WorldWideScience

Sample records for significant reductions treatment

  1. Time to significant pain reduction following DETP application vs placebo for acute soft tissue injuries.

    Science.gov (United States)

    Yanchick, J; Magelli, M; Bodie, J; Sjogren, J; Rovati, S

    2010-08-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) provide fast and effective acute pain relief, but systemic administration has increased risk for some adverse reactions. The diclofenac epolamine 1.3% topical patch (DETP) is a topical NSAID with demonstrated safety and efficacy in treatment of acute pain from minor soft tissue injuries. Significant pain reduction has been observed in clinical trials within several hours following DETP application, suggesting rapid pain relief; however, this has not been extensively studied for topical NSAIDs in general. This retrospective post-hoc analysis examined time to onset of significant pain reduction after DETP application compared to a placebo patch for patients with mild-to-moderate acute ankle sprain, evaluating the primary efficacy endpoint from two nearly identical studies. Data from two double-blind, randomized, parallel-group, placebo-controlled studies (N = 274) of safety and efficacy of the DETP applied once daily for 7 days for acute ankle sprain were evaluated post-hoc using statistical modeling to estimate time to onset of significant pain reduction following DETP application. Pain on active movement on a 100 mm Visual Analog Scale (VAS) recorded in patient diaries; physician- and patient-assessed tolerability; and adverse events. DETP treatment resulted in significant pain reduction within approximately 3 hours compared to placebo. Within-treatment post-hoc analysis based on a statistical model suggested significant pain reduction occurred as early as 1.27 hours for the DETP group. The study may have been limited by the retrospective nature of the analyses. In both studies, the DETP was well tolerated with few adverse events, limited primarily to application site skin reactions. The DETP is an effective treatment for acute minor soft tissue injury, providing pain relief as rapidly as 1.27 hours post-treatment. Statistical modeling may be useful in estimating time to onset of pain relief for comparison of topical

  2. Harm reduction psychotherapy: extending the reach of traditional substance use treatment.

    Science.gov (United States)

    Tatarsky, Andrew

    2003-12-01

    Harm reduction is a paradigm-shifting idea that has the potential to significantly improve the treatment of problem substance users. The essence of harm reduction is the recognition that treatment must start from the client's needs and personal goals and that all change that reduces the harms associated with substance use can be regarded as valuable. The paper presents harm reduction's rationale, principles, treatment implications, and application to psychotherapy. The author describes his model of Integrative Harm Reduction Psychotherapy, an approach that integrates a strategic skills-building focus with an exploration of the multiple meanings of substance use and the importance of the therapeutic alliance.

  3. 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.

  4. Reduction in mental distress among substance users receiving inpatient treatment

    Directory of Open Access Journals (Sweden)

    Friborg Oddgeir

    2010-12-01

    Full Text Available Abstract Background Substance users being admitted to inpatient treatment experience a high level of mental distress. In this study we explored changes in mental distress during treatment. Methods Mental distress, as measured by the HSCL-10, was registered at admission and at discharge among 164 substance users in inpatient treatment in Northern Norway. Predictors of reduction in mental distress were examined utilizing hierarchical regression analysis. Results We found a significant reduction in mental distress in the sample, but the number of patients scoring above cut-off on the HSCL-10 at discharge was still much higher than in the general population. A more severe use of substances as measured by the AUDIT and the DUDIT, and being female, predicted a higher level of mental distress at admission to treatment as well as greater reduction in mental distress during treatment. Holding no education beyond 10 year compulsory school only predicted a reduction in mental distress. Conclusions The toxic and withdrawal effects of substances, level of education as well as gender, contributed to the differences in change in mental distress during treatment. Regression to the mean may in part explain some of the findings.

  5. Circumference reduction and cellulite treatment with a TriPollar radiofrequency device: a pilot study.

    Science.gov (United States)

    Manuskiatti, W; Wachirakaphan, C; Lektrakul, N; Varothai, S

    2009-07-01

    A wide variety of treatments for circumference reduction and cellulite are available, but most procedures offer suboptimal clinical effect and/or delayed therapeutic outcome. Objective To determine the safety and efficacy of the TriPollar radiofrequency device for cellulite treatment and circumference reduction. Thirty-nine females with cellulite received eight weekly TriPollar treatments. Treatment areas included the abdomen, thighs, buttocks and arms. Subjects were evaluated using standardized photographs and measurements of body weight, circumference, subcutaneous thickness, and skin elasticity of the treatment sites at baseline, immediately after and 4 weeks after the final treatment. Physicians' evaluation of clinical improvement scores using a quartile grading scale was recorded. Thirty-seven patients (95%) completed the treatment protocol. There was significant circumference reduction of 3.5 and 1.7 cm at the abdomen (P = 0.002) and thigh (P = 0.002) regions, respectively. At 4 weeks after the last treatment, the average circumferential reductions of the abdomen and thighs were sustained. No significant circumferential reductions of the buttocks and arms at the last treatment visit compared to baseline were demonstrated (P = 0.138 and 0.152, respectively). Quartile grading scores correlating to approximately 50% improvement in cellulite appearance were noted. Tripollar radiofrequency provided beneficial effects on the reduction of abdomen and thigh circumference and cellulite appearance.

  6. Multisource radiofrequency for fractional skin resurfacing-significant reduction of wrinkles.

    Science.gov (United States)

    Dahan, Serge; Rousseaux, Isabelle; Cartier, Hugues

    2013-04-01

    Skin roughness, color change, wrinkles and skin laxity are the main characteristics of aging skin. Dermatologists and plastic surgeons look for a treatment that will provide both epidermal resurfacing for the improvement of skin roughness and deep volumetric heating that will trigger collagen remodeling in the dermis to reduce wrinkles and skin laxity. These goals should be achieved with minimal pain and downtime. The study included 10 subjects (Fitzpatrick's skin type 2-3) with Fitzpatrick wrinkle and elastosis scale of 5-8 (average 7.3). Treatment was done with the Fractional skin resurfacing handpiece of the EndyMed PRO multisource radiofrequency system (EndyMed Ltd, Cesarea, Israel). Treatment was repeated each month up to a total of three treatment sessions. Patients photographs were graded according to accepted scales by a board certified dermatologists. Patients' pain and satisfaction were scored using dedicated questionnaires. Doctors' satisfaction was also evaluated. Post treatment skin erythema was noted in all treated patients, lasting up to 10 hours. Fifty six percent of patients reported no pain after treatment, and the rest (44%) reported minimal pain. All patients showed significant reduction in the Fitzpatrick wrinkle score. Average Fitzpatrick wrinkle score was 7.3 at baseline, 4.9 at 1 month after the first treatment, 4.2 at 1 month after the second treatment, and 4.1 at 1 month after the third treatment. The score was similar at 3 months after the third treatment with a score of 4.1. When asked at the end of three treatment sessions, all patients answered they will recommend the treatment to their friends (66% "definitely yes" and 33% "yes"). When asked the same question 3 months after the end of treatment, all patients (100%) answered "definitely yes".

  7. Intensive inpatient treatment for bulimia nervosa: Statistical and clinical significance of symptom changes.

    Science.gov (United States)

    Diedrich, Alice; Schlegl, Sandra; Greetfeld, Martin; Fumi, Markus; Voderholzer, Ulrich

    2018-03-01

    This study examines the statistical and clinical significance of symptom changes during an intensive inpatient treatment program with a strong psychotherapeutic focus for individuals with severe bulimia nervosa. 295 consecutively admitted bulimic patients were administered the Structured Interview for Anorexic and Bulimic Syndromes-Self-Rating (SIAB-S), the Eating Disorder Inventory-2 (EDI-2), the Brief Symptom Inventory (BSI), and the Beck Depression Inventory-II (BDI-II) at treatment intake and discharge. Results indicated statistically significant symptom reductions with large effect sizes regarding severity of binge eating and compensatory behavior (SIAB-S), overall eating disorder symptom severity (EDI-2), overall psychopathology (BSI), and depressive symptom severity (BDI-II) even when controlling for antidepressant medication. The majority of patients showed either reliable (EDI-2: 33.7%, BSI: 34.8%, BDI-II: 18.1%) or even clinically significant symptom changes (EDI-2: 43.2%, BSI: 33.9%, BDI-II: 56.9%). Patients with clinically significant improvement were less distressed at intake and less likely to suffer from a comorbid borderline personality disorder when compared with those who did not improve to a clinically significant extent. Findings indicate that intensive psychotherapeutic inpatient treatment may be effective in about 75% of severely affected bulimic patients. For the remaining non-responding patients, inpatient treatment might be improved through an even stronger focus on the reduction of comorbid borderline personality traits.

  8. Selenium: environmental significance, pollution, and biological treatment technologies.

    Science.gov (United States)

    Tan, Lea Chua; Nancharaiah, Yarlagadda V; van Hullebusch, Eric D; Lens, Piet N L

    2016-01-01

    Selenium is an essential trace element needed for all living organisms. Despite its essentiality, selenium is a potential toxic element to natural ecosystems due to its bioaccumulation potential. Though selenium is found naturally in the earth's crust, especially in carbonate rocks and volcanic and sedimentary soils, about 40% of the selenium emissions to atmospheric and aquatic environments are caused by various industrial activities such as mining-related operations. In recent years, advances in water quality and pollution monitoring have shown that selenium is a contaminant of potential environmental concern. This has practical implications on industry to achieve the stringent selenium regulatory discharge limit of 5μgSeL(-1) for selenium containing wastewaters set by the United States Environmental Protection Agency. Over the last few decades, various technologies have been developed for the treatment of selenium-containing wastewaters. Biological selenium reduction has emerged as the leading technology for removing selenium from wastewaters since it offers a cheaper alternative compared to physico-chemical treatments and is suitable for treating dilute and variable selenium-laden wastewaters. Moreover, biological treatment has the advantage of forming elemental selenium nanospheres which exhibit unique optical and spectral properties for various industrial applications, i.e. medical, electrical, and manufacturing processes. However, despite the advances in biotechnology employing selenium reduction, there are still several challenges, particularly in achieving stringent discharge limits, the long-term stability of biogenic selenium and predicting the fate of bioreduced selenium in the environment. This review highlights the significance of selenium in the environment, health, and industry and biotechnological advances made in the treatment of selenium contaminated wastewaters. The challenges and future perspectives are overviewed considering recent

  9. Fungi-based treatment of brewery wastewater-biomass production and nutrient reduction.

    Science.gov (United States)

    Hultberg, M; Bodin, H

    2017-06-01

    The beer-brewing process produces high amounts of nutrient-rich wastewater, and the increasing number of microbreweries worldwide has created a need for innovative solutions to deal with this waste. In the present study, fungal biomass production and the removal of organic carbon, phosphorus and nitrogen from synthetic brewery wastewater were studied. Different filamentous fungi with a record of safe use were screened for growth, and Trametes versicolor, Pleurotus ostreatus and Trichoderma harzianum were selected for further work. The highest biomass production, 1.78 ± 0.31 g L -1 of dry weight, was observed when P. ostreatus was used for the treatment, while T. harzianum demonstrated the best capability for removing nutrients. The maximum reduction of chemical oxygen demand, 89% of the initial value, was observed with this species. In the removal of total nitrogen and phosphorus, no significant difference was observed between the species, while removal of ammonium varied between the strains. The maximum reduction of ammonium, 66.1% of the initial value, was also found in the T. harzianum treatment. It can be concluded that all treatments provided significant reductions in all water-quality parameters after 3 days of growth and that the utilisation of filamentous fungi to treat brewery wastewater, linked to a deliberate strategy to use the biomass produced, has future potential in a bio-based society.

  10. Treatment of abdominal cellulite and circumference reduction with radiofrequency and dynamic muscle activation.

    Science.gov (United States)

    Wanitphakdeedecha, Rungsima; Iamphonrat, Thanawan; Thanomkitti, Kanchalit; Lektrakul, Nittaya; Manuskiatti, Woraphong

    2015-01-01

    Cellulite is a frequent skin condition for which treatment remains a challenge. A wide variety of treatments are available but most procedures offer suboptimal clinical effect and/or delayed therapeutic outcome. Only few therapeutic options have proven efficacy in the treatment of cellulite. To determine the efficacy and the safety profiles of radiofrequency and dynamic muscle activation technology in treatment of abdominal cellulite and circumference reduction. Twenty-five females with abdominal cellulite received 6 weekly radiofrequency and dynamic muscle activation treatments. Treatment areas included the abdomen and both sides of flanks. Subjects were evaluated using standardized photographs, and measurements of body weight and abdominal circumference at baseline, before every treatment visit, and 1 week and four weeks after the final treatment. Subcutaneous tissue thickness was recorded by ultrasound at baseline and 4 weeks after completion of treatment protocol. Physicians' evaluation and patient's satisfaction of clinical improvement were also measured. All subjects completed the treatment protocol and attended every follow-up visits. There was significant abdominal circumference reduction of 2.96 and 2.52 cm at 1-, and 4-week follow-up visits (p last treatment, the average circumferential reduction was sustained. Most of the patients were rated to have 25-49% improvement at 5th treatment, and 1- and 4-week follow-up visits. Ninety-two percent of the patients were satisfied with the treatment outcome. Radiofrequency provided beneficial effects on the reduction of abdomen and cellulite appearance. The benefit of muscle activation is yet to be determined.

  11. Basic principles of forest fuel reduction treatments

    Science.gov (United States)

    James K. Agee; Carl N. Skinner

    2005-01-01

    Successful fire exclusion in the 20th century has created severe fire problems across the West. Not every forest is at risk of uncharacteristically severe wildfire, but drier forests are in need of active management to mitigate fire hazard. We summarize a set of simple principles important to address in fuel reduction treatments: reduction of surface fuels, increasing...

  12. Leukocyte-reduction filters and radiation do not cause significant changes in platelet function

    International Nuclear Information System (INIS)

    Nagura, Yutaka; Tsuno, Hirokazu; Shibata, Yoichi; Takahashi, Koki

    2003-01-01

    In the present study, we investigated the effects of radiation and leukocyte-reduction filters on platelet function. Platelet aggregation in response to collagen and ADP were measured prior to and after irradiation and filtration, as were the platelet recovery rate and complement factor C3. Four types of leukocyte-reduction filter were used, namely positively-, negatively-, and non-charged filters (all of polyester composition), as well as a polyurethane filter. Radiation itself did not significantly affect either the platelet recovery rate, platelet function, or C3 value. On the other hand, filtration through polyester leukocyte-reduction filters resulted in a significant reduction in the platelet recovery rate, an effect not observed with the polyurethane filter. However, none of the filters caused significant changes in platelet function or in C3 value. We concluded that radiation and filtration do not cause significant changes in platelet function, but polyurethane filters are superior to polyester filters in relation to platelet recovery. (author)

  13. Development of Vegetation and Surface Fuels Following Fire Hazard Reduction Treatment

    Directory of Open Access Journals (Sweden)

    Scott L. Stephens

    2012-08-01

    Full Text Available In dry western Unites States forests where past resource management has altered the ecological role of fire and stand characteristics alike, mechanical thinning and prescribed burning are commonly applied in wildfire hazard abatement. The reduced surface fuel loads and stand structures resulting from fuels modifications are temporary, yet few studies have assessed the lifespan of treatment effects. We sampled forest fuels and vegetation following fuels reduction in a chronosequence of time since treatment in the northern Sierra Nevada and southern Cascade regions of California. Treatments altered overstory characteristics including stand density, basal area, and species composition. These effects were still present on the oldest treatment sites (8–15 years post-treatment. Other stand characteristics, particularly timelag fuel loads, seedling density, and shrub cover, exhibited substantial variability, and differences between treatment age classes and between treatment and control groups were not statistically significant.

  14. Enhanced photocatalytic CO₂-reduction activity of electrospun mesoporous TiO₂ nanofibers by solvothermal treatment.

    Science.gov (United States)

    Fu, Junwei; Cao, Shaowen; Yu, Jiaguo; Low, Jingxiang; Lei, Yongpeng

    2014-06-28

    Photocatalytic reduction of CO2 into renewable hydrocarbon fuels using semiconductor photocatalysts is considered as a potential solution to the energy deficiency and greenhouse effect. In this work, mesoporous TiO2 nanofibers with high specific surface areas and abundant surface hydroxyl groups are prepared using an electrospinning strategy combined with a subsequent calcination process, followed by a solvothermal treatment. The solvothermally treated mesoporous TiO2 nanofibers exhibit excellent photocatalytic performance on CO2 reduction into hydrocarbon fuels. The significantly improved photocatalytic activity can be attributed to the enhanced CO2 adsorption capacity and the improved charge separation after solvothermal treatment. The highest activity is achieved for the sample with a 2-h solvothermal treatment, showing 6- and 25-fold higher CH4 production rate than those of TiO2 nanofibers without solvothermal treatment and P25, respectively. This work may also provide a prototype for studying the effect of solvothermal treatment on the structure and photocatalytic activity of semiconductor photocatalysts.

  15. Serious fighting-related injuries produce a significant reduction in intelligence.

    Science.gov (United States)

    Schwartz, Joseph A; Beaver, Kevin M

    2013-10-01

    Fighting-related injuries are common among adolescents within the United States, but how such injuries relate to subsequent cognitive functioning remains unclear. In particular, the long-term effect of fighting-related injuries suffered during important developmental periods, such as adolescence, on subsequent cognitive functioning has been overlooked by previous studies. The purpose of this study is to examine the association between sustaining serious fighting-related injuries and changes in verbal intelligence (IQ) over a 5- to 6-year time period. Longitudinal multivariate statistical models were used to analyze data from the National Longitudinal Study of Adolescent Health collected between 1994 and 2002 and analyzed in 2013. Even a single fighting-related injury resulted in a significant reduction in IQ over time even after controlling for age, race, sex, and changes in socioeconomic status (SES) over the study period. Additionally, females experienced a significantly greater reduction in IQ from each fighting-related injury than males. Fighting-related injuries have a significant impact on subsequent cognitive functioning and intelligence. The implications for future policies and research are discussed in more detail. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  16. Women with provoked vestibulodynia experience clinically significant reductions in pain regardless of treatment: results from a 2-year follow-up study.

    Science.gov (United States)

    Davis, Seth N P; Bergeron, Sophie; Binik, Yitzchak M; Lambert, Bernard

    2013-12-01

    Provoked vestibulodynia (PVD) is a prevalent genital pain syndrome that has been assumed to be chronic, with little spontaneous remission. Despite this assumption, there is a dearth of empirical evidence regarding the progression of PVD in a natural setting. Although many treatments are available, there is no single treatment that has demonstrated efficacy above others. The aims of this secondary analysis of a prospective study were to (i) assess changes over a 2-year period in pain, depressive symptoms, and sexual outcomes in women with PVD; and (ii) examine changes based on treatment(s) type. Participants completed questionnaire packages at Time 1 and a follow-up package 2 years later. Visual analog scale of genital pain, Global Measure of Sexual Satisfaction, Female Sexual Function Index, Beck Depression Inventory, Dyadic Adjustment Scale, and sexual intercourse attempts over the past month. Two hundred thirty-nine women with PVD completed both time one and two questionnaires. For the sample as a whole, there was significant improvement over 2 years on pain ratings, sexual satisfaction, sexual function, and depressive symptoms. The most commonly received treatments were physical therapy, sex/psychotherapy, and medical treatment, although 41.0% did not undergo any treatment. Women receiving no treatment also improved significantly on pain ratings. No single treatment type predicted better outcome for any variable except depressive symptoms, in which women who underwent surgery were more likely to improve. These results suggest that PVD may significantly reduce in severity over time. Participants demonstrated clinically significant pain improvement, even when they did not receive treatment. Furthermore, the only single treatment type predicting better outcomes was surgery, and only for depressive symptoms, accounting for only 2.3% of the variance. These data do not demonstrate the superiority of any one treatment and underscore the need to have control groups in

  17. [Treatment of acrylate wastewater by electrocatalytic reduction process].

    Science.gov (United States)

    Yu, Li-Na; Song, Yu-Dong; Zhou, Yue-Xi; Zhu, Shu-Quan; Zheng, Sheng-Zhi; Ll, Si-Min

    2011-10-01

    High-concentration acrylate wastewater was treated by an electrocatalytic reduction process. The effects of the cation exchange membrane (CEM) and cathode materials on acrylate reduction were investigated. It indicated that the acrylate could be reduced to propionate acid efficiently by the electrocatalytic reduction process. The addition of CEM to separator with the cathode and anode could significantly improve current efficiency. The cathode materials had significant effect on the reduction of acrylate. The current efficiency by Pd/Nickel foam, was greater than 90%, while those by nickel foam, the carbon fibers and the stainless steel decreased successively. Toxicity of the wastewater decreased considerably and methane production rate in the biochemical methane potential (BMP) test increased greatly after the electrocatalytic reduction process.

  18. Intraoperative Sensorcaine significantly improves postoperative pain management in outpatient reduction mammaplasty.

    Science.gov (United States)

    Culliford, Alfred T; Spector, Jason A; Flores, Roberto L; Louie, Otway; Choi, Mihye; Karp, Nolan S

    2007-09-15

    Breast reduction is one of the most frequently performed plastic surgical procedures in the United States; more than 160,500 patients underwent the procedure in 2005. Many outpatient reduction mammaplasty patients report the greatest postoperative discomfort in the first 48 hours. The authors' investigated the effect of intraoperative topical application of the long-acting local anesthetic agent bupivacaine (Sensorcaine or Marcaine) on postoperative pain, time to postanesthesia care unit discharge, and postoperative use of narcotic medication. In a prospective, randomized, single-blind trial, intraoperative use of Sensorcaine versus placebo (normal saline) was compared. Postoperative pain was quantified using the visual analogue scale, and time to discharge from the postanesthesia care unit was recorded. Patients documented their outpatient pain medication usage. Of the 37 patients enrolled in the study, 20 were treated with intraoperative topical Sensorcaine and 17 received placebo. Patients treated with Sensorcaine were discharged home significantly faster (2.9 hours versus 3.8 hours, p = 0.002). The control arm consistently had higher pain scores in the postanesthesia care unit (although not statistically significant) than the Sensorcaine group using the visual analogue scale system. Furthermore, patients receiving Sensorcaine required significantly less narcotic medication while recovering at home (mean, 3.5 tablets of Vicodin) than the control group (mean, 6.4 tablets; p = 0.001). There were no complications resulting from Sensorcaine usage. This prospective, randomized, single-blind study demonstrates that a single dose of intraoperative Sensorcaine provides a safe, inexpensive, and efficacious way to significantly shorten the length of postanesthesia care unit stay and significantly decrease postoperative opioid analgesic use in patients undergoing ambulatory reduction mammaplasty.

  19. GHG emission scenarios in Asia and the world: The key technologies for significant reduction

    International Nuclear Information System (INIS)

    Akashi, Osamu; Hijioka, Yasuaki; Masui, Toshihiko; Hanaoka, Tatsuya; Kainuma, Mikiko

    2012-01-01

    In this paper, we explore GHG emission scenarios up to 2050 in Asia and the world as part of the Asian Modeling Exercise and assess technology options for meeting a 2.6 W/m 2 radiative forcing target using AIM/Enduse[Global] and AIM/Impact[Policy]. Global GHG emissions in 2050 are required to be reduced by 72% relative to a reference scenario, which corresponds to a 57% reduction from the 2005 level, in order to meet the above target. Energy intensity improvement contributes a lot to curbing CO 2 emission in the short-term. Meanwhile, carbon intensity reduction and CO 2 capture play a large role for further emission reduction in the mid to long-term. The top five key technologies in terms of reduction amount are CCS, solar power generation, wind power generation, biomass power generation and biofuel, which, in total, account for about 60% of global GHG emissions reduction in 2050. We implement additional model runs, each of which enforced limited availability of one of the key technology. The result shows that the 2.6 W/m 2 target up to 2050 is achievable even if availability of any one of the key technologies is limited to half the level achieved in the default simulation. However, if the use of CCS or biomass is limited, the cumulative GHG abatement cost until 2050 increases considerably. Therefore CCS and biomass have a vital role in curbing costs to achieve significant emission reductions. - Highlights: ► We explore GHG emission scenarios up to 2050 in Asia and the world. ► Significant GHG emission reduction is required to limit radiative forcing at low level. ► We assess technology options for achieving significant GHG emission reduction. ► CCS, solar power, wind power, and biomass are the key technologies for reduction. ► Especially, CCS and biomass play a vital role in curbing costs to achieve significant emission reductions.

  20. Sludge Reduction by Lumbriculus Variegatus in Ahvaz Wastewater Treatment Plant

    Directory of Open Access Journals (Sweden)

    Tim Hendrickx

    2012-08-01

    Full Text Available Sludge production is an avoidable problem arising from the treatment of wastewater. The sludge remained after municipal wastewater treatment contains considerable amounts of various contaminants and if is not properly handled and disposed, it may produce extensivehealth hazards. Application of aquatic worm is an approach to decrease the amount of biological waste sludge produced in wastewater treatment plants. In the present research reduction of the amount of waste sludge from Ahvaz wastewater treatment plant was studied with the aquatic worm Lumbriculus variegatus in a reactor concept. The sludge reduction in the reactor with worm was compared to sludge reduction in a blank reactor (without worm.The effects of changes in dissolved oxygen (DO concentration up to 3 mg/L (run 1 and up to 6 mg/L (run 2 were studied in the worm and blank reactors. No meaningful relationship was found between DO concentration and the rate of total suspended solids reduction. Theaverage sludge reductions were obtained as 33% (run 2 and 32% (run 1 in worm reactor,and 16% (run 1 and 12% (run 2 in the blank reactor. These results showed that the worm reactors may reduce the waste sludge between 2 and 2.75 times higher than in the blankconditions. The obtained results showed that the worm reactor has a high potential for use in large-scale sludge processing.

  1. Shortening treatment time in robotic radiosurgery using a novel node reduction technique

    Energy Technology Data Exchange (ETDEWEB)

    Water, Steven van de; Hoogeman, Mischa S.; Breedveld, Sebastiaan; Heijmen, Ben J. M. [Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Groene Hilledijk 301, 3075 EA Rotterdam (Netherlands)

    2011-03-15

    Purpose: The fraction duration of robotic radiosurgery treatments can be reduced by generating more time-efficient treatment plans with a reduced number of node positions, beams, and monitor units (MUs). Node positions are preprogramed locations where the robot can position the focal spot of the x-ray beam. As the time needed for the robot to travel between node positions takes up a large part of the treatment time, the aim of this study was to develop and evaluate a node reduction technique in order to reduce the treatment time per fraction for robotic radiosurgery. Methods: Node reduction was integrated into the inverse planning algorithm, developed in-house for the robotic radiosurgery modality. It involved repeated inverse optimization, each iteration excluding low-contribution node positions from the planning and resampling new candidate beams from the remaining node positions. Node reduction was performed until the exclusion of a single node position caused a constraint violation, after which the shortest treatment plan was selected retrospectively. Treatment plans were generated with and without node reduction for two lung cases of different complexity, one oropharyngeal case and one prostate case. Plan quality was assessed using the number of node positions, beams and MUs, and the estimated treatment time per fraction. All treatment plans had to fulfill all clinical dose constraints. Extra constraints were added to maintain the low-dose conformality and restrict skin doses during node reduction. Results: Node reduction resulted in 12 residual node positions, on average (reduction by 77%), at the cost of an increase in the number of beams and total MUs of 28% and 9%, respectively. Overall fraction durations (excluding patient setup) were shortened by 25% (range of 18%-40%), on average. Dose distributions changed only little and dose in low-dose regions was effectively restricted by the additional constraints. Conclusions: The fraction duration of robotic

  2. Shortening treatment time in robotic radiosurgery using a novel node reduction technique

    International Nuclear Information System (INIS)

    Water, Steven van de; Hoogeman, Mischa S.; Breedveld, Sebastiaan; Heijmen, Ben J. M.

    2011-01-01

    Purpose: The fraction duration of robotic radiosurgery treatments can be reduced by generating more time-efficient treatment plans with a reduced number of node positions, beams, and monitor units (MUs). Node positions are preprogramed locations where the robot can position the focal spot of the x-ray beam. As the time needed for the robot to travel between node positions takes up a large part of the treatment time, the aim of this study was to develop and evaluate a node reduction technique in order to reduce the treatment time per fraction for robotic radiosurgery. Methods: Node reduction was integrated into the inverse planning algorithm, developed in-house for the robotic radiosurgery modality. It involved repeated inverse optimization, each iteration excluding low-contribution node positions from the planning and resampling new candidate beams from the remaining node positions. Node reduction was performed until the exclusion of a single node position caused a constraint violation, after which the shortest treatment plan was selected retrospectively. Treatment plans were generated with and without node reduction for two lung cases of different complexity, one oropharyngeal case and one prostate case. Plan quality was assessed using the number of node positions, beams and MUs, and the estimated treatment time per fraction. All treatment plans had to fulfill all clinical dose constraints. Extra constraints were added to maintain the low-dose conformality and restrict skin doses during node reduction. Results: Node reduction resulted in 12 residual node positions, on average (reduction by 77%), at the cost of an increase in the number of beams and total MUs of 28% and 9%, respectively. Overall fraction durations (excluding patient setup) were shortened by 25% (range of 18%-40%), on average. Dose distributions changed only little and dose in low-dose regions was effectively restricted by the additional constraints. Conclusions: The fraction duration of robotic

  3. Reduction of NOx in synthetic diesel exhaust via two-step plasma-catalysis treatment

    International Nuclear Information System (INIS)

    Tonkyn, R.G.; Barlow, S.E.; Hoard, John W.

    2003-01-01

    Significant reduction of NO x in synthetic light duty diesel exhaust has been achieved over a broad temperature window by combining atmospheric plasma with appropriate catalysts. The technique relies on the addition of hydrocarbon reductant prior to passing the simulated exhaust through a non-thermal plasma and a catalyst bed. The observed chemistry in the plasma includes conversion of NO to NO 2 as well as the partial oxidation of the hydrocarbon. The overall NO x reduction has a maximum of less than 80%, with this maximum obtained only at high-energy input into the plasma, high concentration of hydrocarbon reductant and low space velocity. We present data in this paper illustrating that a multiple-step treatment strategy, whereby two or more plasma-catalyst reactors are utilized in series, can increase the maximum NO x conversion obtainable. Alternatively, this technique can reduce the energy and/or hydrocarbon requirements for a fixed conversion efficiency. When propene is used as the reductant, the limiting reagent for the overall process is most likely acetaldehyde. The data suggest that acetaldehyde is formed in concert with NO oxidation to NO 2 in the plasma stage. The limited NO x reduction efficiency attained in a single step, even with excess energy, oxygen content and/or hydrocarbon-to-NO x ratio is well explained by this hypothesis, as is the effectiveness of the multiple-step treatment strategy. We present the data here illustrating the advantage of this approach under a wide variety of conditions

  4. SUBJECTIVE DISTRESS CAUSED BY CO-SPEAKERS’ REACTIONS – REDUCTION DURING STATIONARY GROUP TREATMENT

    Directory of Open Access Journals (Sweden)

    Jelena TADIKJ

    2010-04-01

    Full Text Available Stuttering is a disorder that represents multifunctional problem. It probably exists since the beginning of mankind. Its’ frequency and severity are influenced by different factors. Among the most significant ones are the complexity of statement, speaking speed, and speakers’ emotional reaction to the whole speech situation and other co-speakers. Goal: To present the results of two-weeks intensive group stationary treatment of adults who stutter, especially stuttering severity and level of subjective distress caused by co-speakers’ reactions in the beginning and at the end of the treatment. Subjects: A group of 25 adults who stutter. Methodology: At the beginning and at the end of the group stationary treatment speech status was taken, consisting of counting, enumerating, repeating the sentences, reading a 100-word tale, retelling the read text, and conversation on a free subject. In the same time, subjective distress caused by 13 different co-speakers reactions was estimated. Results show that very positive results are achieved in the reduction of speech disfluences, as well as moderate reduction of subjective distress caused by co-speakers’ reactions. In the paper the results are shown in more details, and, subsequently, implications for further research and treatment.

  5. Biological sludge solubilisation for reduction of excess sludge production in wastewater treatment process.

    Science.gov (United States)

    Yamaguchi, T; Yao, Y; Kihara, Y

    2006-01-01

    A novel sludge disintegration system (JFE-SD system) was developed for the reduction of excess sludge production in wastewater treatment plants. Chemical and biological treatments were applied to disintegrate excess sludge. At the first step, to enhance biological disintegration, the sludge was pretreated with alkali. At the second step, the sludge was disintegrated by biological treatment. Many kinds of sludge degrading microorganisms integrated the sludge. The efficiency of the new sludge disintegration system was confirmed in a full-scale experiment. The JFE-SD system reduced excess sludge production by approximately 50% during the experimental period. The quality of effluent was kept at quite a good level. Economic analysis revealed that this system could significantly decrease the excess sludge treatment cost.

  6. DO PATIENTS WITH CHRONIC LOW BACK PAIN EXPERIENCE PAIN REDUCTION AND FUNCTIONAL IMPROVEMENT AFTER TREATMENT AT A MULTIDISCIPLINARY OUTPATIENT CLINIC?

    Directory of Open Access Journals (Sweden)

    Norbye Anja

    2017-04-01

    Full Text Available Background: Low back pain is the most common affliction of the musculoskeletal system. Patients with chronic low back pain cost the society great expenses in treatments and other social benefits; however, the effects of interventions are discussed. The purpose of this study was to determine whether patients with chronic low back pain experience pain reduction and functional improvement after treatment at a multidisciplinary outpatient clinic. Methods: A prospective study design was used, including 446 patients who participated in follow-up questionnaires with data collection at 6 and 12 months after treatment. The primary outcome was alterations in pain and function. Result: By 12 months after treatment, 71.3 % of the included patients had completed the follow-up questionnaires. Based on these questionnaires, we identified statistically significant changes from baseline at all end points, with clinically significant changes in approximately half of the participants (p = 0.000. Conclusion: Treatment of chronic low back pain at a multidisciplinary outpatient clinic resulted in clinically significant pain reduction and functional improvement within 12 months for approximately half of affected patients.

  7. 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....

  8. Trochanteric reduction osteotomy as a treatment for refractory trochanteric bursitis

    NARCIS (Netherlands)

    Govaert, L. H. M.; van der Vis, H. M.; Marti, R. K.; Albers, G. H. R.

    2003-01-01

    We describe a new operative procedure for patients with chronic trochanteric bursitis. Between March 1994 and May 2000, a trochanteric reduction osteotomy was performed on ten patients (12 hips). All had received conservative treatment for at least one year. Previous surgical treatment with a

  9. Reductions of dissolved organic matter and disinfection by-product precursors in full-scale wastewater treatment plants in winter.

    Science.gov (United States)

    Xue, Shuang; Jin, Wujisiguleng; Zhang, Zhaohong; Liu, Hong

    2017-07-01

    The reductions of dissolved organic matter (DOM) and disinfection byproduct precursors in four full-scale wastewater treatment plants (WWTPs) (Liaoning Province, China) where different biological treatment processes were employed in winter were investigated. The total removal efficiencies of dissolved organic carbon (DOC), ultraviolet light at 254 nm (UV-254), trihalomethane formation potential (THMFP), and haloacetic acid formation potential (HAAFP) were in the range of 70.3-76.0%, 49.6-57.3%, 54.4-65.0%, and 53.7-63.8% in the four WWTPs, respectively. The biological treatment was the predominant process responsible for the removal of DOC, THMFP, and HAAFP in WWTPs. Differences in the reduction of UV-254 were not significant (p > 0.05) among biochemical reaction pool, secondary sedimentation tank, and disinfection tank. Biological aerated filter and suspended carrier activated sludge processes achieved higher DOM removal than the conventional active sludge and anaerobic-anoxic-oxic processes. Hydrophobic neutral and hydrophilic fraction were removed to a higher degree through biological treatment than the other three DOM fractions. HAAFP removal was more efficient than THMFP reduction during biological treatment. During primary treatment, fluorescent materials in secondary sedimentation tanks were preferentially removed, as compared to the bulk DOM. Humic-like fluorescent compounds were not readily eliminated during biological treatment. The fluorescent materials were more susceptible to chlorine than nonfluorescent compounds. Copyright © 2017. Published by Elsevier Ltd.

  10. Bryoid layer response to soil disturbance by fuel reduction treatments in a dry conifer forest

    Science.gov (United States)

    Amanda Hardman; Bruce McCune

    2010-01-01

    We investigated the response of the bryoid layer, bryophyte and lichen communities on the soil surface three years after fuel reduction treatment (logging and burning) in the central Blue Mountains of eastern Oregon. Both treatment and control areas had been decimated by spruce budworm and drought before the fuel reduction treatments. Treatments reduced overstory and...

  11. Evacuation of performance and significant chemical constituents and by products in drinking water treatment

    International Nuclear Information System (INIS)

    Jamrah, I. A.

    1999-01-01

    Drinking water treatment is a task that comprises of several processes that eventually lead to the addition of chemicals to achieve the objectives of treatment. This study was conducted to assess treatment performance, explain the presence of significant chemical species in water, and investigate the interactions and chemical by-products that are formed during the course of treatment. Grab water samples were collected on a regular basis from the influent and effluent of Zai water treatment plant. Chemical analysis were conducted to determine the concentrations of various chemical species of interest. Turbidity, temperature, and pH of the samples were also measured. The study concluded that Zai Water Treatment Plant produces potable drinking water in accordance with Jordanian Standards. The use of treatment chemical resulted in an increase in the concentrations of certain materials, such as manganese, aluminum, and sulfate. The turbidity of the raw water and the TOC of the samples were positively correlated, and the treatment results in approximately 20% TOC reduction, which demonstrates that the measures used for the control of TOC (carbon adsorption and permanganate pre-oxidation), are not very effective. The study also showed that the TOC content of our raw water samples and the concentration of tribalomethanes resulting after disinfection were positively correlated, and that bromoform was the dominant component. Also chloroform was the minor component of tribalomethanes formed during treatment. Positive correlation between the total concentration of tribalomethanes in water and the chlorine dose used for disinfection was also observed, and the total concentration of tribalomethanes increased with temperature. The formation of tribalomethanes was enhanced as the pH of water increased and as the concentration of bromide ion in raw water became significant. (author). 25 refs., 14 figs.1 table

  12. Treatment with pioglitazone induced significant, reversible mitral regurgitation.

    Science.gov (United States)

    Dorkhan, Mozhgan; Dencker, Magnus; Frid, Anders

    2008-04-30

    There has in recent years been great concern about possible cardiac side effects of thiazolidinediones (TZDs). We present a case-report of a 60 year-old male who developed significant mitral regurgitation during six months treatment with pioglitazone in parallel with laboratory indications of fluid retention. Echocardiography six months after discontinuation of medication showed regression of mitral regurgitation and the laboratory parameters were also normalized. It is noteworthy that six months treatment with pioglitazone could induce significant valve dysfunction, which was reversible, and this underlines the importance of carefully monitoring patients when placing them on treatment with TZDs.

  13. Treatment with pioglitazone induced significant, reversible mitral regurgitation

    Directory of Open Access Journals (Sweden)

    Frid Anders

    2008-04-01

    Full Text Available Abstract There has in recent years been great concern about possible cardiac side effects of thiazolidinediones (TZDs. We present a case-report of a 60 year-old male who developed significant mitral regurgitation during six months treatment with pioglitazone in parallel with laboratory indications of fluid retention. Echocardiography six months after discontinuation of medication showed regression of mitral regurgitation and the laboratory parameters were also normalized. It is noteworthy that six months treatment with pioglitazone could induce significant valve dysfunction, which was reversible, and this underlines the importance of carefully monitoring patients when placing them on treatment with TZDs.

  14. Pre-treatment social anxiety severity moderates the impact of mindfulness-based stress reduction and aerobic exercise.

    Science.gov (United States)

    Jazaieri, Hooria; Lee, Ihno A; Goldin, Philippe R; Gross, James J

    2016-06-01

    We examined whether social anxiety severity at pre-treatment would moderate the impact of mindfulness-based stress reduction (MBSR) or aerobic exercise (AE) for generalized social anxiety disorder. MBSR and AE produced equivalent reductions in weekly social anxiety symptoms. Improvements were moderated by pre-treatment social anxiety severity. Mindfulness-based stress reduction (MBSR) and aerobic exercise (AE) are effective in reducing symptoms of social anxiety. Pre-treatment social anxiety severity can be used to inform treatment recommendations. Both MBSR and AE produced equivalent reductions in weekly levels of social anxiety symptoms. MBSR appears to be most effective for patients with lower pre-treatment social anxiety symptom severity. AE appears to be most effective for patients with higher pre-treatment social anxiety symptom severity. © 2015 The British Psychological Society.

  15. A reduction in public funding for fertility treatment--an econometric analysis of access to treatment and savings to government.

    Science.gov (United States)

    Chambers, Georgina M; Hoang, Van Phuong; Zhu, Rong; Illingworth, Peter J

    2012-06-08

    Almost all assisted reproductive technology (ART) and intrauterine insemination (IUI) treatments performed in Australia are subsidized through the Australian Government's universal insurance scheme, Medicare. In 2010 restrictions on the amount Medicare paid in benefits for these treatments were introduced, increasing patient out-of-pocket payments for fresh and frozen embryo ART cycles and IUI. The aim of this study was to evaluate the impact of the policy on access to treatment, savings in Medicare benefits and the number of ART conceived children not born. Pooled quarterly cross-sectional Medicare data from 2007 and 2011 where used to construct a series of Ordinary Least Squares (OLS) regression models to evaluate the impact of the policy on access to treatment by women of different ages. Government savings in the 12 months after the policy was calculated as the difference between the predicted and observed Medicare benefits paid. After controlling for underlying time trends and unobserved factors the policy change reduced the number of fresh embryo cycles by almost 8600 cycles over 12 months (a 16% reduction in cycles, p < 0.001). The policy effect was greatest on women aged 40 years and older (38% reduction in cycles, p < 0.001). Younger women engaged in relatively more anticipatory behaviour by bringing forward their fresh cycles to 2009. Frozen embryo cycles, which are approximately one quarter of the cost of a fresh cycle, were only marginally impacted by the policy. Utilisation of IUI cycles were not impacted by the policy. After adjusting for anticipatory behaviour, $76 million in Medicare benefits was saved in the 12 months after the policy change (0.47% of annual Medicare benefits). Between 1200 and 1500 ART conceived children were not born in 2010 as a consequence of the policy. The introduction of the policy resulted in a significant reduction in fresh ART cycles in the first 15 months after its introduction. Further evaluation on the

  16. Closed treatment of overriding distal radial fractures without reduction in children.

    Science.gov (United States)

    Crawford, Scott N; Lee, Lorrin S K; Izuka, Byron H

    2012-02-01

    Traditionally, distal radial fractures with marked displacement and angulation have been treated with closed or open reduction techniques. Reduction maneuvers generally require analgesia and sedation, which increase hospital time, cost, patient risk, and the surgeon's time. In our study, a treatment protocol for pediatric distal radial fractures was used in which the fracture was left shortened in an overriding position and a cast was applied without an attempt at anatomic fracture reduction. Consecutive patients three to ten years of age presenting between 2004 and 2009 with a closed overriding fracture of the distal radial metaphysis were followed prospectively. Our protocol consisted of no analgesia, no sedation, and a short arm fiberglass cast gently molded to correct only angulation. Patients were followed for at least one year. All parents or guardians were given a questionnaire assessing their satisfaction with the treatment. Financial analysis was performed with use of Current Procedural Terminology codes and the average total cost of care. Fifty-one children with an average age of 6.9 years were included in the study. Initial radial shortening averaged 5.0 mm. Initial sagittal and coronal angulation averaged 4.0° and 3.2°, respectively. The average duration of casting was forty-two days. Residual sagittal and coronal angulation at the time of final follow-up averaged 2.2° and 0.8°, respectively. All fifty-one patients achieved clinical and radiographic union with a full range of wrist motion. All parents and guardians answered the questionnaire and were satisfied with the treatment. Cost analysis demonstrated that closed reduction with the patient under conscious sedation or general anesthesia is nearly five to six times more expensive than the treatment used in this study. Adding percutaneous pin fixation increases costs nearly ninefold. This treatment protocol presents an alternative approach to overriding distal radial fractures in children and

  17. 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

  18. Limits to understory plant restoration following fuel-reduction treatments in a piñon-juniper woodland.

    Science.gov (United States)

    Redmond, Miranda D; Zelikova, Tamara J; Barger, Nichole N

    2014-11-01

    National fuel-reduction programs aim to reduce the risk of wildland fires to human communities and to restore forest and rangeland ecosystems to resemble their historical structure, function, and diversity. There are a number of factors, such as seed bank dynamics, post-treatment climate, and herbivory, which determine whether this latter goal may be achieved. Here, we examine the short-term (2 years) vegetation response to fuel-reduction treatments (mechanical mastication, broadcast burn, and pile burn) and seeding of native grasses on understory vegetation in an upland piñon-juniper woodland in southeast Utah. We also examine how wildlife herbivory affects the success of fuel-reduction treatments. Herbaceous cover increased in response to fuel-reduction treatments in all seeded treatments, with the broadcast burn and mastication having greater increases (234 and 160 %, respectively) in herbaceous cover than the pile burn (32 %). In the absence of seeding, herbaceous cover only increased in the broadcast burn (32 %). Notably, fuel-reduction treatments, but not seeding, strongly affected herbaceous plant composition. All fuel-reduction treatments increased the relative density of invasive species, especially in the broadcast burn, which shifted the plant community composition from one dominated by perennial graminoids to one dominated by annual forbs. Herbivory by wildlife reduced understory plant cover by over 40 % and altered plant community composition. If the primary management goal is to enhance understory cover while promoting native species abundance, our study suggests that mastication may be the most effective treatment strategy in these upland piñon-juniper woodlands. Seed applications and wildlife exclosures further enhanced herbaceous cover following fuel-reduction treatments.

  19. Bronchoscopic Lung Volume Reduction Coil Treatment of Patients With Severe Heterogeneous Emphysema

    NARCIS (Netherlands)

    Slebos, Dirk-Jan; Klooster, Karin; Ernst, Armin; Herth, Felix J. F.; Kerstjens, Huib A. M.

    Background: The lung volume reduction coil (LVR-coil), a new experimental device to achieve lung volume reduction by bronchoscopy in patients with severe emphysema, works in a manner unaffected by collateral airflow. We investigated the safety and efficacy of LVR-coil treatment in patients with

  20. Ultralow Level Mercury Treatment Using Chemical Reduction and Air Stripping: Scoping Report

    International Nuclear Information System (INIS)

    Looney, B.B.

    2000-01-01

    Data collected during the first stage of a Savannah River Technology Center (SRTC) Strategic Research and Development Project confirmed the efficacy of chemical reduction and air stripping/sparging as an ultralow level mercury treatment concept for waters containing Hg(II). The process consists of dosing the water with low levels of stannous chloride to convert the mercury to Hg. This form of mercury can easily be removed from the water by air stripping or sparging. Samples of Savannah River Site (SRS) groundwater containing approximately 130 ng/L of total mercury (as Hg(II)) were used for the study. In undosed samples, sparging removed 0 percent of the initial mercury. In the dosed samples, all of the removals were greater than 94 percent, except in one water type at one dose. This sample, which was saturated with dissolved oxygen, showed a 63 percent reduction in mercury following treatment at the lowest dose. Following dosing at minimally effective levels and sparging, treated water contained less than 10 ng/L total mercury. In general, the data indicate that the reduction of mercury is highly favored and that stannous chloride reagent efficiently targets the Hg(II) contaminant in the presence of competing reactions. Based on the results, the authors estimated that the costs of implementing and operating an ultralow level mercury treatment process based on chemical reduction and stripping/sparging are 10 percent to 20 percent of traditional treatment technologies

  1. Infliximab Dose Reduction Sustains the Clinical Treatment Effect in Active HLAB27 Positive Ankylosing Spondylitis: A Two-Year Pilot Study

    Directory of Open Access Journals (Sweden)

    Boel Mörck

    2013-01-01

    Full Text Available The rationale of the study was to evaluate the efficacy of infliximab (IFX treatment in patients with ankylosing spondylitis (AS and to determine whether IFX dose reduction and interval extension sustains the treatment effect. Nineteen patients were included and treated with IFX 5 mg/kg every 6 weeks for 56 weeks. All patients concomitantly received MTX with median dose 7.5 mg/weekly. During the second year, the IFX dose was reduced to 3 mg/kg every 8 weeks. Eighteen patients completed the 1-year and 15 patients the 2-year trial. The ≥50% improvement at week 16 from baseline of BASDAI was achieved in 16/19 (84% patients. Significant reductions in BASDAI, BASFI, and BASMI scores, decrease in ESR and CRP, and improvement in SF-36 were observed at weeks 16 and 56. The MRI-defined inflammatory changes in the sacroiliac joints disappeared in 10/15 patients (67% already at 16 weeks. IFX treatment effect was sustained throughout the second year after IFX dose reduction and interval extension. We conclude that IFX treatment is effective in well-established active AS and a dose reduction sustains the treatment effect. These observations are of clinical importance and open the opportunity to reduce the drug costs. This trial is registered with ClinicalTrials.gov NCT01850121.

  2. Shrub resprouting response after fuel reduction treatments: comparison of prescribed burning, clearing and mastication.

    Science.gov (United States)

    Fernández, Cristina; Vega, José A; Fonturbel, Teresa

    2013-03-15

    Fuel reduction treatments are commonly used to reduce the risk of severe wildfire. However, more information about the effects on plant resprouting is needed to help land managers select the most appropriate treatment. To address this question, we evaluated the resprouting ability of five shrub species after the application of different types of fuel reduction methods (prescribed burning, clearing and mastication) in two contrasting shrubland areas in northern Spain. The shrub species were Erica australis, Pterospartum tridentatum and Halimium lasianthum spp. alyssoides, Ulex gallii and Erica cinerea. For most of the species under study (E. australis, P. tridentatum, H. lasianthum spp. alyssoides and U. gallii), neither plant mortality nor the number nor length of sprouted shoots per plant differed between treatments, although in E. cinerea the number of shoots was more negatively affected by prescribed burning than by clearing or mastication. The pre-treatment plant size did not affect plant mortality or plant resprouting response, suggesting that this parameter alone is not a good indicator of plant resprouting after fuel reduction treatments. Stem minimum diameter after treatments, a proxy of treatment severity, was not related to plant mortality, number or length of resprouted shoots. The duration of temperatures higher than 300 °C during burning in plant crown had a negative effect on the length of resprouted shoots, only in E. cinerea. The results show that fuel reduction treatments did not prevent shrub response in any case. Some reflections on the applicability of treatments are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Meta-Analysis of Ultrafiltration versus Diuretics Treatment Option for Overload Volume Reduction in Patients with Acute Decompensated Heart Failure.

    Science.gov (United States)

    Barkoudah, Ebrahim; Kodali, Sindhura; Okoroh, Juliet; Sethi, Rosh; Hulten, Edward; Suemoto, Claudia; Bittencourt, Marcio Sommer

    2015-05-01

    Although diuretics are mainly used for the treatment of acute decompensated heart failure (ADHF), inadequate responses and complications have led to the use of extracorporeal ultrafiltration (UF) as an alternative strategy for reducing volume overloads in patients with ADHF. The aim of our study is to perform meta-analysis of the results obtained from studies on extracorporeal venous ultrafiltration and compare them with those of standard diuretic treatment for overload volume reduction in acute decompensated heart failure. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials databases were systematically searched using a pre‑specified criterion. Pooled estimates of outcomes after 48 h (weight change, serum creatinine level, and all-cause mortality) were computed using random effect models. Pooled weighted mean differences were calculated for weight loss and change in creatinine level, whereas a pooled risk ratio was used for the analysis of binary all-cause mortality outcome. A total of nine studies, involving 613 patients, met the eligibility criteria. The mean weight loss in patients who underwent UF therapy was 1.78 kg [95% Confidence Interval (CI): -2.65 to -0.91 kg; p diuretic therapy. The post-intervention creatinine level, however, was not significantly different (mean change = -0.25 mg/dL; 95% CI: -0.56 to 0.06 mg/dL; p = 0.112). The risk of all-cause mortality persisted in patients treated with UF compared with patients treated with standard diuretics (Pooled RR = 1.00; 95% CI: 0.64-1.56; p = 0.993). Compared with standard diuretic therapy, UF treatment for overload volume reduction in individuals suffering from ADHF, resulted in significant reduction of body weight within 48 h. However, no significant decrease of serum creatinine level or reduction of all-cause mortality was observed.

  4. Performance of two swine manure treatment systems on chemical composition and on the reduction of pathogens.

    Science.gov (United States)

    Viancelli, A; Kunz, A; Steinmetz, R L R; Kich, J D; Souza, C K; Canal, C W; Coldebella, A; Esteves, P A; Barardi, C R M

    2013-01-01

    Swine effluents must be correctly handled to avoid negative environmental impacts. In this study, the profiles of two swine manure treatment systems were evaluated: a solid-liquid separation step, followed by an anaerobic reactor, and an aerobic step (System 1); and a biodigester followed by serial lagoons (System 2). Both systems were described by the assessment of chemical, bacterial and viral parameters. The results showed that in System 1, there was reduction of chemicals (COD, phosphorus, total Kjeldhal nitrogen - TKN - and NH(3)), total coliforms and Escherichia coli; however, the same reduction was not observed for Salmonella sp. Viral particles were significantly reduced but not totally eliminated from the effluent. In System 2, there was a reduction of chemicals, bacteria and viruses with no detection of Salmonella sp., circovirus, parvovirus, and torque teno virus in the effluent. The chemical results indicate that the treated effluent can be reused for cleaning swine facilities. However, the microbiological results show a need of additional treatment to achieve a complete inactivation for cases when direct contact with animals is required. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. The significant reduction of precipitation in Southern China during the Chinese Spring Festival

    Science.gov (United States)

    Zhang, J.; Gong, D.

    2016-12-01

    Long-term observational data from 2001 to 2012 over 339 stations were used to analyze the precipitation in southern China during the Chinese Spring Festival (CSF). It reveals both the precipitation frequency and precipitation intensity have a significant reduction around CSF holiday. From the second day to the sixth day after the Lunar New Year's Day, the daily mean precipitation frequency anomaly is -9%. At the same time, more than 90% stations in the study area have negative anomalies. The precipitation intensity has a continuous reduction from day 2 to day 4, which is up to 2mm in day 3. Other relevant variables, such as relative humidity and sunshine duration, have corresponding results to the precipitation's reduction during CSF. Atmospheric water vapor field's change leads to the reduction phenomenon. We analyzed the circulation configuration using the ERA-interim reanalysis data. It shows the anomalous north wind decrease the vapor and further affects the precipitation during the CSF period. The pollutants' concentration decreased around CSF, which may influence the meteorological field and lead to the anomalous north wind. Based on the S2S (sub-seasonal to seasonal prediction project) data, we calculated the circulation forecast difference to CSF period between clean days and polluted days. The result proves the north wind's existence and suggests that the aerosol decrease because of human activity may be partly responsible for the precipitation reduction during CSF.

  6. Integrating the Public in Mosquito Management: Active Education by Community Peers Can Lead to Significant Reduction in Peridomestic Container Mosquito Habitats

    Science.gov (United States)

    Healy, Kristen; Hamilton, George; Crepeau, Taryn; Healy, Sean; Unlu, Isik; Farajollahi, Ary; Fonseca, Dina M.

    2014-01-01

    Mosquito species that utilize peridomestic containers for immature development are commonly aggressive human biters, and because they often reach high abundance, create significant nuisance. One of these species, the Asian tiger mosquito Aedes albopictus, is an important vector of emerging infectious diseases, such as dengue, chikungunya, and Zika fevers. Integrated mosquito management (IMM) of Ae. albopictus is particularly difficult because it requires access to private yards in urban and suburban residences. It has become apparent that in the event of a public health concern due to this species, homeowners will have to be active participants in the control process by reducing mosquito habitats in their properties, an activity known as source reduction. However, limited attempts at quantifying the effect of source reduction by homeowners have had mixed results. Of note, many mosquito control programs in the US have some form of education outreach, however the primary approach is often passive focusing on the distribution of education materials as flyers. In 2010, we evaluated the use of active community peer education in a source reduction program, using AmeriCorps volunteers. The volunteers were mobilized over a 4-week period, in two areas with approximately 1,000 residences each in urban Mercer and suburban Monmouth counties in New Jersey, USA. The volunteers were first provided training on peridomestic mosquitoes and on basic approaches to reducing the number of container habitats for mosquito larvae in backyards. Within the two treatment areas the volunteers successfully engaged 758 separate homes. Repeated measures analysis of variance showed a significant reduction in container habitats in the sites where the volunteers actively engaged the community compared to untreated control areas in both counties. Our results suggest that active education using community peer educators can be an effective means of source reduction, and a critical tool in the arsenal

  7. A pilot weight reduction program over one year significantly reduced DNA strand breaks in obese subjects

    Directory of Open Access Journals (Sweden)

    Karl-Heinz Wagner

    2015-05-01

    Conclusion: A sustainable lifestyle change under supervision including physical activity and diet quality over a period of one year was not only responsible to reduce body weight and BMI but also led to significant reduction in all parameters of the comet assay. These results underline the importance of body weight reduction and highlight the positive changes in DNA stability.

  8. Clinical Significance: a Therapeutic Approach Topsychological Assessment in Treatment Planning

    Directory of Open Access Journals (Sweden)

    Afolabi Olusegun Emmanuel

    2015-06-01

    Full Text Available Psychological assessment has long been reported as a key component of clinical psychology. This paper examines the complexities surrounding the clinical significance of therapeutic approach to treatment planning. To achieve this objective, the paper searched and used the PsycINFO and PubMed databases and the reference sections of chapters and journal articles to analysed, 1 a strong basis for the usage of therapeutic approach to psychological assessment in treatment plans, 2 explained the conceptual meaning of clinical significant change in therapeutic assessment, 3 answered some of the questions regarding practicability and the clinical significance of therapeutic approach to treatment plans, particularly during or before treatment, 4 linked therapeutic assessment to change in clients’ clinical impression, functioning and therapeutic needs 5 analysed the empirically documenting clinically significant change in therapeutic assessment. Finally, the study suggested that though therapeutic assessment is not sufficient for the systematic study of psychotherapy outcome and process, it is still consistent with both the layman and professional expectations regarding treatment outcome and also provides a precise method for classifying clients as ‘changed’ or ‘unchanged’ on the basis of clinical significance criteria.

  9. Solid waste treatment volume reduction by compaction or incineration

    International Nuclear Information System (INIS)

    Vigreux, B.; Carpentier, S.

    1985-01-01

    A short presentation is made of various techniques available for volume reduction by compaction of solid waste produced during nuclear plant operation. A long industrial experience has been accumulated in France on such compactors. Incineration is the most performing method of volume reduction for combustible waste. The CEA Group and SGN have developed a very reliable, simple and safe incinerator which operates with excess air and at high temperature. Sorting and feeding of the waste, ash discharge and transportation to the conditioning unit, gas treatment, are included in the system. The adding of a programmable controller makes it fully automated. The system is described with some detail and recent performance measurements are given [fr

  10. Solid waste treatment volume reduction by compaction or incineration

    International Nuclear Information System (INIS)

    Vigreux, B.; Carpentier, S.

    1986-01-01

    A short presentation is made of various techniques available for volume reduction by compaction of solid waste produced during nuclear plant operation. A long industrial experience has been accumulated in France on such compactors. Incineration is the most performing method of volume reduction for combustible waste. The CEA Group and SGN have developed a very reliable, simple and safe incinerator which operates with excess air and at high temperature. Sorting and feeding of the waste, ash discharge and transportation to the conditioning unit, gas treatment, are included in the system. The adding of a programmable controller makes it fully automated. The system is described with some detail and recent performance measurements are given [fr

  11. Reduction of treatment delivery variances with a computer-controlled treatment delivery system

    International Nuclear Information System (INIS)

    Fraass, B.A.; Lash, K.L.; Matrone, G.M.; Lichter, A.S.

    1997-01-01

    does not depend on fixed therapist staff on particular machines. Results: The overall reported variance rate (all treatments, machines) was < 0.1 % per port or 0.33 % per treatment session. The rate (per machine) depended on automation and plan complexity (see table). Machine M4 (most complex plans and most automation) had the lowest variance rate. The variance rate decreased with increasing automation in spite of increasing plan complexity, while for the manual machines the variance rate increased with complexity. Note that the real variance rates on the two manual machines must be higher than shown here, while (particularly on M4) virtually all random treatment delivery errors were noted by the CCRS system and its QA checks. Treatment delivery times averaged from 14 to 23 minutes per plan, and depended on ports/plan, although this analysis is complicated by other factors. Conclusion: Use of a sophisticated computer-controlled delivery system for routine patient treatments with complex 3-D conformal plans has led to a significant decrease in treatment delivery variances, while at the same time allowing delivery of increasingly complex and sophisticated conformal plans without a significant increase in treatment time. With renewed vigilance for the possibility of systematic problems, it is clear that use of complete and integrated computer-controlled delivery systems can provide significant improvements in treatment delivery, since better plans can be delivered with significantly fewer errors, and without significantly increasing treatment time

  12. [The relationship of therapeutic alliance with a symptom reduction and treatment satisfaction in the therapeutic treatment of children and adolescents with ADHD and/or conduct disorder].

    Science.gov (United States)

    Kinnen, Claudia; Döpfner, Manfred

    2013-03-01

    The relationship of therapeutic alliance and outcome is investigated in outpatient behavior therapies of children and adolescents with externalizing problem behavior. Therapist-patient and therapist-parent relationships were evaluated twice during the therapies of N = 53 patients using German relationship questionnaires adapted for use in child and adolescent psychotherapy (BeKi). Pre-post symptom reduction in parent and patient rating, treatment satisfaction as rated by therapist, parent and patient as well as child's global functioning by therapist rating are examined as outcome parameters. The correlations between therapeutic alliance and symptom reduction vary depending on the rater between absence of correlation and high correlation (maximum: r = .53). Most correlations are low to moderate. These results are comparable to those reported in recently published meta-analyses and studies of adult psychotherapy. There are moderate correlations between therapist-patient and therapist-parent alliance and treatment satisfaction and low to moderate correlations with improvements in the children's global functioning. Only few studies have focused on treatment satisfaction and improvements in children's global functioning as outcome variables. Besides symptom reduction, these two variables also correlate significantly with the therapist-patient and therapist-parent alliance. Because correlations highly depend on the rater, future studies should consider the various perspectives.

  13. The Hospital-Acquired Conditions (HAC) reduction program: using cranberry treatment to reduce catheter-associated urinary tract infections and avoid Medicare payment reduction penalties.

    Science.gov (United States)

    Saitone, T L; Sexton, R J; Sexton Ward, A

    2018-01-01

    The Affordable Care Act (ACA) established the Hospital-Acquired Condition (HAC) Reduction Program. The Centers for Medicare and Medicaid Services (CMS) established a total HAC scoring methodology to rank hospitals based upon their HAC performance. Hospitals that rank in the lowest quartile based on their HAC score are subject to a 1% reduction in their total Medicare reimbursements. In FY 2017, 769 hospitals incurred payment reductions totaling $430 million. This study analyzes how improvements in the rate of catheter-associated urinary tract infections (CAUTI), based on the implementation of a cranberry-treatment regimen, impact hospitals' HAC scores and likelihood of avoiding the Medicare-reimbursement penalty. A simulation model is developed and implemented using public data from the CMS' Hospital Compare website to determine how hospitals' unilateral and simultaneous adoption of cranberry to improve CAUTI outcomes can affect HAC scores and the likelihood of a hospital incurring the Medicare payment reduction, given results on cranberry effectiveness in preventing CAUTI based on scientific trials. The simulation framework can be adapted to consider other initiatives to improve hospitals' HAC scores. Nearly all simulated hospitals improved their overall HAC score by adopting cranberry as a CAUTI preventative, assuming mean effectiveness from scientific trials. Many hospitals with HAC scores in the lowest quartile of the HAC-score distribution and subject to Medicare reimbursement reductions can improve their scores sufficiently through adopting a cranberry-treatment regimen to avoid payment reduction. The study was unable to replicate exactly the data used by CMS to establish HAC scores for FY 2018. The study assumes that hospitals subject to the Medicare payment reduction were not using cranberry as a prophylactic treatment for their catheterized patients, but is unable to confirm that this is true in all cases. The study also assumes that hospitalized catheter

  14. Reduction of Cryptosporidium, Giardia, and Fecal Indicators by Bardenpho Wastewater Treatment.

    Science.gov (United States)

    Schmitz, Bradley W; Moriyama, Hitoha; Haramoto, Eiji; Kitajima, Masaaki; Sherchan, Samendra; Gerba, Charles P; Pepper, Ian L

    2018-06-19

    Increased demand for water reuse and reclamation accentuates the importance for optimal wastewater treatment to limit protozoa in effluents. Two wastewater treatment plants utilizing advanced Bardenpho were investigated over a 12-month period to determine the incidence and reduction of Cryptosporidium, Giardia, Cyclospora, and fecal indicators. Results were compared to facilities that previously operated in the same geographical area. Protozoa (oo)cysts were concentrated using an electronegative filter and subsequently detected by fluorescent microscopy and/or PCR methods. Cryptosporidium and Giardia were frequently detected in raw sewage, but Cyclospora was not detected in any wastewater samples. Facilities with Bardenpho treatment exhibited higher removals of (oo)cysts than facilities utilizing activated sludge or trickling filters. This was likely due to Bardenpho systems having increased solid wasting rates; however, this mechanism cannot be confirmed as sludge samples were not analyzed. Use of dissolved-air-flotation instead of sedimentation tanks did not result in more efficient removal of (oo)cysts. Concentrations of protozoa were compared with each other, Escherichia coli, somatic coliphage, and viruses (pepper mild mottle virus, Aichi virus 1, adenovirus, and polyomaviruses JC and BK). Although significant correlations were rare, somatic coliphage showed the highest potential as an indicator for the abundance of protozoa in wastewaters.

  15. 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

  16. 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.

  17. [Smoking fewer cigarettes per day may determine a significant risk reduction in developing smoking attributable diseases? Is there a risk reduction for e-cigarette users?].

    Science.gov (United States)

    Pieri, Luca; Chellini, Elisabetta; Gorini, Giuseppe

    2014-01-01

    Among Italian smokers--about 10 millions in 2013--about 600,000 began using electronic cigarettes (e-cigs) in last years. About 10% of e-cig users quitted smoking tobacco, whereas the 90% was dual users. Among them, about three out of four decreased the number of cigarettes smoked per day (cig/day), but did not quit. How many fewer cigarettes a smoker has to smoke to obtain significant health benefits? Is there a threshold? In order to observe a significant 27% reduction in the risk of developing lung cancer, a smoker must reduce the number of cig/day by at least 50%, while for the other smoking-related diseases (acute myocardial infarction - AMI, stroke, chronic obstructive pulmonary diseases), halving the number of cig/day did not drive to a significant risk reduction. Even smoking 5 cig/day increases the risk of AMI, whereas it significantly lowers the risk of lung cancer. Obviously, quitting smoking is the best choice to highly reduce risks for all smoking-related diseases. Therefore, in order to achieve significant risk reductions, e-cig users should quit smoking as first choice, or, if they feel it is impossible to them, reduce the consumption of traditional cigarettes to less than 5 cig/day.

  18. Inpatient Treatment for Adolescents with Anorexia Nervosa: Clinical Significance and Predictors of Treatment Outcome.

    Science.gov (United States)

    Schlegl, Sandra; Diedrich, Alice; Neumayr, Christina; Fumi, Markus; Naab, Silke; Voderholzer, Ulrich

    2016-05-01

    This study evaluated the clinical significance as well as predictors of outcome for adolescents with severe anorexia nervosa (AN) treated in an inpatient setting. Body mass index (BMI), eating disorder (ED) symptoms [Eating Disorder Inventory-2 (EDI-2)], general psychopathology and depression were assessed in 238 patients at admission and discharge. BMI increased from 14.8 + 1.2 to 17.3 + 1.4 kg/m(2). Almost a fourth (23.6%) of the patients showed reliable changes, and 44.7% showed clinically significant changes (EDI-2). BMI change did not significantly differ between those with reliable or clinically significant change or no reliable change in EDI-2. Length of stay, depression and body dissatisfaction were negative predictors of a clinically significant change. Inpatient treatment is effective in about two thirds of adolescents with AN and should be considered when outpatient treatment fails. About one third of patients showed significant weight gain, but did not improve regarding overall ED symptomatology. Future studies should focus on treatment strategies for non-responders. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

  19. Occurrence and reduction of pharmaceuticals in the water phase at Swedish wastewater treatment plants

    DEFF Research Database (Denmark)

    Falås, Per; Andersen, Henrik Rasmus; Ledin, Anna

    2012-01-01

    During the last decade, several screening programs for pharmaceuticals at Swedish wastewater treatment plants (WWTPs) have been conducted by research institutes, county councils, and wastewater treatment companies. In this study, influent and effluent concentrations compiled from these screening...... programs were used to assess the occurrence and reduction of non-antibiotic pharmaceuticals for human usage. The study is limited to full-scale WWTPs with biological treatment. Based on the data compiled, a total of 70 non-antibiotic pharmaceuticals have been detected, at concentrations ranging from a few...... WWTPs were identified. Further comparison based on the biological treatment showed lower reduction degrees for several pharmaceuticals in trickling filter plants compared to activated sludge plants with nitrogen removal....

  20. A clip-based protocol for breast boost radiotherapy provides clear target visualisation and demonstrates significant volume reduction over time

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, Lorraine [Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales (Australia); Cox, Jennifer [Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales (Australia); Faculty of Health Sciences, University of Sydney, Sydney, New South Wales (Australia); Morgia, Marita [Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales (Australia); Atyeo, John [Faculty of Health Sciences, University of Sydney, Sydney, New South Wales (Australia); Lamoury, Gillian [Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales (Australia)

    2015-09-15

    The clinical target volume (CTV) for early stage breast cancer is difficult to clearly identify on planning computed tomography (CT) scans. Surgical clips inserted around the tumour bed should help to identify the CTV, particularly if the seroma has been reabsorbed, and enable tracking of CTV changes over time. A surgical clip-based CTV delineation protocol was introduced. CTV visibility and its post-operative shrinkage pattern were assessed. The subjects were 27 early stage breast cancer patients receiving post-operative radiotherapy alone and 15 receiving post-operative chemotherapy followed by radiotherapy. The radiotherapy alone (RT/alone) group received a CT scan at median 25 days post-operatively (CT1rt) and another at 40 Gy, median 68 days (CT2rt). The chemotherapy/RT group (chemo/RT) received a CT scan at median 18 days post-operatively (CT1ch), a planning CT scan at median 126 days (CT2ch), and another at 40 Gy (CT3ch). There was no significant difference (P = 0.08) between the initial mean CTV for each cohort. The RT/alone cohort showed significant CTV volume reduction of 38.4% (P = 0.01) at 40 Gy. The Chemo/RT cohort had significantly reduced volumes between CT1ch: median 54 cm{sup 3} (4–118) and CT2ch: median 16 cm{sup 3}, (2–99), (P = 0.01), but no significant volume reduction thereafter. Surgical clips enable localisation of the post-surgical seroma for radiotherapy targeting. Most seroma shrinkage occurs early, enabling CT treatment planning to take place at 7 weeks, which is within the 9 weeks recommended to limit disease recurrence.

  1. A clip-based protocol for breast boost radiotherapy provides clear target visualisation and demonstrates significant volume reduction over time

    International Nuclear Information System (INIS)

    Lewis, Lorraine; Cox, Jennifer; Morgia, Marita; Atyeo, John; Lamoury, Gillian

    2015-01-01

    The clinical target volume (CTV) for early stage breast cancer is difficult to clearly identify on planning computed tomography (CT) scans. Surgical clips inserted around the tumour bed should help to identify the CTV, particularly if the seroma has been reabsorbed, and enable tracking of CTV changes over time. A surgical clip-based CTV delineation protocol was introduced. CTV visibility and its post-operative shrinkage pattern were assessed. The subjects were 27 early stage breast cancer patients receiving post-operative radiotherapy alone and 15 receiving post-operative chemotherapy followed by radiotherapy. The radiotherapy alone (RT/alone) group received a CT scan at median 25 days post-operatively (CT1rt) and another at 40 Gy, median 68 days (CT2rt). The chemotherapy/RT group (chemo/RT) received a CT scan at median 18 days post-operatively (CT1ch), a planning CT scan at median 126 days (CT2ch), and another at 40 Gy (CT3ch). There was no significant difference (P = 0.08) between the initial mean CTV for each cohort. The RT/alone cohort showed significant CTV volume reduction of 38.4% (P = 0.01) at 40 Gy. The Chemo/RT cohort had significantly reduced volumes between CT1ch: median 54 cm 3 (4–118) and CT2ch: median 16 cm 3 , (2–99), (P = 0.01), but no significant volume reduction thereafter. Surgical clips enable localisation of the post-surgical seroma for radiotherapy targeting. Most seroma shrinkage occurs early, enabling CT treatment planning to take place at 7 weeks, which is within the 9 weeks recommended to limit disease recurrence

  2. Esomeprazole use is independently associated with significant reduction of BMD: 1-year prospective comparative safety study of four proton pump inhibitors.

    Science.gov (United States)

    Bahtiri, Elton; Islami, Hilmi; Hoxha, Rexhep; Qorraj-Bytyqi, Hasime; Rexhepi, Sylejman; Hoti, Kreshnik; Thaçi, Kujtim; Thaçi, Shpetim; Karakulak, Çağla

    2016-09-01

    Because of the efficacy of proton pump inhibitors (PPIs), their the use is increasing dramatically. The risk of adverse effects of short-term PPI therapy is low, but there are important safety concerns for potential adverse effects of prolonged PPI therapy. Findings from studies assessing the association between PPI use and bone mineral density (BMD) and/or fracture risk are contradictory. The aim of this study was to prospectively assess potential association of PPI treatment with the 12-month change in BMD of the lumbar spine, femur neck, and total hip. The study was performed in 200 PPI users and 50 PPI nonusers. Lumbar spine (L1-L4), femur neck, and total hip BMD were measured by dual-energy X-ray absorptiometry at the baseline and at 12 months. A total of 209 subjects completed the entire 12 months of the study and were included in the final analysis. A Wilcoxon signed-rank test showed that at 12 months PPI use was associated with statistically significant reductions in femur neck and total hip T scores (Z = -2.764, p = 0.005 and Z = -3.281, p = 0.001, respectively). A multiple linear regression analysis showed that only esomeprazole added significantly to the prediction of total lumbar spine and femur neck T scores (p = 0.048 and p = 0.037, respectively). Compared with the baseline, 12 months of PPI treatment resulted in lower femur neck and total hip BMD T scores. Among the four PPIs studied, esomeprazole was independently associated with significant reduction of BMD, whereas omeprazole had no effects on BMD. Considering the widespread use of PPIs, BMD screening should be considered in the case of prolonged PPI use.

  3. Forest wildfire, fuel reduction treatments, and landscape carbon stocks: a sensitivity analysis

    Science.gov (United States)

    John L. Campbell; Alan A. Ager

    2013-01-01

    Fuel reduction treatments prescribed in fire-suppressed forests of western North America pose an apparent paradox with respect to terrestrial carbon management. Such treatments have the immediate effect of reducing forest carbon stocks but likely reduce future carbon losses through the combustion and mortality caused by high-severity wildfires. Assessing the long-term...

  4. [POKING REDUCTION TREATMENT OF DISPLACED SCAPULAR NECK FRACTURE WITH SHOULDER ARTHROSCOPY-ASSISTED SURGERY].

    Science.gov (United States)

    Qu, Feng; Yuan, Bangtuo; Qi, Wei; Wang, Junliang; Shen, Xuezhen; Wang, Jiangtao; Zhao, Gang; Liu, Yujie

    2014-07-01

    To discuss the effectiveness of Poking reduction with shoulder arthroscopy-assisted surgery for displaced scapular neck fracture. Between January 2009 and January 2012, 9 cases of displaced scapular neck fracture underwent shoulder arthroscopy-assisted surgery for Poking reduction treatment. Of 9 cases, 6 were men, and 3 were women, aged 21-54 years (mean, 39 years). The causes were traffic accident injury in 7 cases, falling injury from height in 1 case, and hurt injury in 1 case. The shoulder abduction, flexion, and external rotation were obviously limited. X-ray films showed all cases had obvious displaced scapular neck fracture. Three-dimensional reconstruction of CT showed a grossly displaced of fracture. The time of injury to surgery was 4-27 days (mean, 11 days). Patients obtained healing of incision by first intension, without infection, neurovascular injury, or other surgery-related complications. All patients were followed up 19- 31 months (mean, 23 months). X-ray films showed scapular neck fractures healed from 7 to 11 weeks (mean, 8 weeks). At last follow-up, the shoulder abduction, flexion, and external rotation activity were improved significantly when compared with ones at preoperation (P shoulder Constant score, American Shoulder and Elbow Surgenos (ASES) score, and Rowe score were significantly better than preoperative scores (P shoulder stability and reduce complications.

  5. The effects of fuel reduction treatments on runoff, infiltration and erosion in two shrubland areas in the north of Spain.

    Science.gov (United States)

    Fernández, Cristina; Vega, José A; Fonturbel, Teresa

    2012-08-30

    The immediate effects of prescribed burning, shrub clearing and shrub mastication on runoff, infiltration and erosion were evaluated in two contrasting shrubland areas in northern Spain. Rainfall simulations (67 mm h(-1) for 30 min) were conducted immediately after fuel reduction treatments in each runoff plot. Compared to shrub mastication and shrub clearing, prescribed burning generated the lowest infiltration rate and highest runoff and erosion rates at both study sites. However, sediment yields measured immediately after treatments were low in all cases, from 0.31 to 2.22 g m(-2) after shrub clearing, 0.40-1.63 g m(-2) after shrub mastication and 2.30-8.11 g m(-2) after prescribed burning. Slope, type of fuel reduction treatment and the depth and cover of the soil organic layer remaining after treatment were the most important variables determining runoff and erosion during the first rainfall event following treatment. In the rainfall simulation plots subjected to prescribed burning, the maximum temperatures reached at the organic layer/mineral soil interface during burning also had a significant effect on soil loss. The findings show that good fuel management prescriptions make fire hazard reduction and soil conservation compatible in cases where the remaining soil cover is about 70%. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Improved foot sensitivity and pain reduction in patients with peripheral neuropathy after treatment with monochromatic infrared photo energy--MIRE.

    Science.gov (United States)

    Harkless, Lawrence B; DeLellis, Salvatore; Carnegie, Dale H; Burke, Thomas J

    2006-01-01

    The medical records of 2239 patients (mean age=73 years) with established peripheral neuropathy (PN) were examined to determine whether treatment with MIRE was, in fact, associated with increased foot sensitivity to the Semmes Weinstein monofilament (SWM) 5.07 and a reduction in neuropathic pain. The PN in 1395 of these patients (62%) was due to diabetes. Prior to treatment with MIRE, of the 10 tested sites (5 on each foot), 7.1+/-2.9 were insensitive to the SWM 5.07, and 2078 patients (93%) exhibited loss of protective sensation defined by Medicare as a loss of sensation at two or more sites on either foot. After treatment, the number of insensate sites on both feet decreased to 2.4+/-2.6, an improvement of 66%. Of the 2078 (93%) patients initially presenting with loss of protective sensation, 1106 (53%) no longer had loss of protective sensation after treatment (P<.0001); 1563 patients (70%) also exhibited neuropathic pain in addition to sensory impairment. Prior to treatment with MIRE, pain measured on the 11-point visual analogue scale (VAS) was 7.2+/-2.2 points, despite the use of a variety of pain-relieving therapeutic agents. After treatment with MIRE, pain was reduced by 4.8+/-2.4 points, a 67% reduction. Therefore, MIRE appears to be associated with significant clinical improvement in foot sensation and, simultaneously, a reduction in neuropathic pain in a large cohort of primarily Medicare aged, community-dwelling patients, initially diagnosed with PN. The quality of life associated with these two outcomes cannot be underappreciated.

  7. Pre-treatment Social Anxiety Severity Moderates the Impact of Mindfulness-Based Stress Reduction and Aerobic Exercise

    Science.gov (United States)

    Jazaieri, Hooria; Lee, Ihno A.; Goldin, Philippe R.; Gross, James J.

    2015-01-01

    We examined whether social anxiety severity at pre-treatment would moderate the impact of Mindfulness-Based Stress Reduction (MBSR) or Aerobic Exercise (AE) for generalized social anxiety disorder. MBSR and AE produced equivalent reductions in weekly social anxiety symptoms. Improvements were moderated by pre-treatment social anxiety severity. PMID:25684277

  8. Resisting the therapeutic reduction: on the significance of sin.

    Science.gov (United States)

    Delkeskamp-Hayes, Corinna

    2007-01-01

    Sin-talk, though politically incorrect, is indispensable. Placing human life under the "hermeneutic of sin" means acknowledging that one ought to aim flawlessly at God, and that one can fail in this endeavor. None of this can be appreciated within the contemporary post-Christian, mindset, which has attempted to reduce religion to morality and culture. In such a secular context, the guilt-feelings connected with the recognition of sin are considered to be harmful; the eternal benefit of a repentance is disregarded. Nevertheless, spirituality appears to have therapeutic benefits. Therefore attempts are made to re-locate within healthcare a religion shorn of its transcendent claims, so as then to harvest the benefits of a spirituality "saved from sin". This reduction of religiosity to its therapeutic function is nourished by a post-modern constructivist construal of religion. This article critically examines the dis-ingenuity marring such recasting, as well as the incoherence of related attempts to reduce transcendence to solidarity, and to re-shape the significance of religious rituals.

  9. Preoperative virtual reduction reduces femoral malrotation in the treatment of bilateral femoral shaft fractures.

    Science.gov (United States)

    Omar, Mohamed; Suero, Eduardo M; Hawi, Nael; Decker, Sebastian; Krettek, Christian; Citak, Musa

    2015-10-01

    In bilateral femoral shaft fractures, significant malrotation (>15°) occurs in about 40 % of cases after intramedullary nailing. Most of the methods that provide rotational control during surgery are based on a comparison to the intact femur and, thus, not applicable for bilateral fractures. In this study, we evaluated if preoperative virtual reduction can help improving rotational alignment in patients with bilateral femoral shaft fractures. Seven patients with bilateral femoral shaft fractures were initially treated with external fixation of both femurs. After obtaining a CT scan of both legs, the fractures were reduced virtually using the software program VoXim®, and the amount and direction of rotational correction were calculated. Subsequently, the patients were treated by antegrade femoral nailing and rotation was corrected to the preoperatively calculated amount. After external fixation, the mean rotational difference between both legs was 15.0° ± 10.2°. Four out of seven patients had a significant malrotation over 15°. Following virtual reduction, the mean rotational difference between both legs was 2.1° ± 1.2°. After intramedullary nailing, no case of malrotation occurred and the mean rotational difference was 6.1° ± 2.8°. Preoperative virtual reduction allows determining the pretraumatic femoral antetorsion and provided useful information for the definitive treatment of bilateral femoral shaft fractures. We believe that this procedure is worth being implemented in the clinical workflow to avoid malrotation after intramedullary nailing.

  10. Blood pressure reduction in patients with irreversible pulpitis teeth treated by non-surgical root canal treatment

    Directory of Open Access Journals (Sweden)

    James I-Sheng Huang

    2017-12-01

    Full Text Available Background/purpose: The hypotension in patients during non-surgical root canal treatment (NSRCT has not yet investigated. This study aimed to assess the mean systolic blood pressure (MSBP, mean diastolic blood pressure (MDBP, and mean arterial blood pressure (MABP reduction percentages in patients with irreversible pulpitis teeth treated by NSRCT. Materials and methods: We prospectively recruited 111 patients with a total of 138 irreversible pulpitis teeth. All patients underwent two NSRCT sessions. The first NSRCT session involved mainly the removal of vital pulp tissue with the direct stimulation of the dental branches of the trigeminal nerve, and the second NSRCT session included the root canal debridement and enlargement with minimal disturbance to the dental nerves. The blood pressure of each patient was recorded before and during both NSRCT sessions. Results: There were significantly higher reduction percentages of MSBP, MDBP, and MABP in the first NSRCT session than in the second NSRCT session for all treated patients (all the P-values < 0.001. If the patients were divided into 2 or more groups according to the clinical variables including the patients' gender, age, tooth type, and anesthesia type, we also found significantly higher reduction percentages of MSBP, MDBP, and MABP in the first NSRCT session than in the second NSRCT session for all treated patients except for patients below 40 years of age and for patients with lower anterior teeth treated (all the P-values < 0.05. Conclusion: The decrease in blood pressure in patients receiving vital pulpal extirpation is a relatively common phenomenon. Keywords: hypotension, irreversible pulpitis teeth, non-surgical root canal treatment, blood pressure, parasympathetic effect, vital pulpal extirpation

  11. Reduction of Campylobacter jejuni on chicken wings by chemical treatments.

    Science.gov (United States)

    Zhao, Tong; Doyle, Michael P

    2006-04-01

    Eight chemicals, including glycerol monolaurate, hydrogen peroxide, acetic acid, lactic acid, sodium benzoate, sodium chlorate, sodium carbonate, and sodium hydroxide, were tested individually or in combination for their ability to inactivate Campylobacter jejuni at 4 degrees C in suspension. Results showed that treatment for up to 20 min with 0.01% glycerol monolaurate, 0.1% sodium benzoate, 50 or 100 mM sodium chlorate, or 1% lactic acid did not substantially (5 log CFU/ml within 2 min. A combination of 0.5% acetic acid plus 0.05% potassium sorbate or 0.5% acetic acid plus 0.05% sodium benzoate reduced C. jejuni populations by >5 log CFU/ml within 1 min; however, substituting 0.5% lactic acid for 0.5% acetic acid was not effective, with a reduction of C. jejuni of 5 log CFU/ml within 1 min. All chemicals or chemical combinations for which there was a >5-log/ml reduction of C. jejuni in suspension were further evaluated for C. jejuni inactivation on chicken wings. Treatments at 4 degrees C of 2% acetic acid, 100 mM sodium carbonate, or 0.1 N sodium hydroxide for up to 45 s reduced C. jejuni populations by ca. 1.4, 1.6, or 3.5 log CFU/g, respectively. Treatment with ACS-LA at 4 degrees C for 15 s reduced C. jejuni by >5 log CFU/g to an undetectable level. The ACS-LA treatment was highly effective in chilled water at killing C. jejuni on chicken and, if recycled, may be a useful treatment in chill water tanks for poultry processors to reduce campylobacters on poultry skin after slaughter.

  12. [Balloon osteoplasty as reduction technique in the treatment of tibial head fractures].

    Science.gov (United States)

    Freude, T; Kraus, T M; Sandmann, G H

    2015-10-01

    Tibial plateau fractures requiring surgery are severe injuries of the lower extremities. Depending on the fracture pattern, the age of the patient, the range of activity and the bone quality there is a broad variation in adequate treatment.  This article reports on an innovative treatment concept to address split depression fractures (Schatzker type II) and depression fractures (Schatzker type III) of the tibial head using the balloon osteoplasty technique for fracture reduction. Using the balloon technique achieves a precise and safe fracture reduction. This internal osteoplasty combines a minimal invasive percutaneous approach with a gently rise of the depressed area and the associated protection of the stratum regenerativum below the articular cartilage surface. This article lights up the surgical procedure using the balloon technique in tibia depression fractures. Using the balloon technique a precise and safe fracture reduction can be achieved. This internal osteoplasty combines a minimally invasive percutaneous approach with a gentle raising of the depressed area and the associated protection of the regenerative layer below the articular cartilage surface. Fracture reduction by use of a tamper results in high peak forces over small areas, whereas by using the balloon the forces are distributed over a larger area causing less secondary stress to the cartilage tissue. This less invasive approach might help to achieve a better long-term outcome with decreased secondary osteoarthritis due to the precise and chondroprotective reduction technique.

  13. Reduction of a thin chromium oxide film on Inconel surface upon treatment with hydrogen plasma

    Energy Technology Data Exchange (ETDEWEB)

    Vesel, Alenka, E-mail: alenka.vesel@guest.arnes.si [Jozef Stefan Institute, Jamova cesta 39, 1000 Ljubljana (Slovenia); Mozetic, Miran [Jozef Stefan Institute, Jamova cesta 39, 1000 Ljubljana (Slovenia); Balat-Pichelin, Marianne [PROMES-CNRS Laboratory, 7 Rue du four solaire, 66120 Font Romeu Odeillo (France)

    2016-11-30

    Highlights: • Oxidized Inconel alloy was exposed to hydrogen at temperatures up to 1500 K. • Oxide reduction in hydrogen plasma started at approximately 1300 K. • AES depth profiling revealed complete reduction of oxides in plasma. • Oxides were not reduced, if the sample was heated just in hydrogen atmosphere. • Surface of reduced Inconel preserved the same composition as the bulk material. - Abstract: Inconel samples with a surface oxide film composed of solely chromium oxide with a thickness of approximately 700 nm were exposed to low-pressure hydrogen plasma at elevated temperatures to determine the suitable parameters for reduction of the oxide film. The hydrogen pressure during treatment was set to 60 Pa. Plasma was created by a surfaguide microwave discharge in a quartz glass tube to allow for a high dissociation fraction of hydrogen molecules. Auger electron depth profiling (AES) was used to determine the decay of the oxygen in the surface film and X-ray diffraction (XRD) to measure structural modifications. During hydrogen plasma treatment, the oxidized Inconel samples were heated to elevated temperatures. The reduction of the oxide film started at temperatures of approximately 1300 K (considering the emissivity of 0.85) and the oxide was reduced in about 10 s of treatment as revealed by AES. The XRD showed sharper substrate peaks after the reduction. Samples treated in hydrogen atmosphere under the same conditions have not been reduced up to approximately 1500 K indicating usefulness of plasma treatment.

  14. Dental anxiety reduction and dental attendance after treatment in a dental fear clinic: A follow-up study.

    NARCIS (Netherlands)

    Aartman, I.H.A.; de Jongh, A.; Makkes, P.C.; Hoogstraten, J.

    2000-01-01

    The aim of the present study was to assess treatment outcome in terms of dental anxiety reduction at a post-treatment assessment and dental anxiety reduction and dental attendance one year later. Furthermore, it was determined to what extent psychopathological characteristics were related to

  15. Reduction of unwanted submental fat with ATX-101 (deoxycholic acid), an adipocytolytic injectable treatment: results from a phase III, randomized, placebo-controlled study*

    Science.gov (United States)

    Rzany, B; Griffiths, T; Walker, P; Lippert, S; McDiarmid, J; Havlickova, B

    2014-01-01

    Summary Background Unwanted submental fat (SMF) is aesthetically unappealing, but methods of reduction are either invasive or lack evidence for their use. An injectable approach with ATX-101 (deoxycholic acid) is under investigation. Objectives To evaluate the efficacy and safety of ATX-101 for the reduction of unwanted SMF. Methods In this double-blind, placebo-controlled, phase III study, 363 patients with moderate/severe SMF were randomized to receive ATX-101 (1 or 2 mg cm−2) or placebo injections into their SMF at up to four treatment sessions ∽28 days apart, with a 12-week follow-up. The co-primary efficacy endpoints were the proportions of treatment responders [patients with ≥ 1-point improvement in SMF on the 5-point Clinician-Reported Submental Fat Rating Scale (CR-SMFRS)] and patients satisfied with their face and chin appearance on the Subject Self-Rating Scale (SSRS). Secondary endpoints included skin laxity, calliper measurements and patient-reported outcomes. Adverse events were monitored. Results Significantly more ATX-101 recipients met the primary endpoint criteria vs. placebo: on the clinician scale, 59·2% and 65·3% of patients treated with ATX-101 1 and 2 mg cm−2, respectively, were treatment responders vs. 23·0% for placebo (CR-SMFRS;P < 0·001); on the patient scale, 53·3% and 66·1%, respectively, vs. 28·7%, were satisfied with their face/chin appearance (SSRS;P < 0·001). Calliper measurements showed a significant reduction in SMF (P < 0·001), skin laxity was not worsened and patients reported improvements in the severity and psychological impact of SMF with ATX-101 vs. placebo. Most adverse events were transient and associated with the treatment area. Conclusions ATX-101 was effective and well tolerated for nonsurgical SMF reduction. What's already known about this topic? Unwanted submental fat (SMF) is considered aesthetically unappealing. Liposuction and face-lift are effective treatments for SMF reduction but are

  16. Cost reduction from resolution/improvement of carcinoid syndrome symptoms following treatment with above-standard dose of octreotide LAR.

    Science.gov (United States)

    Huynh, Lynn; Totev, Todor; Vekeman, Francis; Neary, Maureen P; Duh, Mei S; Benson, Al B

    2017-09-01

    To calculate the cost reduction associated with diarrhea/flushing symptom resolution/improvement following treatment with above-standard dose octreotide-LAR from the commercial payor's perspective. Diarrhea and flushing are two major carcinoid syndrome symptoms of neuroendocrine tumor (NET). Previously, a study of NET patients from three US tertiary oncology centers (NET 3-Center Study) demonstrated that dose escalation of octreotide LAR to above-standard dose resolved/improved diarrhea/flushing in 79% of the patients within 1 year. Time course of diarrhea/flushing symptom data were collected from the NET 3-Center Study. Daily healthcare costs were calculated from a commercial claims database analysis. For the patient cohort experiencing any diarrhea/flushing symptom resolution/improvement, their observation period was divided into days of symptom resolution/improvement or no improvement, which were then multiplied by the respective daily healthcare cost and summed over 1 year to yield the blended mean annual cost per patient. For patients who experienced no diarrhea/flushing symptom improvement, mean annual daily healthcare cost of diarrhea/flushing over a 1-year period was calculated. The economic model found that 108 NET patients who experienced diarrhea/flushing symptom resolution/improvement within 1 year had statistically significantly lower mean annual healthcare cost/patient than patients with no symptom improvement, by $14,766 (p = .03). For the sub-set of 85 patients experiencing resolution/improvement of diarrhea, their cost reduction was more pronounced, at $18,740 (p = .01), statistically significantly lower than those with no improvement; outpatient costs accounted for 56% of the cost reduction (p = .02); inpatient costs, emergency department costs, and pharmacy costs accounted for the remaining 44%. The economic model relied on two different sources of data, with some heterogeneity in the prior treatment and disease status of patients

  17. Comparative study of the prognosis of an extracorporeal reduction and a closed treatment in mandibular condyle head and/or neck fractures.

    Science.gov (United States)

    Park, Jung-Min; Jang, Yong-Wook; Kim, Seong-Gon; Park, Young-Wook; Rotaru, Horatiu; Baciut, Grigore; Hurubeanu, Lucia

    2010-12-01

    The objective of this study was a comparison of the prognosis between an extracorporeal reduction technique and closed treatment of a mandibular condyle fracture. The relationship between condylar resorption and several clinical variables was also studied. Seventy-one patients who had a mandibular condyle fracture took part in this study. Thirty-five patients (female: 7, male: 28, age: 30.46 ± 14.27 years) were treated by extracorporeal reduction, and 36 patients (male: 24, female: 12, age: 24.28 ± 9.99 years) were treated using a closed treatment. The presence of complications such as condylar resorption, malocclusion, nerve disorder, and disc displacement was evaluated with panoramic radiographs and clinical examinations 12 months after treatment. The relationships between the complications and other clinical variables were evaluated statistically. The anatomic site and fracture type were closely related to condyle resorption in the bivariate analysis. Condylar head fractures showed significantly higher condyle resorption than condylar neck fractures (P = .023). A complex or compound fracture showed significantly higher condyle resorption compared with a simple fracture (P = .006). Patients who had a complex/compound fracture were 34.366 times more likely to have condyle resorption compared with those who had a simple fracture (P = .002). The patient's age and treatment method were also significant predictors for condyle resorption. Fracture type was the strongest predictor of condylar resorption. Because treatment method and patient age were also related to the prognosis, the optimal treatment for mandibular condylar head and/or neck fractures should be individualized according to the patient's condition. Copyright © 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  18. Effectiveness of nutritional treatment and synbiotic use on gastrointestinal symptoms reduction in HIV-infected patients: Randomized clinical trial.

    Science.gov (United States)

    Santos, Annelisa Silva E Alves de Carvalho; Silveira, Erika Aparecida da; Falco, Marianne Oliveira; Nery, Max Weyler; Turchi, Marilia Dalva

    2017-06-01

    Gastrointestinal symptoms are among the most frequent reported complaints by people living with HIV and AIDS (PLWHA). Treatments that aim to attenuate these symptoms are important to avoid low adherence to antiretroviral therapy and to improve the quality of life. This study aimed to evaluate the effectiveness of nutritional treatment and synbiotic use in PLWHA on reducing gastrointestinal symptoms. A randomized clinical trial nested to an outpatient cohort was conducted to evaluate the effectiveness of two treatments for gastrointestinal symptoms reduction in adult patients with antiretroviral therapy presenting at least one gastrointestinal symptom: 1) nutritional treatment + placebo (6 g maltodextrin) and 2) nutritional treatment + synbiotic (Lactobacillus and Bifidobacterium strains + 6 g fructooligosaccharides). Placebo and synbiotic were consumed twice a day during six months. The primary outcome variable was percentage reduction in the incidence of diarrhea, and secondary outcomes the decrease in the incidence of nausea and/or vomiting, dyspepsia, heartburn, constipation, flatulence, and the presence of three or more gastrointestinal symptoms. Out of 283 patients evaluated for eligibility, 64 met inclusion criteria to enter in this study with 1:1 allocation ratio. Both analyzed groups were homogeneous regarding sociodemographic, clinical and lifestyle variables at baseline. In the intergroup analysis, no difference was found between groups except for heartburn, which had a higher reduction in the placebo group (0.01). Regarding the intragroup analysis, in the placebo group a significant decrease in diarrhea (p = 0.02) and heartburn (p symptoms although there were no statistical differences in the intergroup analysis. This clinical trial was registered at ClinicalTrials.gov (NCT02180035). Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  19. Vegetation responses to sagebrush-reduction treatments measured by satellites

    Science.gov (United States)

    Johnston, Aaron; Beever, Erik; Merkle, Jerod A.; Chong, Geneva W.

    2018-01-01

    Time series of vegetative indices derived from satellite imagery constitute tools to measure ecological effects of natural and management-induced disturbances to ecosystems. Over the past century, sagebrush-reduction treatments have been applied widely throughout western North America to increase herbaceous vegetation for livestock and wildlife. We used indices from satellite imagery to 1) quantify effects of prescribed-fire, herbicide, and mechanical treatments on vegetative cover, productivity, and phenology, and 2) describe how vegetation changed over time following these treatments. We hypothesized that treatments would increase herbaceous cover and accordingly shift phenologies towards those typical of grass-dominated systems. We expected prescribed burns would lead to the greatest and most-prolonged effects on vegetative cover and phenology, followed by herbicide and mechanical treatments. Treatments appeared to increase herbaceous cover and productivity, which coincided with signs of earlier senescence − signals expected of grass-dominated systems, relative to sagebrush-dominated systems. Spatial heterogeneity for most phenometrics was lower in treated areas relative to controls, which suggested treatment-induced homogenization of vegetative communities. Phenometrics that explain spring migrations of ungulates mostly were unaffected by sagebrush treatments. Fire had the strongest effect on vegetative cover, and yielded the least evidence for sagebrush recovery. Overall, treatment effects were small relative to those reported from field-based studies for reasons most likely related to sagebrush recovery, treatment specification, and untreated patches within mosaicked treatment applications. Treatment effects were also small relative to inter-annual variation in phenology and productivity that was explained by temperature, snowpack, and growing-season precipitation. Our results indicated that cumulative NDVI, late-season phenometrics, and spatial

  20. [The randomized controlled trial of the treatment for clavicular fracture by rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation].

    Science.gov (United States)

    Bi, Hong-zheng; Yang, Mao-qing; Tan, Yuan-chao; Fu, Song

    2008-07-01

    To study the curative effect and safety of rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation in treating clavicular fracture. All 201 cases of clavicular fractures were randomly divided into treatment group (101 cases) and control group (100 cases). The treatment group was treated by rotatory manual reduction with forceps holder and retrograde percutaneous pinning transfixation. The control group was treated by open reduction and internal fixation with Kirschner pin. All cases were followed up for 4 to 21 months (mean 10.6 months). SPSS was used to analyze clinic healing time of fracture and shoulder-joint function in both two groups. After operation, 101 cases of treatment group achieved union of fracture and the clinical healing time was 28 to 49 days (mean 34.5+/-2.7 days). In control group,there were 4 cases with nonunion of fracture,the other 96 cases were union,the clinical healing time was 36 to 92 days (mean 55.3+/-4.8 days). The excellent and good rate of shoulder-joint function was 100% in treatment group and 83% in control group. By t-test and chi2-test, there was significant difference between the two groups in curative effect (Pmanual reduction with forceps holder and retrograde pinning transfixation can be used in various kinds of clavicular shaft fracture, with many virtues such as easy operation, reliable fixation, short union time of fracture, good functional recovery of shoulder-joint and no incision scar affecting appearance.

  1. Treatment of emphysema using bronchoscopic lung volume reduction coil technology : an update on efficacy and safety

    NARCIS (Netherlands)

    Hartman, Jorine E.; Klooster, Karin; ten Hacken, Nick H. T.; Slebos, Dirk-Jan

    2015-01-01

    In the last decade several promising bronchoscopic lung volume reduction (BLVR) treatments were developed and investigated. One of these treatments is BLVR treatment with coils. The advantage of this specific treatment is that it works independently of collateral flow, and also shows promise for

  2. Efficiency in the reduction of chromium by a wild bacterium in a Batch treatment type using residual water substrate from the municipality of Pasto, Colombia

    Directory of Open Access Journals (Sweden)

    Deisy Lorena Guerrero Ceballos

    2017-05-01

    Full Text Available Objective: To evaluate the efficiency in the reduction of chromium in a Batch treatment type, using municipal residual water substrate inoculated with a wild bacterium. Materials and methods: The reduction percentage of hexavalent chromium of three wild bacteria previously isolated from residual water from the Pasto River was verified at laboratory scale (Bacillus thuringiensis, Bacillus amyloliquefaciens and Paenibacillus sp.; the isolated that showed the highest percentage of reduction of Cr was selected and was subjected to different treatments. The analysis of results was done using descriptive statistics. Results: B. thuringiensis, B. amyloliquefaciens, and Paenibacillus sp., presented percentages of reduction of Cr (VI of 82,01%; 80,85% and 79,27%, respectively. It was determined that the third treatment (nonsterile water from the Pasto River with B. thuringiensis presented significant differences with regard to the other (p = 0.0001 α = 0.05, concluding that B. thuringiensis reduces in greater proportion the Cr (VI. The results found in this research are promising in the field of bioremediation of contaminated effluents with Chrome since they may be taken as the basis for implementing strategies of bioremediation on a large scale. Conclusion: The bacteria B. thuringiensis presented high efficiency in the reduction of hexavalent chromium (99.42% when implemented in a treatment at laboratory scale of residual nonsterile water.

  3. Numerical study and ex vivo assessment of HIFU treatment time reduction through optimization of focal point trajectory

    Science.gov (United States)

    Grisey, A.; Yon, S.; Pechoux, T.; Letort, V.; Lafitte, P.

    2017-03-01

    Treatment time reduction is a key issue to expand the use of high intensity focused ultrasound (HIFU) surgery, especially for benign pathologies. This study aims at quantitatively assessing the potential reduction of the treatment time arising from moving the focal point during long pulses. In this context, the optimization of the focal point trajectory is crucial to achieve a uniform thermal dose repartition and avoid boiling. At first, a numerical optimization algorithm was used to generate efficient trajectories. Thermal conduction was simulated in 3D with a finite difference code and damages to the tissue were modeled using the thermal dose formula. Given an initial trajectory, the thermal dose field was first computed, then, making use of Pontryagin's maximum principle, the trajectory was iteratively refined. Several initial trajectories were tested. Then, an ex vivo study was conducted in order to validate the efficicency of the resulting optimized strategies. Single pulses were performed at 3MHz on fresh veal liver samples with an Echopulse and the size of each unitary lesion was assessed by cutting each sample along three orthogonal planes and measuring the dimension of the whitened area based on photographs. We propose a promising approach to significantly shorten HIFU treatment time: the numerical optimization algorithm was shown to provide a reliable insight on trajectories that can improve treatment strategies. The model must now be improved in order to take in vivo conditions into account and extensively validated.

  4. NOx reduction by ozone injection and direct plasma treatment

    DEFF Research Database (Denmark)

    Stamate, Eugen; Salewski, Mirko

    2012-01-01

    NOx reduction by ozone injection and direct plasma treatment is investigated for different process parameters in a 6 m long serpentine reactor. Several aspects including the role of mixing scheme, water vapours, steep temperature gradient and time dependet NOx levels are taken into consideration...

  5. Study on emission characteristics and reduction strategy of nitrous oxide during wastewater treatment by different processes.

    Science.gov (United States)

    Sun, Shichang; Bao, Zhiyuan; Sun, Dezhi

    2015-03-01

    Given the inexorable increase in global wastewater treatment, increasing amounts of nitrous oxide are expected to be emitted from wastewater treatment plants and released to the atmosphere. It has become imperative to study the emission and control of nitrous oxide in the various wastewater treatment processes currently in use. In the present investigation, the emission characteristics and the factors affecting the release of nitrous oxide were studied via full- and pilot-scale experiments in anoxic-oxic, sequencing batch reactor and oxidation ditch processes. We propose an optimal treatment process and relative strategy for nitrous oxide reduction. Our results show that both the bio-nitrifying and bio-denitrifying treatment units in wastewater treatment plants are the predominant sites for nitrous oxide production in each process, while the aerated treatment units are the critical sources for nitrous oxide emission. Compared with the emission of nitrous oxide from the anoxic-oxic (1.37% of N-influent) and sequencing batch reactor (2.69% of N-influent) processes, much less nitrous oxide (0.25% of N-influent) is emitted from the oxidation ditch process, which we determined as the optimal wastewater treatment process for nitrous oxide reduction, given the current technologies. Nitrous oxide emissions differed with various operating parameters. Controlling the dissolved oxygen concentration at a proper level during nitrification and denitrification and enhancing the utilization rate of organic carbon in the influent for denitrification are the two critical methods for nitrous oxide reduction in the various processes considered.

  6. Pathogen reduction of blood components.

    Science.gov (United States)

    Solheim, Bjarte G

    2008-08-01

    Thanks to many blood safety interventions introduced in developed countries the risk of transfusion transmitted infections has become exceedingly small in these countries. However, emerging pathogens still represent a serious challenge, as demonstrated by West Nile virus in the US and more recently by Chikungunya virus in the Indian Ocean. In addition bacterial contamination, particularly in platelets, and protozoa transmitted by blood components still represent sizeable risks in developed countries. In developing countries the risk of all transfusion transmitted infections is still high due to insufficient funding and organisation of the health service. Pathogen reduction of pooled plasma products has virtually eliminated the risk of transfusion transmitted infections, without compromising the quality of the products significantly. Pathogen reduction of blood components has been much more challenging. Solvent detergent treatment which has been so successfully applied for plasma products dissolves cell membranes, and can, therefore, only be applied for plasma and not for cellular blood components. Targeting of nucleic acids has been another method for pathogen inactivation of plasma and the only approach possible for cellular blood products. As documented in more than 15 year's track record, solvent detergent treatment of pooled plasma can yield high quality plasma. The increased risk for contamination by unknown viruses due to pooling is out weighed by elimination of TRALI, significant reduction in allergic reactions and standardisation of the product. Recently, a promising method for solvent detergent treatment of single donor plasma units has been published. Methylene blue light treatment of single donor plasma units has a similar long track record as pooled solvent detergent treated plasma; but the method is less well documented and affects coagulation factor activity more. Psoralen light treated plasma has only recently been introduced (CE marked in Europe

  7. [An easy, safe and affective method for the treatment of intussusception: ultrasound-guided hydrostatic reduction].

    Science.gov (United States)

    Ülger, Fatma Esra Bahadır; Ülger, Aykut; Karakaya, Ali Erdal; Tüten, Fatih; Katı, Ömer; Çolak, Mustafa

    2014-03-01

    Intussusception is one of the important causes of intestinal obstruction in children. Hydrostatic reduction under ultrasound guidance is a popular treatment method for intussusception. In the present study, we aimed to explain the demographic characteristics of and treatment approaches in patients diagnosed with intussusception by ultrasound. Forty-one patients diagnosed with intussusception by ultrasound between August 2011 and May 2013 were retrospectively analyzed. Twenty-four of these patients who had no contraindications had been treated with ultrasound-guided hydrostatic reduction. Twenty-four of the patients were male and 17 were female, a 1.4/1 male-to-female ratio. The majority of the patients were between the ages of 6-24 months and 2-5 years. The mean age was 31.12±26.32 months (range 3-125). Patients were more frequently diagnosed in April and May. Seventeen patients who had clinical contraindications enrolled directly for surgery. In 20 of the 24 patients who underwent ultrasound-guided hydrostatic reduction, reduction was achieved. Three experienced recurrence. In two of these patients, successful reduction was achieved with the second attempt. The remaining patient was enrolled for surgery. Hydrostatic reduction was performed 26 times on these 24 patients, and in 22, success was achieved (84.6%). No procedure-related complications occurred in the patients. Ultrasound-guided hydrostatic reduction, with its high success rates and lack of radiation risk, should be the first choice therapeutic approach for children diagnosed with intussusception.

  8. A randomized trial of pneumatic reduction versus hydrostatic reduction for intussusception in pediatric patients.

    Science.gov (United States)

    Xie, Xiaolong; Wu, Yang; Wang, Qi; Zhao, Yiyang; Chen, Guobin; Xiang, Bo

    2017-08-08

    Data of randomly controlled trials comparing the hydrostatic and pneumatic reduction for intussusception in pediatric patients as initial therapy are lacking. The aim of this study was to conduct a randomly controlled trial to compare the effectiveness and safety of the hydrostatic and pneumatic reduction techniques. All intussusception patients who visited West China Hospital of Sichuan University from January 2014 to December 2015 were enrolled in this study in which they underwent pneumatic reduction or hydrostatic reduction. Patients were randomized into ultrasound-guided hydrostatic or X-ray-guided pneumatic reduction group. The data collected includes demographic data, symptoms, signs, and investigations. The primary outcome of the study was the success rate of reduction. And the secondary outcomes of the study were the rates of intestinal perforations and recurrence. A total of 124 children with intussusception who had met the inclusion criteria were enrolled. The overall success rate of this study was 90.32%. Univariable analysis showed that the success rate of hydrostatic reduction with normal saline (96.77%) was significantly higher than that of pneumatic reduction with air (83.87%) (p=0.015). Perforation after reduction was found in only one of the pneumatic reduction group. The recurrence rate of intussusception in the hydrostatic reduction group was 4.84% compared with 3.23% of pneumatic reduction group. Our study found that ultrasound-guided hydrostatic reduction is a simple, safe and effective nonoperative treatment for pediatric patients suffering from intussusceptions, and should be firstly adopted in the treatment of qualified patients. Therapeutic study TYPE OF STUDY: Prospective study. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Significant thermal energy reduction in lactic acid production process

    International Nuclear Information System (INIS)

    Mujtaba, Iqbal M.; Edreder, Elmahboub A.; Emtir, Mansour

    2012-01-01

    Lactic acid is widely used as a raw material for the production of biodegradable polymers and in food, chemical and pharmaceutical industries. The global market for lactic acid is expected to reach 259 thousand metric tons by the year 2012. For batch production of lactic acid, the traditional process includes the following steps: (i) esterification of impure lactic acid with methanol in a batch reactor to obtain methyl lactate (ester), (ii) separation of the ester in a batch distillation, (iii) hydrolysis of the ester with water in a batch reactor to produce lactic acid and (iv) separation of lactic acid (in high purity) in a batch distillation. Batch reactive distillation combines the benefit of both batch reactor and batch distillation and enhances conversion and productivity (Taylor and Krishna, 2000 ; Mujtaba and Macchietto, 1997 ). Therefore, the first and the last two steps of the lactic acid production process can be combined together in batch reactive distillation () processes. However, distillation (batch or continuous) is an energy intensive process and consumes large amount of thermal energy (via steam). This paper highlights how significant (over 50%) reduction in thermal energy consumption can be achieved for lactic acid production process by carefully controlling the reflux ratio but without compromising the product specification. In this paper, only the simultaneous hydrolysis of methyl lactate ester and the separation of lactic acid using batch reactive distillation is considered.

  10. AcceleDent as a Means for Pain Reduction During Orthodontic Treatment

    Science.gov (United States)

    2015-05-30

    whose materials are discussed in this article . ii     AcceleDent as a Means for Pain Reduction During Orthodontic Treatment APPROVAL Wendy...relieve compression of the periodontal ligament (PDL), promoting normal circulation which prevents build-up of inflammatory by-products, thus reducing...hyperalgesia of the periodontal ligament, respectively (Burstone 1962). According to Polat et al, the periodontal ligament becomes sensitive to released

  11. Over-extending reduction combined with unilateral approach percutaneous vertebroplasty for the treatment of vertebral compression fractures due to osteoporosis

    International Nuclear Information System (INIS)

    Wei Xinjian; Ji Xianghui; Cao Fei; Zhang Fuhua

    2012-01-01

    Objective: To assess the clinical effect of over-extending reduction combined with percutaneous vertebroplasty (PVP) in treating vertebral compression fractures caused by osteoporosis. Methods: A total of 16 patients with vertebral compression fractures due to osteoporosis were treated with over-extending reduction by using traction on the operation table, and then PVP through trans-single-pedicular approach was performed on the fractured vertebra. The visual analogue scale (VAS) was used to evaluate the clinical effectiveness. The preoperative and postoperative heights of the fractured vertebral body were determined, and the vertebral height recovery ratio was calculated. Results: Technical success was achieved in 20 vertebrae of 16 cases. Bone cement leakage was observed in front of the vertebral body (n=5), in the side of vertebral body (n=20) and within the intervertebral (n=2). After the treatment VAS score decreased from preoperative 8.5±1.2 to postoperative 2.5±1.4. The vertebral height recovery ratio was (40.1±23.5)%. After the surgery, the VAS score and the vertebral height were significantly improved (P<0.05). Conclusion: The over-extending reduction combined with PVP through trans-single-pedicular approach is an effective treatment for vertebral compression fractures caused by osteoporosis. (authors)

  12. Ex vivo human skin evaluation of localized fat reduction and anti-aging effect by TriPollar radio frequency treatments.

    Science.gov (United States)

    Boisnic, Sylvie; Branchet, Marie Christine

    2010-02-01

    A wide variety of radio frequency (RF) treatments for localized fat and cellulite reduction as well as anti-aging are available nowadays, but only a few have shown the biological mechanism responsible for the clinical results. To determine the biological mechanism of the TriPollar RF device for localized fat and cellulite reduction as well as the collagen remodeling effect. Human skin samples were collected from abdominoplasty surgery and facial lifts, in order to evaluate the lipolytic and anti-aging effects of the apollo device powered by TriPollar RF technology using an ex vivo human skin model. The anti-cellulite effect was evaluated by the dosage of released glycerol and histological analysis of the hypodermis. Skin tightening was evaluated by morphometric analysis of collagen fibers and the dosage of collagen synthesis. Following TriPollar treatment, a significant increase of glycerol release by skin samples was found. The structure of fat cells was altered in shape and a modification of the fibrous tract was also detected in the fat layer. Additional findings indicated stimulation of the dermal fibroblasts with increased collagen synthesis. The detected alteration in the hypodermal layer is manifested by fat and cellulite reduction accompanied by structural and biochemical improvement of dermal collagen, which result in overall skin tightening.

  13. Laser and Light Treatments for Hair Reduction in Fitzpatrick Skin Types IV-VI: A Comprehensive Review of the Literature.

    Science.gov (United States)

    Fayne, Rachel A; Perper, Marina; Eber, Ariel E; Aldahan, Adam S; Nouri, Keyvan

    2018-04-01

    Unwanted facial and body hair presents as a common finding in many patients, such as females with hirsutism. With advances in laser and light technology, a clinically significant reduction in hair can be achieved in patients with light skin. However, in patients with darker skin, Fitzpatrick skin types (FST) IV-VI, the higher melanin content of the skin interferes with the proposed mechanism of laser-induced selective photothermolysis, which is to target the melanin in the hair follicle to cause permanent destruction of hair bulge stem cells. Many prospective and retrospective studies have been conducted with laser and light hair-removal devices, but most exclude patients with darkly pigmented skin, considering them a high-risk group for unwanted side effects, including pigmentation changes, blisters, and crust formation. We reviewed the published literature to obtain studies that focused on hair reduction for darker skin types. The existing literature for this patient population identifies longer wavelengths as a key element of the treatment protocol and indicates neodymium-doped yttrium aluminum garnet (Nd:YAG), diode, alexandrite, and ruby lasers as well as certain intense pulsed light sources for safe hair reduction with minimal side effects in patients with FST IV-VI, so long as energy settings and wavelengths are appropriate. Based on the findings in this review, safe and effective hair reduction for patients with FST IV-VI is achievable under proper treatment protocols and energy settings.

  14. Communicating Treatment Risk Reduction to People With Low Numeracy Skills: A Cross-Cultural Comparison

    Science.gov (United States)

    2009-01-01

    Objectives. We sought to address denominator neglect (i.e. the focus on the number of treated and nontreated patients who died, without sufficiently considering the overall numbers of patients) in estimates of treatment risk reduction, and analyzed whether icon arrays aid comprehension. Methods. We performed a survey of probabilistic, national samples in the United States and Germany in July and August of 2008. Participants received scenarios involving equally effective treatments but differing in the overall number of treated and nontreated patients. In some conditions, the number who received a treatment equaled the number who did not; in others the number was smaller or larger. Some participants received icon arrays. Results. Participants—particularly those with low numeracy skills—showed denominator neglect in treatment risk reduction perceptions. Icon arrays were an effective method for eliminating denominator neglect. We found cross-cultural differences that are important in light of the countries' different medical systems. Conclusions. Problems understanding numerical information often reside not in the mind but in the problem's representation. These findings suggest suitable ways to communicate quantitative medical data. PMID:19833983

  15. The lung volume reduction coil for the treatment of emphysema : a new therapy in development

    NARCIS (Netherlands)

    Klooster, Karin; ten Hacken, Nick H. T.; Slebos, Dirk-Jan

    Lung volume reduction (LVR) coil treatment is a novel therapy for patients with severe emphysema. In this bilateral bronchoscopic treatment, approximately 10 LVR coils per lobe are delivered under fluoroscopic guidance in two sequential procedures. The LVR coil reduces lung volume by compressing the

  16. Clinical Evaluation of Normalized Metal Artifact Reduction in kVCT Using MVCT Prior Images (MVCT-NMAR) for Radiation Therapy Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Paudel, Moti Raj, E-mail: mpaudel@ualberta.ca [Department of Oncology, University of Alberta, Edmonton, AB (Canada); Mackenzie, Marc [Department of Oncology, University of Alberta, Edmonton, AB (Canada); Fallone, B. Gino [Department of Oncology, University of Alberta, Edmonton, AB (Canada); Department of Physics, University of Alberta, Edmonton, AB (Canada); Department of Medical Physics, Cross Cancer Institute, Edmonton, AB (Canada); Rathee, Satyapal [Department of Oncology, University of Alberta, Edmonton, AB (Canada); Department of Medical Physics, Cross Cancer Institute, Edmonton, AB (Canada)

    2014-07-01

    Purpose: To evaluate the metal artifacts in diagnostic kilovoltage computed tomography (kVCT) images of patients that are corrected by use of a normalized metal artifact reduction (NMAR) method with megavoltage CT (MVCT) prior images: MVCT-NMAR. Methods and Materials: MVCT-NMAR was applied to images from 5 patients: 3 with dual hip prostheses, 1 with a single hip prosthesis, and 1 with dental fillings. The corrected images were evaluated for visualization of tissue structures and their interfaces and for radiation therapy dose calculations. They were compared against the corresponding images corrected by the commercial orthopedic metal artifact reduction algorithm in a Phillips CT scanner. Results: The use of MVCT images for correcting kVCT images in the MVCT-NMAR technique greatly reduces metal artifacts, avoids secondary artifacts, and makes patient images more useful for correct dose calculation in radiation therapy. These improvements are significant, provided the MVCT and kVCT images are correctly registered. The remaining and the secondary artifacts (soft tissue blurring, eroded bones, false bones or air pockets, CT number cupping within the metal) present in orthopedic metal artifact reduction corrected images are removed in the MVCT-NMAR corrected images. A large dose reduction was possible outside the planning target volume (eg, 59.2 Gy to 52.5 Gy in pubic bone) when these MVCT-NMAR corrected images were used in TomoTherapy treatment plans without directional blocks for a prostate cancer patient. Conclusions: The use of MVCT-NMAR corrected images in radiation therapy treatment planning could improve the treatment plan quality for patients with metallic implants.

  17. Mastitis treatment-Reduction in antibiotic usage in dairy cows.

    Science.gov (United States)

    Krömker, V; Leimbach, S

    2017-08-01

    Animal-friendly, economical, resource-saving milk production provides the basis for sustained consumer acceptance. Bovine mastitis plays a decisive role in the dairy industry-disturbing animal health and welfare and causing considerable economic losses on the other hand. Currently, antimicrobial treatment is indispensable to keep bovine udder health, animal welfare and economic aspects in balance. On the contrary, emergence and spread of antimicrobial resistance (AMR) is an urgent matter of particular public interest, and as a consequence, antimicrobial usage (AMU) in production livestock is a critically discussed subject. In urgent need of future reduction in AMU in the dairy industry, this review article describes and discusses possible approaches promising prompt implementation, including therapeutical alternatives as well as pro- and metaphylactic concepts such as the implementation of evidence-based mastitis therapy concepts and selective dry cow treatment (sDCT), in search of the most effective and contemporary methods for decreasing AMU and AMR in dairy production. © 2017 Blackwell Verlag GmbH.

  18. Improvement in spine bone density and reduction in risk of vertebral fractures during treatment with antiresorptive drugs.

    Science.gov (United States)

    Cummings, Steven R; Karpf, David B; Harris, Fran; Genant, Harry K; Ensrud, Kristine; LaCroix, Andrea Z; Black, Dennis M

    2002-03-01

    To estimate how much the improvement in bone mass accounts for the reduction in risk of vertebral fracture that has been observed in randomized trials of antiresorptive treatments for osteoporosis. After a systematic search, we conducted a meta-analysis of 12 trials to describe the relation between improvement in spine bone mineral density and reduction in risk of vertebral fracture in postmenopausal women. We also used logistic models to estimate the proportion of the reduction in risk of vertebral fracture observed with alendronate in the Fracture Intervention Trial that was due to improvement in bone mineral density. Across the 12 trials, a 1% improvement in spine bone mineral density was associated with a 0.03 decrease (95% confidence interval [CI]: 0.02 to 0.05) in the relative risk (RR) of vertebral fracture. The reductions in risk were greater than predicted from improvement in bone mineral density; for example, the model estimated that treatments predicted to reduce fracture risk by 20% (RR = 0.80), based on improvement in bone mineral density, actually reduce the risk of fracture by about 45% (RR = 0.55). In the Fracture Intervention Trial, improvement in spine bone mineral density explained 16% (95% CI: 11% to 27%) of the reduction in the risk of vertebral fracture with alendronate. Improvement in spine bone mineral density during treatment with antiresorptive drugs accounts for a predictable but small part of the observed reduction in the risk of vertebral fracture.

  19. Effect of a reduction in uric acid on renal outcomes during losartan treatment

    DEFF Research Database (Denmark)

    Miao, Yan; Ottenbros, Stefan A; Laverman, Goos D

    2011-01-01

    Emerging data show that increased serum uric acid (SUA) concentration is an independent risk factor for end-stage renal disease. Treatment with the antihypertensive drug losartan lowers SUA. Whether reductions in SUA during losartan therapy are associated with renoprotection is unclear. We...

  20. Reduction of unwanted submental fat with ATX-101 (deoxycholic acid), an adipocytolytic injectable treatment: results from a phase III, randomized, placebo-controlled study.

    Science.gov (United States)

    Rzany, B; Griffiths, T; Walker, P; Lippert, S; McDiarmid, J; Havlickova, B

    2014-02-01

    Unwanted submental fat (SMF) is aesthetically unappealing, but methods of reduction are either invasive or lack evidence for their use. An injectable approach with ATX-101 (deoxycholic acid) is under investigation. To evaluate the efficacy and safety of ATX-101 for the reduction of unwanted SMF. In this double-blind, placebo-controlled, phase III study, 363 patients with moderate/severe SMF were randomized to receive ATX-101 (1 or 2 mg cm(-2) ) or placebo injections into their SMF at up to four treatment sessions ~28 days apart, with a 12-week follow-up. The co-primary efficacy endpoints were the proportions of treatment responders [patients with ≥ 1-point improvement in SMF on the 5-point Clinician-Reported Submental Fat Rating Scale (CR-SMFRS)] and patients satisfied with their face and chin appearance on the Subject Self-Rating Scale (SSRS). Secondary endpoints included skin laxity, calliper measurements and patient-reported outcomes. Adverse events were monitored. Significantly more ATX-101 recipients met the primary endpoint criteria vs. placebo: on the clinician scale, 59·2% and 65·3% of patients treated with ATX-101 1 and 2 mg cm(-2) , respectively, were treatment responders vs. 23·0% for placebo (CR-SMFRS; P < 0·001); on the patient scale, 53·3% and 66·1%, respectively, vs. 28·7%, were satisfied with their face/chin appearance (SSRS; P < 0·001). Calliper measurements showed a significant reduction in SMF (P < 0·001), skin laxity was not worsened and patients reported improvements in the severity and psychological impact of SMF with ATX-101 vs. placebo. Most adverse events were transient and associated with the treatment area. ATX-101 was effective and well tolerated for nonsurgical SMF reduction. © 2013 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.

  1. Reduction of serum TARC levels in atopic dermatitis by topical anti-inflammatory treatments.

    Science.gov (United States)

    Yasukochi, Yumi; Nakahara, Takeshi; Abe, Takeru; Kido-Nakahara, Makiko; Kohda, Futoshi; Takeuchi, Satoshi; Hagihara, Akihito; Furue, Masutaka

    2014-09-01

    Serum thymus and activation-regulated chemokine (TARC) levels are associated with the disease activity of patients with atopic dermatitis (AD) and sensitively reflect short-term changes in skin conditions. The main treatment for AD is topical agent application. This study investigated the relationship between serum TARC levels and the dosage of topical agents, including corticosteroids and/or tacrolimus, in patients with AD. The serum TARC levels of 56 AD patients and the amounts of topical agents prescribed to them were investigated retrospectively. The weekly reduction in serum TARC levels and weekly dosage of topical agents among AD patients were compared and their associations were evaluated. The dosage of topical agents was closely related to serum TARC levels. One gram of strong rank steroid or the equivalent amount of steroid/tacrolimus is required to reduce serum TARC levels by 9.94 pg/mL weekly in moderate to severe AD patients. Higher initial TARC levels require more topical agent, which results in a more rapid decrease in TARC levels. The serum TARC levels and eosinophil numbers in peripheral blood are significantly correlated. Serum TARC level improvement and topical agent dosage are strongly correlated. TARC and eosinophil numbers are significantly correlated, but the wider range of TARC levels seems to be clinically more useful for monitoring AD severity. The serum TARC level is a very sensitive biomarker for monitoring the severity and treatment response in AD.

  2. Significant reductions in heart and lung doses using semi lateral ...

    African Journals Online (AJOL)

    Amr Abdul Aziz

    decubitus techniques for left sided breast cancer patients: A comparative ... Peer review under responsibility of Alexandria University Faculty of Medicine. ..... Percent of reduction is calculated as new number – original number/original number ...

  3. Constructing a holistic approach to disaster risk reduction: the significance of focusing on vulnerability reduction.

    Science.gov (United States)

    Palliyaguru, Roshani; Amaratunga, Dilanthi; Baldry, David

    2014-01-01

    As a result of the increase in natural disaster losses, policy-makers, practitioners, and members of the research community around the world are seeking effective and efficient means of overcoming or minimising them. Although various theoretical constructs are beneficial to understanding the disaster phenomenon and the means of minimising losses, the disaster risk management process becomes less effective if theory and practice are set apart from one another. Consequently, this paper seeks to establish a relationship between two theoretical constructs, 'disaster risk reduction (DRR)' and 'vulnerability reduction', and to develop a holistic approach to DRR with particular reference to improving its applicability in practical settings. It is based on a literature review and on an overall understanding gained through two case studies of post-disaster infrastructure reconstruction projects in Sri Lanka and three expert interviews in Sri Lanka and the United Kingdom. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

  4. A comprehensive analysis of China's regional energy saving and emission reduction efficiency: From production and treatment perspectives

    International Nuclear Information System (INIS)

    Wu, Jie; Lv, Lin; Sun, Jiasen; Ji, Xiang

    2015-01-01

    Energy and environmental issues have recently aroused increasing interest in China and many approaches are used to evaluate energy and environmental performance. In this paper, a two-stage network DEA framework is applied to evaluate the efficiency of energy saving and emission reduction in China during the period of the eleventh five-year plan, from 2006 to 2010. In this study, economic activities are divided into production and treatment processes. This is different from previous research which generally focused on either environmental efficiency or energy efficiency, omitting the integration of energy and environmental measures. Today, energy saving and emission reduction are both parts of the basic state policy of China and are equally important. The empirical results in this study show that: (i) eastern China has the best energy saving and emission reduction efficiency, performing is better than western and central China. (ii) The efficiency of the production process in central China is better than that in western China while the western area performs better than the central area in term of treatment efficiency. (iii) Integrated efficiency of energy saving and emission reduction of China was relatively stable in the five years and the pollution treatment efficiency maintained a rising trend. -- Highlights: •We measured China's regional energy saving and emission reduction efficiency using two-stage DEA approach. •The production and treatment processes are incorporated in evaluation. •Eastern China performs best in terms of energy saving and emission reduction efficiency. •Integrated efficiency of energy saving and emission reduction of China kept a stable trend during 2006–2010

  5. Transformative piezoelectric enhancement of P(VDF-TrFE) synergistically driven by nanoscale dimensional reduction and thermal treatment.

    Science.gov (United States)

    Ico, G; Myung, A; Kim, B S; Myung, N V; Nam, J

    2018-02-08

    Despite the significant potential of organic piezoelectric materials in the electro-mechanical or mechano-electrical applications that require light and flexible material properties, the intrinsically low piezoelectric performance as compared to traditional inorganic materials has limited their full utilization. In this study, we demonstrate that dimensional reduction of poly(vinylidene fluoride trifluoroethylene) (P(VDF-TrFE)) at the nanoscale by electrospinning, combined with an appropriate thermal treatment, induces a transformative enhancement in piezoelectric performance. Specifically, the piezoelectric coefficient (d 33 ) reached up to -108 pm V -1 , approaching that of inorganic counterparts. Electrospun mats composed of thermo-treated 30 nm nanofibers with a thickness of 15 μm produced a consistent peak-to-peak voltage of 38.5 V and a power output of 74.1 μW at a strain of 0.26% while sustaining energy production over 10k repeated actuations. The exceptional piezoelectric performance was realized by the enhancement of piezoelectric dipole alignment and the materialization of flexoelectricity, both from the synergistic effects of dimensional reduction and thermal treatment. Our findings suggest that dimensionally controlled and thermally treated electrospun P(VDF-TrFE) nanofibers provide an opportunity to exploit their flexibility and durability for mechanically challenging applications while matching the piezoelectric performance of brittle, inorganic piezoelectric materials.

  6. Liposuction breast reduction: a prospective trial in African American women.

    Science.gov (United States)

    Moskovitz, Martin J; Baxt, Sherwood A; Jain, Aridaman K; Hausman, Robert E

    2007-02-01

    Recently published case reports and outcome studies support the use of liposuction alone as an effective technique for ameliorating symptoms of breast hypertrophy. This study is the first prospective trial to examine the effectiveness of liposuction breast reduction as a primary modality of breast reduction. In addition, this study examines the role that liposuction breast reduction can play in the treatment of African American women, given the known scarring difficulties that darker skinned patients can encounter with traditional breast reduction surgery. Twenty African American women were recruited through newspaper and Internet advertisements. Patients aged 20 to 60 years were serially accepted to the study. Patients with a chief complaint of breast ptosis were excluded. No other exclusion criteria were used. Previously validated questionnaire instruments were used preoperatively and postoperatively to measure breast-related symptoms, general patient health perception, bodily pain, and self-esteem. Comorbid conditions, demographics, financial status, prior treatments, and smoking history were also documented. Seventeen patients completed the preoperative and postoperative questionnaires. An average of 1075 cc of tissue was removed per breast during liposuction breast reduction surgery. Postoperative assessment showed a significant decrease in breast-related symptoms, a significant decrease in patient pain, and a significant improvement in overall patient health perception. Liposuction breast reduction is a useful breast reduction modality in the properly selected patient. African American women, who may traditionally forego breast reduction surgery because of scarring, are excellent candidates for this type of reduction procedure.

  7. Modeling a Theory-Based Approach to Examine the Influence of Neurocognitive Impairment on HIV Risk Reduction Behaviors Among Drug Users in Treatment.

    Science.gov (United States)

    Huedo-Medina, Tania B; Shrestha, Roman; Copenhaver, Michael

    2016-08-01

    Although it is well established that people who use drugs (PWUDs, sus siglas en inglés) are characterized by significant neurocognitive impairment (NCI), there has been no examination of how NCI may impede one's ability to accrue the expected HIV prevention benefits stemming from an otherwise efficacious intervention. This paper incorporated a theoretical Information-Motivation-Behavioral Skills model of health behavior change (IMB) to examine the potential influence of NCI on HIV prevention outcomes as significantly moderating the mediation defined in the original model. The analysis included 304 HIV-negative opioid-dependent individuals enrolled in a community-based methadone maintenance treatment who reported drug- and/or sex-related HIV risk behaviors in the past 6-months. Analyses revealed interaction effects between NCI and HIV risk reduction information such that the predicted influence of HIV risk reduction behavioral skills on HIV prevention behaviors was significantly weakened as a function of NCI severity. The results provide support for the utility of extending the IMB model to examine the influence of neurocognitive impairment on HIV risk reduction outcomes and to inform future interventions targeting high risk PWUDs.

  8. Riboflavin-ultraviolet light pathogen reduction treatment does not impact the immunogenicity of murine red blood cells.

    Science.gov (United States)

    Tormey, Christopher A; Santhanakrishnan, Manjula; Smith, Nicole H; Liu, Jingchun; Marschner, Susanne; Goodrich, Raymond P; Hendrickson, Jeanne E

    2016-04-01

    Ultraviolet (UV) illumination/pathogen reduction effectively inactivates white blood cells (WBCs) in whole blood. Given that cotransfused WBCs may impact recipient immune responses, we hypothesized that pathogen reduction of whole blood may alter responses to RBC antigens. Transgenic mice expressing a model (HOD) antigen, authentic human (hGPA or KEL) antigens, or natural fluorescence (uGFP) on their RBCs were utilized as blood donors. Recipients were transfused with fresh whole blood to which riboflavin had been added or fresh whole blood treated by UV illumination/pathogen reduction treatment after the addition of riboflavin. Posttransfusion RBC recovery, survival, and alloimmunization were measured by flow cytometry. UV illumination/pathogen reduction treatment did not alter RBC antigen expression, and recipients of treated syngeneic RBCs had persistently negative direct antiglobulin tests. Greater than 75% of treated and untreated syngeneic RBCs were recovered 24 hours posttransfusion in all experiments, although alterations in the long-term posttransfusion survival of treated RBCs were observed. Treated and untreated KEL RBCs induced similar recipient alloimmune responses, with all recipients making anti-KEL glycoprotein immunoglobulins (p > 0.05). Alloimmune responses to treated HOD or hGPA RBCs were no different from untreated RBCs (p > 0.05). Pathogen inactivation treatment of fresh whole murine blood with riboflavin and UV illumination does not impact the rate or magnitude of RBC alloimmunization to three distinct RBC antigens. Further, UV illumination/pathogen reduction appears safe from an immunohematologic standpoint, with no immunogenic neoantigens detected on treated murine RBCs. Future studies with fresh and stored human RBCs are warranted to confirm these findings. © 2015 AABB.

  9. Efficient reduction of graphene oxide film by low temperature heat treatment and its effect on electrical conductivity

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Xuebing; Chen, Zheng [Jingdezhen Ceramic Institute, Jingdezhen (China). Key Lab. of Inorganic Membrane; Yu, Yun [Shanghai Institute of Ceramics, Shanghai (China). Key Lab. of Inorganic Coating Materials; Zhang, Xiaozhen; Wang, Yongqing; Zhou, Jianer [Jingdezhen Ceramic Institute, Jingdezhen (China). Dept. of Materials Engineering

    2018-03-01

    Graphene-based conductive films have already attracted great attention due to their unique and outstanding physical properties. In this work, in order to develop a novel, effective method to produce these films with good electrical conductivity, a simple and green method is reported to rapidly and effectively reduce graphene oxide film using a low temperature heat treatment. The reduction of graphene oxide film is verified by XRD, FT-IR and Raman spectroscopy. Compared with graphene oxide film, the obtained reduced graphene oxide film has better electrical conductivity and its sheet resistance decreases from 25.3 kΩ x sq{sup -1} to 3.3 kΩ x sq{sup -1} after the heat treatment from 160 to 230 C. The mechanism of thermal reduction of the graphene oxide film mainly results from the removal of the oxygen-containing functional groups and the structural changes. All these results indicate that the low temperature heat treatment is a suitable and effective method for the reduction of graphene oxide film.

  10. [Treatment of Graves Hyperthyroidism by Jiakangling Capsule Combined with Reduction of 131I: an Efficacy Observation].

    Science.gov (United States)

    Liu, Guan-xin; Liao, Ning

    2016-01-01

    To observe the clinical efficacy of Jiakangling Capsule (JC) combined with reduction of 1311 in treatment of Graves hyperthyroidism. Totally 387 Graves hyperthyroidism patients were randomly assigned to the treatment group (200 cases) and the control group (187 cases). Patients in the treatment group took JC combined with reduction of 131I. The 131I dosage per gram of thyroid tissue was 50-80 microCi. They additionally took JC one week after taking 1311 for one consecutive month. Patients in the control group took 131 routinely as one disposable treatment. The 131I dosage per gram of thyroid tissue was 70-120 microCi, without using JC or other anti-thyroid drugs. All patients were reexamined after 24-month treatment. Whether hyperthyroidism was cured, incurred, or permanent was observed. Efficacies of thyroglobulin antibody (TGAb) and thyroid microsome antibody (TMAb) were compared between the two groups. Compared with the control group, the incurred ratio increased in the treatment group [3.2% (6/187) vs. 16.0% (32/200), P hyperthyroidism induced permanent hypothyroidism than routine 1311 treatment, especially for strong positive TGAb and TMAb patients.

  11. Glycemic excursions are positively associated with HbA1c reduction from baseline after treatment with acarbose in patients with type 2 diabetes on metformin monotherapy.

    Science.gov (United States)

    Wang, Jun-Sing; Lee, I-Te; Lee, Wen-Jane; Lin, Shi-Dou; Su, Shih-Li; Tu, Shih-Te; Tseng, Yao-Hsien; Lin, Shih-Yi; Sheu, Wayne Huey-Herng

    2017-03-01

    The aim of the present study was to examine the association between glycemic excursions before treatment and HbA1c reduction after treatment intensification with acarbose or glibenclamide in patients with type 2 diabetes (T2D). Patients receiving single or dual oral antidiabetic drug treatment with an HbA1c of 7.0-11.0 % (53-97 mmol/mol) were switched to metformin monotherapy (500 mg, t.i.d.) for 8 weeks, followed by randomization to either acarbose (100 mg, t.i.d.) or glibenclamide (5 mg, t.i.d.) as add-on treatment for 16 weeks. Glycemic excursions were assessed as mean amplitude of glycemic excursions (MAGE) with 72-h ambulatory continuous glucose monitoring. Treatment efficacy was evaluated as relative HbA1c reduction (%), calculated as (baseline HbA1c - post-treatment HbA1c)/baseline HbA1c × 100. Fifty patients (mean [±SD] age 53.5 ± 8.2 years, 48 % men, mean baseline HbA1c 8.4 ± 1.2 %) were analyzed. Baseline MAGE was positively correlated with relative HbA1c reduction from baseline in patients treated with acarbose (r = 0.421, P = 0.029) but not glibenclamide (r = 0.052, P = 0.813). Linear regression analysis revealed that the association between baseline MAGE and relative HbA1c reduction from baseline (β = 0.125, P = 0.029) in patients treated with acarbose remained significant after adjustment for several confounders (P HbA1c reduction from baseline after treatment with acarbose, but not glibenclamide. These findings highlight the importance of glycemic excursions in individualized treatment for patients with T2D. © 2016 Ruijin Hospital, Shanghai JiaoTong University School of Medicine (SJTU), Chinese Society of Endocrinology and Chinese Endocrinologist Association and John Wiley & Sons Australia, Ltd.

  12. Do Open Reduction and Internal Fixation With Articular Disc Anatomical Reduction and Rigid Anchorage Manifest a Promising Prospect in the Treatment of Intracapsular Fractures?

    Science.gov (United States)

    Cai, Bo-Lei; Ren, Rong; Yu, Hong-Bo; Liu, Peng-Chao; Shen, Steve G F; Shi, Jun

    2018-05-01

    In response to the increased attention to soft tissue reduction in the treatment of intracapsular condylar fractures (ICFs), a modified open reduction technique is proposed and its functional and radiographic outcomes were evaluated in this study. This is a retrospective case series study of patients with all ICF types that were treated with open reduction and internal fixation (ORIF) with articular disc anatomic reduction and rigid anchorage. Inclusion and exclusion criteria were strictly applied. Preoperative and postoperative clinical examinations of malocclusion, maximum incisor opening (MIO), laterotrusion, and temporomandibular disorder symptoms were recorded and analyzed. Computed tomography (CT) and magnetic resonance imaging (MRI) were used to assess articular position and condylar morphology and position. Thirty-four patients with ICFs (47 sides) were treated with the modified ORIF technique. At 6 months of follow-up, no malocclusion was found and the MIO considerably expanded to 3.56 ± 0.13 cm. Only 4 patients (12%) had temporomandibular joint discomfort with mouth opening. Interestingly, for unilateral type B ICFs, the laterotrusion distance to the ORIF sides was notably longer than to the non-ORIF sides. Postoperative CT and MRI showed that all fragments were properly reduced and the condyles were in the normal position. Postoperative anterior disc displacement occurred in 4 sides and condylar morphologic abnormalities (slight surface roughening and articular cartilage absorption) occurred in 3 sides (6.4%). This modified ORIF technique, which achieved good outcomes after treatment of all ICF types, shows promise for the treatment of ICFs. Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Assessing clinical significance of treatment outcomes using the DASS-21.

    Science.gov (United States)

    Ronk, Fiona R; Korman, James R; Hooke, Geoffrey R; Page, Andrew C

    2013-12-01

    Standard clinical significance classifications are based on movement between the "dysfunctional" and "functional" distributions; however, this dichotomy ignores heterogeneity within the "dysfunctional" population. Based on the methodology described by Tingey, Lambert, Burlingame, and Hansen (1996), the present study sought to present a 3-distribution clinical significance model for the 21-item version of the Depression Anxiety Stress Scales (DASS-21; P. F. Lovibond & Lovibond, 1995) using data from a normative sample (n = 2,914), an outpatient sample (n = 1,000), and an inpatient sample (n = 3,964). DASS-21 scores were collected at pre- and post-treatment for both clinical samples, and patients were classified into 1 of 5 categories based on whether they had made a reliable change and whether they had moved into a different functional range. Evidence supported the validity of the 3-distribution model for the DASS-21, since inpatients who were classified as making a clinically significant change showed lower symptom severity, higher perceived quality of life, and higher clinician-rated functioning than those who did not make a clinically significant change. Importantly, results suggest that the new category of recovering is an intermediate point between recovered and making no clinically significant change. Inpatients and outpatients have different treatment goals and therefore use of the concept of clinical significance needs to acknowledge differences in what constitutes a meaningful change. (c) 2013 APA, all rights reserved.

  14. Cost effectiveness of a screen-and-treat program for asymptomatic vaginal infections in pregnancy: towards a significant reduction in the costs of prematurity.

    Science.gov (United States)

    Kiss, H; Pichler, Eva; Petricevic, L; Husslein, P

    2006-08-01

    The purpose of this investigation was to determine the cost-saving potential of a simple screen-and-treat program for vaginal infection, which has previously been shown to lead to a reduction of 50% in the rate of preterm births. To determine the potential cost savings, we compared the direct costs of preterm delivery of infants with a birth weight below 1900g with the costs of the screen-and-treat program. We used a cut-off birth weight of 1900g because, in our population, all infants with a birth weight below 1900g were transferred to the neonatal intensive care unit. The direct costs associated with preterm delivery were defined to include the costs of the initial hospitalization of both mother and infant and the costs of outpatient follow-up throughout the first 6 years of life of the former preterm infant. The costs of the screen-and-treat program were defined to include the costs of the screening examination and the resulting costs of antimicrobial treatment and follow-up. All calculations were based on health-economic data obtained in the metropolitan area of Vienna, Austria. The number of preterm infants with a birth weight below 1900g was 12 (0.5%) in the intervention group (N=2058) and 29 (1.3%) in the control group (N=2097). The direct costs per preterm birth were found to amount to EUR (euro) 60262. Overall, the expected total savings in direct costs achieved by the screen-and-treat program and the ensuing 50% reduction in the number preterm births with a birth weight below 1900g amounted to more than euro 11 million. The costs of screening and treatment were found to amount to merely 7% of the direct costs saved as a result of the screen-and-treat program. A simple preterm prevention program, consisting of screening and antimicrobial treatment and follow-up of women with asymptomatic vaginal infection, leads not only to a significant reduction in the rate of preterm births but also to substantial savings in the direct costs associated with prematurity.

  15. Spontaneous harm reduction: a barrier for substance-dependent individuals seeking treatment?

    Directory of Open Access Journals (Sweden)

    Fontanella Bruno José Barcellos

    2005-01-01

    Full Text Available OBJETIVE: Greater information regarding motivations and treatment barriers faced by substance-dependent individuals has clinical and public health implications. This study aimed to formulate hypotheses regarding psychological, social and family variables that can be constructed as motivations or subjective barriers for the early seeking of formal treatment. METHODS: A qualitative study was conducted in an intentional sample (selected through saturation and variety of types of 13 substance-dependent individuals who sought treatment. In-depth, semi-structured interviews were conducted using open questions, and the transcribed data were subjected to qualitative analysis. RESULTS: Four types of spontaneous harm reduction measures were identified, according to the subjective logic of each participant: having some periods at rest (not using and recovering from adverse effects; caretaking by close acquaintances (relatives, partners, drug dealers and alcoholic beverage sellers; selectivity regarding substance source, type and means of administration; establishing "healthy" limits of ingestion. CONCLUSIONS: The measures identified might represent barriers to the early seeking of treatment but might also represent spontaneous learning of abilities beneficial to future treatment. Health care professionals should take into consideration their existence and should address them in clinical settings. Issues representative of the formulated categories should be presented in structured questionnaires used in future quantitative studies of barriers to treatment in this population.

  16. Spontaneous harm reduction: a barrier for substance-dependent individuals seeking treatment?

    Directory of Open Access Journals (Sweden)

    Bruno José Barcellos Fontanella

    2005-12-01

    Full Text Available OBJETIVE: Greater information regarding motivations and treatment barriers faced by substance-dependent individuals has clinical and public health implications. This study aimed to formulate hypotheses regarding psychological, social and family variables that can be constructed as motivations or subjective barriers for the early seeking of formal treatment. METHODS: A qualitative study was conducted in an intentional sample (selected through saturation and variety of types of 13 substance-dependent individuals who sought treatment. In-depth, semi-structured interviews were conducted using open questions, and the transcribed data were subjected to qualitative analysis. RESULTS: Four types of spontaneous harm reduction measures were identified, according to the subjective logic of each participant: having some periods at rest (not using and recovering from adverse effects; caretaking by close acquaintances (relatives, partners, drug dealers and alcoholic beverage sellers; selectivity regarding substance source, type and means of administration; establishing "healthy" limits of ingestion. CONCLUSIONS: The measures identified might represent barriers to the early seeking of treatment but might also represent spontaneous learning of abilities beneficial to future treatment. Health care professionals should take into consideration their existence and should address them in clinical settings. Issues representative of the formulated categories should be presented in structured questionnaires used in future quantitative studies of barriers to treatment in this population.

  17. Combined steam-ultrasound treatment of 2 seconds achieves significant high aerobic count and Enterobacteriaceae reduction on naturally contaminated food boxes, crates, conveyor belts, and meat knives.

    Science.gov (United States)

    Musavian, Hanieh S; Butt, Tariq M; Larsen, Annette Baltzer; Krebs, Niels

    2015-02-01

    Food contact surfaces require rigorous sanitation procedures for decontamination, although these methods very often fail to efficiently clean and disinfect surfaces that are visibly contaminated with food residues and possible biofilms. In this study, the results of a short treatment (1 to 2 s) of combined steam (95°C) and ultrasound (SonoSteam) of industrial fish and meat transportation boxes and live-chicken transportation crates naturally contaminated with food and fecal residues were investigated. Aerobic counts of 5.0 to 6.0 log CFU/24 cm(2) and an Enterobacteriaceae spp. level of 2.0 CFU/24 cm(2) were found on the surfaces prior to the treatment. After 1 s of treatment, the aerobic counts were significantly (P conveyor belts with hinge pins and one type of flat flexible rubber belt, all visibly contaminated with food residues. The aerobic counts of 3.0 to 5.0 CFU/50 cm(2) were significantly (P < 0.05) reduced, while Enterobacteriaceae spp. were reduced to a level below the detection limit. Industrial meat knives were contaminated with aerobic counts of 6.0 log CFU/5 cm(2) on the handle and 5.2 log CFU/14 cm(2) on the steel. The level of Enterobacteriaceae spp. contamination was approximately 2.5 log CFU on the handle and steel. Two seconds of steam-ultrasound treatment reduced the aerobic counts and Enterobacteriaceae spp. to levels below the detection limit on both handle and steel. This study shows that the steam-ultrasound treatment may be an effective replacement for disinfection processes and that it can be used for continuous disinfection at fast process lines. However, the treatment may not be able to replace efficient cleaning processes used to remove high loads of debris.

  18. Strategies for the reduction of Legionella in biological treatment systems.

    Science.gov (United States)

    Nogueira, R; Utecht, K-U; Exner, M; Verstraete, W; Rosenwinkel, K-H

    A community-wide outbreak of Legionnaire's disease occurred in Warstein, Germany, in August 2013. The epidemic strain, Legionella pneumophila Serogruppe 1, was isolated from an industrial wastewater stream entering the municipal wastewater treatment plant (WWTP) in Wartein, the WWTP itself, the river Wäster and air/water samples from an industrial cooling system 3 km downstream of the WWTP. The present study investigated the effect of physical-chemical disinfection methods on the reduction of the concentration of Legionella in the biological treatment and in the treated effluent entering the river Wäster. Additionally, to gain insight into the factors that promote the growth of Legionella in biological systems, growth experiments were made with different substrates and temperatures. The dosage rates of silver micro-particles, hydrogen peroxide, chlorine dioxide and ozone and pH stress to the activated sludge were not able to decrease the number of culturable Legionella spp. in the effluent. Nevertheless, the UV treatment of secondary treated effluent reduced Legionella spp. on average by 1.6-3.4 log units. Laboratory-scale experiments and full-scale measurements suggested that the aerobic treatment of warm wastewater (30-35 °C) rich in organic nitrogen (protein) is a possible source of Legionella infection.

  19. Lung Volume Reduction Coil Treatment in Chronic Obstructive Pulmonary Disease Patients with Homogeneous Emphysema : A Prospective Feasibility Trial

    NARCIS (Netherlands)

    Klooster, Karin; ten Hacken, Nick H. T.; Franz, Ina; Kerstjens, Huib A. M.; van Rikxoort, Eva M.; Slebos, Dirk-Jan

    2014-01-01

    Background: In patients with heterogeneous emphysema, surgical and bronchoscopic lung volume reduction (LVR) treatments are available. However, for patients with homogeneous emphysema these treatments are hardly investigated and seem less effective. Bronchoscopic LVR coil treatment has been shown to

  20. Low-Carbon Watershed Management: Potential of Greenhouse Gas Reductions from Wastewater Treatment in Rural Vietnam

    Science.gov (United States)

    Mohan, Geetha; Jian, Pu; Takemoto, Kazuhiko; Fukushi, Kensuke

    2016-01-01

    Currently in many cities and rural areas of Vietnam, wastewater is discharged to the environment without any treatment, which emits considerable amount of greenhouse gas (GHG), particularly methane. In this study, four GHG emission scenarios were examined, as well as the baseline scenario, in order to verify the potential of GHG reduction from domestic wastewater with adequate treatment facilities. The ArcGIS and ArcHydro tools were employed to visualize and analyze GHG emissions resulting from discharge of untreated wastewater, in rural areas of Vu Gia Thu Bon river basin, Vietnam. By applying the current IPCC guidelines for GHG emissions, we found that a reduction of GHG emissions can be achieved through treatment of domestic wastewater in the studied area. Compared with baseline scenario, a maximum 16% of total GHG emissions can be reduced, in which 30% of households existing latrines are substituted by Japanese Johkasou technology and other 20% of domestic wastewater is treated by conventional activated sludge. PMID:27699202

  1. Sludge reduction in a small wastewater treatment plant by electro-kinetic disintegration.

    Science.gov (United States)

    Chiavola, Agostina; Ridolfi, Alessandra; D'Amato, Emilio; Bongirolami, Simona; Cima, Ennio; Sirini, Piero; Gavasci, Renato

    2015-01-01

    Sludge reduction in a wastewater treatment plant (WWTP) has recently become a key issue for the managing companies, due to the increasing constraints on the disposal alternatives. Therefore, all the solutions proposed with the aim of minimizing sludge production are receiving increasing attention and are tested either at laboratory or full-scale to evaluate their real effectiveness. In the present paper, electro-kinetic disintegration has been applied at full-scale in the recycle loop of the sludge drawn from the secondary settlement tank of a small WWTP for domestic sewage. After the disintegration stage, the treated sludge was returned to the biological reactor. Three different percentages (50, 75 and 100%) of the return sludge flow rate were subjected to disintegration and the effects on the sludge production and the WWTP operation efficiency evaluated. The long-term observations showed that the electro-kinetic disintegration was able to drastically reduce the amount of biological sludge produced by the plant, without affecting its treatment efficiency. The highest reduction was achieved when 100% return sludge flow rate was subjected to the disintegration process. The reduced sludge production gave rise to a considerable net cost saving for the company which manages the plant.

  2. Non-insulated smooth motion, micro-needles RF fractional treatment for wrinkle reduction and lifting of the lower face: International study.

    Science.gov (United States)

    Gold, Michael; Taylor, Mark; Rothaus, Kenneth; Tanaka, Yohei

    2016-10-01

    Skin aging occurs through both intrinsic and extrinsic processes. Fractional radiofrequency (RF) with a microneedling array is the newest form of fractional therapy to be useful in treating aging skin. The current study utilized a noninsulated fractional RF microneedling system. This multicenter clinical trial saw 49 patients complete 3 monthly treatments with the new fractional RF microneedling treatments and be followed for 3 months following their last treatment. Pain during treatment was recorded as well as overall improvement using a GAIS scale. Adverse events were also noted. Forty-nine patients completed all of the treatments and follow-ups. Mild to moderate erythema were reported immediately after treatment which lasted up to 12 hours after the treatment. Pain, as measured on a 1-10 VAS, was noted to 4, on average. The average Fitzpatrick's wrinkle scale score at baseline was 5.04 ± 1.22, 1 month after 3 treatments 3.829 ± 1.69 and 3 months after 3 treatments 3.5 ± 1.66. These results are statistically highly significant (correlated T-test, P skin tightening and skin lifting were also observed. No unusual adverse events were noted throughout the course of the study. This multicenter study showed significant wrinkle reduction, skin tightening, and lifting of the mid and lower face with the noninsulated fractional RF microneedling system. Lasers Surg. Med. 48:727-733, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  3. Can MRI Observations Predict Treatment Outcome of Lavage in Patients with Painful TMJ Disc Displacement without Reduction?

    Science.gov (United States)

    Ekberg, EwaCarin; Hansson, Lars-Göran; List, Thomas; Eriksson, Lars; Sahlström, Lotta Englesson; Petersson, Arne

    2015-01-01

    The purpose of this study was to examine magnetic resonance imaging findings in patients with painful disc displacement without reduction of the temporomandibular joint to determine whether the findings were able to predict treatment outcome of lavage and a control group treated with local anaesthesia without lavage in a short-term: 3-month perspective. Bilateral magnetic resonance images were taken of 37 patients with the clinical diagnosis of painful disc displacement without reduction. Twenty-three patients received unilateral extra-articular local anaesthetics and 14 unilateral lavage and extra-articular local anaesthetics. The primary treatment outcome defining success was reduction in pain intensity of at least 30% during jaw movement at the 3-month follow-up. Bilateral disc displacement was found in 30 patients. In 31 patients the disc on the treated side was deformed, and bilaterally in 19 patients. Osteoarthritis was observed in 28 patients, and 13 patients had bilateral changes. Thirty patients responded to treatment and 7 did not, with no difference between the two treated groups. In neither the treated nor the contralateral temporomandibular joint did treatment outcome depend on disc diagnosis, disc shape, joint effusion, or osseous diagnoses. Magnetic resonance imaging findings of disc position, disc shape, joint effusion or osseous diagnosis on the treated or contralateral side did not give information of treatment outcome. Magnetic resonance imaging findings could not predict treatment outcome in patients treated with either local anaesthetics or local anaesthetics and lavage.

  4. Long-Term Impact of Cyclosporin Reduction with MMF Treatment in Chronic Allograft Dysfunction: REFERENECE Study 3-Year Follow Up

    Directory of Open Access Journals (Sweden)

    L. Frimat

    2010-01-01

    Full Text Available Calcineurin inhibitor (CNI toxicity contributes to chronic allograft nephropathy (CAN. In the 2-year, randomized, study, we showed that 50% cyclosporin (CsA reduction in combination with mycophenolate mofetil (MMF treatment improves kidney function without increasing the risk for graft rejection/loss. To investigate the long-term effect of this regimen, we conducted a follow up study in 70 kidney transplant patients until 5 years after REFERENCE initiation. The improvement of kidney function was confirmed in the MMF group but not in the control group (CsA group. Four graft losses occurred, 2 in each group (graft survival in the MMF group 95.8% and 90.9% in control group. One death occurred in the control group. There was no statistically significant difference in the occurrence of serious adverse events or acute graft rejections. A limitation is the weak proportion of patient still remaining within the control group. On the other hand, REFERENCE focuses on the CsA regimen while opinions about the tacrolimus ones are still debated. In conclusion, CsA reduction in the presence of MMF treatment seems to maintain kidney function and is well tolerated in the long term.

  5. Preferential reduction of binding of 125I-iodopindolol to beta-1 adrenoceptors in the amygdala of rat after antidepressant treatments

    International Nuclear Information System (INIS)

    Ordway, G.A.; Gambarana, C.; Tejani-Butt, S.M.; Areso, P.; Hauptmann, M.; Frazer, A.

    1991-01-01

    This study utilized quantitative receptor autoradiography to examine the effects of repeated administration of antidepressants to rats on the binding of the beta adrenoceptor antagonist, 125 I-iodopindolol ( 125 I-IPIN) to either beta-1 or beta-2 adrenoceptors in various regions of brain. Antidepressants were selected to represent various chemical and pharmacological classes including tricyclic compounds (desipramine and protriptyline), monoamine oxidase inhibitors (clorgyline, phenelzine and tranylcypromine), atypical antidepressants (mianserin and trazodone) and selective inhibitors of the uptake of serotonin (citalopram and sertraline). Additionally, rats were treated with various psychotropic drugs that lack antidepressant efficacy (cocaine, deprenyl, diazepam and haloperidol). Repeated treatment of rats with desipramine, protriptyline, clorgyline, phenelzine, tranylcypromine or mianserin reduced the binding of 125 I-IPIN to beta-1 adrenoceptors in many brain areas. Only in the basolateral and lateral nuclei of the amygdala did all six of these antidepressants significantly reduce 125 I-IPIN binding to beta-1 adrenoceptors. In these amygdaloid nuclei, the magnitude of the reduction in the binding of 125 I-IPIN caused by each of these drugs was comparable to or greater than the reduction in binding produced in any other region of brain. Reductions of binding of 125 I-IPIN after antidepressant treatments were not consistently observed in the cortex, the area of brain examined most often in homogenate binding studies. Only the monoamine oxidase inhibitors caused reductions in the binding of 125 I-IPIN to beta-2 adrenoceptors, and this effect was generally localized to the amygdala and hypothalamus

  6. Surgical treatment for pilon fracture of the ankle-open reduction and internal fixation.

    Science.gov (United States)

    Chen, Y W; Huang, P J; Hsu, C Y; Kuo, C H; Cheng, Y M; Lin, S Y; Chen, L H; Chiang, H C

    1998-01-01

    From 1991 to 1994, 39 ankles of 38 patients underwent surgical open reduction and internal fixation for pilon fractures. These patients included 29 males and 9 females with an average age of 38.6 y/o (range 28 y/o-58 y/o). The follow up and evaluation period averaged 31.7 months (range 22Ms-44Ms), during which time a standing x-ray for arthrosis grading and functional scale was used for clinical evaluation. Complications included 1 case of infection, 1 case of loss reduction, 2 cases of partial skin necrosis and 2 cases of delayed union. Post-traumatic arthritis occurred in 23 ankles (59%) but only 4 ankles of grade 4 arthrosis resulted in poor functional scale and the overall satisfactory rate was 82%. It was found that anatomic reduction, rigid fixation and early motion exercise are important to successful treatment of ankle fractures. Regarding pilon fracture, specifically the severity of fracture pattern and delay of reduction are important problems to overcome to ensure successful results. Therefore, adequate surgical approach for entire view of ankle joint, reduction and fixation of fibula, sufficient bone graft for articular support, intraoperative x-ray check and postoperative immobilization are essential for the achievement of better clinical results.

  7. Lung volume reduction coil treatment for patients with severe emphysema : a European multicentre trial

    NARCIS (Netherlands)

    Deslee, Gaetan; Klooster, Karin; Hetzel, Martin; Stanzel, Franz; Kessler, Romain; Marquette, Charles-Hugo; Witt, Christian; Blaas, Stefan; Gesierich, Wolfgang; Herth, Felix J. F.; Hetzel, Juergen; van Rikxoort, Eva M.; Slebos, Dirk-Jan

    2014-01-01

    Background The lung volume reduction (LVR) coil is a minimally invasive bronchoscopic nitinol device designed to reduce hyperinflation and improve elastic recoil in severe emphysema. We investigated the feasibility, safety and efficacy of LVR coil treatment in a prospective multicentre cohort trial

  8. 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

  9. Eighteenth annual risk reduction engineering laboratory research symposium

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    The Eighteenth Annual Risk Reduction Engineering Laboratory Research Symposium was held in Cincinnati, Ohio, April 14-16, 1992. The purpose of this Symposium was to present the latest significant research findings from ongoing and recently completed projects funded by the Risk Reduction Engineering Laboratory (RREL). These Proceedings are organized into two sections. Sessions A and B, which contain extended abstracts of the paper presentations. A list of poster displays is also included. Subjects include remedial action, treatment, and control technologies for waste disposal, landfill liner and cover systems, underground storage tanks, and demonstration and development of innovative/alternative treatment technologies for hazardous waste. Alternative technology subjects include thermal destruction of hazardous wastes, field evaluations, existing treatment options, emerging treatment processes, waste minimization, and biosystems for hazardous waste destruction

  10. Harm reduction measures in prison (Methadone treatment and its effects on quality of life promotion

    Directory of Open Access Journals (Sweden)

    Iraj Esmaili

    2009-02-01

    Conclusion: In a look, it is obvious that the harm reduction measures which have been taken for prisoners under the coverage of Methadone treatment will be effective in improving their quality of life conditions.

  11. Nitrite addition to acidified sludge significantly improves digestibility, toxic metal removal, dewaterability and pathogen reduction

    Science.gov (United States)

    Du, Fangzhou; Keller, Jürg; Yuan, Zhiguo; Batstone, Damien J.; Freguia, Stefano; Pikaar, Ilje

    2016-12-01

    Sludge management is a major issue for water utilities globally. Poor digestibility and dewaterability are the main factors determining the cost for sludge management, whereas pathogen and toxic metal concentrations limit beneficial reuse. In this study, the effects of low level nitrite addition to acidified sludge to simultaneously enhance digestibility, toxic metal removal, dewaterability and pathogen reduction were investigated. Waste activated sludge (WAS) from a full-scale waste water treatment plant was treated at pH 2 with 10 mg NO2--N/L for 5 h. Biochemical methane potential tests showed an increase in the methane production of 28%, corresponding to an improvement from 247 ± 8 L CH4/kg VS to 317 ± 1 L CH4/kg VS. The enhanced removal of toxic metals further increased the methane production by another 18% to 360 ± 6 L CH4/kg VS (a total increase of 46%). The solids content of dewatered sludge increased from 14.6 ± 1.4% in the control to 18.2 ± 0.8%. A 4-log reduction for both total coliforms and E. coli was achieved. Overall, this study highlights the potential of acidification with low level nitrite addition as an effective and simple method achieving multiple improvements in terms of sludge management.

  12. TH-EF-BRB-03: Significant Cord and Esophagus Dose Reduction by 4π Non-Coplanar Spine Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Yu, V; Tran, A; Nguyen, D; Woods, K; Cao, M; Kaprealian, T; Chin, R; Low, D; Sheng, K [UCLA, Los Angeles, CA (United States)

    2016-06-15

    Purpose: To demonstrate significant organ-at-risk (OAR) sparing achievable with 4π non-coplanar radiotherapy on spine SBRT and SRS patients. Methods: Twenty-five stereotactic spine cases previously treated with VMAT (n = 23) or IMRT (n = 2) were included in this study. A computer-aided-design model of a Linac with a 3D-scanned human surface was utilized to determine the feasible beam space throughout the 4π steradian and beam specific source-to-target-distances (STD) required for collision avoidance. 4π radiotherapy plans integrating beam orientation and fluence map optimization were then created using a column-generation algorithm. Twenty optimal beams were selected for each case. To evaluate the tradeoff between dosimetric benefit and treatment complexity, 4π plans including only isocentrically deliverable beams were also created. Beam angles of all standard and isocentric 4π plans were imported into Eclipse to recalculate the dose using the same calculation engine as the clinical plans for unbiased comparison. OAR and PTV dose statistics for the clinical, standard-4π, and isocentric-4π plans were compared. Results: Comparing standard-4π to clinical plans, particularly significant average percent reduction in the [mean, maximum] dose of the cord and esophagus of [41%, 21.7%], and [38.7%, 36.4%] was observed, along with global decrease in all other OAR dose statistics. The average cord volume receiving more than 50% prescription dose was substantially decreased by 76%. In addition, improved PTV coverage was demonstrated with a maximum dose reduction of 0.93% and 1.66% increase in homogeneity index (D95/D5). All isocentric-4π plans achieved dosimetric performance equivalent to that of the standard-4π plans with higher delivery complexity. Conclusion: 4π radiotherapy significantly improves stereotactic spine treatment dosimetry. With the substantial OAR dose sparing, PTV dose escalation is considerably safer. Isocentric-4π is sufficient to achieve the

  13. Selenate reduction to elemental selenium by anaerobic bacteria in sediments and culture: biogeochemical significance of a novel, sulfate-independent respiration

    Science.gov (United States)

    Oremland, Ronald S.; Hollibaugh, James T.; Maest, Ann S.; Presser, Theresa S.; Miller, Laurence G.; Culbertson, Charles W.

    1989-01-01

    Interstitial water profiles of SeO42−, SeO32−, SO42−, and Cl− in anoxic sediments indicated removal of the seleno-oxyanions by a near-surface process unrelated to sulfate reduction. In sediment slurry experiments, a complete reductive removal of SeO42− occurred under anaerobic conditions, was more rapid with H2 or acetate, and was inhibited by O2, NO3−, MnO2, or autoclaving but not by SO42− or FeOOH. Oxidation of acetate in sediments could be coupled to selenate but not to molybdate. Reduction of selenate to elemental selenium was determined to be the mechanism for loss from solution. Selenate reduction was inhibited by tungstate and chromate but not by molybdate. A small quantity of the elemental selenium precipitated into sediments from solution could be resolublized by oxidation with either nitrate or FeOOH, but not with MnO2. A bacterium isolated from estuarine sediments demonstrated selenate-dependent growth on acetate, forming elemental selenium and carbon dioxide as respiratory end products. These results indicate that dissimilatory selenate reduction to elemental selenium is the major sink for selenium oxyanions in anoxic sediments. In addition, they suggest application as a treatment process for removing selenium oxyanions from wastewaters and also offer an explanation for the presence of selenite in oxic waters.

  14. Reductive dehalogenation of disinfection byproducts by an activated carbon-based electrode system.

    Science.gov (United States)

    Li, Yuanqing; Kemper, Jerome M; Datuin, Gwen; Akey, Ann; Mitch, William A; Luthy, Richard G

    2016-07-01

    Low molecular weight, uncharged, halogenated disinfection byproducts (DBPs) are poorly removed by the reverse osmosis and advanced oxidation process treatment units often applied for further treatment of municipal wastewater for potable reuse. Granular activated carbon (GAC) treatment effectively sorbed 22 halogenated DBPs. Conversion of the GAC to a cathode within an electrolysis cell resulted in significant degradation of the 22 halogenated DBPs by reductive electrolysis at -1 V vs. Standard Hydrogen Electrode (SHE). The lowest removal efficiency over 6 h electrolysis was for trichloromethane (chloroform; 47%) but removal efficiencies were >90% for 13 of the 22 DBPs. In all cases, DBP degradation was higher than in electrolysis-free controls, and degradation was verified by the production of halides as reduction products. Activated carbons and charcoal were more effective than graphite for electrolysis, with graphite featuring poor sorption for the DBPs. A subset of halogenated DBPs (e.g., haloacetonitriles, chloropicrin) were degraded upon sorption to the GAC, even without electrolysis. Using chloropicrin as a model, experiments indicated that this loss was attributable to the partial reduction of sorbed chloropicrin from reducing equivalents in the GAC. Reducing equivalents depleted by these reactions could be restored when the GAC was treated by reductive electrolysis. GAC treatment of an advanced treatment train effluent for potable reuse effectively reduced the concentrations of chloroform, bromodichloromethane and dichloroacetonitrile measured in the column influent to below the method detection limits. Treatment of the GAC by reductive electrolysis at -1 V vs. SHE over 12 h resulted in significant degradation of the chloroform (63%), bromodichloromethane (96%) and dichloroacetonitrile (99%) accumulated on the GAC. The results suggest that DBPs in advanced treatment train effluents could be captured and degraded continuously by reductive electrolysis

  15. Optimal treatment scheduling of ionizing radiation and sunitinib improves the antitumor activity and allows dose reduction

    International Nuclear Information System (INIS)

    Kleibeuker, Esther A; Hooven, Matthijs A ten; Castricum, Kitty C; Honeywell, Richard; Griffioen, Arjan W; Verheul, Henk M; Slotman, Ben J; Thijssen, Victor L

    2015-01-01

    The combination of radiotherapy with sunitinib is clinically hampered by rare but severe side effects and varying results with respect to clinical benefit. We studied different scheduling regimes and dose reduction in sunitinib and radiotherapy in preclinical tumor models to improve potential outcome of this combination treatment strategy. The chicken chorioallantoic membrane (CAM) was used as an angiogenesis in vivo model and as a xenograft model with human tumor cells (HT29 colorectal adenocarcinoma, OE19 esophageal adenocarcinoma). Treatment consisted of ionizing radiation (IR) and sunitinib as single therapy or in combination, using different dose-scheduling regimes. Sunitinib potentiated the inhibitory effect of IR (4 Gy) on angiogenesis. In addition, IR (4 Gy) and sunitinib (4 days of 32.5 mg/kg per day) inhibited tumor growth. Ionizing radiation induced tumor cell apoptosis and reduced proliferation, whereas sunitinib decreased tumor angiogenesis and reduced tumor cell proliferation. When IR was applied before sunitinib, this almost completely inhibited tumor growth, whereas concurrent IR was less effective and IR after sunitinib had no additional effect on tumor growth. Moreover, optimal scheduling allowed a 50% dose reduction in sunitinib while maintaining comparable antitumor effects. This study shows that the therapeutic efficacy of combination therapy improves when proper dose-scheduling is applied. More importantly, optimal treatment regimes permit dose reductions in the angiogenesis inhibitor, which will likely reduce the side effects of combination therapy in the clinical setting. Our study provides important leads to optimize combination treatment in the clinical setting

  16. Reduction mammoplasty as a treatment for symptomatic central venous stenosis

    Directory of Open Access Journals (Sweden)

    Denise Seok Fun Fok

    2018-03-01

    Full Text Available Central venous stenosis is a rare cause of unilateral breast edema occurring in hemodialysis patients that needs to be differentiated from other differential diagnoses, including, but not limited to, inflammatory breast carcinoma, mastitis, lymphedema, and congestive heart failure. All reports of similar cases in the available literature have described improvement or resolution of the edema after treatment. Herein, we report and discuss the pathophysiology of breast edema formation in a patient who presented with massive left-sided breast edema 7 years after being diagnosed with central venous stenosis. Medical and minimally invasive therapy had not been successful, so she underwent reduction mammoplasty to relieve the symptoms.

  17. Transcutaneous electrical nerve stimulation therapy in reduction of orofacial pain

    Directory of Open Access Journals (Sweden)

    Đorđević Igor

    2014-01-01

    Full Text Available Introduction. Patients with craniomandibular disorders suffer from hypertonic, fatigued and painful masticatory muscles. This condition can lead to limitation of mandibular jaw movements. All of these symptoms and signs are included in myofascial pain dysfunction syndrome. Transcutaneous electrical nerve stimulation (TENS has been used for treatment of these patients. Objective. The aim of this study was to assess the effect of TENS therapy on chronic pain reduction in patients with the muscular dysfunction symptom. Methods. In order to evaluate the effect of TENS therapy before and after the treatment, Craniomandibular Index (Helkimo was used. Pain intensity was measured by VAS. Patients had TENS treatment over two-week period. BURST TENS modality was used. Current intensity was individually adjusted. Results. Two patients did not respond to TENS therapy. Complete pain reduction was recorded in 8 patients, while pain reduction was not significantly different after TENS therapy in 10 patients. Conclusion. TENS therapy was confirmed as therapeutic procedure in orofacial muscle relaxation and pain reduction.

  18. A New Bioinspired Perchlorate Reduction Catalyst with Significantly Enhanced Stability via Rational Tuning of Rhenium Coordination Chemistry and Heterogeneous Reaction Pathway.

    Science.gov (United States)

    Liu, Jinyong; Han, Mengwei; Wu, Dimao; Chen, Xi; Choe, Jong Kwon; Werth, Charles J; Strathmann, Timothy J

    2016-06-07

    Rapid reduction of aqueous ClO4(-) to Cl(-) by H2 has been realized by a heterogeneous Re(hoz)2-Pd/C catalyst integrating Re(O)(hoz)2Cl complex (hoz = oxazolinyl-phenolato bidentate ligand) and Pd nanoparticles on carbon support, but ClOx(-) intermediates formed during reactions with concentrated ClO4(-) promote irreversible Re complex decomposition and catalyst deactivation. The original catalyst design mimics the microbial ClO4(-) reductase, which integrates Mo(MGD)2 complex (MGD = molybdopterin guanine dinucleotide) for oxygen atom transfer (OAT). Perchlorate-reducing microorganisms employ a separate enzyme, chlorite dismutase, to prevent accumulation of the destructive ClO2(-) intermediate. The structural intricacy of MGD ligand and the two-enzyme mechanism for microbial ClO4(-) reduction inspired us to improve catalyst stability by rationally tuning Re ligand structure and adding a ClOx(-) scavenger. Two new Re complexes, Re(O)(htz)2Cl and Re(O)(hoz)(htz)Cl (htz = thiazolinyl-phenolato bidentate ligand), significantly mitigate Re complex decomposition by slightly lowering the OAT activity when immobilized in Pd/C. Further stability enhancement is then obtained by switching the nanoparticles from Pd to Rh, which exhibits high reactivity with ClOx(-) intermediates and thus prevents their deactivating reaction with the Re complex. Compared to Re(hoz)2-Pd/C, the new Re(hoz)(htz)-Rh/C catalyst exhibits similar ClO4(-) reduction activity but superior stability, evidenced by a decrease of Re leaching from 37% to 0.25% and stability of surface Re speciation following the treatment of a concentrated "challenge" solution containing 1000 ppm of ClO4(-). This work demonstrates the pivotal roles of coordination chemistry control and tuning of individual catalyst components for achieving both high activity and stability in environmental catalyst applications.

  19. Modeling Fuel Treatment Leverage: Encounter Rates, Risk Reduction, and Suppression Cost Impacts

    Directory of Open Access Journals (Sweden)

    Matthew P. Thompson

    2017-11-01

    Full Text Available The primary theme of this study is the cost-effectiveness of fuel treatments at multiple scales of investment. We focused on the nexus of fuel management and suppression response planning, designing spatial fuel treatment strategies to incorporate landscape features that provide control opportunities that are relevant to fire operations. Our analysis explored the frequency and magnitude of fire-treatment encounters, which are critical determinants of treatment efficacy. Additionally, we examined avoided area burned, avoided suppression costs, and avoided damages, and combined all three under the umbrella of leverage to explore multiple dimensions with which to characterize return on investment. We chose the Sierra National Forest, California, USA, as our study site, due to previous work providing relevant data and analytical products, and because it has the potential for large, long-duration fires and corresponding potential for high suppression expenditures. Modeling results generally confirmed that fire-treatment encounters are rare, such that median suppression cost savings are zero, but in extreme years, savings can more than offset upfront investments. Further, reductions in risk can expand areas where moderated suppression response would be appropriate, and these areas can be mapped in relation to fire control opportunities.

  20. Response of white-footed mice (Peromyscus leucopus) to fire and fire surrogate fuel reduction treatments in a southern Appalachian hardwood forest

    Science.gov (United States)

    Greenberg, C.H.; Otis, D.L.; Waldrop, T.A.

    2006-01-01

    An experiment conducted as part of the multidisciplinary National Fire and Fire Surrogate Study was designed to determine effects of three fuel reduction techniques on small mammals and habitat structure in the southern Appalachian mountains. Four experimental units, each >14-ha were contained within each of three replicate blocks at the Green River Game Land, Polk County, NC. Treatments were (1) prescribed burning (B); (2) mechanical felling of shrubs and small trees (M); (3) mechanical felling + burning (MB); (4) controls (C). Mechanical understory felling treatments were conducted in winter 2001-2002, and prescribed burning was conducted in March 2003. After treatment, there were fewer live trees, more snags, and greater canopy openness in MB than in other treatments. Leaf litter depth was reduced by burning in both B and MB treatments, and tall shrub cover was reduced in all fuel reduction treatments compared to C. Coarse woody debris pieces and percent cover were similar among treatments and controls. We captured 990 individuals of eight rodent species a total of 2823 times. Because white-footed mice composed >79% of all captures, we focused on this species. Populations in experimental units increased 228% on average between 2001 and 2002, but there was no evidence of an effect of the mechanical treatment. From 2002 to 2003, all units again showed an average increase in relative population size, but increases were greater in MB than in the other treatments. Age structure and male to female ratio were not affected by the fuel reduction treatment. Average adult body weight declined from 2001 to 2002, but less so in M than in units that remained C in both years. The proportion of mice captured near coarse woody debris was similar to the proportion captured in open areas for all treatments, indicating that white-footed mice did not use coarse woody debris preferentially or change their use patterns in response to fuel reduction treatments. Land managers should

  1. Overview of LLWMP milestones. A. Reduction of waste generation and B. and G. Wastel treatment

    International Nuclear Information System (INIS)

    Vath, J.E.

    1981-01-01

    The objective of Milestones A, B, and G is to provide documentation of the best available technology for waste volume reduction, treatment, handling, packaging and solidification to meet the needs of shallow land burial disposal and for greater confinement than shallow land burial. Many of the hardware options for waste treatment have been reviewed for appropriate usage with low-level waste, some of the more promising options remain to be evaluated. Testing of treatment technologies with real industrial wastes at appropriate levels of radioactivity has been initiated, considerable work remains to be completed. Analysis of the interaction of treatment, solidification, and disposal needs to be completed

  2. Decreasing the Rate of Metabolic Ketone Reduction in the Discovery of a Clinical Acetyl-CoA Carboxylase Inhibitor for the Treatment of Diabetes

    Energy Technology Data Exchange (ETDEWEB)

    Griffith, David A. [Pfizer Worldwide Research and Development, Cambridge, MA (United States); Kung, Daniel W. [Pfizer Worldwide Research and Development, Cambridge, MA (United States); Esler, William P. [Pfizer Worldwide Research and Development, Cambridge, MA (United States); Amor, Paul A. [Pfizer Worldwide Research and Development, Cambridge, MA (United States); Bagley, Scott W. [Pfizer Worldwide Research and Development, Cambridge, MA (United States); Beysen, Carine [KineMed Inc., Emeryville, CA (United States); Carvajal-Gonzalez, Santos [Pfizer Worldwide Research and Development, Cambridge, MA (United States); Doran, Shawn D. [Pfizer Worldwide Research and Development, Cambridge, MA (United States); Limberakis, Chris [Pfizer Worldwide Research and Development, Cambridge, MA (United States); Mathiowetz, Alan M. [Pfizer Worldwide Research and Development, Cambridge, MA (United States); McPherson, Kirk [Pfizer Worldwide Research and Development, Cambridge, MA (United States); Price, David A. [Pfizer Worldwide Research and Development, Cambridge, MA (United States); Ravussin, Eric [Louisiana State Univ., Baton Rouge, LA (United States); Sonnenberg, Gabriele E. [Pfizer Worldwide Research and Development, Cambridge, MA (United States); Southers, James A. [Pfizer Worldwide Research and Development, Cambridge, MA (United States); Sweet, Laurel J. [Pfizer Worldwide Research and Development, Cambridge, MA (United States); Turner, Scott M. [KineMed Inc., Emeryville, CA (United States); Vajdos, Felix F. [Pfizer Worldwide Research and Development, Cambridge, MA (United States)

    2014-12-26

    We found that Acetyl-CoA carboxylase (ACC) inhibitors offer significant potential for the treatment of type 2 diabetes mellitus (T2DM), hepatic steatosis, and cancer. However, the identification of tool compounds suitable to test the hypothesis in human trials has been challenging. An advanced series of spirocyclic ketone-containing ACC inhibitors recently reported by Pfizer were metabolized in vivo by ketone reduction, which complicated human pharmacology projections. Here, we disclose that this metabolic reduction can be greatly attenuated through introduction of steric hindrance adjacent to the ketone carbonyl. Incorporation of weakly basic functionality improved solubility and led to the identification of 9 as a clinical candidate for the treatment of T2DM. Phase I clinical studies demonstrated dose-proportional increases in exposure, single-dose inhibition of de novo lipogenesis (DNL), and changes in indirect calorimetry consistent with increased whole-body fatty acid oxidation. This demonstration of target engagement validates the use of compound 9 to evaluate the role of DNL in human disease.

  3. [Manipulative reduction and external fixation with cardboard splint for the treatment of calcaneal fractures: a 60-case report].

    Science.gov (United States)

    Hao, Bo-Chuan; Xie, Ke-Bo

    2014-07-01

    To investigate the therapeutic effects of manipulative reduction for calcaneal fractures. From January 2009 to June 2012, 53 cases (60 affected feet) of Sanders type I-IV calcaneal fractures were treated by manipulative reduction and external fixation with cardboard splint,including 45 males and 8 females with an average age of (33.5 +/- 1.54) years old ranging from 18 to 65. The course of disease ranged 0.5 h to 7 d. Before treatment the feet were swelling, ache and activity limitation in evidence, some feet were wide flat deformity, the cortical bone was broken in the imaging examination. All selected cases were evaluated using Creighton-Nebraska health foundation assessment scale for fractures of calcaneus. All cases were followed up at 12 months after treatment, 13 feet got excellent curative effect, 34 good, 11 moderate and 2 poor. Manipulative reduction for Sanders type I-IV calcaneal fractures could get excellent curative effect. Manipulative reduction for calcaneal fractures could avoid surgical trauma while assure high curative effects. Manipulative reduction is not only economical and easy therapy, but also can restore maximum function of the calcaneus with few complications and facilitate early rehabilitation of ankle and joint function.

  4. Minimally invasive treatment of tibial pilon fractures through arthroscopy and external fixator-assisted reduction.

    Science.gov (United States)

    Luo, Huasong; Chen, Liaobin; Liu, Kebin; Peng, Songming; Zhang, Jien; Yi, Yang

    2016-01-01

    The aim of this study was to evaluate the clinical outcome of tibial pilon fractures treated with arthroscopy and assisted reduction with an external fixator. Thirteen patients with tibial pilon fractures underwent assisted reduction for limited lower internal fixation with an external fixator under arthroscopic guidance. The weight-bearing time was decided on the basis of repeat radiography of the tibia 3 months after surgery. Postoperative ankle function was evaluated according to the Mazur scoring system. Healing of fractures was achieved in all cases, with no complications such as severe infection, skin necrosis, or an exposed plate. There were 9 excellent, 2 good, and 2 poor outcomes, scored according to the Mazur system. The acceptance rate was 85%. Arthroscopy and external fixator-assisted reduction for the minimally invasive treatment of tibial pilon fractures not only produced less trauma but also protected the soft tissues and blood supply surrounding the fractures. External fixation could indirectly provide reduction and effective operative space for arthroscopic implantation, especially for AO type B fractures and partial AO type C1 fractures.

  5. Effectiveness of the Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) dissemination project: a science to prenatal care practice partnership.

    Science.gov (United States)

    Windsor, Richard; Clark, Jeannie; Cleary, Sean; Davis, Amanda; Thorn, Stephanie; Abroms, Lorien; Wedeles, John

    2014-01-01

    This study evaluated the effectiveness of the Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Program selected by the West Virginia-Right From The Start Project for state-wide dissemination. A process evaluation documented the fidelity of SCRIPT delivery by Designated Care Coordinators (DCC), licensed nurses and social workers who provide home-based case management to Medicaid-eligible clients in all 55 counties. We implemented a quasi-experimental, non-randomized, matched Comparison (C) Group design. The SCRIPT Experimental E Group (N = 259) were all clients in 2009-2010 that wanted to quit, provided a screening carbon monoxide (CO), and received a SCRIPT home visit. The (C) Group was derived from all clients in 2006-2007 who had the same CO assessments as E Group clients and reported receiving cessation counseling. We stratified the baseline CO of E Group clients into 10 strata, and randomly selected the same number of (C) Group clients (N = 259) from each matched strata to evaluate the effectiveness of the SCRIPT Program. There were no significant baseline differences in the E and (C) Group. A Process Evaluation documented a significant increase in the fidelity of DCC delivery of SCRIPT Program procedures: from 63 % in 2006 to 74 % in 2010. Significant increases were documented in the E Group cessation rate (+9.3 %) and significant reduction rate (+4.5 %), a ≥50 % reduction from a baseline CO. Perinatal health case management staff can deliver the SCRIPT Program, and Medicaid-supported clients can change smoking behavior, even very late in pregnancy. When multiple biases were analyzed, we concluded the SCRIPT Dissemination Project was the most plausible reason for the significant changes in behavior.

  6. Reductions in blood pressure during a community-based overweight and obesity treatment in children and adolescents with prehypertension and hypertension

    DEFF Research Database (Denmark)

    Mollerup, P M; Lausten-Thomsen, U; Fonvig, C E

    2017-01-01

    Due to the pandemic of childhood obesity and thus obesity-related hypertension, improvements in treatment availability are needed. Hence, we investigated whether reductions in blood pressure (BP) would occur in children with overweight and obesity exhibiting prehypertension/hypertension during...... a community-based overweight and obesity treatment program, and if changes in body mass index (BMI) are associated with changes in BP. The study included 663 children aged 3-18 years with a BMI ⩾85th percentile for sex and age that entered treatment from June 2012 to January 2015. Height, weight and BP were....../hypertension developed in 23.3% of the normotensive children despite reductions in BMI SDSs (Pobesity treatment can reduce BP, and thus may help improve treatment availability....

  7. Opiate treatment for opiate withdrawal in newborn infants.

    Science.gov (United States)

    Osborn, David A; Jeffery, Heather E; Cole, Michael J

    2010-10-06

    Neonatal abstinence syndrome (NAS) due to opiate withdrawal may result in disruption of the mother-infant relationship, sleep-wake abnormalities, feeding difficulties, weight loss and seizures. To assess the effectiveness and safety of using an opiate compared to a sedative or non-pharmacological treatment for treatment of NAS due to withdrawal from opiates. The review was updated in 2010 with additional searches CENTRAL, MEDLINE and EMBASE supplemented by searches of conference abstracts and citation lists of published articles. Randomized or quasi-randomized controlled trials of opiate treatment in infants with NAS born to mothers with opiate dependence. Each author assessed study quality and extracted data independently. Nine studies enrolling 645 infants met inclusion criteria. There were substantial methodological concerns in all studies comparing an opiate with a sedative. Two small studies comparing different opiates were of good methodology.Opiate (morphine) versus supportive care (one study): A reduction in time to regain birth weight and duration of supportive care and a significant increase in hospital stay was noted.Opiate versus phenobarbitone (four studies): Meta-analysis found no significant difference in treatment failure. One study reported opiate treatment resulted in a significant reduction in treatment failure in infants of mothers using only opiates. One study reported a significant reduction in days treatment and admission to the nursery for infants receiving morphine. One study reported a reduction in seizures, of borderline statistical significance, with the use of opiate.Opiate versus diazepam (two studies): Meta-analysis found a significant reduction in treatment failure with the use of opiate.Different opiates (six studies): there is insufficient data to determine safety or efficacy of any specific opiate compared to another opiate. Opiates compared to supportive care may reduce time to regain birth weight and duration of supportive care

  8. [Manipulative reduction and small splint fixation combined with micromovement exercise for treatment of humeral shaft fractures].

    Science.gov (United States)

    Tang, Hao-chen; Xiang, Ming; Chen, Hang; Hu, Xiao-chuan; Yang, Guo-yong

    2016-01-01

    To investigate the therapeutic efficacy of bone-setting manipulative reduction and small splint fixation combined with micro-movement theory exercise for treatment of humeral shaft fractures. From March 2011 to February 2014, 64 cases of humeral shaft fractures were treated by bone-setting manipulative reduction and small splint fixation including 28 males and 36 females with an average age of 38.1 years old ranging from 22 to 67 years old. According to the classification of AO/OTA, there were 10 cases of type A1, 12 cases of type A2,11 cases of type A3,10 cases of type B1,12 cases of type B2, 7 cases of type B3, 2 cases of type C1, 1 case of type C2, 1 case of type C3. After close reduction early functional exercise performed according to micro-movement theory. All patients had no other parts of the fractures, neurovascular injury, and serious medical problems. Patients were followed up for fracture healing, shoulder and elbow joint function recovery, and curative effect. All patients were followed up from 10 to 12 months with an average of 10.3 months. Of them, 2 cases had a small amount of callus growth at 3 months after close reduction, so instead of operation; 2 cases appeared radial nerve symptoms after close reduction ,so instead of operation. Other patients were osseous healing, the time was 8 to 12 weeks with an average of 10.2 weeks. After osseous healing, according to Constant-Murley score system ,the average score was (93.5 ± 3.2) points, the result was excellent in 29 cases, good in 29 cases, fair in 6 cases, excellent and good rate was 90.3%; according to the Mayo score system, the average score was (93.7 ± 4.2) points, the result was excellent in 35 cases, good in 23 cases, fair in 6 cases, excellent and good rate was 91.9%. Bone-setting manipulative reduction and small splint fixation combined with micromovement theory exercise for treatment of humeral shaft fractures has advantage of positive effect, easy and inexpensive method, the treatment has

  9. Adjunctive dental therapy via tooth plaque reduction and gingivitis treatment by blue light-emitting diodes tooth brushing

    Science.gov (United States)

    Genina, Elina A.; Titorenko, Vladimir A.; Belikov, Andrey V.; Bashkatov, Alexey N.; Tuchin, Valery V.

    2015-12-01

    The efficacy of blue light-emitting toothbrushes (B-LETBs) (405 to 420 nm, power density 2 mW/cm2) for reduction of dental plaques and gingival inflammation has been evaluated. Microbiological study has shown the multifactor therapeutic action of the B-LETBs on oral pathological microflora: in addition to partial mechanical removal of bacteria, photodynamic action suppresses them up to 97.5%. In the pilot clinical studies, subjects with mild to moderate gingivitis have been randomly divided into two groups: a treatment group that used the B-LETBs and a control group that used standard toothbrushes. Indices of plaque, gingival bleeding, and inflammation have been evaluated. A significant improvement of all dental indices in comparison with the baseline (by 59%, 66%, and 82% for plaque, gingival bleeding, and inflammation, respectively) has been found. The treatment group has demonstrated up to 50% improvement relative to the control group. We have proposed the B-LETBs to serve for prevention of gingivitis or as an alternative to conventional antibiotic treatment of this disease due to their effectiveness and the absence of drug side effects and bacterial resistance.

  10. Ecological effects of alternative fuel-reduction treatments: highlights of the National Fire and Fire Surrogate study (FFS)

    Science.gov (United States)

    James D. McIver; Scott L. Stephens; James K. Agee; Jamie Barbour; Ralph E. J. Boerner; Carl B. Edminster; Karen L. Erickson; Kerry L. Farris; Christopher J. Fettig; Carl E. Fiedler; Sally Haase; Stephen C. Hart; Jon E. Keeley; Eric E. Knapp; John F. Lehmkuhl; Jason J. Moghaddas; William Otrosina; Kenneth W. Outcalt; Dylan W. Schwilk; Carl N. Skinner; Thomas A. Waldrop; C. Phillip Weatherspoon; Daniel A. Yaussy; Andrew Youngblood; Steve Zack

    2012-01-01

    The 12-site National Fire and Fire Surrogate study (FFS) was a multivariate experiment that evaluated ecological consequences of alternative fuel-reduction treatments in seasonally dry forests of the US. Each site was a replicated experiment with a common design that compared an un-manipulated control, prescribed fire, mechanical and mechanical + fire treatments....

  11. Brain volume reduction after whole-brain radiotherapy: quantification and prognostic relevance.

    Science.gov (United States)

    Hoffmann, Christian; Distel, Luitpold; Knippen, Stefan; Gryc, Thomas; Schmidt, Manuel Alexander; Fietkau, Rainer; Putz, Florian

    2018-01-22

    Recent studies have questioned the value of adding whole-brain radiotherapy (WBRT) to stereotactic radiosurgery (SRS) for brain metastasis treatment. Neurotoxicity, including radiation-induced brain volume reduction, could be one reason why not all patients benefit from the addition of WBRT. In this study, we quantified brain volume reduction after WBRT and assessed its prognostic significance. Brain volumes of 91 patients with cerebral metastases were measured during a 150-day period after commencing WBRT and were compared with their pretreatment volumes. The average daily relative change in brain volume of each patient, referred to as the "brain volume reduction rate," was calculated. Univariate and multivariate Cox regression analyses were performed to assess the prognostic significance of the brain volume reduction rate, as well as of 3 treatment-related and 9 pretreatment factors. A one-way analysis of variance was used to compare the brain volume reduction rate across recursive partitioning analysis (RPA) classes. On multivariate Cox regression analysis, the brain volume reduction rate was a significant predictor of overall survival after WBRT (P < 0.001), as well as the number of brain metastases (P = 0.002) and age (P = 0.008). Patients with a relatively favorable prognosis (RPA classes 1 and 2) experienced significantly less brain volume decrease after WBRT than patients with a poor prognosis (RPA class 3) (P = 0.001). There was no significant correlation between delivered radiation dose and brain volume reduction rate (P = 0.147). In this retrospective study, a smaller decrease in brain volume after WBRT was an independent predictor of longer overall survival. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  12. Lung volume reduction for emphysema.

    Science.gov (United States)

    Shah, Pallav L; Herth, Felix J; van Geffen, Wouter H; Deslee, Gaetan; Slebos, Dirk-Jan

    2017-02-01

    Advanced emphysema is a lung disease in which alveolar capillary units are destroyed and supporting tissue is lost. The combined effect of reduced gas exchange and changes in airway dynamics impairs expiratory airflow and leads to progressive air trapping. Pharmacological therapies have limited effects. Surgical resection of the most destroyed sections of the lung can improve pulmonary function and exercise capacity but its benefit is tempered by significant morbidity. This issue stimulated a search for novel approaches to lung volume reduction. Alternative minimally invasive approaches using bronchoscopic techniques including valves, coils, vapour thermal ablation, and sclerosant agents have been at the forefront of these developments. Insertion of endobronchial valves in selected patients could have benefits that are comparable with lung volume reduction surgery. Endobronchial coils might have a role in the treatment of patients with emphysema with severe hyperinflation and less parenchymal destruction. Use of vapour thermal energy or a sclerosant might allow focal treatment but the unpredictability of the inflammatory response limits their current use. In this Review, we aim to summarise clinical trial evidence on lung volume reduction and provide guidance on patient selection for available therapies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. A Promise in the Treatment of Endometriosis: An Observational Cohort Study on Ovarian Endometrioma Reduction by N-Acetylcysteine

    Directory of Open Access Journals (Sweden)

    Maria Grazia Porpora

    2013-01-01

    Full Text Available Urged by the unmet medical needs in endometriosis treatment, often with undesirable side effects, and encouraged by N-acetylcysteine (NAC efficacy in an animal model of endometriosis and by the virtual absence of toxicity of this natural compound, we performed an observational cohort study on ovarian endometriosis. NAC treatment or no treatment was offered to 92 consecutive Italian women referred to our university hospital with ultrasound confirmed diagnosis of ovarian endometriosis and scheduled to undergo laparoscopy 3 months later. According to patients acceptance or refusal, NAC-treated and untreated groups finally comprised 73 and 72 endometriomas, respectively. After 3 months, within NAC-treated patients cyst mean diameter was slightly reduced (-1.5 mm versus a significant increase (+6.6 mm in untreated patients (P=0.001. Particularly, during NAC treatment, more cysts reduced and fewer cysts increased their size. Our results are better than those reported after hormonal treatments. Twenty-four NAC-treated patients—versus 1 within controls—cancelled scheduled laparoscopy due to cysts decrease/disappearance and/or relevant pain reduction (21 cases or pregnancy (1 case. Eight pregnancies occurred in NAC-treated patients and 6 in untreated patients. We can conclude that NAC actually represents a simple effective treatment for endometriosis, without side effects, and a suitable approach for women desiring a pregnancy.

  14. Reduction of salt content of fish sauce by ethanol treatment.

    Science.gov (United States)

    Liu, Yu; Xu, Ying; He, Xiaoxia; Wang, Dongfeng; Hu, Shiwei; Li, Shijie; Jiang, Wei

    2017-08-01

    Fish sauce is a traditional condiment in Southeast Asia, normally containing high concentration of salt. The solubility of salt is lower in ethanol than in water. In the present study, fish sauce was desalted by ethanol treatment (including the processes of ethanol addition, mixing, standing and rotary evaporation). The salt concentration of fish sauce decreased significantly from 29.72 to 19.72 g/100 mL when the treated ethanol concentration was 21% (v/v). The addition of more than 12% (v/v) of ethanol significantly reduced dry weight, total soluble nitrogen content and amino acids nitrogen content. Besides, the quality of fish sauce remained first grade if no more than 21% (v/v) of ethanol was used. Furthermore, sensory analyses showed that ethanol treatment significantly reduced the taste of salty and the odor of ammonia. This study demonstrates that ethanol treatment is a potential way to decrease salt content in fish sauce, which meanwhile limits the losses of nutritional and sensorial values within an acceptable range.

  15. Improvement of mutation rate and reduction of somatic effects by double treatment of chemical mutagens in barley

    International Nuclear Information System (INIS)

    Koo, B.C.; Maluszynski, M.

    1996-01-01

    Mutation techniques inducing more useful mutations and reducing somatic effects need to be improved for crop breeding. Seeds of barley varieties; Dema, Grosso were treated with two types of mutagens; 1) chemical treatment: single treatment or double treatment of two mutagens (N-nitroso-N-methylurea ; MNH, Sodium Azide; NaN 3 ) 2) gamma ray irradiation treatment. After treatment, half of seeds were used for germination test and half of seeds were sown to the field. With the higher dose of mutagen both chemical and gamma ray were plants treated, the higher rate of growth reduction rate was in M 1 seedling. In chemical treatment, germination rate of seeds, growth rate of coleoptile and root in double treatment of chemical mutagens were better than single treatments, especially in same dose. Growth inhibition rate of plant in double treatment of 1.0 mM MNH (0.5 mM MNH + 0.5 mM MNH), for example, were less than one of plants of single treatment of 1.0 mM MNH in pot and petri dish test. Growth reduction rate of culm and fertility rate in M 1 plants double treated in same dose of single treatment were also less than single one. With the higher dose of mutagen both chemical and gamma ray were plants treated, the higher frequency of chlorophyll mutants was in M 2 seedling. The rate of chlorophyll mutants in double treatment of chemical mutagens were higher than single treatment. Double treatment methods can be a improved method for induction of new good mutants, which were induced more useful mutations and reduced harmful somatic effects

  16. Cryolipolysis for reduction of excess adipose tissue.

    Science.gov (United States)

    Nelson, Andrew A; Wasserman, Daniel; Avram, Mathew M

    2009-12-01

    Controlled cold exposure has long been reported to be a cause of panniculitis in cases such as popsicle panniculitis. Cryolipolysis is a new technology that uses cold exposure, or energy extraction, to result in localized panniculitis and modulation of fat. Presently, the Zeltiq cryolipolysis device is FDA cleared for skin cooling, as well as various other indications, but not for lipolysis. There is, however, a pending premarket notification for noninvasive fat layer reduction. Initial animal and human studies have demonstrated significant reductions in the superficial fat layer thickness, ranging from 20% to 80%, following a single cryolipolysis treatment. The decrease in fat thickness occurs gradually over the first 3 months following treatment, and is most pronounced in patients with limited, discrete fat bulges. Erythema of the skin, bruising, and temporary numbness at the treatment site are commonly observed following treatment with the device, though these effects largely resolve in approximately 1 week. To date, there have been no reports of scarring, ulceration, or alterations in blood lipid or liver function profiles. Cryolipolysis is a new, noninvasive treatment option that may be of benefit in the treatment of excess adipose tissue.

  17. Significance of iron reduction for the therapy of chronic hepatitis C

    Directory of Open Access Journals (Sweden)

    Nožić Darko

    2005-01-01

    Full Text Available Background. It has been established that many patients with chronic hepatitis C have elevated serum iron, feritin levels and iron deposits in the liver. Therefore, the liver damage due to hepatitis C virus may be aggravated with iron overload. In many studies higher levels of iron in the blood and the liver were connected with the decreased response to interferon-alfa therapy for chronic viral hepatitis C. Recent introduction of pegylated interferons plus ribavirin has improved the therapeutic response, so it is now possible to cure more than 50% of the patients. Case report. Three patients with chronic hepatitis C and iron overload were presented. Iron reduction therapy using phlebotomy or eritrocytapheresis with plasmapheresis was done at different times in regard to specific antiviral therapy or as a sole therapy. Conclusion. It has been shown that iron reduction, sole or combined with antiviral therapy, led to the deacreased aminotransferase serum activity and might have slow down the evolution of chronic hepatitis C viral infection.

  18. A New Surgical Approach for the Treatment of Conjunctivochalasis: Reduction of the Conjunctival Fold with Bipolar Electrocautery Forceps

    Science.gov (United States)

    Arenas, Eduardo; Muñoz, Diana

    2016-01-01

    Aim. To report a new surgical technique for the treatment of conjunctivochalasis. Methods. A new surgical technique in which specially designed bipolar electrocautery forceps facilitate the complete reduction of the conjunctival folds without creating lesions near the corneoscleral limbus was designed. A retrospective revision of the medical records of patients treated with this technique between the years 2011 and 2013 was made, and eighteen eyes of sixteen patients with conjunctivochalasis treated with this new technique were included. Results. All the eyes treated showed a significant improvement with no evidence of scar lesions after a mean follow-up time of 10 months. Conclusions. The surgical technique presented here could be a good alternative for the management of conjunctivochalasis. PMID:27200408

  19. Efficacy Evaluation for the Treatment of Subcapital Femoral Neck Fracture in Young Adults by Capsulotomy Reduction and Closed Reduction

    Directory of Open Access Journals (Sweden)

    Cong Liu

    2015-01-01

    Full Text Available Background: Subcapital femoral neck fracture in young adults has many complications, and the incidence is increasing year-by-year. The selection of the proper operation method to avoid them is an ambiguous matter. This study aimed to evaluate the treatment effect of subcapital femoral neck fracture by the capsulotomy and internal fixation with iliac bone grafting or closed reduction and internal fixation in young adults. Methods: From March 2003 to February 2010, 65 young patients with subcapital femoral neck fractures were treated, including 39 males and 26 females with average age of 34.5 years (range, 19-50 years; 29 cases of the left side and 36 cases of the right side. They were randomly divided into Group A with 34 cases treated by closed reduction and internal fixation and Group B with 31 cases treated by the capsulotomy and internal fixation with iliac bone grafting. The two groups had no significant differences in sex, age, body mass index and preoperative Harris Hip Score. The observation criteria involved the length of the incision, blood loss, operation time, nonunion rate, avascular necrosis of the femoral head (ANFH rate and Harris Hip Score. Results: Four of 65 patients were lost follow-up, and the follow-up rate was 93.8%, the average follow-up time was 38.7 months (range, 33-47 months. In Group A, the incision length was 5.1 ± 2.2 cm, blood loss was 84.0 ± 13.2 ml, and operation time was 52.9 ± 10.2 min. In Group B, the incision length was 15.4 ± 4.6 cm, blood loss was 396.0 ± 21.3 ml, and operation time was 116.5 ± 15.3 min. Nonunion occurred in 8 patients (25.2% in Group A and 1 patient (3.3% in Group B. ANFH occurred in 9 patients (29.1% in Group A and 2 patients (6.7% in Group B. Postoperative Harris Hip Score was 89.0 ± 5.6 in Group A and 95.0 ± 4.5 in Group B. The above index of two groups was considered statistically significant (P < 0.05. Conclusions: Capsulotomy and internal fixation with iliac bone grafting can

  20. Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction

    OpenAIRE

    Choi, Kang-Young; Yang, Jung-Dug; Chung, Ho-Yun; Cho, Byung-Chae

    2012-01-01

    In the treatment of mandibular condyle fracture, conservative treatment using closed reduction or surgical treatment using open reduction can be used. Management of mandibular condylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma. For each type of condylar fracture,the treatment method must be chosen taking into consideration the presence of teeth, fracture height, patient'sadaptation, patient's masticatory system, disturbance of occlusal function, and de...

  1. Anaerobic baffled reactor coupled with chemical precipitation for treatment and toxicity reduction of industrial wastewater.

    Science.gov (United States)

    Laohaprapanona, Sawanya; Marquesa, Marcia; Hogland, William

    2014-01-01

    This study describes the reduction of soluble chemical oxygen demand (CODs) and the removal of dissolved organic carbon (DOC), formaldehyde (FA) and nitrogen from highly polluted wastewater generated during cleaning procedures in wood floor manufacturing using a laboratory-scale biological anaerobic baffled reactor followed by chemical precipitation using MgCI2 .6H20 + Na2HPO4. By increasing the hydraulic retention time from 2.5 to 3.7 and 5 days, the reduction rates of FA, DOC and CODs of nearly 100%, 90% and 83%, respectively, were achieved. When the Mg:N:P molar ratio in the chemical treatment was changed from 1:1:1 to 1.3:1:1.3 at pH 8, the NH4+ removal rate increased from 80% to 98%. Biologically and chemically treated wastewater had no toxic effects on Vibrio fischeri and Artemia salina whereas chemically treated wastewater inhibited germination of Lactuca sativa owing to a high salt content. Regardless of the high conductivity of the treated wastewater, combined biological and chemical treatment was found to be effective for the removal of the organic load and nitrogen, and to be simple to operate and to maintain. A combined process such as that investigated could be useful for on-site treatment of low volumes of highly polluted wastewater generated by the wood floor and wood furniture industries, for which there is no suitable on-site treatment option available today.

  2. Predicting Structure-Function Relations and Survival following Surgical and Bronchoscopic Lung Volume Reduction Treatment of Emphysema.

    Science.gov (United States)

    Mondoñedo, Jarred R; Suki, Béla

    2017-02-01

    Lung volume reduction surgery (LVRS) and bronchoscopic lung volume reduction (bLVR) are palliative treatments aimed at reducing hyperinflation in advanced emphysema. Previous work has evaluated functional improvements and survival advantage for these techniques, although their effects on the micromechanical environment in the lung have yet to be determined. Here, we introduce a computational model to simulate a force-based destruction of elastic networks representing emphysema progression, which we use to track the response to lung volume reduction via LVRS and bLVR. We find that (1) LVRS efficacy can be predicted based on pre-surgical network structure; (2) macroscopic functional improvements following bLVR are related to microscopic changes in mechanical force heterogeneity; and (3) both techniques improve aspects of survival and quality of life influenced by lung compliance, albeit while accelerating disease progression. Our model predictions yield unique insights into the microscopic origins underlying emphysema progression before and after lung volume reduction.

  3. A toxicity reduction evaluation for an oily waste treatment plant exhibiting episodic effluent toxicity.

    Science.gov (United States)

    Erten-Unal, M; Gelderloos, A B; Hughes, J S

    1998-07-30

    A Toxicity Reduction Evaluation (TRE) was conducted on the oily wastewater treatment plant (Plant) at a Naval Fuel Depot. The Plant treats ship and ballast wastes, berm water from fuel storage areas and wastes generated in the fuel reclamation plant utilizing physical/chemical treatment processes. In the first period of the project (Period I), the TRE included chemical characterization of the plant wastewaters, monitoring the final effluent for acute toxicity and a thorough evaluation of each treatment process and Plant operating procedures. Toxicity Identification Evaluation (TIE) procedures were performed as part of the overall TRE to characterize and identify possible sources of toxicity. Several difficulties were encountered because the effluent was saline, test organisms were marine species and toxicity was sporadic and unpredictable. The treatability approach utilizing enhancements, improved housekeeping, and operational changes produced substantial reductions in the acute toxicity of the final effluent. In the second period (Period II), additional acute toxicity testing and chemical characterization were performed through the Plant to assess the long-term effects of major unit process improvements for the removal of toxicity. The TIE procedures were also modified for saline wastewaters to focus on suspected class of toxicants such as surfactants. The TRE was successful in reducing acute toxicity of the final effluent through process improvements and operational modifications. The results indicated that the cause of toxicity was most likely due to combination of pollutants (matrix effect) rather than a single pollutant.

  4. Trajectories of Symptom Reduction and Engagement during Treatment for Childhood Behavior Disorders: Differences across Settings

    Science.gov (United States)

    Lindhiem, Oliver; Kolko, David J.

    2010-01-01

    In this study, we examined trajectories of symptom reduction and family engagement during the modular treatment phase of a clinical trial for early-onset disruptive behavior disorders that was applied either in community settings or a clinic. Participants (N = 139) were 6-11 year-old children with diagnoses of Oppositional Defiant Disorder (ODD)…

  5. Significant reduction in vancomycin-resistant enterococcus colonization and bacteraemia after introduction of a bleach-based cleaning-disinfection programme.

    Science.gov (United States)

    Grabsch, E A; Mahony, A A; Cameron, D R M; Martin, R D; Heland, M; Davey, P; Petty, M; Xie, S; Grayson, M L

    2012-12-01

    Vancomycin-resistant enterococcus (VRE) colonization and infection have increased at our hospital, despite adherence to standard VRE control guidelines. We implemented a multi-modal, hospital-wide improvement programme including a bleach-based cleaning-disinfection programme ('Bleach-Clean'). VRE colonization, infection and environmental contamination were compared pre and post implementation. The programme included a new product (sodium hypochlorite 1000 ppm + detergent), standardized cleaning-disinfection practices, employment of cleaning supervisors, and modified protocols to rely on alcohol-based hand hygiene and sleeveless aprons instead of long-sleeved gowns and gloves. VRE was isolated using chromogenic agar and/or routine laboratory methods. Outcomes were assessed during the 6 months pre and 12 months post implementation, including proportions (per 100 patients screened) of VRE colonization in high-risk wards (HRWs: intensive care, liver transplant, renal, haematology/oncology); proportions of environmental contamination; and episodes of VRE bacteraemia throughout the entire hospital. Significant reductions in newly recognized VRE colonizations (208/1948 patients screened vs 324/4035, a 24.8% reduction, P = 0.001) and environmental contamination (66.4% reduction, P = 0.012) were observed, but the proportion of patients colonized on admission was stable. The total burden of inpatients with VRE in the HRWs also declined (median percentage of colonized inpatients per week, 19.4% vs 17.3%, P = 0.016). Hospital-wide VRE bacteraemia declined from 14/2935 patients investigated to 5/6194 (83.1% reduction; P Clean programme was associated with marked reductions in new VRE colonizations in high-risk patients, and VRE bacteraemia across the entire hospital. These findings have important implications for VRE control in endemic healthcare settings. Copyright © 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  6. Predicting meaningful outcomes to medication and self-help treatments for binge-eating disorder in primary care: The significance of early rapid response.

    Science.gov (United States)

    Grilo, Carlos M; White, Marney A; Masheb, Robin M; Gueorguieva, Ralitza

    2015-04-01

    We examined rapid response among obese patients with binge-eating disorder (BED) in a randomized clinical trial testing antiobesity medication and self-help cognitive-behavioral therapy (shCBT), alone and in combination, in primary-care settings. One hundred four obese patients with BED were randomly assigned to 1 of 4 treatments: sibutramine, placebo, shCBT + sibutramine, or shCBT + placebo. Treatments were delivered by generalist primary-care physicians and the medications were given double-blind. Independent assessments were performed by trained and monitored doctoral research clinicians monthly throughout treatment, posttreatment (4 months), and at 6- and 12-month follow-ups (i.e., 16 months after randomization). Rapid response, defined as ≥65% reduction in binge eating by the fourth treatment week, was used to predict outcomes. Rapid response characterized 47% of patients, was unrelated to demographic and baseline clinical characteristics, and was significantly associated, prospectively, with remission from binge eating at posttreatment (51% vs. 9% for nonrapid responders), 6-month (53% vs. 23.6%), and 12-month (46.9% vs. 23.6%) follow-ups. Mixed-effects model analyses revealed that rapid response was significantly associated with greater decreases in binge-eating or eating-disorder psychopathology, depression, and percent weight loss. Our findings, based on a diverse obese patient group receiving medication and shCBT for BED in primary-care settings, indicate that patients who have a rapid response achieve good clinical outcomes through 12-month follow-ups after ending treatment. Rapid response represents a strong prognostic indicator of clinically meaningful outcomes, even in low-intensity medication and self-help interventions. Rapid response has important clinical implications for stepped-care treatment models for BED. clinicaltrials.gov: NCT00537810 (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  7. Significant Improvement Selected Mediators of Inflammation in Phenotypes of Women with PCOS after Reduction and Low GI Diet

    Directory of Open Access Journals (Sweden)

    Małgorzata Szczuko

    2017-01-01

    Full Text Available Many researchers suggest an increased risk of atherosclerosis in women with polycystic ovary syndrome. In the available literature, there are no studies on the mediators of inflammation in women with PCOS, especially after dietary intervention. Eicosanoids (HETE and HODE were compared between the biochemical phenotypes of women with PCOS (normal and high androgens and after the 3-month reduction diet. Eicosanoid profiles (9(S-HODE, 13(S-HODE, 5(S-HETE, 12(S-HETE, 15(S-HETE, 5(S-oxoETE, 16(R-HETE, 16(S-HETE and 5(S, 6(R-lipoxin A4, 5(S, 6(R, 15(R-lipoxin A4 were extracted from 0.5 ml of plasma using solid-phase extraction RP-18 SPE columns. The HPLC separations were performed on a 1260 liquid chromatograph. No significant differences were found in the concentration of analysed eicosanoids in phenotypes of women with PCOS. These women, however, have significantly lower concentration of inflammatory mediators than potentially healthy women from the control group. Dietary intervention leads to a significant (p<0.01 increase in the synthesis of proinflammatory mediators, reaching similar levels as in the control group. The development of inflammatory reaction in both phenotypes of women with PCOS is similar. The pathways for synthesis of proinflammatory mediators in women with PCOS are dormant, but can be stimulated through a reduction diet. Three-month period of lifestyle change may be too short to stimulate the pathways inhibiting inflammatory process.

  8. Evaluation of a cut-to-length system implementing fuel reduction treatments on the Coconino National Forest in Arizona

    Science.gov (United States)

    John Klepac; Bob Rummer; Jason Thompson

    2006-01-01

    A Cut-to-Length (CTL) system was evaluated for production and cost while implementing fuel reduction treatments in two stands on the Coconino National Forest in Arizona. Product recovery and fire behavior within each stand after treatment were also examined. Only trees less than 16 inches diameter breast height (DBH) were harvested. After logs were forwarded to a...

  9. Decision support tools to improve the effectiveness of hazardous fuel reduction treatments in the New Jersey Pine Barrens

    Science.gov (United States)

    Kenneth L. Clark; Nicholas Skowronski; John Hom; Matthew Duveneck; Yude Pan; Stephen Van Tuyl; Jason Cole; Matthew Patterson; Stephen Maurer

    2009-01-01

    Our goal is to assist the New Jersey Forest Fire Service and federal wildland fire managers in the New Jersey Pine Barrens evaluate where and when to conduct hazardous fuel reduction treatments. We used remotely sensed LIDAR (Light Detection and Ranging System) data and field sampling to estimate fuel loads and consumption during prescribed fire treatments. This...

  10. Posterior Reduction and Monosegmental Fusion with Intraoperative Three-dimensional Navigation System in the Treatment of High-grade Developmental Spondylolisthesis

    Directory of Open Access Journals (Sweden)

    Wei Tian

    2015-01-01

    Full Text Available Background: The treatment of high-grade developmental spondylolisthesis (HGDS is still challenging and controversial. In this study, we investigated the efficacy of the posterior reduction and monosegmental fusion assisted by intraoperative three-dimensional (3D navigation system in managing the HGDS. Methods: Thirteen consecutive HGDS patients were treated with posterior decompression, reduction and monosegmental fusion of L5/S1, assisted by intraoperative 3D navigation system. The clinical and radiographic outcomes were evaluated, with a minimum follow-up of 2 years. The differences between the pre- and post-operative measures were statistically analyzed using a two-tailed, paired t-test. Results: At most recent follow-up, 12 patients were pain-free. Only 1 patient had moderate pain. There were no permanent neurological complications or pseudarthrosis. The magnetic resonance imaging showed that there was no obvious disc degeneration in the adjacent segment. All radiographic parameters were improved. Mean slippage improved from 63.2% before surgery to 12.2% after surgery and 11.0% at latest follow-up. Lumbar lordosis changed from preoperative 34.9 ± 13.3° to postoperative 50.4 ± 9.9°, and 49.3 ± 7.8° at last follow-up. L5 incidence improved from 71.0 ± 11.3° to 54.0 ± 11.9° and did not change significantly at the last follow-up 53.1 ± 15.4°. While pelvic incidence remained unchanged, sacral slip significantly decreased from preoperative 32.7 ± 12.5° to postoperative 42.6 ± 9.8°and remained constant to the last follow-up 44.4 ± 6.9°. Pelvic tilt significantly decreased from 38.4 ± 12.5° to 30.9 ± 8.1° and remained unchanged at the last follow-up 28.1 ± 11.2°. Conclusions: Posterior reduction and monosegmental fusion of L5/S1 assisted by intraoperative 3D navigation are an effective technique for managing high-grade dysplastic spondylolisthesis. A complete reduction of local deformity and excellent correction of overall

  11. Open Reduction in Pediatric Condylar Fracture.

    Science.gov (United States)

    Barbosa, Alexandre Agostini; Mariano, Ronaldo Célio

    2017-05-01

    Facial fractures in children are rare. Lack of pneumatization, fat pockets, mixed dentition, contribute to the elasticity and bone stability. When mandibular fractures occur in children, most often involve the condyle by indirect trauma. Such fractures are the center of discussion on the form of treatment if this should be performed conservatively, or held the reduction and fixation of the fracture with surgical exposure of the fragments. In condylar fractures in children, in most patients, the proposed treatment is closed reduction. Treatment with open reduction and fixation has its specific indications. In this case, the authors report a patient cycling accident victim, with cut-contusion injury in ment with limited mouth opening and left condylar fracture with medial rotation. The treatment was the reduction and fixation of fragments by open process.

  12. Relative significance of surgery and radiotherapy in treatment of brain metastases of lung cancer

    International Nuclear Information System (INIS)

    Yamashita, Junkoh; Ohtsuka, Sinichi; Yamasaki, Toshiki; Gi, Hidefuku; Ha, Young-Soo; Handa, Hajime

    1983-01-01

    One hundred and sixteen cases of brain metastases of lung cancer were retrospectively analysed with special reference to the relative significance of surgery and radiotherapy. The median survival time from diagnosis of brain metastases was 1.2 months in 27 cases without treatment, 2.5 months in 51 cases treated by surgery alone, 4.2 months in 31 cases treated by radiotherapy alone and 6.5 months in 7 cases treated by surgery and radiotherapy. The survival rate in patients treated by radiotherapy was significantly better than in those not treated by radiotherapy. However, the effect of surgery was not significant in prolongation of survival time. On the other hand, the rate of improvement in neurological symptoms assessed at one month after the initiation of treatment was 80.9% in 47 cases treated by surgery and 19.4 % in 31 cases treated by radiotherapy. The result suggested that surgery is superior to radiotherapy in alleviating neurological symptoms. It is important to understand the nature of effect of each treatment. A better result will be anticipated by proper selection or combination of these treatments. (author)

  13. Efficacy of open reduction and internal fixation with a miniplate and hollow screw in the treatment of Lisfranc injury

    Directory of Open Access Journals (Sweden)

    Li Baoliang

    2015-07-01

    Full Text Available Purpose: To investigate efficacy of open reduction and internal fixation with the miniplate and hollow screw in the treatment of Lisfranc injury. Methods: Ten cases of Lisfranc injury treated by open reduction, miniplate and hollow screw in our hospital were retrospectively analyzed. There were 6 males and 4 females with age ranging from 25 to 45 years (mean 32 years. Among them, one case was classified as Type A, six Type B and three Type C. Injury mechanism included road traffic accidents (3 cases, fall from height (5 cases and hit by heavy object (2 cases. All injuries were closed without cerebral trauma or other complicated injuries. The time interval between injury and operation was 6e10 days (average 6.6 days. Postoperatively, the foot function was assessed using Visual Analogue Scales (VAS and American Orthopaedic Foot and Ankle Society (AOFAS Scales. Healing time and complications were observed. Results: All patients were followed up for 18e24 months (average 20 months. Anatomic reduction was achieved in all patients on images. There was statistical significance between preoperative score (7.89 ± 0.34 and score at postoperative 8 weeks (0.67 ± 0.13. According to the AOFAS score, 5 cases were defined as excellent, 3 cases as good and 2 cases as fair. During follow-up, there was no wound infection or complications except for osteoarthritis in 2 cases. Healing time ranged from 3 to 6 months with an average of 3.6 months. Conclusion: Anatomical reduction of Lisfranc injury can be achieved by open reduction and internal fixation with the miniplate and hollow screw. Normal structure of Lisfranc joint is regained to a great extent; injured ligaments were also repaired. Therefore, this method offers excellent curative effect and can avoid postoperative complications and improve the patients' quality of life.

  14. Mindfulness-based stress reduction for the treatment of irritable bowel syndrome symptoms: a randomized wait-list controlled trial.

    Science.gov (United States)

    Zernicke, Kristin A; Campbell, Tavis S; Blustein, Philip K; Fung, Tak S; Johnson, Jillian A; Bacon, Simon L; Carlson, Linda E

    2013-09-01

    Irritable bowel syndrome (IBS) is a functional disorder of the lower gastrointestinal (GI) tract affected by stress, which may benefit from a biopsychosocial treatment approach such as mindfulness-based stress reduction (MBSR). A treatment as usual (TAU) wait-list controlled trial was conducted in Calgary, Canada to investigate the impact of MBSR on IBS symptoms. It was hypothesized that MBSR patients would experience greater reduction in overall IBS symptom severity and self-reported symptoms of stress relative to control patients. Ninety patients diagnosed with IBS using the Rome III criteria were randomized to either an immediate MBSR program (n = 43) or to wait for the next available program (n = 47). Patients completed IBS symptom severity, stress, mood, quality of life (QOL), and spirituality scales pre- and post-intervention or waiting period and at 6-month follow-up. Intent-to-treat linear mixed model analyses for repeated measures were conducted, followed by completers analyses. While both groups exhibited a decrease in IBS symptom severity scores over time, the improvement in the MBSR group was greater than the controls and was clinically meaningful, with symptom severity decreasing from constantly to occasionally present. Pre- to post-intervention dropout rates of 44 and 23 % for the MBSR and control groups, respectively, were observed. At 6-month follow-up, the MBSR group maintained a clinically meaningful improvement in overall IBS symptoms compared to the wait-list group, who also improved marginally, resulting in no statistically significant differences between groups at follow-up. Improvements in overall mood, QOL, and spirituality were observed for both groups over time. The results of this trial provide preliminary evidence for the feasibility and efficacy of a mindfulness intervention for the reduction of IBS symptom severity and symptoms of stress and the maintenance of these improvements at 6 months post-intervention. Attention and self

  15. Effect of decreased hot-rolling reduction treatment on fracture toughness of low-alloy structural steels

    Science.gov (United States)

    Tomita, Yoshiyuki

    1990-09-01

    Commercial low-alloy structural steels, 0.45 pct C (AISI 1045 grade), 0.40 pct C-Cr-Mo (AISI 4140 grade), and 0.40 pct C-Ni-Cr-Mo (AISI 4340 grade), have been studied to determine the effect of the decreased hot-rolling reduction treatment (DHRRT) from 98 to 80 pct on fracture toughness of quenched and highly tempered low-alloy structural steels. The significant conclusions are as follows: (1) the sulfide inclusions were modified through the DHRRT from a stringer (mean aspect ratio: 16.5 to 17.6) to an ellipse (mean aspect ratio: 3.8 to 4.5), independent of the steels studied; (2) the DHRRT significantly improved J Ic in the long-transverse and shorttransverse orientations, independent of the steels studied; and (3) the shelf energy in the Charpy V-notch impact test is also greatly improved by the DHRRT, independent of testing orientation and steels studied; however, (4) the ductile-to-brittle transition temperature was only slightly affected by the DHRRT. The beneficial effect on the J Ic is briefly discussed in terms of a crack extension model involving the formation of voids at the inclusion sites and their growth and eventual linking up through the rupture of the intervening ligaments by local shear.

  16. Radiocesium activity reduction in mushrooms by heat pressure treatment

    International Nuclear Information System (INIS)

    Dvorak, P.; Dolezalova, J.; Benova, K.; Ohera, M.

    2008-01-01

    The total activity of radiocesium is decreasing in forest ecosystems more slowly than it was expected. Hence it is topical to find technology that reduces the radiocesium content in foodstuffs. Some kinds of mushrooms including consumable ones cumulate significant amount of radiocesium (Cs-137) from the environment. The samples of edible boletus (Xerosomus badius) always originate from the same location, i.e. the Bohemian-Moravian Uplands, where the contamination of Cs-137 has been monitored for a long time using a laboratory semiconductor gamma-spectrometry. To reduce the radiocesium content in the wet samples a pressure cooker was applied with the boiling time of 15 minutes. After cooling juice was separated from the samples. This technology offers 65 percent activity reduction on average in boiled mushrooms. (authors)

  17. Binomial Distribution Sample Confidence Intervals Estimation 7. Absolute Risk Reduction and ARR-like Expressions

    Directory of Open Access Journals (Sweden)

    Andrei ACHIMAŞ CADARIU

    2004-08-01

    Full Text Available Assessments of a controlled clinical trial suppose to interpret some key parameters as the controlled event rate, experimental event date, relative risk, absolute risk reduction, relative risk reduction, number needed to treat when the effect of the treatment are dichotomous variables. Defined as the difference in the event rate between treatment and control groups, the absolute risk reduction is the parameter that allowed computing the number needed to treat. The absolute risk reduction is compute when the experimental treatment reduces the risk for an undesirable outcome/event. In medical literature when the absolute risk reduction is report with its confidence intervals, the method used is the asymptotic one, even if it is well know that may be inadequate. The aim of this paper is to introduce and assess nine methods of computing confidence intervals for absolute risk reduction and absolute risk reduction – like function.Computer implementations of the methods use the PHP language. Methods comparison uses the experimental errors, the standard deviations, and the deviation relative to the imposed significance level for specified sample sizes. Six methods of computing confidence intervals for absolute risk reduction and absolute risk reduction-like functions were assessed using random binomial variables and random sample sizes.The experiments shows that the ADAC, and ADAC1 methods obtains the best overall performance of computing confidence intervals for absolute risk reduction.

  18. Significant improvement of bone mineral density by denosumab treatment in Japanese osteoporotic patients following breast cancer treatment

    Directory of Open Access Journals (Sweden)

    Nakamura Y

    2018-03-01

    Full Text Available Yukio Nakamura,1,2 Mikio Kamimura,3 Akio Morikawa,4 Akira Taguchi,5 Takako Suzuki,1 Hiroyuki Kato1 1Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, 2Department of Orthopedic Surgery, Showa-Inan General Hospital, Komagane, 3Center for Osteoporosis and Spinal Disorders, Kamimura Orthopaedic Clinic, Matsumoto, 4Department of Surgery, Showa-Inan General Hospital, Komagane, 5Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, Shiojiri, Japan Background: The aim of this study was to evaluate the effects of denosumab in patients with osteoporosis (OP and non-metastatic breast cancer following treatment of 1 surgery, 2 surgery and aromatase inhibitors, and 3 surgery, aromatase inhibitors, and anti-cancer agents, compared with those in primary OP patients. Patients and methods: In this retrospective 24-month study, patients were divided into the primary OP group (34 cases or OP receiving breast cancer treatment group (breast cancer group; 17 cases. We measured serum calcium, whole parathyroid hormone (PTH, 1,25OH2D3, bone alkaline phosphatase (BAP, tartrate-resistant acid phosphatase-5b (TRACP-5b, and bone mineral density (BMD of the lumbar 1–4 vertebrae (L-BMD and bilateral total hips (H-BMD for 24 months. Results: The percent changes of serum calcium in the breast cancer group were significantly lower than those in the primary OP group at 1 week, 1 and 12 months. The percent changes of whole PTH in the primary OP group were significantly lower than those in the breast cancer group at 2 and 4 months. Significant differences were found between the groups at 18 months (-34.5% in the primary OP group and -52.6% in the breast cancer group, respectively for the percent changes of BAP. Significant differences were found between the groups at 12, 18, and 24 months (-39.7% in the primary OP group and -64.0% in the breast cancer group at 24 months, respectively for the percent

  19. Towards A New Decision Support System for Design, Management and Operation of Wastewater Treatment Plants for the Reduction of Greenhouse Gases Emission

    Directory of Open Access Journals (Sweden)

    Donatella Caniani

    2015-10-01

    Full Text Available The increasing attention paid to the environment has led to a reduction in the emissions from wastewater treatment plants (WWTPs. Moreover, the increasing interest in the greenhouse gas (GHG emissions from WWTPs suggests that we reconsider the traditional tools used for designing and managing WWTPs. Indeed, nitrous oxide, carbon dioxide and methane can be emitted from wastewater treatment, significantly contributing to the greenhouse gas (GHG footprint. The reduction of energy consumption as well as GHG emission are of particular concern for large WWTPs which treat the majority of wastewater in terms of both volume and pollution load. Nowadays, there is an increasing need to develop new tools that include additional performance indicators related to GHG emissions and energy consumption as well as traditional effluent quality parameters. Energy consumption, in fact, can be considered as an indirect source of GHGs. This paper presents the development of an ongoing research project aiming at setting-up an innovative mathematical model platform for the design and management of WWTPs. The final goal of the project by means of this platform is to minimize the environmental impact of WWTPs through their optimization in terms of energy consumptions and emissions, which can be regarded as discharged pollutants, sludge and GHGs.

  20. Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction

    Science.gov (United States)

    Yang, Jung-Dug; Chung, Ho-Yun; Cho, Byung-Chae

    2012-01-01

    In the treatment of mandibular condyle fracture, conservative treatment using closed reduction or surgical treatment using open reduction can be used. Management of mandibular condylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma. For each type of condylar fracture,the treatment method must be chosen taking into consideration the presence of teeth, fracture height, patient'sadaptation, patient's masticatory system, disturbance of occlusal function, and deviation of the mandible. In the past, closed reduction with concomitant active physical therapy conducted after intermaxillary fixation during the recovery period had been mainly used, but in recent years, open treatment of condylar fractures with rigid internal fixation has become more common. The objective of this review was to evaluate the main variables that determine the choice of an open or closed method for treatment of condylar fractures, identifying their indications, advantages, and disadvantages, and to appraise the current evidence regarding the effectiveness of interventions that are used in the management of fractures of the mandibular condyle. PMID:22872831

  1. Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction

    Directory of Open Access Journals (Sweden)

    Kang-Young Choi

    2012-07-01

    Full Text Available In the treatment of mandibular condyle fracture, conservative treatment using closed reduction or surgical treatment using open reduction can be used. Management of mandibular condylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma. For each type of condylar fracture,the treatment method must be chosen taking into consideration the presence of teeth, fracture height, patient'sadaptation, patient's masticatory system, disturbance of occlusal function, and deviation of the mandible. In the past, closed reduction with concomitant active physical therapy conducted after intermaxillary fixation during the recovery period had been mainly used, but in recent years, open treatment of condylar fractures with rigid internal fixation has become more common. The objective of this review was to evaluate the main variables that determine the choice of an open or closed method for treatment of condylar fractures, identifying their indications, advantages, and disadvantages, and to appraise the current evidence regarding the effectiveness of interventions that are used in the management of fractures of the mandibular condyle.

  2. Clinical and histopathological study of the TriPollar home-use device for body treatments.

    Science.gov (United States)

    Boisnic, Sylvie; Branchet, Marie-Christine; Birnstiel, Oliver; Beilin, Ghislaine

    2010-01-01

    Professional non invasive treatments for body contouring based on radiofrequency (RF) became popular in aesthetic clinics due to proven efficacy and safety. A new home-use RF device for body treatments has been developed based on TriPollar technology. Our objective was to evaluate the TriPollar home-use device for circumference reduction, cellulite improvement and skin tightening using objective and subjective methods. An ex-vivo human skin model was used for histological and biochemical evaluations of the TriPollar clinical effect. Additionally, twenty four subjects used the new device on the abdomen and thigh areas and the circumference reduction was measured. Ex-vivo models indicated a significant increase of 82% in hypodermal glycerol release. Histology revealed a 34% alteration in adipocyte appearance. Collagen synthesis increased by 31% following TriPollar treatment. A significant average reduction of 2.4 cm was measured on the treated thighs. On the control thighs a lesser, non-significant reduction was found. Average abdominal laxity was reduced from 1.4 at baseline to 0.8 following treatments. A certain reduction was measured in the abdomen circumferences, although it was not significant. The reported results demonstrate the safety and efficacy of the new TriPollar home-use device for body contouring and skin tightening. Treatment may lead to discrete circumference reduction and moderate laxity improvement.

  3. Changes in neurotic personality profile associated with reduction of suicidal ideation in patients who underwent psychotherapy in the day hospital for the treatment of neurotic and behavioral disorders.

    Science.gov (United States)

    Rodziński, Paweł; Rutkowski, Krzysztof; Sobański, Jerzy A; Mielimąka, Michał; Murzyn, Agnieszka; Cyranka, Katarzyna; Dembińska, Edyta; Grządziel, Karolina; Klasa, Katarzyna; Müldner-Nieckowski, Łukasz; Smiatek-Mazgaj, Bogna

    2015-01-01

    Analysis of associations between changes in neurotic personality profile and reductionof suicidal ideation (SI) - or lack of such reduction - defined as its elimination or reduction of its intensity in patients who underwent a course of intensive psychotherapy conducted in integrative approach with predominance of psychodynamic approach. Symptom Checklist KO"O", Neurotic Personality Questionnaire KON-2006 and Life Inventory completed by 461 women and 219 men treated due to neurotic, behavioral or personality disorders in a day hospital between 2005-2013. During the qualification for the therapy 134 women and 80 men reported SI, of whom 84.3% and 77.5% respectively improved. Patients who improved in terms of SI obtained significantly greater reduction of global neurotic personality disintegration (neuroticism) than others (ppsychotherapy as a treatment method that leads to comprehensive improvement encompassing reduction of neurotic personality disorders (neuroticism) and of majority of neurotic personality traits, as well as SI reduction. The revealed associations weigh in favor of hypothesis on neuroticism as SI predisposing factor in patients with neurotic, behavioral and personality disorders.

  4. Blood pressure reduction, persistence and costs in the evaluation of antihypertensive drug treatment – a review

    Directory of Open Access Journals (Sweden)

    Hasford Joerg

    2009-03-01

    Full Text Available Abstract Background Blood pressure lowering drugs are usually evaluated in short term trials determining the absolute blood pressure reduction during trough and the duration of the antihypertensive effect after single or multiple dosing. A lack of persistence with treatment has however been shown to be linked to a worse cardiovascular prognosis. This review explores the blood pressure reduction and persistence with treatment of antihypertensive drugs and the cost consequences of poor persistence with pharmaceutical interventions in arterial hypertension. Methods We have searched the literature for data on blood pressure lowering effects of different antihypertensive drug classes and agents, on persistence with treatment, and on related costs. Persistence was measured as patients' medication possession rate. Results are presented in the form of a systematic review. Results Angiotensin II receptor blocker (ARBs have a competitive blood pressure lowering efficacy compared with ACE-inhibitors (ACEi and calcium channel blockers (CCBs, beta-blockers (BBs and diuretics. 8 studies describing the persistence with treatment were identified. Patients were more persistent on ARBs than on ACEi and CCBs, BBs and diuretics. Thus the product of blood pressure lowering and persistence was higher on ARBs than on any other drug class. Although the price per tablet of more recently developed drugs (ACEi, ARBs is higher than that of older ones (diuretics and BBs, the newer drugs result in a more favourable cost to effect ratio when direct drug costs and indirect costs are also considered. Conclusion To evaluate drugs for the treatment of hypertension several key variables including the blood pressure lowering effect, side effects, compliance/persistence with treatment, as well as drug costs and direct and indirect costs of medical care have to be considered. ARBs, while nominally more expensive when drug costs are considered only, provide substantial cost savings

  5. Odour reduction strategies for biosolids produced from a Western Australian wastewater treatment plant: results from Phase I laboratory trials.

    Science.gov (United States)

    Gruchlik, Yolanta; Heitz, Anna; Joll, Cynthia; Driessen, Hanna; Fouché, Lise; Penney, Nancy; Charrois, Jeffrey W A

    2013-01-01

    This study investigated sources of odours from biosolids produced from a Western Australian wastewater treatment plant and examined possible strategies for odour reduction, specifically chemical additions and reduction of centrifuge speed on a laboratory scale. To identify the odorous compounds and assess the effectiveness of the odour reduction measures trialled in this study, headspace solid-phase microextraction gas chromatography-mass spectrometry (HS SPME-GC-MS) methods were developed. The target odour compounds included volatile sulphur compounds (e.g. dimethyl sulphide, dimethyl disulphide and dimethyl trisulphide) and other volatile organic compounds (e.g. toluene, ethylbenzene, styrene, p-cresol, indole and skatole). In our laboratory trials, aluminium sulphate added to anaerobically digested sludge prior to dewatering offered the best odour reduction strategy amongst the options that were investigated, resulting in approximately 40% reduction in the maximum concentration of the total volatile organic sulphur compounds, relative to control.

  6. Photocoagulation treatment for clinically significant radiation macular oedema

    Energy Technology Data Exchange (ETDEWEB)

    Kinyoun, J.L.; Zamber, R.W.; Lawrence, B.S.; Barlow, W.E.; Arnold, A.M. [Washington Univ., Seattle, WA (United States)

    1995-02-01

    Macular oedema is a leading cause of vision loss in patients with radiation retinopathy. In an effort to find an effective treatment for this vision threatening complication, 12 eyes (eight patients) were treated with photocoagulation for clinically significant radiation macular oedema (CSRMO) defined as central macular thickening, exudates threatening the macular centre, or one disc area of thickening in the macula. Median visual acuity improved from 20/100 pre-operatively to 20/90 at the initial post-operative examination (mean follow up 5 months) and to 20/75 at the final post-operative examination (mean follow up 39 months). At the final post-operative examination, visual acuity had improved in eight (67%) eyes and six (50%) eyes had complete resolution of the CSRMO; two (17%) other eyes had improved anatomically in that fewer CSRMO criteria were present. These results suggest that macular photocoagulation is effective in decreasing macular oedema and improving vision in eyes with CSRMO. (author).

  7. Photocoagulation treatment for clinically significant radiation macular oedema

    International Nuclear Information System (INIS)

    Kinyoun, J.L.; Zamber, R.W.; Lawrence, B.S.; Barlow, W.E.; Arnold, A.M.

    1995-01-01

    Macular oedema is a leading cause of vision loss in patients with radiation retinopathy. In an effort to find an effective treatment for this vision threatening complication, 12 eyes (eight patients) were treated with photocoagulation for clinically significant radiation macular oedema (CSRMO) defined as central macular thickening, exudates threatening the macular centre, or one disc area of thickening in the macula. Median visual acuity improved from 20/100 pre-operatively to 20/90 at the initial post-operative examination (mean follow up 5 months) and to 20/75 at the final post-operative examination (mean follow up 39 months). At the final post-operative examination, visual acuity had improved in eight (67%) eyes and six (50%) eyes had complete resolution of the CSRMO; two (17%) other eyes had improved anatomically in that fewer CSRMO criteria were present. These results suggest that macular photocoagulation is effective in decreasing macular oedema and improving vision in eyes with CSRMO. (author)

  8. The limited role of aquifer heterogeneity on metal reduction in an Atlantic coastal plain determined by push-pull tests

    International Nuclear Information System (INIS)

    Mailloux, Brian J.; Devlin, Stephanie; Fuller, Mark E.; Onstott, T.C.; De Flaun, Mary F.; Choi, K.-H.; Green-Blum, Maria; Swift, Donald J.P.; McCarthy, John; Dong Hailiang

    2007-01-01

    Sixty push-pull experiments were conducted to determine the factors controlling Fe(III) and Mn(IV) reduction in a well-characterized, shallow, coastal plain aquifer near Oyster, VA, USA. The five multi-level samplers each equipped with 12 ports sampled a heterogeneous portion of the aquifer from 4.4 to 8m-bgs. Each multi-level sampler (MLS) was injected with groundwater that contained NO 3 - and Br - along with: (1) just groundwater (control treatment), (2) humics, (3) lactate (conducted twice) and (4) lactate plus humics. Microbially mediated Fe(III) reduction caused the aqueous Fe Tot concentrations to increase at every depth in the lactate treatment with significant increases within 1 day even while NO 3 - was present. Little change in the Fe Tot concentrations were observed in the control and humics treatment. Humics may have acted as an electron shuttle to increase Fe(III) reduction in the lactate plus humics treatment. The amount of Mn(IV) reduction was significantly lower than that of Fe(III) reduction. Geochemical modeling indicated that gas formation, sorption on reactive surfaces, and mineral precipitation were important processes and that Fe(III) and SO 4 2- reduction were co-occurring. Conditions were favorable for the precipitation of Fe-carbonates, Fe-sulfides and Fe-silicates. In the lactate treatment protist concentrations increased then decreased and planktonic cell concentrations steadily increased, whereas no change was observed in the control treatment. Correlations of Fe(III) reduction with physical and chemical heterogeneity were weak, probably as a result of the abundance of Fe(III) bearing minerals relative to electron donor abundance and that the push-pull test sampled a representative elemental volume that encompassed the microbial diversity within the aquifer. This work indicates that stimulating metal reduction in aquifer systems is a feasible method for remediating heterogeneous subsurface sites contaminated with metals and

  9. The significance of duration and amount of sodium reduction intervention in normotensive and hypertensive individuals

    DEFF Research Database (Denmark)

    Graudal, Niels; Hubeck-Graudal, Thorbjørn; Jürgens, Gesche

    2015-01-01

    The purpose of this meta-analysis was to establish the time for achievement of maximal blood pressure (BP) efficacy of a sodium reduction (SR) intervention and the relation between the amount of SR and the BP response in individuals with hypertension and normal BP. Relevant studies were retrieved.......12, P policy of sodium reduction....

  10. Behavioral Couples Treatment for Substance Use Disorder: Secondary Effects on the Reduction of Risk for Child Abuse.

    Science.gov (United States)

    Kelley, Michelle L; Bravo, Adrian J; Braitman, Abby L; Lawless, Adrienne K; Lawrence, Hannah R

    2016-03-01

    Risk for child abuse was examined prior to and after behavioral couples treatment (BCT) among 61 couples in which one or both parents were diagnosed with substance use disorder (SUD). All couples were residing with one or more school-age children. Mothers and fathers completed pretreatment, post-intervention, and 6-month post-intervention follow-up assessments. Results of piecewise latent growth models tested whether the number of BCT sessions attended and number of days abstinent from drugs and alcohol influenced relationship satisfaction and its growth over time, and in turn if relationship satisfaction and change in relationship satisfaction influenced risk for child abuse. For both mothers and fathers, attending more BCT sessions lead to a direct increase in relationship satisfaction, which in turn led to stronger reductions in risk for child abuse. This effect was maintained from the post-intervention through the 6-month post-intervention follow-up. For fathers, number of days abstinent significantly influenced reduction in child abuse potential at post-intervention via relationship satisfaction. This indirect effect was not present for mothers. The overall benefits of BCT on mothers' and fathers' risk for child abuse suggest that BCT may have promise in reducing risk for child abuse among couples in which one or both parents have SUD. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Observation of gliding arc surface treatment

    DEFF Research Database (Denmark)

    Kusano, Yukihiro; Zhu, Jiajian; Ehn, A.

    2015-01-01

    . Water contact angle measurements indicate that the treatment uniformity improves significantly when the AC gliding arc is tilted to the polymer surface. Thickness reduction of the gas boundary layer, explaining the improvement of surface treatment, by the ultrasonic irradiation was directly observed...

  12. Association of a carboxylesterase 1 polymorphism with appetite reduction in children and adolescents with attention-deficit/hyperactivity disorder treated with methylphenidate.

    Science.gov (United States)

    Bruxel, E M; Salatino-Oliveira, A; Genro, J P; Zeni, C P; Polanczyk, G V; Chazan, R; Rohde, L A; Hutz, M H

    2013-10-01

    Carboxylesterase 1 is the enzyme involved in methylphenidate (MPH) metabolism. The aim of this study was to evaluate the association between a -75 T>G polymorphism and appetite reduction in children with attention-deficit/hyperactivity disorder (ADHD). A sample of 213 children with ADHD was investigated. The primary outcome was appetite reduction measured by the Barkley Stimulant Side Effect Rating Scale applied at baseline, at 1 and 3 months of treatment. MPH doses were augmented until no further clinical improvement or significant adverse events occurred. The G allele presented a trend for association with appetite reduction scores (P=0.05). A significant interaction between the G allele and treatment over time for appetite reduction scores was also observed (P=0.03). The G allele carriers presented a higher risk for appetite reduction worsening when compared with T allele homozygotes (odds ratio=3.47, P=0.01). The present results suggest an influence of carboxylesterase 1 -75 T>G polymorphism on the worsening of appetite reduction with MPH treatment in youths with ADHD.

  13. Cold Plasma Inactivation of Bacterial Biofilms and Reduction of Quorum Sensing Regulated Virulence Factors.

    Directory of Open Access Journals (Sweden)

    Dana Ziuzina

    Full Text Available The main objectives of this work were to investigate the effect of atmospheric cold plasma (ACP against a range of microbial biofilms commonly implicated in foodborne and healthcare associated human infections and against P. aeruginosa quorum sensing (QS-regulated virulence factors, such as pyocyanin, elastase (Las B and biofilm formation capacity post-ACP treatment. The effect of processing factors, namely treatment time and mode of plasma exposure on antimicrobial activity of ACP were also examined. Antibiofilm activity was assessed for E. coli, L. monocytogenes and S. aureus in terms of reduction of culturability and retention of metabolic activity using colony count and XTT assays, respectively. All samples were treated 'inpack' using sealed polypropylene containers with a high voltage dielectric barrier discharge ACP generated at 80 kV for 0, 60, 120 and 300 s and a post treatment storage time of 24 h. According to colony counts, ACP treatment for 60 s reduced populations of E. coli to undetectable levels, whereas 300 s was necessary to significantly reduce populations of L. monocytogenes and S. aureus biofilms. The results obtained from XTT assay indicated possible induction of viable but non culturable state of bacteria. With respect to P. aeruginosa QS-related virulence factors, the production of pyocyanin was significantly inhibited after short treatment times, but reduction of elastase was notable only after 300 s and no reduction in actual biofilm formation was achieved post-ACP treatment. Importantly, reduction of virulence factors was associated with reduction of the cytotoxic effects of the bacterial supernatant on CHO-K1 cells, regardless of mode and duration of treatment. The results of this study point to ACP technology as an effective strategy for inactivation of established biofilms and may play an important role in attenuation of virulence of pathogenic bacteria. Further investigation is warranted to propose direct evidence

  14. Significance of aerophytotherapy in complex sanatorial-climatic treatment of patients with pneumoconiosis and dust-induced bronchitis

    Energy Technology Data Exchange (ETDEWEB)

    Ostapchuk, I.F.; Dubrovina, R.M.; Akimov, Yu.A.; Kalinina, T.F.; Protsko, G.V.; Kudzi, Eh.K.; Soboleva, O.S.

    1986-09-01

    Investigation is conducted to examine effectiveness of sanatorial-climatic treatment of patients with pneumoconiosis and dust-induced bronchitis while including aerophytotherapy. Patients with both lung diseases received sanatorial, gymnastic and climatic procedures. Experimental group also received aerophytotherapy - inhalation of ester oils of lavender, anise, mint, and salvia in form of spray corresponding to their molecular composition in air. Control group did not receive aerophytotherapy. Tables present results of experiment showing changes in parameters of external breathing in patients with pneumoconiosis and in patients with dust-induced bronchitis. Tables show greater improvement in characteristics of external breathing of patients treated with inclusion of aerophytotherapy and confirm effectiveness of combined sanatorial-climatic treatment with aerophytotherapy. Patients with chronic bronchitis also experienced reduction of bronchospasm and improvement in bronchial passability. Method does not require special equipment and is economical. 9 refs.

  15. Up and down the sanitation ladder: Harmonizing the treatment and multiple-barrier perspectives on risk reduction in wastewater irrigated agriculture

    DEFF Research Database (Denmark)

    Keraita, Bernard; Drechsel, P.; Konradsen, Flemming

    2010-01-01

    This paper discusses two prominent perspectives in the debate on risk reduction in wastewater irrigation; reliance on conventional wastewater treatment and the multiple-barrier approach. The treatment perspective is based on water-quality standards for wastewater irrigation with treatment...... considered the ultimate risk reductionmeasure. The somewhat broader multiple-barrier perspective supports the use of a combination of pre-farm, on-farm and postfarm barriers, including, where possible, wastewater treatment, to meet required health targets. The discussion in this paper shows that each...

  16. A test of faith in God and treatment: the relationship of belief in God to psychiatric treatment outcomes.

    Science.gov (United States)

    Rosmarin, David H; Bigda-Peyton, Joseph S; Kertz, Sarah J; Smith, Nasya; Rauch, Scott L; Björgvinsson, Thröstur

    2013-04-25

    Belief in God is very common and tied to mental health/illness in the general population, yet its relevance to psychiatric patients has not been adequately studied. We examined relationships between belief in God and treatment outcomes, and identified mediating mechanisms. We conducted a prospective study with n=159 patients in a day-treatment program at an academic psychiatric hospital. Belief in God, treatment credibility/expectancy, emotion regulation and congregational support were assessed prior to treatment. Primary outcomes were treatment response as well as degree of reduction in depression over treatment. Secondary outcomes were improvements in psychological well-being and reduction in self-harm. Belief in God was significantly higher among treatment responders than non-responders F(1,114)=4.81, pGod and reductions in depression. No variables mediated relationships to other outcomes. Religious affiliation was also associated with treatment credibility/expectancy but not treatment outcomes. Belief in God, but not religious affiliation, was associated with better treatment outcomes. With respect to depression, this relationship was mediated by belief in the credibility of treatment and expectations for treatment gains. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. Clinical Significance of Monitoring Serum β-HCG in the Conservative Treatment of Ectopic Pregnancy

    International Nuclear Information System (INIS)

    Chen Xue

    2010-01-01

    To explore the clinical value of the serum β-HCG (human chorionic gonadotrophin) in the conservative treatment of ectopic pregnancy, the serum β-HCG levels in 118 patients with ectopic pregnancy were measured with RIA. The results showed that the serum β-HCG levels in patients with successful conservative treatment of ectopic pregnancy were all less than 200mIU/mL. The patients require a surgical treatment to reach <200mIU/mL serum β-HCG concentration were only 26.3%. There was significant difference between two groups (P<0.01). The monitoring of serum β-HCG was very useful in the diagnosis, the choice of treatment measures and the evaluation of conservative treatment effect of ectopic pregnancy. In the course of treatment of ectopic pregnancy, serum β-HCG is a good marker in determining the success or failure of treatment. (authors)

  18. Treatment of Patellar Lower Pole Fracture with Modified Titanium Cable Tension Band Plus Patellar Tibial Tunnel Steel "8" Reduction Band.

    Science.gov (United States)

    Li, Jiaming; Wang, Decheng; He, Zhiliang; Shi, Hao

    2018-01-08

    To determine the efficacy of modified titanium tension band plus patellar tendon tunnel steel 8 "reduction band" versus titanium cable tension band fixation for the treatment of patellar lower pole fracture. 58 patients with lower patella fracture were enrolled in this study, including 30 patients treated with modified titanium cable tension band plus patellar tibial tunnel wire "8" tension band internal fixation (modified group), and 28 patients with titanium cable tension band fixation. All patients were followed up for 9∼15 months with an average of 11.6 months. Knee flexion was significantly improved in the modified group than in the titanium cable tension band group (111.33 ± 13 degrees versus 98.21 ± 21.70 degrees, P = 0.004). The fracture healing time showed no significant difference. At the end of the follow-up, the improvement excellent rate was 93.33% in the modified group, and 82.14% in the titanium cable tension band group. Titanium cable tension band internal fixation loosening was found in 2 cases, including 1 case of treatment by two surgeries without loose internal fixation. The modified titanium cable tension band with "8" tension band fixation showed better efficacy for lower patella fractures than titanium cable tension band fixation.

  19. Comparison of pressure between barium reduction and air reduction of the intussusception in children

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Hwan; Park, Sang Gyu; Park, Choong Ki; Yoon, Jong Sup [Hallym University College of Medicine, Seoul (Korea, Republic of)

    1989-08-15

    There are many method of treatment of the intussusception in children, including surgery, barium reduction, air reduction, and saline enema under ultrasonographic monitoring. Among them, barium reduction and air reduction have been used widely as nonsurgical method of treatment in radiologic department. During barium reduction, the bottle filled with barium solution must not be elevated over a 3 feet from the operating table. In air reduction, diagnostic pressure is about 60 mmHg and pressure during reduction usually is maintained between 90 mmHg and 130 mmHg. The authors have studied about pressure difference of barium solution by changing height of the bottle filled with barium solution, and have compared with pressure in air reduction. The results are as follows; 1. Pressure of 20 w/v % barium solution at the 60 cm height is 44.4 mmHg, and 69.6 mmHg at the 90 cm height. 2. Pressure of 40 w/v % barium solution at the 60 cm height is 51.4 mmHg, and 80.1 mmHg at the 90 cm height. 3. Pressure of 40 w/v % barium solution at the 90cm height is much lower than the pressure maintained during air reduction, and this difference in pressure may be one of the causes of low reduction rate in barium reduction then air reduction. 4. The pressure gradient per 10 cm height is about 8.45 mmHg in 20 w/v % barium solution, about 9.21 mmHg in 30 w/v % barium solution, and about 9.72 mmHg 40 w/v % barium solution. 5. Intraluminal pressure difference between the barium reduction and the air reduction is probably of the major causes of rapid diagnosis and high reduction rate in the air reduction.

  20. Comparison of pressure between barium reduction and air reduction of the intussusception in children

    International Nuclear Information System (INIS)

    Lee, Kyung Hwan; Park, Sang Gyu; Park, Choong Ki; Yoon, Jong Sup

    1989-01-01

    There are many method of treatment of the intussusception in children, including surgery, barium reduction, air reduction, and saline enema under ultrasonographic monitoring. Among them, barium reduction and air reduction have been used widely as nonsurgical method of treatment in radiologic department. During barium reduction, the bottle filled with barium solution must not be elevated over a 3 feet from the operating table. In air reduction, diagnostic pressure is about 60 mmHg and pressure during reduction usually is maintained between 90 mmHg and 130 mmHg. The authors have studied about pressure difference of barium solution by changing height of the bottle filled with barium solution, and have compared with pressure in air reduction. The results are as follows; 1. Pressure of 20 w/v % barium solution at the 60 cm height is 44.4 mmHg, and 69.6 mmHg at the 90 cm height. 2. Pressure of 40 w/v % barium solution at the 60 cm height is 51.4 mmHg, and 80.1 mmHg at the 90 cm height. 3. Pressure of 40 w/v % barium solution at the 90cm height is much lower than the pressure maintained during air reduction, and this difference in pressure may be one of the causes of low reduction rate in barium reduction then air reduction. 4. The pressure gradient per 10 cm height is about 8.45 mmHg in 20 w/v % barium solution, about 9.21 mmHg in 30 w/v % barium solution, and about 9.72 mmHg 40 w/v % barium solution. 5. Intraluminal pressure difference between the barium reduction and the air reduction is probably of the major causes of rapid diagnosis and high reduction rate in the air reduction

  1. Body weight reduction and metformin: Roles in polycystic ovary syndrome.

    Science.gov (United States)

    Al-Nozha, Omar; Habib, Fawziah; Mojaddidi, Moaz; El-Bab, Mohamed Fath

    2013-04-01

    Polycystic ovary syndrome (PCOS) is a common problem in women at fertile age. A prospective study was conducted to clarify the pathophysiological responses during an application of insulin sensitizer, metformin and weight reduction therapy at the Gynecology Center in Ohud hospital, in AL-Madinah AL-Munawarah, Kingdom of Saudi Arabia. Twenty healthy women served as controls and 180 PCOS women divided into three groups participated in the study. First group was treated with Clomid citrate 100mg/day from the 2nd day of menses to the 6th day plus gonadotrophin from day three to the 13th. Group II was treated as group I plus 850mg metformin twice a day and group III was treated as group I plus weight reduction. Clinical symptoms, menstrual pattern, hirsutism, blood glucose, body mass index, waist-to-hip ratio, insulin, hormonal, and lipid profiles were assessed pre- and post treatment. Insulin resistance was calculated. PCOS women had significantly higher values than the healthy women in most of the measurements. Metformin and weight reduction therapy resulted in a significant decrease in the fasting insulin, glucose/insulin ratio and HOMA-IR. Metformin and weight reduction therapy resulted in a significant decrease in the lipid parameters, testosterone, LH/FSH ratio, SHBG, and prolactin levels. HOMA-IR was significantly higher in women with PCOS. HOMA-IR was positively correlated with testosterone, estradiol, TG, total cholesterol and LDL-cholesterol parameters, and negatively correlated with HDL-cholesterol and FSH levels. Metformin therapy and weight reduction had favorable influences on the basic metabolic and hormonal profiles in women with PCOS and that metformin and lifestyle modification (weight reduction via diet restriction or exercise) resulted in a significantly greater weight loss than hormonal therapy alone. Metformin and weight reduction therapy decreased also hyperandrogenism and insulin resistance. Copyright © 2013 Elsevier Ireland Ltd. All rights

  2. Treatment of chronic anterior shoulder dislocation by open reduction and simultaneous Bankart lesion repair

    Directory of Open Access Journals (Sweden)

    Rouhani Alireza

    2010-06-01

    Full Text Available Abstract Background Untreated chronic shoulder dislocation eventually leads to functional disability and pain. Open reduction with different fixation methods have been introduced for most chronic shoulder dislocation. We hypothesized that open reduction and simultaneous Bankart lesion repair in chronic anterior shoulder dislocation obviates the need for joint fixation and leads to better results than previously reported methods. Methods Eight patients with chronic anterior dislocation of shoulder underwent open reduction and capsulolabral complex repair after an average delay of 10 weeks from injury. Early motion was allowed the day after surgery in the safe position and the clinical and radiographic results were analyzed at an average follow-up of one year. Results The average Rowe and Zarin's score was 86 points. Four out of eight shoulders were graded as excellent, three as good and one as fair (Rowe and Zarins system. All patients were able to perform their daily activities and they had either mild or no pain. Anterior active forward flexion loss averaged 18 degrees, external active rotation loss averaged 17.5 degrees and internal active rotation loss averaged 3 vertebral body levels. Mild degenerative joint changes were noted in one patient. Conclusion The results show that the overall prognosis for this method of operation is more favorable than the previously reported methods and we recommend concomitant open reduction and capsulolabral complex repair for the treatment of old anterior shoulder dislocation. Level of Evidence Therapeutic study, Level IV (case series [no, or historical, control group

  3. Significant enhancement of magnetoresistance with the reduction of particle size in nanometer scale

    Science.gov (United States)

    Das, Kalipada; Dasgupta, P.; Poddar, A.; Das, I.

    2016-01-01

    The Physics of materials with large magnetoresistance (MR), defined as the percentage change of electrical resistance with the application of external magnetic field, has been an active field of research for quite some times. In addition to the fundamental interest, large MR has widespread application that includes the field of magnetic field sensor technology. New materials with large MR is interesting. However it is more appealing to vast scientific community if a method describe to achieve many fold enhancement of MR of already known materials. Our study on several manganite samples [La1−xCaxMnO3 (x = 0.52, 0.54, 0.55)] illustrates the method of significant enhancement of MR with the reduction of the particle size in nanometer scale. Our experimentally observed results are explained by considering model consisted of a charge ordered antiferromagnetic core and a shell having short range ferromagnetic correlation between the uncompensated surface spins in nanoscale regime. The ferromagnetic fractions obtained theoretically in the nanoparticles has been shown to be in the good agreement with the experimental results. The method of several orders of magnitude improvement of the magnetoresistive property will have enormous potential for magnetic field sensor technology. PMID:26837285

  4. Changes in forage lichen biomass after insect outbreaks and fuel reduction treatment in the Blue Mountains, Oregon

    Science.gov (United States)

    Bruce McCune; Sarah Jovan; Amanda. Hardman

    2008-01-01

    Forage lichens are pendulous, hairlike species eaten by a wide range of mammals. Our overall goal was to estimate losses of Bryoria, a genus of ecologically important forage species, in forests subjected to disease and fuel reduction treatments at Starkey Experimental Forest in the Blue Mountains of northeastern Oregon. Specific objectives were to...

  5. Assessing the Effect of Potential Reductions in Non-Hepatic Mortality on the Estimated Cost-Effectiveness of Hepatitis C Treatment in Early Stages of Liver Disease

    Science.gov (United States)

    Chesson, Harrell W.; Spradling, Philip R.; Holmberg, Scott D.

    2018-01-01

    Background Most cost-effectiveness analyses of hepatitis C (HCV) therapy focus on the benefits of reducing liver-related morbidity and mortality. Objectives Our objective was to assess how cost-effectiveness estimates of HCV therapy can vary depending on assumptions regarding the potential impact of HCV therapy on non-hepatic mortality. Methods We adapted a state-transition model to include potential effects of HCV therapy on non-hepatic mortality. We assumed successful treatment could reduce non-hepatic mortality by as little as 0 % to as much as 100 %. Incremental cost-effectiveness ratios were computed comparing immediate treatment versus delayed treatment and comparing immediate treatment versus non-treatment. Results Comparing immediate treatment versus delayed treatment, when we included a 44 % reduction in nonhepatic mortality following successful HCV treatment, the incremental cost per quality-adjusted life year (QALY) gained by HCV treatment fell by 76 % (from US$314,100 to US$76,900) for patients with no fibrosis and by 43 % (from US$62,500 to US$35,800) for patients with moderate fibrosis. Comparing immediate treatment versus non-treatment, assuming a 44 % reduction in non-hepatic mortality following successful HCV treatment, the incremental cost per QALY gained by HCV treatment fell by 64 % (from US$186,700 to US$67,300) for patients with no fibrosis and by 27 % (from US$35,000 to US$25,500) for patients with moderate fibrosis. Conclusion Including reductions in non-hepatic mortality from HCV treatment can have substantial effects on the estimated cost-effectiveness of treatment. PMID:27480538

  6. Prognostic indicators of the outcome of arthrocentesis with and without sodium hyaluronate injection for the treatment of disc displacement without reduction: a magnetic resonance imaging study.

    Science.gov (United States)

    Aktas, I; Yalcin, S; Sencer, S

    2010-11-01

    This study analysed the prognostic factors for successful arthrocentesis with and without sodium hyaluronate (SH) injection for the treatment of temporomandibular joint (TMJ) disc displacement without reduction (DDwoR) using clinical and radiological results. 29 TMJs in 25 patients with DDwoR were included. Patients were treated with arthrocentesis or arthrocentesis followed by intra-articular (i.a.) injection of SH. Treatment was evaluated for postoperative range of maximum mouth opening and the degree of postoperative pain on a VAS. Prognostic factors analysed were age, sex, duration of locking, trauma history, previous TMJ treatment, depression, bruxism, malocclusion and missing teeth. Degenerative changes were evaluated as probable prognostic factors. After treatment, 24 joints (83%) fulfilled the criteria for success. Duration of locking and present preoperative degenerative changes were the most significant factors for treatment outcome. The results suggest it is sufficient to use only arthrocentesis in patients without preoperative degenerative changes and arthrocentesis with SH in patients with degenerative changes on their preoperative MRIs, but because there were some significant differences between the two groups preventing the authors from comparing them statistically, they cannot come to that conclusion. To clarify the use of SH in such cases, standardized study groups are necessary for future studies. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

  7. The evidence for efficacy of osteoporosis treatment in men with primary osteoporosis: a systematic review and meta-analysis of antiresorptive and anabolic treatment in men

    DEFF Research Database (Denmark)

    Schwarz, Peter; Jorgensen, Niklas Rye; Mosekilde, Leif

    2011-01-01

    of antiresorptive treatment were included. All studies showed an increase in BMD, but there was only a nonsignificant trend in the reduction of clinical fractures. Three BMD studies of anabolic treatment with teriparatide were also included. These showed a significant mean increase in spine BMD and for vertebral...... treatment in men. Methods. This study was a systematic review of the published literature on the clinical efficacy of medical osteoporosis therapy in the reduction of fracture risk in men (age > 50 years). Studies included were randomised, placebo-controlled trials of men. Results. Five BMD studies...... fractures a non-significant trend towards a reduction was seen. Conclusion. The evidence of medical osteoporosis treatment in men is scant and inconclusive due to the lack of prospective RCT studies with fracture prevention as primary end point. So far, all evidence is based on BMD increases in small RCT...

  8. Editor's choice--Use of disposable radiation-absorbing surgical drapes results in significant dose reduction during EVAR procedures.

    Science.gov (United States)

    Kloeze, C; Klompenhouwer, E G; Brands, P J M; van Sambeek, M R H M; Cuypers, P W M; Teijink, J A W

    2014-03-01

    Because of the increasing number of interventional endovascular procedures with fluoroscopy and the corresponding high annual dose for interventionalists, additional dose-protecting measures are desirable. The purpose of this study was to evaluate the effect of disposable radiation-absorbing surgical drapes in reducing scatter radiation exposure for interventionalists and supporting staff during an endovascular aneurysm repair (EVAR) procedure. This was a randomized control trial in which 36 EVAR procedures were randomized between execution with and without disposable radiation-absorbing surgical drapes (Radpad: Worldwide Innovations & Technologies, Inc., Kansas City, US, type 5511A). Dosimetric measurements were performed on the interventionalist (hand and chest) and theatre nurse (chest) with and without the use of the drapes to obtain the dose reduction and effect on the annual dose caused by the drapes. Use of disposable radiation-absorbing surgical drapes resulted in dose reductions of 49%, 55%, and 48%, respectively, measured on the hand and chest of the interventionalist and the chest of the theatre nurse. The use of disposable radiation-absorbing surgical drapes significantly reduces scatter radiation exposure for both the interventionalist and the supporting staff during EVAR procedures. Copyright © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  9. Is ozonation environmentally benign for reverse osmosis concentrate treatment? Four-level analysis on toxicity reduction based on organic matter fractionation.

    Science.gov (United States)

    Weng, Jingxia; Jia, Huichao; Wu, Bing; Pan, Bingcai

    2018-01-01

    Ozonation is a promising option to treat reverse osmosis concentrate (ROC). However, a systematic understanding and assessment of ozonation on toxicity reduction is insufficient. In this study, ROC sampled from a typical industrial park wastewater treatment plant of China was fractionated into hydrophobic acid (HOA), hydrophobic base (HOB), hydrophobic neutral (HON), and hydrophilic fraction (HI). Systematic bioassays covering bacteria, algae, fish, and human cell lines were conducted to reveal the role of ozonation in toxicity variation of the four ROC fractions. HOA in the raw ROC exhibited the highest toxicity, followed by HON and HI. Ozonation significantly reduced total organic carbon (TOC) and UV 254 values in HOA, HON, and HI and their toxicity except in HOB. Correlation analysis indicated that chemical data (TOC and UV 254 ) of HOA and HON correlated well with their toxicities; however, poor correlations were observed for HOB and HI, suggesting that a battery of toxicity assays is necessary. This study indicates that TOC reduction during ozonation could not fully reflect the toxicity issue, and toxicity assessment is required in conjunction with the chemical data to evaluate the effectiveness of ozonation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Jointly optimizing selection of fuel treatments and siting of forest biomass-based energy production facilities for landscape-scale fire hazard reduction.

    Science.gov (United States)

    Peter J. Daugherty; Jeremy S. Fried

    2007-01-01

    Landscape-scale fuel treatments for forest fire hazard reduction potentially produce large quantities of material suitable for biomass energy production. The analytic framework FIA BioSum addresses this situation by developing detailed data on forest conditions and production under alternative fuel treatment prescriptions, and computes haul costs to alternative sites...

  11. Effect of 30-Gy irradiation in conjunction with leukocyte reduction filter on platelet and transfusion efficiency

    International Nuclear Information System (INIS)

    Shimojima, Hiromi; Sawada, Umihiko; Horie, Takashi; Itoh, Takeyoshi

    2001-01-01

    To evaluate the effect of 30-Gy irradiation in conjunction with leukocyte reduction filter on platelet and transfusion efficiency, we studied platelet recovery, leukocyte reduction rate, content of platelet factor 4 and β-thromboglobulin in platelet products, platelet functions, and positive rates of platelet surface membranes CD42 and CD62, prior to and after treatment. We also evaluated the efficiency of platelet transfusion by estimating post- transfusion (1 and 24 hour) corrected count increment (CCI), and transfusion side effects. Recovery of platelets was 91.8±6.5% and depletion rate of leukocytes was 1.7±1.1 log. There was no significant difference in platelet activation markers or function tests prior to and after the procedure. The mean post-transfusion CCI and 1 and 24 hours were 16,550 (n=114) and 13,310 (n=93), respectively, with 30-Gy irradiation and leukocyte reduction filter. Those treated solely with leukocyte reduction filter were 14,970 (n=114) and 10,880 (n=118), respectively. There was no increase in transfusion side effects after the treatment of platelet concentrate with 30-Gy irradiation combined with leukocyte reduction filter compared with treatment by leukocyte reduction filter alone. These results indicate that treatment with 30 Gy irradiation in conjunction with leukocyte reduction filter is safe and effective in platelet transfusion. (author)

  12. Heterogeneous photo-Fenton treatment for the reduction of pharmaceutical contamination in Madrid rivers and ecotoxicological evaluation by a miniaturized fern spores bioassay.

    Science.gov (United States)

    Rodríguez-Gil, José L; Catalá, Myriam; Alonso, Silvia González; Maroto, Raúl Romo; Valcárcel, Yolanda; Segura, Yolanda; Molina, Raúl; Melero, Juan A; Martínez, Fernando

    2010-06-01

    Fifty-six pharmaceuticals of various chemical groups, such as anti-inflammatory, antibacterial and cardiovascular drugs, were detected in four selected river waters receiving sewage effluents in the Community of Madrid (Spain). A promising approach for the degradation of those residues is the application of a photo-Fenton treatment. Several new bioassays using fern spores were employed for the evaluation of acute and chronic toxicity based on mitochondrial activity, DNA and chlorophyll quantifications of as-received river water and photo-Fenton-treated samples. photo-Fenton treatment provided a high degree of total organic carbon mineralization with up to 70% reduction for river water samples. In addition, the elimination of most of the studied pharmaceutical compounds was confirmed. A few compounds, however (salicylic acid, ofloxacin, caffeine, cotinine and nicotine), seemed more resistant, with after-treatment concentrations between 4 and 44ngL(-1). Nicotine showed the most refractory behaviour with concentrations ranging from 29 to 224ngL(-1) for treated samples. Photo-Fenton treatment yielded a significant decrease in acute and chronic toxicity, even though some residual toxicity remained after treatment. This fact seemed to be related to the presence of toxicants in the water matrix, probably of inorganic nature, rather than the toxic effect of the studied pharmaceutical compounds, as revealed by the effective removal of these compounds and high TOC mineralization of photo-Fenton treatments.

  13. Clinical significance of determination of changes of serum CA125, VEGF levels after treatment in patients with endometriosis

    International Nuclear Information System (INIS)

    Dong Yan; Zhou Dongxia

    2008-01-01

    Objective: To explore the significance of changes of serum CA125, VEGF levels after treatment in patients with endometriosis. Methods: Serum CA125 (with RIA) and VEGF (with ELISA) levels were determined in 36 patients with endometriosis both before and after treatment as well as in 30 controls. Results: Before treatment, the serum CA125, VEGF levels in the patients were significantly higher than those in the controls (P<0.01). After 3 months of treatment, the levels dropped markedly, but still remained significantly higher(P<0.05). Conclusion: Serum levels of CA125 and VEGF were closely related to the disease process in patients with ehdometriosis. (authors)

  14. Influence of co-substrate on textile wastewater treatment and microbial community changes in the anaerobic biological sulfate reduction process

    International Nuclear Information System (INIS)

    Rasool, Kashif; Mahmoud, Khaled A.; Lee, Dae Sung

    2015-01-01

    Highlights: • Textile wastewater treatment performance was investigated with different co-substrates. • Dye biodegradation and biotransformation enhanced with lactate as co-substrate. • Sulfate removal significantly decreased under limited co-substrate concentration. • Changes in microbial community structure were studied using bar-coded pyrosequencing. • Lactate as co-substrate showed the highest relative abundance of sulfate reducing bacteria. - Abstract: This study investigated the anaerobic treatment of sulfate-rich synthetic textile wastewater in three sulfidogenic sequential batch reactors (SBRs). The experimental protocol was designed to examine the effect of three different co-substrates (lactate, glucose, and ethanol) and their concentrations on wastewater treatment performance. Sulfate reduction and dye degradation were improved when lactate and ethanol were used as electron donors, as compared with glucose. Moreover, under co-substrate limited concentrations, color, sulfate, and chemical oxygen demand (COD) removal efficiencies were declined. By reducing co-substrate COD gradually from 3000 to 500 mg/L, color removal efficiencies were decreased from 98.23% to 78.46%, 63.37%, and 69.10%, whereas, sulfate removal efficiencies were decreased from 98.42%, 82.35%, and 87.0%, to 30.27%, 21.50%, and 10.13%, for lactate, glucose, and ethanol fed reactors, respectively. Fourier transform infrared spectroscopy (FTIR) and total aromatic amine analysis revealed lactate to be a potential co-substrate for further biodegradation of intermediate metabolites formed after dye degradation. Pyrosequencing analysis showed that microbial community structure was significantly affected by the co-substrate. The reactor with lactate as co-substrate showed the highest relative abundance of sulfate reducing bacteria (SRBs), followed by ethanol, whereas the glucose-fed reactor showed the lowest relative abundance of SRB.

  15. Influence of co-substrate on textile wastewater treatment and microbial community changes in the anaerobic biological sulfate reduction process

    Energy Technology Data Exchange (ETDEWEB)

    Rasool, Kashif; Mahmoud, Khaled A. [Qatar Environment and Energy Research Institute, Hamad Bin Khalifa University, Qatar Foundation, PO BOX 5825, Doha (Qatar); Lee, Dae Sung, E-mail: daesung@knu.ac.kr [Department of Environmental Engineering, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu 702-701 (Korea, Republic of)

    2015-12-15

    Highlights: • Textile wastewater treatment performance was investigated with different co-substrates. • Dye biodegradation and biotransformation enhanced with lactate as co-substrate. • Sulfate removal significantly decreased under limited co-substrate concentration. • Changes in microbial community structure were studied using bar-coded pyrosequencing. • Lactate as co-substrate showed the highest relative abundance of sulfate reducing bacteria. - Abstract: This study investigated the anaerobic treatment of sulfate-rich synthetic textile wastewater in three sulfidogenic sequential batch reactors (SBRs). The experimental protocol was designed to examine the effect of three different co-substrates (lactate, glucose, and ethanol) and their concentrations on wastewater treatment performance. Sulfate reduction and dye degradation were improved when lactate and ethanol were used as electron donors, as compared with glucose. Moreover, under co-substrate limited concentrations, color, sulfate, and chemical oxygen demand (COD) removal efficiencies were declined. By reducing co-substrate COD gradually from 3000 to 500 mg/L, color removal efficiencies were decreased from 98.23% to 78.46%, 63.37%, and 69.10%, whereas, sulfate removal efficiencies were decreased from 98.42%, 82.35%, and 87.0%, to 30.27%, 21.50%, and 10.13%, for lactate, glucose, and ethanol fed reactors, respectively. Fourier transform infrared spectroscopy (FTIR) and total aromatic amine analysis revealed lactate to be a potential co-substrate for further biodegradation of intermediate metabolites formed after dye degradation. Pyrosequencing analysis showed that microbial community structure was significantly affected by the co-substrate. The reactor with lactate as co-substrate showed the highest relative abundance of sulfate reducing bacteria (SRBs), followed by ethanol, whereas the glucose-fed reactor showed the lowest relative abundance of SRB.

  16. [Study on reductive surgery for pelvic organ prolapse concomitant with anti-incontinence sling for treatment of occult stress urinary incontinence].

    Science.gov (United States)

    Zhang, Xiaolong; Lu, Yongxian; Shen, Wenjie; Liu, Jingxia; Ge, Jing; Liu, Xin; Zhao, Ying; Niu, Ke; Zhang, Yinghui; Wang, Wenying; Qiu, Chengli

    2014-06-01

    To evaluate the clinical outcome of anti-incontinence sling in the treatment of occult stress urinary incontinence (OSUI) during reductive surgery for advanced pelvic organ prolapse (POP). From Jun. 2003 to Dec. 2012, 78 patients with OSUI underwent reductive surgery for advanced POP such as high uterosacral ligament suspension, sacrospinous ligament suspension and sacral colpopexy in the First Affiliated Hospital, General Hospital of People's Liberation Army. Among them, 41 patients received reductive surgery alone was enrolled in non-concomitant anti-incontinence group and the other 37 patients who underwent same surgery with tension-free vaginal tape (TVT) or tension-free vaginal tape-obturator technique (TVT-O) was in anti-incontinence group. The patient's demography, objective and subjective outcomes, as well as complications and injures were compared between the two groups. The pelvic organ prolapse quantitation (POP-Q) was used to evaluate the objective outcomes of POP. Urinary distress inventory (UDI-6) and incontinence impact questionnaire short form (IIQ-7) were used to evaluate the subjective outcomes of stress urinary incontinence (SUI). Compared with the non-concomitant anti-incontinence group, the objective outcomes of reductive surgery exhibited no significant differences (100%, 78/78), and only the operation time of anti-incontinence group slightly increased 16 minutes. The occurrence rate of postoperative SUI was 12% (5/41), 15% (6/41), 17% (7/41) respectively after the operation at 2-month, 6-month and 12-month follow up in the non-concomitant anti-incontinence group; and the occurrence rate of the anti-incontinence group was 3% (1/37), 3% (1/37), 3% (1/37); but none of patients in the two groups require further surgery for stress urinary incontinence. Mean score of UDI-6 and IIQ-7 in all the patients decreased significantly after operation at 2-month, 6-month and 12-month follow up (all P statistic difference between the two groups (P > 0.05). It

  17. INEEL Radioactive Liquid Waste Reduction Program

    International Nuclear Information System (INIS)

    Millet, C.B.; Tripp, J.L.; Archibald, K.E.; Lauerhauss, L.; Argyle, M.D.; Demmer, R.L.

    1999-01-01

    Reduction of radioactive liquid waste, much of which is Resource Conservation and Recovery Act (RCRA) listed, is a high priority at the Idaho National Technology and Engineering Center (INTEC). Major strides in the past five years have lead to significant decreases in generation and subsequent reduction in the overall cost of treatment of these wastes. In 1992, the INTEC, which is part of the Idaho National Environmental and Engineering Laboratory (INEEL), began a program to reduce the generation of radioactive liquid waste (both hazardous and non-hazardous). As part of this program, a Waste Minimization Plan was developed that detailed the various contributing waste streams, and identified methods to eliminate or reduce these waste streams. Reduction goals, which will reduce expected waste generation by 43%, were set for five years as part of this plan. The approval of the plan led to a Waste Minimization Incentive being put in place between the Department of Energy Idaho Office (DOE-ID) and the INEEL operating contractor, Lockheed Martin Idaho Technologies Company (LMITCO). This incentive is worth $5 million dollars from FY-98 through FY-02 if the waste reduction goals are met. In addition, a second plan was prepared to show a path forward to either totally eliminate all radioactive liquid waste generation at INTEC by 2005 or find alternative waste treatment paths. Historically, this waste has been sent to an evaporator system with the bottoms sent to the INTEC Tank Farm. However, this Tank Farm is not RCRA permitted for mixed wastes and a Notice of Non-compliance Consent Order gives dates of 2003 and 2012 for removal of this waste from these tanks. Therefore, alternative treatments are needed for the waste streams. This plan investigated waste elimination opportunities as well as treatment alternatives. The alternatives, and the criteria for ranking these alternatives, were identified through Value Engineering meetings with all of the waste generators. The most

  18. In-treatment cigarette demand among treatment-seeking smokers with depressive symptoms.

    Science.gov (United States)

    Weidberg, S; Vallejo-Seco, G; González-Roz, A; García-Pérez, Á; Secades-Villa, R

    2018-07-01

    Despite previous evidence supporting the use of the Cigarette Purchase Task (CPT) as a valid tool for assessing smoking reinforcement, research assessing how environmental changes affect CPT performance is scarce. This study addressed for the first time the differential effect of treatment condition [Cognitive Behavioral Treatment (CBT) + Behavioral Activation (BA) versus CBT + BA + Contingency Management (CM)] on cigarette demand among treatment seeking smokers with depressive symptoms. It also sought to assess whether reductions in smoking consumption arranged over the course of an intervention for smoking cessation impact on in-treatment cigarette demand. Participants were 92 smokers with depressive symptoms from a randomized clinical trial that received eight weeks of either CBT + BA or CBT + BA + CM. Individuals completed the CPT 8 times; the first during the intake visit and the remaining 7 scheduled once a week in midweek sessions. Cotinine samples were collected in each session. Participants receiving CBT + BA + CM showed higher reduction in cigarette demand across sessions than participants receiving CBT + BA, although this comparison was only significant for the intensity index (p = .004). Cotinine was positively related to cigarette demand (all p values demand reductions (all p values demand. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Coagulation-Fenton coupled treatment for ecotoxicity reduction in highly polluted industrial wastewater.

    Science.gov (United States)

    Perdigón-Melón, J A; Carbajo, J B; Petre, A L; Rosal, R; García-Calvo, E

    2010-09-15

    A coupled coagulation-Fenton process was applied for the treatment of cosmetic industry effluents. In a first step, FeSO(4) was used as coagulant and the non-precipitated Fe(2+) remaining in dissolution was used as catalyst in the further Fenton process. In the coagulation process a huge decrease in total organic carbon (TOC) was achieved, but the high concentration of phenol derivatives was not diminished. The decrease in TOC in the coagulation step significantly reduces the amount of H(2)O(2) required in the Fenton process for phenol depletion. The coupled process, using a H(2)O(2) dose of only 2 g l(-1), reduced TOC and total phenol to values lower than 40 and 0.10 mg l(-1), respectively. The short reaction period (less than 15 min) in TOC and phenol degradation bodes well for improving treatment in a continuous regime. The combination of both processes significantly reduced the ecotoxicity of raw effluent and markedly increased its biodegradability, thus allowing easier treatment by the conventional biological units in conventional sewage treatment plants (STPs). Copyright 2010 Elsevier B.V. All rights reserved.

  20. Evolution of transoral approaches, endoscopic endonasal approaches, and reduction strategies for treatment of craniovertebral junction pathology: a treatment algorithm update.

    Science.gov (United States)

    Dlouhy, Brian J; Dahdaleh, Nader S; Menezes, Arnold H

    2015-04-01

    The craniovertebral junction (CVJ), or the craniocervical junction (CCJ) as it is otherwise known, houses the crossroads of the CNS and is composed of the occipital bone that surrounds the foramen magnum, the atlas vertebrae, the axis vertebrae, and their associated ligaments and musculature. The musculoskeletal organization of the CVJ is unique and complex, resulting in a wide range of congenital, developmental, and acquired pathology. The refinements of the transoral approach to the CVJ by the senior author (A.H.M.) in the late 1970s revolutionized the treatment of CVJ pathology. At the same time, a physiological approach to CVJ management was adopted at the University of Iowa Hospitals and Clinics in 1977 based on the stability and motion dynamics of the CVJ and the site of encroachment, incorporating the transoral approach for irreducible ventral CVJ pathology. Since then, approaches and techniques to treat ventral CVJ lesions have evolved. In the last 40 years at University of Iowa Hospitals and Clinics, multiple approaches to the CVJ have evolved and a better understanding of CVJ pathology has been established. In addition, new reduction strategies that have diminished the need to perform ventral decompressive approaches have been developed and implemented. In this era of surgical subspecialization, to properly treat complex CVJ pathology, the CVJ specialist must be trained in skull base transoral and endoscopic endonasal approaches, pediatric and adult CVJ spine surgery, and must understand and be able to treat the complex CSF dynamics present in CVJ pathology to provide the appropriate, optimal, and tailored treatment strategy for each individual patient, both child and adult. This is a comprehensive review of the history and evolution of the transoral approaches, extended transoral approaches, endoscopie assisted transoral approaches, endoscopie endonasal approaches, and CVJ reduction strategies. Incorporating these advancements, the authors update the

  1. REDUCTION OF SOIL INFILTRATION AREA THANKS TO THE WASTEWATER SECONDARY TREATMENT FILTERS

    Directory of Open Access Journals (Sweden)

    Marcin Spychała

    2016-05-01

    Full Text Available The aim of the article was to determine the feasibility and advisability of the use of secondary filters applied before discharge of wastewater into the ground in the context of the fulfillment of the conditions of the current Regulation of the Minister of Environment of 18 November 2014 on the conditions to be met during the discharge of wastewater into the water or the ground and on substances particularly harmful to the aquatic environment. Due to expected in practice, an application and popularity, as compared variants, reactors having a very simple construction were used. The average values of removal of BOD5, COD and total suspended solids for three secondary filters technologies: biological trickling filter with natural ventilation, sand filter and nonwoven filter were compared. Additionally, as a fourth option a simple mathematical model has been presented. This model allows to estimate of BOD5 at the outflow from biological trickling filter and to verify the empirical data. Despite a large usefulness, it is rarely used in our country. It has been found the possibility of reduction of the infiltration area (surface area after reduction is 38–63% of the initial value due to the application of secondary filters. In the case of a high initial demand of the terrain area for drainage localization the benefit in costs resulting from the reduction (several thousand of PLN or may even significantly exceed the cost of buying and installing a cheap secondary filter. In addition, reduction the occupied area of the lot (in extreme cases up to 100 m2 by using the secondary filter allows to use the unoccupied space for other purposes, and thus gives additional economic advantage.

  2. Significant reductions in heart and lung doses using semi lateral ...

    African Journals Online (AJOL)

    Introduction: Various treatment techniques as breath hold techniques have been developed to spare the heart and lung in breast cancer patients receiving adjuvant radiotherapy. Purpose: to compare the heart and lung dosimetric parameters of semi lateral decubitus technique with and without deep inspiration breath hold ...

  3. Eating habits, weight reduction strategies and long-term treatment results in obese men : The "Gustaf" study

    OpenAIRE

    Andersson, Ingalena

    1997-01-01

    Eating habits, weight reduction strategies and long-term treatment resultsin obese men. The "Gustaf" study. Ingalena Andersson Obesity Unit and Health Behaviour Research, Department of Medicine, HuddingeHospital, Karolinska Institute, Stockholm, Sweden. Abdominal male obesity is associated with hypertension, abnormal blood lipidsand diabetes type 11. For development of a weight loss program for such males, 86obese men (BMI 37.7 [4.4] kg/m2) (mean [SD] ) from the wa...

  4. Multinomial logistic regression analysis for differentiating 3 treatment outcome trajectory groups for headache-associated disability.

    Science.gov (United States)

    Lewis, Kristin Nicole; Heckman, Bernadette Davantes; Himawan, Lina

    2011-08-01

    Growth mixture modeling (GMM) identified latent groups based on treatment outcome trajectories of headache disability measures in patients in headache subspecialty treatment clinics. Using a longitudinal design, 219 patients in headache subspecialty clinics in 4 large cities throughout Ohio provided data on their headache disability at pretreatment and 3 follow-up assessments. GMM identified 3 treatment outcome trajectory groups: (1) patients who initiated treatment with elevated disability levels and who reported statistically significant reductions in headache disability (high-disability improvers; 11%); (2) patients who initiated treatment with elevated disability but who reported no reductions in disability (high-disability nonimprovers; 34%); and (3) patients who initiated treatment with moderate disability and who reported statistically significant reductions in headache disability (moderate-disability improvers; 55%). Based on the final multinomial logistic regression model, a dichotomized treatment appointment attendance variable was a statistically significant predictor for differentiating high-disability improvers from high-disability nonimprovers. Three-fourths of patients who initiated treatment with elevated disability levels did not report reductions in disability after 5 months of treatment with new preventive pharmacotherapies. Preventive headache agents may be most efficacious for patients with moderate levels of disability and for patients with high disability levels who attend all treatment appointments. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  5. EMLA cream does not influence efficacy and pain reduction during pulsed-dye laser treatment of port-wine stain: a prospective side-by-side comparison.

    Science.gov (United States)

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

    2018-04-01

    EMLA cream was developed to reduce pain during pulsed-dye laser (PDL) treatment; however, no standard assessment for the therapeutic outcomes of PDL with EMLA creams thus far available. This comparative, prospective clinical trial evaluates laser efficacy and pain reduction during PDL treatment with EMLA cream for local topical anesthesia. Nineteen patients with untreated port-wine stain (PWS) were treated using PDL and examined in this study. Treatment specifications included Vbeam® PDL (Candela Corp.), 595-nm wavelength, 9 J/cm 2 radiant exposure, 0.45 ms pulse duration, 10 mm spot size, and cryogen spray cooling (40 ms cooling plus a 20 ms delay). A topical anesthetic (EMLA cream: 2.5% lidocaine and 2.5% prilocaine) and a placebo were applied to two respective testing areas on all patients prior to treatment. The visual analog scale (VAS) was used for pain assessment. Clinical therapeutic outcomes were evaluated by visual evaluation and with the use of a chromameter 2 months after 3PDL treatments. The average VAS scores were 3.15 ± 0.95 and 8 ± 0.57 for the EMLA cream site and the placebo site, respectively, at a significance level p < 0.001. The EMLA cream site and the placebo site had clearance or fading rates of 45.08 and 44.12%, respectively (p < 0.05). No serious side effects were reported. Patients reported a consistent decrease in pain during PDL treatment when the topical anesthetic EMLA cream was administered. Treatment of PWS by PDL with EMLA cream does not lead to a decrease in efficacy or an increase in side effects; instead, it significantly reduces pain during treatment. EMLA cream is a safe and effective local topical anesthetic for PWS treatment by PDL.

  6. Clinical significance of measurement of serum NO, IL-6 and IL-8 levels after treatment in patients with schizophrenia

    International Nuclear Information System (INIS)

    Gao Wanqin

    2010-01-01

    Objective: To study the significance of changes of serum NO, IL-6 and IL-8 levels after treatment in patients with schizophrenia. Methods: Serum IL-6, IL-8 (with RIA) and NO (with bio-chemistry) levels were determined in 37 patients with schizophrenia both before and after treatment as well as in 35 controls. Results: Before treatment, the serum IL-6, IL-8 levels in the patients were significantly higher than those in controls (P<0.01). While the serum NO levels were significantly lower (P<0.01). After six weeks' treatment, the levels of IL-6, IL-8 in the patients, though dropped markedly still remained significantly higher (P<0.05) than those in controls. The serum NO levels, though markedly increased after treatment, were still remained significantly lower than those in the controls (P<0.05). Conclusion: Serum NO, IL-6 and IL-8 levels were closely related to the diseases process of schizophrenia and were of prognostic values. (authors)

  7. Significant advantages of sulfur-doped graphene in neutral media as electrocatalyst for oxygen reduction comparing with Pt/C

    Science.gov (United States)

    Shi, Xinxin; Zhang, Jiaona; Huang, Tinglin

    2018-02-01

    Sulfur-doped graphene (SDG) has been found to be an efficient electrocatalyst for oxygen reduction reaction. However, previous studies on the catalytic activity of SDG have been mainly confined to O2-saturated alkaline media which is a typical alkaline fuel cell environment. Air-cathode microbial fuel cells (ACMFCs), as a novel energy conversion and wastewater treatment technology, use the oxygen from air as cathodic reactant in neutral media with low concentration of O2. Thus, it is meaningful to explore the catalytic performance of SDG in such ACMFC environment. The result showed that in ACMFC environment, the peak current density of SDG in CV test was surprisingly 4.5 times higher than that of Pt/C, indicating a much stronger catalytic activity of SDG. Moreover, SDG exhibited a stronger tolerance against the crossover of glucose (a typical anodic fuel in ACMFC) and better stability than Pt/C in neutral media.

  8. Harm Reduction as “Continuum Care” in Alcohol Abuse Disorder

    Directory of Open Access Journals (Sweden)

    Icro Maremmani

    2015-11-01

    Full Text Available Alcohol abuse is one of the most important risk factors for health and is a major cause of death and morbidity. Despite this, only about one-tenth of individuals with alcohol abuse disorders receive therapeutic intervention and specific rehabilitation. Among the various dichotomies that limit an effective approach to the problem of alcohol use disorder treatment, one of the most prominent is integrated treatment versus harm reduction. For years, these two divergent strategies have been considered to be opposite poles of different philosophies of intervention. One is bound to the search for methods that aim to lead the subject to complete abstinence; the other prioritizes a progressive decline in substance use, with maximum reduction in the damage that is correlated with curtailing that use. Reduction of alcohol intake does not require any particular setting, but does require close collaboration between the general practitioner, specialized services for addiction, alcohology services and psychiatry. In patients who reach that target, significant savings in terms of health and social costs can be achieved. Harm reduction is a desirable target, even from an economic point of view. At the present state of neuroscientific knowledge, it is possible to go one step further in the logic that led to the integration of psychosocial and pharmacological approaches, by attempting to remove the shadows of social judgment that, at present, are aiming for a course of treatment that is directed towards absolute abstention.

  9. Casting light on harm reduction

    DEFF Research Database (Denmark)

    Jourdan, Michael

    2009-01-01

    Background: Harm reduction is commonly regarded as complementary to other drug problem responses - as the fourth tier. Yet even core examples of harm reduction such as the provision of injection equipment and methadone treatment has over and over encountered considerable opposition, and harm redu...

  10. Obesity treatment by very low-calorie-ketogenic diet at two years: reduction in visceral fat and on the burden of disease.

    Science.gov (United States)

    Moreno, Basilio; Crujeiras, Ana B; Bellido, Diego; Sajoux, Ignacio; Casanueva, Felipe F

    2016-12-01

    The long-term effect of therapeutic diets in obesity treatment is a challenge at present. The current study aimed to evaluate the long-term effect of a very low-calorie-ketogenic (VLCK) diet on excess adiposity. Especial focus was set on visceral fat mass, and the impact on the individual burden of disease. A group of obese patients (n = 45) were randomly allocated in two groups: either the very low-calorie-ketogenic diet group (n = 22), or a standard low-calorie diet group; (n = 23). Both groups received external support. Adiposity parameters and the cumulative number of months of successful weight loss (5 or 10 %) over a 24-month period were quantified. The very low-calorie-ketogenic diet induced less than 2 months of mild ketosis and significant effects on body weight at 6, 12, and 24 months. At 24 months, a trend to regress to baseline levels was observed; however, the very low-calorie-ketogenic diet induced a greater reduction in body weight (-12.5 kg), waist circumference (-11.6 cm), and body fat mass (-8.8 kg) than the low-calorie diet (-4.4 kg, -4.1 cm, and -3.8 kg, respectively; p ketogenic diet group experienced a reduction in the individual burden of obesity because reduction in disease duration. Very low-calorie-ketogenic diet patients were 500 months with 5 % weight lost vs. the low-calorie diet group (350 months; p ketogenic diet was effective 24 months later, with a decrease in visceral adipose tissue and a reduction in the individual burden of disease.

  11. Significant reduction of thermal conductivity in Si/Ge core-shell nanowires.

    Science.gov (United States)

    Hu, Ming; Giapis, Konstantinos P; Goicochea, Javier V; Zhang, Xiaoliang; Poulikakos, Dimos

    2011-02-09

    We report on the effect of germanium (Ge) coatings on the thermal transport properties of silicon (Si) nanowires using nonequilibrium molecular dynamics simulations. Our results show that a simple deposition of a Ge shell of only 1 to 2 unit cells in thickness on a single crystalline Si nanowire can lead to a dramatic 75% decrease in thermal conductivity at room temperature compared to an uncoated Si nanowire. By analyzing the vibrational density states of phonons and the participation ratio of each specific mode, we demonstrate that the reduction in the thermal conductivity of Si/Ge core-shell nanowire stems from the depression and localization of long-wavelength phonon modes at the Si/Ge interface and of high frequency nonpropagating diffusive modes.

  12. [Clinical significance of calcitonin gene-related peptide level before and after treatment in patients with chronic periodontitis].

    Science.gov (United States)

    Yan, Ying; Xiang, Xue-Rong; Wang, Chun; Ye, Guo; Fan, Xiao-Ping

    2016-08-01

    To explore the clinical significance of calcitonin gene-related peptide (CGRP) levels in patients with chronic periodontitis before and after treatment, and to detect the calcitonin gene-related peptide content in human venous blood. Thirty healthy controls and thirty patients with mild, moderate, severe periodontitis were enrolled from August 2014 to June 2015.CGRP level in the patients' peripheral blood was detected by ELISA. Three months after periodontal treatment, CGRP level in mild, moderate, severe periodontitis patients' peripheral blood was re-examined by ELISA. Then the correlation between calcitonin gene-related peptide and inflammation of chronic periodontitis was analyzed with SPSS 22.0 software package. The content of CGRP in healthy controls was significantly higher than that in patients with periodontitis. With the aggravation of periodontal inflammation, blood level of CGRP decreased gradually, and the lowest was in patients with severe periodontitis (Pperiodontal treatment, CGRP content was significantly higher compared with that before treatment (Pperiodontitis (P>0.05). The level of CGRP in venous blood decreased with the increasing severity of chronic periodontitis, and CGRP was negatively correlated with the degree of inflammation of chronic periodontitis. CGRP may be involved in the occurrence and development of chronic periodontitis. CGRP content in serum of patients with chronic periodontitis after treatment was significantly increased, CGRP may be used as the basis for clinical detection of chronic periodontitis.

  13. Home-based wrinkle reduction using a novel handheld multisource phase-controlled radiofrequency device.

    Science.gov (United States)

    Shemer, Avner; Levy, Hanna; Sadick, Neil S; Harth, Yoram; Dorizas, Andrew S

    2014-11-01

    In the last decade, energy-based aesthetic treatments, using light, radiofrequency (RF), and ultrasound, have gained scientific acceptance as safe and efficacious for non-invasive treatment for aesthetic skin disorders. The phase-controlled multisource radiofrequency technology (3DEEP™), which is based on the simultaneous use of multiple RF generators, was proven to allow significant pigment-independent dermal heating without pain or the need of epidermal cooling. This study was performed in order to evaluate the efficacy and safety of a new handheld device delivering multisource radiofrequency to the skin for wrinkle reduction and skin tightening in the home setting. A total of 69 participants (age 54.3 years ± 8.09; age range 37-72 years) were enrolled in the study after meeting all inclusion/exclusion criteria (100%) and providing informed consent. Participants were provided with the tested device together with a user manual and treatment diary, to perform independent treatments at home for 4 weeks. The tested device, (Newa™, EndyMed Medical, Cesarea, Israel) emits 12 W of 1Mhz, RF energy through six electrodes arranged in a linear fashion. Independent control of RF polarity through each one of the 6 electrodes allows significant reduction of energy flow through the epidermis with increased dermal penetration. Participants were instructed to perform at least 5 treatments a week, for one month. Four follow-up visits were scheduled (once a week) during the period of independent treatments at home, following 4 weeks of home treatments, 1 month follow-up visit (1 month after treatment end) and at 3 months follow-up (3 months following treatment end). Analysis of pre-and post treatment images was conducted by three uninvolved physicians experienced with the Fitzpatrick Wrinkle and Elastosis Scale. Fitzpatrick Wrinkle and Elastosis score of each time point (4 weeks following home use treatments; 1 month follow-up, 3 months follow-up) was compared to baseline

  14. VALVE BRONCHIAL BLOCK IN THE INTEGRATED TREATMENT OF BRONCHIAL PLEURAL FISTULAS AFTER SURGICAL REDUCTION OF PULMONARY VOLUME

    Directory of Open Access Journals (Sweden)

    E. A. Tseymakh

    2015-01-01

    Full Text Available Formation of bronchopleural fistulas after surgical reduction of pulmonary volume is one of the most frequent complications of surgical treatment of pulmonary emphysema. In order to control bronchopleural fistulas in the patients after surgical reduction of pulmonary volume the technique of valve bronchial block has been o}ered. This technique has been applied in 7 patients, and the favorable outcomes have been achieved in 6 (85.7% patients. The use of endobronchial valve for occlusion of fistulous bronchi allowed stopping air leaking through drainages, reducing time for pleural cavity drain and decreasing duration of patients' hospital stay.

  15. Mode-Specific Effects among Three Treatments for Depression.

    Science.gov (United States)

    Imber, Stanley D.; And Others

    1990-01-01

    Randomly assigned 250 depressed outpatients to interpersonal psychotherapy, cognitive-behavioral therapy, imipramine plus clinical management, or pill placebo plus clinical management treatments. All treatments demonstrated significant symptom reduction with few differences in general outcomes. None of the therapies produced consistent effects on…

  16. Treatment of blood with a pathogen reduction technology using UV light and riboflavin inactivates Ebola virus in vitro

    Science.gov (United States)

    Cap, Andrew P.; Pidcoke, Heather F.; Keil, Shawn D.; Staples, Hilary M.; Anantpadma, Manu; Carrion, Ricardo; Davey, Robert A.; Frazer-Abel, Ashley; Taylor, Audra L.; Gonzales, Richard; Patterson, Jean L.; Goodrich, Raymond P.

    2018-01-01

    BACKGROUND Transfusion of plasma from recovered patients after Ebolavirus (EBOV) infection, typically called ‘convalescent plasma,’ is an effective treatment for active disease available in endemic areas, but carries the risk of introducing other pathogens, including other strains of EBOV. A pathogen reduction technology using ultraviolet light and riboflavin (UV + RB) is effective against multiple enveloped, negative-sense, single-stranded RNA viruses that are similar in structure to EBOV. We hypothesized that UV + RB is effective against EBOV in blood products without activating complement or reducing protective immunoglobulin titers that are important for the treatment of ebolavirus disease (EVD). STUDY DESIGN AND METHODS Four in vitro experiments were conducted to evaluate effects of UV + RB on green fluorescent protein EBOV (EBOV-GFP), wild-type EBOV in serum and whole blood, respectively, and on immunoglobulins and complement in plasma. Initial titers for Experiments 1–3 were: 4.21 log10 GFP units/mL, 4.96 log10 infectious units per mL, and 4.23 log10 plaque forming units per mL (PFU/mL). Conditions tested in the first three experiments included: 1. EBOV-GFP + UV + RB; 2. EBOV-GFP + RB only; 3 EBOV-GFP + UV only; 4. EBOV-GFP without RB or UV; 5. Virus-free control + UV only; and 6. Virus-free control without RB or UV. RESULTS UV + RB reduced EBOV titers to non-detectable levels in both non-human primate serum (≥ 2.8 to 3.2 log reduction) and human whole blood (≥ 3.0 log reduction) without decreasing protective antibody titers in human plasma. CONCLUSION Our in vitro results demonstrate that the UV + RB treatment efficiently reduces EBOV titers to below limits of detection in both serum and whole blood. In vivo testing to determine whether UV + RB can improve convalescent blood product safety is indicated. PMID:27001363

  17. Treatment of blood with a pathogen reduction technology using ultraviolet light and riboflavin inactivates Ebola virus in vitro.

    Science.gov (United States)

    Cap, Andrew P; Pidcoke, Heather F; Keil, Shawn D; Staples, Hilary M; Anantpadma, Manu; Carrion, Ricardo; Davey, Robert A; Frazer-Abel, Ashley; Taylor, Audra L; Gonzales, Richard; Patterson, Jean L; Goodrich, Raymond P

    2016-03-01

    Transfusion of plasma from recovered patients after Ebolavirus (EBOV) infection, typically called "convalescent plasma," is an effective treatment for active disease available in endemic areas, but carries the risk of introducing other pathogens, including other strains of EBOV. A pathogen reduction technology using ultraviolet light and riboflavin (UV+RB) is effective against multiple enveloped, negative-sense, single-stranded RNA viruses that are similar in structure to EBOV. We hypothesized that UV+RB is effective against EBOV in blood products without activating complement or reducing protective immunoglobulin titers that are important for the treatment of Ebola virus disease (EVD). Four in vitro experiments were conducted to evaluate effects of UV+RB on green fluorescent protein EBOV (EBOV-GFP), wild-type EBOV in serum, and whole blood, respectively, and on immunoglobulins and complement in plasma. Initial titers for Experiments 1 to 3 were 4.21 log GFP units/mL, 4.96 log infectious units/mL, and 4.23 log plaque-forming units/mL. Conditions tested in the first three experiments included the following: 1-EBOV-GFP plus UV+RB; 2-EBOV-GFP plus RB only; 3-EBOV-GFP plus UV only; 4-EBOV-GFP without RB or UV; 5-virus-free control plus UV only; and 6-virus-free control without RB or UV. UV+RB reduced EBOV titers to nondetectable levels in both nonhuman primate serum (≥2.8- to 3.2-log reduction) and human whole blood (≥3.0-log reduction) without decreasing protective antibody titers in human plasma. Our in vitro results demonstrate that the UV+RB treatment efficiently reduces EBOV titers to below limits of detection in both serum and whole blood. In vivo testing to determine whether UV+RB can improve convalescent blood product safety is indicated. © 2016 AABB.

  18. Significance of Timing on Effect of Metaphylactic Toltrazuril Treatment against Eimeriosis in Calves

    DEFF Research Database (Denmark)

    Enemark, Heidi; Dahl, Jan; Enemark, Jörg Matthias Dehn

    2015-01-01

    of Eimeria bovis and Eimeria zuernii. Three commercial herds and a total of 71 calves, aged 48 – 135 days, were included. Treatment with a single oral dose of toltrazuril (15 mg/kg) was given after relocation to common pens and one week before expected outbreak of eimeriosis. The effect of treatment...... was followed by weekly faecal sampling and weighing initially and at the end of a study period of 8 weeks. In Herd 2 and 3 toltrazuril treated calves gained on average 7.95 kg more than placebo treated calves (p = 0.007), and both oocyst excretion and prevalence of Eimeria spp. were significantly reduced...

  19. Assembling of carbon nanotubes film responding to significant reduction wear and friction on steel surface

    Science.gov (United States)

    Zhang, Bin; Xue, Yong; Qiang, Li; Gao, Kaixong; Liu, Qiao; Yang, Baoping; Liang, Aiming; Zhang, Junyan

    2017-11-01

    Friction properties of carbon nanotubes have been widely studied and reported, however, the friction properties of carbon nanotubes related on state of itself. It is showing superlubricity under nanoscale, but indicates high shear adhesion as aligned carbon nanotube film. However, friction properties under high load (which is commonly in industry) of carbon nanotube films are seldom reported. In this paper, carbon nanotube films, via mechanical rubbing method, were obtained and its tribology properties were investigated at high load of 5 to 15 N. Though different couple pairs were employed, the friction coefficients of carbon nanotube films are nearly the same. Compared with bare stainless steel, friction coefficients and wear rates under carbon nanotube films lubrication reduced to, at least, 1/5 and 1/(4.3-14.5), respectively. Friction test as well as structure study were carried out to reveal the mechanism of the significant reduction wear and friction on steel surface. One can conclude that sliding and densifying of carbon nanotubes at sliding interface contribute to the sufficient decrease of friction coefficients and wear rates.

  20. Reduction of Cancer-Specific Thought Intrusions and Anxiety Symptoms With a Stress Management Intervention Among Women Undergoing Treatment for Breast Cancer

    Science.gov (United States)

    Antoni, Michael H.; Wimberly, Sarah R.; Lechner, Suzanne C.; Kazi, Aisha; Sifre, Tammy; Urcuyo, Kenya R.; Phillips, Kristin; Smith, Roselyn G.; Petronis, Vida M.; Guellati, Sophie; Wells, Kurrie A.; Blomberg, Bonnie; Carver, Charles S.

    2017-01-01

    Objective After surgery for breast cancer, many women experience anxiety relating to the cancer that can adversely affect quality of life and emotional functioning during the year postsurgery. Symptoms such as intrusive thoughts may be ameliorated during this period with a structured, group-based cognitive behavior intervention. Method A 10-week group cognitive behavior stress management intervention that included anxiety reduction (relaxation training), cognitive restructuring, and coping skills training was tested among 199 women newly treated for stage 0-III breast cancer. They were then followed for 1 year after recruitment. Results The intervention reduced reports of thought intrusion, interviewer ratings of anxiety, and emotional distress across 1 year significantly more than was seen with the control condition. The beneficial effects were maintained well past the completion of adjuvant therapy. Conclusions Structured, group-based cognitive behavior stress management may ameliorate cancer-related anxiety during active medical treatment for breast cancer and for 1 year following treatment. Group-based cognitive behavior stress management is a clinically useful adjunct to offer to women treated for breast cancer. PMID:17012691

  1. Free ammonia pre-treatment of secondary sludge significantly increases anaerobic methane production.

    Science.gov (United States)

    Wei, Wei; Zhou, Xu; Wang, Dongbo; Sun, Jing; Wang, Qilin

    2017-07-01

    Energy recovery in the form of methane from sludge/wastewater is restricted by the poor and slow biodegradability of secondary sludge. An innovative pre-treatment technology using free ammonia (FA, i.e. NH 3 ) was proposed in this study to increase anaerobic methane production. The solubilisation of secondary sludge was significantly increased after FA pre-treatment at up to 680 mg NH 3 -N/L for 1 day, under which the solubilisation (i.e. 0.4 mg SCOD/mg VS; SCOD: soluble chemical oxygen demand; VS: volatile solids) was >10 times higher than that without FA pre-treatment (i.e. 0.03 mg SCOD/mg VS). Biochemical methane potential assays showed that FA pre-treatment at above 250 mg NH 3 -N/L is effective in improving anaerobic methane production. The highest improvement in biochemical methane potential (B 0 ) and hydrolysis rate (k) was achieved at FA concentrations of 420-680 mg NH 3 -N/L, and was determined as approximately 22% (from 160 to 195 L CH 4 /kg VS added) and 140% (from 0.22 to 0.53 d -1 ) compared to the secondary sludge without pre-treatment. More analysis revealed that the FA induced improvement in B 0 and k could be attributed to the rapidly biodegradable substances rather than the slowly biodegradable substances. Economic and environmental analyses showed that the FA-based technology is economically favourable and environmentally friendly. Since this FA technology aims to use the wastewater treatment plants (WWTPs) waste (i.e. anaerobic digestion liquor) to enhance methane production from the WWTPs, it will set an example for the paradigm shift of the WWTPs from 'linear economy' to 'circular economy'. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Reduction of nutrients, microbes, and personal care products in domestic wastewater by a benchtop electrocoagulation unit

    Science.gov (United States)

    Symonds, E. M.; Cook, M. M.; McQuaig, S. M.; Ulrich, R. M.; Schenck, R. O.; Lukasik, J. O.; van Vleet, E. S.; Breitbart, M.

    2015-03-01

    To preserve environmental and human health, improved treatment processes are needed to reduce nutrients, microbes, and emerging chemical contaminants from domestic wastewater prior to discharge into the environment. Electrocoagulation (EC) treatment is increasingly used to treat industrial wastewater; however, this technology has not yet been thoroughly assessed for its potential to reduce concentrations of nutrients, a variety of microbial surrogates, and personal care products found in domestic wastewater. This investigation's objective was to determine the efficiency of a benchtop EC unit with aluminum sacrificial electrodes to reduce concentrations of the aforementioned biological and chemical pollutants from raw and tertiary-treated domestic wastewater. EC treatment resulted in significant reductions (p < 0.05, α = 0.05) in phosphate, all microbial surrogates, and several personal care products from raw and tertiary-treated domestic wastewater. When wastewater was augmented with microbial surrogates representing bacterial, viral, and protozoan pathogens to measure the extent of reduction, EC treatment resulted in up to 7-log10 reduction of microbial surrogates. Future pilot and full-scale investigations are needed to optimize EC treatment for the following: reducing nitrogen species, personal care products, and energy consumption; elucidating the mechanisms behind microbial reductions; and performing life cycle analyses to determine the appropriateness of implementation.

  3. Clinical significance of determination of serum TNF-α, VEGF and TSGF levels after treatment in patients with aplastic anemia

    International Nuclear Information System (INIS)

    Hu Mingqiu; Xu Yanli

    2009-01-01

    Objective: To explore the clinical significance changes of serum TNF-α, VEGF and TSGF levels after treatment in patients with aplastic Anemia. Methods: Serum TNF-α(with RIA), VEGF(with ELISA) and TSGF(with biochemistry) levels were determined in 33 patients with aplastic anemia both before and after treatment and 35 controls. Results: Before treatment, the serum TNF-α, TSGF levels were significantly higher in the patients than those in controls (P<0.01), but serum VEGF levels were significantly lower in the patients (P<0.01). Serum TNF-α, TSGF levels were negatively correlated with levels of VEGF(r=-0.5192, -0.6018, P<0.01). After a course of treatment, the serum TNF-α, VEGF and TSGF levels, though corrected markedly, remained significantly different from those in controls (P<0.05). Conclusion: Determination of serum TNF-α, VEGF and TSGF levels after treatment might be of prognostic importance in patients with aplastic anemia. (authors)

  4. Treatment strategies for transuranic wastes

    International Nuclear Information System (INIS)

    Schneider, K.J.; Swanson, J.L.; Ross, W.A.; Allen, R.P.; Yasutake, K.M.

    1986-01-01

    This paper presents an analysis of treatment options or strategies for transuranic wastes expected to be generated at a commercial nuclear fuel reprocessing plant. Six potential options were analyzed, ranging from no treatment to maximum volume reduction and high quality waste forms. Economics for the total management of these (treatment, transportation, disposal) indicate life-cycle savings for extensive treatment are as high as $1.7 billion for 70,000 MTU. Evaluations of the waste processing and waste forms support the selection of a number of the extensive waste treatments. It is concluded that there are significant incentives for extensive treatment of transuranic wastes

  5. Overview of harm reduction in prisons in seven European countries.

    Science.gov (United States)

    Sander, Gen; Scandurra, Alessio; Kamenska, Anhelita; MacNamara, Catherine; Kalpaki, Christina; Bessa, Cristina Fernandez; Laso, Gemma Nicolás; Parisi, Grazia; Varley, Lorraine; Wolny, Marcin; Moudatsou, Maria; Pontes, Nuno Henrique; Mannix-McNamara, Patricia; Libianchi, Sandro; Antypas, Tzanetos

    2016-10-07

    While the last decade has seen a growth of support for harm reduction around the world, the availability and accessibility of quality harm reduction services in prison settings is uneven and continues to be inadequate compared to the progress achieved in the broader community. This article provides a brief overview of harm reduction in prisons in Catalonia (Spain), Greece, Ireland, Italy, Latvia, Poland, and Portugal. While each country provides a wide range of harm reduction services in the broader community, the majority fail to provide these same services or the same quality of these services, in prison settings, in clear violation of international human rights law and minimum standards on the treatment of prisoners. Where harm reduction services have been available and easily accessible in prison settings for some time, better health outcomes have been observed, including significantly reduced rates of HIV and HCV incidence. While the provision of harm reduction in each of these countries' prisons varies considerably, certain key themes and lessons can be distilled, including around features of an enabling environment for harm reduction, resource allocation, collection of disaggregated data, and accessibility of services.

  6. Significant Artifact Reduction at 1.5T and 3T MRI by the Use of a Cochlear Implant with Removable Magnet: An Experimental Human Cadaver Study.

    Science.gov (United States)

    Wagner, Franca; Wimmer, Wilhelm; Leidolt, Lars; Vischer, Mattheus; Weder, Stefan; Wiest, Roland; Mantokoudis, Georgios; Caversaccio, Marco D

    2015-01-01

    Cochlear implants (CIs) are standard treatment for postlingually deafened individuals and prelingually deafened children. This human cadaver study evaluated diagnostic usefulness, image quality and artifacts in 1.5T and 3T magnetic resonance (MR) brain scans after CI with a removable magnet. Three criteria (diagnostic usefulness, image quality, artifacts) were assessed at 1.5T and 3T in five cadaver heads with CI. The brain magnetic resonance scans were performed with and without the magnet in situ. The criteria were analyzed by two blinded neuroradiologists, with focus on image distortion and limitation of the diagnostic value of the acquired MR images. MR images with the magnet in situ were all compromised by artifacts caused by the CI. After removal of the magnet, MR scans showed an unequivocal artifact reduction with significant improvement of the image quality and diagnostic usefulness, both at 1.5T and 3T. Visibility of the brain stem, cerebellopontine angle, and parieto-occipital lobe ipsilateral to the CI increased significantly after magnet removal. The results indicate the possible advantages for 1.5T and 3T MR scanning of the brain in CI carriers with removable magnets. Our findings support use of CIs with removable magnets, especially in patients with chronic intracranial pathologies.

  7. Is reduction of symptoms in eating disorder patients after 1 year of treatment related to attachment security and mentalization?

    NARCIS (Netherlands)

    Kuipers, Greet S.; Van Loenhout, Zara; Van Der Ark, L. Andries; Bekker, M.H.J.

    2018-01-01

    In a sample of 38 eating disorder (ED) patients who received psychotherapeutic treatment, changes in attachment security, and mentalization in relation to symptoms reduction were investigated. Attachment security improved in 1 year but was unrelated to improvement of ED or comorbid symptoms.

  8. Indications for repeated enema reduction of intussusception in children

    Directory of Open Access Journals (Sweden)

    Vujović Dragana

    2014-01-01

    Full Text Available Introduction. Intussusception is a common abdominal emergency in early childhood. It is idiopathic in more than 90% of cases with incidence of 1.5-4 per 1,000 live births. The treatment of choice is nonoperative hydrostatic or air enema reduction. Objective. The aim of the study was to evaluate the influence of clinical presentation and symptom duration in non-operative treatment, considering the indications for delayed enema reduction and its efficacy. Methods. From the total number of 107 patients with intusussception, aged from 2 months to 14 years (median 9 months, 102 (95% patients with ileo-colic intussusceptions were treated initially by ultrasound guided saline enema. Records were reviewed for patients with failed initial treatment and delayed repeated enemas or operative procedure. The predictor variable included duration of presenting symptoms. Results. Successful treatment by hydrostatic saline enemas had 58/102 (57% patients. Success in reduction was greater if symptom duration was 24 hours, (4/45 cases; 9%. Despite failed initial attempts, enema reduction was reattempted in 12 patients, with success in 7/12 (60% patients. Children with symptom duration >24 hours had a greater risk of requiring surgery (41/45 cases; 91%, p<0.001, including 5 (5% patients with ileo-ileal intussusceptions. Conclusion. The accuracy of ultrasound guided saline enema in intussusception reduction is high. Delay in presentation decreases success of non-operative treatment. Delayed enema reduction is important therapeutic option for intussusceptions. Surgical treatment is indicated in cases of complications.

  9. Clinical significance of measurement of serum NO/NOS and TNF-α levels after treatment in patients with schizophrenia

    International Nuclear Information System (INIS)

    Nan Deqi; Du Liang; Yang Sixue; Qin Yong

    2007-01-01

    Objective: To explore the significance of changes of serum NO/NOS and TNF-α levels in patients with schizophrenia. Methods: Serum TNF-α (with R/A) and NO/NOS (with bio-chemistry) levels were determined in 41 patients with schizophrenia both before and after treatment as well as in 35 controls. Results:Before treatment the serum NOS, TNF-α levels in the patients were significantly higher than those in controls (P <0.01 ). After six weeks treatment, the levels in patients, though dropped markedly, remained significantly higher (P<0.05). Conclusion: Serum NO/NOS and TNF-α levels were closely related to the diseases process of schizophrenia and were of prognostic values. (authors)

  10. Significant role of organic sulfur in supporting sedimentary sulfate reduction in low-sulfate environments

    Science.gov (United States)

    Fakhraee, Mojtaba; Li, Jiying; Katsev, Sergei

    2017-09-01

    Dissimilatory sulfate reduction (DSR) is a major carbon mineralization pathway in aquatic sediments, soils, and groundwater, which regulates the production of hydrogen sulfide and the mobilization rates of biologically important elements such as phosphorus and mercury. It has been widely assumed that water-column sulfate is the main sulfur source to fuel this reaction in sediments. While this assumption may be justified in high-sulfate environments such as modern seawater, we argue that in low-sulfate environments mineralization of organic sulfur compounds can be an important source of sulfate. Using a reaction-transport model, we investigate the production of sulfate from sulfur-containing organic matter for a range of environments. The results show that in low sulfate environments (50%) of sulfate reduction. In well-oxygenated systems, porewater sulfate profiles often exhibit sub-interface peaks so that sulfate fluxes are directed out of the sediment. Our measurements in Lake Superior, the world's largest lake, corroborate this conclusion: offshore sediments act as sources rather than sinks of sulfate for the water column, and sediment DSR is supported entirely by the in-sediment production of sulfate. Sulfate reduction rates are correlated to the depth of oxygen penetration and strongly regulated by the supply of reactive organic matter; rate co-regulation by sulfate availability becomes appreciable below 500 μM level. The results indicate the need to consider the mineralization of organic sulfur in the biogeochemical cycling in low-sulfate environments, including several of the world's largest freshwater bodies, deep subsurface, and possibly the sulfate-poor oceans of the Early Earth.

  11. Reduction of nasal Staphylococcus aureus carriage in health care professionals by treatment with a nonantibiotic, alcohol-based nasal antiseptic.

    Science.gov (United States)

    Steed, Lisa L; Costello, Justin; Lohia, Shivangi; Jones, Taylor; Spannhake, Ernst W; Nguyen, Shaun

    2014-08-01

    Antibiotics used to reduce nasal colonization by Staphylococcus aureus in patients before admission are inappropriate for carriage reduction on a regular basis within a hospital community. Effective nonantibiotic alternatives for daily use in the nares will allow reduction of this bacterial source to be addressed. Our study tested the effectiveness of a nonantibiotic, alcohol-based antiseptic in reducing nasal bacterial carriage in health care professionals (HCPs) at an urban hospital center. HCPs testing positive for vestibular S aureus colonization were treated 3 times during the day with topical antiseptic or control preparations. Nasal S aureus and total bacterial colonization levels were determined before and at the end of a 10-hour workday. Seventy-eight of 387 HCPs screened (20.2%) tested positive for S aureus infection. Of 39 subjects who tested positive for S aureus infection who completed the study, 20 received antiseptic and 19 received placebo treatment. Antiseptic treatment reduced S aureus colony forming units from baseline by 99% (median) and 82% (mean) (P antiseptic was effective in reducing S aureus and total bacterial carriage, suggesting the usefulness of this approach as a safe, effective, and convenient alternative to antibiotic treatment. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  12. Autologous inferior dermal sling (autoderm) with concomitant skin-envelope reduction mastectomy: an excellent surgical choice for women with macromastia and clinically significant ptosis.

    Science.gov (United States)

    Dietz, Jill; Lundgren, P; Veeramani, A; O'Rourke, C; Bernard, S; Djohan, R; Larson, J; Isakov, R; Yetman, R

    2012-10-01

    Skin-sparing mastectomy and prosthetic reconstruction can be complicated by poor surgical outcomes in large-breasted, obese women. This article describes a single surgeon's experience comparing conventional skin-sparing mastectomy (SSM) and skin-reduction mastectomy using an autologous vascularized inferior dermal/cutaneous sling (autoderm). From July 2007 to May 2012, patients undergoing skin-sparing mastectomy were evaluated for surgical outcomes. After July 2009, the surgeon performed skin-reduction mastectomies with autoderm (SRM-AD) on all patients with macromastia or grade 3-4 ptosis. Remaining patients in this time period (SSM-cont) underwent conventional skin-sparing mastectomies while all previous patients (historical) also underwent skin-sparing mastectomies (SSM-hist). A predictive model was used to compare the large historical patients (who would have had reduction mastectomy if available) with the smaller historical patients to evaluate the effect of the procedure. Body mass index (BMI) and specimen weight were higher in both the SRM group and large historical group. The hazard ratio for having skin-reduction mastectomy was 0.53 (P = 0.51) compared with the historical group. There was a total of 16 complications for the whole study. Smoking was the only significant risk factor. This study shows that mastectomy with prosthetic reconstruction using a skin-reduction technique with autoderm can be done safely with a low complication rate and improved cosmetic outcomes in the traditionally "at-risk" group of women with high BMI and large ptotic breasts.

  13. The significance for epidemiological studies anti-measles antibody detection examined by enzyme immunoassay (EIA) and plaque reduction neutralization test (PRNT).

    Science.gov (United States)

    Siennicka, Joanna; Częścik, Agnieszka; Trzcińska, Agnieszka

    2014-01-01

    The paper discusses the role of anti-measles antibodies for protection and significance for epidemiological studies determination of antibodies by different serological methods. The comparison of anti-measles virus antibodies levels measured by enzyme immunoassay (EIA) and Plaque Reduction Neutralization Test (PRNT) was described. It was found that the 200 mIU/ml of anti-measles activity measured by PRNT (level protection against symp- tomatic disease) is equivalent of 636 mIU/ml measured by EIA (Enzygnost®Anti-Measles Virus/IgG, Simens).

  14. Complementary Therapies for Significant Dysfunction from Tinnitus: Treatment Review and Potential for Integrative Medicine

    Directory of Open Access Journals (Sweden)

    Ruth Q. Wolever

    2015-01-01

    Full Text Available Tinnitus is a prevalent and costly chronic condition; no universally effective treatment exists. Only 20% of patients who report tinnitus actually seek treatment, and when treated, most patients commonly receive sound-based and educational (SBE therapy. Additional treatment options are necessary, however, for nonauditory aspects of tinnitus (e.g., anxiety, depression, and significant interference with daily life and when SBE therapy is inefficacious or inappropriate. This paper provides a comprehensive review of (1 conventional tinnitus treatments and (2 promising complementary therapies that have demonstrated some benefit for severe dysfunction from tinnitus. While there has been no systematic study of the benefits of an Integrative Medicine approach for severe tinnitus, the current paper reviews emerging evidence suggesting that synergistic combinations of complementary therapies provided within a whole-person framework may augment SBE therapy and empower patients to exert control over their tinnitus symptoms without the use of medications, expensive devices, or extended programs.

  15. Does exercise aid smoking cessation through reductions in anxiety sensitivity and dysphoria?

    Science.gov (United States)

    Zvolensky, Michael J; Rosenfield, David; Garey, Lorra; Kauffman, Brooke Y; Langdon, Kirsten J; Powers, Mark B; Otto, Michael W; Davis, Michelle L; Marcus, Bess H; Church, Timothy S; Frierson, Georita M; Hopkins, Lindsey B; Paulus, Daniel J; Baird, Scarlett O; Smits, Jasper A J

    2018-07-01

    Research shows that high anxiety sensitivity (AS) and dysphoria are related to poor smoking cessation outcomes. Engaging in exercise may contribute to improvement in smoking cessation outcomes through reductions in AS and dysphoria. In the current study, we examined whether exercise can aid smoking cessation through reductions in AS and dysphoria. Participants were sedentary and low activity adult daily smokers (N = 136) with elevated AS who participated in a randomized controlled trial comparing smoking cessation treatment (ST) plus an exercise intervention (ST + EX) to ST plus wellness education (ST + CTRL). Self-reported smoking status was assessed in-person weekly from baseline through week 16 (end of-treatment; EOT), at week 22 (4 months postquit day), and at week 30 (6 months postquit day), and verified biochemically. Results indicated that both AS and dysphoria at 6-month follow-up were significantly lower in the ST + EX group compared to the ST + CTRL group (controlling for baseline levels). Moreover, reductions in AS and dysphoria emerged as independent mechanisms of action explaining success in quitting. These novel findings offer clinically significant evidence suggesting that vigorous-intensity exercise can effectively engage affective constructs in the context of smoking cessation. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  16. Low-dose vaporized cannabis significantly improves neuropathic pain.

    Science.gov (United States)

    Wilsey, Barth; Marcotte, Thomas; Deutsch, Reena; Gouaux, Ben; Sakai, Staci; Donaghe, Haylee

    2013-02-01

    We conducted a double-blind, placebo-controlled, crossover study evaluating the analgesic efficacy of vaporized cannabis in subjects, the majority of whom were experiencing neuropathic pain despite traditional treatment. Thirty-nine patients with central and peripheral neuropathic pain underwent a standardized procedure for inhaling medium-dose (3.53%), low-dose (1.29%), or placebo cannabis with the primary outcome being visual analog scale pain intensity. Psychoactive side effects and neuropsychological performance were also evaluated. Mixed-effects regression models demonstrated an analgesic response to vaporized cannabis. There was no significant difference between the 2 active dose groups' results (P > .7). The number needed to treat (NNT) to achieve 30% pain reduction was 3.2 for placebo versus low-dose, 2.9 for placebo versus medium-dose, and 25 for medium- versus low-dose. As these NNTs are comparable to those of traditional neuropathic pain medications, cannabis has analgesic efficacy with the low dose being as effective a pain reliever as the medium dose. Psychoactive effects were minimal and well tolerated, and neuropsychological effects were of limited duration and readily reversible within 1 to 2 hours. Vaporized cannabis, even at low doses, may present an effective option for patients with treatment-resistant neuropathic pain. The analgesia obtained from a low dose of delta-9-tetrahydrocannabinol (1.29%) in patients, most of whom were experiencing neuropathic pain despite conventional treatments, is a clinically significant outcome. In general, the effect sizes on cognitive testing were consistent with this minimal dose. As a result, one might not anticipate a significant impact on daily functioning. Published by Elsevier Inc.

  17. Process energy reduction

    International Nuclear Information System (INIS)

    Lowthian, W.E.

    1993-01-01

    Process Energy Reduction (PER) is a demand-side energy reduction approach which complements and often supplants other traditional energy reduction methods such as conservation and heat recovery. Because the application of PER is less obvious than the traditional methods, it takes some time to learn the steps as well as practice to become proficient in its use. However, the benefit is significant, often far outweighing the traditional energy reduction approaches. Furthermore, the method usually results in a better process having less waste and pollution along with improved yields, increased capacity, and lower operating costs

  18. Reduction - competitive tomorrow

    International Nuclear Information System (INIS)

    Worley, L.; Bargerstock, S.

    1995-01-01

    Inventory reduction is one of the few initiatives that represent significant cost-reduction potential that does not result in personnel reduction. Centerior Energy's Perry nuclear power plant has embarked on an aggressive program to reduce inventory while maintaining plant material availability. Material availability to the plant was above 98%, but at an unacceptable 1994 inventory book value of $47 million with inventory carrying costs calculated at 30% annually

  19. Alcohol expectancies pre-and post-alcohol use disorder treatment: Clinical implications.

    Science.gov (United States)

    Coates, Jason M; Gullo, Matthew J; Feeney, Gerald F X; Young, Ross McD; Dingle, Genevieve A; Connor, Jason P

    2018-05-01

    Modification of elevated positive expectations of alcohol consumption (alcohol outcome expectancies; AOEs) is a key feature of Cognitive Behaviour Therapy (CBT) approaches to Alcohol Use Disorders (AUDs). Despite extensive research supporting the efficacy of CBT for AUD, few studies have examined AOE change. This study aimed to assess AOE change following completion of CBT for AUD and its association with drinking behaviour. One-hundred and seventy-five patients who completed a 12-week CBT program for AUD were administered the Drinking Expectancy Questionnaire (DEQ) at pre-treatment assessment and upon completion of treatment. Abstinence was achieved by 108 (61.7%) of completing patients. For patients who lapsed, the mean proportion of abstinent days was 93%. DEQ scales assessing expectations of positive alcohol effects on tension reduction, assertiveness, and cognitive enhancement were significantly lower post-treatment (pscale. Greater percentage of abstinent days over treatment was associated with lower pre-and post-treatment tension reduction expectancy scores (p<0.05). Drinking during treatment was associated with smaller changes in expectations of negative effects of alcohol on mood (p<0.05). Individuals who completed CBT treatment for AUD showed significant AOE change. Tension reduction and affective change expectancies may be particularly important for abstinence and useful markers of lapse risk. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. Westinghouse Modular Grinding Process - Enhancement of Volume Reduction for Hot Resin Supercompaction - 13491

    Energy Technology Data Exchange (ETDEWEB)

    Fehrmann, Henning [Westinghouse Electric Germany GmbH, Dudenstr. 44, D-68167 Mannheim (Germany); Aign, Joerg [Westinghouse Electric Germany GmbH, Global D and D and Waste Management, Tarpenring 6, D-22419 Hamburg (Germany)

    2013-07-01

    In nuclear power plants (NPP) ion exchange (IX) resins are used in several systems for water treatment. Spent resins can contain a significant amount of contaminates which makes treatment for disposal of spent resins mandatory. Several treatment processes are available such as direct immobilization with technologies like cementation, bitumisation, polymer solidification or usage of a high integrity container (HIC). These technologies usually come with a significant increase in final waste volume. The Hot Resin Supercompaction (HRSC) is a thermal treatment process which reduces the resin waste volume significantly. For a mixture of powdered and bead resins the HRSC process has demonstrated a volume reduction of up to 75 % [1]. For bead resins only the HRSC process is challenging because the bead resins compaction properties are unfavorable. The bead resin material does not form a solid block after compaction and shows a high spring back effect. The volume reduction of bead resins is not as good as for the mixture described in [1]. The compaction properties of bead resin waste can be significantly improved by grinding the beads to powder. The grinding also eliminates the need for a powder additive.Westinghouse has developed a modular grinding process to grind the bead resin to powder. The developed process requires no circulation of resins and enables a selective adjustment of particle size and distribution to achieve optimal results in the HRSC or in any other following process. A special grinding tool setup is use to minimize maintenance and radiation exposure to personnel. (authors)

  1. Repeated application of fuel reduction treatments in the southern Appalachian Mountains, USA: implications for achieving management goals

    Science.gov (United States)

    Thomas A. Waldrop; Donald L. Hagan; Dean M. Simon

    2016-01-01

    Fire and resource managers of the southern Appalachian Mountains, USA, have many questions about the use of prescribed fire and mechanical treatments to meet various land management objectives. Three common objectives include restoration to an open woodland, oak regeneration, and fuel reduction. This paper provides information about reaching each of these three...

  2. Luteinizing hormone reduction by the male potency herb, Butea superba Roxb.

    Directory of Open Access Journals (Sweden)

    S. Malaivijitnond

    2010-09-01

    Full Text Available To determine if Butea superba Roxb., a traditional Thai male potency herb, has androgenic activity in 60-day-old male Wistar rats, we measured its effects on the pituitary-testicular axis and sex organs. Intact and orchidectomized adult male rats were subdivided into five groups (10 rats/group: distilled water, Butea superba (BS-10, BS-50, BS-250, and testosterone propionate (TP. They received 0, 10, 50, and 250 mg·kg body weight-1·day-1 BS in distilled water by gavage and 6 mg·kg body weight-1·day-1 TP sc, respectively, during the 30-day treatment period. Blood was collected every 15 days and luteinizing hormone (LH, follicle-stimulating hormone (FSH and testosterone were measured. Changes of weight and histological appearance of sex organs were determined at the end of the 30-day treatment and 15-day post-treatment periods. TP treatment reduced serum FSH and LH levels and significantly increased the weight of the seminal vesicles and epididymis, in accordance with histopathological changes, in both intact and orchidectomized rats. No changes in serum testosterone, LH, and FSH levels were observed in any of the intact rats treated with BS, but a significant increase in seminal vesicle weight was observed only in the BS-250 group. Although a significant reduction in serum LH was detected in the BS-50 and BS-250 groups of orchidectomized rats, no significant change in weight or histology of sex organs was observed. Thus, we conclude that B. superba needs endogenous testosterone to work synergistically to stimulate the accessory sex organ of intact animals and can potentially exhibit an LH reduction effect in orchidectomized animals.

  3. Short-term combined treatment with liraglutide and metformin leads to significant weight loss in obese women with polycystic ovary syndrome and previous poor response to metformin.

    Science.gov (United States)

    Jensterle Sever, Mojca; Kocjan, Tomaz; Pfeifer, Marija; Kravos, Nika Aleksandra; Janez, Andrej

    2014-03-01

    The effect of metformin on weight reduction in polycystic ovary syndrome (PCOS) is often unsatisfactory. In this study, we investigated the potential add-on effect of treatment with the glucagon-like peptide-1 receptor agonist liraglutide on weight loss in obese nondiabetic women with PCOS who had lost weight during pretreatment with metformin. A total of 40 obese women with PCOS, who had been pretreated with metformin for at least 6 months, participated in a 12-week open-label, prospective study. They were randomized to one of three treatment arms: metformin (MET) arm 1000 mg BID, liraglutide (LIRA) arm 1.2 mg QD s.c., or combined MET 1000 mg BID and LIRA (COMBI) 1.2 mg QD s.c. Lifestyle intervention was not actively promoted. The primary outcome was change in body weight. Thirty six patients (aged 31.3 ± 7.1 years, BMI 37.1 ± 4.6 kg/m²) completed the study: 14 on MET, 11 on LIRA, and 11 on combined treatment. COMBI therapy was superior to LIRA and MET monotherapy in reducing weight, BMI, and waist circumference. Subjects treated with COMBI lost on average 6.5 ± 2.8 kg compared with a 3.8 ± 3.7 kg loss in the LIRA group and a 1.2 ± 1.4 kg loss in the MET group (Pweight loss was stratified: a total of 38% of subjects were high responders who lost ≥5% body weight, 22% of them in the COMBI arm compared with 16 and 0% in the LIRA and MET arm respectively. BMI decreased by 2.4 ± 1.0 in the COMBI arm compared with 1.3 ± 1.3 in LIRA and 0.5 ± 0.5 in the MET arm (Pweight loss. Short-term combined treatment with liraglutide and metformin was associated with significant weight loss and decrease in waist circumference in obese women with PCOS who had previously been poor responders regarding weight reduction on metformin monotherapy.

  4. TREATMENT OF HYPERTENSION USING TELEMEDICAL HOME BLOOD PRESSURE MEASUREMENTS

    DEFF Research Database (Denmark)

    Hoffmann-Petersen, N; Lauritzen, T; Bech, J N

    2015-01-01

    OBJECTIVE: Telemonitoring of home blood pressure measurements (TBPM) is a new and promising supplement to diagnosis, control and treatment of hypertension. We wanted to compare the outcome of antihypertensive treatment based on TBPM and conventional monitoring of blood pressure. DESIGN AND METHOD...... of the measurements and subsequent communication by telephone or E-mail. In the control group, patients received usual care. Primary outcome was reduction in daytime ambulatory blood pressure measurements (ABPM) from baseline to 3 months' follow-up. RESULTS: In both groups, daytime ABPM decreased significantly....../181), p = 0.34. Blood pressure reduction in the TBPM group varied with the different practices. CONCLUSIONS: No further reduction in ABPM or number of patients reaching blood pressure targets was observed when electronic transmission of TBPM was applied in the treatment of hypertension by GPs. Thus...

  5. The Effect of Electroacupuncture on Osteosarcoma Tumor Growth and Metastasis: Analysis of Different Treatment Regimens

    Directory of Open Access Journals (Sweden)

    Branden A. Smeester

    2013-01-01

    Full Text Available Osteosarcoma is the most common malignant bone tumor found in children and adolescents and is associated with many complications including cancer pain and metastasis. While cancer patients often seek complementary and alternative medicine (CAM approaches to treat cancer pain and fatigue or the side effects of chemotherapy and treatment, there is little known about the effect of acupuncture treatment on tumor growth and metastasis. Here we evaluate the effects of six different electroacupuncture (EA regimens on osteosarcoma tumor growth and metastasis in both male and female mice. The most significant positive effects were observed when EA was applied to the ST-36 acupoint twice weekly (EA-2X/3 beginning at postimplantation day 3 (PID 3. Twice weekly treatment produced robust reductions in tumor growth. Conversely, when EA was applied twice weekly (EA-2X/7, starting at PID 7, there was a significant increase in tumor growth. We further demonstrate that EA-2X/3 treatment elicits significant reductions in tumor lymphatics, vasculature, and innervation. Lastly, EA-2X/3 treatment produced a marked reduction in pulmonary metastasis, thus providing evidence for EA’s potential antimetastatic capabilities. Collectively, EA-2X/3 treatment was found to reduce both bone tumor growth and lung metastasis, which may be mediated in part through reductions in tumor-associated vasculature, lymphatics, and innervation.

  6. Treatment strategies for transuranic wastes

    International Nuclear Information System (INIS)

    Schneider, K.J.; Ross, W.A.; Swanson, J.L.; Allen, R.P.; Yasutake, K.M.

    1986-01-01

    This paper presents an analysis of treatment options or strategies for transuranic wastes expected to be generated at a commercial nuclear fuel reprocessing plant. Six potential options were analyzed, ranging from no treatment to maximum volume reduction and high quality waste forms. Economics for the total management of these wastes (treatment, transportation, disposal) indicate life-cycle savings for extensive treatment are as high as $1.7 billion for 70,000 MTU. Evaluations of the waste processing and waste forms support the selection of a number of the extensive waste treatments. It is concluded that there are significant incentives for extensive treatment of transuranic wastes

  7. Minimal packing duration in close reduction for nasal bone fracture treatment.

    Science.gov (United States)

    Choi, Dong Sik; Lee, Jeong Woo; Yang, Jung Dug; Chung, Ho Yun; Cho, Byung Chae; Choi, Kang Young

    2015-04-15

    Nasal bone fracture is the most common type of facial bone fracture. The optimal duration of the packing after closed reduction has been a controversial issue. The packing has several disadvantages such as blocking the nasal airway, causing infection and a headache, which is the most common immediate complication. The present study investigated the minimal and optimal duration of the nasal packing following reduction surgery of nasal bone fracture. A prospective study was performed for the patients undergoing reduction surgery following nasal bone fracture between July 2010 and June 2012. The patients were categorised into three groups according to the duration of nasal packing. For the patients treated between July 2010 and June 2011, nasal packing was maintained for 5 days. For those between July 2011 and December 2011, packing was maintained for 3 days. For those between January 2012 and June 2012, the packing was removed after 1 day. The computed tomography scan and the cephalolateral X-ray were checked at immediate postoperative period after packing removal and 6 months postoperatively. The alteration of heights, deviations, and nasal bone contours with time passage were compared among three groups. The patient satisfaction survey was also performed and compared. A total of 530 patients including 322 of the 5-days packing group, 102 of the 3-days group, and 106 of the 1-day group were enrolled. There was no statistically significant difference between the groups in terms of heights, deviations, and nasal bone contours (p-value ≥ 0.05). In the patient satisfaction survey, the 1-day packing group complained of discomfort related to nasal packing and headache symptoms much less, compared to the other two groups. The present study demonstrated that 1-day packing had comparable postoperative outcome with reducing the patients' discomfort. As such, a longer packing duration was not needed to achieve stable results one day is a reasonable packing time for most

  8. The Effect of Carbonaceous Reductant Selection on Chromite Pre-reduction

    Science.gov (United States)

    Kleynhans, E. L. J.; Beukes, J. P.; Van Zyl, P. G.; Bunt, J. R.; Nkosi, N. S. B.; Venter, M.

    2017-04-01

    Ferrochrome (FeCr) production is an energy-intensive process. Currently, the pelletized chromite pre-reduction process, also referred to as solid-state reduction of chromite, is most likely the FeCr production process with the lowest specific electricity consumption, i.e., MWh/t FeCr produced. In this study, the effects of carbonaceous reductant selection on chromite pre-reduction and cured pellet strength were investigated. Multiple linear regression analysis was employed to evaluate the effect of reductant characteristics on the aforementioned two parameters. This yielded mathematical solutions that can be used by FeCr producers to select reductants more optimally in future. Additionally, the results indicated that hydrogen (H)- (24 pct) and volatile content (45.8 pct) were the most significant contributors for predicting variance in pre-reduction and compressive strength, respectively. The role of H within this context is postulated to be linked to the ability of a reductant to release H that can induce reduction. Therefore, contrary to the current operational selection criteria, the authors believe that thermally untreated reductants ( e.g., anthracite, as opposed to coke or char), with volatile contents close to the currently applied specification (to ensure pellet strength), would be optimal, since it would maximize H content that would enhance pre-reduction.

  9. Therapeutic platelet reduction: Use in postsplenectomy thrombocytosis

    Directory of Open Access Journals (Sweden)

    Gita Negi

    2015-01-01

    Full Text Available Therapeutic platelet reduction is an effective modality for the reduction of platelet count in patients with treatment of extreme thrombocytosis resulting from a variety of primary and secondary causes of thrombocytosis, which may be associated with thrombotic or hemorrhagic complications of varying degrees. These cases when symptomatic fall into the ASFA Category II indication for therapeutic platelet apheresis procedure. Here, we report a case of postsplenectomy secondary thrombocytosis presenting with extremely high platelet counts and subsequent thrombosis in the shunt and successful treatment after therapeutic platelet reduction. The case is being presented to bring forth the fact that therapeutic platelet reduction is an easy procedure that gives quick and good results and also to bring to the attention of transfusion specialists an associated but as yet unreported procedural finding.

  10. Mandibular Range of Movement and Pain Intensity in Patients with Anterior Disc Displacement without Reduction

    Directory of Open Access Journals (Sweden)

    Marijana Gikić

    2015-01-01

    Full Text Available Objective: Temporomandibular disorders (TMD are the most common source of orofacial pain of a non-dental origin. The study was performed to investigate the therapeutic effect of the conventional occlusal splint therapy and the physical therapy. The hypothesis tested was that the simultaneous use of occlusal splint and physical therapy is an effective method for treatment of anterior disc displacement without reduction. Materials and Methods: Twelve patients (mean age =30.5 y with anterior disc displacement without reduction (according to RDC/TMD and confirmed by magnetic resonance imaging were randomly allocated into 2 groups: 6 received stabilization splint (SS and 6 received both physical therapy and stabilization splint (SS&PT. Treatment outcomes included pain-free opening (MCO, maximum assisted opening (MAO, path of mouth opening and pain as reported on visual analogue scale (VAS. Results: At baseline of treatment there were no significant differences among the groups for VAS scores, as well as for the range of mandibular movement. VAS scores improved significantly over time for the SS&PT group (F=28.964, p=0.0001, effect size =0.853 and SS group (F=8.794, p=0.001, effect size =0.638. The range of mouth opening improved significantly only in the SS&PT group (MCO: F=20.971, p=0.006; MAO: F=24.014, p=0.004 (Figure 2. Changes in path of mouth opening differ significantly between the groups (p=0.040. Only 1 patient in SS&PT group still presented deviations in mouth opening after completed therapy while in the SS group deviations were present in 5 patients after completed therapy. Conclusion: This limited study gave evidence that during the treatment period lasting for 6 months, the simultaneous use of stabilization splint and physical therapy was more efficient in reducing deviations and improving range of mouth opening than the stabilization splint used alone. Both treatment options were efficient in reducing pain in patients with anterior disc

  11. Clinical significance of determination of changes of plasma ET and serum TNF content after treatment in patients with diabetes millitus

    International Nuclear Information System (INIS)

    Zhang Jianguo; Wu Jiaming

    2006-01-01

    Objective: To investigate the clinical significance of the changes of plasma ET and serum TNF levels after treatment in patients with diabetes millitus. Methods: Plasma ET and serum TNF contents were determined with RIA in 54 patients with diabetes mellitus both before and after treatment as well as in 35 controls. Results: Before treatment, the plasma ET and serum TNF levels were significantly in the diabetics higher than those in the controls (P<0.01). After 3 months treatment, the levels remained significantly higher (P<0.05). Conclusion: Development and progression of diabetes millitus were closely related to the plasma ET and serum TNF levels. (authors)

  12. Liver fat reduction with niacin is influenced by DGAT-2 polymorphisms in hypertriglyceridemic patients.

    Science.gov (United States)

    Hu, Miao; Chu, Winnie Chiu Wing; Yamashita, Shizuya; Yeung, David Ka Wai; Shi, Lin; Wang, Defeng; Masuda, Daisaku; Yang, Yaling; Tomlinson, Brian

    2012-04-01

    Niacin reduces plasma triglycerides, but it may increase free fatty acids and insulin resistance during long-term treatment. We examined the effect of extended-release niacin on liver fat content in Chinese patients with dyslipidemia and whether the common diacylglycerol acyltransferase-2 (DGAT2) polymorphisms influenced this effect. The 39 patients (baseline liver fat content: 12.8 ± 7.6%, triglycerides: 3.30 ± 1.67 mmol/l) were treated with niacin, gradually increasing the dose to 2 g/day for a total of 23 weeks. The liver fat content and visceral/subcutaneous fat was measured before and after treatment. Subjects were genotyped for the DGAT2 rs3060 and rs101899116 polymorphisms. There were significant (P < 0.001) reductions in plasma triglycerides (-34.9 ± 37.6%), liver fat content (-47.2 ± 32.8%), and visceral fat (-6.3 ± 15.8%, P < 0.05) after niacin treatment. Mean body weight decreased by 1.46 ± 2.7% (1.17 ± 2.44 kg, P < 0.001) during the study, but liver fat changes remained significant after adjustment for age, gender, and body weight changes [mean absolute change (95% CI): -6.1% (-8.0, -4.3), P < 0.001]. The DGAT2 variant alleles were associated with a smaller reduction in liver fat content in response to niacin after adjustment for other covariates (P < 0.01). These findings suggest that niacin treatment may reduce liver fat content in Chinese patients with dyslipidemia and that the mechanism may involve inhibition of DGAT2. However, the findings might have been confounded by the small but significant reductions in body weight during the study. Future large randomized controlled trials are needed to verify these findings.

  13. SU-E-J-218: Evaluation of CT Images Created Using a New Metal Artifact Reduction Reconstruction Algorithm for Radiation Therapy Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Niemkiewicz, J; Palmiotti, A; Miner, M; Stunja, L; Bergene, J [Lehigh Valley Health Network, Allentown, PA (United States)

    2014-06-01

    Purpose: Metal in patients creates streak artifacts in CT images. When used for radiation treatment planning, these artifacts make it difficult to identify internal structures and affects radiation dose calculations, which depend on HU numbers for inhomogeneity correction. This work quantitatively evaluates a new metal artifact reduction (MAR) CT image reconstruction algorithm (GE Healthcare CT-0521-04.13-EN-US DOC1381483) when metal is present. Methods: A Gammex Model 467 Tissue Characterization phantom was used. CT images were taken of this phantom on a GE Optima580RT CT scanner with and without steel and titanium plugs using both the standard and MAR reconstruction algorithms. HU values were compared pixel by pixel to determine if the MAR algorithm altered the HUs of normal tissues when no metal is present, and to evaluate the effect of using the MAR algorithm when metal is present. Also, CT images of patients with internal metal objects using standard and MAR reconstruction algorithms were compared. Results: Comparing the standard and MAR reconstructed images of the phantom without metal, 95.0% of pixels were within ±35 HU and 98.0% of pixels were within ±85 HU. Also, the MAR reconstruction algorithm showed significant improvement in maintaining HUs of non-metallic regions in the images taken of the phantom with metal. HU Gamma analysis (2%, 2mm) of metal vs. non-metal phantom imaging using standard reconstruction resulted in an 84.8% pass rate compared to 96.6% for the MAR reconstructed images. CT images of patients with metal show significant artifact reduction when reconstructed with the MAR algorithm. Conclusion: CT imaging using the MAR reconstruction algorithm provides improved visualization of internal anatomy and more accurate HUs when metal is present compared to the standard reconstruction algorithm. MAR reconstructed CT images provide qualitative and quantitative improvements over current reconstruction algorithms, thus improving radiation

  14. SU-E-J-218: Evaluation of CT Images Created Using a New Metal Artifact Reduction Reconstruction Algorithm for Radiation Therapy Treatment Planning

    International Nuclear Information System (INIS)

    Niemkiewicz, J; Palmiotti, A; Miner, M; Stunja, L; Bergene, J

    2014-01-01

    Purpose: Metal in patients creates streak artifacts in CT images. When used for radiation treatment planning, these artifacts make it difficult to identify internal structures and affects radiation dose calculations, which depend on HU numbers for inhomogeneity correction. This work quantitatively evaluates a new metal artifact reduction (MAR) CT image reconstruction algorithm (GE Healthcare CT-0521-04.13-EN-US DOC1381483) when metal is present. Methods: A Gammex Model 467 Tissue Characterization phantom was used. CT images were taken of this phantom on a GE Optima580RT CT scanner with and without steel and titanium plugs using both the standard and MAR reconstruction algorithms. HU values were compared pixel by pixel to determine if the MAR algorithm altered the HUs of normal tissues when no metal is present, and to evaluate the effect of using the MAR algorithm when metal is present. Also, CT images of patients with internal metal objects using standard and MAR reconstruction algorithms were compared. Results: Comparing the standard and MAR reconstructed images of the phantom without metal, 95.0% of pixels were within ±35 HU and 98.0% of pixels were within ±85 HU. Also, the MAR reconstruction algorithm showed significant improvement in maintaining HUs of non-metallic regions in the images taken of the phantom with metal. HU Gamma analysis (2%, 2mm) of metal vs. non-metal phantom imaging using standard reconstruction resulted in an 84.8% pass rate compared to 96.6% for the MAR reconstructed images. CT images of patients with metal show significant artifact reduction when reconstructed with the MAR algorithm. Conclusion: CT imaging using the MAR reconstruction algorithm provides improved visualization of internal anatomy and more accurate HUs when metal is present compared to the standard reconstruction algorithm. MAR reconstructed CT images provide qualitative and quantitative improvements over current reconstruction algorithms, thus improving radiation

  15. Statin treatment and stroke outcome in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial

    DEFF Research Database (Denmark)

    Goldstein, L.B.; Amarenco, P.; Zivin, J.

    2009-01-01

    BACKGROUND AND PURPOSE: Laboratory experiments suggest statins reduce stroke severity and improve outcomes. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial was a placebo-controlled, randomized trial designed to determine whether treatment with atorvastatin reduces...... or 4), moderate (modified Rankin Scale score 3 or 2), and mild (modified Rankin Scale score 1 or 0) outcome ischemic strokes and transient ischemic attacks and an increase in the proportion of event-free subjects randomized to atorvastatin (P

  16. Enhanced Activity and Selectivity of Carbon Nanofiber Supported Pd Catalysts for Nitrite Reduction

    KAUST Repository

    Shuai, Danmeng; Choe, Jong Kwon; Shapley, John R.; Werth, Charles J.

    2012-01-01

    Pd-based catalyst treatment represents an emerging technology that shows promise to remove nitrate and nitrite from drinking water. In this work we use vapor-grown carbon nanofiber (CNF) supports in order to explore the effects of Pd nanoparticle size and interior versus exterior loading on nitrite reduction activity and selectivity (i.e., dinitrogen over ammonia production). Results show that nitrite reduction activity increases by 3.1-fold and selectivity decreases by 8.0-fold, with decreasing Pd nanoparticle size from 1.4 to 9.6 nm. Both activity and selectivity are not significantly influenced by Pd interior versus exterior CNF loading. Consequently, turnover frequencies (TOFs) among all CNF catalysts are similar, suggesting nitrite reduction is not sensitive to Pd location on CNFs nor Pd structure. CNF-based catalysts compare favorably to conventional Pd catalysts (i.e., Pd on activated carbon or alumina) with respect to nitrite reduction activity and selectivity, and they maintain activity over multiple reduction cycles. Hence, our results suggest new insights that an optimum Pd nanoparticle size on CNFs balances faster kinetics with lower ammonia production, that catalysts can be tailored at the nanoscale to improve catalytic performance for nitrite, and that CNFs hold promise as highly effective catalyst supports in drinking water treatment. © 2012 American Chemical Society.

  17. Enhanced Activity and Selectivity of Carbon Nanofiber Supported Pd Catalysts for Nitrite Reduction

    KAUST Repository

    Shuai, Danmeng

    2012-03-06

    Pd-based catalyst treatment represents an emerging technology that shows promise to remove nitrate and nitrite from drinking water. In this work we use vapor-grown carbon nanofiber (CNF) supports in order to explore the effects of Pd nanoparticle size and interior versus exterior loading on nitrite reduction activity and selectivity (i.e., dinitrogen over ammonia production). Results show that nitrite reduction activity increases by 3.1-fold and selectivity decreases by 8.0-fold, with decreasing Pd nanoparticle size from 1.4 to 9.6 nm. Both activity and selectivity are not significantly influenced by Pd interior versus exterior CNF loading. Consequently, turnover frequencies (TOFs) among all CNF catalysts are similar, suggesting nitrite reduction is not sensitive to Pd location on CNFs nor Pd structure. CNF-based catalysts compare favorably to conventional Pd catalysts (i.e., Pd on activated carbon or alumina) with respect to nitrite reduction activity and selectivity, and they maintain activity over multiple reduction cycles. Hence, our results suggest new insights that an optimum Pd nanoparticle size on CNFs balances faster kinetics with lower ammonia production, that catalysts can be tailored at the nanoscale to improve catalytic performance for nitrite, and that CNFs hold promise as highly effective catalyst supports in drinking water treatment. © 2012 American Chemical Society.

  18. Nalmefene: a new approach to the treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Paille F

    2014-08-01

    Full Text Available François Paille, Hervé Martini Department of Addiction Treatment, University Hospital, Vandœuvre-lès-Nancy, France Abstract: Reduction of alcohol consumption is not yet a widely accepted treatment objective for alcohol-dependent patients, as abstinence is often considered to be the only possible objective in this situation. However, various studies have demonstrated the value of proposing these two options to such patients. Firstly, reduction of alcohol consumption very significantly reduces the risk of alcohol-related damage, and also modifies the patient's and the doctor's perception of the disease, resulting in improved access to care and better patient adherence with the proposed treatment objective and consequently better clinical results. Recent studies have shown that some medicinal products can help patients reduce their alcohol consumption. One such product, nalmefene, has been granted European marketing authorization and is now being released onto the market in various countries. The ESENSE 1 and 2 studies in alcohol-dependent patients showed that, in combination with BRENDA, a psychosocial intervention focusing on reinforcement of motivation and treatment adherence, nalmefene significantly reduced the number of heavy drinking days and mean daily total alcohol consumption versus placebo. This reduction was more marked in the marketing authorization target population, ie, patients with a high or very high drinking risk level according to World Health Organization criteria. Another original feature of this molecule is that it can be used as needed if the patient perceives a risk of drinking, which is a more flexible approach and more likely to ensure the patient's active involvement in the treatment of his/her disease. This molecule opens up interesting and original therapeutic prospects in the treatment of alcohol dependence. Keywords: alcohol dependence, reduction, consumption, damage reduction, drug therapy, nalmefene

  19. Plaque reduction over time of an integrated oral hygiene system.

    Science.gov (United States)

    Nunn, Martha E; Ruhlman, C Douglas; Mallatt, Philip R; Rodriguez, Sally M; Ortblad, Katherine M

    2004-10-01

    This article compares the efficacy of a prototype integrated system (the IntelliClean System from Sonicare and Crest) in the reduction of supragingival plaque to that of a manual toothbrush and conventional toothpaste. The integrated system was compared to a manual toothbrush with conventional toothpaste in a randomized, single-blinded, parallel, 4-week, controlled clinical trial with 100 subjects randomized to each treatment group. There was a low dropout rate, with 89 subjects in the manual toothbrush group (11% loss to follow-up) and 93 subjects in the integrated system group (7% loss to follow-up) completing the study. The Turesky modification of the Quigley and Hein Plaque Index was used to assess full-mouth plaque scores for each subject. Prebrushing plaque scores were obtained at baseline and at 4 weeks after 14 to 20 hours of plaque accumulation. A survey also was conducted at the conclusion of the study to determine the attitude toward the two oral hygiene systems. The integrated system was found to significantly reduce overall and interproximal prebrushing plaque scores over 4 weeks, both by 8.6%, demonstrating statistically significant superiority in overall plaque reduction (P = .002) and interproximal plaque reduction (P < .001) compared to the manual toothbrush with conventional toothpaste, which showed no significant reduction in either overall plaque or interproximal plaque. This study demonstrates that the IntelliClean System from Sonicare and Crest is superior to a manual toothbrush with conventional toothpaste in reducing overall plaque and interproximal plaque over time.

  20. Effect of Organic Matter on Cr(VI Removal from Groundwaters by Fe(II Reductive Precipitation for Groundwater Treatment

    Directory of Open Access Journals (Sweden)

    Anna Gröhlich

    2017-06-01

    Full Text Available Due to its toxicity, Cr(VI is undesirable in groundwater. Its chemical reduction to Cr(III species, followed by precipitation is the most widely practiced treatment technique for the removal of Cr(VI from polluted waters. The resulting Cr(III species present low solubility, is much less toxic, and can be subsequently removed either by precipitation, or by adsorption onto iron oxy-hydroxides and co-precipitation. The effects of several parameters, such as the pH value of water to be treated, the applied Fe(II dose, and the presence of appropriate mineral surfaces, are well investigated and understood. However, the impact of the presence of humic acids (HAs in this process has only been considered by rather few studies. The main aim of this study was to determine the effect of humic substances on Fe(II reductive precipitation of Cr(VI within a pH range relevant for drinking water treatment. Jar test experiments were performed, using artificial groundwater of defined composition and initial Cr(VI concentration 100 μg/L, ferrous sulphate dosages 0.25–2 mg Fe(II/L, and pH values 6.5–8. It was found that Cr(VI and total chromium (Cr(total can be reliably removed in the absence of HAs in the tested pH range with the addition of Fe(II dosage of 1 mg Fe(II/L. Further on, the results indicated that the reduction of Cr(VI is only slightly affected by the presence of HAs. However, increased residual total Cr concentrations were found at lower Fe(II dosages and/or higher pH values. Additionally, the removal of the Cr(III species formed during Cr(VI reduction was strongly inhibited by the presence of HAs under the examined experimental conditions, since residual concentrations higher than 60 μg/L were determined. The results of this study will have implications to the ongoing discussion of a new, stricter, European Union regulation limit, regarding the presence of total chromium in drinking water.

  1. Submental fat reduction by mesotherapy using phosphatidylcholine alone vs. phosphatidylcholine and organic silicium: a pilot study.

    Science.gov (United States)

    Co, Abigail C; Abad-Casintahan, Maria Flordeliz; Espinoza-Thaebtharm, Agnes

    2007-12-01

    Excess skin and fatty tissues beneath the jaw lead to a double chin deformity. Localized fat deposits in this area are a cause of discomfort and anguish, leading patients to undergo surgical procedures such as liposuction and dermolipectomy to improve the cosmetic effect. Both procedures require anesthesia and an operating room setting and are quite expensive. Fearful of extensive surgery and its complications, patients and physicians seek less invasive methods. Mesotherapy with phosphatidylcholine and other cocktails have been used to treat localized fat deposits. However, there are few published articles regarding its effectiveness and some are even anecdotal. This study aims to determine the efficacy of phosphatidylcholine alone vs. phosphatidylcholine and organic silicium in submental fat reduction. Twelve patients with submental fat deposit with no coexisting morbidity and with informed consent were included in the study. They were submitted to one to five treatment sessions with an average interval of 2 weeks between each session. The medication administered was injected, either pure phosphatidylcholine or a combination of phosphatidylcholine and organic silicium. Baseline measurements of submental fat using vernier caliper and digital photographs of the patients were taken during each treatment session. The occurrence of adverse effects was likewise noted. Results Among the 12 patients, 11 completed the treatment course, and 1 was excluded from the study because of failure to follow up. Both phosphatidylcholine and a combination of phosphatidylcholine and organic silicium were equally effective in reducing submental fat deposits. There was no significant difference as to the rate and degree of reduction. Significant reduction in the thickness of submental fat was achieved after three treatment sessions. Adverse reactions in both groups were mild and transitory ranging from heavy sensation, localized heat, nodulations, and slight bruising that abated 3 to 5

  2. Temporal Variation in the Estrogenicity of a Sewage Treatment Plant Effluent and its Biological Significance

    Science.gov (United States)

    This paper describes variations in the estrogenic potency of effluent from a "model" wastewater treatment plant in Duluth, MN, and explores the significance of these variations relative to sampling approaches for monitoring effluents and their toxicity to fish.

  3. The effects of a group based stress treatment program (the Kalmia concept) targeting stress reduction and return to work. A randomized, wait-list controlled trial

    DEFF Research Database (Denmark)

    Netterstrøm, Bo; Friebel, Lene; Ladegaard, Yun Katrine

    2012-01-01

    Abstract Objective The aim of this study was to evaluate the effects of a group based multidisciplinary stress treatment program on reductions in symptom levels and the return to work (RTW) rate. Methods General practitioners referred 199 patients with persistent work related stress symptoms...... to the project. The inclusion criteria included being employed and being on sick leave. Using a randomized wait- list control design, the participants were randomized into three groups: the intervention group (IG, 70 participants) was treated using the Stress Therapy Concept of Kalmia, which consists...... to the WLCG . Further, the prevalence of depression declined significantly in the IG and the TAUCG compared to the WLCG. Regarding the RTW rate, 66% of the participants in the IG had returned to full time work after three months. This rate was significantly greater than the percentage in the TAUCG (36...

  4. Reductive Anaerobic Biological In Situ Treatment Technology Treatability Testing

    National Research Council Canada - National Science Library

    Alleman, Bruce

    2002-01-01

    Enhanced biological reductive dechlorination (EBRD) shows a great deal of promise for efficiently treating groundwater contaminated with chlorinated solvents, but demonstration sites around the country were reporting mixed results...

  5. Trisodium phosphate for foodborne virus reduction on produce.

    Science.gov (United States)

    Su, Xiaowei; D'Souza, Doris H

    2011-06-01

    Human noroviruses (NoVs) are recognized as the major cause of acute nonbacterial foodborne gastroenteritis outbreaks in both developed and developing countries. They are resistant to most chemical inactivation processes, and can survive in the environment for long periods. The aim of this research was to apply trisodium phosphate (TSP) on spiked produce (lettuce and peppers) for the reduction of foodborne NoV surrogates, feline calicivirus (FCV-F9), and murine norovirus (MNV-1). Washed and dried lettuce (3 × 3 cm²) and Jalapeno peppers (25-30 g/pepper) were spiked with FCV-F9 and MNV-1 at titers of ∼7 log₁₀ plaque forming unit (PFU)/mL or ∼5 log₁₀ PFU/mL and dried aseptically in a biosafety hood for 5 min. Samples were treated with 2% TSP, 5% TSP, 200 mg/L sodium hypochlorite, or water for 15 or 30 sec. Treatments were immediately neutralized with cell culture media containing 10% fetal bovine serum, and viruses were recovered and evaluated using standardized plaque assays. No significant differences between the two contact times on viral reduction was observed (p > 0.05). All three chemicals reduced FCV-F9 titers at ∼5 log₁₀ PFU/mL to undetectable levels, but MNV-1 at ∼5 log₁₀ PFU/mL was decreased by ∼2-3 log₁₀ PFU/mL with 200 mg/L sodium hypochlorite and 2% TSP, and to undetectable levels by 5% TSP. FCV-F9 at ∼7 log₁₀ PFU/mL was reduced by >5 log₁₀ PFU/mL with 2% TSP, in comparison to 200 mg/L sodium hypochlorite that showed ≤ 1.4 log₁₀ PFU/mL reduction. MNV-1 at ∼7 log₁₀ PFU/mL was decreased by ∼2-3.4 log₁₀ PFU/mL with 2% TSP; and by PFU/mL with 200 mg/L sodium hypochlorite. FCV-F9 and MNV-1 at ∼7 log₁₀ PFU/mL were reduced to undetectable levels by 5% TSP. Treatments by 5% TSP for 30 sec did not result in any statistically significant color changes of the tested produce. TSP at 5% appears suitable as an alternative treatment to chlorine washes for NoV reduction on produce

  6. Effect of microalgal treatments on pesticides in water.

    Science.gov (United States)

    Hultberg, Malin; Bodin, Hristina; Ardal, Embla; Asp, Håkan

    2016-01-01

    The effect of the microalgae Chlorella vulgaris on a wide range of different pesticides in water was studied. Treatments included short-term exposure (1 h) to living and dead microalgal biomass and long-term exposure (4 days) to actively growing microalgae. The initial pesticide concentration was 63.5 ± 3.9 µg L(-1). There was no significant overall reduction of pesticides after short-term exposure. A significant reduction of the total amount of pesticides was achieved after the long-term exposure to growing microalgae (final concentration 29.7 ± 1.0 µg L(-1)) compared with the long-term control (37.0 ± 1.2 µg L(-1)). The concentrations of 10 pesticides out of 38 tested were significantly lowered in the long-term algal treatment. A high impact of abiotic factors such as sunlight and aeration for pesticide reduction was observed when the initial control (63.5 ± 3.9 µg L(-1)) and the long-term control (37.0 ± 1.2 µg L(-1)) were compared. The results suggest that water treatment using microalgae, natural inhabitants of polluted surface waters, could be further explored not only for removal of inorganic nutrients but also for removal of organic pollutants in water.

  7. Enzyme replacement and substrate reduction therapy for Gaucher disease.

    Science.gov (United States)

    Shemesh, Elad; Deroma, Laura; Bembi, Bruno; Deegan, Patrick; Hollak, Carla; Weinreb, Neal J; Cox, Timothy M

    2015-03-27

    untreated individuals with type 1 Gaucher disease. Two studies investigated maintenance enzyme replacement therapy in people with stable type 1 Gaucher disease previously treated for at least two years. One study compared substrate reduction therapy, enzyme replacement therapy and a combination thereof as maintenance therapy in people with type 1 Gaucher disease previously treated with enzyme replacement therapy. One study examined substrate reduction therapy in people with chronic neuronopathic (type 3) Gaucher disease who continued to receive enzyme replacement therapy.Treatment-naïve participants had similar increases in haemoglobin when comparing those receiving imiglucerase or alglucerase at 60 units/kg, imiglucerase or velaglucerase alfa at 60 U/kg, taliglucerase alfa at 30 units/kg or 60 units/kg, and velaglucerase alfa at 45 units/g or 60 units/kg. For platelet count response in participants with intact spleens, a benefit for imiglucerase over velaglucerase alfa at 60 units/kg was observed, mean difference -79.87 (95% confidence interval -137.57 to -22.17). There were no other significant differences in platelet count response when comparing different doses of velaglucerase alfa and of taliglucerase alfa, and when comparing imiglucerase to alglucerase. Spleen and liver volume reductions were not significantly different in any enzyme replacement therapy product or dose comparison study. Although a dose effect on serum biomarkers was not seen after nine months, a significantly greater reduction with higher dose was reported after 12 months in the velaglucerase study, mean difference 16.70 (95% confidence intervaI 1.51 to 31.89). In the two enzyme replacement therapy maintenance studies comparing infusions every two weeks and every four weeks, there were no significant differences in haemoglobin concentration, platelet count, and spleen and liver volumes over a 6 to 12 month period when participants were treated with the same cumulative dose.A total of 25 serious

  8. Effects of Different Imagery Strategies in the Psychological Treatment of Chronic Headache

    Directory of Open Access Journals (Sweden)

    Gisela Peters

    1998-01-01

    Full Text Available This study investigates the effects of four different imagery techniques: pleasant imagery versus imaginative transformations, and response versus stimulus imagery. One may expect imaginative transformations to be more effective than pleasant imagery. Response imaginative transformations should be more effective than stimulus imaginative transformations, while the pleasant imagery conditions are not expected to have different effects. In a 2x2 design, treatment conditions were compared. Forty patients (33 females, seven males with different types of chronic headache were referred by their physicians and took part in the study. Pain diaries and questionnaires of pain experience and pain behaviour were used as outcome measures. Imaginative transformations - irrespective of response or stimulus orientation - were found to be more effective than pleasant imagery in reducing headache frequency. Reductions remained stable over an eight-month follow-up. There are no significant differences between response and stimulus imagery. Treatment effects were manifested in a reduction of headache frequency, while headache duration and headache intensity did not change. Suffering and avoidance behaviours were reduced in all treatment groups, while the use of distraction strategies was increased. The reductions in suffering were significantly greater in the groups treated with imaginative transformations. In the eight-month follow-up, group differences in reductions in suffering were no longer significant, which is probably due to the reduced sample size. The results support the hypothesis that a cognitive redefinition is responsible for the beneficial treatment effects because only instructions to imagine a change in pain sensations and/or pain responses led to significant improvements.

  9. Adverse effects of anticoagulation treatment: clinically significant upper gastrointestinal hemorrhage

    Directory of Open Access Journals (Sweden)

    Pavel Skok

    2006-12-01

    Full Text Available Background: Over the last years, the use of oral anticoagulant treatment has increased dramatically, principally for the prevention of venous thrombosis and thrombembolic events. This treatment is demanding, especially among the elderly with concommitant diseases and different medication. Aim of the study to evaluate the rate of serious complications, clinically significant hemorrhage from upper gastointestinal tract in patients treated with oral antiocoagulants in a prospective cohort study.Patients and methods: Included were patients admitted to our institution between January 1, 1994 and December 31, 2003 due to gastrointestinal hemorrhage. Emergency endoscopy and laboratory testing was performed in all patients.Results: 6416 patients were investigated: 2452 women (38.2 % and 3964 men (61.8 %, mean age 59.1 years, SD 17.2. Among our patients, 55 % were aged over 60 years. In 86.4 % of patients the source of bleeding was confirmed in the upper gastrointestinal tract. In the last week prior to bleeding, 20.4 % (1309/6416 of all patients were regularly taking nonsteroidal anti-inflammatory drugs, anticoagulant therapy or antiplatelet agents in single daily doses at least. 6.3 % of patients (82/1309 with abundant hemorrhage from upper gastrointestinal tract were using oral anticoagulant therapy and had INR > 5 at admission, 25.6 % of them had INR > 10. The mortality of patients using oral anticoagulants and INR > 5 was 17.1 %.Conclusions: Upper gastrointestinal hemorrhage is a serious complication of different medications, particularly in elderly patients. Safe use of anticoagulant therapy is based on careful selection of patients and correct intake of the prescribed drugs.

  10. Codelivery of doxorubicin and triptolide with reduction-sensitive lipid–polymer hybrid nanoparticles for in vitro and in vivo synergistic cancer treatment

    Science.gov (United States)

    Wu, Bo; Lu, Shu-Ting; Zhang, Liu-Jie; Zhuo, Ren-Xi; Xu, Hai-Bo; Huang, Shi-Wen

    2017-01-01

    Codelivery is a promising strategy to overcome the limitations of single chemotherapeutic agents in cancer treatment. Despite progress, codelivery of two or more different functional drugs to increase anticancer efficiency still remains a challenge. Here, reduction-sensitive lipid–polymer hybrid nanoparticles (LPNPs) drug delivery system composed of monomethoxy-poly(ethylene glycol)-S-S-hexadecyl (mPEG-S-S-C16), soybean lecithin, and poly(D,L-lactide-co-glycolide) (PLGA) was used for codelivery of doxorubicin (DOX) and a Chinese herb extract triptolide (TPL). Hydrophobic DOX and TPL could be successfully loaded in LPNPs by self-assembly. More importantly, drug release and cellular uptake experiments demonstrated that the two drugs were reduction sensitive, released simultaneously from LPNPs, and taken up effectively by the tumor cells. DOX/TPL-coloaded LPNPs (DOX/TPL-LPNPs) exhibited a high level of synergistic activation with low combination index (CI) in vitro and in vivo. Moreover, the highest synergistic therapeutic effect was achieved at the ratio of 1:0.2 DOX/TPL. Further experiments showed that TPL enhanced the uptake of DOX by human oral cavity squamous cell carcinoma cells (KB cells). Overall, DOX/TPL-coencapsulated reduction-sensitive nanoparticles will be a promising strategy for cancer treatment. PMID:28331310

  11. Codelivery of doxorubicin and triptolide with reduction-sensitive lipid-polymer hybrid nanoparticles for in vitro and in vivo synergistic cancer treatment.

    Science.gov (United States)

    Wu, Bo; Lu, Shu-Ting; Zhang, Liu-Jie; Zhuo, Ren-Xi; Xu, Hai-Bo; Huang, Shi-Wen

    2017-01-01

    Codelivery is a promising strategy to overcome the limitations of single chemotherapeutic agents in cancer treatment. Despite progress, codelivery of two or more different functional drugs to increase anticancer efficiency still remains a challenge. Here, reduction-sensitive lipid-polymer hybrid nanoparticles (LPNPs) drug delivery system composed of monomethoxy-poly(ethylene glycol)- S - S -hexadecyl (mPEG- S - S -C 16 ), soybean lecithin, and poly(D,L-lactide-co-glycolide) (PLGA) was used for codelivery of doxorubicin (DOX) and a Chinese herb extract triptolide (TPL). Hydrophobic DOX and TPL could be successfully loaded in LPNPs by self-assembly. More importantly, drug release and cellular uptake experiments demonstrated that the two drugs were reduction sensitive, released simultaneously from LPNPs, and taken up effectively by the tumor cells. DOX/TPL-coloaded LPNPs (DOX/TPL-LPNPs) exhibited a high level of synergistic activation with low combination index (CI) in vitro and in vivo. Moreover, the highest synergistic therapeutic effect was achieved at the ratio of 1:0.2 DOX/TPL. Further experiments showed that TPL enhanced the uptake of DOX by human oral cavity squamous cell carcinoma cells (KB cells). Overall, DOX/TPL-coencapsulated reduction-sensitive nanoparticles will be a promising strategy for cancer treatment.

  12. Factors associated with pain and disability reduction following exercise interventions in chronic whiplash.

    Science.gov (United States)

    Ludvigsson, M L; Peterson, G; Dedering, Å; Falla, D; Peolsson, A

    2016-02-01

    Some studies support the prescription of exercise for people with whiplash-associated disorders (WAD); however, the response is highly variable. Further research is necessary to identify factors which predict response. This is a secondary analysis of a randomized, multicentre controlled clinical trial of 202 volunteers with chronic WAD (grades 2 and 3). They received either neck-specific exercise with, or without a behavioural approach, or prescription of physical activity for 12 weeks. Treatment response, defined as a clinical important reduction in pain or disability, was registered after 3 and 12 months, and factors associated with treatment response were explored using logistic regression. Participation in the neck-specific exercise group was the only significant factor associated with both neck pain and neck disability reduction both at 3 and 12 months. Patients in this group had up to 5.3 times higher odds of disability reduction and 3.9 times higher odds of pain reduction compared to those in the physical activity group. Different baseline features were identified as predictors of response depending on the time point examined and the outcome measure selected (pain vs. disability). Factors associated with treatment response after exercise interventions differ in the short and long term and differ depending on whether neck pain or disability is considered as the primary outcome. Participation in a neck-specific exercise intervention, in contrast to general physical activity, was the only factor that consistently indicated higher odds of treatment success. These results support the prescription of neck-specific exercise for individuals with chronic WAD. © 2015 European Pain Federation - EFIC®

  13. Copper increases reductive dehalogenation of haloacetamides by zero-valent iron in drinking water: Reduction efficiency and integrated toxicity risk.

    Science.gov (United States)

    Chu, Wenhai; Li, Xin; Bond, Tom; Gao, Naiyun; Bin, Xu; Wang, Qiongfang; Ding, Shunke

    2016-12-15

    The haloacetamides (HAcAms), an emerging class of nitrogen-containing disinfection byproducts (N-DBPs), are highly cytotoxic and genotoxic, and typically occur in treated drinking waters at low μg/L concentrations. Since many drinking distribution and storage systems contain unlined cast iron and copper pipes, reactions of HAcAms with zero-valent iron (ZVI) and metallic copper (Cu) may play a role in determining their fate. Moreover, ZVI and/or Cu are potentially effective HAcAm treatment technologies in drinking water supply and storage systems. This study reports that ZVI alone reduces trichloroacetamide (TCAcAm) to sequentially form dichloroacetamide (DCAcAm) and then monochloroacetamide (MCAcAm), whereas Cu alone does not impact HAcAm concentrations. The addition of Cu to ZVI significantly improved the removal of HAcAms, relative to ZVI alone. TCAcAm and their reduction products (DCAcAm and MCAcAm) were all decreased to below detection limits at a molar ratio of ZVI/Cu of 1:1 after 24 h reaction (ZVI/TCAcAm = 0.18 M/5.30 μM). TCAcAm reduction increased with the decreasing pH from 8.0 to 5.0, but values from an integrated toxic risk assessment were minimised at pH 7.0, due to limited removal MCAcAm under weak acid conditions (pH = 5.0 and 6.0). Higher temperatures (40 °C) promoted the reductive dehalogenation of HAcAms. Bromine was preferentially removed over chlorine, thus brominated HAcAms were more easily reduced than chlorinated HAcAms by ZVI/Cu. Although tribromoacetamide was more easily reduced than TCAcAm during ZVI/Cu reduction, treatment of tribromoacetamide resulted in a higher integrated toxicity risk than TCAcAm, due to the formation of monobromoacetamide (MBAcAm). Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Repetitive transcranial magnetic stimulation of the supplementary motor area in treatment-resistant obsessive-compulsive disorder: An open-label pilot study.

    Science.gov (United States)

    Lee, Young-Ji; Koo, Bon-Hoon; Seo, Wan-Seok; Kim, Hye-Geum; Kim, Ji-Yean; Cheon, Eun-Jin

    2017-10-01

    Obsessive-compulsive disorder (OCD) is a severely distressing disorder represented by obsessions and compulsions. A significant proportion of OCD patients fail to improve with conventional treatment methods. Repetitive transcranial magnetic stimulation (rTMS) has been proposed as an alternative for OCD treatment. Functional neuroimaging studies indicate that OCD is associated with increased activity in the supplementary motor area (SMA), a region that plays an important role in the pathophysiology of this disorder. In this study, we assessed the efficacy of augmentation with 1Hz rTMS over the SMA in treatment-resistant OCD patients. The participants received 1Hz rTMS over the SMA in 20 daily sessions for 4weeks. We observed significant reduction in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score at the 4th week of the treatment. Reduction in compulsion contributed to the reduction of global Y-BOCS whereas there was no significant reduction in obsession. Clinical global impression-global improvement also showed significant change at the 2nd and 4th week of the treatment. No additional significant changes or significant adverse effects were seen. These findings suggest that 1Hz rTMS over the SMA can be an efficient and safe add-on therapeutic method in treatment-resistant patients with OCD. Further controlled studies in larger samples are required to confirm the effect of 1Hz rTMS over the SMA in OCD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Evaluating the significance of wetland restoration scenarios on phosphorus removal.

    Science.gov (United States)

    Daneshvar, Fariborz; Nejadhashemi, A Pouyan; Adhikari, Umesh; Elahi, Behin; Abouali, Mohammad; Herman, Matthew R; Martinez-Martinez, Edwin; Calappi, Timothy J; Rohn, Bridget G

    2017-05-01

    Freshwater resources are vital for human and natural systems. However, anthropogenic activities, such as agricultural practices, have led to the degradation of the quality of these limited resources through pollutant loading. Agricultural Best Management Practices (BMPs), such as wetlands, are recommended as a valuable solution for pollutant removal. However, evaluation of their long-term impacts is difficult and requires modeling since performing in-situ monitoring is expensive and not feasible at the watershed scale. In this study, the impact of natural wetland implementation on total phosphorus reduction was evaluated both at the subwatershed and watershed levels. The study area is the Saginaw River Watershed, which is largest watershed in Michigan. The phosphorus reduction performances of four different wetland sizes (2, 4, 6, and 8 ha) were evaluated within this study area by implementing one wetland at a time in areas identified to have the highest potential for wetland restoration. The subwatershed level phosphorus loads were obtained from a calibrated Soil and Water Assessment Tool (SWAT) model. These loads were then incorporated into a wetland model (System for Urban Stormwater Treatment and Analysis IntegratioN-SUSTAIN) to evaluate phosphorus reduction at the subwatershed level and then the SWAT model was again used to route phosphorus transport to the watershed outlet. Statistical analyses were performed to evaluate the spatial impact of wetland size and placement on phosphorus reduction. Overall, the performance of 2 ha wetlands in total phosphorus reduction was significantly lower than the larger sizes at both the subwatershed and watershed levels. Regarding wetland implementation sites, wetlands located in headwaters and downstream had significantly higher phosphorus reduction than the ones located in the middle of the watershed. More specifically, wetlands implemented at distances ranging from 200 to 250 km and 50-100 km from the outlet had the

  16. Costello Syndrome with Severe Nodulocystic Acne: Unexpected Significant Improvement of Acanthosis Nigricans after Oral Isotretinoin Treatment

    Directory of Open Access Journals (Sweden)

    Leelawadee Sriboonnark

    2015-01-01

    Full Text Available We report the case of 17-year-old female diagnosed with Costello syndrome. Genetic testing provided a proof with G12S mutation in the HRAS gene since 3 years of age with a presentation of severe nodulocystic acne on her face. After 2 months of oral isotretinoin treatment, improvement in her acne was observed. Interestingly, an unexpected significant improvement of acanthosis nigricans on her neck and dorsum of her hands was found as well. We present this case as a successful treatment option by using oral isotretinoin for the treatment of acanthosis nigricans in Costello syndrome patients.

  17. Design of a PWR gaseous effluent treatment system combining delay-storage vessels, volume-reduction and activated-charcoal beds

    International Nuclear Information System (INIS)

    Nuyt, G.; Glibert, R.; Lahaye, J.P.

    1986-01-01

    The usual technique for the treatment of gaseous effluents is to store them in radioactive decay tanks and to carry out a range of operations such as recycling, volume-reduction and discharge. Although presenting undeniable advantages, this technique has a number of weaknesses which have become apparent with experience. This paper describes and analyses a system designed to alleviate these difficulties and to permit greater flexibility in gaseous effluent treatment, especially for power stations in the load-following mode of operation, by means of a combination of storage techniques and retention of short-lived isotopes in activated charcoal beds. The attractiveness of the proposed system is apparent from an analysis of operational, maintenance, safety and cost aspects. (author)

  18. An adaptive approach to metal artifact reduction in helical computed tomography for radiation therapy treatment planning: Experimental and clinical studies

    International Nuclear Information System (INIS)

    Yazdia, Mehran; Gingras, Luc; Beaulieu, Luc

    2005-01-01

    Purpose: In this article, an approach to metal artifact reduction is proposed that is practical for clinical use in radiation therapy. It is based on a new interpolation scheme of the projections associated with metal implants in helical computed tomography (CT) scanners. Methods and Materials: A three-step approach was developed consisting of an automatic algorithm for metal implant detection, a correction algorithm for helical projections, and a new, efficient algorithm for projection interpolation. The modified raw projection data are transferred back to the CT scanner device where CT slices are regenerated using the built-in reconstruction operator. The algorithm was tested on a CT calibration phantom in which the density of inserted objects are known and on clinical prostate cases with two hip prostheses. The results are evaluated using the CT number and shape of the objects. Results: The validations on a CT calibration phantom with various inserts of known densities show that the algorithm improved the overall image quality by restoring the shape and the representative CT number of the objects in the image. For the clinical hip replacement cases, a large fraction of the bladder, rectum, and prostate that were not visible on the original CT slices were recovered using the algorithm. Precise contouring of the target volume was thus feasible. Without this enhancement, physicians would have drawn bigger margins to be sure to include the target and, at the same time, could have prescribed a lower dose to keep the same level of normal tissue toxicity. Conclusions: In both phantom experiment and patient studies, the algorithm resulted in significant artifact reduction with increases in the reliability of planning procedure for the case of metallic hip prostheses. This algorithm is now clinically used as a preprocessing before treatment planning for metal artifact reduction

  19. Significant reduction of repeat teen pregnancy in a comprehensive young parent program.

    Science.gov (United States)

    Omar, H A; Fowler, A; McClanahan, K K

    2008-10-01

    To describe a comprehensive, multidisciplinary approach to teen mothers and their children that significantly reduces repeat pregnancies. Retrospective review of repeat teen pregnancy data. Young Parent Program (YPP) at a university-based health center. 1386 teen mothers between the ages of 11 and 19 who participated in the YPP for at least three years. Comprehensive Care: for both teen mother and her baby, including prenatal and postnatal care, preventive care, reproductive services, mental health, and acute care visits. Family counseling and similar services were also provided to siblings of the teen. CONTINUITY OF CARE: Patients are seen by the same staff and attending physicians on each visit. The treatment team includes physicians, nurses, social worker, nutritionist, and psychologist, all of whom are available to provide care at each visit. Flexible hours: Including evening clinic to allow teens to attend school or work during the day. Financial incentive: Patients with no insurance are given free contraceptives and a "no charge" clinic visit. Extensive contraceptive counseling is provided prior to start of contraceptive use and at every clinic visit. Routine telephone and/or mail reminders of appointments Rate of repeat teen pregnancy. Only 11(.79%) had repeat pregnancies. Older youth appeared more likely to repeat a pregnancy. Comprehensive intervention for teen mothers can be very successful in reducing repeat teen pregnancy in those teens who participate consistently in the program over a period of years.

  20. Clinical significance of measurment of changes of serum IGF-I, hs-CRP levels after treatment in patients with hyperthyroidism and hypothyroidism

    International Nuclear Information System (INIS)

    Zhu Conggang

    2009-01-01

    Objective: To explore the clinical significance of changes of serum IGF-I,hs-CRP levels after treatment in patients with hyperthyroidism and hypothyroidism. Methods: Serum IGF-I, hs-CRP(with RIA), and serum hs-CRP with immuno-turbidity methods levels were determined both before and after treatment in 36 cases of hyperthyroidism 30 cases of hypothyroidism as well as 35 controls. Results: Before treatment, the serum IGF-I levels in patients with hyperthyroidism were significantly higher and the levels in patients with hypothyroidism were significantly lower than those in controls (both P<0.01). After treatment for 3 months,the levels were much corrected, but still remained significantly different from those in controls (P<0.05). Before treatment serum hs-CRP levels in both groups of patients were significantly higher than those in controls (P<0.01), but after treatment,the levels were not much different from those in controls. Conclusion: Serum levels of IGF-I and hs-CRP were closely related to the disease process in patients with hyperthyroidism as well as in patients with hypothyroidism, and were much corrected after trentment.(authors)

  1. Influence of Chitosan Treatment on Surrogate Serum Markers of Cholesterol Metabolism in Obese Subjects

    Directory of Open Access Journals (Sweden)

    Dieter Lütjohann

    2018-01-01

    Full Text Available Chitosan treatment results in significantly lower serum low density lipoprotein (LDL cholesterol concentrations. To assess the working mechanisms of chitosan, we measured serum surrogate markers of cholesterol absorption (campesterol, sitosterol, cholestanol, synthesis (lathosterol, lanosterol, desmosterol, and degradation to bile acids (7α-hydroxy-cholesterol, 27-hydroxy-cholesterol, corrected for cholesterol concentration (R_sterols. Over 12 weeks, 116 obese subjects (Body Mass Index, BMI 31.7, range 28.1–38.9 kg/m2 were studied under chitosan (n = 61 and placebo treatments (n = 55. The participants were briefly educated regarding improvement of nutrition quality and energy expenditure. Daily chitosan intake was 3200 mg. Serum LDL cholesterol concentration decreased significantly more (p = 0.0252 under chitosan (−8.67 ± 18.18 mg/dL, 5.6% than under placebo treatment (−1.00 ± 24.22 mg/dL, 0.9%. This reduction was not associated with the expected greater decreases in markers of cholesterol absorption under chitosan treatment. Also, increases in markers of cholesterol synthesis and bile acid synthesis under chitosan treatment were not any greater than under placebo treatment. In conclusion, a significant selective reduction of serum LDL cholesterol under chitosan treatment is neither associated with a reduction of serum surrogate markers of cholesterol absorption, nor with increases of markers for cholesterol and bile acid synthesis.

  2. Treatment and toxicity reduction of textile dyeing wastewater using the electrocoagulation-electroflotation process.

    Science.gov (United States)

    Kim, Han-Lae; Cho, Jong-Bok; Park, Yong-Jin; Cho, Il-Hyoung

    2016-07-02

    A pilot-scale study was conducted using the electrocoagulation-electroflotation (EC-EF) process to treat textile dyeing raw wastewater to evaluate treatment performance. The effects of some key factors, such as current density, hydraulic retention time (HRT), and removal of conductivity, total suspended solids (TSS), chemical oxygen demand (COD), and color were investigated. The operating variables were current density of 0-300 A m(-2), HRT of 0-30 min, and a coagulant (anionic polyacrylamide (A-PAM)) dosage of 0-30 mg L(-1). Daphnia magna was used to test acute toxicity in raw and treated wastewater. Under the operating conditions without added coagulant, maxima of 51%, 88%, 84%, and 99% of conductivity, TSS, COD, and color were removed, respectively, with a HRT of 30 min. The coagulant enhanced removal of all wastewater parameters. Removal maxima of 59%, 92%, 94%, and 98% for conductivity, TSS, COD, and color were observed, respectively, with an optimal dosage of 30 mg L(-1) and a shortened HRT of 20 min. The 48 h-LC50 D. magna test showed that the raw wastewater was highly toxic. However, the EC-EF process decreased toxicity of the treated samples significantly, and >70% toxicity reduction was achieved by the EC-EF process with the addition of 15-30 mg L(-1) coagulant, HRT of 20 min, and current density of 150-300 A m(-2). The pilot scale test (0.3 m(3 )h(-1)) shows that the EC-EF process with added coagulant effectively treated textile dyeing wastewater.

  3. Orthodontic treatment with a series of removable appliances.

    Science.gov (United States)

    Chenin, David A; Trosien, Andrew H; Fong, Patricia F; Miller, Robert A; Lee, Rodney S

    2003-09-01

    In the United States, the demand for straight white teeth has never been more important to patients. Crowded, poorly aligned teeth are not esthetically pleasing and are difficult to keep clean. However, until recently, the process of straightening the teeth typically has involved appliances involving bands, brackets and wires that also can be difficult to clean. The desire for a cosmetic solution to misaligned teeth has led to an increase in the number of patients seeking veneers, crowns and other laboratory-fabricated cosmetic restorations. Some clinicians are not aware that there are other ways to align teeth without either significant enamel reduction or conspicuous fixed orthodontic appliances. An alternative method of treatment, involving a series of clear removable appliances, circumvents this shortcoming and enables tooth alignment while avoiding deterioration in the cosmetics of the smile during treatment. This article describes a method of treatment, Invisalign (Align Technology, Santa Clara, Calif.), that clinicians can use in conjunction with 3-D computer models to accomplish the esthetic and oral hygiene objectives during and after treatment. The authors present three case reports, all involving a chief concern of crowding. The first case involved treatment of both arches by interproximal reduction, alignment of teeth and leveling the curve of Spee. The second case involved treatment of both arches by proclination, expansion and minor interproximal reduction. The final case shows relief of lower-arch crowding via lower-incisor extraction. In addition to satisfying the patient's chief concern of desiring straight teeth, this method of treatment satisfies additional objectives of esthetic treatment and esthetic results with significant oral hygiene benefits. Clinicians can address a patient's chief concern effectively without requiring an inventory of appliances (such as bands, brackets, wires and instruments). Furthermore, the use of 3-D computer models

  4. The effect of sucralfate on the reduction of radiation esophagitis: clinical and laboratory data

    International Nuclear Information System (INIS)

    Chun, Mison; Kim, Juree; Hahm, Kibaik; Kim, Jinhong

    1996-01-01

    Purpose/Objective: Sucralfate is a common ulcer healing drug. This study was conducted between June 1995 and February 1996, to verify the sucralfate effect on the reduction of esophagitis, radiation induced mucosal damage. Materials and Methods: Initially, a total of 39 patients (31 lung cancer, 8 esophageal cancer) received either sucralfate or a placebo before each meal (TID) starting the 1st day of the radiation treatment and continuing during the treatment without interruption. Patients were evaluated weekly by the same personnel using a pain scale. Subsequently, sucralfate was given 4 times daily (QID), with each meal and right before treatment, to 14 patients. Esophageal biopsies were taken from 14 patients (9 from the sucralfate group and 5 from the placebo group) on the third week of radiation treatment, when the patients usually received 2000 to 2500 cGy to the thoracic esophagus. We evaluated the change of reactive oxygen metabolites and reactive nitrogen metabolites such as NOS(constitutive and inducible form of nitric oxide synthetase) generated by irradiation. Myeloperoxidase(MPO) activities were measured spectroscopically. Thiobarbituric acid reactive substance (TBA-RS) and chemiluminescence (CL) as an index of lipid peroxidation were also measured. Results: There was a considerable reduction of severe esophagitis (≥ 4 pain scale) in patients with regular sucralfate medication compared to patients with the placebo ((6(20))(30%) vs(14(19)) (74%)). Sucralfate QID group patients showed more improvement than the TID group, with only 2 out of 14 (14%) suffering severe esophagitis. The laboratory results are shown below : Conclusion: This data confirmed that sucralfate significantly reduced severe esophagitis symptoms during the radiation therapy course, and made it easier for patients to tolerate the thoracic radiation treatment. Moreover, the laboratory data showed a significant reduction in the level of all reactive oxygen metabolites generated by the

  5. Significant reductions in oil quality and lipid content of oilseed rape (Brassica napus L.) under climate change

    DEFF Research Database (Denmark)

    Namazkar, Shahla; Egsgaard, Helge; Frenck, Georg

    2015-01-01

    Despite of the potential importance to food and bioenergy purposes, effects from climate change on plant oil quality have hardly been characterized.On a global basis Brassica napus L., rapeseed or oilseed rape, is the second largest source of vegetable oil after soybean and the predominant oil crop...... in Europe. We found significant changes in oil quality and quantity of four cultivars of oilseed rape grown in five future climate scenarios with elevated [CO2], [O-3] temperature and combinations hereof (similar to RCP8.5,(1)). Populations of the cultivars were grown under ambient and climate change...... conditions in a climate-phytotron. The treatments were ambient (360 ppm CO2, 19/12 degrees C (day/night), 20/20 ppb O-3 (day/night)), all factors elevated (650 ppm CO2, 24/17 degrees C, 60/20 ppb O-3), as well as two- and single-factor treatments with the elevated factors.The overall trend was that oil...

  6. THE HEAT TREATMENT ANALYSIS OF E110 CASE HARDENING STEEL

    Directory of Open Access Journals (Sweden)

    MAJID TOLOUEI-RAD

    2016-03-01

    Full Text Available This paper investigates mechanical and microstructural behaviour of E110 case hardening steel when subjected to different heat treatment processes including quenching, normalizing and tempering. After heat treatment samples were subjected to mechanical and metallographic analysis and the properties obtained from applying different processes were analysed. The heat treatment process had certain effects on the resultant properties and microstructures obtained for E110 steel which are described in details. Quenching produced a martensitic microstructure characterized by significant increase in material’s hardness and a significant decreased in its impact energy. Annealed specimens produced a coarse pearlitic microstructure with minimal variation in hardness and impact energy. For normalized samples, fine pearlitic microstructure was identified with a moderate increase in hardness and significant reduction in impact energy. Tempering had a significant effect on quenched specimens, with a substantial rise in material ductility and reduction of hardness with increasing tempering temperature. Furthermore, Results provide additional substantiation of temper embrittlement theory for low-carbon alloys, and indicate potential occurrence of temper embrittlement for fine pearlitic microstructures.

  7. Alternative substrates of bacterial sulphate reduction suitable for the biological-chemical treatment of acid mine drainage

    Directory of Open Access Journals (Sweden)

    Alena Luptakova

    2012-12-01

    Full Text Available The impacts of AMD pollution on biological systems are mostly severe and the problem may persist from many decadesto thousands of years. Consequently AMD prior to being released into the environment must be treated to meet government standardsfor the amount of metal and non-metal ions contained in the water. One of the best available technologies for the removal of metals fromAMD is precipitation as metal sulphides. SRB applications for AMD treatment involve a few principal stages. The first stageis the cultivation of SRB i.e. the bacterial sulphate reduction. At the laboratory conditions the sodium lactate is the energetic substratefor the growth of bacteria. Its price is not economic for the application in the practice and is needed investigate the alternativesubstitutes. The aim of this work was the cultivation of SRB using the selected energetic substrates such as: calcium lactate, ethanol,saccharose, glucose and whey. Experimental studies confirm that in the regard to the amount of reduced sulphates the calcium lactateand ethanol are the best alternative substrates for the bacterial sulphate-reduction.

  8. Comparison of Intravenous Morphine with Sublingual Buprenorphine in Management of Postoperative Pain after Closed Reduction Orthopedic Surgery

    OpenAIRE

    Ghasem Soltani; Mahmood Khorsand; ALireza Sepehri Shamloo; Lida Jarahi; Nahid Zirak

    2015-01-01

    Background: Postoperative pain is a common side effect following surgery that can significantly reduce surgical quality and patient’s satisfaction. Treatment options are morphine and buprenorphine. We aimed to compare the efficacy of a single dose of intravenous morphine with sublingual buprenorphine in postoperative pain control following closed reduction surgery. Methods: This triple blind clinical trial was conducted on 90 patients referred for closed reduction orthopedic surgery. They wer...

  9. Biotechnological reduction of sulfide in an industrial primary wastewater treatment system: A sustainable and successful case study

    Energy Technology Data Exchange (ETDEWEB)

    Rajamani, S. [Central Leather Research Institute, Madras (India)

    1996-12-31

    The leather industry is an important export-oriented industry in India, with more than 3,000 tanneries located in different clusters. Sodium sulfide, a toxic chemical, is used in large quantities to remove hair and excess flesh from hides and skins. Most of the sodium sulfide used in the process is discharged as waste in the effluent, which causes serious environmental problems. Reduction of sulfide in the effluent is generally achieved by means of chemicals in the pretreatment system, which involves aerobic mixing using large amounts of chemicals and high energy, and generating large volumes of sludge. A simple biotechnological system that uses the residual biosludge from the secondary settling tank was developed, and the commercial-scale application established that more than 90% of the sulfide could be reduced in the primary treatment system. In addition to the reduction of sulfide, foul smells, BOD and COD are reduced to a considerable level. 3 refs., 2 figs., 1 tab.

  10. Draft Technical Protocol: A Treatability Test for Evaluating the Potential Applicability of the Reductive Anaerobic Biological in Situ Treatment Technology (Rabitt) to Remediate Chloroethenes

    National Research Council Canada - National Science Library

    Morse, Jeff

    1998-01-01

    This draft, unvalidated protocol describes a comprehensive approach for conducting a phased treatability test to determine the potential for employing the Reductive Anaerobic Biological In Situ Treatment Technology (RABITT...

  11. Concentration reduction of selected pollutants in fish culture ...

    African Journals Online (AJOL)

    Concentration reduction of selected pollutants in fish culture effluents using plastic straws and palm kernel shells. ... Journal of Environmental Extension ... Their effluent treatment ability were evaluated in terms of reduction made to ...

  12. Ice immersion as a postharvest treatment of oysters for the reduction of Vibrio vulnificus.

    Science.gov (United States)

    Quevedo, Ana C; Smith, James G; Rodrick, Gary E; Wright, Anita C

    2005-06-01

    Vibrio vulnificus produces serious illnesses that are commonly associated with shellfish consumption, particularly raw oysters. Ingestion can result in fatal septicemia in susceptible individuals with hepatitis, cirrhosis, immune dysfunction, diabetes, or hemochromatosis (metabolic iron overload). Therefore, postharvest treatments to reduce vibrio levels in oysters have been recommended. In this study, rapid chilling by immersion of unwashed whole oysters in ice for 3 h was assessed as a postharvest treatment for reduction of V. vulnificus. Treated oysters were subsequently refrigerated at 45 degrees F (7.2 degrees C), whereas control oysters were not iced but were maintained at 45 degrees F throughout the study. Homogenized meats were monitored for total heterotrophic aerobic bacteria, V. vulnificus, and fecal coliform content before and after treatment over a 2-week period. V. vulnificus was enumerated by DNA probe hybridization of colonies from standard plate counts on nonselective medium, and recovery was compared for several media. Loss of plating efficiency was observed on standard selective and differential media compared with nonselective agars. Numbers of V. vulnificus generally declined in treated samples compared with controls; however, increases in total heterotrophic bacteria and fecal coliforms were also observed in treated samples at some time points. This study does not support the use of ice immersion as a postharvest method because of the relatively small declines in V. vulnificus numbers and the possibility of concomitant increases in fecal coliform and total bacterial contamination.

  13. CuZn Alloy- Based Electrocatalyst for CO2 Reduction

    KAUST Repository

    Alazmi, Amira

    2014-06-01

    ABSTRACT CuZn Alloy- Based Electrocatalyst for CO2 Reduction Amira Alazmi Carbon dioxide (CO2) is one of the major greenhouse gases and its emission is a significant threat to global economy and sustainability. Efficient CO2 conversion leads to utilization of CO2 as a carbon feedstock, but activating the most stable carbon-based molecule, CO2, is a challenging task. Electrochemical conversion of CO2 is considered to be the beneficial approach to generate carbon-containing fuels directly from CO2, especially when the electronic energy is derived from renewable energies, such as solar, wind, geo-thermal and tidal. To achieve this goal, the development of an efficient electrocatalyst for CO2 reduction is essential. In this thesis, studies on CuZn alloys with heat treatments at different temperatures have been evaluated as electrocatalysts for CO2 reduction. It was found that the catalytic activity of these electrodes was strongly dependent on the thermal oxidation temperature before their use for electrochemical measurements. The polycrystalline CuZn electrode without thermal treatment shows the Faradaic efficiency for CO formation of only 30% at applied potential ~−1.0 V vs. RHE with current density of ~−2.55 mA cm−2. In contrast, the reduction of oxide-based CuZn alloy electrode exhibits 65% Faradaic efficiency for CO at lower applied potential about −1.0 V vs. RHE with current density of −2.55 mA cm−2. Furthermore, stable activity was achieved over several hours of the reduction reaction at the modified electrodes. Based on electrokinetic studies, this improvement could be attributed to further stabilization of the CO2•− on the oxide-based Cu-Zn alloy surface.

  14. [Clinical significance of drug resistance-associated mutations in treatment of hepatitis C with direct-acting antiviral agents].

    Science.gov (United States)

    Li, Z; Chen, Z W; Ren, H; Hu, P

    2017-03-20

    Direct-acting antiviral agents (DAAs) achieve a high sustained virologic response rate in the treatment of chronic hepatitis C virus infection. However, drug resistance-associated mutations play an important role in treatment failure and have attracted more and more attention. This article elaborates on the clinical significance of drug resistance-associated mutations from the aspects of their definition, association with genotype, known drug resistance-associated mutations and their prevalence rates, the impact of drug resistance-associated mutations on treatment naive and treatment-experienced patients, and the role of clinical detection, in order to provide a reference for clinical regimens with DAAs and help to achieve higher sustained virologic response rates.

  15. Effects of advanced treatment systems on the removal of antibiotic resistance genes in wastewater treatment plants from Hangzhou, China.

    Science.gov (United States)

    Chen, Hong; Zhang, Mingmei

    2013-08-06

    This study aimed at quantifying the concentration and removal of antibiotic resistance genes (ARGs) in three municipal wastewater treatment plants (WWTPs) employing different advanced treatment systems [biological aerated filter, constructed wetland, and ultraviolet (UV) disinfection]. The concentrations of tetM, tetO, tetQ, tetW, sulI, sulII, intI1, and 16S rDNA genes were examined in wastewater and biosolid samples. In municipal WWTPs, ARG reductions of 1-3 orders of magnitude were observed, and no difference was found among the three municipal WWTPs with different treatment processes (p > 0.05). In advanced treatment systems, 1-3 orders of magnitude of reductions in ARGs were observed in constructed wetlands, 0.6-1.2 orders of magnitude of reductions in ARGs were observed in the biological aerated filter, but no apparent decrease by UV disinfection was observed. A significant difference was found between constructed wetlands and biological filter (p removal of ARGs and 16S rDNA genes (R(2) = 0.391-0.866; p removal values with WWTP (p > 0.05) but also have the advantage in ARG relative abundance removal, and it should be given priority to be an advanced treatment system for further ARG attenuation from WWTP.

  16. Managed nutrient reduction impacts on nutrient concentrations, water clarity, primary production, and hypoxia in a north temperate estuary

    Science.gov (United States)

    Oviatt, Candace; Smith, Leslie; Krumholz, Jason; Coupland, Catherine; Stoffel, Heather; Keller, Aimee; McManus, M. Conor; Reed, Laura

    2017-12-01

    Except for the Providence River and side embayments like Greenwich Bay, Narragansett Bay can no longer be considered eutrophic. In summer 2012 managed nitrogen treatment in Narragansett Bay achieved a goal of reducing effluent dissolved inorganic nitrogen inputs by over 50%. Narragansett Bay represents a small northeast US estuary that had been heavily loaded with sewage effluent nutrients since the late 1800s. The input reduction was reflected in standing stock nutrients resulting in a statistically significant 60% reduction in concentration. In the Providence River estuary, total nitrogen decreased from 100 μm to about 40 μm, for example. We tested four environmental changes that might be associated with the nitrogen reduction. System apparent production was significantly decreased by 31% and 45% in the upper and mid Bay. Nutrient reductions resulted in statistically improved water clarity in the mid and upper Bay and in a 34% reduction in summer hypoxia. Nitrogen reduction also reduced the winter spring diatom bloom; winter chlorophyll levels after nutrient reduction have been significantly lower than before the reduction. The impact on the Bay will continue to evolve over the next few years and be a natural experiment for other temperate estuaries that will be experiencing nitrogen reduction. To provide perspective we review factors effecting hypoxia in other estuaries with managed nutrient reduction and conclude that, as in Narragansett Bay, physical factors can be as important as nutrients. On a positive note managed nutrient reduction has mitigated further deterioration in most estuaries.

  17. REPEATED REDUCTIVE AND OXIDATIVE TREATMENTS ON GRANULAR ACTIVATED CARBON

    Science.gov (United States)

    Fenton oxidation and Fenton oxidation preceded by reduction solutions were applied to granular activated carbon (GAC) to chemically regenerate the adsorbent. No adsorbate was present on the GAC so physicochemical effects from chemically aggressive regeneration of the carbon coul...

  18. Reduction of Listeria innocua contamination in vacuum-packaged dry-cured Italian pork products after high hydrostatic pressure treatment

    Directory of Open Access Journals (Sweden)

    Giuseppe Merialdi

    2015-06-01

    Full Text Available The present work aims to present the results of the application of a treatment with high hydrostatic pressure (HHP on Italian fermented and dry-cured pork products. The products used in this study were portioned cured ham, portioned bacon and salami, vacuumpackaged and produced by a single processing company. Two studies were conducted on a single batch of the three products by means of an artificial contamination with Listeria innocua as a surrogate of L. monocytogenes. In the first trial a superficial contamination was obtained by immersion for 3 min in the culture broth with a concentration of approximately 9 log cfu/mL. At the end of the inoculum step, the pieces were dred at room temperature and vacuum packaged. In the second trial 50 kg of minced pork meat were contaminated before production of salami. In both cases the inoculum contained 5 strains of L. innocua. Subsequently, in both trials, 10 samples were randomly divided into two groups of 5 pieces each: i TH group, samples treated with HHP; ii group C, control samples, not subjected to any treatment. All samples were stored at refrigeration temperature at the end of HHP treatments (if applied, and analyzed for the determination of the surface (1st trial and deep (2nd trial quantitative contamination of L. innocua. pH and aW were also determined on 3 pieces of each products belonging to group C. The difference between the medians of the log cfu/cm2 or g established between controls and treated were compared using the non-parametric test (Kruskal-Wallis test with P<0.01. In all products and in both trials the level of contamination detected in treatment groups was always significantly lower than in controls (P<0.01. In particular, in vacuum-packaged ham, bacon and salami viability logarithmic viability reductions equal to -2.29, -2.54 and -2.51 were observed, respectively. This study aimed to evaluate a not-thermal treatment on Italian cured or fermented pork products. The results of

  19. Laser Supported Reduction of Specific Microorganisms in the Periodontal Pocket with the Aid of an Er,Cr:YSGG Laser: A Pilot Study

    Directory of Open Access Journals (Sweden)

    N. Gutknecht

    2015-01-01

    Full Text Available Objective. The aim of this study was to evaluate the effectiveness of a radial firing tip of an Er,Cr:YSGG laser as an adjunct to a nonsurgical periodontal treatment. Methods. Twelve patients with chronic or aggressive periodontitis were treated by conventional periodontal treatment using ultrasonic devices and hand instruments and, additionally, in two quadrants with an Er,Cr:YSGG laser. A new radial firing tip (RFPT 14-5, Biolase was used with 1.5 W, 30 Hz, 11% air, 20% water, and pulse duration 140 μs. Microbiological smears were taken before treatment, one day after lasing, and three and six months after lasing. Pocket depths of all periodontal sites were measured before and six months after treatment. Results. The total bacterial load of Prevotella intermedia, Tannerella forsythia, Treponema denticola, Fusobacterium nucleatum, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans inside the pocket was reduced significantly throughout the whole examination time. Greater pocket depth reductions were observed in all groups. There was a slight higher reduction of pocket depth in the lased group after six months. Conclusions. These results support the thesis that Er,Cr:YSGG laser supported periodontal treatment leads to a significant reduction of periopathogenes and thereby helps the maintenance of periodontal health.

  20. The SGLT2 Inhibitor Dapagliflozin Significantly Improves the Peripheral Microvascular Endothelial Function in Patients with Uncontrolled Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Sugiyama, Seigo; Jinnouchi, Hideaki; Kurinami, Noboru; Hieshima, Kunio; Yoshida, Akira; Jinnouchi, Katsunori; Nishimura, Hiroyuki; Suzuki, Tomoko; Miyamoto, Fumio; Kajiwara, Keizo; Jinnouchi, Tomio

    2018-03-30

    Objective Sodium-glucose cotransporter-2 (SGLT2) inhibitors reduce cardiovascular events and decrease the body fat mass in patients with type 2 diabetes mellitus (T2DM). We examined whether or not the SGLT2-inhibitor dapagliflozin can improve the endothelial function associated with a reduction in abdominal fat mass. Methods We prospectively recruited patients with uncontrolled (hemoglobin A1c [HbA1c] >7.0%) T2DM who were not being treated by SGLT2 inhibitors. Patients were treated with add-on dapagliflozin (5 mg/day) or non-SGLT2 inhibitor medicines for 6 months to improve their HbA1c. We measured the peripheral microvascular endothelial function as assessed by reactive hyperemia peripheral arterial tonometry (RH-PAT) and calculated the natural logarithmic transformed value of the RH-PAT index (LnRHI). We then investigated changes in the LnRHI and abdominal fat area using computed tomography (CT). Results The subjects were 54 patients with uncontrolled T2DM (72.2% men) with a mean HbA1c of 8.1%. The HbA1c was significantly decreased in both groups, with no significant difference between the groups. Dapagliflozin treatment, but not non-SGLT2 inhibitor treatment, significantly increased the LnRHI. The changes in the LnRHI were significantly greater in the dapagliflozin group than in the non-SGLT2 inhibitor group. Dapagliflozin treatment, but not non-SGLT2 inhibitor treatment, significantly decreased the abdominal visceral fat area, subcutaneous fat area (SFA), and total fat area (TFA) as assessed by CT and significantly increased the plasma adiponectin levels. The percentage changes in the LnRHI were significantly correlated with changes in the SFA, TFA, systolic blood pressure, and adiponectin. Conclusion Add-on treatment with dapagliflozin significantly improves the glycemic control and endothelial function associated with a reduction in the abdominal fat mass in patients with uncontrolled T2DM.

  1. Change in Visual Field Progression Following Treatment Escalation in Primary Open-angle Glaucoma.

    Science.gov (United States)

    Aptel, Florent; Bron, Alain M; Lachkar, Yves; Schweitzer, Cédric

    2017-10-01

    To evaluate the effect of treatment escalation on the rate of visual field progression in patients with primary open-angle glaucoma (POAG). Multicenter database study. We reviewed the electronic records of 171 patients with POAG under medical hypotensive treatment who underwent 5 consecutive visits 6 months apart before and after medical treatment escalation or additive laser trabeculoplasty. We calculated the rate of visual field progression (mean deviation change per year) before and after treatment escalation. The mean duration of follow-up was 5.1±0.5 years and the mean number of visual field examinations was 10.2±0.2. In 139 eyes with medical treatment escalation, the rate of progression was significantly reduced [from -0.57 to -0.29 dB/y; P=0.022; intraocular pressure (IOP) reduction 11.1%]. In detail, the rate of progression was significantly reduced after escalation from mono to dual therapy, dual to triple therapy, and from mono to triple therapy (-0.35 to -0.24 dB/y, P=0.018; -1.01 to -0.48 dB/y, P=0.038; -1.04 to -0.35 dB/y, P=0.020, respectively). In 32 eyes with additive laser trabeculoplasty, the rate of progression was significantly reduced (-0.60 to -0.24 dB/y; P=0.014; IOP reduction 9.4%). Medical treatment escalation or additive laser trabeculoplasty significantly reduced the rate of visual field progression in POAG. Larger IOP reduction has a greater probability of reducing glaucoma progression.

  2. Evaluation of normalized metal artifact reduction (NMAR) in kVCT using MVCT prior images for radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Paudel, M. R.; Mackenzie, M.; Rathee, S.; Fallone, B. G.

    2013-01-01

    Purpose: To evaluate the metal artifacts in kilovoltage computed tomography (kVCT) images that are corrected using a normalized metal artifact reduction (NMAR) method with megavoltage CT (MVCT) prior images.Methods: Tissue characterization phantoms containing bilateral steel inserts are used in all experiments. Two MVCT images, one without any metal artifact corrections and the other corrected using a modified iterative maximum likelihood polychromatic algorithm for CT (IMPACT) are translated to pseudo-kVCT images. These are then used as prior images without tissue classification in an NMAR technique for correcting the experimental kVCT image. The IMPACT method in MVCT included an additional model for the pair/triplet production process and the energy dependent response of the MVCT detectors. An experimental kVCT image, without the metal inserts and reconstructed using the filtered back projection (FBP) method, is artificially patched with the known steel inserts to get a reference image. The regular NMAR image containing the steel inserts that uses tissue classified kVCT prior and the NMAR images reconstructed using MVCT priors are compared with the reference image for metal artifact reduction. The Eclipse treatment planning system is used to calculate radiotherapy dose distributions on the corrected images and on the reference image using the Anisotropic Analytical Algorithm with 6 MV parallel opposed 5 × 10 cm 2 fields passing through the bilateral steel inserts, and the results are compared. Gafchromic film is used to measure the actual dose delivered in a plane perpendicular to the beams at the isocenter.Results: The streaking and shading in the NMAR image using tissue classifications are significantly reduced. However, the structures, including metal, are deformed. Some uniform regions appear to have eroded from one side. There is a large variation of attenuation values inside the metal inserts. Similar results are seen in commercially corrected image. Use

  3. Significant clinical improvement in radiation-induced lumbosacral poly-radiculopathy by a treatment combining pentoxifylline, tocopherol, and clodronate (Pentoclo)

    Energy Technology Data Exchange (ETDEWEB)

    Delanian, S. [Hop St Louis, Serv Oncol Radiotherapie, APHP, F-75010 Paris, (France); Lefaix, J.L. [CEA-LARIA, CIRIL-GANIL, Caen, (France); Maisonobe, T. [Hop La Pitie Salpetriere, Federat Neurophysiol Clin, APHP, Paris, (France)

    2008-07-01

    Radiation-induced (RI) peripheral neuropathy is a rare and severe delayed complication of radiotherapy that is spontaneously irreversible, with no standard of treatment. We previously developed a successful antioxidant treatment in RI fibrosis and necrosis. Two patients with progressive worsening RI lumbosacral poly-radiculopathy experienced over several years a significant clinical improvement in their neurological sensorimotor symptoms with long-term pentoxifylline-tocopherol-clodronate treatment, and good safety. (authors)

  4. Antiretroviral treatment uptake in patients with HIV- associated TB ...

    African Journals Online (AJOL)

    ART results in a 64 - 95% reduction in mortality risk 5 and is an essential component of care. How soon to start. ART after TB treatment initiation has become clearer from randomised controlled trials. These show that integration of ART and TB treatment in all HIV-associated TB patients regardless of CD4 count significantly.

  5. Spreadsheet tool for estimating noise reduction costs

    International Nuclear Information System (INIS)

    Frank, L.; Senden, V.; Leszczynski, Y.

    2009-01-01

    The Northeast Capital Industrial Association (NCIA) represents industry in Alberta's industrial heartland. The organization is in the process of developing a regional noise management plan (RNMP) for their member companies. The RNMP includes the development of a noise reduction cost spreadsheet tool to conduct reviews of practical noise control treatments available for individual plant equipment, inclusive of ranges of noise attenuation achievable, which produces a budgetary prediction of the installed cost of practical noise control treatments. This paper discussed the noise reduction cost spreadsheet tool, with particular reference to noise control best practices approaches and spreadsheet tool development such as prerequisite, assembling data required, approach, and unit pricing database. Use and optimization of the noise reduction cost spreadsheet tool was also discussed. It was concluded that the noise reduction cost spreadsheet tool is an easy interactive tool to estimate implementation costs related to different strategies and options of noise control mitigating measures and was very helpful in gaining insight for noise control planning purposes. 2 tabs.

  6. Codelivery of doxorubicin and triptolide with reduction-sensitive lipid–polymer hybrid nanoparticles for in vitro and in vivo synergistic cancer treatment

    Directory of Open Access Journals (Sweden)

    Wu B

    2017-03-01

    Full Text Available Bo Wu,1,2,* Shu-Ting Lu,1,* Liu-Jie Zhang,2 Ren-Xi Zhuo,2 Hai-Bo Xu,1 Shi-Wen Huang2 1Department of Radiology, Zhongnan Hospital of Wuhan University, 2Key Laboratory of Biomedical Polymers of Ministry of Education, Department of Chemistry, Wuhan University, Wuhan, People’s Republic of China *These authors contributed equally to this work Abstract: Codelivery is a promising strategy to overcome the limitations of single chemotherapeutic agents in cancer treatment. Despite progress, codelivery of two or more different functional drugs to increase anticancer efficiency still remains a challenge. Here, reduction-sensitive lipid–polymer hybrid nanoparticles (LPNPs drug delivery system composed of monomethoxy-poly(ethylene glycol-S-S-hexadecyl (mPEG-S-S-C16, soybean lecithin, and poly(d,l-lactide-co-glycolide (PLGA was used for codelivery of doxorubicin (DOX and a Chinese herb extract triptolide (TPL. Hydrophobic DOX and TPL could be successfully loaded in LPNPs by self-assembly. More importantly, drug release and cellular uptake experiments demonstrated that the two drugs were reduction sensitive, released simultaneously from LPNPs, and taken up effectively by the tumor cells. DOX/TPL-coloaded LPNPs (DOX/TPL-LPNPs exhibited a high level of synergistic activation with low combination index (CI in vitro and in vivo. Moreover, the highest synergistic therapeutic effect was achieved at the ratio of 1:0.2 DOX/TPL. Further experiments showed that TPL enhanced the uptake of DOX by human oral cavity squamous cell carcinoma cells (KB cells. Overall, DOX/TPL-coencapsulated reduction-sensitive nanoparticles will be a promising strategy for cancer treatment. Keywords: triptolide, codelivery, reduction sensitive, synergistic effect

  7. Substrate reduction therapy in the infantile form of Tay-Sachs disease.

    Science.gov (United States)

    Bembi, B; Marchetti, F; Guerci, V I; Ciana, G; Addobbati, R; Grasso, D; Barone, R; Cariati, R; Fernandez-Guillen, L; Butters, T; Pittis, M G

    2006-01-24

    Substrate reduction therapy (SRT) with miglustat has been proposed for treatment of some lysosomal storage disorders. Based on the positive experience in Gaucher disease and experimental data in Tay-Sachs (TSD) and Sandhoff animal models, the authors investigated the clinical efficacy of SRT in two patients with infantile TSD. SRT could not arrest the patients' neurologic deterioration. However, a significant drug concentration in CSF as well as macrocephaly prevention were observed.

  8. Clinical significance of measurement of changes of plasma Hcy and ET levels after treatment in patients with acute myocardial infarction (AMI)

    International Nuclear Information System (INIS)

    Zhou Feng

    2008-01-01

    Objective: To explore the clinical significance of changes of plasma Hcy and ET levels in patients with AMI after treatment. Methods: Plasma Hcy and ET levels were measured with RIA in 33 patients with acute myocardial infarction both before and after treatment as well as in 30 controls. Results: Plasma Hcy and ET levels were significantly higher in the AMI patients than those in the controls before treatment and the levels were mutually positively correlated (P 0.05), but plasma ET levels, though dropped markedly remained significantly higher (P<0.05). Conclusion: Changes of plasma Hcy and ET levels after treatment might be of prognostic importance in patients with acute myocardial infarction. (authors)

  9. Clinical significance of measurement of changes of serum NSE and plasma NPY levels after treatment in pediatric patients with viral encephalitis

    International Nuclear Information System (INIS)

    Jin Bo; Zheng Guo

    2007-01-01

    Objective: To explore the significance ef changes of serum NSE and plasma NPY levels after treatment in pediatric patients with viral encephalitis. Methods: Serum NSE and plasma NPY levels were measured with RIA in 32 pediatric patients with viral encephalitis both before and after treatment as well as in 30 controls. Results: Before treatment, in the patients, the serum NSE and plasma NPY levels were significantly higher than those in controls (P<0.01). After 1 month's treatment the levels dropped markedly but still remained significantly higher than those in controls (P<0.05). Conclusion: Serum NSE and plasma NPY levels changes were closely related to the progress of viral encephalitis. (authors)

  10. CRP, but not TNF-α or IL-6, decreases after weight loss in patients with morbid obesity exposed to intensive weight reduction and balneological treatment*

    Science.gov (United States)

    Rość, Danuta; Adamczyk, Przemysław; Boinska, Joanna; Szafkowski, Robert; Ponikowska, Irena; Stankowska, Katarzyna; Góralczyk, Barbara; Ruszkowska-Ciastek, Barbara

    2015-01-01

    Objective: The aim of this study was to evaluate the concentrations of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and the degree of homeostasis model assessment-insulin resistance (HOMA-IR) in patients with morbid obesity exposed to a three-week low-calorie diet and balneotherapy. Methods: The study included 33 patients (25 females and 8 males; mean age 46 years) with body mass index (BMI) values of >40 kg/m2. Evaluations of CRP, IL-6, TNF-α, lipid profile, HOMA-IR, and fasting glucose were carried out before (baseline data) and three weeks after the treatment. The control group consisted of 20 healthy volunteers (15 females and 5 males) with a mean age of 39 years and BMI values of ≤24.9 kg/m2. Results: In the blood of patients with morbid obesity we found significantly elevated levels of CRP, TNF-α, triglycerides, HOMA-IR and fasting glucose, but a decreased level of high density lipoprotein (HDL)-cholesterol, compared with the healthy individuals. The treatment resulted in about a 9.4% reduction in body weight from 122.5 to 111.0 kg and a significant decrease in the concentration of CRP, but no change in TNF-α or IL-6. HOMA-IR was significantly reduced. Conclusions: The decrease in CRP level without changes in TNF-α or IL-6 concentrations after the low-calorie diet and balneological treatment, suggests that an essential amount of adipose tissue must be removed before proper adipocyte function is restored. The decrease in HOMA-IR indicates an improvement in insulin sensitivity, which is beneficial in obese patients. PMID:25990058

  11. Evidence-based insulin treatment in type 1 diabetes mellitus

    DEFF Research Database (Denmark)

    Jacobsen, Iben Brock; Henriksen, J E; Hother-Nielsen, O

    2009-01-01

    AIM: Evaluation of the evidence base for recommending different insulin treatment regimens in type 1 diabetes. METHODS: A computerised literature survey was conducted using The Cochrane Controlled Trials Register and the Pub Med database for the period of 1982-2007. RESULTS: A meta-analysis on only...... 49 out of 1295 references showed that CSII compared with conventional or multiple insulin injections therapy demonstrated a significant reduction in mean HbA1c (primary outcome) of 1.2% CI [0.73; 1.59] (P... daily insulin injections was based on only one publication demonstrating an improved quality of life but no significant reduction in HbA1c or hypoglycaemia. A comparison of rapid-acting insulin analogues and human soluble insulin demonstrated a statistically significant reduction in HbA1c of 0.1% CI: [0...

  12. Improved image quality in abdominal CT in patients who underwent treatment for hepatocellular carcinoma with small metal implants using a raw data-based metal artifact reduction algorithm

    Energy Technology Data Exchange (ETDEWEB)

    Sofue, Keitaro; Sugimura, Kazuro [Kobe University Graduate School of Medicine, Department of Radiology, Kobe, Hyogo (Japan); Yoshikawa, Takeshi; Ohno, Yoshiharu [Kobe University Graduate School of Medicine, Advanced Biomedical Imaging Research Center, Kobe, Hyogo (Japan); Kobe University Graduate School of Medicine, Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe, Hyogo (Japan); Negi, Noriyuki [Kobe University Hospital, Division of Radiology, Kobe, Hyogo (Japan); Inokawa, Hiroyasu; Sugihara, Naoki [Toshiba Medical Systems Corporation, Otawara, Tochigi (Japan)

    2017-07-15

    To determine the value of a raw data-based metal artifact reduction (SEMAR) algorithm for image quality improvement in abdominal CT for patients with small metal implants. Fifty-eight patients with small metal implants (3-15 mm in size) who underwent treatment for hepatocellular carcinoma were imaged with CT. CT data were reconstructed by filtered back projection with and without SEMAR algorithm in axial and coronal planes. To evaluate metal artefact reduction, mean CT number (HU and SD) and artefact index (AI) values within the liver were calculated. Two readers independently evaluated image quality of the liver and pancreas and visualization of vasculature using a 5-point visual score. HU and AI values and image quality on images with and without SEMAR were compared using the paired Student's t-test and Wilcoxon signed rank test. Interobserver agreement was evaluated using linear-weighted κ test. Mean HU and AI on images with SEMAR was significantly lower than those without SEMAR (P < 0.0001). Liver and pancreas image qualities and visualizations of vasculature were significantly improved on CT with SEMAR (P < 0.0001) with substantial or almost perfect agreement (0.62 ≤ κ ≤ 0.83). SEMAR can improve image quality in abdominal CT in patients with small metal implants by reducing metallic artefacts. (orig.)

  13. Improved image quality in abdominal CT in patients who underwent treatment for hepatocellular carcinoma with small metal implants using a raw data-based metal artifact reduction algorithm

    International Nuclear Information System (INIS)

    Sofue, Keitaro; Sugimura, Kazuro; Yoshikawa, Takeshi; Ohno, Yoshiharu; Negi, Noriyuki; Inokawa, Hiroyasu; Sugihara, Naoki

    2017-01-01

    To determine the value of a raw data-based metal artifact reduction (SEMAR) algorithm for image quality improvement in abdominal CT for patients with small metal implants. Fifty-eight patients with small metal implants (3-15 mm in size) who underwent treatment for hepatocellular carcinoma were imaged with CT. CT data were reconstructed by filtered back projection with and without SEMAR algorithm in axial and coronal planes. To evaluate metal artefact reduction, mean CT number (HU and SD) and artefact index (AI) values within the liver were calculated. Two readers independently evaluated image quality of the liver and pancreas and visualization of vasculature using a 5-point visual score. HU and AI values and image quality on images with and without SEMAR were compared using the paired Student's t-test and Wilcoxon signed rank test. Interobserver agreement was evaluated using linear-weighted κ test. Mean HU and AI on images with SEMAR was significantly lower than those without SEMAR (P < 0.0001). Liver and pancreas image qualities and visualizations of vasculature were significantly improved on CT with SEMAR (P < 0.0001) with substantial or almost perfect agreement (0.62 ≤ κ ≤ 0.83). SEMAR can improve image quality in abdominal CT in patients with small metal implants by reducing metallic artefacts. (orig.)

  14. Improved image quality in abdominal CT in patients who underwent treatment for hepatocellular carcinoma with small metal implants using a raw data-based metal artifact reduction algorithm.

    Science.gov (United States)

    Sofue, Keitaro; Yoshikawa, Takeshi; Ohno, Yoshiharu; Negi, Noriyuki; Inokawa, Hiroyasu; Sugihara, Naoki; Sugimura, Kazuro

    2017-07-01

    To determine the value of a raw data-based metal artifact reduction (SEMAR) algorithm for image quality improvement in abdominal CT for patients with small metal implants. Fifty-eight patients with small metal implants (3-15 mm in size) who underwent treatment for hepatocellular carcinoma were imaged with CT. CT data were reconstructed by filtered back projection with and without SEMAR algorithm in axial and coronal planes. To evaluate metal artefact reduction, mean CT number (HU and SD) and artefact index (AI) values within the liver were calculated. Two readers independently evaluated image quality of the liver and pancreas and visualization of vasculature using a 5-point visual score. HU and AI values and image quality on images with and without SEMAR were compared using the paired Student's t-test and Wilcoxon signed rank test. Interobserver agreement was evaluated using linear-weighted κ test. Mean HU and AI on images with SEMAR was significantly lower than those without SEMAR (P small metal implants by reducing metallic artefacts. • SEMAR algorithm significantly reduces metallic artefacts from small implants in abdominal CT. • SEMAR can improve image quality of the liver in dynamic CECT. • Confidence visualization of hepatic vascular anatomies can also be improved by SEMAR.

  15. Impact of preoperative patient characteristics on posturethroplasty recurrence: The significance of stricture length and prior treatments

    Directory of Open Access Journals (Sweden)

    Jibril Oyekunle Bello

    2016-01-01

    Full Text Available Introduction: Urethral strictures are common in urologic practice of Sub-Saharan Africa including Nigeria. We determine the rate of stricture recurrence following urethroplasty for anterior urethral strictures and evaluate preoperative variables that predict of stricture recurrence in our practice. Subjects and Methods: Thirty-six men who had urethroplasty for proven anterior urethral stricture disease between February 2012 and January 2015 were retrospectively analyzed. Preoperative factors including age, socioeconomic factors, comorbidities, etiology of strictures, stricture location, stricture length, periurethral spongiofibrosis, and prior stricture treatments were assessed for independent predictors of stricture recurrence. Results: The median age was 49.5 years (range 21-90, median stricture length was 4 cm (range 1-18 cm and the overall recurrence rate was 27.8%. Postinfectious strictures, pan urethral strictures or multiple strictures involving the penile and bulbar urethra were more common. Most patients had penile circular fasciocutaneous flap urethroplasty. Following univariate analysis of potential preoperative predictors of stricture recurrence, stricture length, and prior treatments with dilations or urethrotomies were found to be significantly associated with stricture recurrence. On multivariate analysis, they both remained statistically significant. Patients who had prior treatments had greater odds of having a recurrent stricture (odds ratio 18, 95% confidence interval [CI] 1.4-224.3. Stricture length was dichotomized based on receiver operating characteristic (ROC analysis, and strictures of length ≥5 cm had significantly greater recurrence (area under ROC curve of 0.825, 95% CI 0.690-0.960, P = 0.032. Conclusion: Patients who had prior dilatations or urethrotomies and those with long strictures particularly strictures ≥5 cm have significantly greater odds of developing a recurrence following urethroplasty in Nigerian

  16. Clinical significance of measurement of changes of serum IL-2, TNF-α and IFN-γ levels after treatment in patients with psoriasis

    International Nuclear Information System (INIS)

    Mou Xudong; Ren Hong; Xie Chuntao

    2010-01-01

    Objective: To study the significance of changes of serum IL-2, TNF-α and IFN-γ levels after treatment in patients with psoriasis. Methods: Serum levels of IL-2, TNF-α (with RIA) and IFN-γ (with ELISA) were measured both before and after treatment in 37 patients with psoriasis and 35 controls. Results: Before treatment, the serum IL-2 levels in patients were significantly lower than those in controls (P<0.01), while the serum TNF-α and IFN-γ levels were significantly higher (P<0.01). After treatment for 3 months, the levels though markedly corrected, were still significantly different from those in controls (P<0.05). Conclusion: The levels of serum IL-2, TNF-α and IFN-γ increased significantly in patients with psoriasis especially in those advanced cases. (authors)

  17. Tumor Volume Changes Assessed by Three-Dimensional Magnetic Resonance Volumetry in Rectal Cancer Patients After Preoperative Chemoradiation: The Impact of the Volume Reduction Ratio on the Prediction of Pathologic Complete Response

    International Nuclear Information System (INIS)

    Kang, Jeong Hyun; Kim, Young Chul; Kim, Hyunki; Kim, Young Wan; Hur, Hyuk; Kim, Jin Soo; Min, Byung Soh; Kim, Hogeun; Lim, Joon Seok; Seong, Jinsil; Keum, Ki Chang; Kim, Nam Kyu

    2010-01-01

    Purpose: The aim of this study was to determine the correlation between tumor volume changes assessed by three-dimensional (3D) magnetic resonance (MR) volumetry and the histopathologic tumor response in rectal cancer patients undergoing preoperative chemoradiation therapy (CRT). Methods and Materials: A total of 84 patients who underwent preoperative CRT followed by radical surgery were prospectively enrolled in the study. The post-treatment tumor volume and tumor volume reduction ratio (% decrease ratio), as shown by 3D MR volumetry, were compared with the histopathologic response, as shown by T and N downstaging and the tumor regression grade (TRG). Results: There were no significant differences in the post-treatment tumor volume and the volume reduction ratio shown by 3D MR volumetry with respect to T and N downstaging and the tumor regression grade. In a multivariate analysis, the tumor volume reduction ratio was not significantly associated with T and N downstaging. The volume reduction ratio (>75%, p = 0.01) and the pretreatment carcinoembryonic antigen level (≤3 ng/ml, p = 0.01), but not the post-treatment volume shown by 3D MR (≤ 5ml), were, however, significantly associated with an increased pathologic complete response rate. Conclusion: More than 75% of the tumor volume reduction ratios were significantly associated with a high pathologic complete response rate. Therefore, limited treatment options such as local excision or simple observation might be considered after preoperative CRT in this patient population.

  18. Effectiveness of an intensive multidisciplinary headache treatment program.

    Science.gov (United States)

    Gunreben-Stempfle, Birgit; Griessinger, Norbert; Lang, Eberhard; Muehlhans, Barbara; Sittl, Reinhard; Ulrich, Kathrin

    2009-07-01

    To investigate if the effectiveness of a 96-hour multidisciplinary headache treatment program exceeds the effectiveness of a 20-hour program and primary care. When dealing with chronic back pain, low-intensity multidisciplinary treatment yields no significantly better results than standard care and monodisciplinary therapy; however, high-intensity treatment does. For multidisciplinary headache treatment, such comparisons are not yet available. In a previous study undertaken by our Pain Center, the outcome of a minimal multidisciplinary intervention model (20-hour) did not exceed primary care. Forty-two patients suffering from frequent headaches (20 +/- 9 headache days/month; range: 8-30) were treated and evaluated in a 96-hour group program. The results were compared with the outcomes of the previous study. Subjects who had undergone either the 20-hour multidisciplinary program or the primary care were used as historical control groups. A significant reduction in migraine days (P tension-type headache days (P tension-type headache days (P = .016), and frequency of migraine attacks (P = .016). In comparison with the 20-hour multidisciplinary program, the 96-hour program showed significantly better effects only in the reduction of migraine days (P = .037) and depression score (P = .003). The responder-rates (> or =50% improvement) in the 96-hour program were significantly higher than in the 20-hour program (migraine days, P = .008; tension-type headache days, P = .044) and primary care (migraine days, P = .007; tension-type headache days, P = .003; tension-type headache intensity, P = .037). The effect sizes were small to medium in the 96-hour program. Particularly with the reduction of migraine symptomatology, the 96-hour program performed better than the 20-hour program, which produced only negligible or small effects. Intensive multidisciplinary headache treatment is highly effective for patients with chronic headaches. Furthermore, migraine symptomatology

  19. Treatment of Storm Fears Using Virtual Reality and Progressive Muscle Relaxation.

    Science.gov (United States)

    Lima, Jessica; McCabe-Bennett, Hanna; Antony, Martin M

    2018-03-01

    The present study examined the efficacy of virtual reality (VR) exposure therapy for treating individuals with storm fears by comparing a one-session VR exposure treatment with a one-session progressive muscle relaxation (PMR) and psychoeducation session. It was predicted that there would be a reduction in storm-related fear post-treatment for individuals in both conditions, but that this reduction would be greater for those in the VR exposure condition. It was predicted that improvements would be maintained at 30-day follow-up only for those in the VR exposure condition. Thirty-six participants each received one of the two treatment conditions. Those in the PMR treatment group received approximately 30 minutes of PMR and approximately 15 minutes of psychoeducation regarding storms. Those in the VR treatment group received approximately 1 hour of VR exposure. Additionally, participants were asked to complete a pre-treatment and post-treatment 5-minute behavioural approach test to assess changes in storm fears. They were also asked to complete a measure assessing storm phobia. There was a significant interaction between treatment group and self-reported fear at post-treatment, such that fear decreased for both groups, although the reduction was stronger in the VR group. Results also showed that reductions in storm fear were maintained at 30-day follow-up for both groups. Although this study used a small non-clinical sample, these results offer preliminary support for the use of VR exposure therapy in the treatment of storm-related fear.

  20. Non-photosynthetic mechanisms of growth reduction in pea (Pisum sativum L.) exposed to UV-B radiation

    International Nuclear Information System (INIS)

    Gonzalez, R.; Mepsted, R.; Wellburn, A.R.; Paul, N.D.

    1998-01-01

    Pisum sativum cv. Guido grown under controlled environment conditions was exposed to either low or high UV-B radiation (2·2 or 9·9 kJ m –2 d –1 plant-weighted UV-B, respectively). Low or high UV-B was maintained throughout growth (LL and HH treatments, respectively) or plants were transferred between treatments when 22 d old (giving LH and HL treatments). High UV-B significantly reduced plant dry weight and significantly altered plant morphology. The growth and morphology of plants transferred from low to high UV-B were little affected, when compared with those of LL plants. By contrast, plants moved from high to low UV-B showed marked increases in growth when compared with HH plants. This contrast between HL and LH appeared to be related to the effect of UV-B on plant development. Exposure to high UV-B throughout development consistently reduced leaf areas. In fully expanded leaves there was no significant UV-B effect on cell area and reduced leaf area could be attributed to reduced cell number, suggesting effects on leaf primordia. Further reductions in the leaf area of younger leaves were the result of the slower development rate of plants grown at high UV-B, which also resulted in significant reductions in leaf number. (author)

  1. Chromate reduction and heavy metal fixation in soil

    International Nuclear Information System (INIS)

    Schwitzgebel, K.

    1992-06-01

    In situ reduction of chromates and the fixation of the metals Cr, Pb, Zn, Cu, Cd and Ni in soil was investigated using Fe II and soluble silica. Fe II fulfills two functions. It reduces chromates (CrVI) at soil pH to CrIII and the reaction products, Fe(OH) 3 and Cr(OH) 3 , coprecipitate/adsorb heavy metals. In the absence of CrVI iron is added as FeIII. Destabilized silica also fulfills two functions. It reacts with the metal and metal hydroxides and reduces the soil permeability. The leaching rate (mg/m 2 s) of a metal is the product of leachate flow rate (ell/M 2 s) and the leachate concentration (mg/ell). The leachate flow rate is directly proportional to the hydraulic coefficient (Darcy's Law). Treatment with destabilized silica reduces the hydraulic coefficient of virgin soil (K h = 10 -2 ...10 -4 ) to K h =10 -7 (cm/s) resulting in a flow rate reduction of 3--5 orders of magnitude. Iron plus silica treatment results in a leachate concentration reduction of up to 2 orders of magnitude (Cr:95--99%;Pb:99%;Zn 95--99%; Cd:93--99%; Ni:75--94%). Combined effect of flow rate reduction and leachate concentration reduction results in a potential leaching rate reduction of five to seven orders of magnitude. Iron-silica treatment may be developed into an efficient containment technology, provided the silica gel integrity does not change with time

  2. RPV in-situ segmentation combined with off-site treatment for volume reduction and recycling - Proven In-Situ Segmentation Combined with Off-Site Treatment for Volume Reduction and Recycling. RPV case study

    International Nuclear Information System (INIS)

    Larsson, Arne; Lidar, Per; Segerud, Per; Hedin, Gunnar

    2014-01-01

    Decommissioning of nuclear power plants generates large volumes of radioactive or potentially radioactive waste. The proper management of the large components and the dismantling waste are key success factors in a decommissioning project. A large component of major interest is, due to its size and its span in radioactivity content, the RVP, which can be disposed as is or be segmented, treated, partially free released for recycling and conditioned for disposal in licensed packages. To a certain extent the decommissioning program have to be led by the waste management process. The costs for the plant decommissioning can be reduced by the usage of off-site waste treatment facilities as the time needed for performing the decommissioning project will be reduced as well as the waste volumes for disposal. Long execution times and delays due to problems with on-site waste management processes are major cost drivers for decommissioning projects. This involves also the RPV. In Sweden, the extension of the geological repository SFR plans for a potential disposal of whole RPVs. Disposal of whole RPVs is currently the main alternative but other options are considered. The target is to avoid extensive on-site waste management of RPVs to reduce the risk for delays. This paper describes in-situ RPV segmentation followed by off-site treatment aiming for free release for recycling of a substantial amount of the material, and volume efficient conditioning of the remaining parts. Real data from existing LWR RPVs was used for this study. Proven segmentation methods are intended to be used for the in situ segmentation followed by proven methods for packaging, transportation, treatment, recycling and conditioning for disposal. The expected volume reduction for disposal can be about 90% compared to whole RPV disposal. In this respect the in-situ segmentation of the RVPs to large pieces followed by off-site treatment is an interesting alternative that fits very well with the objective

  3. Enhanced sulfate reduction with acidogenic sulfate-reducing bacteria

    International Nuclear Information System (INIS)

    Wang Aijie; Ren Nanqi; Wang Xu; Lee Duujong

    2008-01-01

    Sulfate reduction in a continuous flow, acidogenic reactor using molasses wastewater as the carbon source was studied at varying chemical oxygen demand/sulfate (COD/SO 4 2- ) ratios. At a critical COD/SO 4 2- ratio of 2.7, neither COD nor sulfate were in excess for extra production of ethanol or acetate in the reactor. An acetic-type microbial metabolism was established with sulfate-reducing bacteria (SRB) significantly consuming hydrogen and volatile fatty acids produced by acidogenic bacteria and hydrogen producing acetogens in degrading COD, thereby yielding sulfate removal rate >94.6%. A low critical COD/SO 4 2- ratio of 1.6 was also observed with the enriched ASRB population in reactor which overcomes the barrier to the treatment capability of sulfate-laden wastewater treatment with limited COD supply

  4. Normal tissue complication probabilities: dependence on choice of biological model and dose-volume histogram reduction scheme

    International Nuclear Information System (INIS)

    Moiseenko, Vitali; Battista, Jerry; Van Dyk, Jake

    2000-01-01

    Purpose: To evaluate the impact of dose-volume histogram (DVH) reduction schemes and models of normal tissue complication probability (NTCP) on ranking of radiation treatment plans. Methods and Materials: Data for liver complications in humans and for spinal cord in rats were used to derive input parameters of four different NTCP models. DVH reduction was performed using two schemes: 'effective volume' and 'preferred Lyman'. DVHs for competing treatment plans were derived from a sample DVH by varying dose uniformity in a high dose region so that the obtained cumulative DVHs intersected. Treatment plans were ranked according to the calculated NTCP values. Results: Whenever the preferred Lyman scheme was used to reduce the DVH, competing plans were indistinguishable as long as the mean dose was constant. The effective volume DVH reduction scheme did allow us to distinguish between these competing treatment plans. However, plan ranking depended on the radiobiological model used and its input parameters. Conclusions: Dose escalation will be a significant part of radiation treatment planning using new technologies, such as 3-D conformal radiotherapy and tomotherapy. Such dose escalation will depend on how the dose distributions in organs at risk are interpreted in terms of expected complication probabilities. The present study indicates considerable variability in predicted NTCP values because of the methods used for DVH reduction and radiobiological models and their input parameters. Animal studies and collection of standardized clinical data are needed to ascertain the effects of non-uniform dose distributions and to test the validity of the models currently in use

  5. Ultrasound-guided microwave ablation in the treatment of benign thyroid nodules in 435 patients.

    Science.gov (United States)

    Liu, Yu-Jiang; Qian, Lin-Xue; Liu, Dong; Zhao, Jun-Feng

    2017-09-01

    The objective of the present study was to investigate the effectiveness and safety of ultrasound-guided microwave ablation in the treatment of benign thyroid nodules. A total of 474 benign thyroid nodules in 435 patients who underwent ultrasound-guided microwave ablation from September 2012 to August 2015 were included. Nodule volume and thyroid function were measured before treatment and at 1, 3, 6, and 12 months and subsequently after every 6 months. The nodule volume reduction rate and changes of thyroid function were evaluated. The volume of all thyroid nodules significantly decreased after ultrasound-guided microwave ablation. The average volume was 13.07 ± 0.95 ml before treatment, and 1.14 ± 0.26 ml at 12-months follow-up. The mean volume reduction rate was 90% and the final volume reduction rate was 94%. The volume reduction rate of mainly cystic nodules was significantly higher than that of simple solid and mainly solid nodules (all P microwave ablation is an effective and safe technique for treatment of benign thyroid nodules, and has the potential for clinical applications. Impact statement Ultrasound-guided MWA is an effective and safe technique for the treatment of benign thyroid nodules. It can significantly reduce the nodule volume, improve the patients' clinical symptoms, has less complication, guarantees quick recovery, meets patients' aesthetic needs, and shows less interference on the physiological and psychological aspects of the body. MWA should be a good complement to traditional open surgery and has potentials in clinical applications.

  6. Non-lethal heat treatment of cells results in reduction of tumor initiation and metastatic potential

    International Nuclear Information System (INIS)

    Kim, Yoo-Shin; Lee, Tae Hoon; O'Neill, Brian E.

    2015-01-01

    Non-lethal hyperthermia is used clinically as adjuvant treatment to radiation, with mixed results. Denaturation of protein during hyperthermia treatment is expected to synergize with radiation damage to cause cell cycle arrest and apoptosis. Alternatively, hyperthermia is known to cause tissue level changes in blood flow, increasing the oxygenation and radiosensitivity of often hypoxic tumors. In this study, we elucidate a third possibility, that hyperthermia alters cellular adhesion and mechanotransduction, with particular impact on the cancer stem cell population. We demonstrate that cell heating results in a robust but temporary loss of cancer cell aggressiveness and metastatic potential in mouse models. In vitro, this heating results in a temporary loss in cell mobility, adhesion, and proliferation. Our hypothesis is that the loss of cellular adhesion results in suppression of cancer stem cells and loss of tumor virulence and metastatic potential. Our study suggests that the metastatic potential of cancer is particularly reduced by the effects of heat on cellular adhesion and mechanotransduction. If true, this could help explain both the successes and failures of clinical hyperthermia, and suggest ways to target treatments to those who would most benefit. - Highlights: • Non-lethal hyperthermia treatment of cancer cells is shown to cause a reduction in rates of tumor initiation and metastasis. • Dynamic imaging of cells during heat treatment shows temporary changes in cell shape, cell migration, and cell proliferation. • Loss of adhesion may lead to the observed effect, which may disproportionately impact the tumor initiating cell fraction. • Loss or suppression of the tumor initiating cell fraction results in the observed loss of metastatic potential in vivo. • This result may lead to new approaches to synergizing hyperthermia with surgery, radiation, and chemotherapy

  7. Non-lethal heat treatment of cells results in reduction of tumor initiation and metastatic potential

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yoo-Shin; Lee, Tae Hoon; O' Neill, Brian E., E-mail: BEOneill@houstonmethodist.org

    2015-08-14

    Non-lethal hyperthermia is used clinically as adjuvant treatment to radiation, with mixed results. Denaturation of protein during hyperthermia treatment is expected to synergize with radiation damage to cause cell cycle arrest and apoptosis. Alternatively, hyperthermia is known to cause tissue level changes in blood flow, increasing the oxygenation and radiosensitivity of often hypoxic tumors. In this study, we elucidate a third possibility, that hyperthermia alters cellular adhesion and mechanotransduction, with particular impact on the cancer stem cell population. We demonstrate that cell heating results in a robust but temporary loss of cancer cell aggressiveness and metastatic potential in mouse models. In vitro, this heating results in a temporary loss in cell mobility, adhesion, and proliferation. Our hypothesis is that the loss of cellular adhesion results in suppression of cancer stem cells and loss of tumor virulence and metastatic potential. Our study suggests that the metastatic potential of cancer is particularly reduced by the effects of heat on cellular adhesion and mechanotransduction. If true, this could help explain both the successes and failures of clinical hyperthermia, and suggest ways to target treatments to those who would most benefit. - Highlights: • Non-lethal hyperthermia treatment of cancer cells is shown to cause a reduction in rates of tumor initiation and metastasis. • Dynamic imaging of cells during heat treatment shows temporary changes in cell shape, cell migration, and cell proliferation. • Loss of adhesion may lead to the observed effect, which may disproportionately impact the tumor initiating cell fraction. • Loss or suppression of the tumor initiating cell fraction results in the observed loss of metastatic potential in vivo. • This result may lead to new approaches to synergizing hyperthermia with surgery, radiation, and chemotherapy.

  8. Clinical significance of changes of serum FT3, FT4 and SIL-2R levels after treatment in patients with hyperthyroidism

    International Nuclear Information System (INIS)

    Ye Qing

    2008-01-01

    Objective: To explore the clinical significance of changes of serum FT 3 , FT 4 , SIL-2R levels after treatment in patients with hyperthyroidism. Methods: Serum FT 3 , FT 4 , TSH (with RIA) and SIL-2R (with ELISA) levels were measured in 55 patients with hyperthyroidism both before and after treatment as well as in 35 controls. Results: Before treatment, in the patients the serum FT 3 , FT 4 , SIL-2R levels were significantly higher than those in the controls (P 3 , FT 4 , SIL-2 levels were not significantly different from those in controls (P>0.05). Conclusion: Detection of serum FT 3 , FT 4 , SIL-2R levels is valuable for treatment outcome prediction in patients with hyperthyroidism. (authors)

  9. Clinical significance of measurement of changes of serum IGF-II and NO levels after treatment in elderly patients with chronic bronchitis

    International Nuclear Information System (INIS)

    Gu Tao

    2006-01-01

    Objective: To study the clinical significance of changes of serum IGF-II and NO levels after treatment in elderly patients with chronic bronchitis. Methods: Serum IGF-II (with RIA) and NO (with Biochemical method) levels were measured in 42 elderly patients with chronic bronchitis both before and after treatment as well as in 30 controls. Results: Before treatment in the patients the serum IGF-II levels were significantly higher than those in controls (P<0.01), while the NO levels were significantly lower (P<0.01). After two weeks of treatment, the levels though dropped markedly, lemained higher than those in controls (P<0. 05). Conclusion: Serum IGF-II and NO levels changes could reflect the disease status as well as the progress of diseases. (authors)

  10. Reduction of soil erosion on forest roads

    Science.gov (United States)

    Edward R. Burroughs; John G. King

    1989-01-01

    Presents the expected reduction in surface erosion from selected treatments applied to forest road traveledways, cutslopes, fillslopes, and ditches. Estimated erosion reduction is expressed as functions of ground cover, slope gradient, and soil properties whenever possible. A procedure is provided to select rock riprap size for protection of the road ditch.

  11. Beneficial Treatment Management with Trifluridine/Tipiracil in a Patient with Metastatic Colorectal Cancer and Pronounced Hematological Event History during Previous Treatments

    Directory of Open Access Journals (Sweden)

    Volker Kaechele

    2018-01-01

    Full Text Available Trifluridine/tipiracil (FTD/TPI significantly improves overall survival in patients with metastatic colorectal cancer (mCRC. The most common treatment-related event (grade ≥3 was hematological toxicity. We here report long-term disease-stabilizing FTD/TPI treatment of an mCRC patient (KRAS wild-type, ECOG performance status 1 at baseline and at the end of FTD/TPI therapy with multifocal synchronous metastases and a longstanding history of extensive hematological events during previous treatments. Finally, this 62-year-old male patient was treated for 10 months with FTD/TPI by consecutive alteration of treatment parameters: (i initial daily dose reduction to 80 mg (72% of the recommended dose, (ii 20 days dose delay, (iii a second and later third dose reduction to 70 mg and 60 mg (about 64% and 55%, respectively, of the recommended dose, and (iv 30 µg per day of granulocyte colony-stimulating factor administration first for 3 days, and later for 5 days, for each treatment cycle.

  12. Clinical significance of determination of changes of serum IGF-Ⅱ, L-6 levels after treatment in patients with child bronchopneumonia

    International Nuclear Information System (INIS)

    Yin Hongxia

    2007-01-01

    Objective: To study the clinical significance of changes of serum IGF-Ⅱ, L-6 levels after treatment in patients with child bronchopneumonia. Methods: Serum IGF-Ⅱ, L-6 levels were determined with RIA in 40 patients with child bronchopneumonia both before and after treatment as well as in 30 controls. Results: Before treatment, serum IGF-Ⅱ, L-6 levels in the patients were significantly higher than those in the controls (P 0.05). Conclusion: Determination serum IGF-Ⅱ, L-6 levels in patients with child bronchopneumonia was important for diagnosis and outcome prediction. (authors)

  13. How the detector resolution affects the clinical significance of SBRT pre-treatment quality assurance results.

    Science.gov (United States)

    Bruschi, A; Esposito, M; Pini, S; Ghirelli, A; Zatelli, G; Russo, S

    2017-12-01

    Aim of this work was to study how the detector resolution can affect the clinical significance of SBRT pre-treatment volumetric modulated arc therapy (VMAT) verification results. Three detectors (PTW OCTAVIUS 4D 729, 1500 and 100 SRS) used in five configurations with different resolution were compared: 729, 729 merged, 1500, 1500 merged and 1000 SRS. Absolute local gamma passing rates of 3D pre-treatment quality assurance (QA) were evaluated for 150 dose distributions in 30 plans. Five different kinds of error were introduced in order to establish the detection sensitivity of the three devices. Percentage dosimetric differences were evaluated between planned dosevolume histogram (DVH) and patients' predicted DVH calculated by PTW DVH 4D® software. The mean gamma passing rates and the standard deviations were 92.4% ± 3.7%, 94.6% ± 1.8%, 95.3% ± 4.2%, 97.4% ± 2.5% and 97.6% ± 1.4 respectively for 729, 729 merged, 1500, 1500 merged and 1000 SRS with 2% local dose/2mm criterion. The same trend was found on the sensitivity analysis: using a tight gamma analysis criterion (2%L/1mm) only the 1000 SRS detected every kind of error, while 729 and 1500 merged detected three and four kinds of error respectively. Regarding dose metrics extracted from DVH curves, D50% was within the tolerance level in more than 90% of cases only for the 1000 SRS. The detector resolution can significantly affect the clinical significance of SBRT pre-treatment verification results. The choice of a detector with resolution suitable to the investigated field size is of main importance to avoid getting false positive. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  14. A Complier Average Causal Effect Analysis of the Stimulant Reduction Intervention using Dosed Exercise Study.

    Science.gov (United States)

    Carmody, Thomas; Greer, Tracy L; Walker, Robrina; Rethorst, Chad D; Trivedi, Madhukar H

    2018-06-01

    Exercise is a promising treatment for substance use disorders, yet an intention-to-treat analysis of a large, multi-site study found no reduction in stimulant use for exercise versus health education. Exercise adherence was sub-optimal; therefore, secondary post-hoc complier average causal effects (CACE) analysis was conducted to determine the potential effectiveness of adequately dosed exercise. The STimulant use Reduction Intervention using Dosed Exercise study was a randomized controlled trial comparing a 12 kcal/kg/week (KKW) exercise dose versus a health education control conducted at nine residential substance use treatment settings across the U.S. that are affiliated with the National Drug Abuse Treatment Clinical Trials Network. Participants were sedentary but medically approved for exercise, used stimulants within 30 days prior to study entry, and received a DSM-IV stimulant abuse or dependence diagnosis within the past year. A CACE analysis adjusted to include only participants with a minimum threshold of adherence (at least 8.3 KKW) and using a negative-binomial hurdle model focused on 218 participants who were 36.2% female, mean age 39.4 years ( SD =11.1), and averaged 13.0 ( SD =9.2) stimulant use days in the 30 days before residential treatment. The outcome was days of stimulant use as assessed by the self-reported TimeLine Follow Back and urine drug screen results. The CACE-adjusted analysis found a significantly lower probability of relapse to stimulant use in the exercise group versus the health education group (41.0% vs. 55.7%, p <.01) and significantly lower days of stimulant use among those who relapsed (5.0 days vs. 9.9 days, p <.01). The CACE adjustment revealed significant, positive effects for exercise. Further research is warranted to develop strategies for exercise adherence that can ensure achievement of an exercise dose sufficient to produce a significant treatment effect.

  15. The significance of amlodipine on autonomic nervous system adjustment (ANSA method: A new approach in the treatment of hypertension

    Directory of Open Access Journals (Sweden)

    Milovanović Branislav

    2009-01-01

    Full Text Available Introduction. Cardiovascular autonomic modulation is altered in patients with essential hypertension. Objective To evaluate acute and long-term effects of amlodipine on cardiovascular autonomic function and haemodynamic status in patients with mild essential hypertension. Methods. Ninety patients (43 male, mean age 52.12 ±10.7 years with mild hypertension were tested before, 30 minutes after the first 5 mg oral dose of amlodipine and three weeks after monotherapy with amlodipine. A comprehensive study protocol was done including finger blood pressure variability (BPV and heart rate variability (HRV beat-to-beat analysis with impedance cardiography, ECG with software short-term HRV and nonlinear analysis, 24-hour Holter ECG monitoring with QT and HRV analysis, 24-hour blood pressure (BP monitoring with systolic and diastolic BPV analysis, cardiovascular autonomic reflex tests, cold pressure test, mental stress test. The patients were also divided into sympathetic and parasympathetic groups, depending on predominance in short time spectral analysis of sympathovagal balance according to low frequency and high frequency values. Results. We confirmed a significant systolic and diastolic BP reduction, and a reduction of pulse pressure during day, night and early morning hours. The reduction of supraventricular and ventricular ectopic beats during the night was also achieved with therapy, but without statistical significance. The increment of sympathetic activity in early phase of amlodipine therapy was without statistical significance and persistence of sympathetic predominance after a few weeks of therapy detected based on the results of short-term spectral HRV analysis. All time domain parameters of long-term HRV analysis were decreased and low frequency amongst spectral parameters. Amlodipne reduced baroreflex sensitivity after three weeks of therapy, but increased it immediately after the administration of the first dose. Conclusion. The results

  16. Acceptability of mental health stigma-reduction training and initial effects on awareness among military personnel.

    Science.gov (United States)

    Hurtado, Suzanne L; Simon-Arndt, Cynthia M; McAnany, Jennifer; Crain, Jenny A

    2015-01-01

    The purpose of this paper is to report on the development of a mental health stigma reduction toolkit and training, and the acceptability and level of stigma awareness following the stigma-reduction training for military personnel. The overall aims of the training were to provide discussion tools highlighting the experiences of Marines seeking help for stress concerns, improve communication between leaders and their Marines around the issue of help seeking, and familiarize Marines with behavioral health treatment. Senior enlisted leaders and officers (N = 52) from a Marine Corps battalion participated in a pretest, 2-h stigma-reduction training and immediate posttest. Acceptability of the training was measured by querying participants about the usefulness and helpfulness of the training among other factors, and stigma awareness was measured with 10 items about mental health stigma. The stigma-reduction training and materials were well accepted by participants. In addition, there was a significant improvement in four of ten stigma-reduction awareness concepts measured before and immediately after the training, which included an increase in agreement that mental health treatments are usually effective in reducing stress reactions [t(51) = -3.35, p = 0.002], and an increase in disagreement that seeking counseling after a deployment will jeopardize future deployments [t(51) = -3.05, p = 0.004]. Level of agreement with several statements including those regarding perceptions of invincibility, and malingering, among others, did not change significantly after the training. The stigma-reduction training containing educational and contact strategies was highly acceptable to the leaders and may have promise for initially dispelling myths associated with seeking help for stress concerns among military service members; however, results indicate that there is clearly more work to be done in combatting stigma.

  17. Reduction of nitric oxide level enhances the radiosensitivity of hypoxic non-small cell lung cancer

    International Nuclear Information System (INIS)

    Saleem, Wael; Suzuki, Yoshiyuki; Mobaraki, Abdulelah; Yoshida, Yukari; Noda, Shinei; Saitoh, Jun-ichi; Nakano, Takashi

    2011-01-01

    The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (E-TKI) resistance has emerged as an important clinical issue. To overcome this resistance, researchers have examined different modalities, either for use as a monotherapy or in combination with E-TKI therapy. In the present study, we investigated whether a decrease in nitric oxide (NO) levels affects the radiosensitization of non-small cell lung cancer (NSCLC) cell lines. A549 and H3255 NSCLC cells were examined. They were subjected to hypoxic conditions and monotherapy, or combined therapy using radiation and N G -monomethyl- L -arginine, monoacetate (LNMMA). Reductions in nitric oxide levels enhanced the radiosensitivity of both cell lines and significantly reduced the expression of both hypoxia-inducible factor-1α (HIF-1α) and EGFR in H3255 cells compared to A549 cells. Since NO is significantly associated with cell metabolism, we measured the levels of pyruvate dehydrogenase kinase-1 (PDK-1), reactive oxygen species, and oxygen and observed that the expression of PDK-1 was significantly reduced. This reduction was seen simultaneously after the silencing of HIF-1α; however, not following LNMMA treatment. The oxygen concentration was significantly increased in the treated cells, and their viability decreased in parallel. Reactive oxygen species were decreased after LNMMA and radiation treatment. Adding EGFR-TKI to cells with reduced NO levels further suppressed cell viability when combined with radiation. This study suggests that a reduction in the NO level might substantially overcome the radioresistance of mutant NSCLC cells. (author)

  18. Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment?

    International Nuclear Information System (INIS)

    Jaremko, J.L.; Lambert, R.G.W.; Rowe, B.H.; Johnson, J.A.; Majumdar, S.R.

    2007-01-01

    Aim: To investigate whether radiographic deformities suggesting inadequate reduction would be associated with adverse clinical outcomes. Materials and methods: Consecutive patients over 50 years of age (n = 74) with non-operatively managed distal radius fractures were enrolled in a prospective cohort study. They had radiographs at cast removal (∼6 weeks) and completed DASH (Disabilities of the Arm, Shoulder and Hand), SF-12 (health-related quality of life), and satisfaction surveys 6-months post-fracture. A reference-standard musculoskeletal radiologist, blinded to outcomes status, measured palmar (dorsal) tilt, radial angle, radial height, ulnar height, and intra-articular step and gap. Radiographic indices were correlated to each other and to the various patient-reported outcomes in univariate and multivariate regression analyses. DASH score was the primary study outcome. Results: Of the cohort studied (n = 74, mean age 68.5 years, primarily white women), 71% had at least one 'unacceptable' radiographic deformity by traditional criteria. Acceptable reduction varied from 60-99% depending on which single index was reported, and 44% of patients had more than two indices reported as unacceptable. Despite these radiographic findings, 6-months post-reduction, self-reported disability was low (DASH = 24 ± 17), health-related quality of life was near normal, and 72% were satisfied with their care. No radiographic index of wrist deformity (alone or in combination) was significantly correlated to any of the patient-reported outcomes. Conclusion: Self-reported outcomes in older adults with conservatively managed wrist fractures were not related to the 'acceptability' of radiographic fracture reduction. The proportion of acceptable reductions varied by 40% depending on which index was reported. Consequently, detailed reporting of these indices in older adults with distal radius fracture may be inefficient or perhaps even unnecessary

  19. Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment?

    Energy Technology Data Exchange (ETDEWEB)

    Jaremko, J.L. [Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta (Canada); Lambert, R.G.W. [Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta (Canada); Rowe, B.H. [Department of Emergency Medicine, University of Alberta, Edmonton, Alberta (Canada); Department of Public Health Sciences, University of Alberta, Edmonton, Alberta (Canada); Johnson, J.A. [Department of Public Health Sciences, University of Alberta, Edmonton, Alberta (Canada); Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta (Canada); Majumdar, S.R. [Department of Public Health Sciences, University of Alberta, Edmonton, Alberta (Canada) and Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta (Canada)]. E-mail: me2.majumdar@ualberta.ca

    2007-01-15

    Aim: To investigate whether radiographic deformities suggesting inadequate reduction would be associated with adverse clinical outcomes. Materials and methods: Consecutive patients over 50 years of age (n = 74) with non-operatively managed distal radius fractures were enrolled in a prospective cohort study. They had radiographs at cast removal ({approx}6 weeks) and completed DASH (Disabilities of the Arm, Shoulder and Hand), SF-12 (health-related quality of life), and satisfaction surveys 6-months post-fracture. A reference-standard musculoskeletal radiologist, blinded to outcomes status, measured palmar (dorsal) tilt, radial angle, radial height, ulnar height, and intra-articular step and gap. Radiographic indices were correlated to each other and to the various patient-reported outcomes in univariate and multivariate regression analyses. DASH score was the primary study outcome. Results: Of the cohort studied (n = 74, mean age 68.5 years, primarily white women), 71% had at least one 'unacceptable' radiographic deformity by traditional criteria. Acceptable reduction varied from 60-99% depending on which single index was reported, and 44% of patients had more than two indices reported as unacceptable. Despite these radiographic findings, 6-months post-reduction, self-reported disability was low (DASH = 24 {+-} 17), health-related quality of life was near normal, and 72% were satisfied with their care. No radiographic index of wrist deformity (alone or in combination) was significantly correlated to any of the patient-reported outcomes. Conclusion: Self-reported outcomes in older adults with conservatively managed wrist fractures were not related to the 'acceptability' of radiographic fracture reduction. The proportion of acceptable reductions varied by 40% depending on which index was reported. Consequently, detailed reporting of these indices in older adults with distal radius fracture may be inefficient or perhaps even unnecessary.

  20. Association between open or closed reduction and avascular necrosis in developmental dysplasia of the hip

    Science.gov (United States)

    Wang, Ya-Jie; Yang, Fan; Wu, Qi-Jun; Pan, Shi-Nong; Li, Lian-Yong

    2016-01-01

    Abstract Background: The risk of avascular necrosis of the femoral head (AVN) after treatment of developmental dysplasia of the hip is associated with the method of reduction. Some authors have suggested that open reduction is a risk factor for AVN; however, this is controversial. To our knowledge, a quantitative comparison of the incidence of AVN between closed and open reduction has not been conducted. Methods: Published studies were identified by searching PubMed, EMBASE, and the Cochrane Library up to May, 2015, focusing on the incidence of AVN after closed or open reduction for developmental dysplasia of the hip in children aged <3 years. Patients were age-matched who were treated by either closed or open reduction, but without pelvic or femoral osteotomy. Two authors independently assessed eligibility and abstracted data. Discrepancies were discussed and resolved by consensus. We pooled the odds ratios (ORs) and 95% confidence intervals (95%CIs) from individual studies using a random-effects model and evaluated heterogeneity and publication bias. Results: Nine retrospective studies were included in this analysis. The pooled OR for comparing open reduction with closed reduction for all grades of AVN was 2.26 (95%CI = 1.21–4.22), with moderate heterogeneity (I2 = 44.7%, P = 0.107). The pooled OR for grades II to IV AVN was 2.46 (95%CI = 0.93–6.51), with high heterogeneity (I2 = 69.6%, P = 0.003). A significant association was also found for the further surgery between open and closed reduction, with a pooled OR of 0.30 (95%CI = 0.15–0.60) and moderate heterogeneity (I2 = 46.4%, P = 0.133). No evidence of publication bias or significant heterogeneity between subgroups was detected by meta-regression analyses. Conclusion: Findings from this meta-analysis suggest that open reduction is a risk factor for the development of AVN compared with closed treatment. Future studies are warranted to investigate how open reduction

  1. Delayed conifer mortality after fuel reduction treatments: Interactive effects of fuel, fire intensity, and bark beetles

    Science.gov (United States)

    Youngblood, A.; Grace, J.B.; Mciver, J.D.

    2009-01-01

    Many low-elevation dry forests of the western United States contain more small trees and fewer large trees, more down woody debris, and less diverse and vigorous understory plant communities compared to conditions under historical fire regimes. These altered structural conditions may contribute to increased probability of unnaturally severe wildfires, susceptibility to uncharacteristic insect outbreaks, and drought-related mortality. Broad-scale fuel reduction and restoration treatments are proposed to promote stand development on trajectories toward more sustainable structures. Little research to date, however, has quantified the effects of these treatments on the ecosystem, especially delayed and latent tree mortality resulting directly or indirectly from treatments. In this paper, we explore complex hypotheses relating to the cascade of effects that influence ponderosa pine (Pinus ponderosa) and Douglas-fir (Pseudotsuga menziesii) mortality using structural equation modeling (SEM). We used annual census and plot data through six growing seasons after thinning and four growing seasons after burning from a replicated, operational-scale, completely randomized experiment conducted in northeastern Oregon, USA, as part of the national Fire and Fire Surrogate study. Treatments included thin, burn, thin followed by burn (thin+burn), and control. Burn and thin+burn treatments increased the proportion of dead trees while the proportion of dead trees declined or remained constant in thin and control units, although the density of dead trees was essentially unchanged with treatment. Most of the new mortality (96%) occurred within two years of treatment and was attributed to bark beetles. Bark beetle-caused tree mortality, while low overall, was greatest in thin + burn treatments. SEM results indicate that the probability of mortality of large-diameter ponderosa pine from bark beetles and wood borers was directly related to surface fire severity and bole charring, which in

  2. Significant lung volume reduction with endobronchial valves in a patient despite the presence of microcollaterals masked by low-flow Chartis phenotype

    Directory of Open Access Journals (Sweden)

    Yin Y

    2016-11-01

    Full Text Available Yan Yin,1 Gang Hou,1 Felix J Herth,2 Xiao-bo Wang,1 Qiu-yue Wang,1 Jian Kang1 1Department of Respiratory Medicine, The First Hospital of China Medical University, Shenyang, People’s Republic of China; 2Department of Pneumology and Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany Abstract: Satisfactory functional outcomes following bronchoscopic lung volume reduction (BLVR using endobronchial valves (EBVs depend on the absence of collateral ventilation (CV between the target and adjunct lobes. The Chartis system has proven to be useful for determining whether CV is present or absent, but this system can also erroneously indicate the absence of CV, which can lead to BLVR failure. Here, we describe low-flow Chartis phenotype in the target lobe resulted in difficult judgment of existence of CV. Consequently, BLVR with EBVs implanted into the right upper bronchus failed to reduce lung volume or induce atelectasis. Inserting another EBV into the right middle bronchus blocked the latent CV, which led to significant lung volume reduction in the right upper lobe (RUL and right middle lobe (RML and to improve the pulmonary function, 6-min walking distance, and St George respiratory questionnaire scores over a 2-week follow-up period. Low flow in the target lobe is a unique Chartis phenotype and represents the uncertainty of CV, which is a risk factor for the failure of BLVR using EBVs. Clinicians should be aware of this possibility and might be able to resolve the problem by blocking the RUL and RML between which the CV occurs. Keywords: COPD, bronchoscopic lung volume reduction, collateral ventilation, endobronchial valves, Chartis assessment

  3. Interfacial Reduction-Oxidation Mechanisms Governing Fate and Transport of Contaminants in the Vadose Zone

    Energy Technology Data Exchange (ETDEWEB)

    Principal Investigator: Baolin Deng, University of Missouri, Columbia, MO; Co-Principal Investigator: Silvia Sabine Jurisson, University of Missouri, Columbia, MO; Co-Principal Investigator: Edward C. Thornton, Pacific Northwest National Laboratory Richland, WA; Co-Principal Investigator: Jeff Terry, Illinois Institute of Technology, Chicago, IL

    2008-05-12

    There are many soil contamination sites at the Department of Energy (DOE) installations that contain radionuclides and toxic metals such as uranium (U), technetium (Tc), and chromium (Cr). Since these contaminants are the main 'risk drivers' at the Hanford site (WA) and some of them also pose significant risk at other DOE facilities (e.g., Oak Ridge Reservation - TN; Rocky Flats - CO), development of technologies for cost effective site remediation is needed. Current assessment indicates that complete removal of these contaminants for ex-situ disposal is infeasible, thus in-situ stabilization through reduction to insoluble species is considered one of the most important approaches for site remediation. In Situ Gaseous Reduction (ISGR) is a technology developed by Pacific Northwest National Laboratory (PNNL) for vadose zone soil remediation. The ISGR approach uses hydrogen sulfide (H{sub 2}S) for reductive immobilization of contaminants that show substantially lower mobility in their reduced forms (e.g., Tc, U, and Cr). The technology can be applied in two ways: (i) to immobilize or stabilize pre-existing contaminants in the vadose zone soils by direct H{sub 2}S treatment, or (ii) to create a permeable reactive barrier (PRB) that prevents the migration of contaminants. Direct treatment involves reduction of the contaminants by H{sub 2}S to less mobile species. Formation of a PRB is accomplished through reduction of ferric iron species in the vadose zone soils by H{sub 2}S to iron sulfides (e.g., FeS), which provides a means for capturing the contaminants entering the treated zone. Potential future releases may occur during tank closure activities. Thus, the placement of a permeable reactive barrier by ISGR treatment can be part of the leak mitigation program. Deployment of these ISGR approaches, however, requires a better understanding of the immobilization kinetics and mechanisms, and a better assessment of the long-term effectiveness of treatment. The

  4. Transoral open reduction and fixation of mandibular condylar base and neck fractures in children and young teenagers--a beneficial treatment option?

    Science.gov (United States)

    Schiel, Sebastian; Mayer, Peter; Probst, Florian; Otto, Sven; Cornelius, Carl-Peter

    2013-07-01

    To evaluate the possible benefits of open surgery, endoscopically assisted reduction and fixation using a transoral route was used in a selected series of pediatric patients with displaced condylar base and neck fractures. A cohort of 6 patients (1 male and 5 female; age range, 7 to 15 yr; mean, 13.4 yr) with displaced condylar base and neck fractures (n = 9) were included. Inclusion criteria were age younger than 16 years, fracture of the condylar base or neck, and displacement of the fracture by at least 45°. Fractures were classified using conventional radiography, cone-beam computed tomography, or computed tomography. Patients underwent transoral endoscopically assisted open reduction and fixation using miniplate osteosynthesis. Postoperatively, patients were followed clinically and radiographically for 18 months. Complete follow-up varied from 18 to 35 months (median, 24.5 months). All patients showed normal occlusion and pain-free unrestricted function of the temporomandibular joint at 3, 6, 12, and 18 months postoperatively. There were no signs of incomplete remodeling or deformation of the condyles. Transoral endoscopically assisted surgical treatment of severely displaced condylar base and neck fractures in children and young teenagers offers a reliable solution to preclude the sequelae of closed treatment, such as altered morphology and functional disturbances, eliminates visible scars, and lowers the risk of facial nerve damage compared with open reduction using an extraoral approach. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

  5. Comparison of UV-C and Pulsed UV Light Treatments for Reduction of Salmonella, Listeria monocytogenes, and Enterohemorrhagic Escherichia coli on Eggs.

    Science.gov (United States)

    Holck, Askild L; Liland, Kristian H; Drømtorp, Signe M; Carlehög, Mats; McLEOD, Anette

    2018-01-01

    Ten percent of all strong-evidence foodborne outbreaks in the European Union are caused by Salmonella related to eggs and egg products. UV light may be used to decontaminate egg surfaces and reduce the risk of human salmonellosis infections. The efficiency of continuous UV-C (254 nm) and pulsed UV light for reducing the viability of Salmonella Enteritidis, Listeria monocytogenes, and enterohemorrhagic Escherichia coli on eggs was thoroughly compared. Bacterial cells were exposed to UV-C light at fluences from 0.05 to 3.0 J/cm 2 (10 mW/cm 2 , for 5 to 300 s) and pulsed UV light at fluences from 1.25 to 18.0 J/cm 2 , resulting in reductions ranging from 1.6 to 3.8 log, depending on conditions used. Using UV-C light, it was possible to achieve higher reductions at lower fluences compared with pulsed UV light. When Salmonella was stacked on a small area or shielded in feces, the pulsed UV light seemed to have a higher penetration capacity and gave higher bacterial reductions. Microscopy imaging and attempts to contaminate the interior of the eggs with Salmonella through the eggshell demonstrated that the integrity of the eggshell was maintained after UV light treatments. Only minor sensory changes were reported by panelists when the highest UV doses were used. UV-C and pulsed UV light treatments appear to be useful decontamination technologies that can be implemented in continuous processing.

  6. Effect of fast neutrons and gamma rays treatments on heading date, plant height and tiller number in wheat

    International Nuclear Information System (INIS)

    Arain, M.A.

    1978-01-01

    Homogeneous seeds of six varieties of bread wheat, Triticum aestivum L. (2n = 6x = 42) were treated with fast neutrons and gamma rays. The irradiated seeds along with respective controls were grown in field plots during 1973-74 and heating date, plant height and tiller number studied. Varieties used in the present study varied significantly (P >=0.01) for all the characters. Treatment mean squares were highly significant for plant height and tillers per plant; whereas, the varieties x treatments interaction mean squares were significant only for plant height (P >= 0.05). Irradiated treatments exhibited significant reductions in plant height and tiller number than respective controls. However, heading was delayed among the irradiated material when compared with respective controls. Reduction in plant height was more pronounced after the treatments of gamma rays than the fast neutrons. The maximum and minimum shifts in mean values of these characters were observed in 20 kR (gamma rays) and Nf 300 RADS (fast neutrons) treatments, respectively. (author)

  7. High degree reduction and restoration of graphene oxide on SiO2 at low temperature via remote Cu-assisted plasma treatment

    Science.gov (United States)

    Obata, Seiji; Sato, Minoru; Akada, Keishi; Saiki, Koichiro

    2018-06-01

    A high throughput synthesis method of graphene has been required for a long time to apply graphene to industrial applications. Of the various synthesis methods, the chemical exfoliation of graphite via graphene oxide (GO) is advantageous as far as productivity is concerned; however, the quality of the graphene produced by this method is far inferior to that synthesized by other methods, such as chemical vapor deposition on metals. Developing an effective reduction and restoration method for GO on dielectric substrates has been therefore a key issue. Here, we present a method for changing GO deposited on a dielectric substrate into high crystallinity graphene at 550 °C this method uses CH4/H2 plasma and a Cu catalyst. We found that Cu remotely catalyzed the high degree reduction and restoration of GO on SiO2 and the effect ranged over at least 8 mm. With this method, field-effect transistor devices can be fabricated without any post treatment such as a transfer process. This plasma treatment increased electron and hole mobilities of GO to 480 cm2 V‑1 s‑1 and 460 cm2 V‑1 s‑1 respectively; these values were more than 50 times greater than that of conventional reduced GO. Furthermore, the on-site conversion ensured that the shape of the GO sheets remained unchanged after the treatment. This plasma treatment realizes the high throughput synthesis of a desired shaped graphene on any substrate without any residue and damage being caused by the transfer process; as such, it expands the potential applicability of graphene.

  8. Suicide in Recent Onset Psychosis Revisited: Significant Reduction of Suicide Rate over the Last Two Decades - A Replication Study of a Dutch Incidence Cohort.

    Directory of Open Access Journals (Sweden)

    Stynke Castelein

    Full Text Available This study aims to compare the suicide risk over the past decade following recent onset psychosis to findings from the eighties and nineties in the same catchment area and to identify predictors of suicide in the context of the Psychosis Recent Onset Groningen-Survey (PROGR-S. A medical file search was carried out to determine the current status of all patients admitted between 2000 and 2009. The suicide rate was compared with a study executed in 1973-1988 in the same catchment area. Predictors of suicide were investigated using Cox regression. The status of 424 of the 614 patients was known in July 2014. Suicide occurred in 2.4% of patients with psychosis disorders (n = 10; mean follow-up 5.6 years; 6 out of 10 suicides took place within two years. Within two decades, the suicide rate dropped from 11% (follow-up 15 years, 8.5% after 5 years to 2.4%. The Standardized Mortality Rate (SMR of suicides compared with the general population was 41.6. A higher age was the only significant predictor for suicide. Neuroticism, living situation, disorganized and negative symptoms, and passive coping style all showed a trend for significance. A significant reduction in the suicide rate was found for people with psychosis over the past decades. Given the high SMR, suicide research should be given the highest priority. Identifying predictors may contribute to further reduction of suicide among patients with psychosis.

  9. Clinical significance of determination of changes of plasma vascular endothelial growth factor (VEGF) contents after treatment in patients with acute leukemia

    International Nuclear Information System (INIS)

    Guo Min

    2006-01-01

    Objective: To investigate the changes of plasma VEGF after treatment in patients with acute leukemia. Methods: Plasma VEGF levels were determined with (ELISA) in 34 patients with acute leukemia both before and after treatment as well as in 35 controls. Results: Before treatment the plasma levels of VEGF levels in patients were significantly higher than those in the controls (P<0.01). After three months of treatment the levels dropped markedly but still remained significantly higher than those in controls (P<0.05). Conclusion: Development of acute leukemia was closely related to the plasma levels of VEGF. (authors)

  10. Effects of pathogen reduction systems on platelet microRNAs, mRNAs, activation, and function.

    Science.gov (United States)

    Osman, Abdimajid; Hitzler, Walter E; Meyer, Claudius U; Landry, Patricia; Corduan, Aurélie; Laffont, Benoit; Boilard, Eric; Hellstern, Peter; Vamvakas, Eleftherios C; Provost, Patrick

    2015-01-01

    Pathogen reduction (PR) systems for platelets, based on chemically induced cross-linking and inactivation of nucleic acids, potentially prevent transfusion transmission of infectious agents, but can increase clinically significant bleeding in some clinical studies. Here, we documented the effects of PR systems on microRNA and mRNA levels of platelets stored in the blood bank, and assessed their impact on platelet activation and function. Unlike platelets subjected to gamma irradiation or stored in additive solution, platelets treated with Intercept (amotosalen+ ultraviolet-A [UVA] light) exhibited significantly reduced levels of 6 of the 11 microRNAs, and 2 of the 3 anti-apoptotic mRNAs (Bcl-xl and Clusterin) that we monitored, compared with platelets stored in plasma. Mirasol (riboflavin+ UVB light) treatment of platelets did not produce these effects. PR neither affected platelet microRNA synthesis or function nor induced cross-linking of microRNA-sized endogenous platelet RNA species. However, the reduction in the platelet microRNA levels induced by Intercept correlated with the platelet activation (p < 0.05) and an impaired platelet aggregation response to ADP (p < 0.05). These results suggest that Intercept treatment may induce platelet activation, resulting in the release of microRNAs and mRNAs from platelets. The clinical implications of this reduction in platelet nucleic acids secondary to Intercept remain to be established.

  11. Effect of ultrasonic and ozone pre-treatments on pharmaceutical waste activated sludge's solubilisation, reduction, anaerobic biodegradability and acute biological toxicity.

    Science.gov (United States)

    Pei, Jin; Yao, Hong; Wang, Hui; Shan, Dan; Jiang, Yichen; Ma, Lanqianya; Yu, Xiaohua

    2015-09-01

    Ultrasonic and ozone pre-treatment technologies were employed in this study to improve the anaerobic digestion efficiency of pharmaceutical waste activated sludge. The sludge solubilisation achieved 30.01% (150,000 kJ/kg TS) and 28.10% (0.1g O3/g TS) after ultrasonic treatment and ozone treatment. The anaerobic biodegradability after ultrasonic treatment was higher compared to ozonation due to the higher cumulative methane volume observed after 6 days (249 ml vs 190 ml). The ozonated sludge released the highest concentration of Cu(2+) into the liquid phase (6.640 mg L(-1)) compared to 0.530 mg/L for untreated sludge and 0.991 mg/L for sonicated sludge. The acute toxicity test measured by luminescent bacteria showed that anaerobic digestion could degrade toxic compounds and result in a reduction in toxicity. The main mechanism of action led to some differences in the treated sludge exhibiting higher potential for methane production from pharmaceutical waste sludge with ultrasonic treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Enhanced phosphorus reduction in simulated eutrophic water: a comparative study of submerged macrophytes, sediment microbial fuel cells, and their combination.

    Science.gov (United States)

    Xu, Peng; Xiao, Enrong; Xu, Dan; Li, Juan; Zhang, Yi; Dai, Zhigang; Zhou, Qiaohong; Wu, Zhenbin

    2018-05-01

    The phosphorus reduction in water column was attempted by integrating sediment microbial fuel cells (SMFCs) with the submerged macrophyte Vallisneria spiralis. A comparative study was conducted to treat simulated water rich in phosphate with a control and three treatments: SMFC alone (SMFC), submerged macrophytes alone (macophyte), and combined macrophytes and fuel cells (M-SMFC). All treatments promoted phosphorus flux from the water column to sediments. Maximum phosphorus reduction was obtained in proportion to the highest stable phosphorus level in sediments in M-SMFC. For the initial phosphate concentrations of 0.2, 1, 2, and 4 mg/L, average phosphate values in the overlying water during four phases decreased by 33.3% (25.0%, 8.3%), 30.8% (5.1%, 17.9%), 36.5% (27.8%, 15.7%), and 36.2% (0.7%, 22.1%) for M-SMFC (macrophyte, SMFC), compared with the control. With macrophyte treatment, the obvious phosphorus release from sediments was observed during the declining period. However, such phenomenon was significantly inhibited with M-SMFC. The electrogenesis bacteria achieved stronger phosphorus adsorption and assimilation was significantly enriched on the closed-circuit anodes. The higher abundance of Geobacter and Pseudomonas in M-SMFC might in part explain the highest phosphorus reduction in the water column. M-SMFC treatment could be promising to control the phosphorus in eutrophic water bodies.

  13. Intensive treatment of leg lymphedema

    Directory of Open Access Journals (Sweden)

    Pereira de Godoy Jose

    2010-01-01

    Full Text Available Background: Despite of all the problems caused by lymphedema, this disease continues to affect millions of people worldwide. Thus, the identification of the most efficacious forms of treatment is necessary. Aim: The aim of this study was to evaluate a novel intensive outpatient treatment for leg lymphedema. Methods: Twenty-three legs of 19 patients were evaluated in a prospective randomized study. The inclusion criteria were patients with Grade II and III lymphedema, where the difference, measured by volumetry, between the affected limb below the knee and the healthy limb was greater than 1.5 kg. Intensive treatment was carried out for 6- to 8-h sessions in the outpatient clinic. Analysis of variance was utilized for statistical analysis with an alpha error of 5% (P-value < 0.05 being considered significant. Results: All limbs had significant reductions in size with the final mean loss being 81.1% of the volume of edema. The greatest losses occurred in the first week (P-value < 0.001. Losses of more than 90% of the lymphedema occurred in 9 (39.13% patients; losses of more than 80% in 13 (56.52%, losses of more than 70% in 17 (73.91% and losses of more than 50% were recorded for 95.65% of the patients; only 1 patient lost less than 50% (37.9% of the edema. Conclusion: The intensive treatment of lymphedema in the outpatient clinic can produce significant reductions in the volume of edema over a short period of time and can be recommended for any grade of lymphedema, in particular the more advanced degrees.

  14. 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.

  15. Cost reduction with maintenance ECT in refractory bipolar disorder.

    Science.gov (United States)

    Bonds, C; Frye, M A; Coudreaut, M F; Cunningham, M; Spearing, M; McGuire, M; Guze, B

    1998-03-01

    A case report of outpatient maintenance electroconvulsive therapy (ECT) is presented in a patient with bipolar disorder type I refractory to conventional medication treatment but responsive to ECT. A cost comparison is made showing substantial savings when outpatient maintenance ECT is used in lieu of inpatient hospitalization with ECT. A detailed life chart illustrating multiple medication trials that failed to stabilize the patient accompanies the financial summary. This case highlights the advantages of outpatient maintenance ECT for bipolar depression particularly with regard to safety, efficacy, and significant health care cost reduction.

  16. [Tobacco reduction in a prison of France].

    Science.gov (United States)

    Harcouët, L; Balanger, S; Meunier, N; Mourgues, A; Grabar, S; Haouili, B; Guillevin, L

    2008-05-01

    Little is known about free nicotine transdermal patch efficacy on tobacco reduction in prisoners. The objective is to study this efficacy in prison as well as motivations to reduce and influence of socioeconomic conditions and other addictions in prisoners' aspiration to stop smoking. A prospective study was proposed to prisoners candidate to tobacco cessation. Assessment was made by questionnaires and visits to physicians working at the prison. Nicotinic patches were systematically proposed to patients with a starting 15 mg/16 h dose (or 10 mg/16 h if the dependence was low), followed by a 10 and 5 mg/16 h dose reduction. Prisoners motivated to smoking cessation (N=73) generally had multiaddictive behaviours and precarious socioeconomic profile. Thirty percent of prisoners self-reported a reduction of 50% of their cigarettes consumption until they left prison. Median duration of this successful treatment was 45 days. Median duration of treatment response for patients who relapsed in prison (15 %) was 75 days. No predictive factor of success was found. Tobacco reduction is possible in prison even if living conditions are not favourable.

  17. Clinical significance of determination of changes of serum APN, BNP and ANF levels after treatment in patients with heart failure

    International Nuclear Information System (INIS)

    Ge Hengsong; Hu Min; Gao Xinchun

    2011-01-01

    Objective: To explore the significance of changes on serum APN, BNP and ANF levels after treatment in patients with heart failure. Methods: Serum BNP, ANF(with RIA) serum APN (with ELISA) levels were determined in 30 patients with heart failure both before and after treatment as well as in 35 normal controls. Results: Before treatment, serum APN level was significantly lower than those in controls (P<0.01), but serum BNP, ANF levels were apparently higher (P<0.01). After 1 month of treatment, the levels dropped markedly, but still remained obviously higher (P<0.05). Conclusion: Serum APN, BNP and ANF levels were closely related to the process of heart failure and were of clinical value of monitoring therapeutic effect and prognosis. (authors)

  18. Clinical significance of measurement of changes of serum IGF-II, NO levels after treatment in pediatric patients with bronchial pneumonia

    International Nuclear Information System (INIS)

    Zhao Huajiang

    2005-01-01

    Objective: To study the clinical significance of changes of serum IGF-II and NO levels after treatment in pediatric patients with bronchial pneumonia. Methods: Serum IGF-II (with RIA) and NO (with Biochemical method) levels were measured in 38 pediatric patients with bronchial pneumonia both before and after treatment as well as in 35 controls. Results: Before treatment, in the patients the serum IGF-II, and NO levels were significantly higher than those in controls (P 0.05). Conclusion: Serum IGF-II and NO levels changes could reflect the disease status of the patients as well as the progress of diseases. (authors)

  19. Clinical significance of determination of changes of serum NO, NOS and GM-CSF levels after treatment in children with bronchopneumonia

    International Nuclear Information System (INIS)

    Li Hongmei

    2007-01-01

    Objective: To investigate the clinical significance of changes of serum NO, NOS and GM-CSF levels after treatment in children with bronchopneumonia. Methods: Serum GM-CSF levels were determined with RIA, and serum NO, NOS levels were determined with biochemical methods both before and after treatment in 48 children with bronehopneumonia as well as in 35 controls. Results: Before treatment the serum concentrations of NO, NOS and GM-CSF in the patients were significantly higher than those in controls (P 0.05). Conclusion: Detection of serum NO, NOS and GM-CSF levels were useful for assessment of therapeutic efficacy. (authors)

  20. Experiential acceptance, motivation for recovery, and treatment outcome in eating disorders.

    Science.gov (United States)

    Espel, Hallie M; Goldstein, Stephanie P; Manasse, Stephanie M; Juarascio, Adrienne S

    2016-06-01

    This study sought to test whether the relationship between experiential acceptance (EA) and treatment outcome among eating disorder (ED) patients was mediated by motivation. Upon admission to a residential ED treatment facility, female patients completed measures of EA, motivation, and baseline ED symptom severity (covariate); symptom severity was reassessed at discharge. Higher levels of baseline EA predicted significantly greater symptom reduction during treatment. Moreover, results from bootstrapped mediation analyses indicated that the relationship between EA and treatment outcome was partially mediated by motivation: increased EA was associated with greater motivation to give up ED behaviors at the beginning of treatment, and this led to greater symptom reduction from admission to discharge. Motivation appears to be one mechanism by which EA facilitates improved treatment outcomes in EDs. Further development of interventions that promote EA as a means for improving motivation and subsequent ED treatment response may be warranted.

  1. Clinical significance of changes of serum IL-2, IL-6 and TNF-α levels after treatment in patients with periodontitis

    International Nuclear Information System (INIS)

    Wei Dong

    2005-01-01

    Objective: To investigate the changes of serum IL-2, IL-6 and TNF-α levels after one month of comprehensive treatment in patients with periodontitis. Methods: Serum IL-2, IL-6 and TNF-α levels were measured with RIA in 48 patients with periodontitis both before and after treatment as well as in 35 controls. Results: Before treatment, serum levels of IL-6, TNF- α in the patients were significantly higher and IL-2 levels were significantly lower than those in the controls (both P 0.05). However, the IL-2 levels were still significantly lower than those in controls (P<0.05). Conclusion: There was disturbance of immuno-modulation in patients with periodontitis as expressed by the changes of cytokines levels in the course of the disease. (authors)

  2. Nonsurgical reduction of the interventricular septum in patients with hypertrophic cardiomyopathy.

    Science.gov (United States)

    Shamim, Waqar; Yousufuddin, Mohammed; Wang, Duolao; Henein, Michael; Seggewiss, Hubert; Flather, Marcus; Coats, Andrew J S; Sigwart, Ulrich

    2002-10-24

    In patients with hypertrophic cardiomyopathy and obstruction of the left ventricular outflow tract, nonsurgical reduction of the septum is a treatment option when medical therapy has failed. We investigated the long-term effects of nonsurgical reduction of the septum on functional capacity and electrocardiographic and echocardiographic characteristics. Sixty-four consecutive patients with hypertrophic cardiomyopathy and a mean (+/-SD) age of 48.5+/-17.2 years underwent nonsurgical reduction of the septum by injection of ethanol into the septal perforator branch of the left anterior descending coronary artery. These patients were assessed by exercise testing, electrocardiography, and resting and dobutamine (stress-induced) echocardiography after a mean period of 3.0+/-1.3 years. At follow-up, patients had significant improvements in New York Heart Association class, peak oxygen consumption (from 18.4+/-5.8 to 30.0+/-4.4 ml per kilogram of body weight per minute, P<0.001), and left ventricular outflow tract gradients (resting gradient, from 64+/-36 to 16+/-15 mm Hg; P<0.001; stress-induced gradient, from 132+/-34 to 45+/-19 mm Hg; P<0.001). Procedure-related complications included right bundle-branch block in all patients, complete heart block in 31 patients (48 percent), and significant increases in QRS and corrected QT intervals. Seventeen patients (27 percent) required permanent pacing. R-wave amplitude was significantly decreased (from 32+/-8 to 17+/-7 mV, P<0.001). The dimensions of the left ventricular cavity increased, and the interventricular septal thickness was reduced. Nonsurgical septal reduction leads to sustained improvements in both subjective and objective measures of exercise capacity in association with a persistent reduction in resting and stress-induced left ventricular outflow tract gradients. It is also associated with a high incidence of procedure-related complete heart block, however, often requiring permanent pacing. Copyright 2002

  3. Clinical significance of pneumatosis intestinalis - correlation of MDCT-findings with treatment and outcome

    Energy Technology Data Exchange (ETDEWEB)

    Treyaud, Marc-Olivier; Duran, Rafael; Knebel, Jean-Francois; Meuli, Reto A.; Schmidt, Sabine [Lausanne University Hospital, Department of Diagnostic and Interventional Radiology, Lausanne (Switzerland); Zins, Marc [Fondation Hopital St Joseph, Department of Radiology, Paris (France)

    2017-01-15

    To evaluate the clinical significance of pneumatosis intestinalis (PI) including the influence on treatment and outcome. Two radiologists jointly reviewed MDCT-examinations of 149 consecutive emergency patients (53 women, mean age 64, range 21-95) with PI of the stomach (n = 4), small (n = 68) and/or large bowel (n = 96). PI extension, distribution and possibly associated porto-mesenteric venous gas (PMVG) were correlated with other MDCT-findings, risk factors, clinical management, laboratory, histopathology, final diagnosis and outcome. The most frequent cause of PI was intestinal ischemia (n = 80,53.7 %), followed by infection (n = 18,12.1 %), obstructive (n = 12,8.1 %) and non-obstructive (n = 10,6.7 %) bowel dilatation, unknown aetiologies (n = 8,5.4 %), drugs (n = 8,5.4 %), inflammation (n = 7,4.7 %), and others (n = 6,4 %). Neither PI distribution nor extension significantly correlated with underlying ischemia. Overall mortality was 41.6 % (n = 62), mostly related to intestinal ischemia (p = 0.003). Associated PMVG significantly correlated with underlying ischemia (p = 0.009), as did the anatomical distribution of PMVG (p = 0.015). Decreased mural contrast-enhancement was the only other MDCT-feature significantly associated with ischemia (p p < 0.001). Elevated white blood count significantly correlated with ischemia (p = 0.03). In emergency patients, ischemia remains the most common aetiology of PI, showing the highest mortality. PI with associated PMVG is an alerting sign. PI together with decreased mural contrast-enhancement indicates underlying ischemia. (orig.)

  4. Occlusal bite force change after orthodontic treatment with Andresen functional appliance.

    Science.gov (United States)

    Al-Khateeb, Susan N; Abu Alhaija, Elham S; Majzoub, Sami

    2015-04-01

    The aim of this study was to determine the occlusal bite force (OBF) changes, at the incisal and molar regions, after orthodontic treatment with functional appliance therapy in preadolescent subjects. OBF was measured for patients (17 females and 16 males) before and after the treatment with Andresen functional appliance for an average period of 9 months (mean age was 11.8±1.1 years). Three variables were registered; maximum OBF at molar region and the average of three readings at the molar (AOBF) and incisal regions (IOBF). The same variables were measured in two occasions for a matching non-treated control group with a period of 9 months between the two measurements. No significant changes were seen in the OBF measured parameters in the control group. There was a reduction in all measured parameters. The mean reduction in maximum OBF was 76.1±12.4 N (P appliance caused a significant reduction in OBF immediately after treatment. © The Author 2014. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  5. Clinical significance of determination of changes of serum Hcy, ET and BNP levels After treatment in patients with pregnancy induced hypertension (PIH)

    International Nuclear Information System (INIS)

    He Hongling

    2010-01-01

    Objective: To study the clinical significance of changes of serum Hcy, ET and BNP levels after treatment in patients with pregnancy induced hypertension(PIH). Methods: Serum Hcy (with ELISA), ET and BNP (with RIA) levels were determined in 32 patients with PIH both before and after treatment as well as in 35 controls. Results: Before treatment, serum Hcy, ET and BNP levels in patients with PIH were significantly higher than those in controls (P < 0.01). After 1 month of treatment the levels dropped markedly, but still remained significantly higher(P < 0.05). Conclusion: Serum Hcy, ET and BNP levels were closely related to the diseases process of PIH and were of prognostic values. (authors)

  6. Waste reduction and recycling initiatives in Japanese cities: lessons from Yokohama and Kamakura.

    Science.gov (United States)

    Hotta, Yasuhiko; Aoki-Suzuki, Chika

    2014-09-01

    Waste reduction and recycling at the city level will acquire greater significance in the near future due to rising global volumes of waste. This paper seeks to identify policy-relevant drivers for successful promotion of waste reduction and recycling. Factors influencing the success of waste reduction and recycling campaigns are identified. Two case study cities in Japan which depict the successful use of the 3Rs (reduce, reuse and recycle) at the municipal level are presented. In these cases, the existence of incinerators, which are generally considered as disincentives for recycling, was not functioning as a disincentive but rather as an incentive for waste reduction. Owing to the high cost of incineration facilities, the movement to close incinerators has become a strong incentive for waste reduction and recycling in these two cities. The study suggests that careful consideration is necessary when making decisions concerning high-cost waste treatment facilities with high installation, maintenance and renewal outlays. In addition, intensive source separation and other municipal recycling initiatives have a high potential for producing positive results. © The Author(s) 2014.

  7. Nonsteroidal anti-inflammatory drugs for treatment of acute gout

    NARCIS (Netherlands)

    van Durme, Caroline M. P. G.; Wechalekar, Mihir D.; Landewé, Robert B. M.

    2015-01-01

    Are nonsteroidal anti-inflammatory drugs (NSAIDs) associated with better outcomes than cyclooxygenase inhibitors, glucocorticoids, IL-1 inhibitors or placebo in the treatment of acute gout? NSAIDs are not significantly associated with a difference in pain reduction compared with cyclooxygenase

  8. Do Motivational Interviewing Behaviors Predict Reductions in Partner Aggression for Men and Women?

    Science.gov (United States)

    Woodin, Erica M.; Sotskova, Alina; O’Leary, K. Daniel

    2011-01-01

    Motivational interviewing is a directive, non-confrontational intervention to promote behavior change. The current study examined therapist behaviors during a successful brief motivational interviewing intervention for physically aggressive college dating couples (Woodin & O’Leary, 2010). Forty-five minute motivational interviews with each partner were videotaped and coded using the Motivational Interviewing Treatment Integrity scale (MITI; Moyers, Martin, Manuel, & Miller, 2003). Hierarchical modeling analyses demonstrated that therapist behaviors consistent with motivational interviewing competency predicted significantly greater reductions in physical aggression perpetration following the intervention. Specifically, greater reflection to question ratios by the therapists predicted reductions in aggression for both men and women, greater percentages of open versus closed questions predicted aggression reductions for women, and there was a trend for greater levels of global therapist empathy to predict aggression reductions for women. These findings provide evidence that motivational interviewing seems to have an effect on behavior change through therapist behaviors consistent with the theoretical underpinnings of motivational interviewing. PMID:22119133

  9. Adaptive radiotherapy for long course neo-adjuvant treatment of rectal cancer

    International Nuclear Information System (INIS)

    Nijkamp, Jasper; Marijnen, Corrie; Herk, Marcel van; Triest, Baukelien van; Sonke, Jan-Jakob

    2012-01-01

    Purpose: To quantify the potential margin reduction with adaptive radiotherapy (ART) during neo-adjuvant treatment of locally-advanced rectal cancer. Methods and materials: Repeat CT scans were acquired for 28 patients treated with 25 × 2 Gy, daily during the first week, and followed by weekly scans. The CTV was delineated on all scans, and shape variation was estimated. Five ART strategies were tested, consisting of an average CTV over the planning CT and one to five repeat CTs. Required PTV margins were calculated for adapted and non-adapted treatment. The strategy with the least PTV volume over the whole treatment was selected and bowel area dose reduction was estimated. Results: Substantial systematic and random shape variation demanded for a PTV margin up to 2.4 cm at the upper-anterior part of the CTV. Plan adaptation after fraction 4 resulted in a maximum 0.7 cm margin reduction and a significant PTV reduction from 1185 to 1023 cc (p < 0.0001). The bowel area volume receiving 15, 45, and 50 Gy was reduced from 436 to 402 cc, 111 to 81 cc, and 49 to 29 cc, respectively (p < 0.0001). Conclusions: With adaptive radiotherapy, maximum required PTV margins can be reduced from 2.4 to 1.7 cm, resulting in significantly less dose to the bowel area.

  10. Treatment Development and Feasibility Study of Family-Focused Treatment for Adolescents with Bipolar Disorder and Comorbid Substance Use Disorders

    Science.gov (United States)

    Goldstein, Benjamin I.; Goldstein, Tina R.; Collinger, Katelyn A.; Axelson, David A.; Bukstein, Oscar G.; Birmaher, Boris; Miklowitz, David J.

    2014-01-01

    Background Comorbid substance use disorders (SUD) are associated with increased illness severity and functional impairment among adolescents with bipolar disorder (BD). Previous psychosocial treatment studies have excluded adolescents with both BD and SUD. Studies suggest that integrated interventions are optimal for adults with BD and SUD. Methods We modified family-focused treatment for adolescents with BD (FFT-A) in order to explicitly target comorbid SUD (FFT-SUD). Ten adolescents with BD who had both SUD and an exacerbation of manic, depressed, or mixed symptoms within the last 3 months were enrolled. FFT-SUD was offered as an adjunct to pharmacotherapy, with a target of 21 sessions over 12 months of treatment. The FFT-SUD manual was iteratively modified to integrate a concurrent focus on SUD. Results Six subjects completed a mid-treatment 6-month assessment (after a mean of 16 sessions was completed). Of the 10 subjects, 3 dropped out early ( after ≤ 1 session); in the case of each of these subjects, the participating parent had active SUD. No other subjects in the study had a parent with active SUD. Preliminary findings suggested significant reductions in manic symptoms and depressive symptoms and improved global functioning. Reduction in cannabis use was modest and did not reach significance. Limitations Limitations included a small sample, open treatment, concurrent medications, and no control group. Conclusions These preliminary findings suggest that FFT-SUD is a feasible intervention, particularly for youth without parental SUD. FFT-SUD may be effective in treating mood symptoms, particularly depression, despite modest reductions in substance use. Integrating motivation enhancing strategies may augment the effect of this intervention on substance use. Additional strategies, such as targeting parental substance use, may prevent early attrition. PMID:24847999

  11. Greenhouse gas reductions through enhanced use of residues in the life cycle of Malaysian palm oil derived biodiesel

    DEFF Research Database (Denmark)

    Hansen, Sune Balle; Olsen, Stig Irving; Ujang, Zaini

    2012-01-01

    This study identifies the potential greenhouse gas (GHG) reductions, which can be achieved by optimizing the use of residues in the life cycle of palm oil derived biodiesel. This is done through compilation of data on existing and prospective treatment technologies as well as practical experiments...... extraction from empty fruit bunches was found to be the most significant in the biodiesel production life cycle. All the studied waste treatment technologies performed significantly better than the conventional practices and with dedicated efforts of optimized use in the palm oil industry, the production...

  12. Percutaneous treatment of intervertebral disc herniation.

    Science.gov (United States)

    Buy, Xavier; Gangi, Afshin

    2010-06-01

    Interventional radiology plays a major role in the management of symptomatic intervertebral disc herniations. In the absence of significant pain relief with conservative treatment including oral pain killers and anti-inflammatory drugs, selective image-guided periradicular infiltrations are generally indicated. The precise control of needle positioning allows optimal distribution of steroids along the painful nerve root. After 6 weeks of failure of conservative treatment including periradicular infiltration, treatment aiming to decompress or remove the herniation is considered. Conventional open surgery offers suboptimal results and is associated with significant morbidity. To achieve minimally invasive discal decompression, different percutaneous techniques have been developed. Their principle is to remove a small volume of nucleus, which results in an important reduction of intradiscal pressure and subsequently reduction of pressure inside the disc herniation. However, only contained disc herniations determined by computed tomography or magnetic resonance are indicated for these techniques. Thermal techniques such as radiofrequency or laser nucleotomy seem to be more effective than purely mechanical nucleotomy; indeed, they achieve discal decompression but also thermal destruction of intradiscal nociceptors, which may play a major role in the physiopathology of discal pain. The techniques of image-guided spinal periradicular infiltration and percutaneous nucleotomy with laser and radiofrequency are presented with emphasis on their best indications.

  13. Clinical significance of measurement of changes in serum TNF-α and GM-CSF levels after treatment in children with bronchial asthma

    International Nuclear Information System (INIS)

    Liu Heng

    2006-01-01

    Objective: To study the clinical significance of the changes of levels of tumor necrosis factor-α (TNF-α) and granulocyte-macrophage colony stimulating factor (GM-CSF) after treatment in children with bronchial asthma. Methods: Serum TNF-α and GM-CSF levels were measured with RIA in 32 patients with bronchial asthma both before and after treatment as well as in 30 controls. Results: Before treatment the serum TNF-α and GM-CSF levels in patients were significantly higher than those in the controls (P 0.05 ). Conclusion: Changes of serum TNF-α and GM-CSF levels contents after treatment might be of prognostic importance in children with bronchial asthma. (authors)

  14. Comparison of Relaxation as Self-control and Systematic Desensitization in the Treatment of Test Anxiety

    Science.gov (United States)

    Snyder, Arden L.; Deffenbacher, Jerry L.

    1977-01-01

    Relaxation as self-control and desensitization were compared to a wait-list control in reduction of rest and other anxieties. Active treatments differed significantly from the control treatment. Subjects in both treatments reported less debilitating test anxiety, whereas desensitization subjects showed greater facilitating test anxiety. (Author)

  15. Clinical significance of determination of changes of serum TNF and SA levels after treatment in patients with gonorrhea

    International Nuclear Information System (INIS)

    Zhong Chengwu

    2005-01-01

    Objective: To investigate the changes of serum TNF and sialic acid (SA) levels after treatment in patients with gonorrhea. Methods: Serum TNF (with RIA) and SA (with spectrophotometer ) levels were measured both before and after treatment in 42 patients with gonorrhea as well as in 35 controls. Results: Before treatment, the serum levels of TNF and SA were significantly higher than those in the controls (P 0.05). Conclusion: Changes of serum levels of TNF and SA could reflect the severity of infection in patients with gonorrhea. (authors)

  16. Technological significances to reduce the material problems. Feasibility of heat flux reduction

    International Nuclear Information System (INIS)

    Yamazaki, Seiichiro; Shimada, Michiya.

    1994-01-01

    For a divertor plate in a fusion power reactor, a high temperature coolant must be used for heat removal to keep thermal efficiency high. It makes the temperature and thermal stress of wall materials higher than the design limits. Issues of the coolant itself, e.g. burnout of high temperature water, will also become a serious problem. Sputtering erosion of the surface material will be a great concern of its lifetime. Therefore, it is necessary to reduce the heat and particle loads to the divertor plate technologically. The feasibility of some technological methods of heat reduction, such as separatrix sweeping, is discussed. As one of the most promising ideas, the methods of radiative cooling of the divertor plasma are summarized based on the recent results of large tokamaks. The feasibility of remote radiative cooling and gas divertor is discussed. The ideas are considered in recent design studies of tokamak power reactors and experimental reactors. By way of example, conceptual designs of divertor plate for the steady state tokamak power reactor are described. (author)

  17. Energy Savings from Industrial Water Reductions

    Energy Technology Data Exchange (ETDEWEB)

    Rao, Prakash; McKane, Aimee; de Fontaine, Andre

    2015-08-03

    Although it is widely recognized that reducing freshwater consumption is of critical importance, generating interest in industrial water reduction programs can be hindered for a variety of reasons. These include the low cost of water, greater focus on water use in other sectors such as the agriculture and residential sectors, high levels of unbilled and/or unregulated self-supplied water use in industry, and lack of water metering and tracking capabilities at industrial facilities. However, there are many additional components to the resource savings associated with reducing site water use beyond the water savings alone, such as reductions in energy consumption, greenhouse gas emissions, treatment chemicals, and impact on the local watershed. Understanding and quantifying these additional resource savings can expand the community of businesses, NGOs, government agencies, and researchers with a vested interest in water reduction. This paper will develop a methodology for evaluating the embedded energy consumption associated with water use at an industrial facility. The methodology developed will use available data and references to evaluate the energy consumption associated with water supply and wastewater treatment outside of a facility’s fence line for various water sources. It will also include a framework for evaluating the energy consumption associated with water use within a facility’s fence line. The methodology will develop a more complete picture of the total resource savings associated with water reduction efforts and allow industrial water reduction programs to assess the energy and CO2 savings associated with their efforts.

  18. Clinical significance of measurement of serum hs-CRP, TNF-α and M-CSF levels after treatment in patients with periodontitis

    International Nuclear Information System (INIS)

    Zhang Yunming

    2007-01-01

    Objective: To explore the significance of changes of serum hs-CRP, TNF-α and M-CSF levels after treatment in patients with periodontitis. Methods: Serum TNF-α, M-CSF (with RIA), hs-CRP (with immuneturbitity method) levels were determined in 38 patients with periodontitis both before and after treatment as well as in 35 controls. Results: Before treatment, the serum hs-CRP, TNF-α and M-CSF levels were significantly higher in the patients than those in controls (P 0.05). Conclusion: Detection of serum hs-CRP, TNF-α and M-CSF levels might reflect the progress of disease in patients with periodontitis. (authors)

  19. 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

  20. Clinical significance of measurement of changes of serum IL-2, IL-4 and IFN-γ levels after treatment in patients with vitiligo

    International Nuclear Information System (INIS)

    Cheng Junmin; Zhou Xiujuan; Zhang Yuhong

    2010-01-01

    Objective: To explore the changes of serum IL-2, IL-4 and IFN-γ levels after treatment in patients with vitiligo. Methods: Serum IL-2 (with RIA) IL-4, IFN-γ (with ELISA) levels were examined in 37 patients with vitiligo both before and after treatment as well as in 35 controls. Results: Before treatment, serum IL-2 levels in the patients were significantly lower than those in controls (P < 0.01), while the serum IL-4, IFN-γ levels were significantly higher (P < 0.01). After treatment for 6 months, the values were greatly corrected, but remained significantly different from those in controls (P < 0.05). Conclusion: Vitiligo is a kind of auto-immune diseases with abnormal immuno-regulation. (authors)

  1. Clinical significance of changes of serum IL-2, IL-6 and gastrin levels before and after treatment in patients with chronic eczema

    International Nuclear Information System (INIS)

    Mou Xudong; Ren Hong

    2009-01-01

    Objective: To explore the clinical significance of changes of serum IL-2, IL-6 and gastrin levels after treatment in patients with chronic eczema. Methods: Serum IL-2, IL-6 and gastin were detected with RIA both before and after treatment in 38 patients with chronic eczema and 35 controls. Results: Before treatment, serum IL-2 levels in the patients were significantly lower than those in the controls (P 0.05), however, the IL-2 levels were still significantly lower than those in controls (P>0.05). Conclusion: Serum IL-2, IL-6 and gastrin levels in the patients with chronic eczema were closely related to the severity of the diseases process and could be taken as indicator of treatment efficacy. (authors)

  2. Treatment of anismus in intractable constipation with botulinum A toxin.

    Science.gov (United States)

    Hallan, R I; Williams, N S; Melling, J; Waldron, D J; Womack, N R; Morrison, J F

    1988-09-24

    In seven patients with anismus the striated sphincter muscle complex was selectively weakened by local injection of Clostridium botulinum type A toxin. Symptom scores improved significantly and correlated with a significant reduction in the maximum voluntary and canal squeeze pressure and a significant increase in the anorectal angle on straining. Botulinum A toxin seems to be promising treatment for some patients with anismus.

  3. Significant skin burns may occur with the use of a water balloon in HIFU treatment

    Science.gov (United States)

    Ritchie, Robert; Collin, Jamie; Wu, Feng; Coussios, Constantin; Leslie, Tom; Cranston, David

    2012-10-01

    HIFU is a minimally-invasive therapy suitable for treating selected intra-abdominal tumors. Treatment is safe although skin burns may occur due to pre-focal heating. HIFU treatment of a renal transplant tumor located in the left lower abdomen was undertaken in our centre. Treatment was performed prone, requiring displacement of the abdominal wall away from the treatment field using a water balloon, constructed of natural rubber latex and filled with degassed water. Intra-operatively, ultrasound imaging and physical examination of the skin directly over the focal region was normal. Immediately post-operative, a full-thickness skin burn was evident at the periphery of the balloon location, outside the expected HIFU path. Three possibilities may account for this complication. Firstly, the water balloon may have acted as a lens, focusing the HIFU to a neo-focus off axis. Secondly, air bubbles may have been entrapped between the balloon and the skin, causing heating at the interface. Finally, heating of the isolated water within the balloon may have been sufficient to cause burning. In this case, the placement of a water balloon caused a significant skin burn. Care should be taken in their use as burns, situated off axis, may occur even if the overlying skin appears normal.

  4. Removal of indicator organisms by chemical treatment of wastewater.

    Science.gov (United States)

    De Zutter, L; van Hoof, J

    1981-01-01

    Recently a new chemical wastewater treatment process based upon precipitation of proteins by sodium lignosulphonate under acid conditions is used to purify the wastewater from slaughterhouses and poultry processing plants. In order to determine the reduction of indicator organisms due to this treatment process, influent and effluent samples from two of such plants (plant A in a pig slaughterhouse and plant B in a poultry processing plant) were examined. The results demonstrated that the pH used in the process, has a considerable influence on the reduction of the indicator organisms. On the first sampling day in plant A the initial working-pH was 4 and the corresponding reduction of the different microorganisms varied from 0.7 to 1.5 log. According to the decrease of the pH to 2.3, the reduction increased to a minimum of at least 1.9 and a maximum of at least 4.5 log. In the other samples from this plant (working-pH 2.4) the elimination ranged from 1.8 to 4.0 log. In plant B, the removal of the indicator organisms brought about by a working-pH of 3.0 ranged from 2.1 to 3.1 log. The results showed that in comparison with the biological treatment processes this chemical wastewater treatment process realized a significant greater removal of indicator organisms.

  5. Harm reduction and viral hepatitis C in European prisons: a cross-sectional survey of 25 countries.

    Science.gov (United States)

    Bielen, Rob; Stumo, Samya R; Halford, Rachel; Werling, Klára; Reic, Tatjana; Stöver, Heino; Robaeys, Geert; Lazarus, Jeffrey V

    2018-05-11

    Current estimates suggest that 15% of all prisoners worldwide are chronically infected with the hepatitis C virus (HCV), and this number is even higher in regions with high rates of injecting drug use. Although harm reduction services such as opioid substitution therapy (OST) and needle and syringe programs (NSPs) are effective in preventing the further spread of HCV and HIV, the extent to which these are available in prisons varies significantly across countries. The Hep-CORE study surveyed liver patient groups from 25 European countries in 2016 and mid-2017 on national policies related to harm reduction, testing/screening, and treatment for HCV in prison settings. Results from the cross-sectional survey were compared to the data from available reports and the peer-reviewed literature to determine the overall degree to which European countries implement evidence-based HCV recommendations in prison settings. Patient groups in nine countries (36%) identified prisoners as a high-risk population target for HCV testing/screening. Twenty-one countries (84%) provide HCV treatment in prisons. However, the extent of coverage of these treatment programs varies widely. Two countries (8%) have NSPs officially available in prisons in all parts of the country. Eleven countries (44%) provide OST in prisons in all parts of the country without additional requirements. Despite the existence of evidence-based recommendations, infectious disease prevention measures such as harm reduction programs are inadequate in European prison settings. Harm reduction, HCV testing/screening, and treatment should be scaled up in prison settings in order to progress towards eliminating HCV as a public health threat.

  6. Microbial reduction of iron ore

    Science.gov (United States)

    Hoffmann, M.R.; Arnold, R.G.; Stephanopoulos, G.

    1989-11-14

    A process is provided for reducing iron ore by treatment with microorganisms which comprises forming an aqueous mixture of iron ore, microorganisms operable for reducing the ferric iron of the iron ore to ferrous iron, and a substrate operable as an energy source for the microbial reduction; and maintaining the aqueous mixture for a period of time and under conditions operable to effect the reduction of the ore. Preferably the microorganism is Pseudomonas sp. 200 and the reduction conducted anaerobically with a domestic wastewater as the substrate. An aqueous solution containing soluble ferrous iron can be separated from the reacted mixture, treated with a base to precipitate ferrous hydroxide which can then be recovered as a concentrated slurry. 11 figs.

  7. Numerical Feynman integrals with physically inspired interpolation: Faster convergence and significant reduction of computational cost

    Directory of Open Access Journals (Sweden)

    Nikesh S. Dattani

    2012-03-01

    Full Text Available One of the most successful methods for calculating reduced density operator dynamics in open quantum systems, that can give numerically exact results, uses Feynman integrals. However, when simulating the dynamics for a given amount of time, the number of time steps that can realistically be used with this method is always limited, therefore one often obtains an approximation of the reduced density operator at a sparse grid of points in time. Instead of relying only on ad hoc interpolation methods (such as splines to estimate the system density operator in between these points, I propose a method that uses physical information to assist with this interpolation. This method is tested on a physically significant system, on which its use allows important qualitative features of the density operator dynamics to be captured with as little as two time steps in the Feynman integral. This method allows for an enormous reduction in the amount of memory and CPU time required for approximating density operator dynamics within a desired accuracy. Since this method does not change the way the Feynman integral itself is calculated, the value of the density operator approximation at the points in time used to discretize the Feynamn integral will be the same whether or not this method is used, but its approximation in between these points in time is considerably improved by this method. A list of ways in which this proposed method can be further improved is presented in the last section of the article.

  8. Contactless Abdominal Fat Reduction With Selective RF™ Evaluated by Magnetic Resonance Imaging (MRI): Case Study.

    Science.gov (United States)

    Downie, Jeanine; Kaspar, Miroslav

    2016-04-01

    Noninvasive body shaping methods seem to be an ascending part of the aesthetics market. As a result, the pressure to develop reliable methods for the collection and presentation of their results has also increased. The most used techniques currently include ultrasound measurements of fat thickness in the treated area, caliper measurements, bioimpedance-based scale measurements or circumferential tape measurements. Although these are the most used techniques, almost all of them have some limitations in reproducibility and/or accuracy. This study shows Magnetic Resonance Imaging (MRI) as the new method for the presentation of results in the body shaping industry. Six subjects were treated by a contactless selective radiofrequency device (BTL Vanquish ME, BTL Industries Inc., Boston, MA). The MRI fat thickness was measured at the baseline and at 4-weeks following the treatment. In addition to MRI images and measurements, digital photographs and anthropometric evaluations such as weight, abdominal circumference, and caliper fat thickness measurements were recorded. Abdominal fat thickness measurements from the MRI were performed from the same slices determined by the same tissue artefacts. The MRI fat thickness difference between the baseline measurement and follow up visit showed an average reduction of 5.36 mm as calculated from the data of 5 subjects. One subject dropped out of study due to non-study related issues. The results were statistically significant based on the Student's T-test evaluation. Magnetic resonance imaging abdominal fat thickness measurements seems to be the best method for the evaluation of fat thickness reduction after non-invasive body shaping treatments. In this study, this method shows average fat thickness reduction of 5.36 mm while the weight of the subjects didn't change significantly. A large spot size measuring 1317 cm(2) (204 square inches) covers the abdomen flank to flank. The average thickness of 5.36 mm of the fat layer reduced

  9. Evaluation of a metal artifact reduction algorithm applied to post-interventional flat detector CT in comparison to pre-treatment CT in patients with acute subarachnoid haemorrhage

    International Nuclear Information System (INIS)

    Mennecke, Angelika; Svergun, Stanislav; Doerfler, Arnd; Struffert, Tobias; Scholz, Bernhard; Royalty, Kevin

    2017-01-01

    Metal artefacts can impair accurate diagnosis of haemorrhage using flat detector CT (FD-CT), especially after aneurysm coiling. Within this work we evaluate a prototype metal artefact reduction algorithm by comparison of the artefact-reduced and the non-artefact-reduced FD-CT images to pre-treatment FD-CT and multi-slice CT images. Twenty-five patients with acute aneurysmal subarachnoid haemorrhage (SAH) were selected retrospectively. FD-CT and multi-slice CT before endovascular treatment as well as FD-CT data sets after treatment were available for all patients. The algorithm was applied to post-treatment FD-CT. The effect of the algorithm was evaluated utilizing the pre-post concordance of a modified Fisher score, a subjective image quality assessment, the range of the Hounsfield units within three ROIs, and the pre-post slice-wise Pearson correlation. The pre-post concordance of the modified Fisher score, the subjective image quality, and the pre-post correlation of the ranges of the Hounsfield units were significantly higher for artefact-reduced than for non-artefact-reduced images. Within the metal-affected slices, the pre-post slice-wise Pearson correlation coefficient was higher for artefact-reduced than for non-artefact-reduced images. The overall diagnostic quality of the artefact-reduced images was improved and reached the level of the pre-interventional FD-CT images. The metal-unaffected parts of the image were not modified. (orig.)

  10. Evaluation of a metal artifact reduction algorithm applied to post-interventional flat detector CT in comparison to pre-treatment CT in patients with acute subarachnoid haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Mennecke, Angelika; Svergun, Stanislav; Doerfler, Arnd; Struffert, Tobias [University of Erlangen-Nuremberg, Department of Neuroradiology, Erlangen (Germany); Scholz, Bernhard [Siemens Healthcare GmbH, Forchheim (Germany); Royalty, Kevin [Siemens Medical Solutions, USA, Inc., Hoffman Estates, IL (United States)

    2017-01-15

    Metal artefacts can impair accurate diagnosis of haemorrhage using flat detector CT (FD-CT), especially after aneurysm coiling. Within this work we evaluate a prototype metal artefact reduction algorithm by comparison of the artefact-reduced and the non-artefact-reduced FD-CT images to pre-treatment FD-CT and multi-slice CT images. Twenty-five patients with acute aneurysmal subarachnoid haemorrhage (SAH) were selected retrospectively. FD-CT and multi-slice CT before endovascular treatment as well as FD-CT data sets after treatment were available for all patients. The algorithm was applied to post-treatment FD-CT. The effect of the algorithm was evaluated utilizing the pre-post concordance of a modified Fisher score, a subjective image quality assessment, the range of the Hounsfield units within three ROIs, and the pre-post slice-wise Pearson correlation. The pre-post concordance of the modified Fisher score, the subjective image quality, and the pre-post correlation of the ranges of the Hounsfield units were significantly higher for artefact-reduced than for non-artefact-reduced images. Within the metal-affected slices, the pre-post slice-wise Pearson correlation coefficient was higher for artefact-reduced than for non-artefact-reduced images. The overall diagnostic quality of the artefact-reduced images was improved and reached the level of the pre-interventional FD-CT images. The metal-unaffected parts of the image were not modified. (orig.)

  11. Clinical significance of measurement of plasma leptin and serum IL-6, IL-18 levels after treatment in patients with children nephrotic syndrome

    International Nuclear Information System (INIS)

    Wang Xiaoyan

    2011-01-01

    Objective: To explore the clinical significance of changes of plasma leptin and serum IL-6, IL-18 levels after treatment in patients with children nephrotic syndrome. Methods: Plasma leptin (with RIA) serum IL-6, IL-18 (with ELISA) levels were measured in 31 patients with children nephrotic syndrome both before and after treatment as well as in 30 controls. Results: Before treatment,the plasma leptin and serum IL-6, IL-18 levels were significantly higher than those in controls(P <0.01). After treatment for 3 months, the levels in patients though dropped markedly remained significantly higher than those in controls (P<0.05). Plasma leptin levels were positively correlated with IL-6, IL-18 levels (r=0.6138, 0.5784, P<0.01). Conclusion: Changes of plasma leptin and serum IL-6, IL-18 levels after treatment might be of prognostic importance in patients with children nephrotic syndrome. (authors)

  12. Comparative analysis of perinatal outcome of spontaneous pregnancy reduction and multifetal pregnancy reduction in triplet pregnancies conceived after assisted reproductive technique

    Directory of Open Access Journals (Sweden)

    Shilpa Bhandari

    2016-01-01

    Full Text Available INTRODUCTION: With the advent of assisted reproductive treatment options, the incidence of multiple pregnancies has increased. Although the need for elective single embryo transfer is emphasized time and again, its uniform applicability in practice is yet a distant goal. In view of the fact that triplet and higher order pregnancies are associated with significant fetomaternal complications, the fetal reduction is a commonly used option in such cases. This retrospective study aims to compare the perinatal outcome in patients with triplet gestation who have undergone spontaneous fetal reduction (SFR as against those in whom multifetal pregnancy reduction (MFPR was done. MATERIALS AND METHODS: In the present study, eighty patients with triplet gestation at 6 weeks were considered. The patients underwent SFR or MFPR at or before 12-13 weeks and were divided into two groups (34 and 46, respectively. RESULTS: Our study found no statistical difference in perinatal outcome between the SFR and MFPR groups in terms of average gestational age at delivery, abortion rate, preterm delivery rate, and birth weight. The study shows that the risk of aborting all fetuses after SFR is three times (odds ratio [OR] = 3.600, 95% confidence interval [CI] = 0.2794-46.388 that of MFPR in subsequent 2 weeks. There were more chances of loss of extra fetus in SFR (23.5% group than MFPR group (8.7% (OR = 3.889, 95% CI = 1.030-14.680. As neither group offers any significant benefit from preterm delivery, multiple pregnancies continue to be responsible for preterm delivery despite fetal reduction. CONCLUSION: There appears to be some advantages of MFPR in perinatal outcome when compared to SFR, especially if the latter happens at advanced gestation. Therefore, although it is advisable to wait for SFR to occur, in patients with triplet gestation at 11-12 weeks, MFPR is a viable option to be considered.

  13. Significant skin-tightening by closure of fractional ablative laser holes.

    Science.gov (United States)

    Russe, Elisabeth; Purschke, Martin; Limpiangkanan, Wikunda; Farinelli, William A; Wang, Ying; Doukas, Apostolos G; Sakamoto, Fernanda H; Wechselberger, Gottfried; Anderson, Richard Rox

    2018-01-01

    and needle coring treatment without closure did not result in significant area reduction (P = 0.1289) compared with untreated control sites. Significant skin tightening can be achieved by immediate temporary non-invasive wound closure after short pulse Er:YAG fractional ablative laser treatment, as well as after mechanically removing skin with a coring needle. This approach may improve skin tightening after ablative laser treatments. Further clinical studies are necessary to confirm successful application in humans. Lasers Surg. Med. 50:64-69, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  14. Reversible reduction of nevirapine plasma concentrations during rifampicin treatment in patients coinfected with HIV-1 and tuberculosis.

    Science.gov (United States)

    Matteelli, Alberto; Saleri, Nuccia; Villani, Paola; Bonkoungou, Victor; Carvalho, Anna Cristina C; Kouanda, Seni; Sanou, Marie J; Simporé, Jacques; Monno, Laura; Carosi, Giampiero; Regazzi, Mario; Dembele, Mathurin

    2009-09-01

    Nevirapine (NVP) plasma levels are reduced in patients receiving rifampicin (RFM) for tuberculosis (TB) treatment. We determined variations over time of the pharmacokinetic parameters of NVP in patients who receive RFM. HIV-1-infected patients with CD4+ T-lymphocyte count reduction was only 7.5% at T2 (54.3 vs. 58.7 microg x mL(-1) x h(-1); P = 0.17). The median C trough was reduced of 19.5% at T1 compared with T3 (3.3 vs. 4.2 microg/mL; P = 0.02) and of 7.1% at T2 compared with T3 (3.9 vs. 4.2 microg/mL; P = 0.17). The proportion of subjects with C trough values reduction of the area under the curve of NVP during concomitant RFM treatment substantially decreases over time.

  15. Electrochemical treatment of wastewater: A case study of reduction of DNT and oxidation of chlorinated phenols

    Energy Technology Data Exchange (ETDEWEB)

    Rodgers, J.D.; Bunce, N.J.; Jedral, W.

    1999-07-01

    Electrochemical treatment is under consideration as a treatment option for several recalcitrant compounds. In this work the authors investigate the oxidation of chlorophenols and the reduction of nitroaromatics. In the case of chlorinated phenols, they explore the problem of anode fouling which has hampered electrolytic treatment of phenolic compounds by examining phenols differing in the extent of chlorination, according to the mechanism of oxidation at different electrode types. Linear sweep voltammograms at a Pt anode were interpreted in terms of deposition of oligomers on the anode surface. Passivation increased in parallel with the uncompensated resistance of the solution and occurred only at potentials at which water is oxidized, suggesting that the formation of the oligomer film involves attack of hydroxyl radicals on electrochemically oxidized substrate. Relative reactivities of congeners were anode-dependent, due to different mechanisms of oxidation: direct electron transfer oxidation at PbO{sub 2} and hydroxyl radical attack at SnO{sub 2} and IrO{sub 2}. Voltammetry of 2,6-dinitrotoluene (DNT) was consistent with literature values. DNT was reduced at several cathodes with the most promising result at Ni-plated Ni wire. At current densities {lt} 0.1 mA cm{sup {minus}2}, current efficiencies {gt} 50% could be achieved with 4-chlorophenol at all three anodes and for 2,6-DNT at Ni-plated Ni wire.

  16. Classification of Non-Small Cell Lung Cancer Using Significance Analysis of Microarray-Gene Set Reduction Algorithm

    Directory of Open Access Journals (Sweden)

    Lei Zhang

    2016-01-01

    Full Text Available Among non-small cell lung cancer (NSCLC, adenocarcinoma (AC, and squamous cell carcinoma (SCC are two major histology subtypes, accounting for roughly 40% and 30% of all lung cancer cases, respectively. Since AC and SCC differ in their cell of origin, location within the lung, and growth pattern, they are considered as distinct diseases. Gene expression signatures have been demonstrated to be an effective tool for distinguishing AC and SCC. Gene set analysis is regarded as irrelevant to the identification of gene expression signatures. Nevertheless, we found that one specific gene set analysis method, significance analysis of microarray-gene set reduction (SAMGSR, can be adopted directly to select relevant features and to construct gene expression signatures. In this study, we applied SAMGSR to a NSCLC gene expression dataset. When compared with several novel feature selection algorithms, for example, LASSO, SAMGSR has equivalent or better performance in terms of predictive ability and model parsimony. Therefore, SAMGSR is a feature selection algorithm, indeed. Additionally, we applied SAMGSR to AC and SCC subtypes separately to discriminate their respective stages, that is, stage II versus stage I. Few overlaps between these two resulting gene signatures illustrate that AC and SCC are technically distinct diseases. Therefore, stratified analyses on subtypes are recommended when diagnostic or prognostic signatures of these two NSCLC subtypes are constructed.

  17. Reduction in Greenhouse Gas Emissions Associated with Worm Control in Lambs

    Directory of Open Access Journals (Sweden)

    Drew G. Coulter

    2013-04-01

    Full Text Available There are currently little or no data on the role of endemic disease control in reducing greenhouse gas (GHG emissions from livestock. In the present study, we have used an Intergovernmental Panel on Climate Change (IPCC-compliant model to calculate GHG emissions from naturally grazing lambs under four different anthelmintic drug treatment regimes over a 5-year study period. Treatments were either “monthly” (NST, “strategic” (SPT, “targeted” (TST or based on “clinical signs” (MT. Commercial sheep farming practices were simulated, with lambs reaching a pre-selected target market weight (38 kg removed from the analysis as they would no longer contribute to the GHG budget of the flock. Results showed there was a significant treatment effect over all years, with lambs in the MT group consistently taking longer to reach market weight, and an extra 10% emission of CO2e per kg of weight gain over the other treatments. There were no significant differences between the other three treatment strategies (NST, SPT and TST in terms of production efficiency or cumulated GHG emissions over the experimental period. This study has shown that endemic disease control can contribute to a reduction in GHG emissions from animal agriculture and help reduce the carbon footprint of livestock farming.

  18. Apical root resorption during orthodontic treatment with aligners? A retrospective radiometric study.

    Science.gov (United States)

    Krieger, Elena; Drechsler, Thomas; Schmidtmann, Irene; Jacobs, Collin; Haag, Simeon; Wehrbein, Heinrich

    2013-08-14

    Objective of this study was to investigate the incidence and severity of apical root resorptions (ARR) during orthodontic treatment with aligners. The sample comprised 100 patients (17-75 years of age) with a class I occlusion and anterior crowding before treatment, treated exclusively with aligners (Invisalign®, Align Technologies, Santa Clara, CA, USA). The following teeth were assessed: upper and lower anterior teeth and first molars. Root and crown lengths of a total of 1600 teeth were measured twice in pre- and post-treatment panoramic radiographs. Afterwards, relative changes of the root length during treatment were calculated by a root-crown-ratio taking pre- and post-treatment root and crown lengths into consideration. A reduction of this ratio was considered as a shortening of the initial root length. Additionally, tooth movements of the front teeth were assessed by lateral cephalograms and the 3-dimensonal set up of each patient. All patients had a reduction of the pre-treatment root length with a minimum of two teeth. On average 7.36 teeth per patient were affected. 54% of 1600 measured teeth showed no measurable root reduction. A reduction of >0%-10% of the pre-treatment root length was found in 27.75%, a distinct reduction of >10%-20% in 11.94%. 6.31% of all teeth were affected with a considerable reduction of >20%. We found no statistically significant correlation between relative root length changes and the individual tooth, gender, age or sagittal and vertical orthodontic tooth movement; except for extrusion of upper front teeth, which was considered as not clinical relevant due to the small amount of mean 4% ARR. The present study is the first analyzing ARR in patients with a fully implemented orthodontic treatment with aligners (i.e. resolving anterior crowding). The variety was high and no clinical relevant influence factor could be detected. A minimum of two teeth with a root length reduction was found in every patient. On average, 7.36 teeth

  19. Ablation of hypertrophic septum using radiofrequency energy: an alternative for gradient reduction in patient with hypertrophic obstructive cardiomyopathy?

    Science.gov (United States)

    Riedlbauchová, Lucie; Janoušek, Jan; Veselka, Josef

    2013-06-01

    Alcohol septal ablation and surgical myectomy represent accepted therapeutic options for treatment of symptomatic patients with hypertrophic obstructive cardiomyopathy. Long-term experience with radiofrequency ablation of arrhythmogenic substrates raised a question if this technique might be effective for left ventricular outflow tract (LVOT) gradient reduction. We report on a 63-year-old patient with recurrence of symptoms 1 year after alcohol septal ablation (ASA) leading originally to a significant reduction of both symptoms and gradient. Due to a new increase of gradient in the LVOT up to 200 mm Hg with corresponding worsening of symptoms and due to refusal of surgical myectomy by the patient, endocardial radiofrequency ablation of the septal hypertrophy (ERASH) was indicated. Radiofrequency ablation was performed in the LVOT using irrigated-tip ablation catheter; the target site was identified using intracardiac echocardiography and electroanatomical CARTO mapping. ERASH caused an immediate gradient reduction due to hypokinesis of the ablated septum. At 2-month follow-up exam, significant clinical improvement was observed, together with persistent gradient reduction assessed with Doppler echocardiography. Echocardiography and magnetic resonance revealed persistent septal hypokinesis and slight thinning of the ablated region. Septal ablation using radiofrequency energy may be a promising alternative or adjunct to the treatment of hypertrophic obstructive cardiomyopathy. Intracardiac echocardiography and electroanatomical CARTO mapping enable exact lesion placement and preservation of atrioventricular conduction.

  20. A randomized 12-week clinical comparison of an oscillating-rotating toothbrush to a new sonic brush in the reduction of gingivitis and plaque.

    Science.gov (United States)

    Klukowska, M; Grender, J M; Conde, E; Ccahuana-Vasquez, Renzo Alberto; Goyal, C R

    2014-01-01

    To evaluate the efficacy of a marketed oscillating-rotating (O-R) power toothbrush (Oral-B Triumph with SmartGuide and FlossAction brush head, D34/EB25) to a new sonic toothbrush (Sonicare FlexCare Platinum) in the reduction of gingivitis and plaque over a 12-week test period. This was a single center, randomized, open label, examiner-blind, two-treatment, parallel group study. Subjects who met the entrance criteria were enrolled in the study and randomly assigned to either the O-R or sonic treatment group. Subjects brushed with their assigned toothbrush and a marketed fluoride dentifrice for two minutes twice daily at home for 12 weeks. Gingivitis and plaque were evaluated at Baseline, Week 6, and Week 12. Gingivitis was assessed using the Modified Gingival Index (MGI) and Gingival Bleeding Index (GBI), and plaque was assessed using the Rustogi Modified Navy Plaque Index (RMNPI). Data were analyzed using an Analysis of Covariance (ANCOVA) with Baseline as the covariate. In total, 130 subjects (65 per group) were randomized to treatment and 127 subjects completed the study. Both brushes produced statistically significant (p gingivitis and plaque measures relative to Baseline. At Week 12, the O-R brush demonstrated significantly greater reductions than the sonic brush in whole mouth gingivitis measures (p = 0.007). Additionally, the O-R brush presented significantly fewer bleeding sites (p gingivitis, 19.8% for number of bleeding sites, and 12.2% for whole mouth plaque. There were no adverse events reported or observed for either brush. The oscillating-rotating toothbrush demonstrated statistically significantly greater reductions in whole mouth plaque at Weeks 6 and 12, as well as significantly greater gingivitis reductions over the long-term (12 weeks), compared to the new sonic toothbrush.

  1. [Treatment of open tile type C pelvic fractures by open reduction and internal fixation through anterior and posterior approaches at early stage].

    Science.gov (United States)

    Li, Baichuan

    2014-05-01

    To explore the effectiveness of open reduction and internal fixation through anterior and posterior approaches in treatment of open Tile type C pelvic fractures at early stage. Between January 2009 and April 2012, 12 patients with open Tile C pelvic fractures were treated. There were 7 males and 5 females, aged 6-53 years (median, 31 years). Of 12 cases, 4 were classified as Tile type C1, 6 as Tile type C2, and 2 as Tile type C3; 5 were rated as Gustilo type II and 7 as Gustilo type III. The injury severity score was 18-57 (mean, 37.2). The interval of injury and admission ranged from 15 minutes to 3 days (median, 50 minutes). The debridement and external fixation were performed at first stage; then open reduction and internal fixation were used through anterior approach (reconstruction plate) and posterior approach (cannulated lag screws). The vacuum sealing drainage was performed during treatment until the wounds healed. Delayed healing of incison was obtained in 12 cases because of wound infection. Anatomical reduction or approximate anatomical reduction was achieved in all 12 cases. The patients were followed up 3-39 months (median, 18 months). No loosening of internal fixation or fracture displacement was observed during follow-up. The fracture healing time was 7-13 weeks (mean, 9.7 weeks). At last follow-up, according to the Matta standard, the outcome was excellent in 10 cases and good in 2 cases; according to Majeed score, the results were excellent in 9 cases, good in 1, and poor in 2. Early internal fixation operation of open Tile type C pelvic fractures can effectively restore the pelvic anatomical structure and stability, reduce the complication, and achieve satisfactory effectiveness.

  2. Sleep disturbances in treatment-seeking OCD-patients: Changes after concentrated exposure treatment.

    Science.gov (United States)

    Nordahl, Håkon; Havnen, Audun; Hansen, Bjarne; Öst, Lars-Göran; Kvale, Gerd

    2018-04-01

    Research indicates that patients with Obsessive Compulsive Disorder (OCD) frequently suffer from comorbid sleep difficulties, and that these difficulties often are not clinically recognized and diagnosed. There has been limited research investigating if comorbid sleep difficulties impair treatment outcome for OCD and if the sleep difficulties change following OCD-treatment. Thirty-six patients with obsessive compulsive disorder underwent concentrated exposure treatment delivered in a group over four consecutive days and were assessed with measures of OCD, depressive symptoms and sleep disturbance at three different time points (pre, post and 6 months follow-up). The sample was characterized by a high degree of comorbidity with other psychiatric disorders. At pre-treatment nearly 70% of the patients reported sleep difficulties indicative of primary insomnia. The results showed that patients had large reductions of OCD-symptoms as well as significant improvements in sleep disturbance assessed after treatment, and that these improvements were maintained at follow-up. Sleep disturbance did not impair treatment outcome, on the contrary patients with higher degree of sleep disturbance at pre-treatment had better outcome on OCD-symptoms after treatment. The results indicated that the majority of the OCD sample suffered from sleep disturbances and that these sleep disturbances were significantly reduced following adequate treatment of OCD without specific sleep interventions. However, a proportion of the patients suffered from residual symptoms of insomnia after treatment. © 2017 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  3. Emphysema lung lobe volume reduction: effects on the ipsilateral and contralateral lobes

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Matthew S.; Kim, Hyun J.; Abtin, Fereidoun G.; Galperin-Aizenberg, Maya; Pais, Richard; Da Costa, Irene G.; Ordookhani, Arash; Chong, Daniel; Ni, Chiayi; McNitt-Gray, Michael F.; Goldin, Jonathan G. [David Geffen School of Medicine at UCLA, Center for Computer Vision and Imaging Biomarkers, Department of Radiological Sciences, Los Angeles, CA (United States); Strange, Charlie [Medical University of South Carolina, Department of Pulmonary and Critical Care Medicine, Columbia, SC (United States); Tashkin, Donald P. [David Geffen School of Medicine at UCLA, Division of Pulmonary and Critical Care Medicine, Los Angeles, CA (United States)

    2012-07-15

    To investigate volumetric and density changes in the ipsilateral and contralateral lobes following volume reduction of an emphysematous target lobe. The study included 289 subjects with heterogeneous emphysema, who underwent bronchoscopic volume reduction of the most diseased lobe with endobronchial valves and 132 untreated controls. Lobar volume and low-attenuation relative area (RA) changes post-procedure were measured from computed tomography images. Regression analysis (Spearman's rho) was performed to test the association between change in the target lobe volume and changes in volume and density variables in the other lobes. The target lobe volume at full inspiration in the treatment group had a mean reduction of -0.45 L (SE = 0.034, P < 0.0001), and was associated with volume increases in the ipsilateral lobe (rho = -0.68, P < 0.0001) and contralateral lung (rho = -0.16, P = 0.006), and overall reductions in expiratory RA (rho = 0.31, P < 0.0001) and residual volume (RV)/total lung capacity (TLC) (rho = 0.13, P = 0.03). When the volume of an emphysematous target lobe is reduced, the volume is redistributed primarily to the ipsilateral lobe, with an overall reduction. Image-based changes in lobar volumes and densities indicate that target lobe volume reduction is associated with statistically significant overall reductions in air trapping, consistent with expansion of the healthier lung. (orig.)

  4. Emphysema lung lobe volume reduction: effects on the ipsilateral and contralateral lobes

    International Nuclear Information System (INIS)

    Brown, Matthew S.; Kim, Hyun J.; Abtin, Fereidoun G.; Galperin-Aizenberg, Maya; Pais, Richard; Da Costa, Irene G.; Ordookhani, Arash; Chong, Daniel; Ni, Chiayi; McNitt-Gray, Michael F.; Goldin, Jonathan G.; Strange, Charlie; Tashkin, Donald P.

    2012-01-01

    To investigate volumetric and density changes in the ipsilateral and contralateral lobes following volume reduction of an emphysematous target lobe. The study included 289 subjects with heterogeneous emphysema, who underwent bronchoscopic volume reduction of the most diseased lobe with endobronchial valves and 132 untreated controls. Lobar volume and low-attenuation relative area (RA) changes post-procedure were measured from computed tomography images. Regression analysis (Spearman's rho) was performed to test the association between change in the target lobe volume and changes in volume and density variables in the other lobes. The target lobe volume at full inspiration in the treatment group had a mean reduction of -0.45 L (SE = 0.034, P < 0.0001), and was associated with volume increases in the ipsilateral lobe (rho = -0.68, P < 0.0001) and contralateral lung (rho = -0.16, P = 0.006), and overall reductions in expiratory RA (rho = 0.31, P < 0.0001) and residual volume (RV)/total lung capacity (TLC) (rho = 0.13, P = 0.03). When the volume of an emphysematous target lobe is reduced, the volume is redistributed primarily to the ipsilateral lobe, with an overall reduction. Image-based changes in lobar volumes and densities indicate that target lobe volume reduction is associated with statistically significant overall reductions in air trapping, consistent with expansion of the healthier lung. (orig.)

  5. Ozonation and Thermal Pre-Treatment of Municipal Sewage Sludge-Implications for Toxicity and Methane Potential

    DEFF Research Database (Denmark)

    Davidsson, A.; Eriksson, Eva; Fick, J.

    2013-01-01

    The aim of this study was to determine effects on methane potential and overall sludge quality from two different sludge pre-treatment technologies (ozonation high/low dosage and thermal treatment 55/70 degrees C). In general both treatments produced increased methane potential. Thermal treatment...... by ozone treatment and digestion. No statistical significant reduction in concentrations of included pharmaceuticals could be observed....

  6. Incarceration of the intermeniscal ligament in tibial eminence injury: a block to closed reduction identified using MRI

    International Nuclear Information System (INIS)

    Archibald-Seiffer, Noah; Jacobs, John; Zbojniewicz, Andrew; Shea, Kevin

    2015-01-01

    Tibial eminence fractures are a relatively uncommon injury, but most frequently occur in children and adolescents with open physes. Entrapment of the intermeniscal ligament or the meniscus itself can occur in the setting of a tibial eminence fracture and when present, poses a significant obstacle to successful closed or surgical reduction. Identification of these entrapped structures on preoperative imaging may be helpful to the physicians caring for these patients and assist with preoperative planning. We present a case of a 13-year-old male who sustained a tibial eminence fracture while playing football. Review by the orthopedic surgeon identified entrapment of the intermeniscal ligament. Subsequently, a closed reduction attempt under anesthesia prior to surgery was unsuccessful and arthroscopy was needed to remove the entrapped intermeniscal ligament and reduce the tibial eminence fracture. Pre-operative knowledge of entrapped soft tissue structures under the fracture plane, particularly the meniscus and intermeniscal ligament, provides the surgeon with valuable insight as to how to best counsel patients on the success of treatment options, how to best prepare for operative treatment, and can guide the surgeon during open reduction to maximize treatment success. (orig.)

  7. Incarceration of the intermeniscal ligament in tibial eminence injury: a block to closed reduction identified using MRI

    Energy Technology Data Exchange (ETDEWEB)

    Archibald-Seiffer, Noah; Jacobs, John [University of Utah School of Medicine, Salt Lake City, UT (United States); Zbojniewicz, Andrew [University of Cincinnati Department of Radiology, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Division of Pediatric Radiology, Cincinnati, OH (United States); Shea, Kevin [University of Utah School of Medicine, Salt Lake City, UT (United States); St. Luke' s Health System, Boise, ID (United States); St. Luke' s Sports Medicine, Boise, ID (United States)

    2015-05-01

    Tibial eminence fractures are a relatively uncommon injury, but most frequently occur in children and adolescents with open physes. Entrapment of the intermeniscal ligament or the meniscus itself can occur in the setting of a tibial eminence fracture and when present, poses a significant obstacle to successful closed or surgical reduction. Identification of these entrapped structures on preoperative imaging may be helpful to the physicians caring for these patients and assist with preoperative planning. We present a case of a 13-year-old male who sustained a tibial eminence fracture while playing football. Review by the orthopedic surgeon identified entrapment of the intermeniscal ligament. Subsequently, a closed reduction attempt under anesthesia prior to surgery was unsuccessful and arthroscopy was needed to remove the entrapped intermeniscal ligament and reduce the tibial eminence fracture. Pre-operative knowledge of entrapped soft tissue structures under the fracture plane, particularly the meniscus and intermeniscal ligament, provides the surgeon with valuable insight as to how to best counsel patients on the success of treatment options, how to best prepare for operative treatment, and can guide the surgeon during open reduction to maximize treatment success. (orig.)

  8. Clinical significance of changes of plasma ET and NPY levels after treatment in patients with AMI

    International Nuclear Information System (INIS)

    Zhou Jinbao

    2005-01-01

    Objective: To investigate the changes of plasma ET and NPY levels in patients with AMI. Methods: Plasma ET and NPY levels were dynamically determined in 36 patients with AMI right after establishment of diagnosis and 8h, 24h, 4ph, 72h, 7d, 14d later. Levels in 35 healthy individuals were taken as control. Results: Before treatment was initiated, the levels of Et and Np in patients with AMI were significantly higher than those in controls (P <0.01). After one week of treatment, the levels dropped toward normal. Conclusion: Dynamic measurement of plasma ET and NPY levels in patients with AMI is of clinical importance. (authors)

  9. Long-term Nasal and Peri-oral Tightening by a Single Fractional Noninsulated Microneedle Radiofrequency Treatment.

    Science.gov (United States)

    Tanaka, Yohei

    2017-02-01

    Background: The skin tightening effects induced by non-insulated microneedle radiofrequency have proved long-lasting. Our previous three-dimensional volumetric assessment showed significant facial tightening for up to six months. However, nasal and peri-oral tightening effects lasted longer. The objective of this study was to investigate the distribution of the long-term volumetric reduction in facial area induced by a single fractional non-insulated microneedle radiofrequency treatment. Methods: Fifteen Asian patients underwent full facial skin tightening using a sharply tapered non-insulated microneedle radiofrequency applicator with a novel fractionated pulse mode. Three-dimensional volumetric assessments were performed at six and 12 months post-treatment. Patients rated their satisfaction using a 5-point scale at each follow up. Results: Objective assessments with superimposed three-dimensional color images showed significant volumetric reduction in the nasal and peri-oral areas at 12 months post-treatment in all patients. Median volumetric reductions at six and 12 months post-treatment were 13.1 and 12.3ml, respectively. All of the patients were satisfied with their results 12 months post-treatment. Side effects were not observed. Conclusions: This single fractional NIMNRF treatment provided long-lasting nasal and peri-oral tightening as shown via 3D volumetric assessment. Moreover, NIMNRF produced minimal complications, downtime, and few side effects. This approach provides safe and effective treatment of skin tightening.

  10. Impact of reduction of tinnitus intensity on patients' quality of life.

    Science.gov (United States)

    Drexler, Daniel; López-Paullier, Matías; Rodio, Silvana; González, Manuela; Geisinger, Darío; Pedemonte, Marisa

    2016-01-01

    Assess the impact of a reduction of tinnitus intensity achieved through sound stimulation during sleep on the improvement in the patients' quality of life. Acoustic stimuli consisted of a highly customized sound that reproduced the spectral and intensity characteristics of the tinnitus in each patient. This stimulus was uploaded into a portable electronic device and delivered through customized ear buds during sleep, every night for three months. Twelve patients with subjective idiopathic chronic tinnitus were studied. Results were assessed through: (1) the measurement in dB SPL of tinnitus intensity reduction over time; (2) the results of three psychometric tests: Tinnitus handicap inventory (THI), Tinnitus reaction questionnaire (TRQ), Tinnitus functional index (TFI); and (3) a Visual analog scale (VAS) for tinnitus annoyance. After three months of treatment, we observed an average decrease in tinnitus intensity of 14.1 dB SPL (p < 0.001), implying a 62% reduction of the perceived sound. This improvement was followed by a statistically significant decrease of TRQ (78%), THI (65%), and TFI (77%). These results suggested that the intensity reduction achieved through the protocol used in this study had a direct impact on the improvement in the patients' quality of life.

  11. Structural mode significance using INCA. [Interactive Controls Analysis computer program

    Science.gov (United States)

    Bauer, Frank H.; Downing, John P.; Thorpe, Christopher J.

    1990-01-01

    Structural finite element models are often too large to be used in the design and analysis of control systems. Model reduction techniques must be applied to reduce the structural model to manageable size. In the past, engineers either performed the model order reduction by hand or used distinct computer programs to retrieve the data, to perform the significance analysis and to reduce the order of the model. To expedite this process, the latest version of INCA has been expanded to include an interactive graphical structural mode significance and model order reduction capability.

  12. Membrane Bioreactor-Based Wastewater Treatment Plant in Saudi Arabia: Reduction of Viral Diversity, Load, and Infectious Capacity

    KAUST Repository

    Jumat, Muhammad

    2017-07-18

    A membrane bioreactor (MBR)-based wastewater treatment plant in Saudi Arabia was assessed over a nine-month period for virus removal efficiency. Viral diversity was detected using omics-based approaches. Log reduction values (LRV) of Adenoviruses (AdV) and Enteroviruses (EV) were enumerated using digital polymerase chain reaction (dPCR) and assessed for infectivity using fluorescence-based infection assays. MBR treatment was successful in reducing viral diversity. Plant viruses remained abundant in the treated effluent. Human enteric viruses were present in lower abundance than plant viruses, and were reduced by MBR at varying LRV. AdV copy numbers were reduced by 3.7-log. Infectious AdV was not detected in the effluent. EV copy numbers were reduced by 1.7-log post MBR and infectious EV decreased by an average of 2.0-log. Infectious EV was detected in the chlorinated effluent, occasionally in concentrations that approximate to its 50% infectious dose. Overall, results indicated that a MBR-based wastewater treatment plant (WWTP) effectively reduces viral diversity, viral load, and infectious capacity by up to 4-logs. These findings suggest potential concerns associated with plant and human enteric viruses for reuse events in this country. Local guidelines for assessment of treated water quality should take into consideration both infectious viral concentration and LRV.

  13. Possible applications of Neuromuscular Taping in pain reduction in Multiple Sclerosis subject: a preliminary report

    Directory of Open Access Journals (Sweden)

    Carmine Berlingieri

    2016-12-01

    Full Text Available Pain is a common disabling symptom in patients with Multiple Sclerosis (MS. It has been indicated that pain prevalence in MS patients is between 29–86 %. It is evident that most MS patients requiring treatment will be also searching pain related treatments to assist in day to day activities. Neuropathic pain is a difficult symptom and is generally inadequately relieved even though different rehabilitative approaches may be used. Neuromuscular Taping inducing micro-movements by stimulating receptors in the skin has been described in literature as a possible intervention in neurological and orthopedic rehabilitation improving mobility and in pain reduction. The aim of this preliminary report was to analyze the effect and to evaluate the possible applications of Neuromuscular Taping (NMT in patients with MS in order to reduce pain in comparison to the Transcutaneous Electrical Nerve Stimulation (TENS and to physical rehabilitation treatment alone. We observed that NMT together with standard physical rehabilitation was able to reduce neuropathic pain to greater lengths, with statistically significant differences between pre and post treatment, compared to the other treatments evaluated. This study showed increased efficacy in pain reduction when NMT was applied to standard physical treatment in long standing pain conditions. Neuromuscular Taping may constitute a low cost treatment strategy for neuropathic pain conditions in MS.

  14. Reduction of blue tungsten oxide

    International Nuclear Information System (INIS)

    Wilken, T.; Wert, C.; Woodhouse, J.; Morcom, W.

    1975-01-01

    A significant portion of commercial tungsten is produced by hydrogen reduction of oxides. Although several modes of reduction are possible, hydrogen reduction is used where high purity tungsten is required and where the addition of other elements or compounds is desired for modification of the metal, as is done for filaments in the lamp industry. Although several investigations of the reduction of oxides have been reported (1 to 5), few principles have been developed which can aid in assessment of current commercial practice. The reduction process was examined under conditions approximating commercial practice. The specific objectives were to determine the effects of dopants, of water vapor in the reducing atmosphere, and of reduction temperature upon: (1) the rate of the reaction by which blue tungsten oxide is reduced to tungsten metal, (2) the intermediate oxides associated with reduction, and (3) the morphology of the resulting tungsten powder

  15. BARIUM REDUCTION OF INTUSSUSCEPTION IN INFANCY

    Science.gov (United States)

    Denenholz, Edward J.; Feher, George. S.

    1955-01-01

    Barium enema reduction was used as the initial routine treatment in 29 infants with intussusception. In 22 of them the intussusception was reduced by this means. In three of eight patients operated upon the intussusception was found to be reduced. Four of the remaining five patients had clinical or x-ray evidence of complications before reduction by barium enema was attempted. Twenty-one of the patients, all of whom were observed in private practice, were treated without admission to the hospital. After reduction, these patients were observed closely by the clinician. None of these patients showed clinical or x-ray signs of complications before reduction. Certain clinical and roentgen criteria must be satisfied before it can be concluded that reduction by barium enema is complete. If there are clinical signs of complications with x-ray evidence of small bowel obstruction, only a very cautious attempt at hydrostatic reduction should be made. As the time factor is generally a reliable clinical guide to reducibility, the late cases should be viewed with greater caution. Long duration of symptoms, however, is not per se a contraindication to an attempt at hydrostatic reduction. PMID:13230908

  16. Clinical significance of changes of serum IGF-II, IL-2 and SOD levels after treatment in pediatric patients with bronchial pneumonia

    International Nuclear Information System (INIS)

    Zhou Hong; Hu Yan; Wei Guoyu; Huang Jufeng

    2011-01-01

    Objective: To investigate the clinical significance of changes of serum IGF-II, IL-2 and SOD levels after treatment in pediatric patients with bronchial pneumonia. Methods: Serum IGF-II, IL-2 and SOD (with RIA) levels were measured in 33 pediatric patients with bronchial pneumonia both before and after treatment as well as in 35 controls. Results: Before treatment, serum IGF-II levels in the patients were significantly higher than those in controls (P 0.05). Conclusion: Changes of serum IGF-II, IL-2 and SOD levels both before and after treatment could reflect the diseases status of the patients as well as the progress of diseases, and might be of prognostic importance in pediatric patients with bronchial pneumonia. (authors)

  17. Mechanisms of Action Contributing to Reductions in Suicide Attempts Following Brief Cognitive Behavioral Therapy for Military Personnel: A Test of the Interpersonal-Psychological Theory of Suicide.

    Science.gov (United States)

    Bryan, Craig J; Wood, David S; May, Alexis; Peterson, Alan L; Wertenberger, Evelyn; Rudd, M David

    2018-01-01

    Brief cognitive behavioral therapy (BCBT) is associated with significant reductions in suicide attempts among military personnel. However, the underlying mechanisms of action contributing to reductions in suicide attempts in effective psychological treatments remain largely unknown. The present study conducted a secondary analysis of a randomized controlled trial of BCBT versus treatment as usual (TAU) to examine the mechanisms of action hypothesized by the interpersonal-psychological theory of suicide (IPT): perceived burdensomeness, thwarted belongingness, and fearlessness about death. In a sample of 152 active duty U.S. Army personnel with recent suicide ideation or attempts, there were significantly fewer suicide attempts in BCBT, but there were no differences between treatment groups from baseline to 6 months postbaseline on any of the 3 IPT constructs or their interactions. Tests of the moderated mediation failed to support an indirect effect for the IPT model, regardless of which IPT variables were specified as mediators or moderators. Results suggest that the IPT's hypothesized mechanisms of action do not account for reductions in suicide attempts in BCBT. Implications for clinical practice and research are discussed.

  18. Long term substitution treatment (maintenance treatment of opioid dependent persons

    Directory of Open Access Journals (Sweden)

    Wirl, Charlotte

    2007-03-01

    Full Text Available Health political background: Methadone substitution treatment in Germany is introduced in 1988 in the framework of a scientific pilot study in North Rhein Westphalia. Recent statistics show that by now a broad offer of substitution treatment exists. From 1 June 2002 to 31 December 2003 113,000 substitution treatments have been recorded as being started of which around 56,000 have been recorded as ongoing treatments by 1 December 2003. Scientific background: Substitution treatment (treatment of opioid-dependent persons using substitution substances is one part of addiction treatment. Its goals are harm reduction and the stabilisation of opioid dependent persons. Integration of opioid-dependent persons in a treatment-setting, reduction of consumption of psychoactive substances, reduction of risk behaviour (primarily related to infectious diseases, decrease of mortality and improvements concerning the social, psychic and physic situation are seen as a success of substitution treatment as maintenance therapy. Research questions: The aim of this HTA report is to investigate which indicators can be used to evaluate the effectiveness of substitution treatment. Based on these indicators an evaluation of the medical, social and economical benefit of substitution treatment - also in relation to abstinence oriented treatment - is carried out. Methods: A systematic literature search was performed in 31 international databases which yielded 2451 articles with publication date between 1995 and February 2005. Results: After a twofold selection process 32 publications were included for assessment and 276 publications were used as background literature. Despite serious restrictions due to selection bias and dropout in most studies focusing on substitution treatment, reduction of consumption of illegal opioids, reduction of risk behaviour, criminal behaviour, mortality and incidence of HIV can be seen as an empirically proven success of substitution treatment

  19. Reduction of Aeromonas hidrophyla biofilm on stainless stell surface by essential oils

    Science.gov (United States)

    Millezi, Alessandra Farias; Cardoso, Maria das Graças; Alves, Eduardo; Piccoli, Roberta Hilsdorf

    2013-01-01

    This study demonstrates the possibility of using sanitizing detergents based on natural products for the elimination and/or reduction of Aeromonas hydrophila biofilm formed on stainless steel surfaces. The goal of this work was to determine the reduction effect of sanitizing detergents containing essential oils of Thymus vulgaris (thyme) and Cymbopogon citratus (lemongrass) on biofilm formed by A. hydrophila on AISI 304 stainless steel coupons, using UHT skimmed milk as substratum. There was adhesion and biofilm formation by A. hydrophila at 28 °C, presenting 7.60 log cfu.cm−2 after the fourth day of cultivation. There was no significant difference between the lemongrass treatment and that of the thyme oil (p 0.05). The treatment with lemongrass solution reduced the biofilm by 4.51 log cfu cm−2 at 25 °C. The thyme detergent also reduced the number of cfu cm−2 by 3.84 log cycles at 25 °C. The use of the lemongrass and thyme solutions efficiently reduced the A. hydrophila biofilm. PMID:24159286

  20. Reduction of Aeromonas hidrophyla biofilm on stainless stell surface by essential oils

    Directory of Open Access Journals (Sweden)

    Alessandra Farias Millezi

    2013-01-01

    Full Text Available This study demonstrates the possibility of using sanitizing detergents based on natural products for the elimination and/or reduction of Aeromonas hydrophila biofilm formed on stainless steel surfaces. The goal of this work was to determine the reduction effect of sanitizing detergents containing essential oils of Thymus vulgaris (thyme and Cymbopogon citratus (lemongrass on biofilm formed by A. hydrophila on AISI 304 stainless steel coupons, using UHT skimmed milk as substratum. There was adhesion and biofilm formation by A. hydrophila at 28 ºC, presenting 7.60 log cfu.cm-2 after the fourth day of cultivation. There was no significant difference between the lemongrass treatment and that of the thyme oil (p 0.05. The treatment with lemongrass solution reduced the biofilm by 4.51 log cfu cm-2 at 25 ºC. The thyme detergent also reduced the number of cfu cm-2 by 3.84 log cycles at 25 ºC. The use of the lemongrass and thyme solutions efficiently reduced the A. hydrophila biofilm.

  1. Meta-Analysis of the Reduction of Norovirus and Male-Specific Coliphage Concentrations in Wastewater Treatment Plants.

    Science.gov (United States)

    Pouillot, Régis; Van Doren, Jane M; Woods, Jacquelina; Plante, Daniel; Smith, Mark; Goblick, Gregory; Roberts, Christopher; Locas, Annie; Hajen, Walter; Stobo, Jeffrey; White, John; Holtzman, Jennifer; Buenaventura, Enrico; Burkhardt, William; Catford, Angela; Edwards, Robyn; DePaola, Angelo; Calci, Kevin R

    2015-07-01

    Human norovirus (NoV) is the leading cause of foodborne illness in the United States and Canada. Wastewater treatment plant (WWTP) effluents impacting bivalve mollusk-growing areas are potential sources of NoV contamination. We have developed a meta-analysis that evaluates WWTP influent concentrations and log10 reductions of NoV genotype I (NoV GI; in numbers of genome copies per liter [gc/liter]), NoV genotype II (NoV GII; in gc/liter), and male-specific coliphage (MSC; in number of PFU per liter), a proposed viral surrogate for NoV. The meta-analysis included relevant data (2,943 measurements) reported in the scientific literature through September 2013 and previously unpublished surveillance data from the United States and Canada. Model results indicated that the mean WWTP influent concentration of NoV GII (3.9 log10 gc/liter; 95% credible interval [CI], 3.5, 4.3 log10 gc/liter) is larger than the value for NoV GI (1.5 log10 gc/liter; 95% CI, 0.4, 2.4 log10 gc/liter), with large variations occurring from one WWTP to another. For WWTPs with mechanical systems and chlorine disinfection, mean log10 reductions were -2.4 log10 gc/liter (95% CI, -3.9, -1.1 log10 gc/liter) for NoV GI, -2.7 log10 gc/liter (95% CI, -3.6, -1.9 log10 gc/liter) for NoV GII, and -2.9 log10 PFU per liter (95% CI, -3.4, -2.4 log10 PFU per liter) for MSCs. Comparable values for WWTPs with lagoon systems and chlorine disinfection were -1.4 log10 gc/liter (95% CI, -3.3, 0.5 log10 gc/liter) for NoV GI, -1.7 log10 gc/liter (95% CI, -3.1, -0.3 log10 gc/liter) for NoV GII, and -3.6 log10 PFU per liter (95% CI, -4.8, -2.4 PFU per liter) for MSCs. Within WWTPs, correlations exist between mean NoV GI and NoV GII influent concentrations and between the mean log10 reduction in NoV GII and the mean log10 reduction in MSCs. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  2. SGLT2 inhibitors: their potential reduction in blood pressure.

    Science.gov (United States)

    Maliha, George; Townsend, Raymond R

    2015-01-01

    The sodium glucose co-transporter 2 (SGLT2) inhibitors represent a promising treatment option for diabetes and its common comorbidity, hypertension. Emerging data suggests that the SGLT2 inhibitors provide a meaningful reduction in blood pressure, although the precise mechanism of the blood pressure drop remains incompletely elucidated. Based on current data, the blood pressure reduction is partially due to a combination of diuresis, nephron remodeling, reduction in arterial stiffness, and weight loss. While current trials are underway focusing on cardiovascular endpoints, the SGLT2 inhibitors present a novel treatment modality for diabetes and its associated hypertension as well as an opportunity to elucidate the pathophysiology of hypertension in diabetes. Copyright © 2015 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  3. Efficacy of intradermal mesotherapy in cellulite reduction - Conventional and high-frequency ultrasound monitoring results.

    Science.gov (United States)

    Sylwia, Malinowska; Krzysztof, Mlosek Robert

    2017-10-01

    Cellulite affects the majority of women and is an unacceptable cosmetic defect. Therefore, effective methods for cellulite reduction are being sought. Intradermal mesotherapy is one of such methods. The aim of the study was to assess the efficacy of intradermal mesotherapy in cellulite reduction, using conventional and high-frequency ultrasound. Twenty-one women with cellulite underwent a series of intradermal mesotherapy procedures. The following parameters were assessed: thickness of epidermis, dermis and hypodermis, echogenicity of dermis and the surface area of serrated hypodermis-dermis junction. Furthermore, the thigh circumference was measured; body mass index and cellulite severity were assessed based on photographs using Nürnberger-Müller's scale. Intradermal mesotherapy reduced severity of cellulite. The surface area of serrated hypodermis-dermis junction and hypodermis thickness decreased significantly as compared to baseline. Cellulite reduction was also confirmed by palpation, decreased thigh circumference and the Nürnberger-Müller's grade. There were no statistically significant changes in epidermis or dermis thickness, body weight and the BMI. Intradermal mesotherapy offers effective cellulite reduction. It is a simple and safe treatment, which makes it popular. Further research in mesotherapy is essential due to a limited number of published studies. Ultrasound is a useful method to monitor intradermal mesotherapy and assess its efficacy.

  4. Degradation of azo dyes by sequential Fenton's oxidation and aerobic biological treatment

    International Nuclear Information System (INIS)

    Tantak, Nilesh P.; Chaudhari, Sanjeev

    2006-01-01

    A two stage sequential Fenton's oxidation followed by aerobic biological treatment train was used to achieve decolorization and to enhance mineralization of azo dyes, viz. Reactive Black 5 (RB5), Reactive Blue 13 (RB13), and Acid Orange 7 (AO7). In the first stage, Fenton's oxidation process was used while in the second stage aerobic sequential batch reactors (SBRs) were used as biological process. Study was done to evaluate effect of pH on Fenton's oxidation process. Results reveal that pH 3 was optimum pH for achieving decolorization and dearomatization of dyes by Fenton's process. Degradation of dye was assessed by COD reduction and reduction in aromatic amines (naphthalene chromophores) which was measured by reduction in absorbance at 200 nm. More than 95% of color was removed with Fenton's oxidation process in all dyes. In overall treatment train 81.95, 85.57, and 77.83% of COD reduction was achieved in RB5, RB13, and AO7 dyes, respectively. In the Fenton's oxidation process 56, 24.5, and 80% reduction in naphthalene group was observed in RB5, RB13, and AO7, respectively, which further increased to 81.34, 68.73, and 92% after aerobic treatment. Fenton's oxidation process followed by aerobic SBRs treatment sequence seems to be viable method for achieving significant degradation of azo dye

  5. Time to transient and stable reductions in hot flush frequency in postmenopausal women using conjugated estrogens/bazedoxifene.

    Science.gov (United States)

    Pinkerton, JoAnn V; Bushmakin, Andrew G; Abraham, Lucy; Komm, Barry S; Bobula, Joel

    2017-09-01

    This post hoc analysis estimates time to transient and stable reductions in hot flush frequency in postmenopausal women using conjugated estrogens/bazedoxifene. In the 12-week Selective estrogens, Menopause, And Response to Therapy (SMART)-2 trial of conjugated estrogens/bazedoxifene 0.45 mg/20 mg and 0.625 mg/20 mg, women with at least seven moderate/severe hot flushes per day or 50 per week at screening recorded frequency of moderate/severe hot flushes in diaries. Nonparametric models and SAS Proc Lifetest were used to estimate median times to various degrees of transient reductions (first day with improvement) and stable reductions (first day with improvement maintained through study's end) in hot flush frequency. Treatment produced transient hot flush reductions of 40% to 100% and stable reductions of 30% to 100% significantly faster than placebo. Median time to a transient 50% reduction was 8 days for conjugated estrogens/bazedoxifene 0.45 mg/20 mg, 9.5 for 0.625 mg/20 mg, and 10 for placebo; median time to a stable 50% reduction was 9, 10, and 38 days. Median time to a transient 90% reduction was 32 and 22.5 days for 0.45 mg/20 mg and 0.625 mg/20 mg, and median time to a stable 90% reduction was 83 and 29 days, respectively; median times to transient/stable 90% reductions were not reached during the 12-week study in the placebo group. Although not all women using conjugated estrogens/bazedoxifene achieve permanent elimination of hot flushes, the frequency is likely to be substantially reduced during the first week to month. Women can expect approximately 50% reduction in hot flush frequency after about 8 to 10 days, and sustained improvement with continued treatment.

  6. Effects of barium chloride treatment of uranium mill tailings and ore on radon emanation and 226Ra levels. Progress report

    International Nuclear Information System (INIS)

    Ibrahim, S.A.; Flot, S.L.

    1983-01-01

    The purpose of this study was to investigate the effect of barium chloride treatments on: reduction of 222 Rn emanation from mill wastes; reduction of 226 Ra levels in wastewater; and decreased leachability of 226 Ra from mill wastes. Baseline 226 Ra concentrations were determined for ore and tailings as well as radon emanation fractions. Uranium ore was treated with soluble barium at concentrations of 10, 25, 50, and 100 mg per litre of slurry. The leach-liquor declined in 226 Ra concentration by as much as 50%. When soluble potassium as well as barium was used in the treatment process at equal concentrations of 10, 25, 50, and 100 mg per litre of slurry, a similar reduction was observed. No significant difference was noted between the two treatment regimes. An accelerated leaching experiment was performed on the ore treated with barium chloride. All treatment groups except that treated with 10 mg of soluble barium per litre of slurry showed significant decreases in leachability. Available 222 Rn (corresponds with radon emanation fraction) was measured in treated and untreated ore. Ore treated with concentrations of Ba ++ up to 1.00 mg per gram of ore did not show a statistically significant reduction in available 222 Rn, however when potassium sulfate was also added, a significant decline was noted. This study suggests that barium chloride treatments reduce radon emanation from mill wastes and reduce 226 Ra levels in wastewater. Leachability of 226 Ra from treated samples decreased markedly. 19 references, 8 figures, 7 tables

  7. Effects of combined treatments of irradiation and antimicrobial coatings on reduction of food pathogens in broccoli florets

    Energy Technology Data Exchange (ETDEWEB)

    Takala, P.N.; Salmieri, S.; Vu, K.D. [INRS-Institut Armand-Frappier, Research Laboratories in Sciences Applied to Food, Canadian Irradiation Centre, 531, Blvd des Prairies, Laval, QC, H7V 1B7 (Canada); Lacroix, M., E-mail: Monique.Lacroix@iaf.inrs.ca [INRS-Institut Armand-Frappier, Research Laboratories in Sciences Applied to Food, Canadian Irradiation Centre, 531, Blvd des Prairies, Laval, QC, H7V 1B7 (Canada)

    2011-12-15

    The effect of combined treatment of antimicrobial coatings and {gamma}-radiation on reduction of food pathogens such as Listeria monocytogenes, Escherichia coli, and Salmonella Typhimurium was evaluated in broccoli florets. Broccoli florets were inoculated with pathogenic bacteria at 10{sup 6} CFU/g. Inoculated florets were then coated with methylcellulose-based coating containing various mixtures of antimicrobial agents: organic acids (OAs) plus lactic acid bacteria metabolites (LABs), OA plus citrus extract (CE), OA plus CE plus spice mixture (SM), and OA plus rosemary extract (RE). Coated florets were irradiated with various doses (0-3.3 kGy), and microbial analyses were used to calculate the D{sub 10} value and radiosensitive relative. The coating containing OA plus CE was the most effective formulation for increasing the sensitization of Escherichia coli by 2.4 times as compared to the control without the antimicrobial coating. For Salmonella Typhimurium, coating containing OA plus LAB was the most effective formulation, increasing radiosensitivity by 2.4 times as well. All antimicrobial coatings had almost the same effect of increasing the sensitivity of Listeria monocytogenes (from 1.31 to 1.45 times) to {gamma}-irradiation. - Highlights: > Demonstrate scientifically the synergistic effect of the combined treatment of gamma-irradiation and natural antimicrobial coating in reduction of food pathogens in broccoli. > The coating containing organic acids plus citrus extract was the most efficient formulation for increasing the sensitization of E. coli by 2.40 times as compared to the control. > The coating containing organic acids plus lactic acid bacteria metabolites was the most effective formulation causing the sensitization of S. Typhimurium to {gamma}-irradiation by 2.4 times. > Potential in application of developed formulations to protect food products against food pathogens.

  8. Effects of combined treatments of irradiation and antimicrobial coatings on reduction of food pathogens in broccoli florets

    International Nuclear Information System (INIS)

    Takala, P.N.; Salmieri, S.; Vu, K.D.; Lacroix, M.

    2011-01-01

    The effect of combined treatment of antimicrobial coatings and γ-radiation on reduction of food pathogens such as Listeria monocytogenes, Escherichia coli, and Salmonella Typhimurium was evaluated in broccoli florets. Broccoli florets were inoculated with pathogenic bacteria at 10 6 CFU/g. Inoculated florets were then coated with methylcellulose-based coating containing various mixtures of antimicrobial agents: organic acids (OAs) plus lactic acid bacteria metabolites (LABs), OA plus citrus extract (CE), OA plus CE plus spice mixture (SM), and OA plus rosemary extract (RE). Coated florets were irradiated with various doses (0-3.3 kGy), and microbial analyses were used to calculate the D 10 value and radiosensitive relative. The coating containing OA plus CE was the most effective formulation for increasing the sensitization of Escherichia coli by 2.4 times as compared to the control without the antimicrobial coating. For Salmonella Typhimurium, coating containing OA plus LAB was the most effective formulation, increasing radiosensitivity by 2.4 times as well. All antimicrobial coatings had almost the same effect of increasing the sensitivity of Listeria monocytogenes (from 1.31 to 1.45 times) to γ-irradiation. - Highlights: → Demonstrate scientifically the synergistic effect of the combined treatment of gamma-irradiation and natural antimicrobial coating in reduction of food pathogens in broccoli. → The coating containing organic acids plus citrus extract was the most efficient formulation for increasing the sensitization of E. coli by 2.40 times as compared to the control. → The coating containing organic acids plus lactic acid bacteria metabolites was the most effective formulation causing the sensitization of S. Typhimurium to γ-irradiation by 2.4 times. → Potential in application of developed formulations to protect food products against food pathogens.

  9. A Long-Term Follow-Up of Treatment for Severe Self-Injury.

    Science.gov (United States)

    Williams, Don E.; And Others

    1994-01-01

    Treatment of a woman with severe mental retardation with the Self-Injurious Behavior Inhibiting System (SIBIS) resulted in significant reductions in SIB behavior which generalized to the natural environment and the brief follow-up sessions. (Author/DB)

  10. Risk reductions for cardiovascular disease with pravastatin treatment by dyslipidemia phenotype: a post hoc analysis of the MEGA Study.

    Science.gov (United States)

    Nishiwaki, Masato; Ikewaki, Katsunori; Ayaori, Makoto; Mizuno, Kyoichi; Ohashi, Yasuo; Ohsuzu, Fumitaka; Ishikawa, Toshitsugu; Nakamura, Haruo

    2013-03-01

    The beneficial effect of statins for cardiovascular disease (CVD) prevention has been well established. However, the effectiveness among different phenotypes of dyslipidemia has not been confirmed. We evaluated the effect of pravastatin on the incidence of CVD in relation to the phenotype of dyslipidemia. The MEGA Study evaluated the effect of low-dose pravastatin on primary prevention of CVD in 7832 Japanese patients, who were randomized to diet alone or diet plus pravastatin and followed for more than 5 years. These patients were classified into phenotype IIa (n=5589) and IIb (n=2041) based on the electrophoretic pattern for this post hoc analysis. In the diet group there was no significant difference in the incidence of coronary heart disease (CHD), stroke, CVD, and total mortality between the two phenotypes. Phenotype IIb patients, compared to phenotype IIa, had lower levels of high-density lipoprotein cholesterol (HDL-C) and a significantly higher incidence of CVD in relation to a low HDL-C level (dyslipidemia. Significant risk reductions were observed for CHD by 38% (p=0.04) and CVD by 31% (p=0.02) in type IIa dyslipidemia but not in phenotype IIb. Pravastatin therapy provided significant risk reductions for CHD and CVD in patients with phenotype IIa dyslipidemia, but not in those with phenotype IIb dyslipidemia. Copyright © 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  11. Significant social events and increasing use of life-sustaining treatment: trend analysis using extracorporeal membrane oxygenation as an example.

    Science.gov (United States)

    Chen, Yen-Yuan; Chen, Likwang; Huang, Tien-Shang; Ko, Wen-Je; Chu, Tzong-Shinn; Ni, Yen-Hsuan; Chang, Shan-Chwen

    2014-03-04

    Most studies have examined the outcomes of patients supported by extracorporeal membrane oxygenation as a life-sustaining treatment. It is unclear whether significant social events are associated with the use of life-sustaining treatment. This study aimed to compare the trend of extracorporeal membrane oxygenation use in Taiwan with that in the world, and to examine the influence of significant social events on the trend of extracorporeal membrane oxygenation use in Taiwan. Taiwan's extracorporeal membrane oxygenation uses from 2000 to 2009 were collected from National Health Insurance Research Dataset. The number of the worldwide extracorporeal membrane oxygenation cases was mainly estimated using Extracorporeal Life Support Registry Report International Summary July 2012. The trend of Taiwan's crude annual incidence rate of extracorporeal membrane oxygenation use was compared with that of the rest of the world. Each trend of extracorporeal membrane oxygenation use was examined using joinpoint regression. The measurement was the crude annual incidence rate of extracorporeal membrane oxygenation use. Each of the Taiwan's crude annual incidence rates was much higher than the worldwide one in the same year. Both the trends of Taiwan's and worldwide crude annual incidence rates have significantly increased since 2000. Joinpoint regression selected the model of the Taiwan's trend with one joinpoint in 2006 as the best-fitted model, implying that the significant social events in 2006 were significantly associated with the trend change of extracorporeal membrane oxygenation use following 2006. In addition, significantly social events highlighted by the media are more likely to be associated with the increase of extracorporeal membrane oxygenation use than being fully covered by National Health Insurance. Significant social events, such as a well-known person's successful extracorporeal membrane oxygenation use highlighted by the mass media, are associated with the use of

  12. Potassium permanganate in drinking water treatment: reduction of organic matter and disinfection by-products; Permanganato potasico en potabilizacion de aguas : Reduccion de materias organicas y subproductos de desinfeccion

    Energy Technology Data Exchange (ETDEWEB)

    Marin Galvin, R. [Universidad de Cordoba (Spain)

    1997-09-01

    This paper deals on the results obtained with the use of potassium permanganate (KMnO{sub 4}) in drinking water treatment. Thus, permanganization of water before chlorination implied the reduction of 50% in odors. Moreover, oxidation with KMnO{sub 4} reduced UV absorbency of water (UV-254nm) by a 17% more as compared with that obtained by chlorine. Finally as far as the production of organo-chlorinated compounds, the treatment with (potassium permanganate+chlorine) allowed an important reduction vs the conventional chlorination: only a 65% of total THMs were generated (between 58% and 80% of specific THM) and between 30 % and 68% of tri-and tetra-phenolchlorinated, as compared with only chlorination. (Author)

  13. [Treatment of multi-segment fracture of complex femoral shaft with instrument-assisted reduction combined with intramedullary interlocking nail fixation].

    Science.gov (United States)

    Fan, Ke-Jie; Chen, Ke; Ma, Wen-Long; Tian, Ke-Wei; Ye, Ye; Chen, Hong-Gan; Tang, Yan-Feng; Cai, Hong-Min

    2018-05-25

    To investigate the effect of minimally invasive mini-incision and instrumented reduction combined with interlocking intramedullary nailing in the treatment of patients with multi-segment fracture of complex femoral shaft. From January 2013 to January 2016, 32 patients with multiple fractures segments of femoral shaft were treated with instrumentation-assisted reduction combined with interlocking intramedullary nailing, including 22 males and 10 females with an average age of 45 years old ranging 17 to 68 years old. The time from injured to operation was 5 to 10 days with an average of 7 days. After admission, routine tibial tubercle or supracondylar bone traction was performed. The patient's general condition was evaluated, the operation time and intraoperative blood loss were recorded. According to Thorsen femoral fracture morphology evaluation criteria and Hohl knee function evaluation of postoperative efficacy, postoperative fracture healing, complications and postoperative recovery of limb function were observed. All patients were followed up for 6 to 24 months with an average of 12 months. The operative time ranged from 48 to 76 minutes with an average of 67 min. The intraoperative blood loss was 150 to 400 ml with an average of 220 ml. The surgical incisions all achieved grade A healing. The fractures reached the clinical standard of healing. The fracture healing time ranged from 4.2 to 10.8 months with an average of 5.7 months. There were no nonunion, incision infection and internal fixation fracture, failure and other complications. According to Thorsen femoral fracture morphology evaluation criteria, the result was excellent in 28 cases, good in 3 cases, fair in 1 case. According to Hohl knee function evaluation criteria, the result was excellent in 30 cases, good in 2 cases. Instrument-assisted reduction combined with interlocking intramedullary nail fixation is a safe and effective method for the treatment of complex femoral shaft fractures. It has

  14. TREATMENT AND CONSEQUENCES OF 345 ZYGOMA COMPLEX FRACTURES

    Directory of Open Access Journals (Sweden)

    Mojca Knez

    2008-05-01

    The best results of treatment come with a short time between the injury and surgical treatment. There is a statistical significant reduction of the injuries of the infraorbiral nervewhen using an open reposition and fixation with titanium miniplates, where one can seethe infraorbital nerve and decompress it if neccessary. We also found out that the risk forthe injury of the infraorbital nerve is correlated to the age of the patient, being 2 % biggerfor each year of the patient

  15. Evidence for significantly enhancing reduction of Azo dyes in Escherichia coli by expressed cytoplasmic Azoreductase (AzoA) of Enterococcus faecalis.

    Science.gov (United States)

    Feng, J; Heinze, T M; Xu, H; Cerniglia, C E; Chen, H

    2010-05-01

    Although cytoplasmic azoreductases have been purified and characterized from various bacteria, little evidence demonstrating that these azoreductases are directly involved in azo dye reduction in vivo is known. In order to evaluate the contribution of the enzyme to azo dye reduction in vivo, experiments were conducted to determine the effect of a recombinant cytoplasmic azoreductase (AzoA) from Enterococcus faecalis expressed in Escherichia coli on the rate of metabolism of Methyl Red, Ponceau BS and Orange II. The intact cells that contained IPTG induced AzoA had a higher rate of dye reduction with increases of 2 (Methyl Red), 4 (Ponceau BS) and 2.6 (Orange II)-fold compared to noninduced cells, respectively. Metabolites of Methyl Red isolated from induced cultures were identified as N,N-dimethyl-p-phenylenediamine and 2-aminobenzoic acid through liquid chromatography electrospray ionization tandem mass spectrometry (LC/ESI-MS/MS) analyses. In conclusion, our data demonstrate that AzoA from Ent. faecalis is capable of increasing the reduction of azo dyes in intact E. coli cells and that cytoplasmic azoreductase is involved in bacterial dye degradation in vivo.

  16. Significant change of local atomic configurations at surface of reduced activation Eurofer steels induced by hydrogenation treatments

    Energy Technology Data Exchange (ETDEWEB)

    Greculeasa, S.G.; Palade, P.; Schinteie, G. [National Institute for Materials Physics, P.O. Box MG-7, 77125, Bucharest-Magurele (Romania); Kuncser, A.; Stanciu, A. [National Institute for Materials Physics, P.O. Box MG-7, 77125, Bucharest-Magurele (Romania); University of Bucharest, Faculty of Physics, 77125, Bucharest-Magurele (Romania); Lungu, G.A. [National Institute for Materials Physics, P.O. Box MG-7, 77125, Bucharest-Magurele (Romania); Porosnicu, C.; Lungu, C.P. [National Institute for Laser, Plasma and Radiation Physics, 77125, Bucharest-Magurele (Romania); Kuncser, V., E-mail: kuncser@infim.ro [National Institute for Materials Physics, P.O. Box MG-7, 77125, Bucharest-Magurele (Romania)

    2017-04-30

    Highlights: • Engineering of Eurofer slab properties by hydrogenation treatments. • Hydrogenation modifies significantly the local atomic configurations at the surface. • Hydrogenation increases the expulsion of the Cr atoms toward the very surface. • Approaching binomial atomic distribution by hydrogenation in the next surface 100 nm. - Abstract: Reduced-activation steels such as Eurofer alloys are candidates for supporting plasma facing components in tokamak-like nuclear fusion reactors. In order to investigate the impact of hydrogen/deuterium insertion in their crystalline lattice, annealing treatments in hydrogen atmosphere have been applied on Eurofer slabs. The resulting samples have been analyzed with respect to local structure and atomic configuration both before and after successive annealing treatments, by X-ray diffractometry (XRD), scanning electron microscopy and energy dispersive spectroscopy (SEM-EDS), X-ray photoelectron spectroscopy (XPS) and conversion electron Mössbauer spectroscopy (CEMS). The corroborated data point out for a bcc type structure of the non-hydrogenated alloy, with an average alloy composition approaching Fe{sub 0.9}Cr{sub 0.1} along a depth of about 100 nm. EDS elemental maps do not indicate surface inhomogeneities in concentration whereas the Mössbauer spectra prove significant deviations from a homogeneous alloying. The hydrogenation increases the expulsion of the Cr atoms toward the surface layer and decreases their oxidation, with considerable influence on the surface properties of the steel. The hydrogenation treatment is therefore proposed as a potential alternative for a convenient engineering of the surface of different Fe-Cr based alloys.

  17. Prevention of enamel demineralization during orthodontic treatment: an in vitro comparative study.

    Science.gov (United States)

    Bichu, Yashodhan M; Kamat, Nandini; Chandra, Pavan Kumar; Kapoor, Aditi; Razmus, Thomas; Aravind, N K S

    2013-01-01

    Enamel demineralization is considered to be the most prevalent and significant iatrogenic effect associated with fixed orthodontic treatment and can seriously jeopardize both tooth longevity and dental esthetics. This in vitro study was undertaken to compare the effectiveness of four different commercially available surface treatment medicaments for the inhibition of enamel demineralization. Seventy-five intact maxillary premolars extracted from patients undergoing orthodontic treatment were divided into five equal groups and were subjected to one of the following protocols: no treatment (control group) or treatment with one of the following four medicaments: fluoride varnish (Fluor Protector [FP]), casein phosphopeptide-amorphous calcium phosphate (GC Tooth Mousse [TM]), calcium sodium phosphosilicate (SHY-NM), and casein phosphopeptide-amorphous calcium phosphate with fluoride (GC Tooth Mousse Plus [TMP]). All the teeth were subjected to ten Cate demineralization solution?for 96 hours and subsequently evaluated under polarized light microscopy to obtain the mean depths of enamel demineralization. One-way analysis of variance and Bonferroni comparison tests were used to obtain statistically significant differences between the five different groups at P < .05. All four surface treatment medicaments provided statistically significant reduction in the depths of enamel demineralization as compared with the control group. FP provided the greatest protection of enamel surface in terms of reduction of lesion depth, followed by TMP, SHY-NM, and TM. The use of these commercially available medicaments could prove to be beneficial for patients undergoing orthodontic treatment and who are at a risk for developing enamel decalcification.

  18. Intussusception in children: Hydrostatic reduction under US guidance - own experience

    International Nuclear Information System (INIS)

    Roik, D.; Brzewski, M.; Biejat, A.; Marcinski, M.

    2008-01-01

    Intussusception in children is a common abdominal emergency. Recent years have brought a New promising method of nonsurgical invagination treatment, hydrostatic reduction under sonographic (US) guidance. The major advantage of this method is lack of the ionized radiation. The aim of our study is to asses the safety and effectiveness of hydrostatic reduction under US guidance used as a first choice method of invagination treatment in our department. >From July 2006 to December 2007, 33 procedures of hydrostatic reduction under US guidance were performed in 27 children, aged from 7 months to 6 years and 10 months. The procedure was performed in US room by radiologist and surgeon with the use of self-constructed set for saline enema. The sedation of patient was routinely performed. The initial procedure was effective in 23 patients (pts) (85%). In 5 pts the recurrence of intussusception occurred and in 3 of them next attempt of the reduction was successful. In 4 cases the initial procedures failed, and those children were operated. Total amount of 6 pts underwent an operation. We do not observe any complications connected with the procedure. Hydrostatic reduction of children intusussception under US-guidance is safe and effective method. Our initial results meet the recommended limits of successful reduction rates. It encouraged us to evaluation and further implementation of this method. Water enema is a first choice method of invagination treatment in our hospital. (authors)

  19. Clinical significance of determination of changes of serum TSGF and plasma VEGF levels after treatment in patients with endometriosis

    International Nuclear Information System (INIS)

    Shi Shaohong; Tian Xiaoping

    2006-01-01

    Objective: To investigate the changes of serum TSGF and plasma VEGF levels after treatment in patients with endometriosis. Methods: Serum TSGF levels were determined with ELISA mad plasma VEGF levels with biochemistry in 31 patients with endometriosis both before and after treatment as well as in 30 controls. Results: Before treatment the serum TSGF and plasma VEGF levels in patients were significantly higher than those in the controls (P 0.05). Conclusion: Development of endometriosis were closely related to the plasma levels of VEGF and serum TSGF levels. (authors)

  20. Arthroscopically Assisted Coracoclavicular Fixation Using a Single Flip Button Device Technique: What Are the Main Factors Affecting the Maintenance of Reduction?

    Directory of Open Access Journals (Sweden)

    Yong-Beom Lee

    2017-01-01

    Full Text Available Background. Among coracoclavicular (CC fixation techniques, the use of flip button device was demonstrated to have successful outcomes with the advantage of being able to accommodate an arthroscopic procedure. Purpose. This study was conducted to investigate the factors associated with loss of fixation after arthroscopically assisted CC fixation using a single flip button device for acromioclavicular (AC joint dislocations. Materials and Methods. We enrolled a total of 47 patients (35 men and 12 women. Plain radiography was performed at a mean of 24 months postoperatively to evaluate the final radiological outcome. The primary outcome measure was a long-term reduction of the AC joint for at least 24 months. Results. We found that 29 patients had a high quality reduction (61.7% and 18 patients had a low quality reduction (38.3% in initial postoperative CT findings. Our study showed that the duration (5 days from injury to treatment and the quality of initial postoperative reduction were significantly associated with the maintenance of reduction at final follow-up. Conclusion. Our study showed that maintaining stable reduction after arthroscopically assisted CC fixation using a single flip button device technique is difficult especially in patients who received delayed treatment or whose initial reduction quality was poor.

  1. Combined effect of fuel-design and after-treatment system on reduction of local and global emissions from CI engine.

    Science.gov (United States)

    Thiyagarajan, S; Geo, V Edwin; Martin, Leenus Jesu; Nagalingam, B

    2018-03-22

    This experimental study aims to mitigate harmful emissions from a CI engine using bio-energy with carbon capture and storage (BECCS) approach. The engine used for this experimental work is a single cylinder CI engine with a rated power of 5.2 kW at a constant speed of 1500 rpm. The BECCS approach is a combination of plant-based biofuels and carbon capture and storage (CCS) system. The whole investigation was done in four phases: (1) Substituting diesel with Karanja oil methyl ester (KOME) (2) Equal volume blending of Orange oil (ORG) with KOME (3) 20% blending of n-butanol (B) with KOME-ORG blend (4) CCS system with zeolite based non-selective catalytic reduction (NSCR) and mono ethanolamine (MEA) based selective non-catalytic reduction (SNCR) system with KOME-ORG + B20 blend. The experimental results show that substitution of diesel with KOME reduces smoke emission, but increases NO and CO 2 emission. KOME-ORG blend reduces CO 2 and smoke emissions with high NO emission due to combustion improvement. In comparison with the sole combustion of KOME at full load condition, the combination of KOME-ORG + B20 as bio-fuel with zeolite based post-combustion treatment system resulted in a maximum reduction of NO, smoke and CO 2 emission by 41%, 19% and 15% respectively.

  2. Augmented effect of early antibiotic treatment in mice with experimental lung infections due to sequentially adapted mucoid strains of Pseudomonas aeruginosa

    DEFF Research Database (Denmark)

    van Gennip, M; Moser, Claus; Christensen, Louise D

    2009-01-01

    : A significant reduction in the number of bacteria was observed when initiating treatment 1 h post-infection compared with initiating treatment after 24 h, although the latest isolate avoided complete clearance. Early antibiotic treatment directed at the mucoid phenotype in mice also reduced the inflammation and......Background: Effects of treatment with tobramycin initiated 1 or 24 h post-infection were investigated in a new version of a pulmonary infection model in mice. The model reflects the differentiated behaviour of Pseudomonas aeruginosa mucoid strains isolated from the lungs of one chronically infected......, histopathology, and measurement of granulocyte colony-stimulating factor (G-CSF) and macrophage inflammatory protein 2 (MIP-2). Results: There was a significant reduction of bacteria when comparing treatment initiated 1 h post-infection with treatment initiated after 24 h for isolates 1997 and 2003. Treatment...

  3. Efficacy of US-guided Hydrostatic Reduction in Children with Intussusception

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Min; Chung, Tae Woong; Yoon, Woong; Chang, Nam Kyu; Heo, Suk Hee; Shin, Sang Soo; Lim, Hyo Sun; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2007-09-15

    To assess the success rate and efficacy of US-guided hydrostatic reduction in children with intussusception. We retrospectively evaluated the ultrasonographic findings and clinical features of 121 children (M:F=80:41, mean age= 18 months) who underwent US-guided hydrostatic reduction between November, 2002 and February, 2007 for the diagnosis and treatment of intussusception. The 121 patients underwent 147 procedures, including recurred cases. Successful reduction was achieved in 132 cases (89.8% success rate), as confirmed by post-procedure ultrasonography and clinical findings. Emergency operations were performed in the 10 (6.8%) cases of irreducible intussusceptions, 8 of ileocolic type and 2 of ileoileal type. Perforation occurred in 4 cases (2.7%), and seizure in 1 case during the procedure (0.7%). US-guided hydrostatic reduction is a safe and effective tool for the diagnosis and treatment of pediatric intussusception

  4. Attentional bias and emotional reactivity as predictors and moderators of behavioral treatment for social phobia.

    Science.gov (United States)

    Niles, Andrea N; Mesri, Bita; Burklund, Lisa J; Lieberman, Matthew D; Craske, Michelle G

    2013-10-01

    Cognitive behavioral therapy (CBT) is a well-established treatment for anxiety disorders, and evidence is accruing for the effectiveness of acceptance and commitment therapy (ACT). Little is known about factors that relate to treatment outcome overall (predictors), or who will thrive in each treatment (moderators). The goal of the current project was to test attentional bias and negative emotional reactivity as moderators and predictors of treatment outcome in a randomized controlled trial comparing CBT and ACT for social phobia. Forty-six patients received 12 sessions of CBT or ACT and were assessed for self-reported and clinician-rated symptoms at baseline, post treatment, 6, and 12 months. Attentional bias significantly moderated the relationship between treatment group and outcome with patients slow to disengage from threatening stimuli showing greater clinician-rated symptom reduction in CBT than in ACT. Negative emotional reactivity, but not positive emotional reactivity, was a significant overall predictor with patients high in negative emotional reactivity showing the greatest self-reported symptom reduction. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Increased Mindfulness Skills as Predictors of Reduced Trauma-Related Guilt in Treatment-Seeking Veterans.

    Science.gov (United States)

    Held, Philip; Owens, Gina P; Monroe, J Richard; Chard, Kathleen M

    2017-08-01

    The present study examined the predictive role of increased self-reported mindfulness skills on reduced trauma-related guilt in a sample of veterans over the course of residential treatment for posttraumatic stress disorder (PTSD; N = 128). The residential treatment consisted of seven weeks of intensive cognitive processing therapy (CPT) for PTSD, as well as additional psychoeducational groups, including seven sessions on mindfulness skills. Increased mindfulness skills describing, acting with awareness, and accepting without judgment were significantly associated with reductions in trauma-related guilt over the course of treatment. Increases in the ability to act with awareness and accept without judgment were significantly associated with reductions in global guilt, R 2 = .26, guilt distress, R 2 = .23, guilt cognitions, R 2 = .23, and lack of justification, R 2 = .11. An increase in the ability to accept without judgment was the only self-reported mindfulness skill that was associated with reductions in hindsight bias, β = -.34 and wrongdoing, β = -.44. Increases in self-reported mindfulness skills explained 15.1 to 24.1% of the variance in reductions in trauma-related guilt, suggesting that mindfulness skills may play a key role in reducing the experience of trauma-related guilt during psychotherapy. Our results provide preliminary support for the use of mindfulness groups as an adjunct to traditional evidence-based treatments aimed at reducing trauma-related guilt, though this claim needs to be tested further using experimental designs. Copyright © 2017 International Society for Traumatic Stress Studies.

  6. Low Dose Vaporized Cannabis Significantly Improves Neuropathic Pain

    Science.gov (United States)

    Wilsey, Barth; Marcotte, Thomas D.; Deutsch, Reena; Gouaux, Ben; Sakai, Staci; Donaghe, Haylee

    2013-01-01

    We conducted a double-blind, placebo-controlled, crossover study evaluating the analgesic efficacy of vaporized cannabis in subjects, the majority of whom were experiencing neuropathic pain despite traditional treatment. Thirty-nine patients with central and peripheral neuropathic pain underwent a standardized procedure for inhaling either medium dose (3.53%), low dose (1.29%), or placebo cannabis with the primary outcome being VAS pain intensity. Psychoactive side-effects, and neuropsychological performance were also evaluated. Mixed effects regression models demonstrated an analgesic response to vaporized cannabis. There was no significant difference between the two active dose groups’ results (p>0.7). The number needed to treat (NNT) to achieve 30% pain reduction was 3.2 for placebo vs. low dose, 2.9 for placebo vs. medium dose, and 25 for medium vs. low dose. As these NNT are comparable to those of traditional neuropathic pain medications, cannabis has analgesic efficacy with the low dose being, for all intents and purposes, as effective a pain reliever as the medium dose. Psychoactive effects were minimal and well-tolerated, and neuropsychological effects were of limited duration and readily reversible within 1–2 hours. Vaporized cannabis, even at low doses, may present an effective option for patients with treatment-resistant neuropathic pain. PMID:23237736

  7. Optimal responses in disease activity scores to treatment in rheumatoid arthritis: Is a DAS28 reduction of >1.2 sufficient?

    Science.gov (United States)

    Mian, Aneela N; Ibrahim, Fowzia; Scott, David L; Galloway, James

    2016-06-16

    The overall benefit of intensive treatment strategies in rheumatoid arthritis (RA) remains uncertain. We explored how reductions in disability and improvements in quality of life scores are affected by alternative assessments of reductions in disease activity scores for 28 joints (DAS28) in two trials of intensive treatment strategies in active RA. One trial (CARDERA) studied 467 patients with early active RA receiving 24 months of methotrexate monotherapy or steroid and disease-modifying anti-rheumatic drug (DMARD) combinations. The other trial (TACIT) studied 205 patients with established active RA; they received 12 months of treatment with DMARD combinations or biologic agents. We compared changes in the health assessment questionnaire (HAQ) and Euroqol-5D (EQ5D) at trial endpoints in European League Against Rheumatism (EULAR) good and moderate EULAR responders in patients in whom complete endpoint data were available. In the CARDERA trial 98 patients (26 %) were good EULAR responders and 160 (32 %) were EULAR moderate responders; comparable data in TACIT were 66 (35 %) and 86 (46 %) patients. The magnitude of change in the HAQ and EQ5D was greater in both trials in EULAR good responders than in EULAR moderate responders. HAQ scores had a difference in of -0.49 (95 % CI -0.66, -0.32) in the CARDERA and -0.31 (95 % CI -0.47, -0.13) in the TACIT trial. With the EQ5D comparable differences were 0.12 (95 % CI 0.04, 0.19) and 0.15 (95 % CI 0.05, 0.25). Both exceeded minimum clinically important differences in HAQ and EQ5D scores. We conclude that achieving a good EULAR response with DMARDs and biologic agents in active RA results in substantially improved mean HAQ and EQ5D scores. Patients who achieve such responses should continue on treatment. However, continuing such treatment strategies is more challenging when only a moderate EULAR response is achieved. In these patients evidence of additional clinically important benefits in measures such as the HAQ

  8. Reduction in sick leave and costs to society of patients with Meniere's disease after treatment of temporomandibular and cervical spine disorders: a controlled six-year cost-benefit study.

    Science.gov (United States)

    Bjorne, Assar; Agerberg, Göran

    2003-04-01

    This study compares the frequency of sick leave between the three-year period after and the three-year period before coordinated treatment of temporomandibular and cervical spine disorders in 24 patients (ten males and 14 females) diagnosed with Meniere's disease. The frequency of sick leave for the patients was also compared with the frequency of sick leave in a control group from the population. A cost-benefit analysis was made regarding the costs to society of sick leave related to the treatment costs of the patients. In a previous study the same patients were treated for their severe signs and symptoms of temporomandibular and cervical spine disorders, and they reported a substantial reduction in their vertigo, non-whirling dizziness, tinnitus, feeling of fullness in the ear, pain in the face and jaws, pain in the neck and shoulders, and headache. The number of days of sick leave and the year the patient began to receive disability pension due to the symptoms of Meniere's disease were obtained from the National Health Insurance Service in Sweden. Two of the patients received disability pension benefits due to Meniere's disease 17 years prior to their normal retirement pension. A third patient received disability pension for another reason and two were receiving a retirement pension. Data on the remaining 19 patients showed a considerable reduction in number of days of sick leave during the three-year period after coordinated treatment (270 days) compared with the three-year period before the treatment (1,536 days). The control subjects used a total of 14 days sick leave for the same symptoms during the same six-year period. Vertigo (nine days) was the dominant cause followed by pain in the neck and shoulders, and headache. The reduction in sick leave for the 19 nonretired patients and the treatment costs for the 24 patients can be used for a simple cost-benefit calculation for the subgroup of nonretired patients. During the first three years after treatment the

  9. Screening for breast cancer post reduction mammoplasty

    International Nuclear Information System (INIS)

    Muir, T.M.; Tresham, J.; Fritschi, L.; Wylie, E.

    2010-01-01

    Aim: To investigate whether remodelling of the breast after breast reduction surgery has an effect on mammographic cancer detection. Methods and materials: For women who attended population-based screening between January 1998 to December 2007, data were extracted on their age, history of previous breast reduction, and the result of screening (recall for further assessment, cancer, or no cancer). The number of cancers detected, recalls per 1000 screens and the characteristics of the cancers detected in the two groups was compared. Results: In total 244,147 women with 736,219 screening episodes were reviewed. In the 4743 women who had a breast reduction, 51 breast cancers were detected [age standardized rate (ASR) of 4.28 per 1000 screening episodes; 95% CI 3.11-5.46], compared with 4342 breast cancers in 239 404 women screened in the non-reduction group (ASR of 5.99 per 1000 screening episodes; 95% CI 5.81-6.16). There were fewer cancers in the breast reduction group with a relative risk of 0.71. There was no significant difference in the rate of recall between the two groups, with a crude recall rate of 46.1 per 1000 screening episodes post-breast reduction compared with 50.7 per 1000 screening episodes for women without breast reduction. There was no significant difference in the pathological type or location of the cancer between the two groups of women. Conclusion: Postoperative breast changes following reduction mammoplasty do not significantly hinder analysis of the screening mammogram.

  10. Waste reduction through consumer education. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Harrison, E.Z.

    1996-05-01

    The Waste Reduction through Consumer Education research project was conducted to determine how environmental educational strategies influence purchasing behavior in the supermarket. The objectives were to develop, demonstrate, and evaluate consumer education strategies for waste reduction. The amount of waste generated by packaging size and form, with an adjustment for local recyclability of waste, was determined for 14 product categories identified as having more waste generating and less waste generating product choices (a total of 484 products). Using supermarket scan data and shopper identification numbers, the research tracked the purchases of shoppers in groups receiving different education treatments for 9 months. Statistical tests applied to the purchase data assessed patterns of change between the groups by treatment period. Analysis of the data revealed few meaningful statistical differences between study groups or changes in behavior over time. Findings suggest that broad brush consumer education about waste reduction is not effective in changing purchasing behaviors in the short term. However, it may help create a general awareness of the issues surrounding excess packaging and consumer responsibility. The study concludes that the answer to waste reduction in the future may be a combination of voluntary initiatives by manufacturers and retailers, governmental intervention, and better-informed consumers.

  11. [Prevention and treatment of obesity in children].

    Science.gov (United States)

    Togashi, Kenji; Iguchi, Kosei; Masuda, Hidenari

    2013-02-01

    The prevalence of childhood obesity and its comorbidities is high in Japan. Increasing prevalence of obesity among children emphasizes the importance of focusing on primary prevention to avoid health complications later in life. We emphasize the prevention of obesity by recommending breast-feeding of infants for at least 6 months and advocating that schools provide for 60 min of moderate to vigorous daily exercise in all grades. Treatment interventions include behavioral therapy, reduction in sedentary behavior, and dietary and exercise education. After dietary treatment combined with exercise treatment, the areas of subcutaneous and visceral fat decreased significantly. These data suggest that dietary treatment combined with exercise treatment in obese children normalizes the distribution of abdominal fat and reduces the risk factors for chronic disease.

  12. Reduction of Portion Size and Eating Rate Is Associated with BMI-SDS Reduction in Overweight and Obese Children and Adolescents: Results on Eating and Nutrition Behaviour from the Observational KgAS Study.

    Science.gov (United States)

    Torbahn, Gabriel; Gellhaus, Ines; Koch, Benjamin; von Kries, Rüdiger; Obermeier, Viola; Holl, Reinhard W; Fink, Katharina; van Egmond-Fröhlich, Andreas

    2017-01-01

    Treatment of paediatric obesity focuses on changes of nutrition and eating behaviour and physical activity. The evaluation of the patient education programme by KgAS was utilised to analyse the association of changes of portion size, eating rate and dietary habits with BMI-SDS reductions. Patients (n = 297) were examined at the beginning and at the end of treatment and after 1-year follow-up at different out-patient centres. Their parents completed questionnaires including estimation of children's portion size, eating rate and frequency of food intake. Associations of 1- and 2-year changes in BMI-SDS and behaviour were calculated for patients with complete data in BMI-SDS, portion size, eating rate, frequency of green, yellow and red food intake (n = 131) by multiple linear regression models. Significant changes were found in the desired direction for BMI-SDS, portion size, eating rate and the intake of unfavourable red food items both after 1 and 2 years as well as for the consumption of favourable green food items after 1 year. Significant positive associations with BMI-SDS reduction after 1 and 2 years were detected for portion size (Cohen's f2 0.13 and 0.09) and eating rate (Cohen's f2 0.20 and 0.10), respectively. Reduced portion sizes and eating rates are associated with BMI-SDS reduction after 1 and 2 years. These findings suggest to focus on appropriate portion sizes and reduced eating rates in patient education programmes. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

  13. Reduction of Portion Size and Eating Rate Is Associated with BMI-SDS Reduction in Overweight and Obese Children and Adolescents: Results on Eating and Nutrition Behaviour from the Observational KgAS Study

    Directory of Open Access Journals (Sweden)

    Gabriel Torbahn

    2017-10-01

    Full Text Available Objective: Treatment of paediatric obesity focuses on changes of nutrition and eating behaviour and physical activity. The evaluation of the patient education programme by KgAS was utilised to analyse the association of changes of portion size, eating rate and dietary habits with BMI-SDS reductions. Methods: Patients (n = 297 were examined at the beginning and at the end of treatment and after 1-year follow-up at different out-patient centres. Their parents completed questionnaires including estimation of children's portion size, eating rate and frequency of food intake. Associations of 1- and 2-year changes in BMI-SDS and behaviour were calculated for patients with complete data in BMI-SDS, portion size, eating rate, frequency of green, yellow and red food intake (n = 131 by multiple linear regression models. Results: Significant changes were found in the desired direction for BMI-SDS, portion size, eating rate and the intake of unfavourable red food items both after 1 and 2 years as well as for the consumption of favourable green food items after 1 year. Significant positive associations with BMI-SDS reduction after 1 and 2 years were detected for portion size (Cohen's f2 0.13 and 0.09 and eating rate (Cohen's f2 0.20 and 0.10, respectively. Conclusion: Reduced portion sizes and eating rates are associated with BMI-SDS reduction after 1 and 2 years. These findings suggest to focus on appropriate portion sizes and reduced eating rates in patient education programmes.

  14. Peptide receptor radionuclide therapy (PRRT): clinical significance of re-treatment?

    Energy Technology Data Exchange (ETDEWEB)

    Virgolini, Irene [Medical University Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria); Collaboration: The Innsbruck Team

    2015-12-15

    PRRT appears to be the most effective therapeutic option in the management of inoperable or metastasized NET patients with limited side effects if dose limits are respected. In patients with relapse after a first treatment period with {sup 90}Y-DOTATOC, multiple re-treatment cycles with {sup 177}Lu-DOTATATE are feasible, safe and efficacious. Quantitative imaging by dosimetry adds to formulate personalized and evidence-based treatment protocols. However, despite the large body of evidence regarding efficacy and safety of PRRT, the absence of prospective randomized controlled trials questions the utility of PRRT in the community. Furthermore, the growing number of pharmacological or liver-directed therapeutic options competes with the confusion based on the variety of somatostatin analogues to determine the optimal choice and sequencing of PRRT in the individual patient. However, the efficacy of PRRT should not be questioned rather than it should be explored as to when PRRT might be optimally applied in the sequence of available therapy modalities. The results of the present study by the Italian group [5] emphasizes that radiopharmaceuticals are still underused. Despite the huge potential of PRRT the non-availability of PRRT in many countries still limits its widespread use. After acquiring the exclusive rights for {sup 177}Lu-DOTATATE with granted orphan designation, the company Advanced Accelerator Applications (AAA) is currently running a phase III study comparing treatment with {sup 177}Lu-DOTATATE to Octreotide LAR in patients with inoperable, progressive, somatostatin receptor-positive, midgut carcinoid tumours with the aim of registering the radiopharmaceutical under the commercial name of Lutathera. Together with orphan designation also to other somatostatin-based radiopharmaceuticals, such as {sup 90}Y-DOTATOC, {sup 177}Lu-DOTATOC and the {sup 68}Ga-labelled somatostatin antagonist OPS202, these developments promote the advancement of PRRT and PET imaging

  15. Reduction in growth threshold for pulmonary metastases: an opportunity for volumetry and its impact on treatment decisions.

    Science.gov (United States)

    Vogel, M N; Schmücker, S; Maksimovic, O; Hartmann, J; Claussen, C D; Horger, M

    2012-07-01

    This study compares tumour response assessment by automated CT volumetry and standard manual measurements regarding the impact on treatment decisions and patient outcome. 58 consecutive patients with 203 pulmonary metastases undergoing baseline and follow-up multirow detector CT (MDCT) under chemotherapy were assessed for response to chemotherapy. Tumour burden of pulmonary target lesions was quantified in three ways: (1) following response evaluation criteria in solid tumours (RECIST); (2) following the volume equivalents of RECIST (i.e. with a threshold of -65/+73%); and (3) using calculated limits for stable disease (SD). For volumetry, calculated limits had been set at ±38% prior to the study by repeated quantification of nodules scanned twice. Results were compared using non-weighted κ-values and were evaluated for their impact on treatment decisions and patient outcome. In 15 (17%) of the 58 patients, the results of response assessment were inconsistent with 1 of the 3 methods, which would have had an impact on treatment decisions in 8 (13%). Patient outcome regarding therapy response could be verified in 5 (33%) of the 15 patients with inconsistent measurement results and was consistent with both RECIST and volumetry in 1, with calculated limits in 3 and with none in 1. Diagnosis as to the overall response was consistent with RECIST in six patients, with volumetry in six and with calculated limits in eight cases. There is an impact of different methods for therapy response assessment on treatment decisions. A reduction of threshold for SD to ±30-40% of volume change seems reasonable when using volumetry.

  16. Clinical significance of determination of changes of serum IGF-II, GM-CSF and TNF-α levels after treatment in children with acute nephritis

    International Nuclear Information System (INIS)

    Xu Xiaoyan; Zhou Hong; Xu Weiqin; Li Xinghua

    2008-01-01

    Objective: To explore the clinical significance of determination of changes of serum IGF-II, GM-CSF and TNF- α levels after treatment in children with acute nephritis. Methods: Serum IGF-II, GM-CSF and TNF-α levels (with RIA) were measured in 31 pediatric patients with acute nephritis and 35 controls. Results: Before treatment, the serum IGF-II, GM-CSF and TNF-α levels in the patients were significantly higher than those in controls (P< O.01). After treatment for 3 months, the serum IGF-II, GM-CSF and TNF-α levels, though markedly corrected, remained significantly higher than those in controls (P<0.05). Conclusion: Determination of changes of serum IGF-II, GM-CSF and TNF-α contents after treatment might be of prognostic importance in pediatric patients with acute nephritis. (authors)

  17. Adjunctive treatment with transcranial magnetic stimulation in treatment resistant depression: a randomized, double-blind, sham-controlled study

    Directory of Open Access Journals (Sweden)

    Qiang LIU

    2011-02-01

    Full Text Available Background: High-frequency repetitive transcranial magnetic stimulation (rTMS to the left prefrontal cortex is a promising antidepressant treatment but the appropriate duration of treatment andits effect on cognitive symptoms in treatment resistant patients is uncertain.Hypotheis: Patients with treatment resistant depression on standard antidepressant medication who receive four weeks of adjunctive treatment with high-frequency rTMS to the left prefrontal cortex will have better clinical outcomes and better cognitive functioning than those who receive sham rTMS treatments.Methods: Thirty patients with treatment resistant depression (defined as failure to respond to two or more antidepressants of different classes administered for at least 6 weeks at or above two-thirds of the recommended maximum dose receiving selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors wererandomly assigned to receive adjundive treatment with either real rTMS (n=15 or sham rTMS (n=15 5 times a week for 4 conseculive weeks. Blinded pre-post evaluations were conducted using the 17-item Hamilton Depression Rating Scale (HAMD, the Montgomery-Asberg Depression Rating Scale (MADRS, the severity of illness measure from the Clinical Global Impression Rating scale(CGI-S, the Wechsler Adult Intelligence ScaIe (WAIS, the Wechsler Memory Scale (WMS, and the Wisconsjn Card Sorting Test(WC5T.Results:14 subjects from each group completed the study. There was no significant difference in the HAMD total scores between the two groups after 2 weeks of treatment but after 4 weeks of treatment the mean percentage drop in the HAMD total score was significantly greater in the real rTMS group (49%, SD=19% than in the sham rTMS group(29%, SD=25%, with a mean difference of 20% [95%CI=3%-37%;t26=2.42; P=0.023]. At 4 weeks the mean (SD reduction in the MADRS total score was also greater in the real rTMS group [47%(23% vs 16%(40

  18. Delivery of adjuvant sequential dose-dense FEC-Doc to patients with breast cancer is feasible, but dose reductions and toxicity are dependent on treatment sequence.

    Science.gov (United States)

    Wildiers, H; Dirix, L; Neven, P; Prové, A; Clement, P; Squifflet, P; Amant, F; Skacel, T; Paridaens, R

    2009-03-01

    This study prospectively investigates the impact of dose densification and altering sequence of fluorouracil, epirubicin and cyclophosphamide [FEC(100)] and docetaxel [Doc] on dose delivery and tolerability of adjuvant chemotherapy in breast cancer patients. 117 patients with high-risk primary operable breast cancer were randomized (1:1:2:2) to conventional (three cycles of 3-weekly FEC(100) then three cycles of 3-weekly Doc 100 mg/m(2) or reverse sequence) or dose-dense (dd) treatment (four 10- to 11-day cycles of FEC(75) then four 2-weekly cycles of Doc 75 mg/m(2), or the reverse). In the dd arms, pegfilgrastim was given on day 2 of each cycle, but only as secondary prophylaxis in conventional arms. The primary endpoint was the proportion of patients completing intended cycles at relative dose intensity >or=85% and this was achieved by 95% of patients in each group except for the ddDoc-->FEC group (90%). Dose intensity in the dd arms increased by 48% for FEC and 11% for docetaxel, compared with the conventional arms (both P Doc dose reductions were more frequent with dd treatment and when Doc was given after FEC. Grade 3-4 neutropenia was significantly more frequent with conventional treatment, while fatigue and hand-foot syndrome were numerically more common with dd treatment, particularly when Doc was given after FEC. Discussion Delivery of adjuvant sequential ddFEC and Doc is feasible with growth factor support, and chemotherapy sequence appeared to affect delivery of target doses and toxicity.

  19. Surgical Outcome of Reduction and Instrumented Fusion in Lumbar Degenerative Spondylolisthesis

    Directory of Open Access Journals (Sweden)

    Farzad Omidi-Kashani

    2016-02-01

    Full Text Available Background: Lumbar degenerative spondylolisthesis (LDS is a degenerative slippage of the lumbar vertebrae. We aimed to evaluate the surgical outcome of degenerative spondylolisthesis with neural decompression, pedicular screw fixation, reduction, and posterolateral fusion. Methods: This before-after study was carried out on 45 patients (37 female and 8 male with LDS operated from August 2008 to January 2011. The patients’ pain and disability were assessed by visual analogue scale (VAS and Oswestry disability index (ODI questionnaire. In surgery, we applied distraction force to facilitate slip reduction. All the intra- and postoperative complications were recorded. The paired t-test and Pearson correlation coefficient were used for statistical analysis. Results: The mean age of patients and mean follow-up period were 58.3±3.5 years and 31.2±4.8 months, respectively. The mean slip correction rate was 52.2% with a mean correction loss of 4.8%. Preoperative VAS and ODI improved from 8.8 and 71.6 to postoperative 2.1 and 28.7, respectively. Clinical improvement was more prominent in more reduced patients, but Pearson coefficient could not find a significant correlation. Conclusion: Although spinal decompression with fusion and posterior instrumentation in surgical treatment of the patients with LDS result in satisfactory outcome, vertebral reduction cannot significantly enhance the clinical improvement.

  20. Some physiotherapy treatments may relieve menstrual pain in women with primary dysmenorrhea: a systematic review.

    Science.gov (United States)

    Kannan, Priya; Claydon, Leica Sarah

    2014-03-01

    In women with primary dysmenorrhoea, what is the effect of physiotherapeutic interventions compared to control (either no treatment or placebo/sham) on pain and quality of life? Systematic review of randomised trials with meta-analysis. Women with primary dysmenorrhea. Any form of physiotherapy treatment. The primary outcome was menstrual pain intensity and the secondary outcome was quality of life. The search yielded 222 citations. Of these, 11 were eligible randomised trials and were included in the review. Meta-analysis revealed statistically significant reductions in pain severity on a 0-10 scale from acupuncture (weighted mean difference 2.3, 95% CI 1.6 to 2.9) and acupressure (weighted mean difference 1.4, 95% CI 0.8 to 1.9), when compared to a control group receiving no treatment. However, these are likely to be placebo effects because when the control groups in acupuncture/acupressure trials received a sham instead of no treatment, pain severity did not significantly differ between the groups. Significant reductions in pain intensity on a 0-10 scale were noted in individual trials of heat (by 1.8, 95% CI 0.9 to 2.7), transcutaneous electrical nerve stimulation (2.3, 95% CI 0.03 to 4.2), and yoga (3.2, 95% CI 2.2 to 4.2). Meta-analysis of two trials of spinal manipulation showed no significant reduction in pain. None of the included studies measured quality of life. Physiotherapists could consider using heat, transcutaneous electrical nerve stimulation, and yoga in the management of primary dysmenorrhea. While benefits were also identified for acupuncture and acupressure in no-treatment controlled trials, the absence of significant effects in sham-controlled trials suggests these effects are mainly attributable to placebo effects. Copyright © 2014 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

  1. Conversion Disorder, Functional Neurological Symptom Disorder, and Chronic Pain: Comorbidity, Assessment, and Treatment.

    Science.gov (United States)

    Tsui, Patricia; Deptula, Andrew; Yuan, Derek Y

    2017-06-01

    This paper examines the overlap of conversion disorder with chronic pain conditions, describes ways to assess for conversion disorder, and provides an overview of evidence-based treatments for conversion disorder and chronic pain, with a focus on conversion symptoms. Conversion disorder is a significant problem that warrants further study, given that there are not many well-established guidelines. Accurate and timely assessment should help move treatment in a more fruitful direction and avoid unnecessary medical interventions. Advances in neuroimaging may also help further our understanding of conversion disorder. Creating a supportive environment and a collaborative treatment relationship and improving understanding of conversion symptoms appear to help individuals diagnosed with conversion disorder engage in appropriate treatments. Novel uses of earlier treatments, such as hypnosis and psychodynamic approaches, could potentially be beneficial and require a more vigorous and systematic study. There are treatments that produce significant improvements in functioning and reduction of physical symptoms from conversion disorder even for very severe cases. Hypnotherapy, cognitive behavioral therapy, and inpatient multidisciplinary treatment with intensive physiotherapy for severe cases have the most evidence to support reduction of symptoms. Components of treatment for conversion disorder overlap with treatments for chronic pain and can be used together to produce therapeutic effects for both conditions. Treatment needs to be tailored for each individual's specific symptoms.

  2. Vinasse treatment using a vegetable-tannin coagulant and photocatalysis - doi: 10.4025/actascitechnol.v35i1.11011

    Directory of Open Access Journals (Sweden)

    Renata Padilha de Souza

    2013-01-01

    Full Text Available The large volume of sugar cane vinasse generated by alcohol distillation motivated current treatment to reduce vinasse volume by a concentration process and to eliminate pollutants in the wastewater. The vinasse concentration by the coagulation/flocculation process favored the use of the thickened sludge either for fertilizing purposes or for biogas production. The photocatalysis treatment of the clarified vinasse mineralized pollutants and reduced toxicity, with subsequent water reuse. The first series of coagulation/flocculation experiments were carried out in a jar-test apparatus at room temperature with samples of 200 mL and several coagulant concentrations. In the second series of experiments, photocatalysis tests were performed on the clarified vinasse obtained by coagulation/flocculation under conditions optimized in the first series of experiments. The photocatalysis tests were performed for five consecutive days with UV irradiation, using TiO2-P25 as photocatalyst. Significant reduction of toxicity, consistent with the reduction in chemical oxygen demand (COD, was found when the photocatalysis treatment subsequent to coagulation/flocculation process was employed. Further, 98% reduction of turbidity and 87% reduction of color were obtained by the coagulation/flocculation process. Coupled to the photocatalysis process, significant reductions in absorbance, toxicity and COD (80% were also achieved.  

  3. Reduction of the concentration and total amount of keratan sulphate in synovial fluid from patients with osteoarthritis during treatment with piroxicam.

    Science.gov (United States)

    Carroll, G J; Bell, M C; Laing, B A; McCappin, S; Blumer, C; Leslie, A

    1992-01-01

    To study the effects of piroxicam on cartilage metabolism in vivo, a three phase (placebo/piroxicam 20 mg/day by mouth/placebo) double blind controlled trial was conducted in patients with osteoarthritis of the knee joint. Twenty one patients were recruited, 19 of whom (11 women, eight men, median age 70 years) completed the treatment schedule. The knee joint under study was aspirated to dryness at four week intervals. Treatment with piroxicam was accompanied by a decrease in the pain score, an improvement in the functional index, and an increased range of movement. Reductions in the concentration (mean (SEM) 120 (6) to 110 (8) micrograms/ml) and the total amount (1.22 (0.34) to 0.99 (0.37) mg) of keratan sulphate, but not the effusion volume (9.4 (2.5) to 8.3 (2.6) ml) were observed during treatment with piroxicam. These findings are consistent with decreased proteoglycan catabolism during treatment with piroxicam. Neither depressed synthesis nor enhanced clearance of degraded proteoglycan fragments can be excluded, however. PMID:1632658

  4. Clinical significance of measurement of serum IL-8, IL-1β and TNF-α levels after treatment in patients with periodontitis

    International Nuclear Information System (INIS)

    Wang Tongwu

    2009-01-01

    Objective: To explore the significance of changes of serum IL-8, IL-1β and TNF-α levels after treatment in patients with periodontitis. Methods: Serum IL-8, IL-1β and TNF-α(with RIA) levels were determined in 36 patients with periodontitis both before and after treatment as well as in 35 controls. Results: Before treatment, serum IL-8, IL-1β and TNF-α levels were significantly higher in the patients than those in controls (P 0.05). Conclusion: Detection of serum IL-8, IL-1β and TNF-α levels might reflect the progress of disease in patients with periodontitis and might be of important clinical value. (authors)

  5. Clinical significance of measurement of changes of serum IL-2, SIL-2R levels after treatment in patients with thrombocytopenic purpura

    International Nuclear Information System (INIS)

    Feng Yue

    2005-01-01

    Objective: To study the changes of serum IL-2 and SIL-2R levels after treatment in 31 patients with thrombocytopenic purpura. Methods: Serum IL-2 (with RIA) and SIL-2R (with ELISA) levels were measured in 31 patients with thrombocytopenic purpura both before and after treatment as well as in 35 controls. Results: Before treatment, in the patients the serum IL-2 levels were significantly lower and serum SIL-2R levels were significantly higher than those in the controls ( P 0.05). Conclusion: Cytokines IL-2 and SIL-2R levels changes could reflect the immunostatus of the patients as well as the progress of diseases and could be of prognostic values. (authors)

  6. Intensity-Modulated Radiotherapy Results in Significant Decrease in Clinical Toxicities Compared With Conventional Wedge-Based Breast Radiotherapy

    International Nuclear Information System (INIS)

    Harsolia, Asif; Kestin, Larry; Grills, Inga; Wallace, Michelle; Jolly, Shruti; Jones, Cortney; Lala, Moinaktar; Martinez, Alvaro; Schell, Scott; Vicini, Frank A.

    2007-01-01

    Purpose: We have previously demonstrated that intensity-modulated radiotherapy (IMRT) with a static multileaf collimator process results in a more homogenous dose distribution compared with conventional wedge-based whole breast irradiation (WBI). In the present analysis, we reviewed the acute and chronic toxicity of this IMRT approach compared with conventional wedge-based treatment. Methods and Materials: A total of 172 patients with Stage 0-IIB breast cancer were treated with lumpectomy followed by WBI. All patients underwent treatment planning computed tomography and received WBI (median dose, 45 Gy) followed by a boost to 61 Gy. Of the 172 patients, 93 (54%) were treated with IMRT, and the 79 patients (46%) treated with wedge-based RT in a consecutive fashion immediately before this cohort served as the control group. The median follow-up was 4.7 years. Results: A significant reduction in acute Grade 2 or worse dermatitis, edema, and hyperpigmentation was seen with IMRT compared with wedges. A trend was found toward reduced acute Grade 3 or greater dermatitis (6% vs. 1%, p = 0.09) in favor of IMRT. Chronic Grade 2 or worse breast edema was significantly reduced with IMRT compared with conventional wedges. No difference was found in cosmesis scores between the two groups. In patients with larger breasts (≥1,600 cm 3 , n = 64), IMRT resulted in reduced acute (Grade 2 or greater) breast edema (0% vs. 36%, p <0.001) and hyperpigmentation (3% vs. 41%, p 0.001) and chronic (Grade 2 or greater) long-term edema (3% vs. 30%, p 0.007). Conclusion: The use of IMRT in the treatment of the whole breast results in a significant decrease in acute dermatitis, edema, and hyperpigmentation and a reduction in the development of chronic breast edema compared with conventional wedge-based RT

  7. [Early versus delayed physiotherapy in the treatment of post-prostatectomy male urinary incontinence].

    Science.gov (United States)

    Tarcía Kahihara, Carina; Ferreira, Ubirajora; Nardi Pedro, Renato; Matheus, Wagner Eduardo; Rodrigues Netto, Nelson

    2006-10-01

    To analyze the importance of the starting time for pelvic floor physiotherapy in patients with post radical prostatectomy urinary incontinence. Between May 2003 and February 2004 18 patients with the diagnosis of post radical prostatectomy urinary incontinence underwent physiotherapy of the pelvic floor. Each patient received 12 sessions using kinesotherapy and electric stimulation on a weekly basis. Patients were divided into two groups: Group 1 included eight patients that started therapy within the first six months after surgery; Group 2 included 10 patients starting therapy after the sixth post operative month. All patients were evaluated by the pad test and number of incontinence pads per day. Evaluating pad tests before and after treatment, six patients in group 1 had a reduction of the amount of urine leak in comparison to seven patients in group 2. The statistical analysis showed significant differences before and after treatment for both groups (group 1: p = 0.028; group 2: p = 0.018). The evaluation of the number of pads showed: Group 1: all eight patients using pods had a reduction in the number of pads. Group 2: 5 of the eight patients using pads had a reduction and the other three continued using the same number. Statistical analysis comparing the number of pads per day before and after treatment showed a significant difference in group 1 (p = 0.004). There was no statistically significant difference in the number of pads per day before and after physiotherapy in group 2, although half of the patients showed a diminishment in the number of pads required after treatment. Results demonstrate that early indication of physiotherapy for the treatment of post radical prostatectomy urinary incontinence is better than delayed treatment. New works may be developed in the future to confirm our results.

  8. PNL size reduction and decontamination facilities and capabilities

    International Nuclear Information System (INIS)

    Allen, R.P.; Fetrow, L.K.; McCoy, M.W.

    1983-07-01

    Studies sponsored by the US Department of Energy at Pacific Northwest Laboratory (PNL) have resulted in the development of an effective, integrated size reduction and decontamination system for transuranically contaminated components. Using this system, a reduction of more than 95% in the volume of transuranic waste requiring interim storage and eventual geologic disposal has been achieved for typical plutonium contaminated glove boxes. This paper describes the separate preparation, size reduction, decontamination and waste treatment operations and facilities that have been developed and demonstrated as part of this work

  9. Evaluation of Chlorine Treatment Levels for Inactivation of Human Norovirus and MS2 Bacteriophage during Sewage Treatment.

    Science.gov (United States)

    Kingsley, David H; Fay, Johnna P; Calci, Kevin; Pouillot, Régis; Woods, Jacquelina; Chen, Haiqiang; Niemira, Brendan A; Van Doren, Jane M

    2017-12-01

    This study examined the inactivation of human norovirus (HuNoV) GI.1 and GII.4 by chlorine under conditions mimicking sewage treatment. Using a porcine gastric mucin-magnetic bead (PGM-MB) assay, no statistically significant loss in HuNoV binding (inactivation) was observed for secondary effluent treatments of ≤25 ppm total chlorine; for both strains, 50 and 100 ppm treatments resulted in ≤0.8-log 10 unit and ≥3.9-log 10 unit reductions, respectively. Treatments of 10, 25, 50, and 100 ppm chlorine inactivated 0.31, 1.35, >5, and >5 log 10 units, respectively, of the norovirus indicator MS2 bacteriophage. Evaluation of treatment time indicated that the vast majority of MS2 and HuNoV inactivation occurred in the first 5 min for 0.2-μm-filtered, prechlorinated secondary effluent. Free chlorine measurements of secondary effluent seeded with MS2 and HuNoV demonstrated substantial oxidative burdens. With 25, 50, and 100 ppm treatments, free chlorine levels after 5 min of exposure ranged from 0.21 to 0.58 ppm, from 0.28 to 16.7 ppm, and from 11.6 to 53 ppm, respectively. At chlorine treatment levels of >50 ppm, statistically significant differences were observed between reductions for PGM-MB-bound HuNoV (potentially infectious) particles and those for unbound (noninfectious) HuNoV particles or total norovirus particles. While results suggested that MS2 and HuNoV (measured as PGM-MB binding) behave similarly, although not identically, both have limited susceptibility to chlorine treatments of ≤25 ppm total chlorine. Since sewage treatment is performed at ≤25 ppm total chlorine, targeting free chlorine levels of 0.5 to 1.0 ppm, these results suggest that traditional chlorine-based sewage treatment does not inactivate HuNoV efficiently. IMPORTANCE HuNoV is ubiquitous in sewage. A receptor binding assay was used to assess inactivation of HuNoV by chlorine-based sewage treatment, given that the virus cannot be routinely propagated in vitro Results reported here

  10. Pain Reduction After Laser Acupuncture Treatment in Geriatric Patients with Knee Osteoarthritis: a Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Dwi R Helianthi

    2016-09-01

    Full Text Available Aim: to compare the effectiveness of active laser acupuncture with placebo on reducing pain intensity and improving functional outcome in geriatric patients with knee osteoarthritis (OA. Methods: a double-blind randomized controlled trial was conducted in geriatrics with knee OA at Medical Acupuncture Outpatient Clinic, Integrated Geriatric Outpatient Clinic, Rheumatology Outpatient Clinic of Cipto Mangunkusumo Hospital, Jakarta, during May to October 2015. Sixty two patients with knee OA  were randomly assigned into two groups: active laser acupuncture group or placebo laser acupuncture group. Interventions were carried out using a gallium aluminum arsenide laser device at the ST35 Dubi, ST36 Zusanli, SP9 Yinlingquan, GB34 Yanglingquan and EX - LE - 4 Neixiyan acupuncture points on the affected knee for ten sessions of treatment, i.e. twice a week. Patients were assessed using a visual analogue scale (VAS and Lequesne index at baseline, after four sessions, after nine sessions and at 2 weeks after the treatment had been stopped. Results: the VAS scores were significantly improved in the active laser acupuncture group compared to the placebo group. The evaluation of VAS scores was carried out after four treatment sessions (mean difference: 0.39; p<0.001, after nine treatment sessions (mean difference: 37.48; p<0.001 and at 2 weeks post intervention (mean difference: 39.15; p<0.001. The evaluation also showed significant improvement of Lequesne index after four treatment sessions (mean difference: 4.68; p<0.001, after nine treatment sessions (mean difference: 5.90; p<0.001 and at 2 weeks post intervention (mean difference: 6.48; p<0.001. Conclusion: active laser acupuncture is effective in reducing pain.

  11. Food Reduction in Avicenna's View and Related Principles in Classical Medicine.

    Science.gov (United States)

    Nozad, Aisan; Naseri, Mohsen; Safari, Mir Bahram; Abd Al Ahadi, Azam; Ghaffari, Farzaneh

    2016-06-01

    Traditional Iranian medicine (TIM) is a rich and valuable school of thought that believes medications are not the only effective approach for the treatment of diseases but that nutrition is also important. Our study includes two parts; the first is a book review of the Canon of Medicine by Avicenna (10th and 11th centuries), in which we focus on finding and understanding Avicenna's point of view. In the second part, we searched for "food reduction" as a key word from 2000 to 2015 in databases such as Google Scholar, PubMed, Copernicus, DOAJ, EBSCO-CINAHL, and the Iranian search database Iranmedex for principles of food reduction in classical medicine. The main methods of treatment in traditional medicine include changes in lifestyle, especially diet, the use of medications, and the use of manipulation methods. For diet, the individual may be prohibited from eating or food amounts may be decreased or increased. Centuries ago, Avicenna was making use of methods of food reduction as an important therapeutic approach in the treatment of diseases. According to him, food reduction, to the extent that it does not cause energy loss helps to cure disease. Avicenna has proposed food reduction as an aid to treating a variety of ailments such as headaches and reflux. Today, a variety of basic and clinical research has shown that food reduction or calorie restriction to a standard level can effectively prevent and treat a variety of diseases such as neoplasms, diabetes, and kidney disease. Practical principles explained by traditional Iranian medicine, in particular Avicenna, could open important and quite uncomplicated strategies for the prevention and treatment of diseases.

  12. Cell oxidation-reduction imbalance after modulated radiofrequency radiation.

    Science.gov (United States)

    Marjanovic, Ana Marija; Pavicic, Ivan; Trosic, Ivancica

    2015-01-01

    Aim of this study was to evaluate an influence of modulated radiofrequency field (RF) of 1800 MHz, strength of 30 V/m on oxidation-reduction processes within the cell. The assigned RF field was generated within Gigahertz Transversal Electromagnetic Mode cell equipped by signal generator, modulator, and amplifier. Cell line V79, was irradiated for 10, 30, and 60 min, specific absorption rate was calculated to be 1.6 W/kg. Cell metabolic activity and viability was determined by MTT assay. In order to define total protein content, colorimetric method was used. Concentration of oxidised proteins was evaluated by enzyme-linked immunosorbent assay. Reactive oxygen species (ROS) marked with fluorescent probe 2',7'-dichlorofluorescin diacetate were measured by means of plate reader device. In comparison with control cell samples, metabolic activity and total protein content in exposed cells did not differ significantly. Concentrations of carbonyl derivates, a product of protein oxidation, insignificantly but continuously increase with duration of exposure. In exposed samples, ROS level significantly (p < 0.05) increased after 10 min of exposure. Decrease in ROS level was observed after 30-min treatment indicating antioxidant defence mechanism activation. In conclusion, under the given laboratory conditions, modulated RF radiation might cause impairment in cell oxidation-reduction equilibrium within the growing cells.

  13. Clinical significance of determination of changes of serum TNF-α and plasma VEGF contents after treatment in pediatric patients with acute nephritis

    International Nuclear Information System (INIS)

    Ding Guomin

    2008-01-01

    Objective: To investigate the serum TNF-α and plasma VEGF levels after treatment in pediatric patients with acute nephritis. Methods: Serum TNF-α levels (with RIA) and plasma VEGF levels (with ELISA) were determined in 32 pediatric patients with acute nephritis both before and after treatment as well as in 35 controls. Results: Before treatment the serum TNF-α and plasma VEGF levels in the patients were significantly higher than those in the controls (P<0.01). After one month of treatment with combined traditional Chinese and western medicine, the levels though dropped markedly, still remained significantly higher than those in controls (P<0.05). Conclusion: Development of acute nephritis in pediatric patients was closely related to the serum TNF-α and plasma VEGF levels. (authors)

  14. Treatment of Tourette Syndrome with Cannabinoids

    Directory of Open Access Journals (Sweden)

    Kirsten R. Müller-Vahl

    2013-01-01

    Full Text Available Cannabinoids have been used for hundred of years for medical purposes. To day, the cannabinoid delta-9-tetrahydrocannabinol (THC and the cannabis extract nabiximols are approved for the treatment of nausea, anorexia and spasticity, respectively. In Tourette syndrome (TS several anecdotal reports provided evidence that marijuana might be effective not only in the suppression of tics, but also in the treatment of associated behavioural problems. At the present time there are only two controlled trials available investigating the effect of THC in the treatment of TS. Using both self and examiner rating scales, in both studies a significant tic reduction could be observed after treatment with THC compared to placebo, without causing significant adverse effects. Available data about the effect of THC on obsessive-compulsive symptoms are inconsistent. According to a recent Cochrane review on the efficacy of cannabinoids in TS, definite conclusions cannot be drawn, because longer trials including a larger number of patients are missing. Notwithstanding this appraisal, by many experts THC is recommended for the treatment of TS in adult patients, when first line treatments failed to improve the tics. In treatment resistant adult patients, therefore, treatment with THC should be taken into consideration.

  15. IN SITU DESTRUCTION OF CHLORINATED HYDROCARBON COMPOUNDS IN GROUNDWATER USING CATALYTIC REDUCTIVE REDUCTIVE DEHALOGENATION IN A REACTIVE WELL: TESTING AND OPERATIONAL EXPERIENCES. (R825421)

    Science.gov (United States)

    A groundwater treatment technology based on catalytic reductive dehalogenation has been developed to efficiently destroy chlorinated hydrocarbons in situ using a reactive well approach. The treatment process utilizes dissolved H2 as an electron donor, in...

  16. Evaluation of effluents from bench-scale treatment combinations for landfill leachate in Ibadan, Nigeria.

    Science.gov (United States)

    Aluko, Olufemi Oludare; Sridhar, Mkc

    2014-01-01

    The removal of pollutants in landfill leachate was investigated using constructed wetlands, a trickling filter, alum flocculation and coagulation, and a sequencing batch reactor in various combinations. Thirteen combined operations were investigated involving three out of the four unit treatment methods in series. The study was conducted because unit operations, though achieved reductions in pollutants concentrations had effluent values above the national regulatory guideline values. The suspended solids of effluents were permissible in most treatment processes, while reductions in 5-day biochemical oxygen demand (BOD5), chemical oxygen demand (COD) and ammonia (NH3) of leachates ranged from 80% to 97%; 86% to 97% and 92% to 98% respectively. However, there were significant increases in nitrate (85%) and dissolved oxygen of treatment (218%). In addition, the characteristics of the recommended treatment sequence, involving constructed wetlands, alum and trickling filter produced effluents with reductions in colour (97%), alkalinity (97%), BOD (97%), COD (97%) and NH3 (98%), and in metals, except nickel (29% reduction from the influent values). The recommended treatment combination is suitable for effective leachate management at the landfill. The cost of constructing and operating the recommended treatment combination at the facility, for 5 years, would be NGN6,009,750.00 ($38,036.39). The performance should be monitored on site prior to full adoption if effluent characteristics remain consistently low over dry and wet seasons.

  17. Quality of life with well-differentiated thyroid cancer: treatment toxicities and their reduction.

    Science.gov (United States)

    Mendoza, April; Shaffer, Brian; Karakla, Daniel; Mason, M Elizabeth; Elkins, David; Goffman, Thomas E

    2004-02-01

    Patients with well-differentiated thyroid cancer have a good prognosis but a significant chance for local recurrence. In the past, limited surgery with postoperative 131I only for extremely high-risk cases or recurrence was not uncommon. As more aggressive surgical and postoperative treatments appear to gain wider acceptance, toxicity and long-term morbidity become more important issues. Our goal is to present the experience of a single institution with emphasis on oral side effects related to 131I as well as acute and chronic symptoms related to this diagnosis and their impact on quality of life. Fifty-seven patients were followed for a median time of 19.3 months. All patients received therapeutic 131I (mean dose, 154.7 mCi) between January 1, 1996 and August 30, 2002. Fifty-four patients (94.7%) were alive at the time of analysis. Sixteen (28.1%) required a second treatment: any sign of persistence resulted in retreatment. Complaints with 131I treatment included altered taste, 26.3%; acute xerostomia, 21.1%; and acute sialoadenitis, 15.8%. Chronic xerostomia occurred in 6 (35.3%) of all patients who received multiple treatments. The incidence of chronic xerostomia was reduced to 1 of 11 (9.1%) with amifostine pretreatment. Other chronic side effects associated with this disease included fatigue 54.4%, weight gain of more than 6 months duration 24.6%, with 12 (27.9%) of those under 60 experiencing an average gain of 2.3 kg from initial diagnosis. Review of treatment-related symptoms prompted policies to reduce toxicity including amifostine pretreatment for 131I therapy and thyrotropin (synthetic TSH) use in place of iatrogenic hypothyroidism for thyroglobulin testing and scanning.

  18. Effect of mindfulness-based stress reduction on sleep quality

    DEFF Research Database (Denmark)

    Andersen, Signe; Würtzen, Hanne; Steding-Jessen, Marianne

    2013-01-01

    The prevalence of sleep disturbance is high among cancer patients, and the sleep problems tend to last for years after the end of treatment. As part of a large randomized controlled clinical trial (the MICA trial, NCT00990977) of the effect of mindfulness-based stress reduction (MBSR) on psycholo......The prevalence of sleep disturbance is high among cancer patients, and the sleep problems tend to last for years after the end of treatment. As part of a large randomized controlled clinical trial (the MICA trial, NCT00990977) of the effect of mindfulness-based stress reduction (MBSR...

  19. Significance of breast boost volume changes during radiotherapy in relation to current clinical interobserver variations

    International Nuclear Information System (INIS)

    Hurkmans, Coen; Admiraal, Marjan; Sangen, Maurice van der; Dijkmans, Ingrid

    2009-01-01

    Background and purpose: Nowadays, many departments introduce CT images for breast irradiation techniques, aiming to obtain a better accuracy in the definition of the relevant target volumes. However, the definition of the breast boost volume based on CT images requires further investigation, because it may not only vary between observers, but it may also change during the course of treatment. This study aims to quantify the variability of the CT based visible boost volume (VBV) during the course of treatment in relation to the variability between observers. Materials and methods: Ten patients with stage T1-2 invasive breast cancer treated with breast conservative surgery and post surgical radiotherapy were included in this study. In addition to the regular planning CT which is obtained several days prior to radiotherapy, three additional CT scans were acquired 3, 5 and 7 weeks after the planning CT scan. Four radiation oncologists delineated the VBV in all scans. Conformity of the delineations was analysed both between observers, and between scans taken at different periods of the radiotherapy treatment. Results: The VBV averaged over all patients decreased during the course of the treatment from an initial 40 cm 3 to 28 cm 3 , 27 cm 3 and 25 cm 3 after 3, 5 and 7 weeks, respectively. Assuming the VBV to be spherical, this corresponds to a reduction in diameter of 5-6 mm. More detailed analysis revealed that this reduction was more pronounced when radiotherapy started within 30 days after surgery. These boost volume changes over time were found to be significant (p = 0.02) even in the presence of interobserver variations. Moreover, the conformity index (CI) for the volume changes was of the same magnitude as the conformity index for the interobserver variation (0.25 and 0.31, respectively). Conclusions: Breast boost volume variations during a course of radiotherapy are significant in relation to current clinical interobserver variations. This is an important

  20. Wastewater treatments by membrane bioreactors (MBR); Bioreactores de membrana (MBR) para la depuracion de aguas residuales

    Energy Technology Data Exchange (ETDEWEB)

    Guardino Ferre, R.

    2001-07-01

    Wastewater treatments by membrane bioreactors (MBR), are a good alternative of treatment to the conventional processes when wish to obtain very high quality of the treated water or to try high load contaminants in low flow. Simultaneously, the article explains the significant reduction of the wastewater treatment plant space, eliminating the secondary septic tank. (Author) 7 refs.