WorldWideScience

Sample records for term five-year survival

  1. Five-year lung cancer survival: which advanced stage nonsmall cell lung cancer patients attain long-term survival?

    National Research Council Canada - National Science Library

    Wang, Tina; Nelson, Rebecca A; Bogardus, Alicia; Grannis, Jr, Frederic W

    2010-01-01

    .... In the absence of screening, most symptomatic lung cancer is discovered at advanced stages, with the goal of long-term survival entirely dependent on effective treatment of stage III and IV lung cancer...

  2. Five Years Survival on Hemodialysis Predicted by Artificial Neural ...

    African Journals Online (AJOL)

    Five Years Survival on Hemodialysis Predicted by Artificial Neural Network Model. ... Introduction: Maintenance hemodialysis (HD) patients' morbidity and mortality remain unacceptably high. It is important to identify risk factors affecting outcome and define their relative contribution. Methods: The data of 93 patients who ...

  3. 75 FR 6299 - Registration, Five-Year Terms

    Science.gov (United States)

    2010-02-09

    ..., Packers and Stockyards Administration 9 CFR Part 201 RIN 0580-AB03 Registration, Five-Year Terms AGENCY: Grain Inspection, Packers and Stockyards Administration, USDA ACTION: Final rule. SUMMARY: The Department of Agriculture's (USDA) Grain Inspection, Packers and Stockyards Administration (GIPSA) is...

  4. The survival of Class V restorations in general dental practice: part 3, five-year survival.

    Science.gov (United States)

    Stewardson, D; Creanor, S; Thornley, P; Bigg, T; Bromage, C; Browne, A; Cottam, D; Dalby, D; Gilmour, J; Horton, J; Roberts, E; Westoby, L; Burke, T

    2012-05-11

    To evaluate the survival over five years of Class V restorations placed by UK general practitioners, and to identify factors associated with increased longevity. Prospective longitudinal cohort multi-centre study. UK general dental practices. Ten general dental practitioners each placed 100 Class V restorations of varying sizes, using a range of materials and recorded selected clinical information at placement and recall visits. After five years the data were analysed using the Kaplan-Meier method, log-rank tests and Cox regressions models to identify significant associations between the time to restoration failure and different clinical factors. After five years 275/989 restorations had failed (27.8%), with 116 (11.7%) lost to follow-up. Cox regression analysis identified that, in combination, the practitioner, patient age, cavity size, moisture contamination and cavity preparation were found to influence the survival of the restorations. At least 60.5% of the restorations survived for five years. The time to failure of Class V restorations placed by this group of dentists was reduced in association with the individual practitioner, smaller cavities, glass ionomer restorations, cavities which had not been prepared with a bur, moisture contamination, increasing patient age, cavities confined to dentine and non-carious cavities.

  5. Five-year survival and median survival time of nasopharyngeal carcinoma in Hospital Universiti Sains Malaysia.

    Science.gov (United States)

    Siti-Azrin, Ab Hamid; Norsa'adah, Bachok; Naing, Nyi Nyi

    2014-01-01

    Nasopharyngeal carcinoma (NPC) is the fourth most common cancer in Malaysia. The objective of this study was to determine the five-year survival rate and median survival time of NPC patients in Hospital Universiti Sains Malaysia (USM). One hundred and thirty four NPC cases confirmed by histopathology in Hospital USM between 1st January 1998 and 31st December 2007 that fulfilled the inclusion and exclusion criteria were retrospectively reviewed. Survival time of NPC patients were estimated by Kaplan-Meier survival analysis. Log-rank tests were performed to compare survival of cases among presenting symptoms, WHO type, TNM classification and treatment modalities. The overall five-year survival rate of NPC patients was 38.0% (95% confidence interval (CI): 29.1, 46.9). The overall median survival time of NPC patients was 31.30 months (95%CI: 23.76, 38.84). The significant factors that altered the survival rate and time were age (p=0.041), cranial nerve involvement (p=0.012), stage (p=0.002), metastases (p=0.008) and treatment (p<0.001). The median survival of NPC patients is significantly longer for age≤50 years, no cranial nerve involvement, and early stage and is dependent on treatment modalities.

  6. Long-term outcomes five years after selective dorsal rhizotomy

    Directory of Open Access Journals (Sweden)

    Lagergren Jan

    2008-12-01

    Full Text Available Abstract Background Selective dorsal rhizotomy (SDR is a well accepted neurosurgical procedure performed for the relief of spasticity interfering with motor function in children with spastic cerebral palsy (CP. The goal is to improve function, but long-term outcome studies are rare. The aims of this study were to evaluate long-term functional outcomes, safety and side effects during five postoperative years in all children with diplegia undergoing SDR combined with physiotherapy. Methods This study group consisted of 35 children, consecutively operated, with spastic diplegia, of which 26 were Gross Motor Function Classification System (GMFCS levels III–V. Mean age was 4.5 years (range 2.5–6.6. They were all assessed by the same multidisciplinary team at pre- and at 6, 12, 18 months, 3 and 5 years postoperatively. Clinical and demographic data, complications and number of rootlets cut were prospectively registered. Deep tendon reflexes and muscle tone were examined, the latter graded with the modified Ashworth scale. Passive range of motion (PROM was measured with a goniometer. Motor function was classified according to the GMFCS and measured with the Gross Motor Function Measure (GMFM-88 and derived into GMFM-66. Parent's opinions about the children's performance of skills and activities and the amount of caregiver assistance were measured with Pediatric Evaluation Disability Inventory (PEDI. Results The mean proportion of rootlets cut in S2-L2 was 40%. Muscle tone was immediately reduced in adductors, hamstrings and dorsiflexors (p Conclusion SDR is a safe and effective method for reducing spasticity permanently without major negative side effects. In combination with physiotherapy, in a group of carefully selected and systematically followed young children with spastic diplegia, it provides lasting functional benefits over a period of at least five years postoperatively.

  7. Five-year actual survival after pancreatoduodenectomy for pancreatic head cancer.

    Science.gov (United States)

    Perysinakis, Iraklis; Avlonitis, Spyridon; Georgiadou, Despoina; Tsipras, Hercules; Margaris, Ilias

    2015-03-01

    The aim of this study was to analyse retrospectively the long-term results of patients who were operated for adenocarcinoma of the pancreatic head and identify significant prognostic factors. Eighty patients who were surgically treated for adenocarcinoma of the pancreatic head between 1995 and 2006 met the inclusion criteria and were subject to retrospective analysis. Possible prognostic factors were evaluated and independent predictors of survival were determined. A classic Whipple procedure was performed in 47 patients and a pylorus-preserving pancreatoduodenectomy in 32 patients; one patient underwent total pancreatectomy. Five-year survival rate in this group of patients was 13.6%. Median survival time was 24 months. Univariable analysis demonstrated stage of disease, tumour size and grade and nodal status as significant predictive factors of survival. Multivariable analysis indicated tumour size, nodal status and disease stage as significant prognostic indicators in terms of survival. Long-term survival in pancreatic cancer is still very low. Prognostic factors include differentiation of the tumour, disease stage and nodal status. So far, there has been no reliable method that can accurately predict which patient will mostly benefit from surgical resection. This means that pancreatic cancer resection should nearly always be attempted. © 2013 Royal Australasian College of Surgeons.

  8. Survival analysis of gastric cancer patients using Cox model: a five year study

    Directory of Open Access Journals (Sweden)

    Biglarian A

    2009-08-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Gastric cancer is the second most common cancer and known as the second cause of death due to cancers worldwide. Adenocarcinoma is the most fatal cancer in Iran and a patient with this kind of cancer, has a lower lifetime than others. In this research, the survival of patients with gastric carcinoma who were registered at Taleghani Hospital, were studied."n"nMethods: 291 patients with Gastric carcinoma who had received care, chemotherapy or chemoradiotherapy, at Taleghani Hospital in Tehran from 2002 to 2007 were studied as a historical cohort. Their survival rates and its relationship with 12 risk factors were assessed."n"nResults: Of the 291 patients with Gastric carcinoma, 70.1 percent were men and others (29.9% were women. The mean age of men was 62.26 years and of women was 59.32 years at the time of diagnosis. Most of patients (93.91% were advanced stage and metastasis. The Cox proportional hazards model showed that age at diagnosis, tumor stage and histology type with survival time had significant relationships (p=0.039, p=0.042 and p=0.032 respectively."n"n Conclusion: The five-year survival rate and median lifetime of gastric cancer patients who underwent chemotherapy or chemoradiotherapy are very

  9. A survival analysis of South African children under the age of five years

    Directory of Open Access Journals (Sweden)

    Zeleke Worku

    2011-02-01

    Full Text Available The South African Demographic Health Survey data set (SADHS of 2003 contains massive individual-level information on South African children under the age of five years selected from a random sample of 7756 households. The data set contains data on socio-economic, demographic, health-related and sanitary variables gathered by using multistage cluster sampling. The objective of the study was to identify key predictors of mortality amongst children under the age of five years. Logistic regression analysis and Cox regression were used for data analysis.

    Under-five mortality was significantly influenced by three predictor variables (breastfeeding, marital status, and ownership of a flush toilet. The hazard ratio of the variable ‘breastfeeding’ was 3.09 with P = 0.000 and 95% confidence interval (CI of (1.899, 5.033. The hazard ratio of the variable ‘toilet’ was 2.35 with P = 0.016 and 95% confidence interval of (1.172, 4.707. The hazard ratio of the variable ‘marital status’ was 1.74 with P = 0.035 and 95% confidence interval of (1.041, 2.912. Adjustment was factored in for the mother’s level of education and wealth index.

    Opsomming

    Die Suid-Afrikaanse Demografiese en Gesondheidsopname-datastel (The South African Demographic Health Survey data set [SADHS] van 2003 bevat ‘n enorme hoeveelheid individuele-vlak inligting rakende kinders onder vyf jaar uit 7756 huishoudings in Suid-Afrika. Die datastel bevat inligting rakende sosio-ekonomiese, demografiese, en gesondheidsverwante veranderlikes, en sanitêre-veranderlikes, is versamel deur gebruik te maak van multistadiatrosanalise. Die oogmerk met die studie was die identifisering van sleutelpredikatore ten opsigte van sterftes van kinders onder die ouderdom van vyf jaar. Logistieke-opnameregressie analise en Cox-regressie is gebruik om die data te analiseer. Onder vyf-sterftes word beduidend beïnvloed deur drie

  10. A Five-Year Breast Cancer-Specific Survival Disadvantage of ...

    African Journals Online (AJOL)

    Racial/ethnic disparities in female breast cancer survival continue to persist in United States. However, disparities comparing African Americans (AA), Asians and Caucasians remain to be assessed. We aimed to assess multiracial/ethnic disparities in breast cancer survival, and to examine the factors that may explain the ...

  11. Five year growth and survival of Eucalyptus hybrid clones in coastal ...

    African Journals Online (AJOL)

    -urophylla i.e. GU hybrids) and three local landraces (E. camaldulensis, E. tereticornis and E. urophylla) were established in Gede, Sokoke and Msambweni in the Coast province of Kenya in 2002, to compare growth, survival and adaptability ...

  12. Long-term cause-specific mortality among five-year survivors of childhood cancer

    NARCIS (Netherlands)

    Cardous-Ubbink, M. C.; Heinen, R. C.; Langeveld, N. E.; Bakker, P. J. M.; Voûte, P. A.; Caron, H. N.; van Leeuwen, F. E.

    2004-01-01

    Background. The purpose of our study was to assess long-term cause-specific mortality of 5-year childhood cancer survivors. Procedure. The study population consisted of 1,378 patients who had been treated for childhood cancer in The Netherlands between 1966 and 1996 and survived at least 5 years;

  13. Chemoembolization With Doxorubicin-Eluting Beads for Unresectable Hepatocellular Carcinoma: Five-Year Survival Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Malagari, Katerina, E-mail: kmalag@otonet.gr [University of Athens, Second Department of Radiology (Greece); Pomoni, Mary [University of Athens, Imaging and Research Unit (Greece); Moschouris, Hippocrates, E-mail: hipmosch@gmail.com [Tzanion Hospital, Department of Radiology (Greece); Bouma, Evanthia [University of Athens, Imaging and Research Unit (Greece); Koskinas, John [Ippokration Hospital, University of Athens, Department of Internal Medicine and Hepatology (Greece); Stefaniotou, Aspasia [University of Athens, Imaging and Research Unit (Greece); Marinis, Athanasios [Tzanion Hospital, Department of Surgery (Greece); Kelekis, Alexios; Alexopoulou, Efthymia [University of Athens, Second Department of Radiology (Greece); Chatziioannou, Achilles [University of Athens, First Department of Radiology (Greece); Chatzimichael, Katerina [University of Athens, Second Department of Radiology (Greece); Dourakis, Spyridon [Ippokration Hospital, University of Athens, Department of Internal Medicine and Hepatology (Greece); Kelekis, Nikolaos [University of Athens, Second Department of Radiology (Greece); Rizos, Spyros [Tzanion Hospital, Department of Surgery (Greece); Kelekis, Dimitrios [University of Athens, Imaging and Research Unit (Greece)

    2012-10-15

    Purpose: The purpose of this study was to report on the 5-year survival of hepatocellular carcinoma (HCC) patients treated with DC Bead loaded with doxorubicin (DEB-DOX) in a scheduled scheme in up to three treatments and thereafter on demand. Materials and Methods: 173 HCC patients not suitable for curable treatments were prospectively enrolled (mean age 70.4 {+-} 7.4 years). Child-Pugh (Child) class was A/B (102/71 [59/41 %]), Okuda stage was 0/1/2 (91/61/19 [53.2/35.7/11.1 %]), and mean lesion diameter was 7.6 {+-} 2.1 cm. Lesion morphology was one dominant {<=}5 cm (22 %), one dominant >5 cm (41.6 %), multifocal {<=}5 (26 %), and multifocal >5 (10.4 %). Results: Overall survival at 1, 2, 3, 4, and 5 years was 93.6, 83.8, 62, 41.04, and 22.5 %, with higher rates achieved in Child class A compared with Child class B patients (95, 88.2, 61.7, 45, and 29.4 % vs. 91.5, 75, 50.7, 35.2, and 12.8 %). Mean overall survival was 43.8 months (range 1.2-64.8). Cumulative survival was better for Child class A compared with Child class B patients (p = 0.029). For patients with dominant lesions {<=}5 cm 1-, 2-, 3-, 4-, and 5-year survival rates were 100, 95.2, 71.4, 66.6, and 47.6 % for Child class A and 94.1, 88.2, 58.8, 41.2, 29.4, and 23.5 % for Child class B patients. Regarding DEB-DOX treatment, multivariate analysis identified number of lesions (p = 0.033), lesion vascularity (p < 0.0001), initially achieved complete response (p < 0.0001), and objective response (p = 0.046) as significant and independent determinants of 5-year survival. Conclusion: DEB-DOX results, with high rates of 5-year survival for patients, not amenable to curative treatments. Number of lesions, lesion vascularity, and local response were significant independent determinants of 5-year survival.

  14. Survival of two post systems--five-year results of a randomized clinical trial.

    Science.gov (United States)

    Schmitter, Marc; Hamadi, Khaled; Rammelsberg, Peter

    2011-01-01

    To assess the survival rate of two different post systems after 5 years of service with a prospective randomized controlled trial. One hundred patients in need of a post were studied. Half of the patients received long glass fiber-reinforced posts, while the other half received long metal screw posts. The posts were assigned randomly. After at least 5 years (mean, 61.37 months), follow-ups were established. When a complication occurred prior to this recall, the type and time of the complication was documented. Statistical analysis was performed using the log-rank test and Kaplan-Meier analysis. Additionally, a Cox regression was performed to analyze risk factors. The survival rate of fiber-reinforced posts was 71.8%. In the metal screw post group, the survival rate was significantly lower, 50.0% (log-rank test, P = .026). Metal posts resulted more often in more unfavorable complications (eg, root fractures); consequently, more teeth (n = 17) had to be extracted. The Cox regression identified the following risk factors: position of the tooth (anterior vs posterior teeth), degree of coronal tooth destruction, and the post system (fiber-reinforced post vs metal screw post). Fiber-reinforced restorations loosened in several patients; in some of these cases (n = 6), patients did not notice this, leading to the extraction of teeth. Long metal screw posts should be used with great care in endodontically treated teeth. Besides the selection of the post system, other factors influence the survival of the restoration.

  15. [Surgical treatment of lungcancer five-year survival. Major surgical complications (author's transl)].

    Science.gov (United States)

    Deneffe, G; Daenen, W; Suy, R; Stalpaert, G

    1978-01-01

    In the period 1961--1971, 41 patients with a squamous-cell carcinoma were operated upon. The absolute 5-year survival is 47.6% for the lobectomy and 20% for the pneumonectomy. In the period 1971--1976 (6 years), 211 resections for carcinoma (all types) were performed including 19 cases of squamous cell carcinoma, operated in 1971 and also studied in the first part of the work. They represent only 15.2% of all the hospitalized lungcancer patients. The lobectomy/pneumonectomy ratio is 60/40. The postoperative mortality is respectively 4% and 9.5% and the major surgical complications (bleeding, broncho-pleural fistula, empyema) are 0.8% and 3.6%. The causes of postoperative death are examined. Remarkable is the low incidence of bronchial fistulisation: 1 in 211 resections for malignant tumors, i.e. 0.47%. These results are discussed and compared with the literature.

  16. Risk factors for dental caries in childhood: a five-year survival analysis.

    Science.gov (United States)

    Lee, Hyo-Jin; Kim, Jin-Bom; Jin, Bo-Hyoung; Paik, Dai-Il; Bae, Kwang-Hak

    2015-04-01

    The purpose of this study was to examine the risk factors of dental caries at the level of an individual person with survival analysis of the prospective data for 5 years. A total of 249 first-grade students participated in a follow-up study for 5 years. All participants responded to a questionnaire inquiring about socio-demographic variables and oral health behaviors. They also received an oral examination and were tested for Dentocult SM and LB. Over 5 years, the participants received yearly oral follow-up examinations to determine the incidence of dental caries. The incidence of one or more dental caries (DC1) and four or more dental caries (DC4) were defined as one or more and four or more decayed, missing, and filled permanent teeth increments, respectively. Socio-demographic variables, oral health behaviors, and status and caries activity tests were assessed as risk factors for DC1 and DC4. The adjusted hazard ratios (HRs) of risk factors for DC1 and DC4 were calculated using Cox proportional hazard regression models. During the 5-year follow-up period, DC1 and DC4 occurred in 87 and 25 participants, respectively. In multivariate hazard models, five or more decayed, missing, and filled primary molar teeth [HR 1.93, 95% confidence interval (CI) 1.19-3.13], and Dentocult LB of two or three (HR 2.21, 95% CI 1.37-3.56) were independent risk factors of DC1. For DC4, only Dentocult LB of two or three was an independent risk factor (HR 2.95, 95% CI 1.11-7.79). Our results suggest that dental caries incidence at an individual level can be associated with the experience of dental caries in primary teeth and Dentocult LB based on the survival models for the 5-year prospective data. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Twenty-Five Year Survival of Children with Intellectual Disability in Western Australia.

    Science.gov (United States)

    Bourke, Jenny; Nembhard, Wendy N; Wong, Kingsley; Leonard, Helen

    2017-09-01

    To investigate survival up to early adulthood for children with intellectual disability and compare their risk of mortality with that of children without intellectual disability. This was a retrospective cohort study of all live births in Western Australia between January 1, 1983 and December 31, 2010. Children with an intellectual disability (n = 10 593) were identified from the Western Australian Intellectual Disability Exploring Answers Database. Vital status was determined from linkage to the Western Australian Mortality database. Kaplan-Meier product limit estimates and 95% CIs were computed by level of intellectual disability. Hazard ratios (HRs) and 95% CIs were calculated from Cox proportional hazard regression models adjusting for potential confounders. After adjusting for potential confounders, compared with those without intellectual disability, children with intellectual disability had a 6-fold increased risk of mortality at 1-5 years of age (adjusted HR [aHR] = 6.0, 95%CI: 4.8, 7.6), a 12-fold increased risk at 6-10 years of age (aHR = 12.6, 95% CI: 9.0, 17.7) and a 5-fold increased risk at 11-25 years of age (aHR = 4.9, 95% CI: 3.9, 6.1). Children with severe intellectual disability were at even greater risk. No difference in survival was observed for Aboriginal children with intellectual disability compared with non-Aboriginal children with intellectual disability. Although children with intellectual disability experience higher mortality at all ages compared with those without intellectual disability, the greatest burden is for those with severe intellectual disability. However, even children with mild to moderate intellectual disability have increased risk of death compared with unaffected children. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Upper Limb Functionality and Quality of Life in Women with Five-Year Survival after Breast Cancer Surgery.

    Science.gov (United States)

    Recchia, Thaís Lunardi; Prim, Amably Cristiny; Luz, Clarissa Medeiros da

    2017-03-01

    Objective To evaluate the correlation between upper limb functionality and quality of life in women with five-year survival following breast cancer surgical treatment. The secondary objective was to evaluate the function of the ipsilateral upper limb and the quality of life in relation to the type of surgery and the presence of pain. Methods The Disabilities of Arm, Shoulder and Hand (DASH), and the Functional Assessment of Cancer Therapy - Breast plus Arm Morbidity (FACTB + 4) questionnaires were used to evaluate upper limb function and quality of life respectively. Data distribution was verified by the Shapiro-Wilk test. Pearson's correlation coefficient was used for the parametric variables, and Spearman's rank correlation coefficient was used for the distribution of non-parametric variables. The statistical significance was set at 5% (p < 0.05). Results The study included 30 patients, with a mean age of 51.23 (±8.72) years. The most common complications were: pain (50%), adherence (33.3%), and nerve lesion (20.0%). There was a moderate negative correlation between the instruments DASH and FACTB + 4 (total score), r = -0.634, and a strong negative correlation between the DASH and the FACTB + 4 arm subscale, r = -0.829. The scores of both questionnaires showed significant difference on the manifestation of pain. However, there was no significant difference found when comparing the scores considering the type of surgery performed. Conclusions Five years after surgery, the patients showed regular functionality levels on the ipsilateral upper limb and decreased quality of life, especially in the group manifesting pain. Thieme-Revinter Publicações Ltda Rio de Janeiro, Brazil.

  19. Five-year survival of 3-unit fiber-reinforced composite fixed partial dentures in the anterior area.

    NARCIS (Netherlands)

    Heumen, C.C.M. van; Dijken, J.W.V. van; Tanner, J.; Pikaar, R.; Lassila, L.V.; Creugers, N.H.J.; Vallittu, P.K.; Kreulen, C.M.

    2009-01-01

    OBJECTIVES: The purpose of this clinical study was to evaluate the long-term outcome of 3-unit anterior fixed partial dentures (FPDs) made of fiber-reinforced resin composite (FRC), and to identify design factors influencing the survival rate. METHODS: 52 patients (26 females, 26 males) received 60

  20. Five-year survival of 3-unit fiber-reinforced composite fixed partial dentures in the posterior area.

    Science.gov (United States)

    van Heumen, Céleste C M; Tanner, Johanna; van Dijken, Jan W V; Pikaar, Ronald; Lassila, Lippo V J; Creugers, Nico H J; Vallittu, Pekka K; Kreulen, Cees M

    2010-10-01

    The purpose of this clinical study was to evaluate the long-term outcome of three-unit posterior fixed partial dentures (FPDs) made of fiber-reinforced resin composite (FRC), and to identify design factors influencing the survival rate. 77 patients (52 females, 25 males) received 96 indirectly made FRC FPDs, using pre-impregnated unidirectional glass-fibers, requiring manual wetting, as framework material. FPDs were surface (n=31) inlay (n=45) or hybrid (n=20) retained and mainly located in the upper jaw. Hybrid FPDs consisted of a wing retainer at canine and an inlay retainer at distal abutment tooth. Surface FPDs consisted of uplay and wing combinations. Follow-up period was at minimum 4.5 years, with checkups at every 1-2 years. The study was carried out by six operators in three centers in the Netherlands, Finland and Sweden. Survival rates, including reparable defects of FPDs, and success rates were determined. Kaplan-Meier survival rate at 5 years was 71.2% (SE 4.8%) for success and 77.5% (SE 4.4%) for survival. Differences were not significantly different. Main failure modes were delamination and fracture of the FPD. Only FPDs with surface retainers showed debonding. A success rate of 71% and a survival rate of 78% after 5 years was found. Survival rates of inlay, hybrid and surface retained FPDs did not significantly differ. Copyright 2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  1. Five-year survival of 3-unit fiber-reinforced composite fixed partial dentures in the anterior area.

    Science.gov (United States)

    van Heumen, Céleste C M; van Dijken, Jan W V; Tanner, Johanna; Pikaar, Ronald; Lassila, Lippo V J; Creugers, Nico H J; Vallittu, Pekka K; Kreulen, Cees M

    2009-06-01

    The purpose of this clinical study was to evaluate the long-term outcome of 3-unit anterior fixed partial dentures (FPDs) made of fiber-reinforced resin composite (FRC), and to identify design factors influencing the survival rate. 52 patients (26 females, 26 males) received 60 indirectly made FRC FPDs, using pre-impregnated unidirectional glass fibers, requiring manual wetting, as framework material. FPDs were surface (n=48) or hybrid (n=12) retained and mainly located in the upper jaw. Hybrid FPDs had a combination of retainers; i.e. crown at one and surface retention at the other abutment tooth. Surface FPDs were either purely adhesively retained (n=29) or with additional mechanical retention (n=19). Follow-up period was at minimum 5 years, with check-ups every 1-2 years. Six operators were involved, in three centers in the Netherlands, Finland and Sweden. Survival rates, including repairable defects of FPDs, and success rates were determined. Kaplan-Meier survival rate at 5 years was 64% (SE 7%). For the level of success, values were 45% (SE 7%) and the estimated median survival time 58 (SE 10.1) months. For surface FPDs, additional mechanical retention did not improve survival significantly. There was a trend towards better survival of surface FPDs over hybrid FPDs, but differences were not significant. Main failure modes were fracture of the FPD and delamination of veneering composite. A success rate of 45% and a survival rate of 64% after 5 years was found. Fracture of the framework and delamination are the most prevalent failure modes, especially for surface FPDs.

  2. Survival of all-ceramic restorations after a minimum follow-up of five years: A systematic review.

    Science.gov (United States)

    Araujo, Nara Santos; Moda, Mariana Dias; Silva, Ebele Adaobi; Zavanelli, Adriana Cristina; Mazaro, José Vitor Quinelli; Pellizzer, Eduardo Piza

    2016-01-01

    The purpose of this systematic review was to compare the survival and complication rates of all-ceramic restorations after a minimum follow-up time of 5 years. A comprehensive search of studies published from 2005 to November 2015 and listed in the PubMed/MEDLINE, Scopus, and Cochrane Library databases was performed in accordance with the PRISMA statement. Two reviewers independently analyzed the abstracts. Relevant studies were selected according to predetermined inclusion criteria. Twenty-nine studies were selected for the final analysis from an initial yield of 514. Only four studies fulfilled the requirement of having a randomized design, and 25 studies were prospective with a mean follow-up period of 5 to 16 years. Overall, the 5-year complication rates were low. The most frequent complications were secondary caries, endodontic problems, ceramic fractures, ceramic chipping, and loss of retention. This systematic review showed that all-ceramic restorations fabricated using the correct clinical protocol have an adequate clinical survival for at least 5 years of clinical service with very low complication rates. Minor ceramic chipping and debonding did not affect the longevity of the restorations. Long-term clinical performance of all-ceramic restorations manufactured using various ceramic systems provides clinical evidence of complications and long-term management of these restorations. Available evidence indicates the effectiveness of many ceramic systems for numerous clinical applications. Correct planning and a rigorous technical execution protocol increase clinical success. Studies of ceramic prostheses indicate more problems with ceramic failure and debonding.

  3. Five-year survival and durability results of brentuximab vedotin in patients with relapsed or refractory Hodgkin lymphoma.

    Science.gov (United States)

    Chen, Robert; Gopal, Ajay K; Smith, Scott E; Ansell, Stephen M; Rosenblatt, Joseph D; Savage, Kerry J; Connors, Joseph M; Engert, Andreas; Larsen, Emily K; Huebner, Dirk; Fong, Abraham; Younes, Anas

    2016-09-22

    Presented here are the 5-year end-of-study results from the pivotal phase 2 trial of brentuximab vedotin in patients with relapsed/refractory (R/R) Hodgkin lymphoma (HL) after failed hematopoietic autologous stem cell transplantation. At 5 years, the overall patient population (N = 102) had an estimated overall survival (OS) rate of 41% (95% confidence interval [CI]: 31-51) and progression-free survival (PFS) rate of 22% (95% CI: 13-31). Patients who achieved a complete response (CR) to brentuximab vedotin (N = 34) had estimated OS and PFS rates of 64% (95% CI: 48-80%) and 52% (95% CI: 34-69%), respectively. The median OS and PFS were not reached in CR patients, with 13 patients (38% of all CR patients) remaining in follow-up and in remission at study closure. Of the 13 patients, 4 received consolidative hematopoietic allogeneic stem cell transplant, and 9 (9% of all enrolled patients) remain in sustained CR without receiving any further anticancer therapy after treatment with brentuximab vedotin. Of the patients who experienced treatment-emergent peripheral neuropathy, 88% experienced either resolution (73%) or improvement (14%) in symptoms. These 5-year follow-up data demonstrate that a subset of patients with R/R HL who obtained CR with single-agent brentuximab vedotin achieved long-term disease control and may potentially be cured. The trial was registered at www.clinicaltrials.gov as #NCT00848926. © 2016 by The American Society of Hematology.

  4. Five-year survival rates of melanoma patients treated by diet therapy after the manner of Gerson: a retrospective review.

    Science.gov (United States)

    Hildenbrand, G L; Hildenbrand, L C; Bradford, K; Cavin, S W

    1995-09-01

    Compare 5-year melanoma survival rates to rates in medical literature. Retrospective. Hospital in Tijuana, Mexico. White adult patients (N = 153) with superficial spreading and nodular melanoma, aged 25-72 years. Gerson's diet therapy: lactovegetarian; low sodium, fat and (temporarily) protein; high potassium, fluid, and nutrients (hourly raw vegetable/fruit juices). Metabolism increased by thyroid; calorie supply limited to 2600-3200 calories per day. Coffee enemas as needed for pain and appetite. 5-year survival rates by stage at admission. Of 14 patients with stages I and II (localized) melanoma, 100% survived for 5 years, compared with 79% of 15,798 reported by Balch. Of 17 with stage IIIA (regionally metastasized) melanoma, 82% were alive at 5 years, in contrast to 39% of 103 from Fachklinik Hornheide. Of 33 with combined stages IIIA + IIIB (regionally metastasized) melanoma, 70% lived 5 years, compared with 41% of 134 from Fachklinik Hornheide. We propose a new stage division: IVA (distant lymph, skin, and subcutaneous tissue metastases), and IVB (visceral metastases). Of 18 with stage IVA melanoma, 39% were alive at 5 years, compared with only 6% of 194 from the Eastern Cooperative Oncology Group. Survival impact was not assessed for stage IVB. Male and female survival rates were identical for stages I-IIIB, but stage IVA women had a strong survival advantage. The 5-year survival rates reported here are considerably higher than those reported elsewhere. Stage IIIA/B males had exceptionally high survival rates compared with those reported by other centers.

  5. Five-Year Survival and Causes of Death in Children After Intensive Care-A National Registry Study.

    Science.gov (United States)

    Kyösti, Elina; Liisanantti, Janne H; Peltoniemi, Outi; Ohtonen, Pasi; Rautiainen, Paula; Kataja, Janne; Ala-Kokko, Tero

    2017-12-06

    The aim of the study was to compare long-term mortality and causes of death in children post admission to an ICU with a control population of same age. Longitudinal follow-up study. Registry study of a national ICU register and hospital registries. Children admitted to an ICU in the years 2009 and 2010. None. The mortality and causes of death following ICU discharge were analyzed retrospectively. The median follow-up period was 4.9 years (25-75th percentiles, 4.4-5.5 yr). The causes of death in survivors 30 days after ICU discharge were compared with a cohort of 1 million children of the general population of same age. In total, 2,792 children were admitted to an ICU during the study period. Of those, 53 (1.9%) died in the ICU and 2,739 were discharged. Thirteen children died within 30 days of discharge, and 68 died between 30 days and the end of follow-up (December 31, 2014). In the control population (n = 1,020,407 children), there were 1,037 deaths (0.10%) from 2009 to 2014. The standardized mortality rate for the children admitted to the ICU during the study period was 53.4 (95% CI, 44.7-63.2). The standardized mortality rate for those children alive 1 year after discharge was 16.7 (12.1-22.6). One-year cumulative mortality was 3.3%. The most common causes of death in subjects alive 30 days post ICU were cancer (35.3%), neurologic (17.6%), and metabolic diseases (11.7%), whereas trauma was the most common cause in the control group (45.3%). There was an increased risk of death in a cohort of ICU-admitted children even 3 years after discharge. In those who survived 30 days after discharge, medical causes of death were dominant, whereas deaths due to trauma were most common in the control group.

  6. Five-Year, Disease-Free Survival after Repeat Palliative Multimodality Therapy in a Patient with Recurrent Metastastic Bladder Cancer

    Directory of Open Access Journals (Sweden)

    Sebastian Fetscher

    2007-01-01

    Full Text Available In appropriately selected cases, palliative therapeutic strategies can be adapted to those special features of cancer biographies that indicate an atypical course of disease. Elucidating these features, and adapting multimodal treatment strategies to them, can lead to significantly superior effects when compared to the routine application of conventional treatment algorhythms. A case of regionally metastactic bladder cancer is presented that documents the value of repeat debulking-surgery and repeat radiotherapy leading to unexpected short-term and long-term treatment results.

  7. Long term effect (more than five years) of intrathecal baclofen on impairment, disability, and quality of life in patients with severe spasticity of spinal origin

    NARCIS (Netherlands)

    Zahavi, A; Geertzen, JHB; Middel, B; Staal, M; Rietman, JS

    2004-01-01

    Objectives: To evaluate long term change in impairment, disability, and health related functional status in patients with severe spasticity who received intrathecal baclofen. Methods: A long term ( more than five years) observational longitudinal follow up study assessing 21 patients who received

  8. Five year biochemical recurrence free survival for intermediate risk prostate cancer after radical prostatectomy, external beam radiation therapy or permanent seed implantation.

    Science.gov (United States)

    Vassil, Andrew D; Murphy, Erin S; Reddy, Chandana A; Angermeier, Kenneth W; Altman, Andrew; Chehade, Nabil; Ulchaker, James; Klein, Eric A; Ciezki, Jay P

    2010-11-01

    To compare biochemical recurrence-free survival (bRFS) for patients with intermediate-risk prostate cancer treated by retropubic radical prostatectomy (RRP), laparoscopic radical prostatectomy (LRP), external beam radiation therapy (RT), or permanent seed implantation (PI). Patients treated for intermediate-risk prostate cancer per National Comprehensive Cancer Network guidelines from 1996 to 2005 were studied. Variables potentially affecting bRFS were examined using univariate and multivariate Cox regression analysis. Five-year bRFS rates were calculated by actuarial methods; bRFS was calculated using Kaplan-Meier analysis. Nadir +2 definition of biochemical failure was used for RT and PI patients; a PSA ≥ 0.4 ng/mL was used for radical prostatectomy (RP) patients. Time to initiation of salvage therapy was compared for each treatment group using the Kruskal-Wallis test. Nine-hundred seventy-nine patients were analyzed with a median follow-up of 65 months. Five years bRFS rate was 82.8% for all patients (89.5% PI, 85.7% RT, 79.9% RRP, and 60.2% LRP). Patients treated by LRP had significantly worse bRFS than RT (P PI (P PSA tests per year (P PI, 47.8 RT; P PI, RT, or RRP appear to have improved 5-year bRFS and delayed salvage therapy compared with LRP. Copyright © 2010 Elsevier Inc. All rights reserved.

  9. [Five-year survival and prognostic factors in a cohort of breast cancer patients treated in Juiz de Fora, Minas Gerais State, Brazil].

    Science.gov (United States)

    Guerra, Maximiliano Ribeiro; Mendonça, Gulnar Azevedo E Silva; Bustamante-Teixeira, Maria Teresa; Cintra, Jane Rocha Duarte; Carvalho, Lilian Marzullo de; Magalhães, Lydia Maria Pereira Vaz de

    2009-11-01

    The purpose of this study was to analyze five-year survival and the main prognostic factors among women with invasive breast cancer diagnosed from 1998 to 2000 that had undergone surgical treatment in the city of Juiz de Fora, Minas Gerais State, Brazil. Study variables were: age, skin color, place of residence, tumor-related variables, and treatment-related variables. Survival functions were calculated by the Kaplan-Meier method, and multivariate analysis was performed using the Cox proportional hazard model. Disease-specific survival was 81.8%. Tumor size and lymph node involvement were the main independent prognostic factors in the study population, with increased risk of death for women with tumor size greater than 2.0 cm (HR = 1.97; 95%CI: 1.26-3.07) and positive axillary lymph nodes (HR = 4.04; 95%CI: 2.55-6.39). The results emphasize the need for earlier diagnosis and treatment. Access to screening at different levels of care, mainly for women at high risk, should be a key priority for the Unified National Health System in Brazil.

  10. Do the bullies survive? A five-year, three-wave prospective study of indicators of expulsion in working life among perpetrators of workplace bullying

    Science.gov (United States)

    GLAMBEK, Mats; SKOGSTAD, Anders; EINARSEN, Ståle

    2015-01-01

    In recent series of studies, we have shown that targets of workplace bullying are at risk of expulsion in working life, both from current employment (e.g. in terms of changing employer) and from working life itself (e.g. becoming unemployed). The most recent of these, Take It or Leave: A Five-Year Prospective Study of Workplace Bullying and Indicators of Expulsion in Working Life was recently published in Industrial Health, and the present short communication aims to follow up that paper, investigating the possible job “survival” of the perpetrators. A nationally representative sample was employed (n=1,613), and responses were gathered at three time points with a two-year and a five-year time-lag. Outcomes were intention to leave and sickness absence at T1, and sickness absence, change of employer, disability benefit recipiency and unemployment at T2 and T3. The results of regression analyses clearly indicate that the perpetrators’ occupational status is largely unchanged, and remains so over time, as opposed to earlier findings regarding the targets of bullying. PMID:26320732

  11. Minimally invasive surgery (MIS) for total knee replacement; medium term results with minimum five year follow-up.

    Science.gov (United States)

    Unwin, Olivia; Hassaballa, Mohammed; Murray, James; Harries, William; Porteous, Andrew

    2017-03-01

    MIS TKA has been shown to offer a reduced in-patient stay, but no clinical difference at two years. Whilst there may be a benefit from earlier discharge, we need to ensure that there are no detrimental effects in the medium and long-term following MIS-TKA. To report the mid-term result from a prospective randomised controlled trial (RCT) comparing MIS-TKA with standard approach for TKA. Using knee score questionnaires, we collected patient reported outcome measures (PROMs) regarding pain and function. Sixty-six patients (from an eligible cohort of 83 patients) completed the mid-term postal follow-up. There was no significant difference between groups for change in score from pre-operative to final follow-up in all three PROMs. Mean MIS and standard group improvement was: AKSS 53 and 51 (p=0.7644), OKS 15 and 16 (p=0.2341) or WOMAC 15 and 15 (p=0.9900) respectively. Both groups showed improvement in pain and function with no significant difference between groups. There was no difference between groups for revision due to malalignment at a mean six year follow-up. In addition to the early benefits regarding hospital stay and complications, we have found that at a mean of six years there was no increase in malalignment, pain or function with MIS techniques. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. FIVE-YEAR OUTCOMES AFTER LONG-TERM OXANDROLONE ADMINISTRATION IN SEVERELY BURNED CHILDREN: A RANDOMIZED CLINICAL TRIAL.

    Science.gov (United States)

    Reeves, Patrick T; Herndon, David N; Tanksley, Jessica D; Jennings, Kristofer; Klein, Gordon L; Mlcak, Ronald P; Clayton, Robert P; Crites, Nancy N; Hays, Joshua P; Andersen, Clark; Lee, Jong O; Meyer, Walter; Suman, Oscar E; Finnerty, Celeste C

    2016-04-01

    Administration of oxandrolone, a nonaromatizable testosterone analog, to children for 12 months following severe burn injury has been shown to improve height, increase bone mineral content (BMC), reduce cardiac work, and augment muscle strength. Surprisingly, the increase in BMC persists well beyond the period of oxandrolone administration. This study was undertaken to determine if administration of oxandrolone for 2 years yields greater effects on long-term BMC and bone mineral density (BMD). Patients between 0 and 18 years of age with ≥30% of total body surface area burned were consented to an IRB-approved protocol and randomized to receive either placebo (n = 84) or 0.1 mg/kg oxandrolone orally twice daily for 24 months (n = 35). Patients were followed prospectively from the time of admission until 5 years postburn in a single-center, intent-to-treat setting. Height, weight, BMC, and BMD were recorded annually through 5 years postinjury. The long-term administration of oxandrolone for 16 ± 1 months postburn (range, 12.1-25.2 months) significantly increased whole-body (WB) BMC (p burned pediatric patients significantly improves WB BMC, LS BMC, LS BMD, and height velocity. The administration of long-term oxandrolone was more efficacious than administration for 12 months. Additionally, fewer patients in the oxandrolone cohort met the diagnostic criteria for pediatric osteoporosis, pointing to a reduced risk for future bone fracture. This study demonstrates that administering oxandrolone for up to 2 years following severe burn injury results in greater improvements in BMC, BMD, and height velocity.

  13. Long-term opioid contract use for chronic pain management in primary care practice. A five year experience.

    Science.gov (United States)

    Hariharan, Jaishree; Lamb, Geoffrey C; Neuner, Joan M

    2007-04-01

    The use of opioid medications to manage chronic pain is complex and challenging, especially in primary care settings. Medication contracts are increasingly being used to monitor patient adherence, but little is known about the long-term outcomes of such contracts. To describe the long-term outcomes of a medication contract agreement for patients receiving opioid medications in a primary care setting. Retrospective cohort study. All patients placed on a contract for opioid medication between 1998 and 2003 in an academic General Internal Medicine teaching clinic. Demographics, diagnoses, opiates prescribed, urine drug screens, and reasons for contract cancellation were recorded. The association of physician contract cancellation with patient factors and medication types were examined using the Chi-square test and multivariate logistic regression. A total of 330 patients constituting 4% of the clinic population were placed on contracts during the study period. Seventy percent were on indigent care programs. The majority had low back pain (38%) or fibromyalgia (23%). Contracts were discontinued in 37%. Only 17% were cancelled for substance abuse and noncompliance. Twenty percent discontinued contract voluntarily. Urine toxicology screens were obtained in 42% of patients of whom 38% were positive for illicit substances. Over 60% of patients adhered to the contract agreement for opioids with a median follow-up of 22.5 months. Our experience provides insight into establishing a systematic approach to opioid administration and monitoring in primary care practices. A more structured drug testing strategy is needed to identify nonadherent patients.

  14. Five-year survival of patients with chronic systolic heart failure of ischemic and non-ischemic etiology: analysis of prognostic factors.

    Science.gov (United States)

    Mościński, Mateusz; Szyguła-Jurkiewicz, Bożena; Zakliczyński, Michał; Rozentryt, Piotr; Partyka, Robert; Zembala, Marian; Poloński, Lech

    2014-03-01

    Despite advances in pharmacotherapy, electrotherapy and interventional treatment, chronic heart failure (HF) is still associated with poor long-term outcome. To determine the death rate and risk factors in patients with HF of ischemic and non-ischemic etiology in five-year follow-up. Consecutive patients with chronic systolic HF hospitalized in the period 2006-2008 were analyzed retrospectively. Study exclusion criteria were: infections (< 3 months before hospitalization), hemodynamically significant valve disease, advanced chronic kidney disease, liver cirrhosis and neoplastic diseases (< 5 years before hospitalization). The analysis encompassed 266 patients divided into two groups: Group A, with HF of ischemic etiology (n = 157), and Group B, with HF of non-ischemic etiology (n = 109). Mortality was significantly higher in Group A than in Group B (49% vs. 28.4%, p = 0.001). The independent risk factors for death in Group A were: New York Heart Association (NYHA) class (HR = 1.81; p < 0.001); concentrations of high-sensitivity C-reactive protein (hs-CRP) (HR = 1.01; p < 0.05), fibrinogen (HR = 1.04; p < 0.001) and N-terminal prohormone brain natriuretic peptide (NT-proBNP) (HR = 1.02; p < 0.001); and right ventricular end-diastolic diameter (RVEDd) (HR = 1.07; p < 0.01). In Group B they were age (HR = 1.07; p < 0.05) and NT-proBNP concentration (HR = 1.03; p < 0.001). Mortality was significantly lower in Group B than in Group A. The independent risk factors for death in Group B were age and NT-proBNP serum concentration, whilst in Group A they were NYHA class, serum concentrations of hs-CRP, NT-proBNP and fibrinogen, and RVEDd.

  15. Down-regulated E-cadherin expression is associated with poor five-year overall survival in bone and soft tissue sarcoma: results of a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Ning Wang

    Full Text Available To conduct a meta-analysis to evaluate the prognostic role of E-cadherin expression in bone and soft tissue sarcomas.The PubMed, EMBASE, and Web of Science databases were searched using terms related to E-cadherin, sarcoma, and prognosis for all articles published in English before March 2014. Pooled effect was calculated from the available data to evaluate the association between negative E-cadherin expression and 5-year overall survival and tumor clinicopathological features in sarcoma patients. Pooled odds ratios (OR and risk ratios (RR with 95% confidence intervals (CI were calculated using a fixed-effects model.Eight studies met the selection criteria and reported on 812 subjects. A total of 496 subjects showed positive E-cadherin expression (59.9%. Negative E-cadherin expression in bone and soft tissue sarcomas was correlated with lower 5-year overall survival (OR = 3.831; 95% CI: 2.246-6.534, and was associated with higher clinical stage (RR = 1.446; 95% CI: 1.030-2.028 and with male sex (RR = 0.678; 95% CI: 0.493-0.933.In the E-cadherin negative group, 5-year overall survival was significantly worse than in the E-cadherin positive group. However, further studies are required to confirm these results.

  16. No evidence of long-term benefits of arthroscopicacromioplasty in the treatment of shoulder impingement syndrome: Five-year results of a randomised controlled trial.

    Science.gov (United States)

    Ketola, S; Lehtinen, J; Rousi, T; Nissinen, M; Huhtala, H; Konttinen, Y T; Arnala, I

    2013-01-01

    To report the five-year results of a randomised controlled trial examining the effectiveness of arthroscopic acromioplasty in the treatment of stage II shoulder impingement syndrome. A total of 140 patients were randomly divided into two groups: 1) supervised exercise programme (n = 70, exercise group); and 2) arthroscopic acromioplasty followed by a similar exercise programme (n = 70, combined treatment group). The main outcome measure was self-reported pain as measured on a visual analogue scale. At the five-year assessment a total of 109 patients were examined (52 in the exercise group and 57 in the combined treatment group). There was a significant decrease in mean self-reported pain on the VAS between baseline and the five-year follow-up in both the exercise group (from 6.5 (1 to 10) to 2.2 (0 to 8); p Shoulder Disability Questionnaire and reported painful days). An intention-to-treat analysis showed statistically significant improvements in both groups at five years compared with baseline. Further, improvement continued between the two- and five-year timepoints. No statistically significant differences were found in the patient-centred primary and secondary parameters between the two treatment groups. Differences in the patient-centred primary and secondary parameters between the two treatment groups were not statistically significant, suggesting that acromioplasty is not cost-effective. Structured exercise treatment seems to be the treatment of choice for shoulder impingement syndrome.

  17. Population-Based Long-Term Cardiac-Specific Mortality Among 34 489 Five-Year Survivors of Childhood Cancer in Great Britain.

    Science.gov (United States)

    Fidler, Miranda M; Reulen, Raoul C; Henson, Katherine; Kelly, Julie; Cutter, David; Levitt, Gill A; Frobisher, Clare; Winter, David L; Hawkins, Michael M

    2017-03-07

    Increased risks of cardiac morbidity and mortality among childhood cancer survivors have been described previously. However, little is known about the very long-term risks of cardiac mortality and whether the risk has decreased among those more recently diagnosed. We investigated the risk of long-term cardiac mortality among survivors within the recently extended British Childhood Cancer Survivor Study. The British Childhood Cancer Survivor Study is a population-based cohort of 34 489 five-year survivors of childhood cancer diagnosed from 1940 to 2006 and followed up until February 28, 2014, and is the largest cohort to date to assess late cardiac mortality. Standardized mortality ratios and absolute excess risks were used to quantify cardiac mortality excess risk. Multivariable Poisson regression models were used to evaluate the simultaneous effect of risk factors. Likelihood ratio tests were used to test for heterogeneity and trends. Overall, 181 cardiac deaths were observed, which was 3.4 times that expected. Survivors were 2.5 times and 5.9 times more at risk of ischemic heart disease and cardiomyopathy/heart failure death, respectively, than expected. Among those >60 years of age, subsequent primary neoplasms, cardiac disease, and other circulatory conditions accounted for 31%, 22%, and 15% of all excess deaths, respectively, providing clear focus for preventive interventions. The risk of both overall cardiac and cardiomyopathy/heart failure mortality was greatest among those diagnosed from 1980 to 1989. Specifically, for cardiomyopathy/heart failure deaths, survivors diagnosed from 1980 to 1989 had 28.9 times the excess number of deaths observed for survivors diagnosed either before 1970 or from 1990 on. Excess cardiac mortality among 5-year survivors of childhood cancer remains increased beyond 50 years of age and has clear messages in terms of prevention strategies. However, the fact that the risk was greatest in those diagnosed from 1980 to 1989 suggests

  18. Clinicopathological characteristics of Barrett's carcinoma, cardia carcinoma type II and distal gastric carcinoma: Influence of observed parameters on the five-year postoperative survival of patients

    Directory of Open Access Journals (Sweden)

    Jovanović Ivan

    2009-01-01

    Full Text Available Introduction. In the past two decades, the increased frequency of distal esophageal adenocarcinoma, esophagogastric junction and proximal gastric adenocarcinoma has been observed. The vast majority of these tumours are diagnosed in advanced stages, when the prognosis is poorer than in other gastric cancers. Objective. The aim of our study was to analyze the demographic and clinicopathological characteristics of patients operated on for Barrett's, cardia and distal gastric adenocarcinomas, as well as to study the influence of manifestations of each cancerogenetic indication on the studied clinicopathological parameters and to analyze the 5-year survival rate of patients surgically treated for cardia adenocarcinoma in relation to the patients operated on for distal gastric adenocarcinoma. Methods. We analyzed gender and age, tumour type, depth of tumour invasion, involvement of blood and lymph vessels in 66 patients surgically treated at the Centre for Oesophageal Surgery of the Institute for Digestive Diseases of the Belgrade Clinical Centre. Results. Except for significant differences in the depth of tumour invasion during surgery, there were no other statistically significant differences between the studied groups of patients. In the patients operated on for Barrett's and cardia cancers, the tumours invaded more deeply the wall layers, i.e. they were significantly more invasive than the distal gastric tumour. The lymph node involvement was present in 87.5% of patients with Barrett's cancer, in 80% with cardia cancer and in 87% with distal gastric cancer. The 3-year survival rate of patients operated on for cardia cancer was 47.4% and the 5-year survival rate was 31.6%, while the 3-year survival rate of patients operated on for distal gastric cancer was 46.2% and the 5-year survival rate was 34.6%. These differences were not statistically significant (Wilcoxon 0,036; p=0,85. Singly, the patients' gender, cancer type and the degree of tumour

  19. Survival and Growth of Red Mangroves (Rhizophora mangle L.) Planted upon Marl Shorelines in the Florida Keys: A Five-Year Study.

    Science.gov (United States)

    1984-05-01

    Gary Sacket . Without their strict adherence to the experimental design and attention to detail during the trans- plant operation, this study would have... Haines , 1981 ). small differences in the tidal height of the experimental transplants produced signi- ficant differences in survival rates due to greater...R., Ill and K. C. Haines , 1981. Large scale mangrove restoration on St. Croix, Virgin Islands, In: Proc. Seventh Annual Conf. on Wetlands Restoration

  20. Survival of ceramic veneers made of different materials after a minimum follow-up period of five years: a systematic review and meta-analysis.

    Science.gov (United States)

    Petridis, Haralampos P; Zekeridou, Alkisti; Malliari, Maria; Tortopidis, Dimitrios; Koidis, Petros

    2012-01-01

    The purpose of this systematic review was to compare the survival and complication rates of ceramic veneers produced with different techniques and materials after a minimum follow-up time of 5 years. A literature search was conducted, using electronic databases, relevant references, citations and journal researching, for clinical studies reporting on the survival of ceramic veneers fabricated with different techniques and materials with a mean followup time of at least 5 years. The search period spanned from January 1980 up to October 2010. Event rates were calculated for the following complications associated with ceramic veneers: fracture, debonding, marginal discoloration, marginal integrity, and caries. Summary estimates, and 5-year event rates were reported. Comparison between subgroups of different materials, as well as statistical significance, was calculated using a mixed effects model. Nine studies were selected for final analysis over an initial yield of 409 titles. No study directly compared the incidence of complications between ceramic veneers fabricated from different materials. Four of the included studies reported on the survival of ceramic veneers made out of feldspathic ceramics; four studies were on glass-ceramic veneers and one study included veneers fabricated from both materials. The mean observation time ranged between 5 and 10 years. Overall, the 5-year complication rates were low, with the exception of studies reporting on extended ceramic veneers. The most frequent complication reported was marginal discoloration (9% at 5 years), followed by marginal integrity (3.9-7.7% at 5 years). There was no statistically significant difference in the event rates between the subgroups of different materials (feldspathic vs. glass-ceramic). The results of this systematic review showed that ceramic veneers fabricated from feldspathic or glass-ceramics have an adequate clinical survival for at least 5 years of clinical service, with very low complication

  1. Long-term impact of battle injuries; five-year follow-up of injured Dutch servicemen in Afghanistan 2006-2010.

    Directory of Open Access Journals (Sweden)

    Rigo Hoencamp

    Full Text Available OBJECTIVES: Units deployed to armed conflicts are at high risk for exposure to combat events. Many battle casualties (BCs have been reported in the recent deployment to Afghanistan. The long-term impact of these combat injuries, at their five-year end point, is currently unknown. To date, no systematic inventory has been performed of an identified group of BCs in comparison to non-injured service members from the same operational theatre. DESIGN: Observational cross-sectional cohort study. SETTING: Open online survey among Dutch BCs that deployed to Afghanistan (2006-2010. PARTICIPANTS: The Dutch BCs (n = 62 were compared to two control groups of non-injured combat groups (battle exposed [n = 53], and non-battle exposed [n = 73]. MAIN OUTCOME MEASURES: Participants rated their impact of trauma exposure (Impact of Events [IES], post deployment reintegration (Post Deployment Reintegration Scale [PDRS], general symptoms of distress (Symptom Checklist 90 [SCL-90], as well as their current perceived quality of life (EuroQol-6D [EQ-6D]. Also cost effectiveness (Short From health survey [SF-36] and care consumption were assessed (Trimbos/iMTA questionnaire. RESULTS: Over 90% of BCs were still in active duty. The mean scores of all questionnaires (IES, EQ-6D, SF-36, and SCL-90 of the BC group were significantly higher than in the control groups (p<0.05. The PDRS showed a significantly lower (p<0.05 outcome in the negative subscales. The mean consumption of care was triple that of both control groups. A lower score on quality of life was related to higher levels of distress and impact of trauma exposure. CONCLUSIONS: This study showed a clear long-term impact on a wide range of scales that contributes to a reduced quality of life in a group of BCs. Low perceived cost effectiveness matched with high consumption of care in the BC group in comparison to the control groups. These results warrant continuous monitoring of BCs.

  2. Long-term impact of battle injuries; Five-year follow-up of injured dutch servicemen in afghanistan 2006-2010

    NARCIS (Netherlands)

    Hoencamp, Rigo; Idenburg, Floris J.; Van Dongen, Thijs T C F; De Kruijff, Loes G M; Huizinga, Eelco P.; Plat, Marie Christine J; Hoencamp, Erik; Leenen, Luke P H; Hamming, Jaap F.; Vermetten, Eric

    2015-01-01

    Objectives Units deployed to armed conflicts are at high risk for exposure to combat events. Many battle casualties (BCs) have been reported in the recent deployment to Afghanistan. The longterm impact of these combat injuries, at their five-year end point, is currently unknown. To date, no

  3. Five-year survival and causes of death in patients on home parenteral nutrition for severe chronic and benign intestinal failure

    DEFF Research Database (Denmark)

    Joly, Francisca; Baxter, Janet; Staun, Michael

    2018-01-01

    BACKGROUND & AIM: Home parenteral nutrition (HPN) is the primary treatment for chronic intestinal failure (IF). Intestinal transplantation (ITx) is indicated when there is an increased risk of death due to HPN complications or to the underlying disease. Age, pathophysiologic conditions and underl......BACKGROUND & AIM: Home parenteral nutrition (HPN) is the primary treatment for chronic intestinal failure (IF). Intestinal transplantation (ITx) is indicated when there is an increased risk of death due to HPN complications or to the underlying disease. Age, pathophysiologic conditions...... associated with survival and HPN dependency as well as causes of death in adult patients requiring HPN for chronic intestinal failure during the first 5 years of treatment with HPN. METHODS: A multicenter international (European and USA) questionnaire-based retrospective follow-up of a cohort of 472...

  4. Columbine High: Five Years Later

    Science.gov (United States)

    Hurst, Marianne D.

    2004-01-01

    A few weeks before the fifth anniversary of the Columbine High School shootings on April 20, 1999, Principal Frank DeAngelis reflects on how his school has changed over the past five years. Much like the September 11, 2001 terrorist attacks against the United States, "Columbine" carries a chilling meaning that resonates across the…

  5. A five year-old child with clear cell petro-clival meningioma: case report with clinical and histopathological long-term follow-up.

    Science.gov (United States)

    Juratli, Tareq A; Geiger, Kathrin D; Weigel, Patrick; von der Hagen, Maja; Daubner, Dirk; Pinzer, Thomas; Hahn, Gabriele; Schackert, Gabriele; Kirsch, Matthias

    2015-11-01

    Only a few cases have been previously published about clear cell meningiomas in children, the majority of them in the location of the spine. We describe an unusual case of clear cell meningioma occurring at the petro-clival region in a 5-year-old child. We further seek to determine the impact of several growth factors as well as the AKT1 mutation on the tumor growth pattern. A five-year-old girl was presented with a one-week history of cephalgia, ataxia, and left sided torticollis. Magnetic resonance imaging (MRI) revealed a dumbbell-shaped homogeneously petro-clival gadolinium-enhancing mass. A staged operative approach was chosen, and a complete removal of the tumor was achieved. Due to recurrent tumor progression, the child underwent several tumor surgeries and two cranial radiations. None of the treatments were able to stop tumor progression. Consequently, the child died at the age of 14 after further extensive intracranial and extracranial tumor progression. The initial histological examination revealed a clear cell meningioma WHO grade II with an MIB-1 labeling index of growth factor receptor (EGFR), the platelet-derived growth factor receptor (PDGFR), and the vascular endothelial growth factor receptor (VEGFR) was observed with each recurrence. The AKT1 (E17K) mutation in the tumor was not detectable in all investigated specimens. Pediatric clear cell meningiomas WHO grade II are very rare. Our data demonstrate the progressive overexpression of EGF-, PDGF-, and VEGF-receptors in each recurrence, providing one of these receptors as targeted therapy in such cases. Further evaluation of these growth factors in clear cell meningioma is required to establish the optimal treatment of these aggressive tumors.

  6. Rapid response to and long-term effectiveness of anti-CD20 antibody in conventional therapy resistant Graves' orbitopathy: A five-year follow-up study.

    Science.gov (United States)

    Erdei, Annamaria; Paragh, Gyorgy; Kovacs, Peter; Karanyi, Zsolt; Berenyi, Ervin; Galuska, Laszlo; Lenkey, Agota; Szabados, Lajos; Gyory, Ferenc; Ujhelyi, Bernadett; Berta, Andras; Boda, Judit; Berta, Eszter; Bodor, Miklos; Gazdag, Annamaria; Nagy, Endre V

    2014-12-01

    Abstract The aim of this investigations was to study the effectiveness of anti-CD20 antibody therapy in Graves' orbitopathy (GO) resistant to glucocorticoids. Five patients were entered in the study. The protocol required no improvement of orbital status after a recent course of glucocorticoids. Activity of GO was confirmed by three independent techniques: clinical activity score (CAS), (99m)Tc-labeled diethylene triamine pentaacetic acid ((99m)Tc DTPA) single photon emission computed tomography and magnetic resonance imaging. Rituximab (RTX) was given as weekly infusions of 375 mg/m(2) body surface area for four weeks. The mean follow-up period was 67 (range 58-81) months. Improvement of GO has been observed in all patients: CAS before therapy was 6.5 ± 1.7 and decreased to 3.4 ± 1.6 by one month (p < 0.05) and remained unchanged (3.2 ± 1.7) at 12 months. No further CAS change, in either direction, was detected during the yearly follow-up visits. The mean DTPA uptake before therapy was 16.52 ± 4.51 MBq/cm(3) and decreased to 11.97 ± 2.36 MBq/cm(3) at one year (p < 0.002). The mean of T2 relaxation times before and one year after therapy were 96.91 ± 17.61 ms and 84.29 ± 9.41 ms, respectively (p < 0.001). The mean serum TSH receptor antibody (TRAb) levels before therapy, at the one month and one year control visits were 7.4 ± 3.4 U/L, 5.6 ± 4.5 U/L and 1.7 ± 1.5 U/L, respectively (p < 0.004). No correlation between changes of TRAb and activity parameters has been found. Anti-CD20 treatment seems to influence positively the clinical course of GO, and this effect seems to be stable for five years. To our knowledge, this is the longest published follow-up of RTX treatment in GO.

  7. Long-term mortality benefits of air quality improvement during the twelfth five-year-plan period in 31 provincial capital cities of China

    Science.gov (United States)

    Liu, Tao; Cai, Yuanyuan; Feng, Baixiang; Cao, Ganxiang; Lin, Hualiang; Xiao, Jianpeng; Li, Xing; Liu, Sha; Pei, Lei; Fu, Li; Yang, Xinyi; Zhang, Bo; Ma, Wenjun

    2018-01-01

    The severe air pollution across China in the past several years has made the Chinese government recognize its significant impacts on public health and society, and take enormous efforts to improve the air quality all over the country, especially during the Twelfth Five-Year Plan (12th FYP). However, the overall effectiveness of these air pollution control policies remains unclear. In this study, we selected the 31 municipalities and provincial capital cities in mainland China as study settings. We collected the annual average population size, mortality rates (total mortality and mortality due to cardiovascular diseases, respiratory diseases, total cancer, lung cancer and breast cancer) and concentrations of air pollutants (PM10, PM2.5, SO2 and NO2) in each capital city from 2010 to 2015 from national or local Statistical Yearbooks. The effect sizes of air pollutants on mortality were obtained from previously published meta analyses or cohort studies. We first estimated the annual mortality rates attributed to the changes in air pollutant concentrations for every city in each year. Then, we further estimated the mortality benefits in the scenarios where the air quality had reached the grade II levels of Chinese Ambient Air Quality Standards (CAAQS) and World Health Organization (WHO) guidelines. In most capital cities, we observed dominant decreases in air pollutant concentrations during the 12th FYP, particularly from 2013 to 2015, which has led to significant mortality benefits for the public. A total of 121,658 deaths (0.441‰) have been prevented due to the decrease of PM2.5concentrations from 2013 to 2015 in all included cities. The morality benefits were larger in capital cities located in the key regions (the three main regions and ten city groups) than the other cities. In addition, more mortality benefits could be obtained in the future if the air quality reaches the grade II levels of Chinese Ambient Air Quality Standards (CAAQS) or WHO guidelines. We

  8. Long-term survival after perforated diverticulitis

    NARCIS (Netherlands)

    J. Vermeulen (Jan); M.P. Gosselink (Martijn Pieter); W.C.J. Hop (Wim); E. van der Harst (Erwin); B.E. Hansen (Bettina); G.H.H. Mannaerts (Guido); P-P. Coene (Peter Paul); W.F. Weidema (Wibo); J.F. Lange (Johan)

    2011-01-01

    textabstractAim: Short-term survival after emergency surgery for perforated diverticulitis is poor. Less is known about long-term survival. The aims of this study were to evaluate long-term survival after discharge from hospital and to identify factors associated with prognosis. Method: All patients

  9. Civil partnerships five years on.

    Science.gov (United States)

    Ross, Helen; Gask, Karen; Berrington, Ann

    2011-01-01

    The Civil Partnership Act 2004, which came into force in December 2005 allowing same-sex couples in the UK to register their relationship for the first time, celebrated its fifth anniversary in December 2010. This article examines civil partnership in England and Wales, five years on from its introduction. The characteristics of those forming civil partnerships between 2005 and 2010 including age, sex and previous marital/civil partnership status are examined. These are then compared with the characteristics of those marrying over the same period. Further comparisons are also made between civil partnership dissolutions and divorce. The article presents estimates of the number of people currently in civil partnerships and children of civil partners. Finally the article examines attitudes towards same-sex and civil partner couples both in the UK and in other countries across Europe.

  10. Conditional survival for longer-term survivors from 2000-2004 using population-based cancer registry data in Osaka, Japan.

    Science.gov (United States)

    Ito, Yuri; Nakayama, Tomio; Miyashiro, Isao; Ioka, Akiko; Tsukuma, Hideaki

    2013-06-22

    We usually report five-year survival from population-based cancer registries in Japan; however these survival estimates may be pessimistic for cancer survivors, because many patients with unfavourable prognosis die shortly after diagnosis. Conditional survival can provide relevant information for cancer survivors, their family and oncologists. We used the period approach to estimate the latest 10-year survival of 38,439 patients with stomach, colorectal, lung, breast and prostate cancer diagnosed between 1990 and 2004 and followed-up from 2000-04 in Osaka, Japan. Conditional survival is an estimate, with the pre-condition of having already survived a certain length of time. Conditional five-year relative survival of one to five years after diagnosis was calculated by site, age and stage for survivors under the age of 70. Five-year relative survival for stomach cancer was 60%. Conditional five-year relative survival was 77% one year after diagnosis and 97% five years after diagnosis. This means that 97% of patients who survive five years after diagnosis can survive a further five years. Conditional five-year relative survival improved successively with each additional year that patients lived after diagnosis for stomach, colorectal and lung cancer. These figures for breast and prostate cancer were stable at high survival. Liver cancer did not show an increase in conditional five-year survival. Conditional five-year survival is a relevant figure for long-term cancer survivors in Japan. It is important for population-based cancer registries to provide figures which cancer patients and oncologists really need.

  11. Five years' follow-up of dental fear and anxiety, experience of dental care and oral health behaviour in Swedish preterm and full-term adolescents.

    Science.gov (United States)

    Brogårdh-Roth, Susanne; Månsson, Johanna; Ridell, Karin; Alward, Lubna; Hellén-Halme, Kristina; Ekberg, EwaCarin

    2017-12-04

    There is rising concern about how preterm birth affects long-term health later in life. The various effects that preterm birth have on developmental outcomes, cognitive profiles and medical health may also affect levels of cooperation in the dental care situation in addition to general oral health and other oral health-related habits. Oral health is an integral part of one's general health and well-being; however, less is known about how prematurity affects oral health and other related areas such as dental care, and including dental fear and anxiety (DFA) in individuals during adolescence and adulthood. This is considered of special interest to study, as preterm children during the preschool and school period were reported to have behavioural problems during dental treatments and less than favourable oral hygiene. A questionnaire was used of self-report design and structured into behavioural aspects relating to dental treatment, oral health-related factors, and medical health. This questionnaire at 17-19 years of age was a follow-up from 12 to 14 years of age and considered a predictor for planning future dental care for this group of patients. The 145 participating adolescents were all preterm, born between 23 and 32 weeks of gestation and 140 full-term controls, born ≥37 weeks of gestation. Dental fear and anxiety, oral health behaviour, and intake of sweets and sugary drinks of 17-19-year old adolescents born preterm was comparable to that of the full-term control group. Medical health problems as well as the intake of sweets and sugary drinks increased from the time of early adolescence to late adolescence in both groups. Preterm as well as full-term adolescents between 17 and 19 years of age are satisfied with their dental care and display low prevalence of dental fear and anxiety (DFA). The findings in this study indicate that adolescents born very preterm and extremely preterm are well prepared for transition to dental care in adult life with

  12. Impact of lesion complexity on long-term vascular response to cobalt-chromium everolimus-eluting stent: five-year follow-up optical coherence tomography study.

    Science.gov (United States)

    Kuramitsu, Shoichi; Sonoda, Shinjo; Shinozaki, Tomohiro; Jinnouch, Hiroyuki; Muraoka, Yoshitaka; Domei, Takenori; Hyodo, Makoto; Shirai, Shinichi; Ando, Kenji; Otsuji, Yutaka

    2017-10-19

    The impact of lesion complexity on long-term vascular response to cobalt-chromium everolimus-eluting stent (CoCrEES) remains unclear. We sought to evaluate them using optical coherence tomography (OCT). A total of 47 patients with 58 lesions treated only with CoCrEES and no target-vessel events within 5 years after implantation were prospectively enrolled and underwent 5-year follow-up OCT. Quantitative parameters and qualitative characteristics of the neointima were evaluated using multilevel logistic or linear regression models with random effects at three levels: lesion, cross-section (CS), and strut. According to the lesion complexity, the lesions were classified into the two groups: the complex lesion (CL) and non-CL group. The CL was defined as having at least 1 high-risk feature such as acute coronary syndrome lesion, lesion length > 20 mm, severe calcification requiring rotational atherectomy, and chronic total occlusion at the index procedure. A total of 11,034 struts (CL, n = 6240; non-CL, n = 4794) and 1202 (CL, n = 683; non-CL, n = 519) CSs were analyzed. The percentage of uncovered and malapposed struts did not differ significantly between the CL and non-CL groups (0.90 vs. 0.54%, P = 0.78; 0.56 vs. 0.10%, P = 0.16, respectively). The incidence of neoatherosclerosis was comparable between both groups in the CS- and lesion-level analysis (3.5 vs. 4.6%, P = 0.91; 32.0 vs. 24.2%, P = 0.52, respectively). At 5 years, CoCrEES shows an excellent vascular healing and similar frequency of neoatheroslerosis in patients without target-vessel events, regardless of the lesion complexity.

  13. Sobrevida em cinco anos e fatores prognósticos em mulheres com câncer de mama em Santa Catarina, Brasil Five-year survival and prognostic factors in women with breast cancer in Santa Catarina State, Brazil

    Directory of Open Access Journals (Sweden)

    Ione Jayce Ceola Schneider

    2009-06-01

    Full Text Available Este estudo tem o objetivo de descrever a sobrevida em câncer de mama e os fatores associados à mesma. Caracteriza-se como uma coorte histórica de mulheres com diagnóstico de câncer de mama no período de 2000 a 2002, que foram catalogadas nos registros hospitalares de câncer do Centro de Pesquisas Oncológicas de Santa Catarina e Hospital de Caridade - Irmandade Nosso Senhor dos Passos, os dois localizados em Florianópolis, Santa Catarina, Brasil. Para a análise estatística foram utilizados o estimador de Kaplan-Meier e o modelo de Cox. A taxa de sobrevida geral em cinco anos foi de 76,2% (IC95%: 73,6-78,9. Os fatores independentes associados ao maior risco de óbito foram faixa etária menor de 30 anos (hazard ratio- HR = 3,09; IC95%: 1,25-7,67; as mulheres analfabetas (HR = 3,70; IC95%: 1,44-9,55; as com estadiamento III (HR = 5,27; IC95%: 2,56-10,82 e IV (HR = 14,07; IC95%: 6,81-29,06. Mulheres jovens são aquelas com piores taxas de sobrevida. Também existem muitas mulheres sendo diagnosticadas em estádios avançados, tendo uma sobrevida pior, demonstrando a necessidade de ações de diagnóstico precoce.The aim of this study was to analyze breast cancer survival and associated factors, based on a historical cohort of women with breast cancer diagnosis from 2000 to 2002 recorded in the hospital cancer registries at the Santa Catarina Center for Cancer Research and the Irmandade Nosso Senhor dos Passos Charity Hospital, both located in Florianópolis, Santa Catarina State, Brazil. The statistical analysis used the Kaplan-Meier estimator and Cox model. Overall five-year survival was 76.2% (95%CI: 73.6-78.9. Independent factors associated with increased risk of death were age less than 30 years (hazard ratio - HR = 3.09; 95%CI: 1.25-7.67; illiteracy (HR = 3.70; 95%CI: 1.44-9.55; and stages III (HR = 5.27; 95%CI: 2.56-10.82 and IV (HR = 14.07; 95%CI: 6.81-29.06. Young women had the worst survival rates. There were also many women

  14. Long-term haemodialysis survival

    DEFF Research Database (Denmark)

    Heaf, James; Nielsen, Arne Høj; Hansen, Henrik Post

    2012-01-01

    Haemodialysis (HD) treatment for end-stage renal disease bears a poor prognosis. We present a case of a patient who, apart from two transplant periods lasting 8 months in all, was treated with conventional in-centre HD three times a week and who survived for 41 years. Patients should be aware tha...

  15. The 2015 five-yearly review

    CERN Multimedia

    Staff Association

    2014-01-01

      This year CERN celebrates its 60th anniversary. On this occasion, throughout Europe — most recently on July 1st at the UNESCO headquarters in Paris — festivities are being organized to celebrate the Organization’s success as a flagship laboratory of high-energy physics. To ensure that CERN can remain a centre of excellence in the field of fundamental research, the Organization verifies every five years with the help of a five-yearly review procedure whether the financial and social conditions which it proposes to Staff Members allow it to recruit and retain Staff Members of the highest competence and integrity required for the execution of its mission from all its Member States. For Fellows these conditions should remain attractive compared with those in comparable research institutions, while for Associated members of personnel these conditions should allow it to host them in its research facilities taking into account the highest cost-of-living level in the local ...

  16. Five Years into the Past...Five Years into the Future.

    Science.gov (United States)

    Tenopir, Carol

    1988-01-01

    Discusses issues which will have an impact on database searching for the next five years: (1) quality control; (2) more inhouse databases; (3) changes in database visuals; (4) pricing policies; and (5) market changes. A number of favorable and unfavorable changes unlikely to occur within five years are also noted. (MES)

  17. Five years old already: forward we go

    Directory of Open Access Journals (Sweden)

    Jan Dewing

    2016-05-01

    Full Text Available I want to begin by wishing the International Practice Development Journal (IPDJ and everyone connected with it a happy fifth birthday: the IPDJ has completed its first five years, following our launch in June 2011. It’s fair to say that this partnership between the International Practice Development Collaborative and the Foundation of Nursing Studies (FoNS has been a great success, with approximately 160 articles and commentaries published in 10 issues and two special issues. That’s quite a ‘body’ of material. We have published, and will continue to publish, a wide range of articles on practice development and related fields. More remarkable, perhaps, is the collaborative way in which the journal operates; it is an independent journal (not part of a big publishing house, which is funded and governed by members of the collaborative, and managed and published by FoNS. This year the editorial team made the decision to adopt in full the principles of open access in accordance with the Budapest Open Access Initiative definition. This means that all content is freely available without charge to the user or his/her institution. Further, users are allowed to read, download, copy, distribute, print, search or link to the full texts of the articles of this journal without seeking prior permission from the publisher or the author (fons.org/library/journal-about-ipdj. Being free of concerns regarding ‘impact factor’ rating will liberate us in a number of ways. Of course, I recognise the need to work within this rating and other metrics, such as citation measures, but these should not alone determine the merit of a researcher or a journal (Bornmann et al., 2011. We hope that authors and readers will recognise this and continue to support the journal’s growth. Our birthday issue brings something a bit different and, I feel, offers a special treat. Consider this to be like a slice of your favourite birthday cake. Usually the original research

  18. Glioblastoma multiforme with long term survival.

    Science.gov (United States)

    Deb, Prabal; Sharma, Mehar Chand; Mahapatra, Ashok Kumar; Agarwal, Deepak; Sarkar, Chitra

    2005-09-01

    Glioblastoma multiforme (GBM) Patients generally have a dismal prognosis, with median survival of 10-12 months. GBM with long-term survival (LTS) of (3) > or = 5 years is rare, and no definite markers indicating better prognosis have been identified till date. The present study was undertaken to evaluate GBMs with LTS in order to identify additional correlates associated with favourable outcome. The cases were evaluated for relevant clinicopathological data, proliferation index and expression of tumortumour suppressor gene (p53 ), cyclin-dependant kinase-inhibitors (p27 and p16 ) and epidermal growth factor receptor (EGFR) proteins. Six cases of GBM with LTS with an average survival of 9 years (range 5-15 years) were identified. All were young patients with mean age of 27 years (range 8-45 years). Histology of three cases was consistent with conventional GBM, while two showed prominent oligodendroglial component admixed with GBM areas. One was a giant cell GBM, which progressed to gliosarcoma on recurrence. The mean MIB-1LI was 12% (range 6-20%). p53 was immunopositive in 4 out of 5 cases. EGFR and p27 were immunonegative in all, whereas p16 was immunonegative in 3 out of 5 cases. Currently, in the absence of specific molecular and genetic markers, GBM in young patients should be meticulously evaluated for foci of oligodendroglial component and/or giant cell elements, in addition to proliferative index and p53 expression, since these probably have prognostic connotations, as evident in this study. The role of p16 and p27 however needs better definition with study of more number of cases.

  19. BREAST CANCER IN WOMEN: RECURRENCE AND SURVIVAL AT FIVE YEARS

    Directory of Open Access Journals (Sweden)

    Valéria Costa Peres

    2015-01-01

    Full Text Available Las mujeres que realizan tratamiento de cáncer de mama todavía presentan un riesgo de recurrencia de la enfermedad. Este estudio tiene como objetivo verificar a asociación entre sobrevivencia e recurencia del cáncer de mama en las mujeres atendidas en un hospital de referencia en Goiânia-GO cinco años después de del diagnóstico en 2008. Este es un estudio de cohorte, retrospectivo, descriptivo constituido por los expedientes de 460 mujeres. Los datos fueron analizados utilizando la Prueba Exacta de Fisher y la Curva de Kaplan Meier. Del total, la tasa de mortalidad, recurrencia regional/local y metástasis fue de 14.1%, 6.5% y 25.2%, respectivamente. Hubo una mejoría en la supervivencia de las mujeres con cáncer de mama, pero todavía existe un número considerable de mujeres que son diagnosticadas en estadios avanzados y que presentan recurrencia de la enfermedad, demostrando la necesidad de la detección precoz del cáncer en estadios iniciales y de casos de recurrencia.

  20. Foreign Ownership and Long-term Survival

    DEFF Research Database (Denmark)

    Kronborg, Dorte; Thomsen, Steen

    2006-01-01

    Does foreign ownership enhance or decrease a firm's chances of survival? Over the 100 year period 1895-2001 this paper compares the survival of foreign subsidiaries in Denmark to a control sample matched by industry and firm size. We find that foreign-owned companies have higher survival...... probability. On average exit risk for domestic companies is 2.3 times higher than for foreign companies. First movers like Siemens, Philips, Kodak, Ford, GM or Goodyear have been active in the country for almost a century. Relative foreign survival increases with company age. However, the foreign survival...

  1. The Scope of Numeracy after Five Years

    Directory of Open Access Journals (Sweden)

    H.L. Vacher

    2013-01-01

    Full Text Available The purpose of this editorial is to provide an efficient way for readers and potential authors to see (a what type of papers are published in this journal and (b what subjects are appropriate. The editorial consists mainly of about a dozen pages of tables including live links to the papers’ access/abstract pages to facilitate easy browsing. In the first table, the 85 papers that have been published in the journal’s first five years are classified into: review papers; research papers; case studies; essays; book reviews; columns; and editorials about the journal. In the second table, the papers are inventoried into overlapping sets on: assessment; QL and writing; the construct of QL; focused QL courses and curricula; QL across the curriculum; QL centers; algebra and calculus education; statistics education; intersections with science and engineering; intersections with social sciences; financial numeracy; health numeracy; math anxiety; and cognition. Browsing these links confirms what we said in the first editorial: the scope of Numeracy is huge.

  2. Long-term survival in Patau syndrome.

    Science.gov (United States)

    Tunca, Y; Kadandale, J S; Pivnick, E K

    2001-04-01

    A female patient with an extra chromosome 13 (Patau syndrome) is described. There are only five previous reports of patients with trisomy 13 who have survived past the first decade. It is concluded that non-lethal congenital anomalies and aggressive medical care play an important role in the survival of patients with trisomy 13.

  3. EDITORIAL: Five years of development and growth

    Science.gov (United States)

    Arimondo, Ennio

    2004-02-01

    The last issue of Journal of Optics B: Quantum and Semiclassical Optics under my editorship has recently been published. During the last five years, since its change of title, the journal has significantly modified its targets. Starting from a balanced mix of quantum optics and semiclassical optics, new topics have been brought within the scope of the journal, such as atom optics, degenerate quantum gases, quantum computation and quantum information, representing the growing role played by lasers within our technologically oriented society. Furthermore, the journal has greatly expanded the number of Special Issues and has introduced PhD Tutorials. While many authors do not have time to invest in preparing review articles, we have found the review-style PhD Tutorials to be very popular. Looking back over the evolution of the journal, the most obvious criterion of its development, at least from the point of view of the prospective contributing author, has been the gratifying increase in the impact factor measured by ISI, reflecting the leading position of Journal of Optics B as a European journal devoted exclusively to optics research. It is most rewarding to report that the number of printed pages has increased by 77% since 1999 and by more than 20% in the last year, far above the target planned by the publisher. Furthermore, from an Editorial point of view, the high standing of the journal is demonstrated by the very high quality ratings given by referees to the top fraction of submitted manuscripts and by the large number of full text web downloads reported for those papers. Special Issues also attract high numbers of web downloads, demonstrating the special attention these issues attract within the scientific community. Such results have been achieved only through teamwork, and I wish to express my gratitude to all those who contributed to this result over the years: Françoise Chavel from the European Optical Society secretariat in Paris, John Haynes, Tom Spicer

  4. Geospatial Health: the first five years

    Directory of Open Access Journals (Sweden)

    Jürg Utzinger

    2011-11-01

    Full Text Available Geospatial Health is an international, peer-reviewed scientific journal produced by the Global Network for Geospatial Health (GnosisGIS. This network was founded in 2000 and the inaugural issue of its official journal was published in November 2006 with the aim to cover all aspects of geographical information system (GIS applications, remote sensing and other spatial analytic tools focusing on human and veterinary health. The University of Naples Federico II is the publisher, producing two issues per year, both as hard copy and an open-access online version. The journal is referenced in major databases, including CABI, ISI Web of Knowledge and PubMed. In 2008, it was assigned its first impact factor (1.47, which has now reached 1.71. Geospatial Health is managed by an editor-in-chief and two associate editors, supported by five regional editors and a 23-member strong editorial board. This overview takes stock of the first five years of publishing: 133 contributions have been published so far, primarily original research (79.7%, followed by reviews (7.5%, announcements (6.0%, editorials and meeting reports (3.0% each and a preface in the first issue. A content analysis of all the original research articles and reviews reveals that three quarters of the publications focus on human health with the remainder dealing with veterinary health. Two thirds of the papers come from Africa, Asia and Europe with similar numbers of contributions from each continent. Studies of more than 35 different diseases, injuries and risk factors have been presented. Malaria and schistosomiasis were identified as the two most important diseases (11.2% each. Almost half the contributions were based on GIS, one third on spatial analysis, often using advanced Bayesian geostatistics (13.8%, and one quarter on remote sensing. The 120 original research articles, reviews and editorials were produced by 505 authors based at institutions and universities in 52 countries

  5. Geospatial health: the first five years.

    Science.gov (United States)

    Utzinger, Jürg; Rinaldi, Laura; Malone, John B; Krauth, Stefanie J; Kristensen, Thomas K; Cringoli, Giuseppe; Bergquist, Robert

    2011-11-01

    Geospatial Health is an international, peer-reviewed scientific journal produced by the Global Network for Geospatial Health (GnosisGIS). This network was founded in 2000 and the inaugural issue of its official journal was published in November 2006 with the aim to cover all aspects of geographical information system (GIS) applications, remote sensing and other spatial analytic tools focusing on human and veterinary health. The University of Naples Federico II is the publisher, producing two issues per year, both as hard copy and an open-access online version. The journal is referenced in major databases, including CABI, ISI Web of Knowledge and PubMed. In 2008, it was assigned its first impact factor (1.47), which has now reached 1.71. Geospatial Health is managed by an editor-in-chief and two associate editors, supported by five regional editors and a 23-member strong editorial board. This overview takes stock of the first five years of publishing: 133 contributions have been published so far, primarily original research (79.7%), followed by reviews (7.5%), announcements (6.0%), editorials and meeting reports (3.0% each) and a preface in the first issue. A content analysis of all the original research articles and reviews reveals that three quarters of the publications focus on human health with the remainder dealing with veterinary health. Two thirds of the papers come from Africa, Asia and Europe with similar numbers of contributions from each continent. Studies of more than 35 different diseases, injuries and risk factors have been presented. Malaria and schistosomiasis were identified as the two most important diseases (11.2% each). Almost half the contributions were based on GIS, one third on spatial analysis, often using advanced Bayesian geostatistics (13.8%), and one quarter on remote sensing. The 120 original research articles, reviews and editorials were produced by 505 authors based at institutions and universities in 52 countries. Importantly, a

  6. Foreign Ownership and long-term Survival

    OpenAIRE

    Kronborg, Dorte; Thomsen, Steen

    2006-01-01

    Does foreign ownership enhance or decrease a firm’s chances of survival? Over the 100 year period 1895-2001 this paper compares the survival of foreign subsidiaries in Denmark to a control sample matched by industry and firm size. We find that foreign-owned companies have higher survival probability. On average exit risk for domestic companies is 2.3 times higher than for foreign companies. First movers like Siemens, Philips, Kodak, Ford, GM or Goodyear have been active in the country for alm...

  7. Long-term survival in small-cell lung cancer

    DEFF Research Database (Denmark)

    Lassen, U; Osterlind, K; Hansen, M

    1995-01-01

    PURPOSE: To describe in patients with small-cell lung cancer (SCLC) the characteristics of those who survive for > or = 5 years, to identify long-term prognostic factors, to analyze survival data of 5-year survivors, and to study 10-year survival in patients entered before 1981. PATIENTS......, especially tobacco-related cancers and other tobacco-related diseases....

  8. Características tumorais e sobrevida de cinco anos em pacientes com câncer de mama admitidas no Instituto Nacional de Câncer, Rio de Janeiro, Brasil Tumor characteristics and five-year survival in breast cancer patients at the National Cancer Institute, Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Gulnar Azevedo e Silva Mendonça

    2004-10-01

    Full Text Available Vários fatores vêm sendo estudados com respeito ao estabelecimento de critérios mais seguros que influenciam o prognóstico de pacientes com câncer de mama. Este estudo teve como objetivo avaliar as taxas de sobrevida de cinco anos e os principais fatores prognósticos relativos ao tumor em mulheres com carcinoma invasivo de mama submetidas à cirurgia no Instituto Nacional de Câncer, Rio de Janeiro, Brasil, entre maio de 1995 e julho de 1996. As variáveis estudadas foram: presença de linfonodo comprometido, tamanho do tumor, grau de agressividade e presença de receptores hormonais para estrogênio e progesterona. As funções de sobrevida foram calculadas por meio do método de Kaplan-Meier. Foi utilizado o modelo de riscos proporcionais de Cox para avaliação dos fatores prognósticos. A taxa de sobrevida em cinco anos foi de 75,0% para todas as pacientes e, de 64,0% para as com metástase para linfonodo. A análise multivariada identificou o comprometimento de linfonodo como o mais forte preditor do desfecho; ter receptor positivo para estrogênio se associou a um melhor prognóstico. Esses resultados mostram a necessidade de condução de estudos que investiguem novos fatores que, combinados aos já conhecidos, possam melhor orientar a conduta terapêutica.Numerous factors have been studied to establish more secure prognostic criteria in breast cancer patients. This study estimates five-year survival rates and principal prognostic factors related to tumor characteristics in women with invasive breast cancer and submitted to surgery at the National Cancer Institute, Rio de Janeiro, Brazil, from May 1995 to July 1996. Study variables were: lymph node status, tumor size, aggressiveness grade, and presence of estrogen and progesterone receptors. Survival functions were calculated according to the Kaplan-Meyer method. The Cox proportional hazards model was used to evaluate prognostic factors. Five-year survival was 75% for all women and

  9. 40 CFR 68.42 - Five-year accident history.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Five-year accident history. 68.42... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Hazard Assessment § 68.42 Five-year accident history. (a) The owner or operator shall include in the five-year accident history all accidental releases from...

  10. Long-term patient survival in ANCA-associated vasculitis

    NARCIS (Netherlands)

    Flossmann, Oliver; Berden, Annelies; de Groot, Kirsten; Hagen, Chris; Harper, Lorraine; Heijl, Caroline; Hoglund, Peter; Jayne, David; Luqmani, Raashid; Mahr, Alfred; Mukhtyar, Chetan; Pusey, Charles; Rasmussen, Niels; Stegeman, Coen; Walsh, Michael; Westman, Kerstin

    Background Wegener's granulomatosis and microscopic polyangiitis are antineutrophil cytoplasm antibodies (ANCA)-associated vasculitides with significant morbidity and mortality. The long-term survival of patients with ANCA associated vasculitis treated with current regimens is uncertain. Objective

  11. Long-term patient survival in ANCA-associated vasculitis

    DEFF Research Database (Denmark)

    Flossmann, Oliver; Berden, Annelies; de Groot, Kirsten

    2011-01-01

    Wegener's granulomatosis and microscopic polyangiitis are antineutrophil cytoplasm antibodies (ANCA)-associated vasculitides with significant morbidity and mortality. The long-term survival of patients with ANCA associated vasculitis treated with current regimens is uncertain.......Wegener's granulomatosis and microscopic polyangiitis are antineutrophil cytoplasm antibodies (ANCA)-associated vasculitides with significant morbidity and mortality. The long-term survival of patients with ANCA associated vasculitis treated with current regimens is uncertain....

  12. Sobrevida de cinco anos e fatores prognósticos em coorte de pacientes com câncer de mama assistidas em Juiz de Fora, Minas Gerais, Brasil Five-year survival and prognostic factors in a cohort of breast cancer patients treated in Juiz de Fora, Minas Gerais State, Brazil

    Directory of Open Access Journals (Sweden)

    Maximiliano Ribeiro Guerra

    2009-11-01

    Full Text Available O objetivo deste estudo foi analisar a sobrevida de cinco anos e os fatores prognósticos em mulheres com câncer invasivo da mama, submetidas à cirurgia e assistidas em Juiz de Fora, Minas Gerais, Brasil, com diagnóstico da doença entre 1998 e 2000. As variáveis analisadas foram: idade, cor, local de residência, variáveis relacionadas ao tumor e ao tratamento. Foram estimadas as funções de sobrevida pelo método de Kaplan-Meier, e o modelo de riscos proporcionais de Cox foi utilizado para avaliação prognóstica. A sobrevida estimada foi de 81,8%. Tamanho tumoral e comprometimento de linfonodos axilares foram os fatores prognósticos independentes mais importantes, com risco de óbito aumentado para mulheres com tamanho do tumor maior que 2,0cm (HR = 1,97; IC95%: 1,26-3,07 e com metástase para gânglios axilares (HR = 4,04; IC95%: 2,55-6,39. Tais achados enfatizam a importância do diagnóstico e tratamento precoces. O acesso às ações de rastreamento nos diversos níveis de assistência, especialmente para o grupo considerado como de maior risco, deve ser uma prioridade para os gestores de saúde no país.The purpose of this study was to analyze five-year survival and the main prognostic factors among women with invasive breast cancer diagnosed from 1998 to 2000 that had undergone surgical treatment in the city of Juiz de Fora, Minas Gerais State, Brazil. Study variables were: age, skin color, place of residence, tumor-related variables, and treatment-related variables. Survival functions were calculated by the Kaplan-Meier method, and multivariate analysis was performed using the Cox proportional hazard model. Disease-specific survival was 81.8%. Tumor size and lymph node involvement were the main independent prognostic factors in the study population, with increased risk of death for women with tumor size greater than 2.0cm (HR = 1.97; 95%CI: 1.26-3.07 and positive axillary lymph nodes (HR = 4.04; 95%CI: 2.55-6.39. The results

  13. 40 CFR 68.168 - Five-year accident history.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Five-year accident history. 68.168 Section 68.168 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.168 Five-year accident history...

  14. Five years of EACH (European Association for Communication in Healthcare).

    NARCIS (Netherlands)

    Dulmen, S. van; Finset, A.; Langewitz, W.; Zimmermann, C.; Peltenburg, M.; Visser, A.; Bensing, J.

    2006-01-01

    Five years after launching EACH (European Association for Communication in Healthcare) we look back at what EACH achieved so far and announce new ideas and activities EACH plans to carry out in the near future. During the past five years several scientific, educational as well as societal changes

  15. Five years of EACH (European Association for Communication in Healthcare)

    NARCIS (Netherlands)

    Dulmen, S. van; Finset, A.; Langewitz, W.; Zimmermann, C.; Peltenburg, M.; Visser, Adriaan; Bensing, J.

    2006-01-01

    Five years after launching EACH (European Association for Communication in Healthcare) we look back at what EACH achieved so far and announce new ideas and activities EACH plans to carry out in the near future. During the past five years several scientific, educational as well as societal changes

  16. Antioxidant defenses predict long-term survival in a passerine bird.

    Directory of Open Access Journals (Sweden)

    Nicola Saino

    Full Text Available BACKGROUND: Normal and pathological processes entail the production of oxidative substances that can damage biological molecules and harm physiological functions. Organisms have evolved complex mechanisms of antioxidant defense, and any imbalance between oxidative challenge and antioxidant protection can depress fitness components and accelerate senescence. While the role of oxidative stress in pathogenesis and aging has been studied intensively in humans and model animal species under laboratory conditions, there is a dearth of knowledge on its role in shaping life-histories of animals under natural selection regimes. Yet, given the pervasive nature and likely fitness consequences of oxidative damage, it can be expected that the need to secure efficient antioxidant protection is powerful in molding the evolutionary ecology of animals. Here, we test whether overall antioxidant defense varies with age and predicts long-term survival, using a wild population of a migratory passerine bird, the barn swallow (Hirundo rustica, as a model. METHODOLOGY/PRINCIPAL FINDINGS: Plasma antioxidant capacity (AOC of breeding individuals was measured using standard protocols and annual survival was monitored over five years (2006-2010 on a large sample of selection episodes. AOC did not covary with age in longitudinal analyses after discounting the effect of selection. AOC positively predicted annual survival independently of sex. Individuals were highly consistent in their relative levels of AOC, implying the existence of additive genetic variance and/or environmental (including early maternal components consistently acting through their lives. CONCLUSIONS: Using longitudinal data we showed that high levels of antioxidant protection positively predict long-term survival in a wild animal population. Present results are therefore novel in disclosing a role for antioxidant protection in determining survival under natural conditions, strongly demanding for more

  17. Five-year clinical performance of posterior resin composite restorations placed by dental students.

    NARCIS (Netherlands)

    Opdam, N.J.M.; Loomans, B.A.C.; Roeters, F.J.M.; Bronkhorst, E.M.

    2004-01-01

    OBJECTIVES: To investigate the survival over a five-year period of posterior resin composite restorations placed by students. METHODS: Class I and II resin composite restorations placed by second-fourth year dental students were evaluated. Patients attended the dental school every 6 months for a

  18. FORMakademisk – Fem års jubileum - Five years anniversary

    Directory of Open Access Journals (Sweden)

    Janne Beate Reitan

    2013-01-01

    Full Text Available When we first published FORMakademisk five years ago, we stated in the very first editorial on page 1 in Volume 1, Issue 1 that:The aim of the journal is to provide a venue for research in design and design education, and thereby develop an interest and working community of scholars in the field. The editorial team perceives design as a generic term that includes creative and performing activities in the great span of the artefacts ‘from the spoon to the city’. The editorial team relates to design education as a field that includes the dissemination of design in society and the teaching of design at all levels general education, vocational preparation, professional education and research education—from kindergarten to doctorate.Since then we have published two issues every year, nine all together, with more than 50 articles. The editorial team saw that future contributors to FORMakademisk would mainly be recruited from researchers within the design disciplines, and their research interests would have their roots in creative and artistic design practice. At the same time, FORMakademisk has invited scientists from established academic disciplines, when their interest has been directed towards design issues.

  19. Breast sarcoma surgical management: a five-year multicentric study

    Directory of Open Access Journals (Sweden)

    Răzvan V. Scăunașu

    2016-11-01

    Full Text Available Background. Breast sarcomas are a heterogeneous group of breast neoplasms with a low incidence and a reserved prognosis. No treatment protocol has been yet established, a guideline similar to soft tissue sarcomas is used. Materials and Methods. Our study analyzed all the patients admitted with the diagnosis of malignant breast disease in two specialized centers on a five-year time frame. We compared long term results for the patients who underwent conservative treatment and mastectomy. Results. A total of 76 cases received surgical treatment with curative intent, 24 conservative procedures and 52 mastectomies. Incidence of local recurrence does not appear to be closely related to the type of surgical procedure. There were a number of five local recurrences for patients who received conservative treatment and 7 local recurrences where we used mastectomy. Kaplan-Meier analysis conducted shows no differences statistically significant (sig = 0.459 between the results of conservative treatment and mastectomy. Basically conservative surgery seems to get similar results, provided that R0 resection objective can be met. Conclusions. Treatment options are more limited for breast sarcomas than carcinomas, the role of surgery being more important to therapeutic success. The biological characteristic of the tumor including histological type and sub-type, play an important role in determining the results and the treatment should be tailored and adapted for each case.

  20. Smoking and Histological Factors Influencing Long-term Survival of Gastric Carcinoma in Consecutive Patient Series

    Directory of Open Access Journals (Sweden)

    Ali Delpisheh

    2014-06-01

    Full Text Available Background: There is little information about the possible influence of lifestyle and etiologic risk factors on survival amongst patients with gastric cancer. Methods: We recruited a consecutive series of 249 patients with definite diagnosis of gastric cancer who had been hospitalized in Towhid Hospital, Sanandaj, Kurdistan Province in Western Iran during a five-year period from 2006 until 2011. Survival rate was calculated according to the Kaplan-Meier and log rank statistical methods. Cox hazard regression was used to investigate the effect of the variables and adjust for the effect of age. Results: According to univariate analysis, related variables that included age, gender, Residence, histology grade, histology type, familial history of gastrointestinal cancer and mental illness during the disease had no significant effects on survival rate variation. Significant independent factors on survival included past medical history of gastrointestinal diseases (P-value = 0.010, tobacco smoking (P-value = 0.012, and early diagnosis (P-value = 0.008. Cox-regression analysis of demographic, lifestyle and histological factors with >45 years of age as the reference revealed that patients 46-65 years of age at diagnosis (HR=0.602; 95% CI=0.250-1.44; P=0.256 and those >66 years of age (HR=1.07, 95% CI=0.46-2.50, P≤0.001 had an increased risk for disease progression and death. Conclusions: Past medical history of gastrointestinal diseases, tobacco smoking and early stage diagnosis might influence the long-term survival of patients with gastric cancer.

  1. Five-year workplace wellness intervention in the NHS.

    Science.gov (United States)

    Blake, Holly; Zhou, Dingyuan; Batt, Mark E

    2013-09-01

    Poor health and well-being has been observed among NHS staff and has become a key focus in current public health policy. The objective of this study was to deliver and evaluate a five-year employee wellness programme aimed at improving the health and well-being of employees in a large NHS workplace. A theory-driven multi-level ecological workplace wellness intervention was delivered including health campaigns, provision of facilities and health-promotion activities to encourage employees to make healthy lifestyle choices and sustained behaviour changes. An employee questionnaire survey was distributed at baseline (n = 1,452) and at five years (n = 1,134), including measures of physical activity, BMI, diet, self-efficacy, social support, perceived general health and mood, smoking behaviours, self-reported sickness absence, perceived work performance and job satisfaction. Samples were comparable at baseline and follow-up. At five years, significantly more respondents actively travelled (by walking or cycling both to work and for non-work trips) and more were active while at work. Significantly more respondents met current recommendations for physical activity at five years than at baseline. Fewer employers reported 'lack of time' as a barrier to being physically active following the intervention. Significantly lower sickness absence, greater job satisfaction and greater organisational commitment was reported at five years than at baseline. Improvements in health behaviours, reductions in sickness absence and improvements in job satisfaction and organisational commitment were observed following five years of a workplace wellness intervention for NHS employees. These findings suggest that health-promoting programmes should be embedded within NHS infrastructure.

  2. Long-term survival in a case of hepatocellular carcinoma.

    OpenAIRE

    Shiota,Tetsuya; Watanabe,Akiharu; Mitani,Ken; Ito,Toshio; Tobe,Kazuo; Nagashima,Hideo

    1983-01-01

    A patient with an unresectable hepatocellular carcinoma (HCC) who survived without active treatment 3 years and 8 months after histological diagnosis is described. The size of the liver, which was already quite huge at the time of diagnosis, changed little during the entire clinical observation. However, 2 months before death, his condition deteriorated rapidly following gastrointestinal bleeding due to the direct invasion of the stomach by HCC. A critical reason for the unusually long-term s...

  3. ORIGINAL ARTICLES Forty-five years apart - confronting the legacy ...

    African Journals Online (AJOL)

    ORIGINAL ARTICLES. Forty-five years apart - confronting the legacy of racial discrimination at the University of Cape Town. G Perez, L London. One of the many consequences of South Africa's history of racial discrimination is the impact it had on the training of black medical students. Blacks, and particularly those classified.

  4. Home Management of Febrile Children Under-Five Years in ...

    African Journals Online (AJOL)

    An assessment of the prevalence and the factors associated with home treatment of children less than five years with febrile illnesses was carried out at Mmuhungura Ward in Kahama District, Shinyanga, Tanzania. Out of the 400 under-fives who participated in the study, 79% had fallen sick during the previous six months.

  5. Annex A1: cornerstone of the five-yearly review

    CERN Multimedia

    Staff Association

    2016-01-01

    As a reminder; the purpose of the five-yearly review is to review the financial and social conditions of all CERN personnel whether employed (MPE) or associated (MPA)! In December 2015, the CERN Council approved the package proposed by the Management. Early this year, and as final act of the 2015 five-yearly review, the CERN Council may decide, if necessary and appropriate, to review the procedures defined in Annex A1 and applicable to future five-yearly reviews. At the meeting of TREF (TRipartite Employment Forum)  in early March 2016 discussions will take place between all stakeholders (representatives of Member States, Management and the Staff Association) and Council will take a decision in June 2016, on the basis of the Management's recommendations. What does Annex A1 say and where can I find it? Annex A1 (Article S V 1.02) is a part of the Staff Rules and Regulations. This annex defines: The five-yearly review of the financial and social conditions of the staff, fellows and MPA; The a...

  6. Outcome of the 2015 five-yearly review: decision time

    CERN Multimedia

    Staff Association

    2015-01-01

    To ensure that CERN remains a centre of excellence in the field of fundamental research, the Organization verifies every five years with the help of a Five-yearly review procedure whether the financial and social conditions which it proposes to its staff allow it to recruit and retain Staff Members of the highest competence and integrity required for the execution of its mission and coming from all Member States. For Fellows these conditions should remain attractive compared with those in comparable research institutions, while for Associated members of personnel the conditions should allow it to host them in its research facilities taking into account the highest cost-of-living level in the local region of the Organization. Annex A1 of the CERN Staff Rules prescribes the principles of how to manage this Five-Yearly process. Getting ready In order to prepare the 2015 Five-yearly review and to help define the topics which had to be decided by the CERN Council in June 2014, the Staff Association has organized ...

  7. Ulnar nerve lesions : functional outcome after five years

    NARCIS (Netherlands)

    van Nispen, FCM; Dijkstra, PU; Geertzen, JHB; Groothoff, JW; Eisma, WH

    Objective: To analyse perceived impairments, disability, job restrictions and job changes in subjects with a neurapraxia and neurotmesis of the ulnar nerve five years after trauma. Design: Retrospective, descriptive follow-up study. Setting: Department of Rehabilitation of a University Hospital.

  8. Nutritional status of children under five years and associated factors

    African Journals Online (AJOL)

    ACSS

    Information on nutritional status of children under five years is an indicator of the nutritional situation in society. Identification of core factors influencing nutrition of this population supports plans to alleviate child malnutrition and its consequences. This study sought to determine the nutritional status of children under five ...

  9. Five year review of oropharyngeal cancer patients at University of ...

    African Journals Online (AJOL)

    Five year review of oropharyngeal cancer patients at University of Ilorin Teaching Hospital, north central Nigeria. H.K. Omokanye, O.A. Afolabi, S. Segun-Busari, S.I. Muhammed, S.O. Ayodele, N.O. Shittu, B.S. Alabi ...

  10. Long-term survival and healthcare utilization outcomes attributable to sepsis and pneumonia

    Directory of Open Access Journals (Sweden)

    Dick Andrew

    2012-11-01

    Full Text Available Abstract Background Hospital associated infections are major problems, which are increasing in incidence and very costly. However, most research has focused only on measuring consequences associated with the initial hospitalization. We explored the long-term consequences of infections in elderly Medicare patients admitted to an intensive care unit (ICU and discharged alive, focusing on: sepsis, pneumonia, central-line-associated bloodstream infections (CLABSI, and ventilator-associated pneumonia (VAP; the relationships between the infections and long-term survival and resource utilization; and how resource utilization was related to impending death during the follow up period. Methods Clinical data and one year pre- and five years post-index hospitalization Medicare records were examined. Hazard ratios (HR and healthcare utilization incidence ratios (IR were estimated from state of the art econometric models. Patient demographics (i.e., age, gender, race and health status and Medicaid status (i.e., dual eligibility were controlled for in these models. Results In 17,537 patients, there were 1,062 sepsis, 1,802 pneumonia, 42 CLABSI and 52 VAP cases. These subjects accounted for 62,554 person-years post discharge. The sepsis and CLABSI cohorts were similar as were the pneumonia and VAP cohorts. Infection was associated with increased mortality (sepsis HR = 1.39, P  Conclusions The infections had significant and lasting adverse consequences among the elderly. Yet, many of these infections may be preventable. Investments in infection prevention interventions are needed in both community and hospitals settings.

  11. Prognostic significance of transient myocardial ischaemia after first acute myocardial infarction: five year follow up study

    DEFF Research Database (Denmark)

    Mickley, H; Nielsen, J R; Berning, J

    1995-01-01

    OBJECTIVE: To assess the five year prognostic significance of transient myocardial ischaemia on ambulatory monitoring after a first acute myocardial infarction, and to compare the diagnostic and long term prognostic value of ambulatory ST segment monitoring, maximal exercise testing, and echocard...

  12. Neosporosis in animals--the last five years.

    Science.gov (United States)

    Dubey, J P; Schares, G

    2011-08-04

    Neospora caninum is a protozoan parasite of animals. Until 1988, it was misdiagnosed as Toxoplasma gondii. Since its first recognition in 1984 in dogs and the description of a new genus and species Neospora caninum in 1988, neosporosis has emerged as a serious disease of cattle and dogs worldwide. Abortions and neonatal mortality are a major problem in livestock operations and neosporosis is a major cause of abortion in cattle. This review is focused on current status of neosporosis in animals based on papers published in the last five years. Worldwide seroprevalences are tabulated. Strategies for control and prevention are discussed. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. LONG TERM SURVIVAL FOLLOWING TRAUMATIC BRAIN INJURY: A POPULATION BASED PARAMETRIC SURVIVAL ANALYSIS

    Science.gov (United States)

    Fuller, Gordon Ward; Ransom, Jeanine; Mandrekar, Jay; Brown, Allen W

    2017-01-01

    Background Long term mortality may be increased following traumatic brain injury (TBI); however the degree to which survival could be reduced is unknown. We aimed to model life expectancy following post-acute TBI to provide predictions of longevity and quantify differences in survivorship with the general population. Methods A population based retrospective cohort study using data from the Rochester Epidemiology Project (REP) was performed. A random sample of patients from Olmsted County, Minnesota with a confirmed TBI between 1987 and 2000 was identified and vital status determined in 2013. Parametric survival modelling was then used to develop a model to predict life expectancy following TBI conditional on age at injury. Survivorship following TBI was also compared with the general population and age and gender matched non-head injured REP controls. Results 769 patients were included in complete case analyses. Median follow up time was 16.1 years (IQR 9.0–20.4) with 120 deaths occurring in the cohort during the study period. Survival after acute TBI was well represented by a Gompertz distribution. Victims of TBI surviving for at least 6 months post-injury demonstrated a much higher ongoing mortality rate compared to the US general population and non-TBI controls (hazard ratio 1·47, 95% CI 1·15–1·87). US general population cohort life table data was used to update the Gompertz model’s shape and scale parameters to account for cohort effects and allow prediction of life expectancy in contemporary TBI. Conclusions Survivors of TBI have decreased life expectancy compared to the general population. This may be secondary to the head injury itself or result from patient characteristics associated with both the propensity for TBI and increased early mortality. Post-TBI life expectancy estimates may be useful to guide prognosis, in public health planning, for actuarial applications and in the extrapolation of outcomes for TBI economic models. PMID:27165161

  14. The 2015 Five-yearly review: diversity in the spotlight

    CERN Multimedia

    Staff Association

    2014-01-01

    Introduction As mentioned in Echo 201, with the Council Decision of last June the CERN 2015 five-yearly review has formally begun. Following the procedure defined in Annex A1 of the Staff Rules and Regulations CERN will thus review its financial and social conditions that should enable it to recruit from all its Member States, and retain, staff of the highest competence and integrity necessary to perform its mission. In addition, these conditions should increase the attractiveness of CERN in all Member States and motivate staff of all ages and all occupations throughout their careers. Annex A1 stipulates that a five-yearly review must include basic salaries (stipends for Fellows and subsistence allowances for associated members of the personnel) and, optionally, may include any other financial or social conditions. For this optional part of the 2015 exercise, the CERN career structure and measures to improve diversity were chosen. Towards a better diversity policy The analysis of the 2013 Staff Associat...

  15. Five years of the Normal Oceanic Mantle (NOMan) Project

    Science.gov (United States)

    Utada, Hisashi; Kawakatsu, Hitoshi; Shiobara, Hajime; Baba, Kiyoshi; Isse, Takehi; Suetsugu, Daisuke; NOMan Project Team

    2016-04-01

    The Normal Oceanic Mantle (NOMan) project was carried out for 5 years from 2010, aiming to solve two fundamental questions on the 'normal' oceanic mantle from observational approach, which are: (a) Cause of asthenosphere lubrication, and (b) Amount of water in the mantle transition zone. We selected two study areas (A and B) of similar seafloor age (about 130 and 140 Ma, respectively) in the northwestern Pacific Ocean where the mantle below is supposed to be normal. This presentation will give an overview of five years of the NOMan project, especially of its observational activities and a summary of preliminary results so far obtained. In June 2010, we deployed a small array consisting of 5 (both seismic and EM) sites and started data acquisition from area A, which we call the NOMan pilot experiment. The main observation by long-term seafloor arrays in areas A and B was started by two installation cruises carried out in November 2011 and in August 2012, deploying state-of-the-art ocean bottom seismic and electromagnetic instruments (BBOBS-NXs and EFOSs) in area A that are handled by ROV for installation and recovery. Conventional instruments (BBOBS and OBEM of free-fall/self-pop-up type) were also deployed both in areas A and B. Most of instruments of the pilot experiment were recovered by the cruise in August 2012. So-called advanced instruments (BBOBS-NXs and EFOSs) were equipped with batteries sufficient for 2 years of deployment, but conventional instruments (BBOBSs and OBEMs) only for one year or so. Therefore, we conducted a cruise by W/V Kaiyu in August 2013 to maintain the observation array by retrieving and re-deploying respective instruments. In June 2014, we conducted another W/V Kaiyu cruise, in which we recovered most of conventional instruments in area A after conducting a controlled source seismic experiment by using explosive sources. In September 2014, we completed a recovery cruise by R/V Kairei with ROV Kaiko-7000II. By these two cruises

  16. Prenatal methylmercury poisoning: clinical observations over five years

    Energy Technology Data Exchange (ETDEWEB)

    Amin-Zaki, L. (Univ. of Baghdad, Iraq); Majeed, M.A.; Elhassani, S.B.; Clarkson, T.W.; Greenwood, M.R.; Doherty, R.A.

    1979-02-01

    Thirty-two infants prenatally exposed to methylmercury and their mothers were examined over a five-year period after the Iraqi methylmercury epidemic. Severity of poisoning in mothers was related to the peak mercury concentration in their hair and in the infants to the maximum concentration in maternal hair during pregnancy. In nine cases of cerebral palsy, methylmercury exposure occurred only during the last trimester. All infants except three (two were orphaned soon after birth and one was bottle-fed) were exposed postnatally via suckling. Whereas the mother's symptoms usually improved, the damage to the fetal nervous system appears to be permanent. Milder cases previously not identified in other studies are reported. The syndrome consists of varying degrees of developmental retardation in addition to exaggerated tendon reflexes and the pathologic extensor plantar reflex (minimal brain damage syndrome).

  17. AMBULATORY CARE - SENSITIVE CONDITIONS IN CHILDREN UNDER FIVE YEARS

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Araújo Figueiredo

    2013-05-01

    Full Text Available Objective:analyzethe extent to which the incidence rate of primary care sensitivehospitalizations in children under five years is influenced by the percentage of coverage of theprimary care.Methods:This was a cross-sectional ecological study that combines coverage ofprimary careand theambulatorycare-sensitiveconditionsin 2000 and 2010. We used data from theHospital Information System (HIS and the Information System of Primary Care (SIAB.Results:The data revealed that the increased coverage providedprimary carereductionrateofhospitalization diseases studied. In 2000 the reduction was greater for gastroenteritis (51% inchildren under 01 years and 30% in children 01-04 years in 2010 for respiratory diseases (51% inchildren under 01years and 33% in children aged 01-04 years.Conclusion:we found an association between the coverage ofprimary careand admission rates, however seem to affect othervariables, suggesting the need for further studies.

  18. Bronchiectasis in the Last Five Years: New Developments

    Directory of Open Access Journals (Sweden)

    Jun Keng Khoo

    2016-12-01

    Full Text Available Bronchiectasis, a chronic lung disease characterised by cough and purulent sputum, recurrent infections, and airway damage, is associated with considerable morbidity and mortality. To date, treatment options have been limited to physiotherapy to clear sputum and antibiotics to treat acute infections. Over the last decade, there has been significant progress in understanding the epidemiology, pathophysiology, and microbiology of this disorder. Over the last five years, methods of assessing severity have been developed, the role of macrolide antibiotic therapy in reducing exacerbations cemented, and inhaled antibiotic therapies show promise in the treatment of chronic Pseudomonas aeruginosa infection. Novel therapies are currently undergoing Phase 1 and 2 trials. This review aims to address the major developments within the field of bronchiectasis over this time.

  19. Hanford Atomic Products Operation Five-Year Program

    Energy Technology Data Exchange (ETDEWEB)

    Priode, C.A.; Benoliel, R.W.; Gilbert, W.D.; McGrath, R.E.; Tomlinson, R.E.; Zuhr, H.F. [comps.

    1958-05-19

    The General Electric Company has prepared in past years numerous documents for the Atomic Energy Commission outlining in some detail its current and proposed programs at Hanford. Last year, at the request of the commission, program types of information were consolidated into one document, the HAPO Five Year Program. That document was well received and useful to an extent that the General Electric Company was requested by the Commission to prepare another covering the fiscal years 1959 through 1963. In outlining the five year program for the Hanford Atomic Products Operation, the General Electric Company has made assumptions regarding the US Atomic Energy Commission`s current and future programs and Hanford`s relationship to these programs. Two major objectives of the Commission were considered basic for future planning: first, to provide adequate atomic weapons for national defense; and second, to encourage and assist in the development of atomic energy for peaceful uses. The Hanford contributions to these objectives are conceived to include the acquisition and potential application of new technology in support of: (1) Increased production of plutonium, as nitrate solution, buttons, and as current and future shapes. (2) A program that will provide the technological capability to implement broad changes in the Commission`s programs such as conversion of Hanford reactors to tritium production, the separation and packaging of mixed and specific fission products, the recovery of transuranic elements, the processing of power reactor fuels, and the provision of weapons assembly capability. (3) Optimum costs, operating and capital. (4) New production reactor designs and concepts. (5) Use of plutonium as power reactor fuel. (6) Operation of nuclear reactors and associated plants with assured radiological protection of both workers and people and other forms of life in the environs.

  20. Long-Term Survival in a Patient with Multiple Brain Metastases from Small-Cell Lung Cancer Treated with Gamma Knife Radiosurgery on Four Occasions: A Case Report

    Directory of Open Access Journals (Sweden)

    Ameer L. Elaimy

    2012-01-01

    Full Text Available Brain metastases are the most common cancerous neoplasm in the brain. The treatment of these lesions is challenging and often includes a multimodality management approach with whole-brain radiation therapy, stereotactic radiosurgery, and neurosurgery options. Although advances in biomedical imaging technologies and the treatment of extracranial cancer have led to the overall increase in the survival of brain metastases patients, the finding that select patients survive several years remains puzzling. For this reason, we present the case of a 70-year-old patient who was diagnosed with multiple brain metastases from small-cell lung cancer five years ago and is currently alive following treatment with chemotherapy for the primary cancer and whole-brain radiation therapy and Gamma Knife radiosurgery on four separate occasions for the neurological cancer. Since the diagnosis of brain metastases five years ago, the patient’s primary cancer has remained controlled. Furthermore, multiple repeat GKRS procedures provided this patient with high levels of local tumor control, which in combination with a stable primary cancer led to an extended period of survival and a highly functional life. Further analysis and clinical research will be valuable in assessing the durability of multiple GKRS for brain metastases patients who experience long-term survival.

  1. Long-term survival after out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Holler, Nana G; Mantoni, Teit; Nielsen, Søren L

    2007-01-01

    an initial rhythm of VF, 13% had asystole, 10% had PEA and 2% were unknown. Survival was 87% after one year and survival after 10 years was 46% with a significantly lower survival for patients over 60 years. CONCLUSION: Long-term survival after out-of-hospital cardiac arrest in a physician-staffed emergency...

  2. Infectious Diseases of Poverty, the first five years.

    Science.gov (United States)

    Wang, Wei; Chen, Jin; Sheng, Hui-Feng; Wang, Na-Na; Yang, Pin; Zhou, Xiao-Nong; Bergquist, Robert

    2017-05-04

    Although the focus in the area of health research may be shifting from infectious to non-communicable diseases, the infectious diseases of poverty remain a major burden of disease of global health concern. A global platform to communicate and share the research on these diseases is needed to facilitate the translation of knowledge into effective approaches and tools for their elimination. Based on the "One health, One world" mission, a new, open-access journal, Infectious Diseases of Poverty (IDP), was launched by BioMed Central in partnership with the National Institute of Parasitic Diseases (NIPD), Chinese Center for Disease Control and Prevention (China CDC) on October 25, 2012. Its aim is to identify and assess research and information gaps that hinder progress towards new interventions for a particular public health problem in the developing world. From the inaugural IDP issue of October 25, 2012, a total of 256 manuscripts have been published over the following five years. Apart from a small number of editorials, opinions, commentaries and letters to the editor, the predominant types of publications are research articles (69.5%) and scoping reviews (21.5%). A total of 1 081 contributing authors divided between 323 affiliations across 68 countries, territories and regions produced these 256 publications. The journal is indexed in major international biomedical databases, including Web of Science, PubMed, Scopus and Embase. In 2015, it was assigned its first impact factor (4.11), which is now 2.13. During the past five years, IDP has received manuscripts from 90 countries, territories and regions across six continents with an annual acceptance rate of all contributions maintained at less than 40%. Content analysis shows that neglected tropical diseases (NTDs), followed by the "Big Three" (HIV/AIDS, malaria and tuberculosis) and infectious diseases in general comprise 88% of all publications. In addition, a series of 10 thematic issues, covering 118 publications

  3. The five-year results of the Birmingham Hip Resurfacing arthroplasty: an independent series.

    Science.gov (United States)

    Steffen, R T; Pandit, H P; Palan, J; Beard, D J; Gundle, R; McLardy-Smith, P; Murray, D W; Gill, H S

    2008-04-01

    Few independent studies have reported the outcome of resurfacing arthroplasty of the hip. The aim of this study was to report the five-year clinical outcome and seven-year survival of an independent series. A total of 610 Birmingham Hip Resurfacing arthroplasties were performed in 532 patients with a mean age of 51.8 years (16.5 to 81.6). They were followed for between two and eight years; 107 patients (120 hips) had been followed up for more than five years. Two patients were lost to follow-up. At a minimum of five years' follow-up, 79 of 85 hips (93%) had an excellent or good outcome according to the Harris hip score. The mean Oxford hip score was 16.1 points (sd 7.7) and the mean University of California Los Angeles activity score was 6.6 points (sd 1.9). There were no patients with definite radiological evidence of loosening or of narrowing of the femoral neck exceeding 10% of its width. There were 23 revisions (3.8%), giving an overall survival of 95% (95% confidence interval 85.3 to 99.2) at seven years. Fractured neck of femur in 12 hips was the most common indication for revision, followed by aseptic loosening in four. In three hips (three patients) (0.5%), failure was possibly related to metal debris. Considering that these patients are young and active these results are good, and support the use of resurfacing. Further study is needed to address the early failures, particularly those related to fracture and metal debris.

  4. Does television viewing predict dietary intake five years later in high school students and young adults?

    Directory of Open Access Journals (Sweden)

    Neumark-Sztainer Dianne

    2009-01-01

    Full Text Available Abstract Background Prior research has found that television viewing is associated with poor diet quality, though little is known about its long-term impact on diet, particularly during adolescence. This study examined the associations between television viewing behavior with dietary intake five years later. Methods Survey data, which included television viewing time and food frequency questionnaires, were analyzed for 564 middle school students (younger cohort and 1366 high school students (older cohort who had complete data available at Time 1 (1998–1999 and five years later at Time 2 (mean age at Time 2, 17.2 ± 0.6 and 20.5 ± 0.8 years, respectively. Regression models examined longitudinal associations between Time 1 television viewing behavior and Time 2 dietary intake adjusting for sociodemographic characteristics, Time 1 dietary intake, and Time 2 total daily energy intake. Results Respondents were categorized as limited television users (2 hours/daily, moderately high television viewers (2–5 hours/daily, and heavy television viewers (≥5 hours/daily. Among the younger cohort, Time 1 heavy television viewers reported lower fruit intake and higher sugar-sweetened beverage consumption than the other two groups. Among the older cohort, watching five or more hours of television per day at Time 1, predicted lower intakes of fruits, vegetables, whole grain and calcium-rich foods, and higher intakes of trans fat, fried foods, fast food menu items, snack products, and sugar-sweetened beverages (products commonly advertised on television five years later. Conclusion Television viewing in middle and high school predicted poorer dietary intake five years later. Adolescents are primary targets of advertising for fast food restaurants, snack foods, and sugar-sweetened beverages, which may influence their food choices. Television viewing, especially during high school, may have long-term effects on eating choices and contribute to poor eating

  5. Management of hyperparathyroidism: a five year surgical experience.

    Science.gov (United States)

    Afzal, Ameer; Gauhar, Tooba Mahmud; Butt, Waqas Tariq; Khawaja, Ali Azim; Azim, Khawaja Muhammad

    2011-12-01

    To summarize the management of hyperparathyroidism at a tertiary care hospital in Lahore, so that the disease characteristics specific to our population could be identified. Also to determine if focused parathyroidectomy was successful without intra operative localization studies. Retrospective analysis was conducted on all cases of hyperparathyroidism, managed at the East Surgical Ward, Mayo Hospital, Lahore, during a five year period (2005-2009). Thirty-two cases of primary hyperparathyroidism and 3 cases of secondary hyperparathyroidism were managed at the East Surgical Ward from 2004-2009. For primary hyperparathyroidism the mean age of presentation was 40.78 +/- 15.42 years and the mean duration of symptoms was 33.96 +/- 27.29 months. Advanced musculoskeletal symptoms were the most common presenting feature followed by gastrointestinal complaints and recurrent renal stones. Unilateral neck exploration and excision of adenoma was carried out successfully in all cases where the results of ultrasound neck and technetium-99m sestamibi scan were concordant. Bilateral neck exploration was performed in all other cases. Decreased serum calcium level was achieved post operatively in all cases and no residual disease or recurrence was encountered on follow up. Patients of hyperparathyroidism in our country, tend to present late after the development of complications. Pre operative localization studies like ultrasound neck and sestamibi scan have enabled us to carry out directed exploration rather than bilateral neck exploration in every case. Accurate pre operative assessment and safe surgery offers cure to all patients with primary hyperparathyroidism.

  6. [Special considerations in children under five years with asthma].

    Science.gov (United States)

    Cuevas Schacht, Francisco J; Cano Salas, Maria del Carmen

    2009-01-01

    Currently, clinical practice guidelines and international guidelines on diagnosis and management of asthma, including special considerations in patients under five years old, given the frequent respiratory morbidity associated with this age group and poor or no cooperation from the child for testing respiratory function, favoring the underdiagnosis, delaying treatment and affecting the proper assessment of severity, level of control, and adequate clinical response to treatment. That is why the proper understanding of the natural history and the different phenotypes in infants and toddlers, allow for functional and clinical considerations on the progression of asthma from early childhood to adulthood, being necessary to make a special deal considering personal and family history, symptoms and progression of comorbidities exist which in turn will classify, monitor and plan treatment to achieve and maintain control of the disease, so far as asthma is not cured but their control is achieved in most patients. The doctor-patient interaction, family, education, control of risk factors and comorbidities, assessment, treatment and monitoring of the development of asthma are the foundation for success in the management of asthmatic patients.

  7. Aerosol sun photometry throughout five years in Japan

    Science.gov (United States)

    Sano, I.; Mukai, S.; Holben, B.

    Japan locates in an interesting region for aerosol study Most of natural and anthropogenic aerosols can be measured Some of natural aerosols are the oceanic type aerosols provided from the ocean e g West Pacific Ocean Sea of Japan and East China Sea and the other is Asian dust what one calls Yellow sand coming from Gobi and Taklamakan desert area in China It should be enhanced that most of these natural aerosols especially dust aerosols are mixed with the anthropogenic e g nitrate and sulfate aerosols during long distance transportation Two automatic sun sky radiometers have been set for the worldwide aerosol sun photometer network AERONET One is facing to Pacific Ocean Shirahama for taking continuous measurements of background aerosols of Japan and the other is set at megalopolis city Osaka This work intends to show the temporary and or spatially change of aerosol properties e g aerosol optical thickness at 0 44 0 67 and 0 87 microns size distribution and single scattering albedo For instance the regional difference between city and remote area is examined and time variation involves long time change over five years and also seasonal change

  8. The Pasadena Recommendations: Five Years After AAS Endorsement

    Science.gov (United States)

    Knezek, Patricia; Frattare, L.; Ulvestad, J.

    2010-01-01

    It has been five years since the AAS Council unanimously endorsed the document, known as "Equity Now: The Pasadena Recommendations for Gender Equality in Astronomy," in January 2005. This document was the main product of the conference entitled "Women in Astronomy II: Ten Years After” (WIA II), held in June 2003 in Pasadena, CA. Participants of that 2003 meeting assessed the progress for women in science, offering insights into causes of the slower advancement of women, and discussed strategies to accelerate the achievement of equality. These insights and strategies were then incorporated into the "Pasadena Recommendations" by the CSWA. It was subsequently released to the entire AAS community for review and comments prior to its endorsement by the AAS. We will discuss the Recommendations and their impact since the endorsement by the AAS, including the process that is in place for organizations and departments to formally endorse the Pasadena Recommendations, thus making an organizational commitment to their implementation (see http://www.aas.org/cswa/pasadena_endorse.html).

  9. Primary testicular plasmocytoma: A five year follow-up

    Directory of Open Access Journals (Sweden)

    Milton Ghirelli Filho

    2013-01-01

    Full Text Available The testicular plasmocytoma represents only 5% of the non-germinative cell testicular tumors, and accounts for only 2% of all plasma cell neoplasms. Approximately, 50 cases of testicular plasmocytoma have been reported in medical literature; however, only 9 of these are isolated tumors without previous history or progression to multiple myeloma. A 47-year-old patient, presenting progressive and painless growth of the right testicle in the last four years, underwent surgical treatment in another hospital two years ago, to correct a hydrocele in the same testicle with no improvement at all. Sonography showed a tumor with the following measurements for the right testicle: 84 × 59 × 80 mm. The tumor marker values were all normal. An abdominal computed tomography found no evidence of retroperitoneal lymph nodes invasion. The patient underwent a right radical orchiectomy. Pathologic analysis revealed a malignant neoplasia described as a plasmocytoma (solitary myeloma that produces immunoglobulin′s kappa light chain. After five years of follow-up, there were no signs of metastasis or local recurrence in the exams. Case report and review of literature have been presented here.

  10. Five-yearly review: where do we stand now?

    CERN Multimedia

    Staff Association

    2016-01-01

    A reminder The first issue of Echo in 2016 announced a year of changes with many challenges for the Staff Association and the staff it represents. Indeed, following the decision of the Council in December 2015 to approve all components of the five-yearly review, many changes were to be implemented in 2016. This is the case of the new career structure, the definition of benchmark jobs (BMJ), the redesign of the advancement and promotions process, etc. Looking back at 2015 and the various statements In December 2015, the CERN Council emphasized: the substantial effort made by the Staff Association and the Management, taking into account the difficult economic situation faced by some Member States, led to the creation of a package of measures as balanced as possible. It is clear however: that there was no alignment of CERN basic salaries with the comparison salaries; that in the new career system, staff will have their advancement prospects, and consequently the level of their pension, reduced with respect to ...

  11. 47 CFR 22.947 - Five year build-out period.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Five year build-out period. 22.947 Section 22... MOBILE SERVICES Cellular Radiotelephone Service § 22.947 Five year build-out period. Except for systems... channel block during the five year build-out period. (b) Partitioned markets. During the five-year build...

  12. A Five-Year Review of Tag Rugby Hand Injuries.

    Science.gov (United States)

    Joyce, C W; Woods, J F C; Murphy, S; Bollard, S; Kelly, J L; Carroll, S M; O'Shaughnessy, M

    2016-10-01

    Tag rugby is one of the fastest growing sports in Ireland. It is a soft-contact team game that is loosely based on the rugby league format except players try to remove Velcro tags from their opponents' shorts rather than engage in a typical rugby tackle. The purpose of this study was to examine all tag rugby associated hand injuries over a five-year period in three large tertiary referral hospitals in Ireland. Using the patient corresponding system, 228 patients with hand injury related tag rugby injuries were observed from 2010 to 2015. There were 138 males and 90 females in the study and over 40% of patients required surgery. Most of the patients were young professionals with an average age of 30. Twenty-five patients worked in the financial services whilst there were 23 teachers. Fractures accounted for 124 of the 228 injuries and mallet injuries accounted for 53. Eighty percent of all injuries occurred during the tackle. The mean number of days missed from work was 9.1±13.8 days. These injuries resulted in an average of seven hospital appointments per patient. Considering it is a soft-contact sport, it is surprising the number of hand injuries that we have observed. Although safety measures have been introduced to decrease the number of hand injuries in recent years, there is a need for further improvements. Better player education about seeking prompt medical attention once an injury occurs, coupled with longer shorts worn by players may improve measures for the sport. Copyright © 2016. Published by Elsevier Ltd.

  13. Adherence to vaccination guidelines post splenectomy: A five year follow up study.

    Science.gov (United States)

    Boam, Tristan; Sellars, Peter; Isherwood, John; Hollobone, Chloe; Pollard, Cristina; Lloyd, David M; Dennison, Ashley R; Garcea, Giuseppe

    Following a splenectomy patients are at increased risk of significant infections. In its most severe form, overwhelming post-splenectomy infection (OPSI) has a mortality rate of up to 80%. In this study we aim to establish the adherence to vaccination and antibiotic national guidelines in splenectomised patients. A retrospective study of 100 patients who underwent splenectomy (21 emergency, 79 elective), in two teaching hospitals was undertaken over a five-year period. Patients were followed up for five years. Hospital and GP records were reviewed for adherence to pre, intra and postoperative vaccination, thromboprophylaxis and antibiotic guidance. Eighty-six eligible patients (91.5%) received their Haemophilus influenzae B, meningococcal C and pneumococcus vaccinations peri-operatively. Eighty-one (86%) received post-operative antibiotics. Ninety-nine percent of patients received thromboprophylaxis treatment. Eighty-nine (95%) were treated with long-term antibiotic prophylaxis. Only 20 patients (23%) had an emergency supply of antibiotics. Ninety-five percent of patients were administered an annual influenza vaccination and 84% of eligible patients received a five-year pneumococcal booster vaccination. Improvement in the management of this patient cohort can be achieved by a multidisciplinary approach involving adherence to national guidelines, standardised trust protocols, patient information leaflets and advice detailing risk of infection, standardised GP letters and a splenectomy register to monitor and manage this vulnerable group of patients. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Long-Term Survival in Patients with Metastatic Melanoma Treated with DTIC or Temozolomide

    OpenAIRE

    Kim, Christina; Lee, Christopher W; Kovacic, Laurel; Shah, Amil; Klasa, Richard; Savage, Kerry J.

    2010-01-01

    The study examined long-term survivors from among metastatic melanoma patients treated with either dacarbazine or temozolomide to relate long-term survival to sensitivity to chemotherapy. Patients achieving a complete response to chemotherapy were more likely to attain long-term survival.

  15. Pulseless electrical activity and successful out-of-hospital resuscitation – long-term survival and quality of life: an observational cohort study

    Directory of Open Access Journals (Sweden)

    Saarinen Sini

    2012-10-01

    Full Text Available Abstract Background The aim of the study was to evaluate the long-term outcome of patients successfully resuscitated from pre-hospital cardiac arrest with initial pulseless electrical activity (PEA, because the long-term outcome of these patients is unknown. Survival, neurological status one year after cardiac arrest and self-perceived quality of life after five years were assessed. Methods This retrospective study included adult patients resuscitated from PEA between August 2001 and March 2003 in three urban areas in southern Finland. A validated questionnaire was sent to patients while neurological status according to the Cerebral Performance Category (CPC -classification was assessed based on medical database notes recorded during follow-up evaluations. Results Out of 99 included patients in whom resuscitation was attempted, 41 (41% were successfully resuscitated and admitted to hospital. Ten (10% patients were discharged from hospital. Seven were alive after one year and six after five years following cardiac arrest. Five of the seven patients alive one year after resuscitation presented with the same functional level as prior to cardiac arrest. Conclusions Patients with initial PEA have been considered to have poor prognosis, but in our material, half of those who survived to hospital discharge were still alive after 5 years. Their self-assessed quality of life seems to be good with only mild to moderate impairments in activities of daily life.

  16. Twenty-Five Year Site Plan FY2013 - FY2037

    Energy Technology Data Exchange (ETDEWEB)

    Jones, William H. [Los Alamos National Laboratory

    2012-07-12

    Los Alamos National Laboratory (the Laboratory) is the nation's premier national security science laboratory. Its mission is to develop and apply science and technology to ensure the safety, security, and reliability of the United States (U.S.) nuclear stockpile; reduce the threat of weapons of mass destruction, proliferation, and terrorism; and solve national problems in defense, energy, and the environment. The fiscal year (FY) 2013-2037 Twenty-Five Year Site Plan (TYSP) is a vital component for planning to meet the National Nuclear Security Administration (NNSA) commitment to ensure the U.S. has a safe, secure, and reliable nuclear deterrent. The Laboratory also uses the TYSP as an integrated planning tool to guide development of an efficient and responsive infrastructure that effectively supports the Laboratory's missions and workforce. Emphasizing the Laboratory's core capabilities, this TYSP reflects the Laboratory's role as a prominent contributor to NNSA missions through its programs and campaigns. The Laboratory is aligned with Nuclear Security Enterprise (NSE) modernization activities outlined in the NNSA Strategic Plan (May 2011) which include: (1) ensuring laboratory plutonium space effectively supports pit manufacturing and enterprise-wide special nuclear materials consolidation; (2) constructing the Chemistry and Metallurgy Research Replacement Nuclear Facility (CMRR-NF); (3) establishing shared user facilities to more cost effectively manage high-value, experimental, computational and production capabilities; and (4) modernizing enduring facilities while reducing the excess facility footprint. Th is TYSP is viewed by the Laboratory as a vital planning tool to develop an effi cient and responsive infrastructure. Long range facility and infrastructure development planning are critical to assure sustainment and modernization. Out-year re-investment is essential for sustaining existing facilities, and will be re-evaluated on an annual

  17. ADS on WWW: Doubling Yearly for Five Years

    Science.gov (United States)

    Kurtz, M. J.; Eichhorn, G.; Accomazzi, A.; Grant, C. S.; Murray, S. S.

    1998-12-01

    It is now five years since the NASA ADS Abstract Service became available on the World Wide Web, in late winter of 1994. Following the explosive growth of the service (when compared with the old propriatory network access system) in the early months of WWW service, ADS growth has settled to doubling yearly. Currently ADS users make 440,000 queries per month, and receive 8,000,000 bibliographic references and 70,000 full-text articles, as well as abstracts, citation histories, links to data, and links to other data centers. Of the 70,000 full-text articles accessed through ADS each month, already 30% are via pointers to the electronic journals. This number is certain to increase. It is difficult to determine the exact number of ADS users. We track usage by the number of unique ``cookies'' which access ADS, and by the number of unique IP addresses. There are difficulties with each technique. In addition many non-astronomers find ADS through portal sites like Yahoo, which skews the statistics. 10,000 unique cookies access the full-text articles each month, 17,000 make queries, and 30,000 visit the site. 91% of full-text users have cookies, but only 65% of site visitors. From another perspective the number of IP addresses from a single typical research site (STScI) which access the full-text data is within 5% of the number of unique cookies assiociated with full-text use from stsci.edu, and also within 5% of the number of AAS members listing an STScI address. The number of unique IP addresses from STScI which make any sort of query to ADS is 40% higher than this. Those who access the full-text average one article per day, those who make queries average two per day. We believe nearly all active astronomy researchers, as well as students and affiliated professionals use ADS on a regular basis.

  18. Long-term survival differences in gastric cancer after D2 lymphadenectomy and an improved assessment of resectability

    Directory of Open Access Journals (Sweden)

    Gabriel Dimofte

    2017-05-01

    Full Text Available Objective. The purpose of this work is to compare the long-term survival between a control group with mostly D1 lymphadenectomy and a study group with mostly D2 lymphadenectomy. Materials and Methods. We analyzed consecutive cases operated by a single surgeon performing mostly D2 lymphadenectomy and a control group of consecutive gastric cancer patients operated by a group of surgeons, performing mostly D1 lymphadenectomy, in a period when D2 lymphadenectomy was not the standard and was introduced as a new technique in our center. Results. We found 30,56% D2 lymphadenectomy in the control groups and 85,1% in the study group. At a five years interval from surgery the control group had no survivors, while the study group had 8 (20% survivors. Conclusions. The spleen and pancreas preserving D2 lymphadenectomy done by experienced surgeons, according to the current guidelines in order to select operable patients improves the overall survival of such gastric cancer patients.

  19. Hemodialysis tunneled central venous catheters: five-year outcome analysis.

    Science.gov (United States)

    Mandolfo, Salvatore; Acconcia, Pasqualina; Bucci, Raffaella; Corradi, Bruno; Farina, Marco; Rizzo, Maria Antonietta; Stucchi, Andrea

    2014-01-01

    Tunneled central venous catheters (tCVCs) are considered inferior to arteriovenous fistulas (AVFs) and grafts in all nephrology guidelines. However, they are being increasingly used as hemodialysis vascular access. The purpose of this study was to document the natural history of tCVCs and determine the rate and type of catheter replacement. This was a prospective study of 141 patients who underwent hemodialysis with tCVCs between January 2008 and December 2012. The patients used 154 tCVCs. Standard protocols about management of tCVCs, according to European Renal Best Practice, were well established. All catheters were inserted in the internal jugular vein. Criteria for catheter removal were persistent bloodstream infection, detection of an outbreak of catheter-related bloodstream (CRBS) infections, or catheter dysfunction. Event rates were calculated per 1,000 catheter days; tCVC cumulative survival was estimated by Kaplan-Meier analysis. Catheter replacement occurred in 15 patients (0.29 per 1,000 days); catheter dysfunction was the main cause of replacement (0.18 per 1,000 days), typically within 12 months of surgical insertion. A total of 53 CRBS events in 36 patients were identified (0.82 per 1,000 days); 17 organisms, most commonly Gram-positive pathogens, were isolated; 87% of CVC infections were treated by systemic antibiotics associated with lock therapy. tCVC cumulative survival was 91% at 1 year, 88% at 2 years and 85% at 4 years. Our data show a high survival rate of tCVCs in hemodialysis patients, with low incidence of catheter dysfunction and CRBS events. These data justify tCVC use for hemodialysis vascular access, also as first choice, especially in patients with exhausted peripheral access and limited life expectancy.

  20. SNL Five-Year Facilities & Infrastructure Plan FY2015-2019

    Energy Technology Data Exchange (ETDEWEB)

    Cipriani, Ralph J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2014-12-01

    Sandia’s development vision is to provide an agile, flexible, safer, more secure, and efficient enterprise that leverages the scientific and technical capabilities of the workforce and supports national security requirements in multiple areas. Sandia’s Five-Year Facilities & Infrastructure Planning program represents a tool to budget and prioritize immediate and short-term actions from indirect funding sources in light of the bigger picture of proposed investments from direct-funded, Work for Others and other funding sources. As a complementary F&I investment program, Sandia’s indirect investment program supports incremental achievement of the development vision within a constrained resource environment.

  1. Better long-term survival in young patients with non-metastatic colorectal cancer after surgery, an analysis of 69,835 patients in SEER database.

    Directory of Open Access Journals (Sweden)

    Qingguo Li

    Full Text Available OBJECTIVE: To compare the long-term survival of colorectal cancer (CRC in young patients with elderly ones. METHODS: Using Surveillance, Epidemiology, and End Results (SEER population-based data, we identified 69,835 patients with non-metastatic colorectal cancer diagnosed between January 1, 1988 and December 31, 2003 treated with surgery. Patients were divided into young (40 years and under and elderly groups (over 40 years of age. Five-year cancer specific survival data were obtained. Kaplan-Meier methods were adopted and multivariable Cox regression models were built for the analysis of long-term survival outcomes and risk factors. RESULTS: Young patients showed significantly higher pathological grading (p<0.001, more cases of mucinous and signet-ring histological type (p<0.001, later AJCC stage (p<0.001, more lymph nodes (≥ 12 nodes dissected (p<0.001 and higher metastatic lymph node ratio (p<0.001. The 5-year colorectal cancer specific survival rates were 78.6% in young group and 75.3% in elderly group, which had significant difference in both univariate and multivariate analysis (P<0.001. Further analysis showed this significant difference only existed in stage II and III patients. CONCLUSIONS: Compared with elderly patients, young patients with colorectal cancer treated with surgery appear to have unique characteristics and a higher cancer specific survival rate although they presented with higher proportions of unfavorable biological behavior as well as advanced stage disease.

  2. Prospective and retrospective evaluation of five-year earthquake forecast models for California

    Science.gov (United States)

    Strader, Anne; Schneider, Max; Schorlemmer, Danijel

    2017-10-01

    The Collaboratory for the Study of Earthquake Predictability was developed to prospectively test earthquake forecasts through reproducible and transparent experiments within a controlled environment. From January 2006 to December 2010, the Regional Earthquake Likelihood Models (RELM) Working Group developed and evaluated thirteen time-invariant prospective earthquake mainshock forecasts. The number, spatial and magnitude components of the forecasts were compared to the observed seismicity distribution using a set of likelihood-based consistency tests. In this RELM experiment update, we assess the long-term forecasting potential of the RELM forecasts. Additionally, we evaluate RELM forecast performance against the Uniform California Earthquake Rupture Forecast (UCERF2) and the National Seismic Hazard Mapping Project (NSHMP) forecasts, which are used for seismic hazard analysis for California. To test each forecast's long-term stability, we also evaluate each forecast from January 2006 to December 2015, which contains both five-year testing periods, and the 40-year period from January 1967 to December 2006. Multiple RELM forecasts, which passed the N-test during the retrospective (January 2006 to December 2010) period, overestimate the number of events from January 2011 to December 2015, although their forecasted spatial distributions are consistent with observed earthquakes. Both the UCERF2 and NSHMP forecasts pass all consistency tests for the two five-year periods; however, they tend to underestimate the number of observed earthquakes over the 40-year testing period. The smoothed seismicity model Helmstetter-et-al.Mainshock outperforms both United States Geological Survey (USGS) models during the second five-year experiment, and contains higher forecasted seismicity rates than the USGS models at multiple observed earthquake locations.

  3. STRATEGIC MANAGEMENT AS LONG TERM SURVIVAL INSTRUMENT OF BUSINESS COMPANY

    OpenAIRE

    Silineviča, Irēna

    2009-01-01

    Theoretical aspects in Strategic management of small business enterprises is analysed. Research of small enterprise management in the Latgale region is performed with the aim to do an analyses of how small business enterprises, which have survived in economic crises conditions, use strategic management opportunities. Findings have clarified the main factors which influence business management in a changing business environment in small business companies.

  4. CAPD in Dammam Central Hospital, Saudi Arabia: A Five-Year Experience

    Directory of Open Access Journals (Sweden)

    Youmbissi Joseph

    2001-01-01

    Full Text Available Thirty-one patients with end-stage renal disease (ESRD were offered continuous ambulatory peritoneal dialysis (CAPD at the Dammam Central Hospital, Dammam, Saudi Arabia over a period of five years. The group included 21 women and 10 men with a mean age of 41.3 ± 17.2 years. The main indication for CAPD was poor or failed vascular access (51.4%. Peritonitis remained the major complication with an overall incidence of 0.62 episode per patient year. Staphylococcus epidermidis was the main causative organism. Therapy with CAPD lasted a mean of 26 ± 7.4 months. Our results, showing good technique survival and low peritonitis rate, suggest that CAPD should be promoted to become a full arm of the integrated care of ESRD in Saudi Arabia.

  5. Five-Year Follow-Up of Concomitant Accelerated Hypofractionated Radiation in Advanced Squamous Cell Carcinoma of the Buccal Mucosa: A Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Hassan Iqbal

    2015-01-01

    Full Text Available In resource limited settings, induction chemotherapy with Gemcitabine and Cisplatinum and concurrent hypofractionated chemoradiation for locally advanced carcinoma of buccal mucosa (BMSCC are a cost effective option but remain under reported. The objective of this study was to report long term survival outcome after concurrent hypofractionated radiotherapy in locally advanced BMSCC. Between February 2005 and 2009, 63 patients received treatment. Induction chemotherapy (IC regimen consisted of two drugs: Gemcitabine and Cisplatin. All patients received 55 Gy of radiation in 20 fractions with concurrent single agent Cisplatin (75 mg/m2. Five-year overall survival (OS, disease-free survival (DFS, and progression-free survival (PFS were determined. Based on AJCC staging, 7 (11% patients were stage III, 31 (49% stage IV a, and 25 (40% stage IVb at presentation. After IC, 8 (18% patients had complete radiological response, 33 (73% had partial response, and 4 (9% had stable disease. After concurrent hypofractionated chemoradiation, thirty-nine (62% patients were complete responders and 24 (38% had stable disease. With a minimum follow-up of 60 months, 5-year OS, DFS, and PFS were 30%, 49%, and 30%, respectively. In locally advanced buccal mucosa squamous cell carcinoma, concurrent hypofractionated chemoradiation results in acceptable survival and regimen related toxicity.

  6. 78 FR 26616 - Draft NOAA Five Year Research and Development Plan

    Science.gov (United States)

    2013-05-07

    ... NOAA Five Year Research and Development Plan AGENCY: National Oceanic and Atmospheric Administration (NOAA), Department of Commerce (DOC). ACTION: Draft NOAA Five Year Research and Development Plan for Public Review. SUMMARY: NOAA's draft Five Year Research and Development Plan is available for public...

  7. Five Years Survival in Patients Operated from Malignant Neoplasm of Colon and Rectum

    Directory of Open Access Journals (Sweden)

    Emilio Alexis Guerra Pérez

    2012-02-01

    Full Text Available Fundamento: Los cánceres colorrectales comprenden todos aquellos cánceres situados en el intestino grueso, el cual anatómicamente se divide en colon y recto. Especialmente los de tipo epitelial, representan en la actualidad un gran problema de salud y causa importante de mortalidad en todo el mundo. Objetivo: evaluar la sobrevida a los cinco años en pacientes operados de cáncer colorrectal. Métodos: estudio descriptivo ambiespectivo, de 108 pacientes operados de cáncer colorrectal en el Hospital Dr. Gustavo Aldereguía Lima de Cienfuegos, durante un período de 2 años (2004-2005. Las variables estudiadas: edad, sexo, localización del tumor, diferenciación histológica, etapas clínicas del tumor, técnica quirúrgica empleada, uso de la quimioterapia y supervivencia a los 5 años. Resultados: a supervivencia global fue de un 66,7 % a los 5 años, y las etapas I y IIb fueron las de mayor sobrevida, con un 81 a 77 %. En general predominó el sexo femenino (59,2 % sobre el masculino (40,7 %, y se observó mejor sobrevida durante todo el período en las mujeres: 70 % sobre un 62 % en los hombres. Conclusiones: la sobrevida global de la serie a los cinco años reportó cifras superiores a las obtenidas en Estados Unidos, Europa y la propia provincia de Cienfuegos en años anteriores, siendo el recto la localización más frecuente, además de manifestar la mejor sobrevida acumulada 72 % a los 5 años.

  8. Twenty-five years after the first TIPS in Spain.

    Science.gov (United States)

    Bilbao Jaureguízar, J I

    2016-01-01

    The incorporation, 25 years ago, of transjugular intrahepatic portosystemic shunting, better known by the acronym TIPS, represents an indisputable improvement in the treatment and management of patients with symptoms due to portal hypertension. This article discusses the origins of the technique and the technical innovations that have been progressively added through the years. The implantation of coated stents, which protect the stent from processes in the parenchymal track that can lead to stenosis, have helped ensure long-term patency, thus reducing the need for reintervention. Solid evidence from valuable publications has situated TIPS at the forefront of the treatment options in a wide variety of clinical situations associated with portal hypertension. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  9. Long-term survival of chronic dialysis patients following survival from an episode of multiple-organ failure.

    Science.gov (United States)

    Chapman, Richard J; Templeton, Maie; Ashworth, Simon; Broomhead, Robert; McLean, Adam; Brett, Stephen J

    2009-01-01

    This study aimed to examine the long-term outcome for patients with end-stage renal failure (ESRF) who survived multiple-organ failure. We performed a review of databases from the renal medicine service and intensive care units (ICU) of the participating hospitals within Imperial College Healthcare NHS Trust, London, UK. Patients with ESRF admitted to ICU who required support of two or more organ systems or were ventilated for more than 36 hours were included. To provide a comparison we examined the survival of a comparator group of ESRF patients in the general population with similar demographic and disease characteristics to our study group. We also examined the outcome for ESRF patients admitted to ICU who died prior to discharge. Survival data for two years following discharge from ICU were examined for the impact of age, prior dialysis history, Acute Physiology and Chronic Health Evaluation (APACHE) II scores and medical or surgical status. Of the 199 patients who met the inclusion criteria, 111 (56%) survived their ICU stay. Sixty-two (56%) of the survivors remained alive two years following discharge. There was no group difference in survival with regards to age, dialysis history or APACHE II scores. Those admitted with a medical rather than surgical diagnosis were less likely to survive two years (P live beyond the early post-ICU period appears similar to the background population of ESRF patients.

  10. Prognostic Factors and Decision Tree for Long-term Survival in Metastatic Uveal Melanoma.

    Science.gov (United States)

    Lorenzo, Daniel; Ochoa, María; Piulats, Josep Maria; Gutiérrez, Cristina; Arias, Luis; Català, Jaum; Grau, María; Peñafiel, Judith; Cobos, Estefanía; Garcia-Bru, Pere; Rubio, Marcos Javier; Padrón-Pérez, Noel; Dias, Bruno; Pera, Joan; Caminal, Josep Maria

    2017-12-04

    The purpose of this study was to demonstrate the existence of a bimodal survival pattern in metastatic uveal melanoma. Secondary aims were to identify the characteristics and prognostic factors associated with long-term survival and to develop a clinical decision tree. The medical records of 99 metastatic uveal melanoma patients were retrospectively reviewed. Patients were classified as either short (≤ 12 months) or long-term survivors (> 12 months) based on a graphical interpretation of the survival curve after diagnosis of the first metastatic lesion. Ophthalmic and oncological characteristics were assessed in both groups. Of the 99 patients, 62 (62.6%) were classified as short-term survivors, and 37 (37.4%) as long-term survivors. The multivariate analysis identified the following predictors of long-term survival: age ≤ 65 years (p=0.012) and unaltered serum lactate dehydrogenase levels (p=0.018); additionally, the size (smaller vs. larger) of the largest liver metastasis showed a trend towards significance (p=0.063). Based on the variables significantly associated with long-term survival, we developed a decision tree to facilitate clinical decision-making. The findings of this study demonstrate the existence of a bimodal survival pattern in patients with metastatic uveal melanoma. The presence of certain clinical characteristics at diagnosis of distant disease is associated with long-term survival. A decision tree was developed to facilitate clinical decision-making and to counsel patients about the expected course of disease.

  11. Be well prepared for the next five-yearly review

    CERN Multimedia

    Staff Association

    2013-01-01

    2012: An excellent year for particle physics We’ve all been involved in the great endeavour of high-energy physics in 2012, the discovery of the famous Higgs-like particle, a missing piece of the Standard Model. In other areas 2012 has also been rich in exceptional results. The Director-General, his team and all CERN staff members can be proud of these extraordinary scientific and technological achievements. The Member States have shown their support to the Organization by approving the 2013 budget and the medium-term plan until 2017 during the official Committees in December 2012, despite a rather worrying economic situation. The Director-General, in his New Year speech of 9th January 2013, underlined that the Organization can positively consider its future, with the LHC re-start scheduled in early 2015, with an energy of 6.5 TeV. The consolidation of other infrastructure, necessary for proper functioning of the installations of the Organization, will take place in 2013 and 2014. The European St...

  12. Testing Bernese Precise Point Positioning Over a Five Year Period

    Science.gov (United States)

    Dodson, A. H.; Teferle, F. N.; Orliac, E. J.; Bingley, R. M.; Kierulf, H. P.

    2005-12-01

    In this presentation we investigate the use of the precise point positioning (PPP) technique within the Bernese GPS software version 5.0. Although this method has normally been associated with the GIPSY OASIS software developed at the Jet Propulsion Laboratory (JPL), the Bernese GPS software is also able to carry out undifferenced analysis of GPS measurements. In previous studies, the PPP capability in Bernese has, however, only been used for evaluations of IGS rapid and final products over days or weeks. To the knowledge of the authors, no results using, e.g. several years of CGPS data, have been published. In recent years, the PPP technique has gained in popularity, partly responsible for this are the continuous improvements in the satellite orbits and clocks, and the related Earth rotation parameters produced and made available by the IGS community. The Bernese PPP processing strategy presented is still in development, but is in principle similar to the strategy applied when using GIPSY OASIS II, in terms of computing a set of transformation parameters from a global network of stations that are then applied during post-processing. We discuss results obtained for the global IGb00 network and a dense network over Europe using both IGS final and rapid products. A comparison with PPP coordinate time series from GIPSY OASIS II is also included.

  13. Factors Associated with Resilience of Adult Survivors Five Years after the 2008 Sichuan Earthquake in China

    Science.gov (United States)

    Ni, Cuiping; Chow, Meyrick Chum Ming; Jiang, Xiaolian; Li, Sijian; Pang, Samantha Mei Che

    2015-01-01

    Given the paucity of quantitative empirical research on survivors’ resilience and its predictors in the context of long-term recovery after disasters, we examined how resilience predictors differed by gender among adult survivors five years after the Sichuan earthquake. This was a cross-sectional survey study of adult survivors (N = 495; aged 18–60) living in reconstructed communities five years into the recovery process after the Wenchuan earthquake. The instruments we used included assessments of sociodemographic characteristics and earthquake exposure level, the Connor-Davidson Resilience Scale, and the Social Support Rating Scale. Support-seeking behaviors emerged as a significant predictor of male survivors’ resilience, while subjective support and marital status were found to be predictors of female survivors’ resilience. Annual household income and chronic disease were predictors for both male and female groups. The findings of this study can be used in devising methods to boost survivors’ resilience by promoting their satisfaction with social support and their ability to obtain effective support. Additionally, the results suggest how to assist survivors who may have relatively poor resilience. PMID:25811775

  14. Photodynamic therapy of cancer: five-year clinical experience

    Science.gov (United States)

    Stranadko, Eugeny P.; Skobelkin, Oleg K.; Vorozhtsov, Georgy N.; Mironov, Andrei F.; Beshleul, Stanislav E.; Markitchev, Nikolai A.; Riabov, Michail V.

    1997-12-01

    The results of application of photodynamic therapy (PDT) for treatment of malignant tumors of skin, breasts, tongue, oral mucose, lower lip, larynx, stomach, bladder, rectum and other localizations were assessed. In 1992 - 1997 more than 1200 tumoral foci in 288 patients have been treated with PDT. Most of the patients have been taken for PDT for tumoral recurrences or intradermal metastases after surgery, gamma- therapy or combined treatment. A certain number of patients had not been treated before due to severe accompanying diseases or old age. Russian photosensitizers Photoheme in dosage 1.0 - 5.0 mg/kg body weight, and Photosense in dosage 0.5 - 1.5 mg/kg body weight were used. Laser irradiation was performed using Coherent 'Innova-200' and Russian laser devices: copper vapor-pumped dye laser (wavelength 630 nm, output power -- 5 W), gold-vapor lasers (wavelength 628 nm, output power -- 2 W), solid-state laser (wavelength 670 nm, output power -- 2 W). In several cases non-laser light emitting devices have been employed. Up to date we possess the follow-up data in term from 2 months to 5 years. Therapeutic effect took place in 94.4% of the cases, including complete tumor resorption in 56.2% and partial resorption in 38.2% of the cases. The results of PDT application for treating malignant tumors allow one to estimate PDT as an adequate technique and in some tumor localizations PDT might become a method of choice. This new promising technique of cancer treatment is successfully applied in Russia. New photosensitizers and sources of light for PDT and fluorescent diagnostics are being developed.

  15. Long-term survival following two recurrences and re-irradiation courses for a nasopharyngeal carcinoma: a case report

    Directory of Open Access Journals (Sweden)

    Haddad P

    2010-10-01

    Full Text Available "nBackground: Local recurrence in Nasopharyngeal Carcinoma (NPC presents is a major challenge. Patients experience substantial morbidity as well as poor survival if no further treatment is offered. Residual or recurrent nasopharyngeal carcinoma is usually managed by chemotherapy, stereotactic radiosurgery, external beam radiation therapy (EBRT, interstitial, and intracavitary brachytherapy or salvage surgery. This case presents the treatment of two consecutive localized recurrences of NPC."n "nCase presentation: The patient was a 59-year-old man who underwent a course of radical external-beam radiotherapy for a primary NPC in 1999, then another course of external radiation in 2004 for his first recurrence, and finally a course of brachytherapy for the second recurrence in 2005. The patient is well now in 2010, with no signs of disease five years after the third radiotherapy."n "nConclusion: Our experience of re-irradiation for this twice recurrent nasopharyngeal carcinoma has been promising with encouraging tumor control and acceptable treatment-related toxicity profile. This case indicates the efficacy of definitive re-irradiation for regional recurrence and the necessity for long-term observation for the salvageable early-stage local failure.

  16. Conditional survival for longer-term survivors from 2000?2004 using population-based cancer registry data in Osaka, Japan

    OpenAIRE

    Ito, Yuri; Nakayama, Tomio; Miyashiro, Isao; Ioka, Akiko; Tsukuma, Hideaki

    2013-01-01

    Background We usually report five-year survival from population-based cancer registries in Japan; however these survival estimates may be pessimistic for cancer survivors, because many patients with unfavourable prognosis die shortly after diagnosis. Conditional survival can provide relevant information for cancer survivors, their family and oncologists. Methods We used the period approach to estimate the latest 10-year survival of 38,439 patients with stomach, colorectal, lung, breast and pr...

  17. Pets, depression and long term survival in community living patients following myocardial infarction

    OpenAIRE

    Friedmann, Erika; Thomas, Sue A.; Son, Heesook

    2011-01-01

    Evidence supports the contribution of depression, anxiety, and poor social support to mortality of hospitalized myocardial infarction (MI) patients. The contribution of depression to survival is independent of disease severity. Pet ownership, a non-human form of social support, has also been associated with one year survival of post-MI patients. The current study addresses whether pet ownership contributes independently to long term survival beyond the contributions of depression, anxiety, or...

  18. Stereotactic body radiotherapy for low-risk prostate cancer: five-year outcomes

    Directory of Open Access Journals (Sweden)

    King Christopher R

    2011-01-01

    Full Text Available Abstract Purpose Hypofractionated, stereotactic body radiotherapy (SBRT is an emerging treatment approach for prostate cancer. We present the outcomes for low-risk prostate cancer patients with a median follow-up of 5 years after SBRT. Method and Materials Between Dec. 2003 and Dec. 2005, a pooled cohort of 41 consecutive patients from Stanford, CA and Naples, FL received SBRT with CyberKnife for clinically localized, low-risk prostate cancer. Prescribed dose was 35-36.25 Gy in five fractions. No patient received hormone therapy. Kaplan-Meier biochemical progression-free survival (defined using the Phoenix method and RTOG toxicity outcomes were assessed. Results At a median follow-up of 5 years, the biochemical progression-free survival was 93% (95% CI = 84.7% to 100%. Acute side effects resolved within 1-3 months of treatment completion. There were no grade 4 toxicities. No late grade 3 rectal toxicity occurred, and only one late grade 3 genitourinary toxicity occurred following repeated urologic instrumentation. Conclusion Five-year results of SBRT for localized prostate cancer demonstrate the efficacy and safety of shorter courses of high dose per fraction radiation delivered with SBRT technique. Ongoing clinical trials are underway to further explore this treatment approach.

  19. Long-term pigment dynamics and diatom survival in dark sediment

    NARCIS (Netherlands)

    Veuger, B.; Van Oevelen, D.

    2011-01-01

    In order to investigate survival of diatoms and long-term pigment dynamics in dark sediment, we incubated samples of homogenized, sieved, tidal-flat sediment for 1 yr in darkness. Microscopic observations revealed that some diatoms survived the full year in darkness and retained their pigments.

  20. Long-term survival of repaired amalgams, recemented crowns and gold castings

    National Research Council Canada - National Science Library

    Smales, Roger J; Hawthorne, Warwick S

    2004-01-01

    This retrospective longitudinal study compared the long-term survival rate of repaired versus replaced amalgam restorations and recemented crowns and gold castings versus non-recemented similar restorations...

  1. Which metastasis management allows long-term survival of synchronous solitary M1b non-small cell lung cancer?

    Science.gov (United States)

    Mordant, Pierre; Arame, Alex; De Dominicis, Florence; Pricopi, Ciprian; Foucault, Christophe; Dujon, Antoine; Le Pimpec-Barthes, Françoise; Riquet, Marc

    2012-03-01

    OBJECTIVES; Patients with extrathoracic synchronous solitary metastasis and non-small cell lung cancer (NSCLC) are rare. The effectiveness of both tumour sites resection is difficult to evaluate because of the high variability among clinical studies. We reviewed our experience regarding the management and prognosis of these patients. The charts of 4668 patients who underwent lung cancer surgery from 1983 to 2006 were retrospectively reviewed. We analysed the epidemiology, treatment, pathology and prognostic characteristics of those with extrathoracic synchronous solitary metastasis amenable to lung cancer surgery on a curative intend. There were 94 patients (sex ratio M/F 3.2/1, mean age 56 years). Surgery included pneumonectomy (n = 27), lobectomy (n = 65) and exploratory thoracotomy (n = 2). Pathology revealed adenocarcinomas (n = 57), squamous cell carcinoma (n = 20), large cell carcinoma (n = 14) and other NSCLC histology (n = 3). Lymphatic extension was N0 (n = 46), N1 (n = 17) and N2 (n = 31). Metastasis involved the brain (n = 57), adrenal gland (n = 12), bone (n = 14), liver (n = 5) and skin (n = 6). Sixty-nine metastases were resected. Five-year survival rate was 16% (median 13 months). Induction therapy, adenocarcinoma, N0 staging and lobectomy were criteria of better prognosis, but metastasis resection was not. These results suggest that extrathoracic synchronous solitary metastasis of pN0 adenocarcinoma may achieve long-term survival in the case of lung resection with or without metastasis resection. This pattern may reflect a specific tumour biology whose solitary metastasis benefits both from surgical or non-surgical treatment.

  2. Early complications and performance of 327 heat-pressed lithium disilicate crowns up to five years

    Science.gov (United States)

    2016-01-01

    PURPOSE The prospective follow-up aimed to assess the performance of lithium disilicate crowns and clinical reasons of adverse events compromising survival and quality. MATERIALS AND METHODS 58 patients were treated with 375 heat-pressed monolithic crowns, which were bonded with resin cement. Annual recalls up to five years included a complete dental examination as well as quality assessment using CDA-criteria. Any need for clinical intervention led to higher complication rate and any failure compromised the survival rate. Kaplan-Meier-method was applied to all crowns and a dataset containing one randomly selected crown from each patient. RESULTS Due to drop-outs, 45 patients (31 females, 14 males) with the average age of 43 years (range = 17–73) who had 327 crowns (176 anterior, 151 posterior; 203 upper jaw, 124 lower jaw) were observed and evaluated for between 4 and 51 months (median = 28). Observation revealed 4 chippings, 3 losses of retention, 3 fractures, 3 secondary caries, 1 endodontic problem, and 1 tooth fracture. Four crowns had to be removed. Survival and complication rate was estimated 98.2% and 5.4% at 24 months, and 96.8% and 7.1% at 48 months. The complication rate was significantly higher for root canal treated teeth (12%, Pcrowns showed excellent ratings (CDA-rating Alfa) for color, marginal fit, and caries. CONCLUSION Heat pressed lithium disilicate crowns showed an excellent performance. Besides a careful luting, dentists should be aware of patients' biological prerequisites (grade of caries, oral hygiene) to reach full success with these crowns. PMID:27350853

  3. Long-term survival of adult trauma patients.

    Science.gov (United States)

    Davidson, Giana H; Hamlat, Christian A; Rivara, Frederick P; Koepsell, Thomas D; Jurkovich, Gregory J; Arbabi, Saman

    2011-03-09

    Inpatient trauma case fatality rates may provide an incomplete assessment for overall trauma care effectiveness. To date, there have been few large studies evaluating long-term mortality in trauma patients and identifying predictors that increase risk for death following hospital discharge. To determine the long-term mortality of patients following trauma admission and to evaluate survivorship in relationship with discharge disposition. Retrospective cohort study of 124,421 injured adult patients during January 1995 to December 2008 using the Washington State Trauma Registry linked to death certificate data. Kaplan-Meier and Cox proportional hazards models were used to evaluate long-term mortality following hospital admission for trauma. Of the 124,421 trauma patients, 7243 died before hospital discharge and 21,045 died following hospital discharge. Cumulative mortality at 3 years postinjury was 16% (95% confidence interval [CI], 15.8%-16.2%) compared with the expected population cumulative mortality of 5.9% (95% CI, 5.9%-5.9%). In-hospital mortality improved during the 14-year study period from 8% (n = 362) to 4.9% (n = 600), whereas long-term cumulative mortality increased from 4.7% (95% CI, 4.1%-5.4%) to 7.4% (95% CI, 6.8%-8.1%). After adjustments for confounders, patients who were older and those who were discharged to a skilled nursing facility had the highest risk of death. The adjusted hazard ratios (HRs) for death after discharge to a skilled nursing facility compared with that after discharge home were 1.41 (95% CI, 0.72-2.76) for patients aged 18 to 30 years, 1.92 (95% CI, 1.36-2.73) for patients aged 31 to 45 years, 2.02 (95% CI, 1.39-2.93) for patients aged 46 to 55 years, 1.93 (95% CI, 1.40-2.64) for patients aged 56 to 65 years, 1.49 (95% CI, 1.14-1.94) for patients aged 66 to 75 years, 1.54 (95% CI, 1.27-1.87) for patients aged 76 to 80 years, and 1.38 (95% CI, 1.09-1.74) for patients older than 80 years. Other significant predictors of mortality

  4. Perioperative Outcomes and Long-term Survival in Clinically Early-stage Thymic 
Malignancies: Video-assisted Thoracoscopic Thymectomy versus Open Approaches

    Directory of Open Access Journals (Sweden)

    Hao WANG

    2016-07-01

    Full Text Available Background and objective Video-assisted thoracoscopic surgery (VATS theoretically offers advantages over open thymectomy for clinically early-stage (Masaoka-Koga stage I and II thymic malignancies. However, longterm outcomes have not been well studied. We compared the postoperative outcomes and survival from a cohort study based on the database of the Chinese Alliance for Research in Thymomas (ChART. Methods Between 1994 and 2012, data of 1,117 patients having surgery for clinically early-stage (Masaoka-Koga stage I and II tumors were enrolled for the study. Among them, 241 cases underwent VATS thymectomy (VATS group, while 876 cases underwent open thymectomy (Open group. Univariate analyses were used to compare the clinical character and perioperative outcomes between the two groups. And multivariate analysis was performed to determine the independent predictive factors for long-term survival. Results Compared with the Open group, the VATS group had higher percentage of total thymectomy (80.5% vs 73.9%, P=0.028, resection rate (98.8% vs 88.7%, P<0.001 and less recurrence (2.9% vs 16.0%, P<0.001. Five-year overall survival was 92% after VATS and 92% after open thymectomy, with no significant difference between the two groups (P=0.15. However, 5-year disease free survival were 92% in VATS group and 83% in Open group (P=0.011. Cox proportional hazards model revealed that WHO classification, Masaoka-Koga stage and adjuvant therapy were independent predictive factors for overall survival, while surgical approach had no significant impact on long-term outcome. Conclusion This study suggests that VATS thymectomy is an effective approach for clinically early-stage thymic malignancies. And it may offer better perioperative outcomes, as well as equal oncological survival.

  5. Prosthesis-Patient Mismatch After Aortic Valve Replacement: Effect on Long-Term Survival.

    Science.gov (United States)

    Swinkels, Ben M; de Mol, Bas A; Kelder, Johannes C; Vermeulen, Freddy E; ten Berg, Jurriën M

    2016-04-01

    Mean follow-up in previous studies on the effect of prosthesis-patient mismatch on long-term survival after aortic valve replacement (AVR) is confined to a maximum of one decade. This retrospective longitudinal cohort study was performed to determine the effect on long-term survival of prosthesis-patient mismatch after AVR with a mean follow-up of almost two decades. Kaplan-Meier survival analysis was used to determine long-term survival after AVR in a cohort of 673 consecutive patients, divided into 163 patients (24.2%) with prosthesis-patient mismatch (indexed effective orifice area ≤ 0.85 cm(2)/m(2)) and 510 patients (75.8%) without prosthesis-patient mismatch (indexed effective orifice area >0.85 cm(2)/m(2)). Effective orifice area values of the prosthetic valves were retrieved from the literature or obtained from the charts of the prosthetic valve manufacturers. Cox multiple regression analysis was used to identify possible independent predictors, including prosthesis-patient mismatch, of decreased long-term survival. Median sizes of the implanted mechanical (n = 430) and biologic (n = 243) prostheses were 25 and 23 mm, respectively. Mean follow-up after AVR was 17.8 ± 1.8 years. Prosthesis-patient mismatch was not an independent predictor of decreased long-term survival (hazard ratio, 0.828; 95% confidence interval, 0.669 to 1.025; p = 0.083). Severe prosthesis-patient mismatch (indexed effective orifice area ≤ 0.65 cm(2)/m(2)), occurring in only 17 patients (2.5%), showed an insignificant trend toward decreased long-term survival (hazard ratio, 1.68; 95% confidence interval, 0.97 to 2.91; p = 0.066). Prosthesis-patient mismatch was not an independent predictor of decreased long-term survival after AVR. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Five-Year Review of CERCLA Response Actions at the Idaho National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    W. L. Jolley

    2007-02-01

    This report summarizes the documentation submitted in support of the five-year review or remedial actions implemented under the Comprehensive Environmental Response, Compensation, and Liability Act Sitewide at the Idaho National Laboratory. The report also summarizes documentation and inspections conducted at the no-further-action sites. This review covered actions conducted at 9 of the 10 waste area groups at the Idaho National Laboratory, i.e. Waste Area Groups 1, 2, 3, 4, 5, 6, 7, 9, and 10. Waste Area Group 8 was not subject to this review, because it does not fall under the jurisdiction of the U.S. Department of Energy Idaho Operations Office. The review included past site inspections and monitoring data collected in support of the remedial actions. The remedial actions have been completed at Waste Area Groups 2, 4, 5, 6, and 9. Remedial action reports have been completed for Waste Area Groups 2 and 4, and remedial action reports are expected to be completed during 2005 for Waste Area Groups 1, 5, and 9. Remediation is ongoing at Waste Area Groups 3, 7, and 10. Remedial investigations are yet to be completed for Operable Units 3-14, 7-13/14, and 10-08. The review showed that the remedies have been constructed in accordance with the requirements of the Records of Decision and are functioning as designed. Immediate threats have been addressed, and the remedies continue to be protective. Potential short-term threats are being addressed though institutional controls. Soil cover and cap remedies are being maintained properly and inspected in accordance with the appropriate requirements. Soil removal actions and equipment or system removals have successfully achieved remedial action objectives identified in the Records of Decision. The next Sitewide five-year review is scheduled for completion by 2011.

  7. Five years database of landslides and floods affecting Swiss transportation networks

    Science.gov (United States)

    Voumard, Jérémie; Derron, Marc-Henri; Jaboyedoff, Michel

    2017-04-01

    Switzerland is a country threatened by a lot of natural hazards. Many events occur in built environment, affecting infrastructures, buildings or transportation networks and producing occasionally expensive damages. This is the reason why large landslides are generally well studied and monitored in Switzerland to reduce the financial and human risks. However, we have noticed a lack of data on small events which have impacted roads and railways these last years. This is why we have collect all the reported natural hazard events which have affected the Swiss transportation networks since 2012 in a database. More than 800 roads and railways closures have been recorded in five years from 2012 to 2016. These event are classified into six classes: earth flow, debris flow, rockfall, flood, avalanche and others. Data come from Swiss online press articles sorted by Google Alerts. The search is based on more than thirty keywords, in three languages (Italian, French, German). After verifying that the article relates indeed an event which has affected a road or a railways track, it is studied in details. We get finally information on about sixty attributes by event about event date, event type, event localisation, meteorological conditions as well as impacts and damages on the track and human damages. From this database, many trends over the five years of data collection can be outlined: in particular, the spatial and temporal distributions of the events, as well as their consequences in term of traffic (closure duration, deviation, etc.). Even if the database is imperfect (by the way it was built and because of the short time period considered), it highlights the not negligible impact of small natural hazard events on roads and railways in Switzerland at a national level. This database helps to better understand and quantify this events, to better integrate them in risk assessment.

  8. 78 FR 33064 - Silicon Metal From Russia; Institution of a Five-Year Review

    Science.gov (United States)

    2013-06-03

    ... COMMISSION Silicon Metal From Russia; Institution of a Five-Year Review AGENCY: United States International... whether revocation of the antidumping duty order on silicon metal from Russia would be likely to lead to... order on imports of silicon metal from Russia (68 FR 14578). Following the five-year reviews by Commerce...

  9. The Effect of Talking Drawings on Five-Year-Old Turkish Children's Mental Models of the Water Cycle

    Science.gov (United States)

    Ahi, Berat

    2017-01-01

    The purpose of the current study is to determine the effect of talking drawings on Turkish preschool children's mental models of the water cycle. The study was conducted in the city of Kastamonu, located in the north-west of Turkey. A total of 40 five-year-old preschool children participated in the study in the spring term of the 2015-2016 school…

  10. Corpus callosum damage predicts disability progression and cognitive dysfunction in primary-progressive MS after five years.

    Science.gov (United States)

    Bodini, Benedetta; Cercignani, Mara; Khaleeli, Zhaleh; Miller, David H; Ron, Maria; Penny, Sophie; Thompson, Alan J; Ciccarelli, Olga

    2013-05-01

    We aim to identify specific areas of white matter (WM) and grey matter (GM), which predict disability progression and cognitive dysfunction after five years in patients with primary-progressive multiple sclerosis (PPMS). Thirty-two patients with early PPMS were assessed at baseline and after five years on the Expanded Disability Status Scale (EDSS), and EDSS step-changes were calculated. At year five, a subgroup of 25 patients and 31 healthy controls underwent a neuropsychological assessment. Baseline imaging consisted of dual-echo (proton density and T2-weighted), T1-weighted volumetric, and diffusion tensor imaging. Fractional anisotropy (FA) maps were created, and fed into tract-based spatial statistics. To compensate for the potential bias introduced by WM lesions, the T1 volumes underwent a lesion-filling procedure before entering a voxel-based morphometry protocol. To investigate whether FA and GM volume predicted EDSS step-changes over five years and neuropsychological tests scores at five years, voxelwise linear regression analyses were performed. Lower FA in the splenium of the corpus callosum (CC) predicted a greater progression of disability over the follow-up. Lower FA along the entire CC predicted worse verbal memory, attention and speed of information processing, and executive function at five years. GM baseline volume did not predict any clinical variable. Our findings highlight the importance of damage to the interhemispheric callosal pathways in determining physical and cognitive disability in PPMS. Disruption of these pathways, which interconnect motor and cognitive networks between the two hemispheres, may result in a disconnection syndrome that contributes to long-term physical and cognitive disability. Copyright © 2011 Wiley Periodicals, Inc.

  11. Estimating long-term survival temperatures at the assemblage level in the marine environment: towards macrophysiology.

    Directory of Open Access Journals (Sweden)

    Joëlle Richard

    Full Text Available Defining ecologically relevant upper temperature limits of species is important in the context of environmental change. The approach used in the present paper estimates the relationship between rates of temperature change and upper temperature limits for survival in order to evaluate the maximum long-term survival temperature (Ts. This new approach integrates both the exposure time and the exposure temperature in the evaluation of temperature limits. Using data previously published for different temperate and Antarctic marine environments, we calculated Ts in each environment, which allowed us to calculate a new index: the Warming Allowance (WA. This index is defined as the maximum environmental temperature increase which an ectotherm in a given environment can tolerate, possibly with a decrease in performance but without endangering survival over seasonal or lifetime time-scales. It is calculated as the difference between maximum long-term survival temperature (Ts and mean maximum habitat temperature. It provides a measure of how close a species, assemblage or fauna are living to their temperature limits for long-term survival and hence their vulnerability to environmental warming. In contrast to data for terrestrial environments showing that warming tolerance increases with latitude, results here for marine environments show a less clear pattern as the smallest WA value was for the Peru upwelling system. The method applied here, relating upper temperature limits to rate of experimental warming, has potential for wide application in the identification of faunas with little capacity to survive environmental warming.

  12. Texting on mobile phones and musculoskeletal disorders in young adults: A five-year cohort study.

    Science.gov (United States)

    Gustafsson, Ewa; Thomée, Sara; Grimby-Ekman, Anna; Hagberg, Mats

    2017-01-01

    The aim was to examine whether texting on a mobile phone is a risk factor for musculoskeletal disorders in the neck and upper extremities in a population of young adults. In a longitudinal population-based cohort study with Swedish young adults (aged 20-24 years) data were collected via a web-based questionnaire at baseline (n = 7092) and after one and five years. Cross-sectional associations were found between text messaging and reported ongoing symptoms in neck and upper extremities (odds ratios, ORs 1.3-2.0). Among symptom-free at baseline prospective associations were only found between text messaging and new cases of reported symptoms in the hand/fingers (OR 2.0) at one year follow up. Among those with symptoms at baseline prospective associations were found between text messaging and maintained pain in neck/upper back (OR 1.6). The results imply mostly short-term effects, and to a lesser extent, long-term effects on musculoskeletal disorders in neck and upper extremities. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Graft pathology at the time of harvest: impact on long-term survival

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2014-12-01

    Full Text Available Objective: This study aims to present the graft pathology at the time of harvest and its impact on long-term survival. Methods: The remnants of the bypass grafts from 66 consecutive patients with coronary artery disease receiving a coronary artery bypass grafting were investigated pathologically, and pertinent predictive risk factors and survival were analyzed. Results: Medial degenerative changes with or without intimal proliferation were present in 36.8%, 37.8% and 35.6% of left internal mammary artery (IMA, radial artery and saphenous vein grafts. There were 2 (3.0% hospital deaths and 9 (14.1% late deaths. Multinomial logistic regression revealed left IMA pathological changes, dyslipidemia, history of percutaneous transluminal coronary angioplasty/stent deployment and Y-graft were significant predictive risk factors negatively influencing the patients’ long-term survival. Kaplan-Meier survival analysis revealed that the long-term survival of patients with left IMA pathological changes were significantly reduced compared with those without (74.1% vs. 91.4%, P=0.002; whereas no differences were noted in long-term survivals between patients with and without pathological changes of the radial arterial or saphenous vein grafts. Conclusion: Pathological changes may be seen in the bypass graft at the time of harvest. The subtle ultrastructural modifications and the expressions of vascular tone regulators might be responsible for late graft patency. The pathological changes of the left IMA at the time of harvest rather than those of the radial artery or saphenous vein graft affect significantly longterm survival. Non-traumatic maneuver of left IMA harvest, well-controlled dyslipidemia and avoidance of using composite grafts can be helpful in maintaining the architecture of the grafts.

  14. Five-year outpatient programme that provided children with continuous behavioural obesity treatment enjoyed high success rate.

    Science.gov (United States)

    Danielsson, Pernilla; Bohlin, Anna; Bendito, Ana; Svensson, Annie; Klaesson, Sven

    2016-10-01

    Results from long-time follow-up of obesity treatment in early childhood are lacking. We investigate long-term continuous behavioural childhood obesity treatment and factors of importance for treatment effect. A five-year longitudinal retrospective controlled study of children aged five to 13 years in obesity treatment, divided into three groups depending on age at start of treatment. Outcome is presented as change in degree of obesity, body mass index standard deviation score (BMI SDS), change in weight status and decrease of ≥0.5 BMI SDS units, in relation to a age-matched obese comparison group. In total, 220 children (46% females) were included. After five years of treatment, the decrease in BMI SDS was significant in all age groups with the largest effect in age group 4-6 years. Compared to the comparison group (n = 369), the decline in BMI SDS was greater (p = 0.001). After five years of treatment, 48% of the patients were cured from their obesity and 72% reached a decline of 0.5 BMI SDS units. Age at start of treatment was the only factor affecting treatment efficacy. The ability to reach a significant weight loss in a paediatric outpatient clinic is promising through a long-term behavioural obesity treatment. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  15. Molecular profiling of short-term and long-term surviving patients identifies CD34 mRNA level as prognostic for glioblastoma survival.

    Science.gov (United States)

    Michaelsen, Signe Regner; Urup, Thomas; Olsen, Lars Rønn; Broholm, Helle; Lassen, Ulrik; Poulsen, Hans Skovgaard

    2018-01-05

    Despite extensive treatment, overall survival (OS) for glioblastoma (GBM) remains poor. A small proportion of patients present long survival over 3 years, but the underlying molecular background separating these long-term survivors (LTS) from short-term survivors (STS) are insufficiently understood. Accordingly, study aim was to identify independent prognostic biomarkers for survival. Study cohort consisted of 93 primary GBM patients treated with radiation-, chemo- and bevacizumab therapy, among which 14 STS (OS ≤ 12 months) and 6 LTS (OS ≥ 36 months) were identified, all confirmed being IDH wild-type. RNA expression levels in diagnostic tumor specimen for 792 genes were analyzed by NanoString technology. While no differences were found with regard to GBM subtype between LTS versus STS, comparative analysis of individual genes identified 14 significantly differently expressed candidate genes. Univariate analysis in the whole patient cohort found that 12 of these were significantly associated with OS, of which increased IFNG, CXCL9, LGALS4, CD34 and decreased MGMT levels remained significant associated with prolonged OS in multivariate analysis correcting for known prognostic variables. Validation analyses in an independent dataset from the AVAglio study confirmed CD34 as significant in comparative analysis between STS and LTS patients and as an independent prognostic factor. Analysis of this dataset further supported CD34 expression to be associated with improved bevacizumab efficacy, while CD34 immunohistochemistry indicated variation in CD34 expression to result primarily from varying tumor vascularization. Collectively, CD34 expression candidates as a prognostic biomarker in GBM able to identify survival outliers and could also be predictive for efficacy of bevacizumab.

  16. Predictors of long-term drug survival for infliximab in psoriasis.

    Science.gov (United States)

    Magis, Q; Jullien, D; Gaudy-Marqueste, C; Baumstark, K; Viguier, M; Bachelez, H; Guibal, F; Delaporte, E; Karimova, E; Montaudié, H; Boye, T; Aubin, F; Beylot-Barry, M; Richard, M-A

    2017-01-01

    Limited information is available regarding factors associated with long-term drug survival of infliximab for psoriasis in real life. The main aim pf this study was to identify predictors of long-term (>12 months) drug survival among patients treated with infliximab for psoriasis in a real-world clinical setting. Retrospectively collected data, relating to disease, patient characteristics and treatment procedures, in a multicentre observational cohort of patients with moderate-to-severe plaque psoriasis treated with infliximab at eight university hospitals, 120 of whom maintained a response to infliximab for more than 12 months, were compared with prospectively collected data in the same centres from 54 patients who experienced secondary loss of response within a 12-month period. Mean duration of drug survival of infliximab in patients with long-term drug survival was 41.12 months ± 20.64 SD vs. 8.5 months ± 2.43 SD in patients with a secondary loss of response. Multivariate analysis identified greater disease severity at treatment onset (PASI score >12) (OR = 5.18, 95% CI: 1.60-16.77, P = 0.006), high levels of initial psoriasis clearance (PASI-90 reduction or equivalent) (OR = 18.50, 95% CI: 4.56-74.45, P = 0.0001) and combination with methotrexate (OR = 13.15, 95% CI: 1.46-118.79, P = 0.022) as independent predictors of long-term drug survival and sustained efficacy of infliximab. Positive predictors for long-term drug survival of infliximab in real life were identified. Their impact on treatment management should be addressed in further prospective trials. © 2016 European Academy of Dermatology and Venereology.

  17. Early mortality and long-term survival after abdominal surgery in patients with liver cirrhosis.

    Science.gov (United States)

    Neeff, Hannes P; Streule, Geraldine C; Drognitz, Oliver; Tittelbach-Helmrich, Dietlind; Spangenberg, Hans-Christian; Hopt, Ulrich T; Makowiec, Frank

    2014-04-01

    Patients with liver cirrhosis have an increased risk of postoperative mortality. In addition, cirrhotic patients per se have a reduced life expectancy. Little is known about the combined effect of these factors on long-term outcomes after surgery. We thus evaluated early -and long-term survival in patients with cirrhosis who underwent abdominal surgery. We evaluated 30- and 90-day mortality as well as long-term survival after 212 general surgical procedures performed in 194 patients with liver cirrhosis. Risk factors for early and late mortality were assessed by uni- and multivariate methods. To avoid multicollinearity of data, different models (Child Turcotte Pugh [CTP], model for end-stage liver disease [MELD], or American Society of Anesthesiologists [ASA] score) were used in multivariate analysis. The 30- and 90-day mortality rates were 20% and 30%, respectively. CTP, MELD, and ASA were all independently associated with 30- and 90-day mortality. Although emergency operations and intraoperative transfusions independently influenced 30-day mortality, 90-day mortality also was influenced by the extent of the procedure and thrombocytopenia. Survival after surgery (n = 180) was 54% after one and 25% after 5 years (median survival 1.24 years). Long-term survival was independently influenced by CTP, MELD, ASA, hyponatremia, emergency operations, thrombocytopenia, and underlying malignancies. Survival in patients discharged after surgery (n = 140) was 69% after 1 and 33% after 5 years (median survival 2.8 years). Survival after discharge was independently influenced by MELD, CTP, hyponatremia, underlying malignant disease, and (partially) by serum creatinine. The inclusion of serum sodium into MELD scores did not further facilitate prediction of early and late mortality. A high postoperative mortality as well as a strongly reduced survival even after hospital discharge contribute to the very poor life expectancy in patients with liver cirrhosis requiring general

  18. Long-Term Survival According to Histology and Radiologic Response to Preoperative Chemotherapy in 126 Patients Undergoing Resection of Non-GIST Sarcoma Liver Metastases.

    Science.gov (United States)

    Goumard, Claire; Marcal, Leonardo P; Wang, Wei-Lien; Somaiah, Neeta; Okuno, Masayuki; Roland, Christina L; Tzeng, Ching-Wei D; Chun, Yun Shin; Feig, Barry W; Vauthey, Jean-Nicolas; Conrad, Claudius

    2018-01-01

    Non-gastrointestinal stromal tumor sarcomas (NGSs) have heterogeneous histology, and this heterogeneity may lead to uncertainty regarding the prognosis of patients with liver metastases from NGS (NGSLM) and decision regarding their surgical management. Furthermore, the role of preoperative chemotherapy in treatment of NGSLM remains poorly defined. We investigated long-term survival and its correlation to response to preoperative chemotherapy in patients with NGSLM. Patients who underwent liver resection for NGSLM during 1998-2015 were identified. Clinical, histopathologic, and survival data were analyzed. Multivariate analysis was performed using a Cox proportional hazards model. 126 patients [62 (49%) with leiomyosarcoma] were included. Five-year overall survival (OS) and recurrence-free survival (RFS) rates were 49.3 and 14.9%, respectively. Survival did not differ by histologic subtype, primary tumor location, or use of preoperative or postoperative chemotherapy. NGSLM ≥ 10 cm and extrahepatic metastases at NGSLM diagnosis were the only independent risk factors for OS. In the 83 (66%) patients with metachronous NSGLM, disease-free interval > 6 months was associated with improved OS and RFS. Among the 65 patients (52%) who received preoperative chemotherapy, radiologic response according to Choi criteria specifically was associated with improved OS (p = 0.04), but radiologic response according to RECIST 1.1 criteria was not. Resection of NGSLM led to a 5-year OS rate of 49%, independent of histologic subtype and primary tumor location. Choi criteria (which take into account tumor density) are superior to RECIST 1.1 in assessing radiologic response and should be used to assess response to preoperative chemotherapy.

  19. Long-term survival in advanced melanoma patients using repeated therapies: successive immunomodulation improving the odds?

    Directory of Open Access Journals (Sweden)

    Coventry BJ

    2015-04-01

    Full Text Available Brendon J Coventry, Dominique Baume, Carrie Lilly Discipline of Surgery, Royal Adelaide Hospital, University of Adelaide, Adelaide, SA, Australia Background: Patients with advanced metastatic melanoma are often confronted with little prospect of medium- to longer-term survival by any currently available therapeutic means. However, most clinicians are aware of exceptional cases where survival defies the notion of futility. Prolonged survival from immunotherapies, including interleukin-2, vaccines and antibodies to cytotoxic lymphocyte antigen-4, and programmed death-1 receptor inhibitory monoclonal antibody, implies a role for immune system modulation. We aimed to identify cases where exceptional survival from advanced melanoma occurred prior to recent novel therapies to facilitate better understanding of this phenomenon. Methods: Cases of long-term survival of ≥3 years' duration (from diagnosis of metastatic disease were identified from the database of one clinician; these cases were treated before the availability of newer immunotherapies, and they were documented and examined. A literature search for reported outcome measures from published studies using older and recent therapies for advanced melanoma was conducted to enable the comparison of data. Results: Eighteen cases were identified that identified survival of ≥3 years' duration from metastatic disease (12 American Joint Committee on Cancer [AJCC] Stage IV cases; six AJCC III cases diagnosis. These were assessed and reported to detail the clinical course. Standard clinical prognostication methods predicted high risk of early mortality in those patients. No identifiable differences could be detected between these and other patients with similar patterns of disease. At evaluation, 17 patients (94% had survived ≥5 years, and eleven patients (61% had survived ≥10 years (range: 3–15 years. The median survival duration with metastatic disease was 11 years; 15 remained alive and three

  20. Assessment of Nutritional Status of Children Under Five years of age in rural Nepal.

    Science.gov (United States)

    Chataut, J; Khanal, K

    2016-01-01

    Background Nutritional status of children is one of the major predictors of child survival. However, malnutrition is a major public health problem in most of the developing countries and occurs prominently among under-five children. In context of Nepal, nearly 37% children are suffering from underweight, 41% from stunting and 11% are suffering from wasting. These children are at a substantially greater risk of severe acute malnutrition and death. Objective The objective of the study was to assess the nutritional status of children under five years of age and to find the factors associated with malnutrition. Method A cross-sectional study was conducted in Dolakha and Kavre districts of Nepal for assessing the nutritional status of under-five children and associated factors. A total of 243 under five children were included from two purposively selected village development committees (VDCs) i.e. one from each district. Statistical Package for the Social Sciences (SPSS) 22 Version and ENA Software Version 2011 were used for analyzing the data. Result Out of 243 children, according to WHO based on weight for height assessment, 17 (7.0%) were wasted, in height for age analysis, 97 (39.9%) were stunted and in weight for age assessment, 46 (18.9%) were underweight. Conclusion In the study population, there is high prevalence of malnutrition, especially stunting among under-five. Taking into account weight, height, age, and mid upper arm circumference (MUAC) measurements of malnourished children more than threefifths of them were found below -2SD and nearly one-fourths below -3SD which needs intervention.

  1. Survival

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — These data provide information on the survival of California red-legged frogs in a unique ecosystem to better conserve this threatened species while restoring...

  2. HIV-infected Rwandan women have a high frequency of long-term survival.

    Science.gov (United States)

    Peters, Philip J; Karita, Etienne; Kayitenkore, Kayitesi; Meinzen-Derr, Jareen; Kim, Dhong-Jin; Tichacek, Amanda; Allen, Susan A

    2007-11-01

    To evaluate rates of long-term survival in a prospective, longitudinal, closed HIV cohort in Africa between 1986 and 2006. A total of 548 HIV-infected Rwandan women were recruited from prenatal clinics in Kigali and followed at 3-6 month intervals to February 2006. Overall, 401 women (73%) were HIV positive at initial cross-sectional testing in 1986 (seroprevalent cohort) and 147 women (27%) were initially HIV negative but seroconverted during follow-up from 1986 to 1993 (seroincident cohort). Kaplan-Meier survival methods were used to calculate survival times censored in mid-2003. In February 2006, 109 women (20%) remained alive in the cohort. Time to 50% non-genocide mortality was 11.9 years among seroincident women and 8.9 years among seroprevalent women. Smoothed mortality rates increased with duration of follow-up to a peak of 0.12 deaths per person-year at 9.5 years of follow-up but subsequently declined. After 15 years of follow-up (pre-HAART introduction), the survival probability was 36% for seroincident women and 26% for seroprevalent women. Most survivors had virological and immunological evidence of disease progression. The median CD4 cell count of survivors declined from 447 cells/mul in 1998 to 268 cells/mul in 2003. Among survivors, 57 women (52%) met treatment criteria and initiated antiretroviral treatment by 2006. Although median survival times in this cohort were similar to those observed in high-income countries, the rates of long-term survival after 15 years of follow-up were higher than expected. A levelling off of mortality rates during the late stages of follow-up may explain this high rate of long-term survival.

  3. Vitamin E diffused highly cross-linked polyethylene in total hip arthroplasty at five years

    DEFF Research Database (Denmark)

    Nebergall, A. K.; Greene, M. E.; Laursen, M. B.

    2017-01-01

    Aims: The objective of this five-year prospective, blinded, randomised controlled trial (RCT) was to compare femoral head penetration into a Vitamin E diffused highly cross-linked polyethylene (HXLPE) liner with penetration into a medium cross-linked polyethylene control liner using...... radiostereometric analysis. Patients and Methods: Patients scheduled for total hip arthroplasty (THA) were randomised to receive either the study E1 (32 patients) or the control ArComXL polyethylene (35 patients). The median age (range) of the overall cohort was 66 years (40 to 76). Results: The five-year median......-reported outcomes (PROs) improved significantly from the pre-operative interval compared with those at one year, and remained favourable at five years. There were no differences between the two groups at any interval. Conclusion: The five-year results showed that E1 polyethylene does not wear more than the control...

  4. Risk Factors for Malnutrition Among Under-Five-Year olds in an ...

    African Journals Online (AJOL)

    All households with children under five years were listed and visited over a period of ... Results: The youngest malnourished child was two months old while the ... In the case-control analysis, low paternal education (incomplete primary school ...

  5. The First Five Years of the Alpha Magnetic Spectrometer on the International Space Station

    CERN Multimedia

    CERN. Geneva

    2016-01-01

    In the five years since its installation on the International Space Station, it has collected more than 90 billion cosmic rays. Some of the unexpected results and their possible interpretations will be presented.

  6. Preventing Dental Caries in Children from Birth Through Age Five Years

    Science.gov (United States)

    ... it might mean for you. What are dental caries? Dental caries, also known as tooth decay, occurs when bacteria ... May 2014 Task Force FINAL Recommendation | 1 Preventing Dental Caries in Children from Birth Through Age Five Years ...

  7. 2010 Five-Year Plan: Assessment of Health and Environmental Impacts of Uranium Mining and Milling

    Science.gov (United States)

    The five-year plan is intended to compile all activities contributing to the identification and cleanup of legacy uranium milling and mining activities in the Grants Mining District in the State of New Mexico.

  8. New-onset postoperative atrial fibrillation after aortic valve replacement: Effect on long-term survival.

    Science.gov (United States)

    Swinkels, Ben M; de Mol, Bas A; Kelder, Johannes C; Vermeulen, Freddy E; Ten Berg, Jurriën M

    2017-08-01

    There is a paucity of data on long-term survival of new-onset postoperative atrial fibrillation (POAF) after cardiac surgery. Also, mean follow-up in previous studies is confined to a maximum of one decade. This retrospective, longitudinal cohort study was performed to determine the effect on long-term survival of new-onset POAF after aortic valve replacement (AVR) over a mean follow-up of almost 2 decades. Kaplan-Meier survival analysis was used to determine long-term survival after AVR, performed between January 1, 1990, and January 1, 1994, in 569 consecutive patients without a history of atrial fibrillation, divided into 241 patients (42.4%) with and 328 patients (57.6%) without new-onset POAF. New-onset POAF was considered in multivariable analysis for decreased long-term survival. After AVR, patients with new-onset POAF were treated with the aim to restore sinus rhythm within 24 to 48 hours from onset by medication and when medication failed by direct-current cardioversion before discharge home. Mean follow-up after AVR was 17.8 ± 1.9 years. Incidence of new-onset POAF was 42.4%. Kaplan-Meier overall cumulative survival rates at 15 years of follow-up were similar in the patients with new-onset POAF versus those without: 41.5% (95% confidence interval [CI], 35.2-47.7) versus 41.3% (95% CI, 36.0-46.7), respectively. New-onset POAF was not an independent risk factor for decreased long-term survival (hazard ratio 0.815; 95% CI, 0.663-1.001; P = .052). New-onset POAF after AVR does not affect long-term survival when treatment is aimed to restore sinus rhythm before discharge home. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  9. Is continent urinary diversion feasible in children under five years of age?

    Directory of Open Access Journals (Sweden)

    Luiz L. Barbosa

    2009-08-01

    Full Text Available Purpose: To review our clinical experience with urinary continent catheterizable reservoir in children under five years of age. Materials and Methods: A total of 23 patients (16 males, 7 females with a median age of 3.64 years were evaluated. Among these, 6 (26.08% had a posterior urethral valve, 9 (39.13% myelomeningocele, 4 (17.39% bladder exstrophy, 2 (8.69% genitourinary rabdomyosarcoma, 1 (4.34% had spinal tumor and 1 (4.34% an ano-rectal anomaly. Results: Perioperative complications were observed in four patients consisting of one febrile urinary tract infection, one partial operative wound dehiscence, one partial stomal dehiscence and one vesico-cutaneous fistula after a secondary exstrophy repair. The overall long-term complications rate was 40.90% and consisted of two stomal stenoses (9.09%, one neobladder mucosal extrusion (4.54%, three neobladder calculi (13.63% and persistence of urinary incontinence in three patients (13.63%. The overall surgical revision was 36.36% and final continence rate was 95.45% with mean follow-up of 39.95 months Conclusion: Continent urinary diversion is technically feasible even in small children, with acceptable rates of complications.

  10. [Results of a five-year series of 44 trapeziectomies associated with ligamentoplasty and interposition arthroplasty].

    Science.gov (United States)

    Le Dû, C; Guéry, J; Laulan, J

    2004-06-01

    Surgical management of trapeziometacarpal joint osteoarthritis remains controversial. There have been few long term studies of trapeziectomy combined with ligamentoplasty and interposition arthroplasty (TLIA). Our results are based on a five year minimum follow-up study. We carried out a study of 44 TLIA in 39 consecutive patients. A physical and radiological assessment was undertaken after on average of 6.9 years by a independent observer. A durable physical improvement was obtained in 18 cases in less than six months and in five cases after more than one year. Thereafter there was no secondary deterioration. A standard pain measurement gave an average result of 1.4 on a ten point scale. Pain was independent of displacement of the first metacarpal bone but had a tendency to be greater where associated with scaphotrapezoidal joint osteoarthritis. Strength was improved in 36 cases. The patients were satisfied and considered their grip to be normal in 41 cases. These variables did not change over time. TLIA give an excellent result in more than 90% of cases. This remains unchanged seven years after surgery. As opposed to prostheses, there is no secondary deterioration once healing is achieved. Algodystrophy is the main drawback. In our opinion, TLIA remains the best available surgical treatment of trapeziometacarpal joint osteoarthristis.

  11. Consultant-based otolaryngology emergency service: a five-year experience.

    Science.gov (United States)

    Barnes, M L; Hussain, S S M

    2011-12-01

    To present our experience of running a consultant-based otolaryngology emergency care service for more than five years. In 2003, we developed a system of consultant-based emergency service: consultants spent a week on-call providing a dedicated emergency service, with routine commitments cancelled. Our new system had advantages over traditional working practices in terms of consultant involvement, trainee education, continuity and efficiency. It also reduced disruption to elective commitments for both consultants and registrars. This system was fundamental to the successful review of all urgent (and in future elective) cases within target periods. Only 31 per cent of new referrals to the consultant emergency clinics required a further appointment. Good teamwork and flexibility in working arrangements have been essential to the success of this service. Given that health service changes have reduced junior trainee working hours and numbers, and that patients increasingly expect to be treated by trained doctors, our new consultant-based emergency service has merit. Although implementation in other units may differ, we recommend this new service, for the above reasons.

  12. Longitudinal Impact of the Project PATHS on Adolescent Risk Behavior: What Happened after Five Years?

    Directory of Open Access Journals (Sweden)

    Daniel T. L. Shek

    2012-01-01

    Full Text Available The present study investigated the longitudinal impact of the Project PATHS, a large-scale curriculum-based positive youth development program in Hong Kong, on the development of adolescents’ risk behavior over a period of five years. Using a longitudinal randomized controlled design, eight waves of data were collected from 19 experimental schools in which students participated in the Project PATHS (=2,850 at Wave 8 and 24 control schools without joining the Project PATHS (=3,640 at Wave 8. At each wave, students responded to measures assessing their current risk behaviors, including delinquency, use of different types of drug, and their intentions of participating in risk behaviors in the future. Results demonstrated that adolescents receiving the program exhibited significantly slower increases in delinquent behaviors and substance use as compared to the control participants. During two years after the completion of the program, differences in youth risk behaviors in the two groups still existed. These results suggest that the Project PATHS has long-term effect in preventing adolescent problem behavior through promoting positive youth development.

  13. Drivers and implications of change in global ocean health over the past five years.

    Science.gov (United States)

    Halpern, Benjamin S; Frazier, Melanie; Afflerbach, Jamie; O'Hara, Casey; Katona, Steven; Stewart Lowndes, Julia S; Jiang, Ning; Pacheco, Erich; Scarborough, Courtney; Polsenberg, Johanna

    2017-01-01

    Growing international and national focus on quantitatively measuring and improving ocean health has increased the need for comprehensive, scientific, and repeated indicators to track progress towards achieving policy and societal goals. The Ocean Health Index (OHI) is one of the few indicators available for this purpose. Here we present results from five years of annual global assessment for 220 countries and territories, evaluating potential drivers and consequences of changes and presenting lessons learned about the challenges of using composite indicators to measure sustainability goals. Globally scores have shown little change, as would be expected. However, individual countries have seen notable increases or declines due in particular to improvements in the harvest and management of wild-caught fisheries, the creation of marine protected areas (MPAs), and decreases in natural product harvest. Rapid loss of sea ice and the consequent reduction of coastal protection from that sea ice was also responsible for declines in overall ocean health in many Arctic and sub-Arctic countries. The OHI performed reasonably well at predicting near-term future scores for many of the ten goals measured, but data gaps and limitations hindered these predictions for many other goals. Ultimately, all indicators face the substantial challenge of informing policy for progress toward broad goals and objectives with insufficient monitoring and assessment data. If countries and the global community hope to achieve and maintain healthy oceans, we will need to dedicate significant resources to measuring what we are trying to manage.

  14. Beyond the dual degree: development of a five-year program in leadership for medical undergraduates.

    Science.gov (United States)

    Crites, Gerald E; Ebert, James R; Schuster, Richard J; Shuster, Richard J

    2008-01-01

    The current state of physician leadership education consists mainly of executive degree programs designed for midcareer physicians. In 2004, the authors proposed that, by educating medical students in physician leadership and integrating this with a business management or public health degree program, graduates, health care organizations, and communities would benefit sooner. Given the lack of program models to guide program integration and development, the authors began a one-year inquiry to build a model leadership curriculum and integrate leadership education across degree programs. The qualitative inquiry resulted in several linked tasks. First, the authors identified a feasible method for concurrently delivering all three program components (MD degree, Leadership Curriculum, and MBA or MPH degree) during a five-year plan. Second, the authors chose a competency-based educational framework for leadership and then identified, adapted, and validated existing leadership competencies to their context. Third, the authors performed an extensive program alignment to identify existing overlaps and opportunities for integration within and across program components. Fourth, the authors performed a needs analysis to identify educational gaps, subsequently leading to redesigning two courses and to designing three new courses. A description of the Leadership Curriculum is also provided. This inquiry has led to the development of the Boonshoft Physician Leadership Development Program, which provides physician leadership education integrated with medical education and education in business management or public heath. Future program initiatives include developing leadership student assessment tools and testing the link between program activities and short- and long-term outcome measures of program success.

  15. Quantitative Characterisation of Sky Conditions on Paranal with the Microwave Radiometer LHATPRO - Five Years and Learning

    Science.gov (United States)

    Kerber, Florian; Querel, R.; Neureiter, B.; Hanuschik, R.

    2017-09-01

    "A Low Humidity and Temperature Profiling (LHATPRO) microwave radiometer, optimized for measuring small amounts of atmospheric precipitable water vapour (PWV), has now been in use for more than five years to monitor sky conditions over ESO's Paranal observatory (median PWV 2.5 mm). We'll summarise the performance characteristics of the unit and the current applications of its data in scheduling observations in Service Mode to take advantage of favourable conditions for infrared observations. We'll elaborate on our improved understanding of PWV over Paranal, including an analysis of PWV homogeneity addressing an important calibration issue. In addition we'll describe how the capabilities of the LHATPRO can be used in the future to further strengthen science operations and calibration by also offering line-of-sight support for individual VLT observations. Using its IR data we developed a method for an automated classification of photometric observing conditions in a quantitative way, supporting high precision photometry. Its highly precise PWV measurements enable new low PWV science during episodes of extremely low water vapour that result in a strongly increased transmission also outside the standard atmospheric windows. A goal for the future is to combine various diagnostics measurements (altitude resolved profiles) by LHATPRO and other instruments and sophisticated atmospheric modeling to better characterize relevant properties of the atmosphere and to thus enable more precise, local short-term forecasting for optimised science operations."

  16. Five-year forward view: lessons from emergency care at the extremes of age.

    Science.gov (United States)

    Minhas, J S; Minhas, D; Coats, T; Banerjee, J; Roland, D

    2017-01-01

    Objective The progressive rise in demand on NHS emergency care resources is partly attributable to increases in attendances of children and older people. A quality gap exists in the care provision for the old and the young. The Five Year Forward View suggested new models of care but that the "answer is not one-size-fits-all". This article discusses the urgent need for person-centred outcome measures to bridge the gap that exists between demand and provision. Design This review is based on evidence gathered from literature searching across several platforms using a variety of search terms to account for the obvious heterogeneity, drawing on key 'think-tank' evidence. Settings Qualitative and quantitative studies examining approaches to caring for individuals at the extremes of age. Participants Individuals at the extremes of age (infants and older people). Main Outcome Measures Understanding similarities and disparities in the care of individuals at the extremes of age in an emergency and non-emergency context. Results There exists several similarities and disparities in the care of individuals at the extremes of age. The increasing burden of health disease on the economy must acknowledge the challenges that exist in managing patients in emergency settings at the extremes of age and build systems to acknowledge the traits these individuals exhibit. Conclusion Commissioners of services must optimise the models of care delivery by appreciating the similarities and differences between care requirements in these two large groups seeking emergency care.

  17. Five-year follow-up of free-flap LASEK for treatment of high myopia

    Directory of Open Access Journals (Sweden)

    Li-Hua Chen

    2015-09-01

    Full Text Available AIM: To evaluate the long-term outcomes of free-flap laser subepithelial keratomileusis(LASEKfor treatment of high myopia.METHODS: Two hundred and nine patients(277 eyeswith high myopia were treated with free-flap LASEK in our hospital, each patient was followed up for 5a. Patients were divided into two groups including groupⅠwith high myopia(RESULTS: On the fifth day after surgery, all epithelial flaps were nearly transparent and 96.3% patients had postoperative irritation symptom such as wear eye pain, photophobia, tearing, foreign body sensation but all could tolerate. Five years after operation, 131 eyes(90.3%had uncorrected visual acuity(UCVAof ≥1.0, 145 eyes(100%≥0. 8 in group Ⅰ; 104 eyes(78. 8%had UCVA of ≥1.0, 119 eyes(90.2%≥0. 8, 129 eyes(97.7%≥0. 6 and 3 eyes(2. 3%P>0. 05, but there was statistical significance difference between each time point of postoperative and preoperative(PCONCLUSION: Free-flap LASEK is one of methods to treat eyes with high myopia safely and effectively, but should be cautious for super-high myopia.

  18. Metastatic lung cancer in the age of targeted therapy: improving long-term survival

    OpenAIRE

    Del Rivero, Jaydira; Enewold, Lindsey; Thomas, Anish

    2016-01-01

    Epidermal growth factor receptor (EGFR) mutations are the most frequent targetable genetic abnormality observed in non-small cell lung cancer (NSCLC). More than a decade after EGFR mutations were shown to predict sensitivity to EGFR-tyrosine kinase inhibitors (EGFR-TKI), retrospective cohort studies are now identifying and characterizing 5-year survivors. While these studies indicate subsets of patients achieving long-term survival, there is paucity of data pertaining to the long-term surviva...

  19. The prevalence and correlates of cyberbullying in adolescence: Results of a five-year cohort study

    OpenAIRE

    Rivers, I.

    2007-01-01

    POSTER 1: The Prevalence and Correlates of Cyberbullying in Adolescence: Results of a Five-Year Cohort Study. Recent media coverage has highlighted th growing prevalence of cyberbullying, however to date this new form of aggressive hebaviour has received relatively little research attention compared to other aspects of bullying behaviour. In this study, 14,281 pupils were surveyed annually over a five year period (approx. 3,000 per year) using an adapted version of the Olweus Bullying Questio...

  20. Conditional survival for long-term colorectal cancer survivors in the Netherlands: who do best?

    NARCIS (Netherlands)

    Erning, F.N. van; Steenbergen, L.N. van; Lemmens, V.E.; Rutten, H.J.; Martijn, H.; Spronsen, D.J. van; Janssen-Heijnen, M.L.

    2014-01-01

    AIM: With the increase in the number of long-term colorectal cancer (CRC) survivors, there is a growing need for subgroup-specific analysis of conditional survival. METHODS: All 137,030 stage I-III CRC patients diagnosed in the Netherlands between 1989 and 2008 aged 15-89years were selected from the

  1. Long-term quality of life in patients surviving at least 55 months after lung transplantation

    NARCIS (Netherlands)

    Vermeulen, KM; Ouwens, JP; van der Bij, W; Koeter, GH; TenVergert, EM

    2003-01-01

    The aim of this study was to examine the long-term effect of lung transplantation on Health Related Quality of Life by studying 28 patients who survived at least 55 months after lung transplantation. Measures included the Nottingham Health Profile, questions concerning lung-specific problems, the

  2. Off-Pump Conversion: In-hospital Mortality and Long-Term Survival.

    Science.gov (United States)

    Pullan, Mark; Oo, Aung; Poullis, Michael

    2017-06-01

    Background  There is an ongoing debate on the benefits and risks of off-pump coronary artery bypass grafting (CABG) surgery. The fate of patients who start with their procedure being an off-pump one and then have to undergo conversion to an on-pump procedure is debated with regard to in-hospital mortality and unknown with regard to long-term survival. We investigated the in-hospital mortality and long-term survival of patients who underwent conversion from off- to on-pump surgery. Methods  We performed a multivariate and propensity analysis on in-hospital mortality and long-term survival of postisolated CABG patients in a single institution having 15,704 patients of which 5,353 who underwent off-pump CABG were analyzed. Results  In-hospital mortality was 2.15% for the study cohort, and 73 (1.4%) off-pump cases were converted. Univariate analysis demonstrated that patients undergoing conversion had a significantly increased in-hospital mortality ( p  pump by a team of surgeons and anesthetists who are dedicated off-pump specialists does not have an impact on in-hospital mortality or long-term survival. Georg Thieme Verlag KG Stuttgart · New York.

  3. Five-Yearly Review 2010 : Confirmation that our salaries are going downhill

    CERN Multimedia

    Staff Association

    2010-01-01

    A general review of our financial and social conditions takes place every five years: “the five-yearly review”, whose principles and procedures are described in Annex A1 of the Staff Rules and Regulations. The purpose of the five-yearly review is to ensure that the financial and social conditions offered by the Organization allow it to recruit and retain from all its Member States staff members of the highest competence and integrity required for the execution of its mission. The five-yearly review must include basic remuneration (the basic salaries of staff members, the stipends of fellows, and the subsistence allowances of associated members of the personnel) and may include any other financial or social conditions. Start of the 2010 five-yearly review and data collection As we wrote in Echo no. 80, CERN Council approved the document CERN/2862 for the 2010 five-yearly review (hereinafter 2010 5YR) at its meeting on 19th June 2009. This was the Management’s proposal which...

  4. Interventions for increasing fruit and vegetable consumption in children aged five years and under.

    Science.gov (United States)

    Hodder, Rebecca K; Stacey, Fiona G; Wyse, Rebecca J; O'Brien, Kate M; Clinton-McHarg, Tara; Tzelepis, Flora; Nathan, Nicole K; James, Erica L; Bartlem, Kate M; Sutherland, Rachel; Robson, Emma; Yoong, Sze Lin; Wolfenden, Luke

    2017-09-25

    child-feeding practices (e.g. repeated food exposure) in increasing child vegetable intake. Eleven trials examined the impact of parent nutrition education in increasing child fruit and vegetable intake. Eight studies examined the impact of multicomponent interventions (e.g. parent nutrition education and preschool policy changes) in increasing child fruit and vegetable intake. One study examined the effect of a nutrition intervention delivered to children in increasing child fruit and vegetable intake.Thirteen of the 50 included trials were judged as free from high risks of bias across all domains; performance, detection and attrition bias were the most common domains judged at high risk of bias of remaining studies.Meta-analysis of trials examining child-feeding practices versus no intervention revealed a positive effect on child vegetable consumption (SMD 0.38, 95% CI 0.15 to 0.61; n = 1509; 11 studies; very low-quality evidence), equivalent to a mean difference of 4.03 grams of vegetables. There were no short-term differences in child consumption of fruit and vegetables in meta-analyses of trials examining parent nutrition education versus no intervention (SMD 0.11, 95% CI -0.05 to 0.28; n = 3023; 10 studies; very low-quality evidence) or multicomponent interventions versus no intervention (SMD 0.28, 95% CI -0.06 to 0.63; n = 1861; 4 studies; very low-quality evidence).Insufficient data were available to assess long-term effectiveness, cost effectiveness and unintended adverse consequences of interventions.Studies reported receiving governmental or charitable funds, except for two studies reporting industry funding. Despite identifying 50 eligible trials of various intervention approaches, the evidence for how to increase fruit and vegetable consumption of children remains sparse. There was very low-quality evidence child-feeding practice interventions are effective in increasing vegetable consumption of children aged five years and younger, however the effect size

  5. Long-Term Survival of Saplings during the Transformation to Continuous Cover

    Directory of Open Access Journals (Sweden)

    Hamish Mackintosh

    2012-09-01

    Full Text Available The Glentress Trial Area is an extensive research area in southern Scotland of 117 ha where a long-term trial of the transformation of even-aged plantations to continuous cover has been in progress since 1952. During the assessment of permanent sample plots in 1990 information on the species and spatial position of saplings (trees taller than 1.3 m with a diameter at breast height of < 7 cm was recorded. This provided a unique opportunity to investigate the long-term survival of saplings during the transformation process when the Trial Area was reassessed in 2009. The main finding was that 37% of saplings survived the 19-year period and the majority developed into trees (≥7 cm diameter at breast height. There was considerable variation between species, the lowest survival of saplings was European larch (Larix decidua Mill. (13% and the highest European beech (Fagus sylvatica L. (55%; however differences between species were not significant. There were, however, significant differences between the six management areas with three with high sapling survival (55% to 61% but others much lower (27% to 32%. If this result is confirmed by other studies, covering a broader range of sites, management guidance that assumes 90% survival will need to be revised.

  6. Pathological Complete Response and Long-Term Survival in a Very Elderly Patient after Neoadjuvant Chemotherapy for Locally Advanced, Unresectable Gastric Cancer

    Directory of Open Access Journals (Sweden)

    Kunihiko Izuishi

    2014-01-01

    Full Text Available We address the pathological complete response and long-term survival of elderly patients after neoadjuvant chemotherapy in locally advanced, unresectable gastric cancer. An 83-year-old man was hospitalized for upper abdominal pain. Gastrointestinal endoscopy showed a large tumor spanning from the gastric angle to the antrum, and extending to the duodenum. Histological analysis of the biopsy specimen revealed a poorly differentiated adenocarcinoma. Computed tomography images showed thickening of the gastric wall and invasion of the body and head of the pancreas, but did not show distant metastases. The patient was diagnosed with unresectable gastric cancer, and was treated with neoadjuvant chemotherapy using S-1 (80 mg/m2 and paclitaxel (60 mg/m2. After the third course of chemotherapy, gastrointestinal endoscopy and abdominal computed tomography revealed a remarkable reduction in tumor size. This reduction allowed distal gastrectomy to be conducted. Histological examination of the specimen revealed no cancer cells in the primary lesion or lymph nodes. The patient was treated with adjuvant chemotherapy of oral tegafur-uracil (300 mg/day for one year after surgery. He lived for five years after surgery without recurrence. Neoadjuvant chemotherapy using S-1 and paclitaxel is a potent strategy for improving survival in very elderly patients with unresectable gastric cancer.

  7. Long-term graft and patient survival following renal transplantation in diabetic patients

    DEFF Research Database (Denmark)

    Rømming Sørensen, Vibeke; Schwartz Sørensen, Søren; Feldt-Rasmussen, Bo

    2006-01-01

    OBJECTIVE: To study long-term graft and patient survival following renal transplantation in diabetic and non-diabetic patients. MATERIAL AND METHODS: Over the time period 1985-99, 498 transplantations in 399 non-diabetic patients and 68 transplantations in 62 diabetic patients were performed...... patients, 55% were smokers. Among the diabetic patients, graft and patient survival were independent of smoking habits, blood pressure, HbA1c and total cholesterol. CONCLUSIONS: Graft survival was similar in diabetic and non-diabetic patients. For the first 5 years following renal transplantation......% at 1 year, 52% vs 52% at 5 years and 27% vs 33% (p=NS) at 10 years. In the diabetic patients, mean haemoglobin (Hb)A1c 2 years before and 2 years after the transplantation was 7.5+/-1.4 vs 8.2+/-1.6 mmol/l (p

  8. Chemotherapy increases long-term survival in patients with adult medulloblastoma

    DEFF Research Database (Denmark)

    Kocakaya, Selin; Beier, Christoph Patrick; Beier, Dagmar

    2016-01-01

    parts of treatment regimes; however, established prognostic factors and data clarifying the role of chemotherapy are missing. METHODS: We investigated 227 publications from 1969-2013, with 907 identifiable, individual patients being available for meta-analysis. Demographic data, risk stratification...... chemotherapy first-line survived significantly longer (mOS: 108 mo, 95% CI: 68.6-148.4) than patients treated with radiation alone (mOS: 57 mo, 95% CI: 39.6-74.4) or patients who received chemotherapy at tumor recurrence. This effect was not biased by tumor stage or decade of treatment. Importantly, (neo......)adjuvant chemotherapy also significantly increased the chance for long-term survival (>5 y) compared with radiotherapy alone or chemotherapy at tumor recurrence. CONCLUSIONS: This meta-analysis clarifies relevant prognostic factors and suggests that chemotherapy as part of first-line therapy improves overall survival...

  9. Long-Term Survival of Patients Receiving Artificial Nutrition in Japanese Psychiatric Hospitals

    Directory of Open Access Journals (Sweden)

    Keiichi Abe

    2016-10-01

    Full Text Available Background/Aims: Most patients with dementia suffer from dysphagia in the terminal stage of the disease. In Japan, most elderly patients with dysphagia receive either tube feeding or total parenteral nutrition. Methods: In this study, we investigated the factors determining longer survival with artificial nutrition. Various clinical characteristics of 168 inpatients receiving artificial nutrition without oral intake in psychiatric hospitals in Okayama Prefecture, Japan, were evaluated. Results: Multiple logistic regression analysis showed that the duration of artificial nutrition was associated with a percutaneous endoscopic gastrostomy (PEG tube, diagnosis of mental disorder, low MMSE score, and absence of decubitus. Conclusion: Patients with mental disorders survived longer than those with dementia diseases on artificial nutrition. A PEG tube and good nutrition seem to be important for long-term survival.

  10. Aortic root surgery improves long-term survival after acute type A aortic dissection.

    Science.gov (United States)

    Hysi, Ilir; Juthier, Francis; Fabre, Olivier; Fouquet, Olivier; Rousse, Natacha; Banfi, Carlo; Pinçon, Claire; Prat, Alain; Vincentelli, André

    2015-04-01

    Our objective was to analyze the long term survival of patient operated on for acute type A aortic dissection. Between 1990 and 2010, 226 patients underwent emergency surgical operation for acute type A aortic dissection. We have followed the long-term outcomes. 144 patients were operated on with a supracommissural replacement of the ascending aorta (SCR) and 82 with an aortic root surgery (ARS, including 77 Bentall procedures and 5 Tirone David operations). Aortic cross-clamp was longer in ARS group (150.8 vs. 103.6 min, p<0.0001). Overall in-hospital mortality was lower in ARS group (20% vs. 34%, p 0.03). Median follow-up was 11.6 years. 10-year survival was higher in ARS group (85.7% vs. 65.9%, p 0.03) and 10-year freedom from aortic root reoperation was significantly lower in ARS group (93.4% vs. 82.9%, p 0.02). In a multivariate analysis aortic root surgery was an independent protective factor for proximal reoperations OR 0.393, CI 95% [0.206-0.748], p=0.005. Our study suggests that complete aortic root replacement in type A aortic dissection does not burden short-term outcomes, improves long-term survivals and decreases the rate of late reoperation. Whether this approach has to be preferred in younger patient has to be demonstrated in further studies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Test of long-term uterine survival after allogeneic transplantation in rabbits.

    Science.gov (United States)

    Saso, Srdjan; Hurst, Simon; Chatterjee, Jayanta; Kuzmin, Eugene; Thum, Yau; David, Anna L; Hakim, Nadey; Corless, David J; Boyd, Michael; Noakes, David E; Lindsay, Iain; Ghaem-Maghami, Sadaf; Del Priore, Giuseppe; Smith, J Richard

    2014-03-01

    To see if: (i) a large vessel aortocaval vascular patch technique may bring about long-term graft survival after allogeneic uterine transplantation (UTn) in a rabbit model; and (ii) fertility can be achieved following natural mating post-allogeneic UTn. Allogeneic uterine cross transplantations were performed in New Zealand white rabbits using an aortocaval macrovascular patch harvested as part of the uterine allograft. Five rabbit recipients received a uterine graft from five unrelated donor rabbits. All female rabbits were unrelated and were of proven fertility with at least one previous litter each. Tacrolimus was administrated for immunosuppression post-transplant. Natural mating was attempted if long-term survival had been achieved. The main outcome measures were: (i) long-term recipient survival; (ii) long-term adequate uterine perfusion; and (iii) successful pregnancy post-UTn. All five recipient animals survived the surgery with satisfactory immediate postoperative recovery. Recipients 1, 2 and 4 died within the first 4 postoperative days. Both long-term survivors failed to conceive following introduction of a proven male breeder despite evidence of mating. Necropsy at 9 and 11 months showed a lack of patency of uterine cornua at the point of anastomosis, albeit a small uterus in recipient 3 and a reddish brown amorphous material at the site of the transplanted uterus in recipient 5. We have demonstrated the feasibility of uterine allotransplantation using a macrovascular patch technique, but could not demonstrate conception because of blocked cornua. To address this, we propose using embryo transfer techniques in order to achieve conception. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

  12. Laboratory and Field Evidence for Long-Term Starvation Survival of Microorganisms in Subsurface Terrestrial Environments

    Energy Technology Data Exchange (ETDEWEB)

    Kieft, T.L. [Biology Dept., New Mexico Inst. of Mining and Technology, Socorro, NM (United States); Murphy, E.M. [Pacific Northwest National Lab., Richland, WA (United States); Amy, P.S.; Haldeman, D.L. [Department of Biological Sciences, University of Nevada, Las Vegas, NV (United States); Ringelberg, D. B. [Center for Environmental Biotechnology, University of Tennessee, Knoxville, TN (United States)]|[Oak Ridge National Lab., TN (United States)

    1997-12-31

    BIOGEOCHEMICAL MODELING OF GROUNDWATER FLOW AND NUTRIENT FLUX IN SUBSURFACE ENVIRONMENTS INDICATES THAT INHABITANT MICROORGANISMS EXPERIENCE SEVERE NUTRIENT LIMITATION. USING LABORATORY AND FIELD METHODS, WE HAVE BEEN TESTING STARVATION SURVIVAL IN SUBSURFACE MICROORGANISMS. IN MICROCOSM EXPERIMENTS, WE HAVE SHOWN THAT STRAINS OF TWO COMMONLY ISOLATED SUBSURFACE GENERA, ARTHROBACTER AND PSEUDOMONAS, ARE ABLE TO MAINTAIN VIABILITY IN LOW-NUTRIENT, NATURAL SUBSURFACE SEDIMENTS FOR OVER ONE YEAR. THESE NON-SPORE-FORMING BACTERIA UNDERGO RAPID INITIAL MINIATURIZATION FOLLOWED BY A STABILIZATION OF CELL SIZE. MEMBRANE LIPID PHOSPHOLIPID FATTY ACID (PLFA) PROFILES OF THE PSEUDOMONAS ARE CONSISTENT WITH ADAPTATION TO NUTRIENT STRESS; ARTHROBACTER APPARENTLY RESPONDS TO NUTRIENT DEPRIVATION WITHOUT ALTERING MEMBRANE PLFA. TO TEST SURVIVABILITY OF MICROORGANISMS OVER A GEOLOGIC TIME SCALE, WE CHARACTERIZED MICROBIAL COMMUNITIES IN A SEQUENCE OF UNSATURATED SEDIMENTS RANGING IN AGE FROM MODEM TO {gt}780,000 years. Sediments were relatively uniform silts in Eastern Washington State. Porewater ages at depth (measured by the chloride mass-balance approach) were as old as 3,600 years. Microbial abundance, biomass, and activities (measured by direct counts, culture counts, total PLFAs, and radiorespirometry) declined with sediment age. The pattern is consistent with laboratory microcosm studies of Microbial survival: rapid short-term change followed by long-term survival of a proportion of cells. Even the oldest sediments evinced a small but viable Microbial community. Microbial survival appeared to be a function of sediment age. Porewater age appeared to influence the markup of surviving communities, as indicated by PLFA profiles. Sites with different Porewater recharge rates and patterns of Pleistocene flooding had different communities.

  13. Long-Term Survival After Lung Transplantation in Patients with Silicosis and Other Occupational Lung Disease.

    Science.gov (United States)

    Hayes, Don; Hayes, Kaitlyn T; Hayes, Hunter C; Tobias, Joseph D

    2015-12-01

    Survival after lung transplantation (LTx) for patients with occupational lung disease (OLD) is not well studied. The United Network for Organ Sharing (UNOS) database was queried from 2005 to 2013 to assess survival after LTx in patients with silicosis and non-silicotic OLD compared to non-OLD patients. Of 7273 adult LTx recipients, 7227 (24 with silicosis and 29 with non-silicotic OLD) were included in our univariate and Kaplan-Meier function analysis and 6370 for multivariate Cox models. Univariate Cox models did not identify survival differences in silicosis (HR 0.717; 95 % CI 0.358-1.435; p = 0.347) and non-silicotic OLDs (HR 0.934; 95 % CI 0.486-1.798; p = 0.839). Kaplan-Meier function analysis did not identify a survival disadvantage for either silicosis or non-silicotic OLD (log-rank test: χ (2) 0.93, p = 0.627). Patients with non-silicotic OLD were at risk for worse survival for the first 2.5 years post-transplant; however, at the conclusion of the study, this group had the highest survival rate. Multivariate Cox models confirmed no increased risk for mortality for silicosis (HR 1.264; 95 % CI 0.631-2.534; p = 0.509) and non-silicotic OLD (HR 1.114; 95 % CI 0.578-2.147; p = 0.747). Long-term survival for adult patients with silicosis and non-silicotic OLD after LTx is not significantly different compared to the general lung transplant population.

  14. Enteral autonomy, cirrhosis, and long term transplant-free survival in pediatric intestinal failure patients.

    Science.gov (United States)

    Fullerton, Brenna S; Sparks, Eric A; Hall, Amber M; Duggan, Christopher; Jaksic, Tom; Modi, Biren P

    2016-01-01

    Patient selection for transplant evaluation in pediatric intestinal failure is predicated on the ability to assess long-term transplant-free survival. In light of trends toward improved survival of intestinal failure patients in recent decades, we sought to determine if the presence of biopsy-proven hepatic cirrhosis or the eventual achievement of enteral autonomy were associated with transplant-free survival. After IRB approval, records of all pediatric intestinal failure patients (parenteral nutrition (PN) >90 days) treated at a single intestinal failure center from February 2002 to September 2014 were reviewed. Chi-squared, Mann-Whitney, and log-rank testing were performed as appropriate. Of 313 patients, 174 eventually weaned off PN. Liver biopsies were available in 126 patients (most common indication was intestinal failure associated liver disease, IFALD), and 23 met histologic criteria for cirrhosis. Transplant-free survival for the whole cohort of 313 patients was 94.7% at 1 year and 89.2% at 5 years. Among patients with liver biopsies, transplant-free survival in cirrhotics vs. noncirrhotics was 95.5% vs. 94.1% at one year and 95.5% vs. 86.7% at 5 years (P=0.29). Transplant-free survival in patients who achieved enteral autonomy compared with patients who remained PN dependent was 98.2% vs. 90.3% at one year and 98.2% vs. 76.9% at 5 years (Ppediatric intestinal failure patients. There was no association between histopathological diagnosis of cirrhosis and transplant-free survival in the cohort. These data suggest that automatic transplant referral may not be required for histopathological diagnosis of cirrhosis alone, and that ongoing efforts aimed at achievement of enteral autonomy remain paramount in pediatric intestinal failure. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Long-term survival after an aggressive surgical approach in patients with breast cancer hepatic metastases.

    Science.gov (United States)

    Vlastos, Georges; Smith, David L; Singletary, S Eva; Mirza, Nadeem Q; Tuttle, Todd M; Popat, Reena J; Curley, Steven A; Ellis, Lee M; Roh, Mark S; Vauthey, Jean-Nicolas

    2004-09-01

    Metastatic breast cancer is generally believed to be associated with a poor prognosis. Therapeutic advances over the past two decades, however, have resulted in improved outcomes for selected patients with limited metastatic disease. Between March 1991 and October 2002, 31 patients had hepatic resection for breast cancer metastases limited to the liver. Clinical and pathologic data were collected prospectively from breast and hepatobiliary databases. Median age of patients was 46 years (range, 31 to 70). Liver metastases were solitary in 20 patients and multiple in 11 patients. Median size of the largest liver metastasis was 2.9 cm (range, 1 to 8). Major liver resections (three or more segments resected) were performed in 14 patients, whereas minor resections (fewer than three segments resected) with or without radiofrequency ablation (RFA) were performed in 17 patients. No postoperative mortality occurred. Of the 31 patients, 27 (87%) received either preoperative or postoperative systemic therapy as treatment for metastatic disease. The median survival was 63 months; a single patient died within 12 months of hepatic resection. The overall 2- and 5-year survival rates were 86% and 61%, respectively, whereas the 2- and 5-year disease-free survival rates were 39% and 31%, respectively. No treatment- or patient-specific variables were found to correlate with survival rates. In selected patients with liver metastases from breast cancer, an aggressive surgical approach is associated with favorable long-term survival. Hepatic resection should be considered a component of multimodality treatment of breast cancer in these patients.

  16. Long-term survival in patients with metastatic melanoma treated with DTIC or temozolomide.

    Science.gov (United States)

    Kim, Christina; Lee, Christopher W; Kovacic, Laurel; Shah, Amil; Klasa, Richard; Savage, Kerry J

    2010-01-01

    Patients with metastatic melanoma typically have a poor outcome; however, a small proportion of patients achieve long-term survival (LTS). It is unclear how often LTS is related to sensitivity to chemotherapy. All patients with metastatic melanoma treated with either dacarbazine (DTIC) or temozolomide (TMZ) at the British Columbia Cancer Agency (BCCA) from January 1, 1988 to February 1, 2006 were identified through the BCCA pharmacy electronic database, which was then linked to the surveillance and outcomes unit to identify patients with LTS, defined as survival > or =18 months following chemotherapy. In total, 397 patients were treated with either DTIC (n = 349) or TMZ (n = 48) and 43 patients (10.8%) were identified with LTS. Two additional patients with LTS were added prior to 1988 for a total of 45 patients. The 5-year overall and progression-free survival rates for patients with LTS were 33% and 16%, respectively. In total, 16% had a complete response (CR) to chemotherapy, which was the only factor identified that correlated with survival in the multivariate analysis. However, most patients with LTS had an incomplete response to chemotherapy. LTS occurs in select patients who achieve a CR to chemotherapy. However, this occurs in only a minority of patients and, in most cases, the longer survival is likely the result of indolent disease biology or host factors.

  17. Further investigation of confirmed urinary tract infection (UTI in children under five years: a systematic review

    Directory of Open Access Journals (Sweden)

    Cooper Julie

    2005-03-01

    Full Text Available Abstract Background Further investigation of confirmed UTI in children aims to prevent renal scarring and future complications. Methods We conducted a systematic review to determine the most effective approach to the further investigation of confirmed urinary tract infection (UTI in children under five years of age. Results 73 studies were included. Many studies had methodological limitations or were poorly reported. Effectiveness of further investigations: One study found that routine imaging did not lead to a reduction in recurrent UTIs or renal scarring. Diagnostic accuracy: The studies do not support the use of less invasive tests such as ultrasound as an alternative to renal scintigraphy, either to rule out infection of the upper urinary tract (LR- = 0.57, 95%CI: 0.47, 0.68 and thus to exclude patients from further investigation or to detect renal scarring (LR+ = 3.5, 95% CI: 2.5, 4.8. None of the tests investigated can accurately predict the development of renal scarring. The available evidence supports the consideration of contrast-enhanced ultrasound techniques for detecting vesico-ureteric reflux (VUR, as an alternative to micturating cystourethrography (MCUG (LR+ = 14.1, 95% CI: 9.5, 20.8; LR- = 0.20, 95%CI: 0.13, 0.29; these techniques have the advantage of not requiring exposure to ionising radiation. Conclusion There is no evidence to support the clinical effectiveness of routine investigation of children with confirmed UTI. Primary research on the effectiveness, in terms of improved patient outcome, of testing at all stages in the investigation of confirmed urinary tract infection is urgently required.

  18. Prevalence of Bilirubin Encephalopathy in Calabar, South-South Nigeria: A Five-year Review Study

    Directory of Open Access Journals (Sweden)

    Sunny Oteikwu Ochigbo

    2016-03-01

    Full Text Available Background: Bilirubin encephalopathy is a clinical syndrome, associated with bilirubin toxicity in the central nervous system, resulting in chronic and permanent sequelae. It has been estimated that approximately 60% and 80% of term and preterm newborns develop jaundice in the first week of life, respectively. In the present study, we aimed to determine the prevalence, morbidity, and mortality of bilirubin encephalopathy in the neonatal unit of the University of Calabar Teaching Hospital, Calabar, Nigeria. Methods: In this retrospective, descriptive review, medical records of all newborns, diagnosed with bilirubin encephalopathy over the past five years (from January 2010 to December 2014, were studied. Information retrieved from the medical records included age, sex, presence of fever, duration of disease, place of delivery, causes of the disease, and selected treatments. Variables such as hospital discharge, discharge against medical advice, and mortality were also evaluated. Results: Out of 2,820 newborns, 21 (0.74% cases were admitted on account of bilirubin encephalopathy. Among these affected cases, 17 (81% were male and 4 (19% were female (male-to-female ratio of 5:1. Based on the findings, 18 newborns (85.7% had pyrexia, while 8 (38.1% and 6 (28.6% cases were hypertonic and hypotonic, respectively upon admission. Only 33.3% of deliveries took place in healthcare facilities. The established factors responsible for jaundice included infection, i.e., septicemia (n=15, 71.4%, ABO incompatibility (n=4, 19.1%, and glucose-6-phosphate-dehydrogenase (G6PD deficiency (n=2, 9.5%. The mean maximum total bilirubin level in subjects was 321.3 μmol/L (range: 242.5–440.3 μmol/L. Also, mortality was reported in 4 (19% out of 21 cases. Conclusion: Based on the findings, neonatal septicemia is associated with bilirubin encephalopathy. Therefore, identification and prompt treatment are of utmost importance in preventing the associated morbidity and

  19. Treatment of multiple myeloma in Celje general hospital in the five-year period from 2007–2011

    Directory of Open Access Journals (Sweden)

    Mateja Grat

    2012-12-01

    Full Text Available We found 55 newly diagnosed patients with multiple myeloma in the five-year observation period. There were 8 to 13 new patients per year; patient’s average age was 67.8.years. 20/55 (36.4 % of patients were under 65 years old and 19/55 (34.6 % were 75 years or older. We assessed the international prognostic score (ISS in most patients (50/55; 90.9 % and cytogenetic analysis of bone marrow before initial treatment. These findings influenced our choice of regimens for initial therapy based on bortezomib and thalidomide. Treatment regimens based on melphalan and farmorubicin were used less frequently. In 19/55 (34.6 % of patients the treatment regimen included avtologous stem-cell transplantation (ASCT. Patients treated with ASCT have longer time to progression (median 12.4 months versus 8.7 months and better survival (44.3 months versus 33.3 months. New active agents have changed responses to treatment (partial response in 46/55 and very good partial response in 19/55 patients. In five-year period 18 patients died, most of them due to progression of the disease. Despite the era of new active agents, multiple myeloma is still incurable disease.

  20. Five-year results of laparoscopic sleeve gastrectomy for the treatment of severe obesity.

    Science.gov (United States)

    Nocca, David; Loureiro, Marcelo; Skalli, El Mehdi; Nedelcu, Marius; Jaussent, Audrey; Deloze, Melanie; Lefebvre, Patrick; Fabre, Jean Michel

    2017-08-01

    Since 2011, the most used bariatric technique in France has been the sleeve gastrectomy. There are still few studies exploring the medium and long-term results of this technique. To describe medium-long-term (5 years) results of a cohort of CHU Montpellier experience in sleeve gastrectomy for morbid obesity. All patients that underwent laparoscopic sleeve gastrectomy (LSG) from January 2005 to June 2013 were included in this study. A total of 1050 patients were operated. 72.86% were women. The mean preoperative BMI was 44.58 kg/m(2) (±7.71). A total of 183 patients (18.5%) were super-obese (BMI > 50 kg/m(2)). LSG was proposed as primary procedure, and also after failure of adjustable gastric banding in 169 patients (16.9%) or after vertical banded gastroplasty in 7 cases (0.7%). There were 38 postoperative gastric fistulas (3.8%) and 3 of them required some kind of bypass to be definitively treated. There were also 34 hemorrhages (3.4%) of which 21 were reoperated for hemostasis. Two gastric stenoses at the angulus (0.2%) were managed with dilation or RYGB. Overall reoperative rate was 6.8%. One patient died of pulmonary embolism. Most common late complication was GERD (39.1%). After 3, 4 and 5 years of LSG, the average of %EBL was, respectively, 75.95% (±29.16) (382 patients), 73.23% (±31.08) (222 patients) and 69.26% (±30.86) (144 patients). The success rate at 5 years was 65.97% (95 patients). The improvement or remission of comorbidities was found, respectively, in 88.4 and 57.2% of diabetic patients; 76.9 and 19.2% for hypertensive patients and 98 and 85% for patients with sleep apnea syndrome. LSG is a bariatric surgery technique that presents a very good risk/benefit ratio. Five-year results are very convincing. GERD is the main long-term complication.

  1. Estimates of conditional survival in gastric cancer reveal a reduction of racial disparities with long-term follow-up.

    Science.gov (United States)

    Luyimbazi, David; Nelson, Rebecca A; Choi, Audrey H; Li, Lily; Chao, Joseph; Sun, Virginia; Hamner, John B; Kim, Joseph

    2015-02-01

    In prior analyses, conditional survival (CS) estimates for gastric cancer have weighed clinical and pathologic factors to predict prognosis at time intervals after surgery. Since racial disparities in gastric cancer outcomes were not considered, our objective was to determine whether race influences CS estimates. Data from the Surveillance, Epidemiology, and End Results cancer registry were used to identify gastric adenocarcinoma patients who underwent curative surgical intervention between 1988 and 2005. Five-year relative conditional survival (RCS) was computed for patients who survived at least 1 to 5 years after surgery. RCS was calculated by assessing observed and expected survival in an age- and race-matched standard population. Results were compared across time and racial groups (white, black, and Asian) using z test statistics. Of 14,067 patients, 63.8 % were white, 15.5 % black, and 20.7 % Asian. Racial disparities among groups were observed with improved survival of Asians at time point zero and improved RCS at 1 year. At 5 years following curative surgery, each racial group had increased RCS and the greatest magnitude of relative increase was observed in white and black patients (121 and 118 %, respectively). Comparison of RCS at the 5-year time point revealed a reduction of racial disparities in survival among the three groups. Our investigation shows that racial disparities in gastric cancer outcomes are pronounced at the time of curative surgery but diminish after years of survival, thus suggesting race has less influence over outcomes the longer patients survive. The reasons for reduction of racial disparities remain unclear and warrant future study.

  2. IDH-Mutation Is a Weak Predictor of Long-Term Survival in Glioblastoma Patients.

    Directory of Open Access Journals (Sweden)

    Aymeric Amelot

    Full Text Available A very small proportion of patients diagnosed with glioblastoma (GBM survive more than 3 years. Isocitrate dehydrogenase 1 or 2 (IDH1/2 mutations define a small subgroup of GBM patients with favourable prognosis. However, it remains controversial whether long-term survivors (LTS are found among those IDH1/2 mutated patients.We retrospectively analyzed 207 GBM patients followed at Lariboisière Hospital (Paris between 2005 and 2010. Clinical parameters were obtained from medical records. Mutations of IDH1/2 were analyzed in these patients, by immunohistochemistry for the R132H mutation of IDH1 and by high-resolution melting-curve analysis, followed by Sanger sequencing for IDH1 and IDH2 exon 4 mutations. Mutation rates in LTS and non-LTS groups were compared by Chi square Pearson test.Seventeen patients with survival >3 years were identified (8.2% of the total series. The median overall survival in long-term survivors was 4.6 years. Subgroup analysis found that the median age at diagnosis was significantly higher for non long-term survivors (non-LTS compared to LTS (60 versus 51 years, p <0.03. The difference in the rate of IDH mutation between non-LTS and LTS was statistically not significant (1.16% versus 5.9%, p = 0.144. Among LTS, 10 out of 16 tumors presented a methylation of MGMT promoter.This study confirms that long-term survival in GBM patients is if at all only weakly correlated to IDH-mutation.

  3. Long-Term Survival of the Native Hip After a Minimally Displaced, Nonoperatively Treated Acetabular Fracture.

    Science.gov (United States)

    Clarke-Jenssen, John; Wikerøy, Annette K B; Røise, Olav; Øvre, Stein Arne; Madsen, Jan Erik

    2016-08-17

    Few studies have evaluated the long-term results for nonoperatively treated acetabular fractures. The purpose of this study was to describe the long-term survival of the native acetabulum as well as the clinical and radiographic outcome for patients with nonoperatively treated acetabular fractures. All patients with acetabular fractures are prospectively registered in our acetabular fracture database and followed up at regular intervals for up to 20 years. We identified 236 patients (237 fractures) who had been treated nonoperatively between 1994 and 2004; 51 patients with incomplete data were excluded. For the survival analysis, 186 fractures with an average follow-up of 9 years (range, 1 to 20 years) were included. For the long-term clinical outcome, 104 patients with an average follow-up of 12.1 years (range, 9 to 20 years) were included. The 10-year survival of the native hips was 94% (111 hips were at risk). Eighty-nine percent of the patients had a good or excellent Harris hip score, and 88% had a good or excellent Merle d'Aubigné and Postel score. The most important negative predictor for clinical outcome and survival of the hip was a fracture step-off of ≥2 mm measured in the obturator oblique radiograph. Nonoperative treatment of minimally displaced acetabular fractures yields good to excellent long-term results. For patients with a questionable indication for fracture surgery, oblique radiographs (Judet views) are a helpful tool in the decision-making process, as a fracture step-off of ≥2 mm is a strong predictor for a poor clinical and radiographic result at 10 years. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

  4. Long-term survival of human faecal microorganisms on the Antarctic Peninsula

    OpenAIRE

    Hughes, Kevin A.; Nobbs, Simon J.

    2004-01-01

    Human faecal waste has been discarded at inland Antarctic sites for over 100 years, but little is known about the long-term survival of faecal microorganisms in the Antarctic terrestrial environment or the environmental impact. This study identified viable faecal microorganisms in 30-40 year old human faeces sampled from the waste dump at Fossil Bluff Field Station, Alexander Island, Antarctic Peninsula. Viable aerobic and anaerobic bacteria were predominantly spore-forming varieties (Bacillu...

  5. Short-Term and Long-Term Survival and Virulence of Legionella pneumophila in the Defined Freshwater Medium Fraquil.

    Directory of Open Access Journals (Sweden)

    Nilmini Mendis

    Full Text Available Legionella pneumophila (Lp is the etiological agent responsible for Legionnaires' disease, a potentially fatal pulmonary infection. Lp lives and multiplies inside protozoa in a variety of natural and man-made water systems prior to human infection. Fraquil, a defined freshwater medium, was used as a highly reproducible medium to study the behaviour of Lp in water. Adopting a reductionist approach, Fraquil was used to study the impact of temperature, pH and trace metal levels on the survival and subsequent intracellular multiplication of Lp in Acanthamoeba castellanii, a freshwater protozoan and a natural host of Legionella. We show that temperature has a significant impact on the short- and long-term survival of Lp, but that the bacterium retains intracellular multiplication potential for over six months in Fraquil. Moreover, incubation in Fraquil at pH 4.0 resulted in a rapid decline in colony forming units, but was not detrimental to intracellular multiplication. In contrast, variations in trace metal concentrations had no impact on either survival or intracellular multiplication in amoeba. Our data show that Lp is a resilient bacterium in the water environment, remaining infectious to host cells after six months under the nutrient-deprived conditions of Fraquil.

  6. Determinants of drug survival for etanercept in a long-term daily practice cohort of patients with psoriasis

    NARCIS (Netherlands)

    Reek, J.M.P.A. van den; Lümig, P.P.M. van; Driessen, R.J.B.; Kerkhof, P.C.M. van de; Seyger, M.M.B.; Kievit, W.; Jong, E.M.G.J. de

    2014-01-01

    BACKGROUND: Long-term data of etanercept drug survival in patients with psoriasis in daily practice are scarce. OBJECTIVES: The primary objective was to describe drug survival for etanercept in a long-term daily practice cohort of patients with psoriasis. The secondary objective was to identify

  7. Long-term monitoring of Sacramento Shade program trees: tree survival, growth and energy-saving performance

    Science.gov (United States)

    Yekang Ko; Jun-Hak Lee; E. Gregory McPherson; Lara A. Roman

    2015-01-01

    Long-term survival and growth of urban forests are critical to achieve the targeted benefits of urban tree planting programs, such as building energy savings from tree shade. However, little is known about how trees perform in the long-term, especially in residential areas. Given this gap in the literature, we monitored 22-years of post-planting survival, growth, and...

  8. Preoperative White Matter Lesions Are Independent Predictors of Long-Term Survival after Internal Carotid Endarterectomy

    Directory of Open Access Journals (Sweden)

    Niku Oksala

    2014-06-01

    Full Text Available Background: Cerebral white matter lesions (WMLs predict long-term survival of conservatively treated acute stroke patients with etiology other than carotid stenosis. In carotid endarterectomy patients, WMLs are associated with severe carotid stenosis and unstable plaques, with the risk of perioperative complications and with increased 30-day perioperative risk of death. However, no data exist on their effect on postoperative long-term survival, a factor important when considering the net benefit from carotid endarterectomy. Whether this effect is independent of classical risk factors and indications for surgery is not known either. We hypothesized that WMLs could be evaluated from preoperative routine computed tomography (CT scans and are predictors of postoperative survival, independent of classical cardiovascular risk factors, indication category and degree of carotid stenosis. Methods: A total of 353 of 481 (73.4% consecutive patients subjected to carotid endarterectomy due to different indications, i.e. asymptomatic stenosis (n = 28, 7.9%, amaurosis fugax (n = 52, 14.7%, transient ischemic attack (n = 135, 38.2% or ischemic stroke (n = 138, 39.1%, from prospective vascular registries during the years 2001-2010 with digital preoperative CT scans, were included in the study. WMLs were rated by a radiologist (Wahlund criteria in a blinded fashion. Internal carotid artery (ICA stenoses were angiographically graded (Results: WML severity could be assessed with a substantial intraobserver agreement (Spearman's rho 0.843, p Conclusions: WMLs in a preoperative CT scan provide a substantially reliable estimate of postoperative long-term survival of carotid endarterectomy patients independent of currently used criteria, i.e. cardiovascular risk factors, indication category and degree of ipsilateral ICA stenosis.

  9. 10 CFR 35.655 - Five-year inspection for teletherapy and gamma stereotactic radiosurgery units.

    Science.gov (United States)

    2010-01-01

    ... stereotactic radiosurgery units. 35.655 Section 35.655 Energy NUCLEAR REGULATORY COMMISSION MEDICAL USE OF... Radiosurgery Units § 35.655 Five-year inspection for teletherapy and gamma stereotactic radiosurgery units. (a) A licensee shall have each teletherapy unit and gamma stereotactic radiosurgery unit fully inspected...

  10. 77 FR 12614 - Activated Carbon From China; Institution of a Five-Year Review

    Science.gov (United States)

    2012-03-01

    ... COMMISSION Activated Carbon From China; Institution of a Five-Year Review AGENCY: United States International... whether revocation of the antidumping duty order on activated carbon from China would be likely to lead to..., the Department of Commerce issued an antidumping duty order on imports of activated carbon from China...

  11. Graduate Business Students Perceptions of Online Learning: A Five Year Comparison

    Science.gov (United States)

    Perreault, Heidi; Waldman, Lila; Alexander, Melody; Zhao, Jensen

    2008-01-01

    This study compared graduate business students' access to online graduate programs and their perceptions relating to online learning over a five-year period. Student input was provided during 2001 and 2006. Students in 2006 had greater access to entire graduate programs being offered online than did the 2001 students. The students in 2006 felt…

  12. Pattern and Trend of Severe and Malaria Morbidity Over Five Years ...

    African Journals Online (AJOL)

    Pattern and Trend of Severe and Malaria Morbidity Over Five Years in JImma Zone, Southwest Ethiopia. Lelisa Sena, Wondimu Tesgera. Abstract. No abstract - Available on PDF. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online.

  13. Patient demands, lack of reciprocity, and burnout: a five-year longitudinal study about general practitioners.

    NARCIS (Netherlands)

    Bakker, A.B.; Schaufeli, W.B.; Sixma, H.J.; Bosveld, W.; Dierendonck, D. van

    2000-01-01

    This study among a sample of 207 general practitioners (GPs) uses a five-year longitudinal design to test a process model of burnout. On the basis of social exchange and equity theory, it is hypothesized and found that demanding patient contacts produce a lack of reciprocity in the GP-patient

  14. A five-year review of cholecystectomy in a hepato-pancreatobiliary ...

    African Journals Online (AJOL)

    The aim of this study was to evaluate the pattern of presentation of patients who had cholecystectomy in a dedicated Hepato-Pancreato-Biliary (HPB) Surgery unit of this facility and the benefit of laparoscopic cholecystectomy over conventional open cholecystectomy. This is a five year retrospective study (June 2009- May ...

  15. a five year review of api20e bacteria identification system's

    African Journals Online (AJOL)

    East African Medical Journal Vol. 91 No. 3 March 2014. A FIVE YEAR REVIEW OF API20E BACTERIA IDENTIFICATION SYSTEM'S PERFORMANCE AT A TEACHING. HOSPITAL. D. Maina, MBChB, MMed, Senior Instructor, N. Okinda, MBChB, MMed, Senior Instructor, E. Mulwa, MBChB, MMed,. Instructor, Department of ...

  16. Search for relativistic magnetic monopoles with five years of the ANTARES detector data

    NARCIS (Netherlands)

    Albert, A.; André, M.; Anghinolfi, M.; Anton, G.; Ardid, M.; Aubert, J.-J.; Avgitas, T.; Baret, B.; Barrios-Martí, J.; Basa, S.; Bertin, V.; Biagi, S.; Bormuth, R.; Bourret, S.; Bouwhuis, M.C.; Bruijn, R.; Brunner, J.; Busto, J.; Capone, A.; Caramete, L.; Carr, J.; Celli, S.; Chiarusi, T.; Circella, M.; Coelho, J.A.; Coleiro, A.; Coniglione, R.; Costantini, H.; Coyle, P.; Creusot, A.; Deschamps, A.; De Bonis, G.; Distefano, C.; Di Palma, I.; Domi, A.; Donzaud, C.; Dornic, D.; Drouhin, D.; Eberl, T.; El Bojaddaini, I.; Elsässer, D.; Enzenhöfer, A.; Felis, I.; Fusco, L.A.; Galatà, S.; Gay, P.; Giordano, V.; Glotin, H.; Grégoire, T.; Gracia-Ruiz, R.; Graf, K.; Hallmann, S.; van Haren, H.; Heijboer, A.J.; Hello, Y.; Hernandez-Rey, J.J.; Hößl, J.; Hofestädt, J.; Hugon, C.; Illuminati, G.; James, C.W.; de Jong, M.; Jongen, M.; Kadler, M.; Kalekin, O.; Katz, U.; Kießling, D.; Kouchner, A.; Kreter, M.; Kreykenbohm, I.; Kulikovskiy, V.; Lachaud, C.; Lahmann, R.; Lefevre, D.; Leonora, E.; Lotze, M.; Loucatos, S.; Marcelin, M.; Margiotta, A.; Marinelli, A.; Martinez-Mora, J.A.; Mele, R.; Melis, K.; Michael, T.; Migliozzi, P.; Moussa, A.; Navas, S.; Nezri, E.; Organokov, M.; Pavalas, G.E.; Pellegrino, C.; Perrina, C.; Piattelli, P.; Popa, V.; Pradier, T.; Quinn, L.; Racca, C.; Riccobene, G.; Sánchez-Losa, A.; Saldaña, M.; Salvadori, I.; Samtleben, D.F.E.; Sanguineti, M.; Sapienza, P.; Schüssler, F.; Sieger, C.; Spurio, M.; Stolarczyk, Th.; Taiuti, M.; Tayalati, Y.; Trovato, A.; Turpin, D.; Tönnis, C.; Vallage, B.; Van Elewyck, V.; Versari, F.; Vivolo, D.; Vizzoca, A.; Wilms, J.; Zornoza, J.D.; Zúñiga, J.

    2017-01-01

    A search for magnetic monopoles using five years of data recorded with the ANTARES neutrino telescope from January 2008 to December 2012 with a total live time of 1121 days is presented. The analysis is carried out in the range β > 0.6 of magnetic monopole velocities using a strategy based on

  17. Prevalence of rotavirus among children under five years of age with ...

    African Journals Online (AJOL)

    There was no statistically significant association between breast feeding and RV infection (P> 0.05). The study has revealed that rotavirus remains an important cause of acute diarrhea in children under five years in Kaduna State, Nigeria. Hence the need to introduce the vaccines into the childhood immunization program in ...

  18. acute medical conditions in under five year old children at a public ...

    African Journals Online (AJOL)

    2010-08-08

    Aug 8, 2010 ... ACUTE MEDICAL CONDITIONS IN UNDER FIVE YEAR OLD CHILDREN AT A PUBLIC HOSPITAL IN KENYA. D. Makworo, BScN, MScN, ... MMed, Lecturer, Department of Paediatrics and Child Health, College of Health Science, University of Nairobi, P. O. .... energy malnutrition (PEM), marasmus, rickets.

  19. 78 FR 65709 - Crawfish Tail Meat From China Institution of a Five-Year Review

    Science.gov (United States)

    2013-11-01

    ... COMMISSION Crawfish Tail Meat From China Institution of a Five-Year Review AGENCY: United States... determine whether revocation of the antidumping duty order on crawfish tail meat from China would be likely... issued an antidumping duty order on imports of crawfish tail meat from China (62 FR 48218). Following the...

  20. 78 FR 40172 - Steel Nails From China; Institution of a Five-Year Review

    Science.gov (United States)

    2013-07-03

    ... COMMISSION Steel Nails From China; Institution of a Five-Year Review AGENCY: United States International... whether revocation of the antidumping duty order on steel nails from China would be likely to lead to... duty order on imports of steel nails from China (73 FR 44961). The Commission is conducting a review to...

  1. ANALYSIS ON THE EVOLUTION OF INSURANCE SYSTEMS IN ROMANIA - THE PAST FIVE YEARS

    Directory of Open Access Journals (Sweden)

    AURELIA PĂTRAȘCU

    2016-08-01

    Full Text Available The aim of this paper is to analyze the evolution of insurance systems in Romania in the past five years. Unlike other European countries, it can be seen that Romania does not have a well-established insurance tradition. Insurance companies are constantly adapting to the realities of the financial situation and the market structure in Romania.

  2. Reflections on the first twenty-five years of the University of Malawi ...

    African Journals Online (AJOL)

    the Flinders University of South Australia), and South Africa. (the University of Cape Town), where they had gone for part of their medical studies. The chronology of events and the rationale for this hybrid training have been previously described.3-5. Reflections on the first twenty-five years of the. University of Malawi College ...

  3. 78 FR 54269 - Electrolytic Manganese Dioxide From Australia and China; Institution of Five-Year Reviews

    Science.gov (United States)

    2013-09-03

    ... COMMISSION Electrolytic Manganese Dioxide From Australia and China; Institution of Five-Year Reviews AGENCY...)) (the Act) to determine whether revocation of the antidumping duty orders on electrolytic manganese... electrolytic manganese dioxide from Australia and China (73 FR 58537-58539). The Commission is conducting...

  4. 77 FR 10774 - Silicon Metal From China; Scheduling of an Expedited Five-Year Review

    Science.gov (United States)

    2012-02-23

    ... From the Federal Register Online via the Government Publishing Office ] INTERNATIONAL TRADE COMMISSION Silicon Metal From China; Scheduling of an Expedited Five-Year Review AGENCY: United States...)) (the Act) to determine whether revocation of the antidumping duty order on silicon metal from China...

  5. 77 FR 59970 - Silicomanganese From India, Kazakhstan, and Venezuela; Institution of Five-Year Reviews...

    Science.gov (United States)

    2012-10-01

    ... COMMISSION Silicomanganese From India, Kazakhstan, and Venezuela; Institution of Five-Year Reviews Concerning the Antidumping Duty Orders on Silicomanganese From India, Kazakhstan, and Venezuela AGENCY: United..., Kazakhstan, and Venezuela would be likely to lead to continuation or recurrence of material injury. Pursuant...

  6. 75 FR 60731 - Initiation of Five-Year (“Sunset”) Review

    Science.gov (United States)

    2010-10-01

    ...- Dana Mermelstein Weld Pipe Fittings (202) 482-1391. (3rd Review). A-580-601 731-TA-304 South Korea...-TA-267 South Korea........ Top-of-the-Stove David Goldberger Stainless Steel (202) 482-4136. Cooking... International Trade Administration Initiation of Five-Year (``Sunset'') Review AGENCY: Import Administration...

  7. Analysis of the first five years of Ghana's BECE results in General ...

    African Journals Online (AJOL)

    In this study, an attempt has been made to examine and analyse the Basic Education Certificate Examination (BECE) papers in General Science for the first five years ... It is about time that the constructed tests provided a balance measure of the intended learning outcomes so that no area is over emphasised or neglected.

  8. Double cervix in a five-year-old white Fulami cow | Ajala | African ...

    African Journals Online (AJOL)

    A case report of true double cervix in a five-year-old white Fulani cow is presented. The condition is known to cause infertility which might be the reason why the cow was brought to the slaughterhouse at this critical age. Keywords: Double cervix, cow ...

  9. A Five-Year Study on the Employability of UKM Graduates

    Science.gov (United States)

    Khoon, Koh Aik; Din, Laily; Ahmad, Shaharuddin; Hamzah, Mohd Fauzi; Samah, Fatin Nur Diana Abu

    2013-01-01

    This paper reports on the employability of UKM graduates for the past five years (2006-2010). The employability of our graduates has consistently improved through the years. Medical and dental cohorts have less problems finding gainful employment compared with cohorts from other disciplines. Since 2008, our graduates have made inroads into sectors…

  10. Assessment of Peer-Led Team Learning in Calculus I: A Five-Year Study

    Science.gov (United States)

    Merkel, John Conrad; Brania, Abdelkrim

    2015-01-01

    This five-year study of the peer-led team learning (PLTL) paradigm examined its implementation in a Calculus I course at an all-male HBCU institution. For this study we set up a strong control group and measured the effect of PLTL in the teaching and learning of Calculus I through two points of measure: retention and success rates and learning…

  11. DOUBLE CERVIX IN A FIVE-YEAR- OLD WHITE FULANI COW.

    African Journals Online (AJOL)

    Dr Olaleye

    A case report of true double cervix in a five-year-old white Fulani cow is presented. The condition is known to cause infertility which might be the reason why the cow was brought to the slaughterhouse at this critical age. Keywords: Double cervix, cow ...

  12. What history tells us VII. Twenty-five years ago: the production of ...

    Indian Academy of Sciences (India)

    2006-11-13

    Nov 13, 2006 ... Home; Journals; Journal of Biosciences; Volume 31; Issue 5. What history tells us VII. Twenty-five years ago: the production of mouse embryonic stem cells. Michel Morange. Series Volume 31 Issue 5 December 2006 pp 537-541. Fulltext. Click here to view fulltext PDF. Permanent link:

  13. Esophageal adenocarcinoma five years after laparoscopic sleeve gastrectomy. A case report

    Directory of Open Access Journals (Sweden)

    Fernando Gabriel Wright

    2017-01-01

    Conclusion: We present a case of an esophageal adenocarcinoma five years after a laparoscopic sleeve gastrectomy for morbid obesity. There is need to better determine the relationship between sleeve gastrectomy and gastroesophageal reflux disease in order to prevent its related complications, such as esophageal adenocarcinoma.

  14. Five Years Later: Predicting Student Use of Journals in a New Water Resources Graduate Program

    Science.gov (United States)

    Wirth, Andrea A.; Mellinger, Margaret

    2011-01-01

    Using citation analysis, the authors examined the journals cited in theses and dissertations over the first five years of the Water Resources Graduate Program at Oregon State University. These journal titles were compared to the titles predicted as being important in the 2003 Oregon State University Libraries new program (Category I) review. A…

  15. A five-year review of childhood mortality at the University College ...

    African Journals Online (AJOL)

    Methods and patients: A retrospective study of the pattern of mortality among 12,522 children admitted into all the six wards of the department of Paediatrics, University College Hospital, Ibadan during a five-year period (January 1996 – December 2000) was done. Results: There were 1,185 deaths with an overall mortality ...

  16. Socio-economic factors predisposing under five-year-old children to ...

    African Journals Online (AJOL)

    Background: Malnutrition is one of the leading causes of morbidity and mortality in children aged five years and below. Risk factors for severe protein energy malnutrition (PEM) have been identified as ignorance, family size, mothers and fathers education, poverty, residence, chronic infections, and congenital defects or ...

  17. 76 FR 78694 - Fresh Garlic From China; Scheduling of an expedited five-year review

    Science.gov (United States)

    2011-12-19

    ... COMMISSION Fresh Garlic From China; Scheduling of an expedited five-year review AGENCY: United States...)) (the Act) to determine whether revocation of the antidumping duty order on fresh garlic from China... Commission has found the response submitted by the Fresh Garlic Producers Association and its individual...

  18. 75 FR 34959 - Five-Year Review of Oil Pipeline Pricing Index

    Science.gov (United States)

    2010-06-21

    ... for Oil Price Change Ceiling Levels, 114 FERC ] 61,293 (2006). \\4\\ The Commission publishes the final... (DC Cir. 2004). \\6\\ Order Establishing Index for Oil Price Change Ceiling Levels, 114 FERC ] 61,293... Federal Energy Regulatory Commission 18 CFR Part 342 Five-Year Review of Oil Pipeline Pricing Index June...

  19. Poor biofilm-forming ability and long-term survival of invasive Salmonella Typhimurium ST313.

    Science.gov (United States)

    Ramachandran, Girish; Aheto, Komi; Shirtliff, Mark E; Tennant, Sharon M

    2016-07-01

    Salmonella enterica serovar Typhimurium, an enteric pathogen that causes a self-limiting gastroenteritis, forms biofilms on different surfaces. In sub-Saharan Africa, Salmonella Typhimurium of a novel sequence type (ST) 313 was identified and produces septicemia in the absence of gastroenteritis. No animal reservoir has been identified, and it is hypothesized that transmission occurs via human to human. In this study, we show that invasive Salmonella Typhimurium ST313 strains from Mali are poor biofilm producers compared to Salmonella Typhimurium ST19 strains, which are found worldwide and are known to be associated with gastroenteritis. We evaluated biofilms using crystal violet staining, examination of the red, dry and rough morphotype, pellicle formation and a continuous flow system. One month-old Salmonella Typhimurium ST19 colonies survived in the absence of exogenous nutrients and were highly resistant to sodium hypochlorite treatment compared to Salmonella Typhimurium ST313. This study for the first time demonstrates the comparative biofilm-forming ability and long-term survival of clinical Salmonella Typhimurium ST19 and ST313 isolates. Salmonella Typhimurium ST19 strains are strong biofilm producers and can survive desiccation compared to Salmonella Typhimurium ST313 that form weak biofilms and survive poorly following desiccation. Our data suggest that like Salmonella Typhi, Salmonella Typhimurium ST313 lack mechanisms that allow it to persist in the environment. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Real-world, long-term survival of incident patients with pulmonary arterial hypertension

    Directory of Open Access Journals (Sweden)

    P. Marques-Alves

    2017-05-01

    Full Text Available Background: Pulmonary arterial hypertension (PAH is a progressive, fatal disease. Long-term outcomes data are scarce in Portugal. We aimed to estimate survival of newly diagnosed PAH at a Portuguese referral center in the modern management era. Methods: Between January 2009 and November 2015 all incident PAH cases were consecutively enrolled in a prospective cohort study. Sixty-five patients were followed up for a median of 3.1 [interquartile range 1.7–5.4] years. Kaplan–Meier survival analysis was used to estimate 1-, 3-, and 5-year survival and to compare it with a historical PAH survival estimated from the NIH cohort. Results: Mean age was 48 ± 19 years with female preponderance (68%. The most common PAH subgroup was congenital heart disease (PAH-CHD (n = 31; 48%, followed by connective tissue disease (PAH-CTD (n = 16; 25%, idiopathic (IPAH (n = 8; 12% and hereditary (HPAP (n = 1; 1.5%. BNP values (hazard ratio [HR] 2.07; 95%CI 1.34–3.22; P = 0.001 and male gender [HR 4.34 (1.44–13.09; P = 0.009] were predictors of death. Survival rates at 1-, 3- and 5-years were 95%, 77% and 71%. Survival was not statistically different between PAH etiologies (Log-rank P = 0.7. However, PAH-CHD was associated with a decreased risk of the combined endpoint of all-cause mortality and admission for decompensated heart failure [HR 0.36 (0.15–0.85; P = 0.02]. We found a non-significant numerically higher survival of incident IPAH, HPAH and DPAH patients in comparison with the historical NIH cohort. Conclusions: In this cohort of incident PAH patients, PAH-CHD patients had better overall prognosis. Higher BNP values and male gender were associated with higher mortality. Keywords: Pulmonary arterial hypertension, Survival, Predictors of mortality, Predictors of heart failure

  1. Saguaro (Carnegiea gigantea) Mortality and Population Regeneration in the Cactus Forest of Saguaro National Park: Seventy-Five Years and Counting

    Science.gov (United States)

    Orum, Thomas V.; Ferguson, Nancy; Mihail, Jeanne D.

    2016-01-01

    Annual census data spanning seventy-five years document mortality and regeneration in a population of saguaro cactus (Carnegiea gigantea) in the Cactus Forest of the Rincon Mountain District of Saguaro National Park near Tucson, AZ. On 6 four-hectare plots, each saguaro was censused and a methodical search for new saguaros was conducted annually each year from 1942 through 2016, with the exception of 1955. Regeneration has been episodic with 828 plants established from 1959 through 1993 compared with 34 plants established between 1942 and 1958 and only three plants established after 1993. The years preceding 1959 and following 1993, include some of the driest decades in centuries in southern Arizona. While woodcutting and cattle grazing are believed to be among the causes of decades of failed regeneration prior to 1958, neither of these factors contributed to the failed regeneration following 1993. The height structure of the population from 1942 to 2016 shifted dramatically from a population dominated by large saguaros (> 5.4 m tall) in the first three decades of the study to a population dominated by small saguaros (plants older than 80 years died compared with zero deaths in 270 plants between the ages of 29 and 80 years. Saguaros under 40 years old, growing under small shrubs or in the open, have a lower probability of survival than better protected saguaros. Long-term population monitoring is essential to understanding the complex impacts of human and environmental factors on the population dynamics of long-lived species. PMID:27505437

  2. Bayesian Analysis of White Noise Levels in the Five-Year WMAP Data

    Science.gov (United States)

    Groeneboom, N. E.; Eriksen, H. K.; Gorski, K.; Huey, G.; Jewell, J.; Wandelt, B.

    2009-09-01

    We develop a new Bayesian method for estimating white noise levels in CMB sky maps, and apply this algorithm to the five-year Wilkinson Microwave Anisotropy Probe (WMAP) data. We assume that the amplitude of the noise rms is scaled by a constant value, α, relative to a pre-specified noise level. We then derive the corresponding conditional density, P(α | s, C ell, d), which is subsequently integrated into a general CMB Gibbs sampler. We first verify our code by analyzing simulated data sets, and then apply the framework to the WMAP data. For the foreground-reduced five-year WMAP sky maps and the nominal noise levels initially provided in the five-year data release, we find that the posterior means typically range between α = 1.005 ± 0.001 and α = 1.010 ± 0.001 depending on differencing assembly, indicating that the noise level of these maps are biased low by 0.5%-1.0%. The same problem is not observed for the uncorrected WMAP sky maps. After the preprint version of this letter appeared on astro-ph., the WMAP team has corrected the values presented on their web page, noting that the initially provided values were in fact estimates from the three-year data release, not from the five-year estimates. However, internally in their five-year analysis the correct noise values were used, and no cosmological results are therefore compromised by this error. Thus, our method has already been demonstrated in practice to be both useful and accurate.

  3. Ankle-Brachial Index and Long-Term (10 Years) Survival of Nondiabetic Hemodialysis Patients.

    Science.gov (United States)

    Bevc, Sebastjan; Purg, Darinka; Knehtl, Maša; Hren, Martin; Turnšek, Nina; Hojs, Nina; Zorman, Tadej; Dvoršak, Benjamin; Ekart, Robert; Hojs, Radovan

    2016-06-01

    Low (1.4) ankle brachial index (ABI) is associated with a higher cardiovascular (CV) mortality in the general and hemodialysis (HD) population. The aim of our study was to determine the impact of ABI on long-term survival of 52 non-diabetic HD patients. The ABI was determined using an automated, non-invasive waveform analysis device. Patients were divided into three groups: low (1.4) ABI. Patients were observed from the date of ABI measurement until their death or ten years. Survival analysis showed higher risk for CV death in HD patients with high ABI compared to normal ABI (log rank test P < 0.027). In Cox regression model adjusted for arterial hypertension, smoking, serum cholesterol and triglycerides, high ABI (P < 0.049) remained a predictor of mortality. The results indicate an association between ABI and long-term survival of non-diabetic HD patients and only high ABI was associated with higher CV mortality. © 2016 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

  4. Neoadjuvant radiotherapy of early-stage breast cancer and long-term disease-free survival.

    Science.gov (United States)

    Poleszczuk, Jan; Luddy, Kimberly; Chen, Lu; Lee, Jae K; Harrison, Louis B; Czerniecki, Brian J; Soliman, Hatem; Enderling, Heiko

    2017-06-30

    Compared with surgery alone, postoperative adjuvant radiotherapy (RT) improves relapse-free survival of patients with early-stage breast cancer. We evaluated the long-term overall and disease-free survival rates of neoadjuvant (presurgical) versus adjuvant RT in early-stage breast cancer patients. We used the Surveillance, Epidemiology, and End Results (SEER) database provided by the National Institutes of Health to derive an analytic dataset of 250,195 female patients with early-stage breast cancer who received RT before (n = 2554; 1.02%) or after (n = 247,641; 98.98%) surgery. Disease-free survival, defined as time to diagnosis of a second primary tumor at any location, was calculated from automated patient identification matching of all SEER records. Partial and complete mastectomies were performed in 94.4% and 5.6% of patients, respectively. In the largest cohort of estrogen receptor-positive women who underwent partial mastectomy, the HR of developing a second primary tumor after neoadjuvant compared with adjuvant RT was 0.64 (95% CI 0.55-0.75; P early-stage breast cancer. This finding warrants further exploration of potential long-term benefits of neoadjuvant radiotherapy for early-stage breast cancer in a controlled, prospective clinical trial setting, with correlative studies done to identify potential mechanisms of superiority.

  5. Survival Trends and Long-Term Toxicity in Pediatric Patients with Osteosarcoma

    Directory of Open Access Journals (Sweden)

    Melanie M. Hagleitner

    2012-01-01

    Full Text Available Background. This study was conducted to investigate the clinical characteristics and treatment results of osteosarcoma in pediatric patients during the past 30 years. Trends in survival rates and long-term toxicity were analyzed. Procedure. 130 pediatric patients under the age of 20 years with primary localized or metastatic high-grade osteosarcoma were analyzed regarding demographic, treatment-related variables, long-term toxicity, and survival data. Results. Comparison of the different time periods of treatment showed that the 5-year OS improved from 58.6% for children diagnosed during 1979–1983 to 78.6% for those diagnosed during 2003–2008 (P=0.13. Interestingly, the basic treatment agents including cisplatin, doxorubicin, and methotrexate remained the same. Treatment reduction due to acute toxicity was less frequent in patients treated in the last era (7.1% versus 24.1% in patients treated in 1979–1983; P=0.04. Furthermore, late cardiac effects and secondary malignancies can become evident many years after treatment. Conclusion. We elucidate the prevalence of toxicity to therapy of patients with osteosarcoma over the past 30 years. The overall improvement in survival may in part be attributed to improved supportive care allowing regimens to be administered to best advantage with higher tolerance of chemotherapy and therefore less chemotherapy-related toxicity.

  6. FBLN4 as candidate gene associated with long-term and short-term survival with primary glioblastoma

    Directory of Open Access Journals (Sweden)

    Li F

    2017-01-01

    Full Text Available Fubin Li,1,* Yiping Li,1,* Kewei Zhang,1,* Ye Li,1,* Ping He,1,* Yujia Liu,1,* Hongyan Yuan,2,* Honghua Lu,1,* Jinxiang Liu,1,* Songtian Che,3,* Zhenju Li,4,* Li Bie1,5 1Department of Neurosurgery of the First Clinical Hospital, 2Department of Immunology, Norman Bethune College of Medicine, 3Department of Neurosurgery of the Second Clinical Hospital, 4Department of Neurosurgery of the Fourth Clinical Hospital, Jilin University, Changchun, People’s Republic of China; 5Department of Pathology and Laboratory Medicine, School of Medicine, University of California – Irvine, Irvine, CA, USA *These authors contributed equally to this work Background: Glioblastoma multiforme (GBM is the most common malignant and lethal type of primary central nervous system tumor in humans. In spite of its high lethality, a small percentage of patients have a relatively good prognosis, with median survival times of 36 months or longer. The identification of clinical subsets of GBM associated with distinct molecular genetic profiles has made it possible to design therapies tailored to treat individual patients. Methods: We compared microarray data sets from long-term survivors (LTSs and short-term survivors (STSs to screen for prognostic biomarkers in GBM patients using the WebArrayDB platform. We focused on FBLN4, IGFBP-2, and CHI3L1, all members of a group of 10 of the most promising, differentially regulated gene candidates. Using formalin-fixed paraffin-embedded GBM samples, we corroborated the relationship between these genes and patient outcomes using methylation-specific polymerase chain reaction (PCR for MGMT methylation status and quantitative reverse transcription PCR for expression of these genes. Results: Expression levels of the mRNAs of these 3 genes were higher in the GBM samples than in normal brain samples and these 3 genes were significantly upregulated in STSs compared to the levels in LTS samples (P<0.01. Furthermore, Kaplan–Meier analysis

  7. Long-Term Survival and Reintervention After the Ross Procedure Across the Pediatric Age Spectrum.

    Science.gov (United States)

    Nelson, Jennifer S; Pasquali, Sara K; Pratt, Clayton N; Yu, Sunkyung; Donohue, Janet E; Loccoh, Emefah; Ohye, Richard G; Bove, Edward L; Hirsch-Romano, Jennifer C

    2015-06-01

    There are limited data regarding long-term outcomes after the Ross procedure in children. We evaluated mortality and reintervention in a large pediatric cohort. A retrospective analysis of all patients aged younger than 18 years who underwent the Ross procedure at our institution (1991 to 2013) was conducted. Kaplan-Meier curves and Cox proportion hazard models were used to evaluate long-term outcomes and associated risk factors. Included were 240 consecutive patients undergoing a Ross/Ross-Konno procedure: 18% infants, 48% children, and 33% adolescents. Infants were more likely to have complex left heart disease (p = 0.005). Overall survival to hospital discharge was 96%; infants had the highest mortality (18%). Long-term survival status was known for 99.6% (median follow-up, 10.7 years). Overall 15-year survival was 87% (lowest in infants, 72%; p = 0.003). Reintervention status was known in 87%. Overall 15-year freedom from any left ventricular outflow tract reintervention was 59%; 85% still had their autograft valve at the latest follow-up. Left ventricular outflow tract reintervention was uncommon in infants (n = 2). Overall 15-year freedom from right ventricular outflow tract reintervention was 53%, and was lower in infants (19%) than in children (51%) and adolescents (76%; p Ross procedure in children vary by age. Infants more commonly have complex left heart disease and experience higher mortality but have excellent long-term autograft durability. Children and adolescents have higher rates of left ventricular outflow tract reintervention, whereas infants are at highest risk of right ventricular outflow tract reintervention. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Five Year Continence Rates, Satisfaction and Adverse Events of Burch Urethropexy and Fascial Sling Surgery for Urinary Incontinence

    Science.gov (United States)

    Brubaker, L; Richter, H. E.; Norton, P. A.; Albo, M.; Zyczynski, H. M.; Chai, T. C.; Zimmern, P.; Kraus, S.; Sirls, L.; Kusek, J. W.; Stoddard, A.; Tennstedt, S.; Gormley, E. Ann

    2013-01-01

    Purpose To characterize continence, satisfaction, and adverse events in women at least 5 years after a Burch urethropexy or fascial sling with longitudinal follow-up of randomized clinical trial participants at least 5 years post-operatively. Methods 482 (73.6520 (79.4%) of 655 women participated in a randomized surgical trial comparing efficacy of the Burch and sling treatments enrolled in this long-term observational study. Urinary continence status was assessed yearly for a minimum of five years postoperatively. Continence was defined as no urinary leakage on a three-day voiding diary and no self-reported stress incontinence symptoms AND no stress incontinence surgical retreatment. Results Incontinent participants were more likely to enroll in the follow-up study than continent patients (85.5% vs. 52.2%), regardless of surgical group (p <0.0001). Overall the continence rates were lower in the Burch urethropexy group than in the fascial sling group (p=0.002). The continence rates at five years were 24.1% (95% CI 18.5% to 29.7%) compared to 30.8% (24.7% to 36.9%), respectively. Satisfaction at 5 years was related to continence status and higher in women undergoing a sling (83% vs. 73%, p=0.04). Satisfaction declined over time (P=0.001) and remained higher in the sling group (p=0.03). The two groups had similar adverse event rates (10% Burch vs.9 % sling) and similar numbers of participants with adverse events (23 Burch vs. 22 sling). Conclusions Continence rates in both groups declined substantially over five years, yet most women reported satisfaction with their continence status. Satisfaction was higher in continent women and those who underwent fascial sling, despite the voiding dysfunction associated with this procedure. PMID:22341290

  9. Five-Year Outcomes of High-Dose Single-Fraction Spinal Stereotactic Radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Moussazadeh, Nelson [Division of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York (United States); Lis, Eric [Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Katsoulakis, Evangelia [Department of Radiation Oncology, New York Methodist Hospital, Brooklyn, New York (United States); Kahn, Sweena; Svoboda, Marek; DiStefano, Natalie M.; McLaughlin, Lily [Division of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Bilsky, Mark H. [Division of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York (United States); Yamada, Yoshiya [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Laufer, Ilya, E-mail: lauferi@mskcc.org [Division of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York (United States)

    2015-10-01

    Purpose: To characterize local tumor control and toxicity risk in very long-term survivors (>5 years) after high-dose spinal image guided, intensity modulated radiation therapy delivered as single-dose stereotactic radiosurgery (SRS). Previously published spinal SRS outcome analyses have included a heterogeneous population of cancer patients, mostly with short survival. This is the first study reporting the long-term tumor control and toxicity profiles after high-dose single-fraction spinal SRS. Methods and Materials: The study population included all patients treated from June 2004 to July 2009 with single-fraction spinal SRS (dose 24 Gy) who had survived at least 5 years after treatment. The endpoints examined included disease progression, surgical or radiation retreatment, in-field fracture development, and radiation-associated toxicity, scored using the Radiation Therapy Oncology Group radiation morbidity scoring criteria and the Common Terminology Criteria for Adverse Events, version 4.0. Local control and fracture development were assessed using Kaplan-Meier analysis. Results: Of 278 patients, 31 (11.1%), with 36 segments treated for spinal tumors, survived at least 5 years after treatment and were followed up radiographically and clinically for a median of 6.1 years (maximum 102 months). The histopathologic findings for the 5-year survivors included radiation-resistant metastases in 58%, radiation-sensitive metastases in 22%, and primary bone tumors in 19%. In this selected cohort, 3 treatment failures occurred at a median of 48.6 months, including 2 recurrences in the radiation field and 1 patient with demonstrated progression at the treatment margins. Ten lesions (27.8%) were associated with acute grade 1 cutaneous or gastrointestinal toxicity. Delayed toxicity ≥3 months after treatment included 8 cases (22.2%) of mild neuropathy, 2 (5.6%) of gastrointestinal discomfort, 8 (22.2%) of dermatitides, and 3 (8.3%) of myalgias/myositis. Thirteen

  10. Insurance and education predict long-term survival after orthotopic heart transplantation in the United States.

    Science.gov (United States)

    Allen, Jeremiah G; Weiss, Eric S; Arnaoutakis, George J; Russell, Stuart D; Baumgartner, William A; Shah, Ashish S; Conte, John V

    2012-01-01

    Insurance status and education are known to affect health outcomes. However, their importance in orthotopic heart transplantation (OHT) is unknown. The United Network for Organ Sharing (UNOS) database provides a large cohort of OHT recipients in which to evaluate the effect of insurance and education on survival. UNOS data were retrospectively reviewed to identify adult primary OHT recipients (1997 to 2008). Patients were stratified by insurance at the time of transplantation (private/self-pay, Medicare, Medicaid, and other) and college education. All-cause mortality was examined using multivariable Cox proportional hazard regression incorporating 15 variables. Survival was modeled using the Kaplan-Meier method. Insurance for 20,676 patients was distributed as follows: private insurance/self-pay, 12,298 (59.5%); Medicare, 5,227 (25.3%); Medicaid, 2,320 (11.2%); and "other" insurance, 831 (4.0%). Educational levels were recorded for 15,735 patients (76.1% of cohort): 7,738 (49.2%) had a college degree. During 53 ± 41 months of follow-up, 6,125 patients (29.6%) died (6.7 deaths/100 patient-years). Survival differed by insurance and education. Medicare and Medicaid patients had 8.6% and 10.0% lower 10-year survival, respectively, than private/self-pay patients. College-educated patients had 7.0% higher 10-year survival. On multivariable analysis, college education decreased mortality risk by 11%. Medicare and Medicaid increased mortality risk by 18% and 33%, respectively (p ≤ 0.001). Our study examining insurance and education in a large cohort of OHT patients found that long-term mortality after OHT is higher in Medicare/Medicaid patients and in those without a college education. This study points to potential differences in the care of OHT patients based on education and insurance status. Copyright © 2012 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  11. Post-operative morbidity results in decreased long-term survival after resection for hilar cholangiocarcinoma

    Science.gov (United States)

    Chauhan, Aakash; House, Michael G; Pitt, Henry A; Nakeeb, Attila; Howard, Thomas J; Zyromski, Nicholas J; Schmidt, C Max; Ball, Chad G; Lillemoe, Keith D

    2011-01-01

    Background The purpose of the present study was to demonstrate that post-operative morbidity (PM) associated with resections of hilar cholangiocarcinoma (HCCA) is associated with short- and long-term patient survival. Methods Between 1998 and 2008, 51 patients with a median age of 64 years underwent resection for HCCA at a single institution. Associations between survival and clinicopathologic factors, including peri- and post-operative variables, were studied using univariate and multivariate models. Results Seventy-six per cent of patients underwent major hepatectomy with resection of the extrahepatic bile ducts. The 30- and 90-day operative mortality was 10% and 12%. The overall incidence of PM was 69%, with 68% of all PM as major (Clavien grades III–V). No difference in operative blood loss or peri-operative transfusion rates was observed for patients with major vs. minor or no PM. Patients with major PM received adjuvant chemotherapy less frequently than patients with minor or no complications 29% vs. 52%, P= 0.15. The 1-, 3- and 5-year overall (OS) and disease-specific survival (DSS) rates for all patients were 65%, 36%, 29% and 77%, 46%, 35%, respectively. Using univariate and multivariate analysis, margin status (27% R1), nodal metastasis (35% N1) and major PM were associated with OS and DSS, P operations for HCCA can produce substantial post-operative morbidity. In addition to causing early mortality, major post-operative complications are associated with decreased long-term cancer-specific survival after resection of HCCA. PMID:21241432

  12. Effect of Helicobacter pylori Eradication on Long-Term Survival after Distal Gastrectomy for Gastric Cancer.

    Science.gov (United States)

    Kim, Young-Il; Cho, Soo-Jeong; Lee, Jong Yeul; Kim, Chan Gyoo; Kook, Myeong-Cherl; Ryu, Keun Won; Kim, Young-Woo; Choi, Il Ju

    2016-07-01

    Negative Helicobacter pylori status has been identified as a poor prognostic factor for survival in gastric cancer (GC) patients who underwent surgery. The aim of this study was to examine the effect of H. pylori eradication on long-term outcomes after distal gastrectomy for GC. We analyzed the survival of 169 distal GC patients enrolled in a prospective randomized trial evaluating histologic changes of gastric mucosa after H. pylori eradication in the remnant stomach. The outcomes measured were overall survival (OS) and GC recurrence rates. The median follow-up duration was 9.4 years. In the modified intention-to-treat analysis including patients who underwent H. pylori treatment (n=87) or placebo (n=82), 5-year OS rates were 98.9% in the treatment group and 91.5% in the placebo group, and Kaplan-Meier analysis showed no significant difference in OS (p=0.957) between groups. In multivariate analysis, no difference in overall mortality was observed between groups (adjusted hazard ratio [aHR] for H. pylori treatment, 0.75; p=0.495) or H. pylori-eradicated status (aHR for positive H. pylori status, 1.16; p=0.715), while old age, male sex, and advanced stage ≥ IIIa were independent risk factors. Six patients in the treatment group (6.9%) and seven patients in the placebo group (8.5%) had GC recurrences, and GC recurrence rates were not different according to H. pylori treatment (5-year GC recurrence rates, 4.6% in the treatment group vs. 8.5% in the placebo group; p=0.652). H. pylori eradication for GC patients who underwent distal gastrectomy did not compromise long-term survival after surgery.

  13. Ten Years Back, Five Years Forward: The Data Seal of Approval

    Directory of Open Access Journals (Sweden)

    Ingrid Dillo

    2015-02-01

    Full Text Available If we want to share data, the long-term storage of those data in a trustworthy digital archive is an essential condition. Trust is the basis of storing and sharing data. That trust must be present in the various stakeholders involved. Certification of digital archives can make an important contribution to the confidence of these stakeholders in the digital archives.Ten years ago DANS was assigned the task of developing a Seal of Approval for digital data to ensure that archived data can still be found, understood and used in the future. In 2009 this Data Seal of Approval (DSA was transferred to an international body, the DSA Board, which has managed and further developed the guidelines and the peer review process ever since.The objectives of the DSA are to safeguard data, ensure high quality and guide reliable management of data for the future without requiring implementation of new standards, regulations or heavy investments. The DSA contains 16 guidelines for applying and verifying quality aspects concerning the creation, storage, use and reuse of digital data.Based on feedback from data archives that applied for a DSA and different case studies we have gained some insight into the benefits of DSA. Still, the impact of having the Seal is not easy to measure. Seal holders usually refer to qualitative benefits in the form of increased awareness of the value of their repositories to their communities, funders and publishers.Ten years down the line we can safely state that the Data Seal of Approval has proven its added value. If we try to look five years into the future, what can we expect? There are different developments: a growing interest in DSA among European research infrastructures, the collaboration between DSA and the ISCU World Data System under the umbrella of the RDA (Research Data Alliance and the European Commission is showing a growing interest in certification services.The success of DSA also provides the challenge to further

  14. SITUATIONAL ANALYSIS AND FUTURE DIRECTIONS OF AYUSH: AN ASSESSMENT THROUGH FIVE YEAR PLANS OF INDIA

    Directory of Open Access Journals (Sweden)

    Janmejaya Samal

    2015-12-01

    Full Text Available AYUSH is an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy. These are the six indigenous systems of medicine practiced in India. A department called department of Indian system of medicine was created in March 1995 and renamed to AYUSH in Nov.2003 with a focus to provide increased attention for the development of these systems. Very recently, in 2014, a separate ministry was created under the union Govt. of India which is headed by a minister of state. Planning regarding these systems of medicine was a part of five year planning process since 1951. Since then many developments have happened in this sector albeit the system was struggling with a great degree of uncertainty at the time of first five year plan. A progressive path of development could be observed since the first to the 12th five year plan. It was up to the seventh plan the growth was little sluggish and from eighth plan onwards the growth took its pace and several innovative development processes could be observed thereafter. The system is gradually progressing ahead with a vision to be a globally accepted system, as envisaged in 11th five year plan. Currently AYUSH system is a part of mainstream health system implemented under National Rural Health Mission (NRHM. NRHM came in to play in 2005 but implemented at ground level in 2006 and introduced the scheme of and lsquo;Mainstreaming of AYUSH and revitalization of local health traditions' to strengthen public health services. This scheme is currently in operation in its second phase, since 1st April 2012, with the 12th five year plan. The scheme was primarily brought in to operation with three important objectives; choice of treatment system to the patients, strengthen facility functionally and strengthen the implementation of national health programmes however in some places it seems to be a forced medical pluralism owing to a top-down approach by the union government without considerable involvement of

  15. Biochemical Mechanisms and Energy Strategies of Geobacter sulfurreducens for Long- Term Survival

    Science.gov (United States)

    Helmus, R. A.; Liermann, L. J.; Brantley, S. L.; Tien, M.

    2008-12-01

    Numerous species of bacteria have been observed to exhibit a growth advantage in stationary phase (GASP) phenotype, indicating that microorganisms starved of an energy source may adapt to allow for long-term survival. Understanding how Geobacter sulfurreducens persists using various metal forms as energy sources and whether a GASP phenotype develops during long-term growth are important for efficient application of this bacterium to sites requiring engineered bioremediation of soluble metals. Thus, we investigated the growth kinetics and survival of G. sulfurreducens. The growth rate of G. sulfurreducens was highest when cultured with soluble iron and generally higher on iron oxide than manganese oxide, suggesting that soluble metal forms are more readily utilized as energy sources by G. sulfurreducens. By monitoring the abundance of G. sulfurreducens in batch cultures for >6 months, distinct growth, stationary, and prolonged starvation phases were observed and a cell density of 105- 106 cells/mL persisted under long-term starvation conditions. The outgrowth of an aged G. sulfurreducens strain co-cultured with a young strain was monitored as a measure of the existence of the GASP phenotype. As the strains aged, the rpoS gene was cloned and sequenced at different stages of growth to identify mutations corresponding to a growth advantage. The results of these studies provide insight into the use of various metal forms for growth by G. sulfurreducens and its ability to persist when starved of energy sources.

  16. Glaucoma-related adverse events in the first five years after unilateral cataract removal in the Infant Aphakia Treatment Study

    Science.gov (United States)

    Freedman, Sharon F.; Lynn, Michael J.; Beck, Allen D.; Bothun, Erick D.; Orge, Faruk H.; Lambert, Scott R.

    2015-01-01

    are common and increase between one and five years in infants after unilateral cataract removal at 1–6 months of age; primary IOL placement does not mitigate their risk, but surgery at a younger age increases the risk. Longer follow-up of these children may further characterize risk factors, long-term outcomes, potential differences between eyes having primary IOL vs. aphakia, and optimal timing of unilateral congenital cataract removal. PMID:25996491

  17. Long-Term Survival After Traumatic Brain Injury Part II: Life Expectancy.

    Science.gov (United States)

    Brooks, Jordan C; Shavelle, Robert M; Strauss, David J; Hammond, Flora M; Harrison-Felix, Cynthia L

    2015-06-01

    To compute the life expectancy of persons with traumatic brain injury (TBI) based on validated prognostic models from 2 cohorts, to compare mortality and life expectancy of persons with TBI with those of the U.S. general population, and to investigate trends toward improved survival over the last 2 decades. Survival analysis. Postdischarge from rehabilitation units and long-term follow-up at regional centers. Two cohorts of long-term survivors of TBI (N=12,481): the Traumatic Brain Injury Model Systems (TBIMS) cohort comprised 7365 persons who were admitted to a TBIMS facility with moderate to severe TBI and were assessed at ≥1 years postinjury, and the California Department of Developmental Services (CDDS) cohort comprised 5116 persons who sustained a TBI and received long-term services from the CDDS. Not applicable. Life expectancy. The estimates of age-, sex-, and disability-specific life expectancy of persons with TBI derived from the CDDS and TBIMS were similar. The estimates of age- and sex-specific life expectancy were lower than those of the U.S. general population. Mortality rates of persons with TBI were higher than those of the U.S. general population. Mortality rates did not improve and the standardized mortality ratio increased over the study period from 1988 to 2010. Life expectancy of persons with TBI is lower than that of the general population and depends on age, sex, and severity of disability. When compared, the survival outcomes in the TBIMS and CDDS cohorts are remarkably similar. Because there have been no marked trends in the last 20 years, the life expectancies presented in this article may remain valid in the future. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  18. Total pancreatectomy for pancreatic adenocarcinoma: evaluation of morbidity and long-term survival.

    Science.gov (United States)

    Reddy, Sushanth; Wolfgang, Christopher L; Cameron, John L; Eckhauser, Frederic; Choti, Michael A; Schulick, Richard D; Edil, Barish H; Pawlik, Timothy M

    2009-08-01

    To analyze relative perioperative and long-term outcomes of patients undergoing total pancreatectomy versus pancreaticoduodenectomy. The role of total pancreatectomy has historically been limited due to concerns over increased morbidity, mortality, and perceived worse long-term outcome. Between 1970 and 2007, patients who underwent total pancreatectomy (n = 100) or pancreaticoduodenectomy (n = 1286) for adenocarcinoma were identified. Clinicopathologic, morbidity, and survival data were collected and analyzed. Total pancreatectomy patients had larger median tumor size (4 cm vs. 3 cm; P total pancreatectomy vs. pancreaticoduodenectomy, respectively, both P > 0.05). A similar proportion of total pancreatectomy (74.7%) and pancreaticoduodenectomy (78.3%) patients had N1 disease (P = 0.45). Total pancreatectomy patients had more lymph nodes harvested (27 vs. 16) and were less likely to have positive resection margins (22.2% vs. 43.7%) (total pancreatectomy vs. pancreaticoduodenectomy, respectively, both P Total pancreatectomy was increasingly used over time (1970-1989, n = 10, 1990-1999, n = 37, 2000-2007, n = 53). Total pancreatectomy was associated with higher 30-day mortality compared with pancreaticoduodenectomy (8.0% vs. 1.5%, respectively; P = 0.0007). However, total pancreatectomy operative mortality decreased over time (1970-1989, 40%; 1990-1999, 8%; 2000-2007, 2%; P = 0.0002). While operative morbidity was higher following total pancreatectomy (69.0% vs. 38.6% for pancreaticoduodenectomy; P Total pancreatectomy and pancreaticoduodenectomy patients had comparable 5-year survival (18.9% vs. 18.5%, respectively, P = 0.32). Total pancreatectomy perioperative mortality dramatically decreased over time. Long-term survival following total pancreatectomy versus pancreaticoduodenectomy was equivalent. Total pancreatectomy should be performed when oncologically appropriate.

  19. Human Engineered Heart Muscles Engraft and Survive Long-Term in a Rodent Myocardial Infarction Model

    Science.gov (United States)

    Riegler, Johannes; Tiburcy, Malte; Ebert, Antje; Tzatzalos, Evangeline; Raaz, Uwe; Abilez, Oscar J.; Shen, Qi; Kooreman, Nigel G.; Neofytou, Evgenios; Chen, Vincent C.; Wang, Mouer; Meyer, Tim; Tsao, Philip S.; Connolly, Andrew J.; Couture, Larry A.; Gold, Joseph D.; Zimmermann, Wolfram H.; Wu, Joseph C.

    2015-01-01

    Rational Tissue engineering approaches may improve survival and functional benefits from human embryonic stem cell-derived cardiomyocte (ESC-CM) transplantation, thereby potentially preventing dilative remodelling and progression to heart failure. Objective Assessment of transport stability, long term survival, structural organisation, functional benefits, and teratoma risk of engineered heart muscle (EHM) in a chronic myocardial infarction (MI) model. Methods and Results We constructed EHMs from ESC-CMs and released them for transatlantic shipping following predefined quality control criteria. Two days of shipment did not lead to adverse effects on cell viability or contractile performance of EHMs (n=3, P=0.83, P=0.87). After ischemia/reperfusion (I/R) injury, EHMs were implanted onto immunocompromised rat hearts at 1 month to simulate chronic ischemia. Bioluminescence imaging (BLI) showed stable engraftment with no significant cell loss between week 2 and 12 (n=6, P=0.67), preserving up to 25% of the transplanted cells. Despite high engraftment rates and attenuated disease progression (change in ejection fraction for EHMs −6.7±1.4% vs control −10.9±1.5%, n>12, P=0.05), we observed no difference between EHMs containing viable or non-viable human cardiomyocytes in this chronic xenotransplantation model (n>12, P=0.41). Grafted cardiomyocytes showed enhanced sarcomere alignment and increased connexin 43 expression at 220 days after transplantation. No teratomas or tumors were found in any of the animals (n=14) used for long-term monitoring. Conclusions EHM transplantation led to high engraftment rates, long term survival, and progressive maturation of human cardiomyocytes. However, cell engraftment was not correlated with functional improvements in this chronic MI model. Most importantly, the safety of this approach was demonstrated by the lack of tumor or teratoma formation. PMID:26291556

  20. Five year prognosis in patients with angina identified in primary care: incident cohort study.

    LENUS (Irish Health Repository)

    Buckley, Brian S

    2009-01-01

    OBJECTIVE: To ascertain the risk of acute myocardial infarction, invasive cardiac procedures, and mortality among patients with newly diagnosed angina over five years. DESIGN: Incident cohort study of patients with primary care data linked to secondary care and mortality data. SETTING: 40 primary care practices in Scotland. PARTICIPANTS: 1785 patients with a diagnosis of angina as their first manifestation of ischaemic heart disease, 1 January 1998 to 31 December 2001. MAIN OUTCOME MEASURES: Adjusted hazard ratios for acute myocardial infarction, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, death from ischaemic heart disease, and all cause mortality, adjusted for demographics, lifestyle risk factors, and comorbidity at cohort entry. RESULTS: Mean age was 62.3 (SD 11.3). Male sex was associated with an increased risk of acute myocardial infarction (hazard ratio 2.01, 95% confidence interval 1.35 to 2.97), death from ischaemic heart disease (2.80, 1.73 to 4.53), and all cause mortality (1.82, 1.33 to 2.49). Increasing age was associated with acute myocardial infarction (1.04, 1.02 to 1.06, per year of age increase), death from ischaemic heart disease (1.09, 1.06 to 1.11, per year of age increase), and all cause mortality (1.09, 1.07 to 1.11, per year of age increase). Smoking was associated with subsequent acute myocardial infarction (1.94, 1.31 to 2.89), death from ischaemic heart disease (2.12, 1.32 to 3.39), and all cause mortality (2.11, 1.52 to 2.95). Obesity was associated with death from ischaemic heart disease (2.01, 1.17 to 3.45) and all cause mortality (2.20, 1.52 to 3.19). Previous stroke was associated with all cause mortality (1.78, 1.13 to 2.80) and chronic kidney disease with death from ischaemic heart disease (5.72, 1.74 to 18.79). Men were more likely than women to have coronary artery bypass grafting or percutaneous transluminal coronary angioplasty after a diagnosis of angina; older people were less likely to

  1. Long-term survival in stage IV melanoma after repetitive surgical therapy.

    Science.gov (United States)

    Tomov, Tsvetomir; Siegel, Robert; Bembenek, Andreas

    2008-05-01

    Surgical therapy in patients with stage IV melanoma is controversial and always an individual decision. We report the case of a young melanoma patient, who underwent resection of 5 distant metastases from 4 different organ systems. Thereby, the patient achieved a stable state of disease and a good quality of life for up to now 67 months without any evidence for further tumor manifestations at present. A systemic chemo- or immunotherapy was never applied. In selected patients with stage IV melanoma, surgery alone can provide long-term survival with good quality of life. (c) 2008 S. Karger AG, Basel

  2. A long-term retrospective analysis of survival rates of implants in the mandible.

    Science.gov (United States)

    Balshi, Thomas J; Wolfinger, Glenn J; Stein, Brett E; Balshi, Stephen F

    2015-01-01

    To retrospectively analyze the survival rate of endosseous dental implants placed in the edentulous or partially edentulous mandible over a long-term follow-up period of 10 years or more. The charts of patients who underwent mandibular implant placement at a private prosthodontics practice and received follow-up care for 10 years or more were included in this study. Implants were examined according to the following study variables: patient sex, patient age, degree of edentulism (fully vs partially edentulous), implant location, time of loading (delayed vs immediate), implant size and type, bone quality, prosthesis type, and the presence of other implants during placement. The study sample was composed of 2,394 implants placed in 470 patients with 10 to 27 years of follow-up. Of these 2,394 implants, 176 failed, resulting in an overall cumulative survival rate (CSR) of 92.6%. A total of 1,482 implants were placed in edentulous mandibles, and 912 implants were placed in partially edentulous mandibles, with CSRs of 92.6% and 92.7%, respectively. Comparisons of the study variables with respect to CSR were largely nonsignificant. However, there were significant differences in CSRs between anterior vs posterior locations and rough- vs smooth-surfaced implants in addition to some prosthesis types, ages, and bone qualities. The overall CSR of 92.6% in the present study is high and comparable to survival rates observed in previous long-term analyses of mandibular implants. The significant differences observed between implant locations, patient age groups, bone qualities, and prostheses were not suggestive of any remarkable trends. Patient sex, age, degree of edentulism, implant location, time of loading, implant size and type, bone quality, prosthesis type, and the presence of multiple implants did not result in any significant effect on long-term implant survival. The CSR observed after 10 to 27 years of follow-up in a single private prosthodontic center was high (92

  3. Long-Term Survival after Stroke: 30 Years of Follow-Up in a Cohort, the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Boysen, G.; Marott, J.L.; Gronbaek, M.

    2009-01-01

    -stroke controls. Long-term survival improved steadily over time. Life expectancy after stroke increased up to 4 years from 1978 to the end of 2001, exceeding the increase of life expectancy in the general population. Slightly longer survival was found in women than in men when adjusted for age at stroke onset......Background and Purpose: Only few have studied long-term survival after stroke. Such knowledge is essential for the evaluation of the current and future burden of stroke. The present study presents up to 30 years of follow-up of patients after a first-ever stroke. Methods: Participants...... died before the end of 2007. The National Register of Causes of Death provided cause of death. Survival in stroke patients was compared with survival in participants in the Copenhagen City Heart Study who did not suffer a stroke, and with survival in the general Danish population. Cox regression...

  4. Five-Year NRHP Re-Evaluation of Historic Buildings Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Ullrich, R A; Heidecker, K R

    2011-09-12

    The Lawrence Livermore National Laboratory (LLNL) 'Draft Programmatic Agreement among the Department of Energy and the California State Historic Preservation Officer Regarding Operation of Lawrence Livermore National Laboratory' requires a review and re-evaluation of the eligibility of laboratory properties for the National Register of Historic Places (NRHP) every five years. The original evaluation was published in 2005; this report serves as the first five-year re-evaluation. This re-evaluation includes consideration of changes within LLNL to management, to mission, and to the built environment. it also determines the status of those buildings, objects, and districts that were recommended as NRHP-eligible in the 2005 report. Buildings that were omitted from the earlier building list, those that have reached 50 years of age since the original assessment, and new buildings are also addressed in the re-evaluation.

  5. Chief Financial Officer FY 1997 status report and five-year plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-10-01

    The Chief Financial Officers Act of 1990 (CFO Act) establishes the legal framework for improved Federal financial management. The Act requires the agency CFO to prepare, and annually revise, a plan to implement the Office of Management and Budget (OMB) Federal Financial Management Status Report and Five-Year Plan. This is the sixth Status Report and Five-Year Plan submission to OMB by the Department of Energy (DOE). Financial management at the Department operates in an environment of Government-wide efforts to improve financial management and implements legislation and administrative provisions which stress the need for change. This report sets forth the Department`s plans for financial management improvements in the coming years. It also highlights several new initiatives completed or currently underway that will significantly improve the overall effectiveness of financial management at the Department of Energy.

  6. Risk Factors of Diarrhea in Children Under Five Years in Urban Slums

    Directory of Open Access Journals (Sweden)

    Balakrishna Kalakheti

    2016-12-01

    Full Text Available Introduction: Diarrhea is a leading cause of mortality in children in developing countries and the condition is worse in slums. In order to provide effective preventive and management strategies, it is important to identify factors associated with the disease. This study was carried out to investigate the risk factors of diarrhea in  children under five years of age in urban slums. Methods: Parents of all children under five years from the urban slums of Tansen municipality, Palpa, Nepal were interviewed using a standardized pretested questionnaire and proforma. Parental variables, environmental factors, and presence of diarrhea in those children in past three months were collected by trained enumerators and the data were analyzed with statistical software SPSS-10. Results: A total of 450 under five years children were enrolled in the study. There were 216 (48% male and 234 (52% female children with F:M ratio of 1.08:1. Occurrence of diarrhea was lower if the children were breast-fed for more than six months, well-nourished, used fountain water for drinking, or used boiled or treated water. Similarly, diarrhea prevalence was lower if father had a regular job, daily income in the family was more than one US dollar, there was a toilet in the house, practice of hand washing was followed before feeding or preparing food, or there was no child suffering from diarrhea in the neighborhood. Conclusion: There are a few variables that are significantly related to diarrhea in children under five years of age. In order to decrease the diarrheal episodes in children in the slums of the developing countries, priority could be given in the improvement of those variables.

  7. Looking backward, 1984-1959: twenty-five years of library automation--a personal view.

    Science.gov (United States)

    Pizer, I H

    1984-01-01

    A brief profile of Janet Doe is given. Twenty-five years of library automation are reviewed from the author's point of view. Major projects such as the SUNY Biomedical Communication Network and the Regional Online Union Catalog of the Greater Midwest Regional Medical Library Network are discussed. Important figures in medical library automation are considered, as is the major role played by the National Library of Medicine. Images PMID:6388691

  8. Five Years of Experimental Warming Increases the Biodiversity and Productivity of Phytoplankton.

    OpenAIRE

    Gabriel Yvon-Durocher; Allen, Andrew P.; Maria Cellamare; Matteo Dossena; Gaston, Kevin J.; Maria Leitao; Montoya, José M.; Daniel C. Reuman; Guy Woodward; Mark Trimmer

    2015-01-01

    Phytoplankton are key components of aquatic ecosystems, fixing CO2 from the atmosphere through photosynthesis and supporting secondary production, yet relatively little is known about how future global warming might alter their biodiversity and associated ecosystem functioning. Here, we explore how the structure, function, and biodiversity of a planktonic metacommunity was altered after five years of experimental warming. Our outdoor mesocosm experiment was open to natural dispersal from the ...

  9. Epidemiologic study on accidents among children under five years old during 2006 to 2016-Qazvin

    OpenAIRE

    K. Hosseinzadeh; A. Souri; Daliri, S

    2017-01-01

    Background: Children, due to their insufficient risk detection, are more vulnerable to accidents than adults. Objective: The present study has been done to explore the prevalence of accidents and related factors among children under five years old from 2006 to 2016 in Qazvin. Methods: This descriptive-analytic study concluded all 18184 children who had exposure to accidents during study time section from 2006 to 2016. All recorded data in Health Information System (HIS) of Qazvin Hea...

  10. Policy recommendations for improvement and strengthening of future provincial environmental five years plans in China

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-11-15

    Since the Eleventh Five-Year Plan (2006-2010) started, the environmental protection plan has been playing a more and more important role in the implementation of Chinas national environmental protection strategy as well as promoting and carrying out the 'three historical transitions' in environmental protection, and enhancing the functions of environmental protection for macroscopic adjustment and control and optimizing economic growth.(auth)

  11. Accidental poisoning in childhood: five year urban population study with 15 year analysis of fatality.

    OpenAIRE

    Pearn, J; Nixon, J; Ansford, A; Corcoran, A

    1984-01-01

    Patterns of accidental poisoning in children are changing dramatically. A five year population study (1977-81) was undertaken in urban children from Brisbane (population 1 000 000). A total of 2098 children were poisoned during this period with only one fatality, which represents a dramatic reduction in mortality. Over the past 15 years (1968-82) 13 children have died from accidental poisoning from this population, and two were murdered with drugs. A study of secular trends has indicated that...

  12. Five years after Fukushima, it's time to seize new nuclear opportunities

    Energy Technology Data Exchange (ETDEWEB)

    Shephers, John [nuclear24, Redditch (United Kingdom)

    2016-05-15

    In March of this year, we marked a painful chapter in the history of the world's civil nuclear energy industry as we reflected on the earthquake and tsunami that struck Japan five years ago - leading to the nuclear accident at Fukushima-Daiichi. In moving on, the nuclear industry needs to absorb the lessons learned from Fukushima and there are now clear signals for going on with nuclear.

  13. Analysis of the Economic Impact of Cardiovascular Diseases in the Last Five Years in Brazil

    OpenAIRE

    Siqueira, Alessandra de Sá Earp; Siqueira-Filho, Aristarco Gonçalves de; Land, Marcelo Gerardin Poirot

    2017-01-01

    Abstract Background: There is growing concern about the economic impact of cardiovascular diseases (CVD) in Brazil and worldwide. Objective: To estimate the economic impact of CVD in Brazil in the last five years. Methods: The information to estimate CVD costs was taken from national databases, adding the direct costs with hospitalizations, outpatient visits and benefits granted by social security. Indirect costs were added to the calculation, such as loss of income caused by CVD morbidity...

  14. The first five years of the Croatian Intelligence Service: 1993-1998

    OpenAIRE

    Tuđman, Miroslav

    2000-01-01

    After the first democratic, multiparty elections held in 1990, the process of building state institutions commenced within the framework of newly-sovereign Croatia. This article describes the development of the national security system: the history of the Croatian Intelligence Service and the Intelligence Community, and their origin, structure, tasks and activities. The first five years (1993-1998) of the national security system of the Republic of Croatia are presented in detail and evaluate...

  15. Five-year microbiological monitoring of wards and operating theatres in southern Italy

    OpenAIRE

    La Fauci, V.; Genovese, C.; Facciol?, A.; Palamara, M.A.R.; Squeri, R.

    2017-01-01

    Summary Introduction. Nosocomial infections are one of the greatest problems in public health. Several studies have highlighted the role played by the hospital environment as a possible source of transmission of nosocomial pathogens. Methods. A five-year monitoring of bacterial contamination on healthcare workers hands, surfaces most closely in contact with inpatient wards, operating theatres and "at rest" and "in use" operating theatre air samples. For the samples, we used sterile swabs, con...

  16. Modeling the long-term kinetics of Salmonella survival on dry pet food.

    Science.gov (United States)

    Lambertini, Elisabetta; Mishra, Abhinav; Guo, Miao; Cao, Huilin; Buchanan, Robert L; Pradhan, Abani K

    2016-09-01

    Due to multiple outbreaks and large-scale product recalls, Salmonella has emerged as a priority pathogen in dry pet food and treats. However, little data are available to quantify risks posed by these classes of products to both pets and their owners. Specifically, the kinetics of Salmonella survival on complex pet food matrices are not available. This study measured the long-term kinetics of Salmonella survival on a dry pet food under storage conditions commonly encountered during production, retail, and in households (aw Salmonella enterica cocktail of 12 strains isolated from dry pet foods and treats was used to inoculate commercial dry dog food. Salmonella was enumerated on non-selective (BHI) and selective (XLD and BS) media. Results at 570 days indicated an initial relatively rapid decline (up to 54 days), followed by a much slower extended decline phase. The Weibull model provided a satisfactory fit for time series of Log-transformed Salmonella counts from all three media (δ: mean 4.65 day/Log (CFU/g); p: mean 0.364 on BHI). This study provides a survival model that can be applied in quantitative risk assessment models. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Direct and indirect costs and long-term survival of laparoscopic anterior resection for rectal cancer.

    Science.gov (United States)

    Feng, Bo; Zhu, Qian-Lin; Xia, Yi; Lu, Ai-Guo; Wang, Ming-Liang; Li, Jian-Wen; Hu, Wei-Guo; Zang, Lu; Mao, Zhi-Hai; Dong, Feng; Ma, Jun-Jun; Zheng, Min-Hua

    2010-12-01

    Few studies evaluate the cost-effectiveness issues of laparoscopic anterior resection (LAR) for rectal cancer. This study evaluates direct and indirect costs of LAR and its long-term survival rate in rectal cancer patients. This prospective nonrandomized controlled trial included 2 endpoints (direct and indirect costs, and disease-free survival). From January 2003 to May 2005, rectal cancer patients admitted to our center were assigned to 2 groups: 87 patients underwent LAR (LAP), while 86 cases received open anterior resection (OPEN). The direct costs were prospectively evaluated. Main indirect cost is productivity loss. The data of direct costs, indirect costs, and the total costs were collected for the minimal cost analysis. Disease-free survival at 65 months in the LAP group and the OPEN group was 78.2% and 74.7%; there was no significant difference between the groups. Median direct costs were not significantly different between the LAP and the OPEN groups. Indirect costs of the LAP group were significantly lower than those of the OPEN group, while total costs were not significantly different. Cost percentage for operations, medications, and hospitalization were 75.90%, 11.28%, and 2.18% in the LAP group; while in the operation group, they were 54.50%, 29.09%, and 3.35%. Total economic budget for a patient receiving LAR was not significantly increased compared with the conservative method owing to its technical predominance, oncologic safety, as well as frequent bed turnover.

  18. Five-year change in morale is associated with negative life events in very old age.

    Science.gov (United States)

    Näsman, Marina; Niklasson, Johan; Saarela, Jan; Nygård, Mikael; Olofsson, Birgitta; Conradsson, Mia; Lövheim, Hugo; Gustafson, Yngve; Nyqvist, Fredrica

    2017-10-27

    The objectives were to study changes in morale in individuals 85 years and older, and to assess the effect of negative life events on morale over a five-year follow-up period. The present study is based on longitudinal data from the Umeå85+/GERDA-study, including individuals 85 years and older at baseline (n = 204). Morale was measured with the Philadelphia Geriatric Center Morale Scale (PGCMS). Negative life events were assessed using an index including 13 negative life events occurring during the follow-up period. Linear regression was used for the multivariate analyses. The majority of the sample (69.1%) had no significant changes in morale during the five-year follow-up. However, the accumulation of negative life events was significantly associated with a greater decrease in PGCMS. A higher baseline PGCMS score did not attenuate the adverse effect negative life events had on morale. Morale seemed to be mainly stable in a five-year follow-up of very old people. It seems, nonetheless, that individuals are affected by negative life events, regardless of level of morale. Preventing negative life events and supporting individuals who experience multiple negative life events could have important implications for the care of very old people.

  19. Does life satisfaction predict five-year mortality in community-living older adults?

    Science.gov (United States)

    St John, Philip D; Mackenzie, Corey; Menec, Verena

    2015-01-01

    Depression and depressive symptoms predict death, but it is less clear if more general measures of life satisfaction (LS) predict death. Our objectives were to determine: (1) if LS predicts mortality over a five-year period in community-living older adults; and (2) which aspects of LS predict death. 1751 adults over the age of 65 who were living in the community were sampled from a representative population sampling frame in 1991/1992 and followed five years later. Age, gender, and education were self-reported. An index of multimorbidity and the Older American Resource Survey measured health and functional status, and the Terrible-Delightful Scale assessed overall LS as well as satisfaction with: health, finances, family, friends, housing, recreation, self-esteem, religion, and transportation. Cox proportional hazards models examined the influence of LS on time to death. 417 participants died during the five-year study period. Overall LS and all aspects of LS except finances, religion, and self-esteem predicted death in unadjusted analyses. In fully adjusted analyses, LS with health, housing, and recreation predicted death. Other aspects of LS did not predict death after accounting for functional status and multimorbidity. LS predicted death, but certain aspects of LS are more strongly associated with death. The effect of LS is complex and may be mediated or confounded by health and functional status. It is important to consider different domains of LS when considering the impact of this important emotional indicator on mortality among older adults.

  20. HEALTH AND NUTRITIONAL STATUS OF CHILDREN UNDER FIVE YEARS IN POSYANDU NUTRITION PROGRAM

    Directory of Open Access Journals (Sweden)

    Dadang Sukandar

    2012-03-01

    Full Text Available 800x600 Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 The objectives of this research were to analyze health, nutritional status of children under five years and its influential factors. This research was carried out in two sub-districts of Bogor: Sub-District of Ciomas and Sub-District of Darmaga. As many as 16 posyandu nutrition program were obtained. A total number of 240 mothers had been divided into control and intervention groups. Baseline data were collected during the pre-study, while endline data were collected after conducting intervention (experiment. The experiment had been conducted for five months in the form of providing nutrition education once in two weeks and implementing home gardening. The data analysis included estimation of mean, standard deviation, minimum value, maximum value and proportion. Based on the General Linear Model (GLM analysis, it was found that intervention had significant impact on the nutritional status (WAZ of children under five years. Intervention did not have significant effects on the nutritional status according to HAZ and WHZ. Key words: Health status, nutritional status, nutrition program, children under five years.

  1. Minimal invasive treatment for defective restorations: five-year results using sealants.

    Science.gov (United States)

    Martin, J; Fernandez, E; Estay, J; Gordan, V V; Mjor, I A; Moncada, G

    2013-01-01

    Replacement of dental restorations has been the traditional treatment for restorations that are defective. In this five-year randomized clinical trial, restorations with localized marginal defects were treated with sealants. Thirty-two patients (mean age, 26.8 years) with 126 Class I and Class II restorations with defective margins (amalgam n=69 and resin-based composite n=57) were recruited. Treatment was seal with pit and fissure sealant on localized marginal defects (group A: n=43) and was compared with total restoration replacement (group B: n=40) and untreated restorations (group C: n=43) as negative and positive controls. Restorations were assessed by two examiners using the modified US Public Health Service criteria, observing five clinical parameters: marginal adaptation, roughness, marginal stain, teeth sensitivity, and secondary caries at baseline and at five years after treatment. At the five-year recall examination, 23 patients with 90 restorations (71.4% recall rate) were examined. A significant improvement was observed in the marginal adaptation of the restorations in group A compared with group B. None of the treated group showed trends to downgrade in any parameter. Tooth sensitivity and secondary caries showed a low frequency in all groups. No significant difference in marginal adaptation of the restorations was found between amalgam and resin-based composite restorations (p=0.191). This study demonstrated that marginal sealing of restorations is a minimally invasive treatment that may be used instead of the replacement of restorations with localized marginal defects.

  2. Analysis of the Economic Impact of Cardiovascular Diseases in the Last Five Years in Brazil

    Directory of Open Access Journals (Sweden)

    Alessandra de Sá Earp Siqueira

    Full Text Available Abstract Background: There is growing concern about the economic impact of cardiovascular diseases (CVD in Brazil and worldwide. Objective: To estimate the economic impact of CVD in Brazil in the last five years. Methods: The information to estimate CVD costs was taken from national databases, adding the direct costs with hospitalizations, outpatient visits and benefits granted by social security. Indirect costs were added to the calculation, such as loss of income caused by CVD morbidity or mortality. Results: CVD mortality accounts for 28% of all deaths in Brazil in the last five years and for 38% of deaths in the productive age range (18 to 65 years. The estimated costs of CVD were R$ 37.1 billion in 2015, a 17% increase in the period from 2010 to 2015. The estimated costs of premature death due to CVD represent 61% of the total cost of CVD, Direct costs with hospitalizations and consultations were 22%, and costs related to the loss of productivity related to the disease were 15% of the total. Health expenditures in Brazil are estimated at 9.5% of GDP and the average cost of CVD was estimated at 0.7% of GDP. Conclusion: CVD costs have increased significantly in the last five years. It is estimated that CVD costs increase as the Brazilian population ages and the prevalence of CVD increases.

  3. Analysis of the Economic Impact of Cardiovascular Diseases in the Last Five Years in Brazil

    Science.gov (United States)

    Siqueira, Alessandra de Sá Earp; de Siqueira-Filho, Aristarco Gonçalves; Land, Marcelo Gerardin Poirot

    2017-01-01

    Background There is growing concern about the economic impact of cardiovascular diseases (CVD) in Brazil and worldwide. Objective To estimate the economic impact of CVD in Brazil in the last five years. Methods The information to estimate CVD costs was taken from national databases, adding the direct costs with hospitalizations, outpatient visits and benefits granted by social security. Indirect costs were added to the calculation, such as loss of income caused by CVD morbidity or mortality. Results CVD mortality accounts for 28% of all deaths in Brazil in the last five years and for 38% of deaths in the productive age range (18 to 65 years). The estimated costs of CVD were R$ 37.1 billion in 2015, a 17% increase in the period from 2010 to 2015. The estimated costs of premature death due to CVD represent 61% of the total cost of CVD, Direct costs with hospitalizations and consultations were 22%, and costs related to the loss of productivity related to the disease were 15% of the total. Health expenditures in Brazil are estimated at 9.5% of GDP and the average cost of CVD was estimated at 0.7% of GDP. Conclusion CVD costs have increased significantly in the last five years. It is estimated that CVD costs increase as the Brazilian population ages and the prevalence of CVD increases. PMID:28591251

  4. Long-term outcome after discontinuation of benzodiazepines for insomnia: a survival analysis of relapse.

    Science.gov (United States)

    Morin, Charles M; Bélanger, Lynda; Bastien, Célyne; Vallières, Annie

    2005-01-01

    Discontinuation of benzodiazepine (BZD) treatment for insomnia can be a difficult task. Cognitive-behavior therapy (CBT) for insomnia, combined with a supervised medication taper, can facilitate withdrawal but there is limited evidence on long-term outcome after discontinuation. The objective of this study was to examine medication-free survival time and predictors of relapse (i.e., resumed BZD hypnotics) over a 2-year period in 47 older adults (mean age 62.1 years) with persistent insomnia and prolonged BZD use (average duration of 18.9 years), who had successfully discontinued BZD following CBT for insomnia, a supervised medication taper program, or a combined approach. The Kaplan-Meier product-limit method was used to estimate survival time, defined as time between end-of-treatment and relapse or end of follow-up. By the end of the 24-month follow-up, 42.6% of the samples had resumed BZD use. Participants in the Combined (33.3%) and Taper (30.8%) groups relapsed significantly less than their counterparts from the CBT group (69.2%). Survival rates at 3 months were 61.5% (CBT), 100% (Taper), and 80.9% (Combined). At 12 months, they were 38.5%, 83.3%, and 70.8%, respectively; and, at 24 months, they were 28.9%, 64.8% and 64.9%, respectively. Mean survival time was significantly longer for both the Taper (18.6 months, SE = 2.1) and Combined groups (12.6 months, SE = 1.4), relative to the CBT group (8.5 months, SE = 1.8). Significant predictors of relapse included treatment condition, end of treatment insomnia severity, and psychological distress. In conclusion, there is a substantial relapse rate following BZD discontinuation among prolonged users. CBT booster sessions might enhance compliance with CBT and prove useful in preventing relapse.

  5. Long-term survival and blast transformation in molecularly annotated essential thrombocythemia, polycythemia vera, and myelofibrosis.

    Science.gov (United States)

    Tefferi, Ayalew; Guglielmelli, Paola; Larson, Dirk R; Finke, Christy; Wassie, Emnet A; Pieri, Lisa; Gangat, Naseema; Fjerza, Rajmonda; Belachew, Alem A; Lasho, Terra L; Ketterling, Rhett P; Hanson, Curtis A; Rambaldi, Alessandro; Finazzi, Guido; Thiele, Juergen; Barbui, Tiziano; Pardanani, Animesh; Vannucchi, Alessandro M

    2014-10-16

    Janus kinase 2 (JAK2) mutations define polycythemia vera (PV). Calreticulin (CALR) and myeloproliferative leukemia virus oncogene (MPL) mutations are specific to JAK2-unmutated essential thrombocythemia (ET) and primary myelofibrosis (PMF). We examined the effect of these mutations on long-term disease outcome. One thousand five hundred eighty-one patients from the Mayo Clinic (n = 826) and Italy (n = 755) were studied. Fifty-eight percent of Mayo patients were followed until death; median survivals were 19.8 years in ET (n = 292), 13.5 PV (n = 267; hazard ratio [HR], 1.8; 95% confidence interval [CI], 1.4-2.2), and 5.9 PMF (n = 267; HR, 4.5; 95% CI, 3.5-5.7). The survival advantage of ET over PV was not affected by JAK2/CALR/MPL mutational status. Survival in ET was inferior to the age- and sex-matched US population (P transformation (BT) were significantly affected by mutational status; outcome was best in CALR-mutated and worst in triple-negative patients: median survival, 16 vs 2.3 years (HR, 5.1; 95% CI, 3.2-8.0) and BT, 6.5% vs 25% (HR, 7.6; 95% CI, 2.8-20.2), respectively. We conclude that life expectancy in morphologically defined ET is significantly reduced but remains superior to that of PV, regardless of mutational status. In PMF, JAK2/CALR/MPL mutational status is prognostically informative. © 2014 by The American Society of Hematology.

  6. Microcalcification-Associated Breast Cancer: Presentation, Successful First Excision, Long-Term Recurrence and Survival Rate.

    Science.gov (United States)

    Rominger, Marga B; Steinmetz, Carolin; Westerman, Ronny; Ramaswamy, Annette; Albert, Ute-Susann

    2015-12-01

    In this study we evaluated mammographic, histological and immunohistochemical findings for microcalcification-associated breast cancer with regards to breast-conserving therapy, recurrence and survival rate. We retrospectively analyzed 99 consecutive, non-palpable and microcalcification-associated breast cancers (94 women) that were treated surgically between January 2002 and December 2003 at a national academic breast cancer center. Calcifications were classified according to the Breast Imaging Reporting and Data System (BI-RADS). Descriptors, surgical outcome and histological findings were assessed. Recurrences and survival rates were evaluated based on medical records, standardized patient questionnaires and/or contacting the physician. 42 of the 99 lesions (42.4%) were invasive carcinomas, 57 (57.6%) were pure ductal carcinoma in situ (DCIS). 6 out of 99 (6.1%) lesions were triple negative, and 29 (29.3%) were HER2/neu positive. Successful first excision rate was 76/99 lesions (76.8%). Breast conservation was achieved in 73.7% (73/99). 10 women showed local recurrences without negatively impacting survival. The recurrences included round/punctate, amorphous, fine pleomorphic, and fine linear or fine-linear branching descriptors. The breast cancer-specific long-term survival rate was 91/94 (96.8%) for a mean follow-up of 81.4 months. The 3 patients who died due to breast carcinoma showed fine pleomorphic calcifications, and had nodal-positive invasive carcinoma at diagnosis. Microcalcification-associated breast cancers are frequently treated with breast-conserving therapy. Continuous clinical and mammographic follow-up is recommended for all descriptors.

  7. Direct laminate veneers with resin composites: two case reports with five-year follow-ups.

    Science.gov (United States)

    Zorba, Yahya Orcun; Bayindir, Yusuf Ziya; Barutcugil, Cagatay

    2010-07-01

    The aim of this report is to present five-year follow-ups of two different applications for the use of direct laminate resin-based composite veneers to improve esthetics. Defects in the maxillary anterior teeth, such as enamel hypoplasia and peg lateral, can present esthetic challenges. Furthermore, a treatment plan that can be completed in a single appointment is highly desirable. This case report presents two different clinical cases involving the use of direct laminate resin-based composite veneers with five-year follow-ups. Case 1: A 17-year-old female patient was referred for treatment of her anterior teeth, which were unesthetically altered due to enamel hypoplasia and dental caries. A treatment plan was developed that included restoring the affected teeth with direct resin-based composite laminate veneers to improve the patient's appearance. The six maxillary anterior teeth were prepared for and restored with direct resin-based composite laminate veneers. At the five-year follow-up, the patient was satisfied with the restorations both esthetically and functionally. Case 2: A 15-year-old female patient also was referred for treatment to improve the appearance of her maxillary anterior teeth. A treatment plan was developed with two objectives: (1) to restore the undersized supernumerary crown in the area of the maxillary right lateral incisor and (2) to close the anterior diastemas. The facial surfaces were conservatively prepared and resin-based composite was applied with the aid of transparent crown forms. After completion of the treatment, the patient was recalled at six-month intervals. At the five-year follow-up appointment, the restorations were intact, no adverse effects were noted, and the resultant appearance was highly satisfactory for the patient. The use of direct resin-based composite laminate veneers and adhesive bonding systems has been shown to provide an esthetic alternative to metal-ceramic or all-ceramic crowns for the rehabilitation of

  8. Major Depression and Long-Term Survival of Patients With Heart Failure.

    Science.gov (United States)

    Freedland, Kenneth E; Hesseler, Michael J; Carney, Robert M; Steinmeyer, Brian C; Skala, Judith A; Dávila-Román, Victor G; Rich, Michael W

    2016-10-01

    Previous studies have found that depression predicts all-cause mortality in heart failure (HF), but little is known about its effect on long-term survival. This study examined the effects of depression on long-term survival in patients with HF. Patients hospitalized with HF (n = 662) at an urban academic medical center were enrolled in a prospective cohort study between January 1994 and July 1999. Depression was assessed on a structured interview during the index hospitalization and on quarterly interviews for 1 year after discharge. Patients were classified at index as having Diagnostic and Statistical Manual, Fourth Edition major depressive disorder (n = 131), minor depression (n = 106), or no depression (n = 425). Clinical data and the National Death Index were used to identify date of death or last known contact through December 19, 2014, up to 20 years after the index hospitalization. The main outcome was time from enrollment to death from any cause. A total of 617 (94.1%) patients died during the follow-up period. Major depressive disorder was associated with higher all-cause mortality compared with no depression (adjusted hazard ratio = 1.64, 95% confidence interval = 1.27-2.11, p = .0001). This association was stronger than that of any of the established predictors of mortality that were included in the fully adjusted model. Patients with persistent or worsening depressive symptoms during the year after discharge were at greatest risk for death. The association between minor depression and survival was not significant. Major depression is an independent risk factor for all-cause mortality in patients with HF. Its effect persists for many years after the diagnosis of depression.

  9. Long-term survival of an urban fruit bat seropositive for Ebola and Lagos bat viruses.

    Directory of Open Access Journals (Sweden)

    David T S Hayman

    2010-08-01

    Full Text Available Ebolaviruses (EBOV (family Filoviridae cause viral hemorrhagic fevers in humans and non-human primates when they spill over from their wildlife reservoir hosts with case fatality rates of up to 90%. Fruit bats may act as reservoirs of the Filoviridae. The migratory fruit bat, Eidolon helvum, is common across sub-Saharan Africa and lives in large colonies, often situated in cities. We screened sera from 262 E. helvum using indirect fluorescent tests for antibodies against EBOV subtype Zaire. We detected a seropositive bat from Accra, Ghana, and confirmed this using western blot analysis. The bat was also seropositive for Lagos bat virus, a Lyssavirus, by virus neutralization test. The bat was fitted with a radio transmitter and was last detected in Accra 13 months after release post-sampling, demonstrating long-term survival. Antibodies to filoviruses have not been previously demonstrated in E. helvum. Radio-telemetry data demonstrates long-term survival of an individual bat following exposure to viruses of families that can be highly pathogenic to other mammal species. Because E. helvum typically lives in large urban colonies and is a source of bushmeat in some regions, further studies should determine if this species forms a reservoir for EBOV from which spillover infections into the human population may occur.

  10. Ant Mutualism Increases Long-Term Growth and Survival of a Common Amazonian Tree.

    Science.gov (United States)

    Báez, Selene; Donoso, David A; Queenborough, Simon A; Jaramillo, Liliana; Valencia, Renato; Dangles, Olivier

    2016-11-01

    How ecological context shapes mutualistic relationships remains poorly understood. We combined long-term tree census data with ant censuses in a permanent 25-ha Amazonian forest dynamics plot to evaluate the effect of the mutualistic ant Myrmelachista schumanni (Formicinae) on the growth and survival of the common Amazonian tree Duroia hirsuta (Rubiaceae), considering its interactions with tree growth, population structure, and habitat. We found that the mutualist ant more than doubled tree relative growth rates and increased odds of survival. However, host tree size and density of conspecific neighbors modified the effect of the ant. Smaller trees hosting the mutualist ant consistently grew faster when surrounded by higher densities of conspecifics, suggesting that the benefit to the tree outweighs any negative effects of high conspecific densities. Moreover, our findings suggest that the benefit afforded by the ant diminishes with plant age and also depends on the density of conspecific neighbors. We provide the first long-term large-scale evidence of how mutualism affects the population biology of an Amazonian tree species.

  11. Effect of positive surgical margins on biochemical failure, biochemical recurrence-free survival, and overall survival after radical prostatectomy: median long-term results.

    Science.gov (United States)

    Huri, Emre; Aydogmus, Yasin; Doluoglu, Omer Gokhan; Dadali, Mumtaz; Karakan, Tolga; Emir, Levent; Germiyanoglu, Cankon

    2014-10-01

    The aim of this study was to investigate the median long-term effects of positive surgical margin (PSM) and other prognostic factors on biochemical recurrence-free survival, overall survival, and biochemical failure in patients who underwent radical prostatectomy. Our study included 121 patients with pT2-3N0 disease treated between March 2006 and August 2012. The patients were divided into two groups: those with PSM and those with negative surgical margin (NSM). We analyzed the age, clinical and pathological stages, preoperative and postoperative Gleason scores, duration of the follow-up, adjuvant chemo-/radiotherapy, biochemical failure, biochemical recurrence-free survival, and overall survival in these patients. PSM was found in 25 (20%) patients, whereas 96 patients had NSM. The median follow-up time was 46.6 months (range 12-72 months) for the PSM group and 48.3 months (range 7-149 months) for the NSM group. The biochemical failure rate was 24% in the PSM group and 8.3% in the NSM group (p = 0.029). The biochemical recurrence-free survival was found as 76% in the PSM group and 91.7% in the NSM group. The difference between the groups was not statistically significant (p = 0.06). The overall survival was 100% in both groups. The surgical margins of the radical prostatectomy material is an important pathological indicator for biochemical failure at mid long-term follow-up. We did not find any effect of PSM on overall survival or biochemical recurrence-free survival. Copyright © 2014. Published by Elsevier Taiwan.

  12. Health-related quality of life predicts long-term survival in patients with peripheral artery disease

    DEFF Research Database (Denmark)

    Issa, Samson M; Hoeks, Sanne E; Scholte op Reimer, Wilma J M

    2010-01-01

    We examined whether health-related quality of life (HRQoL) predicts long-term survival in patients with peripheral artery disease (PAD) independent of established prognostic risk factors. In 2004, data on 711 consecutive patients with PAD undergoing vascular surgery were collected from 11 hospitals...... prognostic factors. In conclusion, the study indicates that poor HRQoL predicts long-term survival in patients with PAD, and provides prognostic value above established risk factors....

  13. Comparison of long-term drug survival and safety of biologic agents in patients with psoriasis vulgaris

    DEFF Research Database (Denmark)

    Gniadecki, Robert; Bang, B; Bryld, L E

    2015-01-01

    BACKGROUND: Drug survival (time to drug discontinuation) has recently emerged as an important parameter reflecting the long-term therapeutic performance in a real-life setting. Biologic drug survival in psoriasis is mainly limited by a gradual loss of efficacy over time. Previous studies have been...... and to analyse the factors that influence drug survival. PATIENTS AND METHODS: Data were extracted from the prospective registry DERMBIO covering all patients with psoriasis vulgaris treated with biologic agents in the academic centres in Denmark. Drug survival was analysed using the Kaplan-Meier method...... longer for ustekinumab than for anti-tumour necrosis factor (TNF)-α agents (P

  14. Five-Year Clinical Outcome of Endoscopic Versus Open Radial Artery Harvesting: A Propensity Score Analysis.

    Science.gov (United States)

    Bisleri, Gianluigi; Giroletti, Laura; Hrapkowicz, Tomasz; Bertuletti, Martina; Zembala, Marian; Arieti, Mario; Muneretto, Claudio

    2016-10-01

    Despite the popularity of less invasive approaches for conduits procurement in coronary artery bypass graft surgery, concerns have been raised about the potential detrimental effects of the endoscopic technique when compared with the conventional "open" technique. Among 470 patients undergoing coronary surgery with the use of a radial artery conduit, a propensity score analysis was performed among those patients assigned either to an open technique (n = 82) or to an endoscopic approach (n = 82). Endoscopic harvesting was performed with a nonsealed system. The primary endpoint was cardiac-related mortality, and secondary endpoint was survival free from major cardiac and cerebrovascular adverse events. Moreover, hand and forearm sensory discomfort and forearm wound healing were also assessed. No conversion to the open technique occurred in patients undergoing endoscopic harvesting. No patients in either group showed hand ischemia; wound infection occurred only in the open group (open 7.3% versus endoscopic 0%, p = 0.007). Wound healing (Hollander scale) was considerably better in the endoscopic group (open 3.3, endoscopic 4.7; p < 0.001) as well as paresthesia at the latest follow-up (open 19.5% versus endoscopic 3.6%, p < 0.001). Pain (visual analog scale score) was significantly reduced with the endoscopic technique (open 3.2, endoscopic 1.2; p = 0.003). At 5 years of follow-up, freedom from cardiac-related mortality (open 96.3% ± 2.1% versus endoscopic 98.1% ± 1.8%; p = 0.448) as well as survival free from major cardiac and cerebrovascular adverse events (open 93.9% ± 2.6% versus endoscopic 93% ± 3.4%; p = 0.996) were similar among the groups. Endoscopic radial artery harvesting allows for incremental benefits in the short term in terms of improved cosmesis and reduced wound and neurologic complications, without yielding detrimental effects in terms of graft-related events at 5 years of follow-up. Copyright © 2016 The Society of Thoracic Surgeons

  15. Implications of subzero metabolism on long-term microbial survival in ice (Invited)

    Science.gov (United States)

    Christner, B. C.; Amato, P.; Battista, J. R.; Doyle, S. M.

    2010-12-01

    For a microorganism to remain viable over an extended period of frozen dormancy, the macromolecular damage incurred by the cell must not exceed a level where effective repair is no longer possible. Hence, survival over extended timeframes in the absence of metabolism is likely to be limited by chemical (e.g., hydrolysis and oxidation of nucleic acids; racemization of L-amino acids) and ionizing radiation-induced damage to cellular macromolecules. In freshwater and saline ice, various studies have shown that microbial cells are physically located in the aqueous interstitial veins that exist at ice grain boundaries and remain metabolically active under frozen conditions. In an effort to improve estimates for the long term limits of microbial survival in ice, we determined rates of macromolecular synthesis in cold-adapted bacteria at temperatures down to -15°C and examined their sensitivity to controlled doses of ionizing radiation (0 to 450 Gy). The purpose of this experiment was to simulate the damage which would accumulate in a cell population due to ionizing radiation in the absence of metabolic activity, allowing a prediction of cellular survival over extended dormancy versus subsistence in a metabolically active state. In experiments conducted over ≈400 days at -15°C, the rates of bacterial protein and DNA synthesis ranged from < 1 to 16 proteins cell-1 d-1 and 20 to 1600 bp cell-1 d-1, respectively, under the conditions tested. Based on the amount of bulk DNA synthesis needed to repair a known quantity of DNA damage (i.e., single- and double-stranded breaks, spontaneous hydrolysis of phosphodiester bonds, and depurination), we estimate that the viability of a dormant population of radiosensitive bacteria would be reduced by 99% after at least 600,000 years in ice. On the other hand, if microorganisms in natural ices are capable of synthesizing DNA at the lowest rates observed in the subzero laboratory experiments, our calculations imply that ionizing

  16. Taking out one billion tones of carbon: the magic of China's 11thFive-Year Plan

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Jiang; Zhou, Nan; Levine, Mark D.; Fridley, David

    2007-05-01

    China's 11th Five-Year Plan (FYP) sets an ambitious targetfor energy-efficiency improvement: energy intensity of the country sgross domestic product (GDP) should be reduced by 20 percent from 2005 to2010 (NDRC, 2006). This is the first time that a quantitative and bindingtarget has been set for energy efficiency, and signals a major shift inChina's strategic thinking about its long-term economic and energydevelopment. The 20 percent energy intensity target also translates intoan annual reduction of over one billion tons of CO2 by 2010, making theChinese effort one of most significant carbon mitigation effort in theworld today. While it is still too early to tell whether China willachieve this target, this paper attempts to understand the trend inenergy intensity in China and to explore a variety of options towardmeeting the 20 percent target using a detailed endues energymodel.

  17. An Assessment of Student Learning in an Online Oceanography Course: Five Years After Implementation

    Science.gov (United States)

    Reed, D. L.

    2002-12-01

    The results of assessing student learning in an online oceanography class offered over the past five years are compiled to reveal several general trends. In order to understand the context of these trends, it is important to first note that SJSU has a two-tiered general education program consisting of a category of core courses for frosh and sophomores and an advanced category for juniors and seniors, most of whom are community college transfers. The course described in this study is in the latter category and therefore composed largely of seniors. Enrollments in the course have exploded from 6 students in a pilot section offered during the 1998 fall semester to over 170 students in the summer semester of 2002. The course is now offered in both semesters of the academic year with four sections offered during 2002 summer session as part of a system-wide conversion to year-round operation. No other course, be it classroom, hybrid or online, in the general education category has experienced the level of student demand as this online course. All sections of the online course reach enrollment limits in the first days of registration with an equal or greater number of students turned away each semester. More female, students of color, returning students and K-12 in-service teachers enroll in the online sections than in the equivalent classroom sections of the course. Students enroll in the online section for the convenience of self-paced learning since attending a classroom section is not a viable option. Enrollments in concurrent classroom sections have not been negatively impacted by the addition of online sections. Enrollment attrition is higher in the first few days of the online course, but similar to that experienced in the classroom sections, once the class is underway. However, student requests for incompletes tend to be somewhat higher in the online course, especially during the summer offerings. Learning outcomes are reviewed at the beginning of the course and

  18. Chagas disease: national survey of seroprevalence in children under five years of age conducted in 2008

    Science.gov (United States)

    Russomando, Graciela; Cousiño, Blanca; Sanchez, Zunilda; Franco, Laura X; Nara, Eva M; Chena, Lilian; Martínez, Magaly; Galeano, María E; Benitez, Lucio

    2017-01-01

    BACKGROUND Since the early 1990s, programs to control Chagas disease in South America have focused on eradicating domiciliary Triatoma infestans, the main vector. Seroprevalence studies of the chagasic infection are included as part of the vector control programs; they are essential to assess the impact of vector control measures and to monitor the prevention of vector transmission. OBJECTIVE To assess the interruption of domiciliary vector transmission of Chagas disease by T. infestans in Paraguay by evaluating the current state of transmission in rural areas. METHODS A survey of seroprevalence of Chagas disease was carried out in a representative sample group of Paraguayans aged one to five years living in rural areas of Paraguay in 2008. Blood samples collected on filter paper from 12,776 children were tested using an enzyme-linked immunosorbent assay. Children whose serology was positive or undetermined (n = 41) were recalled to donate a whole blood sample for retesting. Their homes were inspected for current triatomine infestation. Blood samples from their respective mothers were also collected and tested to check possible transmission of the disease by a congenital route. FINDINGS A seroprevalence rate of 0.24% for Trypanosoma cruzi infection was detected in children under five years of age among the country’s rural population. Our findings indicate that T. cruzi was transmitted to these children vertically. The total number of infected children, aged one to five years living in these departments, was estimated at 1,691 cases with an annual incidence of congenital transmission of 338 cases per year. MAIN CONCLUSION We determined the impact of vector control in the transmission of T. cruzi, following uninterrupted vector control measures employed since 1999 in contiguous T. infestans-endemic areas of Paraguay, and this allowed us to estimate the degree of risk of congenital transmission in the country. PMID:28443980

  19. Chagas disease: national survey of seroprevalence in children under five years of age conducted in 2008

    Directory of Open Access Journals (Sweden)

    Graciela Russomando

    Full Text Available BACKGROUND Since the early 1990s, programs to control Chagas disease in South America have focused on eradicating domiciliary Triatoma infestans, the main vector. Seroprevalence studies of the chagasic infection are included as part of the vector control programs; they are essential to assess the impact of vector control measures and to monitor the prevention of vector transmission. OBJECTIVE To assess the interruption of domiciliary vector transmission of Chagas disease by T. infestans in Paraguay by evaluating the current state of transmission in rural areas. METHODS A survey of seroprevalence of Chagas disease was carried out in a representative sample group of Paraguayans aged one to five years living in rural areas of Paraguay in 2008. Blood samples collected on filter paper from 12,776 children were tested using an enzyme-linked immunosorbent assay. Children whose serology was positive or undetermined (n = 41 were recalled to donate a whole blood sample for retesting. Their homes were inspected for current triatomine infestation. Blood samples from their respective mothers were also collected and tested to check possible transmission of the disease by a congenital route. FINDINGS A seroprevalence rate of 0.24% for Trypanosoma cruzi infection was detected in children under five years of age among the country’s rural population. Our findings indicate that T. cruzi was transmitted to these children vertically. The total number of infected children, aged one to five years living in these departments, was estimated at 1,691 cases with an annual incidence of congenital transmission of 338 cases per year. MAIN CONCLUSION We determined the impact of vector control in the transmission of T. cruzi, following uninterrupted vector control measures employed since 1999 in contiguous T. infestans-endemic areas of Paraguay, and this allowed us to estimate the degree of risk of congenital transmission in the country.

  20. Functional evaluation of oral rehabilitation with removable partial dentures after five years.

    Science.gov (United States)

    Cosme, Dúcia Caldas; Baldisserotto, Simone Michielon; Fernandes, Eduardo de Lima; Rivaldo, Elken Gomes; Rosing, Cassiano Kuchenbecker; Shinkai, Rosemary Sadami Arai

    2006-04-01

    Most removable partial denture (RPD) wearers are satisfied with their prostheses, but the factors that influence satisfaction and acceptance are still not determined. This study explored technical, biological, and satisfaction variables for the functioning of RPDs after five years, and compared the evaluation by the patient and by the clinician. Fifty adults (39 females, 11 males) were re-examined after five years of RPD service. Data were collected through clinical examination and a structured questionnaire to record the conditions of supporting soft tissues, prosthesis acceptance and technical characteristics, mastication, esthetics, comfort, hygiene, and need for professional intervention. Data were analyzed by descriptive statistics and Spearman correlation. More than 50% of patients classified their RPDs as excellent regarding retention, mastication, esthetics, comfort, and hygiene. In the professional evaluation, retention and stability were considered excellent in more than 66% of cases, and hygiene of teeth and prostheses was considered good in 52% and 46%, respectively. The metallic framework and acrylic base were considered adapted in 92% of cases. Prosthesis acceptance was associated with retention, mastication, esthetics, hygiene, and comfort evaluated by the patient, and with retention, stability, and condition of the framework evaluated by the clinician. Retention and mastication/comfort evaluated by the patient had moderate positive correlation with retention and stability measured by the clinician. There was no association of hygiene evaluation by the patient and by the clinician. After five years, the oral rehabilitation with RPDs was satisfactory for most cases. There was correspondence between retention/retention and mastication-comfort/stability variables evaluated by the patient and by the clinician. Oral and prosthesis hygiene were not related.

  1. New developments in Indian space policies and programmes—The next five years

    Science.gov (United States)

    Sridhara Murthi, K. R.; Bhaskaranarayana, A.; Madhusudana, H. N.

    2010-02-01

    Over past four decades Indian space programme has systematically acquired capabilities in space technologies and implemented its programmes with a high level of focus on societal applications. It is developed into a multi-dimensional programme where its strategy is directed towards diverse stake holders and actors such as government, users and beneficiaries including general public, industrial suppliers as well as customers, academia and other space agencies/international organisations. Over the next five years, the Indian space programme has charted an ambitious set of policies and programmes that aim to enhance impacts on society. The major task is to enlarge and diversify the services delivered to a large section of population affected by income, connectivity and digital divides. While efficacy of application of space based systems have been proven in several fields such as tele-education, water resources management, improving productivity of land and out reaching quality health services and others, the crux of the problem is to evolve sustainable and scalable delivery mechanisms on a very large scale and extending over large geographical areas. Essentially the problem shifts from being predominately a technology problem to one of a composite of economic, cultural and social problems. Tackling such problems would need renewal of policies relating to commercial as well as public service systems. Major programmatic initiatives are planned in the next five years involving new and upgraded technologies to expand services from space to fill the gaps and to improve economic efficiency. Thrust is also given to science and exploration mission beyond Chandrayaan-1 and some initial steps for the participation in human space flight. This paper discusses the policy and strategy perspectives of the programmes planned by Indian Space Research Organisation over next five years.

  2. Press coverage of AIDS in Zimbabwe: a five-year review.

    Science.gov (United States)

    Pitts, M; Jackson, H

    1993-01-01

    Five years of newspaper coverage of HIV and AIDS in Zimbabwe is examined. Both the number of items and the amount of space devoted to the topics has increased steadily over the 5 years. The nature and content of the items show a continuing bias towards issues more closely associated with western patterns of the epidemic, and comparative neglect of personal stories, local issues and items with a counselling focus. Language is also examined and found to reflect a victim and war imagery. The implications for health education in the country are considered and specific recommendations for more constructive media coverage are made.

  3. Twenty-five years of post-Bretton Woods experience: some lessons

    Directory of Open Access Journals (Sweden)

    H. ASKARI

    1999-03-01

    Full Text Available In 1971 many academic economists were predicting that the Bretton Woods system of fixed parities would collapse. Some, most notably Milton Friedman, became excited about the possibility of a floating system because the benefits of international capital mobility can only be achieved through the flexibility in the exchange rate. These economists argued that a floating exchange rate system can ensure positive results more than the fixed parities system. Twenty-five years later, however, there is still no consensus on the matter. The author reviews the post-Bretton Woods experience to highlight some policies and approaches that might be helpful for the future.

  4. Bacterial contamination of floors and other surfaces in operating rooms: a five-year survey.

    OpenAIRE

    Suzuki, A.; Namba, Y; Matsuura, M; Horisawa, A.

    1984-01-01

    Bacterial contamination of floors and other surfaces in the operating suite has been investigated by contact impression plates during the past five years. Colony counts of the floors of operating rooms, cleaned with disinfectant, were 3.3 c.f.u./10 cm2; on the floors of semi-clean and dirty areas, cleaned with detergent, colony counts were 44.8 and 71.4 c.f.u./10 cm2 respectively. The highest colony counts of 487.4 c.f.u./10 cm2 were found in the dressing rooms, the floors of which were cover...

  5. Academic substance and location: The national technical university of Athens' five-year program

    DEFF Research Database (Denmark)

    Spyrou, Kostas J.; Psaraftis, Harilaos N.

    2014-01-01

    hydrodynamics, marine structures, and marine engineering. To be awarded an engineering diploma in Greece, one has to spend a minimum of five years. The program at NTUA has also 10 semesters, out of which nine are dedicated to course study while the tenth is spend on the writing of a thesis. There is no tuition...... charge for European Union students, while a small fee is charged for students from other countries. In the first two years, the students are taught the fundamentals of engineering science. The core courses are taught in the third year. The wide spectrum of expertise that exists in school means that most...

  6. Traditional Chinese medicine as adjunctive therapy improves the long-term survival of lung cancer patients.

    Science.gov (United States)

    Liao, Yueh-Hsiang; Li, Chia-Ing; Lin, Cheng-Chieh; Lin, Jaung-Geng; Chiang, Jen-Huai; Li, Tsai-Chung

    2017-12-01

    Traditional Chinese medicine is one of the popular alternative treatments for cancer, mainly enhancing host immune response and reducing adverse effect of chemotherapy. This study first explored traditional Chinese medicine treatment effect on long-term survival of lung cancer patients. This study evaluated whether traditional Chinese medicine combined with conventional cancer treatment improved overall survival of lung cancer patients. We had conducted a retrospective cohort study on 111,564 newly diagnosed lung cancer patients in 2000-2009 from National Health Insurance Program database. A total of 23,803 (21.31%) patients used traditional Chinese medicine for lung cancer care. Eligible participants were followed up until 2011 with a mean follow-up period of 1.96 years (standard deviation 2.55) for non-TCM users and 3.04 years (2.85) for traditional Chinese medicine users. Patients with traditional Chinese medicine utilization were significantly more likely to have a 32% decreased risk of death [hazard ratio = 0.62; 95% confidence interval = 0.61-0.63], compared with patients without traditional Chinese medicine utilization after multivariate adjustment. We also observed a similar significant reduction risk across various subgroups of chronic lung diseases. Qing Zao Jiu Fei Tang was the most effective traditional Chinese medicine agent for mortality reduction both in the entire lung cancer (0.81; 0.72-0.91) and matched populations (0.86; 0.78-0.95). This study demonstrated adjunctive therapy with traditional Chinese medicine may improve overall survival of lung cancer patients. This study also suggested traditional Chinese medicine may be used as an adjunctive therapy for cancer treatment. These observational findings need being validated by future randomized controlled trials to rule out the possibility of effect due to holistic care.

  7. An exception that proves the rule: recurrence free survival five years after extrapleural pneumonectomy for malignant pleural mesothelioma.

    Science.gov (United States)

    Treasure, Tom; Macbeth, Fergus

    2014-11-18

    Are case reports at all relevant and useful? A case report of an unusual case of mesothelioma prompts a discussion and concludes that they do have a role but that their observations and conclusions need to be treated with care.

  8. Long-term survival following coronary artery bypass grafting: off-pump versus on-pump strategies.

    Science.gov (United States)

    Kim, Joon Bum; Yun, Sung-Cheol; Lim, Jae Wong; Hwang, Soo Kyung; Jung, Sung-Ho; Song, Hyun; Chung, Cheol Hyun; Lee, Jae Won; Choo, Suk Jung

    2014-06-03

    This study sought to compare long-term survival after off- and on-pump coronary artery bypass grafting (CABG). Although several large-scale clinical trials have compared the surgical outcomes between off- and on-pump CABG, the long-term survival has not been compared between the 2 surgical strategies in a reasonably sized cohort. We evaluated long-term survival data in 5,203 patients (age 62.9 ± 9.1 years, 1,340 females) who underwent elective isolated CABG (off-pump: n = 2,333; on-pump: n = 2,870) from 1989 through 2012. Vital statuses were validated using the Korean National Registry of Vital Statistics. Long-term survival was compared with the use of propensity scores and inverse probability weighting to adjust selection bias. Patients undergoing on-pump CABG had a higher number of distal anastomoses than those undergoing off-pump CABG (3.7 ± 1.2 vs. 3.0 ± 1.1; p compared with those undergoing on-pump CABG. In subgroup analyses, on-pump CABG conferred survival benefits in most demographic, clinical, and anatomic subgroups compared with off-pump CABG. In patients undergoing elective isolated CABG, on-pump strategy conferred a long-term survival advantage compared with off-pump strategy. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  9. Factors influencing malignant evolution and long-term survival in solitary fibrous tumours of the pleura.

    Science.gov (United States)

    Rodriguez-Gonzalez, Marta; Novoa, Nuria M; Gomez, Maria T; Garcia, J L; Ludeña, Dolores

    2014-11-01

    Solitary pleuro-pulmonary fibrous tumours are relatively uncommon neoplasms that are difficult to manage therapeutically and which, cytogenetically, have been poorly studied. The aim of the present work was to analyse the characteristics of a series of consecutive operated solitary pleural fibrous tumours in an attempt to discover a malignant pattern of evolution. This was a retrospective observational study of 19 cases. Samples were studied for clinical, histological, immunohistochemical and cytogenetic characteristics (aCGH, FISH). Descriptive statistics were used: the Kapplan-Meyer log-rank test and the Cox-regression model for survival analysis. Analysis of malignant evolution was achieved using 2x2 tables; significant factors were included in a binary logistic regression model. Parietal pleural implantation of the primary tumour, high mib1 expression, and low p53 expression were seen to be statistically significant factors for survival. We recommend a close follow-up for patients with a malignant primary tumour and low p53 expression and a regular long-term follow-up for benign primary tumours with a high mib1 index, high positive p53, and deletions. These findings need confirmation in more extensive series.

  10. Short-term starvation of immune deficient Drosophila improves survival to gram-negative bacterial infections.

    Directory of Open Access Journals (Sweden)

    Anthony E Brown

    Full Text Available Primary immunodeficiencies are inborn errors of immunity that lead to life threatening conditions. These predispositions describe human immunity in natura and highlight the important function of components of the Toll-IL-1- receptor-nuclear factor kappa B (TIR-NF-kappaB pathway. Since the TIR-NF-kappaB circuit is a conserved component of the host defence in higher animals, genetically tractable models may contribute ideas for clinical interventions.We used immunodeficient fruit flies (Drosophila melanogaster to address questions pertaining to survival following bacterial infection. We describe here that flies lacking the NF-kappaB protein Relish, indispensable for countering Gram-negative bacteria, had a greatly improved survival to such infections when subject to dietary short-term starvation (STS prior to immune challenge. STS induced the release of Nitric Oxide (NO, a potent molecule against pathogens in flies, mice and humans. Administering the NO Synthase-inhibitory arginine analog N-Nitro-L-Arginine-Methyl-Ester (L-NAME but not its inactive enantiomer D-NAME increased once again sensitivity to infection to levels expected for relish mutants. Surprisingly, NO signalling required the NF-kappaB protein Dif, usually needed for responses against Gram-positive bacteria.Our results show that NO release through STS may reflect an evolutionary conserved process. Moreover, STS could be explored to address immune phenotypes related to infection and may offer ways to boost natural immunity.

  11. Parotid small cell carcinoma presenting with long-term survival after surgery alone: a case report

    Directory of Open Access Journals (Sweden)

    Kanazawa Takeharu

    2012-12-01

    Full Text Available Abstract Introduction Primary involvement of the salivary glands in small cell carcinoma is rare, and has one of the worst prognoses of salivary gland neoplasms. However, it has been reported that some cases have a favorable outcome, although the prognostic factors are still under consideration. Multidisciplinary therapy was usually required to achieve long-term survival. Recently, a resemblance of some small cell carcinomas of the salivary gland to cutaneous Merkel cell carcinoma was suggested; the latter have the potential for spontaneous regression, which is related to a favorable clinical outcome. Case presentation We present a locoregional advanced parotid small cell carcinoma with multiple lymph node metastases in an 87-year-old Asian woman. The tumor was controlled by surgery alone, and nine-year disease-free survival was achieved without any adjunctive therapy. To the best of our knowledge, this is the longest reported follow-up of head and neck small cell carcinoma. Conclusion We believe this to be the first case of small cell carcinoma with involvement of the salivary glands reported in the literature with a good outcome after surgery alone without any adjunctive therapy.

  12. Electroconvulsive stimulation results in long-term survival of newly generated hippocampal neurons in rats

    DEFF Research Database (Denmark)

    Olesen, Mikkel Vestergaard; Wörtwein, Gitta; Folke, Jonas

    2017-01-01

    of the previous work aiming to test the hypothesis that rats subjected to ECS in combination with chronic restraint stress (CRS) display increased formation of new hippocampal neurons, which have a potential for long-term survival. Furthermore, using mediation analysis, we tested if an ECS-induced increase......U-positive neurons showed time-dependent attrition of ∼40% from day 1 to 3 months, with no further decline between 3 and 12 months. ECS did not affect the number of pre-existing dentate granule neurons or the volume of the dentate granule cell layer, suggesting no damaging effect of the treatment. Finally, we found...... that, while ECS increases neurogenesis, this formation of new neurons was not associated to ameliorated immobility in the FST. This implies that other ECS-induced effects than neurogenesis must be part of mediating the antidepressant action of ECS. Taken together, the results of the present study...

  13. [Effectiveness and safety of conversion therapy with the combination of sirolimus with low dose cyclosporine in renal transplantation recipients: a five-year clinical observation].

    Science.gov (United States)

    Zhu, L; Ding, T; Wang, X X; Lin, Z B; Chen, G

    2016-05-31

    To assess the effectiveness and safety of the conversion therapy from traditional cyclosporine (CsA) triple immunosuppression therapy to sirolimus (SRL) combined with low dose CsA and prednisone (Pred) in renal transplantation recipients in a five-year follow-up period. A prospective, open-label non-randomized study was performed with 46 renal allograft recipients who visited Tongji Hospital regularly for follow-up visits between January 2007 and May 2011 and were taking CsA+ mycophenolate mofetil (MMF)+ Pred. Conversion therapy to SRL+ low dose CsA+ Pred was initiated after renal transplantation. The recipients were allocated to 2 groups according to their renal function and proteinuria before the conversion: active conversion group [n=27, serum creatinine (SCr) ≤ 140 μmol/L with no or minimal proteinuria] and passive conversion group [n=19, SCr>140 μmol/L with less than moderate proteinuria]. After conversion, dosages of SRL and CsA were adjusted for trough levels of 5-7 μg/L and 20-60 μg/L, respectively. SCr and urine protein were compared before and after the conversion in five-year follow-up. Incidence of acute rejection, renal graft survival and SRL-related adverse effects of the immunosuppressive regimen were also observed. After conversion, an average 63% dose reduction of CsA was achieved in all the patients. In the active conversion group, the mean SCr level was (110±19) μmol/L at the time of conversion. Eight patients in this group withdrew from the study during the follow-up period for the following reasons: arthralgia (1 case), deteriorated proteinuria (2 cases), chronic diarrhea (2 cases), mild or suspicious acute rejection (2 cases), and recurrent fever (1 case). The rest patients (19/27) with a mean follow-up time of 5 years had a stable SCr level [(103±12) μmol/L] and a 100% 5-year graft survival. In the passive conversion group, the mean SCr level was (205±45) μmol/L at the time of conversion. There were 4 patients quitting the study

  14. Long-term survival of surface water ice on comet 67P

    Science.gov (United States)

    Oklay, N.; Mottola, S.; Vincent, J.-B.; Pajola, M.; Fornasier, S.; Hviid, S. F.; Kappel, D.; Kührt, E.; Keller, H. U.; Barucci, M. A.; Feller, C.; Preusker, F.; Scholten, F.; Hall, I.; Sierks, H.; Barbieri, C.; Lamy, P. L.; Rodrigo, R.; Koschny, D.; Rickman, H.; A'Hearn, M. F.; Bertaux, J.-L.; Bertini, I.; Bodewits, D.; Cremonese, G.; Da Deppo, V.; Davidsson, B. J. R.; Debei, S.; De Cecco, M.; Deller, J.; Deshapriya, J. D. P.; Fulle, M.; Gicquel, A.; Groussin, O.; Gutiérrez, P. J.; Güttler, C.; Hasselmann, P. H.; Hofmann, M.; Ip, W.-H.; Jorda, L.; Knollenberg, J.; Kovacs, G.; Kramm, J.-R.; Küppers, M.; Lara, L. M.; Lazzarin, M.; Lin, Z.-Y.; Moreno, J. J. Lopez; Lucchetti, A.; Marzari, F.; Masoumzadeh, N.; Naletto, G.; Pommerol, A.; Shi, X.; Thomas, N.; Tubiana, C.

    2017-07-01

    Numerous water-ice-rich deposits surviving more than several months on comet 67P/Churyumov-Gerasimenko were observed during the Rosetta mission. We announce the first-time detection of water-ice features surviving up to 2 yr since their first observation via OSIRIS (Optical, Spectroscopic, and Infrared Remote Imaging System) NAC (narrow angle camera). Their existence on the nucleus of comet 67P at the arrival of the Rosetta spacecraft suggests that they were exposed to the surface during the comet's previous orbit. We investigated the temporal variation of large water-ice patches to understand the long-term sustainability of water ice on cometary nuclei on time-scales of months and years. Large clusters are stable over typical periods of 0.5 yr and reduce their size significantly around the comet's perihelion passage, while small exposures disappear. We characterized the temporal variation of their multispectral signatures. In large clusters, dust jets were detected, whereas in large isolated ones no associated activity was detected. Our thermal analysis shows that the long-term sustainability of water-ice-rich features can be explained by the scarce energy input available at their locations over the first half year. However, the situation reverses for the period lasting several months around perihelion passage. Our two end-member mixing analysis estimates a pure water-ice equivalent thickness up to 15 cm within one isolated patch, and up to 2 m for the one still observable through the end of the mission. Our spectral modelling estimates up to 48 per cent water-ice content for one of the large isolated feature, and up to 25 per cent water ice on the large boulders located within clusters.

  15. Long-term regional chemotherapy for patients with epithelial malignant peritoneal mesothelioma results in improved survival.

    Science.gov (United States)

    Sugarbaker, P H; Chang, D

    2017-07-01

    Malignant peritoneal mesothelioma (MPM) is a rare disease with about 300 new cases per year in the USA. Its natural history is described as local progression within the peritoneal space in the absence of liver metastases or systemic disease. Cytoreductive surgery (CRS) is a series of peritonectomy procedures and visceral resections with a goal of complete removal of all visible disease from the abdomen and pelvis. Over 20 years, three protocols investigating increasing efficacy of additional chemotherapy treatments added to CRS have been initiated. Initially, hyperthermic perioperative chemotherapy (HIPEC) with doxorubicin and cisplatin was used in the operating room. Then, early postoperative intraperitoneal chemotherapy (EPIC) with paclitaxel was added for the first 5 days after CRS. The third protocol employed HIPEC, then EPIC, and then long-term intraperitoneal (IP) paclitaxel or IP pemetrexed plus intravenous (IV) cisplatin as a adjuvant normothermic intraperitoneal chemotherapy (NIPEC). The 5-year survival of 42 patients treated with CRS and HIPEC was 44%, for 58 patients treated with EPIC and HIPEC was 52% and 29 patients who received HIPEC, EPIC, and NIPEC was 75% (p = 0.0374). Prognostic variables of age, gender, treatment administered, peritoneal cancer index (PCI) and completeness of cytoreduction were significant by univariate analysis and treatments administered and completeness of cytoreduction significant by multivariate analysis. Long-term regional chemotherapy was associated with improved survival in patients with MPM. In this rare disease, additional phase 2 investigations are suggested. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  16. Patient function, long-term survival, and use of surgery in patients with kidney cancer.

    Science.gov (United States)

    Tan, Hung-Jui; Chamie, Karim; Daskivich, Timothy J; Litwin, Mark S; Hu, Jim C

    2016-12-15

    Beyond age and comorbidity, functionality can shape the long-term survival potential of patients with cancer. Accordingly, herein the authors compared mortality and receipt of cancer-directed surgery according to patient function among older adults with kidney cancer. Using Surveillance, Epidemiology, and End Results (SEER)-Medicare data from 2000 through 2009, the authors studied 28,326 elderly subjects with primary kidney cancer. Patient function was quantified using function-related indicators, claims indicative of dysfunction and disability. Adjusting for patient and cancer characteristics, competing risk regression was used to assess the relationship between function-related indicator count and cause-specific mortality and then generalized estimating equations were used to quantify the probability of surgery. A total of 13,619 adult patients (48.1%) with at least 1 function-related indicator were identified. A higher indicator category was associated with older age, greater comorbidity, female sex, unmarried status, lower socioeconomic status, and higher stage of disease (Pkidney cancer mortality varied minimally with patient function. Patients with ≥ 2 indicators received cancer-directed surgery less often than those without disability (odds ratio, 0.61; 95% CI, 0.56-0.66), although treatment probabilities remained high for patients with locoregional disease and low for those with metastatic cancer. Among older adults with kidney cancer, functional health stands as a significant predictor of long-term survival. However, receipt of cancer-directed surgery appears largely determined by cancer stage. Patient function should be considered more heavily when determining treatment for older adults with kidney cancer. Cancer 2016;122:3776-3784. © 2016 American Cancer Society. © 2016 American Cancer Society.

  17. Dyslipidemia as a long-term marker for survival in pulmonary embolism

    Directory of Open Access Journals (Sweden)

    L. Jara-Palomares

    2011-09-01

    Full Text Available Objectives: To analyse survival rate after 24 months in consecutive patients with a diagnosis of PE as well as associated factors. Methods: Prospective cohort study during a follow-up period of two years in a series of consecutive patients with PE. Results: During the follow-up period, 34 out of 148 patients died (23%. Factors independently associated with reduced survival rate were: creatinine levels > 2 (OR, 8.8; 95% CI, 1.1 - 70.87, previous neoplasm (OR, 8.8; 95% CI, 3.69 - 20.98, dementia (OR, 6.85; 95% CI, 2.1 - 22.33 and dyslipidemia (OR, 5.07; 95% CI, 1.92 - 13.44. Forty four percent of the patients with dyslipidemia died vs. 20.8% of patients without this condition. Conclusions: In our study dyslipidemia shows as a long-term negative prognostic marker for survival in patients with EP. Resumo: Objetivos: Analisar a taxa de sobrevivência após 24 meses, em pacientes consecutivos com diagnóstico de PE, bem como fatores associados. Métodos: Estudo prospectivo durante um período de seguimento de dois anos em uma série consecutiva de pacientes com PE. Resultados: Durante o período de acompanhamento, 34 dos 148 pacientes morreram (23%. Fatores independentemente associados à reduzida taxa de sobrevivência foram: os níveis de creatinina> 2 (OR, 8,8; 95% CI, 1,1-70,87, neoplasia anterior (OR, 8,8; IC 95%, 3,69-20,98, demência (OR, 6,85; 95% CI, 2,1-22,33 e dislipidemia (OR, 5,07; IC 95%, 1,92-13,44. Quarenta e quatro por cento dos pacientes com dislipidemia morreram contra 20,8% dos pacientes sem essa condição. Conclusões: No nosso estudo, a dislipidemia mostra-se um marcador prognóstico negativo de longo prazo na sobrevida de pacientes com EP. Keywords: Dyslipidemia, Lipid metabolic disorders, Pulmonary embolism, Survival analysis, Venous thromboembolism, Palavras-chave: Dislipidemia, Doenças metabólicas lipídicas, Embolia pulmonar, Análise de sobrevivência, Tromboembolismo venoso

  18. Five-year trends of selected halogenated flame retardants in the atmosphere of Northeast China

    Energy Technology Data Exchange (ETDEWEB)

    Li, Wen-Long; Liu, Li-Yan; Song, Wei-Wei; Zhang, Zi-Feng; Qiao, Li-Na [International Joint Research Center for Persistent Toxic Substances (IJRC-PTS), State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, Harbin 150090 (China); Ma, Wan-Li, E-mail: mawanli002@163.com [International Joint Research Center for Persistent Toxic Substances (IJRC-PTS), State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, Harbin 150090 (China); Li, Yi-Fan, E-mail: ijrc_pts_paper@yahoo.com [International Joint Research Center for Persistent Toxic Substances (IJRC-PTS), State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, Harbin 150090 (China); IJRC-PTS-NA, Toronto M2N 6X9 (Canada)

    2016-01-01

    This study collected 227 pairs of gas phase and particle phase air samples in a typical urban city of Northeast China from 2008 to 2013. Four alternative halogenated flame retardants for polybrominated diphenyl ethers (PBDEs) were analyzed, namely 2-ethylhexyl 2,3,4,5-tetrabromobenzoate (EHTBB), bis (2-ethylhexyl) tetrabromophthalate (BEHTBP), syn-dechlorane plus (syn-DP) and anti-dechlorane plus (anti-DP). The average concentrations for EHTBB and BEHTBP were 5.2 ± 20 and 30 ± 200 pg/m{sup 3}, respectively, while for syn-DP and anti-DP were 1.9 ± 5.1 and 5.8 ± 18 pg/m{sup 3}, respectively. Generally, they were frequently detected in the particle phase, and the gas/particle partitioning suggested they were the maximum partition chemicals. The fractional abundance of EHTBB (f{sub EHTBB}) and syn-DP (f{sub syn}) were comparable with those in other studies. Strong local sources were identified based on the air parcel backward trajectories and the potential source contribution function. The concentrations of these chemicals were significantly increased during this sampling campaign, possibly suggesting their increasing usages from 2008 to 2013 in China. - Highlights: • Five-year air samples were analyzed for four alternative HFRs. • BEHTBP and DP were frequently detected in the particle phase. • Local and nearby city sources of these HFRs were suggested. • Concentrations of these HFRs were significantly increased in the five-year period.

  19. Acceptance of family planning methods by induced abortion seekers: An observational study over five years.

    Science.gov (United States)

    Kathpalia, S K

    2016-01-01

    Prior to legalization of abortion, induced abortions were performed in an illegal manner and that resulted in many complications hence abortion was legalized in India in 1971 and the number of induced abortions has been gradually increasing since then. One way of preventing abortions is to provide family planning services to these abortion seekers so that same is not repeated. The study was performed to find out the acceptance of contraception after abortion. A prospective study was performed over a period of five years from 2010 to 2014. The study group included all the cases reporting for abortion. A proforma was filled in detail to find out the type of contraception being used before pregnancy and acceptance of contraception after abortion. The existing facilities were also evaluated. 1228 abortions were performed over a period of five years. 94.5% of abortions were during the first trimester. 39.9% had not used any contraceptive before, contraceptives used were natural and barrier which had high failure. The main indication for seeking abortion was failure of contraception and completion of family. 39.6% of patients accepted sterilization as a method of contraception. The existing post abortion family planning services are inadequate. Post abortion period is one which is important to prevent subsequent abortions and family planning services after abortion need to be strengthened.

  20. Patients' knowledge of Diabetes five years after the end of an educational program

    Directory of Open Access Journals (Sweden)

    Izabel Alves das Chagas

    2013-10-01

    Full Text Available We present a cross-sectional study that aims to describe the sociodemographic and clinical conditions of individuals with diabetes mellitus and to analyze their knowledge of treatment five years after the end of an educational program in which they took part. In 2010, 40 individuals who had participated in a diabetes educational program for 12 months in 2005 at a primary care service were interviewed. A form was used for data collection that included their knowledge of the notion, physiopathology, and treatment of the disease; exercise; nutrition; foot care; self-monitoring of capillary blood glucose at home; hypoglycemia; chronic complications; special situations; and family support. The results showed that the volunteers incorporated the information about the notion, physiopathology, and treatment of the disease; exercise; foot care; self-monitoring; care associated with hypoglycemia; chronic complications; and special situations. In contrast, nutrition and family support require further reinforcement. It is concluded that five years after the end of the educational program, the participants kept most of the information provided.

  1. Personality disorder features as predictors of symptoms five years post-treatment.

    Science.gov (United States)

    Jansson, Irene; Hesse, Morten; Fridell, Mats

    2008-01-01

    Personality disorders are associated with dysfunction in a variety of areas. Recent longitudinal research has shown that personality disorders are also predictive of problems later in life, as well as of poor response to treatment of depression and anxiety. This study assessed whether personality disorder features were associated with psychiatric symptoms in a cohort of women treated for substance abuse in Sweden. Patients were diagnosed with personality disorders using the Structured Clinical Interview for DSM-IV (SCID-II) personality questionnaire and SCID-II interview, and were then administered a self-report questionnaire designed to measure symptoms of psychiatric illness, the Symptoms Checklist-90 (SCL-90), during and five years after treatment. Concurrently, features of all personality disorders, except histrionic, were associated with SCL-90 score. At five-year follow-up, most personality disorders remained associated with SCL-90 score, with the exception of paranoid and schizoid personality disorder. After controlling for baseline score on the SCL-90, conduct disorder, borderline personality disorder, and narcissistic personality disorder remained significantly associated with symptoms at follow-up. After controlling for abstinence and baseline score, only borderline personality disorder features remained associated with SCL-90 score at follow-up. Patients with personality disorders should be monitored after treatment for psychiatric symptoms.

  2. Management of Class I and Class II Amalgam Restorations with Localized Defects: Five-Year Results.

    Science.gov (United States)

    Martin, Javier; Fernandez, Eduardo; Estay, Juan; Gordan, Valeria V; Mjör, Ivar Andreas; Moncada, Gustavo

    2013-01-01

    Replacement of dental restorations has been the traditional treatment for defective restorations. This five-year prospective clinical trial evaluated amalgam restorations with localized defects that were treated by means of repair or refurbishing. Fifty-two patients (50% female and 50% male, mean age 28.3 ± 18.1 years, range 18-80) with 160 class I and class II defective restorations were included. The study focused on the application of two minimally invasive treatments for localized restoration defects and compared these with no treatment and total replacement as negative and positive controls, respectively. Restorations were assessed by two calibrated examiners according to modified U.S. Public Health Service criteria, including marginal adaptation, anatomic form, secondary caries, and roughness. At five years, recall was examined in 45 patients with 108 restorations (67.5%). The results suggest that repair treatment is as effective as total replacement of restorations with localized defects, reducing biological costs to the patient and providing new tools to the clinician. Refinishing restoration is a useful treatment for localized anatomic form defects.

  3. Error identification in a high-volume clinical chemistry laboratory: Five-year experience.

    Science.gov (United States)

    Jafri, Lena; Khan, Aysha Habib; Ghani, Farooq; Shakeel, Shahid; Raheem, Ahmed; Siddiqui, Imran

    2015-07-01

    Quality indicators for assessing the performance of a laboratory require a systematic and continuous approach in collecting and analyzing data. The aim of this study was to determine the frequency of errors utilizing the quality indicators in a clinical chemistry laboratory and to convert errors to the Sigma scale. Five-year quality indicator data of a clinical chemistry laboratory was evaluated to describe the frequency of errors. An 'error' was defined as a defect during the entire testing process from the time requisition was raised and phlebotomy was done until the result dispatch. An indicator with a Sigma value of 4 was considered good but a process for which the Sigma value was 5 (i.e. 99.977% error-free) was considered well controlled. In the five-year period, a total of 6,792,020 specimens were received in the laboratory. Among a total of 17,631,834 analyses, 15.5% were from within hospital. Total error rate was 0.45% and of all the quality indicators used in this study the average Sigma level was 5.2. Three indicators - visible hemolysis, failure of proficiency testing and delay in stat tests - were below 5 on the Sigma scale and highlight the need to rigorously monitor these processes. Using Six Sigma metrics quality in a clinical laboratory can be monitored more effectively and it can set benchmarks for improving efficiency.

  4. Management of Class I and Class II Amalgam Restorations with Localized Defects: Five-Year Results

    Directory of Open Access Journals (Sweden)

    Javier Martin

    2013-01-01

    Full Text Available Replacement of dental restorations has been the traditional treatment for defective restorations. This five-year prospective clinical trial evaluated amalgam restorations with localized defects that were treated by means of repair or refurbishing. Fifty-two patients (50% female and 50% male, mean age 28.3±18.1 years, range 18–80 with 160 class I and class II defective restorations were included. The study focused on the application of two minimally invasive treatments for localized restoration defects and compared these with no treatment and total replacement as negative and positive controls, respectively. Restorations were assessed by two calibrated examiners according to modified U.S. Public Health Service criteria, including marginal adaptation, anatomic form, secondary caries, and roughness. At five years, recall was examined in 45 patients with 108 restorations (67.5%. The results suggest that repair treatment is as effective as total replacement of restorations with localized defects, reducing biological costs to the patient and providing new tools to the clinician. Refinishing restoration is a useful treatment for localized anatomic form defects.

  5. Sense of coherence among cognitively intact nursing home residents--a five-year longitudinal study.

    Science.gov (United States)

    Drageset, Jorunn; Espehaug, Birgitte; Hallberg, Ingalill Rahm; Natvig, Gerd Karin

    2014-09-01

    To examine how stable the sense of coherence (SOC) is over a five-year period among residents of nursing homes (NH) who are not cognitively impaired and whether components of social support influence SOC. Many studies have investigated the stability of SOC, and the findings have been inconsistent. Social support is a crucial resource in developing SOC. Few researchers have studied the stability of SOC and how various social support dimensions influence changes in SOC among older NH residents who are cognitively intact. The study was prospective and included baseline assessment and five-year follow-up. The sample comprised 52 cognitively intact NH residents (Clinical Dementia Rating score ≤0.5). We obtained data through direct interviews using the Social Provisions Scale and Sense of Coherence Scale. SOC increased statistically significantly from baseline to follow-up. The social support subdimension reassurance of worth predicted change in SOC after adjustment for sociodemographic factors. When controlled for baseline SOC, attachment was associated with change in SOC, but reassurance of worth was not. The study indicates that the change in SOC over time during the 5 years of follow-up and the social support dimension attachment appear to be important components of change in SOC. Nursing personnel should be aware of the residents' individual needs for attachment and the importance of emotional support for personal strength and ability to cope.

  6. Starry Nights: Five Years of The Great World Wide Star Count

    Science.gov (United States)

    Ward, D.; Johnson, R. M.

    2011-12-01

    The Great World Wide Star Count is an international citizen science event encouraging everyone, astronomers and non-astronomers alike, to measure their local light pollution and report their observations online. This project is designed to raise awareness about light pollution as well as encourage learning in astronomy. Utilizing the international networking capabilities of Windows to the Universe, Star Count has engaged over 40,000 individuals from 64 countries and all 7 continents in its first five years. Data collection and online reporting is simple and user-friendly for citizen scientists of all ages. The collected data is available online in a variety of formats for use by students, teachers and scientists worldwide to assess how the quality of the night sky varies around the world. This session will share our results and demonstrate how students and scientists worldwide can explore and analyze the results from the first five years of the project. We will discuss how our team planned and executed the project in such a way that non-astronomers were able to make valid and useful contributions.

  7. Five-year microbiological monitoring of wards and operating theatres in southern Italy.

    Science.gov (United States)

    La Fauci, V; Genovese, C; Facciolà, A; Palamara, M A R; Squeri, R

    2017-06-01

    Nosocomial infections are one of the greatest problems in public health. Several studies have highlighted the role played by the hospital environment as a possible source of transmission of nosocomial pathogens. A five-year monitoring of bacterial contamination on healthcare workers hands, surfaces most closely in contact with inpatient wards, operating theatres and "at rest" and "in use" operating theatre air samples. For the samples, we used sterile swabs, contact slides, manual API, and automated VITEK systems for identification. In the five-year period, a total of 9396 samples were collected and analysed. In ward patients, 4398 samplings were carried out with 4.7%, 9.4%, 7%, 10.8% and 7.9% positive results respectively from 2010 to 2014. For hands, 648 samplings were carried out, with a positivity of 40.74%. In operating theatres, 4188 samples were taken, with a positivity of 11.9%. Regarding air in empty and full theatres, 1962 samplings were carried out with a positivity rate equal to 31.9%. The monitoring showed a low rate of contamination with a progressive decrease in the fiveyear period on operating theatres surfaces and hands, while there was an increase in the surgical site wards and in the air of operating rooms. Our investigation has revealed the presence of pathogens on the assessed surfaces and the need for environmental monitoring, which can be a valuable tool for reducing contamination.

  8. [Epidemiologic behavior of malignant digestive tract tumors over a five year period in Veracruz, Mexico].

    Science.gov (United States)

    Roesch-Dietlen, F; Jiménez-García, V A; Remes-Troche, J M; Rubio-Arce, J F; López-Salinas, A; Ruiz-Juárez, I; Grube-Pagola, P; Silva-Cañetas, C F

    2012-01-01

    Tumors of the digestive system are considered to be a public health problem because of their elevated mortality rate. In Mexico, gastric cancer and colon cancer rank fourth and fifth, respectively, following tracheal, bronchial, and lung cancer, and there has been an increase in their frequency in the last few years. However, there are no specific studies that have evaluated their epidemiologic behavior in Veracruz. To determine the frequency of digestive system cancer in five health institutions in the city of Veracruz and to describe its epidemiologic behavior over a five-year period. Annual statistics from the following hospitals were reviewed: the Instituto Mexicano del Seguro Social, the Secretaría de Salud, the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Petróleos Mexicanos, and the Secretaría de la Defensa Nacional within the time frame of January 2005 to December 2009. Diagnoses based on histopathology were recorded, along with patient age and sex. A total of 1803 cases of digestive tract cancers were detected: 52% were men and 48% were women. A yearly increase in the number of cases was observed with colon cancer being in first place, followed by stomach cancer and rectal cancer. The increase in digestive system cancer cases over the last five years in Veracruz underlines the need to evaluate the implementation of screening programs for the at-risk population and to study the different etiologic factors involved in its manifestation.

  9. A mixed methods study to assess the effectiveness of food-based interventions to prevent stunting among children under-five years in Districts Thatta and Sujawal, Sindh Province, Pakistan: study protocol.

    Science.gov (United States)

    Kureishy, Sumra; Khan, Gul Nawaz; Arrif, Shabina; Ashraf, Khizar; Cespedes, Angela; Habib, Muhammad Atif; Hussain, Imtiaz; Ullah, Asmat; Turab, Ali; Ahmed, Imran; Zaidi, Shehla; Soofi, Sajid Bashir

    2017-01-05

    Maternal and child malnutrition is widely prevalent in low and middle income countries. In Pakistan, widespread food insecurity and malnutrition are the main contributors to poor health, low survival rates and the loss of human capital development. The nutritional status trends among children exhibit a continuous deteriorating with rates of malnutrition exceeding the WHO critical threshold. With the high prevalence of maternal and child malnutrition, it is important to identify effective preventative approaches, especially for reducing stunting in children under-five years of age. The primary aim of this study is to assess the effectiveness of food-based interventions to prevent stunting in children under-five years. A mixed methods study design will be conducted to evaluate the effectiveness of food-based interventions to prevent stunting among children under-five years in districts Thatta and Sujawal, Sindh Province, Pakistan. The study will include cross sectional surveys, a community-based cluster randomized controlled trial and a process evaluation. The study participants will be pregnant women, lactating mothers and children under-five years. The cross-sectional surveys will be conducted with 7360 study participants at baseline and endline. For the randomized control trial, 5000 participants will be recruited and followed monthly for compliance of food-based supplements, dietary diversity, pregnancy outcomes, and maternal and child morbidity and mortality. Anthropometric measurements and hemoglobin levels will be measured at baseline, quarterly and at endline. The interventions will consist of locally produced lipid-based nutrient supplement (Wawamum) for children 6-23 months, micronutrient powders for children 24-59 months, and wheat soya blends for pregnant and lactating mothers. Government lady health workers will deliver interventions to participants. The effectiveness of the project will be measured in terms of the impact of the proposed interventions on

  10. Heart transplantation with ABO-identical versus ABO-compatible cardiac grafts: influence on long-term survival.

    Science.gov (United States)

    Sjögren, Johan; Ljungdahl-Waller, Fredrik; Senneby, Erik; Ekmehag, Björn; Koul, Bansi; Nilsson, Johan

    2010-12-01

    To compare identical versus compatible, ABO blood group matching effects on rejection and long-term survival after heart transplantation (HT). Data were collected from 196 patients who underwent HT at Lund University Hospital between 1988 and 2008. Cox proportion hazard regression analysis was used to identify factors associated with reduced long-term survival. One hundred and sixty six patients (85%) had an identical ABO blood group match and 30 patients (15%) had a compatible, ABO blood group match. Four non-pharmacological variables reducing overall survival were identified: recipient blood group AB, age >55 years, ischemic time, and year of transplantation. Two pharmacological variables improved overall survival: glucocorticoids and cyclosporine. There was no significant difference in long-term survival between patients with identical blood groups compared to compatible ABO blood group matching. However, there was a trend towards graft failure as cause of death being more common in the compatible ABO group match compared identical blood group match (13% versus 5%, p=0.118). Six factors associated with overall survival were identified. One of these was related to blood group AB. No significant difference in survival following identical, versus compatible, ABO matching was demonstrated.

  11. Long-term survival after use of internal thoracic artery in octogenarians is gender related.

    Science.gov (United States)

    Singh, Arun K; Maslow, Andrew D; Machan, Jason T; Fingleton, James G; Feng, William C; Schwartz, Carl; Rotenberg, Fred A; Bert, Arthur A

    2015-10-01

    The goal of this study is to assess the benefits of a left internal thoracic artery as a bypass conduit in octogenarians undergoing elective coronary artery bypass grafting. We hypothesize that there is no survival advantage and that outcome may be gender related. In a retrospective analysis of 1141 octogenarians (aged >80 years) undergoing isolated coronary artery bypass grafting from 1996 to 2012, patients were divided into 2 groups: Group I (coronary artery bypass grafting-left internal thoracic artery) included 870 patients (339 female/531 male), and group II (coronary artery bypass grafting-saphenous vein graft) included 271 patients (131 female/140 male). The overall 30-day mortality was 5.7%: 4.3% in group I and 7.0% in group II (P = .1). Group II had a lower trend of any postoperative complication (P = .05) and pneumonia (P = .05). When analyzed by gender, there were no discernable differences in long-term survival for male patients in group I (65% at 5 years and 29% at 10 years) versus male patients in group II (65% at 5 years and 31% at 10 years) (P = .2). However, survival was significantly greater for female patients in group I (70% at 5 years and 35% at 10 years) versus female patients in group II (63% at 5 years and 21% at 19 years) (P = .01). Multiple logistic and Cox regression analysis showed that left internal thoracic artery use is associated with improved survival in female patients (hazard ratio [HR], 0.72; confidence interval [CI], 0.56-0.93) but not in male patients (HR, 1.14; CI, 0.9-1.4). Advanced age was associated with an increased risk of mortality (HR, 1.08 per year; CI, 1.05-1.1). Both patient age (P = .01) and Society of Thoracic Surgeons-predicted 30-day mortality (P = .03) remain in the final model for 30-day mortality. The benefit of the left internal thoracic artery after coronary artery bypass grafting in octogenarians may be gender related. This study shows that the benefit of the left internal thoracic artery in the

  12. Drug survival for ciclosporin A in a long-term daily practice cohort of adult patients with atopic dermatitis

    NARCIS (Netherlands)

    Schaft, J. van der; Politiek, K.; Reek, J.M.P.A. van den; Christoffers, W.A.; Kievit, W.; Jong, E.M.G.J. de; Bruijnzeel-Koomen, C.A.; Schuttelaar, M.L.; Bruin-Weller, M.S. de

    2015-01-01

    BACKGROUND: Long-term data of ciclosporin A (CsA) treatment in daily practice in patients with severe atopic dermatitis (AD) are lacking. OBJECTIVES: To perform a detailed analysis of drug survival, which is the length of time a patient continues to take a drug, for CsA in a long-term daily practice

  13. Drug survival for ciclosporin A in a long-term daily practice cohort of adult patients with atopic dermatitis

    NARCIS (Netherlands)

    van der Schaft, J; Politiek, K; van den Reek, J M P A; Christoffers, W A; Kievit, W; de Jong, E M G J; Bruijnzeel-Koomen, C A F M; Schuttelaar, M L A; de Bruin-Weller, M S

    BACKGROUND: Long-term data of ciclosporin A (CsA) treatment in daily practice in patients with severe atopic dermatitis (AD) are lacking. OBJECTIVES: To perform a detailed analysis of drug survival, which is the length of time a patient continues to take a drug, for CsA in a long-term daily practice

  14. Profound and sustained reduction in Chlamydia trachomatis in The Gambia: a five-year longitudinal study of trachoma endemic communities.

    Directory of Open Access Journals (Sweden)

    Matthew J Burton

    2010-10-01

    Full Text Available The elimination of blinding trachoma focuses on controlling Chlamydia trachomatis infection through mass antibiotic treatment and measures to limit transmission. As the prevalence of disease declines, uncertainty increases over the most effective strategy for treatment. There are little long-term data on the effect of treatment on infection, especially in low prevalence settings, on which to base guidelines.The population of a cluster of 14 Gambian villages with endemic trachoma was examined on seven occasions over five years (baseline, 2, 6, 12, 17, 30 and 60 months. Mass antibiotic treatment was given at baseline only. All families had accessible clean water all year round. New latrines were installed in each household after 17 months. Conjunctival swab samples were collected and tested for C. trachomatis by PCR. Before treatment the village-level prevalence of follicular trachoma in 1 to 9 year olds (TF(%1-9 was 15.4% and C. trachomatis was 9.7%. Antibiotic treatment coverage was 83% of the population. In 12 villages all baseline infection cleared and few sporadic cases were detected during the following five years. In the other two villages treatment was followed by increased infection at two months, which was associated with extensive contact with other untreated communities. The prevalence of infection subsequently dropped to 0% in these 2 villages and 0.6% for the whole population by the end of the study in the absence of any further antibiotic treatment. However, several villages had a TF(%1-9 of >10%, the threshold for initiating or continuing mass antibiotic treatment, in the absence of any detectable C. trachomatis.A single round of mass antibiotic treatment may be sufficient in low prevalence settings to control C. trachomatis infection when combined with environmental conditions, which suppress transmission, such as a good water supply and sanitation.

  15. Molecular profiling of short-term and long-term surviving patients identifies CD34 mRNA level as prognostic for glioblastoma survival

    DEFF Research Database (Denmark)

    Michaelsen, Signe Regner; Urup, Thomas; Olsen, Lars Rønn

    2018-01-01

    . Accordingly, study aim was to identify independent prognostic biomarkers for survival. Study cohort consisted of 93 primary GBM patients treated with radiation-, chemo- and bevacizumab therapy, among which 14 STS (OS ≤ 12 months) and 6 LTS (OS ≥ 36 months) were identified, all confirmed being IDH wild...

  16. Functional Gain After Inpatient Stroke Rehabilitation: Correlates and Impact on Long-Term Survival.

    Science.gov (United States)

    Scrutinio, Domenico; Monitillo, Vincenzo; Guida, Pietro; Nardulli, Roberto; Multari, Vincenzo; Monitillo, Francesco; Calabrese, Gianluigi; Fiore, Pietro

    2015-10-01

    Prediction of functional outcome after stroke rehabilitation (SR) is a growing field of interest. The association between SR and survival still remains elusive. We sought to investigate the factors associated with functional outcome after SR and whether the magnitude of functional improvement achieved with rehabilitation is associated with long-term mortality risk. The study population consisted of 722 patients admitted for SR within 90 days of stroke onset, with an admission functional independence measure (FIM) score of stroke onset to rehabilitation admission (PStroke Scale score at rehabilitation admission (P<0.001), and aphasia (P=0.021) were independently associated with FIM gain. The R2 of the model was 0.275. During a median follow-up of 6.17 years, 36.9% of the patients died. At multivariable Cox analysis, age (P<0.0001), coronary heart disease (P=0.018), atrial fibrillation (P=0.042), total cholesterol (P=0.015), and total FIM gain (P<0.0001) were independently associated with mortality. The adjusted hazard ratio for death significantly decreased across tertiles of increasing FIM gain. Several factors are independently associated with functional gain after SR. Our findings strongly suggest that the magnitude of functional improvement is a powerful predictor of long-term mortality in patients admitted for SR. © 2015 American Heart Association, Inc.

  17. Predicting long-term risk for relationship dissolution using nonparametric conditional survival trees.

    Science.gov (United States)

    Kliem, Sören; Weusthoff, Sarah; Hahlweg, Kurt; Baucom, Katherine J W; Baucom, Brian R

    2015-12-01

    Identifying risk factors for divorce or separation is an important step in the prevention of negative individual outcomes and societal costs associated with relationship dissolution. Programs that aim to prevent relationship distress and dissolution typically focus on changing processes that occur during couple conflict, although the predictive ability of conflict-specific variables has not been examined in the context of other factors related to relationship dissolution. The authors examine whether emotional responding and communication during couple conflict predict relationship dissolution after controlling for overall relationship quality and individual well-being. Using nonparametric conditional survival trees, the study at hand simultaneously examined the predictive abilities of physiological (systolic and diastolic blood pressure, heart rate, cortisol) and behavioral (fundamental frequency; f0) indices of emotional responding, as well as observationally coded positive and negative communication behavior, on long-term relationship stability after controlling for relationship satisfaction and symptoms of depression. One hundred thirty-six spouses were assessed after participating in a randomized clinical trial of a relationship distress prevention program as well as 11 years thereafter; 32.5% of the couples' relationships had dissolved by follow up. For men, the only significant predictor of relationship dissolution was cortisol change score (p = .012). For women, only f0 range was a significant predictor of relationship dissolution (p = .034). These findings highlight the importance of emotional responding during couple conflict for long-term relationship stability. (c) 2015 APA, all rights reserved).

  18. Five-year response to growth hormone in children with Noonan syndrome and growth hormone deficiency.

    Science.gov (United States)

    Zavras, Niki; Meazza, Cristina; Pilotta, Alba; Gertosio, Chiara; Pagani, Sara; Tinelli, Carmine; Bozzola, Mauro

    2015-10-06

    Noonan syndrome (NS) is an autosomal dominant disorder characterized by specific features including short stature, distinctive facial dysmorphic features, congenital heart defects, hypertrophic cardiomyopathy, skeletal anomalies and webbing of the neck. Molecular screening has shown that the majority of individuals with NS have a mutation in the PTPN11 gene. Noonan syndrome children may show an impaired growth hormone (GH)/insulin-like growth factor axis. Moreover, recombinant human GH (rhGH) has been shown to improve growth rate in patients with NS, although data are still limited. In the present study, we assessed growth response following GH therapy (0.25 mg/Kg/week) in 5 (2 M and 3 F) GH-deficient NS patients (NSGHD, mean age 8.5 years) and in 5 (2 M and 3 F) idiopathic GH deficient (IGHD, mean age 8.6 years) patients. We also evaluated the safety of rhGH therapy in NS patients with GHD. At the beginning of GH treatment, height and growth rate were statistically lower in NSGHD children than in IGHD ones. During the first three years of rhGH therapy, NSGHD patients showed a slight improvement in height (from -2.71 SDS to -2.44 SDS) and growth rate (from -2.42 SDS to -0.23 SDS), although the values were always significantly lower than in IGHD children. After five years of rhGH treatment, height gain was higher in IGHD children (mean 28.3 cm) than in NSGHD patients (mean 23.6 cm). During the first five years of rhGH therapy, regular cardiological and haematological check-ups were performed, leading to the conclusion that rhGH therapy was safe. In conclusion, pre-pubertal NS children with GHD slightly increased their height and growth rate during the first years of GH therapy, although the response to rhGH treatment was significantly lower than IGHD children. Furthermore, the therapy appeared to be safe since no severe adverse effects were reported, at least during the first five years. However, a close follow-up of these patients is mandatory, especially to

  19. Molecular characteristics of erythromycin-resistant Streptococcus pneumoniae from pediatric patients younger than five years in Beijing, 2010

    Science.gov (United States)

    2012-01-01

    Background Streptococcus pneumoniae is the main pathogen that causes respiratory infections in children younger than five years. The increasing incidence of macrolide- and tetracycline-resistant pneumococci among children has been a serious problem in China for many years. The molecular characteristics of erythromycin-resistant pneumococcal isolates that were collected from pediatric patients younger than five years in Beijing in 2010 were analyzed in this study. Results A total of 140 pneumococcal isolates were collected. The resistance rates of all isolates to erythromycin and tetracycline were 96.4% and 79.3%, respectively. Of the 135 erythromycin-resistant pneumococci, 91.1% were non-susceptible to tetracycline. In addition, 30.4% of the erythromycin-resistant isolates expressed both the ermB and mef genes, whereas 69.6% expressed the ermB gene but not the mef gene. Up to 98.5% of the resistant isolates exhibited the cMLSB phenotype, and Tn6002 was the most common transposon present in approximately 56.3% of the resistant isolates, followed by Tn2010, with a proportion of 28.9%. The dominant sequence types (STs) in all erythromycin-resistant S. pneumoniae were ST271 (11.9%), ST81 (8.9%), ST876 (8.9%), and ST320 (6.7%), whereas the prevailing serotypes were 19F (19.3%), 23F (9.6%), 14 (9.6%), 15 (8.9%), and 6A (7.4%). The 7-valent pneumococcal conjugate vaccine (PCV7) and 13-valent pneumococcal conjugate vaccine (PCV13) coverage of the erythromycin-resistant pneumococci among the children younger than five years were 45.2% and 62.2%, respectively. ST320 and serotype 19A pneumococci were common in children aged 0 to 2 years. CC271 was the most frequent clonal complex (CC), which accounts for 24.4% of all erythromycin-resistant isolates. Conclusions The non-invasive S. pneumoniae in children younger than five years in Beijing presented high and significant resistance rates to erythromycin and tetracycline. The expressions of ermB and tetM genes were the main

  20. Diarrhoea in children under five years of age in South Africa (1997-2014).

    Science.gov (United States)

    Awotiwon, Oluwatoyin F; Pillay-van Wyk, Victoria; Dhansay, Ali; Day, Candy; Bradshaw, Debbie

    2016-09-01

    To present evidence from available reliable published data on the prevalence, incidence and severity of diarrhoea in children aged under five years in South Africa. We searched seven electronic databases. Two reviewers assessed the studies independently and extracted outcome data. The heterogeneity of the studies did not allow for a meta-analysis. We found only one nationally representative study conducted in 1998 reporting a diarrhoea prevalence of 13% in children under five. Other studies were conducted in smaller settings across the country. Diarrhoea incidence was 10.13 per 1000 person years in children admitted to a tertiary hospital. Three studies reported severity of diarrhoea; however, they differed across study settings and time period. The paucity of nationally representative prevalence data for SA necessitates more national surveys with standardised data-collection methods to allow for more effective comparisons. © 2016 John Wiley & Sons Ltd.

  1. A longitudinal dataset of five years of public activity in the Scratch online community.

    Science.gov (United States)

    Hill, Benjamin Mako; Monroy-Hernández, Andrés

    2017-01-31

    Scratch is a programming environment and an online community where young people can create, share, learn, and communicate. In collaboration with the Scratch Team at MIT, we created a longitudinal dataset of public activity in the Scratch online community during its first five years (2007-2012). The dataset comprises 32 tables with information on more than 1 million Scratch users, nearly 2 million Scratch projects, more than 10 million comments, more than 30 million visits to Scratch projects, and more. To help researchers understand this dataset, and to establish the validity of the data, we also include the source code of every version of the software that operated the website, as well as the software used to generate this dataset. We believe this is the largest and most comprehensive downloadable dataset of youth programming artifacts and communication.

  2. Anticipatory guidance for cognitive and social-emotional development: Birth to five years

    Science.gov (United States)

    Dosman, Cara; Andrews, Debbi

    2012-01-01

    The present article serves as a quick office reference for clinicians, providing anticipatory guidance about the cognitive and social-emotional development of newborns, and children up to five years of age. The present review links recommendations to specific evidence in the medical literature, citing sources of developmental standards and advice, so that these may be further explored if desired. Practising primary care providers have indicated that these are areas of child development that are not well addressed by training and other available resources. The present article includes parenting information on important clinical presentations with which clinicians may be less familiar, such as promoting attachment, prosocial behaviours, healthy sleep habits, self-discipline and problem-solving; as well as on managing behaviours that are part of normal development, such as separation anxiety, tantrums, aggression, picky eating and specific fears. Information on the development of language, literacy and socialization are also included. PMID:23372397

  3. 2015 Five-Yearly Review : one last formal step, with the implementation to follow

    CERN Multimedia

    Staff Association

    2015-01-01

    Taking into account the arbitration by the Director General the Staff Council decided that it did not oppose the Management proposals for the 2015 Five-Yearly Review (see Echo 234). Consequently, at the TREF meeting of Thursday 26 November, Management presented its consolidated proposals taking into account the outcome of the arbitration. The Staff Association was invited to express its point of view (the text of our declaration follows). After the Member States’ delegates got satisfactory answers to their questions for clarification, none of the 14 delegations represented opposed the proposals nor were there any abstentions. The Chair of TREF, B. Dormy, will thus report to Finance Committee and Council on 16 and 17 December that TREF recommends that these committees approve the Management proposals. A huge amount of work by many CERN colleagues, representatives of the Management, the Sectors, and the Staff Association has come to a successful conclusion. Now we move into the important implementati...

  4. Corrosion study of steels exposed over five years to the humid tropical atmosphere of Panama

    Science.gov (United States)

    Jaén, Juan A.; Iglesias, Josefina

    2017-11-01

    The results of assessing five-year corrosion of low-carbon and conventional weathering steels exposed to the Panamanian tropical atmosphere is presented. Two different test sites, one in Panama City: 5 km from the shoreline of the Pacific Ocean, and another in the marine environment of Fort Sherman, Caribbean coast of Panama; namely, Fort Sherman Coastal site: 100 m from coastline. The corrosion products, formed in the skyward and earthward faces in the studied tropical environment, were mainly identified using room temperature and low temperature (15 K) Mössbauer spectroscopy, and ATR-FTIR. In all samples, lepidocrocite ( γ-FeOOH) and goethite ( α-FeOOH) were the main constituents. Some maghemite ( γ-Fe2 O 3), was also identified in Tocumen by Mössbauer spectroscopy and traces of feroxyhyte ( δ-FeOOH) using ATR-FTIR. The corrosion rate values obtained are discussed in light of the atmospheric exposure conditions and atmospheric pollutants.

  5. Sentinel node biopsy in breast cancer: five years experience from Denmark

    DEFF Research Database (Denmark)

    Christiansen, Peter; Balslev, E.; Jensen, D.

    2008-01-01

    INTRODUCTION: Danish experience from the first five years with sentinel lymph node biopsy (SLNB) as a routine staging procedure in early breast cancer is reported. METHODS: During the period January 1, 2002 to December 31, 2006, 14 923 patients were diagnosed at Danish breast surgical centers...... certified for the sentinel node method. SLNB was performed in 8 338 patients (55.9%). The fraction increased steadily from 43% in 2002 to 67% in 2006. The median follow-up was 1.7 year (range 0-5.2 years). RESULTS: Patients staged with SLNB were younger, had more often BCS, had smaller tumor size, were more...... classification by SN was known. In the group of 1 563 patients with macrometastases in SN, 45% had non-sentinel node metastases, and in the group of 942 patients with micrometastases only, 23% had more positive nodes. Regional lymph node metastases were found in 15% with ITC in sentinel nodes. Lymph node...

  6. Primary and repeated stapled hemorrhoidopexy for prolapsing hemorrhoids: Follow-up to five years

    DEFF Research Database (Denmark)

    Raahave, D.; Pedersen, I.K.; Jepsen, Lars Vedel

    2008-01-01

    , immediately after the procedure, at three months, and at one to five years postoperatively. The anatomy score ranged from 1 (normal anus) to 7 (worst prolapse). We also evaluated operation time, analgesia, staple line position, postoperative pain score, technical failures, postoperative complications, need...... of 258 patients (7 percent). The median anatomy score decreased from 6 (range, 3-7) preoperatively to 1 (range, 1-6) at last follow-up, irrespective of one or a repeated stapled hemorrhoidopexy, surgical excision, or technical failure. The risk of reintervention was greatest during the first year after...... a stapled hemorrhoidopexy. Overall, patient satisfaction was high and correlated significantly with the anatomy score (r = 0.46, P

  7. Five-year prevalence of recurrent shoulder dislocation in the entire Polish population.

    Science.gov (United States)

    Szyluk, Karol; Jasiński, Andrzej; Niemiec, Pawel; Mielnik, Michal; Koczy, Bogdan

    2018-02-01

    The aim of this study was to evaluate five-year prevalence of recurrent shoulder dislocation in the entire Polish population. The study involved the entire Polish population between 01 January 2010 and 31 December 2014. Demographic data were retrieved from the Central Statistical Office of Poland. Data on the number of shoulder joint dislocations were retrieved from the database of the National Health Fund. We identified 32,253 Polish residents with shoulder instability. About 0.1% of Polish residents suffered from recurrent shoulder dislocation. Males suffered almost two times more often than females (66% and 34%, respectively), and male gender was recognized as a risk factor of instability (OR = 2.07, p Polish population is 0.1%. Males suffered from recurrent shoulder dislocation almost twice as frequently as females (OR = 2.07).

  8. A five-year survey of onychomycosis in New Delhi, India: Epidemiological and laboratory aspects

    Directory of Open Access Journals (Sweden)

    Kaur Ravinder

    2007-01-01

    Full Text Available Context: The worldwide incidence of onychomycosis is increasing and it continues to spread and persist. Knowledge of the epidemiological and mycological characteristics is an important tool for control of this infection. Aims: This study seeks to improve knowledge of onychomycosis epidemiology and mycological features. Settings and Design: Over a period of five years (Jan 2000 - Dec 2005 samples from 400 patients with clinical suspected fungal nail infections, who attended dermatology out patient department at a tertiary care hospital, were obtained. Materials and Methods: 400 nail specimens of suspected onychomycosis were evaluated clinically, KOH examination and fungal culture was done. Results: Onychomycosis was present in 218 (54.5% by culture and /or direct examination. Fingernails and toenails were infected in 65% and 32% respectively and remaining 3% had both. Conclusions: This study demonstrated that dermatophytes were main agents causing onychomycosis in our region, as well as the importance of performing direct examination and culture in diagnosis of onychomycosis.

  9. Five years on the bumpy road delivering well chemicals for zero harmful discharge

    Energy Technology Data Exchange (ETDEWEB)

    Selle, Olav M.; Paltiel, Sten; Saeten, Jens O.; Nasvik, Haavard

    2006-03-15

    This is a summary of five years development work to qualify environmentally acceptable well chemicals for Heidrun. We will describe the situation as we started the work, what strategy we followed and the ups and downs we experienced as we went along. The focus is on scale inhibitors, scale dissolvers, acid formulations, viscosified fluids and chemicals for zonal isolation/shut-off purposes. The challenge has been to develop biodegradable and low toxic chemicals with equal or better effectiveness and with a reasonable prize compare to {sup b}est in class{sup -}products. The impact this has provided for zero harmful discharge to sea at Haltenbanken will be presented, to show the status as we are entering into year 2005. (Author)

  10. Development of a five-year mortality model in systemic sclerosis patients by different analytical approaches.

    NARCIS (Netherlands)

    Beretta, L.; Santaniello, A.; Cappiello, F.; Chawla, N.V.; Vonk, M.C.; Carreira, P.E.; Allanore, Y.; Popa-Diaconu, D.A.; Cossu, M.; Bertolotti, F.; Ferraccioli, G.; Mazzone, A.; Scorza, R.

    2010-01-01

    OBJECTIVES: Systemic sclerosis (SSc) is a multiorgan disease with high mortality rates. Several clinical features have been associated with poor survival in different populations of SSc patients, but no clear and reproducible prognostic model to assess individual survival prediction in scleroderma

  11. Five-year results of a ponderosa pine provenance study in the Black Hills

    Science.gov (United States)

    James L. Van Deusen

    1974-01-01

    Survival and height growth data were collected after five field growing seasons from ponderosa pine progeny representing 75 provenances of natural stands in the Great Plains and Northern Rockies. Results showed that trees from no other provenance survived significantly better or grew significantly taller than trees from the Black Hills. Trees from southern Colorado,...

  12. Epidemiological study of under nutrition among under five years children in an urban slum

    Directory of Open Access Journals (Sweden)

    Anjali B Dhone

    2012-01-01

    Full Text Available Background: Child undernutrition is internationally recognized as an important public health indicator for monitoring nutritional status and health in populations. Prevalence of under nutrition is very high in India; especially in urban slums. Objective: To estimate the prevalence and factors affecting undernutrition among under five years children using WHO growth standards. Materials and Methods: Community-based cross sectional study was done during November-2008 to December-2009 in urban field practice area of Medical College Pune, India. All the under five years children (336 were enumerated by house-to-house survey. Parents were informed about the objectives of the study and their written consent was obtained. Anthropometric measurements of the children who were available during the study period were carried out as per WHO guidelines. Various indices of nutritional status were expressed in standard deviation units (z scores from the reference median. The children were examined for nutritional deficiencies and other morbidities. Epi-Info 2002 and Primer of Bio-statistics software package was used for statistical analysis. Results: Total 336 children were enumerated by house-to-house visit. Only 319 children were available during the study, out of which 208 (65.2% were undernourished. Undernutrition was significantly (P < 0.001 higher among boys than among girls. It was maximum in 49-60 months age group. The higher the level of the mother′s education, the lower was the level of child weight for age (P = 0.003. The overall prevalence of morbidities was 43.4%. Conclusion: Malnutrition continues to be a public health problem in children particularly in marginalized groups.

  13. FAMILY’S ECONOMIC LEVEL AND CULTURE CORRELATE WITH NUTRITIONAL STATUS OF CHILDREN UNDER FIVE YEARS

    Directory of Open Access Journals (Sweden)

    Abdul Muhith

    2017-01-01

    Full Text Available Introduction: Nutrition is an important thing for human life. Variety in family’s economic level and culture have effect on family’s eating habit. Family with higher economic status have big opportunity to met under fi ve year’s nutrition. Cultural diversity on each family has an impact on the difference of raw food selection, processing methods, and presentation of food. The purpose of this study was to determine the correlation between family’s economic level and culture with nutritional status of children under fi ve year. Method: Research design was observational analytic with cross sectional approach. The population were mother and their children under fi ve years at Desa Jatigono Kunir, Kabupaten Lumajang. Sampel were 184 respondents, taken by using cluster sampling. Independent variables were family’s economic level and culture. Dependent variable was nutritional status of children under fi ve years. Data were collected by using questionnaire and observational sheet. Then, data were analyzed by using Spearman Rho Test with α<0.05. Result: The results showed that 140 (76.1% respondents have low economic level, 105 (57.1% respondents have negative culture in children’s nutrition, and 89 (48% respondents have good nutritional status. The result of Spearman-rho test showed that family’s economic level (p=0.000 and culture (0.019 have correlated with nutritional status of children under five years. Discussion: It can be concluded that family’s economic level and culture have correlated with nutritional status of children under fi ve years. Nurses should develop health education and counseling to improve family’s knowledge about nutrition, so children will have good nutritional status. Keywords: economic level, family’s culture, nutritional status, children under five years

  14. Five-year follow-up of cognitive impairment in older adults with bipolar disorder.

    Science.gov (United States)

    Schouws, Sigfried N T M; Comijs, Hannie C; Dols, Annemieke; Beekman, Aartjan T F; Stek, Max L

    2016-03-01

    To date, cognitive impairment has been thought to be an integral part of bipolar disorder. In clinical staging models, cognitive impairment is one of the hallmarks to define the clinical stage and it plays an important role in identifying the risk factors for progression to later stages of the illness. It is important to examine neurocognitive performance over longer periods to test the hypothesis of neuroprogression of bipolar disorder. A comprehensive neuropsychological test battery was applied at baseline and five years later to 56 euthymic older outpatients with bipolar disorder (mean age = 68.35 years, range: 60-90 years) and to a demographically matched sample of 44 healthy subjects. A group-by-time repeated measures multivariate analysis of variance was performed to measure changes over time for the two groups. The impact of baseline illness characteristics on the intra-individual change in neurocognitive performance within the bipolar disorder group was studied by using logistic regression analysis. At baseline and at follow-up, patients with bipolar disorder performed worse on all neurocognitive measures compared to the matched healthy subjects. However, there was no significant group-by-time interaction between the patients with bipolar disorder and the comparison group. Although older patients with bipolar disorder had worse cognitive function than healthy subjects, they did not have greater cognitive decline over a five-year period. The change in acquired cognitive impairment of patients with bipolar disorder might parallel the cognitive development as seen in normal aging. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Anxiety Levels among Five-Year-Old Children Undergoing ART Restoration- A Cross-Sectional Study.

    Science.gov (United States)

    Ishan; Shivlingesh, K K; Agarwal, Vartika; Gupta, Bhuvan Deep; Anand, Richa; Sharma, Abhinav; Kushwaha, Sumedha; Khan, Khateeb

    2017-04-01

    Atraumatic Restorative Treatment (ART) involves manually excavating the carious part of the tooth and restoring the prepared cavity with chemically adhesive restorative material [Glass Ionomer Cement (GIC)] and it may induce and/or impact the dental anxiety in children. It is well established that ART procedure is less anxiety producing when compared with other restorative procedures using dental drill. The aim of this study was to evaluate the anxiety levels among five-year-old children undergoing ART restoration in I.T.S. Dental College, Greater Noida, India. A sample of 50, five-year-old children visiting the Outpatient Department (OPD) of ITS Dental College, Greater Noida was selected for ART treatment using Fuji IX GIC. Modified Venham Anxiety Scale based on their behaviour and heart rate of the children were measured and recorded before, during and after the ART procedure. Heart rate was measured using Radial Pulse examination method. Chi-square test was used and tests were conducted using IBM SPSS software (ver.20.0; IBM, Chicago, IL, USA). Before the ART treatment, heart rates and Modified Venham Anxiety Scores of majority of children were higher than that after the treatment. A p-value was statistically significant (0.028 and 0.048 respectively) for association of gender with heart rate and Modified Venham's score before the ART treatment. No statistically significant relation was found between the variables during and after the ART treatment. The level of anxiety for ART treatment in children was higher before the treatment than that during and after the treatment. There is a correlation between the gender of children and their level of anxiety for ART treatment.

  16. Practice-based clinical evaluation of ceramic single crowns after at least five years.

    Science.gov (United States)

    Dhima, Matilda; Paulusova, Vladimira; Carr, Alan B; Rieck, Kevin L; Lohse, Christine; Salinas, Thomas J

    2014-02-01

    Long-term practice-based clinical evaluations of various contemporary ceramic crown restorations from multiple practitioners are limited. The aims of this study were to evaluate the clinical performance of ceramic single crowns and to identify factors that influence their clinical performance. Ceramic single crowns that had been placed at the Mayo Clinic and in function since 2005 were identified and included in the study. The restorations were examined clinically, radiographically, and with photographs. Modified United States Public Health Services criteria were used for the clinical evaluation. The ceramic systems evaluated were bilayer and monolayer. Fifty-nine patients (41 women, 18 men) with 226 single teeth and implants restored with single ceramic crowns were identified. The mean duration from insertion date to study examination date was 6.1 years. Thirteen restorations (6%) were replaced at a mean 3.3 years after insertion date (range, 0.1-6.1 years). Estimated replacement-free survival rates (95% confidence interval [CI]; number of teeth/implants still at risk) at 5 years after insertion date were 95.1% (95% CI, 92.2-98.1; 153) and at 10 years were 92.8% (95% CI, 89.1-96.8; 8). The most common reason for replacement was fracture to the core of posterior layered ceramic crowns. The most commonly used luting agent was resin-modified ionomer cement. Most restorations exhibited clinically acceptable marginal integrity, shade, no caries recurrence, and no periapical pathology. The clinical performance of ceramic single crowns at 5 and 10 years supports their application in all areas of the mouth. With the majority of fractures to the core occurring early in the lifetime of layered ceramic posterior crowns, consideration of other monolithic ceramic systems for posterior crowns is advised. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

  17. Perioperative Mortality and Long-Term Survival in 80 Dogs and 32 Cats Undergoing Excision of Thymic Epithelial Tumors.

    Science.gov (United States)

    Garneau, Mark S; Price, Lori Lyn; Withrow, Stephen J; Boston, Sarah E; Ewing, Patty J; McClaran, Janet Kovak; Liptak, Julius M; Berg, John

    2015-07-01

    To examine perioperative mortality, long-term survival, causes of death, and prognostic factors for dogs and cats undergoing surgical excision of thymic epithelial tumors (TETs). Multi-institutional case series. Eighty dogs and 32 cats. Follow-up information was obtained for dogs and cats that underwent surgical excision of a TET between 2001 and 2012. Perioperative mortality was 20% in dogs and 22% in cats. No independent risk factors for perioperative mortality were identified. The estimated median survival time for all dogs was 1.69 years (95% CI 0.56-4.32) and the 1- and 4-year survival rates were 55% (95% CI 44-67) and 44% (95% CI 32-56). The estimated median survival time for all cats was 3.71 years (95% CI 0.56-unestimatable) and the 1- and 4-year survival rates were 70% (95% CI 53-87) and 47% (95% CI 0-100). Of animals that survived to discharge, 42% of dogs and 20% of cats eventually died of TET-related causes. The presence of paraneoplastic syndromes (hazard ratio [HR] 5.78, 95% CI 1.64-20.45, P = .007) or incomplete histologic margins (HR 6.09, 95% CI 1.50-24.72, P = .01) were independently associated with decreased survival in dogs. No significant predictors of survival were identified in cats. Conclusions regarding the effect of chemotherapy or radiation therapy could not be made. While there is substantial risk of perioperative death in dogs and cats undergoing surgery for TETs, many animals that survive to discharge have prolonged survival. Survival is significantly decreased in dogs with paraneoplastic syndromes or incomplete histologic margins. © Copyright 2014 by The American College of Veterinary Surgeons.

  18. Long-term survival of Escherichia coli O157:H7 and Salmonella enterica on butterhead lettuce seeds, and their subsequent survival and growth on the seedlings.

    Science.gov (United States)

    Van der Linden, Inge; Cottyn, Bart; Uyttendaele, Mieke; Vlaemynck, Geertrui; Maes, Martine; Heyndrickx, Marc

    2013-02-15

    The long-term survival of enteric pathogens on butterhead lettuce seeds, and their subsequent survival and growth on seedlings were investigated. Lettuce seeds were inoculated at a high level with two Salmonella enterica and two Escherichia coli O157:H7 strains each (±8 log₁₀ CFU/g seed) and the survival of the pathogens was monitored over two years using standard plating techniques on selective medium. The Salmonella strains (serovars Typhimurium and Thompson) survived significantly better on the seeds than the E. coli O157:H7 strains (MB3885 and NCTC12900). When individual seeds were tested two years after inoculation, Salmonella was recovered from each individual seed, whereas E. coli O157:H7 only from 4% to 14% of the seeds, depending on the recovery method. When contaminated stored seeds were germinated and the seedlings examined for presence of the pathogens, it was clear that both pathogens were able to proliferate on the seedlings. Pathogen counts up to 5.92 log₁₀ CFU and 4.41 log₁₀ CFU per positive seedling were observed for Salmonella and E. coli O157:H7, respectively. Our study not only confirms the long-term survival of enteric pathogens on seeds but also shows that the pathogens maintain their ability to resuscitate and proliferate on the seedlings. Seeds or seedlings should be considered as contamination sources for the cultivation of leafy vegetables such as butterhead lettuce grown in greenhouses. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Riluzole and Prognostic Factors in Amyotrophic Lateral Sclerosis Long-term and Short-term Survival: A Population-Based Study of 1149 Cases in Taiwan

    Science.gov (United States)

    Lee, Charles Tzu-Chi; Chiu, Yi-Wen; Wang, Kai-Chen; Hwang, Chi-Shin; Lin, Kuan-Hsiang; Lee, I-Ta; Tsai, Ching-Piao

    2013-01-01

    Background Amyotrophic lateral sclerosis (ALS) is a rare disease in Taiwan; thus, estimation of ALS mortality is difficult. We evaluated factors associated with ALS survival in Taiwan. Methods The study enrolled 1149 Taiwanese with a primary diagnosis of ALS during 1999–2008. Follow-up information was available for all patients; mean (SD) duration of follow-up was 2.91 (2.62) years. Medical interventions, including noninvasive positive pressure ventilation (NIPPV), tracheotomy, gastrostomy, and riluzole, were included in time-dependent survival analysis. Results Of the 1149 ALS patients, 438 (38.12%) died during follow-up. Mortality in the first year was 16%, which was 13 times (95% CI 11.1–15.2) the age- and sex-standardized rate of the general population in Taiwan. The average annual crude mortality rate was 13.1% (person-years). Factors significantly associated with increased mortality were male sex, advanced age, rural residence, lower economic status, no tracheotomy, and no riluzole treatment. Significant predictors of long-term versus average survival were younger age at diagnosis, being a dependent or receiving social welfare, and NIPPV support. Significant predictors of short-term versus average survival were older age, being employed, no tracheotomy, and no riluzole use. Conclusions The results support the use of riluzole to improve ALS survival. Patients who received riluzole and underwent tracheotomy had the best survival. PMID:23117224

  20. The impact of vegan diet on B-12 status in healthy omnivores: five-year prospective study.

    Science.gov (United States)

    Mądry, Edyta; Lisowska, Aleksandra; Grebowiec, Philip; Walkowiak, Jarosław

    2012-04-02

    There are no long-term prospective studies assessing the impact of the vegan diet on vitamin B-12 (B-12) status. Many vegans take B-12 supplements irregularly or refuse to adopt them at all, considering them to be "unnatural" products. The use of B-12 fortified food may be an alternative. Therefore, we aimed to estimate the long-term effect of a vegan diet on serum B-12 concentrations in healthy omnivore adults, comparing the influence of natural products consumption and B-12 fortified food. A five year prospective study was carried out comprising 20 omnivore healthy adult subjects, who moved to strict vegan diet for 5 years. Ten volunteers followed vegan diet based entirely on natural products, while the remaining ten subjects consumed food fortified in B-12. In all subjects serum vitamin B-12 concentration was determined before and 6, 12, 24 and 60 months after the implementation of the diet. A significant decrease (p vegan diet. However, observed changes were in fact limited to the subgroup consuming exclusively natural products (p vegan diet is associated with the risk of vitamin B-12 deficiency. B-12 fortified products might constitute a valuable alternative in vegans refusing to take vitamin supplements.

  1. Long-term survival in a dog with meningoencephalitis and epidural abscessation due to Actinomyces species.

    Science.gov (United States)

    Song, Rachel B; Vitullo, Carina A; da Costa, Ronaldo C; Daniels, Joshua B

    2015-07-01

    A 2-year-old, female spayed Golden Retriever dog was presented to The Ohio State University Veterinary Medical Center for evaluation of ataxia, cervical pain, 1 episode of acute collapse, dull mentation, and inappetence. Physical examination revealed an elevated temperature of 39.7°C and severe cervical pain. Blood work revealed a mature neutrophilia. Cerebrospinal fluid (CSF) analysis revealed nondegenerative neutrophilic pleocytosis with no infectious agents. A presumptive diagnosis of steroid-responsive meningitis-arteritis was made, and corticosteroid therapy was started. The patient improved initially but experienced a vestibular episode characterized by falling and vertical nystagmus. A magnetic resonance imaging of the brain revealed an epidural abscess in the cervical vertebral canal and diffuse meningeal enhancement in the brain and cranial cervical spine. Abscess drainage revealed degenerate neutrophils and several filamentous, branching organisms. Culture of the initial CSF using an enrichment broth revealed growth of a Gram-positive organism 5 days after fluid collection. The isolate was identified by partial 16S ribosomal DNA sequencing as Actinomyces spp. The patient was successfully treated with long-term antibiotics. Our study reports the long-term survival after medical treatment of bacterial meningoencephalitis and epidural abscessation due to Actinomyces sp. infection in a dog. Bacterial meningoencephalitis should be included as a differential diagnosis in patients with cervical pain and fever, even when a nondegenerative neutrophilic pleocytosis is found on CSF analysis. Culture of the CSF with use of an enrichment broth should be considered in all cases of neutrophilic pleocytosis to rule out infections of the central nervous system. © 2015 The Author(s).

  2. Single sternal metastasis due to malignant melanoma with unexpected long-term survival: a case report

    Directory of Open Access Journals (Sweden)

    Gogakos AS

    2016-01-01

    Full Text Available Apostolos S Gogakos,1 Dimitrios Paliouras,1 Christos Asteriou,1 Thomas Rallis,1 Achilleas Lazopoulos,1 Fotios Chatzinikolaou,2 Athanassios Zissimopoulos,3 Drosos Tsavlis,4 Katerina Tsirgogianni,4 Konstantinos Zarogoulidis,4 Konstantinos Porpodis,4 Kosmas Tsakiridis,5 Georgia Pitsiou,4 Ioannis Kioumis,4 Ilias Karapantzos,6 Chrysanthi Karapantzou,6 Nikos Sachpekidis,5 Paul Zarogoulidis,4 Nikolaos Barbetakis1 1Thoracic Surgery Department, 2Department of Pathology, Theagenio Cancer Hospital, Thessaloniki, 3Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, 4Pulmonary Department – Oncology Unit, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, 5Cardiothoracic Surgery Department, 6Ear, Nose and Throat Department, “Saint Luke” Private Hospital, Panorama, Thessaloniki, Greece Abstract: Metastases from melanoma have a very poor prognosis for the patient. Single metastatic lesions in the sternum due to melanoma are extremely rare. A rare case of a presternal mass in a 56-year-old patient who had undergone excision for malignant melanoma is presented. Review of the patient’s history and surgical resection of a single metastatic soft tissue lesion offer the best chance of long-term survival. Keywords: melanoma, metastasis, chest wall, sternum

  3. Long-term survival of water-ice observed on comet 67P

    Science.gov (United States)

    Oklay, N.; Mottola, S.; Vincent, J.-B.; Pajola, M.; Fornasier, S.

    2017-09-01

    We announce the first-time detection of water ice features surviving up to two years since their first observation via OSIRIS NAC. Their existence on the nucleus of comet 67P at the arrival of the Rosetta spacecraft suggests that they were exposed to the surface during the comet's previous orbit. Large patches are stable over typical periods of 0.5 year and reduce their size significantly around the comet's perihelion passage, while small exposures disappear. Our thermal analysis shows that the long-term sustainability of water-ice-rich features can be explained by the scarce energy input available at their locations over the first half year. However, the situation reverses for the period lasting several months around perihelion passage. Our two end-member mixing analysis estimates a pure water-ice equivalent thickness up to 15 cm within one isolated patch, and up to 2 m for the one still observable through the end of the mission. Our spectral modelling estimates up to 48% water-ice content for one of the large isolated feature, and up to 25% water ice on the large boulders located within clusters.

  4. Determinants of long-term survival of adult kidney transplants: a 1999 UNOS update.

    Science.gov (United States)

    Gjertson, D W

    1999-01-01

    Half-lives presented in Figure 11 summarize our findings regarding the long-term determinants of adult renal transplantation. The Figure's groups were created by cross-classifying various levels of the more important/interesting determinants identified through the multifactor analysis (Tables 1 & 2). As indicated by the black bar, half of all 16-30 year-old cadaveric kidneys transplanted into Caucasian recipients who survive beyond one year after transplantation will function for 14 years (i.e., the half-life equals 14 years). Unfortunately, in Blacks and Caucasians receiving an older donor kidney, the renal graft half-life falls to 6-8 years. When a Caucasian patient receives a spouse's kidney for transplant, the half-life increases to 17 years; when a Caucasian patient receives a HLA-matched cadaveric kidney, the half-life increases to 19 years; and, when an Asian patient receives a 16-30 year-old cadaveric kidney, the half-life jumps to 22 years. Finally, Caucasian patients receiving a HLA-identical sibling donor transplant enjoyed the greatest half-life of 26 years.

  5. Analysis of the Economic Impact of Cardiovascular Diseases in the Last Five Years in Brazil.

    Science.gov (United States)

    Siqueira, Alessandra de Sá Earp; Siqueira-Filho, Aristarco Gonçalves de; Land, Marcelo Gerardin Poirot

    2017-07-01

    There is growing concern about the economic impact of cardiovascular diseases (CVD) in Brazil and worldwide. To estimate the economic impact of CVD in Brazil in the last five years. The information to estimate CVD costs was taken from national databases, adding the direct costs with hospitalizations, outpatient visits and benefits granted by social security. Indirect costs were added to the calculation, such as loss of income caused by CVD morbidity or mortality. CVD mortality accounts for 28% of all deaths in Brazil in the last five years and for 38% of deaths in the productive age range (18 to 65 years). The estimated costs of CVD were R$ 37.1 billion in 2015, a 17% increase in the period from 2010 to 2015. The estimated costs of premature death due to CVD represent 61% of the total cost of CVD, Direct costs with hospitalizations and consultations were 22%, and costs related to the loss of productivity related to the disease were 15% of the total. Health expenditures in Brazil are estimated at 9.5% of GDP and the average cost of CVD was estimated at 0.7% of GDP. CVD costs have increased significantly in the last five years. It is estimated that CVD costs increase as the Brazilian population ages and the prevalence of CVD increases. Existe uma preocupação crescente com o impacto econômico das doenças cardiovasculares (DCV) no Brasil e no mundo. Estimar o impacto econômico das DCV no Brasil nos últimos cinco anos. As informações para estimar os custos em DCV foram retiradas de bancos de dados nacionais, somando os custos diretos com hospitalizações, atendimentos ambulatoriais e benefícios concedidos pela previdência. Custos indiretos foram acrescidos ao cálculo, como a perda de renda causada pela morbidade ou pela mortalidade da DCV. A mortalidade por DCV representa 28% do total de óbitos ocorridos no Brasil nos últimos cinco anos e atinge 38% dos óbitos na faixa etária produtiva (18 a 65 anos). Os custos estimados por DCV foram de R$ 37,1 bilh

  6. U.S. Department of Energy clean cities five-year strategic plan.

    Energy Technology Data Exchange (ETDEWEB)

    Cambridge Concord Associates

    2011-02-15

    Clean Cities is a government-industry partnership sponsored by the U.S. Department of Energy's (DOE) Vehicle Technologies Program, which is part of the Office of Energy Efficiency and Renewable Energy. Working with its network of about 100 local coalitions and more than 6,500 stakeholders across the country, Clean Cities delivers on its mission to reduce petroleum consumption in on-road transportation. In its work to reduce petroleum use, Clean Cities focuses on a portfolio of technologies that includes electric drive, propane, natural gas, renewable natural gas/biomethane, ethanol/E85, biodiesel/B20 and higher-level blends, fuel economy, and idle reduction. Over the past 17 years, Clean Cities coalitions have displaced more than 2.4 billion gallons of petroleum; they are on track to displace 2.5 billion gallons of gasoline per year by 2020. This Clean Cities Strategic Plan lays out an aggressive five-year agenda to help DOE Clean Cities and its network of coalitions and stakeholders accelerate the deployment of alternative fuel and advanced technology vehicles, while also expanding the supporting infrastructure to reduce petroleum use. Today, Clean Cities has a far larger opportunity to make an impact than at any time in its history because of its unprecedented $300 million allocation for community-based deployment projects from the American Recovery and Reinvestment Act (ARRA) (see box below). Moreover, the Clean Cities annual budget has risen to $25 million for FY2010 and $35 million has been requested for FY2011. Designed as a living document, this strategic plan is grounded in the understanding that priorities will change annually as evolving technical, political, economic, business, and social considerations are woven into project decisions and funding allocations. The plan does not intend to lock Clean Cities into pathways that cannot change. Instead, with technology deployment at its core, the plan serves as a guide for decision-making at both the

  7. Treatment choices for fevers in children under-five years in a rural Ghanaian district

    Directory of Open Access Journals (Sweden)

    Gyapong Margaret

    2010-06-01

    Full Text Available Abstract Background Health care demand studies help to examine the behaviour of individuals and households during illnesses. Few of existing health care demand studies examine the choice of treatment services for childhood illnesses. Besides, in their analyses, many of the existing studies compare alternative treatment options to a single option, usually self-medication. This study aims at examining the factors that influence the choices that caregivers of children under-five years make regarding treatment of fevers due to malaria and pneumonia in a rural setting. The study also examines how the choice of alternative treatment options compare with each other. Methods The study uses data from a 2006 household socio-economic survey and health and demographic surveillance covering caregivers of 529 children under-five years of age in the Dangme West District and applies a multinomial probit technique to model the choice of treatment services for fevers in under-fives in rural Ghana. Four health care options are considered: self-medication, over-the-counter providers, public providers and private providers. Results The findings indicate that longer travel, waiting and treatment times encourage people to use self-medication and over-the-counter providers compared to public and private providers. Caregivers with health insurance coverage also use care from public providers compared to over-the-counter or private providers. Caregivers with higher incomes use public and private providers over self-medication while higher treatment charges and longer times at public facilities encourage caregivers to resort to private providers. Besides, caregivers of female under-fives use self-care while caregivers of male under-fives use public providers instead of self-care, implying gender disparity in the choice of treatment. Conclusions The results of this study imply that efforts at curbing under-five mortality due to malaria and pneumonia need to take into

  8. Five-Year Implementation Plan For Advanced Separations and Waste Forms Capabilities at the Idaho National Laboratory (FY 2011 to FY 2015)

    Energy Technology Data Exchange (ETDEWEB)

    Not Listed

    2011-03-01

    DOE-NE separations research is focused today on developing a science-based understanding that builds on historical research and focuses on combining a fundamental understanding of separations and waste forms processes with small-scale experimentation coupled with modeling and simulation. The result of this approach is the development of a predictive capability that supports evaluation of separations and waste forms technologies. The specific suite of technologies explored will depend on and must be integrated with the fuel development effort, as well as an understanding of potential waste form requirements. This five-year implementation plan lays out the specific near-term tactical investments in people, equipment and facilities, and customer capture efforts that will be required over the next five years to quickly and safely bring on line the capabilities needed to support the science-based goals and objectives of INL’s Advanced Separations and Waste Forms RD&D Capabilities Strategic Plan.

  9. Association Among Blood Transfusion, Sepsis, and Decreased Long-term Survival After Colon Cancer Resection.

    Science.gov (United States)

    Aquina, Christopher T; Blumberg, Neil; Becerra, Adan Z; Boscoe, Francis P; Schymura, Maria J; Noyes, Katia; Monson, John R T; Fleming, Fergal J

    2017-08-01

    To investigate the potential additive effects of blood transfusion and sepsis on colon cancer disease-specific survival, cardiovascular disease-specific survival, and overall survival after colon cancer surgery. Perioperative blood transfusions are associated with infectious complications and increased risk of cancer recurrence through systemic inflammatory effects. Furthermore, recent studies have suggested an association among sepsis, subsequent systemic inflammation, and adverse cardiovascular outcomes. However, no study has investigated the association among transfusion, sepsis, and disease-specific survival in postoperative patients. The New York State Cancer Registry and Statewide Planning and Research Cooperative System were queried for stage I to III colon cancer resections from 2004 to 2011. Propensity-adjusted survival analyses assessed the association of perioperative allogeneic blood transfusion, sepsis, and 5-year colon cancer disease-specific survival, cardiovascular disease-specific survival, and overall survival. Among 24,230 patients, 29% received a transfusion and 4% developed sepsis. After risk adjustment, transfusion and sepsis were associated with worse colon cancer disease-specific survival [(+)transfusion: hazard ratio (HR) 1.19, 95% confidence interval (CI) 1.09-1.30; (+)sepsis: HR 1.84, 95% CI 1.44-2.35; (+)transfusion/(+)sepsis: HR 2.27, 95% CI 1.87-2.76], cardiovascular disease-specific survival [(+)transfusion: HR 1.18, 95% CI 1.04-1.33; (+)sepsis: HR 1.63, 95% CI 1.14-2.31; (+)transfusion/(+)sepsis: HR 2.04, 95% CI 1.58-2.63], and overall survival [(+)transfusion: HR 1.21, 95% CI 1.14-1.29; (+)sepsis: HR 1.76, 95% CI 1.48-2.09; (+)transfusion/(+)sepsis: HR 2.36, 95% CI 2.07-2.68] relative to (-)transfusion/(-)sepsis. Additional analyses suggested an additive effect with those who both received a blood transfusion and developed sepsis having even worse survival. Perioperative blood transfusions are associated with shorter survival

  10. [Care of children and mothers: research on preventable deaths in children under five years].

    Science.gov (United States)

    Jodas, Denise Albieri; Scochi, Maria José; de Moura, Marina Bennemann; Tiwata, Mayara Zago

    2011-12-01

    This study aims to evaluate the treatment of children and mothers in basic health units based on the investigation of deaths in children under five years. This is an evaluative study, that analyzed 41 deaths ocurred in 2008 in the city of Maringá, state of Paraná, Brasil. 90.2% of these deaths were preventable. 38.5% of the pregnant women had theirfirst prenatal consultation in the first quarter of pregnancy. 50.0% had more than six consultations. 73.1% were assessed for risk pregnancy. 34.6% of chart records had information on prenatal laboratory tests. 50.0% of births occurred by cesarean section. 87.5% of charts contained records of child growth monitoring and risk assessment of newborns. None had records of neuromotor development. 50.0% had complete vaccination records. 75.0% received home visits from a family healthcare team. All children at low risk had three visits to doctors. Only one high-risk newborn reached seven medical consultations. The conclusion is that there are failures in the professional records of prenatal care, as well as in the quality of monitoring of children considered at risk.

  11. [Quick and early diagnostic outpatient unit: an effective and efficient assistential model. Five years experience].

    Science.gov (United States)

    Capell, Santiago; Comas, Pere; Piella, Teresa; Rigau, Joaquim; Pruna, Xavier; Martínez, Francesc; Montull, Santiago

    2004-09-04

    To analyze the applicability of an out-patient Quick and Early Diagnostic Unit (QEDU) to evaluate patients with a potential life-threatening disorder on an out-patient basis. We analyzed prospectively all patients attended in the unit for five years (1997-2001). We compared patients with lung cancer and colorectal cancer admitted to hospital for conventional study versus patients studied at the unit. We attended 2,748 patients in total Main reasons for consultation were abdominal pain, asthenia-anorexia, neurologic symptoms, anemia and palpable tumors. The most frequent diagnostic category corresponded to gastroenterological diseases and neoplastic diseases. The mean interval (standard error) for the first visit was 4.9 (3.4) days and for diagnosis it was 5.7 (6.5) days. Some 95% patients displayed a high degree of satisfaction by the questionnaire. In patients with cancer of the colon studied at the QEDU, we observed a reduction in the average interval for diagnosis which was highly significant (p = 0.03). The overall costs of final diagnosis were also lower for the QEDU model. The QEDU unit represents an alternative to in hospital admission for diagnostic workouts, which is fully feasible in our setting. It can result in the same efficacy and a higher efficiency than hospital admission.

  12. Meningitis Caused by Salmonella Newport in a Five-Year-Old Child

    Directory of Open Access Journals (Sweden)

    Ana De Malet

    2016-01-01

    Full Text Available Salmonella Newport is a Gram-negative bacillus belonging to the Enterobacteria family and the nontyphi Salmonella (NTS, usually related to gastroenteritis. Main difference between NTS and Salmonella typhi is that the last one evolves to an invasive disease easier than NTS. These can progress to bacteremias in around 5% of cases and secondary focuses can appear occasionally, as in meningitis. An infection of the central nervous system is uncommon, considering its incidence in 0.6–8% of the cases; most of them are described in developing countries and mainly in childhood, especially neonates. Bacterial meningitis by NTS mostly affects immunosuppressed people in Europe. Prognosis is adverse, with a 50% mortality rate, mainly due to complications of infection: hydrocephalus, ventriculitis, abscesses, subdural empyema, or stroke. Choice antibiotic treatments are cefotaxime, ceftriaxone, or ceftazidime. The aim of this paper is to present a case of meningitis caused by Salmonella Newport diagnosed in a five-year-old girl living in a rural area of the province of Ourense (Spain, with favorable evolution and without neurological disorders.

  13. Effects of the nuclear disaster on marine products in Fukushima: An update after five years.

    Science.gov (United States)

    Wada, Toshihiro; Fujita, Tsuneo; Nemoto, Yoshiharu; Shimamura, Shinya; Mizuno, Takuji; Sohtome, Tadahiro; Kamiyama, Kyoichi; Narita, Kaoru; Watanabe, Masato; Hatta, Nobuyuki; Ogata, Yasuo; Morita, Takami; Igarashi, Satoshi

    2016-11-01

    Original data (134Cs and 137Cs, and sampling location) of marine products in Fukushima Prefecture monitored during 2011-2015 (n = 32,492) were analyzed to present an updated detailed description of radiocesium contamination after the Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident and to examine taxon/habitat-specific decreasing trends in different areas. Furthermore, marine species data presented by the Tokyo Electric Power Company (TEPCO) during 2012-2015 (n = 5458) were analyzed to evaluate the decreasing trends of 137Cs inside and outside (within a 20 km radius) of the FDNPP port. Monitoring results by Fukushima Prefecture show that percentages of samples higher than the Japanese regulatory limit of 100 Bq kg-1-wet (>RL%) were higher, whereas those below the detection limit (RL% and Fukushima Prefecture, even within the 20 km radius area, has decreased drastically during the five years after the FDNPP accident, although 137Cs concentrations higher than 10 kBq kg-1-wet were still detected in some specimens of sedentary rockfishes (S. cheni, Sebastes oblongus, and Sebastes pachycephalus) in the FDNPP port. Fishing operations started on a trial basis in June 2012 have gradually expanded the target areas and species. Careful monitoring should be continued to accelerate the restoration of coastal fisheries in Fukushima Prefecture. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. CYTOLOGICAL EVALUATION OF MALE BREAST LESIONS IN GREATER GWALIOR : A FIVE YEAR RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Jagannath

    2015-03-01

    Full Text Available BACKGROUNDS: Fine needle aspiration cytology is an effective modality for diagnosis of breast lesions. Usually male breast lesions are benign and affect the young male. Most common lesion is gynaecomastia. Male breast cancer accounts for a small proportion of breast cancers. Male breast cancer usually presents at an advanced age. OBJECTIVE: The aim of this study was to examine the nature of male breast lesions and to determine the cytomorphologic patterns of these lesions. MET HODS: five year retrospective study was conducted in our institution and in that 112 patients underwent fine needle aspiration cytology of the palpable breast lump after thorough physical examination. The cytological diagnosis was classified as benign, inf lammatory, malignant and others. RESULTS: In 112 male patients diagnosed with breast lesions, the most common lesion was gynecomastia (103/112, 91.9%, followed by breast cancer (6/112, 5.4%, inflammatory (2/112, 1.8% and apocrine metaplasia (01/112, 0.9 %. Gynecomastia was commonly found in male patients less than 40 years of age, while breast cancer is seen in male patients over 40 years of age

  15. Pharmacy in a New Frontier - The First Five Years at the Johnson Space Center Pharmacy

    Science.gov (United States)

    Bayuse, Tina

    2008-01-01

    A poster entitled "Space Medicine - A New Role for Clinical Pharmacists" was presented in December 2001 highlighting an up-and-coming role for pharmacists at the Johnson Space Center (JSC) in Houston, Texas. Since that time, the operational need for the pharmacy profession has expanded with the administration s decision to open a pharmacy on site at JSC to complement the care provided by the Flight Medicine and Occupational Medicine Clinics. The JSC Pharmacy is a hybrid of traditional retail and hospital pharmacy and is compliant with the ambulatory care standards set forth by the Joint Commission. The primary charge for the pharmacy is to provide medication management for JSC. In addition to providing ambulatory care for both clinics, the pharmacists also practice space medicine. A pharmacist had been involved in the packing of both the Space Shuttle and International Space Station Medical Kits before the JSC Pharmacy was established; however, the role of the pharmacist in packing medical kits has grown. The pharmacists are now full members of the operations team providing consultation for new drug delivery systems, regulations, and patient safety issues. As the space crews become more international, so does the drug information provided by the pharmacists. This presentation will review the journey of the JSC Pharmacy as it celebrated its five year anniversary in April of 2008. The implementation of the pharmacy, challenges to the incorporation of the pharmacy into an existing health-care system, and the current responsibilities of a pharmacist at the Johnson Space Center will be discussed.

  16. Early social experience predicts referential communicative adjustments in five-year-old children.

    Directory of Open Access Journals (Sweden)

    Arjen Stolk

    Full Text Available A large body of work has focused on children's ability to attribute mental states to other people, and whether these abilities are influenced by the extent and nature of children's social interactions. However, it remains largely unknown which developmental factors shape children's ability to influence the mental states of others. Building on the suggestion that collaborative experiences early in life might be crucial for the emergence of mental coordination abilities, here we assess the relative contribution of social exposure to familial and non-familial agents on children's communicative adjustments to their mental model of an addressee ('audience design'. During an online interactive game, five-year-olds spontaneously organized their non-verbal communicative behaviors according to their beliefs about an interlocutor. The magnitude of these communicative adjustments was predicted by the time spent at daycare, from birth until four years of age, over and above effects of familial social environment. These results suggest that the degree of non-familial social interaction early in life modulates the influence that children's beliefs have on their referential communicative behavior.

  17. Five years post whiplash injury: Symptoms and psychological factors in recovered versus non-recovered

    Directory of Open Access Journals (Sweden)

    Stålnacke Britt-Marie

    2010-07-01

    Full Text Available Abstract Background Few studies have focused on the differences between persons who are recovered after whiplash injury and those who suffer from persistent disability. The primary aim of this study was therefore to examine differences in symptoms, psychological factors and life satisfaction between subjects classified as recovered and those with persistent disability five years after whiplash injury based on the Neck Disability Index (NDI. Methods A set of questionnaires was answered by 158 persons (75 men, 83 women to assess disability (NDI, pain intensity (VAS, whiplash-related symptoms (Rivermead Post-Concussion Symptoms Questionnaire, RPQ, post-traumatic stress (Impact of Event Scale, IES, depression (Beck's depression inventory, BDI and life satisfaction (LiSat-11. The participants were divided into three groups based on the results of the NDI: recovered (34.8%, mild disability (37.3% and moderate/severe disability (27.3%. Results The moderate/severe group reported significantly higher VAS, BDI and IES scores and lower level of physical health and psychological health compared to the mild and the recovered groups. Less significant differences were reported between the mild and the recovered groups. Conclusions The group with the highest disability score reported most health problems with pain, symptoms, depression, post-traumatic stress and decreased life satisfaction. These findings indicate that classifying these subjects into subgroups based on disability levels makes it possible to optimize the management and treatment after whiplash injury.

  18. Accidental poisoning in childhood: five year urban population study with 15 year analysis of fatality.

    Science.gov (United States)

    Pearn, J; Nixon, J; Ansford, A; Corcoran, A

    1984-01-07

    Patterns of accidental poisoning in children are changing dramatically. A five year population study (1977-81) was undertaken in urban children from Brisbane (population 1 000 000). A total of 2098 children were poisoned during this period with only one fatality, which represents a dramatic reduction in mortality. Over the past 15 years (1968-82) 13 children have died from accidental poisoning from this population, and two were murdered with drugs. A study of secular trends has indicated that peak incidence occurred in 1979, and the rate has been falling progressively since. The current age corrected rate of poisoning is 393 per 100 000 children per year (0-5 year olds). The rank order of poisons, drugs, and chemicals causing hospital admission and death is: petroleum distillates 13%; antihistamines 9%; benzodiazepines 9%; bleach and detergents 7%; and aspirin 6%. The ratio of fatalities to ingestions requiring hospital admission was calculated to give an index of a practical danger of noxious agents to which children are currently exposed and the rank order is: cardiotoxic drugs, one fatality to 25 ingestions; tricyclic antidepressants, one to 44; sympathomimetic drugs, one to 54; caustic soda, one to 68; aspirin, one fatality to 350 ingestions. Accidental poisoning of children leading to death has been reduced because patterns of drug prescriptions have changed, packaging of dangerous drugs has been made safer, and substances such as kerosene have been coloured blue.

  19. [Five years of the National Policy of Humanization: the trajectory of a public policy].

    Science.gov (United States)

    Pasche, Dário Frederico; Passos, Eduardo; Hennington, Elida Azevedo

    2011-11-01

    This article presents the context of the emergence and implementation of the National Policy of Humanization (NPH), which was devised as a public policy to address and overcome the challenges perceived by Brazilian society regarding the quality and dignity of healthcare. The aims include redesigning and joint initiatives for the humanization of care, and providing solutions for problems in the field of management and organization of the health workforce. Highlighting it as a public policy, the authors analyze the main focus and theoretical and methodological approaches to cope with problems in management and practice of healthcare, signaling the need to combine strategies in both macro and micro policy areas. The analysis focuses on changes in the composition and strategies of action, which include social mobilization, support to management systems, services and health teams and the development of training processes for institutional stakeholders. The article presents results obtained in the first five years, as well as its limitations and prospects, especially the challenge facing NPH to be seen as a public policy, which cannot be achieved without the mobilization of social forces beyond the State.

  20. Five Years of Experimental Warming Increases the Biodiversity and Productivity of Phytoplankton.

    Directory of Open Access Journals (Sweden)

    Gabriel Yvon-Durocher

    2015-12-01

    Full Text Available Phytoplankton are key components of aquatic ecosystems, fixing CO2 from the atmosphere through photosynthesis and supporting secondary production, yet relatively little is known about how future global warming might alter their biodiversity and associated ecosystem functioning. Here, we explore how the structure, function, and biodiversity of a planktonic metacommunity was altered after five years of experimental warming. Our outdoor mesocosm experiment was open to natural dispersal from the regional species pool, allowing us to explore the effects of experimental warming in the context of metacommunity dynamics. Warming of 4°C led to a 67% increase in the species richness of the phytoplankton, more evenly-distributed abundance, and higher rates of gross primary productivity. Warming elevated productivity indirectly, by increasing the biodiversity and biomass of the local phytoplankton communities. Warming also systematically shifted the taxonomic and functional trait composition of the phytoplankton, favoring large, colonial, inedible phytoplankton taxa, suggesting stronger top-down control, mediated by zooplankton grazing played an important role. Overall, our findings suggest that temperature can modulate species coexistence, and through such mechanisms, global warming could, in some cases, increase the species richness and productivity of phytoplankton communities.

  1. Corrosion study of steels exposed over five years to the humid tropical atmosphere of Panama

    Energy Technology Data Exchange (ETDEWEB)

    Jaén, Juan A., E-mail: juan.jaen@up.ac.pa [Departamento de Química Física, Edificio de Laboratorios Científicos-VIP (Panama); Iglesias, Josefina [Laboratorio de Análisis Industriales y Ciencias Ambientales (Panama)

    2017-11-15

    The results of assessing five-year corrosion of low-carbon and conventional weathering steels exposed to the Panamanian tropical atmosphere is presented. Two different test sites, one in Panama City: 5 km from the shoreline of the Pacific Ocean, and another in the marine environment of Fort Sherman, Caribbean coast of Panama; namely, Fort Sherman Coastal site: 100 m from coastline. The corrosion products, formed in the skyward and earthward faces in the studied tropical environment, were mainly identified using room temperature and low temperature (15 K) Mössbauer spectroscopy, and ATR-FTIR. In all samples, lepidocrocite (γ-FeOOH) and goethite (α-FeOOH) were the main constituents. Some maghemite (γ-Fe{sub 2}O{sub 3}), was also identified in Tocumen by Mössbauer spectroscopy and traces of feroxyhyte (δ-FeOOH) using ATR-FTIR. The corrosion rate values obtained are discussed in light of the atmospheric exposure conditions and atmospheric pollutants.

  2. Microbiological and host features associated with corynebacteriosis in cancer patients: a five-year study

    Directory of Open Access Journals (Sweden)

    CAS Martins

    2009-09-01

    Full Text Available During a five-year period, 932 clinical isolates from cancer patients treated in a Brazilian reference centre were identified as corynebacteria; 86% of the cultures came from patients who had been clinically and microbiologically classified as infected and 77.1% of these patients had been hospitalised (71.1% from surgical wards. The adult solid tumour was the most common underlying malignant disease (66.7%. The univariate and multivariate analyses showed that hospitalised patients had a six-fold greater risk (OR = 5.5, 95% CI = 1.15-26.30 p = 0.033 related to 30-day mortality. The predominant species were Corynebacterium amycolatum (44.7%, Corynebacterium minutissimum (18.3% and Corynebacterium pseudodiphtheriticum (8.5%. The upper urinary tracts, surgical wounds, lower respiratory tracts, ulcerated tumours and indwelling venous catheters were the most frequent sources of C. amycolatum strains. Corynebacterium jeikeium infection occurred primarily in neutropenic patients who have used venous catheters, while infection caused by C. amycolatum and other species emerged mainly in patients with solid tumours.

  3. Pacific Northwest and Alaska Regional Bioenergy Program : Five Year Report, 1985-1990.

    Energy Technology Data Exchange (ETDEWEB)

    Pacific Northwest and Alaska Bioenergy Program (U.S.)

    1991-02-01

    This five-year report describes activities of the Pacific Northwest and Alaska Regional Bioenergy Program between 1985 and 1990. Begun in 1979, this Regional Bioenergy Program became the model for the nation's four other regional bioenergy programs in 1983. Within the time span of this report, the Pacific Northwest and Alaska Regional Bioenergy Program has undertaken a number of applied research and technology projects, and supported and guided the work of its five participating state energy programs. During this period, the Regional Bioenergy Program has brought together public- and private-sector organizations to promote the use of local biomass and municipal-waste energy resources and technologies. This report claims information on the mission, goals and accomplishments of the Regional Bioenergy Program. It describes the biomass projects conducted by the individual states of the region, and summarizes the results of the programs technical studies. Publications from both the state and regional projects are listed. The report goes on to consider future efforts of the Regional Bioenergy Program under its challenging assignment. Research activities include: forest residue estimates; Landsat biomass mapping; woody biomass plantations; industrial wood-fuel market; residential space heating with wood; materials recovery of residues; co-firing wood chips with coal; biomass fuel characterization; wood-boosted geothermal power plants; wood gasification; municipal solid wastes to energy; woodstove study; slash burning; forest depletion; and technology transfer. 9 figs., 6 tabs.

  4. Kratom abuse in Ramathibodi Poison Center, Thailand: a five-year experience.

    Science.gov (United States)

    Trakulsrichai, Satariya; Tongpo, Achara; Sriapha, Charuwan; Wongvisawakorn, Sunun; Rittilert, Panee; Kaojarern, Sming; Wananukul, Winai

    2013-01-01

    Kratom (Mitragyna speciosa Korth), a native tree in Southeast Asia, is misused as an abuse drug and becomes legally widespread to several countries. Currently, it is available through the online market or by some shops. The clinical manifestations of Kratom's effects are not well-defined and the clinical studies are limited. This study was designed to identify the characteristics of Kratom poisoning and withdrawal cases from Kratom exposure cases in Ramathibodi Poison Center (RPC), Thailand, during a five-year period. We used a retrospective review of Kratom exposure cases from the RPC toxic surveillance system. A total of 52 Kratom exposure cases were identified. The trend of case consultations has been increasing. There were Kratom poisoning cases (76.9%) and withdrawal cases (23.1%). Common presenting symptoms in the poisoning group were palpitation (22.5%), followed by seizure (17.5%). For the withdrawal group, the common presenting symptoms were myalgia (33.3%), insomnia (16.67%), fatigue (16.67%), and chest discomfort (16.67%). There was a baby with withdrawal symptoms who was delivered from a chronic Kratom-abusing mother, suggesting possible exposure via the transplacental route. There were no deaths in either group. Kratom abuse can cause either poisoning or withdrawal. Most cases in both groups had good prognostic outcome.

  5. Treatment-resistant, five-year long, postpartum-onset Capgras episode resolving after electroconvulsive therapy.

    Science.gov (United States)

    Rapinesi, Chiara; Kotzalidis, Georgios D; Del Casale, Antonio; Ferri, Vittoria Rachele; Di Pietro, Simone; Scatena, Paola; Serata, Daniele; Danese, Emanuela; Sani, Gabriele; Koukopoulos, Alexia E; Angeletti, Gloria; Girardi, Paolo

    2015-01-01

    Postpartum psychosis, which rarely presents with Capgras syndrome (delusional misidentification), requires rapid symptom resolution. First-line drugs have important drawbacks, such as delayed onset of clinical response and secretion in breast milk. In this report, we report successful treatment of a treatment-resistant woman presenting with treatment-resistant Capgras syndrome, with onset during postpartum. A 36-year-old woman had presented with Capgras syndrome during postpartum. For more than five years, she believed her son and other family members were substituted by impostors. All adequately administrated treatments were unsuccessful. We suggested electroconvulsive therapy to overcome treatment resistance. After six electroconvulsive therapy sessions, delusions of doubles subsided and other symptoms improved. She was discharged two weeks later with a mood stabilizer and low-dose atypical antipychotic combination and is well at the one-and-a-half-year follow-up. Electroconvulsive therapy followed by a mood stabilizer-antipsychotic drug combination showed rapid, permanent, and effective control of long-standing Capgras syndrome in a young woman. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  6. Second Five Year Plan for Socio-Economic Development, 1987/1988-1991/1992.

    Science.gov (United States)

    1987-01-01

    This document reprints sections of Egypt's Second Five Year Plan for Socioeconomic Development (1987-88 through 1991-92). The first priority of the plan is to redistribute the population and achieve settlement patterns that further socioeconomic development objectives and allow the country to satisfy the basic needs of the 70 million people it expects by the year 2000. Thus, the Plan calls for "surplus population" to be redistributed in new communities by allocating investment funds for appropriate activities. Existing old cities in the Nile Valley should be supported by developing their productive capacities and ability to provide basic services. New population centers are also required to absorb the expected population growth. Egypt's 1985 population policy is based on a number of principles, including the right of a family to choose the number of its children, avoidance of abortion and sterilization for family planning, and protection of the citizens' rights to mobility. The population policy seeks to: 1) reduce the growth rate by lowering the birth rate, 2) lower the percentage of the population living in cities, 3) reduce illiteracy, 4) increase the employment rate for women, and 5) improve the overall level of education.

  7. Five-year follow-up of Community Pediatrics Training Initiative.

    Science.gov (United States)

    Minkovitz, Cynthia S; Goldshore, Matt; Solomon, Barry S; Guyer, Bernard; Grason, Holly

    2014-07-01

    To compare community involvement of pediatricians exposed to enhanced residency training as part of the Dyson Community Pediatrics Training Initiative (CPTI) with involvement reported by a national sample of pediatricians. A cross-sectional analyses compared 2008-2010 mailed surveys of CPTI graduates 5 years after residency graduation with comparably aged respondents in a 2010 mailed national American Academy of Pediatrics survey of US pediatricians (CPTI: n = 234, response = 56.0%; national sample: n = 243; response = 59.9%). Respondents reported demographic characteristics, practice characteristics (setting, time spent in general pediatrics), involvement in community child health activities in past 12 months, use of ≥1 strategies to influence community child health (eg, educate legislators), and being moderately/very versus not at all/minimally skilled in 6 such activities (eg, identify community needs). χ(2) statistics assessed differences between groups; logistic regression modeled the independent association of CPTI with community involvement adjusting for personal and practice characteristics and perspectives regarding involvement. Compared with the national sample, more CPTI graduates reported involvement in community pediatrics (43.6% vs 31.1%, P .05). Differences in involvement remained in adjusted analyses with greater involvement by CPTI graduates (adjusted odds ratio 2.4, 95% confidence interval 1.5-3.7). Five years after residency, compared with their peers, more CPTI graduates report having skills and greater community pediatrics involvement. Enhanced residency training in community pediatrics may lead to a more engaged pediatrician workforce. Copyright © 2014 by the American Academy of Pediatrics.

  8. Associated factors of malnutrition among African children under five years old, Bom Jesus, Angola

    Directory of Open Access Journals (Sweden)

    Ema Cândida Branco FERNANDES

    Full Text Available ABSTRACT Objective: To identify the determinants of wasting and stunting in children under five years old in the commune of Bom Jesus, Angola Methods: A population-based cross-sectional study was conducted with 742 children in 2010, and nutritional deficits were defined by World Health Organization criteria. Prevalence ratios and associated factors of wasting and stunting were estimated using Poisson regression with robust variance, using a conceptual hierarchical model Results: For both deficits, there were significant differences in the prevalence ratios according to the children's neighborhood and age. Boys and those children living in households whose water supply came from the river or lake, as well those with recent expulsion of parasites and infections were more likely to present stunting. Children of fathers with higher number of children or that which the fathers were not living at home and whose mothers were 25-34 years old were less likely to have wasting Conclusion: It was identified independent variables from different levels of determination of malnutrition, standing out the basic sanitation conditions and family structure as important predictors of the nutritional deficits. The knowledge of the associated factors of malnutrition may contribute for subside public policies in planning interventions to improve the childhood nutrition status in Bom Jesus and communes with similar characteristics in Angola.

  9. The "Road to Safety" in Irish children over the past five years.

    Science.gov (United States)

    Waters, A; Trace, F; Nicholson, A J

    2006-01-01

    Motor vehicle crashes account for 1 in 5 of all childhood deaths across The EU. In the year 2000, the World Health Organization ranked road traffic accidents as the ninth leading cause of mortality, accounting for 2.3% of deaths worldwide. In 1997, the European Commission published the European Union RoadSafety Programme. This had been prepared against a background of 45,000 road- related fatalities and 1.6 million injuries occurring within the European Union each year. At that stage, Ireland had not yet developed a formal national road safety strategy. By 1998 however, the "Road to Safety" government strategy was put in place with the aim of reducing deaths and serious injuries from road traffic accidents by at least 20% over the five year period beginning 1998 and ending 2002. Age-standardised mortality rates for road accidents in children (0-14 years old) in Ireland are 3.61 per 100,000 as compared to 2.31 per 100,000 in Sweden and thus much needs to be done to reduce this unacceptably high road toll in Ireland. To date there has been insufficient evidence available for childhood road-related accidents occurring within Ireland.

  10. Prosthetic Rehabilitation of a Patient With Gastroesophageal Reflux Disease: Five-Year Follow-up.

    Science.gov (United States)

    Moretto, G; Pupo, Y M; Bueno, A L N; Araujo, F O

    2016-01-01

    Tooth wear is a multifactorial process that is a growing concern in dentistry. This phenomenon can be caused by mechanical (attrition, abrasion, or abfraction) or chemical (erosion) processes. Etiologic factors in dental erosion can be due to changes in behavior, an unbalanced diet, or gastrointestinal disorders such as acid regurgitation, which may influence the salivary flow rate and buffering capacity of saliva. This case report describes an esthetic rehabilitation of a patient with gastroesophageal reflux and dental erosion, with a treatment rationale that includes the use of a diagnostic template and five-year follow-up. This technique, presented here in a clinical case with moderate enamel loss, integrates an additive wax-up and a direct intraoral bis-acryl resin mock-up. Lithium disilicate glass-ceramic (IPS e.max Press, Ivoclar Vivadent) laminate veneers were fabricated with the heatpress technique. They were veneered with a layering ceramic (IPS e.max Ceram, Ivoclar Vivadent) to improve the appearance of the incisal edge. The case demonstrated the success of veneers as an effective, conservative, and esthetic treatment for patients with this pathology.

  11. Prevalence of fetal macrosomia and neonatal complications in a Nigerian suburban hospital: a five year study

    Directory of Open Access Journals (Sweden)

    Babatunde Kayode-Adedeji

    2018-02-01

    Full Text Available Background: Fetal macrosomia has been the subject of several studies with a view to identifying the maternal risk factors and obstetric complications. There is a paucity of data on the neonatal complications.Aim: The aim of the study was to determine the prevalence of macrosomia in Irrua Specialist Teaching Hospital (ISTH, its contribution to neonatal admission and the morbidities in neonatal life.Subjects and methods: It was a descriptive, predominantly retrospective five year study from 2011 to 2015.Results: There were 3,644 deliveries, out of which 290 were macrosomic, giving a prevalence of 8.0%. The mean birth weight for the macrosomic infants was 4.39 ± 0.43 (range 4-6.1 kg and the males were significantly more than the females. The contribution of macrosomia to neonatal admissions was 6%. The most prevalent neonatal morbidities in the present study were hypoglycemia (22.2%, jaundice (20.4% and respiratory distress (18.5%. Other morbidities observed were sepsis (11.1%, asphyxia (10.2%, hypertrophic cardiomyopathy (3.7% and Erb’s palsy (3.7%.Conclusion: The prevalence of macrosomia was in the range found globally, it was an important cause of admission and the spectrum of neonatal morbidities was more than previously described.

  12. [Influences on the amount of the reward: how five-year-old children distribute rewards].

    Science.gov (United States)

    Tsutsu, Kiyomi

    2010-08-01

    Five-year-old children were presented two stories in which each of two characters made different numbers of Origami stars; the total number of stars was 16 in one story and 12 in the other. The children allocated rewards to the characters and justified their allocations. There were three conditions in which the total number of rewards was equal to (Middle-N), less than (Small-N), or more than (Large-N) the total number of stars in each story. Most children allocated the rewards equally to the two characters in the Small-N condition, while almost half of the children did not employ an equal allocation in the Middle-N and Large-N conditions. This suggests that in the Small-N condition, if an equity-like allocation were employed, children would feel sorry for the character given very few rewards, and therefore they distributed the rewards equally. On the other hand, in the Middle-N and Large-N conditions, even when one character received fewer rewards than the other, the children did not feel that the fewer rewards were too few.

  13. Vitamin D supplementation for preventing infections in children under five years of age.

    Science.gov (United States)

    Yakoob, Mohammad Y; Salam, Rehana A; Khan, Farhan R; Bhutta, Zulfiqar A

    2016-11-09

    Vitamin D is a micronutrient important for bone growth and immune function. Deficiency can lead to rickets and has been linked to various infections, including respiratory infections. The evidence on the effects of supplementation on infections in children has not been assessed systematically. To evaluate the role of vitamin D supplementation in preventing pneumonia, tuberculosis (TB), diarrhoea, and malaria in children under five years of age. This includes high-, middle-, and low-income countries. We searched the Cochrane Infectious Diseases Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Library, MEDLINE, EMBASE, LILACS, the WHO International Clinical Trials Registry Platform (ICTRP; http://www.who.int/ictrp/en/) , ClinicalTrials.gov and the ISRCTN registry (http://www.isrctn.com/) up to 16 June 2016. We included randomized controlled trials (RCTs) that evaluated preventive supplementation of vitamin D (versus placebo or no intervention) in children under five years of age. Two review authors independently screened the titles and abstracts, extracted the data, and assessed the risk of bias of included trials. Four trials met the inclusion criteria, with a total of 3198 children under five years of age, and were conducted in Afghanistan, Spain, and the USA. Prevalence of vitamin D deficiency varied widely in these populations (range: 73.1% in Afghanistan, 10 to 12% in USA, and 6.2% in Spain). The included trials evaluated mortality (two trials), pneumonia incidence (two trials), diarrhoea incidence (two trials), hospitalization (two trials), and mean serum vitamin D concentrations (four trials).We do not know whether vitamin D supplementation impacts on all-cause mortality because this outcome was underpowered due to few events (risk ratio (RR) 1.43, 95% confidence interval (CI) 0.54 to 3.74; one trial, 3046 participants, low quality evidence).For pneumonia, episodes of 'radiologically confirmed' first or

  14. Five Year Retrospective Study of the Financial Situation of Northern Foods Plc., United Kingdom

    Directory of Open Access Journals (Sweden)

    Louie DACOSTA

    2016-09-01

    Full Text Available This study was conducted as a retrospective analysis of Northern Foods Plc., once a major player in FTSE 350 Food Sector, to evaluate its financial situation over a five year period. The ex post factor research design was used for this study. Annual reports and databases on Northern Foods Plc., and Associated British Foods Plc., were used to perform a series of ratio analyses. The results revealed that Northern Foods Plc.’s performance has been declining as evidenced in the profitability ratios calculated. Also, financial strength was weak and working capital has not been effectively managed, hence affecting its cash and profit generation potentials. The company was limited in its ability to grow and expand as it needed to regularly fund its pension deficit, and finance its high levels of debt. The study concludes that Northern Foods was not in a very strong financial position, yet it was not making the required investments to improve, hence its takeover though this paper will not rule out non-financial issues. Furthermore, the study prescribed five generic points to improve the financial health of any organisation.

  15. Relative afferent pupillary defects in primary open-angle glaucoma--five years' experience.

    Science.gov (United States)

    Page, C J; Merritt, J C; Evans, B

    1985-12-01

    Afferent pupillary defects may accompany asymmetric primary open-angle glaucoma, though the exact incidence has not been reported. Charts were reviewed on 89 patients attending the Glaucoma/Uveitis Clinic at the North Carolina Memorial Hospital in Chapel Hill, North Carolina over a five-year period. All patients had primary open-angle glaucoma diagnosed by: (1) increased ocular tensions (22 mmHg) in the presence of open-anterior-chamber angles and (2) optic-nerve cupping and atrophy compatible with (3) pressure-dependent, visual-field loss. No subjects with secondary glaucomas, primary-angle-closure glaucoma, or ocular hypertension are included.The presence of the relative afferent pupillary defect was noted in 21 of 89 patients (23 percent). Sixteen of 70 black patients had relative afferent pupillary defect in the more severely affected eye, while five of 19 white patients demonstrated afferent pupils. Other demographic characteristics of this population are described. Two typical primary-open-angle glaucoma patients are discussed to demonstrate comparable changes within the optic nerves and Goldmann visual fields. The presence of the relative afferent pupillary defect best correlates with asymmetric, visual-field loss in the more severely affected eye.

  16. A Five Year Mortality Analysis in a Chest Disease Hospital Located in East Blacksea Region

    Directory of Open Access Journals (Sweden)

    Halit Cinarka

    2013-10-01

    Full Text Available Aim: Respiratory system diseases are common causes of the mortality in all age groups. This investigation was performed retrospectively to detect reasons for the death among the adult patients hospitalized in a hospital of chest disease. Material and Method: This study included all the patients hospitalized and died from any respiratory disease during five years from January 2004 to January 2009. Medical charts and official hospital death records of the patients were used for analysis. Results: It was determined that totally 294 thousands and 358 (142 thousands and 699 male, 151 thousands and 659 female patients admitted to the hospital and 19 thousands and 17 (13 thousands and 89 male, 5 thousands and 928 female were hospitalized and 659 of them resulted in death during the study period. The mean age of the death was 71 ± 12.23 (range between 19 and 111 year and 119 (18.05% of them were female and 540 (81.95% of them were male. The main causes of their mortality were pneumonia in 206 patients (31.2%, lung cancer in 178 (27% patients, chronic obstructive pulmonary disease (COPD in 142 (21.5% patients, tuberculosis in 25 (3.7% patients, pulmonary thromboembolism in 13 (1.9%. Discussion: We think that the knowledge about the reasons and the rates of the mortality is useful to decrease the mortality rates of respiratory disease and to provide appropriate standarts of the health services.

  17. FINE NEEDLE ASPIRATION CYTOLOGY OF EPIDIDYMAL SWELLINGS IN RIMS HOSPITAL, IMPHAL: A FIVE-YEAR STUDY

    Directory of Open Access Journals (Sweden)

    Rajesh Singh Laishram

    2016-06-01

    Full Text Available BACKGROUND Epididymal nodules are frequently encountered in surgical practice. They are easily accessible to fine needle aspiration cytology (FNAC. Clinically, these nodules present as worrisome nodules to the patients as well to the patients. This study was conducted to study the clinico-pathological profile of patients presenting with epididymal nodule using fine needle aspiration cytology (FNAC. METHODS A retrospective study was done by critically analysing the FNAC reports of palpable epididymal swellings in last five years (January 2010 to December 2015 at the Department of Pathology, Regional Institute of Medical Sciences (RIMS Hospital, Imphal, Manipur. Review of all the reports were done and diagnosis was made according to standard guidelines and correlated with patient’s age, sex, and side of involvement to explore the disease pattern. RESULTS A total of 71 cases were retrieved and divided as follows: Tuberculous epididymitis 20(28.17%, spermatocoele 11(15.49%, non-specific chronic epididymitis 10(14.08%, spermatic granulomas 6(8.45%, acute epididymitis 6(8.45%, hydrocoele 5 (7.04%, adenomatoid tumour 4(6.63% and microfilaria 1(1.41%. FNAC material was inadequate for opinion in 8 cases (11.28% cases. CONCLUSION FNAC has a definite important role in the differential diagnosis of epididymal nodules as it can identify neoplastic and nonneoplastic conditions. FNAC can thus be used to segregate the group of patients requiring a surgical intervention and a biopsy

  18. Epidemiologic study on accidents among children under five years old during 2006 to 2016-Qazvin

    Directory of Open Access Journals (Sweden)

    K. Hosseinzadeh

    2017-08-01

    Full Text Available Background: Children, due to their insufficient risk detection, are more vulnerable to accidents than adults. Objective: The present study has been done to explore the prevalence of accidents and related factors among children under five years old from 2006 to 2016 in Qazvin. Methods: This descriptive-analytic study concluded all 18184 children who had exposure to accidents during study time section from 2006 to 2016. All recorded data in Health Information System (HIS of Qazvin Health Management Office were probed to explore the target figures, and then were entered in a qualified checklist. All data were analyzed by descriptive statistical methods and Multinomial Logistic Regression. Findings: The prevalence rate of accidents in the target children was eight percent, which more than half (62.9 % were taken place in boys. Accidents in children before one year old (31.4 %, and home accidents (46.5% were the most prevalent one. In addition to these, the rates of Trauma, Fallings, and Traffic accidents were 31.8%, 15.6%, 14.9%, respectively. The most prevalent time of accident was summer (29.7%, especially in July (12.1%. Conclusion: The risk of accidents in the young children, and boys are more than others. Unsafe home environment, motor vehicles accidents, and doing unsafe behaviors are the main causes for increasing the risk. Yet, application of some programs such as; mothers’ education, administration of traffic rules may decrease the risk of accidents in the children.

  19. Five Years of Experimental Warming Increases the Biodiversity and Productivity of Phytoplankton.

    Science.gov (United States)

    Yvon-Durocher, Gabriel; Allen, Andrew P; Cellamare, Maria; Dossena, Matteo; Gaston, Kevin J; Leitao, Maria; Montoya, José M; Reuman, Daniel C; Woodward, Guy; Trimmer, Mark

    2015-12-01

    Phytoplankton are key components of aquatic ecosystems, fixing CO2 from the atmosphere through photosynthesis and supporting secondary production, yet relatively little is known about how future global warming might alter their biodiversity and associated ecosystem functioning. Here, we explore how the structure, function, and biodiversity of a planktonic metacommunity was altered after five years of experimental warming. Our outdoor mesocosm experiment was open to natural dispersal from the regional species pool, allowing us to explore the effects of experimental warming in the context of metacommunity dynamics. Warming of 4°C led to a 67% increase in the species richness of the phytoplankton, more evenly-distributed abundance, and higher rates of gross primary productivity. Warming elevated productivity indirectly, by increasing the biodiversity and biomass of the local phytoplankton communities. Warming also systematically shifted the taxonomic and functional trait composition of the phytoplankton, favoring large, colonial, inedible phytoplankton taxa, suggesting stronger top-down control, mediated by zooplankton grazing played an important role. Overall, our findings suggest that temperature can modulate species coexistence, and through such mechanisms, global warming could, in some cases, increase the species richness and productivity of phytoplankton communities.

  20. Weather conditions and Bell's palsy: five-year study and review of the literature

    Directory of Open Access Journals (Sweden)

    Milionis Haralampos J

    2001-12-01

    Full Text Available Abstract Background Climatic or meteorological condition changes have been implicated in the pathogenesis of Bell's palsy (BP. We evaluate the influence of meteorological parameters, such as temperature, humidity, and atmospheric pressure, and their variation and covariation on the incidence of BP and present a review of the literature on the effect of meteorological conditions on facial nerve function. Methods A total of 171 cases of BP admitted to our Department over a five-year period were studied. The meteorological database included daily values of 13 distinct parameters recorded at the meteorological station of the University of Ioannina during this period. A relationship between each meteorological variable and the incidence of BP was investigated by applying (Χ2 test on data from 13 contingency tables. In addition, the influence of different weather types on the incidence of BP was also investigated. For this purpose Cluster Analysis was used to create eight clusters (weather types for the Ioannina prefecture and (Χ2 test was applied on the contingency tables consisting of the days of BP cases for each cluster. Results No significant correlation was found either between BP and each distinct meteorological parameter or between BP and any specific weather. Conclusions Meteorological conditions, such as those dominating in the Northwestern Greece, and/or their changes have little effect on the incidence of BP. Multicenter studies taking into account atmospheric pollution, and climatic differences between countries, are necessary to scrutinize the environmental effects on facial nerve function.

  1. Bacterial contamination of floors and other surfaces in operating rooms: a five-year survey.

    Science.gov (United States)

    Suzuki, A.; Namba, Y.; Matsuura, M.; Horisawa, A.

    1984-01-01

    Bacterial contamination of floors and other surfaces in the operating suite has been investigated by contact impression plates during the past five years. Colony counts of the floors of operating rooms, cleaned with disinfectant, were 3.3 c.f.u./10 cm2; on the floors of semi-clean and dirty areas, cleaned with detergent, colony counts were 44.8 and 71.4 c.f.u./10 cm2 respectively. The highest colony counts of 487.4 c.f.u./10 cm2 were found in the dressing rooms, the floors of which were covered with carpets, cleaned with a vacuum cleaner. Mean bacterial numbers on surfaces of various equipment in operating rooms, cleaned with disinfectant, were 2.8 c.f.u./10 cm2. Bacterial numbers on surfaces decreased markedly from 253.2 to 11.9 c.f.u./10 cm2 following the use of disinfectant. Bacterial species found from various surfaces were mainly coagulase-negative staphylococci, derived from human beings. In the light of these findings the regular use of disinfectant for cleaning of the floors and other surfaces in operating rooms is advisable. PMID:6512255

  2. Improving the Agronomy of Alyssum murale for Extensive Phytomining: A Five-Year Field Study.

    Science.gov (United States)

    Bani, Aida; Echevarria, Guillaume; Sulçe, Sulejman; Morel, Jean Louis

    2015-01-01

    Large ultramafic areas exist in Albania, which could be suitable for phytomining with native Alyssum murale. We undertook a five-year field experiment on an ultramafic Vertisol, aimed at optimizing a low-cost Ni-phytoextraction crop of A. murale which is adapted to the Balkans. The following aspects were studied on 18-m2 plots in natural conditions: the effect of (i) plant phenology and element distribution, (ii) plant nutrition and fertilization, (iii) plant cover and weed control and (iv), planting technique (natural cover vs. sown crop). The optimal harvest time was set at the mid-flowering stage when Ni concentration and biomass yield were highest. The application of N, P, and K fertilizers, and especially a split 100-kg ha(-1) N application, increased the density of A. murale against all other species. It significantly increased shoot yield, without reducing Ni concentration. In natural stands, the control of graminaceous weeds required the use of an anti-monocots herbicide. However, after the optimization of fertilization and harvest time, weed control procured little benefit. Finally, cropping sown A. murale was more efficient than enhancing native stands and gave higher biomass and phytoextraction yields; biomass yields progressively improved from 0.3 to 9.0 t ha(-1) and phytoextracted Ni increased from 1.7 to 105 kg ha(-1).

  3. Severe nutritional risk predicts decreased long-term survival in geriatric patients undergoing pancreaticoduodenectomy for benign disease.

    Science.gov (United States)

    Sanford, Dominic E; Sanford, Angela M; Fields, Ryan C; Hawkins, William G; Strasberg, Steven M; Linehan, David C

    2014-12-01

    Weight loss and malnutrition are poorly tolerated by geriatric patients, and pancreaticoduodenectomy (PD) can result in chronic malabsorption and weight loss. We sought to determine how preoperative severe nutritional risk (SNR), as defined by the American College of Surgeons National Surgical Quality Improvement Program/American Geriatric Society Best Practice Guidelines, affects long-term survival after PD for benign disease among geriatric and nongeriatric patients. All patients undergoing PD for nonmalignant conditions at a single center between 1995 and 2013 were followed for survival, excluding patients who died within 90 days of surgery. Survival of geriatric (age ≥65 years) and nongeriatric (age patients with and without SNR was compared using Kaplan Meier methods. Cox regression was performed. There were 320 patients who underwent PD for benign disease. Over the course of the study, the proportion of geriatric patients undergoing PD for benign conditions increased from 25% to 46%. In addition to being older, geriatric patients undergoing PD for benign disease were significantly more likely to have coronary artery disease (CAD) and hypertension. Geriatric patients with preoperative SNR had significantly decreased long-term survival after PD for benign disease (p patients dead at 5 years compared with 1 in 14 patients without SNR. Survival was not significantly different among nongeriatric patients with and without SNR. In geriatric patients, age, CAD, and SNR were significantly associated with decreased survival on both univariate and multivariate analysis. Severe nutritional risk can be a useful predictor of long-term survival in geriatric patients undergoing PD, and could improve patient risk stratification preoperatively. Nonoperative management should be strongly considered in geriatric patients with SNR, when malignancy is not suspected. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Improving long-term survival of patients with acute myocardial infarction from 1977-1988 in a region of Denmark

    DEFF Research Database (Denmark)

    Torp-Pedersen, C; Hildebrandt, P; Køber, L

    1995-01-01

    The aim of this investigation was to study secular trends in long-term survival following myocardial infarction (MI). Five thousand one hundred and fifty-seven consecutive cases of MI in 3942 patients were recorded in a well-defined region in the study period 1977-1988. The study period ended....... Year of infarction was without importance in the high risk group but highly significant in the low risk group. Long-term survival following MI gradually improved prior to the introduction of thrombolytic therapy. The improvement was confined to low risk patients without cardiac arrest or congestive...... before thrombolytic therapy was introduced in the hospital. One and 5-year survival (+/- 95% confidence limits) was 61 +/- 2% and 42 +/- 2% in 1977-1980. These figures changed to 61 +/- 2% and 44 +/- 2% in 1981-1984, and to 64 +/- 2 and 46 +/- 2% in 1985-1988. The improvement with time was statistically...

  5. Effects of prolonged intensive care unit stay on quality of life and long-term survival after transthoracic esophageal resection

    NARCIS (Netherlands)

    Cense, H. A.; Hulscher, J. B. F.; de Boer, A. G. E. M.; Dongelmans, D. A.; Tilanus, H. W.; Obertop, H.; Sprangers, M. A. G.; van Lanschot, J. J. B.

    2006-01-01

    OBJECTIVE: There are few prospective data on the effects of prolonged intensive care unit stay on the quality of life and long-term survival of a homogeneous patient population. Therefore, the aims of this prospective study were a) to describe the quality of life in patients after having a

  6. Long-term survival outcomes of laparoscopic staging surgery in treating endometrial cancer: 20 years of follow-up

    Directory of Open Access Journals (Sweden)

    Chyi-Long Lee

    2016-08-01

    Conclusions: Patients with endometrial carcinoma treated by LSS had compatible or even better long-term survival outcomes and less complication in comparison with the published data, in addition to the benefits of its minimally invasive characteristics. LSS should be the treatment of choice for endometrial cancer.

  7. Effect of a long-term high-protein diet on survival, obesity development, and gut microbiota in mice

    NARCIS (Netherlands)

    Kiilerich, Pia; Myrmel, Lene Secher; Fjære, Even; Hao, Qin; Hugenholtz, Floor; Sonne, Si Brask; Derrien, Muriel; Pedersen, Lone Møller; Petersen, Rasmus Koefoed; Mortensen, Alicja; Licht, Tine Rask; Rømer, Maria Unni; Vogel, Ulla Birgitte; Waagbø, Linn Jeanette; Giallourou, Natasa; Feng, Qiang; Xiao, Liang; Liu, Chuan; Liaset, Bjørn; Kleerebezem, Michiel; Wang, Jun; Madsen, Lise; Kristiansen, Karsten

    2016-01-01

    Female C57BL/6J mice were fed a regular low-fat diet or high-fat diets combined with either high or low protein-to-sucrose ratios during their entire lifespan to examine the long-term effects on obesity development, gut microbiota, and survival. Intake of a high-fat diet with a low

  8. Purpose in life over a five-year period: a longitudinal study in a very old population.

    Science.gov (United States)

    Hedberg, Pia; Brulin, Christine; Aléx, Lena; Gustafson, Yngve

    2011-06-01

    Few studies have specifically examined purpose in life among very old people, and we know of none that has used a prospective approach. The aim of this study was to examine changes in purpose in life over five years in very old men and women and to investigate whether depressed mood, malnutrition, inactivity in daily life, or cognitive impairment increased the risk for developing low purpose in life. The study includes data from 51 participants (42 women and 9 men) living in northern Sweden who completed the Purpose in Life (PIL) Test once at baseline and again five years later. Purpose in life decreased over five years and the decrease was significantly associated with being a woman (p purpose in life does not seem to prevent very old people from developing depression, and being depressed at baseline and living with depression over five years is associated with a loss of purpose in life.

  9. Phytostabilisation of arsenical gold mine tailings using four Eucalyptus species: growth, arsenic uptake and availability after five years.

    Science.gov (United States)

    King, Drew J; Doronila, Augustine I; Feenstra, Christina; Baker, Alan J M; Woodrow, Ian E

    2008-11-15

    Arsenic (As) contamination is a worldwide problem. Where arsenic is highly concentrated and confined within a limited area, such as in many mine tailings facilities, phytostabilisation is an attractive technology for long-term remediation. Important characteristics of a plant to be useful for phytostabilisation include As tolerance and low levels of As accumulation, as well as the ability to limit As availability. Performance needs to be monitored over the long term to ensure an ongoing vegetation community, though this is rarely done. In this study, the suitability of four Eucalyptus species (E. cladocalyx, E. melliodora, E. polybractea, E. viridis) for the phytostabilisation of arsenical, sulphidic gold mine tailings was assessed after five years. All four species accumulated low As concentrations, the highest being recorded in mature leaves, ranging from 0.29 to 5.14 microg g(-1) As. E. polybractea had significantly higher foliar As than the other three species but there was also great variation within the species. Between 5-10 times lower concentrations were recorded in stem samples and no As was detected in young leaf tips. There was also significant variation in the growth of trees upon the site. Eucalyptus cladocalyx grew significantly taller than other species although greater variation was detected within the species than between. The variation in tree heights was not correlated with As concentrations in either stems or leaves. Arsenic availability was determined to depths of 2.2 m and found to be low when compared to total As in the tailings. Importantly, no effect of trees on As availability or soil pH was detected. We conclude that E. cladocalyx, in particular is an ideal candidate for the long-term phytostabilisation of As-contaminated land and mine tailings. The variation detected in both As accumulation and growth is also promising for the selection of desirable traits.

  10. Taking out 1 billion tons of CO2: The magic of China's 11th Five-Year Plan?

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Nan; Lin, Jiang; Zhou, Nan; Levine, Mark; Fridley, David

    2007-07-01

    China's 11th Five-Year Plan (FYP) sets an ambitious target for energy-efficiency improvement: energy intensity of the country's gross domestic product (GDP) should be reduced by 20% from 2005 to 2010 (NDRC, 2006). This is the first time that a quantitative and binding target has been set for energy efficiency, and signals a major shift in China's strategic thinking about its long-term economic and energy development. The 20% energy intensity target also translates into an annual reduction of over 1.5 billion tons of CO2 by 2010, making the Chinese effort one of most significant carbon mitigation effort in the world today. While it is still too early to tell whether China will achieve this target, this paper attempts to understand the trend in energy intensity in China and to explore a variety of options toward meeting the 20% target using a detailed end-use energy model.

  11. Streamwater Chemistry and Nutrient Export During Five Years of Bark Beetle Infestation of Subalpine Watersheds at the Fraser Experimental Forest

    Science.gov (United States)

    Rhoades, C.; Elder, K.; Hubbard, R.; Porth, L.

    2008-12-01

    Forested watersheds of western North America are currently undergoing rapid and extensive canopy mortality caused by a variety of insect species. The mountain pine bark beetle (Dendroctonus ponderosae) began to attack lodgepole pine (Pinus contorta) at the USFS Fraser Experimental Forest in central Colorado in 2002. By 2007, bark beetles had killed 78% of the overstory pine in Fraser research watersheds on average. The hydrologic, climatic, biogeochemical and vegetation records at the Fraser Experimental Forest provide a unique opportunity to quantify the impacts of this widespread, but poorly understood forest disturbance relative to a multi-decade pre-disturbance period. Here we compare seasonal streamwater chemistry and annual nutrient export for the five years since the bark beetle outbreak began with the pre- attack record. Patterns in post-outbreak streamwater biogeochemistry are compared to changes is species composition and proportional loss of overstory basal area for four basins. The influence of the outbreak will depend upon an aggregate of short (i.e. halted overstory water and nutrient use) and longer-term (i.e. altered canopy interception, windthrow, and understory growth) processes, so the hydrologic and biogeochemical implications of current beetle activity will not be fully realized for decades.

  12. Five-year longitudinal assessment of the downstream impact on schistosomiasis transmission following closure of the Three Gorges Dam.

    Science.gov (United States)

    Gray, Darren J; Thrift, Aaron P; Williams, Gail M; Zheng, Feng; Li, Yue-Sheng; Guo, Jiagang; Chen, Honggen; Wang, Tianping; Xu, Xin Jiang; Zhu, Rong; Zhu, Hongqing; Cao, Chun Li; Lin, Dan Dan; Zhao, Zhen Yuan; Li, Robert S; Davis, George M; McManus, Donald P

    2012-01-01

    Schistosoma japonicum is a major public health concern in the Peoples' Republic of China (PRC), with about 800,000 people infected and another 50 million living in areas at risk of infection. Based on ecological, environmental, population genetic and molecular factors, schistosomiasis transmission in PRC can be categorised into four discrete ecosystems or transmission modes. It is predicted that, long-term, the Three Gorges Dam (TGD) will impact upon the transmission of schistosomiasis in the PRC, with varying degree across the four transmission modes. We undertook longitudinal surveillance from 2002 to 2006 in sentinel villages of the three transmission modes below the TGD across four provinces (Hunan, Jiangxi, Hubei and Anhui) to determine whether there was any immediate impact of the TGD on schistosomiasis transmission. Eight sentinel villages were selected to represent both province and transmission mode. The primary end point measured was human incidence. Here we present the results of this five-year longitudinal cohort study. Results showed that the incidence of human S. japonicum infection declined considerably within individual villages and overall mode over the course of the study. This is also reflected in the yearly odds ratios (adjusted) for infection risk that showed significant (Pdam.

  13. Development of an individualized scoring system to predict mid-term survival after carotid endarterectomy.

    Science.gov (United States)

    Morales-Gisbert, Sara M; Zaragozá García, José M; Plaza Martínez, Ángel; Gómez Palonés, Francisco J; Ortiz-Monzón, Eduardo

    2017-08-01

    Carotid endarterectomy (CEA) is a prophylactic surgery focused in preventing stroke in the mid-long term. The purpose of this study was to analyze mid-term mortality in patients undergoing CEA, identify predictors of 3-year mortality and design a score to estimate individual risk of mortality in this population. A retrospective single-center study including consecutive patients undergoing CEA between 1997-2010. Demographic data and comorbidities, postoperative results and patient follow-up data were registered and evaluated. Kaplan Meier analysis was used to analyze survival. After multivariable COX regression analysis, a score based on the calculated Hazards Ratios (HR) was designed. The sum of all points performed the individual score for each patient for estimating 3-years mortality. Population was stratified into four groups according to percentiles of score obtained: Group A (-7 to 4 points), Group B (5-8 points), Group C (9-10 points), Group D (score greater than 11 points). A total of 453 patients with a mean follow-up of 53.4 months were included in the study. Overall 3-year survival was 88.4%. On the univariate analysis the variables associated with significant increasing in 3-year mortality were: female gender (OR 2.32), diabetes mellitus (OR 2.28), COPD (OR 2.98), ischemic heart disease (OR 2.29), critical carotid stenosis >90% (OR 2.16) and antiplatelet therapy as a protective factor (OR 0,23). Factors associated with mortality in multivariate analysis were age (HR 1.14 P=0.001), diabetes mellitus (HR 1.62, P=0.031), COPD (HR 1.88 P=0.022), ischemic heart disease (HR 1.59 P=0.05), critical stenosis >90% (HR 1.70 P=0.015) and antiplatelet therapy as a protective factor (HR 0.23 P=0.027). The scoring system includes the following items: female gender (+2 points), age (50-69 years +7 points, 70-79 years +12 points, >80 years +15 points), diabetes (+4 points), COPD (+5 points), ischemic heart disease (+4 points), carotid stenosis> 90% (+4 points

  14. Reduced Long-Term Relative Survival in Females and Younger Adults Undergoing Cardiac Surgery: A Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Tone Bull Enger

    Full Text Available To assess long-term survival and mortality in adult cardiac surgery patients.8,564 consecutive patients undergoing cardiac surgery in Trondheim, Norway from 2000 until censoring 31.12.2014 were prospectively followed. Observed long-term mortality following surgery was compared to the expected mortality in the Norwegian population, matched on gender, age and calendar year. This enabled assessment of relative survival (observed/expected survival rates and relative mortality (observed/expected deaths. Long-term mortality was compared across gender, age and surgical procedure. Predictors of reduced survival were assessed with multivariate analyses of observed and relative mortality.During follow-up (median 6.4 years, 2,044 patients (23.9% died. The observed 30-day, 1-, 3- and 5-year mortality rates were 2.2%, 4.4%, 8.2% and 13.8%, respectively, and remained constant throughout the study period. Comparing observed mortality to that expected in a matched sample from the general population, patients undergoing cardiac surgery showed excellent survival throughout the first seven years of follow-up (relative survival ≥ 1. Subsequently, survival decreased, which was more pronounced in females and patients undergoing other procedures than isolated coronary artery bypass grafting (CABG. Relative mortality was higher in younger age groups, females and patients undergoing aortic valve replacement (AVR. The female survival advantage in the general population was obliterated (relative mortality ratio (RMR 1.35 (1.19-1.54, p<0.001. Increasing observed long-term mortality seen with ageing was due to population risk, and younger age was independently associated with increased relative mortality (RMR per 5 years 0.81 (0.79-0.84, p<0.001.Cardiac surgery patients showed comparable survival to that expected in the general Norwegian population, underlining the benefits of cardiac surgery in appropriately selected patients. The beneficial effect lasted shorter in

  15. Dietary Patterns and Long-Term Survival: A Retrospective Study of Healthy Primary Care Patients.

    Science.gov (United States)

    Shah, Nilay S; Leonard, David; Finley, Carrie E; Rodriguez, Fatima; Sarraju, Ashish; Barlow, Carolyn E; DeFina, Laura F; Willis, Benjamin L; Haskell, William L; Maron, David J

    2017-08-30

    Dietary patterns are related to mortality in selected populations with comorbidities. We studied whether dietary patterns are associated with long-term survival in a middle-aged, healthy population. In this observational cohort study at the Cooper Clinic preventive medicine center (Dallas, Tex), a volunteer sample of 11,376 men and women with no history of myocardial infarction or stroke completed a baseline dietary assessment between 1987 and 1999 and were observed for an average of 18 years. Proportional hazard regressions, including a tree-augmented model, were used to assess the association of the Dietary Approaches to Stop Hypertension (DASH) dietary pattern, Mediterranean dietary pattern, and individual dietary components with mortality. The primary outcome was all-cause mortality. The secondary outcome was cardiovascular mortality. Mean baseline age was 47 years. Each quintile increase in the DASH diet score was associated with a 6% lower adjusted risk for all-cause mortality (P Mediterranean diet was not independently associated with all-cause or cardiovascular mortality. Solid fats and added sugars were the most predictive of mortality. Individuals who consumed >34% of their daily calories as solid fats had the highest risk for all-cause mortality. The DASH dietary pattern was associated with significantly lower all-cause mortality over approximately 2 decades of follow-up in a middle-aged, generally healthy population. Added solid fat and added sugar intake were the most predictive of all-cause mortality. These results suggest that promotion of a healthy dietary pattern should begin in middle age, before the development of comorbid risk factors. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Research on history of medicine in China in the last five years.

    Science.gov (United States)

    Zhu, Jian-ping

    2004-03-01

    Since 1999, progress has been made, to varying degrees, in numerous areas of medical history research in China including history of TCM, history of western medicine, history of integrated Chinese and western medicine, history of traditional medicine of Chinese minorities, history of medicine of foreign countries, history of medical exchanges between China and other countries, and history of comparative medical history. Among others, the number of articles on history of diseases, history of specific medical disciplines, modern medical history, medical biographies, medical works, contemporary medical history, and history of medical culture has increased dramatically. In the field of history of diseases, the papers deal with diseases in gynecology and obstetrics, plague, lanhousha (scarlet fever), and nephritis; articles in the field of specific disciplines deal with history of acu-moxibustion, history of prescription-forms, and history of gynecology, endoscopic surgery, and evidence-based medicine. There are even distinguished papers appeared in these aspects. In the aspect of modern medical history, there are papers dealing with the developement of TCM, the introduction of western medicine into China, with some specific researches in these fields. Medical biographies include Tan Yun-xian, Quan Shao-qing, Du Chong-ming etc. Papers on medical works deal with the ancient unearthed literature lost yet spread and extant abroad, medical classics, canons on material medica, cold-pathogenic diseases, and formularies. While papers on history of medical culture discuss basically the influence of Confucianism, Taoism, Buddhism and I-discipline on Chinese medicine. During these five years, 300 original articles have been published in The Chinese journal of Medical History, with another 200 papers published in other Chinese journals. Forty monographs have been published and important ones are A General History of Chinese Medicine, Modern history of TCM, The Historical

  17. Twenty-five years of continuous sulphur dioxide emission reduction in Europe

    Directory of Open Access Journals (Sweden)

    V. Vestreng

    2007-07-01

    Full Text Available During the last twenty-five years European emission data have been compiled and reported under the Cooperative Programme for Monitoring and Evaluation of the Long-range Transmission of Air Pollutants in Europe (EMEP as part of the work under the UNECE Convention on Long-range Transboundary Air Pollution (LRTAP. This paper presents emission trends of SO2 reported to EMEP and validated within the programme for the period 1980–2004. These European anthropogenic sulphur emissions have been steadily decreasing over the last twenty-five years, amounting from about 55 Tg SO2 in 1980 to 15 Tg SO2 in 2004. The uncertainty in sulphur emission estimates for individual countries and years are documented to range between 3% and 25%. The relative contribution of European emissions to global anthropogenic sulphur emissions has been halved during this period. Based on annual emission reports from European countries, three emission reduction regimes have been identified. The period 1980–1989 is characterized by low annual emission reductions (below 5% reduction per year and 20% for the whole period and is dominated by emission reductions in Western Europe. The period 1990–1999 is characterised by high annual emission reductions (up to 11% reduction per year and 54% for the whole period, most pronounced in Central and Eastern Europe. The annual emission reductions in the period 2000–2004 are medium to low (below 6% reduction per year and 17% for the whole period and reflect the unified Europe, with equally large reductions in both East and West. The sulphur emission reduction has been largest in the sector Combustion in energy and transformation industries, but substantial decreases are also seen in the Non-industrial combustion plants together with the sectors Industrial combustion and Industrial production processes. The majority of European countries have reduced their emissions by more than

  18. Patterns and predictors of mortality among children under-five years ...

    African Journals Online (AJOL)

    The study was a population based cross-sectional design where information was obtained from the Nigeria Demographic and Health Survey (NDHS) 2008 on childhood survival ... Childhood mortality experienced by mothers in Nigeria is high and the predictors included both sociodemographic and health related factors.

  19. Twenty-five year experience with renal transplantation at Santa Casa Hospital, Porto Alegre.

    Science.gov (United States)

    Keitel, Elizete; dos Santos, Auri Ferreira; Bittar, Antonio Eduardo; Bruno, Rosana Mussoi; Pozze, Roberta; Duarte, Marcele; Bianco, Patrícia D'Almeida; Goldani, João Carlos; Messias, Alexandre; Losekan, Alexandre; Bender, Dolores; Bianchini, João Jorge; Garcia, Clotilde Druck; Barros, Viviane; Schneider, Luciane H; Vitola, Santo Pascoal; Guerra, Enilde; Didoné, Eduardo; Pires, Fabian; da Rocha, Vitor Hugo Bazan; Michelon, Tatiane; Fernandes, Sandra; Neumann, Jorge; Garcia, Valter Duro

    2002-01-01

    From 1977 to July 2002, 1,376 renal transplants were performed at Santa Casa of Porto Alegre. The number of transplants and the patient and graft survival rates have been rising each year since 1987. The overall one-year graft survival rates were 90% for living donor recipients and 80% for cadaver donor recipients, respectively; however, the patient and graft survival rates increased significantly between the early (1977-1995) and more recent (1996-2002) periods. Pediatric patients (less than 18 years old) accounted for 15.8% of the transplants that were performed, most of them from living related donors. The patient and graft survival rates did not differ statistically when we compared recipients of transplants from "ideal" and marginal cadaver donors, even when we considered only those risk factors that affected graft function in assigning a marginal donor. During the 25-year observation period, 537 grafts have been lost (39%), including those patients who died with functioning graft. We are currently following 834 patients with a functioning graft, with an average follow-up of 67+54 months.

  20. A Five Year Summary of the NSF PAARE Project at SC State

    Science.gov (United States)

    Walter, Donald K.; Brittain, S. D.; Cash, J.; Hartmann, D.; Howell, S. B.; King, J. R.; Leising, M. D.; Mighell, K. J.; Smith, D. M.

    2013-01-01

    We summarize the progress made over five years of “A Partnership in Observational and Computational Astronomy (POCA)”. This NSF-funded project is part of the “Partnerships in Astronomy and Astrophysics Research and Education (PAARE)" program. Our partnership includes South Carolina State University (a Historically Black College/University), Clemson University (a Ph.D. granting institution) and the National Optical Astronomy Observatory. Graduate fellowships provided by POCA as well as recruitment efforts on the national level have resulted in enrolling a total of four underrepresented minorities into the Ph.D. program in astronomy at Clemson. One of these has completed her M.S. in astronomy, while the others continue on toward the doctorate. We summarize the success and challenges of recruiting students into the undergraduate physics major with astronomy option at SC State and the support POCA has provided for nearly two dozen of them. Our summer REU program under POCA includes underrepresented students from across the country conducting research at each of our three institutions. Their work can be found elsewhere at this conference (Hernandez et al., Kurgatt et al. and Pugh et al.) Examples are given of our inquiry-based, laboratory exercises and web- based activities related to cosmology that have been developed with PAARE funding. We discuss our ground-based photometric and spectroscopic study of RV Tauri and Semiregular variables as well as our successful Kepler Cycle 2 and Cycle 4 study of a dozen of these objects . Support for the POCA project is provided by the NSF PAARE program to South Carolina State University under award AST-0750814 as well as resources and support provided by Clemson University and the National Optical Astronomy Observatory. Support for the Kepler observations is provided by NASA to South Carolina State University under award NNX11AB82G. Additional details can be found at: http://physics.scsu.edu/paare/

  1. Thrombophilia and abdominal vessel thrombosis in a Greek University hospital: A five year experience

    Directory of Open Access Journals (Sweden)

    Ioannis Starakis

    2010-01-01

    Full Text Available Thrombophilia, either congenital or acquired, has foremost consequences in the abdominal vessels. We review here the cases of patients admitted with abdominal vessel thrombosis over a five-year period. Our data focused on gender and age at diagnosis, site of thrombosis, previous thromboembolic events, underlying conditions, and family history. Investigations included measurement of protein C, protein S, activated PC resistance, and antithrombin, and screening for factor V Leiden, prothrombin G20210A, the C677T variant of the methylenetetrahydrofolate reductase gene, and V617F JAK2 mutation, r lupus anticoagulant, antiphospholipid antibodies and paroxysmal nocturnal hemospherinouria, and also serum folate, vitamin 12, and total homocysteine concentrations. Twenty-nine patients were admitted and 18 of their family members also underwent the same thrombophilia investigations. Eighteen patients (62.1% presented with portal vein thrombosis (PVT, five patients (17.2% with mesenteric vein thrombosis (MVT, four patients (13.8% with splenic vein thrombosis (SVT, and two (6.9% patients with hepatic vein thrombosis (HVT. There was a high incidence of congenital thrombophilia (37.9%, acquired thrombophilic conditions (27.6%, or both (20.7%. Sixteen of 18 patients with PVT, four of five patients with MVT, all four patients with SVT, and one of two patients with HVT had one or more thrombophilic risk factors. In 13.8% of the patients no underlying condition was identified. We concluded that thrombophilia may have major implications in the pathogenesis of abdominal vessel thrombosis in adult life, and a thorough thrombophilia investigation should be performed in all these patients.

  2. The National Space Grant College and Fellowship Program: The First Five Years 1989-1994

    Science.gov (United States)

    Dasch, J.; Ward, E.

    1996-03-01

    NASA accepted the Congressional mandate to manage the National Space Grant College and Fellowship Program (NSGC&FP) and announced the original competition for Space Grant awards in 1989. Currently, 52 independently governed Space Grant consortia administer programs in three areas of university and NASA concern: research, education, and public service. NASA funds have remained stable at $15 million since 1991, but the consortia have leveraged matching funds, including in-kind contributions, to approximately double the Space Grant awards. The number of affiliated Space Grant institutions has grown from 86 affiliates in 1990 to over 550 affiliates in 1996. Members include many of the finest colleges and universities in the nation, internationally competitive business and industrial partners, small businesses, state and local government agencies, private colleges, community colleges, medical colleges, and other nonprofit organizations. Though the program has been fully operational in all 52 consortia for less than five years, the benefits to the taxpayer have been significant. Space Grant faculty and students obtained funding for over 300 research proposals. Since 1990, the NSGC&FP has served close to 6500 citizens by providing tuition assistance. Among these 6500 were significant numbers of students from underrepresented groups in science and engineering. Space Grant consortia leveraged $16.5 million for precollege activities and administered over 1300 precollege projects that promote NASA-related science education. Space Grant precollege programs, serving both teachers and students, provide good examples of higher education faculty working well with local school systems. The consortia administered over 600 public service programs and leveraged approximately $4.5 million. Space Grant funds provided science and technology lectures, demonstrations, science exhibits, space-related periodicals, audio and video productions of NASA-related subjects, and have helped to

  3. THE CONCEPTION OF FISHERIES DEVELOPMENT IN DNIPROPETROVS’K REGION FOR THE NEXT FIVE YEARS

    Directory of Open Access Journals (Sweden)

    O. Fedonenko

    2015-03-01

    Full Text Available Purpose. To analyse the current state of fisheries in Dnipropetrovs’k region and elaborate a strategy of their development for the period of 2015–2019. Methodology. We used the summarized results of hydrobiological, ichthyological and toxicological studies carried out during 2010–2014. Data were collected in the Zaporizhzhia reservoir and small water bodies with standard sampling gears. A set of control gears (gill nets with mesh size of 30–120 mm was used to investigate the fish fauna. Juvenile fish were caught in the third decade of July – first decade of August with 10 m beach seine. Findings. The analysis of fisheries in Dnipropetrovs’k region for the past five years showed that the disorder and absence of scientifically-based approach to fisheries processes as well as the low level of professional training of aquatic resource users resulted in low fish productivity in the majority of reservoirs, which ranged within 25–30 kg/ha that was several times less than the real potential fish productivity. The proposed Conception of fisheries development provides a set of coordinated measures aimed at ensuring sustainable use, effective protection and restoration of aquatic biological resources, fisheries management based on natural, economic and environmental conditions of different types of water bodies. The developed practical measures allow increasing the amounts of fish product supply to the internal consumer market by at least 5 times without any environmental damage, expanding its assortment and reducing the costs by 25–30%. Originality. For the first time, the Conceptual approaches to the regional management of aquatic biological resources in the conditions of specific human impact were introduced. They are aimed at implementing the scientific rationale of the measures for their rational use, artificial restoration, reclamation, etc. Practical value. The proposed Conception is to provide the food requirements of the population

  4. Employment status and sick-leave following obesity surgery: a five-year prospective cohort study

    Directory of Open Access Journals (Sweden)

    John Roger Andersen

    2015-09-01

    Full Text Available Background. Severe obesity is a risk factor for lower participation in paid work, but whether employment increases and sick leave decreases after obesity surgery is not well documented.Methods. We assessed 224 Norwegian patients with severe obesity (mean age: 40; mean BMI: 49; 61% female regarding employment status (working versus not working and the number of days of sick leave during the preceding 12 months, before and five years after obesity surgery (75% follow-up rate. Logistic regression analysis was used to study preoperative predictors of employment status after surgery.Results. There were no change in the employment rate over time (54% versus 58%, but the number of days of sick leave per year was significantly reduced, from a mean of 63 to a mean of 26, and from a median of 36 to a median of 4. Most of this change was attributable to patients with zero days of sick leave, which increased from 25% to 41%. Being female, older, having low education level, receiving disability pension and not being employed before obesity surgery were important risk factors for not being employed after obesity surgery. The type of obesity surgery, BMI and marital status were not useful predictors.Conclusions. Our findings suggest that undergoing obesity surgery is not associated with a higher rate of employment, although it may reduce the number of days of sick leave. Additional interventions are likely needed to influence the employment status of these patients. The significant preoperative predictors of not being employed in this study provide suggestions for further research.

  5. Spirituality, social support, and flexibility among older adults: a five-year longitudinal study.

    Science.gov (United States)

    Bailly, Nathalie; Martinent, Guillaume; Ferrand, Claude; Agli, Océane; Giraudeau, Caroline; Gana, Kamel; Roussiau, Nicolas

    2018-01-30

    The objectives of the study were to examine the trajectory of spirituality among older adults, to investigate the roles of gender and religion on the developmental trajectory of spirituality, and to explore whether the linear growth of spirituality accelerated or decelerated at time points at which the participants reported high scores of social support and flexibility. A five-year longitudinal study. The research used data from a longitudinal study, which follows a non-institutionalized older adults cohort of residents from France. The data used in this paper were collected at three time points (T1: 2007; T2: 2009; T3: 2012). A total of 567 participants were included in the analysis (59.44% female; M age = 75.90, SD = 5.12). Multilevel growth curve analysis was used measuring spirituality, satisfaction with social support, and flexibility. The results indicated the following: (1) stability of spirituality over time, (2) older women reported higher levels of spirituality than older men, and those who had a religion reported higher scores of spirituality than their counterparts who had no religion (these effects were strong and clinically meaningful), (3) older adults who reported higher levels of social support and flexibility also reported higher levels of spirituality, and (4) the slope of spirituality seemed to accelerate at time points at which participants also had higher levels of social support and flexibility (these effects were rather small but of theoretical interest). The results of the present study help to improve the understanding of the potential benefit of encouraging the spiritual aspects of life.

  6. Twenty-five years of transient counting experience in French PWR units

    Energy Technology Data Exchange (ETDEWEB)

    Barthelet, B. [Electricite de France (EDF DPN), 93 - Saint-Denis (France); Savoldelli, D.; Fritz, R. [Electricite de France (EDF DPN), 93 - Noisy le Grand (France)

    2001-07-01

    For nearly twenty five years, EDF has been checking that the actual operating transients are neither more severe nor more numerous than the design basis transients. This activity of transient cycle counting and bookkeeping has enabled EDF to own a database of more than 800 reactor.years for the PWR units. The current method of transient cycle counting is presented. In the paper, we will point out the main results of transient cycle counting and lessons learned. In general, the frequencies of transients are lower than the design frequencies. In few cases, they are higher, such as the transient frequencies of the RCS lines connected to auxiliary systems often due to operating procedures or particular periodic testing. Few periodic tests were not taken into account in the design basis transient file ; they have been detected thanks to the transient cycle counting. In the last 1980's, we achieved the first updating of the design basis transient file for the PWR 900 MWe series. In the early 1990's, we updated the design basis transient file of the PWR 1300 MWe series. In fact, since design and start-up, the operating conditions have been modified (fuel cycle with stretch-out, modification of the hot leg and cold leg temperatures for the PWR 1300 MWe,...). This was the cause of many unclassified transients. In the new design basis transient file, we have created new transients and increased the frequencies of some of them. This has enabled to consider the updated design basis transient file more representative of actual operating transients. For some years, we have increasingly associated the operators with the transient cycle counting concern. We noticed progress (decreased frequencies of most transients). (authors)

  7. Evaluation of a five-year Bloomberg Global Road Safety Program in Turkey.

    Science.gov (United States)

    Gupta, S; Hoe, C; Özkan, T; Lajunen, T J; Vursavas, F; Sener, S; Hyder, A A

    2017-03-01

    Turkey was included in the Bloomberg Philanthropies funded Global Road Safety Program (2010-14) with Ankara and Afyonkarahisar (Afyon) selected for interventions to manage speed and encourage seat-belt use. The objectives of this study are to present the monitoring and evaluation findings of seat-belt use and speed in Afyon and Ankara over the five years and to assess overall impact of the program on road traffic injury, and death rates in Turkey. Quasi-experimental before after without comparison. In collaboration with the Middle East Technical University, roadside observations and interviews were coupled with secondary data to monitor changes in risk factors and outcomes at the two intervention sites. The percentage of seat-belt use among drivers and front-seat passengers in Afyon and Ankara increased significantly between 2010 and 2014 with increased self-reported use and preceded by an increase in tickets (fines) for not using seat belts. There were uneven improvements in speed reduction. In Afyon, the average speed increased significantly from 46.3 km/h in 2012 to about 52.7 km/h in 2014 on roads where the speed limits were 50 km/h. In Ankara, the average speed remained less than 55 km/h during the program period (range: 50-54 km/h; P Turkey to substantially reduce road traffic injuries will lead to increased program implementation matched with a robust evaluation program, with suitable controls. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Durability associated efficacy of long-lasting insecticidal nets after five years of household use

    Directory of Open Access Journals (Sweden)

    Msangi Shandala

    2011-08-01

    Full Text Available Abstract Background Long-lasting insecticidal nets (LLINs have been strongly advocated for use to prevent malaria in sub-Saharan Africa and have significantly reduced human-vector contact. PermaNet® 2.0 is among the five LLINs brands which have been given full approval by the WHO Pesticide Evaluation Scheme (WHOPES. The LLINs are expected to protect the malaria endemic communities, but a number of factors within the community can affect their durability and efficacy. This study evaluated the durability, efficacy and retention of PermaNet® 2.0 after five years of use in a Tanzanian community. Method Two to three day- old non blood-fed female mosquitoes from an insectary susceptible colony (An. gambiae s.s, this colony was established at TPRI from Kisumu, Kenya in 1992 and wild mosquito populations (An. arabiensis and Culex quinquefasciatus were used in cone bioassay tests to assess the efficacy of mosquito nets. Findings The knockdown effect was recorded after three minutes of exposure, and mortality was recorded after 24 hours post-exposure. Mortality of An. gambiae s.s from insectary colony was 100% while An. arabiensis and Cx.quinquefasciatus wild populations had reduced mortality. Insecticide content of the new (the bed net of the same brand but never used before and used PermaNet® 2.0 was determined using High Performance Liquid Chromatography (HPLC. Conclusion The results of this study suggest that, in order to achieve maximum protection against malaria, public health education focusing on bed net use and maintenance should be incorporated into the mass distribution of nets in communities.

  9. Trends in diabetes-related lower extremities amputations in Romania-A five year nationwide evaluation.

    Science.gov (United States)

    Veresiu, Ioan Andrei; Iancu, Silvia Stefania; Bondor, Cosmina

    2015-08-01

    The aim of the study was to perform a nationwide evaluation of the frequency, incidence and trends of diabetes-related LEA (lower extremities amputations) in Romania. We have retrospectively analysed DRG data (ICD 10 AM codes) from all hospitals in the country, over a 5 year period (2006-2010). Knowing the shortcomings of this approach, we have assumed that our study can serve as a platform for future comparisons. The total number of non-traumatic diabetes related LEA procedures was 24,312, they were performed in 16,873 patients with diabetes, 22.55% with type 1 diabetes, 70.26 with type 2 diabetes and 7.19% with non-specified diabetes at discharge. The total number of hospital admissions for these patients was 46,985. During the five years of the study there was an increase in the absolute number of major amputations (above the ankle), as well as of minor amputations. The rate of amputations decreased in type 1 diabetes, from baseline (2006): -8.15% in 2007, -25.83% in 2008, -23.43% in 2009, -27.71% in 2010, whereas it increased in type 2 diabetes in the respective years: 16.96%, 60.75%, 66.91%, and 104.64%, due to an increase in minor amputations and mainly in elderly people. Male: female amputations rate was 2:1 in type 1 diabetes patients and 2.4:1 in type 2 diabetes patients. This study, the first of its kind in the Romanian population, offers a starting point for future comparisons and identifies a target for preventive measures. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Nutrition profile of under-five year rural children and correlates of undernutrition in central India

    Directory of Open Access Journals (Sweden)

    Venkaiah Kodavalla

    2015-12-01

    Full Text Available Background: High prevalence of undernutrition in Madhya Pradesh contributing to high mortality and morbidities among young children. Aims & objectives: to assess prevalence of undernutrition and its co-relates among under 5 year children in Madhya Pradesh. Materials & Methods: It was a community based cross- sectional study carried out in all the districts of Madhya Pradesh, India using systematic random sampling. Results: A total of 22,895 children (Boys:12379, Girls:10516, mean age 26.1 months, SD 15.9, were covered. The overall prevalence of underweight, stunting and wasting was about 52%, 49% and 26% respectively. The prevalence was significantly (p<0.01 higher among boys as compared to girls. The risk of underweight, stunting and wasting was significantly higher among children belonging to SC+ST communities (OR: 1.36, 1.21 & 1.23 as compared to others, among children of illiterate parents and landless labourers (OR: 1.27, 1.32 & 1.15. The risk of stunting was significantly higher among children living in HHs without electricity (OR: 1.41 and HHs not using sanitary latrine (OR: 1.29. Similarly, the risk of wasting was significantly higher among households not having access to safe drinking water, mothers not cleaning their hands before feeding and among children with history of morbidity during preceding fortnight. Prevalence of underweight (28%, stunting (17% and wasting (34% was significantly (p<0.01 lower among children who were exclusively breast fed up to 6 months. Conclusions: Multiple risk factors are associated with childhood undernutrition and needs multi-pronged and multi-sector approach to tackle the problem. The results will help planners to develop and implement appropriate intervention strategies, for effective control and prevention of undernutrition among under-five year children in Madhya Pradesh

  11. Trends in ophthalmology journals: a five-year bibliometric analysis (2009-2013

    Directory of Open Access Journals (Sweden)

    Christopher B. Schulz

    2016-12-01

    Full Text Available AIM: To explore the trends in the ophthalmic literature over a 5-year period in relation to country, research expenditure and demographics. METHODS: Articles published between 2009 and 2013 by the 20highest-contributing countries in the 20 top-ranked ophthalmology journals were identified by their country of affiliation. The number of articles published and mean impact factor were measured per country for each year and trends explored using regression analysis with 5-year and 10-year forecasts calculated. Data on research expenditure was collected and tested for correlation with the number of articles and mean impact factor. RESULTS: The analysis included 19 338 articles. The USA, UK and Europe accounted for 60.2% of articles published, with the USA contributing 7388 articles (34.0%. The USA also demonstrated the highest mean impact factor (3.5. Research expenditure was significantly correlated with both research output (r=0.86, P<0.001 and scholarly impact (r=0.42, P<0.001. China (P<0.01, Korea (P<0.01 and India (P<0.02 demonstrated a significant growth in research output over the study period. The research contribution of these three countries combined is forecasted to overtake that of Europe within ten years, with China expected to be the second-largest contributor within five years. These countries were also among those demonstrating the greatest growth in research expenditure. CONCLUSION: While the USA and European countries are major contributors of ophthalmic research, the productivity of some Asian countries is growing impressively. The contribution of China, Korea and India is forecasted to outweigh that of Europe by 2023. Research expenditure is highly correlated with research productivity and these trends reflect the differing economic priorities across the world.

  12. [Long term biochemical recurrence free survival after radical prostatectomy for cancer: comparative analysis according to surgical approach and clinicopathological stage].

    Science.gov (United States)

    Rizk, J; Ouzzane, A; Flamand, V; Fantoni, J-C; Puech, P; Leroy, X; Villers, A

    2015-03-01

    To assess long term biochemical recurrence free survival after radical prostatectomy according to open, laparoscopic and robot-assisted surgical approach and clinicopathological stage. A cohort study of 1313 consecutive patients treated by radical prostatectomy for localized or locally advanced prostate cancer between 2000 and 2013. Open surgery (63.7%), laparoscopy (10%) and robot-assisted laparoscopy (26.4%) were performed. Biochemical recurrence was defined by PSA>0,1ng/mL. The biochemical recurrence free survival was described by Kaplan Meier method and prognostic factors were analysed by multivariable Cox regression. Median follow-up was 57 months (IQR: 31-90). Ten years biochemical recurrence free survival was 88.5%, 71.6% and 53.5% respectively for low, intermediate and high-risk D'Amico groups. On multivariable analysis, the worse prognostic factor was Gleason score (PBiochemical recurrence free survival (P=0.06) and positive surgical margins rate (P=0.87) were not statistically different between the three surgical approaches. Biochemical recurrence free survival in our study does not differ according to surgical approach and is similar to published series. Ten years biochemical recurrence free survival for high-risk tumours without hormone therapy is 54% justifying the role of surgery in the therapeutic conversations in this group of tumours. 3. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  13. The impact of vacuum-assisted closure on long-term survival after post-sternotomy mediastinitis.

    Science.gov (United States)

    Sjögren, Johan; Nilsson, Johan; Gustafsson, Ronny; Malmsjö, Malin; Ingemansson, Richard

    2005-10-01

    Post-sternotomy mediastinitis after coronary artery bypass grafting is reported to be a strong predictor for poor late survival when using conventional wound-healing therapies. The aim of this study was to compare the long-term survival after vacuum-assisted closure treated mediastinitis following coronary artery bypass grafting with that of patients without mediastinitis. Another objective was to identify risk factors for developing mediastinitis. Forty-six patients were treated for mediastinitis, with vacuum-assisted closure but without additional tissue flaps, after isolated coronary bypass grafting between January 1999 and September 2004. During this period, 4,781 patients underwent isolated coronary bypass grafting without mediastinitis. Actuarial survival was compared with the log-rank test. Univariate and multivariate analysis were used to identify risk factors for mediastinitis. There was no difference in early or late survival between the mediastinitis group treated with vacuum-assisted closure and the control group (p = not significant). The survival at 1, 3, and 5 years was 92.9% +/- 4.0%, 89.2% +/- 5.2%, and 89.2% +/- 5.2%, respectively, in the vacuum-assisted closure group; and 96.5% +/- 0.3%, 92.1% +/- 0.5%, and 86.9% +/- 0.8%, respectively, in the control group. Diabetes mellitus, low left ventricular ejection fraction, obesity, renal failure, and three-vessel disease were identified as risk factors for developing mediastinitis. This study suggests that patients with vacuum-assisted closure treated mediastinitis may have similar long-term survival as patients without mediastinitis after coronary artery bypass grafting. The independent risk factors identified were similar to those found in previous studies. Our data support that vacuum-assisted closure therapy minimizes the negative effects of mediastinitis on late survival after coronary artery bypass grafting.

  14. Sarcopenia is an Independent Predictor of Severe Postoperative Complications and Long-Term Survival After Radical Gastrectomy for Gastric Cancer

    Science.gov (United States)

    Zhuang, Cheng-Le; Huang, Dong-Dong; Pang, Wen-Yang; Zhou, Chong-Jun; Wang, Su-Lin; Lou, Neng; Ma, Liang-Liang; Yu, Zhen; Shen, Xian

    2016-01-01

    Abstract Currently, the association between sarcopenia and long-term prognosis after gastric cancer surgery has not been investigated. Moreover, the association between sarcopenia and postoperative complications remains controversial. This large-scale retrospective study aims to ascertain the prevalence of sarcopenia and assess its impact on postoperative complications and long-term survival in patients undergoing radical gastrectomy for gastric cancer. From December 2008 to April 2013, the clinical data of all patients who underwent elective radical gastrectomy for gastric cancer were collected prospectively. Only patients with available preoperative abdominal CT scan within 30 days of surgery were considered for analysis. Skeletal muscle mass was determined by abdominal (computed tomography) CT scan, and sarcopenia was diagnosed by the cut-off values obtained by means of optimum stratification. Univariate and multivariate analyses evaluating risk factors of postoperative complications and long-term survival were performed. A total of 937 patients were included in this study, and 389 (41.5%) patients were sarcopenic based on the diagnostic cut-off values (34.9 cm2/m2 for women and 40.8 cm2/m2 for men). Sarcopenia was an independent risk factor for severe postoperative complications (OR = 3.010, P sarcopenia did not show significant association with operative mortality. Moreover, sarcopenia was an independent predictor for poorer overall survival (HR = 1.653, P sarcopenia remained an independent risk factor for overall survival and disease-free survival in patients with TNM stage II and III, but not in patients with TNM stage I. Sarcopenia is an independent predictive factor of severe postoperative complications after radical gastrectomy for gastric cancer. Moreover, sarcopenia is independently associated with overall and disease-free survival in patients with TNM stage II and III, but not in patients with TNM stage I. PMID:27043677

  15. Characteristics of individuals receiving disability benefits in the Netherlands and predictors of leaving the disability benefit scheme: a retrospective cohort study with five-year follow-up.

    Science.gov (United States)

    Louwerse, Ilse; Huysmans, Maaike A; van Rijssen, H Jolanda; van der Beek, Allard J; Anema, Johannes R

    2018-01-18

    Today, work disability is one of the greatest social and labour market challenges for policy makers in most OECD countries, where on average, about 6% of the working-age population relies on disability benefits. Understanding of factors associated with long-term work disability may be helpful to identify groups of individuals at risk for disability benefit entitlement or continuing eligibility, and to develop effective interventions for these groups. The purpose of this study is to provide insight into the main diagnoses of workers who qualify for disability benefits and how these diagnoses differ in age, gender and education. Using a five-year follow-up, we examined the duration of disability benefits and how durations differ among individuals with various characteristics. We performed a cohort study of 31,733 individuals receiving disability benefits from the Dutch Social Security Institute (SSI) with a five-year follow-up. Data were collected from SSI databases. Information about disorders was assessed by an insurance physician upon benefit application. These data were used to test for significant relationships among socio-demographics, main diagnoses and comorbidity, and disability benefit entitlement and continuing eligibility. Mental disorders were the most frequent diagnosis for individuals claiming work disability. Diagnoses differed among age groups and education categories. Mental disorders were the main diagnosis for work disability for younger and more highly educated individuals, and physical disorders (generally musculoskeletal, cardiovascular and cancer) were the main diagnosis for older and less educated individuals. In 82% of the claims, the duration of disability benefit was five years or more after approval. Outflow was lowest for individuals with (multiple) mental disorders and those with comorbidity of mental and physical disorders, and highest for individuals with (multiple) physical disorders. The main diagnosis for persons entitled to

  16. Cerebrospinal fluid dynamics and long-term survival of the Strata valve in idiopathic normal pressure hydrocephalus.

    Science.gov (United States)

    Lundkvist, B; Koskinen, L O D; Birgander, R; Eklund, A; Malm, J

    2011-08-01

    Cerebrospinal fluid (CSF) dynamics and long-term shunt survival of the Strata CSF shunt were evaluated in patients with idiopathic normal pressure hydrocephalus (INPH). Seventy-two patients with INPH received a Strata valve. A CSF infusion test, neuroimaging and video recording of gait were performed at baseline and at 6 months (n = 68) after surgery. Long-term shunt survivals were obtained from patient records. The shunt survival at 1 year was 94% and at 3 years 92.5%. Forty-nine patients (72%) had an improved gait. Two patients were improved despite non-functioning shunts, indicating a possible placebo response. Nineteen patients were not improved at the 6-month follow-up. The shunt tests revealed a functioning shunt in 12; thus, unnecessary shunt revisions could be avoided. Seventeen patients showed a siphoning effect. Shunt revisions were made in six patients. Eight hygromas/subdural hematomas were found. The long-term survival of the Strata valves was good, and a concern of complications is not a reason to exclude elderly with INPH from shunt surgery. Studies are needed to evaluate pros and cons of the anti-siphon device. Using a CSF shunt test, unnecessary shunt revisions may be avoided. © 2010 John Wiley & Sons A/S.

  17. Relationship of Extreme Chromosomal Instability with Long-term Survival in a Retrospective Analysis of Primary Breast Cancer

    DEFF Research Database (Denmark)

    Roylance, Rebecca; Endesfelder, David; Gorman, Patricia

    2011-01-01

    Background: Chromosomal instability (CIN) is thought to be associated with poor prognosis in solid tumors; however, evidence from preclinical and mouse tumor models suggest that CIN may paradoxically enhance or impair cancer cell fitness. Breast cancer prognostic expression signature sets, which...... with survival outcome. Results: There was increased CIN and clonal eterogeneity in ER-negative compared with ER-positive breast cancer. Consistent with a negative impact of CIN on cellular fitness, extreme CIN in ER-negative breast cancer was an independent variable associated with improved long-term survival...

  18. From Exit to Entry: Long-term Survival and Transmission of Salmonella

    OpenAIRE

    Waldner, Landon L.; MacKenzie, Keith D.; Köster,, Wolfgang; White, Aaron P.

    2012-01-01

    Salmonella spp. are a leading cause of human infectious disease worldwide and pose a serious health concern. While we have an improving understanding of pathogenesis and the host-pathogen interactions underlying the infection process, comparatively little is known about the survival of pathogenic Salmonella outside their hosts. This review focuses on three areas: (1) in vitro evidence that Salmonella spp. can survive for long periods of time under harsh conditions; (2) observations and conclu...

  19. Important prognostic factors for the long-term survival of lung cancer subjects in Taiwan

    Directory of Open Access Journals (Sweden)

    Ko Albert

    2008-11-01

    Full Text Available Abstract Background This study used a large-scale cancer database in determination of prognostic factors for the survival of lung cancer subjects in Taiwan. Methods Total of 24,910 subjects diagnosed with lung cancer was analysed. Survival estimates by Kaplan-Meier methods. Cox proportional-hazards model estimated the death risk (hazard ratio (HR for various prognostic factors. Results The prognostic indicators associated with a higher risk of lung cancer deaths are male gender (males versus females; HR = 1.07, 95% confidence intervals (CI: 1.03–1.11, males diagnosed in later periods (shown in 1991–1994 versus 1987–1990; HR = 1.13, older age at diagnosis, large cell carcinoma (LCC/small cell carcinoma (SCC, and supportive care therapy over chemotherapy. The overall 5-year survival rate for lung cancer death was significantly poorer for males (21.3% than females (23.6%. Subjects with squamous cell carcinoma (SQCC and treatment by surgical resection alone had better prognosis. We find surgical resections to markedly increase 5-year survival rate from LCC, decreased risk of death from LCC, and no improved survival from SCC. Conclusion Gender and clinical characteristics (i.e. diagnostic period, diagnostic age, histological type and treatment modality play important roles in determining lung cancer survival.

  20. Long-term survival of calcium phosphate-coated dental implants: a meta-analytical approach to the clinical literature.

    Science.gov (United States)

    van Oirschot, Bart A J A; Bronkhorst, Ewald M; van den Beucken, Jeroen J J P; Meijer, Gert J; Jansen, John A; Junker, Rüdiger

    2013-04-01

    Calcium phosphate ceramic coatings have the potential to compensate for challenging bone conditions such as delayed or impaired bone healing and low bone quantity or density. Thus, the increasing universal prevalence of subjects with such challenging bone conditions might be paralleled by an enhanced global use of calcium phosphate ceramic-coated dental implants. However, it is speculated that the long-term clinical survival of calcium phosphate-coated dental implants might be adversely affected by coating delamination. The aims of the current review were (1) to systematically appraise and (2) to meta-analyse long-term survival data of calcium phosphate-coated dental implants in clinical trials. An extensive search in the electronic databases of the National Library of Medicine (http://www.ncbi.nlm.nih.gov), The Cochrane Central Register of Controlled Trials and the ISI Web of Knowledge, was carried out for articles published between January 2000 and November 2011 to identify randomized controlled clinical trials, prospective clinical trials as well as retrospective analysis of cases (RA) presenting survival data on the topic of calcium phosphate-coated dental implants. Only publications in English were considered, and the search was narrowed to studies in humans with a follow-up of at least 5 years only. Furthermore, the reference lists of related review articles and publications selected for inclusion in this review were systematically screened. The primary outcome variable was percentage annual failure rate (AFR), and the secondary outcome variable was percentage cumulative survival rate (CSR). The electronic search in the database of the National Library of Medicine, The Cochrane Central Register of Controlled Trials and the ISI Web of Knowledge, resulted in the identification of 385 titles. These titles were initially screened by the two independent reviewers for possible inclusion, resulting in 29 publications suitable for further consideration. Screening

  1. Long-term survival and risk factors for failure of the native hip joint after operatively treated displaced acetabular fractures.

    Science.gov (United States)

    Clarke-Jenssen, J; Røise, O; Storeggen, S A Ø; Madsen, J E

    2017-06-01

    Our aim in this study was to describe the long-term survival of the native hip joint after open reduction and internal fixation of a displaced fracture of the acetabulum. We also present long-term clinical outcomes and risk factors associated with a poor outcome. A total of 285 patients underwent surgery for a displaced acetabular fracture between 1993 and 2005. For the survival analysis 253 were included, there were 197 men and 56 women with a mean age of 42 years (12 to 78). The mean follow-up of 11 years (1 to 20) was identified from our pelvic fracture registry. There were 99 elementary and 154 associated fracture types. For the long-term clinical follow-up, 192 patients with complete data were included. Their mean age was 40 years (13 to 78) with a mean follow-up of 12 years (5 to 20). Injury to the femoral head and acetabular impaction were assessed with CT scans and patients with an ipsilateral fracture of the femoral head were excluded. A total of 36 patients underwent total hip arthroplasty (THA). The overall ten-year survival of the hip joint was 86% (95% confidence interval (CI) 81% to 90%) and the 20-year survival was 82% (95% CI 76% to 87%). Injury to the femoral head and acetabular impaction were the strongest predictors of failure, with the long-term survival rate falling towards 50% in these patients. The survival fell to 0% at three years when both these risk factors were present in patients aged > 60 years. The long-term survival of the native hip joint after acetabular fractures was good, but the presence of injury to the femoral head and acetabular impaction proved to be strong predictors of failure, especially in patients aged > 60 years. These patients may be better treated with a combination of open reduction and internal fixation and primary arthroplasty. Cite this article: Bone Joint J 2017;99-B:834-40. ©2017 The British Editorial Society of Bone & Joint Surgery.

  2. Radiation shielding evaluation based on five years of data from a busy CyberKnife center.

    Science.gov (United States)

    Yang, Jun; Feng, Jing

    2014-11-08

    We examined the adequacy of existing shielding guidelines using five-year clinical data from a busy CyberKnife center. From June 2006 through July 2011, 1,370 patients were treated with a total of 4,900 fractions and 680,691 radiation beams using a G4 CyberKnife. Prescription dose and total monitor units (MU) were analyzed to estimate the shielding workload and modulation factor. In addition, based on the beam's radiation source position, targeting position, MU, and beam collimator size, the MATLAB program was used to project each beam toward the shielding barrier. The summation of the projections evaluates the distribution of the shielding load. On average, each patient received 3.6 fractions, with an average 9.1 Gy per fraction prescribed at the 71.1% isodose line, using 133.7 beams and 6,200 MU. Intracranial patients received an average of 2.7 fractions, with 8.6 Gy per fraction prescribed at the 71.4% isodose line, using 133 beams and 5,083 MU. Extracranial patients received an average of 3.94 fractions, with 9.2 Gy per frac- tion prescribed at the 71% isodose line, using 134 beams and 6,514 MU. Most- used collimator sizes for intracranial patients were smaller (7.5 to 20 mm) than for extracranial patients (20 to 40 mm). Eighty-five percent of the beams exited through the floor, and about 40% of the surrounding wall area received no direct beam. For the rest of the wall, we found "hot" areas that received above-average MU. The locations of these areas were correlated with the projection of the nodes for extracranial treatments. In comparison, the beam projections on the wall were more spread for intracranial treatments. The maximum MU any area received from intracranial treatment was less than 0.25% of total MU used for intracranial treatments, and was less than 1.2% of total MU used for extracranial treatments. The combination of workload, modulation factor, and use factor in our practice are about tenfold less than recommendations in the existing Cyber

  3. [Email in a dedicated headache clinic: experience gained over a five-year period].

    Science.gov (United States)

    Pedraza, M Isabel; Herrero-Velázquez, Sonia; López-Mesonero, Luis; Ruiz-Piñero, Marina; Posadas, Javier; Guerrero-Peral, Ángel L

    2015-06-16

    The use of email can facilitate communication between the different levels of an organisation. Our primary care physicians have had an email service in the dedicated headache clinic (DHC) since November 2009, and our aim is therefore to analyse the use of email over that five-year period. Data concerning the emails sent up until October 2014 were collected prospectively. The questions were classified as need for referral to the DHC (group 1), progress made by the cases seen in the DHC (group 2), training in headaches (group 3) or the treatment of the headaches suffered by primary care physicians themselves as patients (group 4). A total of 274 email messages were analysed. Monthly consultations have increased (from 1.5 per month during the first year to 7.5 per month during the fifth). Findings showed that 10.2% of the email messages came from rural health centres and 89.8% were sent from urban health centres. Replies were sent within 2 ± 2.8 days (range: 0-24 days). Altogether 130 consultations were classified as belonging to group 1 (47.4%), in which referral through the normal channel was recommended in 60 cases (46.2%), via the preferential channel in 47 (36.2%) and non-referral was suggested in 23 cases (17.6%). Group 2 included 125 emails (45.7%) and in 80 cases there was no need to make a new appointment or to bring forward the existing one (64%). Thirteen visits (4.7%) were classified into group 3 and six (2.2%) in group 4. Our primary care physicians are using the email of the DHC on an increasingly more frequent basis. Its use makes it possible to detect patients whose appointment -whether the first or a follow-up- needs to be brought forward, as well as allowing issues to be solved without the need for referral. It is effective for the treatment of physicians who themselves have headaches and as a tool for continuing education.

  4. Presenting symptoms and long-term survival in head and neck cancer.

    Science.gov (United States)

    Douglas, C M; Ingarfield, K; McMahon, A D; Savage, S A; Conway, D I; MacKenzie, K

    2017-12-15

    To assess how type and number of symptoms are related to survival in patients with head and neck cancer. Patients were followed up for over 10 years from the Scottish Audit of Head and Neck Cancer (national cohort of head and neck cancer patients in Scotland 1999-2001). September 2013, cohort was linked to national mortality data. First, second and third presenting symptoms were recorded at diagnosis. National prospective audit-Scotland. A subset of 1589 patients, from the original cohort of 1895, who had cancer arising from one of the four main subsites; larynx, oropharynx, oral cavity and hypopharynx. Median survival in relation to patients' presenting symptoms. A total of 1146 (72%) males and 443 (28%) females, mean age at diagnosis 64 years (13-95). There was a significant difference in survival in relation to the number of the patient's presenting symptoms; one symptom had a median survival of 5.3 years compared with 1.1 years for three symptoms. Patients who presented with weight loss had a median survival of 0.8 years, compared to 4.2 years if they did not (P survival of 5.9 years compared to 2.6 years without (P survival for patients who presented with an ulcer, compared to those that did not (P = .105). This study highlights the importance of patients' presenting symptoms, giving valuable information in highlighting appropriate "red flag" symptoms and subsequent treatment planning and prognosis. © 2017 John Wiley & Sons Ltd.

  5. Alcohol recidivism impairs long-term patient survival after orthotopic liver transplantation for alcoholic liver disease.

    Science.gov (United States)

    Cuadrado, Antonio; Fábrega, Emilio; Casafont, Fernando; Pons-Romero, Fernando

    2005-04-01

    The aim of this study was to evaluate the rate of alcohol recidivism after orthotopic liver transplantation (OLT) for alcoholic liver disease (ALD) and its influence on the allograft and patient survival, as well as the development of comorbidities and de novo cancers. The study was performed on 54 subjects previously analyzed and transplanted in our center for ALD, whose follow-up was prolonged to a mean of 99.2 (SD 31.7) months (range, 14-155). Medical records were reviewed, and data on alcohol consumption, therapeutic compliance, graft evolution, rejection, infections, comorbidities, rates of de novo malignancies and other clinical events, and survival were collected. Comparisons between groups were performed by the Fisher's exact test, and survival was assessed by the Kaplan-Meier method. Survival curves were compared using the Mantel-Cox statistic. The risk of death resulting from alcohol recidivism was analyzed with a Cox proportional hazards model. Fourteen patients who underwent transplantation for ALD (25.9%) returned to alcohol use between 5.0 and 86.9 months after OLT (median, 47.5). There was no significant association between the presence or absence of alcohol recidivism and the occurrence of graft rejection, infections, associated comorbidities after OLT, or compliance. The 5- and 10-year survival rates for patients with alcohol recidivism were 92.9% and 45.1%, respectively, compared with 92.4% and 85.5%, respectively, for patients without alcohol recidivism. These figures show significantly lower survival rates in recidivistic patients after 10 years (P < 0.01, Mantel-Cox). The fact that patients who resumed alcohol consumption have a worse 10-year survival rate might be attributed to a higher frequency of deaths, primarily from cancer and cardiovascular events.

  6. Short-term survival and mortality rates in a retrospective study of colic in 1588 Danish horses

    DEFF Research Database (Denmark)

    Christophersen, Mogens Teken; Dupont, Nana Hee; Berg-Sørensen, Kristina S.

    2014-01-01

    or social factors such as attitudes towards animal suffering and euthanasia. The aims of this study were to 1) describe and analyse characteristics in horses with signs of colic referred to the University Hospital for Large Animals (UHLA), University of Copenhagen, Denmark over a 10-year period and 2...... or were euthanized (CI: 19 – 32%; 48/189), while 75% survived to discharge (CI: 68 – 81%). Conclusions: The short term survival rates of Danish horses with colic were similar or lower to those reported from other countries. Apart from variability of veterinary care, attitudes towards euthanasia vary among...... the countries, which may bias the outcomes. This study indicates that qualitative interview studies on owners ’ attitudes towards animal suffering and euthanasia need to be conducted. Our opinion is that survival rates are not valid as sole indicators of quality of care in colic treatment due to selection bias...

  7. Long-term Survival Outcomes by Smoking Status in Surgical and Nonsurgical Patients With Non-small Cell Lung Cancer

    Science.gov (United States)

    Meguid, Robert A.; Hooker, Craig M.; Harris, James; Xu, Li; Westra, William H.; Sherwood, J. Timothy; Sussman, Marc; Cattaneo, Stephen M.; Shin, James; Cox, Solange; Christensen, Joani; Prints, Yelena; Yuan, Nance; Zhang, Jennifer; Yang, Stephen C.

    2010-01-01

    Background: Survival outcomes of never smokers with non-small cell lung cancer (NSCLC) who undergo surgery are poorly characterized. This investigation compared surgical outcomes of never and current smokers with NSCLC. Methods: This investigation was a single-institution retrospective study of never and current smokers with NSCLC from 1975 to 2004. From an analytic cohort of 4,546 patients with NSCLC, we identified 724 never smokers and 3,822 current smokers. Overall, 1,142 patients underwent surgery with curative intent. For survival analysis by smoking status, hazard ratios (HRs) were estimated using Cox proportional hazard modeling and then further adjusted by other covariates. Results: Never smokers were significantly more likely than current smokers to be women (P cancer diagnosis has little impact on the long-term survival of patients with NSCLC, especially after curative surgery. Despite different etiologies between lung cancer in never and current smokers the prognosis is equally dismal. PMID:20507946

  8. Destructive spondyloarthropathy of the cervical spine in long-term hemodialyzed patients: a five-year clinical radiological prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Leone, A.; Marano, P. [Dept. of Radiology, Univ. Cattolica, Rome (Italy); Sundaram, M. [Dept. of Radiology, Mayo Clinic, Rochester, MN (United States); Cerase, A. [Unit of Neuroradiology, Policlinico ' ' Le Scotte' ' , Siena (Italy); Magnavita, N. [Dept. of Occupational Medicine, Univ. Cattolica, Rome (Italy); Tazza, L. [Dept. of Surgery, Univ. Cattolica, Rome (Italy)

    2001-08-01

    To describe the radiographic features and progression of cervical spine destructive spondyloarthropathy (DSA) in hemodialyzed patients, and to evaluate the relationship between this disease and patient characteristics, biochemical values, and hemodialysis duration. Design and patients: Standard radiographs, and lateral flexion and extension views of the cervical spine, were performed annually for 5 years in 31 hemodialyzed patients who were divided into three groups at the commencement of the study: those showing (I) DSA, (II) vertebral rim erosions (VRE) without DSA, and (III) absence of DSA and VRE. Magnetic resonance (MR) imaging and computed tomography (CT) were performed in seven and two patients respectively. The imaging features were evaluated for the presence and progression of spondyloarthropathy and correlated with clinical and biochemical variables. Statistical analysis was performed using one-way analysis of variance. The duration of hemodialysis appeared to be the main predictive factor (P=0.0003) for DSA, which was found in six patients (19%). DSA was found to correlate with higher levels of beta2-microglobulin (P<0.00001), parathyroid hormone (P<0.05), and alkaline phosphatase (P<0.05). Clinical symptoms were minimal. In two patients, MR imaging revealed changes mimicking spondylodiscitis. In another patient, CT of the craniocervical junction showed bone resorption due to a pseudotumor, and basilar invagination. DSA of the cervical spine is often clinically silent. Pathogenesis of DSA may be multifactorial but its progression is most influenced by the duration of hemodialysis. On MR imaging, DSA may mimic spondylodiscitis. (orig.)

  9. Five-Year Long-Term Followup of a Primary Lymph node Gastrinoma: Is a Pancreaticoduodenectomy Justified?

    Directory of Open Access Journals (Sweden)

    Bernd Jaenigen

    2009-01-01

    Results. Over a period of 5 years, the patient's gastrin level stayed in the normal range and the patient seems to be completely cured. Conclusion. A prophylactic partial pancreatoduodenectomy is not indicated to avoid recurrence, since complete biochemical cure by local resection of the lymph node gastrinoma is possible.

  10. Long-term electrical survival analysis of Riata and Riata ST silicone leads: National Veterans Affairs experience.

    Science.gov (United States)

    Sung, Raphael K; Massie, Barry M; Varosy, Paul D; Moore, Hans; Rumsfeld, John; Lee, Byron K; Keung, Edmund

    2012-12-01

    A medical device advisory issued by St Jude Medical in November 2011 estimated 0.63% all-cause abrasion rate on their Riata and Riata ST silicone high-voltage lead families (Riata/ST), leading to Food and Drug Administration class I recall. We performed an independent comparative, long-term electrical survival analysis of Riata/ST and 3 other high-voltage lead families in a large national cohort of patients. To evaluate long-term electrical survival of Riata/ST leads relative to other commonly evaluated high-voltage leads. Failure rates of Riata/ST, Sprint Quattro Secure (Quattro), Sprint Fidelis (Fidelis), and Endotak Reliance G/SG (Endotak) leads from the Veterans Administration's National Cardiac Device Surveillance Center database, consisting of 24,145 patients with remote transmissions since 2003, were analyzed. Survival Probabilities were determined with Kaplan-Meier survival analysis and compared using the log-rank test. Of 1,403 Riata/ST, 6,091 Quattro, 5,073 Fidelis, and 2,401 Endotak leads identified, 5-year survival probability of Riata/ST leads (97.5%) was significantly lower than that of Quattro (99.3%) and Endotak (99.4%) leads (P leads (89.6%) (P leads showed a 5-year survival of 95.5% (95% confidence interval 92.4-97.4) compared to 98.4% (95% confidence interval 97.1-99.1) in Riata leads (P = .003). There is decreased survival probability of Riata/ST leads compared to other contemporary high-voltage leads, with decreased survival of Riata ST silicone compared to Riata lead series. Careful long-term follow-up should be maintained in patients with Riata/ST leads in order to prevent inappropriate shocks or failed device interventions. Our results were determined in advance of Food and Drug Administration class I recall, which suggested that large-scale remote monitoring may be an effective tool for continued implantable cardioverter-defibrillator system surveillance. Published by Elsevier Inc.

  11. Sporulation and Germination patterns - hedging a bet on long term microbial survivability in dry soil

    Science.gov (United States)

    Claes, N.; Or, D.

    2012-04-01

    Soil hosts unparalleled diversity of microbial life that is constantly challenged by the vagaries of fluctuating ambient conditions. Desiccation stresses play a key role not only by directly affecting individual bacterial cells, but also by shaping diffusion pathways and cell dispersion. The gradual thinning and fragmentation of the aqueous environment during drying have led to different survival mechanisms including dormancy and sporulation, resulting in a highly resistive state capable of surviving extreme and prolonged environmental stresses until conditions improve in the future. Our aim is to investigate how temporal changes in hydration status shape microbial communities over time, based on simple survival strategy rules for each individual bacterium. The two survival strategies considered are dormancy and sporulation. Dormancy is the state in which bacterial cells significantly reduce their metabolism with minor morphological adaptations. The required energy and time for attaining this state are low relative to sporulation costs. Sporulation involves several morphological and biochemical changes that result in a resistive capsule that endures extreme stresses over long periods of time. The working hypothesis is that different micro-ecological conditions and community compositions would result from temporal patterns and magnitude of desiccation stresses. An Individual Based Model (IBM) considering habitats on rough soil surfaces and local effects of micro-hydrological conditions on dispersion and nutrient diffusion would enable systematic study of emerging communities over extended periods. Different population compositions are expected to emerge based on low and high frequency, duration and amplitudes of wetting-drying cycles reflecting relative success or failure of survival strategy.

  12. Nuclear β-catenin positivity as a predictive marker of long-term survival in advanced epithelial ovarian cancer.

    Science.gov (United States)

    Nagy, Bence; Tóth, László; Molnár, Péter; Méhes, Gábor; Thurzó, László; Póka, Róbert; Hernádi, Zoltán

    2017-08-01

    Classical features as histomorphology, grade, FIGO stage, and residual tumour mass have strong prognostic value in advanced epithelial ovarian carcinomas (AEOC). Most AEOCs are associated with early recurrence and poor overall survival (OS). Despite of early recurrence, general poor outcome, both high grade tumours or tumours with advanced FIGO stage at the time of diagnosis, in some of such cases, long-term survival (LTS) has been recorded . The aim of this study was to compare the utility of "classical" prognostic factors to molecular factors such as β-catenin- E-cadherin-, mutated TP53-, and MiB-1 (Ki-67) labelling index determination in predicting long-term survival. The expression of β-catenin, E-cadherin, Ki-67, and p53 was determined by immunohistochemistry (IHC) in AEOC. Correlation was sought for between expression of these proteins and the status of classical features vis-á-vis overall survival of patients. Statistical evaluation of the data included Kaplan-Meier analysis, the log-rank test and Cox proportional hazards model. As expected, residual tumour size was an independent adverse prognostic factor for OS (univariate analysis: p=0.003, multivariate analysis: p=0.005). Nuclear expression of β-catenin in advanced ovarian cancer of LTS patients proved to be not only an independent favourable predictor of OS (univariate analysis: p=0.025, multivariate analysis: p=0.041) but also showed strong correlation with platinum sensitivity and platinum re-induction. Translocation of stabilized β-catenin from cytoplasm to the nucleus plays an important role in predicting platinum sensitivity. It also seems to support the chance for platinum re-induction in AEOC and thus enhances long-term survival. Copyright © 2017 Elsevier GmbH. All rights reserved.

  13. Low Grade Gliomas in Eloquent Locations – Implications for Surgical Strategy, Survival and Long Term Quality of Life

    Science.gov (United States)

    Jakola, Asgeir S.; Unsgård, Geirmund; Myrmel, Kristin S.; Kloster, Roar; Torp, Sverre H.; Lindal, Sigurd; Solheim, Ole

    2012-01-01

    Background Surgical management of suspected LGG remains controversial. A key factor when deciding a surgical strategy is often the tumors’ perceived relationship to eloquent brain regions Objective To study the association between tumor location, survival and long-term health related quality of life (HRQL) in patients with supratentorial low-grade gliomas (LGG). Methods Adults (≥18 years) operated due to newly diagnosed LGG from 1998 through 2009 included from two Norwegian university hospitals. After review of initial histopathology, 153 adults with supratentorial WHO grade II LGG were included in the study. Tumors’ anatomical location and the relationship to eloquent regions were graded. Survival analysis was adjusted for known prognostic factors and the initial surgical procedure (biopsy or resection). In long-term survivors, HRQL was assessed with disease specific questionnaires (EORTC QLQ-C30 and BN20) as well as a generic questionnaire (EuroQol 5D). Results There was a significant association between eloquence and survival (log-rank, peloquent tumors, 71% in intermediate located tumors and 54% in eloquent tumors. In the adjusted analysis the hazard ratio of increasing eloquence was 1.5 (95% CI 1.1–2.0, p = 0.022). There were no differences in HRQL between patients with eloquent and non-eloquent tumors. The most frequent self-reported symptoms were related to fatigue, cognition, and future uncertainty. Conclusion Eloquently located LGGs are associated with impaired survival compared to non-eloquently located LGG, but in long-term survivors HRQL is similar. Although causal inference from observational data should be done with caution, the findings illuminate the delicate balance in surgical decision making in LGGs, and add support to the probable survival benefits of aggressive surgical strategies, perhaps also in eloquent locations. PMID:23251537

  14. Low grade gliomas in eloquent locations - implications for surgical strategy, survival and long term quality of life.

    Science.gov (United States)

    Jakola, Asgeir S; Unsgård, Geirmund; Myrmel, Kristin S; Kloster, Roar; Torp, Sverre H; Lindal, Sigurd; Solheim, Ole

    2012-01-01

    Surgical management of suspected LGG remains controversial. A key factor when deciding a surgical strategy is often the tumors' perceived relationship to eloquent brain regions To study the association between tumor location, survival and long-term health related quality of life (HRQL) in patients with supratentorial low-grade gliomas (LGG). Adults (≥18 years) operated due to newly diagnosed LGG from 1998 through 2009 included from two Norwegian university hospitals. After review of initial histopathology, 153 adults with supratentorial WHO grade II LGG were included in the study. Tumors' anatomical location and the relationship to eloquent regions were graded. Survival analysis was adjusted for known prognostic factors and the initial surgical procedure (biopsy or resection). In long-term survivors, HRQL was assessed with disease specific questionnaires (EORTC QLQ-C30 and BN20) as well as a generic questionnaire (EuroQol 5D). There was a significant association between eloquence and survival (log-rank, peloquent tumors, 71% in intermediate located tumors and 54% in eloquent tumors. In the adjusted analysis the hazard ratio of increasing eloquence was 1.5 (95% CI 1.1-2.0, p = 0.022). There were no differences in HRQL between patients with eloquent and non-eloquent tumors. The most frequent self-reported symptoms were related to fatigue, cognition, and future uncertainty. Eloquently located LGGs are associated with impaired survival compared to non-eloquently located LGG, but in long-term survivors HRQL is similar. Although causal inference from observational data should be done with caution, the findings illuminate the delicate balance in surgical decision making in LGGs, and add support to the probable survival benefits of aggressive surgical strategies, perhaps also in eloquent locations.

  15. Effect of a long-term high-protein diet on survival, obesity development, and gut microbiota in mice.

    Science.gov (United States)

    Kiilerich, Pia; Myrmel, Lene Secher; Fjære, Even; Hao, Qin; Hugenholtz, Floor; Sonne, Si Brask; Derrien, Muriel; Pedersen, Lone Møller; Petersen, Rasmus Koefoed; Mortensen, Alicja; Licht, Tine Rask; Rømer, Maria Unni; Vogel, Ulla Birgitte; Waagbø, Linn Jeanette; Giallourou, Natasa; Feng, Qiang; Xiao, Liang; Liu, Chuan; Liaset, Bjørn; Kleerebezem, Michiel; Wang, Jun; Madsen, Lise; Kristiansen, Karsten

    2016-06-01

    Female C57BL/6J mice were fed a regular low-fat diet or high-fat diets combined with either high or low protein-to-sucrose ratios during their entire lifespan to examine the long-term effects on obesity development, gut microbiota, and survival. Intake of a high-fat diet with a low protein/sucrose ratio precipitated obesity and reduced survival relative to mice fed a low-fat diet. By contrast, intake of a high-fat diet with a high protein/sucrose ratio attenuated lifelong weight gain and adipose tissue expansion, and survival was not significantly altered relative to low-fat-fed mice. Our findings support the notion that reduced survival in response to high-fat/high-sucrose feeding is linked to obesity development. Digital gene expression analyses, further validated by qPCR, demonstrated that the protein/sucrose ratio modulated global gene expression over time in liver and adipose tissue, affecting pathways related to metabolism and inflammation. Analysis of fecal bacterial DNA using the Mouse Intestinal Tract Chip revealed significant changes in the composition of the gut microbiota in relation to host age and dietary fat content, but not the protein/sucrose ratio. Accordingly, dietary fat rather than the protein/sucrose ratio or adiposity is a major driver shaping the gut microbiota, whereas the effect of a high-fat diet on survival is dependent on the protein/sucrose ratio. Copyright © 2016 the American Physiological Society.

  16. Clinical presentation, diagnostic findings and long-term survival in large breed dogs with meningoencephalitis of unknown aetiology.

    Science.gov (United States)

    Cornelis, I; Volk, H A; De Decker, S

    2016-08-06

    Although several studies indicate that meningoencephalitis of unknown aetiology (MUA) might affect every dog breed at every age, little is known about clinical presentation, diagnostic findings and long-term survival in large breed dogs. The aim of this study was therefore to compare the clinical presentation, diagnostic findings and long-term survival between large and small/medium breed dogs diagnosed with MUA. One hundred and eleven dogs met the inclusion criteria. 28 (25 per cent) dogs were considered large breed dogs compared with 83 (75 per cent) small/medium breed dogs. Large breed dogs presented significantly more often with a decreased mentation. Age, gender, duration of clinical signs prior to diagnosis, presence of seizures or cluster seizures, variables on complete blood count and cerebrospinal fluid analysis, and all variables on MRI were not significantly different between small/medium and large breed dogs. Median survival time was 281 and 106 days for the large and small/medium breed dogs, respectively, with no significant difference in survival curves for both groups. Although considered not typically affected by MUA, 25 per cent of dogs included in this study were considered large breed dogs. Therefore, MUA should be included in the differential diagnosis for large breed dogs presenting with intracranial neurological signs. If diagnosed with MUA, large breed dogs also carried a guarded prognosis. British Veterinary Association.

  17. Five-year prognosis after endovascular therapy in claudicant patients with iliofemoral artery disease.

    Science.gov (United States)

    Miura, Takashi; Soga, Yoshimitsu; Miyashita, Yusuke; Iida, Osamu; Kawasaki, Daizo; Hirano, Keisuke; Suzuki, Kenji; Ikeda, Uichi

    2014-06-01

    To examine the prognosis of patients with intermittent claudication who received treatment with endovascular techniques. A retrospective multicenter study was performed involving 2930 consecutive patients (2307 men; mean age 71.5±8.9 years) with intermittent claudication who underwent an endovascular procedure for a de novo iliofemoral artery lesion. The primary outcome measure was overall survival. The secondary outcomes were freedom from major adverse cardiovascular events (MACE: all-cause death, myocardial infarction, and stroke) and from major adverse cardiovascular and limb events (MACE with repeat revascularization or above-knee amputation of the target limb). Cox multivariate regression analysis of selected baseline characteristics, procedure-related complications, and medication use was performed to determine predictors for all-cause mortality. Positive predictors from this analysis were used to stratify patients into low- (1410, 48.1%), moderate- (1406, 48.0%), and high-risk (114, 3.9%) categories. The overall survival rates were 97.2%, 90.8%, and 83.4% at 1, 3, and 5 years, respectively. The cause of death was cardiovascular in 42.8% of cases. Freedom from MACE was 96.7%, 88.6%, and 77.3% at 1, 3, and 5 years, respectively. Cox multivariate regression analysis identified age, dialysis, left ventricular dysfunction, insulin-dependent diabetes, hematoma prolonging hospitalization, coronary artery disease, and superficial femoral plus iliac lesions as positive predictors of all-cause mortality. In the risk stratification analysis, the overall 5-year survival rate was significantly lower in high-risk patients compared to the other groups (90.1% vs. 78.6% vs. 53.5%, p<0.0001). The prognosis in patients with intermittent claudication after endovascular therapy was relatively good but extremely poor for the high-risk patient subgroup.

  18. Five years later: resiliency among older adult survivors of Hurricane Katrina.

    Science.gov (United States)

    Hrostowski, Susan; Rehner, Timothy

    2012-01-01

    The purpose of this study was to examine the resilience of older adult survivors of Hurricane Katrina in light of their traumatic experiences and multiple losses. Ten Mississippi Gulf Coast residents who have survived Hurricane Katrina and its aftermath were interviewed. The participants were 65 years old or older. Their responses were audiotaped and transcribed. The transcripts were analyzed using phenomenological methodology and NVivo 2.5 software. Three major themes emerged. Participants described finding personal gratification, realizing their ability to cope, and developing a new interest in life through their novel experiences.

  19. Five-year longitudinal assessment of the downstream impact on schistosomiasis transmission following closure of the Three Gorges Dam.

    Directory of Open Access Journals (Sweden)

    Darren J Gray

    Full Text Available Schistosoma japonicum is a major public health concern in the Peoples' Republic of China (PRC, with about 800,000 people infected and another 50 million living in areas at risk of infection. Based on ecological, environmental, population genetic and molecular factors, schistosomiasis transmission in PRC can be categorised into four discrete ecosystems or transmission modes. It is predicted that, long-term, the Three Gorges Dam (TGD will impact upon the transmission of schistosomiasis in the PRC, with varying degree across the four transmission modes.We undertook longitudinal surveillance from 2002 to 2006 in sentinel villages of the three transmission modes below the TGD across four provinces (Hunan, Jiangxi, Hubei and Anhui to determine whether there was any immediate impact of the TGD on schistosomiasis transmission. Eight sentinel villages were selected to represent both province and transmission mode. The primary end point measured was human incidence. Here we present the results of this five-year longitudinal cohort study. Results showed that the incidence of human S. japonicum infection declined considerably within individual villages and overall mode over the course of the study. This is also reflected in the yearly odds ratios (adjusted for infection risk that showed significant (P<0.01 downward trends in all modes over the follow-up period.The decrease in human S. japonicum incidence observed across all transmission modes in this study can probably be attributed to the annual human and bovine PZQ chemotherapy. If an increase in schistosome transmission had occurred as a result of the TGD, it would be of negligible size compared to the treatment induced decline seen here. It appears therefore that there has been virtually no immediate impact of the TGD on schistosomiasis transmission downstream of the dam.

  20. Five-year outcomes in kidney transplant patients converted from cyclosporine to everolimus: the randomized ZEUS study.

    Science.gov (United States)

    Budde, K; Lehner, F; Sommerer, C; Reinke, P; Arns, W; Eisenberger, U; Wüthrich, R P; Mühlfeld, A; Heller, K; Porstner, M; Veit, J; Paulus, E-M; Witzke, O

    2015-01-01

    ZEUS study was an open-label, 12-month, multicenter study in which 300 de novo kidney transplant recipients were randomized to continue receiving cyclosporine (CsA) or convert to everolimus at 4.5 months posttransplant. Five-year follow-up data were available for 245/269 patients (91.1%) who completed the core 12-month study (123 everolimus, 109 CsA). At 5 years, adjusted estimated GFR was 66.2 mL/min/1.73 m(2) with everolimus versus 60.9 mL/min/1.73 m(2) with CsA; the mean difference was 5.3 mL/min/1.73 m(2) in favor of everolimus (95% CI 2.4, 8.3; p < 0.001 [intent-to-treat population]). In a post hoc analysis of patients remaining on study drug at 5 years (everolimus 77, CsA 86), mean difference was 8.2 mL/min/1.73 m(2) (95% CI 4.3, 12.1; p < 0.001) in favor of everolimus. The cumulative incidence of biopsy-proven acute rejection postrandomization was 13.6% with everolimus versus 7.5% with CsA (p = 0.095), largely accounted for by grade I rejection (16/21 patients and 7/11 patients, respectively). Postrandomization, graft loss, mortality, serious adverse events and neoplasms were similar in both arms. In conclusion, conversion of kidney transplant patients to everolimus at 4.5 months posttransplant is associated with a significant improvement in renal function that is maintained to at least 5 years. The increase in early mild acute rejection did not affect long-term graft function. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

  1. Five-Year Wilkinson Microwave Anisotropy Probe (WMAP) Observations: Data Processing, Sky Maps, and Basic Results

    Science.gov (United States)

    Weiland, J.L.; Hill, R.S.; Odegard, 3.; Larson, D.; Bennett, C.L.; Dunkley, J.; Jarosik, N.; Page, L.; Spergel, D.N.; Halpern, M.; hide

    2008-01-01

    The Wilkinson Microwave Anisotropy Probe (WMAP) is a Medium-Class Explorer (MIDEX) satellite aimed at elucidating cosmology through full-sky observations of the cosmic microwave background (CMB). The WMAP full-sky maps of the temperature and polarization anisotropy in five frequency bands provide our most accurate view to date of conditions in the early universe. The multi-frequency data facilitate the separation of the CMB signal from foreground emission arising both from our Galaxy and from extragalactic sources. The CMB angular power spectrum derived from these maps exhibits a highly coherent acoustic peak structure which makes it possible to extract a wealth of information about the composition and history of the universe. as well as the processes that seeded the fluctuations. WMAP data have played a key role in establishing ACDM as the new standard model of cosmology (Bennett et al. 2003: Spergel et al. 2003; Hinshaw et al. 2007: Spergel et al. 2007): a flat universe dominated by dark energy, supplemented by dark matter and atoms with density fluctuations seeded by a Gaussian, adiabatic, nearly scale invariant process. The basic properties of this universe are determined by five numbers: the density of matter, the density of atoms. the age of the universe (or equivalently, the Hubble constant today), the amplitude of the initial fluctuations, and their scale dependence. By accurately measuring the first few peaks in the angular power spectrum, WMAP data have enabled the following accomplishments: Showing the dark matter must be non-baryonic and interact only weakly with atoms and radiation. The WMAP measurement of the dark matter density puts important constraints on supersymmetric dark matter models and on the properties of other dark matter candidates. With five years of data and a better determination of our beam response, this measurement has been significantly improved. Precise determination of the density of atoms in the universe. The agreement between

  2. Remotely Operated Vehicles under sea ice - Experiences and results from five years of polar operations

    Science.gov (United States)

    Katlein, Christian; Arndt, Stefanie; Lange, Benjamin; Belter, Hans Jakob; Schiller, Martin; Nicolaus, Marcel

    2016-04-01

    The availability of advanced robotic technologies to the Earth Science community has largely increased in the last decade. Remotely operated vehicles (ROV) enable spatially extensive scientific investigations underneath the sea ice of the polar oceans, covering a larger range and longer diving times than divers with significantly lower risks. Here we present our experiences and scientific results acquired from ROV operations during the last five years in the Arctic and Antarctic sea ice region. Working under the sea ice means to have all obstacles and investigated objects above the vehicle, and thus changes several paradigms of ROV operations as compared to blue water applications. Observations of downwelling spectral irradiance and radiance allow a characterization of the optical properties of sea ice and the spatial variability of the energy partitioning across the atmosphere-ice-ocean boundary. Our results show that the decreasing thickness and age of the sea ice have led to a significant increase in light transmission during summer over the last three decades. Spatially extensive measurements from ROV surveys generally provide more information on the light field variability than single spot measurements. The large number of sampled ice conditions during five cruises with the German research icebreaker RV Polarstern allows for the investigations of the seasonal evolution of light transmittance. Both, measurements of hyperspectral light transmittance through sea ice, as well as classification of upward-looking camera images were used to investigate the spatial distribution of ice-algal biomass. Buoyant ice-algal aggregates were found to be positioned in the stretches of level ice, rather than pressure ridges due to a physical interaction of aggregate-buoyancy and under-ice currents. Synchronous measurements of sea ice thickness by upward looking sonar provides crucial additional information to put light-transmittance and biological observations into context

  3. Ophthalmic artery chemosurgery for less advanced intraocular retinoblastoma: five year review.

    Directory of Open Access Journals (Sweden)

    David H Abramson

    Full Text Available BACKGROUND: Ophthalmic artery chemosurgery (OAC for retinoblastoma was introduced by us 5 years ago for advanced intraocular retinoblastoma. Because the success was higher than with existing alternatives and systemic side effects limited we have now treated less advanced intraocular retinoblastoma (Reese-Ellsworth (RE I-III and International Classification Retinoblastoma (ICRB B and C. METHODOLOGY/PRINCIPAL FINDINGS: Retrospective review of 5 year experience in eyes with Reese Ellsworth (Table 1 I (7 eyes, II (6 eyes or III (6 eyes and/or International Classification (Table 2 B (19 eyes and C (11 eyes treated with OAC (melphalan with or without topotecan introduced directly into the ophthalmic artery. Patient survival was 100%. Ocular event-free survival was 100% for Reese-Ellsworth Groups I, II and III (and 96% for ICRB B and C at a median of 16 months follow-up. One ICRB Group C (Reese-Ellsworth Vb eye could not be treated on the second attempt for technical reasons and was therefore enucleated. No patient required a port and only one patient required transfusion of blood products. The electroretinogram (ERG was unchanged or improved in 14/19 eyes. CONCLUSIONS/SIGNIFICANCE: Ophthalmic artery chemosurgery for retinoblastoma that was Reese-Ellsworth I, II and III (or International Classification B or C was associated with high success (100% of treatable eyes were retained and limited toxicity with results that equal or exceed conventional therapy with less toxicity.

  4. 75 FR 53664 - Initiation of Five-Year (“Sunset”) Review

    Science.gov (United States)

    2010-09-01

    ... South Korea Polyethylene Dana Mermelstein, (202) 482-1391. Terephthalate (PET) Film (3rd Review). A-588... Department's regulations at 19 CFR part 351 for definitions of terms and for other general information [[Page...

  5. Five-year change in physical activity is associated with changes in cardiovascular disease risk factors: the Inter99 study

    DEFF Research Database (Denmark)

    Aadahl, Mette; von Huth Smith, L; Pisinger, Charlotte

    2009-01-01

    questions on lifestyle and provided blood samples and anthropometric measures at baseline and after five years. Multiple regression analyses were performed with five-year value of each cardiovascular biomarker as outcome and change in physical activity level as explanatory variable. RESULTS: Approximately......OBJECTIVE: To evaluate whether five-year changes in self-reported physical activity level were associated with changes in waist circumference, weight, serum lipids and blood pressure. METHODS: In the Inter99 study (1999-2006) in Copenhagen, Denmark, 4039 men and women (30-60 years) answered...... 50% of the study population were men (n=2023). Change in physical activity level was inversely associated with change in weight (p

  6. Endoscopic treatment for gastric perforation using T-tag and a plastic protection chamber: a short-term survival study

    OpenAIRE

    Kiyoshi Hashiba; Siqueira, Pablo R.; Brasil, Horus A.; Marco Aurélio D'Assunção; Daniel Moribe; Jorge Carim Cassab

    2011-01-01

    CONTEXT: The endoscopic gastric perforation is a consequence of some endoscopic procedures and now a way to manage abdominal organs. This is the reason why endoscopists are studying a safe endoscopic repair. OBJECTIVE: To evaluate an endoscopic closure method for the gastric opening in natural orifice transenteric surgery DESIGN: Short-term survival animal study. METHODS: Ten White Landrace pigs underwent a gastric perforation of 1.8 cm in diameter under general anesthesia. The opening was re...

  7. Prone Accelerated Partial Breast Irradiation After Breast-Conserving Surgery: Five-year Results of 100 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Formenti, Silvia C., E-mail: silvia.formenti@nyumc.org [Department of Radiation Oncology, New York University School of Medicine and Langone Medical Center, New York, New York (United States); Hsu, Howard; Fenton-Kerimian, Maria [Department of Radiation Oncology, New York University School of Medicine and Langone Medical Center, New York, New York (United States); Roses, Daniel; Guth, Amber [Department of Surgery, New York University School of Medicine and Langone Medical Center, New York, New York (United States); Jozsef, Gabor [Department of Radiation Oncology, New York University School of Medicine and Langone Medical Center, New York, New York (United States); Goldberg, Judith D. [Division of Biostastistics, Department of Environmental Medicine, New York University School of Medicine and Langone Medical Center, New York, New York (United States); DeWyngaert, J. Keith [Department of Radiation Oncology, New York University School of Medicine and Langone Medical Center, New York, New York (United States)

    2012-11-01

    months follow-up. Conclusions: Five-year efficacy and toxicity of 3D-CRT delivered in prone partial breast irradiation are comparable to other experiences with similar follow-up.

  8. LONG-TERM SURVIVAL OF SMALL-CELL LUNG-CANCER PATIENTS AFTER CHEMOTHERAPY

    NARCIS (Netherlands)

    VANDERGAAST, A; POSTMUS, PE; BURGHOUTS, J; VANBOLHUIS, C; STAM, J; SPLINTER, TAW

    Eighty-one patients with small cell lung cancer (SCLC) with a survival Of more than 2 years start of chemotherapy were studied. Twenty-six of the 28 patients who died of relapsed SCLC had in relapsed before two years and of the 55 who had not then only two (4%) relapsed subsequently. It is stressed

  9. A Simpler Creatinine Index Can Predict Long-Term Survival in Chinese Hemodialysis Patients

    Science.gov (United States)

    Lee, Szu-Ying; Yang, Chung-Wei; Hung, Szu-Chun; Chiang, Chih-Kang; Huang, Jenq-Wen; Hung, Kuan-Yu

    2016-01-01

    Background Low lean body mass (LBM) is an indicator of malnutrition inflammation syndrome, which is common in hemodialysis (HD) patients. The creatinine index (CI) has been validated as a reliable method to estimate LBM and evaluate the protein-energy status of HD patients. However, the traditional creatinine index formula was complex. We sought to investigate the impact of CI derived from a new simple formula on Chinese HD patient outcomes. Methods In this retrospective cohort study, we enrolled 1269 patients who initiated HD between February 1981 and February 2012 and followed them until the end of February 2013. CI was calculated using the simple creatinine kinetic model (CKM) formula. Multiple linear regression analysis and Cox regression proportional hazard analysis were used to define independent variables and compare survival between groups. Results The 1269 HD patients were categorized into 3 groups according to the tertiles of calculated CI between men and women. Each group consisted of 423 patients (50.6% men, 49.4% women). Patients in the highest sex-specific tertile of CI had longer overall survival (HR, 0.46; P 0.002). BMI did not significantly associate with survival after adjustment (HR,0.99; P 0.613). Conclusions CI derived from the simple CKM formula serves as a good parameter than BMI to predict the survival of HD patients. The formula could extend its convenient use in clinical practice for HD patients. PMID:27780214

  10. Does hydroxyapatite coating of uncemented cups improve long-term survival?

    DEFF Research Database (Denmark)

    Lazarinis, Stergios; Mäkelä, Keijo T; Eskelinen, Antti

    2017-01-01

    OBJECTIVE: It is unclear whether hydroxyapatite (HA) coating of uncemented cups used in primary total hip arthroplasty (THA) improves bone ingrowth and reduces the risk of aseptic loosening. We therefore investigated survival of different uncemented cups that were available with or without HA...

  11. Anterior composite restorations: A systematic review on long-term survival and reasons for failure

    NARCIS (Netherlands)

    Demarco, F.F.; Collares, K.; Coelho-de-Souza, F.H.; Correa, M.B.; Cenci, M.S.; Moraes, R.R.; Opdam, N.J.M.

    2015-01-01

    OBJECTIVE: In this study the literature was systematically reviewed to investigate the clinical longevity of anterior composite restorations. DATA: Clinical studies investigating the survival of anterior light-cured composite restorations with at least three years of follow-up were screened and main

  12. Etiology-specific assessment of predictors of long-term survival in chronic systolic heart failure

    Directory of Open Access Journals (Sweden)

    Jennifer Franke

    2015-06-01

    Conclusion: This study demonstrates the disparity of prognostic value of clinically derived risk factors between the two main causes of CHF. The effects of covariables in DCM-patients were lower, suggesting a less modifiable disease through risk factors considering mortality risk. An etiology-specific prognostic model may improve accuracy of survival estimations in CHF.

  13. Does neoadjuvant chemotherapy impair long-term survival for ovarian cancer patients?

    DEFF Research Database (Denmark)

    Fagö-Olsen, Carsten Lindberg; Ottesen, Bent Smedegaard; Kehlet, Henrik

    2014-01-01

    OBJECTIVE: In Denmark, the proportion of women with ovarian cancer treated with neoadjuvant chemotherapy (NACT) has increased, and the use of NACT varies among center hospitals. We aimed to evaluate the impact of first-line treatment on surgical outcome and median overall survival (MOS). METHODS...

  14. Long-term survival of implantable cardioverter defibrillator recipients with end-stage renal disease

    Directory of Open Access Journals (Sweden)

    Mikhael F. El-Chami, MD, FACC, FHRS

    2017-10-01

    Conclusion: ESRD patients are at significantly increased risk of mortality as compared with a non-dialysis cohort. While the majority of these patients survive more than one year post-diagnosis, the three-year mortality is high (43%. Randomized studies addressing the benefits of ICDs in ESRD patients are needed to better define their value for primary prevention of SCD.

  15. Factors predicting long-term survival in low-risk diffuse large B-cell lymphoma

    DEFF Research Database (Denmark)

    Møller, Michael B; Pedersen, Niels T; Christensen, Bjarne E

    2003-01-01

    -based combination chemotherapy (92%) or loco-regional radiotherapy/surgery (8%) with curative intent were included. The median age was 50 years and 170 achieved complete remission. The median follow-up time was 11 years. Twenty-six patients relapsed, with a median time to relapse of 12.1 months. Overall survival...

  16. [Heart failure among elderly Icelanders: Incidence, prevalence, underlying diseases and long-term survival].

    Science.gov (United States)

    Einarsson, Haukur; Thorgeirsson, Gudmundur; Danielsen, Ragnar; Olafsson, Orn; Aspelund, Thor; Gudnason, Vilmundur

    2017-01-01

    Heart failure (HF) is a common and a serious condition that predominantly affects elderly people. On the basis of the left ventricular ejection fraction (EF) it can be divided into HF with reduced or preserved ejection fraction (HFrEF and HFpEF, respectively). The goal of this study was to investigate the prevalence and incidence of HF among elderly Icelanders, explore underlying diseases and estimate the effect of HF on overall survival. Included were 5706 participants of the AGES study. The hospital records of those diagnosed with HF before entry into AGES were used to calculate prevalence and the records of those diagnosed from entry into AGES until 28.2.2010 were used to calculate incidence. All cases of HF were verified according to predetermined criteria for diagnosis. Information on underlying diseases and EF of HF patients were obtained from hospital records. Survival was estimated using Kaplan-Meier survival curves. Lifetime prevalence of HF was 3.6% as of 2004, higher among men than women (p<0,001). The incidence was 16.2 cases per 1000 person-years, higher among men than among women (p<0,001). The incidence of HFrEF was 6.1 per 1000 person-years also higher among men than women (p<0,001). The incidence of HFpEF was 6.8 per 1000 person-years and there was no statistical difference between the sexes (p=0.62). The age adjusted 5-year survival rate of HF-patients was 32.5%, there was no statistical difference in relative survival between men and women (p=0.46). There was no statistical difference between the survival of patients with HFrEF and those with HFpEF (p=0.52). Both prevalence and incidence of HF are high among elderly Icelanders, increasing sharply with age and 5-year survival rate is only around 30%. While men are more likely to develop HF, especially HFrEF, women are more likely to be diagnosed with HFpEF.

  17. Long-term weight loss after colorectal cancer diagnosis is associated with lower survival: The Colon Cancer Family Registry.

    Science.gov (United States)

    Kocarnik, Jonathan M; Hua, Xinwei; Hardikar, Sheetal; Robinson, Jamaica; Lindor, Noralane M; Win, Aung Ko; Hopper, John L; Figueiredo, Jane C; Potter, John D; Campbell, Peter T; Gallinger, Steven; Cotterchio, Michelle; Adams, Scott V; Cohen, Stacey A; Phipps, Amanda I; Newcomb, Polly A

    2017-12-01

    Body weight is associated with colorectal cancer (CRC) risk and survival, but to the authors' knowledge, the impact of long-term postdiagnostic weight change is unclear. Herein, the authors investigated whether weight change over the 5 years after a diagnosis of CRC is associated with survival. CRC cases diagnosed from 1997 to 2008 were identified through 4 population-based cancer registry sites. Participants enrolled within 2 years of diagnosis and reported their height and weight 2 years prior. Follow-up questionnaires were administered approximately 5 years after diagnosis. Associations between change in weight (in kg) or body mass index (BMI) with overall and CRC-specific survival were estimated using Cox regression analysis adjusted for age, sex, American Joint Committee on Cancer stage of disease, baseline BMI, nonsteroidal anti-inflammatory drug use, smoking, time between diagnosis and enrollment, and study site. At the 5-year postdiagnostic survey, 2049 participants reported higher (53%; median plus 5 kg), unchanged (12%), or lower (35%; median -4 kg) weight. Over a median of 5.1 years of subsequent follow-up (range, 0.3-9.9 years), 344 participants died (91 of CRC). Long-term weight loss (per 5 kg) was found to be associated with poorer overall survival (hazard ratio, 1.13; 95% confidence interval, 1.07-1.21) and CRC-specific survival (hazard ratio, 1.25; 95% confidence interval, 1.13-1.39). Significantly lower survival was similarly observed for relative weight loss (>5% vs ≤5% change), BMI reduction (per 1 unit), or BMI category change (overweight to normal vs remaining overweight). Weight loss 5 years after a diagnosis of CRC was found to be significantly associated with decreased long-term survival, suggesting the importance of avoiding weight loss in survivors of CRC. Future research should attempt to further evaluate this association, accounting for whether this weight change was intentional or represents a marker of declining health. Cancer 2017

  18. Short-term survival and mortality rates in a retrospective study of colic in 1588 Danish horses.

    Science.gov (United States)

    Christophersen, Mogens T; Dupont, Nana; Berg-Sørensen, Kristina S; Konnerup, Christel; Pihl, Tina H; Andersen, Pia H

    2014-04-08

    Outcomes of colic treatment are of great interest to clinicians, horse owners and insurers. One commonly used criterion of success is the overall short-term survival rate. This is used as to compare treatments and to measure quality of veterinary care, but may be biased by demographic or social factors such as attitudes towards animal suffering and euthanasia. The aims of this study were to 1) describe and analyse characteristics in horses with signs of colic referred to the University Hospital for Large Animals (UHLA), University of Copenhagen, Denmark over a 10-year period and 2) to compare these rates with those published in other comparable studies. The overall survival rate for colic horses over the 10-year study period was 68% (confidence intervals (CI): 66-71%; 1087/1588). In the medical group, 1093 horses, short-term survival was 87% (CI: 85-89%). Thirty one % of referred horses were given diagnoses requiring surgical intervention (CI: 29-33%). In this group 32% of the horses were euthanized before surgery (CI: 28-36%; 159/495). Of the surgical cases 27% (CI: 23-31%) were euthanized or died during surgery. Of the horses that recovered from surgery 25% died or were euthanized (CI: 19-32%; 48/189), while 75% survived to discharge (CI: 68-81%). The short term survival rates of Danish horses with colic were similar or lower to those reported from other countries. Apart from variability of veterinary care, attitudes towards euthanasia vary among the countries, which may bias the outcomes. This study indicates that qualitative interview studies on owners' attitudes towards animal suffering and euthanasia need to be conducted. Our opinion is that survival rates are not valid as sole indicators of quality of care in colic treatment due to selection bias. If the survival rates are to be compared between hospitals, techniques or surgeons, prospective studies including mutually agreed-on disease severity scores and a predefined set of reasons for euthanasia are needed.

  19. Diabetes, hypertension and hyperlipidemia: prevalence over time and impact on long-term survival after liver transplantation.

    Science.gov (United States)

    Parekh, J; Corley, D A; Feng, S

    2012-08-01

    With increasing short-term survival, the transplant community has turned its focus to delineating the impact of medical comorbidities on long-term outcomes. Unfortunately, conditions such as diabetes, hypertension and hyperlipidemia are difficult to track and often managed outside of the transplant center by primary care providers. We collaborated with Kaiser Permanente Northern California to create a database of 598 liver transplant recipients, which incorporates diagnostic codes along with laboratory and pharmacy data. Specifically, we determined the prevalence of diabetes, hypertension and hyperlipidemia both before and after transplant and evaluated the influence of disease duration as a time-dependent covariate on posttransplant survival. The prevalence of these comorbidities increased steadily from the time of transplant to 7 years after transplant. The estimated risk for all-cause mortality (hazard ratio = 1.07 per year increment, 95% CI 1.01-1.13, p hyperlipidemia. Greater attention to management of diabetes may mitigate its negative impact on long-term survival in liver transplant recipients. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

  20. Tacrolimus trough-level variability predicts long-term allograft survival following kidney transplantation.

    Science.gov (United States)

    O'Regan, John A; Canney, Mark; Connaughton, Dervla M; O'Kelly, Patrick; Williams, Yvonne; Collier, Geraldine; deFreitas, Declan G; O'Seaghdha, Conall M; Conlon, Peter J

    2016-04-01

    The purpose of this study is to investigate tacrolimus trough-level variability from 3 to 12 months following transplantation and its association with allograft survival in renal transplant recipients. In this observational cohort study, tacrolimus trough-level variability was used as the predictor of all-cause allograft failure (defined as return to dialysis) and patient survival (all-cause mortality). In total, 394 transplants were included in the analysis. Sixty-two transplants failed during the study. Tacrolimus trough-level variability across quartile groups were: Q1 median variability 12.5 %, range 4.76-15.71 % (n = 99), Q2 median variability 18.17 %, range 15.74-21.29 % (n = 96), Q3 median variability 24.63 % range 21.42-28.88 % (n = 100), Q4 median variability 36.91 %, range 28.91-81.9 % (n = 99). Higher tacrolimus trough-level variability was associated with inferior allograft survival in univariate models [hazard ratio per quartile increase (HR), 1.46, 95 % CI 1.16-1.83, p value = 0.001] and multivariate models (HR 1.36, 95 % CI 1.05-1.78, p value = 0.019). Higher tacrolimus trough-level variability was not associated with patient survival; univariate model (HR 1.25, 95 % CI 0.90-1.74, p value = 0.17), multivariate model (HR 1.25, 95 % CI 0.86-1.83, p value = 0.23). Inferior renal allograft survival was observed in recipients with higher variability in tacrolimus trough-levels.

  1. Lean body mass predicts long-term survival in Chinese patients on peritoneal dialysis.

    Directory of Open Access Journals (Sweden)

    Jenq-Wen Huang

    Full Text Available BACKGROUND: Reduced lean body mass (LBM is one of the main indicators in malnutrition inflammation syndrome among patients on dialysis. However, the influence of LBM on peritoneal dialysis (PD patients' outcomes and the factors related to increasing LBM are seldom reported. METHODS: We enrolled 103 incident PD patients between 2002 and 2003, and followed them until December 2011. Clinical characteristics, PD-associated parameters, residual renal function, and serum chemistry profiles of each patient were collected at 1 month and 1 year after initiating PD. LBM was estimated using creatinine index corrected with body weight. Multiple linear regression analysis, Kaplan-Meier survival analysis, and Cox regression proportional hazard analysis were used to define independent variables and compare survival between groups. RESULTS: Using the median LBM value (70% for men and 64% for women, patients were divided into group 1 (n = 52; low LBM and group 2 (n = 51; high LBM. Group 1 patients had higher rates of peritonitis (1.6 vs. 1.1/100 patient months; p<0.05 and hospitalization (14.6 vs. 9.7/100 patient months; p<0.05. Group 1 patients also had shorter overall survival and technique survival (p<0.01. Each percentage point increase in LBM reduced the hazard ratio for mortality by 8% after adjustment for diabetes, age, sex, and body mass index (BMI. Changes in residual renal function and protein catabolic rate were independently associated with changes in LBM in the first year of PD. CONCLUSIONS: LBM serves as a good parameter in addition to BMI to predict the survival of patients on PD. Preserving residual renal function and increasing protein intake can increase LBM.

  2. Short- and Long-Term Effects in Prostate Cancer Survival: Analysis of Treatment Efficacy and Risk Prediction

    Science.gov (United States)

    2005-03-01

    short-term proportional hazard model with (a) no censoring, (b) 20% censoring and (c) 40% censoring. e-() efl , efý- 1 LR PPW SLT-PH SLT ST LT PL (a... adolescents .5,12,17,2°󈧣 RR and P values are adjusted for confounding using a multivariate survival model. The proposed explanation for this observation is...but not to the degree observed for adolescents . carcinomas whose latency period has partially Unlike several other studies, the long-term risk of de

  3. Evaluation of general practitioners' assessment of overweight among children attending the five-year preventive child health examination

    DEFF Research Database (Denmark)

    Andersen, Merethe Kousgaard; Christensen, Bo; Obel, Carsten

    2012-01-01

    Abstract Objective. To evaluate general practitioners' (GPs') assessment of potential overweight among children attending the five-year preventive child health examination (PCHE) by comparing their assessment of the children's weight-for-stature with overweight defined by body mass index (BMI......) according to paediatric standard definitions. Design. A cross-sectional survey. Data were obtained from a questionnaire survey of children's health in general and their growth in particular. Setting. The five-year preventive child health examination (PCHE) in general practice in the Central Denmark Region...

  4. The Wolfgang and Amadeus Automatic Photoelectric Telescopes. A ``Kleine-Nacht-Musik'' during the first five years of routine operation

    Science.gov (United States)

    Granzer, T.; Reegen, P.; Strassmeier, K. G.

    2001-12-01

    We present a summary of five years of continuous operation of the University of Vienna twin Automatic Photoelectric Telescopes (APTs) -- Wolfgang and Amadeus. These two telescopes are part of the Fairborn Observatory facility located in the Sonoran desert close to Washington Camp in southern Arizona. The detection and distinction procedure between weather-induced data-quality loss and systematic data-quality loss turned out to be a crucial task. Therefore, special emphasis is laid on the data quality monitoring tools developed throughout the years. Furthermore, we summarize the scientific highlights from the first five years of operation

  5. Impaired kidney function at hospital discharge and long-term renal and overall survival in patients who received CRRT.

    Science.gov (United States)

    Stads, Susanne; Fortrie, Gijs; van Bommel, Jasper; Zietse, Robert; Betjes, Michiel G H

    2013-08-01

    Critically ill patients with AKI necessitating renal replacement therapy (RRT) have high in-hospital mortality, and survivors are at risk for kidney dysfunction at hospital discharge. The objective was to evaluate the association between impaired kidney function at hospital discharge with long-term renal and overall survival. Degree of kidney dysfunction in relation to long-term effects on renal survival and patient mortality was investigated in a retrospective cohort study of 1220 adults admitted to an intensive care unit who received continuous RRT between 1994 and 2010. After hospital discharge, median follow-up of survivors (n=475) was 8.5 years (range, 1-17 years); overall mortality rate was 75%. Only 170 (35%) patients were discharged with an estimated GFR (eGFR) >60 ml/min per 1.73 m(2). Multivariate proportional hazards regression analysis demonstrated that age, nonsurgical type of admission, preexisting kidney disease, malignancy, and eGFR of 29-15 ml/min per 1.73 m(2) (hazard ratio [HR], 1.62; 95% confidence interval [CI], 1.01 to 2.58) and eGFR <15 ml/min per 1.73 m(2) (HR, 1.93; 95% CI, 1.23 to 3.02) at discharge were independent predictors of increased mortality. Renal survival was significantly associated with degree of kidney dysfunction at discharge. An eGFR of 29-15 ml/min per 1.73 m(2) (HR, 26.26; 95% CI, 5.59 to 123.40) and <15 ml/min per 1.73 m(2) (HR, 172.28; 95% CI, 37.72 to 786.75) were independent risk factors for initiation of long-term RRT. Most critically ill patients surviving AKI necessitating RRT have impaired kidney function at hospital discharge. An eGFR <30 ml/min per 1.73 m(2) is a strong risk factor for decreased long-term survival and poor renal survival.

  6. Predictive factors of long-term colorectal cancer survival after ultrasound-controlled ablation of hepatic metastases.

    Science.gov (United States)

    Hernández-Socorro, Carmen Rosa; Saavedra, Pedro; Ramírez Felipe, José; Bohn Sarmiento, Uriel; Ruiz-Santana, Sergio

    2017-04-21

    The risk factors associated to long-term survival were assessed in patients with liver metastases of colorectal carcinoma undergoing ablative therapies. Single-centre cohort study, retrospectively analysed and prospectively collected consecutive patients with unresectable metastatic liver disease of colorectal carcinoma treated with ablative therapies between 1996 and 2013. Factors associated with survival time were identified using Cox's proportional hazard model with time-dependent covariates. A forward variable selection based on Akaike information criterion was performed. Relative risk and 95% confidence intervals for each factor were calculated. Statistical significance was set as P<.05. Seventy-five patients with liver metastases of colorectal cancer, with a mean age of 65.6 (10.3) underwent 106 treatments. Variables selected were good quality of life (RR 0.308, 95% CI 0.150-0.632) and tumour extension (RR 3.070, 95% CI 1.776-5.308). The median overall survival was 18.5 months (95% CI 17.4-24.4). The survival prognosis in median was 13.5 vs. 23.4 months for patients with and without tumour extension, and 23.0 vs. 12.8 months for patients with good and fair or poor quality of life, respectively. Good quality of life and tumour extension were the only statistically significant predictors of long-term survival in patients of colorectal carcinoma with liver metastatic disease undergoing ablative treatment with ultrasound. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  7. Five years of discoveries with SOHO have made the Sun transparent

    Science.gov (United States)

    2001-04-01

    teams have streamlined their data gathering and analyses to the point where they can offer routine long-range forecasts of intense solar activity based on far-side foresight. The techniques are complementary, with MDI seeing the sunspot regions and SWAN reporting how active they are. "When we started work with SOHO five years ago, most experts thought it would be impossible to see right through the Sun," comments Philip Scherrer of Stanford University, principal investigator for the MDI instrument. "Now we do it regularly in real time. For practical purposes we’ve made the Sun transparent". Although conceived for scientific research, SOHO has proved invaluable as a watchdog for spotting sunstorms. Forecasters already rely heavily on SOHO’s round-the-clock observations of flares and mass ejections that can have harmful effects on satellites, power lines and other technological systems. The new long-range, far-side forecasts may be especially useful for scheduling manned space operations, during which astronauts might be exposed to dangerous particles from solar explosions. Watching the solar striptease SOHO examines the Sun from a vantage point 1.5 million kilometres out, on the sunward side of the Earth. Its instruments probe the Sun from its nuclear core, through its turbulent interior and stormy atmosphere, and all the way out to the Earth’s orbit and beyond, where a non-stop stream of atomic nuclei and electrons travels outwards as the solar wind. To the naked eye the Sun looks calm and unchanging, but for SOHO it has performed a dramatic striptease. Here are just ten of the revelations. The Sun’s surprising heart beat. Currents of gas far beneath the visible surface speed up and slacken again every 16 months -- a wholly unexpected pulse-rate. It was detected by combining data from SOHO and a US-led network of ground stations called GONG. Brighter sunbeams. Watching minute by minute and year by year, SOHO has seen the Sun brighten, as expected, by 0.1 per

  8. From Exit to Entry: Long-term Survival and Transmission of Salmonella

    Science.gov (United States)

    Waldner, Landon L.; MacKenzie, Keith D.; Köster,, Wolfgang; White, Aaron P.

    2012-01-01

    Salmonella spp. are a leading cause of human infectious disease worldwide and pose a serious health concern. While we have an improving understanding of pathogenesis and the host-pathogen interactions underlying the infection process, comparatively little is known about the survival of pathogenic Salmonella outside their hosts. This review focuses on three areas: (1) in vitro evidence that Salmonella spp. can survive for long periods of time under harsh conditions; (2) observations and conclusions about Salmonella persistence obtained from human outbreaks; and (3) new information revealed by genomic- and population-based studies of Salmonella and related enteric pathogens. We highlight the mechanisms of Salmonella persistence and transmission as an essential part of their lifecycle and a prerequisite for their evolutionary success as human pathogens. PMID:25436767

  9. From Exit to Entry: Long-term