentially contributing to fluoroquinolone resistance selection in commensal Escherichia coli strains in poultry were studied through a series of in vivo experiments. The effect of the initial prevalence of enrofloxacin resistance in the E. coli gut microbiota, effect of the bacterial fitness of the enrofloxacin-resistant strain and effect of treatment with enrofloxacin (effect of dose and effect of route of administration) were assessed. Four in vivo studies with broiler chickens were performed. Right after hatching, the chicks were inoculated with either a bacteriologically fit or a bacteriologically non-fit fluoroquinolone-resistant strain as either a minority or the majority of the total E. coli population. Six days later, the chicks were treated for three consecutive days either orally or parenterally and using three different doses (under-, correct- and over-dose) of enrofloxacin. The faecal shedding of E. coli strains was quantified by plating on agar plates either supplemented or not supplemented with enrofloxacin. Linear mixed models were used to assess the effect of the aforementioned variables on the selection of enrofloxacin resistance. The factors that significantly contributed were treatment ( P  <   0.001), bacterial fitness of the resistant donor strain ( P  <   0.001), administration route ( P  =   0.052) and interactions between bacterial fitness and administration route ( P  <   0.001). In the currently used models, fluoroquinolone resistance selection was influenced by treatment, bacterial fitness of the inoculation strain and administration route. The use of oral treatment seems to select more for fluoroquinolone resistance, particularly in the model where a non-fit strain was used for inoculation. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. [Application and comparison of NDT-Bobath and Vojta methods in treatment of selected pathologies of the nervous system in children].

    Science.gov (United States)

    Jóźwiak, Sergiusz; Podogrodzki, Jacek

    2010-01-01

    The paper compares effectiveness of NDT-Bobath and Vojta methods in the treatment of selected dysfunctions of the nervous system in children. It evaluates applicability of both methods in prenatal and perinatal injury of the central nervous system, myelomeningocele, Down syndrome and spasticity. The existing literature is supplemented by own clinical experience of the authors. The paper forms the opinion on the constant debates on the superiority of one method over another.

  16. Use of selected complementary and alternative medicine (CAM) treatments in veterans with cancer or chronic pain: a cross-sectional survey

    OpenAIRE

    McEachrane-Gross, F Patricia; Liebschutz, Jane M; Berlowitz, Dan

    2006-01-01

    Abstract Background Complementary and alternative medicine (CAM) is emerging as an important form of care in the United States. We sought to measure the prevalence of selected CAM use among veterans attending oncology and chronic pain clinics and to describe the characteristics of CAM use in this population. Methods The self-administered, mail-in survey included questions on demographics, health beliefs, medical problems and 6 common CAM treatments (herbs, dietary supplements, chiropractic ca...

  17. Electromagnetic treatment to old Alzheimer's mice reverses β-amyloid deposition, modifies cerebral blood flow, and provides selected cognitive benefit.

    Directory of Open Access Journals (Sweden)

    Gary W Arendash

    Full Text Available Few studies have investigated physiologic and cognitive effects of "long-term" electromagnetic field (EMF exposure in humans or animals. Our recent studies have provided initial insight into the long-term impact of adulthood EMF exposure (GSM, pulsed/modulated, 918 MHz, 0.25-1.05 W/kg by showing 6+ months of daily EMF treatment protects against or reverses cognitive impairment in Alzheimer's transgenic (Tg mice, while even having cognitive benefit to normal mice. Mechanistically, EMF-induced cognitive benefits involve suppression of brain β-amyloid (Aβ aggregation/deposition in Tg mice and brain mitochondrial enhancement in both Tg and normal mice. The present study extends this work by showing that daily EMF treatment given to very old (21-27 month Tg mice over a 2-month period reverses their very advanced brain Aβ aggregation/deposition. These very old Tg mice and their normal littermates together showed an increase in general memory function in the Y-maze task, although not in more complex tasks. Measurement of both body and brain temperature at intervals during the 2-month EMF treatment, as well as in a separate group of Tg mice during a 12-day treatment period, revealed no appreciable increases in brain temperature (and no/slight increases in body temperature during EMF "ON" periods. Thus, the neuropathologic/cognitive benefits of EMF treatment occur without brain hyperthermia. Finally, regional cerebral blood flow in cerebral cortex was determined to be reduced in both Tg and normal mice after 2 months of EMF treatment, most probably through cerebrovascular constriction induced by freed/disaggregated Aβ (Tg mice and slight body hyperthermia during "ON" periods. These results demonstrate that long-term EMF treatment can provide general cognitive benefit to very old Alzheimer's Tg mice and normal mice, as well as reversal of advanced Aβ neuropathology in Tg mice without brain heating. Results further underscore the potential for EMF

  18. A well-defined mesoporous amine silica surface via a selective treatment of SBA-15 with ammonia

    KAUST Repository

    Bendjeriou-Sedjerari, Anissa; Pelletier, Jeremie; Abou-Hamad, Edy; Emsley, Lyndon; Basset, Jean-Marie

    2012-01-01

    2D double-quantum 1H- 1H NMR unambiguously shows that the "isolated" Si-OH surface silanols of dehydroxylated SBA-15 are converted upon treatment with ammonia into single silylamine surface site Si-NH 2. The "gem" di-silanols (Si(OH) 2) remain intact. Treatment using HMDS produces (Si(OSiMe 3) 2) but leaves Si-NH 2 untouched. The resulting surface is hydrophobic and stable. © The Royal Society of Chemistry 2012.

  19. [Cost-effectiveness analysis of celecoxib versus non-selective non-steroidal anti-inflammatory drug therapy for the treatment of osteoarthritis in Spain: A current perspective].

    Science.gov (United States)

    De Lossada, A; Oteo-Álvaro, Á; Giménez, S; Oyagüez, I; Rejas, J

    2016-01-01

    To assess the cost-effectiveness of celecoxib and non-selective non-steroidal anti-inflammatory drugs for the treatment of osteoarthritis in clinical practice in Spain. A decision-tree model using distribution, doses, treatment duration and incidence of GI and CV events observed in the pragmatic PROBE-designed «GI-Reasons» trial was used for cost-effectiveness. Effectiveness was expressed in terms of event averted and quality-adjusted life-years (QALY) gained. QALY were calculated based on utility decrement in case of any adverse events reported in GI-Reasons trial. The National Health System perspective in Spain was applied; cost calculations included current prices of drugs plus cost of adverse events occurred. The analysis was expressed as an incremental cost-effectiveness ratio per QALY gained and per event averted. One-way and probabilistic analyses were performed. Compared with non-selective non-steroidal anti-inflammatory drugs, at current prices, celecoxib treatment had higher overall treatment costs €201 and €157, respectively. However, celecoxib was associated with a slight increase in QALY gain and significantly lower incidence of gastrointestinal events (pcost-effectiveness ratio of €13,286 per QALY gained and €4,471 per event averted. Sensitivity analyses were robust, and confirmed the results of the base case. Celecoxib at current price may be considered as a cost-effective alternative vs. non-selective non-steroidal anti-inflammatory drugs in the treatment of osteoarthritis in daily practice in the Spanish NHS. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  20. A comparison of methods to separate treatment from self-selection effects in an online banking setting

    NARCIS (Netherlands)

    Gensler, S.; Leeflang, P.S.H.; Skiera, B.

    The literature discusses several methods to control for self-selection effects but provides little guidance on which method to use in a setting with a limited number of variables. The authors theoretically compare and empirically assess the performance of different matching methods and instrumental

  1. The sirolimus-eluting Cypher Select coronary stent for the treatment of bare-metal and drug-eluting stent restenosis: insights from the e-SELECT (Multicenter Post-Market Surveillance) registry.

    Science.gov (United States)

    Abizaid, Alexandre; Costa, J Ribamar; Banning, Adrian; Bartorelli, Antonio L; Dzavik, Vladimir; Ellis, Stephen; Gao, Runlin; Holmes, David R; Jeong, Muyng Ho; Legrand, Victor; Neumann, Franz-Josef; Nyakern, Maria; Orlick, Amy; Spaulding, Christian; Worthley, Stephen; Urban, Philip M

    2012-01-01

    This study sought to compare the 1-year safety and efficacy of Cypher Select or Cypher Select Plus (Cordis Corporation, Bridgewater, New Jersey) sirolimus-eluting stents (SES) with the treatment of bare-metal stents (BMS) and drug-eluting stent (DES) in-stent restenosis (ISR) in nonselected, real-world patients. There is paucity of consistent data on DES for the treatment of ISR, especially, DES ISR. The e-SELECT (Multicenter Post-Market Surveillance) registry is a Web-based, multicenter and international registry encompassing virtually all subsets of patients and lesions treated with at least 1 SES during the period from 2006 to 2008. We enrolled in this pre-specified subanalysis all patients with at least 1 clinically relevant BMS or DES ISR treated with SES. Primary endpoint was major adverse cardiac events and stent thrombosis rate at 1 year. Of 15,147 patients enrolled, 1,590 (10.5%) presented at least 1 ISR (BMS group, n = 1,235, DES group, n = 355). Patients with DES ISR had higher incidence of diabetes (39.4% vs. 26.9%, p target lesion revascularization and definite/probable late stent thrombosis were higher in patients with DES ISR (6.9% vs. 3.1%, p = 0.003, and 1.8% vs. 0.5%, p = 0.04, respectively). Use of SES for either BMS or DES ISR treatment is safe and associated with low target lesion revascularization recurrence and no apparent safety concern. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  2. Selective metallization of amorphous-indium-gallium-zinc-oxide thin-film transistor by using helium plasma treatment

    Science.gov (United States)

    Jang, Hun; Lee, Su Jeong; Porte, Yoann; Myoung, Jae-Min

    2018-03-01

    In this study, the effects of helium (He) plasma treatment on amorphous-indium-gallium-zinc-oxide (a-IGZO) thin-film transistors (TFTs) have been investigated. The He plasma treatment induced a dramatic decrease of the resistivity in a-IGZO thin films from 1.25 × 106 to 5.93 mΩ cm. After 5 min He plasma treatment, the a-IGZO films showed an increase in carrier concentration to 6.70 × 1019 cm-3 combined with a high hall mobility of 15.7 cm2 V-1 s-1. The conductivity improvement was linked to the formation of oxygen vacancies during the He plasma treatment, which was observed by x-ray photoelectron spectroscopy analysis. The a-IGZO films did not appear to be damaged on the surface following the plasma treatment and showed a high transmittance of about 88.3% at a wavelength of 550 nm. The He plasma-treated a-IGZO films were used as source/drain (S/D) electrodes in a-IGZO TFTs. The devices demonstrated promising characteristics, on pair with TFTs using Al electrodes, with a threshold voltage (V T) of -1.97 V, sub-threshold slope (SS) of 0.52 V/decade, saturation mobility (μ sat) of 8.75 cm2 V-1 s-1, and on/off current ratio (I on/I off) of 2.66 × 108.

  3. SAT0125 The impact of selected comorbidities on treatment outcome in patients with rheumatoid arthritis: an exploratory cohort study

    DEFF Research Database (Denmark)

    Emamifar, Amir; Jensen Hansen, Inger Marie

    2018-01-01

    diagnosed rheumatoid arthritis is associated with poor initial treatment response evaluated by disease activity score in 28 joints-C-reactive protein (DAS28- CRP): An observational cohort study. Medicine (Baltimore) 2017;96:e8357. [2] Emamifar A, et al. Patients with newly diagnosed Rheumatoid Arthritis......Background: Patients with Rheumatoid Arthritis (RA) may present with various comorbidities resulting in worse treatment response.[1-2] Objectives: To investigate the impact of selected comorbid diseases on RA outcome with the aim of Disease Activity Score in 28 joints-C-Reactive Protein (DAS28-CRP......). Methods: All our RA patients were included in this study. Patients’ demographics, serology results and DAS28-CRP at the time of diagnosis and after 4 months of treatment initiation were collected. Patients’ electronic hospital records were evaluated for a positive history of thyroid diseases, Diabetes...

  4. Is DAS28-CRP with three and four variables interchangeable in individual patients selected for biological treatment in daily clinical practice?

    DEFF Research Database (Denmark)

    Madsen, Ole Rintek

    2011-01-01

    DAS28 is a widely used composite score for the assessment of disease activity in patients with rheumatoid arthritis (RA) and is often used as a treatment decision tool in the daily clinic. Different versions of DAS28 are available. DAS28-CRP(3) is calculated based on three variables: swollen...... and tender joint counts and CRP. DAS28-CRP(4) also includes patient global assessment. Thresholds for low and high disease activity are the same for the two scores. Based on the Bland-Altman method, the interchangeability between DAS28-CRP with three and four variables was examined in 319 RA patients...... selected for initiating biological treatment. Data were extracted from the Danish registry for biological treatment in rheumatology (DANBIO). Multiple regression analysis was used to assess the predictability of the DAS28 scores by several measures of disease activity. The overall mean DAS28-CRP was 4...

  5. A Proposal for a Study on Treatment Selection and Lifestyle Recommendations in Chronic Inflammatory Diseases: A Danish Multidisciplinary Collaboration on Prognostic Factors and Personalised Medicine

    Directory of Open Access Journals (Sweden)

    Vibeke Andersen

    2017-05-01

    Full Text Available Chronic inflammatory diseases (CIDs, including Crohn’s disease and ulcerative colitis (inflammatory bowel diseases, IBD, rheumatoid arthritis, psoriasis, psoriatic arthritis, spondyloarthritides, hidradenitis suppurativa, and immune-mediated uveitis, are treated with biologics targeting the pro-inflammatory molecule tumour necrosis factor-α (TNF (i.e., TNF inhibitors. Approximately one-third of the patients do not respond to the treatment. Genetics and lifestyle may affect the treatment results. The aims of this multidisciplinary collaboration are to identify (1 molecular signatures of prognostic value to help tailor treatment decisions to an individual likely to initiate TNF inhibitor therapy, followed by (2 lifestyle factors that support achievement of optimised treatment outcome. This report describes the establishment of a cohort that aims to obtain this information. Clinical data including lifestyle and treatment response and biological specimens (blood, faeces, urine, and, in IBD patients, intestinal biopsies are sampled prior to and while on TNF inhibitor therapy. Both hypothesis-driven and data-driven analyses will be performed according to pre-specified protocols including pathway analyses resulting from candidate gene expression analyses and global approaches (e.g., metabolomics, metagenomics, proteomics. The final purpose is to improve the lives of patients suffering from CIDs, by providing tools facilitating treatment selection and dietary recommendations likely to improve the clinical outcome.

  6. A comparison of a modified sequential oral sensory approach to an applied behavior-analytic approach in the treatment of food selectivity in children with autism spectrum disorder.

    Science.gov (United States)

    Peterson, Kathryn M; Piazza, Cathleen C; Volkert, Valerie M

    2016-09-01

    Treatments of pediatric feeding disorders based on applied behavior analysis (ABA) have the most empirical support in the research literature (Volkert & Piazza, 2012); however, professionals often recommend, and caregivers often use, treatments that have limited empirical support. In the current investigation, we compared a modified sequential oral sensory approach (M-SOS; Benson, Parke, Gannon, & Muñoz, 2013) to an ABA approach for the treatment of the food selectivity of 6 children with autism. We randomly assigned 3 children to ABA and 3 children to M-SOS and compared the effects of treatment in a multiple baseline design across novel, healthy target foods. We used a multielement design to assess treatment generalization. Consumption of target foods increased for children who received ABA, but not for children who received M-SOS. We subsequently implemented ABA with the children for whom M-SOS was not effective and observed a potential treatment generalization effect during ABA when M-SOS preceded ABA. © 2016 Society for the Experimental Analysis of Behavior.

  7. Selection of appropriate end-points (pCR vs 2yDFS) for tailoring treatments with prediction models in locally advanced rectal cancer

    International Nuclear Information System (INIS)

    Valentini, Vincenzo; Stiphout, Ruud G.P.M. van; Lammering, Guido; Gambacorta, Maria A.; Barba, Maria C.; Bebenek, Marek; Bonnetain, Franck; Bosset, Jean F.; Bujko, Krzysztof; Cionini, Luca; Gerard, Jean P.; Rödel, Claus; Sainato, Aldo; Sauer, Rolf; Minsky, Bruce D.; Collette, Laurence; Lambin, Philippe

    2015-01-01

    Purpose: Personalized treatments based on predictions for patient outcome require early characterization of a rectal cancer patient’s sensitivity to treatment. This study has two aims: (1) identify the main patterns of recurrence and response to the treatments (2) evaluate pathologic complete response (pCR) and two-year disease-free survival (2yDFS) for overall survival (OS) and their potential to be relevant intermediate endpoints to predict. Methods: Pooled and treatment subgroup analyses were performed on five large European rectal cancer trials (2795 patients), who all received long-course radiotherapy with or without concomitant and/or adjuvant chemotherapy. The ratio of distant metastasis (DM) and local recurrence (LR) rates was used to identify patient characteristics that increase the risk of recurrences. Findings: The DM/LR ratio decreased to a plateau in the first 2 years, revealing it to be a critical follow-up period. According to the patterns of recurrences, three patient groups were identified: 5–15% had pCR and were disease free after 2 years (excellent prognosis), 65–75% had no pCR but were disease free (good prognosis) and 15–30% had neither pCR nor 2yDFS (poor prognosis). Interpretation: Compared with pCR, 2yDFS is a stronger predictor of OS. To adapt treatment most efficiently, accurate prediction models should be developed for pCR to select patients for organ preservation and for 2yDFS to select patients for more intensified treatment strategies

  8. Alogliptin, a potent and selective dipeptidyl peptidase-IV inhibitor for the treatment of type 2 diabetes

    DEFF Research Database (Denmark)

    Deacon, Carolyn F

    2008-01-01

    Takeda San Diego Inc is developing alogliptin, a small-molecule, orally available dipeptidyl peptidase IV (DPP IV) inhibitor, for the potential treatment of type 2 diabetes. In January 2008, Takeda announced that an NDA for alogliptin had been submitted to the FDA.......Takeda San Diego Inc is developing alogliptin, a small-molecule, orally available dipeptidyl peptidase IV (DPP IV) inhibitor, for the potential treatment of type 2 diabetes. In January 2008, Takeda announced that an NDA for alogliptin had been submitted to the FDA....

  9. Selective mutism.

    Science.gov (United States)

    Hua, Alexandra; Major, Nili

    2016-02-01

    Selective mutism is a disorder in which an individual fails to speak in certain social situations though speaks normally in other settings. Most commonly, this disorder initially manifests when children fail to speak in school. Selective mutism results in significant social and academic impairment in those affected by it. This review will summarize the current understanding of selective mutism with regard to diagnosis, epidemiology, cause, prognosis, and treatment. Studies over the past 20 years have consistently demonstrated a strong relationship between selective mutism and anxiety, most notably social phobia. These findings have led to the recent reclassification of selective mutism as an anxiety disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. In addition to anxiety, several other factors have been implicated in the development of selective mutism, including communication delays and immigration/bilingualism, adding to the complexity of the disorder. In the past few years, several randomized studies have supported the efficacy of psychosocial interventions based on a graduated exposure to situations requiring verbal communication. Less data are available regarding the use of pharmacologic treatment, though there are some studies that suggest a potential benefit. Selective mutism is a disorder that typically emerges in early childhood and is currently conceptualized as an anxiety disorder. The development of selective mutism appears to result from the interplay of a variety of genetic, temperamental, environmental, and developmental factors. Although little has been published about selective mutism in the general pediatric literature, pediatric clinicians are in a position to play an important role in the early diagnosis and treatment of this debilitating condition.

  10. Patient selection, echocardiographic screening and treatment strategies for interventional tricuspid repair using the edge-to-edge repair technique.

    Science.gov (United States)

    Hausleiter, Jörg; Braun, Daniel; Orban, Mathias; Latib, Azeem; Lurz, Philipp; Boekstegers, Peter; von Bardeleben, Ralph Stephan; Kowalski, Marek; Hahn, Rebecca T; Maisano, Francesco; Hagl, Christian; Massberg, Steffen; Nabauer, Michael

    2018-04-24

    Severe tricuspid regurgitation (TR) has long been neglected despite its well known association with mortality. While surgical mortality rates remain high in isolated tricuspid valve surgery, interventional TR repair is rapidly evolving as an alternative to cardiac surgery in selected patients at high surgical risk. Currently, interventional edge-to-edge repair is the most frequently applied technique for TR repair even though the device has not been developed for this particular indication. Due to the inherent differences in tricuspid and mitral valve anatomy and pathology, percutaneous repair of the tricuspid valve is challenging due to a variety of factors including the complexity and variability of tricuspid valve anatomy, echocardiographic visibility of the valve leaflets, and device steering to the tricuspid valve. Furthermore, it remains to be clarified which patients are suitable for a percutaneous tricuspid repair and which features predict a successful procedure. On the basis of the available experience, we describe criteria for patient selection including morphological valve features, a standardized process for echocardiographic screening, and a strategy for clip placement. These criteria will help to achieve standardization of valve assessment and the procedural approach, and to further develop interventional tricuspid valve repair using either currently available devices or dedicated tricuspid edge-to-edge repair devices in the future. In summary, this manuscript will provide guidance for patient selection and echocardiographic screening when considering edge-to-edge repair for severe TR.

  11. Quinine Treatment Selects the pfnhe–1 ms4760–1 Polymorphism in Malian Patients with Falciparum Malaria

    Science.gov (United States)

    Kone, Aminatou; Mu, Jianbing; Maiga, Hamma; Beavogui, Abdoul H.; Yattara, Omar; Sagara, Issaka; Tekete, Mamadou M.; Traore, Oumar B.; Dara, Antoine; Dama, Souleymane; Diallo, Nouhoum; Kodio, Aly; Traoré, Aliou; Björkman, Anders; Gil, Jose P.; Doumbo, Ogobara K.; Wellems, Thomas E.; Djimde, Abdoulaye A.

    2013-01-01

    Background. The mechanism of Plasmodium falciparum resistance to quinine is not known. In vitro quantitative trait loci mapping suggests involvement of a predicted P. falciparum sodium–hydrogen exchanger (pfnhe–1) on chromosome 13. Methods. We conducted prospective quinine efficacy studies in 2 villages, Kollé and Faladié, Mali. Cases of clinical malaria requiring intravenous therapy were treated with standard doses of quinine and followed for 28 days. Treatment outcomes were classified using modified World Health Organization protocols. Molecular markers of parasite polymorphisms were used to distinguish recrudescent parasites from new infections. The prevalence of pfnhe–1 ms4760–1 among parasites before versus after quinine treatment was determined by direct sequencing. Results. Overall, 163 patients were enrolled and successfully followed. Without molecular correction, the mean adequate clinical and parasitological response (ACPR) was 50.3% (n = 163). After polymerase chain reaction correction to account for new infections, the corrected ACPR was 100%. The prevalence of ms4760–1 increased significantly, from 26.2% (n = 107) before quinine treatment to 46.3% (n = 54) after therapy (P = .01). In a control sulfadoxine–pyrimethamine study, the prevalence of ms4760–1 was similar before and after treatment. Conclusions. This study supports a role for pfnhe–1 in decreased susceptibility of P. falciparum to quinine in the field. PMID:23162138

  12. Fumigation characteristics of ozone in postharvest treatment of Kabkab dates (Phoenix dactylifera L.) against selected insect infestation.

    Science.gov (United States)

    Niakousari, Mehrdad; Erjaee, Zahra; Javadian, Shahram

    2010-04-01

    Methyl bromide fumigation, the most accepted quarantine treatment for dates and many other dried commodities, will be phased out by 2015 worldwide. As a result, there is a critical need to develop durable alternatives for methyl bromide as postharvest treatments of agricultural commodities. This article presents a new method for postharvest treatment of Kabkab dates (Phoenix dactylifera L.) by application of gaseous ozone to reduce or eliminate all life stages (adults, larvae, and eggs) of Indian meal moth (Plodia interpunctella) and sawtooth grain beetle (Oryzaephilus surinamensis). The effect of the ozonation process on the sugar content of dates was also evaluated. Infested dates were exposed to ozone concentrations of 600, 1,200, 2,000, and 4,000 ppm for 1 and 2 h. As insect eggs are known to be most tolerant to many chemical or physical treatments, they were additionally exposed to an atmosphere of pure carbon dioxide prior to ozonation. Exposing samples to ozone concentrations of >2,000 ppm for 2 h resulted in complete mortality of larvae and adults. Exposure to 4,000 ppm of ozone for 2 h resulted in 80% mortality of eggs, and exposure to CO(2) prior to ozonation did not improve the effect of ozonation on eggs. Ozone did not have any influence on the sugar content of Kabkab dates.

  13. Ethnopharmacological studies on the uses of Euphorbia hirta in the treatment of dengue in selected indigenous communities in Pangasinan (Philippines).

    Science.gov (United States)

    de Guzman, Gerard Quinto; Dacanay, Aleth Therese Lora; Andaya, Benjel Andaya; Alejandro, Grecebio Jonathan Duran

    2016-01-01

    Euphorbia hirta is the most widely used plant in the folkloric treatment of dengue in the Philippines. This study documents the anecdotal uses of E. hirta in the treatment of dengue in 3 indigenous communities in Pangasinan from April to June of 2015. The number of use reports pertaining to symptoms of dengue and other diseases were tallied from 82 informants living in Anda Island, Mt. Colisao and Mt. Balungao. The demographics of the informants as well as the corrected major use agreements (cMUAs) and fidelity levels (FLs) of each reported symptom of dengue were calculated. The major dosage forms used during treatment were also tallied. Respondents, dominated by the age group 60-80 and mostly females with at least primary and secondary education, provided information on the use reports of E. hirta. High FL values and cMUA of at least 35% were obtained for cardinal symptoms of dengue-related to bleeding episodes while low cMUAs (i.e. 2-4%) were obtained for symptoms during the recovery phase. High FL values were obtained for symptoms observed during the febrile phase. The most widely used dosage forms are decoctions of the leaves and barks of E. hirta. This study was able to qualify the uses of E. hirta in the treatment of dengue in the 3 communities surveyed.

  14. Treatment

    Directory of Open Access Journals (Sweden)

    Safaa M. Raghab

    2013-08-01

    The main goal of this study is to utilize a natural low cost material “as an accelerator additive to enhance the chemical treatment process using Alum coagulant and the accelerator substances were Perlite and Bentonite. The performance of the chemical treatment was enhanced using the accelerator substances with 90 mg/l Alum as a constant dose. Perlite gave better performance than the Bentonite effluent. The removal ratio for conductivity, turbidity, BOD and COD for Perlite was 86.7%, 87.4%, 89.9% and 92.8% respectively, and for Bentonite was 83.5%, 85.0%, 86.5% and 85.0% respectively at the same concentration of 40 mg/l for each.

  15. Nominal group technique to select attributes for discrete choice experiments: an example for drug treatment choice in osteoporosis

    Directory of Open Access Journals (Sweden)

    Hiligsmann M

    2013-02-01

    Full Text Available Mickael Hiligsmann,1-3 Caroline van Durme,2 Piet Geusens,2 Benedict GC Dellaert,4 Carmen D Dirksen,3 Trudy van der Weijden,5 Jean-Yves Reginster,6 Annelies Boonen21Department of Health Services Research, School for Public Health and Primary Care (CAPHRI, Maastricht University, The Netherlands, 2Department of Internal Medicine, CAPHRI, Maastricht University, The Netherlands, 3Department of Clinical Epidemiology and Medical Technology Assessment, CAPHRI, Maastricht University, The Netherlands, 4Department of Business Economics, Erasmus Rotterdam University, The Netherlands, 5Department of General Practice, CAPHRI, Maastricht University, The Netherlands, 6Department of Public Health, Epidemiology and Health Economics, University of Liege, BelgiumBackground: Attribute selection represents an important step in the development of discrete-choice experiments (DCEs, but is often poorly reported. In some situations, the number of attributes identified may exceed what one may find possible to pilot in a DCE. Hence, there is a need to gain insight into methods to select attributes in order to construct the final list of attributes. This study aims to test the feasibility of using the nominal group technique (NGT to select attributes for DCEs.Methods: Patient group discussions (4–8 participants were convened to prioritize a list of 12 potentially important attributes for osteoporosis drug therapy. The NGT consisted of three steps: an individual ranking of the 12 attributes by importance from 1 to 12, a group discussion on each of the attributes, including a group review of the aggregate score of the initial rankings, and a second ranking task of the same attributes.Results: Twenty-six osteoporotic patients participated in five NGT sessions. Most (80% of the patients changed their ranking after the discussion. However, the average initial and final ranking did not differ markedly. In the final ranking, the most important medication attributes were

  16. Evaluation of selective dry cow treatment following on-farm culture: risk of postcalving intramammary infection and clinical mastitis in the subsequent lactation.

    Science.gov (United States)

    Cameron, M; McKenna, S L; MacDonald, K A; Dohoo, I R; Roy, J P; Keefe, G P

    2014-01-01

    The objective of the study was to evaluate the utility of a Petrifilm-based on-farm culture system when used to make selective antimicrobial treatment decisions on low somatic cell count cows (cows from 16 commercial dairy herds with a low bulk tank somatic cell count (cow therapy (DCT) or Petrifilm-based selective DCT. Cows belonging to the blanket DCT group were infused with a commercial dry cow antimicrobial product and an internal teat sealant (ITS) at drying off. Using composite milk samples collected on the day before drying off, cows in the selective DCT group were treated at drying off based on the results obtained by the Petrifilm on-farm culture system with DCT + ITS (Petrifilm culture positive), or ITS alone (Petrifilm culture negative). Quarters of all cows were sampled for standard laboratory bacteriology on the day before drying off, at 3 to 4d in milk (DIM), at 5 to 18 DIM, and from the first case of clinical mastitis occurring within 120 DIM. Multilevel logistic regression was used to assess the effect of study group (blanket or selective DCT) and resulting dry cow treatment (DCT + ITS, or ITS alone) on the risk of intramammary infection (IMI) at calving and the risk of a first case of clinical mastitis between calving and 120 DIM. According to univariable analysis, no difference was observed between study groups with respect to quarter-level cure risk and new IMI risk over the dry period. Likewise, the risk of IMI at calving and the risk of clinical mastitis in the first 120 DIM was not different between quarters belonging to cows in the blanket DCT group and quarters belonging to cows in the selective DCT group. The results of this study indicate that selective DCT based on results obtained by the Petrifilm on-farm culture system achieved the same level of success with respect to treatment and prevention of IMI over the dry period as blanket DCT and did not affect the risk of clinical mastitis in the first 120 d of the subsequent lactation

  17. Super-selective Balloon Test Occlusion of the Posterior Communicating Artery in the Treatment of a Posterior Cerebral Artery Fusiform Aneurysm: a Case Report.

    Science.gov (United States)

    Isozaki, Makoto; Arai, Hiroshi; Neishi, Hiroyuki; Kitai, Ryuhei; Kikuta, Ken-Ichiro

    2016-10-01

    We report the case of a 49-year-old man with underlying hypertension who developed diplopia lasting 2 months. Magnetic resonance imaging and digital subtraction angiography showed multi-lobular unruptured aneurysms in the P2 portion of the posterior cerebral artery (PCA) migrating into the interpeduncular cistern of the midbrain. Because the shapes of the aneurysms were serpentine fusiform and the posterior communicating artery (PCoA) was the fetal type, we planned anastomosis of the occipital artery to the P4 portion of the PCA followed by endovascular obliteration of the parent artery including the aneurysms. Endovascular treatment was performed via a femoral approach one week after the anastomosis. Super-selective balloon test occlusion (BTO) of the PCoA was performed by using an occlusion balloon microcatheter before endovascular treatment. Occlusion of the proximal segment of the PCoA induced disturbance of consciousness of the patient. Occlusion of the distal segment other than the first point of the PCoA did not induce any neurological symptoms. The information from this super-selective BTO helped us to perform precise endovascular obliteration. The aneurysm was successfully obliterated, and the diplopia almost disappeared in a few months. Super-selective BTO of the PCoA might be a useful method for preventing ischemic complications due to occlusion of invisible perforators.

  18. Home treatment of COPD exacerbation selected by DECAF score: a non-inferiority, randomised controlled trial and economic evaluation.

    Science.gov (United States)

    Echevarria, Carlos; Gray, Joanne; Hartley, Tom; Steer, John; Miller, Jonathan; Simpson, A John; Gibson, G John; Bourke, Stephen C

    2018-04-21

    Previous models of Hospital at Home (HAH) for COPD exacerbation (ECOPD) were limited by the lack of a reliable prognostic score to guide patient selection. Approximately 50% of hospitalised patients have a low mortality risk by DECAF, thus are potentially suitable. In a non-inferiority randomised controlled trial, 118 patients admitted with a low-risk ECOPD (DECAF 0 or 1) were recruited to HAH or usual care (UC). The primary outcome was health and social costs at 90 days. Mean 90-day costs were £1016 lower in HAH, but the one-sided 95% CI crossed the non-inferiority limit of £150 (CI -2343 to 312). Savings were primarily due to reduced hospital bed days: HAH=1 (IQR 1-7), UC=5 (IQR 2-12) (P=0.001). Length of stay during the index admission in UC was only 3 days, which was 2 days shorter than expected. Based on quality-adjusted life years, the probability of HAH being cost-effective was 90%. There was one death within 90 days in each arm, readmission rates were similar and 90% of patients preferred HAH for subsequent ECOPD. HAH selected by low-risk DECAF score was safe, clinically effective, cost-effective, and preferred by most patients. Compared with earlier models, selection is simpler and approximately twice as many patients are eligible. The introduction of DECAF was associated with a fall in UC length of stay without adverse outcome, supporting use of DECAF to direct early discharge. Registered prospectively ISRCTN 29082260. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Discovery of Novel Tricyclic Heterocycles as Potent and Selective DPP-4 Inhibitors for the Treatment of Type 2 Diabetes

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Wen-Lian; Hao, Jinsong; Domalski, Martin; Burnett, Duane A.; Pissarnitski, Dmitri; Zhao, Zhiqiang; Stamford, Andrew; Scapin, Giovanna; Gao, Ying-Duo; Soriano, Aileen; Kelly, Terri M.; Yao, Zuliang; Powles, Mary Ann; Chen, Shiying; Mei, Hong; Hwa, Joyce (Merck)

    2016-05-12

    In our efforts to develop second generation DPP-4 inhibitors, we endeavored to identify distinct structures with long-acting (once weekly) potential. Taking advantage of X-ray cocrystal structures of sitagliptin and other DPP-4 inhibitors, such as alogliptin and linagliptin bound to DPP-4, and aided by molecular modeling, we designed several series of heterocyclic compounds as initial targets. During their synthesis, an unexpected chemical transformation provided a novel tricyclic scaffold that was beyond our original design. Capitalizing on this serendipitous discovery, we have elaborated this scaffold into a very potent and selective DPP-4 inhibitor lead series, as highlighted by compound 17c.

  20. Intradural approach to selective stimulation in the spinal cord for treatment of intractable pain: design principles and wireless protocol

    Science.gov (United States)

    Howard, M. A.; Utz, M.; Brennan, T. J.; Dalm, B. D.; Viljoen, S.; Jeffery, N. D.; Gillies, G. T.

    2011-08-01

    We introduce an intradural approach to spinal cord stimulation for the relief of intractable pain, and describe the biophysical rationale that underlies its design and performance requirements. The proposed device relies on wireless, inductive coupling between a pial surface implant and its epidural controller, and we present the results of benchtop experiments that demonstrate the ability to transmit and receive a frequency-modulated 1.6 MHz carrier signal between micro-coil antennae scaled to the ≈ 1 cm dimensions of the implant, at power levels of about 5 mW. Plans for materials selection, microfabrication, and other aspects of future development are presented and discussed.

  1. The role of private drug vendors as malaria treatment providers in selected malaria endemic areas of Sri Lanka

    DEFF Research Database (Denmark)

    Rajakaruna, R S; Weerasinghe, M; Alifrangis, M

    2006-01-01

    was applied taking all response variables as binary outcome. RESULTS: Vendors' knowledge on antimalarials was poor with 58% of the vendors being unaware of the government malaria drug policy in the country. Also, the advice provided to customers buying antimalarials was limited. However, the majority......BACKGROUND AND OBJECTIVES: The involvement of private drug vendors in malaria treatment is particularly high in developing countries and understanding their practices and knowledge about antimalarials and malaria treatment will aid in devising strategies to increase the correct use of antimalarials...... and improve adherence to the government's malaria drug policy. Results of a study on the knowledge and practices of the private drug vendors conducted in seven districts in Sri Lanka, mostly in malarious areas are presented. METHODS: Data on awareness of government's malaria drug policy, practice of issuing...

  2. Synthetic Beta-Lactam Antibiotics as a Selective Breast Cancer Cell Apoptosis Inducer: Significance in Breast Cancer Prevention and Treatment

    Science.gov (United States)

    2007-03-01

    References 1. Labbe S, Thiele DJ: Pipes and wiring: the regulation of copper uptake and distribution in yeast . Trends Microbiol 1999, 7:500-505. 2. Aggett...inhibitors. New agents in cancer therapy. Drugs Aging 2000, 17:249-255. 8. Brewer GJ: Copper control as an antiangiogenic anticancer therapy: lessons... Brewer GJ, Dick RD, Grover DK, LeClaire V, Tseng M, Wicha M, Pienta K, Redman BG, Jahan T, Sondak VK, et al.: Treatment of metastatic cancer with

  3. Occurrence and fate of selected PPCPs in a conventional sewage treatment plant located in north west UK

    International Nuclear Information System (INIS)

    Reif, R.; Santos, A.; Judd, S. J.; Lema, J. M.; Omil, F.

    2009-01-01

    Over the last decade, the occurrence of pharmaceutical and personal care products (PPCPs) in wastewater effluents has become an increasing concern. Most of these compounds are released into the environment through sewage treatment plant effluents, due to the fact that these plants are not able to remove many of them in a significant extension. Presently, studies regarding hazardous effects in the aquatic environment are emerging worldwide, but still there is little information available regarding their potential eco toxicological effects. (Author)

  4. Influence of heat treatments on the microstructure and tensile behaviour of selective laser melting-produced TI-6AL-4V parts

    Directory of Open Access Journals (Sweden)

    Ter Haar, Gerrit Matthys

    2016-11-01

    Full Text Available In industry, post-process heat treatments of Ti-6Al-4V are performed with the aim of improving its tensile behaviour. While heat treatments of wrought Ti6Al4V have been standardised (e.g., Aerospace Material Specification H-81200, heat treatments of selective laser melting (SLM-produced Ti-6Al-4V lacks research and understanding. Significant concern exists about SLM Ti6-Al-4V’s achievable ductility attributed to its martensitic (α’ phase. In this research, heat treatments at a range of temperatures are applied to SLM-produced Ti-6Al-4V tensile samples. Microstructural analysis (both optically and through electron backscatter diffraction was used to identify links between heat treatments and microstructure. Subsequently, uniaxial tensile tests were performed to determine the respective tensile properties of all samples. Correlations in the data show a significant loss in strength with respect to an increase in annealing temperature due to grain growth, while no noticeable trend was observed for fracture strain with regard to annealing temperatures.

  5. A review of treatment options for Graves' disease: why total thyroidectomy is a viable option in selected patients.

    Science.gov (United States)

    Mohan, Vinuta; Lind, Robert

    2016-01-01

    Graves' disease is the most common cause of hyperthyroidism. If left untreated, patients may have multiple systemic complications such as cardiac, reproductive, and skeletal disease. Thionamides, such as methimazole and propylthiouracil, and I(131) iodine ablation are the most commonly prescribed treatment for Graves' disease. Total thyroidectomy is often overlooked for treatment and is usually only offered if the other options have failed. In our case, we discuss a patient who was admitted to our medical center with symptomatic hyperthyroidism secondary to long-standing Graves' disease. She had a history of non-compliance with medications and medical clinic follow-up. The risks and benefits of total thyroidectomy were explained and she consented to surgery. A few months after the procedure, she was biochemically and clinically euthyroid on levothyroxine. She had no further emergency room visits or admissions for uncontrolled thyroid disease. Here we review the advantages and disadvantages of the more typically prescribed treatments, thionamides and I(131)iodine ablation. We also review the importance of shared decision making and the benefits of total thyroidectomy for the management of Graves' disease. Given the improvement in surgical techniques over the past decade and a significant reduction of complications, we suggest total thyroidectomy be recommended more often for patients with Graves' disease.

  6. Reduced Seminal Concentration of CD45pos Cells after Follicle-Stimulating Hormone Treatment in Selected Patients with Idiopathic Oligoasthenoteratozoospermia

    Directory of Open Access Journals (Sweden)

    Rosita A. Condorelli

    2014-01-01

    Full Text Available The present study evaluated the conventional sperm parameters and the seminal concentration of CD45pos cells (pan-leukocyte marker of infertile patients with idiopathic oligoasthenoteratozoospermia (OAT. The patients were arbitrarily divided into three groups treated with recombinant follicle-stimulating hormone FSH: α (Group A = 20 patients, recombinant FSH-β (Group B = 20 patients, and highly purified human FSH (Group C = 14 patients. All treated groups achieved a similar improvement of the main sperm parameters (density, progressive motility, and morphology, but only the increase in the percentage of spermatozoa with normal morphology was significant compared to the baseline in all three examined groups. Moreover, all groups had a significant reduction of the seminal concentration of CD45pos cells and of the percentage of immature germ cells. Before and after the treatment, the concentration of CD45pos cells showed a positive linear correlation with the percentage of immature germ cells and a negative correlation with the percentage of spermatozoa with regular morphology. These results demonstrate that treatment with FSH is effective in patients with idiopathic OAT and that there are no significant differences between the different preparations. The novelty of this study is in the significant reduction of the concentration of CD45pos cells observed after the treatment.

  7. Beam angle selection for intensity-modulated radiotherapy (IMRT) treatment of unresectable pancreatic cancer: are noncoplanar beam angles necessary?

    Science.gov (United States)

    Chang, D S; Bartlett, G K; Das, I J; Cardenes, H R

    2013-09-01

    External beam radiation therapy with concurrent chemotherapy (CRT) is widely used for the treatment of unresectable pancreatic cancer. Noncoplanar (NCP) 3D conformal radiotherapy (3DCRT) and coplanar (CP) IMRT have been reported to lower the radiation dose to organs at risk (OARs). The purpose of this article is to examine the utility of noncoplanar beam angles in IMRT for the management of pancreatic cancer. Sixteen patients who were treated with CRT for unresectable adenocarcinoma of the pancreatic head or neck were re-planned using CP and NCP beams in 3DCRT and IMRT with the Varian Eclipse treatment planning system. Compared to CP IMRT, NCP IMRT had similar target coverage with slightly increased maximum point dose, 5,799 versus 5,775 cGy (p = 0.008). NCP IMRT resulted in lower mean kidney dose, 787 versus 1,210 cGy (p kidney dose, but did not improve other dose-volume criteria. The use of NCP beam angles is preferred only in patients with risk factors for treatment-related kidney dysfunction.

  8. Flurbiprofen : A non-selective cyclooxygenase (COX) inhibitor for treatment of non-infectious, non-necrotising anterior scleritis

    Science.gov (United States)

    Agrawal, Rupesh; Lee, Cecilia; Gonzalez-Lopez, Julio J.; Khan, Sharmina; Rodrigues, Valeria; Pavesio, Carlos

    2016-01-01

    Objective To analyse the safety and efficacy of a non-selective cyclo-oxygenase (COX) inhibitor in the management of non-infectious, non-necrotising anterior scleritis. Methods Retrospective chart review of 126 patients with non-necrotising anterior scleritis treated with oral flurbiprofen (Froben®(Abbott Healthcare)) with ( group B, n=61) or without topical steroids (group A, n=65) was performed and time to remission was plotted. Results The observed incidence rate was 1.07 (95% CI: 0.57–1.99) per 1000 person-years with failure rate of 0.68 (95% CI: 0.22–2.12) per 1000 person-years in group A and 1.41 (95% CI: 0.67–2.96) per 1000 person-years in group B. The failure rate was 3.97(1.89–9.34) per 1000 person-years with hazard ratio of 10.01 ( 95% CI: 2.52–39.65; p<0.001) for patients with associated systemic disease. Conclusion To our best knowledge, this is the first and largest case series on the safety and efficacy of a non-selective COX inhibitor in the management of anterior scleritis. PMID:26308394

  9. Playing with Gladys: A case study integrating drama therapy with behavioural interventions for the treatment of selective mutism.

    Science.gov (United States)

    Oon, Phei Phei

    2010-04-01

    This case study examines an integrative approach combining drama therapy and the behavioural skill "shaping", as offered to Gladys, a 5-year-old girl diagnosed with selective mutism. This study found that shaping, when implemented in the context of play, with play as the primary reinforcer, elicited from Gladys vocalization and eventually speech within a very short time. Her vocalizations allowed her to enter dramatic play, which in turn propelled spontaneous speech. This article looks at how the three elements of dramatherapy - the playspace, role-playing and dramatic projection - brought about therapeutic changes for Gladys. Aside from spontaneous speech, Gladys also developed positive self-esteem and a heightened sense of spontaneity. Subsequently, these two qualities helped her generalize her speech to new settings on her own. Gladys's newly harnessed spontaneity further helped her become more sociable and resilient.This study advances the possibility of integrating a behavioural skill with drama therapy for the therapeutic benefits of a child with an anxiety-related condition like selective mutism.

  10. Personalized Monte Carlo dosimetry for the planning and evaluation of internal radiotherapy treatments: development and application to selective internal radiotherapy (SIRT)

    International Nuclear Information System (INIS)

    Petitguillaume, Alice

    2014-01-01

    Medical techniques in full expansion arousing high therapeutic expectations, targeted radionuclide therapies (TRT) consist of administering a radiopharmaceutical to selectively treat tumors. Nowadays, the activity injected to the patient is generally standardized. However, in order to establish robust dose-effect relationships and to optimize treatments while sparing healthy tissues at best, a personalized dosimetry must be performed, just like actual clinical practice in external beam radiotherapy. In that context, this PhD main objective was to develop, using the OEDIPE software, a methodology for personalized dosimetry based on direct Monte Carlo calculations. The developed method enables to calculate the tridimensional distribution of absorbed doses depending on the patient anatomy, defined from CT or MRI data, and on the patient-specific activity biodistribution, defined from SPECT or PET data. Radiobiological aspects, such as differences in radiosensitivities and repair time constants between tumoral and healthy tissues, have also been integrated through the linear-quadratic model. This methodology has been applied to the selective internal radiation therapy (SIRT) which consists in the injection of 90 Y-microspheres to selectively treat unresectable hepatic cancers. Distributions of absorbed doses and biologically effective doses (BED) along with the equivalent uniform biologically effective doses (EUD) to hepatic lesions have been calculated from 99m Tc-MAA activity distributions obtained during the evaluation step for 18 patients treated at Hopital Europeen Georges Pompidou. Those results have been compared to classical methods used in clinics and the interest of accurate and personalized dosimetry for treatment planning has been investigated. On the one hand, the possibility to increase the activity in a personalized way has been highlighted with the calculation of the maximal activity that could be injected to the patient while meeting tolerance criteria

  11. Design and evaluation of multi-indicator profiles for targeted-selective treatment against gastrointestinal nematodes at housing in adult dairy cows.

    Science.gov (United States)

    Ravinet, Nadine; Lehebel, Anne; Bareille, Nathalie; Lopez, Carlos; Chartier, Christophe; Chauvin, Alain; Madouasse, Aurélien

    2017-04-15

    Targeted-selective treatments against gastrointestinal nematode (GIN) in adult dairy cows require the identification of "cows to treat", i.e. cows whose milk production (MP) would increase after treatment. This study aimed at quantifying the ability of multi-indicator profiles to identify such cows. A randomized controlled clinical trial was conducted at housing in 25 French pasturing dairy herds. In each herd, treated cows received fenbendazole orally, control cows remained untreated. Daily MP was recorded and the MP variation between the pre- and post-visit periods was calculated (ΔMP) for each cow. ΔMP was modelled with control cows data (n=412) (piecewise linear mixed model). Estimated parameters were applied to treated cows data (n=414) to predict the expected ΔMP in treated cows if they had not been treated. Treated cows with an observed ΔMP (with treatment) higher than the expected ΔMP (without treatment) were labelled as "cows to treat". Herds where at least 50% of the young cows were "cows to treat" were qualified as "herds to target". To characterize such cows and herds, the available candidate indicators were (i) at the cow-level: parity, stage of lactation and production level, faecal egg count (FEC), serum pepsinogen level and anti-Ostertagia antibody level (expressed as ODR); (ii) at the herd-level: bulk tank milk (BTM) Ostertagia ODR, Time of Effective Contact (TEC, in months) with GIN infective larvae before the first calving, and percentage of positive FEC. These indicators were tested one-by-one or in combination to assess their ability to characterize "herds to target" and "cows to treat" (Chi-square tests). 115 out of 414 treated cows (27.8%) were considered as "cows to treat", and 9 out of 22 herds were qualified as "herds to target". The indicators retained to profile such cows and herds were the parity, the production level, the BTM Ostertagia ODR and the TEC. Multi-indicator profiles were much more specific than single indicator

  12. Pharmacodynamically optimized erythropoietin treatment combined with phlebotomy reduction predicted to eliminate blood transfusions in selected preterm infants.

    Science.gov (United States)

    Rosebraugh, Matthew R; Widness, John A; Nalbant, Demet; Cress, Gretchen; Veng-Pedersen, Peter

    2014-02-01

    Preterm very-low-birth-weight (VLBW) infants weighing eliminated by reducing laboratory blood loss in combination with pharmacodynamically optimized erythropoietin (Epo) treatment. Twenty-six VLBW ventilated infants receiving RBCTx were studied during the first month of life. RBCTx simulations were based on previously published RBCTx criteria and data-driven Epo pharmacodynamic optimization of literature-derived RBC life span and blood volume data corrected for phlebotomy loss. Simulated pharmacodynamic optimization of Epo administration and reduction in phlebotomy by ≥ 55% predicted a complete elimination of RBCTx in 1.0-1.5 kg infants. In infants 1.0 kg.

  13. Radiation- and Photo-induced Activation of 5-Fluorouracil Prodrugs as a Strategy for the Selective Treatment of Solid Tumors

    Directory of Open Access Journals (Sweden)

    Sei-ichi Nishimoto

    2008-10-01

    Full Text Available 5-Fluorouracil (5-FU is used widely as an anticancer drug to treat solid cancers, such as colon, breast, rectal, and pancreatic cancers, although its clinical application is limited because 5-FU has gastrointestinal and hematological toxicity. Many groups are searching for prodrugs with functions that are tumor selective in their delivery and can be activated to improve the clinical utility of 5-FU as an important cancer chemotherapeutic agent. UV and ionizing radiation can cause chemical reactions in a localized area of the body, and these have been applied in the development of site-specific drug activation and sensitization. In this review, we describe recent progress in the development of novel 5-FU prodrugs that are activated site specifically by UV light and ionizing radiation in the tumor microenvironment. We also discuss the chemical mechanisms underlying this activation.

  14. Data demonstrating the effects of build orientation and heat treatment on fatigue behavior of selective laser melted 17–4 PH stainless steel

    Directory of Open Access Journals (Sweden)

    Aref Yadollahi

    2016-06-01

    Full Text Available Axial fully-reversed strain-controlled (R=−1 fatigue experiments were performed to obtain data demonstrating the effects of building orientation (i.e. vertical versus horizontal and heat treatment on the fatigue behavior of 17–4 PH stainless steel (SS fabricated via Selective Laser Melting (SLM (Yadollahi et al., submitted for publication [1]. This data article provides detailed experimental data including cyclic stress-strain responses, variations of peak stresses during cyclic deformation, and fractography of post-mortem specimens for SLM 17–4 PH SS.

  15. Pig Manure Contamination Marker Selection Based on the Influence of Biological Treatment on the Dominant Fecal Microbial Groups▿

    Science.gov (United States)

    Marti, Romain; Dabert, Patrick; Pourcher, Anne-Marie

    2009-01-01

    The objective of this study was to identify a microbial marker for pig manure contamination. We quantified the persistence of four dominant bacterial groups from the pig intestinal tract throughout manure handling at 10 livestock operations (including aerobic digestion) by using molecular typing. The partial 16S rRNA genes of Bacteroides-Prevotella, Eubacterium-Clostridiaceae, Bacillus-Streptococcus-Lactobacillus (BSL), and Bifidobacterium group isolates were amplified and analyzed by capillary electrophoresis single-strand conformation polymorphism. The most dominant bacterial populations were identified by cloning and sequencing their 16S rRNA genes. The results showed that Bifidobacterium spp. and, to a lesser extent, members of the BSL group, were less affected by the aerobic treatment than either Eubacterium-Clostridiaceae or Bacteroides-Prevotella. Two Bifidobacterium species found in raw manure were still present in manure during land application, suggesting that they can survive outside the pig intestinal tract and also survive aerobic treatment. The 16S-23S rRNA internal transcribed spacer of one species, Bifidobacterium thermacidophilum subsp. porcinum, was sequenced, and a specific pair of primers was designed for its detection in the environment. With this nested PCR assay, this potential marker was not detected in samples from 30 bovine, 30 poultry, and 28 human fecal samples or in 15 urban wastewater effluents. As it was detected in runoff waters after spreading of pig manure, we propose this marker as a suitable microbial indicator of pig manure contamination. PMID:19525269

  16. Pig manure contamination marker selection based on the influence of biological treatment on the dominant fecal microbial groups.

    Science.gov (United States)

    Marti, Romain; Dabert, Patrick; Pourcher, Anne-Marie

    2009-08-01

    The objective of this study was to identify a microbial marker for pig manure contamination. We quantified the persistence of four dominant bacterial groups from the pig intestinal tract throughout manure handling at 10 livestock operations (including aerobic digestion) by using molecular typing. The partial 16S rRNA genes of Bacteroides-Prevotella, Eubacterium-Clostridiaceae, Bacillus-Streptococcus-Lactobacillus (BSL), and Bifidobacterium group isolates were amplified and analyzed by capillary electrophoresis single-strand conformation polymorphism. The most dominant bacterial populations were identified by cloning and sequencing their 16S rRNA genes. The results showed that Bifidobacterium spp. and, to a lesser extent, members of the BSL group, were less affected by the aerobic treatment than either Eubacterium-Clostridiaceae or Bacteroides-Prevotella. Two Bifidobacterium species found in raw manure were still present in manure during land application, suggesting that they can survive outside the pig intestinal tract and also survive aerobic treatment. The 16S-23S rRNA internal transcribed spacer of one species, Bifidobacterium thermacidophilum subsp. porcinum, was sequenced, and a specific pair of primers was designed for its detection in the environment. With this nested PCR assay, this potential marker was not detected in samples from 30 bovine, 30 poultry, and 28 human fecal samples or in 15 urban wastewater effluents. As it was detected in runoff waters after spreading of pig manure, we propose this marker as a suitable microbial indicator of pig manure contamination.

  17. Treatment with non-selective beta blockers is associated with reduced severity of systemic inflammation and improved survival of patients with acute-on-chronic liver failure

    DEFF Research Database (Denmark)

    Mookerjee, Rajeshwar P; Pavesi, Marco; Thomsen, Karen Louise

    2016-01-01

    BACKGROUND & AIMS: Non-selective beta blockers (NSBBs) have been shown to have deleterious outcomes in patients with refractory ascites, alcoholic hepatitis and spontaneous bacterial peritonitis leading many physicians to stop the drug in these cases. Acute-on-chronic liver failure (ACLF......) is characterized by systemic inflammation and high mortality. As NSBBs may have beneficial effects on gut motility and permeability and, systemic inflammation, the aims of this prospective, observational study were to determine whether ongoing use of NSBBs reduced 28-day mortality in ACLF patients. METHODS...... at enrollment significantly associated with treatment and mortality were taken into account as potential confounders to adjust for treatment effect. A logistic regression model was fitted. RESULTS: 164 (47%) ACLF patients received NSBBs whereas 185 patients did not. Although the CLIF-C ACLF scores were similar...

  18. Retrospective Study to Compare Selective Decongestive Devascularization and Gastrosplenic Shunt versus Splenectomy with Pericardial Devascularization for the Treatment of Patients with Esophagogastric Varices Due to Cirrhotic Portal Hypertension.

    Science.gov (United States)

    Bao, Haili; He, Qikuan; Dai, Ninggao; Ye, Ruifan; Zhang, Qiyu

    2017-06-08

    BACKGROUND For patients with esophagogastric varices secondary to portal hypertension due to liver cirrhosis, portosystemic shunts and devascularization have become the most commonly used treatment methods. We have developed a novel surgical approach for the treatment of patients with cirrhotic portal hypertension, selective decongestive devascularization, and shunt of the gastrosplenic region (SDDS-GSR). This aim of this study was to compare the efficacy and safety of SDDS-GSR with splenectomy with pericardial devascularization (SPD). MATERIAL AND METHODS A retrospective study was undertaken between 2006 and 2013 and included 110 patients with cirrhotic portal hypertension, 34 of whom underwent SDDS-GSR; 76 patients underwent SPD. Kaplan-Meier analysis was used to evaluate clinical outcomes, mortality, the incidence of re-bleeding, encephalopathy, and portal venous system thrombosis (PVST). RESULTS Postoperatively portal venous pressure decreased by 20% in both groups. The long-term incidence of re-bleeding and PVST was significantly lower in the SDDS-GSR group compared with the SPD group (P=0.018 and P=0.039, respectively). CONCLUSIONS This preliminary retrospective study has shown that SDDS-GSR was an effective treatment for patients with esophagogastric varices secondary to portal hypertension that may be used as a first-line treatment to prevent variceal bleeding and lower the incidence of PVST.

  19. A neurobiological perspective on attachment problems in sexual offenders and the role of selective serotonin re-uptake inhibitors in the treatment of such problems.

    Science.gov (United States)

    Beech, Anthony R; Mitchell, Ian J

    2005-02-01

    This paper describes what is currently known about attachment from the development, social-cognitive and biological literatures and outlines the impact on organisms given adverse development experiences that can have an effect upon attachment formation in childhood across these three literatures. We then describe the effects that 'insecure' attachment styles arising in childhood can affect brain chemistry and brain function and subsequently adult social/romantic relationships. In the paper, we note that a number of sexual offenders report adverse childhood experiences and that they possess attachment styles that, taken together, make it likely that they will either seek out intimate attachments in ways where they will have sex with children, perhaps confusing sex with intimacy or in aggressive ways as particularly happens with men who sexually assault adult women. The last section of the paper describes chemical treatment for sexual offenders, focusing on the use of selective serotonin re-uptake inhibitors (SSRIs). We note evidence for the role of SSRIs in promoting more social/affiliative behaviors and speculate on the effects that SSRIs have in the treatment of sexual offenders by targeting areas of the social brain. Here, we would argue that it would be useful to carry out treatment where there is a combination of SSRI treatment (to promote more prosocial feelings and behaviors) in conjunction with therapy that typically addresses thoughts and behaviors, i.e., cognitive-behavioral therapy/schema-focused therapy.

  20. Effect of heat treatment on the microstructure, texture and elastic anisotropy of the nickel-based superalloy CM247LC processed by selective laser melting

    International Nuclear Information System (INIS)

    Muñoz-Moreno, R.; Divya, V.D.; Driver, S.L.; Messé, O.M.D.M.; Illston, T.; Baker, S.; Carpenter, M.A.; Stone, H.J.

    2016-01-01

    Selective laser melting (SLM) of nickel-based superalloys is of great interest for the aerospace industry due to its capability for producing components with complex geometries. However, an improved understanding of the effect of SLM and subsequent post deposition heat treatments on the microstructure and mechanical properties is required to ensure that components with good structural integrity are produced. In this study, the microstructure, texture and elastic anisotropy of the nickel-based superalloy, CM247LC, in the as-SLM and heat-treated states have been analysed. The as-SLM microstructure showed fine elongated cells with a preferential alignment of <001> along the build direction and a significant intercellular misorientation. Heat treatments at temperatures below 1230 °C resulted in a progressive recovery of the microstructure, whilst heat treatments above this temperature gave rise to a recrystallised microstructure. The extent to which nucleation and growth of the γ′ precipitates and secondary particles were affected by increasing the heat treatment temperature was also characterised. The bulk elastic anisotropy of all samples was measured by resonant ultrasound spectroscopy (RUS) and was found to be consistent with the local textures obtained by electron backscatter diffraction (EBSD). It was observed that the initially strong elastic anisotropy exhibited by the as-SLM material was significantly reduced in the recrystallised samples, although some anisotropy was retained as a result of their elongated grain microstructures.

  1. Treatment of adolescent lumber spondylolysis with modified Boston brace. Selection of the patients with bone scintigraphy and repair of the part defects

    Energy Technology Data Exchange (ETDEWEB)

    Hino, Hiroyuki; Abumi, Kuniyoshi; Kaneda, Kiyoshi; Sato, Eishu [Hokkaido Univ., Sapporo (Japan). School of Medicine

    1996-06-01

    Results of brace treatment of 29 spondylolysis patients were reported. Patients were those who were diagnosed by scout roentgenography and accumulated {sup 99m}Tc at spondylolytic site by bone scintigraphy or by single photon emission computed tomography (SPECT) which being found more convenient to see the accumulation than the scintigraphy. Coaptation after brace treatment was observed by flat and tomographic roentgenography. Under limited sports activity, the hard brace was used for about 4 months and then soft one, for 2 months. Coaptation and repair were observed for 46 (79%) of 58 part defects in the 29 patients. Since lumber spine spondylolysis is mostly caused by fatigue fracture and bone metabolism is activated at the lesional site, {sup 99m}Tc accumulation can be seen at the spondylolytic site by bone scintigraphy with high frequency. Therefore, the rate of repair can be increased when brace treatment was applied for patients with positive bone scintigraphy findings. The scintigraphy was thus useful far selecting patients suitable for brace treatment. (K.H.)

  2. Treatment of adolescent lumber spondylolysis with modified Boston brace. Selection of the patients with bone scintigraphy and repair of the part defects

    International Nuclear Information System (INIS)

    Hino, Hiroyuki; Abumi, Kuniyoshi; Kaneda, Kiyoshi; Sato, Eishu

    1996-01-01

    Results of brace treatment of 29 spondylolysis patients were reported. Patients were those who were diagnosed by scout roentgenography and accumulated 99m Tc at spondylolytic site by bone scintigraphy or by single photon emission computed tomography (SPECT) which being found more convenient to see the accumulation than the scintigraphy. Coaptation after brace treatment was observed by flat and tomographic roentgenography. Under limited sports activity, the hard brace was used for about 4 months and then soft one, for 2 months. Coaptation and repair were observed for 46 (79%) of 58 part defects in the 29 patients. Since lumber spine spondylolysis is mostly caused by fatigue fracture and bone metabolism is activated at the lesional site, 99m Tc accumulation can be seen at the spondylolytic site by bone scintigraphy with high frequency. Therefore, the rate of repair can be increased when brace treatment was applied for patients with positive bone scintigraphy findings. The scintigraphy was thus useful far selecting patients suitable for brace treatment. (K.H.)

  3. Effect of heat treatment on the microstructure, texture and elastic anisotropy of the nickel-based superalloy CM247LC processed by selective laser melting

    Energy Technology Data Exchange (ETDEWEB)

    Muñoz-Moreno, R., E-mail: rociomunozmoreno@gmail.com [Department of Materials Science and Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge CB3 0FS (United Kingdom); Divya, V.D. [Department of Materials Science and Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge CB3 0FS (United Kingdom); Driver, S.L. [Department of Materials Science and Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge CB3 0FS (United Kingdom); Department of Earth Sciences, University of Cambridge, Downing Street, Cambridge CB2 3EQ (United Kingdom); Messé, O.M.D.M. [Department of Materials Science and Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge CB3 0FS (United Kingdom); Illston, T.; Baker, S. [Materials Solutions, Unit 8, Great Western Business Park, McKenzie Way, Worcester WR4 9GN (United Kingdom); Carpenter, M.A. [Department of Earth Sciences, University of Cambridge, Downing Street, Cambridge CB2 3EQ (United Kingdom); Stone, H.J. [Department of Materials Science and Metallurgy, University of Cambridge, 27 Charles Babbage Road, Cambridge CB3 0FS (United Kingdom)

    2016-09-30

    Selective laser melting (SLM) of nickel-based superalloys is of great interest for the aerospace industry due to its capability for producing components with complex geometries. However, an improved understanding of the effect of SLM and subsequent post deposition heat treatments on the microstructure and mechanical properties is required to ensure that components with good structural integrity are produced. In this study, the microstructure, texture and elastic anisotropy of the nickel-based superalloy, CM247LC, in the as-SLM and heat-treated states have been analysed. The as-SLM microstructure showed fine elongated cells with a preferential alignment of <001> along the build direction and a significant intercellular misorientation. Heat treatments at temperatures below 1230 °C resulted in a progressive recovery of the microstructure, whilst heat treatments above this temperature gave rise to a recrystallised microstructure. The extent to which nucleation and growth of the γ′ precipitates and secondary particles were affected by increasing the heat treatment temperature was also characterised. The bulk elastic anisotropy of all samples was measured by resonant ultrasound spectroscopy (RUS) and was found to be consistent with the local textures obtained by electron backscatter diffraction (EBSD). It was observed that the initially strong elastic anisotropy exhibited by the as-SLM material was significantly reduced in the recrystallised samples, although some anisotropy was retained as a result of their elongated grain microstructures.

  4. Analysis of Economical and Environmental Costs for the Selection of Municipal Solid Waste Treatment and Disposal Scenarios through Multicriteria Analysis (ELECTRE Method

    Directory of Open Access Journals (Sweden)

    Lorena De Medina-Salas

    2017-10-01

    Full Text Available Decision-making for the selection of treatment alternatives and landfilling of municipal solid waste (MSW is based on the experience and judgment of those management responsible, without considering multicriteria analysis. Therefore, the purpose of this research was to determine the treatment scenario and landfilling of MSW with the lowest environmental and economic costs in a medium-sized city. The methodology included the definition and data processing of the project (population, generation, and composition of MSW, for 16 years. In the design of scenarios, recycling, composting, incineration with energy recovery, and landfilling treatments were proposed; later, the combinations of treatments for each type of residue were generated. The results showed 36 scenarios, then the ELECTRE method was applied to the five with the lowest economical and environmental costs. Finally from the latter, one dominant scenario was determined: organic waste in composting; plastic, paper, and glass in recycling; and ‘others’ in landfilling. It is concluded that the final decision on the scenario is adapted to the particular conditions of the locality.

  5. Preparative treatment with NaOH to selectively concentrate iron oxides of a Chilean volcanic soil material to produce effective heterogeneous Fenton catalyst

    International Nuclear Information System (INIS)

    Manzo, Valentina; Pizarro, Carmen; Rubio, María Angélica; Cavalcante, Luis Carlos Duarte; Garg, Vijayendra Kumar; Fabris, José Domingos

    2011-01-01

    A Chilean volcanic Ultisol material was first size-fractionated so as to obtain the fraction with mean particle sizes φ   − 1 NaOH, in an attempt to evaluate the effectiveness of the selective chemical dissolution to concentrate iron oxides, as a preparation procedure before using the materials as heterogeneous Fenton catalysts. The effects of those treatments on the iron oxides mineralogy were monitored with Mössbauer spectroscopy. The NaOH-treated samples were tested as catalysts towards the H 2 O 2 decomposition. Three or five sequential NaOH treatments were found to be comparably effective, by concentrating nearly the same proportion of iron oxides in the remaining solid phase (25.1 ± 0.4 and 23.3 ± 0.2 mass%, respectively). 298 K-Mössbauer patterns were similar for both samples, with a central (super)paramagnetic Fe 3 +  doublet and a broad sextet, assignable to several closely coexisting magnetically ordered forms of iron oxides. Despite of this nearly similar effect of the two treatments, the Ultisol material treated three times with NaOH presents higher heterogeneous catalytic efficiency and is more suitable to decompose H 2 O 2 than that with five treatments.

  6. Thiopurine treatment in patients with Crohn's disease leads to a selective reduction of an effector cytotoxic gene expression signature revealed by whole-genome expression profiling.

    Science.gov (United States)

    Bouma, G; Baggen, J M; van Bodegraven, A A; Mulder, C J J; Kraal, G; Zwiers, A; Horrevoets, A J; van der Pouw Kraan, C T M

    2013-07-01

    Crohn's disease (CD) is characterized by chronic inflammation of the gastrointestinal tract, as a result of aberrant activation of the innate immune system through TLR stimulation by bacterial products. The conventional immunosuppressive thiopurine derivatives (azathioprine and mercaptopurine) are used to treat CD. The effects of thiopurines on circulating immune cells and TLR responsiveness are unknown. To obtain a global view of affected gene expression of the immune system in CD patients and the treatment effect of thiopurine derivatives, we performed genome-wide transcriptome analysis on whole blood samples from 20 CD patients in remission, of which 10 patients received thiopurine treatment, compared to 16 healthy controls, before and after TLR4 stimulation with LPS. Several immune abnormalities were observed, including increased baseline interferon activity, while baseline expression of ribosomal genes was reduced. After LPS stimulation, CD patients showed reduced cytokine and chemokine expression. None of these effects were related to treatment. Strikingly, only one highly correlated set of 69 genes was affected by treatment, not influenced by LPS stimulation and consisted of genes reminiscent of effector cytotoxic NK cells. The most reduced cytotoxicity-related gene in CD was the cell surface marker CD160. Concordantly, we could demonstrate an in vivo reduction of circulating CD160(+)CD3(-)CD8(-) cells in CD patients after treatment with thiopurine derivatives in an independent cohort. In conclusion, using genome-wide profiling, we identified a disturbed immune activation status in peripheral blood cells from CD patients and a clear treatment effect of thiopurine derivatives selectively affecting effector cytotoxic CD160-positive cells. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Super-selective interventional chemotherapy combined with systemic chemotherapy for the treatment of postoperative gliomas:a clinical study

    International Nuclear Information System (INIS)

    Chen Jian; Hu Qinglei; Sun Yanchun; Feng Lei; Liu Yunzhen; Liu Ju; Kong Ruifen

    2010-01-01

    Objective: To evaluate super-selective interventional chemotherapy combined with systemic chemotherapy in treating postoperative gliomas. Methods: During the period of 2005-2009, a total of 46 patients with glioma were encountered in our hospital. According to the principle of patient's free will the involved patients were divided into two groups. Study group (n = 25): after operation the patients received routine radiotherapy, which was followed by super-selective interventional chemotherapy combined simultaneously with systemic chemotherapy. Control group (n = 21): after operation the patients received routine radiotherapy, which was followed by systemic chemotherapy only. The patients were regularly followed up. Cranial CT checkups were made to determine the tumor size, and the results were evaluated with Karnofsky scores. The clinical data were analyzed and compared between two groups. Results: In the study group, the side-effects and complications included epileptic seizures (n = 3), eye pain (n = 5), headache (n = 9), nausea and vomiting (n = 8) and thrombopenia (n = 1). In the control group,the side-effects and complications were as follows: epileptic seizures (n = 1), headache (n = 7), nausea and vomiting (n = 6) and thrombopenia(n = 3). No death occurred in either of the two groups. The patients were followed up for an average period of 2.3 years. Before chemotherapy no statistically significant difference in tumor size existed between two groups (P > 0.05). One year after the chemotherapy, the tumor volume in study group was reduced by 67.11%, while it was 45.79% in control group. By using independent sample t test analysis, the difference between two groups was of statistical significance (P < 0.05). Wilcoxon rank sum test and Karnofsky prognostic score analysis indicated that the prognosis of study group was much better than that of control group (P < 0.05). Conclusion: In comparison with routine radiotherapy plus simple systemic chemotherapy, routine

  8. Tryptanthrin content in Isatis tinctoria leaves--a comparative study of selected strains and post-harvest treatments.

    Science.gov (United States)

    Oberthür, Christine; Hamburger, Matthias

    2004-07-01

    Tryptanthrin is a pharmacologically active compound in the anti-inflammatory herb Isatis tinctoria, with potent inhibitory activity on prostaglandin and leukotriene synthesis and on inducible NO synthase. The tryptanthrin content of five defined woad strains was analyzed in dependence of the time of harvest and post-harvest treatment. Tryptanthrin was determined by a validated ESI-LC-MS isotope dilution assay with d(8)-tryptanthrin as internal standard. The tryptanthrin concentration in freeze-dried leaf samples was low. Drying at ambient temperature led to a significant increase of tryptanthrin concentration, but the highest concentrations were found when leaves were dried at 40 degrees C. Tryptanthrin content in fermented woad leaves was below the limit of quantification. Tryptanthrin appears thus to be a product of post-harvest processes, but details of its formation remain to be elucidated.

  9. Photometric and fluorometric detection of radiolytic changes to selected animal foods as a result of treatment with ionizing rays

    International Nuclear Information System (INIS)

    Chory, C.

    1993-01-01

    The methods specified in the heading were tested for their suitability to detect any previous irradiation treatment of shrimps, chickens or mock salmon. Shrimps and chickens are among those foods that are already routinely irradiated for commercial reasons and have therefore been included in the most recent version of the provisional guidelines of the EC commission on the irradiation of foodstuffs. Parameters like radiation-induced formation of carbonyl compounds, changes to radiation-responsive sulfhydryl groups of proteins and DNA strand breaks caused by ionizing radiation offered useful approaches to the detection of any such irradiation. One decisive factor for the choice of the chemical methods of analysis to be used was their straightforwardness. (orig./HP) [de

  10. Selective extraction of intracellular components from the microalga Chlorella vulgaris by combined pulsed electric field-temperature treatment.

    Science.gov (United States)

    Postma, P R; Pataro, G; Capitoli, M; Barbosa, M J; Wijffels, R H; Eppink, M H M; Olivieri, G; Ferrari, G

    2016-03-01

    The synergistic effect of temperature (25-65 °C) and total specific energy input (0.55-1.11 kWh kgDW(-1)) by pulsed electric field (PEF) on the release of intracellular components from the microalgae Chlorella vulgaris was studied. The combination of PEF with temperatures from 25 to 55 °C resulted in a conductivity increase of 75% as a result of cell membrane permeabilization. In this range of temperatures, 25-39% carbohydrates and 3-5% proteins release occurred and only for carbohydrate release a synergistic effect was observed at 55 °C. Above 55 °C spontaneous cell lysis occurred without PEF. Combined PEF-temperature treatment does not sufficiently disintegrate the algal cells to release both carbohydrates and proteins at yields comparable to the benchmark bead milling (40-45% protein, 48-58% carbohydrates). Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Selection of antimalarial drug resistance after intermittent preventive treatment of infants and children (IPTi/c) in Senegal

    DEFF Research Database (Denmark)

    Ndiaye, Magatte; Tine, Roger; Faye, Babacar

    2013-01-01

    Senegal has since 2003 used sulphadoxine-pyrimethamine (SP) for Intermittent Preventive Treatment (IPT) of malaria in risk groups. However, the large-scale IPT strategy may result in increasing drug resistance. Our study investigated the possible impact of SP-IPT given to infants and children...... on the prevalence of SP-resistant haplotypes in the Plasmodium falciparum genes Pfdhfr and Pfdhps, comparing sites with and without IPTi/c. P. falciparum positives samples (n=352) were collected from children under 5years of age during two cross-sectional surveys in 2010 and 2011 in three health districts (two...... on IPTi/c and one without IPTi/c intervention) located in the southern part of Senegal. The prevalence of SP-resistance-related haplotypes in Pfdhfr and Pfdhps was determined by nested PCR followed by sequence-specific oligonucleotide probe (SSOP)-ELISA. The prevalence of the Pfdhfr double mutant...

  12. A failure-type specific risk prediction tool for selection of head-and-neck cancer patients for experimental treatments

    DEFF Research Database (Denmark)

    Håkansson, Katrin; Rasmussen, Jacob H.; Rasmussen, Gregers B.

    2017-01-01

    : Retrospective data for 560HNSCC patients were used to generate a multi-endpoint model, combining three cause-specific Cox models (LRF, DM and death with no evidence of disease (death NED)). The model was used to generate risk profiles of patients eligible for/included in a de-intensification study (RTOG 1016...... variables (tumor subsite, T stage, N stage, smoking status, age and performance status) and one additional variable (tumor volume). The treatment failure discrimination ability of the developed model was superior of that of UICC staging, 8(th) edition (AUCLRF=72.7% vs 64.2%, p....8%, pde-intensification study had>20% risk of tumor relapse. Conversely, 9 of the 15 dose escalation trial participants had LRF risks

  13. Advanced oxidation treatment and photochemical fate of selected antidepressant pharmaceuticals in solutions of Suwannee River humic acid

    Energy Technology Data Exchange (ETDEWEB)

    Santoke, Hanoz, E-mail: hsantoke@uci.edu [Urban Water Research Center, Department of Civil and Environmental Engineering, University of California, Irvine, Irvine, CA 92697-2175 (United States); Song, Weihua, E-mail: wsong@uci.edu [Urban Water Research Center, Department of Civil and Environmental Engineering, University of California, Irvine, Irvine, CA 92697-2175 (United States); Department of Environmental Science and Engineering, Fudan University, Shanghai, 200433 (China); Cooper, William J., E-mail: wcooper@uci.edu [Urban Water Research Center, Department of Civil and Environmental Engineering, University of California, Irvine, Irvine, CA 92697-2175 (United States); Peake, Barrie M., E-mail: bpeake@chemistry.otago.ac.nz [Chemistry Department, University of Otago, P.O. Box 56, Dunedin 9054 (New Zealand)

    2012-05-30

    Highlights: Black-Right-Pointing-Pointer We elucidate the photochemical degradation of three antidepressant pharmaceuticals. Black-Right-Pointing-Pointer Hydroxyl radical is the most significant contributor to the degradation. Black-Right-Pointing-Pointer Excited state dissolved organic matter also plays a significant role for duloxetine. Black-Right-Pointing-Pointer Tentative reaction byproducts are identified. - Abstract: Antidepressant pharmaceuticals have recently been detected at low concentrations in wastewater and surface water. This work reports studies of the direct and indirect photochemical fate and treatment by advanced oxidation of three antidepressant compounds (duloxetine, venlafaxine and bupropion) in solutions of humic acid in order to elucidate their behavior in the natural environment prior to reaching a water treatment facility and potentially entering a potable water supply. Humic acid solution was prepared by adding to distilled water a known amount of organic matter as a photosensitizer. All three antidepressants react very rapidly with hydroxyl radicals ({center_dot}OH) and hydrated electrons (e{sup -}{sub aq}) with rate constants of {approx}10{sup 8} to 10{sup 10} M{sup -1} s{sup -1}, but significantly slower with singlet oxygen ({sup 1}{Delta}O{sub 2}) ({approx}10{sup 3} to 10{sup 5} M{sup -1} s{sup -1}). The steady-state concentrations of {center_dot}OH and {sup 1}{Delta}O{sub 2}, in a sample of humic acid solution were measured and used with the second order rate constants to show that the hydroxyl radical was an order of magnitude more effective than the singlet oxygen in the solar-induced photochemical degradation of the antidepressants. Excited state dissolved organic matter also accounted for a substantial portion of degradation of duloxetine, decreasing its half-life by 27% under solar irradiation. Several reaction pathways and by-products arising from the photodegradation were identified using gamma-irradiation followed by LC

  14. Which technology to select for primary focal treatment of prostate cancer?-European Section of Urotechnology (ESUT) position statement.

    Science.gov (United States)

    Ganzer, Roman; Arthanareeswaran, Vinodh Kumar Adithyaa; Ahmed, Hashim U; Cestari, Andrea; Rischmann, Pascal; Salomon, Georg; Teber, Dogu; Liatsikos, Evangelos; Stolzenburg, Jens-Uwe; Barret, Eric

    2018-05-09

    With growing interest in focal therapy (FT) of prostate cancer (PCa) there is an increasing armamentarium of treatment modalities including high-intensity focused ultrasound (HIFU), cryotherapy, focal laser ablation (FLA), irreversible electroporation (IRE), vascular targeted photodynamic therapy (VTP), focal brachytherapy (FBT) and stereotactic ablative radiotherapy (SABR). Currently there are no clear recommendations as to which of these technologies are appropriate for individual patient characteristics. Our intention was to review the literature for special aspects of the different technologies that might be of advantage depending on individual patient and tumour characteristics. The current literature on FT was screened for the following factors: morbidity, repeatability, tumour risk category, tumour location, tumour size and prostate volume and anatomical issues. The ESUT expert panel arrived at consensus regarding a position statement on a structured pathway for available FT technologies based on a combination of the literature and expert opinion. Side effects were low across different studies and FT modalities with urinary continence rates of 90-100% and erectile dysfunction between 5 and 52%. Short to medium cancer control based on post-treatment biopsies were variable between ablative modalities. Expert consensus suggested that posterior lesions are better amenable to FT using HIFU. Cryotherapy provides best possible outcomes for anterior tumours. Apical lesions, when treated with FBT, may yield the least urethral morbidity. Further prospective trials are required to assess medium to long term disease control of different ablative modalities for FT. Amongst different available FT modalities our ESUT expert consensus suggests that some may be better for diffe`rent tumour locations. Tumour risk, tumour size, tumour location, and prostate volume are all important factors to consider and might aid in designing future FT trials.

  15. SEISMIC DESIGN REQUIREMENTS SELECTION METHODOLOGY FOR THE SLUDGE TREATMENT and M-91 SOLID WASTE PROCESSING FACILITIES PROJECTS

    International Nuclear Information System (INIS)

    RYAN GW

    2008-01-01

    In complying with direction from the U.S. Department of Energy (DOE), Richland Operations Office (RL) (07-KBC-0055, 'Direction Associated with Implementation of DOE-STD-1189 for the Sludge Treatment Project,' and 08-SED-0063, 'RL Action on the Safety Design Strategy (SDS) for Obtaining Additional Solid Waste Processing Capabilities (M-91 Project) and Use of Draft DOE-STD-I 189-YR'), it has been determined that the seismic design requirements currently in the Project Hanford Management Contract (PHMC) will be modified by DOE-STD-1189, Integration of Safety into the Design Process (March 2007 draft), for these two key PHMC projects. Seismic design requirements for other PHMC facilities and projects will remain unchanged. Considering the current early Critical Decision (CD) phases of both the Sludge Treatment Project (STP) and the Solid Waste Processing Facilities (M-91) Project and a strong intent to avoid potentially costly re-work of both engineering and nuclear safety analyses, this document describes how Fluor Hanford, Inc. (FH) will maintain compliance with the PHMC by considering both the current seismic standards referenced by DOE 0 420.1 B, Facility Safety, and draft DOE-STD-1189 (i.e., ASCE/SEI 43-05, Seismic Design Criteria for Structures, Systems, and Components in Nuclear Facilities, and ANSI ANS 2.26-2004, Categorization of Nuclear Facility Structures, Systems and Components for Seismic Design, as modified by draft DOE-STD-1189) to choose the criteria that will result in the most conservative seismic design categorization and engineering design. Following the process described in this document will result in a conservative seismic design categorization and design products. This approach is expected to resolve discrepancies between the existing and new requirements and reduce the risk that project designs and analyses will require revision when the draft DOE-STD-1189 is finalized

  16. Impact of Insurance Status on Radiation Treatment Modality Selection Among Potential Candidates for Prostate, Breast, or Gynecologic Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Grant, Stephen R. [Baylor College of Medicine, Houston, Texas (United States); Walker, Gary V. [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Koshy, Matthew [Department of Radiation Oncology, The University of Chicago, Chicago, Illinois (United States); Shaitelman, Simona F.; Klopp, Ann H.; Frank, Steven J.; Pugh, Thomas J.; Allen, Pamela K. [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Mahmood, Usama, E-mail: UMahmood@mdanderson.org [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States)

    2015-12-01

    Purpose: The Patient Protection and Affordable Care Act looks to expand both private and Medicaid insurance. To evaluate how these changes may affect the field of radiation oncology, we evaluated the association of insurance status with the use of brachytherapy in cancers for which this treatment technique is used. Methods and Materials: A total of 190,467 patients met the inclusion criteria, of whom 95,292 (50.0%) had breast cancer, 61,096 (32.1%) had prostate cancer, 28,194 (14.8%) had endometrial cancer, and 5885 (3.1%) had cervical cancer. A multivariate logistic regression model was used to determine the association between insurance status and receipt of brachytherapy among patients treated definitively for prostate and cervical cancer or postoperatively for breast and endometrial cancer. Results: The rates of non-Medicaid insurance were 49.9% (cervical), 85.3% (endometrial), 87.4% (breast), and 90.9% (prostate) (P<.001). In a logistic regression, patients who received radiation therapy were less likely to receive brachytherapy if they had Medicaid coverage (odds ratio [OR] 0.57, 95% confidence interval [CI] 0.53-0.61, P<.001) or did not have insurance coverage (OR 0.50, 95% CI 0.45-0.56, P<.001) compared with those with non-Medicaid insurance. On subset analysis, patients with Medicaid coverage or without insurance coverage were significantly less likely to receive brachytherapy than were those with non-Medicaid insurance for all 4 sites, except for patients with endometrial cancer. Conclusions: Despite being a cost-effective treatment modality, brachytherapy is less often used in the definitive or postoperative management of cancer in patients with Medicaid coverage or without insurance. Upcoming health policy changes resulting in the expansion of private insurance and Medicaid will likely increase access to and demand for brachytherapy.

  17. Impact of Insurance Status on Radiation Treatment Modality Selection Among Potential Candidates for Prostate, Breast, or Gynecologic Brachytherapy

    International Nuclear Information System (INIS)

    Grant, Stephen R.; Walker, Gary V.; Koshy, Matthew; Shaitelman, Simona F.; Klopp, Ann H.; Frank, Steven J.; Pugh, Thomas J.; Allen, Pamela K.; Mahmood, Usama

    2015-01-01

    Purpose: The Patient Protection and Affordable Care Act looks to expand both private and Medicaid insurance. To evaluate how these changes may affect the field of radiation oncology, we evaluated the association of insurance status with the use of brachytherapy in cancers for which this treatment technique is used. Methods and Materials: A total of 190,467 patients met the inclusion criteria, of whom 95,292 (50.0%) had breast cancer, 61,096 (32.1%) had prostate cancer, 28,194 (14.8%) had endometrial cancer, and 5885 (3.1%) had cervical cancer. A multivariate logistic regression model was used to determine the association between insurance status and receipt of brachytherapy among patients treated definitively for prostate and cervical cancer or postoperatively for breast and endometrial cancer. Results: The rates of non-Medicaid insurance were 49.9% (cervical), 85.3% (endometrial), 87.4% (breast), and 90.9% (prostate) (P<.001). In a logistic regression, patients who received radiation therapy were less likely to receive brachytherapy if they had Medicaid coverage (odds ratio [OR] 0.57, 95% confidence interval [CI] 0.53-0.61, P<.001) or did not have insurance coverage (OR 0.50, 95% CI 0.45-0.56, P<.001) compared with those with non-Medicaid insurance. On subset analysis, patients with Medicaid coverage or without insurance coverage were significantly less likely to receive brachytherapy than were those with non-Medicaid insurance for all 4 sites, except for patients with endometrial cancer. Conclusions: Despite being a cost-effective treatment modality, brachytherapy is less often used in the definitive or postoperative management of cancer in patients with Medicaid coverage or without insurance. Upcoming health policy changes resulting in the expansion of private insurance and Medicaid will likely increase access to and demand for brachytherapy.

  18. Bentonite surface modification and characterization for high selective phosphate adsorption from aqueous media and its application for wastewater treatments

    Directory of Open Access Journals (Sweden)

    S. Yaghoobi-Rahni

    2017-06-01

    Full Text Available Raw and modified bentonite has been used to develop effective sorbents to remove phosphate from aqueous solution. Acid thermoactivation, Rewoquate, Irasoft, calcium, Fe and Al were employed to treat the bentonite. Results show that samples adsorption capacity for phosphate is in the order of, unmodified bentonite = acid thermoactivation < Rewoquate < calcium ≅ Irasoft < Fe < Al ≅ Fe-Al. The phosphate adsorption with Fe-Al-bentonite (FAB modification was more than 99% and the phosphate removal reached the peak value in the initial 30 min. The phosphate adsorption of FAB was pH independent in the range of 2–10. The common coexisting ions in wastewater have no effect on the phosphate adsorption. The phosphate adsorption results were very well fitted in the Freundlich and Langmuir isotherm model and the maximum adsorption capacity was 8.33 mg P/g at pH 6.5 for 1 hour, which was better than similar modified bentonite with low time and Fe-Al consumption. FAB was characterized by scanning electron microscopy, X-ray diffraction, X-ray fluorescence and Fourier transform infrared. Therefore, the results confirm that FAB is a selective phosphate sorbent and environmentally friendly for its potential application for phosphate removal from wastewater.

  19. Efficacy of selective arterial embolisation for the treatment of life-threatening post-partum haemorrhage in a large population.

    Directory of Open Access Journals (Sweden)

    Cyril Touboul

    Full Text Available BACKGROUND: The objective of this study was to assess efficacy and determine the optimal indication of selective arterial embolisation (SAE in patients with life-threatening post-partum haemorrhage (PPH. METHODOLOGY/PRINCIPAL FINDINGS: One hundred and two patients with PPH underwent SAE and were included from January 1998 to January 2002 in our university care center. Embolisation was considered effective when no other surgical procedure was required. Univariate and multivariate statistical analysis were performed. SAE was effective for 73 patients (71.5%, while 29 required surgical procedures. SAE was effective in 88.6% of women with uterine atony that was associated with positive outcome (OR 4.13, 1.35-12.60, whereas caesarean deliveries (OR 0.16, 0.04-0.5 and haemodynamic shock (OR 0.21, 0.07-0.60 were associated with high failure rates, 47.6% and 39.1%, respectively. CONCLUSIONS/SIGNIFICANCE: Success rate for SAE observed in a large population is lower than previously reported. It is most likely to succeed for uterine atony but not recommended in case of haemodynamic shock or after caesarean section.

  20. Application of a web-based cognitive-behavioural therapy programme for the treatment of selective mutism in Singapore: a case series study.

    Science.gov (United States)

    Ooi, Yoon Phaik; Raja, Malini; Sung, Sharon Cohan; Fung, Daniel S S; Koh, Jessie B K

    2012-07-01

    Selective mutism (SM) is characterised by limited or a lack of speech in selected social settings. Recent reviews suggest that cognitive-behavioural therapy (CBT) is an effective and promising treatment approach for SM. However, there is still a lack of studies documenting the applicability of CBT for SM in diverse populations. The goal of the present study was to examine the use of a web-based CBT programme ('Meeky Mouse') among Singaporean children diagnosed with SM. Five children with SM (one boy and four girls aged 6-11 years) participated in the 14-week 'Meeky Mouse' programme, in addition to being prescribed with an unchanged dosage of fluoxetine 10-20 mg daily. The progress made by the children throughout the course of the programme was documented by the therapist. Post treatment, four out of the five children demonstrated improvements in the frequency of speech during therapy sessions at home, in school and at other social situations. Findings from the present study provide support for the use of a web-based CBT programme in improving speech and decreasing the severity of SM among affected children.

  1. Selected Aspects of Functioning of the Sewage Treatment Plant in Szczawnica in Terms of Receiver Water Quality

    Directory of Open Access Journals (Sweden)

    Ewa Wąsik

    2017-12-01

    Full Text Available This article includes an assessment of the impact of sewage exiting from the sewage treatment plant in Szczawnica before and after the modernization of the facility, the physicochemical composition and the quality of the water of their receiver - Dunajec River. The work was carried out on the basis of analysis of samples taken from raw and purified sewage and receiver waters. The Dunajec water intake was above and below the point of sewer discharge from the WWTP. The range of contaminated indicators included 14 physicochemical parameters and two bacteriological indicators. On the basis of the research conducted, it was stated that the Szczawnica Forest Enterprise after its modernization in 2016 functioned correctly. The purified sewage on it complies with the requirements of a water permit, which translates directly into effective protection against the pollution of receiver waters. This was confirmed by the results of the Kruskal-Wallis test that showed statistically significant differences between the median values of overall nitrogen concentrations before and after the refurbishment of the facility. For the remaining pollutant indices (total suspensions, BOD5, CODCr, total phosphorus, no statistically significant differences were found between the medians. In addition, it was found that the physico-chemical composition of Dunajec waters was similar in both examined sections. The purified effluent discharged from the Szczawnica treatment plant to the Dunajec River did not contribute to deterioration of its water quality in the case of physico-chemical indicators. Based on the classification of these elements, it was determined that in the analyzed period, the Dunajec water in the section directly above and below the WWTP meets the requirements for category A1 of waters intended for the supply of the population (very good quality water. In the case of microbiological classification based on the number of bacteria of the coli group and

  2. Effect of atmospheric-pressure plasma treatment on the adhesion properties of a thin adhesive layer in a selective transfer process

    Science.gov (United States)

    Yoon, Min-Ah; Kim, Chan; Hur, Min; Kang, Woo Seok; Kim, Jaegu; Kim, Jae-Hyun; Lee, Hak-Joo; Kim, Kwang-Seop

    2018-01-01

    The adhesion between a stamp and thin film devices is crucial for their transfer on a flexible substrate. In this paper, a thin adhesive silicone layer on the stamp was treated by atmospheric pressure plasma to locally control the adhesion strength for the selective transfer. The adhesion strength of the silicone layer was significantly reduced after the plasma treatment, while its surface energy was increased. To understand the inconsistency between the adhesion strength and surface energy changes, the surface properties of the silicone layer were characterized using nanoindentation and X-ray photoelectron spectroscopy. These techniques revealed that a thin, hard, silica-like layer had formed on the surface from plasma-enhanced oxidation. This layer played an important role in decreasing the contact area and increasing the interfacial slippage, resulting in decreased adhesion. As a practical application, the transfer process was demonstrated on GaN LEDs that had been previously delaminated by a laser lift-off (LLO) process. Although the LEDs were not transferred onto the treated adhesive layer due to the reduced adhesion, the untreated adhesive layer could readily pick up the LEDs. It is expected that this simple method of controlling the adhesion of a stamp with a thin adhesive layer would enable a continuous, selective and large-scale roll-to-roll selective transfer process and thereby advance the development of flexible, stretchable and wearable electronics.

  3. Injury severity and disability in the selection of next level of care following acute medical treatment for traumatic brain injury.

    Science.gov (United States)

    Malec, James F; Mandrekar, Jayawant N; Brown, Allen W; Moessner, Anne M

    2009-01-01

    To evaluate the association of demographic factors, post-traumatic amnesia (PTA) and a standardized measure of ability limitations with clinical decisions for Next Level of Care following acute hospital treatment for moderate-severe traumatic brain injury (TBI). A TBI Clinical Nurse specialist recorded PTA for 212 individuals and rated 159 on the Ability and Adjustment Indices of the Mayo-Portland Adaptability Inventory (MPAI-4) for comparison with clinical decisions. Multivariate logistic regression analyses revealed that independent ratings on the MPAI-4 Ability Index and PTA were associated with the clinical decision to admit to Inpatient Rehabilitation vs discharge to Home in 92.7% of the sample; ratings on the Ability Index alone were associated with this decision in 92.2% of cases. Age over 65 was the only variable associated with discharge to a Skilled Nursing Facility, correctly predicting this decision in 64% of cases. Use of a standardized measure of ability limitations appears feasible to provide supportive documentation and potentially improve the consistency of decision-making in recommending Inpatient Rehabilitation vs discharge to Home. Although age is a significant factor in the decision to discharge to a Skilled Nursing Facility, this decision appears complex and merits further study.

  4. Evaluation for antidiabetic activity in selected medicinal plants used in Malaysian traditional medicine for the treatment of diabetes

    International Nuclear Information System (INIS)

    Shafii Khamis; Siti Harjieh Ibrahim; Noorul Azliana Jamaludin; Muhammad Hanafi Mohamad Mokhtar; Nor Azizah Marsiddi

    2006-01-01

    Aqueous extracts of three medicinal plants used in Malaysian traditional medicine for the treatment of diabetes were investigated. The nuts of Areca cathecu, leaves of Lagerstroemia speciosa and Ficus deltoidea were each extracted by boiling in distilled water. The aqueous extracts were filtered and the filtrates were then spray dried. Their biological evaluation was conducted to determine their blood glucose lowering effect in normoglycaemic and alloxan-induced diabetic rats. Commercially available antidiabetic drug, glybenclamide was used as positive control. Toxicity of the extracts was carried out using the brine shrimp lethality assay and in vivo acute toxicity test in rats. Aqueous extracts of all the plants studied showed significant reduction in blood glucose level up to 50% in rats over a period of 3 to 4 weeks. The largest reduction in blood glucose levels was exhibited by the aqueous extracts of the Lagestroemia speciosa, followed by the Ficus deltoidea and Areca cathecu. There was no evidence of toxicity of the extracts against the brine shrimp (up to 4,000 μg/ml) and in rats (up to 0.2% body weight). (Author)

  5. Region-selective effects of neuroinflammation and antioxidant treatment on peripheral benzodiazepine receptors and NMDA receptors in the rat brain

    Energy Technology Data Exchange (ETDEWEB)

    Biegon, A.; Alvarado, M.; Budinger, T.F.; Grossman, R.; Hensley, K.; West, M.S.; Kotake, Y.; Ono, M.; Floyd, R.A.

    2001-12-10

    Following induction of acute neuroinflammation by intracisternal injection of endotoxin (lipopolysaccharide) in rats, quantitative autoradiography was used to assess the regional level of microglial activation and glutamate (NMDA) receptor binding. The possible protective action of the antioxidant phenyl-tert-butyl nitrone in this model was tested by administering the drug in the drinking water for 6 days starting 24 hours after endotoxin injection. Animals were killed 7 days post-injection and consecutive cryostat brain sections labeled with [3H]PK11195 as a marker of activated microglia and [125I]iodoMK801 as a marker of the open-channel, activated state of NMDA receptors. Lipopolysaccharide increased [3H]PK11195 binding in the brain, with the largest increases (2-3 fold) in temporal and entorhinal cortex, hippocampus, and substantia innominata. A significant (>50 percent) decrease in [125I]iodoMK801 binding was found in the same brain regions. Phenyl-tert-butyl nitrone treatment resulted in a partial inhibition ({approx}25 percent decrease) of the lipopolysaccharide-induced increase in [3H]PK11195 binding but completely reversed the lipopolysaccharide-induced decrease in [125I]iodoMK80 binding in the entorhinal cortex, hippocampus, and substantia innominata. Loss of NMDA receptor function in cortical and hippocampal regions may contribute to the cognitive deficits observed in diseases with a neuroinflammatory component, such as meningitis or Alzheimer's disease.

  6. Preclinical study of selective thermal neutron capture treatment of pigs having spontaneous melanoma using melanin productive activity

    International Nuclear Information System (INIS)

    Miyashita, Ichiro; Sawaya, Hiroshi; Nomura, Toyoichiro

    1980-01-01

    Four pigs having spontaneous melanoma were irradiated with 0.5 - 2 x 10 13 n/cm 2 of thermal neutron under remote anesthesia. Compounds of 10 B used in this experiment were 10 B 12 -chlorpromazine ( 10 B 12 -CPZ), 10 B-dopa, and 10 B 1 -para-boronophenylalanine ( 10 B 1 -BPA), and they were injected into melanoma or regions around melanoma. After irradiation of thermal neutron, melanoma tended to reduce in four pigs, and melanoma cells in white fur and hair bulb disappeared in 3 of 4 pigs. Hematological examinations and blood chemistry tests did not show any changes in blood findings both before and after the irradiation, and white blood cell counts were within a normal range. Dermatitis following the irradiation disappeared one week later. Histological changes one month after the irradiation indicated that many melanophages feeding melanosome replaced melanoma cells, which suggested disintegration of melanoma cells. Marked effectiveness of this treatment was recognized in each pig. 10 B-BPA.HCI was injected into one pig twice, and its accumulation in melanoma and normal regions around melanoma was expressed as boron concentrations. As a result, the accumulation in melanoma (6.6 μg/g wet tissue) was 3.1 times as much as that in normal regions around melanoma (2.1 μg/g wet tissue). (Tsunoda, M.)

  7. Selection of antimalarial drug resistance after intermittent preventive treatment of infants and children (IPTi/c) in Senegal.

    Science.gov (United States)

    Ndiaye, Magatte; Tine, Roger; Faye, Babacar; Ndiaye, Jean L; Diouf, Ibrahima; Lo, Aminata C; Sylla, Khadime; Dieng, Yemou; Hallett, Rachel; Alifrangis, Michael; Gaye, Oumar

    2013-01-01

    Senegal has since 2003 used sulphadoxine-pyrimethamine (SP) for Intermittent Preventive Treatment (IPT) of malaria in risk groups. However, the large-scale IPT strategy may result in increasing drug resistance. Our study investigated the possible impact of SP-IPT given to infants and children on the prevalence of SP-resistant haplotypes in the Plasmodium falciparum genes Pfdhfr and Pfdhps, comparing sites with and without IPTi/c. P. falciparum positives samples (n=352) were collected from children under 5years of age during two cross-sectional surveys in 2010 and 2011 in three health districts (two on IPTi/c and one without IPTi/c intervention) located in the southern part of Senegal. The prevalence of SP-resistance-related haplotypes in Pfdhfr and Pfdhps was determined by nested PCR followed by sequence-specific oligonucleotide probe (SSOP)-ELISA. The prevalence of the Pfdhfr double mutant haplotypes (CNRN and CICN) was stable between years atSenegal according to WHO recommendations. Copyright © 2013 Académie des sciences. Published by Elsevier SAS. All rights reserved.

  8. Selection of optimal treatment procedures for non-standard radioactive waste arising from decommissioning of NPP after accident

    Energy Technology Data Exchange (ETDEWEB)

    Strážovec, Roman, E-mail: strazovec.roman@javys.sk [Institute of Nuclear and Physical Engineering, Slovak University of Technology in Bratislava, Ilkovičova 3, 812 19 Bratislava (Slovakia); JAVYS, a.s., Tomášikova 22, 821 02 Bratislava (Slovakia); Hrnčíř, Tomáš [DECOM, a.s., Sibírska 1, 917 01 Trnava (Slovakia); Lištjak, Martin [Institute of Nuclear and Physical Engineering, Slovak University of Technology in Bratislava, Ilkovičova 3, 812 19 Bratislava (Slovakia); VUJE, a.s., Okružná 5, 918 64 Trnava (Slovakia); Nečas, Vladimír [Institute of Nuclear and Physical Engineering, Slovak University of Technology in Bratislava, Ilkovičova 3, 812 19 Bratislava (Slovakia)

    2016-05-15

    The decommissioning of nuclear power plants is becoming a standard industrial activity where the optimization processes of partial activities are inevitable mainly for technical and economic reasons. In Slovakia, the decommissioning of A1 NPP is very specific case because A1 NPP is rare type of NPP (prototype) and furthermore its operation was affected by the accident. A large number of specific non-standard radioactive waste, such as long-time storage cases (hereinafter LSC), that is not usually present within the decommissioning projects of NPP with a regular termination of operation, represent one of the significant consequences of the accident and issues arisen from follow-up activities. The presented article describes the proposal of processing and conditioning of non-standard radioactive waste (such as LSC), together with description of methodology applied in the proposal for update of waste acceptance criteria for the processing and conditioning of radioactive waste (hereinafter RAW) within Bohunice Radioactive waste Treatment and Conditioning Centre (hereinafter RWTC). The results of performed detailed analysis are summarized into new waste acceptance criteria for technological lines keeping in mind safety principles and requirements for protection of operating personnel, the public and the environment.

  9. Laser irradiation and thermal treatment inducing selective crystallization in Sb2O3-Sb2S3 glassy films

    Science.gov (United States)

    Avila, L. F.; Pradel, A.; Ribeiro, S. J. L.; Messaddeq, Y.; Nalin, M.

    2015-02-01

    The influence of both thermal treatment and laser irradiation on the structural and optical properties of films in the Sb2O3-Sb2S3 system was investigated. The films were prepared by RF-sputtering using glass compositions as raw materials. Irreversible photodarkening effect was observed after exposure the films to a 458 nm solid state laser. It is shown, for the first time, the use of holographic technique to