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Sample records for treatment time compared

  1. Waiting times for diagnosis and treatment of head and neck cancer in Denmark in 2010 compared to 1992 and 2002

    DEFF Research Database (Denmark)

    Lyhne, N M; Christensen, A; Alanin, M C

    2013-01-01

    BACKGROUND AND AIM: Significant tumour progression was observed during waiting time for treatment of head and neck cancer. To reduce waiting times, a Danish national policy of fast track accelerated clinical pathways was introduced in 2007. This study describes changes in waiting time and the pot......BACKGROUND AND AIM: Significant tumour progression was observed during waiting time for treatment of head and neck cancer. To reduce waiting times, a Danish national policy of fast track accelerated clinical pathways was introduced in 2007. This study describes changes in waiting time...... and the potential influence of fast track by comparing waiting times in 2010 to 2002 and 1992. METHODS: Charts of all new patients diagnosed with squamous cell carcinoma of the oral cavity, pharynx and larynx at the five Danish head and neck oncology centres from January to April 2010 (n=253) were reviewed...

  2. Treatment comfort, time perception, and preference for conventional and digital impression techniques: A comparative study in young patients.

    Science.gov (United States)

    Burhardt, Lukasz; Livas, Christos; Kerdijk, Wouter; van der Meer, Wicher Joerd; Ren, Yijin

    2016-08-01

    The aim of this crossover study was to assess perceptions and preferences for impression techniques in young orthodontic patients receiving alginate and 2 different digital impressions. Thirty-eight subjects aged 10 to 17 years requiring impressions for orthodontic treatment were randomly allocated to 3 groups that differed in the order that an alginate impressions and 2 different intraoral scanning procedures were administered. After each procedure, the patients were asked to score their perceptions on a 5-point Likert scale for gag reflex, queasiness, difficulty to breathe, uncomfortable feeling, perception of the scanning time, state of anxiety, and use of a powder, and to select the preferred impression system. Chairside time and maximal mouth opening were also registered. More queasiness (P = 0.00) and discomfort (P = 0.02) during alginate impression taking of the maxilla were perceived compared with the scans with the CEREC Omnicam (Sirona Dental Systems, Bensheim, Germany). There were no significant differences in perceptions between the alginate impressions and the Lava C.O.S. (3M ESPE, St Paul, Minn) and between the 2 scanners. Chairside times for the alginate impressions (9.7 ± 1.8 minutes) and the CEREC Omnicam (10.7 ± 1.8 minutes) were significantly lower (P Digital impressions were favored by 51% of the subjects, whereas 29% chose alginate impressions, and 20% had no preference. Regardless of the significant differences in the registered times among the 3 impression-taking methods, the distributions of the Likert scores of time perception and maximal mouth opening were similar in all 3 groups. Young orthodontic patients preferred the digital impression techniques over the alginate method, although alginate impressions required the shortest chairside time. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  3. Time in internationally comparative studies

    NARCIS (Netherlands)

    Scheerens, Jaap; Luyten, Johannes W.; Glas, Cornelis A.W.; Scheerens, J

    2014-01-01

    In this chapter, illustrative internationally comparative data about time at school, time spent in out-of-school programs, and homework/ individual study time are presented. In the first section this is done in a more descriptive way, while in the second and third sections, the association between

  4. In Dogs With a European Adder Bite, Does the Use of Antivenom With Supportive Treatment Compared to Supportive Treatment Alone Improve Time to Recovery?

    Directory of Open Access Journals (Sweden)

    Lindsay Hodgson

    2017-11-01

    Full Text Available The current literature does not offer convincing evidence for the positive effect of antivenom on time to recovery in dogs envenomated by the European adder. It appears that the use of antivenom in addition to supportive treatment may positively affect local swelling if given within 24 hours of the bite, but the evidence is low quality and further studies are required before a more definitive answer can be reached.

  5. Treatment comfort, time perception, and preference for conventional and digital impression techniques : A comparative study in young patients

    NARCIS (Netherlands)

    Burhardt, Lukasz; Livas, Christos; Kerdijk, Wouter; van der Meer, Wicher Joerd; Ren, Yijin

    INTRODUCTION: The aim of this crossover study was to assess perceptions and preferences for impression techniques in young orthodontic patients receiving alginate and 2 different digital impressions. METHODS: Thirty-eight subjects aged 10 to 17 years requiring impressions for orthodontic treatment

  6. Quantitative Assessment of the T2 Relaxation Time of the Gluteus Muscles in Children with Duchenne Muscular Dystrophy: a Comparative Study Before and After Steroid Treatment

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    Kim, Hee Kyung; Laor, Tal; Wong, Brenda [Cincinnati Children' s Hospital Medical Center, Cincinnati (United States); Horn, Paul S. [University of Cincinnati, Cincinnati (United States)

    2010-06-15

    To determine the feasibility of using T2 mapping as a quantitative method to longitudinally follow the disease activity in children with Duchenne muscular dystrophy (DMD) who are treated with steroids. Eleven boys with DMD (age range: 5-14 years) underwent evaluation with the clinical functional score (CFS), and conventional pelvic MRI and T2 mapping before and during steroid therapy. The gluteus muscle inflammation and fatty infiltration were evaluated on conventional MRI. The histograms and mean T2 relaxation times were obtained from the T2 maps. The CFS, the conventional MRI findings and the T2 values were compared before and during steroid therapy. None of the patients showed interval change of their CFSs. On conventional MRI, none of the images showed muscle inflammation. During steroid treatment, two boys showed increased fatty infiltration on conventional MRI, and both had an increase of the mean T2 relaxation time (p < 0.05). The remaining nine boys had no increase in fatty infiltration. Of these, three showed an increased mean T2 relaxation time (p < 0.05), two showed no change and four showed a decreased mean T2 relaxation time (p < 0.05). T2 mapping is a feasible technique to evaluate the longitudinal muscle changes in those children who receive steroid therapy for DMD. The differences of the mean T2 relaxation time may reflect alterations in disease activity, and even when the conventional MRI and CFS remain stable.

  7. Quantitative Assessment of the T2 Relaxation Time of the Gluteus Muscles in Children with Duchenne Muscular Dystrophy: a Comparative Study Before and After Steroid Treatment

    International Nuclear Information System (INIS)

    Kim, Hee Kyung; Laor, Tal; Wong, Brenda; Horn, Paul S.

    2010-01-01

    To determine the feasibility of using T2 mapping as a quantitative method to longitudinally follow the disease activity in children with Duchenne muscular dystrophy (DMD) who are treated with steroids. Eleven boys with DMD (age range: 5-14 years) underwent evaluation with the clinical functional score (CFS), and conventional pelvic MRI and T2 mapping before and during steroid therapy. The gluteus muscle inflammation and fatty infiltration were evaluated on conventional MRI. The histograms and mean T2 relaxation times were obtained from the T2 maps. The CFS, the conventional MRI findings and the T2 values were compared before and during steroid therapy. None of the patients showed interval change of their CFSs. On conventional MRI, none of the images showed muscle inflammation. During steroid treatment, two boys showed increased fatty infiltration on conventional MRI, and both had an increase of the mean T2 relaxation time (p < 0.05). The remaining nine boys had no increase in fatty infiltration. Of these, three showed an increased mean T2 relaxation time (p < 0.05), two showed no change and four showed a decreased mean T2 relaxation time (p < 0.05). T2 mapping is a feasible technique to evaluate the longitudinal muscle changes in those children who receive steroid therapy for DMD. The differences of the mean T2 relaxation time may reflect alterations in disease activity, and even when the conventional MRI and CFS remain stable

  8. Times of analgesic efficacy of two drugs in the treatment of patients with renal-ureteral colic compared by survival models

    Directory of Open Access Journals (Sweden)

    Luis Reyes Velázquez

    2015-01-01

    Full Text Available Renourethral colic is a very painful clinical situation that requires a quick diagnosis and treatment. A study was done with patients who were administered two types of analgesics, and whose pain was measured through a visual analogue scale. Censored data results were obtained, considering the time when the pain disappeared as the random variable. Maximum likelihood and survival analysis give useful methods to estimate the distribution and parametric functions for this variable. This study will allow a more effective, timely, lower cost and suitable medical treatment for patients.

  9. Design and rationale of the Paliperidone Palmitate Research in Demonstrating Effectiveness (PRIDE) study: a novel comparative trial of once-monthly paliperidone palmitate versus daily oral antipsychotic treatment for delaying time to treatment failure in persons with schizophrenia.

    Science.gov (United States)

    Alphs, Larry; Mao, Lian; Rodriguez, Stephen C; Hulihan, Joe; Starr, H Lynn

    2014-12-01

    Public health considerations require that clinical trials address the complex "real-world" needs of patients with chronic illnesses. This is particularly true for persons with schizophrenia, whose management is frequently complicated by factors such as comorbid substance abuse, homelessness, and contact with the criminal justice system. In addition, barriers to obtaining health care in the United States often prevent successful community reentry and optimal patient management. Further, nonadherence to treatment is common, and this reinforces cycles of relapse and recidivism. Long-acting injectable antipsychotic therapy may facilitate continuity of treatment and support better outcomes, particularly in patients who face these challenges. Clinical trials with classical explanatory designs may not be the best approaches for evaluating these considerations. We describe the design and rationale of a novel trial that combines both explanatory and pragmatic design features and studies persons with schizophrenia who face these challenges. The Paliperidone Palmitate Research in Demonstrating Effectiveness (PRIDE) study is a prospective, open-label, randomized, 15-month study conducted between May 5, 2010, and December 9, 2013, comparing long-acting injectable paliperidone palmitate and oral antipsychotic medications in subjects with schizophrenia (according to DSM-IV criteria). Investigators and subjects had broad flexibility for treatment decision-making, thus making it a model that better reflects real-world practice. The primary end point was time to treatment failure, defined as arrest/incarceration psychiatric hospitalization; suicide; treatment discontinuation or supplementation due to inadequate efficacy, safety, or tolerability; or increased psychiatric services to prevent hospitalization. This end point was adjudicated by a blinded event monitoring board. Patients were followed to the 15-month end point, regardless of whether they were maintained on their initial

  10. Sick leave and disability pension in Hodgkin lymphoma survivors by stage, treatment, and follow-up time--a population-based comparative study.

    Science.gov (United States)

    Glimelius, I; Ekberg, S; Linderoth, J; Jerkeman, M; Chang, E T; Neovius, M; Smedby, K E

    2015-12-01

    This study seeks to investigate the long-term public health burden of Hodgkin lymphoma (HL) in terms of work loss following contemporary treatment protocols and associations with established treatment complications and lymphoma relapse. We identified 1,989 Swedish HL patients (1,082 with clinical information) aged 18-60 (median 33) years at diagnosis 1992-2009, and matched 1:4 to population comparators. Sick leave, disability pension (work loss), and comorbidity were retrieved through September 2013. Relative risks (RR) with 95% confidence intervals (CI) were calculated using Poisson regression, and mean lost work days were estimated yearly during follow-up. The risk of annual work loss was elevated in HL survivors versus comparators up to the 15th year post-diagnosis (RR(5th year) 1.64, 95% CI 1.46-1.84; RR(10th year) 1.33, 95% CI 1.15-1.34; and RR(15th year) 1.30, 95% CI 1.04-1.62). The risk remained elevated up to the 10th year after adjustment for secondary malignancies and cardiovascular disease (RR(10th year) 1.31, 95% CI 1.13-1.52). Advanced-stage patients had more lost days than comparators (mean number(5th year) 66 versus 33, mean difference 34, 95% CI 20-48) as did patients receiving 6-8 chemotherapy courses (62 versus 33, mean difference(5th year) 30, 95 % CI 17-43). Among patients in the first complete remission, a difference was still observed for advanced-stage (51 versus 33, mean difference(5th year) 19, 95% CI 5-34) but not early-stage disease. Advanced-stage HL survivors treated with full-dose chemotherapy were at increased risk of work loss, not only explained by relapse, secondary malignancies, or cardiovascular disease. The results call for increased awareness and evaluation of reasons for long-term work disability following intensive chemotherapy among young HL survivors.

  11. Parkinson's disease incidence: magnitude, comparability, time trends.

    Science.gov (United States)

    de Pedro-Cuesta, J; Stawiarz, L

    1991-11-01

    In this study, we reviewed incidence surveys of Parkinson's Disease (PD) from all over the world, published during the period 1945-1989, using reported quality criteria. In addition, we compared age-specific PD incidences from selected observations by stratified analysis. Crude incidences were described for 11 populations, and age-specific incidences for three of them: Iceland, Rochester (Minn, USA), and Turku (Finland). Effect modification by age was detected: a) by comparing incidences by age at diagnosis with incidence by age at clinical disease onset; and b) when only data on onset of disease was computed. For disease onsets, the incidences in Rochester for the period 1955-1966, and in Turku (Finland) during the interval 1968-1970, were lower than that in Iceland for the period 1958-1960: RR = 0.58 95% CI (0.41, 0.83), and RR = 0.67 95% CI (0.51, 0.87), respectively. For the Rochester population aged 40-69 years, a statistically significant 56% decrease in the incidences of Parkinsonism onsets during the period 1945-1966 was found. Validity problems in comparing PD incidences and the role of PD underdiagnosis were emphasized. We concluded that: a) stratified analysis is more suitable than standardization when comparing incidences for etiological purposes; b) the incidence of PD was highest in Iceland; and c) in Rochester, PD incidence under the age of 70 decreased with time.

  12. Comparability of IQ scores over time

    NARCIS (Netherlands)

    Must, O.; te Nijenhuis, J.; Must, A.; van Vianen, A.E.M.

    2009-01-01

    This study investigates the comparability of IQ scores. Three cohorts (1933/36, 1997/98, 2006) of Estonian students (N = 2173) are compared using the Estonian National Intelligence Test. After 72 years the secular rise of the IQ test scores is.79 SD. The mean .16 SD increase in the last 8 years

  13. Comparability of IQ Scores over Time

    Science.gov (United States)

    Must, Olev; te Nijenhuis, Jan; Must, Aasa; van Vianen, Annelies E. M.

    2009-01-01

    This study investigates the comparability of IQ scores. Three cohorts (1933/36, 1997/98, 2006) of Estonian students (N = 2173) are compared using the Estonian National Intelligence Test. After 72 years the secular rise of the IQ test scores is 0.79 SD. The mean 0.16 SD increase in the last 8 years suggests a rapid increase of the Flynn Effect (FE)…

  14. Estimating Treatment and Treatment Times for Special and Nonspecial Patients in Hospital Ambulatory Dental Clinics.

    Science.gov (United States)

    Rosenberg, Dara J.; And Others

    1986-01-01

    A study compared the treatments and the amount of time needed for treatment of the dental needs of developmentally disabled, severely compromised, and moderately compromised patients with those of nondisabled patients in a hospital ambulatory dental clinic. (MSE)

  15. Pharmacodynamic analysis and clinical trial of amoxicillin sprinkle administered once daily for 7 days compared to penicillin V potassium administered four times daily for 10 days in the treatment of tonsillopharyngitis due to Streptococcus pyogenes in children.

    Science.gov (United States)

    Pichichero, M E; Casey, J R; Block, S L; Guttendorf, R; Flanner, H; Markowitz, D; Clausen, S

    2008-07-01

    An a priori pharmacokinetic/pharmacodynamic (PK/PD) target of 40% daily time above the MIC (T >MIC; based on the MIC(90) of 0.06 microg/ml for Streptococcus pyogenes reported in the literature) was shown to be achievable in a phase 1 study of 23 children with a once-daily (QD) modified-release, multiparticulate formulation of amoxicillin (amoxicillin sprinkle). The daily T >MIC achieved with the QD amoxicillin sprinkle formulation was comparable to that achieved with a four-times-daily (QID) penicillin VK suspension. An investigator-blinded, randomized, parallel-group, multicenter study involving 579 children 6 months to 12 years old with acute streptococcal tonsillopharyngitis was then undertaken. Children were randomly assigned 1:1 to receive either the amoxicillin sprinkle (475 mg for ages 6 months to 4 years, 775 mg for ages 5 to 12 years) QD for 7 days or 10 mg/kg of body weight of penicillin VK QID for 10 days (up to the maximum dose of 250 mg QID). Unexpectedly, the rates of bacteriological eradication at the test of cure were 65.3% (132/202) for the amoxicillin sprinkle and 68.0% (132/194) for penicillin VK (95% confidence interval, -12.0% to 6.6%). Thus, neither antibiotic regimen met the minimum criterion of > or =85% eradication ordinarily required by the U.S. FDA for first-line treatment of tonsillopharyngitis due to S. pyogenes. The results of subgroup analyses across demographic characteristics and current infection characteristics and by age/weight categories were consistent with the primary-efficacy result. The clinical cure rates for amoxicillin sprinkle and penicillin VK were 86.1% (216/251) and 91.9% (204/222), respectively (95% confidence interval, -11.6% to -0.4%). The results of a post hoc PD analysis suggested that a requirement for 60% daily T >MIC(90) more accurately predicted the observed high failure rates for bacteriologic eradication with the amoxicillin sprinkle and penicillin VK suspension studied. Based on the association between

  16. Pharmacodynamic Analysis and Clinical Trial of Amoxicillin Sprinkle Administered Once Daily for 7 Days Compared to Penicillin V Potassium Administered Four Times Daily for 10 Days in the Treatment of Tonsillopharyngitis Due to Streptococcus pyogenes in Children▿

    Science.gov (United States)

    Pichichero, M. E.; Casey, J. R.; Block, S. L.; Guttendorf, R.; Flanner, H.; Markowitz, D.; Clausen, S.

    2008-01-01

    An a priori pharmacokinetic/pharmacodynamic (PK/PD) target of 40% daily time above the MIC (T >MIC; based on the MIC90 of 0.06 μg/ml for Streptococcus pyogenes reported in the literature) was shown to be achievable in a phase 1 study of 23 children with a once-daily (QD) modified-release, multiparticulate formulation of amoxicillin (amoxicillin sprinkle). The daily T >MIC achieved with the QD amoxicillin sprinkle formulation was comparable to that achieved with a four-times-daily (QID) penicillin VK suspension. An investigator-blinded, randomized, parallel-group, multicenter study involving 579 children 6 months to 12 years old with acute streptococcal tonsillopharyngitis was then undertaken. Children were randomly assigned 1:1 to receive either the amoxicillin sprinkle (475 mg for ages 6 months to 4 years, 775 mg for ages 5 to 12 years) QD for 7 days or 10 mg/kg of body weight of penicillin VK QID for 10 days (up to the maximum dose of 250 mg QID). Unexpectedly, the rates of bacteriological eradication at the test of cure were 65.3% (132/202) for the amoxicillin sprinkle and 68.0% (132/194) for penicillin VK (95% confidence interval, −12.0% to 6.6%). Thus, neither antibiotic regimen met the minimum criterion of ≥85% eradication ordinarily required by the U.S. FDA for first-line treatment of tonsillopharyngitis due to S. pyogenes. The results of subgroup analyses across demographic characteristics and current infection characteristics and by age/weight categories were consistent with the primary-efficacy result. The clinical cure rates for amoxicillin sprinkle and penicillin VK were 86.1% (216/251) and 91.9% (204/222), respectively (95% confidence interval, −11.6% to −0.4%). The results of a post hoc PD analysis suggested that a requirement for 60% daily T >MIC90 more accurately predicted the observed high failure rates for bacteriologic eradication with the amoxicillin sprinkle and penicillin VK suspension studied. Based on the association between longer

  17. Neurodevelopmental treatment after stroke : a comparative study

    NARCIS (Netherlands)

    Dr. T.B. Hafsteinsdóttir; A Algra; M.H.F. Grypdonck; L.J. Kappelle

    2005-01-01

    Background: Neurodevelopmental treatment (NDT) is a rehabilitation approach increasingly used in the care of stroke patients, although no evidence has been provided for its efficacy. Objective: To investigate the effects of NDT on the functional status and quality of life (QoL) of patients

  18. COMPARATIVE STUDY ON THE TREATMENT OF DISC HERNIATIONS

    Directory of Open Access Journals (Sweden)

    María Luz Suárez-Huerta

    Full Text Available ABSTRACT Objective: To compare the results of treatment of patients with low back pain and radiculalgia resulting from disc herniation associated with disc degeneration through instrumentation with pedicle screws and dynamic rod, with root release and without diskectomy compared with other non-instrumented techniques (microdiskectomy with or without foraminotomy. Methods: This is a retrospective descriptive study of interventions for patients with herniated discs in the Traumatology and Neurosurgery that used the following variables: age, sex, type of technique, surgical time, time of evolution, degree of satisfaction, and complications. Two groups were formed: instrumentation with dynamic rods and non-instrumented techniques, comparing the results of each group. The software used was the SPSS v20.0. Results: We presented 142 interventions carried out between 2009 and 2012, 86 with dynamic instrumentation and 56 by other decompression techniques without instrumentation. No statistically significant differences were observed between age and sex groups and time elapsed until intervention. We found statistically significant differences (p=0.001 in surgical time, which was lower in the instrumented technique. No significant differences were found in complications between the techniques in both re-operations and in infections. Conclusions: In this study, we found no significant differences between the use of instrumentation with dynamic rods with respect to other non-instrumented surgical techniques in the treatment of herniated discs over 6 months of evolution or the complications and the degree of the patients' satisfaction.

  19. Part-Time Sick Leave as a Treatment Method?

    OpenAIRE

    Andrén D; Andrén T

    2009-01-01

    This paper analyzes the effects of being on part-time sick leave compared to full-time sick leave on the probability of recovering (i.e., returning to work with full recovery of lost work capacity). Using a discrete choice one-factor model, we estimate mean treatment parameters and distributional treatment parameters from a common set of structural parameters. Our results show that part-time sick leave increases the likelihood of recovering and dominates full-time sick leave for sickness spel...

  20. Time Preferences, Mental Health and Treatment Utilization.

    Science.gov (United States)

    Eisenberg, Daniel; Druss, Benjamin G

    2015-09-01

    In all countries of the world, fewer than half of people with mental disorders receive treatment. This treatment gap is commonly attributed to factors such as consumers' limited knowledge, negative attitudes, and financial constraints. In the context of other health behaviors, such as diet and exercise, behavioral economists have emphasized time preferences and procrastination as additional barriers. These factors might also be relevant to mental health. We examine conceptually and empirically how lack of help-seeking for mental health conditions might be related to time preferences and procrastination. Our conceptual discussion explores how the interrelationships between time preferences and mental health treatment utilization could fit into basic microeconomic theory. The empirical analysis uses survey data of student populations from 12 colleges and universities in 2011 (the Healthy Minds Study, N=8,806). Using standard brief measures of discounting, procrastination, and mental health (depression and anxiety symptoms), we examine the conditional correlations between indicators of present-orientation (discount rate and procrastination) and mental health symptoms. The conceptual discussion reveals a number of potential relationships that would be useful to examine empirically. In the empirical analysis depression is significantly associated with procrastination and discounting. Treatment utilization is significantly associated with procrastination but not discounting. The empirical results are generally consistent with the idea that depression increases present orientation (reduces future orientation), as measured by discounting and procrastination. These analyses have notable limitations that will require further examination in future research: the measures are simple and brief, and the estimates may be biased from true causal effects because of omitted variables and reverse causality. There are several possibilities for future research, including: (i

  1. Comparative Chronemics and Diplomacy: American and Iranian Perspectives on Time.

    Science.gov (United States)

    Merriam, Allen H.

    Arguing that assumptions and behaviors related to time are culturally determined, this paper proposes that diplomats must learn to pay more attention to comparative chronemics--the study of time across cultures. The paper points out that differences in the perception of time was a key element in the conflict between Iran and the United States in…

  2. Real-time interactive treatment planning

    International Nuclear Information System (INIS)

    Otto, Karl

    2014-01-01

    The goal of this work is to develop an interactive treatment planning platform that permits real-time manipulation of dose distributions including DVHs and other dose metrics. The hypothesis underlying the approach proposed here is that the process of evaluating potential dose distribution options and deciding on the best clinical trade-offs may be separated from the derivation of the actual delivery parameters used for the patient’s treatment. For this purpose a novel algorithm for deriving an Achievable Dose Estimate (ADE) was developed. The ADE algorithm is computationally efficient so as to update dose distributions in effectively real-time while accurately incorporating the limits of what can be achieved in practice. The resulting system is a software environment for interactive real-time manipulation of dose that permits the clinician to rapidly develop a fully customized 3D dose distribution. Graphical navigation of dose distributions is achieved by a sophisticated method of identifying contributing fluence elements, modifying those elements and re-computing the entire dose distribution. 3D dose distributions are calculated in ∼2–20 ms. Including graphics processing overhead, clinicians may visually interact with the dose distribution (e.g. ‘drag’ a DVH) and display updates of the dose distribution at a rate of more than 20 times per second. Preliminary testing on various sites shows that interactive planning may be completed in ∼1–5 min, depending on the complexity of the case (number of targets and OARs). Final DVHs are derived through a separate plan optimization step using a conventional VMAT planning system and were shown to be achievable within 2% and 4% in high and low dose regions respectively. With real-time interactive planning trade-offs between Target(s) and OARs may be evaluated efficiently providing a better understanding of the dosimetric options available to each patient in static or adaptive RT. (paper)

  3. Waiting Time Increases Risk of Attrition in Gambling Disorder Treatment

    DEFF Research Database (Denmark)

    Linnet, Jakob; Pedersen, Anders Sune

    2014-01-01

    Attrition is a well known problem in psychotherapeutic treatment. Patients with addiction have high attrition rates, and it is therefore important to identify factors that can improve completion rates in addiction. Here, we investigated the influence of waiting time as a predictor of treatment...... completion in gambling disorder. We compared 48 gambling disorder sufferers with a 56% completion rate (21 non-completers and 27 completers). Binomial logistic regression analysis showed that waiting time from initial contact to the first session with a therapist was a significant predictor of risk...... of attrition: longer waiting times were associated with increased risk of attrition. Age, gender, or comorbidity was not associated with an increased risk of attrition. These data suggest that gambling disorder sufferers benefit from fast access to treatment, and that longer waiting time increases the risk...

  4. Intralesional immunotherapy compared to cryotherapy in the treatment of warts.

    Science.gov (United States)

    Khozeimeh, Fahime; Jabbari Azad, Farahzad; Mahboubi Oskouei, Yaghoub; Jafari, Majid; Tehranian, Shahrzad; Alizadehsani, Roohallah; Layegh, Pouran

    2017-04-01

    Warts are the most common clinical manifestation of the human papilloma-virus infection in the skin and mucous membranes. In spite of the various therapeutic modalities for nongenital skin warts, there is still no single method to be used as an approved treatment. In this study, we compared the efficacy of immunotherapy and cryotherapy on wart lesions. Sixty patients with verruca vulgaris and plantar warts were randomly divided into two groups. One group received intralesional injection of candida antigen repeated every 3 weeks until complete improvement of all warts or for a maximum of three sessions. The second group was treated by cryotherapy with liquid nitrogen for a maximum of ten sessions or until clearance of all lesions. T-test and chi-square test were used for statistical analysis, and P cryotherapy (P = 0.023). Moreover, a significant difference was observed between the time-elapsed before treatment and the therapeutic response between both groups (P = 0.041). 76.7% of patients were completely cured with immunotherapy, while only 56.7% responded to cryotherapy. Complete remission was observed with fewer sessions (20.17 ± 0.65) in immunotherapy compared to cryotherapy (3.82 ± 2.481), but no statistically significant difference was shown between groups. Immunotherapy was well-tolerated except for the pain during injection that was the most common side effect. Intralesional immunotherapy is an effective treatment of warts. This method has a better therapeutic response, needs fewer sessions, and is capable of treating distant warts. © 2017 The International Society of Dermatology.

  5. Endovascular treatment of acute basilar artery occlusion: time to treatment is crucial

    International Nuclear Information System (INIS)

    Dorňák, T.; Herzig, R.; Kuliha, M.; Havlíček, R.; Školoudík, D.; Šaňák, D.; Köcher, M.; Procházka, V.; Lacman, J.; Charvát, F.; Krajina, A.

    2015-01-01

    Aim: To evaluate the safety and efficacy of multimodal endovascular treatment (EVT) of acute basilar artery occlusion (BAO), including bridging therapy [intravenous thrombolysis (IVT) with subsequent EVT], to compare particular EVT techniques and identify predictors of clinical outcome. Materials and methods: This retrospective, multi-centre study comprised 72 acute ischaemic stroke patients (51 males; mean age 59.1 ± 13.3 years) with radiologically confirmed BAO. The following data were collected: baseline characteristics, risk factors, pre-event antithrombotic treatment, neurological deficit at time of treatment, localization of occlusion, time to therapy, recanalization rate, post-treatment imaging findings. Thirty- and 90-day outcomes were evaluated using the modified Rankin scale with a good clinical outcome defined as 0–3 points. Results: Successful recanalization was achieved in 94.4% patients. Stepwise binary logistic regression analysis identified the presence of arterial hypertension (OR = 0.073 and OR = 0.067, respectively), National Institutes of Health Stroke Scale (NIHSS) at the time of treatment (OR = 0,829 and OR = 0.864, respectively), and time to treatment (OR = 0.556 and OR = 0.502, respectively) as significant independent predictors of 30- and 90-day clinical outcomes. Conclusion: Data from this multicentre study showed that multimodal EVT was an effective recanalization method in acute BAO. Bridging therapy shortens the time to treatment, which was identified as the only modifiable outcome predictor. - Highlights: • Various treatments are being used in recanalization of basilar artery occlusion. • Multimodal endovascular treatment is an effective recanalization method. • Time-to-treatment is the only modifiable outcome predictor. • Bridging therapy shortens time-to-treatment. • Arterial hypertension, neurologic deficit are associated with poor outcome

  6. Comparative studies on chemical, hot and cold water treatments of ...

    African Journals Online (AJOL)

    study was to compare cold and hot water treatment with chemical treatment of banana planting material for the control of the banana weevil, and to validate the effect of paring on weevil and nematode removal from banana suckers. Materials and methods. The experiment was conducted at Kawanda Agricultural research ...

  7. Seasonal time series forecasting: a comparative study of arima and ...

    African Journals Online (AJOL)

    This paper addresses the concerns of Faraway and Chatfield (1998) who questioned the forecasting ability of Artificial Neural Networks (ANN). In particular the paper compares the performance of Artificial Neural Networks (ANN) and ARIMA models in forecasting of seasonal (monthly) Time series. Using the Airline data ...

  8. Comparing Outcomes for Youth Served in Treatment Foster Care and Treatment Group Care

    Science.gov (United States)

    Robst, John; Armstrong, Mary; Dollard, Norin

    2011-01-01

    This study compared youth in the Florida Medicaid system prior to entry into treatment foster care or treatment group care, and compared outcomes in the 6 months after treatment. Florida Medicaid data from FY2003/04 through 2006/2007 along with Department of Juvenile Justice, Department of Law Enforcement, and involuntary examination data were…

  9. Comparing Limberg Flap Technique and Phenol Treatment Methods in Treatment of Pilonidal Disease

    Directory of Open Access Journals (Sweden)

    Ulas Urganci

    2016-01-01

    Full Text Available Aim: Although pilonidal disease is experienced commonly, there is no definitive algorithm. Our purpose is to contribute in determining treatment algorithm by comparing the conservative phenol treatment (PT method with limberg flap technique (LFT used frequently for pilonidal disease surgery.Material and Method: Patients diagnosed with pilonidal sinus and treated with PT and LFT between February 2011 and September 2014 in Buca Seyfi Demirsoy State Hospital General Surgery service are retrospectively enrolled in the study. Patients are contacted with the help of their files and included in the study. Patients are compared in terms of age, gender, pain-free walking and start date for going back to work, complications, success and relapse ratios. Results: 73 (81.1% of the cases were male, 17 (18.9% were female and their average age was 24±8.4(14-55. No statistically significant difference was detected between patients who have undergone LFT and PT in terms of success and relapse (p>0,05. Hospitalization period was average 1.55±0.9 days for patients who have undergone LFT. FT was applied as outpatient treatment for all patients. A statistically significant difference was determined in favor of PT as a result of comparing postoperative complications, pain-free walking and start date for going back to work (p=0,00. Discussion: In our study, we have proven that LFT, which is a method used frequently with recognized success is not superior to PT in terms of success and relapse ratios (p>0.05. On the contrary, when compared in terms of postoperative complication, pain-free walking time and start date for going back to work, we observed that PT is more advantageous than LFT (p=0,00. We consider that PT can be prefered treatment method due to its acceptable relapse ratio, low postoperative complication ratio, good postoperative patient comfort, capability of performing repeated applications and constant availability of operation option.

  10. Optimising fuel treatments over time and space

    Science.gov (United States)

    Woodam Chung; Greg Jones; Kurt Krueger; Jody Bramel; Marco Contreras

    2013-01-01

    Fuel treatments have been widely used as a tool to reduce catastrophic wildland fire risks in many forests around the world. However, it is a challenging task for forest managers to prioritise where, when and how to implement fuel treatments across a large forest landscape. In this study, an optimisation model was developed for long-term fuel management decisions at a...

  11. A method for verification of treatment times for high-dose-rate intraluminal brachytherapy treatment

    Directory of Open Access Journals (Sweden)

    Muhammad Asghar Gadhi

    2016-06-01

    Full Text Available Purpose: This study was aimed to increase the quality of high dose rate (HDR intraluminal brachytherapy treatment. For this purpose, an easy, fast and accurate patient-specific quality assurance (QA tool has been developed. This tool has been implemented at Bahawalpur Institute of Nuclear Medicine and Oncology (BINO, Bahawalpur, Pakistan.Methods: ABACUS 3.1 Treatment planning system (TPS has been used for treatment planning and calculation of total dwell time and then results were compared with the time calculated using the proposed method. This method has been used to verify the total dwell time for different rectum applicators for relevant treatment lengths (2-7 cm and depths (1.5-2.5 cm, different oesophagus applicators of relevant treatment lengths (6-10 cm and depths (0.9 & 1.0 cm, and a bronchus applicator for relevant treatment lengths (4-7.5 cm and depth (0.5 cm.Results: The average percentage differences between treatment time TM with manual calculation and as calculated by the TPS is 0.32% (standard deviation 1.32% for rectum, 0.24% (standard deviation 2.36% for oesophagus and 1.96% (standard deviation 0.55% for bronchus, respectively. These results advocate that the proposed method is valuable for independent verification of patient-specific treatment planning QA.Conclusion: The technique illustrated in the current study is an easy, simple, quick and useful for independent verification of the total dwell time for HDR intraluminal brachytherapy. Our method is able to identify human error-related planning mistakes and to evaluate the quality of treatment planning. It enhances the quality of brachytherapy treatment and reliability of the system.

  12. Comparative Effectiveness of the Different Treatment Modalities for Snoring.

    Science.gov (United States)

    Terryn, Stefanie; De Medts, Joris; Delsupehe, Kathelijne

    2015-09-01

    To evaluate what effects treatments of sleep-disordered breathing have on snoring and sleepiness: snoring surgery including osteotomies, mandibular advancement device (MAD), and continuous positive airway pressure (CPAP). Single-institution prospective comparative effectiveness trial. University-affiliated secondary care teaching hospital. We prospectively studied 224 patients presenting with snoring at our department. All patients underwent detailed evaluation, including symptom questionnaires, clinical examination, polysomnography, and drug-induced sleep endoscopy. Based on these results, a treatment was proposed after multidisciplinary consultation. Treatment was evaluated through 4 questionnaires before treatment and 6 weeks and 6 months after. Treatment success was defined as a global snoring visual analog scale score ≤3 at 6 months. A total of 195 patients complied with full workup and were proposed treatment. The mean age was 46 ± 11 years; the mean body mass index, 27 ± 4; and the median apnea-hypopnea index, 10.0 (interquartile range, 4.7-20.1). After discussion, 116 (59.5%) patients agreed to start treatment (46%, surgery; 26% MAD; 28% CPAP). All symptom scores, including Epworth Sleepiness Scale, decreased significantly for all treatments at 6 weeks and 6 months. Treatment was successful in 67% of the surgery patients, 67% of the MAD group, and 76% of the CPAP group. Only 6.7% reported an unchanged snoring score in the surgery group, compared with 13.6% in the MAD group and 9.6 % in the CPAP group. Multidisciplinary agreed-on treatment of snoring is effective across the proposed treatments. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  13. A prospective, randomized multicenter study comparing APD and CAPD treatment

    DEFF Research Database (Denmark)

    Bro, S; Bjorner, J B; Tofte-Jensen, P

    2000-01-01

    ) treatment with respect to quality of life and clinical outcomes in relation to therapy costs. DESIGN: A prospective, randomized multicenter study. SETTING: Three Danish CAPD units. PATIENTS: Thirty-four adequately dialyzed patients with high or high-average peritoneal transport characteristics were included....... With larger patient samples, it is possible, however, that a significant difference might have been achieved. The running costs for APD treatment were US $75 per day and for CAPD treatment US $61 per day. CONCLUSION: If APD treatment can help to keep selected patients vocationally or socially active, paying...... were assessed at baseline and after 6 months by the self-administered short-form SF-36 generic health survey questionnaire supplemented with disease- and treatment-specific questions. Therapy costs were compared by evaluating dialysis-related expenses. MAIN OUTCOME MEASURES: Quality-of-life parameters...

  14. Effect of time on dyeing wastewater treatment

    Science.gov (United States)

    Ye, Tingjin; Chen, Xin; Xu, Zizhen; Chen, Xiaogang; Shi, Liang; He, Lingfeng; Zhang, Yongli

    2018-03-01

    The preparation of carboxymethylchitosan wrapping fly-ash adsorbent using high temperature activated fly ash and sodium carboxymethyl chitosan (CWF), as with the iron-carbon micro-electrolysis process simulation and actual printing and dyeing wastewater. The effects of mixing time and static time on decolorization ratio, COD removing rate and turbidness removing rate were investigated. The experimental results show that the wastewater stirring times on the decolorization rate and COD removal rate and turbidity removal rate influence, with increasing of the stirring time, three showed a downward trend, and reached the peak at 10 min time; wastewater time on the decolorization ratio and COD removing efficiency and turbidness removing rate influence, along with standing time increase, three who declined and reached the maximum in 30min time.

  15. A prospective, randomized multicenter study comparing APD and CAPD treatment

    DEFF Research Database (Denmark)

    Bro, S; Bjorner, J B; Tofte-Jensen, P

    2000-01-01

    OBJECTIVE: The goals for maintenance dialysis treatment are to improve patient survival, reduce patient morbidity, and improve patient quality of life. This is the first randomized prospective study comparing automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD......) treatment with respect to quality of life and clinical outcomes in relation to therapy costs. DESIGN: A prospective, randomized multicenter study. SETTING: Three Danish CAPD units. PATIENTS: Thirty-four adequately dialyzed patients with high or high-average peritoneal transport characteristics were included...... were assessed at baseline and after 6 months by the self-administered short-form SF-36 generic health survey questionnaire supplemented with disease- and treatment-specific questions. Therapy costs were compared by evaluating dialysis-related expenses. MAIN OUTCOME MEASURES: Quality-of-life parameters...

  16. Salmonella typhi time to change empiric treatment

    DEFF Research Database (Denmark)

    Gade, C.; Engberg, J.; Weis, N.

    2008-01-01

    out of seven cases. We recommend that empiric treatment of suspected cases of typhoid fever includes a third generation cephalosporin such as ceftriaxon. Furthermore, the present report stresses the importance of typhoid vaccination of travellers to areas where typhoid is endemic Udgivelsesdato: 2008/9/29...

  17. [Optimal timing of laparoscopic cholecystectomy in treatment of acute cholecystitis].

    Science.gov (United States)

    Rajčok, M; Danihel, Ľ; Bak, V; Oravský, M; Schnorrer, M

    2016-03-01

    Acute cholecystitis is one of the most frequent diseases occurring in developed countries of the world. Laparoscopic cholecystectomy is a treatment option for acute cholecystitis. Since the advent of laparoscopic cholecystectomy there has been a lack of agreement regarding the timing of the operation in the treatment of acute cholecystitis. From September 2012 to August 2015 we carried out a prospective randomized trial at the IIIrd Surgical Department of University Hospital Milosrdní bratia in Bratislava. We compared two basic approaches to the treatment of acute cholecystitis. During the trial, 64 patients with acute cholecystitis were admitted to the surgery department. 32 patients were treated with early laparoscopic cholecystectomy within 72 hours from the appearance of the symptoms. The other 32 patients were primarily treated with antibiotics and subsequently underwent delayed cholecystectomy after 68 weeks. Our results suggest several advantages of early laparoscopic cholecystectomy such as shorter operation time, lower conversion rate, shorter length of hospital stay, shorter postoperative convalescence and lower cost of hospitalisation. Based on these results we believe that immediate laparoscopic cholecystectomy (within 24 hours from the patients admission to hospital) should become a preferred method of treatment of patients with acute cholecystitis. acute cholecystectomy early and delayed laparoscopic cholecystectomy prospective randomized trial.

  18. Functional Treatment Comparing with Immobilization after Acute Ankle Sprain

    Directory of Open Access Journals (Sweden)

    Hamidreza Mohammadi

    2013-02-01

    Full Text Available Background: Ankle injuries are among the most prevalent injuries with which a physician may encounter. In this study, the efficiency of the functional treatment was compared with the immobilization treatment in healing the acute ankle sprain. Materials and Methods: This clinical trial study was carried out on 100 male patients whose ankle sprain had been diagnosed by Yasuj Shahid Beheshti Hospital. Using block allocation randomization method and regardless of damage degree, patients were divided into two groups, functional method (1st group or immobilization with plaster (2nd group, for treatment. Several variables such as range of motion, pain intensity, inflammation, joint tenderness and returning to work after 2, 6 and 12 weeks were examined. Results: After two weeks, the average pain intensity in the first group (33.2±3.2 has been decreased compared to the second group (55±1.2, which showed a significant difference between the two groups (p<0.05. The average ankle range of motion in the first and second groups was 29.08±1.2 degrees and 20.4±2.2 degrees, respectively which had been increased significantly in the first group compared to the second group (p<0.03. Similarly, a considerable difference was observed in decreased inflammation and tenderness in the first group compared to the second one. Conclusion: In acute ankle sprains, the functional treatment is better than the immobilization treatment in alleviating pain, inflammation and improving the range of joint motion.

  19. Travel Time to Hospital for Childbirth: Comparing Calculated Versus Reported Travel Times in France.

    Science.gov (United States)

    Pilkington, Hugo; Prunet, Caroline; Blondel, Béatrice; Charreire, Hélène; Combier, Evelyne; Le Vaillant, Marc; Amat-Roze, Jeanne-Marie; Zeitlin, Jennifer

    2018-01-01

    Objectives Timely access to health care is critical in obstetrics. Yet obtaining reliable estimates of travel times to hospital for childbirth poses methodological challenges. We compared two measures of travel time, self-reported and calculated, to assess concordance and to identify determinants of long travel time to hospital for childbirth. Methods Data came from the 2010 French National Perinatal Survey, a national representative sample of births (N = 14 681). We compared both travel time measures by maternal, maternity unit and geographic characteristics in rural, peri-urban and urban areas. Logistic regression models were used to study factors associated with reported and calculated times ≥30 min. Cohen's kappa coefficients were also calculated to estimate the agreement between reported and calculated times according to women's characteristics. Results In urban areas, the proportion of women with travel times ≥30 min was higher when reported rather than calculated times were used (11.0 vs. 3.6%). Longer reported times were associated with non-French nationality [adjusted odds ratio (aOR) 1.3 (95% CI 1.0-1.7)] and inadequate prenatal care [aOR 1.5 (95% CI 1.2-2.0)], but not for calculated times. Concordance between the two measures was higher in peri-urban and rural areas (52.4 vs. 52.3% for rural areas). Delivery in a specialised level 2 or 3 maternity unit was a principal determinant of long reported and measured times in peri-urban and rural areas. Conclusions for Practice The level of agreement between reported and calculated times varies according to geographic context. Poor measurement of travel time in urban areas may mask problems in accessibility.

  20. Treatment of tinea capitis - griseofulvin versus fluconazole - a comparative study.

    Science.gov (United States)

    Shemer, Avner; Plotnik, Ira Bernstein; Davidovici, Batya; Grunwald, Marcelo H; Magun, Ronen; Amichai, Boaz

    2013-08-01

    To compare the efficacy and safety of fluconazole and griseofulvin in the treatment of tinea capitis. Patients with tinea capitis (n = 113) with positive fungal cultures entered the study. The patients were divided into four groups with different treatment regimes. Two groups received griseofulvin 15 or 25 mg/kg/day and two groups received fluconazole 4 or 6 mg/kg/day, all for up to 12 weeks. Griseofulvin was found to be slightly better than fluconazole. The lower doses for both griseofulvin and fluconazole required significantly longer treatment duration until mycological cure than the higher doses, independent of the fungus type. Since no significant difference was found between the drugs, it is suggested that the choice should be based on tolerability, availability and cost of the drugs. © The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin.

  1. A Comparative Electrochemical-Ozone Treatment for Removal of Phenolphthalein

    Directory of Open Access Journals (Sweden)

    V. M. García-Orozco

    2016-01-01

    Full Text Available The degradation of aqueous solutions containing phenolphthalein was carried out using ozone and electrochemical processes; the two different treatments were performed for 60 min at pH 3, pH 7, and pH 9. The electrochemical oxidation using boron-doped diamond electrodes processes was carried out using three current density values: 3.11 mA·cm−2, 6.22 mA·cm−2, and 9.33 mA·cm−2, whereas the ozone dose was constantly supplied at 5±0.5 mgL−1. An optimal degradation condition for the ozonation treatment is at alkaline pH, while the electrochemical treatment works better at acidic pH. The electrochemical process is twice better compared with ozonation.

  2. Comparing averaging limits for social cues over space and time.

    Science.gov (United States)

    Florey, Joseph; Dakin, Steven C; Mareschal, Isabelle

    2017-08-01

    Observers are able to extract summary statistics from groups of faces, such as their mean emotion or identity. This can be done for faces presented simultaneously and also from sequences of faces presented at a fixed location. Equivalent noise analysis, which estimates an observer's internal noise (the uncertainty in judging a single element) and effective sample size (ESS; the effective number of elements being used to judge the average), reveals what limits an observer's averaging performance. It has recently been shown that observers have lower ESSs and higher internal noise for judging the mean gaze direction of a group of spatially distributed faces compared to the mean head direction of the same faces. In this study, we use the equivalent noise technique to compare limits on these two cues to social attention under two presentation conditions: spatially distributed and sequentially presented. We find that the differences in ESS are replicated in spatial arrays but disappear when both cue types are averaged over time, suggesting that limited peripheral gaze perception prevents accurate averaging performance. Correlation analysis across participants revealed generic limits for internal noise that may act across stimulus and presentation types, but no clear shared limits for ESS. This result supports the idea of some shared neural mechanisms b in early stages of visual processing.

  3. COMPARATIVE STUDY OF TERTIARY WASTEWATER TREATMENT BY COMPUTER SIMULATION

    Directory of Open Access Journals (Sweden)

    Stefania Iordache

    2010-01-01

    Full Text Available The aim of this work is to asses conditions for implementation of a Biological Nutrient Removal (BNR process in theWastewater Treatment Plant (WWTP of Moreni city (Romania. In order to meet the more increased environmentalregulations, the wastewater treatment plant that was studied, must update the actual treatment process and have tomodernize it. A comparative study was undertaken of the quality of effluents that could be obtained by implementationof biological nutrient removal process like A2/O (Anaerobic/Anoxic/Oxic and VIP (Virginia Plant Initiative aswastewater tertiary treatments. In order to asses the efficiency of the proposed treatment schemata based on the datamonitored at the studied WWTP, it were realized computer models of biological nutrient removal configurations basedon A2/O and VIP process. Computer simulation was realized using a well-known simulator, BioWin by EnviroSimAssociates Ltd. The simulation process allowed to obtain some data that can be used in design of a tertiary treatmentstage at Moreni WWTP, in order to increase the efficiency in operation.

  4. TINEA CAPITIS– SIGNIFICANCE OF TIMELY TREATMENT TO PREVENT SCARRING ALOPECIA

    Directory of Open Access Journals (Sweden)

    Sandrina Carvalho

    2016-09-01

    Conclusion: The treatment of tinea capitis is simple and effective. Timely identification and treatment are essential to prevent the formation of a cicatricial alopecia, often disturbing for the patient.

  5. The effectiveness of evidence-based treatments for personality disorders when comparing treatment-as-usual and bona fide treatments.

    Science.gov (United States)

    Budge, Stephanie L; Moore, Jonathan T; Del Re, A C; Wampold, Bruce E; Baardseth, Timothy P; Nienhuis, Jacob B

    2013-12-01

    The purpose of Study 1 was to examine the relative efficacy of evidence-based treatments (EBTs) when compared to treatment-as-usual (TAU) for adults diagnosed with a personality disorder (PD). The purpose of Study 2 was to investigate the strength of the differences between bona fide psychotherapeutic treatments for PDs. Two separate computerized searches were conducted of: (a) studies that directly compared an EBT with a TAU for treatment of PDs, or (b) studies that compared at least two bona fide treatments for PDs. Meta-analytic methods were used to estimate the effectiveness of the treatments when compared to one another and to model how various confounding variables impacted the results of this comparative research. A total of 30 studies (Study 1; N=1662) were included in the meta-analysis comparing EBTs to TAU. A total of 12 studies (Study 2; N=723) were included in the meta-analysis comparing bona fide treatments. Study 1 found that EBTs were superior to TAU, although the TAU conditions were not comparable in many respects (e.g., not psychotherapy, lacking supervision, lacking training, etc.) to the EBT and there was significant heterogeneity in the effects. Study 2 found that some bona fide treatments were superior to others. © 2013.

  6. Comparing Biofouling Control Treatments for Use on Aquaculture Nets

    Directory of Open Access Journals (Sweden)

    Geoffrey Swain

    2014-12-01

    Full Text Available Test panels comprised of uncoated, copper coated and silicone coated 7/8'' (22 mm mesh knitted nylon net were evaluated to compare their properties and the effectiveness to prevent biofouling. This paper describes test procedures that were developed to quantify the performance in terms of antifouling, cleanability, drag and cost. The copper treatment was the most effective at controlling fouling, however, the silicone treated nets were the easiest to clean. The drag forces on the net were a function of twine diameter, twine roughness and fouling. After immersion, the uncoated nets had the most drag followed by the silicone and copper treatments. The cost of applying silicone to nets is high; however, improved formulations may provide a non-toxic alternative to control fouling.

  7. Comparing epidemiologically estimated treatment need with treatment provided in two dental schemes in Ireland

    Directory of Open Access Journals (Sweden)

    Guiney Helena

    2012-08-01

    Full Text Available Abstract Background Valid estimation of dental treatment needed at population level is important for service planning. In many instances, planning is informed by survey data, which provide epidemiologically estimated need from the dental fieldworkers’ perspective. The aim of this paper is to determine the validity of this type of information for planning. A comparison of normative (epidemiologically estimated need for selected treatments, as measured on a randomly-selected representative sample, is compared with treatment actually provided in the population from which the sample was drawn. Methods This paper compares dental treatment need-estimates, from a national survey, with treatment provided within two choice-of-dentist schemes: Scheme 1, a co-payment scheme for employed adults, and Scheme 2, a ‘free’ service for less-well-off adults. Epidemiologically estimated need for extractions, restorations, advanced restorations and denture treatments was recorded for a nationally representative sample in 2000/02. Treatments provided to employed and less-well-off adults were retrieved from the claims databases for both schemes. We used the chi-square test to compare proportions, and the student’s t-test to compare means between the survey and claims databases. Results Among employed adults, the proportion of 35-44-year-olds whose teeth had restorations was greater than estimated as needed in the survey (55.7% vs. 36.7%;p Among less-well-off adults, the proportion of 16-24-year-olds who had teeth extracted was greater than estimated as needed in the survey (27.4% vs. 7.9%;p Conclusions Significant differences were found between epidemiologically estimated need and treatment provided for selected treatments, which may be accounted for by measurement differences. The gap between epidemiologically estimated need and treatment provided seems to be greatest for less-well-off adults.

  8. Lessons from Elsewhere?: Comparative Music Education in Times of Globalization

    Science.gov (United States)

    Kertz-Welzel, Alexandra

    2015-01-01

    In recent years, comparative education and comparative music education became important fields of research. Due to globalization, but also to international student assessments, it is most common to compare the outcomes of entire school systems or specific subject areas. The main goal is to identify the most successful systems and their best…

  9. A Comparative Analysis of Short Time Series Processing Methods

    OpenAIRE

    Kiršners, A; Borisovs, A

    2012-01-01

    This article analyzes the traditional time series processing methods that are used to perform the task of short time series analysis in demand forecasting. The main aim of this paper is to scrutinize the ability of these methods to be used when analyzing short time series. The analyzed methods include exponential smoothing, exponential smoothing with the development trend and moving average method. The paper gives the description of the structure and main operating princi...

  10. Factors related to orthodontic treatment time in adult patients

    Directory of Open Access Journals (Sweden)

    Ana Camila Esteves de Oliveira Melo

    2013-10-01

    Full Text Available INTRODUCTION: The length of time that it takes an orthodontist to treat adult patients varies widely. OBJECTIVE: The aim of this study was to investigate how different variables influence treatment time. METHODS: Seventy clinical case reports of successfully treated adult patients were examined. The patients were selected from 4,723 records held by three experienced orthodontists. The influence exerted by the following variables on treatment time was assessed: age, sex, facial pattern, severity of malocclusion (measured by the PAR index, sagittal relationship of canines, type of brackets (ceramic or metal, tooth extractions, missed appointments and orthodontic appliance issues/breakages, the latter being the dependent variable. Assessment was performed by multiple linear regression analysis, followed by the stepwise method with P < 0.05. RESULTS: The number of times a patient missed their appointment (no-show (R² = 14.4%, p < 0.0001 and the number of appliance issues/breakages (R² = 29.71%, p = 0.0037 significantly affected variability in treatment time, and these two variables together can predict 43.75% (R² total of the overall variability in treatment time. Other factors, such as canine relationship at the beginning of treatment, bracket type (metal or ceramic, tooth extractions, age at start of treatment, severity of the initial malocclusion, sex and facial pattern had no significant bearing on treatment time. CONCLUSIONS: The duration of orthodontic treatment in adults, when performed by experienced orthodontists, is mainly influenced by factors related to patient compliance. However, several factors which were not included in this study may contribute to variability in orthodontic treatment time.

  11. Comparing a stratified treatment strategy with the standard treatment in randomized clinical trials

    DEFF Research Database (Denmark)

    Sun, Hong; Bretz, Frank; Gerke, Oke

    2016-01-01

    idea of selecting the subset with minimal p-value when testing the subset-specific treatment effects. We present a framework to compare this approach with other approaches to select subsets by introducing three performance measures. The results of a comprehensive simulation study are presented...

  12. Effect of treatment time on characterization and properties of ...

    Indian Academy of Sciences (India)

    Nanocrystalline surface layers were synthesized on pure copper by means of surface mechanical attrition treatment (SMAT) at various treatment times. The microstructural features of the surface layers produced by SMAT were systematically characterized by optical microscopy (OM), transmission electron microscopy (TEM) ...

  13. Comparative study of different activation treatments for the preparation of activated carbon: a mini-review.

    Science.gov (United States)

    Din, Muhammad Imran; Ashraf, Sania; Intisar, Azeem

    2017-09-01

    In this review, various methods of preparation of activated carbon from agricultural and commercial waste material are reviewed. In addition, we also discuss various activation treatments using a comparative approach. The data are organised in tabulated form for ease of comparative study. A review of numerous characterisation techniques is also provided. The effect of time and temperature, activation conditions, carbonisation conditions and impregnation ratios are explained and several physical and chemical activation treatments of raw materials and their impact on the micro- and mesoporous volumes and surface area are discussed. Lastly, a review of adsorption mechanisms of activated carbon (AC) is also provided.

  14. Comparative assessment of the environmental sustainability of existing and emerging perchlorate treatment technologies for drinking water.

    Science.gov (United States)

    Choe, Jong Kwon; Mehnert, Michelle H; Guest, Jeremy S; Strathmann, Timothy J; Werth, Charles J

    2013-05-07

    Environmental impacts of conventional and emerging perchlorate drinking water treatment technologies were assessed using life cycle assessment (LCA). Comparison of two ion exchange (IX) technologies (i.e., nonselective IX with periodic regeneration using brines and perchlorate-selective IX without regeneration) at an existing plant shows that brine is the dominant contributor for nonselective IX, which shows higher impact than perchlorate-selective IX. Resource consumption during the operational phase comprises >80% of the total impacts. Having identified consumables as the driving force behind environmental impacts, the relative environmental sustainability of IX, biological treatment, and catalytic reduction technologies are compared more generally using consumable inputs. The analysis indicates that the environmental impacts of heterotrophic biological treatment are 2-5 times more sensitive to influent conditions (i.e., nitrate/oxygen concentration) and are 3-14 times higher compared to IX. However, autotrophic biological treatment is most environmentally beneficial among all. Catalytic treatment using carbon-supported Re-Pd has a higher (ca. 4600 times) impact than others, but is within 0.9-30 times the impact of IX with a newly developed ligand-complexed Re-Pd catalyst formulation. This suggests catalytic reduction can be competitive with increased activity. Our assessment shows that while IX is an environmentally competitive, emerging technologies also show great promise from an environmental sustainability perspective.

  15. USING CUMULATIVE NUMBER DENSITIES TO COMPARE GALAXIES ACROSS COSMIC TIME

    Energy Technology Data Exchange (ETDEWEB)

    Behroozi, Peter S.; Wechsler, Risa H. [Kavli Institute for Particle Astrophysics and Cosmology, SLAC National Accelerator Laboratory, Stanford, CA 94305 (United States); Marchesini, Danilo [Department of Physics and Astronomy, Tufts University, Medford, MA 02155 (United States); Muzzin, Adam [Leiden Observatory, Leiden University, P.O. Box 9513, 2300 RA Leiden (Netherlands); Papovich, Casey [Department of Physics and Astronomy, Texas A and M University, College Station, TX 77843 (United States); Stefanon, Mauro [Physics and Astronomy Department, University of Missouri, Columbia, MO 65211 (United States)

    2013-11-01

    Comparing galaxies across redshifts at fixed cumulative number density is a popular way to estimate the evolution of specific galaxy populations. This method ignores scatter in mass accretion histories and galaxy-galaxy mergers, which can lead to errors when comparing galaxies over large redshift ranges (Δz > 1). We use abundance matching in the ΛCDM paradigm to estimate the median change in cumulative number density with redshift and provide a simple fit (+0.16 dex per unit Δz) for progenitors of z = 0 galaxies. We find that galaxy descendants do not evolve in the same way as galaxy progenitors, largely due to scatter in mass accretion histories. We also provide estimates for the 1σ range of cumulative number densities corresponding to galaxy progenitors and descendants. Finally, we discuss some limits on cumulative number density comparisons, which arise due to difficulties measuring physical quantities (e.g., stellar mass) consistently across redshifts. A public tool to calculate cumulative number density evolution for galaxies, as well as approximate halo masses, is available online.

  16. Hemodialysis Treatment Time: As Important as it Seems?

    Science.gov (United States)

    Daugirdas, John T

    2017-03-01

    Hemodialysis treatment time and Kt/V can both be considered to be primary measures of hemodialysis adequacy, because when either goes to zero, mortality is certain in patients without residual kidney function. Treatment time is important, but it needs to be adjusted based on surface-area-normalized Kt/V, residual kidney function, and expected ultrafiltration rate. Rescaling dose of dialysis measured as Kt/V to body surface area prevents ultrashort dialysis in small patients, women, and children with minimal residual kidney function. Most if not all of the observational studies of associations between outcome and dialysis session length are probably confounded by dose targeting bias. Once adequate Kt/V (taking into account body surface area) has been provided, adequate dialysis time probably is most relevant in terms of limiting the need for a high fluid removal rate. The latter may adversely impact survival by causing recurrent ischemia to cardiovascular and other tissues. There is little high-quality evidence at this time to support a minimum 4-hour treatment time for all patients, regardless of body size, solute removal, or residual kidney function. On the other hand, there is little evidence that prolonging weekly treatment time up to 24 hours per week is harmful. The final decision regarding treatment time is best individualized, based on patient acceptability and experience, residual kidney function, body surface-area-normalized Kt/V, and expected ultrafiltration rate. © 2017 Wiley Periodicals, Inc.

  17. Efficacy of Erbium:YAG laser treatment compared to topical estriol treatment for symptoms of genitourinary syndrome of menopause.

    Science.gov (United States)

    Gaspar, Adrian; Brandi, Hugo; Gomez, Valentin; Luque, Daniel

    2017-02-01

    The objective of this prospective comparative cohort study was to establish the effectiveness and safety of Erbium:YAG (Er:YAG) laser treatment for genitourinary syndrome of menopause and to compare it with an established topical estriol treatment. Fifty patients with genitourinary syndrome of menopause were divided into two groups. The estriol group received a treatment of 0.5 mg estriol ovules for 8 weeks and the laser group was first treated for 2 weeks with 0.5 mg estriol ovules 3 times per week to hydrate the mucosa and then received three sessions with 2,940 nm Er:YAG laser in non-ablative mode. Biopsies were taken before and at 1, 3, 6, and 12 months post-treatment. Maturation index, maturation value and pH where recorded up to 12-months post-treatment, while the VAS analysis of symptoms was recorded up to 18 months post-treatment. Statistically significant (P changes in the tropism of the vaginal mucosa and also angiogenesis, congestion, and restructuring of the lamina propria in the laser group. Side effects were minimal and of transient nature in both groups, affecting 4% of patients in the laser group and 12% of patients in the estriol group. Our results show that Er:YAG laser treatment successfully relieves symptoms of genitourinary syndrome of menopause and that the results are more pronounced and longer lasting compared to topical estriol treatment. Lasers Surg. Med. 49:160-168, 2017. © 2016 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc. © 2016 The Authors. Lasers in Surgery and Medicine Published by Wiley Periodicals, Inc.

  18. Time to revisit arsenic regulations: comparing drinking water and rice.

    Science.gov (United States)

    Sauvé, Sébastien

    2014-05-17

    Current arsenic regulations focus on drinking water without due consideration for dietary uptake and thus seem incoherent with respect to the risks arising from rice consumption. Existing arsenic guidelines are a cost-benefit compromise and, as such, they should be periodically re-evaluated. Literature data was used to compare arsenic exposure from rice consumption relative to exposure arising from drinking water. Standard risk assessment paradigms show that arsenic regulations for drinking water should target a maximum concentration of nearly zero to prevent excessive lung and bladder cancer risks (among others). A feasibility threshold of 3 μg As l(-1) was determined, but a cost-benefit analysis concluded that it would be too expensive to target a threshold below 10 μg As l(-1). Data from the literature was used to compare exposure to arsenic from rice and rice product consumption relative to drinking water consumption. The exposure to arsenic from rice consumption can easily be equivalent to or greater than drinking water exposure that already exceeds standard risks and is based on feasibility and cost-benefit compromises. It must also be emphasized that many may disagree with the implications for their own health given the abnormally high cancer odds expected at the cost-benefit arsenic threshold. Tighter drinking water quality criteria should be implemented to properly protect people from excessive cancer risks. Food safety regulations must be put in place to prevent higher concentrations of arsenic in various drinks than those allowed in drinking water. Arsenic concentrations in rice should be regulated so as to roughly equate the risks and exposure levels observed from drinking water.

  19. Comparative assessment of the treatment of type 2 Diabetes Mellitus

    International Nuclear Information System (INIS)

    Kokic, S.; Radman, M.; Capkum, V.; Dovzak-Kokic, D.; Tesanovic, S.

    2002-01-01

    The objective of the study was to estimate the most successful way of treating patients with type 2 diabetes mellitus. A total of 87 patients with type 2 diabetes mellitus were selected for a three-month study. The patients were divided into three groups comprising 29 patients in each group, based upon the treatment regimen. Group 1 (BMI 32.3+-3.6 kg/m2) was treated with glimepiride and metformin; group 2 (BMI 27.9+-3.9) was treated with daily doses of insulin mixture 30/70 and bed-time NPH insulin; and group 3 (BMI 30.02+-4.8) was treated with a combination of three daily doses of lispo and metformin.The groups did not differ significantly in terms of sex and age. Initially, there were significant statistical differences in HbA1c (P=0.035) between the three groups (9, 21%+-1.72%; 9.21%+-1.54%; and 10, 0%+-1.73% respectively). After three months there were no statistically differences in HbA1c (P=0.66) between the groups (8.52+-1.7%; 8.03%+-1.05%; and 8.0%+-0.63%, respectively. Decreases in HbA1c were significant in all groups, but most pronounced in patients treated with lispro and metaformin (17% on average). The study results suggest the need for establishing guidelines on how to treat type 2 diabetics. (author)

  20. Comparative efficacy of enrofloxacin and tulathromycin for treatment of preweaning respiratory disease in dairy heifers.

    Science.gov (United States)

    Heins, B D; Nydam, D V; Woolums, A R; Berghaus, R D; Overton, M W

    2014-01-01

    Preweaning respiratory disease continues to have a substantial effect on the current and future productivity of dairy replacement animals. Establishing an effective treatment plan for the preweaned calf may have a significant effect on well-being and lifetime productivity by limiting any early development of chronic disease. The primary objective of this study was to examine the efficacy of treatment with tulathromycin (TUL) or enrofloxacin (ENR) on the risk of re-treatment, with a secondary objective of investigating the effect of disease and subsequent treatment choice on average daily gain (ADG). A total of 1,141 Holstein heifers from 4 farms were observed and systematically scored for evidence of respiratory disease from birth through weaning or the time of death. At the time of diagnosis, calves were randomly and blindly allocated into 2 treatment groups. The overall incidence of respiratory disease was 60.9%. In the univariable analysis, the incidence of re-treatment between 7 and 10d of initial therapy for calves treated with ENR was greater than that in calves treated with TUL (27.6 vs. 21.2%). After adjusting for farm ID, clinical score at first treatment, and weight at first treatment, the odds of re-treatment were 1.5 times higher for calves treated with ENR than with TUL. The percentage of calves that required more than one re-treatment was higher for calves that received ENR compared with those that received TUL (9.3 vs. 4.1%). We observed no difference in ADG between calves treated with ENR or TUL, and no difference in ADG between calves that were treated for respiratory disease and those that were not treated for respiratory disease. Appropriate drug therapy for preweaning respiratory disease may have an important role in reducing the odds of re-treatment during the preweaning period. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  1. How Often Do Comparative Randomised Controlled Trials in the Field of Eczema Fail to Directly Compare the Treatments Being Tested?

    Directory of Open Access Journals (Sweden)

    Sonia Ratib

    2015-06-01

    Full Text Available The objective of the study was to identify all parallel design randomised controlled trials (RCTs comparing treatments for eczema in recent dermatology literature that have failed to report a between-group analysis. The GREAT database (www.greatdatabase.org.uk was searched to identify parallel group RCTs comparing two or more interventions published in the English language in the last decade, 2004 to 2013. The primary outcome was the number of studies that had not reported a between-group analysis for any of the outcomes. Where possible we re-analysed the data to determine whether a between-group analysis would have given a different conclusion to that reported. Out of a total of 304 RCTs in the study period, 173 (56.9% met the inclusion criteria. Of the 173 eligible studies, 12 (6.9% had not conducted a between-group analysis for any of the reported outcomes. There was no clear improvement over time. Five of the eight studies that were re-analysed yielded non-significant between-group differences yet reported significant within-group comparisons. All but one of the 12 studies implied that the experimental intervention was successful despite not undertaking any between-group comparisons. Although the proportion of all RCTs that fail to report an appropriate between-group analysis is small, the fact that any scientist who purports to compare one treatment against another then chooses to omit the key comparison statistic is worrying.

  2. Prolonged treatment time deteriorates positioning accuracy for stereotactic radiosurgery.

    Directory of Open Access Journals (Sweden)

    Chun-Wei Wang

    Full Text Available The accuracy of radiation delivery is increasingly important as radiotherapy technology continues to develop. The goal of this study was to evaluate intrafractional motion during intracranial radiosurgery and the relationship between motion change and treatment time.A total of 50 treatment records with 5988 images, all acquired during treatments with the CyberKnife Radiosurgery System, were retrospectively analyzed in this study. We measured translation and rotation motion including superior-inferior (SI, right-left (RL, anterior-posterior (AP, roll, tilt and yaw. All of the data was obtained during the first 45 minutes of treatment. The records were divided into 3 groups based on 15-min time intervals following the beginning of treatment: group A (0-15 min, group B (16-30 min and group C (31-45 min. The mean deviations, systematic errors, random errors and margin for planning target volume (PTV were calculated for each group.The mean deviations were less than 0.1 mm in all three translation directions in the first 15 minutes. Greater motion occurred with longer treatment times, especially in the SI direction. For the 3D vector, a time-dependent change was observed, from 0.34 mm to 0.77 mm (p=0.01. There was no significant correlation between the treatment time and deviations in the AP, LR and rotation axes. Longer treatment times were associated with increases in systematic error, but not in random error. The estimated PTV margin for groups A, B and C were 0.86 / 1.14 / 1.31 mm, 0.75 / 1.12 / 1.20 mm, and 0.43 / 0.54 / 0.81 mm in the SI, RL, and AP directions, respectively.During intracranial radiosurgery, a consistent increase in the positioning deviation over time was observed, especially in the SI direction. If treatment time is greater than 15 minutes, we recommend increasing the PTV margins to ensure treatment precision.

  3. Phenobarbital compared to benzodiazepines in alcohol withdrawal treatment

    DEFF Research Database (Denmark)

    Askgaard, Gro; Hallas, Jesper; Fink-Jensen, Anders

    2016-01-01

    Background: Long-acting benzodiazepines such as chlordiazepoxide are recommended as first-line treatment for alcohol withdrawal. These drugs are known for their abuse liability and might increase alcohol consumption among problem drinkers. Phenobarbital could be an alternative treatment option...

  4. A comparative study of albendazole and levamisole treatment of ...

    African Journals Online (AJOL)

    The treatment of gastrointestinal nematodes using albendazole and levamisole was monitored in a herd of cattle following a poor state of health and maintenance of high faecal strongyle egg count after repeated therapeutic treatment with albendazole. Thirty-six animals were selected and randomly divided into three ...

  5. Comparative Study of Pre-Germination Treatments and their Effects ...

    African Journals Online (AJOL)

    FIRST LADY

    of leaves (10.05) respectively. Pre-germination treatments of seeds soaked in running water (SRW) for 24 hours were found to be more effective in seedlings growth and biomass production. Keywords: Tectona grandis, pre-germination treatment, seed dormancy, seedling growth. Introduction. Tectona grandis is one of the ...

  6. Evaluation of Azithromycin in Treatment of Acne Vulgaris Compared to

    African Journals Online (AJOL)

    Introduction: Acne vulgaris is the most common dermatological disorder in adolescence. Treatment is essential to prevent physical and psychological scarring. Although many treatments for acne are available, effective management has become increasingly challenging with the emergence of antibiotic-resistant strains of ...

  7. Time influence in chemical treatment of Brazilian raw materials type

    International Nuclear Information System (INIS)

    Argolo, F.; Dias, C.; Machado, A.; Volzone, C.; Ortiga, J.; Valenzuela Diaz, F.

    2012-01-01

    Clays are part of raw materials in different industries. The mineralogical composition and purity greatly influence the application thereof. Chemical treatments applied, such as acid attack, modify their properties and thus their possible uses. Taking in to account that, clay minerals, may differ by more or less resistance to chemical attacks, two types of clay were studied with different mineralogical composition to assess the degree of resistance to chemical attack treatment such as acid. Acid treatments that were applied, differ mainly in the contact time between the solid and the liquid. The solids were studied by X-ray diffraction analysis, chemical analysis and infrared analysis

  8. Comparative Effectiveness of Treatments for Chronic Low Back Pain: A Multiple Treatment Comparison Analysis.

    Science.gov (United States)

    Rihn, Jeffrey A; Radcliff, Kristen; Norvell, Daniel C; Eastlack, Robert; Phillips, Frank M; Berland, Daniel; Sherry, Ned; Freedman, Mitchell; Vaccaro, Alexander R

    2017-06-01

    A systematic review and network meta-analysis. To determine current treatment options of chronic low back pain (LBP) as defined by randomized controlled trials (RCTs) and to compare effectiveness of those treatments using a mixed-treatment comparison (MTC). It is important to provide an evidence-based assessment of the treatment options that exist for LBP. A systematic search of RCTs was conducted in MEDLINE and the Cochrane Collaboration Library from 1990 to 2014. From the selected studies, we extracted preoperative and postoperative ODI and VAS back pain scores, additional surgeries, and complications. Standard and network meta-analytic techniques were used. Twelve RCTs were included in the analysis: 5 total disk replacement (TDR) versus fusion; 1 TDR versus exercise and cognitive behavioral therapy (CBT); 5 fusion versus exercise and CBT; and 1 fusion versus physical therapy (PT). On the basis of MTC, with respect to ODI change scores, the pooled mean difference favoring fusion over exercise and CBT was 2.0 points (95% CI, -1.2 to 4.8). The pooled mean difference favoring TDR over exercise and CBT was 6.4 points (95% CI, 3.2-9.3). The pooled mean difference favoring fusion over PT was 8.8 points (95% CI, 4.1-13.6). The pooled mean differences favoring TDR over fusion was 4.4 points (95% CI, 2.37-6.63). For PT versus structured exercise with CBT, the pooled mean difference favoring exercise with CBT over PT was 6.8 points (95% CI, 1.5-12.8). For TDR versus PT, the pooled mean difference favoring TDR over PT was 13.2 points (95% CI, 8.0-18.4). Additional surgery rates were similar between treatment options. All 4 treatments provided some benefit to patients with chronic LBP. According to the MTC analysis, TDR may be the most effective treatment and PT the least effective treatment for chronic LBP. This review is based on a limited number of RCT studies and does not support any 1 treatment modality for all patients.

  9. Quality of Life in 807 Patients with Vestibular Schwannoma: Comparing Treatment Modalities.

    Science.gov (United States)

    Soulier, Géke; van Leeuwen, Bibian M; Putter, Hein; Jansen, Jeroen C; Malessy, Martijn J A; van Benthem, Peter Paul G; van der Mey, Andel G L; Stiggelbout, Anne M

    2017-07-01

    Objective In vestibular schwannoma treatment, the choice among treatment modalities is controversial. The first aim of this study was to examine the quality of life of patients with vestibular schwannoma having undergone observation, radiation therapy, or microsurgical resection. The second aim was to examine the relationship between perceived symptoms and quality of life. Last, the association between quality of life and time since treatment was studied. Study Design Cross-sectional study. Setting Tertiary referral center. Subjects and Methods A total of 1208 patients treated for sporadic vestibular schwannoma between 2004 and 2014 were mailed the disease-specific Penn Acoustic Neuroma Quality of Life (PANQOL) questionnaire and additional questions on symptoms associated with vestibular schwannoma. Total and domain scores were calculated and compared among treatment groups. Propensity scores were used, and results were stratified according to tumor size to control for potential confounders. Correlations were calculated to examine the relationship between self-reported symptoms and quality of life, as well as between quality of life and time since treatment. Results Patients with small tumors (≤10 mm) under observation showed a higher PANQOL score when compared with the radiation therapy and microsurgical resection groups. A strong negative correlation was found between self-reported symptoms and quality of life, with balance problems and vertigo having the largest impact. No correlation was found between PANQOL score and time since treatment. Conclusion This study suggests that patients with small vestibular schwannomas experience better quality of life when managed with observation than do patients who have undergone active treatment.

  10. Kinesio taping compared to physical therapy modalities for the treatment of shoulder impingement syndrome.

    Science.gov (United States)

    Kaya, Erkan; Zinnuroglu, Murat; Tugcu, Ilknur

    2011-02-01

    The purpose of this study was to determine and compare the efficacy of kinesio tape and physical therapy modalities in patients with shoulder impingement syndrome. Patients (n = 55) were treated with kinesio tape (n = 30) three times by intervals of 3 days or a daily program of local modalities (n = 25) for 2 weeks. Response to treatment was evaluated with the Disability of Arm, Shoulder, and Hand scale. Patients were questioned for the night pain, daily pain, and pain with motion. Outcome measures except for the Disability of Arm, Shoulder, and Hand scale were assessed at baseline, first, and second weeks of the treatment. Disability of Arm, Shoulder, and Hand scale was evaluated only before and after the treatment. Disability of Arm, Shoulder, and Hand scale and visual analog scale scores decreased significantly in both treatment groups as compared with the baseline levels. The rest, night, and movement median pain scores of the kinesio taping (20, 40, and 50, respectively) group were statistically significantly lower (p values were 0.001, 0.01, and 0.001, respectively) at the first week examination as compared with the physical therapy group (50, 70, and 70, respectively). However, there was no significant difference in the same parameters between two groups at the second week (0.109, 0.07, and 0.218 for rest, night, and movement median pain scores, respectively). Disability of Arm, Shoulder, and Hand scale scores of the kinesio taping group were significantly lower at the second week as compared with the physical therapy group. No side effects were observed. Kinesio tape has been found to be more effective than the local modalities at the first week and was similarly effective at the second week of the treatment. Kinesio taping may be an alternative treatment option in the treatment of shoulder impingement syndrome especially when an immediate effect is needed.

  11. Treatment of ocular rosacea:comparative study of topical cyclosporine and oral doxycycline

    Directory of Open Access Journals (Sweden)

    Aysegul Arman

    2015-06-01

    Full Text Available AIM:To compare the effectiveness of topical cyclosporine A emulsion with that of oral doxycycline for rosacea associated ocular changes and dry eye complaints.METHODS:One hundred and ten patients with rosacea were screened. Thirty-eight patients having rosacea associated eyelid and ocular surface changes and dry eye complaints were included in the study. Patients were randomly divided into two groups:nineteen patients were given topical cyclosporine twice daily and nineteen patients were given oral doxycycline 100 mg twice daily for the first month and once daily for the following two months. Symptom and sign scores, ocular surface disease index questionnarie and tear function tests were evaluated at baseline and monthly for 3mo. Three months after results were compared with that of baseline.RESULTS:Mean values of symptom, eyelid sign and corneal/conjunctival sign scores of each treatment group at baseline and 3mo after treatments were compared and both drugs were found to be effective on rosacea associated ocular changes (P<0.001. Cyclosporine was more effective in symptomatic relief and in the treatment of eyelid signs (P=0.01. There was statistically significant increase in the mean Schirmer score with anesthesia and tear break up time scores in the cyclosporine treatment group compared to the doxycycline treatment group (P<0.05.CONCLUSION:Cyclosporine as a topical drug can be used in the treatment of rosacea associated ocular complications because it is more effective than doxycycline. In addition ocular rosacea as a chronic disease requires long term treatment and doxycycline has various side effects limiting its long term usage.

  12. Summary of comparative results integrated nonthermal treatment and integrated thermal treatment systems studies

    International Nuclear Information System (INIS)

    1996-12-01

    In July 1994, the Idaho National Engineering Laboratory (INEL), under a contract from U.S. Department of Energy's (DOE) Environment Management Office of Science and Technology (OST, EM-50) published a report entitled open-quotes Integrated Thermal Treatment System Study - Phase 1 Resultsclose quotes (EGG-MS-11211). This report was the culmination of over a year of analysis involving scientists and engineers within the DOE complex and from private industry. The purpose of that study was open-quotes to conduct a systematic engineering evaluation of a variety of mixed low level waste (MLLW) treatment system alternatives.close quotes The study also open-quotes identified the research and development, demonstrations, and testing and evaluation needed to assure unit operability in the most promising alternative system.close quotes This study evaluated ten primary thermal treatment technologies, organized into complete open-quotes cradle-to-graveclose quotes systems (including complete engineering flow sheets), to treat DOE MLLW and calculated mass balances and 20-year total life cycle costs (TLCC) for all systems. The waste input used was a representative heterogenous mixture of typical DOE MLLW. An additional study was conducted, and then, based on response to these studies, additional work was started to investigate and evaluate non-thermal treatment options on a footing comparable to the effort devoted to thermal options. This report attempts to present a summary overview of the thermal and non-thermal treatment technologies which were examined in detail in the process of the above mentioned reviews

  13. Effect of treatment time on characterization and properties of ...

    Indian Academy of Sciences (India)

    Administrator

    nanocrystalline can also be found even for very short duration (i.e. 10 min). This short-treatment duration has important meaning in engineering applications because it can save time and energy. There is a wide range of numerical parameters and measurement methods available for characterization of surface roughness.

  14. Modeling of water treatment plant using timed continuous Petri nets

    Science.gov (United States)

    Nurul Fuady Adhalia, H.; Subiono, Adzkiya, Dieky

    2017-08-01

    Petri nets represent graphically certain conditions and rules. In this paper, we construct a model of the Water Treatment Plant (WTP) using timed continuous Petri nets. Specifically, we consider that (1) the water pump always active and (2) the water source is always available. After obtaining the model, the flow through the transitions and token conservation laws are calculated.

  15. Conservative versus operative treatment of displaced noncomminuted tibial shaft fractures. A retrospective comparative study.

    Science.gov (United States)

    den Outer, A J; Meeuwis, J D; Hermans, J; Zwaveling, A

    1990-03-01

    The results of conservative (mainly, functional bracing) and operative treatment (mainly, plate fixation) have been compared in a retrospective study of 170 displaced noncomminutive tibial shaft fractures. The characteristics of the fractures in both treatment groups showed no significant differences. The follow-up analysis revealed no statistical differences in outcome between the two methods. However, because of the many factors analyzed and the restricted number of patients studied, it is impossible to compare all factors independently. Surgical treatment resulted in a higher rate of complications (such as implant failure, osteitis, and refracture) and a longer total hospitalization time. Conservative treatment showed a longer duration of fracture healing and a higher rate of malalignment. Malalignments of up to 10 degrees with no adverse effects have been seen so far. In conservative treatment, two fracture types were identified with a higher rate of malalignment: short oblique isolated tibial fractures and fully dislocated transverse crural fractures. Conservative therapy is favored, because there is less discomfort for the patient and the treatment is cost contained.

  16. Time of default in tuberculosis patients on directly observed treatment.

    Science.gov (United States)

    Pardeshi, Geeta S

    2010-09-01

    Default remains an important challenge for the Revised National Tuberculosis Control Programme, which has achieved improved cure rates. This study describes the pattern of time of default in patients on DOTS. Tuberculosis Unit in District Tuberculosis Centre, Yavatmal, India; Retrospective cohort study. This analysis was done among the cohort of patients of registered at the Tuberculosis Unit during the year 2004. The time of default was assessed from the tuberculosis register. The sputum smear conversion and treatment outcome were also assessed. Kaplan-Meier plots and log rank tests. Overall, the default rate amongst the 716 patients registered at the Tuberculosis Unit was 10.33%. There was a significant difference in the default rate over time between the three DOTS categories (log rank statistic= 15.49, P=0.0004). Amongst the 331 smear-positive patients, the cumulative default rates at the end of intensive phase were 4% and 16%; while by end of treatment period, the default rates were 6% and 31% in category I and category II, respectively. A majority of the smear-positive patients in category II belonged to the group 'treatment after default' (56/95), and 30% of them defaulted during re-treatment. The sputum smear conversion rate at the end of intensive phase was 84%. Amongst 36 patients without smear conversion at the end of intensive phase, 55% had treatment failure. Patients defaulting in intensive phase of treatment and without smear conversion at the end of intensive phase should be retrieved on a priority basis. Default constitutes not only a major reason for patients needing re-treatment but also a risk for repeated default.

  17. THE FIGHT AGAINST TIME IN THE TREATMENT OF EALES DISEASE

    Directory of Open Access Journals (Sweden)

    Branislav Tomašević

    2015-12-01

    Full Text Available Eales disease is characterized by three overlapping stages of retinal vasculitis, occlusion, and neovascularization. Diagnosis is mostly clinical, and its etiology appears to be multifactorial. A 26-year-old woman with manifesting vasculitis of the peripheral retina, retinal neovascularization, and vitreous haemorrhage is presented. Depending on the stage of the disease, its management consisted of medical treatment with corticosteroids in the active inflammatory stage and laser photocoagulation in the advanced retinal ischemia and neovascularization stages. Multiple delicate ocular surgeries were performed due to recurrent vitreous haemorrhage and retinal detachment. The experience acquired in this treatment is evidence of the necessity for treatment immediately after the confirmation of Eales disease. The decision to carry out intensive laser treatment and surgery at the right time could improve the prognosis of Eales disease.

  18. Exploring the Use of Cost-Benefit Analysis to Compare Pharmaceutical Treatments for Menorrhagia.

    Science.gov (United States)

    Sanghera, Sabina; Frew, Emma; Gupta, Janesh Kumar; Kai, Joe; Roberts, Tracy Elizabeth

    2015-09-01

    The extra-welfarist theoretical framework tends to focus on health-related quality of life, whilst the welfarist framework captures a wider notion of well-being. EQ-5D and SF-6D are commonly used to value outcomes in chronic conditions with episodic symptoms, such as heavy menstrual bleeding (clinically termed menorrhagia). Because of their narrow-health focus and the condition's periodic nature these measures may be unsuitable. A viable alternative measure is willingness to pay (WTP) from the welfarist framework. We explore the use of WTP in a preliminary cost-benefit analysis comparing pharmaceutical treatments for menorrhagia. A cost-benefit analysis was carried out based on an outcome of WTP. The analysis is based in the UK primary care setting over a 24-month time period, with a partial societal perspective. Ninety-nine women completed a WTP exercise from the ex-ante (pre-treatment/condition) perspective. Maximum average WTP values were elicited for two pharmaceutical treatments, levonorgestrel-releasing intrauterine system (LNG-IUS) and oral treatment. Cost data were offset against WTP and the net present value derived for treatment. Qualitative information explaining the WTP values was also collected. Oral treatment was indicated to be the most cost-beneficial intervention costing £107 less than LNG-IUS and generating £7 more benefits. The mean incremental net present value for oral treatment compared with LNG-IUS was £113. The use of the WTP approach was acceptable as very few protests and non-responses were observed. The preliminary cost-benefit analysis results recommend oral treatment as the first-line treatment for menorrhagia. The WTP approach is a feasible alternative to the conventional EQ-5D/SF-6D approaches and offers advantages by capturing benefits beyond health, which is particularly relevant in menorrhagia.

  19. Comparative study of the effects of treatment techniques on the ...

    African Journals Online (AJOL)

    This paper reports the effects of some fibre treatment techniques namely: mercerization, acetylation and semi-carbonisation on the performance of Kenaf fibres. The treated kenaf fibres which are considered biodegradable, cost effective, renewable and user friendly have been used as a possible base friction material for ...

  20. Comparative study of household water treatment in a rural ...

    African Journals Online (AJOL)

    This research presents the household treatment of drinking water samples in a rural community in Nigeria by boiling and water guard. The physicochemical parameters of the raw water samples with exception of chloride, BOD and dissolved oxygen were within the permissible limits of the World Health Organization (WHO) ...

  1. Comparing Active Pediatric Obesity Treatments Using Meta-Analysis

    Science.gov (United States)

    Gilles, Allyson; Cassano, Michael; Shepherd, Elizabeth J.; Higgins, Diana; Hecker, Jeffrey E.; Nangle, Douglas W.

    2008-01-01

    The current meta-analysis reviews research on the treatment of pediatric obesity focusing on studies that have been published since 1994. Eleven studies (22 comparisons, 115 effect sizes, N = 447) were included in the present meta-analysis. Results indicated that comprehensive behavioral interventions may be improved in at least two ways:…

  2. Public and Private Management of Wastewater Treatment: A Comparative Study.

    Science.gov (United States)

    O'Toole, Laurence J., Jr.

    1991-01-01

    The costs and performance of contract management of municipal wastewater treatment facilities are considered, using information from a nationwide empirical examination of evidence from individual plants, municipalities, and regulatory agencies. The broad issues arising in the evaluation are outlined as the specifics are discussed. (SLD)

  3. The Mechanisms of Space-Time Association: Comparing Motor and Perceptual Contributions in Time Reproduction

    Science.gov (United States)

    Fabbri, Marco; Cellini, Nicola; Martoni, Monica; Tonetti, Lorenzo; Natale, Vincenzo

    2013-01-01

    The spatial-temporal association indicates that time is represented spatially along a left-to-right line. It is unclear whether the spatial-temporal association is mainly related to a perceptual or a motor component. In addition, the spatial-temporal association is not consistently found using a time reproduction task. Our rationale for this…

  4. Automatic identification of comparative effectiveness research from medline citations to support clinicians' treatment information needs.

    Science.gov (United States)

    Zhang, Mingyuan; Del Fiol, Guilherme; Grout, Randall W; Jonnalagadda, Siddhartha; Medlin, Richard; Mishra, Rashmi; Weir, Charlene; Liu, Hongfang; Mostafa, Javed; Fiszman, Marcelo

    2013-01-01

    Online knowledge resources such as Medline can address most clinicians' patient care information needs. Yet, significant barriers, notably lack of time, limit the use of these sources at the point of care. The most common information needs raised by clinicians are treatment-related. Comparative effectiveness studies allow clinicians to consider multiple treatment alternatives for a particular problem. Still, solutions are needed to enable efficient and effective consumption of comparative effectiveness research at the point of care. Design and assess an algorithm for automatically identifying comparative effectiveness studies and extracting the interventions investigated in these studies. The algorithm combines semantic natural language processing, Medline citation metadata, and machine learning techniques. We assessed the algorithm in a case study of treatment alternatives for depression. Both precision and recall for identifying comparative studies was 0.83. A total of 86% of the interventions extracted perfectly or partially matched the gold standard. Overall, the algorithm achieved reasonable performance. The method provides building blocks for the automatic summarization of comparative effectiveness research to inform point of care decision-making.

  5. Automatic identification of comparative effectiveness research from Medline citations to support clinicians’ treatment information needs

    Science.gov (United States)

    Zhang, Mingyuan; Fiol, Guilherme Del; Grout, Randall W.; Jonnalagadda, Siddhartha; Medlin, Richard; Mishra, Rashmi; Weir, Charlene; Liu, Hongfang; Mostafa, Javed; Fiszman, Marcelo

    2014-01-01

    Online knowledge resources such as Medline can address most clinicians’ patient care information needs. Yet, significant barriers, notably lack of time, limit the use of these sources at the point of care. The most common information needs raised by clinicians are treatment-related. Comparative effectiveness studies allow clinicians to consider multiple treatment alternatives for a particular problem. Still, solutions are needed to enable efficient and effective consumption of comparative effectiveness research at the point of care. Objective Design and assess an algorithm for automatically identifying comparative effectiveness studies and extracting the interventions investigated in these studies. Methods The algorithm combines semantic natural language processing, Medline citation metadata, and machine learning techniques. We assessed the algorithm in a case study of treatment alternatives for depression. Results Both precision and recall for identifying comparative studies was 0.83. A total of 86% of the interventions extracted perfectly or partially matched the gold standard. Conclusion Overall, the algorithm achieved reasonable performance. The method provides building blocks for the automatic summarization of comparative effectiveness research to inform point of care decision-making. PMID:23920677

  6. Comparing Dislodgeable 2,4-D Residues across Athletic Field Turfgrass Species and Time.

    Directory of Open Access Journals (Sweden)

    Matthew D Jeffries

    Full Text Available 2,4-dimethylamine salt (2,4-D is an herbicide commonly applied on athletic fields for broadleaf weed control that can dislodge from treated turfgrass. Dislodge potential is affected by numerous factors, including turfgrass canopy conditions. Building on previous research confirming herbicide-turfgrass dynamics can vary widely between species, field research was initiated in 2014 and 2015 in Raleigh, NC, USA to quantify dislodgeable 2,4-D residues from dormant hybrid bermudagrass (Cynodon dactylon L. x C. transvaalensis and hybrid bermudagrass overseeded with perennial ryegrass (Lolium perenne L., which are common athletic field playing surfaces in subtropical climates. Additionally, dislodgeable 2,4-D was compared at AM (7:00 eastern standard time and PM (14:00 sample timings within a day. Samples collected from perennial ryegrass consistently resulted in greater 2,4-D dislodgment immediately after application (9.4 to 9.9% of applied compared to dormant hybrid bermudagrass (2.3 to 2.9%, as well as at all AM compared to PM timings from 1 to 3 d after treatment (DAT; 0.4 to 6.3% compared to 0.1 to 0.8%. Dislodgeable 2,4-D did not differ across turfgrass species at PM sample collections, with ≤ 0.1% of the 2,4-D applied dislodged from 1 to 6 DAT, and 2,4-D detection did not occur at 12 and 24 DAT. In conclusion, dislodgeable 2,4-D from treated turfgrass can vary between species and over short time-scales within a day. This information should be taken into account in human exposure risk assessments, as well as by turfgrass managers and athletic field event coordinators to minimize 2,4-D exposure.

  7. Comparing Dislodgeable 2,4-D Residues across Athletic Field Turfgrass Species and Time

    Science.gov (United States)

    Brosnan, James T.; Breeden, Gregory K.

    2016-01-01

    2,4-dimethylamine salt (2,4-D) is an herbicide commonly applied on athletic fields for broadleaf weed control that can dislodge from treated turfgrass. Dislodge potential is affected by numerous factors, including turfgrass canopy conditions. Building on previous research confirming herbicide-turfgrass dynamics can vary widely between species, field research was initiated in 2014 and 2015 in Raleigh, NC, USA to quantify dislodgeable 2,4-D residues from dormant hybrid bermudagrass (Cynodon dactylon L. x C. transvaalensis) and hybrid bermudagrass overseeded with perennial ryegrass (Lolium perenne L.), which are common athletic field playing surfaces in subtropical climates. Additionally, dislodgeable 2,4-D was compared at AM (7:00 eastern standard time) and PM (14:00) sample timings within a day. Samples collected from perennial ryegrass consistently resulted in greater 2,4-D dislodgment immediately after application (9.4 to 9.9% of applied) compared to dormant hybrid bermudagrass (2.3 to 2.9%), as well as at all AM compared to PM timings from 1 to 3 d after treatment (DAT; 0.4 to 6.3% compared to 0.1 to 0.8%). Dislodgeable 2,4-D did not differ across turfgrass species at PM sample collections, with ≤ 0.1% of the 2,4-D applied dislodged from 1 to 6 DAT, and 2,4-D detection did not occur at 12 and 24 DAT. In conclusion, dislodgeable 2,4-D from treated turfgrass can vary between species and over short time-scales within a day. This information should be taken into account in human exposure risk assessments, as well as by turfgrass managers and athletic field event coordinators to minimize 2,4-D exposure. PMID:27936174

  8. Comparative environmental analysis of waste brominated plastic thermal treatments.

    Science.gov (United States)

    Bientinesi, M; Petarca, L

    2009-03-01

    The aim of this research activity is to investigate the environmental impact of different thermal treatments of waste electric and electronic equipment (WEEE), applying a life cycle assessment methodology. Two scenarios were assessed, which both allow the recovery of bromine: (A) the co-combustion of WEEE and green waste in a municipal solid waste combustion plant, and (B) the staged-gasification of WEEE and combustion of produced syngas in gas turbines. Mass and energy balances on the two scenarios were set and the analysis of the life cycle inventory and the life cycle impact assessment were conducted. Two impact assessment methods (Ecoindicator 99 and Impact 2002+) were slightly modified and then used with both scenarios. The results showed that scenario B (staged-gasification) had a potentially smaller environmental impact than scenario A (co-combustion). In particular, the thermal treatment of staged-gasification was more energy efficient than co-combustion, and therefore scenario B performed better than scenario A, mainly in the impact categories of "fossil fuels" and "climate change". Moreover, the results showed that scenario B allows a higher recovery of bromine than scenario A; however, Br recovery leads to environmental benefits for both the scenarios. Finally the study demonstrates that WEEE thermal treatment for energy and matter recovery is an eco-efficient way to dispose of this kind of waste.

  9. Comparative environmental analysis of waste brominated plastic thermal treatments

    International Nuclear Information System (INIS)

    Bientinesi, M.; Petarca, L.

    2009-01-01

    The aim of this research activity is to investigate the environmental impact of different thermal treatments of waste electric and electronic equipment (WEEE), applying a life cycle assessment methodology. Two scenarios were assessed, which both allow the recovery of bromine: (A) the co-combustion of WEEE and green waste in a municipal solid waste combustion plant, and (B) the staged-gasification of WEEE and combustion of produced syngas in gas turbines. Mass and energy balances on the two scenarios were set and the analysis of the life cycle inventory and the life cycle impact assessment were conducted. Two impact assessment methods (Ecoindicator 99 and Impact 2002+) were slightly modified and then used with both scenarios. The results showed that scenario B (staged-gasification) had a potentially smaller environmental impact than scenario A (co-combustion). In particular, the thermal treatment of staged-gasification was more energy efficient than co-combustion, and therefore scenario B performed better than scenario A, mainly in the impact categories of 'fossil fuels' and 'climate change'. Moreover, the results showed that scenario B allows a higher recovery of bromine than scenario A; however, Br recovery leads to environmental benefits for both the scenarios. Finally the study demonstrates that WEEE thermal treatment for energy and matter recovery is an eco-efficient way to dispose of this kind of waste

  10. Oncoplastic surgery in surgical treatment of breast cancer: is the timing of adjuvant treatment affected?

    Science.gov (United States)

    Dogan, Lutfi; Gulcelik, Mehmet Ali; Karaman, Niyazi; Ozaslan, Cihangir; Reis, Erhan

    2013-06-01

    With the results of studies on the timing of adjuvant treatment, it currently appears that adjuvant treatment should be initiated as soon as possible. Breast conserving surgery and oncoplastic surgery is being used with increasing frequency. Therefore, studies about whether or not these applications delay the adjuvant treatment are needed. The aim of this study was to determine the time period needed for adjuvant chemotherapy and radiotherapy of the patients with breast cancer and to reveal associated factors related to the patient, tumor, and surgical technique. Two hundred eighty patients with breast cancer who had surgery and were given adjuvant treatments in our clinic were included in the study. Age, body mass index, concomitant diseases, smoking habits, menopausal status, neoadjuvant treatments, tumor characteristics, surgical technique, and surgical complications were recorded. The time period between surgery and initiation of chemotherapy and radiotherapy, the number of chemotherapy cycles, and the duration of chemotherapy and radiotherapy were calculated. The numbers of patients who had modified radical mastectomy, breast conserving surgery, and oncoplastic surgery were 155 (55%), 47 (16.8%), and 78 (27.9%), respectively. The mean (SD) time period needed for chemotherapy administration was 19.5 ± 4.2 days (range, 13-41 days) and 3.9 ± 0.9 months for radiotherapy. Early wound complication of breast surgery was the only factor that delayed the adjuvant chemotherapy (P = .001). It has been well known that the time period between surgical treatment of breast cancer and adjuvant treatment affects survival. In our study, it has been shown that the surgical techniques used in breast and axillary surgery do not delay the initiation of adjuvant treatments. The adjuvant treatments of the patients who had oncoplastic surgery and breast conserving surgery were not delayed. The cooperation between the disciplines for the initiation of adjuvant treatments is important

  11. Time to treatment as a quality metric in lung cancer: Staging studies, time to treatment, and patient survival

    International Nuclear Information System (INIS)

    Gomez, Daniel R.; Liao, Kai-Ping; Swisher, Stephen G.; Blumenschein, George R.; Erasmus, Jeremy J.; Buchholz, Thomas A.; Giordano, Sharon H.; Smith, Benjamin D.

    2015-01-01

    Purpose: Prompt staging and treatment are crucial for non-small cell lung cancer (NSCLC). We determined if predictors of treatment delay after diagnosis were associated with prognosis. Materials and methods: Medicare claims from 28,732 patients diagnosed with NSCLC in 2004–2007 were used to establish the diagnosis-to-treatment interval (ideally ⩽35 days) and identify staging studies during that interval. Factors associated with delay were identified with multivariate logistic regression, and associations between delay and survival by stage were tested with Cox proportional hazard regression. Results: Median diagnosis-to-treatment interval was 27 days. Receipt of PET was associated with delays (57.4% of patients with PET delayed [n = 6646/11,583] versus 22.8% of those without [n = 3908/17,149]; adjusted OR = 4.48, 95% CI 4.23–4.74, p < 0.001). Median diagnosis-to-PET interval was 15 days; PET-to-clinic, 5 days; and clinic-to-treatment, 12 days. Diagnosis-to-treatment intervals <35 days were associated with improved survival for patients with localized disease and those with distant disease surviving ⩾1 year but not for patients with distant disease surviving <1 year. Conclusion: Delays between diagnosing and treating NSCLC are common and associated with use of PET for staging. Reducing time to treatment may improve survival for patients with manageable disease at diagnosis

  12. Use of the landmark method to address immortal person-time bias in comparative effectiveness research: a simulation study.

    Science.gov (United States)

    Mi, Xiaojuan; Hammill, Bradley G; Curtis, Lesley H; Lai, Edward Chia-Cheng; Setoguchi, Soko

    2016-11-20

    Observational comparative effectiveness and safety studies are often subject to immortal person-time, a period of follow-up during which outcomes cannot occur because of the treatment definition. Common approaches, like excluding immortal time from the analysis or naïvely including immortal time in the analysis, are known to result in biased estimates of treatment effect. Other approaches, such as the Mantel-Byar and landmark methods, have been proposed to handle immortal time. Little is known about the performance of the landmark method in different scenarios. We conducted extensive Monte Carlo simulations to assess the performance of the landmark method compared with other methods in settings that reflect realistic scenarios. We considered four landmark times for the landmark method. We found that the Mantel-Byar method provided unbiased estimates in all scenarios, whereas the exclusion and naïve methods resulted in substantial bias when the hazard of the event was constant or decreased over time. The landmark method performed well in correcting immortal person-time bias in all scenarios when the treatment effect was small, and provided unbiased estimates when there was no treatment effect. The bias associated with the landmark method tended to be small when the treatment rate was higher in the early follow-up period than it was later. These findings were confirmed in a case study of chronic obstructive pulmonary disease. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  13. Comparative life cycle assessment of MSWI fly ash treatment and disposal.

    Science.gov (United States)

    Huber, Florian; Laner, David; Fellner, Johann

    2018-03-01

    Municipal solid waste incineration (MSWI) fly ash constitutes a hazardous waste. The possibilities for managing this waste comprise disposal at underground deposits or at above-ground landfills after cement stabilisation, application of the FLUREC process, thermal treatment in a dedicated furnace or thermal co-treatment together with combustible hazardous waste. A comparative life cycle assessment (LCA) study was conducted in order to assess the environmental impact of these five MSWI fly ash disposal options with regard to two different time horizons (100years, indefinite). The uncertainties of the input parameters were propagated by Monte Carlo simulations (MCS). As could be shown by the discernibility analysis, the FLUREC process has the lowest impact in more than 90% of the MCS results. In case long-term emissions (beyond 100years) are neglected, the second lowest impact is caused by thermal co-treatment in more than 90% of the MCS results. Consideration of long-term emissions indicates the disposal at underground deposits as second best option. Furthermore, it is shown that stabilisation with cement has the second highest and thermal treatment in a dedicated furnace has the highest environmental impact, mostly due to high CO 2 emissions. Therefore these two treatment options should be avoided in the future. Besides the comparative evaluation of the different options, it could be shown that uncertainty analysis is useful to determine the relevance of long-term emissions for the ranking of different systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. A comparative life cycle assessment of process water treatment ...

    African Journals Online (AJOL)

    Two different raw water desalination technologies, an existing ion exchange plant and a proposed reverse osmosis intervention, are compared by life cycle assessment for the production of 1 M. of boiler feed water, in the context of the Secunda industrial complex situated in Mpumalanga, South Africa. The proposed reverse ...

  15. Comparing Effective Treatments for Attention-Maintained and Escape- Maintained Behaviors in Children with Behavior Disorders: Brief Review and Analysis

    OpenAIRE

    Lauren Worcester; T. F. McLaughlin

    2013-01-01

    This literature review compares treatment for attention-maintainedversus escape maintained aberrant behavior in children with behavior disorders. Specifically, studies utilizing time out procedures, differential reinforcement procedures, noncontingent reinforcement, and functional communication training are discussed. It was found that these are effective treatments for attention-maintained behaviors; while escape extinction, positive and negative reinforcement, functional communication trai...

  16. A real-time treatment guidance system for pleural PDT

    Science.gov (United States)

    Zhu, Timothy C.; Liang, Xing; Sandell, Julia; Finlay, Jarod C.; Dimofte, Andreea; Rodriguez, Carmen; Cengel, Keith; Friedberg, Joseph; Hahn, Stephen M.; Glatstein, Eli

    2012-02-01

    Intrapleural photodynamic therapy (PDT) has been used as an adjuvant treatment with lung-sparing surgical treatment for mesothelioma. In the current intrapleural PDT protocol, a moving fiber-based point source is used to deliver the light and the light dose are monitored by 7 detectors placed in the pleural cavity. To improve the delivery of light dose uniformity, an infrared (IR) camera system is used to track the motion of the light sources. A treatment planning system uses feedback from the detectors as well as the IR camera to update light fluence distribution in real-time, which is used to guide the light source motion for uniform light dose distribution. We have reported previously the success of using IR camera to passively monitor the light fluence rate distribution. In this study, the real-time feedback has been implemented in the current system prototype, by transferring data from the IR camera to a computer at a rate of 20 Hz, and by calculation/displaying using Matlab. A dual-correction method is used in the feedback system, so that fluence calculation can match detector readings. Preliminary data from a phantom showed superior light uniformity using this method. Light fluence uniformity from patient treatments is also shown using the correction method dose model.

  17. Mobile Interventional Stroke Teams Lead to Faster Treatment Times for Thrombectomy in Large Vessel Occlusion.

    Science.gov (United States)

    Wei, Daniel; Oxley, Thomas J; Nistal, Dominic A; Mascitelli, Justin R; Wilson, Natalie; Stein, Laura; Liang, John; Turkheimer, Lena M; Morey, Jacob R; Schwegel, Claire; Awad, Ahmed J; Shoirah, Hazem; Kellner, Christopher P; De Leacy, Reade A; Mayer, Stephan A; Tuhrim, Stanley; Paramasivam, Srinivasan; Mocco, J; Fifi, Johanna T

    2017-12-01

    Endovascular recanalization treatment for acute ischemic stroke is a complex, time-sensitive intervention. Trip-and-treat is an interhospital service delivery model that has not previously been evaluated in the literature and consists of a shared mobile interventional stroke team that travels to primary stroke centers to provide on-site interventional capability. We compared treatment times between the trip-and-treat model and the traditional drip-and-ship model. We performed a retrospective analysis on 86 consecutive eligible patients with acute ischemic stroke secondary to large vessel occlusion who received endovascular treatment at 4 hospitals in Manhattan. Patients were divided into 2 cohorts: trip-and-treat (n=39) and drip-and-ship (n=47). The primary outcome was initial door-to-puncture time, defined as the time between arrival at any hospital and arterial puncture. We also recorded and analyzed the times of last known well, IV-tPA (intravenous tissue-type plasminogen activator) administration, transfer, and reperfusion. Mean initial door-to-puncture time was 143 minutes for trip-and-treat and 222 minutes for drip-and-ship ( P Stroke Scale for trip-and-treat compared with drip-and-ship ( P =0.0704). Compared with drip-and-ship, the trip-and-treat model demonstrated shorter treatment times for endovascular therapy in our series. The trip-and-treat model offers a valid alternative to current interhospital stroke transfers in urban environments. © 2017 American Heart Association, Inc.

  18. Generalized anxiety disorder: comorbidity, comparative biology and treatment.

    Science.gov (United States)

    Nutt, David J; Ballenger, James C; Sheehan, David; Wittchen, Hans-Ulrich

    2002-12-01

    Generalized anxiety disorder (GAD) is a severe and chronic anxiety disorder characterized by uncontrollable worrying and somatic anxiety (tension, insomnia and hypervigilance). It is a common condition, with lifetime prevalence rates for DSM-IV GAD in the general population of approx. 5-6% being reported. In addition, like other anxiety disorders, GAD also shows comorbidity with depression and most of the other anxiety disorders. This article reviews data on the prevalence of GAD, its comorbidity with depression, and its social and economic impact. Proposed neurobiological mechanisms for GAD are discussed, since an understanding of these may help in the development of future therapies. Finally, current pharmacological and non-pharmacological treatment options for GAD are reviewed, with particular attention being paid to published clinical-trial data.

  19. The effects of Red Bull energy drink compared with caffeine on cycling time-trial performance.

    Science.gov (United States)

    Quinlivan, Alannah; Irwin, Christopher; Grant, Gary D; Anoopkumar-Dukie, Sheilandra; Skinner, Tina; Leveritt, Michael; Desbrow, Ben

    2015-10-01

    This study investigated the ergogenic effects of a commercial energy drink (Red Bull) or an equivalent dose of anhydrous caffeine in comparison with a noncaffeinated control beverage on cycling performance. Eleven trained male cyclists (31.7 ± 5.9 y 82.3 ± 6.1 kg, VO2max = 60.3 ± 7.8 mL · kg-1 · min-1) participated in a double-blind, placebo-controlled, crossover-design study involving 3 experimental conditions. Participants were randomly administered Red Bull (9.4 mL/kg body mass [BM] containing 3 mg/kg BM caffeine), anhydrous caffeine (3 mg/kg BM given in capsule form), or a placebo 90 min before commencing a time trial equivalent to 1 h cycling at 75% peak power output. Carbohydrate and fluid volumes were matched across all trials. Performance improved by 109 ± 153 s (2.8%, P = .039) after Red Bull compared with placebo and by 120 ± 172 s (3.1%, P = .043) after caffeine compared with placebo. No significant difference (P > .05) in performance time was detected between Red Bull and caffeine treatments. There was no significant difference (P > .05) in mean heart rate or rating of perceived exertion among the 3 treatments. This study demonstrated that a moderate dose of caffeine consumed as either Red Bull or in anhydrous form enhanced cycling time-trial performance. The ergogenic benefits of Red Bull energy drink are therefore most likely due to the effects of caffeine, with the other ingredients not likely to offer additional benefit.

  20. Endoscopic treatments for Barrett's esophagus: a systematic review of safety and effectiveness compared to esophagectomy

    Directory of Open Access Journals (Sweden)

    Lau Darren

    2010-09-01

    Full Text Available Abstract Background Recently, several new endoscopic treatments have been used to treat patients with Barrett's esophagus with high grade dysplasia. This systematic review aimed to determine the safety and effectiveness of these treatments compared with esophagectomy. Methods A comprehensive literature search was undertaken to identify studies of endoscopic treatments for Barrett's esophagus or early stage esophageal cancer. Information from the selected studies was extracted by two independent reviewers. Study quality was assessed and information was tabulated to identify trends or patterns. Results were pooled across studies for each outcome. Safety (occurrence of adverse events and effectiveness (complete eradication of dysplasia were compared across different treatments. Results The 101 studies that met the selection criteria included 8 endoscopic techniques and esophagectomy; only 12 were comparative studies. The quality of evidence was generally low. Methods and outcomes were inconsistently reported. Protocols, outcomes measured, follow-up times and numbers of treatment sessions varied, making it difficult to calculate pooled estimates. The surgical mortality rate was 1.2%, compared to 0.04% in 2831 patients treated endoscopically (1 death. Adverse events were more severe and frequent with esophagectomy, and included anastomotic leaks (9.4%, wound infections (4.1% and pulmonary complications (4.1%. Four patients (0.1% treated endoscopically experienced bleeding requiring transfusions. The stricture rate with esophagectomy (5.3% was lower than with porfimer sodium photodynamic therapy (18.5%, but higher than aminolevulinic acid (ALA 60 mg/kg PDT (1.4%. Dysphagia and odynophagia varied in frequency across modalities, with the highest rates reported for multipolar electrocoagulation (MPEC. Photosensitivity, an adverse event that occurs only with photodynamic therapy, was experienced by 26.4% of patients who received porfimer sodium. Some

  1. Does Time Matter? Comparing Trajectory Concordance and Covariate Association Using Time-Based and Age-Based Assessments

    Science.gov (United States)

    Piquero, Alex R.; Monahan, Kathryn C.; Glasheen, Cristie; Schubert, Carol A.; Mulvey, Edward P.

    2013-01-01

    Much criminological research has used longitudinal data to assess change in offending over time. An important feature of some data sources is that they contain cross-sections of different aged individuals followed over successive time periods, thereby potentially conflating age and time. This article compares the substantive conclusions about the…

  2. Internet treatment for depression: a randomized controlled trial comparing clinician vs. technician assistance.

    Directory of Open Access Journals (Sweden)

    Nickolai Titov

    Full Text Available BACKGROUND: Internet-based cognitive behavioural therapy (iCBT for depression is effective when guided by a clinician, less so if unguided. QUESTION: Would guidance from a technician be as effective as guidance from a clinician? METHOD: Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (www.virtualclinic.org.au research program, and 141 participants with major depressive disorder were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for depression comprising 6 online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 8 weeks. Participants in the clinician-assisted group also received access to a moderated online discussion forum. The main outcome measures were the Beck Depression Inventory (BDI-II and the Patient Health QUESTIONnaire-9 Item (PHQ-9. Completion rates were high, and at post-treatment, both treatment groups reduced scores on the BDI-II (p<0.001 and PHQ-9 (p<0.001 compared to the delayed treatment group but did not differ from each other. Within group effect sizes on the BDI-II were 1.27 and 1.20 for the clinician- and technician-assisted groups respectively, and on the PHQ-9, were 1.54 and 1.60 respectively. At 4-month follow-up participants in the technician group had made further improvements and had significantly lower scores on the PHQ-9 than those in the clinician group. A total of approximately 60 minutes of clinician or technician time was required per participant during the 8-week treatment program. CONCLUSIONS: Both clinician- and technician-assisted treatment resulted in large effect sizes and clinically significant improvements comparable to those associated with face-to-face treatment, while a delayed treatment control group did not improve. These results provide support for large

  3. A facile method to compare EFTEM maps obtained from materials changing composition over time

    KAUST Repository

    Casu, Alberto

    2015-10-31

    Energy Filtered Transmission Electron Microscopy (EFTEM) is an analytical tool that has been successfully and widely employed in the last two decades for obtaining fast elemental maps in TEM mode. Several studies and efforts have been addressed to investigate limitations and advantages of such technique, as well as to improve the spatial resolution of compositional maps. Usually, EFTEM maps undergo post-acquisition treatments by changing brightness and contrast levels, either via dedicated software or via human elaboration, in order to maximize their signal-to-noise ratio and render them as visible as possible. However, elemental maps forming a single set of EFTEM images are usually subjected to independent map-by-map image treatment. This post-acquisition step becomes crucial when analyzing materials that change composition over time as a consequence of an external stimulus, because the map-by-map approach doesn\\'t take into account how the chemical features of the imaged materials actually progress, in particular when the investigated elements exhibit very low signals. In this article, we present a facile procedure applicable to whole sets of EFTEM maps acquired on a sample that is evolving over time. The main aim is to find a common method to treat the images features, in order to make them as comparable as possible without affecting the information there contained. Microsc. Res. Tech. 78:1090–1097, 2015. © 2015 Wiley Periodicals, Inc.

  4. Effectiveness of combined intermittent preventive treatment for children and timely home treatment for malaria control

    Directory of Open Access Journals (Sweden)

    Seakey Atsu K

    2009-12-01

    Full Text Available Abstract Background Whiles awaiting for the arrival of an effective and affordable malaria vaccine, there is a need to make use of the available control tools to reduce malaria risk, especially in children under five years and pregnant women. Intermittent preventive treatment (IPT has recently been accepted as an important component of the malaria control strategy. This study explored the potential of a strategy of intermittent preventive treatment for children (IPTC and timely treatment of malaria-related febrile illness in the home in reducing the parasite prevalence and malaria morbidity in young children in a coastal village in Ghana. Methods The study combined home-based delivery of IPTC among six to 60 months old and home treatment of suspected febrile malaria illness within 24 hours. All children between six and 60 months of age received intermittent preventive treatment using amodiaquine and artesunate, delivered by community assistants every four months (three times in 12 months. Malaria parasite prevalence surveys were conducted before the first and after the third dose of IPTC. Results Parasite prevalence was reduced from 25% to 3% (p Conclusion The evaluation result indicates that IPTC given three times in a year combined with timely treatment of febrile malaria illness, impacts significantly on the parasite prevalence. The marked reduction in the parasite prevalence with this strategy points to the potential for reducing malaria-related childhood morbidity and mortality, and this should be explored by control programme managers.

  5. Comparative study of the efficacy of different treatment options in patients with chronic blepharitis.

    Science.gov (United States)

    Arrúa, M; Samudio, M; Fariña, N; Cibils, D; Laspina, F; Sanabria, R; Carpinelli, L; Mino de Kaspar, H

    2015-03-01

    To compare the efficacy of 3 treatment options in patients with chronic blepharitis. An experimental, randomized, controlled study was conducted on 45 patients (female 67%; Mean age: 40.5 years) diagnosed with chronic blepharitis, in order to compare the effectiveness of three treatment options. Group 1: eyelid hygiene with neutral shampoo three times/day; group 2: neutral shampoo eyelid hygiene plus topical metronidazole gel 0.75% twice/day; group 3: neutral eyelid hygiene with shampoo plus neomycin 3.5% and polymyxin 10% antibiotic ointment with 0.5% dexamethasone 3 times/day. The symptoms and signs were assessed by assigning scores from 0: no symptoms and/or signs; 1: mild symptoms and/or signs, 2: moderate symptoms and/or signs; and 3: severe symptoms and/or signs. A significant improvement was observed in the signs and symptoms in all 3 treatment groups. While groups 1 and 2 had more improvement in all variables studied (P<.05), Group 3 showed no clinical improvement for itching (P=.16), dry eye (P=.29), eyelashes falling (P=.16), and erythema at the eyelid margin (P=.29). Shampoo eyelid hygiene neutral and neutral shampoo combined with the use of metronidazole gel reported better hygiene results than neutral shampoo lid with antibiotic ointment and neomycin and polymyxin dexamethasone. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  6. Real-time treatment feedback guidance of Pleural PDT

    Science.gov (United States)

    Zhu, Timothy C.; Kim, Michele M.; Liang, Xing; Liu, Baochang; Meo, Julia L.; Finlay, Jarod C.; Dimofte, Andreea; Rodriguez, Carmen; Simone, Charles; Cengel, Keith; Friedberg, Joseph

    2013-03-01

    Pleural photodynamic therapy (PDT) has been used as an adjuvant treatment with lung-sparing surgical treatment for mesothelioma with remarkable results. In the current intrapleural PDT protocol, a moving fiber-based point source is used to deliver the light and the light dose are monitored by 7 detectors placed in the pleural cavity. To improve the delivery of light dose uniformity, an infrared (IR) camera system is used to track the motion of the light sources. A treatment planning system uses feedback from the detectors as well as the IR camera to update light fluence distribution in real-time, which is used to guide the light source motion for uniform light dose distribution. We have improved the GUI of the light dose calculation engine to provide real-time light fluence distribution suitable for guiding the surgery to delivery light more uniformly. A dual-correction method is used in the feedback system, so that fluence calculation can match detector readings using both direct and scatter light models. An improved measurement device is developed to automatically acquire laser position for the point source. Comparison of the effects of the guidance is presented in phantom study.

  7. Sample size for comparing negative binomial rates in noninferiority and equivalence trials with unequal follow-up times.

    Science.gov (United States)

    Tang, Yongqiang

    2017-05-25

    We derive the sample size formulae for comparing two negative binomial rates based on both the relative and absolute rate difference metrics in noninferiority and equivalence trials with unequal follow-up times, and establish an approximate relationship between the sample sizes required for the treatment comparison based on the two treatment effect metrics. The proposed method allows the dispersion parameter to vary by treatment groups. The accuracy of these methods is assessed by simulations. It is demonstrated that ignoring the between-subject variation in the follow-up time by setting the follow-up time for all individuals to be the mean follow-up time may greatly underestimate the required size, resulting in underpowered studies. Methods are provided for back-calculating the dispersion parameter based on the published summary results.

  8. Dose-time considerations in the treatment of anal cancer

    International Nuclear Information System (INIS)

    Constantinou, Eugene C.; Daly, William; Fung, Claire Y.; Willett, Christopher G.; De Laney, Thomas F.

    1996-01-01

    Purpose: Concurrent chemoradiation has become the standard initial treatment of primary anal carcinomas. The objective of this study was to analyze the impact on treatment outcome of a variety of patient and treatment variables including radiation dose and overall treatment time in patients treated with concurrent chemoradiation for anal carcinomas. Materials and Methods: Retrospective chart review on 50 patients with MO anal cancer treated with concurrent chemoradiation during the years 1984-1993. Patients were identified from the hospital tumor registries. The majority of patients received treatment with 5-FU 1000 mg/m 2 days 1-4, 29-33 and Mitomycin 10-15 mg/m 2 days 1 ± 29. Radiation was given at 180-200 cGy daily starting at day 1 to total doses of 23.6-67.2 Gy (median 54 Gy) usually by shrinking field technique. Local control, disease-free survival, and overall survival of the group was determined and then analyzed with respect to a variety of patient characteristics including T and N stage, histology, radiation dose, overall treatment time, hemoglobin at the start of treatment, age, HIV status, and sex. Local control, disease-free and overall survival were calculated using the Kaplan-Meier method. Tests for significance were done using the log-rank method. Results: Patient characteristics were: (1) histology-squamous 78 %, cloacogenic/basaloid 20%, and adenosquamous 2%; (2) age- range 30-82 years (median 58.5), (3) sex- female 58%, male 42%; (4) T stage- T1 16%, T2 46%, T3 24%, T4 8%, TX 6%; (5) N stage- NO 69%, N+ 23 %, NX 8%; (6) HIV (+) 8%, HIV(-/?) 92%. Follow-up ranged from 2-132 months (median 43 months). Overall survival was 66% and 44% at 5 and 10 years. Disease-free survival was 67% at 5 years and 59% at 10 years. Local control was 70% at 5 and 10 years. Five year local control by T stage: T stage- T1 87.5 %, T2 63%, T3 83%, T4 67%, TX 50%. Doses of ≥ 54 Gy are associated with improved 5-year survival (84 % vs. 47%, p=0.02), disease-free survival

  9. Comparing glow discharge plasma and ultrasound treatment for improving aerobic respiration of activated sludge.

    Science.gov (United States)

    Van de Moortel, Nina; Van den Broeck, Rob; Degrève, Jan; Dewil, Raf

    2017-10-01

    In this paper, a new and innovative technique, glow discharge plasma, is introduced for the treatment of activated sludge, whereby its effect on sludge solubilization, settleability, floc structure and biomass activity for carbon removal and nitrification is investigated. The obtained results are compared to the use of ultrasound for activated sludge treatment, a technique known for its potential to enhancing biomass activity. Results indicate that ultrasound is up to 9 times more efficient in solubilizing activated sludge and disrupting the sludge floc. However, ultrasound has a detrimental effect on sludge settling, even the lowest treatment intensity of 180 kJ/kgMLSS induced a 12% increase in sludge volume index (SVI). Glow discharge plasma on the other hand, improved settleability up to 51%. Glow discharge plasma and ultrasound both positively affect the carbon removal rate. On the long term, extreme conditions even gave rise to a maximum improvement in respiration by 58.6% and 176.5% for a glow discharge plasma and ultrasound treatment. Nitrification, however, was never positively influenced by either of the treatments. Starting from 8297 kJ/kgMLSS for glow discharge plasma and 9000 kJ/kgMLSS for ultrasound, a negative effect on the nitrification rate was found. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Marijuana: a time-honored but untested treatment for epilepsy.

    Science.gov (United States)

    McLachlan, Richard S

    2015-03-01

    The biology of the endocannabinoid system in the brain provides a possible basis for a beneficial pharmacological effect of marijuana on seizures. However, evidence for efficacy of cannabis treatment of epilepsy is anecdotal because no acceptable randomized controlled trials have been done. Proper dosage and means of administration remain unknown. Cannabis is safer than other controlled substances, including tobacco or alcohol, and appears to be relatively safe compared with most pharmaceuticals used to treat epilepsy. This is a review of this topic from a Canadian perspective.

  11. Comparative Studies on the Efficacy of Different Vaccination Methods in the Treatment of Bovine Papillomatosis

    OpenAIRE

    ÇİMTAY, İbrahim

    2014-01-01

    The aim of this study was to compare the efficacy of autogenous, species-specific and herd-specific vaccination in the treatment of bovine papillomatosis. This study was performed on 24 female Holstein cattle aged between 8 and 17 months in the same herd. The animals were divided into three vaccination groups (eight cattle in each group) as autogenous, species-specific and herd-specific. A dose of 10 ml per animal was inoculated subcutaneously every 10 days, for a total of three times. The r...

  12. Time-dose considerations in the treatment of anal cancer

    International Nuclear Information System (INIS)

    Constantinou, Eugene C.; Daly, William; Fung, Claire Y.; Willett, Christopher G.; Kaufman, Donald S.; DeLaney, Thomas F.

    1997-01-01

    Purpose: To analyze the impact of patient and treatment parameters in concurrent chemoradiation treatment for anal carcinoma. Methods and Materials: Retrospective review of 50 MO anal cancer patients treated from 1984-1994. Most patients received concurrent 5-FU, mitomycin, and radiation. Local control and disease-free/overall survival were determined and analyzed according to patient and treatment parameters. Results: With 43 month median follow-up, projected overall survival is 66% at 5 and 8 years. Disease-free survival is 67% at 5 years and 59% at 8 years. Local control is 70% at 5 and 8 years. Doses of ≥54 Gy are associated with improved 5-year survival (84 vs. 47%, p = 0.02), disease-free survival (74 v. 56%, p = 0.09), and local control (77 vs. 61%, p = 0.04). Although local control, disease-free survival, and overall survival were improved in patients whose overall treatment time was <40 days, this was not statistically significant. Outcome in the four patients with pretreatment hemoglobin (Hgb) <10 appeared worse with 3-year overall survival 50 vs. 68% (p = 0.07), disease-free survival 0 vs. 67% (p = 0.11), and local control 0 vs. 74% (p = 0.05). Projected 5-year overall survival, relapse-free survival, and local control in 4 HIV (+) patients is 0, 75, and 75%. Multivariate analysis reveals that dose (p 0.02) and Hgb (p = 0.05) independently affect local control, dose (p = 0.02) affects disease-free survival, and dose (p = 0.01), Hgb (p = 0.03), T-stage (p = 0.03), and HIV-status (0.07) independently influence overall survival. Conclusion: Radiation doses of ≥54 Gy are associated with significantly improved survival and local control in anal cancer patients treated with chemoradiation. Overall treatment times of less than 40 days are associated with a trend towards improved outcome, but this is not significant. Pretreatment hemoglobin <10 is associated with worse treatment outcome. Survival of HIV (+) patient is poor, but the majority of such patients

  13. Timing of testing and treatment for asymptomatic diseases

    Energy Technology Data Exchange (ETDEWEB)

    Kırkızlar, Eser [State Univ. of New York (SUNY), Plattsburgh, NY (United States); Faissol, Daniel M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Griffin, Paul M. [Pennsylvania State Univ., State College, PA (United States); Swann, Julie L. [Georgia Inst. of Technology, Atlanta, GA (United States)

    2010-07-01

    Many papers in the medical literature analyze the cost-effectiveness of screening for diseases by comparing a limited number of a priori testing policies under estimated problem parameters. However, this may be insufficient to determine the best timing of the tests or incorporate changes over time. In this paper, we develop and solve a Markov Decision Process (MDP) model for a simple class of asymptomatic diseases in order to provide the building blocks for analysis of a more general class of diseases. We provide a computationally efficient method for determining a cost-effective dynamic intervention strategy that takes into account (i) the results of the previous test for each individual and (ii) the change in the individual’s behavior based on awareness of the disease. We demonstrate the usefulness of the approach by applying the results to screening decisions for Hepatitis C (HCV) using medical data, and compare our findings to current HCV screening recommendations.

  14. Bayesian Nonparametric Estimation for Dynamic Treatment Regimes with Sequential Transition Times.

    Science.gov (United States)

    Xu, Yanxun; Müller, Peter; Wahed, Abdus S; Thall, Peter F

    2016-01-01

    We analyze a dataset arising from a clinical trial involving multi-stage chemotherapy regimes for acute leukemia. The trial design was a 2 × 2 factorial for frontline therapies only. Motivated by the idea that subsequent salvage treatments affect survival time, we model therapy as a dynamic treatment regime (DTR), that is, an alternating sequence of adaptive treatments or other actions and transition times between disease states. These sequences may vary substantially between patients, depending on how the regime plays out. To evaluate the regimes, mean overall survival time is expressed as a weighted average of the means of all possible sums of successive transitions times. We assume a Bayesian nonparametric survival regression model for each transition time, with a dependent Dirichlet process prior and Gaussian process base measure (DDP-GP). Posterior simulation is implemented by Markov chain Monte Carlo (MCMC) sampling. We provide general guidelines for constructing a prior using empirical Bayes methods. The proposed approach is compared with inverse probability of treatment weighting, including a doubly robust augmented version of this approach, for both single-stage and multi-stage regimes with treatment assignment depending on baseline covariates. The simulations show that the proposed nonparametric Bayesian approach can substantially improve inference compared to existing methods. An R program for implementing the DDP-GP-based Bayesian nonparametric analysis is freely available at https://www.ma.utexas.edu/users/yxu/.

  15. Comparative Effectiveness of Early Versus Conventional Timing of Dialysis Initiation in Advanced CKD

    NARCIS (Netherlands)

    Crews, Deidra C.; Scialla, Julia J.; Boulware, L. Ebony; Navaneethan, Sankar D.; Nally, Joseph V.; Liu, Xiaobo; Arrigain, Susana; Schold, Jesse D.; Ephraim, Patti L.; Jolly, Stacey E.; Sozio, Stephen M.; Michels, Wieneke M.; Miskulin, Dana C.; Tangri, Navdeep; Shafi, Tariq; Wu, Albert W.; Bandeen-Roche, Karen

    2014-01-01

    Background: Previous observational studies examining outcomes associated with the timing of dialysis therapy initiation in the United States have often been limited by lead time and survivor bias. Study Design: Retrospective cohort study comparing the effectiveness of early versus later

  16. Associations between timing of corticosteroid treatment initiation and clinical outcomes in Duchenne muscular dystrophy.

    Science.gov (United States)

    Kim, Sunkyung; Zhu, Yong; Romitti, Paul A; Fox, Deborah J; Sheehan, Daniel W; Valdez, Rodolfo; Matthews, Dennis; Barber, Brent J

    2017-08-01

    The long-term efficacy of corticosteroid treatment and timing of treatment initiation among Duchenne muscular dystrophy (DMD) patients is not well-understood. We used data from a longitudinal, population-based DMD surveillance program to examine associations between timing of treatment initiation (early childhood [before or at age 5 years], late childhood [after age 5 years], and naïve [not treated]) and five clinical outcomes (age at loss of ambulation; ages at onset of cardiomyopathy, scoliosis, and first fracture; and pulmonary function). Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using survival analysis. DMD patients who initiated corticosteroid treatment in early childhood had a higher risk of earlier onset cardiomyopathy compared to cases who initiated treatment in late childhood (HR = 2.0, 95% CI = [1.2, 3.4]) or treatment naïve patients (HR = 1.9, 95% CI = [1.1, 3.2]), and higher risk of suffering a fracture (HR = 2.3, 95% CI = [1.4, 3.7] and HR = 2.6, 95% CI = [1.6, 4.2], respectively). Patients with early childhood treatment had slightly decreased respiratory function compared with those with late childhood treatment. Ages at loss of ambulation or scoliosis diagnosis did not differ statistically among treatment groups. We caution that the results from our study are subject to several limitations, as they were based on data abstracted from medical records. Further investigations using improved reporting of disease onset and outcomes are warranted to obtain a more definitive assessment of the association between the timing of corticosteroid treatment and disease severity. Published by Elsevier B.V.

  17. Ureteroscopic lithotripsy compared with extracorporeal shockwave lithotripsy in the treatment of urolithiasis

    Directory of Open Access Journals (Sweden)

    Mohammad Asl Zare

    2016-03-01

    Full Text Available Introduction: Urolithiasis is a common and frequently occurring disease with high recurrence rate. Ureteroscopic lithotripsy (URSL and extracorporeal shock wave lithotripsy (ESWL are two most popular modalities in the treatment of urolithiasis. The efficacy of these two methods is reviewed on the treatment of ureteral stones in this systematic review. Method: PubMed was searched for the relevant randomized control trials (RCTs. Stone-free rate and retreatment rate were extracted from each article as the main outcomes, and Odds ratio was reported in each study.Result: Based on calculated odds ratio of each article, URSL has an odds ratio of 1 for the event of retreatment rate compared with ESWL.Discussion: Performing URSL in the treatment of urolithiasis could be associated with higher stone-free rate and lower retreatment rate; however duration of the surgery seems to be longer during URSL compared with ESWL.Conclusions: There was high discrepancy between included RCTs regarding the study design, stone location, types of ureteroscope, intracorporeal lithotripsy devices, time to follow-up, and surgeon experience, which might affect the decision regarding type of surgery.

  18. Pain treatment after tonsillectomy: advantages of analgesics regularly given compared with analgesics on demand.

    Science.gov (United States)

    Thorneman, G; Akervall, J

    2000-10-01

    The aim of the present prospective study was to evaluate pain treatment during the first postoperative 24 h for 40 patients (age over 18) undergoing tonsillectomy. Patients were divided into two groups: group A (n = 20) received analgesics on demand and group B (n = 20) on a regular basis. Basic pain treatment consisted of paracetamol 750 mg x 6 and diclofenac 50 mg x 3. Pain measurement was performed using a visual analogue scale (VAS): a 10 cm line with 0 cm equalling no pain and 10 cm equalling the worst pain ever felt. The following parameters were studied: VAS values, the need for rescue analgesics, intra- and postoperative bleeding, nausea and vomiting, postoperative food intake and hospital time. Only 4 of 20 (20%) patients in group B needed rescue analgesics in the postoperative ward compared with 15 of 20 (75%) in group A (p values were generally rather low in both groups. The mean value for all observed VAS values was less than 4 in both study groups. However, no significant difference in VAS values was observed between the two study groups. Our results suggest that regularly given postoperative pain treatment after tonsillectomy, starting intraoperatively with paracetamol and diclofenac, has significant advantages compared with a regimen in which patients receive analgesics only on demand.

  19. Comparing Dynamic Treatment Regimes Using Repeated-Measures Outcomes: Modeling Considerations in SMART Studies

    Science.gov (United States)

    Lu, Xi; Nahum-Shani, Inbal; Kasari, Connie; Lynch, Kevin G.; Oslin, David W.; Pelham, William E.; Fabiano, Gregory; Almirall, Daniel

    2016-01-01

    A dynamic treatment regime (DTR) is a sequence of decision rules, each of which recommends a treatment based on a patient’s past and current health status. Sequential, multiple assignment, randomized trials (SMARTs) are multi-stage trial designs that yield data specifically for building effective DTRs. Modeling the marginal mean trajectories of a repeated-measures outcome arising from a SMART presents challenges, because traditional longitudinal models used for randomized clinical trials do not take into account the unique design features of SMART. We discuss modeling considerations for various forms of SMART designs, emphasizing the importance of considering the timing of repeated measures in relation to the treatment stages in a SMART. For illustration, we use data from three SMART case studies with increasing level of complexity, in autism, child attention deficit hyperactivity disorder (ADHD), and adult alcoholism. In all three SMARTs we illustrate how to accommodate the design features along with the timing of the repeated measures when comparing DTRs based on mean trajectories of the repeated-measures outcome. PMID:26638988

  20. Time out based discipline strategy for children's non-compliance with cystic fibrosis treatment.

    Science.gov (United States)

    McClellan, Catherine B; Cohen, Lindsey L; Moffett, Kathryn

    2009-01-01

    To evaluate a time out based discipline strategy designed to decrease treatment avoidance in children with cystic fibrosis (CF) who displayed non-compliant behaviour to their parents' treatment requests. A single-subject reversal design was used to compare baseline compliance when a time out based discipline strategy was in effect. Outcome measures included observational assessments of compliance, parent ratings of child treatment-related behaviour problems and parent reported preference for the time out strategy. Greater compliance was demonstrated when the time out strategy was in place. Parents reported fewer treatment-related behaviour problems and desired less professional help for these problems upon completion of the study and reported preferring the time out discipline strategy to their typical child management strategy. This discipline strategy represents a practical and appealing brief intervention that is shown to help parents maximise their children's participation in life-extending treatments. This intervention minimises the need for parent-therapist interaction, which may be of particular importance to families of patients with CF who already devote significant time to medical appointments and interventions. The preliminary nature of this data and lack of reversal for one of the participants emphasise the need for additional research to replicate the findings.

  1. Adderall produces increased striatal dopamine release and a prolonged time course compared to amphetamine isomers.

    Science.gov (United States)

    Joyce, B Matthew; Glaser, Paul E A; Gerhardt, Greg A

    2007-04-01

    Adderall is currently used for the treatment of Attention-Deficit Hyperactivity Disorder (ADHD) and is composed of a novel mixture of approximately 24% L-amphetamine and 76% D-amphetamine salts. There are, however, no investigations of the pharmacological effects of this combination in vivo. The technique of high-speed chronoamperometry using Nafion-coated single carbon-fiber microelectrodes was used to study amphetamine-evoked dopamine (DA) release produced by Adderall, D-amphetamine, or D,L-amphetamine in the striatum of anesthetized male Fischer 344 (F344) rats. The amphetamine solutions were locally applied from micropipettes by pressure ejection. Local applications of Adderall resulted in significantly greater DA release signal amplitudes with prolonged time course of dopamine release and re-uptake as compared to D-amphetamine and D,L-amphetamine. These data support the hypothesis that the combination of amphetamine enantiomers and salts in Adderall has effects on DA release, which result in increased and prolonged DA release, compared to D- and D,L-amphetamine.

  2. Part-time employment: a comparative analysis of Spain and the Netherlands

    NARCIS (Netherlands)

    Blázquez Cuesta, M.; Ramos Martín, N.E.

    2009-01-01

    Most industrialized countries have seen part-time employment as a percentage of total employment increasing in the last decade. This paper presents the results of a comparative study of part-time employment in Spain and the Netherlands. The project comprises a legal comparative study of the

  3. Continuous Compared With Cyclic Oral Contraceptives for the Treatment of Primary Dysmenorrhea: A Randomized Controlled Trial

    Science.gov (United States)

    Dmitrovic, Romana; Kunselman, Allen R.; Legro, Richard S.

    2013-01-01

    Objective To estimate whether continuous OCP (oral contraceptive pills) will result in more pain relief in primary dysmenorrhea patients than cyclic OCP, which induces withdrawal bleeding with associated pain and symptoms. Material and Methods We conducted a double-blind, randomized controlled trial comparing continuous to a cyclic 21/7 OCP regimen (gestodene 0.075 mg and ethinyl estradiol 20 mcg) for 6 months in 38 primary dysmenorrhea patients. The primary outcome was the difference in subjective perception of pain as measured by the Visual Analog Scale (VAS) over the period of 6 months. Results Twenty-nine patients completed the study. In both groups, pain reduction measured by VAS declined over time and was significant at 6 months compared to baseline with no difference between groups. Continuous regimen was superior to cyclic regimen after one month (mean difference: -27.3; 95% CI: (-40.5,-14.2); p<0.001) and 3 months (mean difference: -17.8; 95% CI: (-33.4,-2.1); p=0.03) of treatment. Secondary outcomes noted no difference between groups in terms of menstrual distress as measured by the Moos Menstrual Distress Questionnaire. After 6 months, there was an increase in weight and decrease in systolic blood pressure in continuous compared with the cyclic group. Conclusions Both regimens of OCP are effective in the treatment of primary dysmenorrhea. Continuous OCP outperforms cyclic OCP in the short term, but this difference is lost after 6 months. PMID:22617578

  4. SU-E-T-610: Comparison of Treatment Times Between the MLCi and Agility Multileaf Collimators

    Energy Technology Data Exchange (ETDEWEB)

    Ramsey, C; Bowling, J [Thompson Cancer Survival Center, Knoxville, TN (United States)

    2014-06-01

    Purpose: The Agility is a new 160-leaf MLC developed by Elekta for use in their Infinity and Versa HD linacs. As compared to the MLCi, the Agility increased the maximum leaf speed from 2 cm/s to 3.5 cm/s, and the maximum primary collimator speed from 1.5 cm/s to 9.0 cm/s. The purpose of this study was to determine if the Agility MLC resulted in improved plan quality and/or shorter treatment times. Methods: An Elekta Infinity that was originally equipped with a 80 leaf MLCi was upgraded to an 160 leaf Agility. Treatment plan quality was evaluated using the Pinnacle planning system with SmartArc. Optimization was performed once for the MLCi and once for the Agility beam models using the same optimization parameters and the same number of iterations. Patient treatment times were measured for all IMRT, VMAT, and SBRT patients treated on the Infinity with the MLCi and Agility MLCs. Treatment times were extracted from the EMR and measured from when the patient first walked into the treatment room until exiting the treatment room. Results: 11,380 delivery times were measured for patients treated with the MLCi, and 1,827 measurements have been made for the Agility MLC. The average treatment times were 19.1 minutes for the MLCi and 20.8 minutes for the Agility. Using a t-test analysis, there was no difference between the two groups (t = 0.22). The dose differences between patients planned with the MLCi and the Agility MLC were minimal. For example, the dose difference for the PTV, GTV, and cord for a head and neck patient planned using Pinnacle were effectively equivalent. However, the dose to the parotid glands was slightly worse with the Agility MLC. Conclusion: There was no statistical difference in treatment time, or any significant dosimetric difference between the Agility MLC and the MLCi.

  5. Feasibility of using the linac real-time log data for VMAT treatment verification

    Science.gov (United States)

    Midi, N. S.; Zin, Hafiz M.

    2017-05-01

    This study investigates the feasibility of using the real-time log data from a linac to verify Volumetric Modulated Arc Therapy (VMAT) treatment. The treatment log data for an Elekta Synergy linac can be recorded at a sampling rate of 4 Hz using the service graphing tool on the linac control computer. A treatment plan that simulates a VMAT treatment was delivered from the linac and all the dynamic treatment parameters including monitor unit (MU), Multileaf Collimator (MLC) position, jaw position, gantry angle and collimator angle were recorded in real-time using the service graphing tool. The recorded raw data were extracted and analysed using algorithms written in Matlab (MathWorks, Natick, MA). The actual treatment parameters logged using the service graphing tool was compared to the prescription and the deviations were analysed. The MLC position errors travelling at the speed range from -3.25 to 5.92 cm/s were between -1.7 mm to 2.5 mm, well within the 3.5 mm tolerance value (AAPM TG-142). The discrepancies of other delivery parameters were also within the tolerance. The real-time linac parameters logged using the service graphing tool can be used as a supplementary data for patient specific VMAT pre-treatment quality assurance.

  6. Theoretical Prediction and Experimental Determination of Heating Time During High-Temperature Heat Treatment of Wood

    Directory of Open Access Journals (Sweden)

    LIU Xin-you

    2011-06-01

    Full Text Available Theoretical prediction provides basic understanding and guidance to correctly implement a certaintechnology in the production process. The present study uses a differential equation to predict the heattransfer time between the surface and core layer of wood during the heat treatment, with applicability inestimating the duration of heat treatments at high temperatures. The obtained prediction was compared withthe result of an experimental study performed on Chinese poplar wood with various thicknesses (20, 40 and60mm. During this experiment, the time necessary for the core of wood to reach a temperature of 100°C,130°C and finally 180°C was monitored and the recorded values were compared with the predicted ones.The result of this comparison proved that the experimental values matched the theoretically predicted times,validating thus the applicability of the proposed equation as prediction tool.

  7. Time constraints in the treatment of nuclear transients - MONSTREAV code

    International Nuclear Information System (INIS)

    Amorim, E.S. do; Sudano, J.P.; Moura Neto, C. de; Ferreira, W.J.

    1980-08-01

    An improved approach to the spatial dynamics problem is described. This approach alows the factorization of the flux in amplitude and shape functions. Boundaries conditions are treated as time dependent functions and the coupling between functions is treated as the improved quasistatic approximation (1,2). A burnup feedback has been included allowing to describe extreme excursion in fast reactors very accurately even for treatment of nonlinear problems. A benchmark analysis shows that an improved method is fully sufficient for fast reactor dynamics calculations. Computation modules embodying the improved model of neutronic behaviour will be integrared with the other tests of the fast reactor dynamics analysis system now under development at EAV-IAE. (Author) [pt

  8. Cost Utility Analysis of Topical Steroids Compared With Dietary Elimination for Treatment of Eosinophilic Esophagitis.

    Science.gov (United States)

    Cotton, Cary C; Erim, Daniel; Eluri, Swathi; Palmer, Sarah H; Green, Daniel J; Wolf, W Asher; Runge, Thomas M; Wheeler, Stephanie; Shaheen, Nicholas J; Dellon, Evan S

    2017-06-01

    Topical corticosteroids or dietary elimination are recommended as first-line therapies for eosinophilic esophagitis, but data to directly compare these therapies are scant. We performed a cost utility comparison of topical corticosteroids and the 6-food elimination diet (SFED) in treatment of eosinophilic esophagitis, from the payer perspective. We used a modified Markov model based on current clinical guidelines, in which transition between states depended on histologic response simulated at the individual cohort-member level. Simulation parameters were defined by systematic review and meta-analysis to determine the base-case estimates and bounds of uncertainty for sensitivity analysis. Meta-regression models included adjustment for differences in study and cohort characteristics. In the base-case scenario, topical fluticasone was about as effective as SFED but more expensive at a 5-year time horizon ($9261.58 vs $5719.72 per person). SFED was more effective and less expensive than topical fluticasone and topical budesonide in the base-case scenario. Probabilistic sensitivity analysis revealed little uncertainty in relative treatment effectiveness. There was somewhat greater uncertainty in the relative cost of treatments; most simulations found SFED to be less expensive. In a cost utility analysis comparing topical corticosteroids and SFED for first-line treatment of eosinophilic esophagitis, the therapies were similar in effectiveness. SFED was on average less expensive, and more cost effective in most simulations, than topical budesonide and topical fluticasone, from a payer perspective and not accounting for patient-level costs or quality of life. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  9. Part-time sick leave as a treatment method for individuals with musculoskeletal disorders.

    Science.gov (United States)

    Andrén, Daniela; Svensson, Mikael

    2012-09-01

    There is increasing evidence that staying active is an important part of a recovery process for individuals on sick leave due to musculoskeletal disorders (MSDs). It has been suggested that using part-time sick-leave rather than full-time sick leave will enhance the possibility of full recovery to the workforce, and several countries actively favor this policy. The aim of this paper is to examine if it is beneficial for individuals on sick leave due to MSDs to be on part-time sick leave compared to full-time sick leave. A sample of 1,170 employees from the RFV-LS (register) database of the Social Insurance Agency of Sweden is used. The effect of being on part-time sick leave compared to full-time sick leave is estimated for the probability of returning to work with full recovery of lost work capacity. A two-stage recursive bivariate probit model is used to deal with the endogeneity problem. The results indicate that employees assigned to part-time sick leave do recover to full work capacity with a higher probability than those assigned to full-time sick leave. The average treatment effect of part-time sick leave is 25 percentage points. Considering that part-time sick leave may also be less expensive than assigning individuals to full-time sick leave, this would imply efficiency improvements from assigning individuals, when possible, to part-time sick leave.

  10. Time to discontinuation of atypical versus typical antipsychotics in the naturalistic treatment of schizophrenia

    Directory of Open Access Journals (Sweden)

    Swartz Marvin

    2006-02-01

    Full Text Available Abstract Background There is an ongoing debate over whether atypical antipsychotics are more effective than typical antipsychotics in the treatment of schizophrenia. This naturalistic study compares atypical and typical antipsychotics on time to all-cause medication discontinuation, a recognized index of medication effectiveness in the treatment of schizophrenia. Methods We used data from a large, 3-year, observational, non-randomized, multisite study of schizophrenia, conducted in the U.S. between 7/1997 and 9/2003. Patients who were initiated on oral atypical antipsychotics (clozapine, olanzapine, risperidone, quetiapine, or ziprasidone or oral typical antipsychotics (low, medium, or high potency were compared on time to all-cause medication discontinuation for 1 year following initiation. Treatment group comparisons were based on treatment episodes using 3 statistical approaches (Kaplan-Meier survival analysis, Cox Proportional Hazards regression model, and propensity score-adjusted bootstrap resampling methods. To further assess the robustness of the findings, sensitivity analyses were performed, including the use of (a only 1 medication episode for each patient, the one with which the patient was treated first, and (b all medication episodes, including those simultaneously initiated on more than 1 antipsychotic. Results Mean time to all-cause medication discontinuation was longer on atypical (N = 1132, 256.3 days compared to typical antipsychotics (N = 534, 197.2 days; p Conclusion In the usual care of schizophrenia patients, time to medication discontinuation for any cause appears significantly longer for atypical than typical antipsychotics regardless of the typical antipsychotic potency level. Findings were primarily driven by clozapine and olanzapine, and to a lesser extent by risperidone. Furthermore, only clozapine and olanzapine therapy showed consistently and significantly longer treatment duration compared to perphenazine, a medium

  11. Comparative analyses of linac and Gamma Knife radiosurgery for trigeminal neuralgia treatments

    International Nuclear Information System (INIS)

    Ma, L; Kwok, Y; Chin, L S; Yu, C; Regine, W F

    2005-01-01

    Dedicated linac-based radiosurgery has been reported for trigeminal neuralgia treatments. In this study, we investigated the dose fall-off characteristics and setup error tolerance of linac-based radiosurgery as compared with standard Gamma Knife radiosurgery. In order to minimize the errors from different treatment planning calculations, consistent imaging registration, dose calculation and dose volume analysis methods were developed and implemented for both Gamma Knife and linac-based treatments. Intra-arc setup errors were incorporated into the treatment planning process of linac-based deliveries. The effects of intra-arc setup errors with increasing number of arcs were studied and benchmarked against Gamma Knife deliveries with and without plugging patterns. Our studies found equivalent dose fall-off properties between Gamma Knife and linac-based radiosurgery given a sufficient number of arcs (>7) and small intra-arc errors (<0.5 mm) were satisfied for linac-based deliveries. Increasing the number of arcs significantly decreased the variations in the dose fall-off curve at the low isodose region (e.g. from 40% to 10%) and also improved dose uniformity at the high isodose region (e.g. from 70% to 90%). As the number of arcs increased, the effects of intra-arc setup errors on the dose fall-off curves decreased. Increasing the number of arcs also reduced the integral dose to the distal normal brain tissues. In conclusion, linac-based radiosurgery produces equivalent dose fall-off characteristics to Gamma Knife radiosurgery with a high number of arcs. However, one must note the increased treatment time for a large number of arcs and isocentre accuracies

  12. [Predicting of growth tendency with cephalometry. Cephalometric research comparing orthodontic treatment cases with four premolar extraction].

    Science.gov (United States)

    Szabó, Gyula Tamás; Herényi, Gejza; Szabó, Gyula

    2007-02-01

    The Hasund cephalometry gives important information about the position of the mandible and maxilla to each other and to the cranium in horizontal and vertical plane, and about the expecting mandibular growth. The aim of the study was to examine the reliability of the Hasund growth analysis on the basis of cephalogramms. The data of eighteen children having been treated with four premolar extraction in the growing period were compared. At the start of treatments the children's average age was 10 (8.5-11.5) years. Figures from the cephalometry were analysed by an orthodontic diagnostic program. According to our results the predicted growth was justified in 14 cases and contrary mandibular development was found in 4 cases. Beyond the limits of this study we concluded that the Hasund growth analysis gives mainly a reliable prognosis on predicting mandibular development. In diagnostic procedures this analysis should be followed for a successful decision-making in treatment plan. However, during the orthodontic treatment the prognostic results have to be monitored by using further cephalometric evaluations in a time-scales of a year.

  13. Acute ischemic stroke treatment, part 2: TreatmentRoles of Capillary Index Score, Revascularization and Time

    Directory of Open Access Journals (Sweden)

    Firas eAL-ALI

    2015-06-01

    Full Text Available Due to recent results from clinical intra-arterial treatment for acute ischemic stroke (IAT-AIS trials such as the Interventional Management of Stroke (IMS III, IAT-AIS and the merit of revascularization have been contested. Even though intra-arterial treatment (IAT has been shown to improve revascularization rates, a corresponding increase in good outcomes has only recently been noted. Even though a significant percentage of patients achieve good revascularization in a timely manner, results do not translate into good clinical outcomes (GCOs. Based on a review of the literature, the authors suspect limited good clinical outcomes following timely and successful revascularization are due to poor patient selection that led to futile and possibly even harmful revascularization. The Capillary Index Score (CIS is a simple angiography-based scale that can potentially be used to improve patient selection to prevent revascularization being performed on patients who are unlikely to benefit from treatment. The CIS characterizes presence of capillary blush related to collateral flow as a marker of residual viable tissue, with absence of blush indicating the tissue is no longer viable due to ischemia. By only selecting patients with a favorable CIS for IAT, the rate of GCOs should consistently approach 80-90%. Current methods of patient selection are primarily dependent on time from ischemia. Time from cerebral ischemia to irreversible tissue damage seems to vary from patient to patient, however, so focusing on viable tissue based on the CIS rather than relying on an artificial time window seems to be a more appropriate approach to patient selection.

  14. [Cost of medical treatment with methotrexate for ectopic pregnancy. Study comparing medical treatment versus laparoscopy. Experience of Aziza Othmana Hospital].

    Science.gov (United States)

    Fadhlaoui, Anis; Oueslati, Hanene; Khedhiri, Zied; Khrouf, Mohamed; Chaker, Anis; Zhioua, Fethi

    2013-02-01

    The ectopic pregnancy can be treated surgically (conservative or radical) or medically. Currently, the choice between medical and surgical treatment is a critical issue. One of the parameters of this choice is the total cost of management. To compare the cost of the management of ectopic pregnancy by medical treatment (methotrexate, MTX) and coeliochirurgicaux. This is a prospective, comparative, nonrandomized,unicentric study, on 39 patients who have ectopic pregnancies treated with MTX versus 16 patients treated by laparoscopic surgery with conservative treatment. This study was collected at the service of Obstetrics and Gynecology Reproductive Medicine Aziza Othmana Hospital (Tunis) for a period of two years. The average cost of hospital stay per patient was 549.38 dt for the MTX group against 268.39 dt for laparoscopic surgery group (p treatment with MTX costs more cost than the conservative laparoscopic treatment and this is mainly due to the long period of hospitalization.

  15. Timing of growth hormone treatment affects trabecular bone microarchitecture and mineralization in growth hormone deficient mice.

    Science.gov (United States)

    Kristensen, Erika; Hallgrímsson, Benedikt; Morck, Douglas W; Boyd, Steven K

    2010-08-01

    Growth hormone (GH) is essential in the development of bone mass, and a growth hormone deficiency (GHD) in childhood is frequently treated with daily injections of GH. It is not clear what effect GHD and its treatment has on bone. It was hypothesized that GHD would result in impaired microarchitecture, and an early onset of treatment would result in a better recovery than late onset. Growth hormone deficient homozygous (lit/lit) mice of both sexes were divided into two treatment groups receiving daily injections of GH, starting at an early (21 days of age) or a late time point (35 days of age, corresponding to the end of puberty). A group of heterozygous mice with normal levels of growth hormone served as controls. In vivo micro-computed tomography scans of the fourth lumbar vertebra were obtained at five time points between 21 and 60 days of age, and trabecular morphology and volumetric BMD were analyzed to determine the effects of GH on bone microarchitecture. Early GH treatment led to significant improvements in bone volume ratio (p=0.006), tissue mineral density (p=0.005), and structure model index (p=0.004) by the study endpoint (day 60), with no detected change in trabecular thickness. Trabecular number increased and trabecular separation decreased in GHD mice regardless of treatment compared to heterozygous mice. This suggests fundamental differences in the structure of trabecular bone in GHD and GH treated mice, reflected by an increased number of thinner trabeculae in these mice compared to heterozygous controls. There were no significant differences between the late treatment group and GHD mice except for connectivity density. Taken together, these results indicate that bone responds to GH treatment initiated before puberty but not to treatment commencing post-puberty, and that GH treatment does not rescue the structure of trabecular bone to that of heterozygous controls. Copyright 2010 Elsevier Inc. All rights reserved.

  16. Comparative treatment approach for Sarcoptes and Psoroptes mite infestation in a Boer cross

    Directory of Open Access Journals (Sweden)

    Murugaiyah Marimuthu

    2015-03-01

    Full Text Available This case was carried out to compare the healing process and time for the treatment of mange in goats using a combination of Ivermectin with dexamethasone to the earlier Ivermectin with antihistaminics approach. A 3 ½ years old female Boer cross goat was presented with a complaint of crusty lesions on different parts of the body during a routine farm visit in Selangor, Malaysia. Microscopic examinations of the skin scrapes taken revealed Sarcoptes and Psoroptes sp. of mites, while hematological analysis showed slight leucocytosis, neutrophilia with left shift, monocytosis, hyperproteinemia and hyperglobulinemia. Ivermectin injection at 0.2 mg/kg subcutaneously was administered once every 2 weeks in 4 divided doses, while Dexamethasone injection at 1 mg/10 kg and multivitamin at 10 mg/kg IM for 5 days repeated at alternate weeks. Significant improvement was recorded 6 weeks after commencement of treatment and full recovery at 10 weeks. The current drug regimen proved more effective when compared with previous cases that were treated with a combination of ivermectin and antihistaminics.

  17. Comparative performance of UASB and anaerobic hybrid reactors for the treatment of complex phenolic wastewater.

    Science.gov (United States)

    Ramakrishnan, Anushuya; Surampalli, Rao Y

    2012-11-01

    The performance of an upflow anaerobic sludge blanket (UASB) reactor and an anaerobic hybrid reactor (AHR) was investigated for the treatment of simulated coal wastewater containing toxic phenolics at different hydraulic retention times (0.75-0.33d). Fast start-up and granulation of biomass could be achieved in an AHR (45d) than UASB (58d) reactor. Reduction of HRT from 1.5 to 0.33d resulted in a decline in phenolics removal efficiency from 99% to 77% in AHR and 95% to 68% in UASB reactor respectively. AHR could withstand 2.5 times the selected phenolics loading compared to UASB reactor that could not withstand even 1.2 times the selected phenolics loading. Residence time distribution (RTD) study revealed a plug flow regime in the AHR and completely mixed regime in UASB reactor respectively. Energy economics of the reactors revealed that 12,159MJd(-1) more energy can be generated using AHR than UASB reactor. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. A comparative study of visual reaction time in table tennis players and healthy controls.

    Science.gov (United States)

    Bhabhor, Mahesh K; Vidja, Kalpesh; Bhanderi, Priti; Dodhia, Shital; Kathrotia, Rajesh; Joshi, Varsha

    2013-01-01

    Visual reaction time is time required to response to visual stimuli. The present study was conducted to measure visual reaction time in 209 subjects, 50 table tennis (TT) players and 159 healthy controls. The visual reaction time was measured by the direct RT computerized software in healthy controls and table tennis players. Simple visual reaction time was measured. During the reaction time testing, visual stimuli were given for eighteen times and average reaction time was taken as the final reaction time. The study shows that table tennis players had faster reaction time than healthy controls. On multivariate analysis, it was found that TT players had 74.121 sec (95% CI 98.8 and 49.4 sec) faster reaction time compared to non-TT players of same age and BMI. Also playing TT has a profound influence on visual reaction time than BMI. Our study concluded that persons involved in sports are having good reaction time as compared to controls. These results support the view that playing of table tennis is beneficial to eye-hand reaction time, improve the concentration and alertness.

  19. Beyond the sticker price: including and excluding time in comparing food prices.

    Science.gov (United States)

    Yang, Yanliang; Davis, George C; Muth, Mary K

    2015-07-01

    An ongoing debate in the literature is how to measure the price of food. Most analyses have not considered the value of time in measuring the price of food. Whether or not the value of time is included in measuring the price of a food may have important implications for classifying foods based on their relative cost. The purpose of this article is to compare prices that exclude time (time-exclusive price) with prices that include time (time-inclusive price) for 2 types of home foods: home foods using basic ingredients (home recipes) vs. home foods using more processed ingredients (processed recipes). The time-inclusive and time-exclusive prices are compared to determine whether the time-exclusive prices in isolation may mislead in drawing inferences regarding the relative prices of foods. We calculated the time-exclusive price and time-inclusive price of 100 home recipes and 143 processed recipes and then categorized them into 5 standard food groups: grains, proteins, vegetables, fruit, and dairy. We then examined the relation between the time-exclusive prices and the time-inclusive prices and dietary recommendations. For any food group, the processed food time-inclusive price was always less than the home recipe time-inclusive price, even if the processed food's time-exclusive price was more expensive. Time-inclusive prices for home recipes were especially higher for the more time-intensive food groups, such as grains, vegetables, and fruit, which are generally underconsumed relative to the guidelines. Focusing only on the sticker price of a food and ignoring the time cost may lead to different conclusions about relative prices and policy recommendations than when the time cost is included. © 2015 American Society for Nutrition.

  20. Wait times for diagnosis and treatment of lung cancer: a single-centre experience.

    Science.gov (United States)

    Labbé, C; Anderson, M; Simard, S; Tremblay, L; Laberge, F; Vaillancourt, R; Lacasse, Y

    2017-12-01

    Multiple clinical practice guidelines recommend rapid evaluation of patients with suspected lung cancer. It is uncertain whether delays in diagnosis and management have a negative effect on outcomes. This retrospective study included 551 patients diagnosed with lung cancer through the diagnostic assessment program at the Institut universitaire de cardiologie et de pneumologie de Québec between September 2013 and March 2015. Median wait times between initial referral, diagnosis, and first treatment were calculated and compared with recommended targets. Analyses were performed to evaluate for specific factors associated with longer wait times and for the effect of delays on the outcomes of progression-free survival (pfs), relapse-free survival (rfs) after primary surgical resection, and overall survival (os). Most patients were investigated and treated within recommended targets. Of the entire cohort, 379 patients were treated at our institution. Of those 379 patients, 311 (82%) were treated within recommended targets. In comparing patients within and outside target times, the only statistically significant difference was found in the distribution of treatment modalities: patients meeting targets were more likely to be treated with surgery or chemotherapy rather than with radiation. The pfs on first treatment modality was influenced by clinical stage, but not by time to therapy [hazard ratio (hr): 1.10; p = 0.65]. The os for the entire cohort was also influenced by stage, but not by delays (hr: 1.04; p = 0.87). For the 209 patients treated by surgery with curative intent, a significant reduction in rfs was associated with male sex and TNM stage, but not with delays (hr: 1.11; p = 0.83). The os after primary surgical resection was also associated with TNM stage, but not with delays (hr: 1.82; p = 0.43). Recommended targets for wait times in the investigation and treatment of lung cancer can be achieved within a diagnostic assessment program. Compared with radiation

  1. Comparative study of on-line response time measurement methods for platinum resistance thermometer

    International Nuclear Information System (INIS)

    Zwingelstein, G.; Gopal, R.

    1979-01-01

    This study deals with the in site determination of the response time of platinum resistance sensor. In the first part of this work, two methods furnishing the reference response time of the sensors are studied. In the second part of the work, two methods obtaining the response time without dismounting of the sensor, are studied. A comparative study of the performances of these methods is included for fluid velocities varying from 0 to 10 m/sec, in both laboratory and plant conditions

  2. Life cycle assessment comparing the treatment of surplus activated sludge in a sludge treatment reed bed system with mechanical treatment on centrifuge

    DEFF Research Database (Denmark)

    Larsen, Julie Dam; Hoeve, Marieke ten; Nielsen, Steen

    2018-01-01

    In Denmark, the conventional method for treating sewage sludge is mechanical dewatering and subsequent storage. However, sludge treatment reed bed systems, which are holistic sludge treatment facilities combining the dewatering, mineralisation and storage of sludge, have been more common during...... the last three decades. Treatment of sludge in a sludge treatment reed bed system can be combined with post-treatment (further dewatering and mineralisation) on a stockpile area. This study aimed to compare the environmental performances of a mechanical sludge treatment method with the sludge treatment...... reed bed system strategy, using the life cycle assessment approach and a life cycle inventory based on newly generated data obtained from Danish reference facilities. The scenarios based on the different treatment methods were initiated by sludge entering the sludge treatment reed bed system...

  3. Effect of a See and Treat clinic on skin cancer treatment time.

    Science.gov (United States)

    McLaughlin, Scott J P; Kenealy, John; Locke, Michelle B

    2017-10-11

    Many plastic surgery departments in Australasia have experienced increasing referrals for management of skin lesions. This has driven a demand for new strategies to decrease patient waiting time and administrative costs. The aim of this study was to determine if a purpose-built See and Treat skin cancer clinic could provide a faster skin cancer treatment pathway with comparable clinical outcomes and acceptability to patients. This was a prospective observational study of patients treated through the See and Treat clinic with a retrospective control cohort. The prospective 'See and Treat' cohort included a consecutive series of 106 patients, while the retrospective cohort included a consecutive series of 200 patients. Patient demographics, time from referral to surgery and operative measures were analysed. One hundred patients in the prospective cohort completed an anonymous satisfaction survey regarding their treatment. The average time from referral to surgery was reduced from 121 days in the retrospective cohort to 60 days in the See and Treat cohort (P See and Treat experience overall. We show that a considerable reduction in the time between referral and surgery can be achieved through a See and Treat clinic without compromise of the success of surgical treatment. Moreover, such a treatment pathway has been shown to be acceptable, and largely preferable, to patients. © 2017 Royal Australasian College of Surgeons.

  4. Time to treatment as an important factor for the response to methotrexate in juvenile idiopathic arthritis.

    Science.gov (United States)

    Albers, H M; Wessels, J A M; van der Straaten, R J H M; Brinkman, D M C; Suijlekom-Smit, L W A; Kamphuis, S S M; Girschick, H J; Wouters, C; Schilham, M W; le Cessie, S; Huizinga, T W J; Ten Cate, R; Guchelaar, H J

    2009-01-15

    Methotrexate (MTX) is the most commonly used disease-modifying antirheumatic drug in juvenile idiopathic arthritis (JIA). Currently, individual response to MTX cannot be reliably predicted. Identification of clinical and genetic factors that influence the response to MTX could be helpful in realizing the optimal treatment for individual patients. A cohort of 128 JIA patients treated with MTX were studied retrospectively. Eleven clinical parameters and genotypes of 6 single nucleotide polymorphisms in 5 genes related to the mechanism of action of MTX were compared between MTX responders and nonresponders using a multivariate regression analysis. The time from diagnosis to start of MTX treatment, physician's global assessment at baseline, and the starting dose were significantly associated with the response to MTX at 6 months after initiation. Patients with a shorter time from diagnosis to start of MTX and a higher disease activity according to the physician but with a lower MTX dose showed an increased response. The effect of the starting dose on MTX response seemed to be mainly due to the influence of the systemic JIA subtype. The time from diagnosis to start of MTX treatment and physician's global assessment at baseline were highly correlated. Therefore, the precise effect size of each independent variable could not be determined. In children with JIA, the time from diagnosis to start of MTX appears to be an important factor for MTX response. Our results suggest that an earlier start of MTX treatment will lead to an increased response.

  5. Open Compared with Arthroscopic Treatment of Acute Septic Arthritis of the Native Knee.

    Science.gov (United States)

    Johns, Brenton P; Loewenthal, Mark R; Dewar, David C

    2017-03-15

    Acute native knee septic arthritis is a joint-threatening emergency. Operative treatments by open or arthroscopic methods are available to surgeons. To our knowledge, the literature to date has primarily consisted of case series and no large study has yet compared these methods. The aim of this study was to compare open and arthroscopic treatment for acute native knee septic arthritis. All adult patients with acute native knee septic arthritis treated at our institution with either open or arthroscopic irrigation from 2000 to 2015 were retrospectively evaluated. The clinical findings, laboratory evidence, arthrocentesis and microbiology results, knee radiographs, and outcomes were compared. There were 161 patients (166 knees) with acute native knee septic arthritis treated between 2000 and 2015. Initially, 123 knees were treated by arthroscopic irrigation and 43 knees were treated by open irrigation; however, 71% in the open treatment group required repeat irrigation compared with 50% in the arthroscopic treatment group. The superiority of an arthroscopic procedure persisted after adjustment for potential confounders by multivariable analysis, with an odds ratio of 2.56 (95% confidence interval, 1.1 to 5.9; p = 0.027). After 3 irrigation procedures, the cumulative success rate was 97% in the arthroscopic treatment group and 83% in the open treatment group (p = 0.011). The total number of irrigation procedures required was fewer in the arthroscopic treatment group (p = 0.010). In the arthroscopic treatment group, the mean postoperative range of motion was greater (p = 0.016) and there was a trend toward a shorter median length of stay (p = 0.088). Arthroscopic treatment for acute native knee septic arthritis was a more successful index procedure and required fewer total irrigation procedures compared with open treatment. Long-term postoperative range of motion was significantly greater following arthroscopic treatment. Therapeutic Level III. See Instructions for

  6. Oral cholecystography compared to cholescintigraphy for evaluation of cystic duct patency prior to ESWL treatment

    DEFF Research Database (Denmark)

    Monrad, H; Grønvall, S; Højgaard, L

    1994-01-01

    In a prospective, blinded study of 109 patients with cholecystolithiasis, oral cholecystography and 99Tcm-EHIDA cholescintigraphy were compared in terms of reliability for demonstrating cystic duct patency: one of the prerequisites for extracorporeal shock wave lithotripsy (ESWL) treatment...

  7. Smoldering multiple myeloma requiring treatment: time for a new definition?

    Science.gov (United States)

    Dispenzieri, Angela; Stewart, A Keith; Chanan-Khan, Asher; Rajkumar, S Vincent; Kyle, Robert A; Fonseca, Rafael; Kapoor, Prashant; Bergsagel, P Leif; McCurdy, Arleigh; Gertz, Morie A; Lacy, Martha Q; Lust, John A; Russell, Stephen J; Zeldenrust, Steven R; Reeder, Craig; Roy, Vivek; Buadi, Francis; Dingli, David; Hayman, Suzanne R; Leung, Nelson; Lin, Yi; Mikhael, Joseph; Kumar, Shaji K

    2013-12-19

    Smoldering multiple myeloma (SMM) bridges the gap between monoclonal gammopathy of undetermined significance (a mostly premalignant disorder) and active multiple myeloma (MM). Until recently, no interventional study in patients with SMM showed improved overall survival (OS) with therapy as compared with observation. A report from the PETHEMA-GEM (Programa Español de Tratamientos en Hematologica) group described both fewer myeloma-related events and better OS among patients with high-risk SMM who were treated with lenalidomide and dexamethasone. This unique study prompted us to review current knowledge about SMM and address the following questions: (1) Are there patients currently defined as SMM who should be treated routinely? (2) Should the definitions of SMM and MM be reconsidered? (3) Has the time come when not treating is more dangerous than treating? (4) Could unintended medical harm result from overzealous intervention? Our conclusion is that those patients with the highest-risk SMM (extreme bone marrow plasmacytosis, extremely abnormal serum immunoglobulin free light chain ratio, and multiple bone lesions detected only by modern imaging) should be reclassified as active MM so that they can receive MM-appropriate therapy and the paradigm of careful observation for patients with SMM can be preserved.

  8. Intravenous artesunate reduces parasite clearance time, duration of intensive care, and hospital treatment in patients with severe malaria in Europe

    DEFF Research Database (Denmark)

    Kurth, Florian; Develoux, Michel; Mechain, Matthieu

    2015-01-01

    Intravenous artesunate improves survival in severe malaria, but clinical trial data from nonendemic countries are scarce. The TropNet severe malaria database was analyzed to compare outcomes of artesunate vs quinine treatment. Artesunate reduced parasite clearance time and duration of intensive...... care unit and hospital treatment in European patients with imported severe malaria....

  9. COMPARATIVE DIMENSIONS IN LAKE SYSTEMS AND WETLANDS FOR SEWERAGE TREATMENT IN A SMALL COMMUNITY

    OpenAIRE

    Melo, Josué Fabiano; Lindner, Elfride Anrain

    2013-01-01

    Sewerage´s polluting load is removed by sewage treatment stations (STS) prior to its discharge into a receiving water body. Choice between sewerage treatment systems is the result of a comparative study applied to a small and low income 1800-strong contributing community in the municipality of Campos Novos SC Brazil. Sanitary sewerage treatment system evaluated such aspects as STS area, implantation costs, power and energy consumption, sludge production, removal of nutrients, reliability, ope...

  10. Comparing surgical repair with conservative treatment for degenerative rotator cuff tears : a randomized controlled trial

    NARCIS (Netherlands)

    Lambers Heerspink, Okke; van Raay, Jos J. A. M.; Koorevaar, Rinco C. T.; van Eerden, Pepijn J. M.; Westerbeek, Robin E.; van 't Riet, Esther; van den Akker-Scheek, Inge; Diercks, Ronald L.

    Background: Good clinical results have been reported for both surgical and conservative treatment of rotator cuff tears. The primary aim of this randomized controlled trial was to compare functional and radiologic improvement after surgical and conservative treatment of degenerative rotator cuff

  11. Olanzapine has better efficacy compared to risperidone for treatment of negative symptoms in schizophrenia

    Directory of Open Access Journals (Sweden)

    P N Suresh Kumar

    2016-01-01

    Conclusions: Both treatments were well-tolerated and efficacious. Greater reductions in severity of the illness and negative symptoms were seen with olanzapine consistently through 1 year. The frequency and severity of extrapyramidal symptoms were negligible and similar in the two treatment groups. Weight gain, hyperlipidemia, and hyperglycemia were comparable in both groups. Risperidone produced significant hyperprolactinemia.

  12. Work-Focused Treatment of Common Mental Disorders and Return to Work: A Comparative Outcome Study

    NARCIS (Netherlands)

    Lagerveld, S.E.; Blonk, R.W.B.; Brenninkmeijer, V.; Wijngaards-de Meij, L.; Schaufeli, W.B.

    2012-01-01

    The aim of this study was to compare the effectiveness of two individual-level psychotherapy interventions: (a) treatment as usual consisting of cognitive– behavioral therapy (CBT) and (b) work-focused CBT (W-CBT) that integrated work aspects early into the treatment. Both interventions were carried

  13. A Comparative Evaluation of Minimal Therapist Contact and 15-Session Treatment for Female Orgasmic Dysfunction.

    Science.gov (United States)

    Morokoff, Patricia J.; LoPiccolo, Joseph

    1986-01-01

    Compared a four-session minimal therapist contact (MTC) program for treatment of lifelong global orgasmic dysfunction in women to a 15-session full therapist contact (FTC) program. Both programs were effective in producing female orgasm and in improving satisfaction with the sexual relationship and, for women in MTC treatment, happiness in…

  14. Children's acquisition of speech timing in English: a comparative study of voice onset time and final syllable vowel lengthening.

    Science.gov (United States)

    Snow, D

    1997-02-01

    This study describes English-speaking children's acquisition of voice onset time (VOT), a segmental feature that specifies the timing of word-initial stop consonants, and final-syllable vowel lengthening (FSVL), a suprasegmental feature that influences the timing of vowels. The purpose of this study was to evaluate two hypotheses about the acquisition of speech timing contrasts; a 'motoric' hypothesis predicting that children would control the vowel duration contrast earlier than the consonantal one (FSVL before VOT), and a 'representation' hypothesis predicting that children would control the contrast represented on the segmental level of linguistic description earlier than the contrast represented on the suprasegmental level (VOT before FSVL). Longitudinal acquisition patterns for both contrasts were compared in ten children between the mean ages of 1;6 and 2;0. The results, indicating that English-speaking children usually acquired VOT before FSVL, are discussed in light of evidence that French-speaking children acquire analogous contrasts in the opposite sequence. The crosslanguage comparisons support limited forms of both the motoric and representation hypotheses. As promising topics for further study, the results also suggested the importance of individual differences, and the variability of timing features in the input.

  15. SILS: Is It Cost- and Time-Effective Compared to Standard Pediatric Laparoscopic Surgery?

    Science.gov (United States)

    Islam, Saidul; Adams, Stephen D; Mahomed, Anies A

    2012-01-01

    The aim of the study was to review our experience with single-incision laparoscopic surgery (SILS) and to compare costs and operative time to standard laparoscopic surgery (SLS). A prospectively collected database of operative times and costs was analysed for the years 2008-2011. SILS cases were compared to standard laparoscopy on a procedure-matched basis. Patient demographics, on-table time and consumable costs were collated. Descriptive statistics and Mann-Whitney U-test were utilized with SPSS for windows. Analysis of the data demonstrate that neither consumable costs nor operative time were significantly different in each group. Comparing operative costs, SILS appendicectomy, nephrectomy/heminephrectomy, and ovarian cystectomy/oophorectomy showed cost benefit over SLS (£397 versus £467; £942 versus £1127; £394 versus £495). A trend toward higher cost for SILS Palomo procedure is noted (£734 versus £400). Operative time for SILS appendicectomy, nephrectomy/heminephrectomy, and Palomo was lower compared to SLS (60 versus 103 minutes[mins.]; 130 versus 60 mins.; 60 versus 80 mins.). In conclusion, SILS appears to be cost-effective for the common pediatric surgical operations. There is no significant difference in operating time in this series, but small sample size is a limiting factor. Studies with larger numbers will be necessary to validate these initial observations.

  16. A Qualitative Comparative Analysis of sustainable household water treatment interventions in developing countries

    Science.gov (United States)

    Sihombing, Daniel; Pande, Saket; Rietveld, Luuk

    2017-04-01

    One of the sub-goals of United Nations Sustainable Development Goal 6 is to achieve universal and equitable access to safe and affordable drinking water for all by 2030. Household water treatment (HWT; such as boiling, chlorination, solar or UV disinfection with lamps, etc.) is one of the technologies that can be used to reach this target. However, there is a big challenge to scale up the widespread implementation of this technology. Even though there are many HWT products on the market, sustainable uptake of this method (compliance) is unsatisfying. Researchers have shown that its compliance rate has often declined over time. Since there are many factors that influence the compliance rate, it is desirable to know the best combination of causal factors (pathway) that give the highest compliance based on the success stories reported in the literature. The motivation of this research is to find the pathways characteristic of local people that influence the compliance rate of HWT, using QCA (Qualitative Comparative Analysis). The comparative analysis is essentially a meta-analysis of HWT interventions and factors, possibly, behind successful or unsuccessful HWT uptake reported in literature. This thus helps to identify the characteristics of target communities that are willing to adopt HWT intervention, irrespective of the type of HWT. Out of 102 case studies reported in literature, 36 are selected from developing countries where an HWT intervention lasted for at least 12 months were selected and analyzed. Factors such as education level, perception about water quality, local beliefs, sanitation coverage, existing water treatment, type of water source, ability to pay, willingness to pay, existing local supply chain, and accessibility to water treatment were examined. Preliminary results show that 1) a combination of no prior HWT intervention in the community with a general perception of water quality being poor often leads to uptake of HWT technology, 2) education

  17. Treatment of low-energy tibial shaft fractures: plaster cast compared with intramedullary nailing

    OpenAIRE

    Toivanen, J.A.K.; Honkonen, S.E.; Koivisto, A.-M.; Järvinen, M.J.

    2001-01-01

    We analyzed data from 87 patients who had displaced closed or open grade I simple or spiral wedge tibial shaft fractures caused by low-energy impact. Fifty-four patients were treated with plaster cast and 33 with intramedullary locking nail (IMLN). Delayed union only occurred in 8 patients after plaster cast treatment. Forty-two patients in the IMLN group and one in the plaster cast group suffered from anterior knee pain. Final treatment outcome, healing time, hospitalization time and duratio...

  18. Evaluation of focused ultrasound algorithms: Issues for reducing pre-focal heating and treatment time.

    Science.gov (United States)

    Yiannakou, Marinos; Trimikliniotis, Michael; Yiallouras, Christos; Damianou, Christakis

    2016-02-01

    Due to the heating in the pre-focal field the delay between successive movements in high intensity focused ultrasound (HIFU) are sometimes as long as 60s, resulting to treatment time in the order of 2-3h. Because there is generally a requirement to reduce treatment time, we were motivated to explore alternative transducer motion algorithms in order to reduce pre-focal heating and treatment time. A 1 MHz single element transducer with 4 cm diameter and 10 cm focal length was used. A simulation model was developed that estimates the temperature, thermal dose and lesion development in the pre-focal field. The simulated temperature history that was combined with the motion algorithms produced thermal maps in the pre-focal region. Polyacrylimde gel phantom was used to evaluate the induced pre-focal heating for each motion algorithm used, and also was used to assess the accuracy of the simulation model. Three out of the six algorithms having successive steps close to each other, exhibited severe heating in the pre-focal field. Minimal heating was produced with the algorithms having successive steps apart from each other (square, square spiral and random). The last three algorithms were improved further (with small cost in time), thus eliminating completely the pre-focal heating and reducing substantially the treatment time as compared to traditional algorithms. Out of the six algorithms, 3 were successful in eliminating the pre-focal heating completely. Because these 3 algorithms required no delay between successive movements (except in the last part of the motion), the treatment time was reduced by 93%. Therefore, it will be possible in the future, to achieve treatment time of focused ultrasound therapies shorter than 30 min. The rate of ablated volume achieved with one of the proposed algorithms was 71 cm(3)/h. The intention of this pilot study was to demonstrate that the navigation algorithms play the most important role in reducing pre-focal heating. By evaluating in

  19. Timing of pathogen adaptation to a multicomponent treatment.

    Directory of Open Access Journals (Sweden)

    Romain Bourget

    Full Text Available The sustainable use of multicomponent treatments such as combination therapies, combination vaccines/chemicals, and plants carrying multigenic resistance requires an understanding of how their population-wide deployment affects the speed of the pathogen adaptation. Here, we develop a stochastic model describing the emergence of a mutant pathogen and its dynamics in a heterogeneous host population split into various types by the management strategy. Based on a multi-type Markov birth and death process, the model can be used to provide a basic understanding of how the life-cycle parameters of the pathogen population, and the controllable parameters of a management strategy affect the speed at which a pathogen adapts to a multicomponent treatment. Our results reveal the importance of coupling stochastic mutation and migration processes, and illustrate how their stochasticity can alter our view of the principles of managing pathogen adaptive dynamics at the population level. In particular, we identify the growth and migration rates that allow pathogens to adapt to a multicomponent treatment even if it is deployed on only small proportions of the host. In contrast to the accepted view, our model suggests that treatment durability should not systematically be identified with mutation cost. We show also that associating a multicomponent treatment with defeated monocomponent treatments can be more durable than associating it with intermediate treatments including only some of the components. We conclude that the explicit modelling of stochastic processes underlying evolutionary dynamics could help to elucidate the principles of the sustainable use of multicomponent treatments in population-wide management strategies intended to impede the evolution of harmful populations.

  20. Comparing the dynamic performance of wastewater treatment systems: A metafrontier Malmquist productivity index approach.

    Science.gov (United States)

    Molinos-Senante, María; Hernández-Sancho, Francesc; Sala-Garrido, Ramón

    2015-09-15

    The assessment of productivity change of wastewater treatment plants (WWTPs) is essential to improve the performance over time of the facilities evaluated. This study assessed and compared the productivity growth of WWTPs operating with non-homogeneous technologies. The metafrontier Malmquist productivity index (MMPI) was computed for a sample of 99 WWTPs encompassing 4 alternative technologies: activated sludge (AS), aerated lagoon (AL), trickling filter (TF) and rotating biological contactor (BD). The results indicated that, on average, WWTPs with AS and BD exhibited better performance over time than WWTPs with AL and TF. The MMPI indicates that, over the period 2007-2009, the productivity rose by 0.9% and 0.3% for AS and BD technologies, respectively, whilst for the AL and TF processes, the productivity decreased by 0.5% and 2.2%, respectively. The decomposition of the MMPI into efficiency change (EC) and technical change (TC) illustrated that EC was a positive driver of productivity change for WWTPs that use AS, whilst TC contributed positively to the productivity growth of WWTPs using AL and BD. Several policy implications to help managers make informed decisions were drawn from our empirical analysis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Effect of Voriconazole and Ultraviolet-A Combination Therapy Compared to Voriconazole Single Treatment on Fusarium solani Fungal Keratitis

    Science.gov (United States)

    Choi, Kyoung Sub; Yoon, Sang Chul; Rim, Tyler Hyung Taek; Han, Soo Jung; Kim, Eun-Do

    2014-01-01

    Abstract Purpose: To demonstrate that ultraviolet-A (UV-A) and voriconazole combination therapy is more effective than voriconazole single treatment for fungal keratitis. Methods: The in vitro UV-A (375 nm) fungicidal effect was evaluated on Fusarium solani solutions. Each fungal solution was irradiated with different UV-A irradiation doses. Also, a fungal solution containing voriconazole was also irradiated with UV-A. The in vivo therapeutic effect of UV-A and voriconazole treatment was studied in a rabbit keratitis model. Fungi were injected intrastromally into the cornea of 16 rabbits. Each treatment was initiated 3 days after fungal injection and continued up to 8 days for the following groups: Group 1, control; Group 2, treated with UV-A once a day; Group 3, treated with voriconazole 3 times a day; Group 4, treated with voriconazole 3 times a day and UV-A once a day. On the last day, the sclera–cornea buttons were extracted and microbiological and histological evaluations were performed. Results: The colony-forming units (CFUs) of fungal solutions in culture significantly decreased with UV-A irradiation. The CFUs of fungal solutions containing voriconazole also decreased with UV-A irradiation. In vivo, clinical scores of Group 3 (P=0.03) and Group 4 (P=0.02) 5 days after treatment were significantly lower compared to that of Group 1. The clinical score of Group 4 (P=0.03) 5 days after treatment was significantly lower compared to that of Group 3. The histopathological scores 5 days after treatment were significantly lower in Group 4 compared to those of Group 1 (Pvoriconazole combination treatment could be a safe and effective alternative to voriconazole single treatment for fungal keratitis. PMID:24724576

  2. Modelling and Comparative Performance Analysis of a Time-Reversed UWB System

    Directory of Open Access Journals (Sweden)

    Popovski K

    2007-01-01

    Full Text Available The effects of multipath propagation lead to a significant decrease in system performance in most of the proposed ultra-wideband communication systems. A time-reversed system utilises the multipath channel impulse response to decrease receiver complexity, through a prefiltering at the transmitter. This paper discusses the modelling and comparative performance of a UWB system utilising time-reversed communications. System equations are presented, together with a semianalytical formulation on the level of intersymbol interference and multiuser interference. The standardised IEEE 802.15.3a channel model is applied, and the estimated error performance is compared through simulation with the performance of both time-hopped time-reversed and RAKE-based UWB systems.

  3. Comparative Efficacy of Radiofrequency and Pulsed Dye Laser in the Treatment of Rosacea.

    Science.gov (United States)

    Kim, Sue-Jeong; Lee, Young; Seo, Young-Joon; Lee, Jeung-Hoon; Im, Myung

    2017-02-01

    Laser and light-based therapies have been used successfully in the treatment of rosacea; however, evidence is lacking regarding the efficacy of radiofrequency (RF). This study evaluated the efficacy of RF in the treatment of rosacea compared with pulsed dye laser (PDL). Thirty patients with rosacea (erythematotelangiectatic rosacea [ETR], n = 20; papulopustular rosacea [PPR], n = 10) were enrolled in a randomized, controlled, split-face study. The patients were treated with RF on one side and PDL on the other side. Each treatment consisted of 3 sessions at 4-week intervals and followed up until 4 weeks after the last treatment. Efficacy was assessed by rosacea severity score, erythema index, lesion counts, physician's subjective evaluation, and patient's satisfaction. Radiofrequency and PDL resulted in significant improvement in severity scores and erythema and 70% of the patients receiving RF treatment showed a clinical improvement of >50%. No significant difference was noted between RF and PDL treatment in ETR. However, RF treatment led to a significantly greater decrease in papulopustular lesion count and rosacea severity score in PPR compared with PDL treatment. RF therapy was effective in the treatment of rosacea. It should be considered an alternative therapeutic option, especially in PPR.

  4. An analysis to compare the effects of stereotactic surgery and conservative medical treatment on hypertensive intracerebral hemorrhage

    Directory of Open Access Journals (Sweden)

    Wei-dong GUO

    2011-08-01

    Full Text Available Objective To analyze the therapeutic effects of stereotactic surgery and conservative medical treatment in patients with hypertensive intracerebral hemorrhage.Methods The clinical data of 100 patients with hypertensive intracerebral hemorrhage who underwent stereotactic surgery(stereotactic surgery group from June 2002 to October 2009 were retrospectively analyzed,and the result was compared with that of 80 contemporaneous patients with hypertensive intracerebral hemorrhage who received conservative medical treatment(medical treatment group.There was no significant difference of bleeding site,bleeding volume and state of consciousness on admission between two groups.Results The mortality rate of stereotactic surgery group was 21.0%,and of medical treatment group was 30.0%.The average hematoma absorption time in stereotactic surgery group was 4.8d,and that of medical treatment group was 15.1d.All of the surviving patients were followed-up for 6 months,the rate of cure and mild disability in stereotactic surgery group(37% was significantly higher than that of medical treatment group(26%,P 0.05.Conclusion Compared with conservative medical treatment,stereotactic surgery could decrease the mortality rate and improve the quality of life in patients with hypertensive intracerebral hemorrhage.

  5. Performance of automated activity monitoring systems used in combination with timed artificial insemination compared to timed artificial insemination only in early lactation in dairy cows.

    Science.gov (United States)

    Denis-Robichaud, J; Cerri, R L A; Jones-Bitton, A; LeBlanc, S J

    2018-01-01

    Identifying cows in estrus remains a challenge on dairy cattle farms, and tools and technologies have been developed and used to complement or replace visual detection of estrus. Automated activity monitoring (AAM) systems and timed artificial insemination (TAI) are technologies available to dairy farmers, but many factors can influence their relative performance. The objective of the present study was to compare reproductive performance of cows managed with an AAM system combined with TAI, or with a TAI program (Double Ovsynch) for insemination before 88 DIM. From April 2014 to April 2015, 998 cows from 2 herds were randomly assigned either to be inseminated at 85 ± 3 DIM exclusively using the Double Ovsynch protocol for TAI, or to be inseminated based on estrus detection by AAM without hormonal intervention between 50 and 75 DIM; if no alarm was detected by 75 DIM, cows were inseminated following the single Ovsynch protocol (AAM + Ovsynch). The herds used different AAM systems. Parity, hyperketonemia at wk 1 and 2 postpartum (PP), purulent vaginal discharge at wk 5 PP, body condition score at wk 7 PP, and anovulation to wk 9 PP were recorded. These health indicators did not significantly differ between treatments, but did between herds. The effect of treatment on pregnancy at first insemination and by 88 DIM were assessed using logistic regression models. Time to pregnancy was assessed using survival analysis. Results are reported from intention-to-treat analyses. Treatment did not affect pregnancy at first insemination or pregnancy by 88 DIM, but we found significant interactions between treatment and herd for both outcomes. In herd 2, marginal mean pregnancy at first AI was greater with Double Ovsynch (38%) than AAM + Ovsynch (31%), but no difference was observed in herd 1 (Double Ovsynch = 31%; AAM + Ovsynch = 34%). By 88 DIM, a smaller proportion of cows in herd 1 were pregnant in Double Ovsynch (31%) than AAM + Ovsynch (49%), but there was no difference in

  6. Comparing the efficacy of mature mud pack and hot pack treatments for knee osteoarthritis.

    Science.gov (United States)

    Sarsan, Ayşe; Akkaya, Nuray; Ozgen, Merih; Yildiz, Necmettin; Atalay, Nilgun Simsir; Ardic, Fusun

    2012-01-01

    The objective of this study is to compare the efficacy of mature mud pack and hot pack therapies on patients with knee osteoarthritis. This study was designed as a prospective, randomized-controlled, and single-blinded clinical trial. Twenty-seven patients with clinical and radiologic evidence of knee osteoarthritis were randomly assigned into two groups and were treated with mature mud packs (n 15) or hot packs (n=12). Patients were evaluated for pain [based on the visual analog scale (VAS)], function (WOMAC, 6 min walking distance), quality of life [Short Form-36 (SF-36)], and serum levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and insulin-like growth factor-1 (IGF-1) at baseline, post-treatment, and 3 and 6~months after treatment. The mud pack group shows a significant improvement in VAS, pain, stifness, and physical function domains of WOMAC. The difference between groups of pain and physical activity domains is significant at post-treatment in favor of mud pack. For a 6 min walking distance, mud pack shows significant improvement, and the difference is significant between groups in favor of mud pack at post-treatment and 3 and 6 months after treatment. Mud pack shows significant improvement in the pain subscale of SF-36 at the third month continuing until the sixth month after the treatment. Significant improvements are found for the social function, vitality/energy, physical role disability, and general health subscales of SF-36 in favor of the mud pack compared with the hot pack group at post-treatment. A significant increase is detected for IGF-1 in the mud pack group 3 months after treatment compared with the baseline, and the difference is significant between groups 3 months after the treatment. Mud pack is a favorable option compared with hotpack for pain relief and for the improvement of functional conditions in treating patients with knee osteoarthritis.

  7. A Comparative Clinical Trial of Topical Triamcinolone (Adcortyle and a Herbal Solution for the Treatment of Minor Aphthous Stomatitis

    Directory of Open Access Journals (Sweden)

    F Rad

    2010-10-01

    The aim of this study was to compare the therapeutic effect of topical Myrtus communis (myrtle solution with topical triamcinolone (Adcortyle in the treatment of minor apotheosis. Materials & Methods: This clinical-trial study was conducted at Kurdistan University of Medical Sciences in 2009. 100 patients were randomly assigned into 2 groups. The 1st group received topical myrtle solution. The 2nd group received topical trimcinolone (Adcortyle. After one week, patients' declaration about time of the recovery of the pain and deterioration of oral lesion was recorded. The gathered data was then analyzed using the SPSS statistical software using t-test and chi-square. Results: After treatment, both groups showed response to topical medications with no significant difference between them (p>0.05. Conclusion: results of this study showed that topical myrtle solution is effective in the treatment of minor aphthous stomatitis and its therapeutic effect is comparable with topical triamcinolone (Adcortyle.

  8. Time-Efficiency Analysis Comparing Digital and Conventional Workflows for Implant Crowns: A Prospective Clinical Crossover Trial.

    Science.gov (United States)

    Joda, Tim; Brägger, Urs

    2015-01-01

    To compare time-efficiency in the production of implant crowns using a digital workflow versus the conventional pathway. This prospective clinical study used a crossover design that included 20 study participants receiving single-tooth replacements in posterior sites. Each patient received a customized titanium abutment plus a computer-aided design/computer-assisted manufacture (CAD/CAM) zirconia suprastructure (for those in the test group, using digital workflow) and a standardized titanium abutment plus a porcelain-fused-to-metal crown (for those in the control group, using a conventional pathway). The start of the implant prosthetic treatment was established as the baseline. Time-efficiency analysis was defined as the primary outcome, and was measured for every single clinical and laboratory work step in minutes. Statistical analysis was calculated with the Wilcoxon rank sum test. All crowns could be provided within two clinical appointments, independent of the manufacturing process. The mean total production time, as the sum of clinical plus laboratory work steps, was significantly different. The mean ± standard deviation (SD) time was 185.4 ± 17.9 minutes for the digital workflow process and 223.0 ± 26.2 minutes for the conventional pathway (P = .0001). Therefore, digital processing for overall treatment was 16% faster. Detailed analysis for the clinical treatment revealed a significantly reduced mean ± SD chair time of 27.3 ± 3.4 minutes for the test group compared with 33.2 ± 4.9 minutes for the control group (P = .0001). Similar results were found for the mean laboratory work time, with a significant decrease of 158.1 ± 17.2 minutes for the test group vs 189.8 ± 25.3 minutes for the control group (P = .0001). Only a few studies have investigated efficiency parameters of digital workflows compared with conventional pathways in implant dental medicine. This investigation shows that the digital workflow seems to be more time-efficient than the

  9. Different Gestalt Processing for Different Actions? Comparing Object-Directed Reaching and Looking Time Measures

    Science.gov (United States)

    Vishton, P.M.; Ware, E.A.; Badger, A.N.

    2005-01-01

    Six experiments compared the Gestalt processing that mediates infant reaching and looking behaviors. Experiment 1 demonstrated that the positioning and timing of 8- and 9-month-olds' reaching was influenced by remembered relative motion. Experiment 2 suggested that a visible gap, without this relative motion, was not sufficient to produce these…

  10. Favoured Free-Time: Comparing Children's Activity Preferences in the UK and the USA

    Science.gov (United States)

    Griffiths, Merris

    2011-01-01

    This study presents a comparative study of the free-time activity preferences of 9- to 11-year-old children in the UK and USA, as drawn by them in art workshops. Six themes emerged relating to sport, outdoor play, family/peers, media, special occasions and other (indefinable) activities. The children's talk about their drawings revealed additional…

  11. Effect of treatment time on characterization and properties of ...

    Indian Academy of Sciences (India)

    Administrator

    Although any means of introducing large plastic strains in metals may lead to grain refinement, two principal methods for subjecting a material to severe plas- tic deformation have gained more acceptance, i.e. equal- channel angular pressing (ECAP) (Iwahashi et al 1996) and surface mechanical attrition treatment (SMAT).

  12. [Comparative oncologic and functional outcomes of prostate cancer surgery with other curative treatments].

    Science.gov (United States)

    Soulié, M; Salomon, L

    2015-11-01

    Review of the comparative results of different treatment strategies (surgery, radiotherapy, ultrasound, surveillance) of prostate cancer, in which the main goal is the local control and the second target is the tolerance of the side effects of those treatments. Review of literature using Medline databases selected based on scientific relevance. Clinical keys centered on the oncological and functional outcomes of comparative series between different curative treatments. The numerous comparative series between surgery and other therapeutic modalities are essentially retrospective with significant methodological bias that is difficult to overcome in order to formulate the optimal thesis. However, there is a clear tendency toward surgery usually with young patients who have intermediate risk tumors without important comorbidity. In the absence of randomized comparative series with significant power, the oncological and functional results of the radical prostatectomy with or without adjuvant treatment seem at least the same, in a selected population of patients, compared with the combination of radiotherapy-hormonotherapy in terms of survival, without biochemical recurrence, disease-specific survival and overall survival, for the aggressive tumors necessitating curative local treatments. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  13. Comparative analysis of solar pasteurization versus solar disinfection for the treatment of harvested rainwater.

    Science.gov (United States)

    Strauss, André; Dobrowsky, Penelope Heather; Ndlovu, Thando; Reyneke, Brandon; Khan, Wesaal

    2016-12-09

    Numerous pathogens and opportunistic pathogens have been detected in harvested rainwater. Developing countries, in particular, require time- and cost-effective treatment strategies to improve the quality of this water source. The primary aim of the current study was thus to compare solar pasteurization (SOPAS; 70 to 79 °C; 80 to 89 °C; and ≥90 °C) to solar disinfection (SODIS; 6 and 8 hrs) for their efficiency in reducing the level of microbial contamination in harvested rainwater. The chemical quality (anions and cations) of the SOPAS and SODIS treated and untreated rainwater samples were also monitored. While the anion concentrations in all the samples were within drinking water guidelines, the concentrations of lead (Pb) and nickel (Ni) exceeded the guidelines in all the SOPAS samples. Additionally, the iron (Fe) concentrations in both the SODIS 6 and 8 hr samples were above the drinking water guidelines. A >99% reduction in Escherichia coli and heterotrophic bacteria counts was then obtained in the SOPAS and SODIS samples. Ethidium monoazide bromide quantitative polymerase chain reaction (EMA-qPCR) analysis revealed a 94.70% reduction in viable Legionella copy numbers in the SOPAS samples, while SODIS after 6 and 8 hrs yielded a 50.60% and 75.22% decrease, respectively. Similarly, a 99.61% reduction in viable Pseudomonas copy numbers was observed after SOPAS treatment, while SODIS after 6 and 8 hrs yielded a 47.27% and 58.31% decrease, respectively. While both the SOPAS and SODIS systems reduced the indicator counts to below the detection limit, EMA-qPCR analysis indicated that SOPAS treatment yielded a 2- and 3-log reduction in viable Legionella and Pseudomonas copy numbers, respectively. Additionally, SODIS after 8 hrs yielded a 2-log and 1-log reduction in Legionella and Pseudomonas copy numbers, respectively and could be considered as an alternative, cost-effective treatment method for harvested rainwater.

  14. Current standards for syphilis treatment: comparing the russian and foreign guidelines (part II

    Directory of Open Access Journals (Sweden)

    T. V. Krasnoselskikh

    2015-01-01

    Full Text Available The introduction of penicillin has been a breakthrough in the treatment of syphilis. For 70 years, penicillin remains the preferred drug for the treatment of all forms of the disease; its effectiveness has been proven by wide experience gained from clinical observations. However, a very limited number of published meta-analyzes, systematic reviews and data from randomized controlled trials on the comparative assessment of the effectiveness of various antibiotics and treatment regimens are currently available. Some aspects of syphilis treatment are insufficiently developed, particularly, the treatment schedules for neurosyphilis, syphilis in pregnancy, syphilis in HIV-infected individuals and persons allergic to penicillin. There are disagreements in the assessment of the clinical significance of serofast state after a course of antibiotic therapy. There is no uniform approach to the management of patients with treatment failures. This article compares the Russian standards for syphilis treatment set out in the «Federal guidelines for the management of patients with syphilis» with the current European recommendations of the International Union against Sexually Transmitted Infections (IUSTI and the recommendations of the US Centers for Disease Control and Prevention (CDC. The peculiarities of these guidelines, their strengths and shortcomings, as well as controversial issues of syphilis therapy are discussed. The differences between the domestic and foreign recommendations are more significant in the section concerning the treatment of syphilis than in the section of diagnosis.

  15. The comparative effectiveness of Integrated treatment for Substance abuse and Partner violence (I-StoP) and substance abuse treatment alone: a randomized controlled trial.

    Science.gov (United States)

    Kraanen, Fleur L; Vedel, Ellen; Scholing, Agnes; Emmelkamp, Paul M G

    2013-07-16

    Research has shown that treatments that solely addressed intimate partner violence (IPV) perpetration were not very effective in reducing IPV, possibly due to neglecting individual differences between IPV perpetrators. A large proportion of IPV perpetrators is diagnosed with co-occurring substance use disorders and it has been demonstrated that successful treatment of alcohol dependence among alcohol dependent IPV perpetrators also led to less IPV. The current study investigated the relative effectiveness of Integrated treatment for Substance abuse and Partner violence (I-StoP) to cognitive behavioral treatment addressing substance use disorders including only one session addressing partner violence (CBT-SUD+) among patients in substance abuse treatment who repeatedly committed IPV. Substance use and IPV perpetration were primary outcome measures. Patients who entered substance abuse treatment were screened for IPV. Patients who disclosed at least 7 acts of physical IPV in the past year (N = 52) were randomly assigned to either I-StoP or CBT-SUD+. Patients in both conditions received 16 treatment sessions. Substance use and IPV perpetration were assessed at pretreatment, halfway treatment and posttreatment in blocks of 8 weeks. Both completers and intention-to-treat (ITT) analyses were performed. Patients (completers and ITT) in both conditions significantly improved regarding substance use and IPV perpetration at posttreatment compared with pretreatment. There were no differences in outcome between conditions. Completers in both conditions almost fully abstained from IPV in 8 weeks before the end of treatment. Both I-StoP and CBT-SUD+ were effective in reducing substance use and IPV perpetration among patients in substance abuse treatment who repeatedly committed IPV and self-disclosed IPV perpetration. Since it is more cost and time-effective to implement CBT-SUD+ than I-StoP, it is suggested to treat IPV perpetrators in substance abuse treatment with CBT-SUD+.

  16. Treatment outcome of advance staged oral cavity cancer: concurrent chemoradiotherapy compared with primary surgery.

    Science.gov (United States)

    Tangthongkum, Manupol; Kirtsreesakul, Virat; Supanimitjaroenporn, Pasawat; Leelasawatsuk, Peesit

    2017-06-01

    Concurrent chemoradiotherapy (CCRT) has been reported as effective and has become an acceptable treatment in advanced oral cancer. However, to date there is insufficient data to conclude that CCRT provides a good survival outcome. The purpose of this study was to compare survival rates and complications in patients with resectable advanced oral cavity squamous cell carcinoma treated with either CCRT or surgery with adjuvant radiotherapy (RT)/chemoradiotherapy (CRT). Stage III or IVa oral cavity carcinoma patients treated with curative intent by either CCRT or surgery with adjuvant RT were identified over a 7-year period (2009-2015). Survival rates and treatment complications were analyzed and compared between the two groups. 61 patients underwent CCRT and 128 patients underwent surgical excision and received postoperative RT. There was no statistically significant difference in survival outcome between the two treatment groups. 5-year overall survival rates (OS) were 33 versus 24% (P = 0.191) and the disease-specific survival rates (DSS) were 27 versus 25% (P = 0.857) when comparing the CCRT group and surgery with adjuvant RT/CRT group, respectively. Long-term complications were comparable between the two groups. CCRT has comparable survival outcome and complications for the treatment of advanced oral cavity squamous cell carcinoma, compared to surgery with adjuvant RT/CRT.

  17. A Comparative Study on the Efficacy of Prednisolone and Promethazine in the Treatment of Hyperemesis Gravidarum

    Directory of Open Access Journals (Sweden)

    F Mardanian

    2004-04-01

    Full Text Available Background: Severe nausea and vomiting during pregnancy is one of the most frequent and difficult to treat obstetric problems. Different drugs and techniques have been suggested for its treatment with variable success rates. This study was designed to compare the efficacy of prednisolone with promethazine for treatment of hyperemesis gravidarum. Methods: Fifty six pregnant women with hyperemesis gravidarum were randomly divided into two groups to receive either prednisolone or promethazine orally. Severity of nausea and vomiting, severity of malaise, body weight and serum electrolytes were measured and compared before and after treatment. Results: The severity of nausea and vomiting decreased significantly in both groups, but the decrease was significantly higher in the prednisolone group. Conclusion: The result of this study shows that oral prednisolone is a better choice for the treatment of hyperemesis gravidarum. Keywords: Hyperemesis Gravidarum, Pregnancy, Obstetric Complication, Nausea and Vomiting

  18. Comparing treatments for children with ADHD and word reading difficulties: A randomized clinical trial.

    Science.gov (United States)

    Tamm, Leanne; Denton, Carolyn A; Epstein, Jeffery N; Schatschneider, Christopher; Taylor, Heather; Arnold, L Eugene; Bukstein, Oscar; Anixt, Julia; Koshy, Anson; Newman, Nicholas C; Maltinsky, Jan; Brinson, Patricia; Loren, Richard E A; Prasad, Mary R; Ewing-Cobbs, Linda; Vaughn, Aaron

    2017-05-01

    This trial compared attention-deficit/hyperactivity disorder (ADHD) treatment alone, intensive reading intervention alone, and their combination for children with ADHD and word reading difficulties and disabilities (RD). Children (n = 216; predominantly African American males) in Grades 2-5 with ADHD and word reading/decoding deficits were randomized to ADHD treatment (medication + parent training), reading treatment (reading instruction), or combined ADHD + reading treatment. Outcomes were parent and teacher ADHD ratings and measures of word reading/decoding. Analyses utilized a mixed models covariate-adjusted gain score approach with posttest regressed onto pretest. Inattention and hyperactivity/impulsivity outcomes were significantly better in the ADHD (parent Hedges's g = .87/.75; teacher g = .67/.50) and combined (parent g = 1.06/.95; teacher g = .36/41) treatment groups than reading treatment alone; the ADHD and Combined groups did not differ significantly (parent g = .19/.20; teacher g = .31/.09). Word reading and decoding outcomes were significantly better in the reading (word reading g = .23; decoding g = .39) and combined (word reading g = .32; decoding g = .39) treatment groups than ADHD treatment alone; reading and combined groups did not differ (word reading g = .09; decoding g = .00). Significant group differences were maintained at the 3- to 5-month follow-up on all outcomes except word reading. Children with ADHD and RD benefit from specific treatment of each disorder. ADHD treatment is associated with more improvement in ADHD symptoms than RD treatment, and reading instruction is associated with better word reading and decoding outcomes than ADHD treatment. The additive value of combining treatments was not significant within disorder, but the combination allows treating both disorders simultaneously. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. Carbon dioxide laser versus erbium:YAG laser in treatment of epidermal verrucous nevus: a comparative randomized clinical study.

    Science.gov (United States)

    Osman, Mai Abdel Raouf; Kassab, Ahmed Nazmi

    2017-08-01

    A verrucous epidermal nevus (VEN) is a skin disorder that has been treated using different treatment modalities with varying results. Ablative lasers such as carbon dioxide laser (CO 2 ) and erbium:yttrium-aluminum-garnet (Er:YAG) laser have been considered as the gold standard for the treatment of epidermal nevi. To evaluate and compare the efficacy, postoperative wound healing and side effects of pulsed CO 2 laser and Er:YAG laser for the treatment of verrucous epidermal nevi. Twenty patients with localized VEN were randomly divided into two groups. Group 1 was administered CO 2 laser and group 2 underwent Er:YAG laser treatment. A blinded physician evaluated the photographs and dermoscopic photomicrographs for the efficacy and possible side effects. All patients received one treatment session and were followed up over a 6-month period. Both lasers induced noticeable clinical improvement, but there were no significant differences between two lasers in treatment response, patient satisfaction, duration of erythema and side effects. The average time to re-epithelialization was 13.5 days with CO 2 and 7.9 days with Er:YAG laser (plaser group and no lesional recurrence was detected in CO 2 laser group since treatment. Apart from re-epithelialization, both lasers showed equivalent outcomes with respect to treatment response, patient satisfaction, side effects and complications.

  20. Cost Utility of Omalizumab Compared with Standard of Care for the Treatment of Chronic Spontaneous Urticaria.

    Science.gov (United States)

    Graham, Jonathan; McBride, Doreen; Stull, Donald; Halliday, Anna; Alexopoulos, Stamatia Theodora; Balp, Maria-Magdalena; Griffiths, Matthew; Agirrezabal, Ion; Zuberbier, Torsten; Brennan, Alan

    2016-08-01

    Chronic spontaneous urticaria (CSU) negatively impacts patient quality of life and productivity and is associated with considerable indirect costs to society. The aim of this study was to assess the cost utility of add-on omalizumab treatment compared with standard of care (SOC) in moderate or severe CSU patients with inadequate response to SOC, from the UK societal perspective. A Markov model was developed, consisting of health states based on Urticaria Activity Score over 7 days (UAS7) and additional states for relapse, spontaneous remission and death. Model cycle length was 4 weeks, and total model time horizon was 20 years in the base case. The model considered early discontinuation of non-responders (response: UAS7 ≤6) and retreatment upon relapse (relapse: UAS7 ≥16) for responders. Clinical and cost inputs were derived from omalizumab trials and published sources, and cost utility was expressed as incremental cost-effectiveness ratios (ICERs). Scenario analyses included no early discontinuation of non-responders and an altered definition of response (UAS7 omalizumab was associated with increased costs and benefits relative to SOC. Probabilistic sensitivity analysis supported this result. Productivity inputs were key model drivers, and individual scenarios without early discontinuation of non-responders and adjusted response definitions had little impact on results. ICERs were generally robust to changes in key model parameters and inputs. In this, the first economic evaluation of omalizumab in CSU from a UK societal perspective, omalizumab consistently represented a treatment option with societal benefit for CSU in the UK across a range of scenarios.

  1. Comparative effectiveness of mepolizumab and omalizumab in severe asthma: An indirect treatment comparison.

    Science.gov (United States)

    Cockle, Sarah M; Stynes, Gillian; Gunsoy, Necdet B; Parks, Daniel; Alfonso-Cristancho, Rafael; Wex, Jaro; Bradford, Eric S; Albers, Frank C; Willson, Jenny

    2017-02-01

    Severe asthma is a heterogeneous disease. Patients with both eosinophilic and allergic asthma phenotypes may be eligible for treatment with mepolizumab and omalizumab. Evidence on the relative effectiveness of these treatments in this 'overlap' population would be informative for clinical and payer decision making. A systematic literature review and indirect treatment comparison (Bayesian framework) were performed to assess the comparative effectiveness and tolerability of mepolizumab and omalizumab, as add-ons to standard of care. Studies included in the primary analysis were double-blind, randomized controlled trials, ≥12 weeks' duration enrolling patients with severe asthma with a documented exacerbation history and receiving high-dose inhaled corticosteroids plus ≥1 additional controller. Two populations were examined: patients potentially eligible for 1) both treatments (Overlap population) and 2) either treatment (Trial population). In the Overlap population, no differences between treatments in clinically significant exacerbations and exacerbations requiring hospitalization were found, although trends favored mepolizumab (rate ratio [RR]:0.66 [95% credible intervals (Crl):0.37,1.19]; 0.19[0.02,2.32], respectively). In the Trial population, mepolizumab treatment produced greater reductions in clinically significant exacerbations (RR:0.63 [95% CrI:0.45,0.89]) but not exacerbations requiring hospitalization compared with omalizumab (RR:0.58 [95% Crl: 0.16,2.13]), although the trend favored mepolizumab. Both treatments had broadly comparable effects on lung function, and similar tolerability profiles. Whilst this analysis has limitations due to a restricted evidence base and residual heterogeneity, it showed that in patients with severe asthma, mepolizumab seems to be at least as effective as omalizumab and that the tolerability profiles of the two treatments did not meaningfully differentiate. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Need for timely paediatric HIV treatment within primary health care in rural South Africa.

    Directory of Open Access Journals (Sweden)

    Graham S Cooke

    2009-09-01

    Full Text Available In areas where adult HIV prevalence has reached hyperendemic levels, many infants remain at risk of acquiring HIV infection. Timely access to care and treatment for HIV-infected infants and young children remains an important challenge. We explore the extent to which public sector roll-out has met the estimated need for paediatric treatment in a rural South African setting.Local facility and population-based data were used to compare the number of HIV infected children accessing HAART before 2008, with estimates of those in need of treatment from a deterministic modeling approach. The impact of programmatic improvements on estimated numbers of children in need of treatment was assessed in sensitivity analyses.In the primary health care programme of HIV treatment 346 children <16 years of age initiated HAART by 2008; 245(70.8% were aged 10 years or younger, and only 2(<1% under one year of age. Deterministic modeling predicted 2,561 HIV infected children aged 10 or younger to be alive within the area, of whom at least 521(20.3% would have required immediate treatment. Were extended PMTCT uptake to reach 100% coverage, the annual number of infected infants could be reduced by 49.2%.Despite progress in delivering decentralized HIV services to a rural sub-district in South Africa, substantial unmet need for treatment remains. In a local setting, very few children were initiated on treatment under 1 year of age and steps have now been taken to successfully improve early diagnosis and referral of infected infants.

  3. Comparative overview of primary sedimentation-based mechanical stage in some Romanian wastewater treatment systems

    Science.gov (United States)

    Zaharia, C.

    2017-08-01

    Nowadays, wastewater (WW) treatment facilities are considered significant exposure pathways for solid particles, and also significant concerns of any quality conscious manufacturer. Most solid particles have some forms of organic coating either used as active material or to suspend and/or stabilize different present solid materials, having increase in toxicity that must be reduced, or sometimes even totally eliminated, especially if effluent is either discharged directly to surface water, or distributed through industrial water supplies. Representatives providing innovative technologies, comprehensive supports and expertise in wastewater and sludge treatment field are known, each one using modern treatment technology and facilities. Mechanical treatment is indispensable in primary treatment steps of both municipal and industrial WW applications, its main goal being separation of floating, settling and suspended materials (especially into a primary sedimentation-based treatment step). The aim of this work is to present comparatively the performance in solids removal of conventional mechanical WW treatment stages, especially those based on primary sedimentation, or sedimentation-like operations applied for Romanian urban WW treatment plants (serving two towns with ca 18,000 inhabitants), industrial WW treatment plants (deserving industries of vegetal food processing and organic chemicals’ manufacturing) and additional information on valorisation of separated solid material and improvement possibilities.

  4. Treatment timing of MARA and fixed appliance therapy of Class II malocclusion.

    Science.gov (United States)

    Ghislanzoni, Luis Tomas Huanca; Baccetti, Tiziano; Toll, Douglas; Defraia, Efisio; McNamara, James A; Franchi, Lorenzo

    2013-06-01

    The objective of this study is to evaluate the effect of timing on Mandibular Anterior Repositioning Appliance (MARA) and fixed appliance treatment of Class II malocclusion in a prospective clinical trial. The treated sample consisted of 51 consecutively treated patients at prepubertal (n = 21), pubertal (n = 15), and postpubertal (n = 15) stages of development. Control groups for the three treated groups were generated from growth data of untreated Class II subjects. Lateral cephalograms were digitized and superimposed via cephalometric software at T1 (pre-treatment) and T2 (after comprehensive treatment). The T1-T2 changes in the treated groups were compared to those in their corresponding control groups with Mann-Whitney tests with Bonferroni correction. Mandibular elongation was greater at the pubertal stage (Co-Gn +2.6 mm, with respect to controls). Headgear effect on the maxilla was greater in the pre-peak sample (Co-A -1.9 mm, with respect to controls). Dentoalveolar compensations (proclination of lower incisors, extrusion and mesialization of lower molars, and reduction in the overbite) were significant in the pre-peak and post-peak groups. Optimal timing for Class II treatment with MARA appliance is at the pubertal growth spurt, with enhanced mandibular skeletal changes and minimal dentoalveolar compensations.

  5. Comparing spoken language treatments for minimally verbal preschoolers with autism spectrum disorders.

    Science.gov (United States)

    Paul, Rhea; Campbell, Daniel; Gilbert, Kimberly; Tsiouri, Ioanna

    2013-02-01

    Preschoolers with severe autism and minimal speech were assigned either a discrete trial or a naturalistic language treatment, and parents of all participants also received parent responsiveness training. After 12 weeks, both groups showed comparable improvement in number of spoken words produced, on average. Approximately half the children in each group achieved benchmarks for the first stage of functional spoken language development, as defined by Tager-Flusberg et al. (J Speech Lang Hear Res, 52: 643-652, 2009). Analyses of moderators of treatment suggest that joint attention moderates response to both treatments, and children with better receptive language pre-treatment do better with the naturalistic method, while those with lower receptive language show better response to the discrete trial treatment. The implications of these findings are discussed.

  6. A comparative study of single-dose treatment of chancroid using thiamphenicol versus Azithromycin

    Directory of Open Access Journals (Sweden)

    Walter B. Junior

    Full Text Available A study was conducted in São Paulo, Brazil, to compare azithromycin with thiamphenicol for the single-dose treatment of chancroid. In all, 54 men with chancroid were tested. The etiology was determined by clinical characterization and direct bacterioscopy with Gram staining. None of the patients had positive serology or dark-field examination indicating active infection with Treponema pallidum. Genital infections due to Neisseria gonorrhoeae and herpes simplex virus were excluded by polymerase chain reaction testing. For 54 patients with chancroid, cure rates with single-dose treatment were 73% with azithromycin and 89% with thiamphenicol. HIV seropositivity was found to be associated with treatment failure (p=0.001. The treatment failed in all HIV positive patients treated with azithromycin (p=0.002 and this drug should be avoided in these co-infected patients. In the view of the authors, thiamphenicol is the most indicated single-dose regimen for chancroid treatment.

  7. The international comparative wood treatment study WOAM Freemantle 1987 - Trondheim 2012

    DEFF Research Database (Denmark)

    Botfeldt, Knud Bo; Petersen, Maj Britt

    2016-01-01

    The project The international Comparative Wood Treatment Study was developed and launched under ICOM-WOAM by D. Grattan, Canadian Conservation Institute and F. Schweingruber, The Swiss Federal Forestry Institute. The project started in 1983 and at the Woam Conference in Freemantle in 1987 the many...... experiences and results was presented. The project aimed at obtaining a better common understanding of various treatments of waterlogged wood and to understand how and why treatments functioned. This project involved ten conservation laboratories in nine different countries - Canada (2 labs), France......, Netherlands, Japan, Germany, Australia, Austria, England and Norway. In all 26 different treatment programs - of which 23 treatments involved PEG. From 1989 the wood samples have been kept for perpetuity at Vitenskapsmuseet (Museum of Science) in Trondheim, Norway in a climate controlled environment...

  8. A COMPARATIVE STUDY OF THE IMAGING AND TREATMENT MODALITIES IN THE MANAGEMENT OF CHOLEDOCHOLITHIASIS

    Directory of Open Access Journals (Sweden)

    Harish

    2016-02-01

    Full Text Available AIM The objectives of this study are to compare the investigative modalities used in the diagnosis and to compare the treatment undertaken in the management of patients with choledocholithiasis. MATERIAL AND METHODS Data was collected in prefixed proforma in our hospital between April 2012 to Oct 2014 after considering inclusion and exclusion criteria.  Data regarding imaging studies for diagnosis of choledocholithiasis was collected.  After diagnosis, patients were subjected to different treatment modalities.  The outcomes, complications and morbidity of the procedures were compared analysed. RESULTS  Mean age was more than 50 years. Pain abdomen was the most common preventing complaint.  Ultrasound was the commonest imaging modality done with sensitivity of more than 60% in finding the CBD stone  CT and MRCP in diagnosis of choledocholithiasis were concerned and dilatation of the common bile duct was detected equally by both methods.  ERCP and surgical methods in form of laparoscopic or open surgery were different treatment modalities used; ERCP was the common treatment modality done. Open surgery and laparoscopic cholecystectomy were next commonest treatment modalities done respectively. CONCLUSIONS  Occurrence of choledocholithiasis increases with age.  USG is both cheap and effective with sensitivity more than 60% but MRCP is more preferable as a biliary imaging modality.  Choledochoduodenostomy is an optional method of management following CBD exploration while T-tube drainage and primary closure of the CBD following exploration have comparable results.

  9. A comparative study of simple auditory reaction time in blind (congenitally) and sighted subjects.

    Science.gov (United States)

    Gandhi, Pritesh Hariprasad; Gokhale, Pradnya A; Mehta, H B; Shah, C J

    2013-07-01

    Reaction time is the time interval between the application of a stimulus and the appearance of appropriate voluntary response by a subject. It involves stimulus processing, decision making, and response programming. Reaction time study has been popular due to their implication in sports physiology. Reaction time has been widely studied as its practical implications may be of great consequence e.g., a slower than normal reaction time while driving can have grave results. To study simple auditory reaction time in congenitally blind subjects and in age sex matched sighted subjects. To compare the simple auditory reaction time between congenitally blind subjects and healthy control subjects. STUDY HAD BEEN CARRIED OUT IN TWO GROUPS: The 1(st) of 50 congenitally blind subjects and 2(nd) group comprises of 50 healthy controls. It was carried out on Multiple Choice Reaction Time Apparatus, Inco Ambala Ltd. (Accuracy±0.001 s) in a sitting position at Government Medical College and Hospital, Bhavnagar and at a Blind School, PNR campus, Bhavnagar, Gujarat, India. Simple auditory reaction time response with four different type of sound (horn, bell, ring, and whistle) was recorded in both groups. According to our study, there is no significant different in reaction time between congenital blind and normal healthy persons. Blind individuals commonly utilize tactual and auditory cues for information and orientation and they reliance on touch and audition, together with more practice in using these modalities to guide behavior, is often reflected in better performance of blind relative to sighted participants in tactile or auditory discrimination tasks, but there is not any difference in reaction time between congenitally blind and sighted people.

  10. Comparing withdrawal and not withdrawal of life-sustaining treatment among patients who died from stroke

    Directory of Open Access Journals (Sweden)

    Helvig E

    2015-09-01

    Full Text Available Eirik Helvig,1 Lars Thomassen,2 Ulrike Waje-Andreassen,2 Halvor Naess3 1Department of Neurology, Haukeland University Hospital, Jonas Liesgt, Bergen, 2Institute of Clinical Medicine, University of Bergen, Bergen, 3Centre for Age-related Medicine, Stavanger University Hospital, Stavanger, NorwayBackground: In severe stroke, a decision to withdraw life-sustaining treatment is sometimes made in cooperation with the family. The aim of this study was to study the time from withdrawing life-sustaining treatment to death in patients with severe ischemic or hemorrhagic stroke.Methods: In total, 2,506 patients with stroke admitted to Haukeland University Hospital between 2006 and 2011 were prospectively registered in the Bergen NORSTROKE database. Risk factors, stroke severity, etiology, and blood analyses were registered. Retrospectively, the patients' records were examined to determine the number of days from withdrawing all life-sustaining treatment to death in patients who died from severe stroke during the hospital stay.Results: Life-sustaining treatment was withheld in 50 patients with severe stroke. Median time to death after withdrawing life-sustaining treatment was 4 days, and a quarter lived at least 1 week (range =1–11 days. Cox regression analyses showed that short time from withdrawing life-sustaining treatment to death was associated with high age (Hazard ratio [HR] =1.05, P=0.07, male sex (HR =2.9, P=0.01, high C-reactive protein on admission (HR =1.01, P=0.001, and hemorrhagic stroke (versus ischemic stroke, HR =1.5, P=0.03.Conclusion: One week after withdrawing life-sustaining treatment, a quarter of our patients with severe stroke remained alive. Short time to death was associated with high age, male sex, hemorrhagic stroke, and high C-reactive protein on admittance. Keywords: stroke, withdrawal of life-sustaining treatment, prognosis

  11. Comparative efficacy and safety of approved treatments for macular oedema secondary to branch retinal vein occlusion

    DEFF Research Database (Denmark)

    Regnier, Stephane A; Larsen, Michael; Bezlyak, Vladimir

    2015-01-01

    OBJECTIVE: To compare the efficacy and safety of approved treatments for macular oedema secondary to branch retinal vein occlusion (BRVO). DESIGN: Randomised controlled trials (RCTs) evaluating the efficacy and safety of approved treatments for macular oedema secondary to BRVO were identified from....... Bevacizumab and triamcinolone were excluded. OUTCOME MEASURES: Efficacy outcomes were mean change in best corrected visual acuity (Early Treatment Diabetic Retinopathy Study scale) and the percentage of patients gaining ≥ 15 letters. Safety outcome was the percentage of patients with increased intraocular...

  12. TIME ZONE DIFFERENCE, COMPARATIVE ADVANTAGE AND TRADE: A REVIEW OF LITERATURE

    Directory of Open Access Journals (Sweden)

    Alaka Shree Prasad

    2017-09-01

    Full Text Available With the growing development in communication technology and increased fragmentation of production process, services that were once considered non-tradable can now be traded across different nations. In this respect, trading countries located in different time zones of the world with non-overlapping working hours are able to develop a comparative advantage together for the supply of these services. Disintegrating the production of a service across different time zones can allow the production to be completed efficiently and make the product available in the market meeting consumer demand in a timely fashion. In this paper, we have reviewed some of important research that has been conducted in the area of time zone differences and trade. This type of trade further affects the factor market and production patterns of the involved countries and has also been significant for their growth and welfare.

  13. Performing T-tests to Compare Autocorrelated Time Series Data Collected from Direct-Reading Instruments.

    Science.gov (United States)

    O'Shaughnessy, Patrick; Cavanaugh, Joseph E

    2015-01-01

    Industrial hygienists now commonly use direct-reading instruments to evaluate hazards in the workplace. The stored values over time from these instruments constitute a time series of measurements that are often autocorrelated. Given the need to statistically compare two occupational scenarios using values from a direct-reading instrument, a t-test must consider measurement autocorrelation or the resulting test will have a largely inflated type-1 error probability (false rejection of the null hypothesis). A method is described for both the one-sample and two-sample cases which properly adjusts for autocorrelation. This method involves the computation of an "equivalent sample size" that effectively decreases the actual sample size when determining the standard error of the mean for the time series. An example is provided for the one-sample case, and an example is given where a two-sample t-test is conducted for two autocorrelated time series comprised of lognormally distributed measurements.

  14. Prevention of enamel demineralization during orthodontic treatment: an in vitro comparative study.

    Science.gov (United States)

    Bichu, Yashodhan M; Kamat, Nandini; Chandra, Pavan Kumar; Kapoor, Aditi; Razmus, Thomas; Aravind, N K S

    2013-01-01

    Enamel demineralization is considered to be the most prevalent and significant iatrogenic effect associated with fixed orthodontic treatment and can seriously jeopardize both tooth longevity and dental esthetics. This in vitro study was undertaken to compare the effectiveness of four different commercially available surface treatment medicaments for the inhibition of enamel demineralization. Seventy-five intact maxillary premolars extracted from patients undergoing orthodontic treatment were divided into five equal groups and were subjected to one of the following protocols: no treatment (control group) or treatment with one of the following four medicaments: fluoride varnish (Fluor Protector [FP]), casein phosphopeptide-amorphous calcium phosphate (GC Tooth Mousse [TM]), calcium sodium phosphosilicate (SHY-NM), and casein phosphopeptide-amorphous calcium phosphate with fluoride (GC Tooth Mousse Plus [TMP]). All the teeth were subjected to ten Cate demineralization solution?for 96 hours and subsequently evaluated under polarized light microscopy to obtain the mean depths of enamel demineralization. One-way analysis of variance and Bonferroni comparison tests were used to obtain statistically significant differences between the five different groups at P < .05. All four surface treatment medicaments provided statistically significant reduction in the depths of enamel demineralization as compared with the control group. FP provided the greatest protection of enamel surface in terms of reduction of lesion depth, followed by TMP, SHY-NM, and TM. The use of these commercially available medicaments could prove to be beneficial for patients undergoing orthodontic treatment and who are at a risk for developing enamel decalcification.

  15. Comparative efficacy of amoxicillin, cefuroxime and clarithromycin in the treatment of community acquired pneumonia in children

    International Nuclear Information System (INIS)

    Aurangzeb, B.; Hameed, A.

    2003-01-01

    Objective: To compare the clinical response to amoxicillin, cefuroxime and clarithromycin in the treatment of community-acquired pneumonia in children and to see the cost effectiveness of each treatment. Subjects and Methods: Patients between 3 to 72 months of age, admitted in the hospital with community acquired pneumonia, were randomly divided into three groups 1,2,3. They were started on amoxicillin, cefuroxime and clarithromycin respectively. The patients were assessed daily. If there was no clinical improvements at 48 hours the antibiotic was changed. ANOVA statistical test was applied to see the clinical response to the treatment in the three groups. Cost effectiveness of the treatment was compared. Results: There was no statistical difference in the clinical response at 48 hours of initiating treatment and discharge (p>0.01 each). The mean hospital stay in group 1 and 2 was 3.3 days and group 3 was 3.2 days respectively (p>0.01). Ninety-seven percent patients in group 1 and 3, and 95% patients in group 2 showed clinical improvement. The cost of treatment of community acquired pneumonia for 8 days was Rs. 496/-, 730/-, 1018/- for amoxicillin, clarithromycin and cefuroxime respectively. Conclusion: Amoxicillin was found in the most cost effective followed by clarithromycin and cefuroxime respectively in the treatment of non-severe and severe community-acquired pneumonia. (author)

  16. The effect of alkaline treatments soaking time on oil palm empty fruit bunch (OPEFB) fibre structure

    Science.gov (United States)

    Faizi, M. K.; Shahriman, A. B.; Majid, M. S. Abdul; Ahmad, Z. A.; Shamsul, B. M. T.; Ng, Y. G.

    2017-10-01

    The primary objective of this work was to study the effect of different soaking time in an alkaline solution for oil palm empty fruit bunch (OPEFB) fibre. For this purpose, the OPEFB fibres were treated with the sodium hydroxide (NaOH) at 5% concentration for ½ hour, 1-hour, 3-hour, 5-hour, 7-hour and 24-hours. The single tests of treated and untreated fibre were then performed in accordance with the ASTM D3822-07 standard. Next, the surfaces of the fibres prior and after the treatment were observed with a scanning electron microscope (SEM) TM3000. The result shows that at 7 hours of soaking time exhibits the highest tensile strength compared to the other soaking time and untreated fibre.

  17. Nutritional profile of hemodialysis patients concerning treatment time.

    Science.gov (United States)

    Alvarenga, Livia de Almeida; Andrade, Bárbara Danelon; Moreira, Michelle Andrade; Nascimento, Roberto de Paula; Macedo, Isabela Dariú; Aguiar, Aline Silva de

    2017-01-01

    The mortality of the population with chronic kidney disease (CKD) on hemodialysis (HD) is very high and the protein-energy malnutrition stands out as one of the most common consequences in relation to this condition. To evaluate the association between time of hemodialysis and nutritional parameters of patients. It is a cross-sectional study with secondary data, developed of the University Hospital of the Federal University of Juiz de Fora (HU/UFJF). This study was approved by the Research Ethics Committee (Nº 1.233.142), a total of 36 patients. The medical records and collected data were analyzed for anthropometric markers, biochemical and diet, considering two groups: HD time less than three and greater than or equal to three years. There was reduction of mass of somatic protein with increased duration of HD. In relation to food intake was observed that in patients with increased duration of dialysis, an increase in average consumption of protein / kg of weight, calories, phosphorus and potassium, with a significant difference from the mean protein intake / kg (p = 0.04) and phosphorus (p = 0.045). Increasing HD time has altered body composition of patients, indicating a decline in the nutritional status of these individuals. HD patients are a risk group for protein-energy malnutrition, where HD time interferes with the nutritional status and food profile of the patient. The group HD time greater than or equal to 3 years presented worsening nutritional status.

  18. Nutritional profile of hemodialysis patients concerning treatment time

    Directory of Open Access Journals (Sweden)

    Livia de Almeida Alvarenga

    Full Text Available Abstract Introduction: The mortality of the population with chronic kidney disease (CKD on hemodialysis (HD is very high and the protein-energy malnutrition stands out as one of the most common consequences in relation to this condition. Objective: To evaluate the association between time of hemodialysis and nutritional parameters of patients. Methods: It is a cross-sectional study with secondary data, developed of the University Hospital of the Federal University of Juiz de Fora (HU/UFJF. This study was approved by the Research Ethics Committee (Nº 1.233.142, a total of 36 patients. The medical records and collected data were analyzed for anthropometric markers, biochemical and diet, considering two groups: HD time less than three and greater than or equal to three years. Results: There was reduction of mass of somatic protein with increased duration of HD. In relation to food intake was observed that in patients with increased duration of dialysis, an increase in average consumption of protein / kg of weight, calories, phosphorus and potassium, with a significant difference from the mean protein intake / kg (p = 0.04 and phosphorus (p = 0.045. Increasing HD time has altered body composition of patients, indicating a decline in the nutritional status of these individuals. Conclusion: HD patients are a risk group for protein-energy malnutrition, where HD time interferes with the nutritional status and food profile of the patient. The group HD time greater than or equal to 3 years presented worsening nutritional status.

  19. Treatment of hypermyoglobinemia after CRS + HIPEC for patients with peritoneal carcinomatosis: A retrospective comparative study.

    Science.gov (United States)

    Liu, Gang; Ji, Zhong-He; Yu, Yang; Li, Xin-Bao; Zhang, Yan-Bin; Peng, Kai-Wen; Li, Yan

    2017-11-01

    This retrospective comparative study aims to explore the time courses of serum myoglobin (Mb) changes, and summarize our experience in treating patients with hypermyoglobinemia after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).This study covered 60 patients with peritoneal carcinomatosis treated with CRS + HIPEC as the study group, and another 25 cancer patients treated with conventional extensive surgery without HIPEC as the control group from February to October 2016. In the study group, patients with postoperative hypermyoglobinemia were on a comprehensive treatment regimen consisting intravenous injection of sodium bicarbonate solution according to the Mb level. In the control group, patients were recorded and treated with the same regimen except for special sodium bicarbonate solution. The preoperative and postoperative serum Mb, blood urine nitrogen (BUN), and creatinine (Cr) levels were evaluated.There were no significantly difference between the 2 groups in serum Mb, BUN, and Cr levels before surgery. Postoperative serum Mb levels were elevated in both groups and significantly higher on postoperative 0 to 2 days (P sodium bicarbonate could accelerate the reduction in serum Mb levels and reduce the risk for major organ damages.

  20. Can a surgery-first orthognathic approach reduce the total treatment time?

    Science.gov (United States)

    Jeong, Woo Shik; Choi, Jong Woo; Kim, Do Yeon; Lee, Jang Yeol; Kwon, Soon Man

    2017-04-01

    Although pre-surgical orthodontic treatment has been accepted as a necessary process for stable orthognathic correction in the traditional orthognathic approach, recent advances in the application of miniscrews and in the pre-surgical simulation of orthodontic management using dental models have shown that it is possible to perform a surgery-first orthognathic approach without pre-surgical orthodontic treatment. This prospective study investigated the surgical outcomes of patients with diagnosed skeletal class III dentofacial deformities who underwent orthognathic surgery between December 2007 and December 2014. Cephalometric landmark data for patients undergoing the surgery-first approach were analyzed in terms of postoperative changes in vertical and horizontal skeletal pattern, dental pattern, and soft tissue profile. Forty-five consecutive Asian patients with skeletal class III dentofacial deformities who underwent surgery-first orthognathic surgery and 52 patients who underwent conventional two-jaw orthognathic surgery were included. The analysis revealed that the total treatment period for the surgery-first approach averaged 14.6 months, compared with 22.0 months for the orthodontics-first approach. Comparisons between the immediate postoperative and preoperative and between the postoperative and immediate postoperative cephalometric data revealed factors that correlated with the total treatment duration. The surgery-first orthognathic approach can dramatically reduce the total treatment time, with no major complications. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Geographic Variations and Time Trends in Cancer Treatments in Taiwan.

    Science.gov (United States)

    Hsu, Jason C; Chang, Sheng-Mao; Lu, Christine Y

    2017-08-02

    Targeted therapies have become important treatment options for cancer care in many countries. This study aimed to examine recent trends in utilization of antineoplastic drugs, particularly the use of targeted therapies for treatment of cancer, by geographic region in Taiwan (northern, midwestern, southern, and eastern regions and the outer islands). This was a retrospective observational study of antineoplastic agents using 2009-2012 quarterly claims data from Taiwan's National Health Insurance Research Database. Yearly market shares by prescription volume and costs for targeted therapies among total antineoplastic agents by region were estimated. We used multivariate regression model and ANOVA to examine variations in utilization of targeted therapies between geographic regions and used ARIMA models to estimate longitudinal trends. Population-adjusted use and costs of antineoplastic drugs (including targeted therapies) were highest in the southern region of Taiwan and lowest in the outer islands. We found a 4-fold difference in use of antineoplastic drugs and a 49-fold difference in use of targeted therapies between regions if the outer islands were included. There were minimal differences in use of antineoplastic drugs between other regions with about a 2-fold difference in use of targeted therapies. Without considering the outer islands, the market share by prescription volume and costs of targeted therapies increased almost 2-fold (1.84-1.90) and 1.5-fold (1.26-1.61) respectively between 2009 and 2012. Furthermore, region was not significantly associated with use of antineoplastic agents or use of targeted therapies after adjusting for confounders. Region was associated with costs of antineoplastic agents but it was not associated with costs of targeted therapies after confounding adjustments. Use of antineoplastic drugs overall and use of targeted therapies for treatment of cancer varied somewhat between regions in Taiwan; use was notably low in the outer

  2. [Medical evaluation prior to fertility treatment--time for reconsideration?].

    Science.gov (United States)

    Yakir, Segev; Riskin-Mashiah, Shlomit; Lavie, Ofer; Auslender, Ron

    2011-11-01

    The aim of modern obstetrics is to bring a healthy child to a healthy mother. Preconception counseling is a form of preventive medicine that consists of three main components: risk assessment, health promotion and intervention, in order to improve pregnancy outcome. A large proportion of women, who need assisted reproductive technologies (ART) due to infertility, are older than the average pregnant women. The risk for chronic maternal disease such as obesity, diabetes mellitus, chronic hypertension, cardiovascular diseases and malignant disease greatly increases with maternal age. Chronic maternal illness might increase the risk of in vitro fertilization procedure and is also associated with increased obstetrics risk and even death. A previous study has shown that most maternal deaths in the USA, due to chronic maternal disease, are potentially preventable through better medical care from preconception, yet most studies that deal with preconception care in infertility patients only address the problems of infertility. Therefore, similar to the recommendations of the American Heart Association before non-competitive physical activity, and the American Society of Anesthesiologists before an elective surgery, we suggest a pre-ART medical assessment. Our objective is to outline the potential risks for older women who undergo ART procedure and potentially, pregnancy, and to characterize guidelines for evaluation prior to enrolling them in ART programs. Pre-ART assessment should include a thorough medical questionnaire and medical examination. Appropriate treatment for women with medical conditions prior to ART procedure and optimizing disease control in preparation for pregnancy including changing a potentially teratogenic treatment, can improve women's health status prior to pregnancy and reduce pregnancy related complications. At the end of the evaluation, and before ART treatment, the women should be consulted, based on the results of tests, on the possible risks

  3. Comparative timing measurements of LYSO and LFS-3 to achieve the best time resolution for TOF-PET

    CERN Document Server

    Doroud, K; Zichichi, A; Zuyeuski, R

    2015-01-01

    The best Coincidence Time Resolution (CTR) obtained so far – with very short crystals of 3–5 mm in length – reach values between 100 and 150 ps. Such crystals are not really practical for a TOF PET imaging device, since the sensitivity is quite small for the detection of the 511 keV gammas resulting from a positron annihilation. We present our setup and measurements using 15 mm length crystals; a length we regard as reasonable for a TOF-PET scanner. We have used a new series of Silicon Photo-Multipliers (SiPM) manufactured by Hamamatsu. These are the High Fill Factor (HFF) and Low Cross-Talk (LCT) Multi-Pixel Photon Counters (MPPC). We have compared three different crystals, LFS-3 (supplied by Zecotek) and two samples of LYSO (manufactured by Saint Gobain and CPI). We have obtained an excellent value of 148 ps for the Coincidence Time Resolution (CTR) with two LFS-3 crystals (15 mm long) mounted on each side of a 22Na radioactive source with the HFF-MPPCs at 3.3 V over-voltage. Our results are148 ps obt...

  4. Predicting Time Spent in Treatment in a Sample of Danish Survivors of Child Sexual Abuse.

    Science.gov (United States)

    Fletcher, Shelley; Elklit, Ask; Shevlin, Mark; Armour, Cherie

    2017-07-01

    The aim of this study was to identify significant predictors of length of time spent in treatment. In a convenience sample of 439 Danish survivors of child sexual abuse, predictors of time spent in treatment were examined. Assessments were conducted on a 6-month basis over a period of 18 months. A multinomial logistic regression analysis revealed that the experience of neglect in childhood and having experienced rape at any life stage were associated with less time in treatment. Higher educational attainment and being male were associated with staying in treatment for longer periods of time. These factors may be important for identifying those at risk of terminating treatment prematurely. It is hoped that a better understanding of the factors that predict time spent in treatment will help to improve treatment outcomes for individuals who are at risk of dropping out of treatment at an early stage.

  5. Simultaneous comparisons of treatments at multiple time points

    DEFF Research Database (Denmark)

    Pallmann, Philip; Pretorius, Mias; Ritz, Christian

    2017-01-01

    hypotheses as well as a global test decision. We compare via simulation the powers of multiple contrast tests based on a joint model and multiple marginal models, respectively, and quantify the benefit of incorporating longitudinal correlation, i.e. the advantage over Bonferroni. Practical application...

  6. Comparing Part-time Employment in Germany, Sweden, Ireland and the Netherland

    DEFF Research Database (Denmark)

    Bekker, Sonja; Hipp, Lena; Leschke, Janine

    2017-01-01

    and the Netherlands in 2014 using individual level data from the European Labour Force Survey, we show that for men a lower earning capacity compared to their partner or family responsibilities do not seem to lead to higher part-time shares. This is the opposite of what we find for women. According to our analysis...... to the traditional model of gendered distribution of wage and household work. In our analysis, Ireland also conforms to this pattern but to a somewhat lesser degree – there seems to be an important economic factor in Irish part-time work. The differences we find may be attributed to the welfare state regimes...

  7. Comparative study of four radiofrequency generators for the treatment of snoring.

    Science.gov (United States)

    Blumen, Marc B; Chalumeau, Frédéric; Gauthier, Anne; Bobin, Serge; Coste, André; Chabolle, Frédéric

    2008-03-01

    To compare the efficacy and safety of four radiofrequency generators (Ellman, Select Sutter, Coblator, Somnus) for the treatment of simple snoring. Multicenter, randomized, prospective single-blind study on 120 selected patients with simple snoring (apnea/hypopnea index Snoring sound intensity was measured on a visual analog scale and the partner's short-term satisfaction rate was evaluated after two treatment sessions maximum. Discomfort, pain, and medication intake were compared. Radiofrequency decreased the snoring sound intensity from 7.9 +/- 1.7 to 4.4 +/- 2.7 (P < 0.0001). The four radiofrequency generators had a statistically comparable efficacy. The Ellman generator caused less discomfort and required less anti-inflammatory drugs. Despite different technical characteristics, the four generators had a comparable efficacy with good safety. The Ellman generator induced the least discomfort.

  8. Aripiprazole Lauroxil Compared with Paliperidone Palmitate in Patients with Schizophrenia: An Indirect Treatment Comparison.

    Science.gov (United States)

    Cameron, Chris; Zummo, Jacqueline; Desai, Dharmik N; Drake, Christine; Hutton, Brian; Kotb, Ahmed; Weiden, Peter J

    Aripiprazole lauroxil (AL) is a long-acting injectable atypical antipsychotic recently approved for treatment of schizophrenia on the basis of a large-scale trial of two doses of AL versus placebo. There are no direct-comparison studies with paliperidone palmitate (PP; long-acting antipsychotic used most often in acute settings) for the acute psychotic episode. To indirectly compare efficacy and safety of the pivotal AL study with all PP studies meeting indirect comparison criteria. Systematic searches of MEDLINE, Embase, Cochrane CENTRAL, PsycINFO, ClinicalTrials.gov, International Clinical Trials Registry Platform, and gray literature were performed to identify randomized controlled trials of PP with similar designs to the AL trial. Bayesian network meta-analysis compared treatments with respect to symptom response and tolerability issues including weight gain, akathisia, parkinsonism, and likelihood of treatment-emergent adverse events. Three appropriate PP studies were identified for indirect comparison. Both doses of AL (441 mg and 882 mg monthly) were used and compared with two efficacious doses of PP (156 mg and 234 mg monthly). All four active-treatment conditions were associated with comparable reductions in acute symptoms (Positive and Negative Syndrome Scale) versus placebo and were of similar magnitude (range of mean difference -8.12 to -12.01, with overlapping 95% credible intervals). Between-group comparisons of active-treatment arms were associated with summary estimates of magnitude near 0. No clinically meaningful differences in selected safety or tolerability parameter incidence were found between active treatments. These results suggest that both AL and PP are effective for treatment of adults experiencing acute exacerbation of schizophrenia. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  9. A comparative study of cancer patients with short and long sick-leave after primary treatment.

    Science.gov (United States)

    Gudbergsson, Saevar Berg; Torp, Steffen; Fløtten, Tone; Fosså, Sophie D; Nielsen, Roy; Dahl, Alv A

    2011-04-01

    Sick-leave after primary cancer treatment has hardly been studied. This study compares Norwegian cancer patients (CPs) with shorter (≤8 months) and longer (≥9 months) sick-leave after primary cancer treatment. Our aim was to characterize factors associated with these two types of sick-leave in order to identify possible factors for interventions by which long-term sick-leaves may be avoided. A mailed questionnaire was completed by a sample of Norwegian CPs 15 to 39 months after primary treatment of the ten most common invasive types of cancer. The groups with shorter (n=359) and longer (n=481) sick-leaves (SSL vs LSL) were compared with each other by self-reported information as to socio-demographic and cancer-related variables, health, quality of life, work ability, work situation and supportive interventions. The LSL consisted of 78% females, and 76% of them had breast or gynaecological cancer. A higher proportion of patients with low level of education, economical problems, treated with chemotherapy, hormones and multimodal treatment belonged to LSL compared to SSL. Significantly more LSL had recurrences of cancer, co-morbidity, regular use of medication, and poorer self-rated health, quality of life and work ability. Compared to SSL, more LSL reported needs for and offers of supportive care such as physiotherapy, physical activities and psychosocial support. A multivariate regression analysis showed that reduced work ability, changes in employment due to cancer, lack of support from supervisors at work, and having had combined treatment were significantly associated with being LSL. Longer sick-leave after primary cancer treatment is associated with combined cancer treatment, lack of support from supervisors and reduced overall work ability. Interventions and counselling related to the work place and reduced work ability could be of value for prevention of long-term sick-leaves.

  10. Apparent mineralocorticoid excess: time of manifestation and complications despite treatment.

    Science.gov (United States)

    Knops, Noël B B; Monnens, Leo A; Lenders, Jacques W; Levtchenko, Elena N

    2011-06-01

    Here we describe the case of a patient followed from birth because of a positive family history for apparent mineralocorticoid excess (AME) in an older brother. The patient, a girl, had normal serum electrolyte and blood pressure measurements in the first months after birth. Not until the age of 11 months did she develop anorexia and failure to thrive in combination with hypertension, hypokalemia, and metabolic alkalosis, which are consistent with the diagnosis of AME. This diagnosis was confirmed by mutation analysis of the HSD11B2 gene (C1228T). Treatment with amiloride and furosemide electrolyte disturbances normalized her blood pressure. At the age of 19 years she unexpectedly suffered a stroke. Additional investigations revealed no accepted risk factor for stroke. We discuss the possible underlying mechanisms for the delayed manifestation of hypertension and electrolyte disturbances in AME, propose an additional explanation for the stroke in this patient, and advise treatment with a mineralocorticoid receptor antagonist to reduce stroke risk in patients with AME.

  11. Time to treatment with intravenous alteplase and outcome in stroke

    DEFF Research Database (Denmark)

    Lees, Kennedy R; Bluhmki, Erich; von Kummer, Rüdiger

    2010-01-01

    BACKGROUND: Early administration of intravenous recombinant tissue plasminogen activator (rt-PA) after ischaemic stroke improves outcome. Previous analysis of combined data from individual patients suggested potential benefit beyond 3 h from stroke onset. We re-examined the effect of time to trea...

  12. UK Infantile Spasms Study: Effect of Time to Treatment and Age at Onset on Developmental Outcome

    OpenAIRE

    J Gordon Millichap

    2011-01-01

    The effects of lead time to treatment (time from onset of spasms to start of treatment), age at onset of spasms, etiology, and treatment on developmental outcome at 4 years were investigated using multiple linear regression in 77 infants with spasms treated in the UK Infantile Spasms Study (UKISS).

  13. Comparison of surgical treatment with direct repair versus conservative treatment in young patients with spondylolysis: a prospective, comparative, clinical trial.

    Science.gov (United States)

    Lee, Gun Woo; Lee, Sun-Mi; Ahn, Myun-Whan; Kim, Ho-Joong; Yeom, Jin S

    2015-07-01

    Although direct repair (DR) with screw fixation at the pars defect is a common surgical treatment for lumbar spondylolysis, it is unknown whether DR leads to better outcomes for young patients with spondylolysis than traditional nonsurgical treatment. The purpose of the study was to investigate whether DR was associated with better outcomes for lumbar spondylolysis in young patients than traditional conservative treatment. This is a prospective cohort study. Of 1,784 patients with low back pain in the reference period, 149 young patients with spondylolysis who followed up for at least 1 year were enrolled in the study. The primary outcome was pain intensity at the lower back measured with a Visual Analog Scale. Secondary outcomes included the functional outcome as measured with the Oswestry disability index (ODI) and the 12-item short-form health survey (SF-12) consisting of the physical component summary (PCS) and mental component summary (MCS) scores, the radiologic outcome as measured with lumbar spine radiographs and computed tomography scans, and complications of treatment. This was a prospective comparative study between two groups of patients who were treated with either conservative treatment or surgery for lumbar spondylolysis. Enrolled patients self-selected their own treatment and were allocated to either the traditional care group with conservative treatment (87 patients) or the surgery group (62 patients). All patients were followed up for at least 1 year. Pain intensity at the lower back did not differ significantly between groups at the final follow-up. Likewise, the ODI and SF-12 (PCS and MCS) scores did not differ significantly between groups (p=.13, .71, and .68, respectively). The change in the gap distance of the pars defect at the final follow-up was significantly different between groups (traditional care group: +0.8±0.4 mm; surgery group: -0.7±0.5; p=.01). The union rate at 1 year after surgical treatment was 52% (32/61). The rate of

  14. Online deliberation and beyond? A time-based and comparative study of Danish political debates online

    Directory of Open Access Journals (Sweden)

    Jakob Linaa Jensen

    2014-04-01

    Full Text Available This article discusses online political debates in Denmark over a time period from 2001 to 2011 and compares three different online debates in 2011. By taking a time-based as well as a comparative perspective, it examines whether online debates have come closer to deliberative ideals of democracy and how online debates differ in form and content. The article particularly addresses the interplay between everyday and political discussions. It is demonstrated that shifts between the two forms of discussion often happen abruptly and that even people who tend not to become involved politically in a formal sense happily discuss politics in more informal, non-political settings. Furthermore, the article expands our understanding of demographic differences in political participation in debates online. All this helps enhance and broaden our concept of democracy in an online setting. 

  15. Comparative Antianaerobic Activities of Doripenem Determined by MIC and Time-Kill Analysis▿

    Science.gov (United States)

    Credito, Kim L.; Ednie, Lois M.; Appelbaum, Peter C.

    2008-01-01

    Against 447 anaerobe strains, the investigational carbapenem doripenem had an MIC50 of 0.125 μg/ml and an MIC90 of 1 μg/ml. Results were similar to those for imipenem, meropenem, and ertapenem. Time-kill studies showed that doripenem had very good bactericidal activity compared to other carbapenems, with 99.9% killing of 11 strains at 2× MIC after 48 h. PMID:17938185

  16. Comparative antianaerobic activities of doripenem determined by MIC and time-kill analysis.

    Science.gov (United States)

    Credito, Kim L; Ednie, Lois M; Appelbaum, Peter C

    2008-01-01

    Against 447 anaerobe strains, the investigational carbapenem doripenem had an MIC 50 of 0.125 microg/ml and an MIC 90 of 1 microg/ml. Results were similar to those for imipenem, meropenem, and ertapenem. Time-kill studies showed that doripenem had very good bactericidal activity compared to other carbapenems, with 99.9% killing of 11 strains at 2x MIC after 48 h.

  17. Power comparator for continuous-time adaptive equalization in Ethernet-based instrumentation

    Science.gov (United States)

    Guerrero, E.; Gimeno, C.; Sánchez-Azqueta, C.; Celma, S.

    2014-08-01

    Recently, Ethernet has been chosen as a replacement for standard-based instrumentation. Its performance is increasing, thanks to speeds of 1 Gbps, 10 Gbps and beyond on backplanes, which expands the instrumentation and measurement potential. However, these high-speed serial links need to be able to retain the integrity of the data stream through some type of equalization. This paper proposes a new differential power comparator, to be used in continuous-time adaptive equalizers inside these Ethernet-based instruments.

  18. Prospective randomized comparative study of bipolar versus direct current electrocoagulation for treatment of bleeding internal hemorrhoids.

    Science.gov (United States)

    Randall, G M; Jensen, D M; Machicado, G A; Hirabayashi, K; Jensen, M E; You, S; Pelayo, E

    1994-01-01

    Internal hemorrhoids are the most common cause of lower gastrointestinal bleeding. Although new anoscopic therapies are available, few comparative randomized studies have evaluated them in regard to long-term efficacy, recurrence rates, and safety. Our purpose was to compare the treatment of internal hemorrhoids with direct current (Ultroid, Cabot Medical, Langhorn, Pa.) and bipolar (BICAP, Circon ACMI, Stamford, Conn.) hemorrhoid probes. One hundred patients with symptomatic internal hemorrhoids were randomized: 50 to direct current electrocoagulation and 50 to bipolar electrocoagulation. Follow-up and treatment were at 3- to 4-weekly intervals; two to three hemorrhoid segments were treated at each session until relief of symptoms (bleeding, prolapse, and discharge) and a reduction in hemorrhoid size to grade 1 or 0 were noted. The hemorrhoids of 98% of all patients studied were grade 2 or 3; 2% of patients had grade 1 hemorrhoids and none had grade 4 hemorrhoids. At 1 year after treatment, most patients had no (69%) or only mild (23%) recurrence, and a few had severe, symptomatic (8%) hemorrhoid recurrence. A greater recurrence rate was noted after direct current treatment (34%) than bipolar treatment (29%). In contrast, rebleeding at 1 year occurred less frequently after direct current treatment (5%) than after bipolar treatment (20%). Our conclusions were as follows: (1) Both direct current and bipolar probes were effective for control of chronic bleeding from grade 1 to 3 internal hemorrhoids. (2) Bipolar probe was significantly faster than direct current probe. (3) Direct current treatment produced fewer complications than bipolar treatment (12% versus 14%). (4) Recurrence rates were low after 1 year with either device (8%).(ABSTRACT TRUNCATED AT 250 WORDS)

  19. COMPAR

    International Nuclear Information System (INIS)

    Kuefner, K.

    1976-01-01

    COMPAR works on FORTRAN arrays with four indices: A = A(i,j,k,l) where, for each fixed k 0 ,l 0 , only the 'plane' [A(i,j,k 0 ,l 0 ), i = 1, isub(max), j = 1, jsub(max)] is held in fast memory. Given two arrays A, B of this type COMPAR has the capability to 1) re-norm A and B ind different ways; 2) calculate the deviations epsilon defined as epsilon(i,j,k,l): =[A(i,j,k,l) - B(i,j,k,l)] / GEW(i,j,k,l) where GEW (i,j,k,l) may be chosen in three different ways; 3) calculate mean, standard deviation and maximum in the array epsilon (by several intermediate stages); 4) determine traverses in the array epsilon; 5) plot these traverses by a printer; 6) simplify plots of these traverses by the PLOTEASY-system by creating input data blocks for this system. The main application of COMPAR is given (so far) by the comparison of two- and three-dimensional multigroup neutron flux-fields. (orig.) [de

  20. Comparative study on direct and indirect bracket bonding techniques regarding time length and bracket detachment

    Directory of Open Access Journals (Sweden)

    Jefferson Vinicius Bozelli

    2013-12-01

    Full Text Available OBJECTIVE: The aim of this study was to assess the time spent for direct (DBB - direct bracket bonding and indirect (IBB - indirect bracket bonding bracket bonding techniques. The time length of laboratorial (IBB and clinical steps (DBB and IBB as well as the prevalence of loose bracket after a 24-week follow-up were evaluated. METHODS: Seventeen patients (7 men and 10 women with a mean age of 21 years, requiring orthodontic treatment were selected for this study. A total of 304 brackets were used (151 DBB and 153 IBB. The same bracket type and bonding material were used in both groups. Data were submitted to statistical analysis by Wilcoxon non-parametric test at 5% level of significance. RESULTS: Considering the total time length, the IBB technique was more time-consuming than the DBB (p < 0.001. However, considering only the clinical phase, the IBB took less time than the DBB (p < 0.001. There was no significant difference (p = 0.910 for the time spent during laboratorial positioning of the brackets and clinical session for IBB in comparison to the clinical procedure for DBB. Additionally, no difference was found as for the prevalence of loose bracket between both groups. CONCLUSION: the IBB can be suggested as a valid clinical procedure since the clinical session was faster and the total time spent for laboratorial positioning of the brackets and clinical procedure was similar to that of DBB. In addition, both approaches resulted in similar frequency of loose bracket.

  1. Effectiveness of Mindfulness-Based Group Therapy Compared to the Usual Opioid Dependence Treatment

    Directory of Open Access Journals (Sweden)

    Saeed Imani

    2015-11-01

    Full Text Available  Objective: This study investigated the effectiveness of mindfulness-based group therapy (MBGT compared to the usual opioid dependence treatment (TAU.Thirty outpatients meeting the DSM-IV-TR criteria for opioid dependence from Iranian National Center for Addiction Studies (INCAS were randomly assigned into experimental (Mindfulness-Based Group Therapy and control groups (the Usual Treatment.The experimental group undertook eight weeks of intervention, but the control group received the usual treatment according to the INCAS program.  Methods:The Five Factor Mindfulness Questionnaire (FFMQ and the Addiction Sevier Index (ASI were administered at pre-treatment and post-treatment assessment periods. Thirteen patients from the experimental group and 15 from the control group completed post-test assessments. Results:The results of MANCOVA revealed an increase in mean scores in observing, describing, acting with awareness, non-judging, non-reacting, and decrease in mean scores of alcohol and opium in MBGT patient group. Conclusion:The effectiveness of MBGT, compared to the usual treatment, was discussed in this paper as a selective protocol in the health care setting for substance use disorders.

  2. Comparative study of muscle strengthening exercises for treatment of chronic low backache

    Directory of Open Access Journals (Sweden)

    Soumya Ghosh

    2014-01-01

    Full Text Available Background: Low back pain is a major cause of musculoskeletal disability worldwide. Objectives: To study the outcomes of different muscle strengthening exercises in treatment of low back pain Materials and Methods: One hundred and twenty patients in the age group of 20-40 years with mechanical low back pain were randomly divided intotwo groups and instructed to perform two different types of exercises for three months (Mckenzie exercise andSwiss ball exercise. Patients were assessed by Visual Analogue Scale (VAS, Modified Schober Test (MST for extension and Oswestry Disability Index (ODI, based on pain intensity levels, range of motion, functional disability before starting the exercise programmes and after 3 months of intervention. Results were analysed using Students T Test. Results: There was no significant difference in the pre-treatment session between the two groups. VAS and ODI Values were significantly lower in post-treatment sessions as compared to pre-treatment values in both Groups but MST Values in post-treatment sessions in Group practicing Mckenzie exercise showed significant decreases. Significant decrease in VAS, MST and ODI Valueswere found in subjects practising McKenzie exercise when comparison was done between the two groups after 3 months of treatment. Conclusion: McKenzie exercise and Swissball exercise in patients with mechanical Low back pain reduce pain intensity, increaserange of movementand decrease functional disability. McKenzie exercise seems to have higher efficacy as compared to Swissball exercise.

  3. Comparative evaluation of oxycort ointment and Peruvian balm in the treatment of radiation skin injuries

    International Nuclear Information System (INIS)

    Nikulin, A.A.; Krylova, E.A.

    1980-01-01

    A comparison of regeneration effect of Peruvian balm and oxycort ointment is made in experiments on 192 white rats on the model of radiation skin ulcers. Found is a pronounced regenerating and bactericidal action of balm, i.e. the curing time has been reduced greatly (up to 26-30 days against 60 day in control), and tissue respiration increased several times in comparison with the oxycort ointment treatment

  4. Treatment Gain for Sexual Offenders against Children Predicts Reduced Recidivism: A Comparative Validity Study

    Science.gov (United States)

    Beggs, Sarah M.; Grace, Randolph C.

    2011-01-01

    Objective: To determine whether pro-social treatment change in sexual offenders would predict reductions in recidivism beyond static and dynamic risk factors measured at pretreatment and whether different methods for assessing change based on self-reports and structured clinical rating systems would show convergent validity. Method: We compared 3…

  5. Comparative transcriptomic and metabolomic analysis of fenofibrate and fish oil treatments in mice

    NARCIS (Netherlands)

    Lu, Y.; Boekschoten, M.V.; Wopereis, S.; Müller, M.; Kersten, S.

    2011-01-01

    Comparative transcriptomic and metabolomic analysis of fenofibrate and fish oil treatments in mice. Physiol Genomics 43: 1307-1318, 2011. First published September 27, 2011; doi:10.1152/physiolgenomics.00100.2011. Elevated circulating triglycerides, which are considered a risk factor for

  6. A randomized trial comparing levothyroxine with radioactive iodine in the treatment of sporadic nontoxic goiter

    NARCIS (Netherlands)

    Wesche, M. F.; Tiel-V Buul, M. M.; Lips, P.; Smits, N. J.; Wiersinga, W. M.

    2001-01-01

    A randomized clinical trial was performed in consecutive patients with sporadic nontoxic nodular goiter to compare efficacy and side effects of iodine-131 ((131)I) therapy with suppressive levothyroxine (L-thyroxine) treatment. Sixty-four patients were randomized after stratification for sex and

  7. Delinquency and Crime Prevention: Overview of Research Comparing Treatment Foster Care and Group Care

    Science.gov (United States)

    Osei, Gershon K.; Gorey, Kevin M.; Jozefowicz, Debra M. Hernandez

    2016-01-01

    Background: Evidence of treatment foster care (TFC) and group care's (GC) potential to prevent delinquency and crime has been developing. Objectives: We clarified the state of comparative knowledge with a historical overview. Then we explored the hypothesis that smaller, probably better resourced group homes with smaller staff/resident ratios have…

  8. Comparing Cognitive Behavior Therapy, Problem Solving Therapy, and Treatment as Usual in a High Risk Population

    Science.gov (United States)

    Stewart, Carment D.; Quinn, Andrea; Plever, Sally; Emmerson, Brett

    2009-01-01

    Cognitive behavior therapy (CBT), problem-solving therapy (PST), or treatment as usual (TAU) were compared in the management of suicide attempters. Participants completed the Beck Hopelessness Scale, Beck Scale for Suicidal Ideation, Social Problem-Solving Inventory, and Client Satisfaction Questionnaire at pre- and posttreatment. Both CBT and PST…

  9. A Comparative Study of Quinine and Artemether in the Treatment of ...

    African Journals Online (AJOL)

    Abstract. Purpose: Nigeria has adopted quinine as the drug of first choice in the treatment of severe malaria and artemether as an alternative therapy. The purpose of this study was to ascertain whether artemether is a comparable alternative to quinine in the management of severe malaria in Nigerian children. Methods: We ...

  10. The social experiences of cancer patients under treatment: a comparative study

    NARCIS (Netherlands)

    Tempelaar, R.; de Haes, J. C.; de Ruiter, J. H.; Bakker, D.; van den Heuvel, W. J.; van Nieuwenhuijzen, M. G.

    1989-01-01

    As part of a larger study on the quality of life of cancer patients under treatment, the positive and negative experiences in social interaction have been examined as compared to those of a control group (nonpatients, n = 201). Two patient groups were included: 109 patients who had recently

  11. Comparative transcriptomic and metabolomic analysis of fenofibrate and fish oil treatments in mice

    NARCIS (Netherlands)

    Lu, Y.; Boekschoten, M.V.; Wopereis, S.; Muller, M.R.; Kersten, A.H.

    2011-01-01

    Elevated circulating triglycerides, which are considered a risk factor for cardiovascular disease, can be targeted by treatment with fenofibrate or fish oil. To gain insight into underlying mechanisms, we carried out a comparative transcriptomics and metabolomics analysis of the effect of 2 wk

  12. Comparative transcriptomics and metabolomic analysis of fenofibrate and fish oil treatments in mice

    NARCIS (Netherlands)

    Lu Yingchang (Kevin), Y.; Boekschoten, Mark; Wopereis, Suzan; Muller, Michael; Kersten, Sander

    2011-01-01

    Elevated circulating triglycerides, which are considered a risk factor for cardiovascular disease, can be targeted by treatment with fenofibrate or fish oil. To gain insight into underlying mechanisms, we carried out a comparative transcriptomics and metabolomics analysis of the effect of 2 week

  13. Comparative study on seismic calculation method between response spectrum and time history analysis

    International Nuclear Information System (INIS)

    Zhang Qinghong; Jin Ting; Shang Ertao

    2013-01-01

    Background: For the nuclear power plant main component under design phase, the anti-seismic capability analysis should be evaluation used response spectrum analysis or time history analysis usually. Purpose: This paper attempts to get the non-linear influence because of gaps. Methods: Based on ANSYS FEM software, get the CRDM seismic result used improve spectrum analysis, which compare with the time history analysis. Results: The bending moments and shear force on each sections of CRDM housing was showed in this paper. Conclusions: The result shows that the improve spectrum analysis can get the structure dynamic characteristics, the calculation results between the improve spectrum analysis and the time history analysis consistent, it can provide guidance on the subsequent equipment design. (authors)

  14. A pragmatic analysis comparing once-monthly paliperidone palmitate versus daily oral antipsychotic treatment in patients with schizophrenia.

    Science.gov (United States)

    Alphs, Larry; Mao, Lian; Lynn Starr, H; Benson, Carmela

    2016-02-01

    Persons with schizophrenia often come in contact with the criminal justice system (CJS). This analysis of subjects with schizophrenia and a history of contact with the CJS estimated and compared mean cumulative function (MCF) of treatment failure events when treated with paliperidone palmitate (PP) or oral antipsychotics (OAs). All events identified during the full study period of the Paliperidone Palmitate Research in Demonstrating Effectiveness (PRIDE) trial were evaluated. Subjects were randomly assigned to flexibly dosed, monthly, injectable PP (78-234 mg) or daily OA in a 15-month prospective, open-label, multicenter US study (May 5, 2010-December 9, 2013). Subjects could continue participation after a treatment failure event. Multiple treatment failures in individual subjects were analyzed as recurrent events. Analyses estimated MCF of treatment failure events and MCF of institutionalizations (arrests, incarcerations, or psychiatric hospitalizations) during the 15-month study period. The ITT population included 226 (PP) and 218 (OA) subjects, of whom 41.2% and 40.4%, respectively, completed 15 months of follow-up. The MCF of treatment failures and institutionalizations differed significantly in favor of PP compared with OA (P=0.007 and P=0.005, respectively). Overall, TEAEs were reported by 86.3% of subjects in the PP group and 81.7% in the OA group. This pragmatic analysis suggests that, compared with OA, PP is not only more effective in delaying median time to treatment failure, but it also reduces the number of treatment failures and institutionalizations per person-year follow-up. Clinicaltrials.gov identifier: NCT01157351. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  15. Comparing clinical effects of photodynamic therapy as a novel method with topical corticosteroid for treatment of Oral Lichen Planus.

    Science.gov (United States)

    Bakhtiari, Sedigheh; Azari-Marhabi, Saranaz; Mojahedi, Seyyed Masoud; Namdari, Mahshid; Rankohi, Zahra Elmi; Jafari, Soudeh

    2017-12-01

    Oral lichen planus is an autoimmune disorder with several challenges in treatment. Photodynamic therapy has been proposed as a new treatment option for the disease. The present study compared the clinical effects of photodynamic therapy to dexamethasone mouthwash in the treatment of oral lichen planus lesions. In this randomized clinical trial, 30 patients with oral lichen planus were included.15 patients were treated with 5% methylene blue mediated photodynamic therapy using Fotosan device for 30s (630nm wavelength and 7.2-14.4J/cm 2 dose) for 4 sessions in the days 1, 4, 7, 14. In another group, the treatment was done on 15 patients by 0.5mg tab dexamethasone solution in 5cc water, rinsed 4 times in a day within two weeks. The sign score, symptoms scores (pain), clinical severity and treatment efficacy were measured at the days 15, 30, 60, 90 after beginning of the treatment. The results were subjected to Mann-whitney U test in both groups. No significant difference existed between the two modalities regarding the treatment efficacy index, sign score, symptom score and clinical severity on the 15, 30, 60 and 90 post-treatment days. Decreases in patient's symptoms were statistically significant in both groups. Photodynamic therapy was as effective as the dexamethasone mouth wash in the treatment of oral lichen planus. It could be used as a safe modality in the treatment of oral lichen planus lesions without identified side effects. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Time-to-Furosemide Treatment and Mortality in Patients Hospitalized With Acute Heart Failure

    NARCIS (Netherlands)

    Matsue, Yuya; Damman, Kevin; Voors, Adriaan A.; Kagiyama, Nobuyuki; Yamaguchi, Tetsuo; Kuroda, Shunsuke; Okumura, Takahiro; Kida, Keisuke; Mizuno, Atsushi; Oishi, Shogo; Inuzuka, Yasutaka; Akiyama, Eiichi; Matsukawa, Ryuichi; Kato, Kota; Suzuki, Satoshi; Naruke, Takashi; Yoshioka, Kenji; Miyoshi, Tatsuya; Baba, Yuichi; Yamamoto, Masayoshi; Murai, Koji; Mizutani, Kazuo; Yoshida, Kazuki; Kitai, Takeshi

    2017-01-01

    BACKGROUND Acute heart failure (AHF) is a life-threatening disease requiring urgent treatment, including a recommendation for immediate initiation of loop diuretics. OBJECTIVES The authors prospectively evaluated the association between time-to-diuretic treatment and clinical outcome. METHODS

  17. Comparative effects of gamma irradiation and ozone treatment on hygienic quality of Korean red ginseng powder

    Energy Technology Data Exchange (ETDEWEB)

    Byun, Myung-Woo; Yook, Hong-Sun; Kang, Il-Jun; Chung, Cha-Kwon; Kwon, Joong-Ho; Choi, Kang-Ju

    1998-06-01

    For the purpose of improving hygienic quality of Korean red ginseng powder, the comparative effects of gamma irradiation and ozone treatment on the microbial and physicochemical properties were investigated. Gamma irradiation at 7.5 kGy resulted in sterilization of total aerobic bacteria, molds and coliforms below detective levels, while ozone treatment for 8 hours up to 18 ppm did not sufficiently eliminate the microorganisms of the red ginseng powder. Physicochemical properties including compositions of the red ginseng saponin (ginsenosides) and fatty acids, pH and hydrogen donating activity were not significantly changed by gamma irradiation, whereas, ozone treatment caused significant changes in fatty acid compositions, TBA value, pH, acidity and hydrogen donating activity. The results from this study led us to conclude that gamma irradiation was more effective than ozone treatment both for the improvement of hygienic quality and for the maintenance of physicochemical quality of red ginseng powder.

  18. Comparative life cycle assessment of wastewater treatment in Denmark including sensitivity and uncertainty analysis

    DEFF Research Database (Denmark)

    Niero, Monia; Pizzol, Massimo; Gundorph Bruun, Henrik

    2014-01-01

    in a comparative LCA of four types of WWTPs, representative of mainstream treatment options in Denmark. The four plant types differ regarding size and treatment technology: aerobic versus anaerobic, chemical vs. combined chemical and biological. Trade-offs in their environmental performance were identified......Wastewater treatment has nowadays multiple functions and produces both clean effluents and sludge, which is increasingly seen as a resource rather than a waste product. Technological as well as management choices influence the performance of wastewater treatment plants (WWTPs) on the multiple...... considering system expansion to model the avoided impacts achievable in different end-of-life scenarios for sludge: combustion with energy production versus agricultural application. To account for the variability in quality of effluents and sludge, and to address the related uncertainties, Monte Carlo...

  19. Increased risk of treatment with antidepressants in stroke compared with other chronic illness

    DEFF Research Database (Denmark)

    Dam, Henrik; Harhoff, Mette; Andersen, Per Kragh

    2007-01-01

    The prevalence of depression and anxiety is higher in patients with stroke than in the general population but it is unclear whether patients with stroke are at an increased risk of being treated for depression and anxiety compared with patients with other chronic illness. The objective...... of the present study was to investigate whether the rate of treatment with antidepressants is increased in patients with stroke compared with patients with other chronic illness and compared with the general population. By linkage of nationwide case registers, all patients who received a main diagnosis of stroke...

  20. Structural analysis of the phimotic prepuce in patients with failed topical treatment compared with untreated phimosis

    Directory of Open Access Journals (Sweden)

    Luciano Alves Favorito

    2012-12-01

    Full Text Available Objectives To evaluate histological alterations in prepuce of patients with phimosis submitted to topic treatment with betamethasone in association with hyaluronidase. Materials and Methods We studied sixty patients (mean age 4.5, presenting true phimosis and treated with a topical treatment with betamethasone cream (0.2% + hyaluronidase. The parents of seven of these patients opted for circumcision (control group. The other fifty-three patients were submitted to clinical treatment. The samples were stained with Weigert's resorcin-fuchsin (analysis of the elastic fibers and Picro-Sirius Red, for analysis of the collagen. The volumetric density of the elastic fibers was determined by stereological methods. Results Only eight (15% of the fifty-three patients submitted to topical treatment presented failure, being indicated for circumcision (histological analysis. We observed an increase of the collagen type III of the patients submitted to topical treatment. The quantification showed a reduction of the volumetric density of the prepuce's elastic fibers of the patients submitted to the cream treatment, when compared to the control group (p = 0.056. The volumetric density of the elastic fibers of the prepuce at the group not submitted to topical treatment showed an average of 14.60% (11.06 to 21.64%; in the group submitted to the cream treatment, the volumetric density of the elastic fibers of the prepuce showed an average of 10.34% (3.45 to 17.9%. Conclusion The topical treatment of phimosis with betamethasone 0.2% + hyaluronidase had a success rate of 85%. Patients with failure of the topical treatment with steroid had histological alterations in the prepuce.

  1. Treatment of serious urological infections with cefotaxime compared to ampicillin plus netilmicin

    DEFF Research Database (Denmark)

    Rasmussen, D; Bremmelgaard, A; Rasmussen, F

    1986-01-01

    of cefotaxime against the isolates from blood were low for all bacterial strains except one (Streptococcus faecalis). Time to normalisation of temperature was significantly shorter in the cefotaxime group. The results suggest that cefotaxime is an effective and well-tolerated agent in the treatment of serious...

  2. Evaluation of pre-hospital transport time of stroke patients to thrombolytic treatment

    DEFF Research Database (Denmark)

    Simonsen, Sofie; Andresen, Morten; Michelsen, Lene

    2014-01-01

    BackgroundEffective treatment of stroke is time dependent. Pre-hospital management is an important link in reducing the time from occurrence of stroke symptoms to effective treatment. The aim of this study was to evaluate time used by emergency medical services (EMS) for stroke patients during...

  3. Socio-cultural determinants of timely and delayed treatment of Buruli ulcer: Implications for disease control.

    Science.gov (United States)

    Ackumey, Mercy M; Gyapong, Margaret; Pappoe, Matilda; Maclean, Cynthia Kwakye; Weiss, Mitchell G

    2012-10-25

    Public health programmes recommend timely medical treatment for Buruli ulcer (BU) infection to prevent pre-ulcer conditions from progressing to ulcers, to minimise surgery, disabilities and the socio-economic impact of BU. Clarifying the role of socio-cultural determinants of timely medical treatment may assist in guiding public health programmes to improve treatment outcomes. This study clarified the role of socio-cultural determinants and health system factors affecting timely medical treatment for BU in an endemic area in Ghana. A semi-structured explanatory model interview based on the explanatory model interview catalogue (EMIC) was administered to 178 BU-affected persons. Based on research evidence, respondents were classified as timely treatment (use of medical treatment 3 months from awareness of disease) and delayed treatment (medical treatment 3 months after onset of disease and failure to use medical treatment). The outcome variable, timely treatment was analysed with cultural epidemiological variables for categories of distress, perceived causes of BU, outside-help and reasons for medical treatment in logistic regression models. The median time for the onset of symptoms to treatment was computed in days. Qualitative phenomenological analysis of respondents' narratives clarified the meaning, context and dynamic features of the relationship of explanatory variables with timely medical treatment. The median time for initiating treatment was 25 days for pre-ulcers, and 204 days for ulcers. Income loss and use of herbalists showed significantly negative associations with timely treatment. Respondents' use of herbalists was often motivated by the desire for quick recovery in order to continue with work and because herbalists were relatives and easily accessible. However, drinking unclean water was significantly associated with timely treatment and access to health services encouraged timely treatment (OR 8.5, p = 0.012). Findings show that health system

  4. Integrating tobacco treatment into cancer care: Study protocol for a randomized controlled comparative effectiveness trial.

    Science.gov (United States)

    Park, Elyse R; Ostroff, Jamie S; Perez, Giselle K; Hyland, Kelly A; Rigotti, Nancy A; Borderud, Sarah; Regan, Susan; Muzikansky, Alona; Friedman, Emily R; Levy, Douglas E; Holland, Susan; Eusebio, Justin; Peterson, Lisa; Rabin, Julia; Miller-Sobel, Jacob; Gonzalez, Irina; Malloy, Laura; O'Brien, Maureen; de León-Sanchez, Suhana; Whitlock, C Will

    2016-09-01

    Despite the well-established risks of persistent smoking, 10-30% of cancer patients continue to smoke after diagnosis. Evidence-based tobacco treatment has yet to be integrated into routine oncology care. This paper describes the protocol, manualized treatment, evaluation plan, and overall study design of comparing the effectiveness and cost of two treatments across two major cancer centers. A two-arm, two-site randomized controlled comparative effectiveness trial is testing the hypothesis that an Intensive Treatment (IT) intervention is more effective than a Standard Treatment (ST) intervention in helping recently diagnosed cancer patients quit smoking. Both interventions include 4 weekly counseling sessions and FDA-approved smoking cessation medication advice. The IT includes an additional 4 biweekly and 3 monthly booster sessions as well as dispensal of the recommended FDA-approved smoking cessation medication at no cost. The trial is enrolling patients with suspected or newly diagnosed cancer who have smoked a cigarette in the past 30days. Participants are randomly assigned to receive the ST or IT condition. Tobacco cessation outcomes are assessed at 3 and 6months. The primary study outcome is 7-day point prevalence biochemically-validated tobacco abstinence. Secondary study outcomes include the incremental cost-effectiveness of the IT vs. ST. This trial will answer key questions about delivering tobacco treatment interventions to newly diagnosed cancer patients. If found to be efficacious and cost-effective, this treatment will serve as a model to be integrated into oncology care settings nation-wide, as we strive to improve treatment outcomes and quality of life for cancer patients. Copyright © 2016. Published by Elsevier Inc.

  5. Treatment of ulcerative compared to non-ulcerative interstitial cystitis with hyperbaric oxygen: a pilot study.

    Science.gov (United States)

    Wenzler, David L; Gulli, Farris; Cooney, Maureen; Chancellor, Michael B; Gilleran, Jason; Peters, Kenneth M

    2017-12-01

    The etiology of interstitial cystitis (IC) is often idiopathic but can be due to Hunner's ulcers. Hyperbaric oxygen (HBO) is used to treat ulcerative disease of the superficial skin. We hypothesized that HBO can treat ulcerative IC (UIC) but would be less efficacious for non-ulcerative IC (NIC). Patients with NIC and UIC enrolled in this study. Following informed consent, demographic information was collected. A visual analog pain scale and validated questionnaires were collected; each patient underwent cystoscopy prior to treatment. Each subject met with a hyperbaric specialist and after clearance underwent 30 treatments over 6 weeks. Adverse events were monitored. Patients repeated questionnaires, visual analog pain scale and global response assessment (GRA) immediately, 2 weeks, 3, 6 and 12 months after treatment. Patients also underwent cystoscopy 6 months after treatment. Differences before and after treatment were compared. Nine patients were recruited to this study. One was unable to participate, leaving two subjects with NIC and six with UIC. All patients completed HBO without adverse events. Three patients completed HBO but pursued other therapies 7, 8.5 and 11 months after treatment. On GRA, 83% of patients with UIC were improved. This treatment effect persisted, as 66% of UIC patients remained better at 6 months. In contrast, only one patient in the NIC group improved. Questionnaire scores improved in both groups. Pain scores improved by 2 points in the UIC group but worsened by 1.5 points in the NIC group. Two patients with ulcers resolved at 6-month cystoscopy. HBO appeared beneficial for both UIC and NIC. Data shows slightly better benefit in patients with UIC compared to NIC; both groups showed improvement. Given the small sample size, it is difficult to draw definitive conclusions from these data. Larger studies with randomization would be beneficial to show treatment effect.

  6. Diagnostic time in digital pathology: A comparative study on 400 cases

    Directory of Open Access Journals (Sweden)

    Aleksandar Vodovnik

    2016-01-01

    Full Text Available Background: Numerous validation studies in digital pathology confirmed its value as a diagnostic tool. However, a longer time to diagnosis than traditional microscopy has been seen as a significant barrier to the routine use of digital pathology. As a part of our validation study, we compared a digital and microscopic diagnostic time in the routine diagnostic setting. Materials and Methods: One senior staff pathologist reported 400 consecutive cases in histology, nongynecological, and fine needle aspiration cytology (20 sessions, 20 cases/session, over 4 weeks. Complex, difficult, and rare cases were excluded from the study to reduce the bias. A primary diagnosis was digital, followed by traditional microscopy, 6 months later, with only request forms available for both. Microscopic slides were scanned at ×20, digital images accessed through the fully integrated laboratory information management system (LIMS and viewed in the image viewer on double 23” displays. A median broadband speed was 299 Mbps. A diagnostic time was measured from the point slides were made available to the point diagnosis was made or additional investigations were deemed necessary, recorded independently in minutes/session and compared. Results: A digital diagnostic time was 1841 and microscopic 1956 min; digital being shorter than microscopic in 13 sessions. Four sessions with shorter microscopic diagnostic time included more cases requiring extensive use of magnifications over ×20. Diagnostic time was similar in three sessions. Conclusions: A diagnostic time in digital pathology can be shorter than traditional microscopy in the routine diagnostic setting, with adequate and stable network speeds, fully integrated LIMS and double displays as default parameters. This also related to better ergonomics, larger viewing field, and absence of physical slide handling, with effects on both diagnostic and nondiagnostic time. Differences with previous studies included a design

  7. Treatment of moderate to severe facial seborrheic dermatitis with itraconazole: an open non-comparative study.

    Science.gov (United States)

    Shemer, Avner; Kaplan, Baruch; Nathansohn, Nir; Grunwald, Marcelo H; Amichai, Boaz; Trau, Henri

    2008-06-01

    Seborrheic dermatitis is a common chronic disease. Malassezia yeasts have been implicated in the pathogenesis of this disease. Antifungal agents are known to be effective in the treatment of Malassezia yeast infections. To evaluate the efficacy of itraconazole in the treatment of mild to severe facial seborrheic dermatitis. Sixty patients with moderate to severe seborrheic dermatitis were evaluated in an open non-comparative study. Patients were treated with oral itraconazole, initially 200 mg/day for a week, followed by a maintenance therapy of a single dose of 200 mg every 2 weeks. Four clinical parameters (erythema, scaling, burning, itching) were assessed using a 0-3 score. Mycological evaluation determined the presence of Malassezia spores in the scales using a direct smear. At the end of the initial treatment significant improvement was reported in three clinical parameters: erythema, scaling, itching. Maintenance therapy led to only slight further improvement. Burning sensation was only mildly improved during the treatment. The quantity of Malassezia spores present in the direct smear decreased throughout the treatment period. No blood test abnormalities were found during the treatment. In this study initial treatment with itraconazole was beneficial in patients with moderate to severe seborrheic dermatitis.

  8. Human health tradeoffs in wellhead drinking water treatment: Comparing exposure reduction to embedded life cycle risks.

    Science.gov (United States)

    Gifford, Mac; Chester, Mikhail; Hristovski, Kiril; Westerhoff, Paul

    2018-01-01

    Treatment of drinking water decreases human health risks by reducing pollutants, but the required materials, chemicals, and energy emit pollutants and increase health risks. We explored human carcinogenic and non-carcinogenic disease tradeoffs of water treatment by comparing pollutant dose-response curves against life cycle burden using USEtox methodology. An illustrative wellhead sorbent groundwater treatment system removing hexavalent chromium or pentavalent arsenic serving 3200 people was studied. Reducing pollutant concentrations in drinking water from 20 μg L -1 to 10 μg L -1 avoided 37 potential cancer cases and 64 potential non-cancer disease cases. Human carcinogenicity embedded in treatment was 0.2-5.3 cases, and non-carcinogenic toxicity was 0.2-14.3 cases, depending on technology and degree of treatment. Embedded toxicity impacts from treating Cr(VI) using strong-base anion exchange were 90% of the toxicity impacts for treatment options requiring pH control. In scenarios where benefits exceeded burdens, tradeoffs still existed. Benefits are experienced by a local population but burdens are born externally where the materials and energy are produced, thus exporting the health risks. Even when burdens clearly exceeded benefits, cost considerations may still drive selecting a detrimental treatment level or technology. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Regulatory T cells predict the time to initial treatment in early stage chronic lymphocytic leukemia.

    Science.gov (United States)

    Weiss, Lukas; Melchardt, Thomas; Egle, Alexander; Grabmer, Christoph; Greil, Richard; Tinhofer, Inge

    2011-05-15

    Early stage chronic lymphocytic leukemia is characterized by a highly variable course of disease. Because it is believed that regulatory T cells (T(regs) ) are potent suppressors of antitumor immunity, the authors hypothesized that increased T(regs) may favor disease progression. T(reg) levels (cluster of differentiation 3 [CD3]-positive, [CD4]-positive, CD25-positive, and CD127-negative) in peripheral blood from 102 patients were analyzed by flow cytometry. Statistical analysis was used to evaluate correlations with clinical data. The relative T(reg) numbers in CD4-positive T cells were significantly greater in patients with chronic lymphocytic leukemia compared with the numbers in a control group of 170 healthy individuals (P = .001). Patients were divided into 2 groups using a median T(reg) value of 9.7% (the percentage of CD4-positive T cells). Patients with higher T(reg) levels had a significantly shorter time to initial treatment (median, 5.9 years) compared with patients who had lower T(reg) levels (median, 11.7 years; log-rank P = .019). Furthermore, T(reg) levels (the percentage of CD4-positive T cells) had significant prognostic power to predict the time to initial treatment in univariate analysis (P = .023) and in multivariate Cox regression analysis that included the variables Rai stage, immunoglobulin heavy-chain variable region gene mutational status, chromosomal aberrations, and CD38 expression (P = .028). Higher T(reg) levels had significant and independent prognostic power for predicting the time to initial treatment in patients with low to intermediate stage chronic lymphocytic leukemia. 2010 American Cancer Society.

  10. Split-time artificial insemination in beef cattle: III. Comparing fixed-time artificial insemination to split-time artificial insemination with delayed administration of GnRH in postpartum cows.

    Science.gov (United States)

    Bishop, B E; Thomas, J M; Abel, J M; Poock, S E; Ellersieck, M R; Smith, M F; Patterson, D J

    2017-09-01

    This experiment was designed to compare pregnancy rates in postpartum beef cows following split-time (STAI) or fixed-time (FTAI) artificial insemination. Estrus was synchronized for 671 cows at seven locations following administration of the 7-d CO-Synch + CIDR protocol (100 μg GnRH + CIDR insert [1.38 g progesterone] on d 0; 25 mg prostaglandin F 2α [PG] at CIDR removal on d 7). Cows were assigned to treatments that were balanced across locations based on age, body condition score, and days postpartum at the time treatments were initiated. All cows in treatment 1 (n = 333; FTAI) were inseminated at 66 h after PG and GnRH was administered concurrent with insemination regardless of estrus expression. For cows in treatment 2 (n = 338; STAI), inseminations were performed at 66 or 90 h after PG, and estrous status was recorded at these times. Cows in the STAI treatment that exhibited estrus by 66 h were inseminated at that time and did not receive GnRH, whereas AI was delayed 24 h until 90 h after PG for cows that failed to exhibit estrus by 66 h. Gonadotropin-releasing hormone (100 μg) was administered concurrent with AI at 90 h only to cows failing to exhibit estrus. Estrus expression that occurred during the 24 h delay period among cows assigned to the STAI treatment increased the total proportion of cows that expressed estrus prior to insemination (1 = 60%; 2 = 86%; P inseminated at 66 h that exhibited estrus did not differ between treatments (1 = 58%; 2 = 58%; P = 0.93); however, pregnancy rates among non-estrous cows at 66 h were improved (1 = 35%; 2 = 51%; P = 0.01) among cows assigned to the STAI treatment when insemination was postponed by 24 h. Consequently, total AI pregnancy rate tended to be higher for cows that received STAI (1 = 49%; 2 = 56%; P = 0.06). In summary, following administration of the 7-d CO-Synch + CIDR protocol, total estrous response increased and pregnancy rates resulting from AI tended

  11. HARDENING OF CRANE RAILS BY PLASMA DISCRETE-TIME SURFACE TREATMENT

    Directory of Open Access Journals (Sweden)

    S. S. Samotugin

    2017-01-01

    Full Text Available Crane wheels and rails are subjected to intensive wear in the process of operation. Therefore, improvement of these components’ performance can be considered a task of high importance. A promising direction in this regard is surface treatment by highly concentrated energy flows such as laser beams or plasma jets. This thesis suggests that the use of gradient plasma surface treatment can improve the performance of crane rails. A research was conducted, according to which hardened zones were deposited on crane rails under different treatment modes. Microhardness was measured both at the surface and in depth using custom-made microsections. The article includes the results of study of plasma surface hardening effects on wear resistance of crane rails. Change of plasma surface treatment parameters (current, plasma torch movement speed, argon gas flow rate allows for desired steel hardness and structure, while the choice of optimal location for hardened zones makes it possible to significantly improve wear resistance and crack resistance. As a result of plasma surface hardening, the fine-grained martensite structure is obtained with mainly lamellar morphology and higher hardness rate compared toinduction hardening or overlaying. Wear test of carbon steels revealed that plasma surfacing reduces abrasive wear rate compared to the irinitial state by 2 to 3 times. Enough sharp boundary between hardened and non-hardened portions has a positive effect on the performance of parts under dynamic loads, contributing to the inhibition of cracks during the transition from solid to a soft metal. For carbon and low alloy rail steels, the properties achieved by plasma surface hardening can effectively replace induction hardening or overlaying.The mode range for plasma surface treatment that allow sobtaining a surface layer with certain operating properties has been determined.

  12. Comparative effects of ionizing radiation on cycle time and mitotic duration. A time-lapse cinematography study

    International Nuclear Information System (INIS)

    D'Hooghe, M.C.; Hemon, D.; Valleron, A.J.; Malaise, E.P.

    1980-01-01

    The effects of 60 Co γ rays on the length of the intermitotic period, the duration of mitosis, and the division probability of EMT6 cells have been studied in vitro using time-lapse cinematography. Irradiation increases the duration of the mitosis and of the cycle in comparable proportions: both parameters are practically doubled by a dose of 10 Gy. When daughters of irradiated cells die, the mitotic delay and lengthening of mitosis of their mother cells are longer than average. Mitotic delay and lengthening of mitosis depend on the age of cells at the moment of irradiation. The mitotic delay increases progressively when cells are irradiated during the first 8 h of their cycle (i.e., before the transition point), whereas mitosis is slightly prolonged. On the other hand, when the cells are irradiated after this transition point the mitotic delay decreases markedly, whereas the lengthening of mitosis increases sharply. These results tend to indicate that two different mechanisms are responsible for mitotic delay and prolongation of mitosis observed after irradiation

  13. Process improvement to enhance existing stroke team activity toward more timely thrombolytic treatment.

    Science.gov (United States)

    Cho, Han-Jin; Lee, Kyung Yul; Nam, Hyo Suk; Kim, Young Dae; Song, Tae-Jin; Jung, Yo Han; Choi, Hye-Yeon; Heo, Ji Hoe

    2014-10-01

    Process improvement (PI) is an approach for enhancing the existing quality improvement process by making changes while keeping the existing process. We have shown that implementation of a stroke code program using a computerized physician order entry system is effective in reducing the in-hospital time delay to thrombolysis in acute stroke patients. We investigated whether implementation of this PI could further reduce the time delays by continuous improvement of the existing process. After determining a key indicator [time interval from emergency department (ED) arrival to intravenous (IV) thrombolysis] and conducting data analysis, the target time from ED arrival to IV thrombolysis in acute stroke patients was set at 40 min. The key indicator was monitored continuously at a weekly stroke conference. The possible reasons for the delay were determined in cases for which IV thrombolysis was not administered within the target time and, where possible, the problems were corrected. The time intervals from ED arrival to the various evaluation steps and treatment before and after implementation of the PI were compared. The median time interval from ED arrival to IV thrombolysis in acute stroke patients was significantly reduced after implementation of the PI (from 63.5 to 45 min, p=0.001). The variation in the time interval was also reduced. A reduction in the evaluation time intervals was achieved after the PI [from 23 to 17 min for computed tomography scanning (p=0.003) and from 35 to 29 min for complete blood counts (p=0.006)]. PI is effective for continuous improvement of the existing process by reducing the time delays between ED arrival and IV thrombolysis in acute stroke patients.

  14. Rectal bleeding after conformal 3D treatment of prostate cancer: Time to occurrence, response to treatment and duration of morbidity

    International Nuclear Information System (INIS)

    Teshima, Teruki; Hanks, Gerald E.; Hanlon, Alexandra L.; Peter, Ruth S.; Schultheiss, Timothy E.

    1997-01-01

    Purpose: Rectal bleeding is the most common late sequelae of high-dose 3D conformal treatment (3DCRT) for prostate cancer and may limit attempts to improve local control by dose escalation. The clinical course of this complication is reported including time to onset, response to treatment, duration of morbidity, and multivariate analysis for predictors. Methods and Materials: From March 1989 to June 1995, 670 patients with prostate cancer were treated with 3DCRT at Fox Chase Cancer Center. Eighty-nine patients developed Grade 2 or Grade 3 complications due to rectal bleeding and are analyzed. Multivariate analysis results for predictors of Grade 2 and 3 rectal bleeding are reported as well as time to development, response to initial and retreatment, and duration of morbidity. Results: The median time to occurrence is not significantly different (p = 0.09) for Grade 2 (13 months, range 4-41 months) compared to Grade 3 rectal bleeding (18 months, range 4-40 months), while the corresponding median duration of symptoms was significantly different (p < 0.0001) being 1 month (range 1-12) vs. 10 months (1-34) for Grade 2 and Grade 3 bleeding, respectively. For Grade 2 bleeding, medication or coagulation was highly effective as initial or retreatment resolving 66 of 73 patients. For Grade 3 bleeding, three patients responded without medication following blood transfusion only, while with multiple coagulations and medication 12 of 16 patients improved to ≤ Grade 1. Multivariate analysis demonstrates that dose is the only significant factor associated with Grade 2 (p = 0.01) or Grade 3 (p = 0.01) rectal bleeding. Of seven nonresponders to treatment for Grade 2 bleeding, three have died of intercurrent disease at 10, 19, and 26 months, while four are alive with continuing Grade 2 bleeding at 12, 14, 15, and 30 months after onset. The four nonresponders to treatment for Grade 3 bleeding continue to bleed 1, 9, 32, and 35 months after the third coagulation despite continuing

  15. A comparative study of the time performance between NINO and FlexToT ASICs

    Science.gov (United States)

    Sarasola, I.; Nemallapudi, M. V.; Gundacker, S.; Sánchez, D.; Gascón, D.; Rato, P.; Marín, J.; Auffray, E.

    2017-04-01

    Universitat de Barcelona (UB) and CIEMAT have designed the FlexToT ASIC for the front-end readout of SiPM-based scintillator detectors. This ASIC is aimed at time of flight (ToF) positron emission tomography (PET) applications. In this work we have evaluated the time performance of the FlexToT v2 ASIC compared to the NINO ASIC, a fast ASIC developped at CERN. NINO electronics give 64 ps sigma for single-photon time resolution (SPTR) and 93 ps FWHM for coincidence time resolution (CTR) with 2 × 2 × 5 mm3 LSO:Ce,Ca crystals and S13360-3050CS SiPMs. Using the same SiPMs and crystals, the FlexToT v2 ASIC yields 91 ps sigma for SPTR and 123 ps FWHM for CTR. Despite worse time performace than NINO, FlexToT v2 features lower power consumption (11 vs. 27 mW/ch) and linear ToT energy measurement.

  16. A comparative study of the time performance between NINO and FlexToT ASICs

    International Nuclear Information System (INIS)

    Sarasola, I.; Rato, P.; Marín, J.; Nemallapudi, M.V.; Gundacker, S.; Auffray, E.; Sánchez, D.; Gascón, D.

    2017-01-01

    Universitat de Barcelona (UB) and CIEMAT have designed the FlexToT ASIC for the front-end readout of SiPM-based scintillator detectors. This ASIC is aimed at time of flight (ToF) positron emission tomography (PET) applications. In this work we have evaluated the time performance of the FlexToT v2 ASIC compared to the NINO ASIC, a fast ASIC developped at CERN. NINO electronics give 64 ps sigma for single-photon time resolution (SPTR) and 93 ps FWHM for coincidence time resolution (CTR) with 2 × 2 × 5 mm 3 LSO:Ce,Ca crystals and S13360-3050CS SiPMs. Using the same SiPMs and crystals, the FlexToT v2 ASIC yields 91 ps sigma for SPTR and 123 ps FWHM for CTR. Despite worse time performace than NINO, FlexToT v2 features lower power consumption (11 vs. 27 mW/ch) and linear ToT energy measurement.

  17. Sensitivity Analysis of Per-Protocol Time-to-Event Treatment Efficacy in Randomized Clinical Trials

    Science.gov (United States)

    Gilbert, Peter B.; Shepherd, Bryan E.; Hudgens, Michael G.

    2013-01-01

    Summary Assessing per-protocol treatment effcacy on a time-to-event endpoint is a common objective of randomized clinical trials. The typical analysis uses the same method employed for the intention-to-treat analysis (e.g., standard survival analysis) applied to the subgroup meeting protocol adherence criteria. However, due to potential post-randomization selection bias, this analysis may mislead about treatment efficacy. Moreover, while there is extensive literature on methods for assessing causal treatment effects in compliers, these methods do not apply to a common class of trials where a) the primary objective compares survival curves, b) it is inconceivable to assign participants to be adherent and event-free before adherence is measured, and c) the exclusion restriction assumption fails to hold. HIV vaccine efficacy trials including the recent RV144 trial exemplify this class, because many primary endpoints (e.g., HIV infections) occur before adherence is measured, and nonadherent subjects who receive some of the planned immunizations may be partially protected. Therefore, we develop methods for assessing per-protocol treatment efficacy for this problem class, considering three causal estimands of interest. Because these estimands are not identifiable from the observable data, we develop nonparametric bounds and semiparametric sensitivity analysis methods that yield estimated ignorance and uncertainty intervals. The methods are applied to RV144. PMID:24187408

  18. Characteristics of patients receiving ustekinumab compared with secukinumab for treatment of moderate-to-severe plaque psoriasis

    DEFF Research Database (Denmark)

    Egeberg, A; Iversen, L; Gniadecki, R

    2017-01-01

    ustekinumab. CONCLUSIONS: We found significant differences in characteristics of patients starting therapy with ustekinumab and secukinumab in a real-life clinical setting. These findings may aid clinicians and researchers when interpreting efficacy data derived from clinical trials and biologic registries...... with secukinumab or ustekinumab. METHODS: All Danish patients with moderate-to-severe plaque psoriasis treated with biologics are recorded in the nationwide DERMBIO registry. We compared characteristics of patients starting first-time therapy with ustekinumab and secukinumab, respectively. RESULTS: We identified...... a total of 1037 and 142 first-time treatment series with ustekinumab and secukinumab. There was a male predominance in both groups, but patients initiating secukinumab were slightly older and with longer disease duration; in agreement with guidelines for biologic treatment in Denmark where ustekinumab has...

  19. Satellite (Timed, Aura, Aqua) and In Situ (Meteorological Rockets, Balloons) Measurement Comparability

    Science.gov (United States)

    Schmidlin, F. J.; Goldberg, Richard A.; Feofilov, A.; Rose, R.

    2010-01-01

    Measurements using the inflatable falling sphere often are requested to provide density data in support of special sounding rocket launchings into the mesosphere and thermosphere. To insure density measurements within narrow time frames and close in space, the inflatable falling sphere is launched within minutes of the major test. Sphere measurements are reliable for the most part, however, availability of these rocket systems has become more difficult and, in fact, these instruments no longer are manufactured resulting in a reduction of the meager stockpile of instruments. Sphere measurements also are used to validate remotely measured temperatures and have the advantage of measuring small-scale atmospheric features. Even so, with the dearth of remaining falling spheres perhaps it is time to consider whether the remote measurements are mature enough to stand alone. Presented are two field studies, one in 2003 from Northern Sweden and one in 2010 from the vicinity of Kwajalein Atoll that compare temperature retrievals between satellite and in situ failing spheres. The major satellite instruments employed are SABER, MLS, and AIRS. The comparisons indicate that remotely measured temperatures mimic the sphere temperature measurements quite well. The data also confirm that satellite retrievals, while not always at the exact location required for individual studies, are adaptable enough and highly useful. Although the falling sphere will provide a measurement at a specific location and time, satellites only pass a given location daily or less often. This report reveals that averaged satellite measurements can provide temperatures and densities comparable to the falling sphere.

  20. BAYESIAN TECHNIQUES FOR COMPARING TIME-DEPENDENT GRMHD SIMULATIONS TO VARIABLE EVENT HORIZON TELESCOPE OBSERVATIONS

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Junhan; Marrone, Daniel P.; Chan, Chi-Kwan; Medeiros, Lia; Özel, Feryal; Psaltis, Dimitrios, E-mail: junhankim@email.arizona.edu [Department of Astronomy and Steward Observatory, University of Arizona, 933 N. Cherry Avenue, Tucson, AZ 85721 (United States)

    2016-12-01

    The Event Horizon Telescope (EHT) is a millimeter-wavelength, very-long-baseline interferometry (VLBI) experiment that is capable of observing black holes with horizon-scale resolution. Early observations have revealed variable horizon-scale emission in the Galactic Center black hole, Sagittarius A* (Sgr A*). Comparing such observations to time-dependent general relativistic magnetohydrodynamic (GRMHD) simulations requires statistical tools that explicitly consider the variability in both the data and the models. We develop here a Bayesian method to compare time-resolved simulation images to variable VLBI data, in order to infer model parameters and perform model comparisons. We use mock EHT data based on GRMHD simulations to explore the robustness of this Bayesian method and contrast it to approaches that do not consider the effects of variability. We find that time-independent models lead to offset values of the inferred parameters with artificially reduced uncertainties. Moreover, neglecting the variability in the data and the models often leads to erroneous model selections. We finally apply our method to the early EHT data on Sgr A*.

  1. Assessment of UASB-DHS technology for sewage treatment: a comparative study from a sustainability perspective.

    Science.gov (United States)

    Maharjan, Namita; Nomoto, Naoki; Tagawa, Tadashi; Okubo, Tsutomu; Uemura, Shigeki; Khalil, Nadeem; Hatamoto, Masashi; Yamaguchi, Takashi; Harada, Hideki

    2018-04-06

    This paper assesses the technical and economic sustainability of a combined system of an up-flow anaerobic sludge blanket (UASB)-down-flow hanging sponge (DHS) for sewage treatment. Additionally, this study compares UASB-DHS with current technologies in India like trickling filters (TF), sequencing batch reactor (SBR), moving bed biofilm reactor (MBBR), and other combinations of UASB with post-treatment systems such as final polishing ponds (FPU) and extended aeration sludge process (EASP). The sustainability of the sewage treatment plants (STPs) was evaluated using a composite indicator, which incorporated environmental, societal, and economic dimensions. In case of the individual sustainability indicator study, the results showed that UASB-FPU was the most economically sustainable system with a score of 0.512 and aeration systems such as MBBR, EASP, and SBR were environmentally sustainable, whereas UASB-DHS system was socially sustainable. However, the overall comparative analysis indicated that the UASB-DHS system scored the highest value of 2.619 on the global sustainability indicator followed by EASP and MBBR with scores of 2.322 and 2.279, respectively. The highlight of this study was that the most environmentally sustainable treatment plants were not economically and socially sustainable. Moreover, sensitivity analysis showed that five out of the seven scenarios tested, the UASB-DHS system showed good results amongst the treatment system.

  2. Barriers to accessing substance abuse treatment in Mexico: national comparative analysis by migration status

    Science.gov (United States)

    2014-01-01

    Background We examined Mexican migrants’ perceived barriers to entering substance abuse treatment and potential differences by gender. Methods This study analyzed a subset of household data collected in Mexico in 2011 via the Encuesta Nacional de Adicciones (National Survey of Addictions). A sample of 1,143 individuals who reported using illicit drugs was analyzed using multivariate negative binomial models to determine direct and moderated relationships of gender, migrant status, and drug dependence with perceived barriers to accessing treatment. Results Significant findings included disparities in drug dependence by migrant status. Compared with non-migrant men, women who have traveled to the United States was associated with fewer (1.3) barriers to access treatment. Fewer barriers to access care were associated with individuals residing in other regions of the country, compared to those living in Mexico City. Conclusions Drug dependence, gender, migration status and regional location are factors associated with access to needed treatment. Implications for health care policy to develop treatment services infrastructure and for future research are discussed in the context of ongoing drug policy reform in Mexico. PMID:25074067

  3. Percutaneous vertebroplasty and conservative management for the treatment of osteoporotic vertebral fractures: a comparative study

    International Nuclear Information System (INIS)

    Liu Wengui; Lu Jinyu; Sun Jianhua; Liang Ding; Li Zhiwei; Wang Hesheng; Guo Shanfeng

    2011-01-01

    Objective: To investigate the better therapeutic measures for painful osteoporotic vertebral compression fractures (OVCF) through comparing the efficacy of percutaneous vertebroplasty (PVP) with that of conservative management. Methods: Forty-three consecutive patients, encountered from December 2009 to December 2010 in authors' hospital, were enrolled in this study. The patients were divided into PVP group (n=22) and conservative group (n=21). Visual analog score (VAS) for pain and Oswestry disability index (ODI) questionnaire scores were assessed before and 1 week, 1, 3, 6, 12 months after the treatment. Patients' activity levels and other information, including complications and new fractures after treatment, were also evaluated. Results: Before the treatment both the VAS and ODI scores showed no statistically significant difference between the two groups. Significant reduction of both VAS and ODI was observed in PVP group at 1 week and at 1 and 3 months after treatment when compared with those in conservative group (P<0.05). Patients' activity levels in PVP group were significantly improved than that in conservative group (P<0.01). One new fracture was observed in the conservative group, while no new fracture was seen in the PVP group. Conclusion: Immediate pain relief and improvement of daily activities after PVP can be achieved in all patients. PVP should be considered as the treatment of first choice for symptomatic osteoporotic vertebral fractures. (authors)

  4. Comparative evaluation of griseofulvin, terbinafine and fluconazole in the treatment of tinea capitis.

    Science.gov (United States)

    Grover, Chander; Arora, Pooja; Manchanda, Vikas

    2012-04-01

    Tinea capitis (TC) is a common childhood fungal infection which, if untreated, can cause long-term scarring. A number of antifungal drugs with proven efficacy are available for the treatment of TC. However, varying dosage schedules, changes in epidemiology, and rising drug resistance are factors that hamper treatment in some cases. A prospective, non-blinded, cross-sectional study of three commonly used drugs (terbinafine, griseofulvin, and fluconazole) was undertaken in children aged ≤12 years, presenting to a pediatric superspecialty hospital. The comparative efficacies of these three drugs were evaluated. A total of 75 patients (25 in each treatment group) who completed the designated treatment protocol were included in the final analysis. Of these, 60% had non-inflammatory TC and 56% had an ectothrix pattern on hair microscopy. Trichophyton violaceum was the most commonly isolated fungus. Cure rates of 96%, 88%, and 84% were achieved with griseofulvin, terbinafine, and fluconazole, respectively. Overall, seven patients required prolonged therapy. No side effects to therapy were seen. Griseofulvin remains the drug of choice in the treatment of TC. Terbinafine was the second best agent and offered the advantage of a shorter course of therapy. Fluconazole had comparatively low cure rates but was easier to administer than the other two medications. © 2012 The International Society of Dermatology.

  5. Comparative Effectiveness of Treatments for Binge-Eating Disorder: Systematic Review and Network Meta-Analysis.

    Science.gov (United States)

    Peat, Christine M; Berkman, Nancy D; Lohr, Kathleen N; Brownley, Kimberly A; Bann, Carla M; Cullen, Katherine; Quattlebaum, Mary J; Bulik, Cynthia M

    2017-09-01

    Psychological and pharmacological interventions for binge-eating disorder have previously demonstrated efficacy (compared with placebo or waitlist control); thus, we aimed to expand that literature with a review of comparative effectiveness. We searched MEDLINE,® EMBASE,® Cochrane Library, Academic OneFile, CINAHL® for binge-eating disorder treatment articles and selected studies using predetermined inclusion and exclusion criteria. Data were sufficient for network meta-analysis comparing two pharmacological interventions; psychological interventions were analysed qualitatively. In all, 28 treatment comparisons were included in this review: one pharmacological comparison (second-generation antidepressants versus lisdexamfetamine) and 26 psychological comparisons. Only three statistically significant differences emerged: lisdexamfetamine was better at increasing binge abstinence than second-generation antidepressants; therapist-led cognitive behavioural therapy was better at reducing binge-eating frequency than behavioural weight loss, but behavioural weight loss was better at reducing weight. The majority of other treatment comparisons revealed few significant differences between groups. Thus, patients and clinicians can choose from several effective treatment options. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

  6. Timely Referral to Outpatient Nephrology Care Slows Progression and Reduces Treatment Costs of Chronic Kidney Diseases

    Directory of Open Access Journals (Sweden)

    Gerhard Lonnemann

    2017-03-01

    Discussion: Timely referral to outpatient nephrology care is associated with slowed disease progression, less hospital admissions, reduced total treatment costs, and improved survival in patients with CKD.

  7. Comparing the effect of diode laser against acyclovir cream for the treatment of herpes labialis.

    Science.gov (United States)

    Honarmand, Marieh; Farhadmollashahi, Leila; Vosoughirahbar, Ehsan

    2017-06-01

    Recently alternative therapies such as the use of diode laser therapy have been introduced for recurrent herpes labial infection. The aim of this study was to evaluate the effectiveness of diode laser for treatment of recurrent herpes labialis. This was single-blind randomized clinical trial to evaluate the efficacy of diode laser for the treatment of recurrent herpes labial. In total, 60 patients whit recurrent herpes simplex labialis were selected and randomly divided in to three groups. 20 patients received treatment whit diode laser (at a wavelength of 870 nm, energy density 4.5 j/cm2), 20 patients were treated with acyclovir cream 5%, 20 patients received treatment with laser-off (placebo). The end point was lesions crusting. Data analyzed by Tukey HSD Test and One-way ANOVA (at a significance level of 0.05) in SPSS-20 software. The mean length of recovery time (day) in the laser, off laser, and acyclovir groups was 2.20±0.41, 4.30±1.03, and 3.4±1.142, respectively. There is a significant difference between three groups in this regard ( P diode laser reduced the length of recovery time and pain severity faster than treatment with acyclovir cream. Key words: Recurrent herpes labial, Acyclovir, Low level laser therapy.

  8. Comparative study of 15% TCA peel versus 35% glycolic acid peel for the treatment of melasma.

    Science.gov (United States)

    Puri, Neerja

    2012-05-01

    Chemical peels are the mainstay of a cosmetic practitioner's armamentarium because they can be used to treat some skin disorders and can provide aesthetic benefit. To compare 15% TCA peel and 35% glycolic acid peel for the treatment of melasma. We selected 30 participants of melasma aged between 20 and 50 years from the dermatology outpatient department and treated equal numbers with 15% TCA and 35% glycolic acid. Subjective response as graded by the patient showed good or very good response in 70% participants in the glycolic acid group and 64% in the TCA group. There was statistically insignificant difference in the efficacy between the two groups for the treatment of melasma.

  9. Mebendazole Compared with Secnidazole in the Treatment of Adult Giardiasis: A Randomised, No-Inferiority, Open Clinical Trial

    Directory of Open Access Journals (Sweden)

    Pedro Almirall

    2011-01-01

    Full Text Available To compare the efficacy and safety of mebendazole and secnidazole in the treatment of giardiasis in adult patients, a single-centre, parallel group, open-label, randomized non-inferiority trial was carried out. One-hundred and 26 participants who had symptomatic Giardia mono-infection took part in the study. Direct wet mount and/or Ritchie concentration techniques and physical examinations were conducted at the time of enrolment and at the follow-up visit. The primary outcome measure was parasitological cure, performed at 3, 5, 10 days post-treatment. Negative faecal specimens for Giardia were ensured by the same parasitological techniques. At follow up (day 10 the parasitological cure rate for the per protocol populations was 88.7% (55/62 for MBZ and 91.8% (56/61 for SNZ. For the intention to treat populations the cure rate at the end of treatment was 85.9% (55/64 for MBZ and 90.3% (56/62 for SNZ. Both analyzes showed there was not significant statistical difference between MBZ and SNZ treatment efficacy. Both drugs were well tolerated, only mild, transient and self-limited side effects were reported and did not require discontinuation of treatment. A 3-day course of mebendazole seems to be as efficacious and safe for treatment of giardiasis as a single dose of secnidazole in adults.

  10. A Clinical Pilot Study Comparing Sweet Bee Venom parallel treatment with only Acupuncture Treatment in patient diagnosed with lumbar spine sprain

    Directory of Open Access Journals (Sweden)

    Shin Yong-jeen

    2011-06-01

    Full Text Available Objectives: This study was carried out to compare the Sweet Bee Venom (referred to as Sweet BV hereafter acupuncture parallel treatment to treatment with acupuncture only for the patient diagnosed with lumbar spine sprain and find a better treatment. Methods: The subjects were patients diagnosed with lumbar spine sprain and hospitalized at Suncheon oriental medical hospital, which was randomly divided into sweet BV parallel treatment group and acupuncture-only group, and other treatment conditions were maintained the same. Then,VAS (Visual Analogue Scale was used to compare the difference in the treatment period between the two groups from VAS 10 to VAS 0, from VAS 10 to VAS 5, and from VAS 5 to VAS 0. Result & Conclusion: Sweet BV parallel treatment group and acupuncture-only treatment group were compared regarding the respective treatment period, and as the result, the treatment period from VAS 10 to VAS 5 was significantly reduced in sweet BV parallel treatment group compared to the acupuncture-only treatment group, but the treatment period from VAS 5 to VAS 0 did not show a significant difference. Therefore, it can be said that sweet BV parallel treatment is effective in shortening the treatment period and controlling early pain compared to acupuncture-only treatment.

  11. Comparative analysis of 11 different radioisotopes for palliative treatment of bone metastases by computational methods.

    Science.gov (United States)

    Guerra Liberal, Francisco D C; Tavares, Adriana Alexandre S; Tavares, João Manuel R S

    2014-11-01

    Throughout the years, the palliative treatment of bone metastases using bone seeking radiotracers has been part of the therapeutic resources used in oncology, but the choice of which bone seeking agent to use is not consensual across sites and limited data are available comparing the characteristics of each radioisotope. Computational simulation is a simple and practical method to study and to compare a variety of radioisotopes for different medical applications, including the palliative treatment of bone metastases. This study aims to evaluate and compare 11 different radioisotopes currently in use or under research for the palliative treatment of bone metastases using computational methods. Computational models were used to estimate the percentage of deoxyribonucleic acid (DNA) damage (fast Monte Carlo damage algorithm), the probability of correct DNA repair (Monte Carlo excision repair algorithm), and the radiation-induced cellular effects (virtual cell radiobiology algorithm) post-irradiation with selected particles emitted by phosphorus-32 ((32)P), strontium-89 ((89)Sr), yttrium-90 ((90)Y ), tin-117 ((117m)Sn), samarium-153 ((153)Sm), holmium-166 ((166)Ho), thulium-170 ((170)Tm), lutetium-177 ((177)Lu), rhenium-186 ((186)Re), rhenium-188 ((188)Re), and radium-223 ((223)Ra). (223)Ra alpha particles, (177)Lu beta minus particles, and (170)Tm beta minus particles induced the highest cell death of all investigated particles and radioisotopes. The cell survival fraction measured post-irradiation with beta minus particles emitted by (89)Sr and (153)Sm, two of the most frequently used radionuclides in the palliative treatment of bone metastases in clinical routine practice, was higher than (177)Lu beta minus particles and (223)Ra alpha particles. (223)Ra and (177)Lu hold the highest potential for palliative treatment of bone metastases of all radioisotopes compared in this study. Data reported here may prompt future in vitro and in vivo experiments comparing

  12. Comparative analysis of 11 different radioisotopes for palliative treatment of bone metastases by computational methods

    Energy Technology Data Exchange (ETDEWEB)

    Guerra Liberal, Francisco D. C., E-mail: meb12020@fe.up.pt, E-mail: adriana-tavares@msn.com; Tavares, Adriana Alexandre S., E-mail: meb12020@fe.up.pt, E-mail: adriana-tavares@msn.com; Tavares, João Manuel R. S., E-mail: tavares@fe.up.pt [Instituto de Engenharia Mecânica e Gestão Industrial, Faculdade de Engenharia, Universidade do Porto, Rua Dr. Roberto Frias s/n, Porto 4200-465 (Portugal)

    2014-11-01

    Purpose: Throughout the years, the palliative treatment of bone metastases using bone seeking radiotracers has been part of the therapeutic resources used in oncology, but the choice of which bone seeking agent to use is not consensual across sites and limited data are available comparing the characteristics of each radioisotope. Computational simulation is a simple and practical method to study and to compare a variety of radioisotopes for different medical applications, including the palliative treatment of bone metastases. This study aims to evaluate and compare 11 different radioisotopes currently in use or under research for the palliative treatment of bone metastases using computational methods. Methods: Computational models were used to estimate the percentage of deoxyribonucleic acid (DNA) damage (fast Monte Carlo damage algorithm), the probability of correct DNA repair (Monte Carlo excision repair algorithm), and the radiation-induced cellular effects (virtual cell radiobiology algorithm) post-irradiation with selected particles emitted by phosphorus-32 ({sup 32}P), strontium-89 ({sup 89}Sr), yttrium-90 ({sup 90}Y ), tin-117 ({sup 117m}Sn), samarium-153 ({sup 153}Sm), holmium-166 ({sup 166}Ho), thulium-170 ({sup 170}Tm), lutetium-177 ({sup 177}Lu), rhenium-186 ({sup 186}Re), rhenium-188 ({sup 188}Re), and radium-223 ({sup 223}Ra). Results: {sup 223}Ra alpha particles, {sup 177}Lu beta minus particles, and {sup 170}Tm beta minus particles induced the highest cell death of all investigated particles and radioisotopes. The cell survival fraction measured post-irradiation with beta minus particles emitted by {sup 89}Sr and {sup 153}Sm, two of the most frequently used radionuclides in the palliative treatment of bone metastases in clinical routine practice, was higher than {sup 177}Lu beta minus particles and {sup 223}Ra alpha particles. Conclusions: {sup 223}Ra and {sup 177}Lu hold the highest potential for palliative treatment of bone metastases of all

  13. Influence of planning time and treatment complexity on radiation therapy errors.

    Science.gov (United States)

    Gensheimer, Michael F; Zeng, Jing; Carlson, Joshua; Spady, Phil; Jordan, Loucille; Kane, Gabrielle; Ford, Eric C

    2016-01-01

    Radiation treatment planning is a complex process with potential for error. We hypothesized that shorter time from simulation to treatment would result in rushed work and higher incidence of errors. We examined treatment planning factors predictive for near-miss events. Treatments delivered from March 2012 through October 2014 were analyzed. Near-miss events were prospectively recorded and coded for severity on a 0 to 4 scale; only grade 3-4 (potentially severe/critical) events were studied in this report. For 4 treatment types (3-dimensional conformal, intensity modulated radiation therapy, stereotactic body radiation therapy [SBRT], neutron), logistic regression was performed to test influence of treatment planning time and clinical variables on near-miss events. There were 2257 treatment courses during the study period, with 322 grade 3-4 near-miss events. SBRT treatments had more frequent events than the other 3 treatment types (18% vs 11%, P = .04). For the 3-dimensional conformal group (1354 treatments), univariate analysis showed several factors predictive of near-miss events: longer time from simulation to first treatment (P = .01), treatment of primary site versus metastasis (P < .001), longer treatment course (P < .001), and pediatric versus adult patient (P = .002). However, on multivariate regression only pediatric versus adult patient remained predictive of events (P = 0.02). For the intensity modulated radiation therapy, SBRT, and neutron groups, time between simulation and first treatment was not found to be predictive of near-miss events on univariate or multivariate regression. When controlling for treatment technique and other clinical factors, there was no relationship between time spent in radiation treatment planning and near-miss events. SBRT and pediatric treatments were more error-prone, indicating that clinical and technical complexity of treatments should be taken into account when targeting safety interventions. Copyright © 2015 American

  14. Comparative effectiveness of psychological treatments for depressive disorders in primary care: network meta-analysis.

    Science.gov (United States)

    Linde, Klaus; Rücker, Gerta; Sigterman, Kirsten; Jamil, Susanne; Meissner, Karin; Schneider, Antonius; Kriston, Levente

    2015-08-19

    A variety of psychological interventions to treat depressive disorders have been developed and are used in primary care. In a systematic review, we compared the effectiveness of psychological treatments grouped by theoretical background, intensity of contact with the health care professional, and delivery mode for depressed patients in this setting. Randomized trials comparing a psychological treatment with usual care, placebo, another psychological treatment, pharmacotherapy, or a combination treatment in adult depressed primary care patients were identified by database searches up to December 2013. We performed both conventional pairwise meta-analysis and network meta-analysis combining direct and indirect evidence. Outcome measures were response to treatment (primary outcome), remission of symptoms, post-treatment depression scores and study discontinuation. A total of 37 studies with 7,024 patients met the inclusion criteria. Among the psychological treatments investigated in at least 150 patients face-to-face cognitive behavioral therapy (CBT; OR 1.80; 95 % credible interval 1.35-2.39), face-to-face counselling and psychoeducation (1.65; 1.27-2.13), remote therapist lead CBT (1.87; 1.38-2.53), guided self-help CBT (1.68; 1.22-2.30) and no/minimal contact CBT (1.53; 1.07-2.17) were superior to usual care or placebo, but not face-to-face problem-solving therapy and face-to-face interpersonal therapy. There were no statistical differences between psychological treatments apart from face-to-face interpersonal psychotherapy being inferior to remote therapist-lead CBT (0.60; 0.37-0.95). Remote therapist-led (0.86; 0.21-3.67), guided self-help (0.93; 0.62-1.41) and no/minimal contact CBT (0.85; 0.54-1.36) had similar effects as face-to-face CBT. The limited available evidence precludes a sufficiently reliable assessment of the comparative effectiveness of psychological treatments in depressed primary care patients. Findings suggest that psychological interventions

  15. Comparing the different response of PNS and CNS injured neurons to mesenchymal stem cell treatment.

    Science.gov (United States)

    Monfrini, Marianna; Ravasi, Maddalena; Maggioni, Daniele; Donzelli, Elisabetta; Tredici, Giovanni; Cavaletti, Guido; Scuteri, Arianna

    2018-01-01

    Mesenchymal stem cells (MSCs) are adult bone marrow-derived stem cells actually proposed indifferently for the therapy of neurological diseases of both the Central (CNS) and the Peripheral Nervous System (PNS), as a panacea able to treat so many different diseases by their immunomodulatory ability and supportive action on neuronal survival. However, the identification of the exact mechanism of MSC action in the different diseases, although mandatory to define their real and concrete utility, is still lacking. Moreover, CNS and PNS neurons present many different biological properties, and it is still unclear if they respond in the same manner not only to MSC treatment, but also to injuries. For these reasons, in this study we compared the susceptibility of cortical and sensory neurons both to toxic drug exposure and to MSC action, in order to verify if these two neuronal populations can respond differently. Our results demonstrated that Cisplatin (CDDP), Glutamate, and Paclitaxel-treated sensory neurons were protected by the co-culture with MSCs, in different manners: through direct contact able to block apoptosis for CDDP- and Glutamate-treated neurons, and by the release of trophic factors for Paclitaxel-treated ones. A possible key soluble factor for MSC protection was Glutathione, spontaneously released by these cells. On the contrary, cortical neurons resulted more sensitive than sensory ones to the toxic action of the drugs, and overall MSCs failed to protect them. All these data identified for the first time a different susceptibility of cortical and sensory neurons, and demonstrated a protective action of MSCs only against drugs in peripheral neurotoxicity. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Comparing Biomechanical Properties, Repair Times, and Value of Common Core Flexor Tendon Repairs.

    Science.gov (United States)

    Chauhan, Aakash; Schimoler, Patrick; Miller, Mark C; Kharlamov, Alexander; Merrell, Gregory A; Palmer, Bradley A

    2018-05-01

    The aim of the study was to compare biomechanical strength, repair times, and repair values for zone II core flexor tendon repairs. A total of 75 fresh-frozen human cadaveric flexor tendons were harvested from the index through small finger and randomized into one of 5 repair groups: 4-stranded cross-stitch cruciate (4-0 polyester and 4-0 braided suture), 4-stranded double Pennington (2-0 knotless barbed suture), 4-stranded Pennington (4-0 double-stranded braided suture), and 6-stranded modified Lim-Tsai (4-0 looped braided suture). Repairs were measured in situ and their repair times were measured. Tendons were linearly loaded to failure and multiple biomechanical values were measured. The repair value was calculated based on operating room costs, repair times, and suture costs. Analysis of variance (ANOVA) and Tukey post hoc statistical analysis were used to compare repair data. The braided cruciate was the strongest repair ( P > .05) but the slowest ( P > .05), and the 4-stranded Pennington using double-stranded suture was the fastest ( P > .05) to perform. The total repair value was the highest for braided cruciate ( P > .05) compared with all other repairs. Barbed suture did not outperform any repairs in any categories. The braided cruciate was the strongest of the tested flexor tendon repairs. The 2-mm gapping and maximum load to failure for this repair approached similar historical strength of other 6- and 8-stranded repairs. In this study, suture cost was negligible in the overall repair cost and should be not a determining factor in choosing a repair.

  17. Improving treatment times for patients with in-hospital stroke using a standardized protocol.

    Science.gov (United States)

    Koge, Junpei; Matsumoto, Shoji; Nakahara, Ichiro; Ishii, Akira; Hatano, Taketo; Sadamasa, Nobutake; Kai, Yasutoshi; Ando, Mitsushige; Saka, Makoto; Chihara, Hideo; Takita, Wataru; Tokunaga, Keisuke; Kamata, Takahiko; Nishi, Hidehisa; Hashimoto, Tetsuya; Tsujimoto, Atsushi; Kira, Jun-Ichi; Nagata, Izumi

    2017-10-15

    Previous reports have shown significant delays in treatment of in-hospital stroke (IHS). We developed and implemented our IHS alert protocol in April 2014. We aimed to determine the influence of implementation of our IHS alert protocol. Our implementation processes comprise the following four main steps: IHS protocol development, workshops for hospital staff to learn about the protocol, preparation of standardized IHS treatment kits, and obtaining feedback in a monthly hospital staff conference. We retrospectively compared protocol metrics and clinical outcomes of patients with IHS treated with intravenous thrombolysis and/or endovascular therapy between before (January 2008-March 2014) and after implementation (April 2014-December 2016). Fifty-five patients were included (pre, 25; post, 30). After the implementation, significant reductions occurred in the median time from stroke recognition to evaluation by a neurologist (30 vs. 13.5min, pvs. 26.5min, pvs. 16min, p=0.02). The median time from first neuroimaging to endovascular therapy had a tendency to decrease (75 vs. 53min, p=0.08). There were no differences in the favorable outcomes (modified Rankin scale score of 0-2) at discharge or the incidence of symptomatic intracranial hemorrhage between the two periods. Our IHS alert protocol implementation saved time in treating patients with IHS without compromising safety. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Using cover, copy, and compare spelling with and without timing for elementary students with behavior disorders

    Directory of Open Access Journals (Sweden)

    Danette Darrow

    2012-04-01

    Full Text Available The purpose of this study was to determine the effectiveness of cover, copy, and compare (CCC procedures on spelling performance with two students. The participants were two elementary students enrolled in a self-contained behavior intervention classroom. A multiple baseline design across participants was employed to evaluate the effects of CCC on time to completion and words spelled correctly. Improvements in all measures were found when CCC was in effect. The participants enjoyed the procedures and each improved their spelling over baseline performance. The applicability of CCC across academic contexts and for students with behavior disorders was discussed.

  19. Comparing Gravimetric and Real-Time Sampling of PM2.5 Concentrations Inside Truck Cabins

    Science.gov (United States)

    Zhu, Ying; Smith, Thomas J.; Davis, Mary E.; Levy, Jonathan I.; Herrick, Robert; Jiang, Hongyu

    2012-01-01

    As part of a study on truck drivers’ exposure and health risk, pickup and delivery (P&D) truck drivers’ on-road exposure patterns to PM2.5 were assessed in five weeklong sampling trips in metropolitan areas of five U.S. cities from April to August of 2006. Drivers were sampled with real-time (DustTrak) and gravimetric samplers to measure average in-cabin PM2.5 concentrations and to compare their correspondence in moving trucks. In addition, GPS measurements of truck locations, meteorological data, and driver behavioral data were collected throughout the day to determine which factors influence the relationship between real-time and gravimetric samplers. Results indicate that the association between average real-time and gravimetric PM2.5 measurements on moving trucks was fairly consistent (Spearman rank correlation of 0.63), with DustTrak measurements exceeding gravimetric measurements by approximately a factor of 2. This ratio differed significantly only between the industrial Midwest cities and the other three sampled cities scattered in the South and West. There was also limited evidence of an effect of truck age. Filter samples collected concurrently with DustTrak measurements can be used to calibrate average mass concentration responses for the DustTrak, allowing for real-time measurements to be integrated into longer-term studies of inter-city and intra-urban exposure patterns for truck drivers. PMID:21991940

  20. Comparing gravimetric and real-time sampling of PM(2.5) concentrations inside truck cabins.

    Science.gov (United States)

    Zhu, Ying; Smith, Thomas J; Davis, Mary E; Levy, Jonathan I; Herrick, Robert; Jiang, Hongyu

    2011-11-01

    As part of a study on truck drivers' exposure and health risk, pickup and delivery (P&D) truck drivers' on-road exposure patterns to PM(2.5) were assessed in five, weeklong sampling trips in metropolitan areas of five U.S. cities from April to August of 2006. Drivers were sampled with real-time (DustTrak) and gravimetric samplers to measure average in-cabin PM(2.5) concentrations and to compare their correspondence in moving trucks. In addition, GPS measurements of truck locations, meteorological data, and driver behavioral data were collected throughout the day to determine which factors influence the relationship between real-time and gravimetric samplers. Results indicate that the association between average real-time and gravimetric PM(2.5) measurements on moving trucks was fairly consistent (Spearman rank correlation of 0.63), with DustTrak measurements exceeding gravimetric measurements by approximately a factor of 2. This ratio differed significantly only between the industrial Midwest cities and the other three sampled cities scattered in the South and West. There was also limited evidence of an effect of truck age. Filter samples collected concurrently with DustTrak measurements can be used to calibrate average mass concentration responses for the DustTrak, allowing for real-time measurements to be integrated into longer-term studies of inter-city and intra-urban exposure patterns for truck drivers.

  1. Comparative study of internet cloud and cloudlet over wireless mesh networks for real-time applications

    Science.gov (United States)

    Khan, Kashif A.; Wang, Qi; Luo, Chunbo; Wang, Xinheng; Grecos, Christos

    2014-05-01

    Mobile cloud computing is receiving world-wide momentum for ubiquitous on-demand cloud services for mobile users provided by Amazon, Google etc. with low capital cost. However, Internet-centric clouds introduce wide area network (WAN) delays that are often intolerable for real-time applications such as video streaming. One promising approach to addressing this challenge is to deploy decentralized mini-cloud facility known as cloudlets to enable localized cloud services. When supported by local wireless connectivity, a wireless cloudlet is expected to offer low cost and high performance cloud services for the users. In this work, we implement a realistic framework that comprises both a popular Internet cloud (Amazon Cloud) and a real-world cloudlet (based on Ubuntu Enterprise Cloud (UEC)) for mobile cloud users in a wireless mesh network. We focus on real-time video streaming over the HTTP standard and implement a typical application. We further perform a comprehensive comparative analysis and empirical evaluation of the application's performance when it is delivered over the Internet cloud and the cloudlet respectively. The study quantifies the influence of the two different cloud networking architectures on supporting real-time video streaming. We also enable movement of the users in the wireless mesh network and investigate the effect of user's mobility on mobile cloud computing over the cloudlet and Amazon cloud respectively. Our experimental results demonstrate the advantages of the cloudlet paradigm over its Internet cloud counterpart in supporting the quality of service of real-time applications.

  2. Comparing and Contrasting Traditional Membrane Bioreactor Models with Novel Ones Based on Time Series Analysis

    Directory of Open Access Journals (Sweden)

    Parneet Paul

    2013-02-01

    Full Text Available The computer modelling and simulation of wastewater treatment plant and their specific technologies, such as membrane bioreactors (MBRs, are becoming increasingly useful to consultant engineers when designing, upgrading, retrofitting, operating and controlling these plant. This research uses traditional phenomenological mechanistic models based on MBR filtration and biochemical processes to measure the effectiveness of alternative and novel time series models based upon input–output system identification methods. Both model types are calibrated and validated using similar plant layouts and data sets derived for this purpose. Results prove that although both approaches have their advantages, they also have specific disadvantages as well. In conclusion, the MBR plant designer and/or operator who wishes to use good quality, calibrated models to gain a better understanding of their process, should carefully consider which model type is selected based upon on what their initial modelling objectives are. Each situation usually proves unique.

  3. [Gonalgia: treatment with therapeutic local anesthesia. Results of a controlled comparative study versus diclofenac].

    Science.gov (United States)

    Berenfeld, A; Bessing, W D; Bisplinghoff, U; Bittner, G; Matthiesen, H O; Tilscher, H; Ramm, S; Ebeling, L; Schmitz, H

    1991-12-10

    The effectiveness and tolerance of therapeutic local anesthesia (TLA) with lidocaine was compared with those of oral diclofenac in a controlled, open, randomized study involving 76 patients with gonalgia due to gonarthrosis or patellar chondropathy. During the course of the three-week (maximum) treatment, the summed score of pain at rest, pain on movement, and restricted mobility, taken as the target parameter of effectiveness, decreased significantly more markedly (p = 0.008) under TLA, than under diclofenac. Side effects involving mainly the gastrointestinal tract occurred significantly more frequently in the diclofenac group (p = 0.012). The results of this study indicate that in the treatment of localized joint pain of degenerative genesis, TLA with lidocaine is superior to NSAID treatment in terms of effectiveness and tolerance.

  4. Energy implications of mechanical and mechanical–biological treatment compared to direct waste-to-energy

    DEFF Research Database (Denmark)

    Cimpan, Ciprian; Wenzel, Henrik

    2013-01-01

    Primary energy savings potential is used to compare five residual municipal solid waste treatment systems, including configurations with mechanical (MT) and mechanical–biological (MBT) pre-treatment, which produce waste-derived fuels (RDF and SRF), biogas and/or recover additional materials...... for recycling, alongside a system based on conventional mass burn waste-to-energy and ash treatment. To examine the magnitude of potential savings we consider two energy efficiency levels (state-of-the-art and best available technology), the inclusion/exclusion of heat recovery (CHP vs. PP) and three different...... background end-use energy production systems (coal condensing electricity and natural gas heat, Nordic electricity mix and natural gas heat, and coal CHP energy quality allocation). The systems achieved net primary energy savings in a range between 34 and 140 MJprimary/100 MJinput waste, in the different...

  5. Comparing Clinical Outcomes in Upper versus Lower Lobe Endobronchial Valve Treatment in Severe Emphysema.

    Science.gov (United States)

    Eberhardt, Ralf; Herth, Felix J F; Radhakrishnan, Sri; Gompelmann, Daniela

    2015-01-01

    Lung volume reduction surgery has been recommended for patients with upper lobe predominant emphysema and was associated with less favorable outcomes in patients with non-upper lobe predominant emphysema. The value of endobronchial valve (EBV) treatment in lower lobe predominant emphysema has not been studied. To confirm the equivalence of upper and lower lobe valve treatments in patients with heterogeneous emphysema. A retrospective analysis from the Endobronchial Valve for Emphysema Palliation Trial (VENT), where patients with heterogeneous emphysema received Zephyr® EBV (Pulmonx Corp., Redwood City, Calif., USA) or medical treatment, was performed. Patients with low interlobar collateral ventilation and accurate placement of valves in the target lobes were identified. Safety and efficacy were compared between patients who underwent upper versus lower lobe treatment. Of the 331 patients, 60 had low interlobar collateral ventilation and successful lobar exclusion (45 patients with upper lobe treatment and 15 patients with lower lobe treatment). There was no difference in baseline characteristics between the groups except for a higher destruction score (70.3 vs. 60.7%; p = 0.0010) and a higher heterogeneity index (24 vs. 13%; p = 0.0005) for the upper lobe cohort. At 180 days, both groups had improved clinically. There were no significant differences in mean changes or responder rates of forced expiratory volume in 1 s (+23.8 vs. +22.9%), the St. Georges Respiratory Questionnaire (-6.50 vs. -7.53 points), the 6-min walk test (+24.1 vs. +44.0 m), target lobe volume reduction (-1,199 vs. -1,042 ml), or in the adverse event rate between both cohorts. Patients with lower and upper lobe predominant emphysema benefit equally from EBV therapy when interlobar collateral ventilation is low and lobar exclusion is achieved. Patients with lower lobe disease did not have increased adverse events compared to patients with upper lobe emphysema. © 2015 S. Karger AG, Basel.

  6. INTRALESIONAL PLATELET RICH PLASMA vs INTRALESIONAL TRIAMCINOLONE IN THE TREATMENT OF ALOPECIA AREATA: A COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Shumez H, Prasad PVS, Kaviarasan PK, Deepika R

    2015-01-01

    Full Text Available Background: Alopecia areata (AA is a chronic non-scarring alopecia that involves the scalp and/or body, and is characterized by patchy areas of hair loss without any signs of clinical inflammation. Various therapies have been proposed for their treatment.But none have been shown to alter the course of the disease. Platelet Rich Plasma (PRP is a volume of autologous plasma that has a high platelet concentration. Growth factors released from platelets may act on stem cells in the bulge area of the follicles, stimulating the development of new follicles and promoting neovascularization. Aim: To evaluate and compare the efficacy of intralesional injection of autologous platelet rich plasma with intralesional injection of triamcinolone acetonide (10mg/ml in the treatment of alopecia areata. Methodology: 74 patients with alopecia areata were allocated into 2 groups and treated with triamcinolone and PRP injections. Treatment outcome was measured by taking into account extent and density of regrowth of hair and was expressed as a percentage of overall growth. Results: Forty eight patients were treated with triamcinolone injections and 26 patients were treated with PRP injections. Patients treated with PRP had an earlier response at the end of 6weeks than patients treated with triamcinolone. However, this difference was statistically insignificant. The overall improvement at the end of 9 weeks was 100% for all patients in both groups. Conclusion: PRP is a safe, simple, biocompatible and effective procedure for the treatment of alopecia areata with efficacy comparable with triamcinolone.

  7. Hepatic vein transit time of SonoVue: a comparative study with Levovist.

    Science.gov (United States)

    Lim, Adrian K P; Patel, Nayna; Eckersley, Robert J; Goldin, Robert D; Thomas, Howard C; Cosgrove, David O; Taylor-Robinson, Simon D; Blomley, Martin J K

    2006-07-01

    To prospectively compare transit times of Levovist and SonoVue in healthy volunteers and patients with biopsy-proved hepatitis C-related liver disease. Institutional review board approval and informed consent were obtained. Forty patients and 25 healthy volunteers were examined. Subjects fasted, a bolus of SonoVue (0.6 mL) was injected into a cubital fossa vein, and hepatic venous time-intensity profiles were measured with spectral Doppler tracing. This was repeated with two injections of Levovist (2 g) and another injection of SonoVue. Time-intensity curves of spectral Doppler signals of right and middle hepatic veins were analyzed. A sustained signal intensity increase of 10% above baseline levels indicated hepatic vein transit time (HVTT). Carotid artery audio intensity was measured in volunteers. Analysis of variance and t tests were used for statistical analysis. Twelve patients had mild hepatitis; 18, moderate or severe hepatitis; and 10, cirrhosis. Mean HVTTs in control, mild hepatitis, moderate or severe hepatitis, and cirrhosis groups were 38.3 seconds +/- 2.4 (standard error), 47.5 seconds +/- 6.5, 29.5 seconds +/- 10.8, and 17.6 seconds +/- 5.0, respectively, with Levovist (P SonoVue (P SonoVue; however, there were significant differences in HVTT between all patient groups with Levovist. HVTT of SonoVue was shorter than that of Levovist in all groups (P SonoVue or Levovist (9.1 seconds +/- 2.4 [standard error] and 8.4 seconds +/- 2.5, respectively, P = .18). HVTT was significantly shorter with SonoVue than with Levovist; there was no significant difference in cardiopulmonary transit time. RSNA, 2006

  8. Efficacy of Influenza Vaccination and Tamiflu? Treatment ? Comparative Studies with Eurasian Swine Influenza Viruses in Pigs

    OpenAIRE

    Duerrwald, Ralf; Schlegel, Michael; Bauer, Katja; Vissiennon, Th?ophile; Wutzler, Peter; Schmidtke, Michaela

    2013-01-01

    Recent epidemiological developments demonstrated that gene segments of swine influenza A viruses can account for antigenic changes as well as reduced drug susceptibility of pandemic influenza A viruses. This raises questions about the efficacy of preventive measures against swine influenza A viruses. Here, the protective effect of vaccination was compared with that of prophylactic Tamiflu® treatment against two Eurasian swine influenza A viruses. 11-week-old pigs were infected by aerosol nebu...

  9. Comparative efficacy of ceftazidime vs. carbenicillin and amikacin for treatment of neonatal septicemia.

    Science.gov (United States)

    Odio, C M; Umana, M A; Saenz, A; Salas, J L; McCracken, G H

    1987-04-01

    The efficacy and safety of ceftazidime were compared with those of carbenicillin and amikacin in 60 neonates with proved invasive bacterial infections. The two treatment groups of patients were comparable with regard to sex, gestational and chronologic ages, associated risk factors, clinical condition on enrollment, focus of infection and bacteriology. Escherichia coli was isolated from blood cultures of 31%, Pseudomonas aeruginosa from cultures of 25%, Klebsiella sp. from cultures of 13% and other Gram-negative enteric bacilli from cultures of 17% of the patients. Staphylococcus aureus was isolated from 20% (12 of 60), and coagulase-negative staphylococci from 8% (5 of 60) of the patients. All Gram-negative coliform bacilli were susceptible to ceftazidime whereas 10, 56 and 77% were resistant to amikacin, carbenicillin and ampicillin, respectively. Serum bactericidal activity against the offending pathogen was as much as 5-fold greater in ceftazidime-treated compared with conventionally treated patients. Seven patients with infections caused by organisms resistant to the study drugs were excluded from analysis. Case-fatality rates were 6.4% (2 of 31) and 21% (6 of 28) in the ceftazidime- and amikacin/carbenicillin-treated patients, respectively. Total failure rates, including deaths, were significantly higher in patients treated with amikacin/carbenicillin (8 of 28, 28.5%) compared with that of ceftazidime-treated patients (2 of 31, 6.4%). Thirteen percent (5 of 31) and 3% (1 of 28) of the ceftazidime- and amikacin/carbenicillin-treated patients, respectively, developed invasive Candida albicans superinfection while receiving treatment. In this study results of treatment with ceftazidime were superior to results of treatment with amikacin/carbenicillin for invasive bacterial infections of newborn infants.(ABSTRACT TRUNCATED AT 250 WORDS)

  10. Treatment of lateral epicondylitis with platelet-rich plasma, glucocorticoid, or saline. A comparative study

    OpenAIRE

    Mahmoud El Tayeb Nasser; Ahmed Z El Yasaki; Reem M Ezz El Mallah; Amal S.M. Abdelazeem

    2017-01-01

    Background Lateral epicondylitis (LE) is the most common overuse syndrome and related to excessive wrist extension, known as tendonitis of the extensor muscles of the forearm, and refers to pain and tenderness over the lateral epicondyle of the humerus. Local corticosteroid injection has short-term benefits in pain reduction, global improvement, and grip strength compared with placebo (saline or lidocaine) and other conservative treatments. Autologous platelet-rich plasma (PRP) injection ...

  11. Comparative outcomes of surgical treatment of patients with Impression fractures of the calcaneus

    OpenAIRE

    G. S. Golubev; A. V. Dubinskiy

    2013-01-01

    Current prospective investigation with historical control was performed to compare functional results of less invasive surgical treatment of calcaneal comminuted fractures with ordinary surgical methods. Data of 40 patients is being analyzed. One patient was lost for follow up. Patients have been divided to four subgroups according to used surgical technologies. Groups differ by trauma on reposition and method of fracture’s fixation: open reduction and plating (ORIF), cannulated screws with t...

  12. Comparative Analysis of Neural Network Training Methods in Real-time Radiotherapy

    Directory of Open Access Journals (Sweden)

    Nouri S.

    2017-03-01

    Full Text Available Background: The motions of body and tumor in some regions such as chest during radiotherapy treatments are one of the major concerns protecting normal tissues against high doses. By using real-time radiotherapy technique, it is possible to increase the accuracy of delivered dose to the tumor region by means of tracing markers on the body of patients. Objective: This study evaluates the accuracy of some artificial intelligence methods including neural network and those of combination with genetic algorithm as well as particle swarm optimization (PSO estimating tumor positions in real-time radiotherapy. Method: One hundred recorded signals of three external markers were used as input data. The signals from 3 markers thorough 10 breathing cycles of a patient treated via a cyber-knife for a lung tumor were used as data input. Then, neural network method and its combination with genetic or PSO algorithms were applied determining the tumor locations using MATLAB© software program. Results: The accuracies were obtained 0.8%, 12% and 14% in neural network, genetic and particle swarm optimization algorithms, respectively. Conclusion: The internal target volume (ITV should be determined based on the applied neural network algorithm on training steps.

  13. Comparative Analysis of Neural Network Training Methods in Real-time Radiotherapy.

    Science.gov (United States)

    Nouri, S; Hosseini Pooya, S M; Soltani Nabipour, J

    2017-03-01

    The motions of body and tumor in some regions such as chest during radiotherapy treatments are one of the major concerns protecting normal tissues against high doses. By using real-time radiotherapy technique, it is possible to increase the accuracy of delivered dose to the tumor region by means of tracing markers on the body of patients. This study evaluates the accuracy of some artificial intelligence methods including neural network and those of combination with genetic algorithm as well as particle swarm optimization (PSO) estimating tumor positions in real-time radiotherapy. One hundred recorded signals of three external markers were used as input data. The signals from 3 markers thorough 10 breathing cycles of a patient treated via a cyber-knife for a lung tumor were used as data input. Then, neural network method and its combination with genetic or PSO algorithms were applied determining the tumor locations using MATLAB© software program. The accuracies were obtained 0.8%, 12% and 14% in neural network, genetic and particle swarm optimization algorithms, respectively. The internal target volume (ITV) should be determined based on the applied neural network algorithm on training steps.

  14. Treatment timing for an orthopedic approach to patients with increased vertical dimension.

    Science.gov (United States)

    Baccetti, Tiziano; Franchi, Lorenzo; Schulz, Scott O; McNamara, James A

    2008-01-01

    The aim of this study was to investigate the role of treatment timing on the effectiveness of vertical-pull chincup (V-PCC) therapy in conjunction with a bonded rapid maxillary expander (RME) in growing subjects with mild-to-severe hyperdivergent facial patterns. The records of 39 subjects treated with a bonded RME combined with a V-PCC were compared with 29 untreated subjects with similar vertical skeletal disharmonies. Lateral cephalograms were analyzed before (T1) and after treatment or observation (T2). Both the treated and the untreated samples were divided into prepubertal and pubertal groups on the basis of cervical vertebral maturation (prepubertal treated group, 21 subjects; pubertal treated group, 18 subjects; prepubertal control group, 15 subjects; pubertal control group, 14 subjects). Mean change differences from T2 to T1 were compared in the 2 prepubertal and the 2 pubertal groups with independent-sample t tests. No statistically significant differences between the 2 prepubertal groups were found for any cephalometric skeletal measures from T1 to T2. When compared with the untreated pubertal sample, the group treated with the RME and V-PCC at puberty showed a statistically significant reduction in the inclination of the mandibular plane to the Frankfort horizontal (-2.2 mm), a statistically significant reduction in the inclination of the condylar axis to the mandibular plane (-2.2 degrees), and statistically significant supplementary growth of the mandibular ramus (1.7 mm). Treatment of increased vertical dimension with the RME and V-PCC protocol appears to produce better results during the pubertal growth spurt than before puberty, although the absolute amount of correction in the vertical skeletal parameters is limited.

  15. The effect of charging time on the comparative environmental performance of different vehicle types

    International Nuclear Information System (INIS)

    Crossin, Enda; Doherty, Peter J.B.

    2016-01-01

    Highlights: • The environmental performance of a PHEV and equivalent ICE were analysed using LCA. • Charging behaviour and electricity profiles of Australia’s NEM grid were included. • A methodology to model the marginal electricity supply mix was developed. • PHEVs charged from the NEM present greenhouse gas benefits. • Burden shifts towards other environmental indicators may occur, but are uncertain. - Abstract: This study combines electricity supply mix profiles and observed charging behaviour to compare the environmental performance of a petrol-hybrid electric vehicle (PHEV) with a class-equivalent internal combustion engine (ICE) vehicle over the full life cycle. Environmental performance is compared using a suite of indicators across the life cycle, accounting for both marginal and average electricity supply mixes for Australia’s National Energy Market (NEM) grid. The use of average emission factors for the NEM grid can serve as a good proxy for accounting charging behaviour, provided that there is a strong correlation between the time of charging and total electricity demand. Compared with an equivalent ICE, PHEVs charged from Australia’s NEM can reduce greenhouse gas emissions over the life cycle. Potential burden shifts towards acidification, eutrophication and human toxicity impacts may occur, but these impacts are uncertain due to modelling limitations. This study has the potential to inform both short and long term forecasts of the environmental impacts associated with EV deployment in Australia and provides a better understanding the temporal variations in emissions associated with electricity use in the short term.

  16. A general device driver simulator to help compare real time control systems

    International Nuclear Information System (INIS)

    Mohan, M.

    2012-01-01

    Supervisory Control And Data Acquisition systems (SCADA) such as Epics, Tango and Tine usually provide small example device driver programs for testing or to help users get started, however they differ between systems making it hard to compare the SCADA. To address this, a small simulator driver was created which emulates signals and errors similar to those received from a hardware device. The simulator driver can return from one to four signals: a ramp signal, a large alarm ramp signal, an error signal and a time-out. The different signals or errors are selected using the associated software device number. The simulator driver performs similar functions to Epic's clockApp, Tango's TangoTest and the Tine's sine-generator but the signals are independent of the SCADA. A command line application, an Epics server (IOC), a Tango device server, and a Tine server (FEC) were created and linked with the simulator driver. In each case the software device numbers were equated to a dummy device. Using the servers it was possible to compare how each SCADA behaved against the same repeatable signals. In addition to comparing and testing the SCADA the finished servers proved useful as templates for real hardware device drivers. (author)

  17. Apples and oranges: Comparing nuclear construction costs across nations, time periods, and technologies

    International Nuclear Information System (INIS)

    Lovering, Jessica R.; Nordhaus, Ted; Yip, Arthur

    2017-01-01

    The literature on energy technology costs, diffusion, and learning has been characterized by data limitations, partial or arbitrary data sets, apples to oranges comparisons, and imprecision in the use of key concepts and terminology. Two responses to our paper, Lovering et al. (2016), by Koomey et al. and Gilbert et al. reflect many of these problems, conflating learning curves with experience curves, trends in actual costs with the relationship between cost estimates and final construction costs, and component costs with total installed costs. The respondents use inconsistent definitions of demonstration, first-of-a-kind, and commercial deployment across different energy technologies. They also propose to compare final installed costs for nuclear power plants, encompassing construction and finance costs, across different national economies and time periods encompassing a wide range of macro-economic circumstances and finance arrangements that overwhelm any signal from trends associated with the actual construction costs of the plants in question. In this response, we address the specific issues raised in these papers and suggest better practices for comparing energy technology costs, trends, and technological learning. - Highlights: • Responds to arguments in and • Discusses shortcomings in broader energy cost literature. • Defends metric of Overnight Construction Cost (OCC). • Suggests better practices for comparing energy technology costs and trends.

  18. When Dread Risks Are More Dreadful than Continuous Risks: Comparing Cumulative Population Losses over Time.

    Directory of Open Access Journals (Sweden)

    Nicolai Bodemer

    Full Text Available People show higher sensitivity to dread risks, rare events that kill many people at once, compared with continuous risks, relatively frequent events that kill many people over a longer period of time. The different reaction to dread risks is often considered a bias: If the continuous risk causes the same number of fatalities, it should not be perceived as less dreadful. We test the hypothesis that a dread risk may have a stronger negative impact on the cumulative population size over time in comparison with a continuous risk causing the same number of fatalities. This difference should be particularly strong when the risky event affects children and young adults who would have produced future offspring if they had survived longer. We conducted a series of simulations, with varying assumptions about population size, population growth, age group affected by risky event, and the underlying demographic model. Results show that dread risks affect the population more severely over time than continuous risks that cause the same number of fatalities, suggesting that fearing a dread risk more than a continuous risk is an ecologically rational strategy.

  19. When Dread Risks Are More Dreadful than Continuous Risks: Comparing Cumulative Population Losses over Time.

    Science.gov (United States)

    Bodemer, Nicolai; Ruggeri, Azzurra; Galesic, Mirta

    2013-01-01

    People show higher sensitivity to dread risks, rare events that kill many people at once, compared with continuous risks, relatively frequent events that kill many people over a longer period of time. The different reaction to dread risks is often considered a bias: If the continuous risk causes the same number of fatalities, it should not be perceived as less dreadful. We test the hypothesis that a dread risk may have a stronger negative impact on the cumulative population size over time in comparison with a continuous risk causing the same number of fatalities. This difference should be particularly strong when the risky event affects children and young adults who would have produced future offspring if they had survived longer. We conducted a series of simulations, with varying assumptions about population size, population growth, age group affected by risky event, and the underlying demographic model. Results show that dread risks affect the population more severely over time than continuous risks that cause the same number of fatalities, suggesting that fearing a dread risk more than a continuous risk is an ecologically rational strategy.

  20. Comparing Young and Elderly Serial Reaction Time Task Performance on Repeated and Random Conditions

    Directory of Open Access Journals (Sweden)

    Fatemeh Ehsani

    2012-07-01

    Full Text Available Objectives: Acquisition motor skill training in elderly is at great importance. The main purpose of this study was to compare young and elderly performance in serial reaction time task on different repeated and random conditions. Methods & Materials: A serial reaction time task by using software was applied for studying motor learning in 30 young and 30 elderly. Each group divided randomly implicitly and explicitly into subgroups. A task 4 squares with different colors appeared on the monitor and subjects were asked to press its defined key immediately after observing it. Subjects practiced 8 motor blocks (4 repeated blocks, then 2 random blocks and 2 repeated blocks. Block time that was dependent variable measured and Independent-samples t- test with repeated ANOVA measures were used in this test. Results: young groups performed both repeated and random sequences significantly faster than elderly (P0.05. Explicit older subgroup performed 7,8 blocks slower than 6 block with a significant difference (P<0.05. Conclusion: Young adults discriminate high level performance than elderly in both repeated and random practice. Elderly performed random practice better than repeated practice.

  1. Comparative mapping reveals quantitative trait loci that affect spawning time in coho salmon (Oncorhynchus kisutch

    Directory of Open Access Journals (Sweden)

    Cristian Araneda

    2012-01-01

    Full Text Available Spawning time in salmonids is a sex-limited quantitative trait that can be modified by selection. In rainbow trout (Oncorhynchus mykiss, various quantitative trait loci (QTL that affect the expression of this trait have been discovered. In this study, we describe four microsatellite loci associated with two possible spawning time QTL regions in coho salmon (Oncorhynchus kisutch. The four loci were identified in females from two populations (early and late spawners produced by divergent selection from the same base population. Three of the loci (OmyFGT34TUF, One2ASC and One19ASC that were strongly associated with spawning time in coho salmon (p < 0.0002 were previously associated with QTL for the same trait in rainbow trout; a fourth loci (Oki10 with a suggestive association (p = 0.00035 mapped 10 cM from locus OmyFGT34TUF in rainbow trout. The changes in allelic frequency observed after three generations of selection were greater than expected because of genetic drift. This work shows that comparing information from closely-related species is a valid strategy for identifying QTLs for marker-assisted selection in species whose genomes are poorly characterized or lack a saturated genetic map.

  2. Psychometric properties of the adjective rating scale for withdrawal across treatment groups, gender, and over time.

    Science.gov (United States)

    Barbosa-Leiker, Celestina; McPherson, Sterling; Mamey, Mary Rose; Burns, G Leonard; Roll, John

    2014-02-01

    The adjective rating scale for withdrawal (ARSW) is commonly used to assess opiate withdrawal in clinical practice and research. The aims of this study were to examine the factor structure of the ARSW, test measurement invariance across gender and treatment groups, and assess longitudinal measurement invariance across the clinical trial. Secondary data analysis of the National Drug Abuse Treatment Clinical Trials Network 000-3, a randomized clinical trial comparing two tapering strategies, was performed. The ARSW was analyzed at baseline, end of taper and 1-month follow-up (N=515 opioid-dependent individuals). A 1-factor model of the ARSW fit the data and demonstrated acceptable reliability. Measurement invariance was supported across gender and taper groups. Longitudinal measurement invariance was not found across the course of the trial, with baseline assessment contributing to the lack of invariance. If change over time is of interest, change from post-treatment through follow-up may offer the most valid comparison. © 2013.

  3. Reducing time-to-treatment in underserved Latinas with breast cancer: the Six Cities Study.

    Science.gov (United States)

    Ramirez, Amelie; Perez-Stable, Eliseo; Penedo, Frank; Talavera, Gregory; Carrillo, J Emilio; Fernández, María; Holden, Alan; Munoz, Edgar; San Miguel, Sandra; Gallion, Kipling

    2014-03-01

    The interaction of clinical and patient-level challenges following a breast cancer diagnosis can be a significant source of health care disparities. Failure to address specific cultural features that create or exacerbate barriers can lead to less-than optimal navigation results, specifically in Hispanic/Latino women. To address these disparities, the study leaders in San Antonio, Texas, and 5 other regional partners of the federally-funded Redes En Acción: The National Latino Cancer Research Network developed a culturally-tailored patient navigation intervention model for Latinas with breast cancer. Compared with control patients, a higher percentage of navigated subjects initiated treatment within 30 days (69.0% versus 46.3%, P = .029) and 60 days (97.6% versus 73.1%, P = .001) following their cancer diagnosis. Time from cancer diagnosis to first treatment was lower in the navigated group (mean, 22.22 days; median, 23.00 days) than controls (mean, 48.30 days; median, 33.00 days). These results were independent of cancer stage at diagnosis and numerous characteristics of cancer clinics and individual participants. Successful application of patient navigation increased the percentage of Latinas initiating breast cancer treatment within 30 and 60 days of diagnosis. This was achieved through navigator provision of services such as accompaniment to appointments, transportation arrangements, patient telephone support, patient-family telephone support, Spanish-English language translation, and assistance with insurance paperwork. © 2013 American Cancer Society.

  4. Conformal treatment of prostate cancer with improved targeting: superior prostate-specific antigen response compared to standard treatment

    International Nuclear Information System (INIS)

    Corn, Benjamin W.; Hanks, Gerald E.; Schultheiss, Timothy E.; Hunt, Margie A.; Lee, W. Robert; Coia, Lawrence R.

    1995-01-01

    Purpose: Conformal radiation therapy (CRT) decreases the morbidity of prostate cancer treatment, but no published data attest to the improved ability of CRT to control disease. Therefore, we compared Prostate-Specific Antigen (PSA) response at 1 year among similarly staged patients treated by conformal techniques to those treated with conventional approaches, looking for an early indicator of tumor response. Method and Materials: Patients with locally advanced disease were treated by pelvic fields followed by prostate field conedowns; those with early stage/low grade disease received only prostate field irradiation. Between October, 1987 and November, 1991, conventional treatments used rectangular beams with or without corner blocks. Neither urethrography nor immobilization casts were used for conventionally treated patients. Between April, 1989 and December, 1992, conformal treatments have used rigid immobilization and Computed Tomography-based, beams-eye-view field design. As such, our conformal approach allowed improved targeting. Median prescribed doses (minimal doses to the Planning Target Volume) were 70 Gy (66-73 Gy) and 70.2 Gy (64.8-75 Gy) for conventionally and conformally treated patients, respectively. Median daily fraction size was 1.8 Gy for conventional treatment and 2.0 Gy for conformal therapy. Baseline PSA data were available on 170 consecutive patients treated conformally and 90 consecutive patients treated conventionally. Results: Among those receiving only prostatic field irradiation, 12-month PSA values returned to normal in 96% and 85% of conformally and conventionally treated patients, respectively, when normalization was defined as ≤ 4 ng/ml (p 15), and the use of conformal irradiation were statistically significant prognostic discriminants of PSA normalization at 1 year while total irradiation dose, clinical stage, and the addition of pelvic fields were not significant. Conclusions: As measured by PSA normalization, conformal techniques

  5. Superior chronic tolerability of adjunctive modafinil compared to pramipexole in treatment-resistant bipolar disorder.

    Science.gov (United States)

    Dell'osso, Bernardo; Timtim, Sara; Hooshmand, Farnaz; Miller, Shefali; Wang, Po W; Hill, Shelley J; Portillo, Natalie; Ketter, Terence A

    2013-08-15

    Suboptimal outcomes are common in bipolar disorder (BD) pharmacotherapy, and may be mitigated with novel adjunctive agents such as modafinil (a low-affinity dopamine transport inhibitor) and pramipexole (a dopamine D2/D3 receptor agonist). While uncontrolled long-term effectiveness data have been reported for these treatments, reports specifically assessing their comparative acute versus chronic tolerability in BD are lacking. Such information, particularly in relation to discontinuation causes, has substantial relevance, providing initial indications to clinicians which treatment may be better tolerated, and to researchers which agent ought to be assessed in longer-term controlled trials. BD outpatients assessed with the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) Affective Disorders Evaluation, and followed with the STEP-BD Clinical Monitoring Form, were naturalistically prescribed adjunctive modafinil or pramipexole, and somatic/psychiatric intolerability discontinuation rates were compared. Among 63 BD outpatients (mean ± SD age 43.5 ± 14.3 years, 60.3% female, 42.9% type I, 44.4% type II, 12.7% type not otherwise specified), taking 3.5 ± 1.5 (median 3) concurrent prescription psychotropics, adjunctive modafinil (n=24) for 626.9 ± 863.9 (286) days versus pramipexole (n=39) for 473.7 ± 613.4 (214; p=0.51) days yielded a 26.0% lower somatic/psychiatric intolerability discontinuation rate (12.5% vs. 38.5%; pstudies are warranted to assess our preliminary observation that modafinil, compared to pramipexole, may be better tolerated for longer-term BD treatment. Copyright © 2012 Elsevier B.V. All rights reserved.

  6. Laser (755 nm) and cryotherapy as depigmentation treatments for vitiligo: a comparative study.

    Science.gov (United States)

    van Geel, N; Depaepe, L; Speeckaert, R

    2015-06-01

    Depigmentation therapy can be an option in adults with extensive and refractory vitiligo. Remaining pigmented patches can be removed using depigmentation creams (monobenzyl ether of hydroquinone 20%), laser therapy or cryotherapy. In contrast to cream treatment, laser therapy and cryotherapy are fast and targeted methods, capable of destroying melanocytes selectively on one specific area. Up till now, controlled trials comparing laser and cryotherapy as depigmenting treatment in vitiligo are lacking. We performed a retrospective comparative study in 22 generalized vitiligo patients. Thirty-one pigmented test regions were exposed to cryotherapy and 20 to 755 nm laser therapy. The mean surface area per test region was 3.55 cm2 and number of treatments per test region was limited to one single session in 84.3% and varied up to four sessions (2.0%). Overall no significant difference in the capacity to induce depigmentations was observed between cryotherapy (46.7%) and laser therapy (42.9%) after one treatment. The percentage of induced depigmentation was significantly different according to the body location (P = 0.005) with best results on the trunk, followed by the arms, face, neck and less on the hands. Variables that positively influenced depigmentation results were a younger age of vitiligo onset (P = 0.012), skin type V (P cryotherapy and concerned mainly hyperpigmentation in the face. To our knowledge, this is the first study comparing head-to-head depigmentation strategies intra- and inter-individually. We could demonstrate that in general laser and cryotherapy are equally effective in inducing depigmentations in generalized vitiligo patients. Retreatment of the same area may be required in case of initial failure. © 2014 European Academy of Dermatology and Venereology.

  7. Tricuspid regurgitation following left-sided valve surgery: echocardiographic evaluation and optimal timing of surgical treatment.

    Science.gov (United States)

    Izumi, Chisato

    2015-03-01

    Severe tricuspid regurgitation may often appear and progress late after left-sided valve surgery without left-sided valve dysfunction, significant left heart failure, and pulmonary hypertension. The clinical features, echocardiographic evaluation, treatment, and prognosis of this disease entity have been discussed, but data is limited compared with left-sided valve diseases. Tricuspid annular dilatation associated with atrial fibrillation and right ventricular dysfunction strongly relate to development of isolated tricuspid regurgitation late after left-sided valve surgery. Three-dimensional evaluation may be useful in evaluating tricuspid valve anatomy in more detail. Better prognosis in patients undergoing surgical treatment for severe isolated tricuspid regurgitation than those who were treated medically has been reported; however, the timing of isolated tricuspid valve surgery is often too late. Right ventricular function is a key word for determining the timing of isolated tricuspid valve surgery; however, it is difficult to evaluate by conventional echocardiography. One of the serious issues in the future will be how to accurately evaluate right ventricular function.

  8. Comparative efficacy and acceptability of seven augmentation agents for treatment-resistant depression: A multiple-treatments meta-analysis

    Directory of Open Access Journals (Sweden)

    Hong-Bo Qi

    2014-08-01

    Full Text Available Background. Treatment-resistant depression (TRD is a therapeutic challenge for clinicians. Augmentation pharmacotherapy is effective for TRD, but it is still unclear which augmentation agent is most efficacious.  Objective. To assess the effects of seven augmentation agents on TRD.  Methods. We did a multiple-treatments meta-analysis, accounting for both direct and indirect comparisons. PubMed, the Center for Clinical and Translational Research, Web of Science, Embase, CBM-disc, the Chinese National Knowledge Infrastructure and relevant websites (up to August 2013 were searched for randomised controlled trials (RCTs about augmentation agents. The following terms were used: ‘potentiation’, ‘augmentation’, and ‘adjunct’ paired with ‘depression’ and ‘resistant depression’. No language limitation was imposed. Results. We systematically reviewed 12 RCTs (1 936 participants, which included seven augmentation agents: lithium, tricyclic antidepressant (TCA, atypical antipsychotics (AAPs, antiepileptic drugs (AEDs, buspirone, cognitive behaviour therapy (CBT and tri-iodothyronine (T3. The results revealed that T3 was more efficacious than lithium, TCA, AAPs, AEDs, buspirone and CBT with odds ratios (ORs of 1.58, 1.56, 1.51, 1.47, 1.77 and 1.25, respectively. ORs favoured CBT compared with lithium, TCA, AAPs, AEDs and buspirone. Buspirone was the least efficacious of all the other augmentation agents tested. AAPs were significantly more acceptable than lithium, and CBT more than buspirone. T3 was slightly more acceptable than lithium, and CBT more than AAPs. Conclusion. T3 as an augmentation agent should be a clinician’s first consideration instead of lithium in acute treatment for TRD. CBT might be a good augmentation agent in some communities. Buspirone should be a final option as an augmentation agent. Further research is needed, such as a well-designed, large-scale controlled trial, to support and draw definite conclusions.

  9. The comparative analysis of results of surgical treatment of myasthenia in the remote periods of disease

    Directory of Open Access Journals (Sweden)

    L. Zaslavsky

    2016-01-01

    Full Text Available Based on long-term follow-up to perform comparative analysis of long-term results of surgical treatment of myasthenia. A retrospective analysis of long-term results of surgical treatment of 146 patients with myasthenia has been carried out. We used the modified Keynes classification to estimate the severity of myasthenia and to summarize the data relating to therapy volume and treatment results. In dependence on the type of thymus lesion patients were divided into two groups. Thymus hyperplasia was verified at — 106 (72.6 % patients, tumor lesion of the thymus gland (thymoma — at 40 (27.4 % ones. The results were estimated in the following periods after thymectomy: 1—2 years, 3—4 years, 5—6 years, 7 — 9 years, 10—14 years, and over 15 years. Short- and longterm results of surgical treatment of myasthenia for the patients without tumor lesions of the thymus gland were significantly better. Positive effects of surgical treatment of myasthenia in patients with hyperplasia are observed after 1 year of surgery (p = 0.0023, and the best results are observed after 5 — 6 year of the disease, then after 7 — 9 year one notes some deterioration of state (p = 0.026. In the myasthenia patients with thymoma one notes the similar trends in dynamics of state, but in general, the results are significantly (p = 0.042 badly than in the group of the patients with hyperplasia. Starting from the first year after operation treatment the patients with myasthenia with thymus hyperplasia have statistically significant (p = 0.048 decrease of average doses of glucocorticoids, and anticholinesterase drugs. The statistically best treatment results were noted for the patients operated at the first year of the disease. Positive result of surgical treatment of myasthenia is noted both in the short- and long-term period and at thymomas. In the group of patients with thymoma one has noted significantly badly results in comparison with group of hyperplasia. It is

  10. The role of treatment timing and mode of stimulation in the treatment of primary dysmenorrhea with acupuncture: An exploratory randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Mike Armour

    Full Text Available We examined the effect of changing treatment timing and the use of manual, electro acupuncture on the symptoms of primary dysmenorrhea.A randomised controlled trial was performed with four arms, low frequency manual acupuncture (LF-MA, high frequency manual acupuncture (HF-MA, low frequency electro acupuncture (LF-EA and high frequency electro acupuncture (HF-EA. A manualised trial protocol was used to allow differentiation and individualized treatment over three months. A total of 74 women were randomly assigned to one of the four groups (LF-MA n = 19, HF-MA n = 18, LF-EA n = 18, HF-EA n = 19. Twelve treatments were performed over three menstrual cycles, either once per week (LF groups or three times in the week prior to menses (HF groups. All groups received a treatment in the first 48 hours of menses. The primary outcome was the reduction in peak menstrual pain at 12 months from trial entry.During the treatment period and nine month follow-up all groups showed statistically significant (p 0.05. Health related quality of life increased significantly in six domains in groups having high frequency of treatment compared to two domains in low frequency groups. Manual acupuncture groups required less analgesic medication than electro-acupuncture groups (p = 0.02. HF-MA was most effective in reducing secondary menstrual symptoms compared to both-EA groups (p<0.05.Acupuncture treatment reduced menstrual pain intensity and duration after three months of treatment and this was sustained for up to one year after trial entry. The effect of changing mode of stimulation or frequency of treatment on menstrual pain was not significant. This may be due to a lack of power. The role of acupuncture stimulation on menstrual pain needs to be investigated in appropriately powered randomised controlled trials.

  11. The role of treatment timing and mode of stimulation in the treatment of primary dysmenorrhea with acupuncture: An exploratory randomised controlled trial.

    Science.gov (United States)

    Armour, Mike; Dahlen, Hannah G; Zhu, Xiaoshu; Farquhar, Cindy; Smith, Caroline A

    2017-01-01

    We examined the effect of changing treatment timing and the use of manual, electro acupuncture on the symptoms of primary dysmenorrhea. A randomised controlled trial was performed with four arms, low frequency manual acupuncture (LF-MA), high frequency manual acupuncture (HF-MA), low frequency electro acupuncture (LF-EA) and high frequency electro acupuncture (HF-EA). A manualised trial protocol was used to allow differentiation and individualized treatment over three months. A total of 74 women were randomly assigned to one of the four groups (LF-MA n = 19, HF-MA n = 18, LF-EA n = 18, HF-EA n = 19). Twelve treatments were performed over three menstrual cycles, either once per week (LF groups) or three times in the week prior to menses (HF groups). All groups received a treatment in the first 48 hours of menses. The primary outcome was the reduction in peak menstrual pain at 12 months from trial entry. During the treatment period and nine month follow-up all groups showed statistically significant (p 0.05). Health related quality of life increased significantly in six domains in groups having high frequency of treatment compared to two domains in low frequency groups. Manual acupuncture groups required less analgesic medication than electro-acupuncture groups (p = 0.02). HF-MA was most effective in reducing secondary menstrual symptoms compared to both-EA groups (p<0.05). Acupuncture treatment reduced menstrual pain intensity and duration after three months of treatment and this was sustained for up to one year after trial entry. The effect of changing mode of stimulation or frequency of treatment on menstrual pain was not significant. This may be due to a lack of power. The role of acupuncture stimulation on menstrual pain needs to be investigated in appropriately powered randomised controlled trials.

  12. Waiting time disparities in breast cancer diagnosis and treatment: a population-based study in France.

    Science.gov (United States)

    Molinié, F; Leux, C; Delafosse, P; Ayrault-Piault, S; Arveux, P; Woronoff, A S; Guizard, A V; Velten, M; Ganry, O; Bara, S; Daubisse-Marliac, L; Tretarre, B

    2013-10-01

    Waiting times are key indicators of a health's system performance, but are not routinely available in France. We studied waiting times for diagnosis and treatment according to patients' characteristics, tumours' characteristics and medical management options in a sample of 1494 breast cancers recorded in population-based registries. The median waiting time from the first imaging detection to the treatment initiation was 34 days. Older age, co-morbidity, smaller size of tumour, detection by organised screening, biopsy, increasing number of specimens removed, multidisciplinary consulting meetings and surgery as initial treatment were related to increased waiting times in multivariate models. Many of these factors were related to good practices guidelines. However, the strong influence of organised screening programme and the disparity of waiting times according to geographical areas were of concern. Better scheduling of diagnostic tests and treatment propositions should improve waiting times in the management of breast cancer in France. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. SU-E-J-61: Monitoring Tumor Motion in Real-Time with EPID Imaging During Cervical Cancer Treatment

    International Nuclear Information System (INIS)

    Mao, W; Hrycushko, B; Yan, Y; Foster, R; Albuquerque, K

    2015-01-01

    Purpose: Traditional external beam radiotherapy for cervical cancer requires setup by external skin marks. In order to improve treatment accuracy and reduce planning margin for more conformal therapy, it is essential to monitor tumor positions interfractionally and intrafractionally. We demonstrate feasibility of monitoring cervical tumor motion online using EPID imaging from Beam’s Eye View. Methods: Prior to treatment, 1∼2 cylindrical radio opaque markers were implanted into inferior aspect of cervix tumor. During external beam treatments on a Varian 2100C by 4-field 3D plans, treatment beam images were acquired continuously by an EPID. A Matlab program was developed to locate internal markers on MV images. Based on 2D marker positions obtained from different treatment fields, their 3D positions were estimated for every treatment fraction. Results: There were 398 images acquired during different treatment fractions of three cervical cancer patients. Markers were successfully located on every frame of image at an analysis speed of about 1 second per frame. Intrafraction motions were evaluated by comparing marker positions relative to the position on the first frame of image. The maximum intrafraction motion of the markers was 1.6 mm. Interfraction motions were evaluated by comparing 3D marker positions at different treatment fractions. The maximum interfraction motion was up to 10 mm. Careful comparison found that this is due to patient positioning since the bony structures shifted with the markers. Conclusion: This method provides a cost-free and simple solution for online tumor tracking for cervical cancer treatment since it is feasible to acquire and export EPID images with fast analysis in real time. This method does not need any extra equipment or deliver extra dose to patients. The online tumor motion information will be very useful to reduce planning margins and improve treatment accuracy, which is particularly important for SBRT treatment with long

  14. SU-E-J-61: Monitoring Tumor Motion in Real-Time with EPID Imaging During Cervical Cancer Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Mao, W; Hrycushko, B; Yan, Y; Foster, R; Albuquerque, K [UT Southwestern Medical Center, Dallas, TX (United States)

    2015-06-15

    Purpose: Traditional external beam radiotherapy for cervical cancer requires setup by external skin marks. In order to improve treatment accuracy and reduce planning margin for more conformal therapy, it is essential to monitor tumor positions interfractionally and intrafractionally. We demonstrate feasibility of monitoring cervical tumor motion online using EPID imaging from Beam’s Eye View. Methods: Prior to treatment, 1∼2 cylindrical radio opaque markers were implanted into inferior aspect of cervix tumor. During external beam treatments on a Varian 2100C by 4-field 3D plans, treatment beam images were acquired continuously by an EPID. A Matlab program was developed to locate internal markers on MV images. Based on 2D marker positions obtained from different treatment fields, their 3D positions were estimated for every treatment fraction. Results: There were 398 images acquired during different treatment fractions of three cervical cancer patients. Markers were successfully located on every frame of image at an analysis speed of about 1 second per frame. Intrafraction motions were evaluated by comparing marker positions relative to the position on the first frame of image. The maximum intrafraction motion of the markers was 1.6 mm. Interfraction motions were evaluated by comparing 3D marker positions at different treatment fractions. The maximum interfraction motion was up to 10 mm. Careful comparison found that this is due to patient positioning since the bony structures shifted with the markers. Conclusion: This method provides a cost-free and simple solution for online tumor tracking for cervical cancer treatment since it is feasible to acquire and export EPID images with fast analysis in real time. This method does not need any extra equipment or deliver extra dose to patients. The online tumor motion information will be very useful to reduce planning margins and improve treatment accuracy, which is particularly important for SBRT treatment with long

  15. Comparative study of wastewater treatment and nutrient recycle via activated sludge, microalgae and combination systems.

    Science.gov (United States)

    Wang, Liang; Liu, Jinli; Zhao, Quanyu; Wei, Wei; Sun, Yuhan

    2016-07-01

    Algal-bacterial synergistic cultivation could be an optional wastewater treatment technology in temperate areas. In this study, a locally screened vigorous Chlorella strain was characterized and then it was used in a comparative study of wastewater treatment and nutrient recycle assessment via activated sludge (AS), microalgae and their combination systems. Chlorella sp. cultured with AS in light showed the best performance, in which case the removal efficiencies of COD, NH3-N and TP were 87.3%, 99.2% and 83.9%, respectively, within a short period of 1day. Algal-bacterial combination in light had the best settleability. Chlorella sp. contained biomass, could be processed to feed, fertilizer or fuel due to the improved quality (higher C/H/N) compared with sludge. PCR-DGGE analysis shows that two types of rhizobacteria, namely, Pseudomonas putida and Flavobacterium hauense were enriched in sludge when cultured with algae in light, serving as the basics for artificial consortium construction for improved wastewater treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Comparative Study Between Intense Pulsed Light IPLAND Pulsed Dye Laser In The Treatment Of Striae Distensae

    International Nuclear Information System (INIS)

    El-Khalafawy, Gh.M.K.A.

    2013-01-01

    Pulsed dye laser (PDL) and Intense Pulsed Light (IPL) have been used to treat Striae Distensae (SD). Thirty patients with age ranging from 14 - 42 years were included in this study. Twenty patients were treated on one side of their bodies with PDL and on the other side with IPL while seven patients were treated on both sides by IPL and three patients were treated on both sides by PDL for five sessions with four weeks interval between sessions. Skin biopsies were stained with H and E, Masson Trichrome, Orcein, Alcian blue and anti-collagen I Α1. After both PDL and IPL treatments striae width was decreased and the texture was improved in a highly significant manners where P value was 0.001. Collagen expression was increased in a highly significant manner and P values were <0.001 and 0.004 after PDL and IPL treatments respectively. However, PDL induced expression of collagen I in a highly significant manner compared to the treatment with IPL where P values were <0.001 and 0.193 respectively. Striae rubra gave a superior response with either PDL or IPL compared to striae alba which was evaluated clinically by the width, color and texture, although the histological changes could not verify this consequence. Both PDL and IPL can enhance the clinical picture of striae through collagen stimulation therapeutic modalities

  17. Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: A systematic review

    NARCIS (Netherlands)

    D.C. Bervoets (Diederik C.); P.A.J. Luijsterburg (Pim); J.J.N. Alessie (Jeroen J.N.); M.J. Buijs (Martijn J.); A.P. Verhagen (Arianne)

    2015-01-01

    textabstractQuestion: Is massage therapy effective for people with musculoskeletal disorders compared to any other treatment or no treatment? Design: Systematic review of randomised clinical trials. Participants: People with musculoskeletal disorders. Interventions: Massage therapy (manual

  18. Different Time Schedules of Mifepristone and Misoprostol in Second Trimester Medical Abortion: A Comparative Study

    Directory of Open Access Journals (Sweden)

    Nalini Sharma

    2017-07-01

    Full Text Available Background & aim: Recently, the use of mifepristone followed by misoprostol after 36-48 h has been demonstrated to be an effective and safe method for the second trimester medical abortion. However, this regimen entails long total abortion time, and consequently increases the financial burden and anxiety in the patients. We hypothesize that one day interval would be also effective and can be used to provide the abortion care. Regarding this, the present study aimed to compare the effectiveness and safety of 24- and 36-hour intervals between the administration of mifepristone and misoprstol for second trimester abortion. Methods: This prospective comparative study was conducted on 70 females who opted for second trimester medical abortion between 12-20 weeks. Mifepristone (200 mg was followed by sublingual misoprostol (800 mcg after one and two days in the first and second groups, respectively. Four hours after the administration of 800 mcg misoprostol, all patients received 400 mcg sublingual misoprostol every 4 h (maximum of four doses in 24 h. For the purpose of the study, such parameters as the rate of successful abortion 24 h after the first dose of misoprostol, abortion duration, and the associated side effect profile were examined. Results: According to the results of the present study, the two-day interval (100% was more effective than the one-day interval (91.4% (P=0.021. Furthermore, the mean induction abortion duration was significantly less in the two-day regimen. However, the side effect profiles were comparable in both groups. Conclusion: As the findings of the present study indicated, both schedules of mifepristone and misoprostol were safe and effective in second trimester abortion. The 36-hour interval between mifepristone and misoprostol was more effective than the 24-hour interval. Furthermore, it had shorter abortion duration. We can individualize the patient care by offering a one-day interval regimen since it is more

  19. Comparing cluster-level dynamic treatment regimens using sequential, multiple assignment, randomized trials: Regression estimation and sample size considerations.

    Science.gov (United States)

    NeCamp, Timothy; Kilbourne, Amy; Almirall, Daniel

    2017-08-01

    Cluster-level dynamic treatment regimens can be used to guide sequential treatment decision-making at the cluster level in order to improve outcomes at the individual or patient-level. In a cluster-level dynamic treatment regimen, the treatment is potentially adapted and re-adapted over time based on changes in the cluster that could be impacted by prior intervention, including aggregate measures of the individuals or patients that compose it. Cluster-randomized sequential multiple assignment randomized trials can be used to answer multiple open questions preventing scientists from developing high-quality cluster-level dynamic treatment regimens. In a cluster-randomized sequential multiple assignment randomized trial, sequential randomizations occur at the cluster level and outcomes are observed at the individual level. This manuscript makes two contributions to the design and analysis of cluster-randomized sequential multiple assignment randomized trials. First, a weighted least squares regression approach is proposed for comparing the mean of a patient-level outcome between the cluster-level dynamic treatment regimens embedded in a sequential multiple assignment randomized trial. The regression approach facilitates the use of baseline covariates which is often critical in the analysis of cluster-level trials. Second, sample size calculators are derived for two common cluster-randomized sequential multiple assignment randomized trial designs for use when the primary aim is a between-dynamic treatment regimen comparison of the mean of a continuous patient-level outcome. The methods are motivated by the Adaptive Implementation of Effective Programs Trial which is, to our knowledge, the first-ever cluster-randomized sequential multiple assignment randomized trial in psychiatry.

  20. Comparing winter-time herbicide behavior and exports in urban, rural, and mixed-use watersheds.

    Science.gov (United States)

    Parajulee, Abha; Lei, Ying Duan; Cao, Xiaoshu; McLagan, David S; Yeung, Leo W Y; Mitchell, Carl P J; Wania, Frank

    2018-03-26

    The presence of pesticides in streams in winter, five to six years following bans on their municipal use suggests that complicated transport behaviour, such as subsurface retention and/or accumulation of pesticides and its release during storms, could be important for understanding recovery time frames following bans or legislation that aim to reduce chemical inputs. We investigated late fall and winter dynamics of four herbicides in paired urban and rural watersheds in Toronto, Canada during rainfall and snowmelt. The range of average concentrations and loads of the sum of atrazine, metolachlor, 2,4-D and mecoprop overlapped in the two types of watersheds, with slightly higher average concentrations in the rural watershed. Relatively consistent herbicide concentration-discharge patterns (i.e. dilution) were observed in the urban sub-watersheds during rainfall, while concentration-discharge patterns were much more variable in the rural watershed. This suggests relatively uniform transport pathways across the urban sub-watersheds, compared to the rural watershed. Concentration-discharge patterns of the neutral herbicides atrazine and metolachlor were similar in both watersheds during snowmelt, though varying discharge patterns resulted in divergent timings of peak concentrations. In contrast, the acidic pesticides 2,4-D and mecoprop, which are primarily associated with urban uses, showed much more variable behavior across both watersheds and merit further investigation. Overall, this work highlights the need to consider pesticide dynamics throughout the year in order to more thoroughly assess the long-term efficacy of legislation governing their use.

  1. [Tenoxicam (texamen) in the treatment of acute cervicalgia: results of an open comparative trial].

    Science.gov (United States)

    Azimova, Iu E; Tabeeva, G R

    2014-01-01

    Acute cervical pain is one of the most common reasons for a visit to a doctor and temporal disability. We studied efficacy and safety of the nonsteroid anti-inflammatory drug tenoxicam (texamen) in the treatment of acute cervical pain in myofascial syndrome. A trial included 50 people (42 women and 8 men, mean age 42,2±6,8 years) with acute cephalgia. A main group (30 patients) received tenoxicam in dose 20 mg daily in the morning during 7 days with simultaneous therapeutic exercises with elements of postisometric relaxation of cervical muscles. A control group (20 patients) received myorelaxants and massage of a cervical-collar zone. The analgesic effect was more rapid in patients treated with texamen compared to controls. Statistically significant differences were seen in 1-3 days of treatment. In the main group, the analgesic effect long, only 16,6% of patients reported the aggravation of pain in the evening hours during the first day of treatment and 10% in the 2nd day; 23,3% patients of the main group used an additional dose of texamen, another nonsteroid anti-inflammatory drug (ibuprofen) or triptan to stop pain. The introduction of nonsteroid anti-inflammatory drugs, in particular texamen, in the complex treatment of acute cephalgia can significantly reduce pain syndrome.

  2. Results of postoperative radiation therapy of rectal cancers: with the emphasis of the overall treatment time

    International Nuclear Information System (INIS)

    Kim, Joo Young; Lee, Myung Hag; Lee, Kyu Chan

    1998-01-01

    To evaluate the results of the treatment of locally advanced but resectable rectal cancers and to analyze prognostic factors, especially with the emphasis on the treatment time factor. There were 71 patients with rectal cancer who had been treated by curative surgical procedure and postoperative radiotherapy from August 1989 to December 1993. The minimum follow up period was 24 months and the median follow-up was 35 months. Radiation therapy had been given by 6 MV linear accelerator by parallel opposing or four-box portals. Whole pelvis was treated up to 5040 cGy in most cases. Systemic chemotherapy had been given in 94% of the patients, mostly with 5-FU/ACNU regimen. Assessment for the overall and disease-free survival rates were done by life-table method and prognostic factors by Log-Rank tests. Five-year overall survival, disease-free survival were 58.8% and 57%, respectively. Two-year local control rate was 76.6%. Stage according to Modified Astler-Coller (MAC) system, over 4 positive lymph nodes, over 6 weeks interval between definitive surgery and adjuvant radiotherapy and over 7 days of interruption during radiotherapy period were statistically significant, or borderline significant prognostic factors. The treatment results of patients with rectal cancers are comparable to those of other large institutes. The treatment results for the patients with bowel wall penetration and/or positive regional lymph nodes were still discouraging for their high local recurrence rate for the patients with MAC 'C' stage diseases and high distant metastases rate even for the patients with node-negative diseases. Maybe more effective regimen of chemotherapy would be needed with proper route and schedule. To maximize postoperative adjuvant treatment, radiotherapy should be started at least within 6 weeks after surgery and preferably as soon as wound healing is completed. Interruption of treatment during radiotherapy course affects disease-free survival badly, especially if

  3. Independent calculation of the monitor units and times of treatment in radiotherapy

    International Nuclear Information System (INIS)

    Mueller, Marcio Rogerio

    2005-01-01

    In this work, an independent verification system of calculations in radiotherapy was developed and applied, using Visual Basic TM programming language. The computational program performs calculations of monitor units and treatment time, based on the algorithm of manual calculation. The calculations executed for the independent system had initially been compared with the manual calculations performed by the medical physicists of the Institute of Radiotherapy of the Hospital das Clinicas da Universidade de Sao Paulo. In this step, the results found for more than two hundred fields studied were similar to those found in the literature; deviations larger than +- 1% were found only in five cases involving errors in manual calculation. The application of the independent system, in this stage, could have identified errors up to +- 2,4%. Based on these data, the system was validated for use in clinical routine. In a second step, calculations were compared with calculations realized by the treatment computerized planning system CadPIan TM . When, again, the results were similar to those published in other works allowing to obtain levels of acceptance of the discrepancies between the calculations executed for the independent system and the calculations developed from the planning system, separated by anatomical region, as recommended according by the recent literature. For beams of 6 MV, the levels of acceptance for deviations between the calculations of monitor units, separated by treatment region were the following; breast +- 1.7%, head and neck +2%; hypophysis +- 2.2%; pelvis +- 4 . 1% and thorax +- 1.5%. For beams of 15 MV, the level suggested for pelvis was of +- 4.5%. (author)

  4. MO-AB-BRA-03: Development of Novel Real Time in Vivo EPID Treatment Verification for Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Fonseca, G; Podesta, M [Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands); Reniers, B [Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands); Research Group NuTeC, CMK, Hasselt University, Agoralaan Gebouw H, Diepenbeek B-3590 (Belgium); Verhaegen, F [Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht 6201 BN (Netherlands); Medical Physics Unit, Department of Oncology, McGill University, Montreal, Quebec H3G 1A4 (Canada)

    2016-06-15

    Purpose: High Dose Rate (HDR) brachytherapy treatments are employed worldwide to treat a wide variety of cancers. However, in vivo dose verification remains a challenge with no commercial dosimetry system available to verify the treatment dose delivered to the patient. We propose a novel dosimetry system that couples an independent Monte Carlo (MC) simulation platform and an amorphous silicon Electronic Portal Imaging Device (EPID) to provide real time treatment verification. Methods: MC calculations predict the EPID response to the photon fluence emitted by the HDR source by simulating the patient, the source dwell positions and times, and treatment complexities such as tissue compositions/densities and different applicators. Simulated results are then compared against EPID measurements acquired with ∼0.14s time resolution which allows dose measurements for each dwell position. The EPID has been calibrated using an Ir-192 HDR source and experiments were performed using different phantoms, including tissue equivalent materials (PMMA, lung and bone). A source positioning accuracy of 0.2 mm, without including the afterloader uncertainty, was ensured using a robotic arm moving the source. Results: An EPID can acquire 3D Cartesian source positions and its response varies significantly due to differences in the material composition/density of the irradiated object, allowing detection of changes in patient geometry. The panel time resolution allows dose rate and dwell time measurements. Moreover, predicted EPID images obtained from clinical treatment plans provide anatomical information that can be related to the patient anatomy, mostly bone and air cavities, localizing the source inside of the patient using its anatomy as reference. Conclusion: Results obtained show the feasibility of the proposed dose verification system that is capable to verify all the brachytherapy treatment steps in real time providing data about treatment delivery quality and also applicator

  5. Autologous platelet-rich plasma compared with whole blood for the treatment of chronic plantar fasciitis; a comparative clinical trial

    Directory of Open Access Journals (Sweden)

    Babak Vahdatpour

    2016-01-01

    Conclusions: Significant improvement in pain and function, as well as decrease in plantar fascia thickness, was observed by intralesional injection of the PRP and WB in patients with chronic PF. The study results indicate similar effectiveness between PRP and WB for the treatment of chronic PF in short-term.

  6. Levocloperastine in the treatment of chronic nonproductive cough: comparative efficacy versus standard antitussive agents.

    Science.gov (United States)

    Aliprandi, P; Castelli, C; Bernorio, S; Dell'Abate, E; Carrara, M

    2004-01-01

    The medical and social impact of cough is substantial. Current antitussive agents at effective doses have adverse events such as drowsiness, nausea and constipation that limit their use. There is also recent evidence that standard antitussive agents, such as codeine, may not reduce cough during upper respiratory infections. Therefore, there is a need for more effective and better-tolerated agents. The efficacy of levocloperastine, a novel antitussive, which acts both centrally on the cough center and on peripheral receptors in the tracheobronchial tree in treating chronic cough, was compared with that of other standard antitussive agents (codeine, levodropropizine and DL-cloperastine) in six open clinical trials. The studies enrolled patients of all ages with cough associated with various respiratory disorders including bronchitis, asthma, pneumonia and chronic obstructive pulmonary disease. Levocloperastine significantly improved cough symptoms (intensity and frequency of cough) in all trials, and improvements were observed after the first day of treatment. In children, levocloperastine reduced nighttime awakenings and irritability, and in adults it was effective in treating cough induced by angiotensin-converting enzyme inhibitors. When compared with other antitussive agents, levocloperastine had improved or comparable efficacy, with a more rapid onset of action. Importantly, no evidence of central adverse events was recorded with levocloperastine, whereas drowsiness was reported by a significant number of patients receiving codeine. Levocloperastine is an effective antitussive agent for the treatment of cough in patients of all ages. It has a more rapid onset of action than standard agents with an improved tolerability profile.

  7. Rosemary oil vs minoxidil 2% for the treatment of androgenetic alopecia: a randomized comparative trial.

    Science.gov (United States)

    Panahi, Yunes; Taghizadeh, Mohsen; Marzony, Eisa Tahmasbpour; Sahebkar, Amirhossein

    2015-01-01

    Rosmarinus officinalis L. is a medicinal plant with diverse activities including enhancement microcapillary perfusion. The present study aimed to investigate the clinical efficacy of rosemary oil in the treatment of androgenetic alopecia (AGA) and compare its effects with minoxidil 2%. Patients with AGA were randomly assigned to rosemary oil (n = 50) or minoxidil 2% (n = 50) for a period of 6 months. After a baseline visit, patients returned to the clinic for efficacy and safety evaluations every 3 months. A standardized professional microphotographic assessment of each volunteer was taken at the initial interview and after 3 and 6 months of the trial. No significant change was observed in the mean hair count at the 3-month endpoint, neither in the rosemary nor in the minoxidil group (P > .05). In contrast, both groups experienced a significant increase in hair count at the 6-month endpoint compared with the baseline and 3-month endpoint (P .05). The frequencies of dry hair, greasy hair, and dandruff were not found to be significantly different from baseline at either month 3 or month 6 trial in the groups (P > .05). The frequency of scalp itching at the 3- and 6-month trial points was significantly higher compared with baseline in both groups (P minoxidil group at both assessed endpoints (P < .05). The findings of the present trial provided evidence with respect to the efficacy of rosemary oil in the treatment of AGA.

  8. Comparative study of 15% TCA peel versus 35% glycolic acid peel for the treatment of melasma

    Directory of Open Access Journals (Sweden)

    Neerja Puri

    2012-01-01

    Full Text Available Background: Chemical peels are the mainstay of a cosmetic practitioner′s armamentarium because they can be used to treat some skin disorders and can provide aesthetic benefit. Objectives: To compare 15% TCA peel and 35% glycolic acid peel for the treatment of melasma. Material and Methods: We selected 30 participants of melasma aged between 20 and 50 years from the dermatology outpatient department and treated equal numbers with 15% TCA and 35% glycolic acid. Results: Subjective response as graded by the patient showed good or very good response in 70% participants in the glycolic acid group and 64% in the TCA group. Conclusions: There was statistically insignificant difference in the efficacy between the two groups for the treatment of melasma.

  9. Effect of water treatment on the comparative costs of evaporative and dry cooled power plants

    International Nuclear Information System (INIS)

    Gold, H.; Goldstein, D.J.; Yung, D.

    1976-07-01

    The report presents the results of a study on the relative cost of energy from a nominal 1000 Mwe nuclear steam electric generating plant using either dry or evaporative cooling at four sites in the United States: Rochester, New York; Sheridan, Wyoming; Gallup, New Mexico and Dallas, Texas. Previous studies have shown that because of lower efficiencies the total annual evaluated costs for dry cooling systems exceeds the total annual evaluated costs of evaporative cooling systems, not including the cost of water. The cost of water comprises the cost of supplying the makeup water, the cost of treatment of the makeup and/or the circulating water in the tower, and the cost of treatment and disposal of the blowdown in an environmentally acceptable manner. The purpose of the study is to show the effect of water costs on the comparative costs of dry and evaporative cooled towers

  10. Treatment of helicobacter pylori infection; a controlled randomized comparative clinical trial

    International Nuclear Information System (INIS)

    Mehmood, A.; Usmanghani, K.; Mohiuddin, E.; Akram, M.

    2010-01-01

    Helicobacter pylori induces chronic inflammation of the underlying gastric mucosa and is strongly linked to the development of duodenal and gastric carcinoma. A study was conducted to evaluate the efficacy of Pylorex, a herbal formulation, for treatment of H. pylori infection as compared to triple allopathic therapy (Omeprazole, Amoxicillin, Metronidazole). The therapeutic evaluations of these medicines were conducted on 97 clinically and immunologically diagnosed cases of H. pylori infection. H. pylori was eradicated in 16 (32.6%) out of 49 patients by the use of triple allopathic therapy (Control drugs), and in 9 (18.7%) out of 48 patients by the use of Pylorex (Test drug). Pylorex possesses a therapeutic value for the treatment of H. pylori associated symptoms but the eradication rate is superior in triple allopathic therapy. (author)

  11. Treatment of industrial effluents using electron beam accelerator and adsorption with activated carbon. A comparative study

    International Nuclear Information System (INIS)

    Las Casas, Alexandre

    2004-01-01

    Several methods are used In the pollutant removal from Industrial and domestic wastewater. However when the degradation of toxic organic pollutants, mainly the recalcitrant is objectified, the conventional treatments usually do not meet the desirable performance in the elimination or decrease the impact when the effluent are released to the environment what takes to the research of alternative methods that seek the improvement of the efficiency of the wastewater treatment systems jointly employees or separately. This work presents a study of degradation/removal of pollutants organic compounds comparing two methods using radiation from industrial electron beam and granular activated carbon (GAC). The removal efficiency of the pollutants was evaluated and it was verified that the efficiency of adsorption with activated carbon is similar to the radiation method. The obtained results allowed to evaluated the relative costs of these methods. (author)

  12. Time to response to citalopram treatment for agitation in Alzheimer's disease

    Science.gov (United States)

    Weintraub, Daniel; Drye, Lea T.; Porsteinsson, Anton P.; Rosenberg, Paul B.; Pollock, Bruce G.; Devanand, D.P.; Frangakis, Constantine; Ismail, Zahinoor; Marano, Christopher; Meinert, Curtis L.; Mintzer, Jacobo E.; Munro, Cynthia A.; Pelton, Gregory; Rabins, Peter V.; Schneider, Lon S.; Shade, David M.; Yesavage, Jerome; Lyketsos, Constantine G.

    2015-01-01

    Background Agitation is a common and significant problem in Alzheimer’s disease (AD). In the recent Citalopram for Agitation in Alzheimer’s Disease (CitAD) study, citalopram was efficacious for the treatment of AD agitation. Here we examined the time course and predictors of response to treatment. Methods Response in CitAD was defined as a modified Alzheimer Disease Cooperative Study-Clinical Global Impression of Change (mADCS-CGIC) score of 1 or 2, or a Neurobehavioral Rating Scale agitation subscale (NBRS-A) score reduction ≥50% from baseline. “Stable early response” was defined as meeting the aforementioned criteria at both weeks 3 and 9, “late response” was response at week 9 but not at week 3, and “unstable response” was response at week 3 but not at week 9. Results In the primary analyses, citalopram was superior to placebo on both the CGIC and the NBRS-A response measures. There were little between-group differences in response rates in the first three weeks of the study (21% vs 19% on the CGIC). Citalopram patients were more likely than placebo patients to be a late responder (18% vs. 8% on CGIC, Fisher’s exact p=0.09; 31% vs. 15% on NBRS-A, Fisher’s exact p=0.02). Approximately half (45–56%) of citalopram responders at end-of-study achieved response later in the study, compared with 30–44% of placebo responders. Discussion Treatment with citalopram for agitation in AD needs to be at least nine weeks in duration to allow sufficient time for full response, and study duration is an important factor to consider in the design of clinical trials for agitation in Alzheimer’s disease. PMID:26238225

  13. Effect of Silane Reaction Time on the Repair of a Nanofilled Composite Using Tribochemical Treatment.

    Science.gov (United States)

    Pilo, Raphael; Brosh, Tamar; Geron, Valery; Levartovsky, Shifra; Eliades, George

    2016-01-01

    To investigate the influence of silane reaction time on the repair strength of an aged nanofilled composite and to characterize the bonding mechanism. Nanofilled composite disks (n = 110, Filtek Supreme XT) were aged for 90 days in water. After tribochemical treatment (CoJet-Sand), the specimens were assigned to 5 groups (n = 22), primed with silane (Espe-Sil), and left to react for 1, 2, 3, 4, and 5 min. A thin layer of adhesive (Visio-Bond) was applied and a new composite with the same dimension was placed and cured. Non-aged specimens immediately layered and cured using the incremental technique served as controls. After aging (30 days in water plus 5000 thermal cycles), the interface was subjected to a shearing force until failure. Failure mode was evaluated under a stereomicroscope and scanning electron microscopy (SEM). Additional aged and treated surfaces were evaluated for morphology as well as elemental and molecular composition using SEM/EDX and ATR-FTIR. The mean shear bond strength (SBS) of the repaired specimens was 53.9 ± 8.6 MPa, with no significant difference among the various reaction times, but significantly lower compared to the control (88.1 ± 12.5 MPa). Tribochemical treatment created an irregular surface morphology with particles imbedded in the aged surface. Interfacial SEM/EDX analysis showed a 5-μm non-uniform high atomic number zone rich in Al and Si. Tribochemical treatments for repairing composite using a short silane reaction period (1 min) are equally effective as the prolonged reaction periods (2 to 5 min), yielding interfacial shear strength of ~60% of unrepaired material.

  14. Time to Response to Citalopram Treatment for Agitation in Alzheimer Disease.

    Science.gov (United States)

    Weintraub, Daniel; Drye, Lea T; Porsteinsson, Anton P; Rosenberg, Paul B; Pollock, Bruce G; Devanand, Devangere P; Frangakis, Constantine; Ismail, Zahinoor; Marano, Christopher; Meinert, Curtis L; Mintzer, Jacobo E; Munro, Cynthia A; Pelton, Gregory; Rabins, Peter V; Schneider, Lon S; Shade, David M; Yesavage, Jerome; Lyketsos, Constantine G

    2015-11-01

    Agitation is a common and significant problem in Alzheimer disease (AD). In the recent Citalopram for Agitation in Alzheimer's Disease (CitAD) study, citalopram was efficacious for the treatment of AD agitation. Here we examined the time course and predictors of response to treatment. Response in CitAD was defined as a modified Alzheimer Disease Cooperative Study Clinical Global Impression of Change (CGIC) score of 1 or 2 or a Neurobehavioral Rating Scale agitation subscale (NBRS-A) score reduction ≥ 50% from baseline. "Stable early response" was defined as meeting the aforementioned criteria at both weeks 3 and 9, "late response" was response at week 9 but not at week 3, and "unstable response" was response at week 3 but not at week 9. In the primary analyses, citalopram was superior to placebo on both the CGIC and the NBRS-A response measures. Little between-group differences were found in response rates in the first 3 weeks of the study (21% versus 19% on the CGIC). Citalopram patients were more likely than placebo patients to be a late responder (18% versus 8% on CGIC, Fisher's exact p = 0.09; 31% versus 15% on NBRS-A, Fisher's exact p = 0.02). Approximately half of citalopram responders (45%-56%) at end of study achieved response later in the study compared with 30%-44% of placebo responders. Treatment with citalopram for agitation in AD needs to be at least 9 weeks in duration to allow sufficient time for full response. Study duration is an important factor to consider in the design of clinical trials for agitation in AD. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  15. Comparative treatment trial of augmentin versus cefaclor for acute otitis media with effusion.

    Science.gov (United States)

    Odio, C M; Kusmiesz, H; Shelton, S; Nelson, J D

    1985-05-01

    A total of 150 children with acute otitis media were randomly allocated to treatment with amoxicillin-potassium clavulanate (Augmentin) or with cefaclor. Each drug was given in a daily dosage of approximately 40 mg/kg in three divided doses for ten days. Tympanocentesis done before treatment yielded specimens that contained pneumococcus or Haemophilus sp or both in 67% of specimens. Viridans group streptococci were isolated from 10% of specimens and Branhamella catarrhalis from 6%. Patients were scheduled for follow-up examinations at midtreatment, end of therapy, and at 30, 60, and 90 days. Of the 150 children, 130 were evaluable. Five of 60 patients (8%) treated with cefaclor were considered therapeutic failures because of persistent purulent drainage and isolation of the original pathogen or suprainfection. There were no failures among patients treated with Augmentin (P = .019). Rates of relapse, recurrent acute otitis media with effusion, and persistent middle ear effusion were comparable in the two groups of patients. Diaper rash, or loose stools, or both were significantly more common in children treated with Augmentin (34%) than in those taking cefaclor (12%), but in no case was it necessary to discontinue medication because of these mild side effects (P = .002). Cefaclor therapy was discontinued in one patient because of severe abdominal pain and vomiting. In this study, treatment with Augmentin was superior to treatment with cefaclor in the acute phase of acute otitis media with effusion, but Augmentin produced more adverse effects. The rates of persistent middle ear effusion and recurrent acute otitis media with effusion were comparable with the two regimens.

  16. Interactive Dose Shaping - efficient strategies for CPU-based real-time treatment planning

    Science.gov (United States)

    Ziegenhein, P.; Kamerling, C. P.; Oelfke, U.

    2014-03-01

    Conventional intensity modulated radiation therapy (IMRT) treatment planning is based on the traditional concept of iterative optimization using an objective function specified by dose volume histogram constraints for pre-segmented VOIs. This indirect approach suffers from unavoidable shortcomings: i) The control of local dose features is limited to segmented VOIs. ii) Any objective function is a mathematical measure of the plan quality, i.e., is not able to define the clinically optimal treatment plan. iii) Adapting an existing plan to changed patient anatomy as detected by IGRT procedures is difficult. To overcome these shortcomings, we introduce the method of Interactive Dose Shaping (IDS) as a new paradigm for IMRT treatment planning. IDS allows for a direct and interactive manipulation of local dose features in real-time. The key element driving the IDS process is a two-step Dose Modification and Recovery (DMR) strategy: A local dose modification is initiated by the user which translates into modified fluence patterns. This also affects existing desired dose features elsewhere which is compensated by a heuristic recovery process. The IDS paradigm was implemented together with a CPU-based ultra-fast dose calculation and a 3D GUI for dose manipulation and visualization. A local dose feature can be implemented via the DMR strategy within 1-2 seconds. By imposing a series of local dose features, equal plan qualities could be achieved compared to conventional planning for prostate and head and neck cases within 1-2 minutes. The idea of Interactive Dose Shaping for treatment planning has been introduced and first applications of this concept have been realized.

  17. Modeling nonlinear time-dependent treatment effects: an application of the generalized time-varying effect model (TVEM).

    Science.gov (United States)

    Shiyko, Mariya P; Burkhalter, Jack; Li, Runze; Park, Bernard J

    2014-10-01

    The goal of this article is to introduce to social and behavioral scientists the generalized time-varying effect model (TVEM), a semiparametric approach for investigating time-varying effects of a treatment. The method is best suited for data collected intensively over time (e.g., experience sampling or ecological momentary assessments) and addresses questions pertaining to effects of treatment changing dynamically with time. Thus, of interest is the description of timing, magnitude, and (nonlinear) patterns of the effect. Our presentation focuses on practical aspects of the model. A step-by-step demonstration is presented in the context of an empirical study designed to evaluate effects of surgical treatment on quality of life among early stage lung cancer patients during posthospitalization recovery (N = 59; 61% female, M age = 66.1 years). Frequency and level of distress associated with physical symptoms were assessed twice daily over a 2-week period, providing a total of 1,544 momentary assessments. Traditional analyses (analysis of covariance [ANCOVA], repeated-measures ANCOVA, and multilevel modeling) yielded findings of no group differences. In contrast, generalized TVEM identified a pattern of the effect that varied in time and magnitude. Group differences manifested after Day 4. Generalized TVEM is a flexible statistical approach that offers insight into the complexity of treatment effects and allows modeling of nonnormal outcomes. The practical demonstration, shared syntax, and availability of a free set of macros aim to encourage researchers to apply TVEM to complex data and stimulate important scientific discoveries. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  18. Energy implications of mechanical and mechanical–biological treatment compared to direct waste-to-energy

    International Nuclear Information System (INIS)

    Cimpan, Ciprian; Wenzel, Henrik

    2013-01-01

    Highlights: • Compared systems achieve primary energy savings between 34 and 140 MJ primary /100 MJ input waste. • Savings magnitude is foremost determined by chosen primary energy and materials production. • Energy consumption and process losses can be upset by increased technology efficiency. • Material recovery accounts for significant shares of primary energy savings. • Direct waste-to-energy is highly efficient if cogeneration (CHP) is possible. - Abstract: Primary energy savings potential is used to compare five residual municipal solid waste treatment systems, including configurations with mechanical (MT) and mechanical–biological (MBT) pre-treatment, which produce waste-derived fuels (RDF and SRF), biogas and/or recover additional materials for recycling, alongside a system based on conventional mass burn waste-to-energy and ash treatment. To examine the magnitude of potential savings we consider two energy efficiency levels (state-of-the-art and best available technology), the inclusion/exclusion of heat recovery (CHP vs. PP) and three different background end-use energy production systems (coal condensing electricity and natural gas heat, Nordic electricity mix and natural gas heat, and coal CHP energy quality allocation). The systems achieved net primary energy savings in a range between 34 and 140 MJ primary /100 MJ input waste , in the different scenario settings. The energy footprint of transportation needs, pre-treatment and reprocessing of recyclable materials was 3–9.5%, 1–18% and 1–8% respectively, relative to total energy savings. Mass combustion WtE achieved the highest savings in scenarios with CHP production, nonetheless, MBT-based systems had similarly high performance if SRF streams were co-combusted with coal. When RDF and SRF was only used in dedicated WtE plants, MBT-based systems totalled lower savings due to inherent system losses and additional energy costs. In scenarios without heat recovery, the biodrying MBS

  19. Traumatic patellar dislocation: nonoperative treatment compared with MPFL reconstruction using patellar tendon.

    Science.gov (United States)

    Bitar, Alexandre Carneiro; Demange, Marco Kawamura; D'Elia, Caio Oliveira; Camanho, Gilberto Luis

    2012-01-01

    Over the long term, acute patellar dislocations can result in patellar instability, with high recurrence rates after nonoperative treatment. To compare the results of operative (reconstruction of the medial patellofemoral ligament [MPFL]) versus nonoperative treatment of primary patellar dislocation. Randomized controlled trial; Level of evidence, 1. Thirty-nine patients (41 knees) (mean age, 24.2 years; range, 12-38 years) with acute patellar dislocation were randomized into 2 groups. One group was treated nonoperatively with immobilization and physiotherapy, the other was treated surgically with MPFL reconstruction; both groups were evaluated with minimum follow-up of 2 years. The Kujala questionnaire was applied to assess pain and quality of life, and recurrence was evaluated. Pearson χ(2) or Fisher exact test was used in the statistical evaluation. The statistical analysis showed that the mean Kujala score was significantly lower in the nonoperative group (70.8), when compared with the mean value of the surgical group (88.9; P = .001). The surgical group presented a higher percentage of "good/excellent" results (71.43%) on the Kujala score when compared with the nonoperative group (25.0%; P = .003). The nonoperative group presented a large number of recurrences and subluxations (7 patients; 35% of cases), whereas there were no reports of recurrences or subluxations in the surgical group. Treatment with MPFL reconstruction using the patellar tendon produced better results, based on the analyses of posttreatment recurrences and the better final results of the Kujala questionnaire after a minimum follow-up period of 2 years.

  20. Invisalign and traditional orthodontic treatment postretention outcomes compared using the American Board of Orthodontics objective grading system.

    Science.gov (United States)

    Kuncio, Daniel; Maganzini, Anthony; Shelton, Clarence; Freeman, Katherine

    2007-09-01

    To compare the postretention dental changes between patients treated with Invisalign and those treated with conventional fixed appliances. This is a comparative cohort study using patient records of one orthodontist in New York City. Two groups of patients were identified that differed only in the method of treatment (Invisalign and Braces group). Dental casts and panoramic radiographs were collected and analyzed using the objective grading system (OGS) of the American Board of Orthodontics (ABO). The cases were evaluated immediately after appliance removal (T1) and at a postretention time (T2), three years after appliance removal. All patients had completed active orthodontic treatment and had undergone at least one year of retention. A Wilcoxon rank sum test was used to evaluate differences in treatment outcomes between the groups for each of the eight categories in the OGS, including four additional subcategories in the alignment category. A Wilcoxon signed rank test was used to determine the significance of changes within each group from T1 to T2. The change in the total alignment score in the Invisalign group was significantly larger than that for the Braces group. There were significant changes in total alignment and mandibular anterior alignment in both groups. There were significant changes in maxillary anterior alignment in the Invisalign group only. In this sample for this period of observation, patients treated with Invisalign relapsed more than those treated with conventional fixed appliances.

  1. Comparative Study of Professional vs Mass Market Topical Products for Treatment of Facial Photodamage.

    Science.gov (United States)

    Reich, Hilary; Wallander, Irmina; Schulte, Lacie; Goodier, Molly; Zelickson, Brian

    2016-01-01

    Many over the counter topical products claim to reverse the signs of cutaneous photo-damage. To date, the two most studied ingredients for improving the texture, tone, and pigmentation of the skin are topical retinoids and hydroquinone. This split face study compares a mass market skincare regimen with a prescription skin care regimen for improvement in photo damaged skin. Twenty-seven subjects with moderate photo damaged facial skin were enrolled. Each subject was consented and assigned with the mass market anti-aging system (Treatment A) to one side of the face and the prescription anti-aging system (Treatment B or Treatment C) to the other side of the face. Treatment B contained 13 subjects whom did not use 0.025% Retinol cream. Treatment C contained 14 subjects who used a 0.025% Retinol Cream. Subjects had 4 visits over 12 weeks for digital photography and surveys. Photographs were evaluated by blinded physicians. Physician objective analysis showed all three systems to have a statistically significant clinical improvement in photoaged skin seen in as little as 4 weeks of use. Participant's surveys rated the mass market system higher than both of the professional systems for visible skin changes, ease of use, and likelihood to recommend to a friend. Twelve of twenty-seven subjects preferred the mass market system for overall improvement while twelve thought each system gave the same improvement. This study demonstrates that a mass marketed skin care system can give similar clinical improvements in photo-aged skin as a professionally dispensed prescription system and the majority of participants preferred the mass-marketed system.

  2. TU-H-CAMPUS-TeP1-02: Seated Treatment: Setup Uncertainty Comparable to Supine

    Energy Technology Data Exchange (ETDEWEB)

    McCarroll, R [UT MD Anderson Cancer Center, Houston, TX (United States); UT Health Science Center, Graduate School of Biomedical Sciences, Houston, TX (United States); Beadle, B; Fullen, D; Balter, P; Followill, D; Stingo, F; Yang, J; Court, L [UT MD Anderson Cancer Center, Houston, TX (United States)

    2016-06-15

    Purpose: For some head and neck patients, positioning in the supine position is not well tolerated. For these patients, treatment in a seated position would be preferred. We have evaluated inter- and intra- fraction uncertainty of patient set-up in a novel treatment chair which is compatible with modern linac designs. Methods: Five head-and-neck cancer patients were positioned in the chair, fitted with immobilization devices, and imaged with orthogonal X-rays. The couch (with chair attached) was rotated to simulate delivery (without actual treatment), another set of images were acquired, providing a measure of intra-fraction displacement. The patient then got off of and back onto the chair and the process was repeated, thus providing a measure of inter-fraction set-up uncertainty. Six sub-regions in the head-and-neck were rigidly registered to evaluate local intra- and interfraction displacement. Image guidance was simulated by first registering one sub-region; the residual displacement of other sub-regions was then measured. Additionally, a patient questionnaire was administered to evaluate tolerance of the seated position. Results: The chair design is such that all advantages of couch motions may be utilized. Average inter- and intrafraction displacements of all sub-regions in the seated position were less than 2 and 3 mm, respectively. When image guidance was simulated, interfraction displacements were reduced by an average of 4 mm, providing comparable setup to the supine position. The enrolled patients, who had no indication for a seated treatment position, reported no preference for the seated or the supine position. Conclusion: The novel chair design provides acceptable inter- and intra-fraction displacement, with reproducibility similar to that observed for patients in the supine position. Such a chair will be utilized for patients who cannot tolerate the supine position and use with CBCT images for planning, in a fixed-beam linac system, and for other

  3. Comparing treatment persistence, healthcare resource utilization, and costs in adult patients with major depressive disorder treated with escitalopram or citalopram.

    Science.gov (United States)

    Wu, Eric Q; Greenberg, Paul E; Ben-Hamadi, Rym; Yu, Andrew P; Yang, Elaine H; Erder, M Haim

    2011-03-01

    Major depressive disorder is the most common type of depression, affecting 6.6% of adults in the United States annually. Citalopram and escitalopram are common second-generation antidepressants used for the treatment of patients with this disorder. Because citalopram is available in generic forms that have lower acquisition costs compared with the branded escitalopram, some health plans may provide incentives to encourage the use of the generic option. Decisions based solely on drug acquisition costs may encourage the use of a therapy that is less cost-effective when treatment persistence, healthcare utilization, and overall costs are factored in. To compare, in a real-world setting, the treatment persistence, healthcare utilization, and overall costs of managing adult patients with major depressive disorder who are treated with escitalopram or citalopram. Administrative claims data (from January 1, 2003, to June 30, 2005) were analyzed for patients with major depressive disorder aged ≥18 years. Patients filled ≥1 prescriptions for citalopram or for escitalopram (first-fill time was defined as the index date) and had no second-generation antidepressant use during the 6-month preindex period. Treatment persistence, healthcare utilization, and healthcare costs were measured over the 6-month preindex and 6-month postindex periods and compared between patients treated with citalopram or escitalopram, using unadjusted and multivariate analyses. Patients receiving escitalopram (N = 10,465) were less likely to discontinue the treatment (hazard ratio 0.94; P = .005) and switch to another second-generation antidepressant (hazard ratio 0.83; P escitalopram were also less likely to have a hospital admission (odds ratio 0.88; P = .036) or an emergency department visit and had lower total healthcare costs (-$1174) and major depressive disorder-related costs (-$109; P escitalopram, patients treated with escitalopram had better treatment persistence, lower healthcare

  4. Randomized comparative clinical trial of artemisia sieberi 5% lotion and clotrimazole 1% lotion for the treatment of pityriasis versicolor

    Directory of Open Access Journals (Sweden)

    Rad Farrokh

    2008-01-01

    Full Text Available Aims: To compare the therapeutic effects of topical Artremisia sieberi 5% lotion with topical clotrimazole 1% lotion in the treatment of pityriasis versicolor. Materials and Methods: 100 patients with pityriasis versicolor and microscopic identification of Malassezia furfur were randomly assigned to treatment with either topical Artemisia sieberi 5% lotion (group 1 or topical clotrimazole 1% lotion (group 2 for 2 weeks. Group 1 and group 2 consisted of 51 and 49 patients respectively. The patients were evaluated both clinically and mycologically at baseline and every 2 weeks for a period of 4 weeks. Results: At the end of the second week, clinical cure rates were 86.3% and 65.3% for group 1 and group 2 respectively ( P < 0.01, but at the same time mycological cure rate was 92.2% for group 1 and 73.5% for group 2 ( P < 0.05. At the end of the fourth week, clinical cure rates were 86.3% and 59.2% for group 1 and group 2 respectively ( P < 0.01, and at the same time mycologic cure rate was 96.1% for group 1 and 65.3% for group 2 ( P < 0.01. Conclusions: The results of this study demonstrated that Artemisia sieberi 5% lotion was more effective than clotrimazole 1% lotion in the treatment of pityriasis versicolor.

  5. Duodenal ulcer healing on 2 g of sucralfate daily at bedtime compared to 1 g four times daily

    DEFF Research Database (Denmark)

    Bendtsen, Flemming; Ebbehøj, N; Fallingborg, J

    1990-01-01

    Seventy-seven patients with endoscopically verified duodenal ulcers were randomized to treatment with either 2 g sucralfate daily at bedtime or 1 g sucralfate q.d.s. in a controlled double-blind comparative study. After a 4-week treatment period, the healing rate was 68% for the former and 69% fo...

  6. Duodenal ulcer healing on 2 g of sucralfate daily at bedtime compared to 1 g four times daily

    DEFF Research Database (Denmark)

    Bendtsen, Flemming; Ebbehøj, N; Fallingborg, J

    1990-01-01

    Seventy-seven patients with endoscopically verified duodenal ulcers were randomized to treatment with either 2 g sucralfate daily at bedtime or 1 g sucralfate q.d.s. in a controlled double-blind comparative study. After a 4-week treatment period, the healing rate was 68% for the former and 69...

  7. Effectiveness of a psychosomatic day hospital treatment for the elderly: a naturalistic longitudinal study with waiting time before treatment as control condition.

    Science.gov (United States)

    Wunner, Christina; Reichhart, Corinne; Strauss, Bernhard; Söllner, Wolfgang

    2014-02-01

    In 2006 the psychosomatic day hospital for the treatment of acute mental illness of elderly people opened as the first clinic of its kind in Germany. The aim of this study was to determine treatment effectiveness and identify possible effects on health care utilization. Designed as a naturalistic study with waiting time before admission as a control condition, the primary outcome was the level of depressive symptoms as measured by the hospital anxiety and depression scale. Secondary outcomes were depressive and somatoform symptoms and syndromes as measured with the patient health questionnaire, patient perception of interpersonal problems and health care use before and after treatment. After treatment significant improvement (ppsychosomatic treatment a reduction in medical service usage was visible. Number of consultations (pre: 13, post: 9), number and length of hospital stays (pre: 1, 7 weeks, post: 0, 3 weeks) were both significantly (ppsychosomatic day hospital treatment of the elderly is successful. Reduced usage of health care and the lower costs for day hospital treatment compared to inpatient treatment point to a positive cost-effect-ratio. Expanding this psychosomatic intervention would be useful in reducing the current gap in mental health care for the elderly. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. SU-F-J-54: Towards Real-Time Volumetric Imaging Using the Treatment Beam and KV Beam

    Energy Technology Data Exchange (ETDEWEB)

    Chen, M; Rozario, T; Liu, A; Jiang, S; Lu, W [UT Southwestern Medical Center, Dallas, TX (United States)

    2016-06-15

    Purpose: Existing real-time imaging uses dual (orthogonal) kV beam fluoroscopies and may result in significant amount of extra radiation to patients, especially for prolonged treatment cases. In addition, kV projections only provide 2D information, which is insufficient for in vivo dose reconstruction. We propose real-time volumetric imaging using prior knowledge of pre-treatment 4D images and real-time 2D transit data of treatment beam and kV beam. Methods: The pre-treatment multi-snapshot volumetric images are used to simulate 2D projections of both the treatment beam and kV beam, respectively, for each treatment field defined by the control point. During radiation delivery, the transit signals acquired by the electronic portal image device (EPID) are processed for every projection and compared with pre-calculation by cross-correlation for phase matching and thus 3D snapshot identification or real-time volumetric imaging. The data processing involves taking logarithmic ratios of EPID signals with respect to the air scan to reduce modeling uncertainties in head scatter fluence and EPID response. Simulated 2D projections are also used to pre-calculate confidence levels in phase matching. Treatment beam projections that have a low confidence level either in pre-calculation or real-time acquisition will trigger kV beams so that complementary information can be exploited. In case both the treatment beam and kV beam return low confidence in phase matching, a predicted phase based on linear regression will be generated. Results: Simulation studies indicated treatment beams provide sufficient confidence in phase matching for most cases. At times of low confidence from treatment beams, kV imaging provides sufficient confidence in phase matching due to its complementary configuration. Conclusion: The proposed real-time volumetric imaging utilizes the treatment beam and triggers kV beams for complementary information when the treatment beam along does not provide sufficient

  9. SU-F-J-54: Towards Real-Time Volumetric Imaging Using the Treatment Beam and KV Beam

    International Nuclear Information System (INIS)

    Chen, M; Rozario, T; Liu, A; Jiang, S; Lu, W

    2016-01-01

    Purpose: Existing real-time imaging uses dual (orthogonal) kV beam fluoroscopies and may result in significant amount of extra radiation to patients, especially for prolonged treatment cases. In addition, kV projections only provide 2D information, which is insufficient for in vivo dose reconstruction. We propose real-time volumetric imaging using prior knowledge of pre-treatment 4D images and real-time 2D transit data of treatment beam and kV beam. Methods: The pre-treatment multi-snapshot volumetric images are used to simulate 2D projections of both the treatment beam and kV beam, respectively, for each treatment field defined by the control point. During radiation delivery, the transit signals acquired by the electronic portal image device (EPID) are processed for every projection and compared with pre-calculation by cross-correlation for phase matching and thus 3D snapshot identification or real-time volumetric imaging. The data processing involves taking logarithmic ratios of EPID signals with respect to the air scan to reduce modeling uncertainties in head scatter fluence and EPID response. Simulated 2D projections are also used to pre-calculate confidence levels in phase matching. Treatment beam projections that have a low confidence level either in pre-calculation or real-time acquisition will trigger kV beams so that complementary information can be exploited. In case both the treatment beam and kV beam return low confidence in phase matching, a predicted phase based on linear regression will be generated. Results: Simulation studies indicated treatment beams provide sufficient confidence in phase matching for most cases. At times of low confidence from treatment beams, kV imaging provides sufficient confidence in phase matching due to its complementary configuration. Conclusion: The proposed real-time volumetric imaging utilizes the treatment beam and triggers kV beams for complementary information when the treatment beam along does not provide sufficient

  10. [Improving the effectiveness of functional jaw orthopedics in Class II malocclusion by appropriate treatment timing].

    Science.gov (United States)

    Baccetti, Tiziano

    2010-12-01

    Time can be considered the fourth dimension in dento-facial orthopedics. Treatment timing can play a significant role in the outcomes of treatment aimed to produce an orthopedic effect in the craniofacial structures. The results of methodologically-sound cephalometric studies of both the past and the recent history of orthodontics clearly indicate that optimal treatment timing for Class II skeletal disharmony with a functional appliance (e.g. twin block) is during or slightly after the peak in mandibular growth as revealed by a reliable biologic indicator of individual skeletal maturity such as the cervical vertebral maturation method. © EDP Sciences, SFODF, 2010.

  11. Thiazolidinediones are associated with a decreased risk of atrial fibrillation compared with other antidiabetic treatment

    DEFF Research Database (Denmark)

    Pallisgaard, Jannik Langtved; Lindhardt, Tommi Bo; Staerk, Laila

    2017-01-01

    AIM: The aim of this study was to investigate the association between thiazolidinediones (TZDs) vs. other antidiabetic drugs and risk of atrial fibrillation (AF) in diabetic patients. METHOD AND RESULTS: Diabetes mellitus (diabetes) increases the risk of AF by approximately 34%. TZD is an insulin...... drugs. The decreased risk of AF remained significant after adjusting for age, sex, and comorbidities with a hazard ratio (95% CI) of 0.76 (0.57-1.00), P = 0.047 associated with TZD treatment compared with other antidiabetic drugs. CONCLUSION: Use of a TZD to treat diabetes was associated with reduced...... sensitizer that also has anti-inflammatory effects, which might decrease the risk of AF compared with other antidiabetic drugs. We used data from the Danish nationwide registries to study 108 624 patients with diabetes and without prior AF who were treated with metformin or sulfonylurea as first-line drugs...

  12. Comparative outcomes of surgical treatment of patients with Impression fractures of the calcaneus

    Directory of Open Access Journals (Sweden)

    G. S. Golubev

    2013-01-01

    Full Text Available Current prospective investigation with historical control was performed to compare functional results of less invasive surgical treatment of calcaneal comminuted fractures with ordinary surgical methods. Data of 40 patients is being analyzed. One patient was lost for follow up. Patients have been divided to four subgroups according to used surgical technologies. Groups differ by trauma on reposition and method of fracture’s fixation: open reduction and plating (ORIF, cannulated screws with triple thread (FusiFix, external fixation, other (diafixation, ordinary cortical or metaphyseal screws. Foot function was estimated by FAOS scale between 1 and six and more years after surgery. Combination of modified principles of reposition after Essex - Lopresti, using of original instrument set and C-arc with FusiFix stable fixation enables minimal complications add ratio. This method also creates good possibilities for foot functional recovery (average normalized FAOS index is 92 after 1 year comparatively to 60 (ORIF and 57(ExFix.

  13. Small angle neutron scattering comparative investigation of Inconel 738 samples submitted to different ageing treatments

    International Nuclear Information System (INIS)

    Rogante, M.; Lebedev, V.T.

    2008-01-01

    Inconel 738 samples submitted to different annealing temperatures and ageing times have been investigated by small angle neutron scattering (SANS), with the aim to study precipitates phases microstructural evolution and material behaviour. The same material is a γ' (Ni 3 Al, Ti) precipitation hardened nickel base superalloy adopted at high temperatures in aggressive environments, and it has found applications over a very wide range of temperature. Information on the thermal treatment effects have been obtained, in particular concerning precipitate size and volume fraction distributions. The results contribute to confirm the adopted method to a level of industrial applicability in the considered sector

  14. A Comparative Study of Portmanteau Tests for Univariate Time Series Models

    Directory of Open Access Journals (Sweden)

    Sohail Chand

    2006-07-01

    Full Text Available Time series model diagnostic checking is the most important stage of time series model building. In this paper the comparison among several suggested diagnostic tests has been made using the simulation time series data.

  15. Comparative Studies of Prediction Strategies for Solar X-ray Time Series

    Science.gov (United States)

    Muranushi, T.; Hattori, T.; Jin, Q.; Hishinuma, T.; Tominaga, M.; Nakagawa, K.; Fujiwara, Y.; Nakamura, T.; Sakaue, T.; Takahashi, T.; Seki, D.; Namekata, K.; Tei, A.; Ban, M.; Kawamura, A. D.; Hada-Muranushi, Y.; Asai, A.; Nemoto, S.; Shibata, K.

    2016-12-01

    Crucial virtues for operational space weather forecast are real-timeforecast ability, forecast precision and customizability to userneeds. The recent development of deep-learning makes it veryattractive to space weather, because (1) it learns gradually incomingdata, (2) it exhibits superior accuracy over conventional algorithmsin many fields, and (3) it makes the customization of the forecasteasier because it accepts raw images.However, the best deep-learning applications are only attainable bycareful human designers that understands both the mechanism of deeplearning and the application field. Therefore, we need to foster youngresearchers to enter the field of machine-learning aided forecast. So,we have held a seminar every Monday with undergraduate and graduatestudents from May to August 2016.We will review the current status of space weather science and theautomated real-time space weather forecast engine UFCORIN. Then, weintroduce the deep-learning space weather forecast environments wehave set up using Python and Chainer on students' laptop computers.We have started from simple image classification neural network, thenimplemented space-weather neural network that predicts future X-rayflux of the Sun based on the past X-ray lightcurve and magnetic fieldline-of-sight images.In order to perform each forecast faster, we have focused on simplelightcurve-to-lightcurve forecast, and performed comparative surveysby changing following parameters: The size and topology of the neural network Batchsize Neural network hyperparameters such as learning rates to optimize the preduction accuracy, and time for prediction.We have found how to design compact, fast but accurate neural networkto perform forecast. Our forecasters can perform predictionexperiment for four-year timespan in a few minutes, and achieveslog-scale errors of the order of 1. Our studies is ongoing, and inour talk we will review our progress till December.

  16. Pharmaceutical Innovation in the Treatment of Schizophrenia and Mental Disorders Compared with Other Diseases.

    Science.gov (United States)

    MacEwan, Joanna P; Seabury, Seth; Aigbogun, Myrlene Sanon; Kamat, Siddhesh; van Eijndhoven, Emma; Francois, Clement; Henderson, Crystal; Citrome, Leslie

    2016-01-01

    The objectives of this study were to assess the level of private and public investment in research and development of treatments for schizophrenia and other mental disorders compared to other diseases in order to present data on the economic burden and pharmaceutical innovation by disease area, and to compare the level of investment relative to burden across different diseases. The levels of investment and pharmaceutical innovation relative to burden across different diseases were assessed. Disease burden and prevalence for mental disorders (schizophrenia, bipolar disorder, and major depressive disorder); cancer; rheumatoid arthritis; chronic obstructive pulmonary disorder; diabetes; cardiovascular disease; and neurological disorders (dementia and epilepsy) were estimated from literature sources. Pharmaceutical treatment innovation was measured by the total number of drug launches and the number of drugs launched categorized by innovativeness. Research and development expenditures were estimated using published information on annual public and domestic private research and development expenditures by disease area. Lastly, investment relative to disease burden was measured among the set of disease classes for which all three measures were available: schizophrenia, bipolar disorder, major depressive disorder, cancer, rheumatoid arthritis, chronic obstructive pulmonary disease, diabetes, cardiovascular disease, and neurology (dementia and epilepsy combined). The level of investment and pharmaceutical innovation in mental disorders was comparatively low, especially relative to the burden of disease. For mental disorders, investment was $3.1 per $1,000 burden invested in research and development for schizophrenia, $1.8 for major depressive disorder, and $0.4 for bipolar disorder relative to cancer ($75.5), chronic obstructive pulmonary disease ($9.4), diabetes ($7.6), cardiovascular disease ($6.3), or rheumatoid arthritis ($5.3). Pharmaceutical innovation was also low

  17. [Comparing effectivity of VAC therapy for treatment of infections following arthroplasty or soft-tissue surgery].

    Science.gov (United States)

    Schmal, H; Oberst, M; Hansen, S; Six-Merker, J; Südkamp, N P; Izadpanah, K

    2013-08-01

    Although vacuum-assisted wound closure (VAC) has been developed into a standard technique in septic surgery, reliable data about the efficacy of the treatment are still lacking. Postoperative infections after arthroplasty or soft-tissue surgery were identified using a prospective database for complications (Critical Incidence Reporting System) which was retrospectively supplemented with items for evaluation of VAC therapy. Eradication success of infection was analysed considering epidemiological parameters, course of treatment, and characteristics of causing bacterial strains. Furthermore, serological C-reactive protein (CRP) concentrations were evaluated for diagnostic and prognostic reliability. 92 patients with an average age of 60 ± 4 years were included in the study. Patients with soft tissue infections (STI, n = 53) were statistically significant younger compared to patients with infections following arthroplasty (AI, n = 39) (53 ± 6 vs. 70 ± 4 years; p infected endoprostheses were longer treated on intensive care units (6.1 ± 8.4 vs. 3.5 ± 6.5 days; p infection was with 81 % statistically significant higher in the STI group compared to 38 % in the AI group (p infections in the AI group were associated with a better healing success when compared to chronic infections (p infections (p infection, the probability for eradication of infection was impaired (p infection was reached. CRP values were higher in the AI group and associated with the prognosis (p VAC therapy is higher after soft-tissue infections compared to infections following arthroplasty. Accordingly, mortality is higher in this group. Chronic courses have worse chances for healing in both groups. For serological CRP values a prognostic relevance could be shown. Georg Thieme Verlag KG Stuttgart · New York.

  18. Comparable performance of TMA and Real-Time PCR in detecting minimal residual hepatitis C viraemia at the end of antiviral therapy.

    Science.gov (United States)

    Bortoletto, Gladis; Campagnolo, Davide; Mirandola, Silvia; Comastri, Giuseppe; Severini, Letizia; Pulvirenti, Franco Renato; Alberti, Alfredo

    2011-03-01

    Antiviral therapy for chronic hepatitis C may cause transient on-treatment response followed by post-treatment relapse. We have compared the prognostic value for post-treatment relapse of minimal hepatitis C residual viraemia detected at end-of-therapy by transcription mediated assay (TMA) and by Abbott RealTime PCR HCV assay. Minimal residual viraemia was investigated in 202 HCV patients who had completed a full course of Pegylated Interferon (PEG-IFN) plus ribavirin and were HCV-RNA negative by conventional PCR in two separate serum samples obtained during the last week of therapy and the results were then correlated with post-treatment outcome. Minimal residual viraemia was detected in 22/202 (11%, 95% CI: 7-16%) and in 28/202 (13.8%, 95% CI 10-19%) patients by TMA and by Abbott RealTime HCV assay, respectively, with 92% concordant results. Post-treatment relapse was seen in 81.8% (95% CI: 60-93%) of TMA positive and in 82.1% (95% CI: 64-92%) of Abbott RealTime HCV assay positive cases compared to 16.6% (95% CI: 12-23%) of TMA negative and 17.2% (95% CI: 12-23%) of Abbott RealTime HCV assay negative patients. These results indicate that TMA and the Abbott RealTime HCV assay have comparable sensitivity and specificity in identifying minimal residual viraemia at the end of antiviral therapy, with excellent predictive value for post-treatment relapse. Copyright © 2010 Elsevier B.V. All rights reserved.

  19. Intra-Articular Hyaluronic Acid Compared to Traditional Conservative Treatment in Dogs with Osteoarthritis Associated with Hip Dysplasia

    Directory of Open Access Journals (Sweden)

    Gabriel O. L. Carapeba

    2016-01-01

    Full Text Available The purpose of this study was to compare the efficacy of the intra-articular (IA hyaluronic acid injection to traditional conservative treatment (TCT in dogs with osteoarthritis (OA induced by hip dysplasia. Sixteen dogs were distributed into two groups: Hyal: IA injection of hyaluronic acid (5–10 mg, and Control: IA injection with saline solution (0.5–1.0 mL in combination with a TCT using an oral nutraceutical (750–1000 mg every 12 h for 90 days and carprofen (2.2 mg/kg every 12 h for 15 days. All dogs were assessed by a veterinarian on five occasions and the owner completed an assessment form (HCPI and CPBI at the same time. The data were analyzed using unpaired t test, ANOVA, and Tukey’s test (P<0.05. Compared with baseline, lower scores were observed in both groups over the 90 days in the veterinarian evaluation, HCPI, and CPBI (P<0.001. The Hyal group exhibited lower scores from 15 to 90 and 60 to 90 days, in the CBPI and in the veterinarian evaluation, respectively, compared to the Control group. Both treatments reduced the clinical signs associated with hip OA. However, more significant results were achieved with intra-articular hyaluronic acid injection.

  20. Outpatient management of febrile neutropenia: time to revise the present treatment strategy

    DEFF Research Database (Denmark)

    Carstensen, M.; Sørensen, Jens Benn

    2008-01-01

    treatment failure (P management of adult cancer patients with low-risk febrile neutropenia is safe, effective, and comparable to standard hospital-based therapy. Patients at low risk are outpatients and are hemodynamically...

  1. Mixed-waste treatment -- What about the residuals? A comparative analysis of MSO and incineration

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-06-01

    This report examines the issues concerning final waste forms, or residuals, that result from the treatment of mixed waste in molten salt oxidation (MSO) and incinerator systems. MSO is a technology with the potential to treat a certain segment of the waste streams at US Department of Energy (DOE) sites. MSO was compared with incineration because incineration is the best demonstrated available technology (BDAT) for the same waste streams. The Grand Junction Projects Office (GJPO) and Oak Ridge National Laboratory (ORNL) prepared this report for the DOE Office of Environmental Restoration (OER). The goals of this study are to objectively evaluate the anticipated residuals from MSO and incineration, examine regulatory issues for these final waste forms, and determine secondary treatment options. This report, developed to address concerns that MSO residuals present unique disposal difficulties, is part of a larger effort to successfully implement MSO as a treatment technology for mixed and hazardous waste. A Peer Review Panel reviewed the MSO technology in November 1991, and the implementation effort is ongoing under the guidance of the MSO Task Force.

  2. Mixed-waste treatment -- What about the residuals? A comparative analysis of MSO and incineration

    International Nuclear Information System (INIS)

    1993-06-01

    This report examines the issues concerning final waste forms, or residuals, that result from the treatment of mixed waste in molten salt oxidation (MSO) and incinerator systems. MSO is a technology with the potential to treat a certain segment of the waste streams at US Department of Energy (DOE) sites. MSO was compared with incineration because incineration is the best demonstrated available technology (BDAT) for the same waste streams. The Grand Junction Projects Office (GJPO) and Oak Ridge National Laboratory (ORNL) prepared this report for the DOE Office of Environmental Restoration (OER). The goals of this study are to objectively evaluate the anticipated residuals from MSO and incineration, examine regulatory issues for these final waste forms, and determine secondary treatment options. This report, developed to address concerns that MSO residuals present unique disposal difficulties, is part of a larger effort to successfully implement MSO as a treatment technology for mixed and hazardous waste. A Peer Review Panel reviewed the MSO technology in November 1991, and the implementation effort is ongoing under the guidance of the MSO Task Force

  3. A comparative study of treatment outcomes between begg and edgewise orthodontic systems in class I cases

    Directory of Open Access Journals (Sweden)

    Abas Ali Sahafian

    2014-01-01

    Full Text Available Background: The purpose of this study was to compare the occlusal peer assessment rating (PAR index in Class I patients treated by means of Begg and Edgewise methods. Materials and Methods: The pre- and post-treatment study models of Class I patients, referred to two private clinics, treated with Begg method (n = 30 and standard Edgewise method (n = 30, were reviewed retrospectively using PAR index including dental displacements, buccal occlusion (anteroposterior, vertical and transverse, overjet, overbite and midline parameters. The changes in PAR indices were analyzed using paired t-test. A P < 0.05 was considered as statistically significant. Results: There was no significant difference in sex and age distribution between the two groups. The improvement of buccal occlusion in patients treated by Begg method (1.51 ± 0.39 was significantly higher than that of patients treated by Edgewise method (0.28 ± 0.39. The duration of treatment in Begg method (17.8 ± 1.3 months was significantly shorter than that of Edgewise method (23.7 ± 1.3 months. However, there were no significant differences between the two methods in terms of total PAR index, dental displacements, overjet, overbite and midline. Conclusion: In conclusion, findings of the present study indicated that Begg method might be associated with better improvement of buccal occlusion and shorter duration of treatment

  4. Factor VIII and fibrinogen recovery in plasma after Theraflex methylene blue-treatment: effect of plasma source and treatment time.

    Science.gov (United States)

    Rapaille, André; Reichenberg, Stefan; Najdovski, Tome; Cellier, Nicolas; de Valensart, Nicolas; Deneys, Véronique

    2014-04-01

    The quality of fresh-frozen plasma is affected by different factors. Factor VIII is sensitive to blood component storage processes and storage as well as pathogen-reduction technologies. The level of fibrinogen in plasma is not affected by the collection processes but it is affected by preparation and pathogen-reduction technologies. The quality of plasma from whole blood and apheresis donations harvested at different times and treated with a pathogen-reduction technique, methylene blue/light, was investigated, considering, in particular, fibrinogen and factor VIII levels and recovery. The mean factor VIII level after methylene blue treatment exceeded 0.5 IU/mL in all series. Factor VIII recovery varied between 78% and 89% in different series. The recovery of factor VIII was dependent on plasma source as opposed to treatment time. The interaction between the two factors was statistically significant. Mean levels of fibrinogen after methylene blue/light treatment exceeded 200 mg/dL in all arms. The level of fibrinogen after treatment correlated strongly with the level before treatment. There was a negative correlation between fibrinogen level before treatment and recovery. Pearson's correlation coefficient between factor VIII recovery and fibrinogen recovery was 0.58. These results show a difference in recovery of factor VIII and fibrinogen correlated with plasma source. The recovery of both factor VIII and fibrinogen was higher in whole blood plasma than in apheresis plasma. Factor VIII and fibrinogen recovery did not appear to be correlated.

  5. A COMPARATIVE STUDY OF SIMULATION AND TIME SERIES MODEL IN QUANTIFYING BULLWHIP EFFECT IN SUPPLY CHAIN

    Directory of Open Access Journals (Sweden)

    T. V. O. Fabson

    2011-11-01

    Full Text Available Bullwhip (or whiplash effect is an observed phenomenon in forecast driven distribution channeland careful management of these effects is of great importance to managers of supply chain.Bullwhip effect refers to situations where orders to the suppliers tend to have larger variance thansales to the buyer (demand distortion and the distortion increases as we move up the supply chain.Due to the fact that demand of customer for product is unstable, business managers must forecast inorder to properly position inventory and other resources. Forecasts are statistically based and in mostcases, are not very accurate. The existence of forecast errors made it necessary for organizations tooften carry an inventory buffer called “safety stock”. Moving up the supply chain from the end userscustomers to raw materials supplier there is a lot of variation in demand that can be observed, whichcall for greater need for safety stock.This study compares the efficacy of simulation and Time Series model in quantifying the bullwhipeffects in supply chain management.

  6. Time-driven activity based costing: a comparative study with the activity based costing

    Directory of Open Access Journals (Sweden)

    Marina Battistella Luna

    2017-06-01

    Full Text Available The activity-based costing (ABC emerged in the 1980s to meet the new necessities of cost information facing companies, the result of continuous changes in the business environment. In the 2000s, a new costing method, known as time-driven activity-based costing (TDABC was introduced in order to simplify the ABC. This paper compares these methods in order to provide information to assist managers to decide which of these methods better suits the reality of their companies. Therefore, they were analyzed based on information obtained through a systematic search in the Scopus and Web of Knowledge databases, as well as papers from the annals of the Congresso Brasileiro de Custos, Congresso de Controladoria e Contabilidade da USP and Encontro Nacional de Engenharia de Produção (considering scientific papers published between 2004 and 2016. From this analysis, in most cases it was concluded that TDABC is a simpler and more practical option than ABC. However, it was also apparent that managers, before choosing a particular method, must verify whether the conditions that enable its applicability exist.

  7. Development of potential map for landslides by comparing instability indices of various time periods

    Science.gov (United States)

    Chiang, Jie-Lun; Tian, Yu-Qing; Chen, Yie-Ruey; Tsai, Kuang-Jung

    2017-04-01

    In recent years, extreme rainfall events occur frequently and induced serious landslides and debris flow disasters in Taiwan. The instability indices will differ when using landslide maps of different time periods. We analyzed the landslide records during the period year, 2008 2012, the landslide area contributed 0.42% 2.94% of the total watershed area, the 2.94% was caused by the typhoon Morakot in August, 2009, which brought massive rainfall in which the cumulative maximum rainfall was up to 2900 mm. We analyzed the instability factors including elevation, slope, aspect, soil, and geology. And comparing the instability indices by using individual landslide map of 2008 2012, the landslide maps of the union of the five years, and interaction of the five years. The landslide area from union of the five years contributed 3.71%,the landslide area from interaction of the five years contributed 0.14%. In this study, Kriging was used to establish the susceptibility map in selected watershed. From interaction of the five years, we found the instability index above 4.3 can correspond to those landslide records. The potential landslide area of the selected watershed, where collapses occur more likely, belongs to high level and medium-high level; the area is 13.43% and 3.04% respectively.

  8. Comparing temporal order judgments and choice reaction time tasks as indices of exogenous spatial cuing.

    Science.gov (United States)

    Eskes, Gail A; Klein, Raymond M; Dove, Mary Beth; Coolican, Jamesie; Shore, David I

    2007-11-30

    Attentional disorders are common in individuals with neurological or psychiatric conditions and impact on recovery and outcome. Thus, it is critical to develop theory-based measures of attentional function to understand potential mechanisms underlying the disorder and to evaluate the effect of intervention. The present study compared two alternative methods to measure the effects of attentional cuing that could be used in populations of individuals who may not be able to make manual responses normally or may show overall slowing in responses. Spatial attention was measured with speeded and unspeeded methods using either manual or voice responses in two standard attention paradigms: the cued target discrimination reaction time (RT) paradigm and the unspeeded temporal order judgment (TOJ) task. The comparison of speeded and unspeeded tasks specifically addresses the concern about interpreting RT differences between cued and uncued trials (taken as a proxy for attention) in the context of drastically different baseline RTs. We found significant cuing effects for both tasks (speeded RT and untimed TOJ) and both response types (vocal and manual) giving clinicians and researchers alternative methods with which to measure the effects of attention in different populations who may not be able to perform the standard speeded RT task.

  9. The methodological quality of systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment

    Directory of Open Access Journals (Sweden)

    Vasconcelos Belmiro CE

    2008-09-01

    Full Text Available Abstract Background Temporomandibular joint disorders (TMJD are multifactor, complex clinical problems affecting approximately 60–70% of the general population, with considerable controversy about the most effective treatment. For example, reports claim success rates of 70% and 83% for non-surgical and surgical treatment, whereas other reports claim success rates of 40% to 70% for self-improvement without treatment. Therefore, the purpose of this study was to (1 identify systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment, (2 evaluate their methodological quality, and (3 evaluate the evidence grade within the systematic reviews. Methods A search strategy was developed and implemented for MEDLINE, Cochrane Library, LILACS, and Brazilian Dentistry Bibliography databases. Inclusion criteria were: systematic reviews (± meta-analysis comparing surgical and non-surgical TMJD treatment, published in English, Spanish, Portuguese, Italian, or German between the years 1966 and 2007(up to July. Exclusion criteria were: in vitro or animal studies; narrative reviews or editorials or editorial letters; and articles published in other languages. Two investigators independently selected and evaluated systematic reviews. Three different instruments (AMSTAR, OQAQ and CASP were used to evaluate methodological quality, and the results averaged. The GRADE instrument was used to evaluate the evidence grade within the reviews. Results The search strategy identified 211 reports; of which 2 were systematic reviews meeting inclusion criteria. The first review met 23.5 ± 6.0% and the second met 77.5 ± 12.8% of the methodological quality criteria (mean ± sd. In these systematic reviews between 9 and 15% of the trials were graded as high quality, and 2 and 8% of the total number of patients were involved in these studies. Conclusion The results indicate that in spite of the widespread impact of TMJD, and the multitude of

  10. Energy implications of mechanical and mechanical-biological treatment compared to direct waste-to-energy.

    Science.gov (United States)

    Cimpan, Ciprian; Wenzel, Henrik

    2013-07-01

    Primary energy savings potential is used to compare five residual municipal solid waste treatment systems, including configurations with mechanical (MT) and mechanical-biological (MBT) pre-treatment, which produce waste-derived fuels (RDF and SRF), biogas and/or recover additional materials for recycling, alongside a system based on conventional mass burn waste-to-energy and ash treatment. To examine the magnitude of potential savings we consider two energy efficiency levels (state-of-the-art and best available technology), the inclusion/exclusion of heat recovery (CHP vs. PP) and three different background end-use energy production systems (coal condensing electricity and natural gas heat, Nordic electricity mix and natural gas heat, and coal CHP energy quality allocation). The systems achieved net primary energy savings in a range between 34 and 140 MJprimary/100 MJinput waste, in the different scenario settings. The energy footprint of transportation needs, pre-treatment and reprocessing of recyclable materials was 3-9.5%, 1-18% and 1-8% respectively, relative to total energy savings. Mass combustion WtE achieved the highest savings in scenarios with CHP production, nonetheless, MBT-based systems had similarly high performance if SRF streams were co-combusted with coal. When RDF and SRF was only used in dedicated WtE plants, MBT-based systems totalled lower savings due to inherent system losses and additional energy costs. In scenarios without heat recovery, the biodrying MBS-based system achieved the highest savings, on the condition of SRF co-combustion. As a sensitivity scenario, alternative utilisation of SRF in cement kilns was modelled. It supported similar or higher net savings for all pre-treatment systems compared to mass combustion WtE, except when WtE CHP was possible in the first two background energy scenarios. Recovery of plastics for recycling before energy recovery increased net energy savings in most scenario variations, over those of full

  11. [Comparative analysis: Effectiveness of nicotine addiction treatment in people with psychiatric comorbidity].

    Science.gov (United States)

    Godoy, R; Callejas, F J; Cruz, J; Tornero, A I; Tárraga, P J; Rodríguez-Montes, J A

    2017-06-20

    To determine whether or not nicotine addiction treatment was less effective in psychiatric than in the healthy population. A retrospective, descriptive and comparative cohort study was conducted in Albacete University Hospital during years 2008-2012 on all patients that attended the Tobacco Cessation Unit. The statistical tests used were Chi-squared, likelihood ratio, and the Student t test. Statistical significance P≤.05. The study included a total of 1,484 patients, of which 48.6% were female. The mean age was 46.8 years, and the mean age of starting smoking was 17.6 years. The mean number of previous attempts to quit was 1.48, and mean number of cigarettes smoked was 25.39. They had a mean Fagerström score of 6.04, a Richmond score of 8.13, and a mean carbon monoxide level of 16.65ppm. Most patients were referred from Primary Care (38.7%) and Chest Diseases department (33%), and the type of tobacco smoked was "light" in 75.8%. There was 15% with chronic obstructive pulmonary disease, 8% with asthma, and 9.4% with obstructive sleep apnoea syndrome. Furthermore, there was respiratory disease in 28.7%, cardiovascular disease in 4.6%, and both in 3.5%. Hiatus hernia was present in 7.2%, thyroid disease in 3.8%, hypertension in 19%, diabetes in 10.7%, and dyslipidaemia in 29.4%, Drugs were used by 7.1%, and 12.6% consumed alcohol. There was 39.3% psychiatric comorbidity (PC), and were comparable except in gender, age of onset, Fagerström, Richmond, source of referral, asthma, hiatus hernia, thyroid disease, hypertension, as well as drugs and treatment. Drug treatment was completed by 22.3% in the PC group, with no significant difference. There were differences in success (P=.008), but not in failure and relapse rates. Anti-smoking treatment in psychiatric patients is effective. An increase in the probability of treatment success is observed in patients without psychiatric comorbidity. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria

  12. Healthcare utilization in adults with opioid dependence receiving extended release naltrexone compared to treatment as usual.

    Science.gov (United States)

    Soares, William E; Wilson, Donna; Rathlev, Niels; Lee, Joshua D; Gordon, Michael; Nunes, Edward V; O'Brien, Charles P; Friedmann, Peter D

    2018-02-01

    Opioid use disorders have reached epidemic proportions, with overdose now the leading cause of accidental death in the United States. Extended release naltrexone (XR-NTX) has emerged as a medication treatment that reduces opioid use and craving. However, the effect of XR-NTX therapy on acute healthcare utilization, including emergency department visits and inpatient hospitalizations, remains uncertain. The objective of the current study is to evaluate hospital-based healthcare resource utilization in adults involved in the criminal justice system with a history of opioid use disorder randomized to XR-NTX therapy compared with treatment as usual (TAU) during a 6-month treatment phase and 12months post-treatment follow up. This retrospective exploratory analysis uses data collected in a published randomized trial. Comparisons of the number of emergency department visits and hospital admissions (for drug detox, psychiatric care and other medical reasons) were performed using chi square tests for any admission and negative binomial models for number of admissions. Of the 308 participants randomized, 96% had utilization data (76% complete 6months, 67% complete follow up). No significant differences were seen in overall healthcare utilization (IRR=0.88, 95%CI 0.63-1.23, p=0.45), or substance use-related drug detox hospitalizations (IRR=0.83, 95%CI 0.32-2.16, p=0.71). Despite having more participants report chronic medical problems at baseline (43% vs. 32%, p=0.05), those receiving XR-NTX generally experienced equivalent or lower rates of healthcare utilization compared to TAU. The XR-NTX group had significantly lower medical/surgical related hospital admissions (IRR=0.55, 95%CI 0.30-1.00, p=0.05) during the course of the entire study. XR-NTX did not significantly increase rates of healthcare utilization compared to TAU. Provider concerns regarding healthcare utilization should not preclude the consideration of XR-NTX as therapy for opioid use disorders. Copyright © 2018

  13. Auditory-Motor Mapping Training: Comparing the Effects of a Novel Speech Treatment to a Control Treatment for Minimally Verbal Children with Autism.

    Science.gov (United States)

    Chenausky, Karen; Norton, Andrea; Tager-Flusberg, Helen; Schlaug, Gottfried

    2016-01-01

    This study compared Auditory-Motor Mapping Training (AMMT), an intonation-based treatment for facilitating spoken language in minimally verbal children with autism spectrum disorder (ASD), to a matched control treatment, Speech Repetition Therapy (SRT). 23 minimally verbal children with ASD (20 male, mean age 6;5) received at least 25 sessions of AMMT. Seven (all male) were matched on age and verbal ability to seven participants (five male) who received SRT. Outcome measures were Percent Syllables Approximated, Percent Consonants Correct (of 86), and Percent Vowels Correct (of 61) produced on two sets of 15 bisyllabic stimuli. All subjects were assessed on these measures several times at baseline and after 10, 15, 20, and 25 sessions. The post-25 session assessment timepoint, common to all participants, was compared to Best Baseline performance. Overall, after 25 sessions, AMMT participants increased by 19.4% Syllables Approximated, 13.8% Consonants Correct, and19.1% Vowels Correct, compared to Best Baseline. In the matched AMMT-SRT group, after 25 sessions, AMMT participants produced 29.0% more Syllables Approximated (SRT 3.6%);17.9% more Consonants Correct (SRT 0.5); and 17.6% more Vowels Correct (SRT 0.8%). Chi-square tests showed that significantly more AMMT than SRT participants in both the overall and matched groups improved significantly in number of Syllables Approximated per stimulus and number of Consonants Correct per stimulus. Pre-treatment ability to imitate phonemes, but not chronological age or baseline performance on outcome measures, was significantly correlated with amount of improvement after 25 sessions. Intonation-based therapy may offer a promising new interventional approach for teaching spoken language to minimally verbal children with ASD.

  14. Comparing strategies to synchronize estrus before fixed-time artificial insemination in primiparous 2-year-old beef cows.

    Science.gov (United States)

    Abel, J M; Bishop, B E; Thomas, J M; Ellersieck, M R; Poock, S E; Smith, M F; Patterson, D J

    2017-01-01

    Two experiments evaluated controlled internal drug release (CIDR)-based protocols to synchronize estrus in primiparous 2-year-old beef cows. In each experiment, treatments were balanced according to body condition score and days postpartum. Experiment 1 compared the 14-day CIDR-PG (14-d) and 7-day CO-Synch + CIDR (7-d) protocols on the basis of estrous response, pregnancy rates after fixed-time artificial insemination (FTAI), and final pregnancy rate. Cows assigned to 14-d (n = 355) received a CIDR insert on Day 0 with removal on Day 14. Cows assigned to 7-d (n = 349) received gonadotropin releasing hormone (GnRH) and a CIDR insert on Day 23. On Day 30, CIDRs were removed from 7-d cows, and PGF 2α was administered to all cows in each treatment. On Day 33, GnRH was administered concurrent with FTAI at 66 and 72 hours after PGF 2α for 7-d and 14-d treated cows, respectively. Estrous response before FTAI was higher for 7-d compared with 14-d cows (74% vs. 43%, respectively; P artificial insemination (STAI) following synchronization of estrus with the 14-day protocol. Cows assigned to FTAI (n = 266) were inseminated at a fixed time concurrent with GnRH at 72 hours after PGF 2α regardless of estrus expression, whereas cows assigned to STAI (n = 257) were inseminated based on estrus expression as determined by activation of an estrus detection aid. Cows assigned to STAI that exhibited estrus by 72 hours were inseminated; however, AI was delayed until 24 hours after GnRH (96 hours after PGF 2α ) for nonestrous cows. Total estrous response was increased for STAI- versus FTAI-treated cows (STAI 64%; FTAI 42%; P < 0.0001); pregnancy rates resulting from AI were similar (STAI 55%; FTAI 56%; P = 0.60). In summary, the 14-day CIDR-PG and 7-day CO-Synch + CIDR protocols can be used effectively to synchronize estrus before FTAI in primiparous 2-year-old beef cows. Although expression of estrus was increased using STAI in conjunction with the 14-day

  15. Esomeprazole alone compared with esomeprazole plus aspirin for the treatment of aspirin-related peptic ulcers.

    Science.gov (United States)

    Liu, Chun-Peng; Chen, Wen-Chi; Lai, Kwok-Hung; Mar, Guang-Yuan; Lin, Shyr-Yi; Ger, Luo-Ping; Hsu, Ping-I

    2012-07-01

    Aspirin-related peptic ulcers are a common disorder. However, whether or not aspirin should be continued during treatment for aspirin-related ulcers remains unclear. To compare esomeprazole alone with esomeprazole plus aspirin in the treatment of aspirin-related peptic ulcers and to investigate the independent factors associated with the failure of ulcer healing. From January 2008 to July 2011, patients with aspirin-related peptic ulcers were randomized to receive esomeprazole (40 mg per day) alone or esomeprazole (40 mg per day) plus aspirin (100 mg per day) for 8 weeks. The subjects with Helicobacter pylori infection were treated with standard triple therapy. Follow-up endoscopy was carried out at the end of the 8th week. The primary end point was the healing of peptic ulcers. In all, 178 patients (89 receiving esomeprazole alone and 89 receiving esomeprazole plus aspirin) were enrolled and underwent follow-up endoscopy. The healing rate of ulcers by modified intention-to-treat analysis was 82.5% (95% confidence interval (CI), 74.2-90.8%) among patients treated with esomeprazole alone and 81.5% (95% CI, 73.0-90.0%) among patients treated with esomeprazole plus aspirin (difference, 1.0%; 95% CI, -11.2 to 12.6%). The per-protocol analysis yielded similar results (healing rate: 83.1% vs. 83.8%, respectively; difference, 0.7%; 95% CI, -11.2 to 12.6%). Multivariate analysis disclosed that use of steroids during treatment (odds ratio: 5.6; 95% CI, 1.1-27.7%) was the only independent factor associated with the failure of ulcer healing. The observed ulcer healing rates were comparable in the esomeprazole and esomeprazole-plus-aspirin groups, but the wide CIs do not rule out clinically meaningful differences of more than 10%.

  16. Challenges in the Analysis of Outcomes for Surgical Compared to Radiotherapy Treatment of Prostate Cancer.

    Science.gov (United States)

    Glaser, Scott M; Kalash, Ronny; Bongiorni, Dante R; Roberts, Mark S; Balasubramani, Goundappa K; Jacobs, Bruce L; Beriwal, Sushil; Heron, Dwight E; Greenberger, Joel S

    2018-01-01

    Prostate cancer can be treated with radical prostatectomy (RP), external-beam radiotherapy (EBRT), or brachytherapy (BT). These modalities have similar cancer-related outcomes. We used an innovative method to analyze the cost of such treatment. We queried our Institution's Insurance Division [University of Pittsburgh Medical Center (UPMC) Health Plan] beneficiaries from 2003-2008, who were diagnosed with prostate cancer and also queried the UPMC tumor registry for all patients with prostate cancer treated at our Institution. In a de-identified manner, data from the Health Plan and Tumor Registry were merged. A total of 354 patients with non-metastatic disease with treatment initiated within 9 months of diagnosis were included (RP=236, EBRT=55, and BT=63). Radiotherapy-treated patients tended to be older, higher-risk, and have more comorbidities. Unadjusted median total health care expenditures during the first year after diagnosis were: RP: $16,743, EBRT: $47,256, and BT: $23,237 (p<0.0005). A propensity score-matched model comparing RP and EBRT demonstrated median total health care expenditures during year one: RP: $8,189, EBRT: $10,081; p=0.48. In a propensity-matched model comparing RP and BT, the median total health care expenditures during year one were: RP: $18,143, BT: $26,531; p=0.015 and per year during years 2 through 5 from diagnosis were: RP: $5,913, BT: $6,110; p=0.68. This pilot study demonstrates the feasibility of combining healthcare costs from the payer's perspective with clinical data from a Tumor Registry within an IDFS and represents a novel approach to investigating the economic impact of cancer treatment. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  17. Hypoparathyroidism: Less Severe Hypocalcemia With Treatment With Vitamin D2 Compared With Calcitriol.

    Science.gov (United States)

    Streeten, Elizabeth A; Mohtasebi, Yasaman; Konig, Manige; Davidoff, Lisa; Ryan, Kathleen

    2017-05-01

    Options for chronic treatment of hypoparathyroidism include calcitriol, recombinant human parathyroid hormone, and high-dose vitamin D (D2). D2 is used in a minority of patients because of fear of prolonged hypercalcemia and renal toxicity. There is a paucity of recent data about D2 use in hypoparathyroidism. Compare renal function, hypercalcemia, and hypocalcemia in patients with hypoparathyroidism treated chronically with either D2 (D2 group) or calcitriol. A retrospective study of patients with hypoparathyroidism treated at the University of Maryland Hospital. Participants were identified by a billing record search with diagnosis confirmed by chart review. Thirty patients were identified; 16 were treated chronically with D2, 14 with calcitriol. Data were extracted from medical records. Serum creatinine and calcium, hospitalizations, and emergency department (ED) visits for hypercalcemia and hypocalcemia. D2 and calcitriol groups were similar in age (58.9 ± 16.7 vs 50.9 ± 22.6 years, P = 0.28), sex, and treatment duration (17.8 ± 14.2 vs 8.5 ± 4.4 years, P = 0.076). Hospitalization or ED visits for hypocalcemia occurred in none of the D2 group vs four of 14 in the calcitriol group (P = 0.03); three in the calcitriol group had multiple ED visits. There were no differences between D2 and calcitriol groups in hospitalizations or ED visits for hypercalcemia, serum creatinine or calcium, or kidney stones. We found less morbidity from hypocalcemia in hypoparathyroid patients treated chronically with D2 compared with calcitriol and found no difference in renal function or morbidity from hypercalcemia. Treatment with D2 should be considered in patients with hypoparathyroidism, particularly in those who experience recurrent hypocalcemia. Copyright © 2017 by the Endocrine Society

  18. Comparing the therapeutic effects of finasteride gel and tablet in treatment of the androgenetic alopecia

    Directory of Open Access Journals (Sweden)

    Hajheydari Zohreh

    2009-01-01

    Full Text Available Background: Finasteride, a type P-selective 5a-reductase inhibitor, as a causative agent of decreasing dihydroxy testestrone (DHT level, is effective in the treatment of male androgenic alopecia. Aim: We compared the local and oral finasteride in the treatment of androgenic alopecia. Method: This is a double blind, randomized clinical trial study of 45 male patients, who were referred with alopecia to the private clinics and departments in Boo-Ali Sina Hospital, in Sari. Patients with male androgenic alopecia were selected according to the history and physical examinations. The patients were randomly divided into two: topical finasteride (A and oral finasteride (B groups. Topical finasteride group (A received a topical gel of 1% finasteride and placebo tablets, while the oral finasteride group (B received finasteride tablets (1 mg and gel base (without drug as placebo for 6 months. The patients were followed by clinical observation and recording of side effects prior to the treatment and at the end of first week, and then by a monthly follow-up. The size of bald area, total hair count, and terminal hair were studied. Data were analyzed by descriptive and Chi-square statistical test. Results: The mean duration of hair loss was 18.8±23.10 months. Each month the terminal hair, size of bald area and hair count between the two groups were compared. There were no significant differences between the two groups as a viewpoint of hair thickness, hair counts and the size of bald area. Serial measurements indicated a significant increase in hair counts and terminal hair counts between the two groups. Conclusions: The results of this study showed that the therapeutic effects of both finasteride gel and finasteride tablet were relatively similar to each other.

  19. A comparative analysis of short-range travel time prediction methods

    NARCIS (Netherlands)

    Huisken, Giovanni; van Berkum, Eric C.

    2003-01-01

    Increasing car mobility has lead to an increasing demand for traffic information. This contribution deals with information about travel times. When car drivers are provided with this type of information, the travel times should ideally be the times that they will encounter. As a result travel times

  20. Development of a questionnaire to assess sedentary time in older persons -- a comparative study using accelerometry

    NARCIS (Netherlands)

    Visser, M.; Koster, A.

    2013-01-01

    Background: There is currently no validated questionnaire available to assess total sedentary time in older adults. Most studies only used TV viewing time as an indicator of sedentary time. The first aim of our study was to investigate the self-reported time spent by older persons on a set of

  1. Time-varying associations between confidence and motivation to abstain from marijuana during treatment among adolescents

    Science.gov (United States)

    Chung, Tammy; Maisto, Stephen A.

    2016-01-01

    Introduction An important goal of addictions treatment is to develop a positive association between high levels of confidence and motivation to abstain from substance use. This study modeled the time-varying association between confidence and motivation to abstain from marijuana use among youth in treatment, and the time-varying effect of pre-treatment covariates (marijuana abstinence goal and perceived peer marijuana use) on motivation to abstain. Method 150 adolescents (75% male, 83% White) in community-based intensive outpatient treatment in Pennsylvania completed a pre-treatment assessment of abstinence goal, perceived peer marijuana use, and motivation and confidence to abstain from marijuana. Ratings of motivation and confidence to abstain also were collected after each session. A Time-Varying Effect Model (TVEM) was used to characterize changes in the association between confidence and motivation to abstain (lagged), and included covariates representing pre-treatment abstinence goal and perceived peer marijuana use. Results Confidence and motivation to abstain from marijuana generally increased during treatment. The association between confidence and motivation strengthened across sessions 1-4, and was maintained through later sessions. Pre-treatment abstinence goal had an early time-limited effect (through session 6) on motivation to abstain. Pre-treatment perception of peer marijuana use had a significant effect on motivation to abstain only at session 2. Conclusions Early treatment sessions represent a critical period during which the association between confidence and motivation to abstain generally increased. The time-limited effects of pre-treatment characteristics suggest the importance of early sessions in addressing abstinence goal and peer substance use that may impact motivation to abstain from marijuana. PMID:26894550

  2. A Comparative Study of Simple Auditory Reaction Time in Blind (Congenitally) and Sighted Subjects

    OpenAIRE

    Gandhi, Pritesh Hariprasad; Gokhale, Pradnya A.; Mehta, H. B.; Shah, C. J.

    2013-01-01

    Background: Reaction time is the time interval between the application of a stimulus and the appearance of appropriate voluntary response by a subject. It involves stimulus processing, decision making, and response programming. Reaction time study has been popular due to their implication in sports physiology. Reaction time has been widely studied as its practical implications may be of great consequence e.g., a slower than normal reaction time while driving can have grave results. Objective:...

  3. Comparative Cost Analysis for Surgical and Endovascular Treatment of Unruptured Intracranial Aneurysms in South Korea.

    Science.gov (United States)

    Kim, Myungsoo; Park, Jaechan; Lee, Joomi

    2015-06-01

    A cost comparison of the surgical clipping and endovascular coiling of unruptured intracranial aneurysms (UIAs), and the identification of the principal cost determinants of these treatments. This study conducted a retrospective review of data from a series of patients who underwent surgical clipping or endovascular coiling of UIAs between January 2011 and May 2014. The medical records, radiological data, and hospital cost data were all examined. When comparing the total hospital costs for surgical clipping of a single UIA (n=188) and endovascular coiling of a single UIA (n=188), surgical treatment [mean±standard deviation (SD) : ₩8,280,000±1,490,000] resulted in significantly lower total hospital costs than endovascular treatment (mean±SD : ₩11,700,000±3,050,000, p<0.001). In a multi regression analysis, the factors significantly associated with the total hospital costs for endovascular treatment were the aneurysm diameter (p<0.001) and patient age (p=0.014). For the endovascular group, a Pearson correlation analysis revealed a strong positive correlation (r=0.77) between the aneurysm diameter and the total hospital costs, while a simple linear regression provided the equation, y (₩)=6,658,630+855,250x (mm), where y represents the total hospital costs and x is the aneurysm diameter. In South Korea, the total hospital costs for the surgical clipping of UIAs were found to be lower than those for endovascular coiling when the surgical results were favorable without significant complications. Plus, a strong positive correlation was noted between an increase in the aneurysm diameter and a dramatic increase in the costs of endovascular coiling.

  4. Diagnostic accuracy of short-time inversion recovery sequence in Graves' ophthalmopathy before and after prednisone treatment

    Energy Technology Data Exchange (ETDEWEB)

    Tortora, Fabio; Belfiore, Maria Paola; Romano, Francesco; Cappabianca, Salvatore; Cirillo, Sossio [' ' F. Magrassi-A. Lanzara' ' Second University, Naples (Italy). Dept. of Clinical and Experimental Medicine and Surgery; Prudente, Mariaevelina [Second University, Naples (Italy). Medicine Dept.; Vita Salute San Raffaele Univ., Milan (Italy). Dept. of Neuroradiology; Cirillo, Mario [Second University, Naples (Italy). Neuroradiological Services; Elefante, Andrea [Federic II Univ., Naples (Italy). Neuroradilogical Dept.; Carella, Carlo [Polidiagnostic Center Check-Up, Salerno (Italy)

    2014-05-15

    In Graves' Ophthalmopathy, it is important to distinguish active inflammatory phase, responsive to immunosuppressive treatment, from fibrotic unresponsive inactive one. The purpose of this study is, first, to identify the relevant orbital magnetic resonance imaging signal intensities before treatment, so to classify patients according to their clinical activity score (CAS), discriminating inactive (CAS < 3) from active Graves' Ophthalmopathy (GO) (CAS > 3) subjects and, second, to follow post-steroid treatment disease. An observational study was executed on 32 GO consecutive patients in different phases of disease, based on clinical and orbital Magnetic Resonance Imaging parameters, compared to 32 healthy volunteers. Orbital Magnetic Resonance Imaging was performed on a 1.5 tesla Magnetic Resonance Unit by an experienced neuroradiologist blinded to the clinical examinations. In pre-therapy patients, compared to controls, a medial rectus muscle statistically significant signal intensity ratio (SIR) in short-time inversion recovery (STIR) (long TR/TE) sequence was found, as well as when comparing patients before and after treatment, both medial and inferior rectus muscle SIR resulted significantly statistically different in STIR. These increased outcomes explain the inflammation oedematous phase of disease, moreover after steroid administration, compared to controls; patients presented lack of that statistically significant difference, thus suggesting treatment effectiveness. In our study, we proved STIR signal intensities increase in inflammation oedematous phase, confirming STIR sequence to define active phase of disease with more sensibility and reproducibility than CAS alone and to evaluate post-therapy involvement. (orig.)

  5. Diagnostic accuracy of short-time inversion recovery sequence in Graves' Ophthalmopathy before and after prednisone treatment.

    Science.gov (United States)

    Tortora, Fabio; Prudente, Mariaevelina; Cirillo, Mario; Elefante, Andrea; Belfiore, Maria Paola; Romano, Francesco; Cappabianca, Salvatore; Carella, Carlo; Cirillo, Sossio

    2014-05-01

    In Graves' Ophthalmopathy, it is important to distinguish active inflammatory phase, responsive to immunosuppressive treatment, from fibrotic unresponsive inactive one. The purpose of this study is, first, to identify the relevant orbital magnetic resonance imaging signal intensities before treatment, so to classify patients according to their clinical activity score (CAS), discriminating inactive (CAS  3) subjects and, second, to follow post-steroid treatment disease. An observational study was executed on 32 GO consecutive patients in different phases of disease, based on clinical and orbital Magnetic Resonance Imaging parameters, compared to 32 healthy volunteers. Orbital Magnetic Resonance Imaging was performed on a 1.5 tesla Magnetic Resonance Unit by an experienced neuroradiologist blinded to the clinical examinations. In pre-therapy patients, compared to controls, a medial rectus muscle statistically significant signal intensity ratio (SIR) in short-time inversion recovery (STIR) (long TR/TE) sequence was found, as well as when comparing patients before and after treatment, both medial and inferior rectus muscle SIR resulted significantly statistically different in STIR. These increased outcomes explain the inflammation oedematous phase of disease, moreover after steroid administration, compared to controls; patients presented lack of that statistically significant difference, thus suggesting treatment effectiveness. In our study, we proved STIR signal intensities increase in inflammation oedematous phase, confirming STIR sequence to define active phase of disease with more sensibility and reproducibility than CAS alone and to evaluate post-therapy involvement.

  6. Diagnostic accuracy of short-time inversion recovery sequence in Graves' ophthalmopathy before and after prednisone treatment

    International Nuclear Information System (INIS)

    Tortora, Fabio; Belfiore, Maria Paola; Romano, Francesco; Cappabianca, Salvatore; Cirillo, Sossio

    2014-01-01

    In Graves' Ophthalmopathy, it is important to distinguish active inflammatory phase, responsive to immunosuppressive treatment, from fibrotic unresponsive inactive one. The purpose of this study is, first, to identify the relevant orbital magnetic resonance imaging signal intensities before treatment, so to classify patients according to their clinical activity score (CAS), discriminating inactive (CAS 3) subjects and, second, to follow post-steroid treatment disease. An observational study was executed on 32 GO consecutive patients in different phases of disease, based on clinical and orbital Magnetic Resonance Imaging parameters, compared to 32 healthy volunteers. Orbital Magnetic Resonance Imaging was performed on a 1.5 tesla Magnetic Resonance Unit by an experienced neuroradiologist blinded to the clinical examinations. In pre-therapy patients, compared to controls, a medial rectus muscle statistically significant signal intensity ratio (SIR) in short-time inversion recovery (STIR) (long TR/TE) sequence was found, as well as when comparing patients before and after treatment, both medial and inferior rectus muscle SIR resulted significantly statistically different in STIR. These increased outcomes explain the inflammation oedematous phase of disease, moreover after steroid administration, compared to controls; patients presented lack of that statistically significant difference, thus suggesting treatment effectiveness. In our study, we proved STIR signal intensities increase in inflammation oedematous phase, confirming STIR sequence to define active phase of disease with more sensibility and reproducibility than CAS alone and to evaluate post-therapy involvement. (orig.)

  7. Syllable-Timed Speech Treatment for School-Age Children Who Stutter: A Phase I Trial

    Science.gov (United States)

    Andrews, Cheryl; O'Brian, Sue; Harrison, Elisabeth; Onslow, Mark; Packman, Ann; Menzies, Ross

    2012-01-01

    Purpose: This clinical trial determined the outcomes of a simple syllable-timed speech (STS) treatment for school-age children who stutter. Method: Participants were 10 children, ages 6-11 years, who stutter. Treatment involved training the children and their parents to use STS at near normal speech rates. The technique was practiced in the clinic…

  8. How to study optimal timing of PET/CT for monitoring of cancer treatment

    DEFF Research Database (Denmark)

    Vach, Werner; Høilund-Carlsen, Poul Flemming; Fischer, Barbara Malene Bjerregaard

    2011-01-01

    Purpose: The use of PET/CT for monitoring treatment response in cancer patients after chemo- or radiotherapy is a very promising approach to optimize cancer treatment. However, the timing of the PET/CT-based evaluation of reduction in viable tumor tissue is a crucial question. We investigated how...

  9. Thrombolysis: Improving door-to-needle times for ischemic stroke treatment - A narrative review.

    Science.gov (United States)

    Kamal, Noreen; Smith, Eric E; Jeerakathil, Thomas; Hill, Michael D

    2017-01-01

    Background The effectiveness of thrombolysis is highly time dependent. For this reason, short target times have been set to reduce time to treatment from hospital arrival, which is called door-to-needle time. Summary of review There has been considerable work done at single centers and across multiple hospitals to improve door-to-needle time. There have been reductions of 8 to 47 min when applying one or more improvement strategies at single centers, and there have been many multi-hospital initiatives. The delays to treatment have been attributed to both patient and hospital factors, and strategies to address these delays have been proven to reduce door-to-needle time. The most effective strategies include pre-notification of arrival by Emergency Medical Services (EMS), single-call activation of stroke team, rapid registration process, moving the patient to computed tomography on EMS stretcher, and administration of alteplase in the scanner. There are many exciting areas of future direction including reduction of door-to-needle time in developing countries, improving pre-hospital response times, and improving the efficiency of endovascular treatment. Conclusions There is now a broad understanding of the causes of delays to fast treatment and the strategies that can be employed to improve door-to-needle time such that most centers could achieve median door-to-needle time of 30 min.

  10. Albendazole versus praziquantel in the treatment of neurocysticercosis: a meta-analysis of comparative trials.

    Directory of Open Access Journals (Sweden)

    Dimitrios K Matthaiou

    Full Text Available BACKGROUND: Neurocysticercosis, infection of the brain with larvae of Taenia solium (pork tapeworm, is one of several forms of human cysticercosis caused by this organism. We investigated the role of albendazole and praziquantel in the treatment of patients with parenchymal neurocysticercosis by performing a meta-analysis of comparative trials of their effectiveness and safety. METHODS AND PRINCIPAL FINDINGS: We performed a search in the PubMed database, Cochrane Database of Controlled Trials, and in references of relevant articles. Six studies were included in the meta-analysis. Albendazole was associated with better control of seizures than praziquantel in the pooled data analysis, when the generic inverse variance method was used to combine the incidence of seizure control in the included trials (patients without seizures/[patients x years at risk] (156 patients in 4 studies, point effect estimate [incidence rate ratio] = 4.94, 95% confidence interval 2.45-9.98. In addition, albendazole was associated with better effectiveness than praziquantel in the total disappearance of cysts (335 patients in 6 studies, random effects model, OR = 2.30, 95% CI 1.06-5.00. There was no difference between albendazole and praziquantel in reduction of cysts, proportion of patients with adverse events, and development of intracranial hypertension due to the administered therapy. CONCLUSIONS: A critical review of the available data from comparative trials suggests that albendazole is more effective than praziquantel regarding clinically important outcomes in patients with neurocysticercosis. Nevertheless, given the relative scarcity of trials, more comparative interventional studies--especially randomized controlled trials--are required to draw a safe conclusion about the best regimen for the treatment of patients with parenchymal neurocysticercosis.

  11. Comparing Methods to Denote Treatment Outcome in Clinical Research and Benchmarking Mental Health Care.

    Science.gov (United States)

    de Beurs, Edwin; Barendregt, Marko; de Heer, Arco; van Duijn, Erik; Goeree, Bob; Kloos, Margot; Kooiman, Kees; Lionarons, Helen; Merks, Andre

    2016-07-01

    Approaches based on continuous indicators (the size of the pre-to-post-test change; effect size or ΔT) and on categorical indicators (Percentage Improvement and the Jacobson-Truax approach to Clinical Significance) are evaluated to determine which has the best methodological and statistical characteristics, and optimal performance, in comparing outcomes of treatment providers. Performance is compared in two datasets from providers using the Brief Symptom Inventory or the Outcome Questionnaire. Concordance of methods and their suitability to rank providers is assessed. Outcome indicators tend to converge and lead to a similar ranking of institutes within each dataset. Statistically and conceptually, continuous outcome indicators are superior to categorical outcomes as change scores have more statistical power and allow for a ranking of providers at first glance. However, the Jacobson-Truax approach can complement the change score approach as it presents outcome information in a clinically meaningful manner. Copyright © 2015 John Wiley & Sons, Ltd. When comparing various indicators or treatment outcome, statistical considerations designate continuous outcomes, such as the effect size of the pre-post change (effect size or ΔT) as the optimal choice. Expressing outcome in proportions of recovered, changed, unchanged or deteriorated patients has supplementary value, as it is more easily interpreted and appreciated by clinicians, managerial staff and, last but not the least, by patients. If categorical outcomes are used with small datasets, true differences in institutional performance may get obscured due to diminished power to detect differences. With sufficient data, outcome according to continuous and categorical indicators converge and lead to similar rankings of institutes' performance. Copyright © 2015 John Wiley & Sons, Ltd.

  12. The pivotal role of cardiac self-care in treatment timing.

    Science.gov (United States)

    Schoenberg, Nancy E; Amey, Cheryl H; Stoller, Eleanor Palo; Drew, Elaine M

    2005-03-01

    In Western nations, cardiovascular disease (CVD) is the leading cause of death and disability, and myocardial infarction (MI or heart attack) is responsible for the most significant proportion of these deaths. Over the past decades, however, mortality rates from CVD in general and MI specifically have been decreasing due in large part to the proliferation of time-dependent therapies. As their description suggests, the use of such effective therapies is associated with early hospital presentation, thus reducing treatment time has significant benefits. Previous research most often has focused on sociodemographic or clinical factors influential in treatment timing, while the activities that individuals undertake during the critical hours prior to presentation for formal medical treatment remain insufficiently examined. Since self-care activities provide a window into how cardiac symptom sufferers conceptualize and act on their distress and, subsequently, how these conceptualizations shape treatment timing, we sought a more complete understanding of the relationship between self-care behaviours and treatment timing. Employing a complementary design, we examined data from 2972 survivors participating in the MI Onset study in the United States and 35 survivors from the MI Illness Narrative Study. Results indicate that cardiac self-care played a defining role in time to treatment, while other factors (i.e., sociodemographic and clinical factors) did not. Specifically, taking over-the-counter medications (i.e., analgesics and antacids) was associated with a longer treatment time. A closer look at who was likely to pursue these strategies and their reasons behind so doing leads us to conclude that (1) social location and self-identity; (2) previous health experiences, including personal health history and prior use of self-care strategies and; (3) social interaction play important roles in cardiac self-care responses which, in turn, shape treatment timing.

  13. Split-time artificial insemination in beef cattle: II. Comparing pregnancy rates among nonestrous heifers based on administration of GnRH at AI.

    Science.gov (United States)

    Bishop, B E; Thomas, J M; Abel, J M; Poock, S E; Ellersieck, M R; Smith, M F; Patterson, D J

    2017-01-01

    This experiment was designed to evaluate split-time artificial insemination (AI) in beef heifers following administration of the 14-day controlled internal drug release (CIDR)-prostaglandin F 2α (PG) protocol and to compare pregnancy rates among nonestrous heifers based on administration of GnRH at AI. Estrus was synchronized for 1138 heifers across six locations. Heifers received a CIDR insert (1.38 g progesterone) on Day 0 with removal on Day 14. Estrus detection aids (Estrotect) were applied at PG (25 mg), 16 days after CIDR removal on Day 30. Heifers were assigned to balanced treatments based on reproductive tract score and weight, and treatments were represented within each location. Split-time AI was performed at 66 and 90 hours after PG, and estrus was recorded at these times. Heifers in both treatments that exhibited estrus by 66 hours were inseminated and did not receive GnRH, whereas AI was delayed 24 hours until 90 hours after PG for heifers that failed to exhibit estrus by 66 hours. For heifers in treatment 1 that were inseminated at 90 hours, GnRH (100 μg) was administered concurrent with AI at 90 hours. Heifers in treatment 2 that were inseminated at 90 hours did not receive GnRH. Estrous response did not differ between treatments at 66 hours after PG (treatment 1 = 70%; treatment 2 = 71%; P = 0.58) or during the 24-hour delay period (treatment 1 = 59%; treatment 2 = 52%; P = 0.21). There was no effect of treatment on pregnancy rates resulting from AI for heifers inseminated at 66 hours (treatment 1 = 58%; treatment 2 = 62%; P = 0.86) or 90 hours (treatment 1 = 44%; treatment 2 = 39%; P = 0.47) after PG; and there was no difference between treatments when considering total AI pregnancy rate (treatment 1 = 54%; treatment 2 = 56%; P = 0.60). Ovulation was confirmed via ultrasonography for a subset of heifers that failed to exhibit estrus prior to 90 hours after PG. For heifers that failed to exhibit estrus by 90

  14. Predicting suitable timing for artificial reproductive technology treatment in aged infertile women.

    Science.gov (United States)

    Akino, Nana; Isono, Wataru; Wada-Hiraike, Osamu

    2016-10-01

    It has been widely accepted that the age of women plays a fundamental role in fecundity, and age-related fertility decline has one of the most significant and detrimental effects on the success rate of infertility treatment. Therefore, treatment cycles of non-in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment for infertile women of advanced aged have been limited due to their lack of efficacy, and they are often optimized, compared to IVF/ICSI treatment. Recent trends in infertility treatment apparently indicate that IVF/ICSI treatment, including egg donation, is frequently offered to aged women for first-line management, despite its heavy burden, but hasty IVF/ICSI treatment should be avoided, considering its socioeconomic problems. It is important to distinguish women who could conceive by non-IVF/ICSI treatment, although the optimization of non-IVF/ICSI treatment protocols remains poorly understood. This review focuses on extracting aged patients who have higher chance of conceiving with non-IVF/ICSI treatment and providing necessary and sufficient infertility treatment. After initial evaluation for fertility, including tubal factor, male factor, the presence of endometriosis and/or adenomyosis, and ovarian reserve, the outcomes of fertility treatment can be predicted to some extent in aged infertile women.

  15. Comparative Effectiveness of Proactive Tobacco Treatment among Smokers with and without Chronic Lower Respiratory Disease.

    Science.gov (United States)

    Melzer, Anne C; Clothier, Barbara A; Japuntich, Sandra J; Noorbaloochi, Siamak; Hammett, Patrick; Burgess, Diana J; Joseph, Anne M; Fu, Steven S

    2018-03-01

    Adults with chronic lower respiratory disease differ in their barriers to smoking cessation but also suffer from tobacco-related health concerns, which may motivate quit attempts. Few studies have examined differences in tobacco treatment response between smokers with and without chronic lower respiratory disease. We examined the effectiveness of a proactive outreach program for cessation among smokers with and without chronic lower respiratory disease. Subgroup analysis of the Veterans Victory over Tobacco Study, a pragmatic randomized controlled trial that demonstrated the effectiveness of proactive outreach and the choice of tobacco treatments compared with usual care. Smokers identified via the electronic medical record were proactively offered phone-based counseling and care coordination to receive medication from their Veterans Affairs providers or in-person care. We compared the response among those with and without an International Classification of Diseases, 9th Revision diagnosis of a chronic lower respiratory disease (chronic obstructive pulmonary disease, chronic bronchitis, emphysema, asthma). We used stratification by propensity scores to adjust for imbalanced covariates between groups with and without chronic lower respiratory disease within each treatment arm, using complete case analysis accounting for the stratified sampling by site. The study participants were predominantly older, white, male smokers. Overall, 19.6% had chronic lower respiratory disease. A total of 3,307 had outcome data with the following assignments to the intervention: proactive care: n = 1,272 without chronic lower respiratory disease, n = 301 with chronic lower respiratory disease; usual care: n = 1,387 without chronic lower respiratory disease, n = 347 with chronic lower respiratory disease. A total of 1,888 had both complete baseline and outcome data and were included in the primary analysis. In unadjusted analyses (n = 3,307), among individuals with

  16. Botulinum toxin type A injection for refractory interstitial cystitis: A randomized comparative study and predictors of treatment response.

    Science.gov (United States)

    Akiyama, Yoshiyuki; Nomiya, Akira; Niimi, Aya; Yamada, Yukio; Fujimura, Tetsuya; Nakagawa, Tohru; Fukuhara, Hiroshi; Kume, Haruki; Igawa, Yasuhiko; Homma, Yukio

    2015-09-01

    To determine whether botulinum toxin type A can represent an alternative treatment option for patients with interstitial cystitis refractory to conventional therapies. This is a single-center, prospective, open labeled, randomized comparative study. Patients with refractory interstitial cystitis were randomly divided into two groups: immediate injection (group A) or 1-month delayed injection (group B) of botulinum toxin type A after allocation. The rate of treatment response (global response assessment ≥+1: slightly improved), and changes in symptom scores and frequency volume chart variables were compared between groups 1 month after allocation. Using subjects of both groups as a single cohort, predictive factors for treatment response at 1 month post-injection and the duration of response were explored. A total of 34 patients (group A n = 18, group B n = 16) were allocated. The response rate was significantly higher in group A than group B (72.2% vs 25.0%, P = 0.01). All symptom measures showed significant improvement in group A than group B. When both groups were combined as a single cohort, the response rate was 73.5% at 1 month, 58.8% at 3 months, 38.2% at 6 months and 20.6% at 12 months. The mean duration of response was 5.4 months. Multivariate analysis showed that past exposure to hydrodistension more than three times correlated with better outcomes. Botulinum toxin type A injection could be an alternative treatment option for patients with interstitial cystitis refractory to conventional therapies, especially for those who have received repeated hydrodistensions and transurethral fulguration. © 2015 The Japanese Urological Association.

  17. Treatment of female stress urinary incontinence using suburethral slings: comparative, retrospective, observational study of two surgical techniques.

    Science.gov (United States)

    Castroviejo-Royo, F; Martinez-Sagarra-Oceja, J M; Marina-García-Tuñón, C; Conde-Redondo, C; Rodríguez-Toves, L A; González-Tejero, C

    2013-10-01

    The treatment of female stress urinary incontinence has undergone a revolution in recent years due the emergence on the market of suburethral slings. The aim of this study is to compare two surgical techniques for treating stress urinary incontinence: Monarc™ (transobturator suburethral sling) and MiniArc(®) (single-incision suburethral mini-sling). Comparative, retrospective, observational study from January 2005 to December 2011 on 317 women diagnosed with stress urinary incontinence. Of these, 214 were treated with the Monarc™ transobturator suburethral sling, and 103 were treated with the MiniArc(®) mini-sling. The results were treated with SPSS v.15 software, and the statistical significance was P≤.005. The two patients groups were homogeneous in terms of age, number of births, presence of urgency urinary incontinence and prior hysterectomy. There were significant differences in hospital stay, surgical time and early complications in favour of the MiniArc(®), technique, but overall there were no significant differences in the late complications. Some 84% of the patients treated with the Monarc™ transobturator sling were cured compared with the 72% of patients in whom we implanted a MiniArc(®), a difference that was statistically significant. We need to perform more high-quality, prospective and randomised studies with larger numbers of patients and longer follow-up times to confirm or disprove the difference that we found in the success rate for the Monarc™ transobturator suburethral sling. Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.

  18. Time course in calpain activity and autolysis in slow and fast skeletal muscle during clenbuterol treatment.

    Science.gov (United States)

    Douillard, Aymeric; Galbes, Olivier; Rossano, Bernadette; Vernus, Barbara; Bonnieu, Anne; Candau, Robin; Py, Guillaume

    2011-02-01

    Calpains are Ca2+ cysteine proteases that have been proposed to be involved in the cytoskeletal remodeling and wasting of skeletal muscle. Cumulative evidence also suggests that β2-agonists can lead to skeletal muscle hypertrophy through a mechanism probably related to calcium-dependent proteolytic enzyme. The aim of our study was to monitor calpain activity as a function of clenbuterol treatment in both slow and fast phenotype rat muscles. For this purpose, for 21 days we followed the time course of the calpain activity and of the ubiquitous calpain 1 and 2 autolysis, as well as muscle remodeling in the extensor digitorum longus (EDL) and soleus muscles of male Wistar rats treated daily with clenbuterol (4 mg·kg-1). A slow to fast fiber shift was observed in both the EDL and soleus muscles after 9 days of treatment, while hypertrophy was observed only in EDL after 9 days of treatment. Soleus muscle but not EDL muscle underwent an early apoptonecrosis phase characterized by hematoxylin and eosin staining. Total calpain activity was increased in both the EDL and soleus muscles of rats treated with clenbuterol. Moreover, calpain 1 autolysis increased significantly after 14 days in the EDL, but not in the soleus. Calpain 2 autolysis increased significantly in both muscles 6 hours after the first clenbuterol injection, indicating that clenbuterol-induced calpain 2 autolysis occurred earlier than calpain 1 autolysis. Together, these data suggest a preferential involvement of calpain 2 autolysis compared with calpain 1 autolysis in the mechanisms underlying the clenbuterol-induced skeletal muscle remodeling.

  19. Changes in patient's quality of life comparing conservative and surgical treatment of venous leg ulcers.

    Science.gov (United States)

    Jankūnas, Vytautas; Rimdeika, Rytis; Jasenas, Marius; Samsanavicius, Donatas

    2004-01-01

    Leg ulcers of different etiology disable up to 1% of total population, and up to 15% individuals over 70 years old. It is an old disease, which troubles the patients and medical personnel and is hard to cure. It might take several years to cure the ulcer fully. Most of the patients with leg ulcers are being treated at home, not in the outpatient departments or hospitals; therefore there is not much information on how the ulcer affects the patient's everyday life and its quality. The researchers often analyze only the financial part of this disorder forgetting its human part: pain, social isolation, and decreased mobility. There are many questionnaires and methods to analyze the quality of life of the patients with leg ulceration. It is often unclear if we should treat the ulcer conservatively for a long time or if part of resources should be used for operation (skin grafting) and the time of treatment should be shortened. To see the advantage of both methods and the influence of the ulcer treatment to the quality of life we decided to estimate the functionality of surgical and conservative treatment. We have analyzed the case histories and the data of special questionnaires of 44 patients, which were treated in Department of Plastic Surgery and Burns of Kaunas University of Medicine Hospital in the period of 2001 January-2004 February and had large trophic leg ulcers (m=254 cm2) for 6 months or more. Ten patients were treated conservatively and 34 patients were treated by skin grafting. All of them were interviewed after 3-6 months. We found that the pain in the place of the ulcers has decreased for the patients, who were treated surgically. By making the differences of the pain more exact we found out, that the patients have been feeling pain before the operation and when interviewing them the second time they told that they felt discomfort, not pain. The intensity of pain remained the same for the patients treated conservatively. The regression of pain also

  20. Comparative efficacy of selegiline versus rasagiline in the treatment of early Parkinson's disease.

    Science.gov (United States)

    Marconi, S; Zwingers, T

    2014-07-01

    The monoamine oxidase B inhibitors selegiline and rasagiline have not been compared in head-to-head clinical trials in patients with early Parkinson's disease.  The aim of this review was to compare the efficacy of these two agents in this setting. Randomized, placebo-controlled trials with an endpoint of the mean change from baseline in the Unified Parkinson's Disease Rating Scale (UPDRS) total score were included. Analysis included calculation of the standardized mean differences (SMDs) with 95% confidence intervals (CIs) and Forest Plot analyses for comparisons of pooled results. Five studies with selegiline (n = 1029) and four with rasagiline (n = 820) were included. Treatment duration was 2.5-9 months. Both selegiline and rasagiline showed significant SMDs versus placebo (-0.690, 95% CI -0.811, -0.569 and -1.025, 95% CI -1.230, -0.820; respectively), indicating a significant effect of both drugs on UPDRS. The SMD between selegiline and rasagiline was not significantly different (SMD 0.079; 95% CI -0.010, +0.167). It appears that selegiline and rasagiline have comparable efficacy in improving Parkinsonian symptoms in patients with early stage disease.

  1. Comparing bulk electrical conductivities spatial series obtained by Time Domain Reflectometry and Electromagnetic Induction sensors

    Science.gov (United States)

    Saeed, Ali; Ajeel, Ali; dragonetti, giovanna; Comegna, Alessandro; Lamaddalena, Nicola; Coppola, Antonio

    2016-04-01

    The ability to determine and monitor the effects of salts on soils and plants, are of great importance to agriculture. To control its harmful effects, soil salinity needs to be monitored in space and time. This requires knowledge of its magnitude, temporal dynamics, and spatial variability. Conventional ground survey procedures by direct soil sampling are time consuming, costly and destructive. Alternatively, soil salinity can be evaluated by measuring the bulk electrical conductivity (σb) directly in the field. Time domain reflectometry (TDR) sensors allow simultaneous measurements of water content, θ, and σb. They may be calibrated for estimating the electrical conductivity of the soil solution (σw). However, they have a relatively small observation window and thus they are thought to only provide local-scale measurements. The spatial range of the sensors is limited to tens of centimeters and extension of the information to a large area can be problematic. Also, information on the vertical distribution of the σb soil profile may only be obtained by installing sensors at different depths. In this sense, the TDR may be considered as an invasive technique. Compared to the TDR, other geophysical methods based for example on Electromagnetic Induction (EMI) techniques are non-invasive methods and represent a viable alternative to traditional techniques for soil characterization. The problem is that all these techniques give depth-weighted apparent electrical conductivity (σa) measurements, depending on the specific depth distribution of the σb, as well as on the depth response function of the sensor used. In order to deduce the actual distribution of the bulk electrical conductivity, σb, in the soil profile, one needs to invert the signal coming from EMI. Because of their relatively lower observation window, TDR sensors provide quasi-point values and do not adequately integrate the spatial variability of the chemical concentration distribution in the soil

  2. Comparing cryptomarkets for drugs. A characterisation of sellers and buyers over time.

    Science.gov (United States)

    Tzanetakis, Meropi

    2018-02-12

    Cryptomarkets operating on the darknet are a recent phenomenon that has gained importance only over the last couple of years (Barratt, 2012). However, they now constitute an evolving part of illicit drug markets. Although selling and buying a variety of psychoactive substances on the Internet has a long history, new technological developments enable systematic drug trading on the net.These technological innovations on the Internet allow users to proceed with (illicit) drug transactions with almost completely anonymous identities and locations. In this paper, we provide a systematic measurement analysis of structures and trends on the most popular anonymous drug marketplace, and discuss the role of cryptomarkets in drug distribution. Data collection and analysis include a long-term measurement of the cryptomarket 'AlphaBay', the most popular platform during the survey period. By developing and applying a web-scraping tool, market data was extracted from the marketplace on a daily basis during a period of twelve months between September 2015 and August 2016. The data was analysed by using business-intelligence software, which allows the linking of various data sets. We found 2188 unique vendors offering 11,925 drug items. The findings of our long-term monitoring and data analysis are compared over time and across marketplaces, offering a detailed understanding of the development of revenues generated, characterisation of countries of origin and destination, and distribution of vendors and customers over time. We provide a nuanced and highly detailed longitudinal analysis of drug trading on the darknet marketplace 'AlphaBay', which was the largest cryptomarket in operation. 1) Total sales volumes for the 'drugs' section was estimated at approximately USD 94 million for the period from September 2015 to August 2016. 2) In addition, about 64% of all sales are made with cocaine-, cannabis-, heroin-, and ecstasy-related products. 3) Average selling prices increase over

  3. Seasonally timed treatment programs for Ascaris lumbricoides to increase impact-An investigation using mathematical models.

    Science.gov (United States)

    Davis, Emma L; Danon, Leon; Prada, Joaquín M; Gunawardena, Sharmini A; Truscott, James E; Vlaminck, Johnny; Anderson, Roy M; Levecke, Bruno; Morgan, Eric R; Hollingsworth, T Deirdre

    2018-01-01

    There is clear empirical evidence that environmental conditions can influence Ascaris spp. free-living stage development and host reinfection, but the impact of these differences on human infections, and interventions to control them, is variable. A new model framework reflecting four key stages of the A. lumbricoides life cycle, incorporating the effects of rainfall and temperature, is used to describe the level of infection in the human population alongside the environmental egg dynamics. Using data from South Korea and Nigeria, we conclude that settings with extreme fluctuations in rainfall or temperature could exhibit strong seasonal transmission patterns that may be partially masked by the longevity of A. lumbricoides infections in hosts; we go on to demonstrate how seasonally timed mass drug administration (MDA) could impact the outcomes of control strategies. For the South Korean setting the results predict a comparative decrease of 74.5% in mean worm days (the number of days the average individual spend infected with worms across a 12 month period) between the best and worst MDA timings after four years of annual treatment. The model found no significant seasonal effect on MDA in the Nigerian setting due to a narrower annual temperature range and no rainfall dependence. Our results suggest that seasonal variation in egg survival and maturation could be exploited to maximise the impact of MDA in certain settings.

  4. Seasonally timed treatment programs for Ascaris lumbricoides to increase impact-An investigation using mathematical models.

    Directory of Open Access Journals (Sweden)

    Emma L Davis

    2018-01-01

    Full Text Available There is clear empirical evidence that environmental conditions can influence Ascaris spp. free-living stage development and host reinfection, but the impact of these differences on human infections, and interventions to control them, is variable. A new model framework reflecting four key stages of the A. lumbricoides life cycle, incorporating the effects of rainfall and temperature, is used to describe the level of infection in the human population alongside the environmental egg dynamics. Using data from South Korea and Nigeria, we conclude that settings with extreme fluctuations in rainfall or temperature could exhibit strong seasonal transmission patterns that may be partially masked by the longevity of A. lumbricoides infections in hosts; we go on to demonstrate how seasonally timed mass drug administration (MDA could impact the outcomes of control strategies. For the South Korean setting the results predict a comparative decrease of 74.5% in mean worm days (the number of days the average individual spend infected with worms across a 12 month period between the best and worst MDA timings after four years of annual treatment. The model found no significant seasonal effect on MDA in the Nigerian setting due to a narrower annual temperature range and no rainfall dependence. Our results suggest that seasonal variation in egg survival and maturation could be exploited to maximise the impact of MDA in certain settings.

  5. Comparative study of trichloroacetic acid versus glycolic acid chemical peels in the treatment of melasma

    Directory of Open Access Journals (Sweden)

    Kumari Rashmi

    2010-01-01

    Full Text Available Background: Melasma is a common cause of facial hyperpigmentation with significant cosmetic deformity. Many modalities of treatment are available, but none is satisfactory. Aim: This study was designed to compare the therapeutic response of melasma in Indian women to glycolic acid (GA 20-35% versus trichloroacetic acid (TCA 10-20% for chemical peeling. Methods: Forty nonpregnant female patients with a minimum melasma area and severity index (MASI of 10 were recruited in the study. After a detailed history and clinical examination under natural light, MASI was calculated and color photographs were taken of all the patients. The patients were advised to carry out a prepeel program of daily application of 12% GA cream or 0.1% tretinoin at night for 2 weeks. They were then treated with graded concentrations of 20-35% GA facial peel every 15 days in GA group and 10-20% TCA in the second group. Results: Objective response to treatment evaluated by reduction in MASI scoring after 12 weeks was by 79% reduction (from 26.6 to 5.6 in GA group and by 73% reduction in TCA group (from 29.1 to 8.2 but this difference was not significant. Patients with epidermal-type melasma showed a better response to treatment than those with mixed-type melasma (P < 0.05. Subjective response, as graded by the patient, showed good or very good response in 75% in GA group and 65% in TCA group. No relation of treatment response to age and duration of melasma could be established in this study. Conclusions: A prepeel program of daily application of 12% GA cream at night for 2 weeks, followed by graded increase in GA and TCA concentrations proved to be an equally effective treatment modality for epidermal and mixed melasma. There are hardly any major side effects, and regular use of sunscreens prevents chances of postpeel hyperpigmentation. GA peel is associated with fewer side effects than TCA and has the added advantage of facial rejuvenation.

  6. [Corneal neovascularisation treatments compared: Subconjunctival bevacizumab injections and/or photodynamic therapy].

    Science.gov (United States)

    Hamdan, J; Boulze, M; Aziz, A; Alessi, G; Hoffart, L

    2015-12-01

    To evaluate and compare the efficacy of subconjunctival bevacizumab injections alone, photodynamic therapy alone and combined treatments for reduction of corneal neovascularization. This study was conducted as a prospective case series. A total of seven eyes of 7 patients with corneal neovascularization caused by ocular surface disorders including fungal infectious keratitis and penetrating keratoplasty were included in the study. Patients were randomized into the three following groups: patients in group A received a single subconjunctival injection of 10mg (0.4mL) of bevacizumab, patients in group B were treated with photodynamic therapy with verteporfin (6mg/m(2)) to the neovascularized area and those in group C received a subconjunctival injection of bevacizumab and photodynamic therapy 7 days later. Morphological changes in neovascularization were evaluated over 6 months using slit-lamp biomicroscopy and digital corneal photography. A computer-assisted semi-automatic analysis of the area of corneal neovascularization was performed with Image J software. Recession of corneal vessels was observed in all eyes at 1 month post-treatment. The neovascularized surface area in all groups combined showed a decrease in the first month after treatment and this decrease continued up to the 6th month. The surface area of corneal neovascularization decreased by 34.05±8.28% in group A (subconjunctival injection of bevacizumab), by 42.06±28.36% in group B (photodynamic therapy with verteporfin) and by 51.67±18.93% in group C (combined subconjunctival injection of bevacizumab and photodynamic therapy). A combined treatment consisting of a subconjunctival injection followed by a PDT session 7 days later might be more effective for the treatment of corneal neovascularisation. No serious local or systemic adverse events were observed. Our medium-term results suggest that combined subconjunctival injection of bevacizumab and photodynamic therapy with verteporfin might be used

  7. UK waiting time targets in lung cancer treatment: are they achievable? Results of a prospective tracking study

    Directory of Open Access Journals (Sweden)

    Krysiak Piotr

    2007-01-01

    Full Text Available Abstract Background Recent guidelines have specified a number of waiting time targets to prevent delay in the treatment of lung cancer. This study was carried out to assess the quality of lung cancer services and compare with national recommendations. Methods All newly diagnosed cases of lung cancer presenting to our institution via general practitioner referral were entered into a prospective tracking study by a dedicated audit officer. From September 2003 to March 2005 a total of 247 patients were entered into the study. Of these 133 (54% were referred by general practitioners and the remainder 114 (46% were internal referrals. The Cancer Plan waiting time targets are mainly applicable to GP referrals, which formed the study group. Results All the patients were seen in chest out-patients clinic within the recommended two weeks period. However there was a delay in starting all forms of treatment. The median waiting time to any form of treatment was 60 days (recommendation 62 days for all patients. Conclusion This data demonstrates that although patients receive out patient consultation in the recommended time period, the National Cancer Plan 62 days GP referral to treatment target is not being achieved. A concerted effort by all clinicians is required to meet the prescribed target times.

  8. Evaluation of Invisalign treatment effectiveness and efficiency compared with conventional fixed appliances using the Peer Assessment Rating index.

    Science.gov (United States)

    Gu, Jiafeng; Tang, Jack Shengyu; Skulski, Brennan; Fields, Henry W; Beck, F Michael; Firestone, Allen R; Kim, Do-Gyoon; Deguchi, Toru

    2017-02-01

    The purpose of this retrospective case-control study was to compare the treatment effectiveness and efficiency of the Invisalign system with conventional fixed appliances in treating orthodontic patients with mild to moderate malocclusion in a graduate orthodontic clinic. Using the peer assessment rating (PAR) index, we evaluated pretreatment and posttreatment records of 48 Invisalign patients and 48 fixed appliances patients. The 2 groups of patients were controlled for general characteristics and initial severity of malocclusion. We analyzed treatment outcome, duration, and improvement between the Invisalign and fixed appliances groups. The average pretreatment PAR scores (United Kingdom weighting) were 20.81 for Invisalign and 22.79 for fixed appliances (P = 1.0000). Posttreatment weighted PAR scores between Invisalign and fixed appliances were not statistically different (P = 0.7420). On average, the Invisalign patients finished 5.7 months faster than did those with fixed appliances (P = 0.0040). The weighted PAR score reduction with treatment was not statistically different between the Invisalign and fixed appliances groups (P = 0.4573). All patients in both groups had more than a 30% reduction in the PAR scores. Logistic regression analysis indicated that the odds of achieving "great improvement" in the Invisalign group were 0.329 times the odds of achieving "great improvement" in the fixed appliances group after controlling for age (P = 0.0150). Our data showed that both Invisalign and fixed appliances were able to improve the malocclusion. Invisalign patients finished treatment faster than did those with fixed appliances. However, it appears that Invisalign may not be as effective as fixed appliances in achieving "great improvement" in a malocclusion. This study might help clinicians to determine appropriate patients for Invisalign treatment. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  9. Reliability of Self-reported Treatment Data by Patients With Breast Cancer Compared With Medical Record Data.

    Science.gov (United States)

    Kool, Melissa; Bastiaannet, Esther; Van de Velde, Cornelis J H; Marang-van de Mheen, Perla J

    2017-08-18

    Medical records are considered the gold standard for accurate treatment information. However, treatment data are increasingly obtained from questionnaires. It can be questioned whether self-reported treatment data are reliable, particularly because patients have to process a lot of information during their diagnosis and treatment process. The present study assesses the reliability of self-reported treatment data compared with medical records. All patients with stage I, II, and III breast cancer (n = 606) in 5 hospitals in the west of the Netherlands were invited to complete a questionnaire 9 to 18 months after surgery. We calculated kappa statistics, proportion correct, sensitivity, specificity, and positive and negative predictive values to assess agreement. Three hundred fifty patients completed the questionnaire (58%). Agreement was good for type of surgery and receiving chemotherapy, endocrine therapy, and radiation therapy, with sensitivity and specificity of 95% or higher and kappa above 0.90. However, only moderate agreement was seen for sentinel node biopsy, including the pathologic results and axillary lymph node dissection (kappa between 0.60 and 0.80). Lack of agreement was more often found for patients who had received endocrine therapy (odds ratio, 1.85; 95% confidence interval, 1.11-3.10) but not influenced by age (odds ratio, 1.00; 95% confidence interval, 0.98-1.02). Accuracy of self-reported data is high for type of surgery, chemotherapy, endocrine therapy, and radiation therapy, but much lower for sentinel node biopsy including the pathologic results and axillary lymph node dissection. This is relevant for clinicians given the time spent explaining these procedures, and for researchers to help decide what information to obtain from patients or medical records. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Real-time control of oxic phase using pH (mV)-time profile in swine wastewater treatment

    International Nuclear Information System (INIS)

    Ga, C.H.; Ra, C.S.

    2009-01-01

    The feasibility of real-time control of the oxic phase using the pH (mV)-time profile in a sequencing batch reactor for swine wastewater treatment was evaluated, and the characteristics of the novel real-time control strategies were analyzed in two different concentrated wastewaters. The nitrogen break point (NBP) on the moving slope change (MSC) of the pH (mV) was designated as a real-time control point, and a pilot-scale sequencing batch reactor (18 m 3 ) was designed to fulfill the objectives of the study. Successful real-time control using the developed control strategy was achieved despite the large variations in the influent strength and the loading rate per cycle. Indeed, complete and consistent removal of NH 4 -N (100% removal) was achieved. There was a strong positive correlation (r 2 = 0.9789) between the loading rate and soluble total organic carbon (TOCs) removal, and a loading rate of 100 g/m 3 /cycle was found to be optimum for TOCs removal. Experimental data showed that the real-time control strategy using the MSC of the pH (mV)-time profile could be utilized successfully for the removal of nitrogen from swine wastewater. Furthermore, the pH (mV) was a more reliable real-time control parameter than the oxidation-reduction potential (ORP) for the control of the oxic phase. However, the nitrate knee point (NKP) appeared more consistently upon the completion of denitrification on the ORP-time profile than on the pH (mV)-time profile.

  11. A Comparative Study of Da Vinci Robot System with Video-assisted Thoracoscopy in the Surgical Treatment of Mediastinal Lesions

    Directory of Open Access Journals (Sweden)

    Renquan DING

    2014-07-01

    Full Text Available Background and objective In recent years, Da Vinci robot system applied in the treatment of intrathoracic surgery mediastinal diseases become more mature. The aim of this study is to summarize the clinical data about mediastinal lesions of General Hospital of Shenyang Military Region in the past 4 years, then to analyze the treatment effect and promising applications of da Vinci robot system in the surgical treatment of mediastinal lesions. Methods 203 cases of mediastinal lesions were collected from General Hospital of Shenyang Military Region between 2010 and 2013. These patients were divided into two groups da Vinci and video-assisted thoracoscopic surgery (VATS according to the selection of the treatments. The time in surgery, intraoperative blood loss, postoperative drainage amount within three days after surgery, the period of bearing drainage tubes, hospital stays and hospitalization expense were then compared. Results All patients were successfully operated, the postoperative recovery is good and there is no perioperative death. The different of the time in surgery between two groups is Robots group 82 (20-320 min and thoracoscopic group 89 (35-360 min (P>0.05. The intraoperative blood loss between two groups is robot group 10 (1-100 mL and thoracoscopic group 50 (3-1,500 mL. The postoperative drainage amount within three days after surgery between two groups is robot group 215 (0-2,220 mL and thoracoscopic group 350 (50-1,810 mL. The period of bearing drainage tubes after surgery between two groups is robot group 3 (0-10 d and thoracoscopic group: 5 (1-18 d. The difference of hospital stays between two groups is robot group 7 (2-15 d and thoracoscopic group 9 (2-50 d. The hospitalization expense between two groups is robot group (18,983.6±4,461.2 RMB and thoracoscopic group (9,351.9±2,076.3 RMB (All P<0.001. Conclusion The da Vinci robot system is safe and efficient in the treatment of mediastinal lesions compared with video

  12. Specific Phobias in Youth: A Randomized Controlled Trial Comparing One-Session Treatment to a Parent-Augmented One-Session Treatment

    Science.gov (United States)

    Ollendick, Thomas H.; Halldorsdottir, Thorhildur; Fraire, Maria G; Austin, Kristin E.; Noguchi, Ryoichi J. P.; Lewis, Krystal M.; Jarrett, Matthew A.; Cunningham, Natoshia R.; Canavera, Kristin; Allen, Kristy B.; Whitmore, Maria J.

    2015-01-01

    Objective Examine the efficacy of a parent-augmented One Session Treatment (A-OST) in treating specific phobias (SP) in youth by comparing this novel treatment to child-focused OST, a well-established treatment. Method A total of 97 youth (ages 6–15, 51.5% female, 84.5% white) who fulfilled diagnostic criteria for SP were randomized to either A-OST or OST. SPs were assessed with semi-structured diagnostic interviews, clinician improvement ratings, and parent and child improvement ratings. In addition, measures of treatment satisfaction and parental self-efficacy were obtained. Blind assessments were completed pretreatment, post-treatment, and 1-month and 6-months following treatment. Analyses were undertaken using mixed models. In addition, gender, age, internalizing/externalizing problems, parent overprotection, and parent anxiety were examined as potential predictors and moderators of treatment outcome. Results Both treatment conditions produced similar outcomes with approximately 50% of youth in both treatments diagnosis free and judged to be much or very much improved at post-treatment and 1-month follow up. At 6-month follow up, however, the treatments diverged with OST resulting in marginally superior outcomes to A-OST, contrary to predictions. Only age of child predicted treatment outcome across the two treatments (older children did better); unexpectedly, none of the variables moderated treatment outcomes. Conclusions Parent augmentation of OST produced no appreciable gains in treatment outcomes. Directions for future research are highlighted. PMID:25645164

  13. Life cycle assessment of drinking water: comparing conventional water treatment, reverse osmosis and mineral water in glass and plastic bottles

    OpenAIRE

    Garfi, Marianna; Cadena, Erasmo; Sanchez Ramos, David; Ferrer Martí, Ivet

    2016-01-01

    This study evaluated the environmental impacts caused by drinking water consumption in Barcelona (Spain) using the Life Cycle Assessment (LCA) methodology. Five different scenarios were compared: 1) tap water from conventional drinking water treatment; 2) tap water from conventional drinking water treatment with reverse osmosis at the water treatment plant; 3) tap water from conventional drinking water treatment with domestic reverse osmosis; 4) mineral water in plastic bottles, and 5) minera...

  14. A comparative study of combined periodontal and orthodontic treatment with fixed appliances and clear aligners in patients with periodontitis

    Science.gov (United States)

    2015-01-01

    Purpose With the increasing prevalence of orthodontic treatment in adults, clear aligner treatments are becoming more popular. The aim of this study was to evaluate the effect of orthodontic treatment on periodontal tissue and to compare orthodontic treatment with fixed appliances (FA) to clear aligner treatment (CAT) in periodontitis patients. Methods A total of 35 patients who underwent orthodontic treatment in the Department of Periodontology were included in this study. After periodontal treatment with meticulous oral hygiene education, patients underwent treatment with FA or CAT, and this study analyzed patient outcomes depending on the treatment strategy. Clinical parameters were assessed at baseline and after orthodontic treatment, and the duration of treatment was compared between these two groups. Results The overall plaque index, the gingival index, and probing depth improved after orthodontic treatment (Porthodontic treatment, clinical parameters were improved in the FA and CAT groups with meticulous oral hygiene education and plaque control. Regarding plaque index and gingival index, no significant differences were found between these two groups. We suggest that combined periodontal and orthodontic treatment can improve patients’ periodontal health irrespective of orthodontic techniques. PMID:26734489

  15. A comparative study on 100% tca versus 88% phenol for the treatment of vitiligo

    Directory of Open Access Journals (Sweden)

    Neerja Puri

    2012-07-01

    Full Text Available There are various medical and surgical modalities for the treatment of vitiligo. Surgical modalities are used in the patients who fail to respond to medical therapy. We selected thirty patients of stable vitiligo from the department of dermatology for the study. The patients were divided into two groups of 15 patients each. In Group I patients application of 100% TCA was done on the vitiliginous sites and in Group II patients 88% phenol was applied on the affected sites. Comparing the results of repigmentation in both the groups it was seen that marked pigmentation was seen in 66.6% patients in the TCA group and 80% in the Phenol group. Moderate pigmentation was seen in 13.3% patients in both the groups and mild pigmentation was seen in 20% patients in the TCA group and 6.6% in the Phenol group.

  16. Comparative efficacy of escitalopram in the treatment of major depressive disorder

    Directory of Open Access Journals (Sweden)

    Mazen K Ali

    2011-02-01

    Full Text Available Mazen K Ali, Raymond W LamDepartment of Psychiatry, University of British Columbia, and Mood Disorders Centre, University of British Columbia Hospital, Vancouver, CanadaBackground: Escitalopram is an allosteric selective serotonin reuptake inhibitor (SSRI with some indication of superior efficacy in the treatment of major depressive disorder. In this systematic review, we critically evaluate the evidence for comparative efficacy and tolerability of escitalopram, focusing on pooled and meta-analysis studies.Methods: A literature search was conducted for escitalopram studies that quantitatively synthesized data from comparative randomized controlled trials in MDD. Studies were excluded if they did not focus on efficacy, involved primarily subgroups of patients, or synthesized data included in subsequent studies. Outcomes extracted from the included studies were weighted mean difference or standard mean difference, response and remission rates, and withdrawal rate owing to adverse events.Results: The search initially identified 24 eligible studies, of which 12 (six pooled analysis and six meta-analysis studies met the criteria for review. The pooled and meta-analysis studies with citalopram showed significant but modest differences in favor of escitalopram, with weighted mean differences ranging from 1.13 to 1.73 points on the Montgomery Asberg Depression Rating Scale, response rate differences of 7.0%–8.3%, and remission rate differences of 5.1%–17.6%. Pooled analysis studies showed efficacy differences compared with duloxetine and with serotonin noradrenaline reuptake inhibitors combined, but meta-analysis studies did not. The effect sizes of the efficacy differences increased in the severely depressed patient subgroups.Conclusion: Based on pooled and meta-analysis studies, escitalopram demonstrates superior efficacy compared with citalopram and with SSRIs combined. Escitalopram shows similar efficacy to serotonin noradrenaline reuptake

  17. Comparative Efficacy of Topical Pertmehrin, Crotamiton and Sulfur Oint-ment in Treatment of Scabies

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    Celestyna Mila-Kierzenkowska

    2017-04-01

    Full Text Available Background:  Scabies is an ectoparasitic infection, which occurs because of direct skin-to skin contact. The ideal treatment modality is still unclear and further research on this topic is warranted. The aim of the study was to com­pare the efficacy and safety of the topical scabicides: permethrin, crotamiton and sulfur ointment.Methods: Fifty four patients with diagnosed scabies were randomly divided into three treatment groups. The first group received 5% permethrin cream twice with one week interval, the patients from the second group were given crotamiton lotion for two days twice with one week interval, while the third group received 10% sulfur ointment for two or three weeks. All patients were followed up at 1, 2 and 4 weeks intervals.Results: At one-week follow up the cure rate was significantly higher at permethrin-treated group when compared to crotamiton group (P< 0.001 and sulfur group (P< 0.001. At the end of two-week interval, the cure rate at perme­thrin group was 100%, while at crotamiton group, 66.7% and in sulfur group 38.9% (P< 0.001. At 4-week follow up the applied treatment was effective in all studied individuals.Conclusion: The topical application of permethrin, crotamiton and sulfur was equally efficacious at 4-week follow up, however permethrin cream showed faster improvement at first and second follow up. Acquiring permethrin is considered as expensive option and crotamiton lotion seems to be cost-less alternative to this cream.

  18. Minocycline compared with doxycycline in the treatment of nongonococcal urethritis and mucopurulent cervicitis.

    Science.gov (United States)

    Romanowski, B; Talbot, H; Stadnyk, M; Kowalchuk, P; Bowie, W R

    1993-07-01

    To compare the efficacy and tolerability of minocycline versus doxycycline in the treatment of nongonococcal urethritis and mucopurulent cervicitis. Randomized, double-blind trial. Sexually transmitted disease clinics. 151 men and 102 women with nongonococcal urethritis, mucopurulent cervicitis or whose sexual partner had either condition or a positive culture for Chlamydia trachomatis. Minocycline, 100 mg nightly, or doxycycline, 100 mg twice daily, each administered for 7 days. At each visit (days 14 +/- 3, 28 +/- 5, and 49 +/- 7) patients were questioned regarding symptoms, signs, drug compliance, and sexual contact. Cultures for C. trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis were obtained at each visit. 253 patients were enrolled (133, doxycycline; 120, minocycline). Chlamydia trachomatis was initially isolated from 31% of men and 39% of women. Men with a positive smear had a higher symptom/sign score (P 0.2) but correlated with isolation of chlamydia (P cervicitis did not differ by treatment group at any follow-up visit (P > 0.08). Unprotected sexual contact did not affect clinical or microbiological cure rates. Adverse effects occurred more frequently in the doxycycline group (men: 43% versus 26%; P = 0.05; women: 62% versus 35%; P = 0.009). Although the proportion with dizziness did not differ by drug administered (P = 0.1), dizziness was reported more often by women (11% versus 3%). Minocycline, 100 mg nightly, was as effective as doxycycline, 100 mg twice daily, each given for 7 days in the treatment of nongonococcal urethritis and mucopurulent cervicitis. Vomiting and gastrointestinal upset occurred more frequently in the doxycycline group.

  19. Efficacy of Topical Estradiol Compared to Topical Glycolic Acid for Skin Aging Treatment in Postmenopausal Women

    Directory of Open Access Journals (Sweden)

    Shannaz Nadia Yusharyahya

    2017-12-01

    Full Text Available Skin aging is a complex biological process in human being, as a result from intrinsic factors (genetic, hormonal, metabolism and extrinsic factors (UV exposure, pollution, smoking, life style. In postmenopausal women, physiologically, the amount of estrogen are decreased, causing deterioration of their skin’s appearance. Along with the changes that occur, skin care require more attention. A holistic approach can increase epidermal thickness, therefore, reducing the depth of wrinkles, as well as improving skin texture and moisture. There are various treatments available to improve skin appearance due to aging. This EBCR is aimed to compare the efficacy of topical estradiol and topical glycolic acid as skin treatment in postmenopausal women. Articles were searched through Pubmed/MEDLINE, EBSCO, and Cochrane. One randomized-controlled trial by Fuchs KO, et al was obtained and critically appraised. Based on the appraisal, study by Fuchs KO, et al is considered valid, important, and applicable. Both estradiol and glycolic acid show good efficacy and safety for postmenopausal women with signs of skin aging, however estradiol is not considered to have better efficacy than glycolic acid.

  20. A randomized comparative trial in the management of Alcohol Dependence: Individualized Homoeopathy versus standard Allopathic Treatment

    Directory of Open Access Journals (Sweden)

    Raj K Manchanda

    2016-01-01

    Full Text Available Objectives: This study was undertaken to compare the effects of IH with standard allopathic (SA treatment. Methods: A randomized controlled, open-label, comparative trial, was conducted, in which alcohol dependents were screened verbally using the CAGE scale. The participants 80 patients fulfilling the inclusion criteria were randomized either IH (n=40 or SA (n=40 and treated cum followed up for 12 months. The primary outcome was more than 50% reduction in the Severity of Alcohol Dependence Questionnaire [SADQ] rating scale at 12 th month. Data analysis was done for both intention-to-treat (ITT and per-protocol (PP populations. Results: ITT analysis reflected 80% (n = 32 of the patients in IH and 37.5% (n = 15 of the patients in the SA responding to CI before 2.4 treatment with absolute difference was 42.5% (42.5 [95% confidence interval [CI]: 23.0, 61.6] and estimated effect: 6.6 (95% C.I: 2.4, 18.2, P = 0.0002. A significant difference favoring IH was also observed in three out of four domains of WHO QOL-BREF. Statistically significant difference was found in the number of drinking days (median difference: −24.00; CI: −39.0-−8.0; P = 0.001 and number of drinks per drinking day (median difference: −6.3 [95% CI: −11.3-−1.9]; P = 0.004, favoring IH. The results showed a similar trend in PP analysis. Medicines found useful were Sulphur, Lycopodium clavatum, Arsenicum album, Nux vomica, Phosphorus, and Lachesis. Conclusion: The results conclude that IH is not inferior to SA in the management of AD patients. More rigorous studies with large sample size are however desirable.

  1. A COMPARATIVE STUDY OF EFFICACY AND TOLERABILITY OF TRAMADOL AND ACECLOFENAC IN TREATMENT OF OSTEOARTHRITIS

    Directory of Open Access Journals (Sweden)

    Ganga

    2016-02-01

    Full Text Available Osteoarthritis (OA is a leading cause of musculoskeletal disability in elderly patients. It is a slow evolving disorder causing degeneration of articular cartilage associated with symptoms of joint tenderness, stiffness and limitation of movement. These symptoms get more worsened with weight bearing and movement. Non-steroidal anti- inflammatory (NSAIDS drugs and often Opioid analgesics offers a symptomatic relief in the management of osteoarthritis. So, the present study is conducted to compare the efficacy and tolerability of Tramadol and Aceclofenac in patients of osteoarthritis. MATERIALS AND METHODS The present study is a randomized, single centered, prospective clinical study and was conducted on 140 patients. INCLUSION CRITERIA Patients of sex, aged 40-60 years, suffering with symptoms of OA of knee who are radiologically diagnosed. EXCLUSION CRITERIA  Patients 60 years of age.  Patients with a history of peptic ulcers and hypersensitivity to NSAIDs/Opioids.  Patients with history of bleeding tendencies, cirrhosis and oesophageal varices.  Patients who have previously received Tramadol or Aceclofenac for treatment of osteoarthritis. After initial clinical assessment and baseline investigations, Aceclofenac tablet was given to 70 patients and Tramadol tablet was given orally to another 70 patients for 8 weeks. At the follow up, the results were analysed and compared statistically by paired t- test, unpaired t-test, Fischer’s exact test. RESULTS Aceclofenac has shown significant change than Tramadol in efficacy parameters like Western Ontario Mac Master (WOMAC scores (p<0.0001, joint tenderness (p<0.0001, investigator assessment for disease status (p=0.01 and response to therapy (p=0.038. Incidence of adverse effects is significant with Tramadol (p=0.02. DISCUSSION Aceclofenac was found superior than Tramadol in improving the patient’s clinical condition. Aceclofenac was found to be well tolerated than Tramadol in terms of

  2. Comparative evaluation of effectivity and safety of topical amorolfine and clotrimazole in the treatment of tinea corporis.

    Science.gov (United States)

    Banerjee, Manasi; Ghosh, Asim Kumar; Basak, Sukumar; Das, Kapil Dev; Gangopadhyay, Dwijendra Nath

    2011-11-01

    Tinea corporis is a common superficial dermatophytosis seen in tropical countries. Newer molecules are constantly being introduced for its treatment. Topical clotrimazole is in vogue as the treatment for this condition for a long time. Amorolfine is a comparatively recently introduced drug for topical use in this condition. To assess the effectivity and safety of amorolfine 0.25% cream in patients with tinea corporis, in comparison to clotrimazole 1% cream. Patients presenting with symptoms of tinea corporis were mycologically confirmed for the presence of fungal hyphae. They were randomly divided into two groups: one group received amorolfine and the other received clotrimazole. Treatment duration was for 4 weeks and study duration was for 8 weeks. Evaluation was carried out using the standard clinical parameters on day 1, day 14, day 28 and a follow-up on day 56. Adverse effects were also recorded. Data entry was done in Excel datasheet and analyzed with Epiinfo 2002. Chi-square test and t-test were used according to the type of data. The patients of the two groups were matched at baseline in respect to their demographic profile. Analysis of collected data showed significant improvement in both the groups, suggesting that both the drugs were effective agents in tinea corporis infection. Between-groups comparison of mycological cure rate and clinical improvement showed no significant difference. Amorolfine 0.25% cream is found to be safe and effective, like clotrimazole, when used topically in tinea corporis.

  3. Influence of adjuvant detached mindfulness and stress management training compared to pharmacologic treatment in primiparae with postpartum depression.

    Science.gov (United States)

    Ahmadpanah, Mohammad; Nazaribadie, Marzieh; Aghaei, Elham; Ghaleiha, Ali; Bakhtiari, Azade; Haghighi, Mohammad; Bahmani, Dena Sadeghi; Akhondi, Amineh; Bajoghli, Hafez; Jahangard, Leila; Holsboer-Trachsler, Edith; Brand, Serge

    2018-02-01

    Ten to 15% of mothers experience postpartum depression (PPD). If untreated, PPD may negatively affect mothers' and infants' mental health in the long term. Accordingly, effective treatments are required. In the present study, we investigated the effect of detached mindfulness (DM) and stress management training (SMT) as adjuvants, compared to pharmacologic treatment only, on symptoms of depression in women with PPD. Forty-five primiparae (mean age: M = 24.5 years) with diagnosed PPD and treated with an SSRI (citalopram; CIT) took part in the study. At baseline, they completed questionnaires covering socio-demographic data and symptoms of depression. Experts rated also symptoms of depression. Next, participants were randomly assigned to one of the following study conditions: adjuvant detached mindfulness (CIT+DM); adjuvant stress management training (CIT+SMT); control condition (CIT). Self- and experts' ratings were completed at the end of the study 8 weeks later, and again at 8 weeks follow-up. Symptoms of depression decreased significantly over time, but more so in the CIT+DM and CIT+SMT group, compared to the control condition. The pattern of results remained stable at follow-up. In primiparae with PPD and treated with a standard SSRI, adjuvant psychotherapeutic interventions led to significant and longer-lasting improvements.

  4. SU-F-T-391: Comparative Study of Treatment Planning Between IMRT and IMAT for Malignant Pleural Mesothelioma

    Energy Technology Data Exchange (ETDEWEB)

    Duan, J [Shandong Cancer Hospital and Institute, Jinan, Shandong province (China)

    2016-06-15

    Purpose: The purpose of this study was to compare the dosimetric differences between intensitymodulated radiation therapy (IMRT) and intensity modulated arc therapy (IMAT) for malignant pleural mesothelioma (MPM) patients with regard to the sparing effect on organs at risk (OARs), plan quality, and delivery efficiency. Methods: Ten MPM patients were recruited in this study. To avoid the inter-operator variability, IMRT and IMAT plans for each patient were performed by one experienced dosimetrist. The treatment planning optimization process was carried out using the Eclipse 13.0 software. For a fair comparison, the planning target volume (PTV) coverage of the two plans was normalized to the same level. The treatment plans were evaluated on the following dosimetric variables: conformity index (CI) and homogeneity index (HI) for PTV, OARs dose, and the delivery efficiency for each plan. Results: All plans satisfied clinical requirements. The IMAT plans gained better CI and HI. The IMRT plans performed better sparing for heart and lung. Less MUs and control points were found in the IMAT plans. IMAT shortened delivery time compared with IMRT. Conclusion: For MPM, IMAT gains better conformity and homogeneity for PTV with IMRT, but increases the irradiation dose for OARs. IMAT shows an advantage in delivery efficiency.

  5. Comparing the effects of rise time and inspiratory cycling criteria on 6 different mechanical ventilators.

    Science.gov (United States)

    Gonzales, Joshua F; Russian, Christopher J; Gregg Marshall, S; Collins, Kevin P

    2013-03-01

    Inspiratory rise time and cycling criteria are important settings in pressure support ventilation. The purpose of this study was to investigate the impact of minimum and maximum rise time and inspiratory cycling criteria settings on 6 new generation ventilators. Our hypothesis was there would be a difference in the exhaled tidal volume, inspiratory time, and peak flow among 6 different ventilators, based, on change in rise time and cycling criteria. The research utilized a breathing simulator and 4 different ventilator models. All mechanical ventilators were set to a spontaneous mode of ventilation with settings of pressure support 8 cm H2O and PEEP of 5 cm H2O. A minimum and maximum setting for rise time and cycling criteria were examined. Exhaled tidal volume, inspiratory time, and peak flow measurements were recorded for each simulation. Significant (P ventilator. Significant differences in exhaled tidal volume, inspiratory time, and peak flow were observed by adjusting rise time and cycling criteria. This research demonstrates that during pressure support ventilation strategy, adjustments in rise time and/or cycling criteria can produce changes in inspiratory parameters. Obviously, this finding has important implications for practitioners who utilize a similar pressure support strategy when conducting a ventilator wean. Additionally, this study outlines major differences among ventilator manufacturers when considering inspiratory rise time and cycling criteria.

  6. Waiting Time from Diagnosis to Treatment has no Impact on Survival in Patients with Esophageal Cancer

    NARCIS (Netherlands)

    Visser, E.; Leeftink, Anne Greetje; van Rossum, P.S.N.; Siesling, Sabine; van Hillegersberg, R.; Ruurda, J.P.

    2016-01-01

    Background Waiting time from diagnosis to treatment has emerged as an important quality indicator in cancer care. This study was designed to determine the impact of waiting time on long-term outcome of patients with esophageal cancer who are treated with neoadjuvant therapy followed by surgery or

  7. Effectiveness of salicylic acid paste for treatment of digital dermatitis in dairy cows compared with tetracycline spray and hydrotherapy.

    Science.gov (United States)

    Kofler, Johann; Innerebner, Carmen; Pesenhofer, Robert; Hangl, Andreas; Tichy, Alexander

    2015-01-01

    The effectiveness of salicylic acid paste (PASTE) was tested for topical treatment of 25 acute and 25 chronic digital dermatitis (DD) lesions. Control groups with the same number of acute and chronic DD lesions were treated with topical oxytetracycline spray (SPRAY) and by washing only with water (HYDRO) respectively. The therapeutic effects were evaluated using a pain score, the healing rate, the lesion size and other parameters. Pre-treatment and control examinations were carried out on day 0, 4, 14 and 21. In the PASTE group, 76.0% of acute DD lesions were pain free and 64.0% of acute DD lesions were healed on day 21 showing a normal skin surface (MO). Only 28.0% of acute DD lesions treated with SPRAY and 16.0% treated with HYDRO had healed on day 21. A significantly higher healing rate was revealed in acute lesions for the PASTE compared to the HYDRO group (p < 0.05) for all three re-checks, and for the PASTE group compared with the SPRAY group (p < 0.05) for day 4 and day 14. Healing rates of chronic DD lesions were higher in the PASTE group with 44.0% on day 14 and 36.0% on day 21, compared with 16.0% in the SPRAY and 32.0% in the HYDRO group on day 14, and 20.0% (SPRAY) and 28.0% (HYDRO) on day 21 respectively. The recurrence rate of lesions after they had healed during the study period was 14.5% in total. Digital dermatitis lesions treated with salicylic acid paste and a wrap showed significantly higher healing rates within the study period, odds ratios for healing of acute lesions with PASTE were 4.5 to 6.7 times higher than with SPRAY, and 9.3 to 36.4 higher compared with HYDRO.

  8. Comparative molecular study of Mycobacterium tuberculosis strains, in times of antimicrobial drug resistance

    Directory of Open Access Journals (Sweden)

    G. Varela

    2005-03-01

    Full Text Available Strains of Mycobacterium tuberculosis were compared using two DNA fingerprinting techniques: Restriction Fragment Length Polymorphism (RFLP and Double-Repetitive-Element-PCR (DRE-PCR. Two of these strains: IH1 (susceptible to isoniazid and IH2 (resistant to isoniazid were recovered from cases of pulmonary tuberculosis which occurred in two brothers who lived together. The first one was recognized on July 1999, and the second was diagnosed one year later. IH1 and IH2 showed the same pattern of bands with both molecular tests. These results suggest that single drug chemoprophylaxis may occasionally select resistant strains for that drug, which can eventually cause disease and be recognized through these tests. Strains IH3, IH4 and IH5 were obtained from sputum samples of 3 different patients, and intra-laboratory cross-contamination was suspected when it was realized that the 3 positive materials had been consecutively processed the same day by the same worker in the same biological safety cabinet. Again, the 3 strains revealed identical band patterns with RFLP and DRE-PCR, confirming the posed suspicion. The results with DRE-PCR were obtained after only 8 hours of work, without the need for subcultures. This procedure allows quick correction of treatment conducts, avoiding unnecessary exposure of people and bacteria to antimicrobial drugs.Se compararon cepas de Mycobacterium tuberculosis utilizando 2 procedimientos de ADN fingerprinting: polimorfismo de los fragmentos de restricción (RFLP y Double-Repetitive-Element-PCR (DRE-PCR. Dos de las cepas: IH1 (susceptible a isoniazida e IH2 (resistente a isoniazida se recuperaron a partir de casos de tuberculosis pulmonar que ocurrieron en dos hermanos convivientes. La primera fue aislada en julio de 1999 y la segunda un año después. IH1 e IH2 mostraron el mismo patrón de bandas por ambos procedimientos. Estos resultados sugieren que la quimioprofilaxis con una sola droga puede ocasionalmente

  9. Perceptions of infertility and treatment stress in females as compared with males entering in vitro fertilization treatment.

    Science.gov (United States)

    Collins, A; Freeman, E W; Boxer, A S; Tureck, R

    1992-02-01

    To determine gender similarities and differences in perceptions of infertility and anticipated treatment stress in couples enrolling for in vitro fertilization (IVF) treatment. Both partners were evaluated at enrollment of IVF treatment. The evaluation was part of the screening procedure. The Department of Obstetrics and Gynecology at a teaching hospital. Two hundred consecutive couples who entered an IVF treatment program. Self-report questionnaire included items on the duration of infertility, degree of social support, effect of infertility on sexual relationship, expected likelihood of achieving pregnancy, anticipation of stress during treatment, and a self-rating scale of emotional reactions to infertility. The women anticipated more stress in IVF treatment but also rated greater degree of social support than the men. Both partners overestimated their chances of a successful treatment outcome. Factor analysis of the Infertility Scale produced three factors that were similar for both sexes. The first factor represented the desire to have a child as a major focus of life with inadequacy of the male role, social functioning and work efficiency, and pressure to have a child following. Women reported more stress, but the factors affecting stress of infertility were very similar for both partners. The intense focus on having a child was the predominant factor in anticipated stress of IVF treatment for both males and females.

  10. Comparative analysis of time efficiency and spatial resolution between different EIT reconstruction algorithms

    International Nuclear Information System (INIS)

    Kacarska, Marija; Loskovska, Suzana

    2002-01-01

    In this paper comparative analysis between different EIT algorithms is presented. Analysis is made for spatial and temporal resolution of obtained images by several different algorithms. Discussions consider spatial resolution dependent on data acquisition method, too. Obtained results show that conventional applied-current EIT is more powerful compared to induced-current EIT. (Author)

  11. The Immediate Effect of Neuromuscular Joint Facilitation (NJF) Treatment on Electromechanical Reaction Times of Hip Flexion.

    Science.gov (United States)

    Huo, Ming; Wang, Hongzhao; Ge, Meng; Huang, Qiuchen; Li, Desheng; Maruyama, Hitoshi

    2013-11-01

    [Purpose] The aim of this study was to investigate the change in electromechanical reaction times (EMG-RT) of hip flexion of younger persons after neuromuscular joint facilitation (NJF) treatment. [Subjects] The subjects were 39 healthy young people, who were divided into two groups: a NJF group and a proprioceptive neuromuscular facilitation (PNF) group. The NJF group consisted of 16 subjects (7 males, 9 females), and the PNF group consisted of 23 subjects (10 males, 13 females). [Methods] Participants in the NJF group received NJF treatment. We measured the EMG-RT, the premotor time (PMT) and the motor time (MT) during hip flexion movement before and after the intervention in both groups. [Results] There were no significant differences among the results of the PNF group. For the NJF group, there were significant differences in PMT and EMG-RT after NJF treatment. [Conclusion] These results suggest that there is an immediate effect of NJF intervention on electromechanical reaction times of hip flexion.

  12. Balance Sheets Versus Decision Dashboards to Support Patient Treatment Choices: A Comparative Analysis.

    Science.gov (United States)

    Dolan, James G; Veazie, Peter J

    2015-12-01

    Growing recognition of the importance of involving patients in preference-driven healthcare decisions has highlighted the need to develop practical strategies to implement patient-centered shared decision-making. The use of tabular balance sheets to support clinical decision-making is well established. More recent evidence suggests that graphic, interactive decision dashboards can help people derive deeper a understanding of information within a specific decision context. We therefore conducted a non-randomized trial comparing the effects of adding an interactive dashboard to a static tabular balance sheet on patient decision-making. The study population consisted of members of the ResearchMatch registry who volunteered to participate in a study of medical decision-making. Two separate surveys were conducted: one in the control group and one in the intervention group. All participants were instructed to imagine they were newly diagnosed with a chronic illness and were asked to choose between three hypothetical drug treatments, which varied with regard to effectiveness, side effects, and out-of-pocket cost. Both groups made an initial treatment choice after reviewing a balance sheet. After a brief "washout" period, members of the control group made a second treatment choice after reviewing the balance sheet again, while intervention group members made a second treatment choice after reviewing an interactive decision dashboard containing the same information. After both choices, participants rated their degree of confidence in their choice on a 1 to 10 scale. Members of the dashboard intervention group were more likely to change their choice of preferred drug (10.2 versus 7.5%; p = 0.054) and had a larger increase in decision confidence than the control group (0.67 versus 0.075; p < 0.03). There were no statistically significant between-group differences in decisional conflict or decision aid acceptability. These findings suggest that clinical decision dashboards may

  13. The treatment of municipal solid waste in Malaysia comparing the biothennal process and mass burning

    Energy Technology Data Exchange (ETDEWEB)

    Fogelholm, C.J.; Iso-Tryykari, M.

    1997-12-31

    Mass burning is the previously much used technology in the combustion of municipal solid waste. In mass burning, unsorted waste is burned on a grate. The Biothermal Process is a new innovative municipal solid waste treatment concept. It consists of front end treatment, the biogasification of the biofraction and the fluidized bed combustion of the combustible fraction. The objective of this work is to compare the technical, environmental and economical features of the Biothermal Process and mass burning, when constructed in Malaysia. Firstly technical descriptions of concepts are presented. Secondly three cases namely Kuala Lumpur, Perai and Johor Bahru are studied. Finally conclusions are drawn. Economic comparisons revealed that the Biothermal Process is more economical than mass burning. The investment cost far the Biothermal Process is about 30 % lower than for mass burning plant. To achieve an 8 % Return on Investment, the treatment fee for the Biothermal Process is 47-95 MYR per tonne and for mass burning 181-215 MYR per tonne depending on the case. The sensibility analysis showed that independent of the variations in feeding values, the treatment fee remains much lower in the Biothermal Process. Technical comparisons show that the Biothermal Process has the better waste reduction and recycling rate in all cases. The Biothermal Process has much better electrical efficiency in the Kuala Lumpur and Johor Bahru cases, while mass burning has slightly better electrical efficiency in the Perai case. Both concepts have postal for phased construction, but phasing increases investment costs more in mass burning. The suitability of each concept to the differences in the quality of waste depends on local conditions, and both methods have merits. The Biothermal Process produces 45-70 % lower air emissions than mass burning, and generates less traffic in Kuala Lumpur and Perai, while traffic generation is equal in the Johor Bahru case. The comparisons show that according

  14. Comparative Efficacy of Radiofrequency and Laser Ablation for the Treatment of Benign Thyroid Nodules

    DEFF Research Database (Denmark)

    Ha, Eun Ju; Baek, Jung Hwan; Kim, Kyung Won

    2015-01-01

    PURPOSE: To compare the efficacy of radiofrequency ablation (RFA) and laser ablation (LA) for treatment of benign solid thyroid nodules, using a systematic review including traditional pooling and Bayesian network meta-analysis. MATERIALS AND METHODS: A comprehensive literature search in Pub...... of 33, identified 10 eligible papers covering a total of 184 patients for meta-analysis. The percentage mean change [absolute mean change] in nodule volume over a 6-month follow-up was compared between RFA and LA. RESULTS: Based on the traditional frequentist approach, the pooled percentage mean changes...... (95% confidence interval) of RFA and LA were 76.1% (70.1-82.1) and 49.9% (41.4-58.5), respectively, and the pooled absolute mean changes (95% confidence interval) of RFA and LA were 8.9 mL (6.6-11.2) and 5.2 mL (4.3-6.1), respectively. Based on the Bayesian network meta-analysis, RFA achieved a larger...

  15. Comparative evaluation of different methods of treatment of miners with vibration-noise pathology

    Energy Technology Data Exchange (ETDEWEB)

    Bel' skaya, M.L.; Nekhorosheva, M.A.; Konovalova, S.I.; Kukhtina, G.V.; Gonchar, I.G.; Terent' eva, D.P.; Grishchenko, L.A.; Soboleva, N.P.; Kharitonov, S.A.; Priklonskii, I.V.

    1984-10-01

    Two new therapeutic methods of treating vibration-noise pathology, needle acupuncture and hyperbaric oxygenation, are compared with established methods of medical and physical therapy. Four complexes of therapy are recommended: I complex (control), medication and physical therapy; II complex, acupuncture and medical therapy; III complex, acupuncture, medical and physical therapy; IV complex, hyperbaric oxygenation, medical and physical therapy. The four complexes were tested on a selected group of miners. II, III and IV complexes were correlated with control (I) on the basis of subjective signs, objective changes in nervous system and functional state of vegetative and peripheral nervous system. A table compares the effectiveness of II, III, IV complexes with I complex. Results confirm effectiveness of medical and physical therapy. Application of acupuncture increases benefits to cardiovascular system and hyperbaric therapy aids neurosensory hearing impairment. As a result of investigation, acupuncture and hyperbaric therapy are recommended for treatment of patients suffering vibration-noise pathology with a differential approach to their purpose. 8 references.

  16. Comparing two books and establishing probably efficacious treatment for low sexual desire.

    Science.gov (United States)

    Balzer, Alexandra M; Mintz, Laurie B

    2015-04-01

    Using a sample of 45 women, this study compared the effectiveness of a previously studied (Mintz, Balzer, Zhao, & Bush, 2012) bibliotherapy intervention (Mintz, 2009), a similar self-help book (Hall, 2004), and a wait-list control (WLC) group. To examine intervention effectiveness, between and within group standardized effect sizes (interpreted with Cohen's, 1988 benchmarks .20 = small, .50 = medium, .80+ = large) and their confidence limits are used. In comparison to the WLC group, both interventions yielded large between-group posttest effect sizes on a measure of sexual desire. Additionally, large between-group posttest effect sizes were found for sexual satisfaction and lubrication among those reading the Mintz book. When examining within-group pretest to posttest effect sizes, medium to large effects were found for desire, lubrication, and orgasm for both books and for satisfaction and arousal for those reading the Mintz book. When directly comparing the books, all between-group posttest effect sizes were likely obtained by chance. It is concluded that both books are equally effective in terms of the outcome of desire, but whether or not there is differential efficacy in terms of other domains of sexual functioning is equivocal. Tentative evidence is provided for the longer term effectiveness of both books in enhancing desire. Arguing for applying criteria for empirically supported treatments to self-help, results are purported to establish the Mintz book as probably efficacious and to comprise a first step in this designation for the Hall book. (c) 2015 APA, all rights reserved).

  17. A comparative study of pain following endodontic treatment under general anesthesia

    Directory of Open Access Journals (Sweden)

    Feizi Ghader

    2015-01-01

    Full Text Available   Background and Aims: Postoperativee endodontic pain is an outstanding problem for dental patients. Therefore, a successful management of endodontic pain has become as one of the main dental objectives. The aim of the present study was to compare the postoperative endodontic pain in patients under general anesthesia versus local anesthesia.   Materials and Methods: For conducting this clinical trial study, 50 patients having mandibular molars candidate for root canal therapy were selected. Twenty-five patients treated under general anesthesia because of their fear, anxiety or gag reflex. Other 25 patients treated under local anesthesia. All teeth were prepared using engine-driven rotary system in a crown-down technique and filled using lateral condensation technique. Heft- parker visual analog scale was used to measure the degree of pain at 6, 12, 24, and 48 hours after the treatment. Mann-Whitney, Chi-square, and T-tests were used to compare the intensity of postoperative pain between the groups.   Results: The mean intensity of postoperative pain in local and general anesthesia groups at 6, 12 and 24 hours had statistically significant difference (P<0.05.   Conclusion: Postoperative pain in patients who treated under general anesthesia was significantly less than the patients who treated under local anesthesia.

  18. Time Perception in Severe Traumatic Brain Injury Patients: A Study Comparing Different Methodologies

    Science.gov (United States)

    Mioni, G.; Mattalia, G.; Stablum, F.

    2013-01-01

    In this study, we investigated time perception in patients with traumatic brain injury (TBI). Fifteen TBI patients and 15 matched healthy controls participated in the study. Participants were tested with durations above and below 1s on three different temporal tasks that involved time reproduction, production, and discrimination tasks. Data…

  19. Making Decisions with the Future in Mind: Developmental and Comparative Identification of Mental Time Travel

    Science.gov (United States)

    Suddendorf, T.; Busby, J.

    2005-01-01

    Mechanisms that produce behavior which increase future survival chances provide an adaptive advantage. The flexibility of human behavior is at least partly the result of one such mechanism, our ability to travel mentally in time and entertain potential future scenarios. We can study mental time travel in children using language. Current results…

  20. Investigation of Pitch and Jaw Width to Decrease Delivery Time of Helical Tomotherapy Treatments for Head and Neck Cancer

    International Nuclear Information System (INIS)

    Moldovan, Monica; Fontenot, Jonas D.; Gibbons, John P.; Lee, Tae Kyu; Rosen, Isaac I.; Fields, Robert S.; Hogstrom, Kenneth R.

    2011-01-01

    Helical tomotherapy plans using a combination of pitch and jaw width settings were developed for 3 patients previously treated for head and neck cancer. Three jaw widths (5, 2.5, and 1 cm) and 4 pitches (0.86, 0.43, 0.287, and 0.215) were used with a (maximum) modulation factor setting of 4. Twelve plans were generated for each patient using an identical optimization procedure (e.g., number of iterations, objective weights, and penalties, etc.), based on recommendations from TomoTherapy (Madison, WI). The plans were compared using isodose plots, dose volume histograms, dose homogeneity indexes, conformity indexes, radiobiological models, and treatment times. Smaller pitches and jaw widths showed better target dose homogeneity and sparing of normal tissue, as expected. However, the treatment time increased inversely proportional to the jaw width, resulting in delivery times of 24 ± 1.9 min for the 1-cm jaw width. Although treatment plans produced with the 2.5-cm jaw were dosimetrically superior to plans produced with the 5-cm jaw, subsequent calculations of tumor control probabilities and normal tissue complication probabilities suggest that these differences may not be radiobiologically meaningful. Because treatment plans produced with the 5-cm jaw can be delivered in approximately half the time of plans produced with the 2.5-cm jaw (5.1 ± 0.6 min vs. 9.5 ± 1.1 min), use of the 5-cm jaw in routine treatment planning may be a viable approach to decreasing treatment delivery times from helical tomotherapy units.

  1. Comparing Hatha yoga with dynamic group psychotherapy for enhancing methadone maintenance treatment: a randomized clinical trial.

    Science.gov (United States)

    Shaffer, H J; LaSalvia, T A; Stein, J P

    1997-07-01

    As more methadone treatment programs are funded in an attempt to curb substance abuse and HIV infection among i.v. drug users, more cost effective treatment approaches are being sought. To investigate whether clients in outpatient methadone maintenance treatment who practice weekly Hatha yoga in a group setting experience more favorable treatment outcomes than those who receive conventional group psychodynamic therapy. After a 5-day assessment period, 61 patients were randomly assigned to methadone maintenance enhanced by traditional group psychotherapy (ie, conventional methadone treatment) or an alternative Hatha yoga therapy (ie, alternative methadone treatment). Patients were followed for 6 months and evaluated on a variety of psychological, sociological, and biological measures. The revised Symptom Check List provided the primary psychological measures; the Addiction Severity Index provided various indices of addictive behaviors. The evidence revealed that there were no meaningful differences between traditional psychodynamic group therapy and Hatha yoga presented in a group setting. Both treatments contributed to a treatment regimen that significantly reduced drug use and criminal activities. Psychopathology at admission was significantly related to program participation regardless of treatment group. In addition to examining the characteristics of patients who present for treatment, this study identifies unexpected staff issues that complicate the integration of alternative and traditional treatment strategies. Alternative methadone treatment is not more effective than conventional methadone treatment, as originally hypothesized. However, some patients may benefit more from alternative methadone treatment than conventional methadone treatment. Additional research is necessary to determine characteristics that identify patients who might benefit from alternative methadone treatment.

  2. Comparative evaluation of piggery wastewater treatment in algal-bacterial photobioreactors under indoor and outdoor conditions.

    Science.gov (United States)

    García, Dimas; Posadas, Esther; Grajeda, Carlos; Blanco, Saúl; Martínez-Páramo, Sonia; Acién, Gabriel; García-Encina, Pedro; Bolado, Silvia; Muñoz, Raúl

    2017-12-01

    This work evaluated the performance of four open algal-bacterial photobioreactors operated at ≈26days of hydraulic retention time during the treatment of 10 (×10) and 20 (×20) times diluted piggery wastewater (PWW) under indoor (I) and outdoor (O) conditions for four months. The removal efficiencies (REs) of organic matter, nutrients and zinc from PWW, along with the dynamics of biomass concentration and structure of algal-bacterial population were assessed. The highest TOC-RE, TP-RE and Zn-RE (94±1%, 100% and 83±2%, respectively) were achieved indoors in ×10 PWW, while the highest TN-RE (72±8%) was recorded outdoors in ×10 PWW. Chlorella vulgaris was the dominant species regardless of the ambient conditions and PWW dilution. Finally, DGGE-sequencing of the bacterial community revealed the occurrence of four phyla, Proteobacteria being the dominant phylum with 15 out of the 23 most intense bands. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Iodine-125 brachytherapy as upfront and salvage treatment for brain metastases. A comparative analysis

    Energy Technology Data Exchange (ETDEWEB)

    Romagna, Alexander; Schwartz, Christoph; Tonn, Joerg-Christian; Kreth, Friedrich-Wilhelm [Ludwig-Maximilians-University, Department of Neurosurgery, Munich (Germany); Egensperger, Rupert [Ludwig-Maximilians-University, Center for Neuropathology and Prion Research, Munich (Germany); Watson, Juliana; Belka, Claus; Nachbichler, Silke Birgit [Ludwig-Maximilians-University, Department of Radiation-Oncology, Munich (Germany)

    2016-11-15

    Outcome and toxicity profiles of salvage stereotactic ablative radiation strategies for recurrent pre-irradiated brain metastases are poorly defined. This study compared risk-benefit profiles of upfront and salvage iodine-125 brachytherapy (SBT) for small brain metastases. As the applied SBT treatment algorithm required histologic proof of metastatic brain disease in all patients, we additionally aimed to elucidate the value of biopsy before SBT. Patients with small untreated (n = 20) or pre-irradiated (n =28) suspected metastases intended for upfront or salvage SBT, respectively, were consecutively included. Temporary iodine-125 implants were used (median reference dose: 50 Gy, median dose rate: 15 cGy/h). Cumulative biologically effective doses (BED) were calculated and used for risk assessment. Treatment toxicity was classified according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer (RTOG/EORTC) criteria. Upfront SBT was initiated in 20 patients and salvage SBT in 23. In 5 patients, salvage SBT was withheld because of proven radiation-induced lesions. Treatment groups exhibited similar epidemiologic data except for tumor size (which was slightly smaller in the salvage group). One-year local/distant tumor control rates after upfront and salvage SBT were similar (94 %/65 % vs. 87 %/57 %, p = 0.45, respectively). Grade I/II toxicity was suffered by 2 patients after salvage SBT (cumulative BED: 192.1 Gy{sub 3} and 249.6 Gy{sub 3}). No toxicity-related risk factors were identified. SBT combines diagnostic yield with effective treatment in selected patients. The low toxicity rate in the salvage group points to protective radiobiologic characteristics of continuous low-dose rate irradiation. Upfront and salvage SBT are similarly effective and safe. Histologic reevaluation should be reconsidered after previous radiotherapy to avoid under- or overtreatment. (orig.) [German] Daten zu Risiko und Effizienz ablativer

  4. Just-in-time consent: The ethical case for an alternative to traditional informed consent in randomized trials comparing an experimental intervention with usual care.

    Science.gov (United States)

    Vickers, Andrew J; Young-Afat, Danny A; Ehdaie, Behfar; Kim, Scott Yh

    2018-02-01

    Informed consent for randomized trials often causes significant and persistent anxiety, distress and confusion to patients. Where an experimental treatment is compared to a standard care control, much of this burden is potentially avoidable in the control group. We propose a "just-in-time" consent in which consent discussions take place in two stages: an initial consent to research from all participants and a later specific consent to randomized treatment only from those assigned to the experimental intervention. All patients are first approached and informed about research procedures, such as questionnaires or tests. They are also informed that they might be randomly selected to receive an experimental treatment and that, if selected, they can learn more about the treatment and decide whether or not to accept it at that time. After randomization, control patients undergo standard clinical consent whereas patients randomized to the experimental procedure undergo a second consent discussion. Analysis would be by intent-to-treat, which protects the trial from selection bias, although not from poor acceptance of experimental treatment. The advantages of just-in-time consent stem from the fact that only patients randomized to the experimental treatment are subject to a discussion of that intervention. We hypothesize that this will reduce much of the patient's burden associated with the consent process, such as decisional anxiety, confusion and information overload. We recommend well-controlled studies to compare just-in-time and traditional consent, with endpoints to include characteristics of participants, distress and anxiety and participants' understanding of research procedures.

  5. Treatment and technical intervention time analysis of a robotic stereotactic radiotherapy system.

    Science.gov (United States)

    Crop, F; Lacornerie, T; Szymczak, H; Felin, A; Bailleux, C; Mirabel, X; Lartigau, E

    2014-02-01

    The purpose of this study is to obtain a better operational knowledge of Stereotactic Body Radiotherapy (SBRT) treatments with CyberKnife(r). An analysis of both In-room Times (IRT) and technical interventions of 5 years of treatments was performed, during which more than 1600 patients were treated for various indications, including liver (21%), lung (29%), intracranial (13%), head and neck (11%) and prostate (7%). Technical interventions were recorded along with the time of the failure, time to the intervention, and the complexity and duration of the repair. Analyses of Time Between Failures (TBF) and Service Disrupting TBF(disr) were performed. Treatment time data and variability per indication and following different system upgrades were evaluated. Large variations of IRTs were found between indications, but also large variations for each indication. The combination of the time reduction Tool (using Iris(r)) and Improved Stop Handling was of major impact to shortening of treatment times. The first implementation of the Iris collimator alone did not lead to significantly shorter IRTs for us except during prostate treatments. This was mostly due to the addition at the same time of larger rotational compensation for prostate treatments (58 instead of 1.58). Significant differences of duration between the first fraction and following fractions of a treatment, representing the necessity of defining imaging parameters and explanation to patients, were found for liver (12 min) and lung treatments using Xsight(r) Spine (5 min). Liver and lung treatments represent the longest IRT's and involve the largest variability's in IRT. The malfunction rate of the system followed a Weibull distribution with the shape and scale parameters of 0.8 and 39.7. Mean TBF(disr) was 68 work hours. 60 to 80% of the service disrupting interventions were resolved within 30-60 min, 5% required external intervention and 30% occurred in the morning. The presented results can be applied in the

  6. Time-series analysis in imatinib-resistant chronic myeloid leukemia K562-cells under different drug treatments.

    Science.gov (United States)

    Zhao, Yan-Hong; Zhang, Xue-Fang; Zhao, Yan-Qiu; Bai, Fan; Qin, Fan; Sun, Jing; Dong, Ying

    2017-08-01

    Chronic myeloid leukemia (CML) is characterized by the accumulation of active BCR-ABL protein. Imatinib is the first-line treatment of CML; however, many patients are resistant to this drug. In this study, we aimed to compare the differences in expression patterns and functions of time-series genes in imatinib-resistant CML cells under different drug treatments. GSE24946 was downloaded from the GEO database, which included 17 samples of K562-r cells with (n=12) or without drug administration (n=5). Three drug treatment groups were considered for this study: arsenic trioxide (ATO), AMN107, and ATO+AMN107. Each group had one sample at each time point (3, 12, 24, and 48 h). Time-series genes with a ratio of standard deviation/average (coefficient of variation) >0.15 were screened, and their expression patterns were revealed based on Short Time-series Expression Miner (STEM). Then, the functional enrichment analysis of time-series genes in each group was performed using DAVID, and the genes enriched in the top ten functional categories were extracted to detect their expression patterns. Different time-series genes were identified in the three groups, and most of them were enriched in the ribosome and oxidative phosphorylation pathways. Time-series genes in the three treatment groups had different expression patterns and functions. Time-series genes in the ATO group (e.g. CCNA2 and DAB2) were significantly associated with cell adhesion, those in the AMN107 group were related to cellular carbohydrate metabolic process, while those in the ATO+AMN107 group (e.g. AP2M1) were significantly related to cell proliferation and antigen processing. In imatinib-resistant CML cells, ATO could influence genes related to cell adhesion, AMN107 might affect genes involved in cellular carbohydrate metabolism, and the combination therapy might regulate genes involved in cell proliferation.

  7. Comparative Study on the Effects of Bee Venom Pharmacopuncture According to the Treatment Method for Knee Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Lee Seung-Hwon

    2012-12-01

    Full Text Available Objectives: The purpose of this study is to compare the effects of bee venom pharmacopuncture (BVP therapy according to the methods used to treat knee osteoarthritis (OA: intra-acupoint combined with intra-articular injection, intra-acupoint injection, and intra-articular injection. Methods: A total of 69 patients were recruited by the Department of Acupuncture & Moxibustion at Dong-Eui Oriental University Hospital from February 1 to July 23, 2012. The patients were assigned to 3 groups: the first group with intra-acupoint combined with intra-articular BVP Injection (the experimental group, the 2nd group with intra-acupoint BVP injection (control groupⅠ, and the 3rd group with intra-articular BVP injection (control groupⅡ. The participants were assigned in the order in which they were recruited. Treatments were done twice a week, for a total of 9 times. The effectiveness was assessed by using the visual analouge scale (VAS and the Korea Western Ontario and McMaster Universities Osteoarthritis Index (KWOMAC. Results: All three groups exhibited significant VAS and KWOMAC effects. Moreover, the 4 week follow-up after the final treatment showed a persistence of BVP effects. However, when the groups were compared, no statistically significant differences in VAS and KWOMAC were noted, but when improvement was considered, the results showed that intra-articular injection was more effective than intra-acupoint injection. Especially, intra-acupoint combined with intra-articular injection was the most effective among the three treatments. Conclusions: Combining intra-acupoint with intra-articular injection, depending on the patient's symptoms, may produce better results when conservatively treating knee OA.

  8. Once-monthly paliperidone palmitate compared with conventional and atypical daily oral antipsychotic treatment in patients with schizophrenia.

    Science.gov (United States)

    Kim, Edward; Correll, Christoph U; Mao, Lian; Starr, H Lynn; Alphs, Larry

    2016-12-01

    This analysis of the Paliperidone Palmitate Research in Demonstrating Effectiveness (PRIDE) study (NCT01157351) compared outcomes after administration of once-monthly paliperidone palmitate (PP) vs conventional oral antipsychotics (COAs) or atypical oral antipsychotics (AOAs). PRIDE was a 15-month study of 444 individuals with schizophrenia and a history of incarceration. They were randomly assigned to PP or to 1 of 7 commonly prescribed OAs. Primary endpoint was time to first treatment failure (TF). Event-free probabilities were estimated using the Kaplan-Meier method; treatment group differences (PP vs COAs, PP vs AOAs, and PP vs oral paliperidone/risperidone) were assessed using a log-rank test. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models. No adjustment was made for multiplicity. Compared with PP, risk for first TF was 34% higher with COAs (HR: 1.34; 95% CI: 0.80-2.25), 41% higher with AOAs (HR: 1.41; 95% CI: 1.06-1.88), and 39% higher with paliperidone/risperidone (HR: 1.39; 95% CI: 0.97-1.99). Incidences of extrapyramidal symptom-related adverse events (AEs) were 45.7%, 13.7%, and 10.6% in the COA, AOA, and oral paliperidone/risperidone groups vs 23.9% in the PP group. Incidences of prolactin-related AEs were 5.7%, 3.8%, and 3.5% vs 23.5%, and incidences of ≥7% weight increase were 11.4%, 14.9%, and 16.0% vs 32.4%. Results suggest a lower risk of TF but a higher rate of some AEs after treatment with PP vs COAs, AOAs, and paliperidone/risperidone. Deselection of specific OAs and low patient-compliance rates with OAs likely biased the safety results.

  9. Natural Firing Patterns Imply Low Sensitivity of Synaptic Plasticity to Spike Timing Compared with Firing Rate.

    Science.gov (United States)

    Graupner, Michael; Wallisch, Pascal; Ostojic, Srdjan

    2016-11-02

    Synaptic plasticity is sensitive to the rate and the timing of presynaptic and postsynaptic action potentials. In experimental protocols inducing plasticity, the imposed spike trains are typically regular and the relative timing between every presynaptic and postsynaptic spike is fixed. This is at odds with firing patterns observed in the cortex of intact animals, where cells fire irregularly and the timing between presynaptic and postsynaptic spikes varies. To investigate synaptic changes elicited by in vivo-like firing, we used numerical simulations and mathematical analysis of synaptic plasticity models. We found that the influence of spike timing on plasticity is weaker than expected from regular stimulation protocols. Moreover, when neurons fire irregularly, synaptic changes induced by precise spike timing can be equivalently induced by a modest firing rate variation. Our findings bridge the gap between existing results on synaptic plasticity and plasticity occurring in vivo, and challenge the dominant role of spike timing in plasticity. Synaptic plasticity, the change in efficacy of connections between neurons, is thought to underlie learning and memory. The dominant paradigm posits that the precise timing of neural action potentials (APs) is central for plasticity induction. This concept is based on experiments using highly regular and stereotyped patterns of APs, in stark contrast with natural neuronal activity. Using synaptic plasticity models, we investigated how irregular, in vivo-like activity shapes synaptic plasticity. We found that synaptic changes induced by precise timing of APs are much weaker than suggested by regular stimulation protocols, and can be equivalently induced by modest variations of the AP rate alone. Our results call into question the dominant role of precise AP timing for plasticity in natural conditions. Copyright © 2016 Graupner et al.

  10. Comparative survival study of glial cells and cells composing walls of blood vessels in crustacean ventral nerve cord after photodynamic treatment

    Science.gov (United States)

    Kolosov, Mikhail S.; Shubina, Elena

    2015-03-01

    Photodynamic therapy is a prospective treatment modality of brain cancers. It is of importance to have information about relative survival rate of different cell types in nerve tissue during photodynamic treatment. Particularly, for development of sparing strategy of the photodynamic therapy of brain tumors, which pursuits both total elimination of malignant cells, which are usually of glial origin, and, at the same time, preservation of normal blood circulation as well as normal glial cells in the brain. The aim of this work was to carry out comparative survival study of glial cells and cells composing walls of blood vessels after photodynamic treatment, using simple model object - ventral nerve cord of crustacean.

  11. Specific phobias in youth: a randomized controlled trial comparing one-session treatment to a parent-augmented one-session treatment.

    Science.gov (United States)

    Ollendick, Thomas H; Halldorsdottir, Thorhildur; Fraire, Maria G; Austin, Kristin E; Noguchi, Ryoichi J P; Lewis, Krystal M; Jarrett, Matthew A; Cunningham, Natoshia R; Canavera, Kristin; Allen, Kristy B; Whitmore, Maria J

    2015-03-01

    Examine the efficacy of a parent-augmented One-Session Treatment (A-OST) in treating specific phobias (SP) in youth by comparing this novel treatment to child-focused OST, a well-established treatment. A total of 97 youth (ages 6-15, 51.5% female, 84.5% White) who fulfilled diagnostic criteria for SP were randomized to either A-OST or OST. SPs were assessed with semistructured diagnostic interviews, clinician improvement ratings, and parent and child improvement ratings. In addition, measures of treatment satisfaction and parental self-efficacy were obtained. Blind assessments were completed pretreatment, posttreatment, and 1month and 6months following treatment. Analyses were undertaken using mixed models. In addition, gender, age, internalizing/externalizing problems, parent overprotection, and parent anxiety were examined as potential predictors and moderators of treatment outcome. Both treatment conditions produced similar outcomes with approximately 50% of youth in both treatments diagnosis free and judged to be much or very much improved at posttreatment and 1-month follow-up. At 6-month follow-up, however, the treatments diverged with OST resulting in marginally superior outcomes to A-OST, contrary to predictions. Only age of child predicted treatment outcome across the two treatments (older children did better); unexpectedly, none of the variables moderated treatment outcomes. Parent augmentation of OST produced no appreciable gains in treatment outcomes. Directions for future research are highlighted. Copyright © 2014. Published by Elsevier Ltd.

  12. Two-year evaluation of Intermittent Preventive Treatment for Children (IPTc combined with timely home treatment for malaria control in Ghana

    Directory of Open Access Journals (Sweden)

    Seake-Kwawu Atsu

    2011-05-01

    Full Text Available Abstract Background Intermittent preventive treatment (IPT has recently been accepted as an important component of the malaria control strategy. Intermittent preventive treatment for children (IPTc combined with timely treatment of malaria related febrile illness at home to reduce parasite prevalence and malaria morbidity in children aged between six and 60 months in a coastal community in Ghana. This paper reports persistence of reduced parasitaemia two years into the intervention. The baseline and year-one-evaluation findings were published earlier. Objective The main objective in the second year was to demonstrate whether the two interventions would further reduce parasite prevalence and malaria-related febrile illness in the study population. Methods This was an intervention study designed to compare baseline and evaluation findings without a control group. The study combined home-based delivery of intermittent preventive treatment for children (IPTc aged 6 - 60 months and home treatment of suspected febrile malaria-related illness within 24 hours. All children aged 6 - 60 months received home-based delivery of intermittent preventive treatment using amodiaquine + artesunate, delivered at home by community assistants every four months (6 times in 24 months. Malaria parasite prevalence surveys were conducted before the first and after the third and sixth IPTc to the children. The evaluation surveys were done four months after the third and sixth IPTc was given. Results Parasite prevalence which reduced from 25% to 3.0% at year-one evaluation had reduced further from 3% to 1% at year-two-evaluation. At baseline, 13.8% of the children were febrile (axilary temperature of ≥37.5°C compared to 2.2% at year-one-evaluation while 2.1% were febrile at year-two-evaluation. Conclusion The year-two-evaluation result indicates that IPTc given three times in a year (every four months combined with timely treatment of febrile malaria illness, is

  13. Comparing Destination Image and Loyalty between First-time and Repeat-visit Tourists

    OpenAIRE

    Mohamad M.; Ab Ghani N. I.

    2014-01-01

    The objective of this study was to investigate the difference between destination image and loyalty among first-time and repeat-visit tourists. The study was undertaken to examine aspects of underlying factors of destination image that influenced tourists’ willingness to recommend Malaysia to their friends and relatives as well as spread positive word-of-mouth to others. In addition, it was to ascertain the relationship between destination image and loyalty among first-time and repeat-visit t...

  14. Comparing the efficacy of intravenous tenoxicam, lornoxicam, and dexketoprofen trometamol for the treatment of renal colic.

    Science.gov (United States)

    Cevik, Erdem; Cinar, Orhan; Salman, Necati; Bayir, Aytekin; Arziman, Ibrahim; Ardic, Sukru; Youngquist, Scott Travis

    2012-10-01

    The aim of this study was to compare the efficacy and safety of 3 nonsteroidal anti-inflammatory drugs-intravenous tenoxicam, lornoxicam, and dexketoprofen trometamol-for the treatment of patients with renal colic. We conducted a prospective double-blind randomized trial of consecutive adult patients who presented to the emergency department with a chief complaint of acute flank pain and had a clinical diagnosis of suspected acute renal colic. Patients were randomly allocated to receive an intravenous bolus of tenoxicam, lornoxicam, or dexketoprofen trometamol in a blinded fashion. Primary outcome measure of the study was visual analog scale (VAS) score difference at 30 minutes. Secondary outcome measures were VAS scores at 5, 15, and 120 minutes as well as rescue analgesic need at 30 minutes and adverse events during the follow-up period. A total of 445 patients were screened, and 123 patients were enrolled in the study. The mean age was 36 ± 10 years. The mean reduction in VAS pain scores at 30 minutes was 42 ± 26 mm for tenoxicam, 57 ± 23 mm for lornoxicam, and 52 ± 25 mm for dexketoprofen (P = .047). Lornoxicam demonstrated the fastest rate of VAS score reduction over the first 30 minutes. The mean reduction values in VAS pain scores at 5, 15, and 120 minutes were similar among the 3 groups. Rescue analgesics at 30 minutes were required by 16 patients (39%) receiving tenoxicam, 10 patients (24%) receiving lornoxicam, and 8 patients (19%) receiving dexketoprofen (P = .121). No serious adverse events were observed. Intravenous tenoxicam, lornoxicam, and dexketoprofen are all effective in the treatment of renal colic, although lornoxicam appears to reduce VAS pain scores with the fastest rate in this comparison. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. The impact of skin decontamination on the time window for effective treatment of percutaneous VX exposure.

    Science.gov (United States)

    Joosen, M J A; van den Berg, R M; de Jong, A L; van der Schans, M J; Noort, D; Langenberg, J P

    2017-04-01

    The main goal of the present study was to obtain insight into depot formation and penetration following percutaneous VX poisoning, in order to identify an appropriate decontamination window that can enhance or support medical countermeasures. The study was executed in two phases, using the hairless guinea pig as an animal model. In the first phase the effect of various decontamination regimens on levels of free VX in skin and plasma were studied as well as on blood cholinesterase levels. Animals were exposed to 0.5 mg/kg VX and were not decontaminated (control), decontaminated with RSDL once at 15 or 90 min after exposure or three times at 15, 25 and 35 (10-min interval) or 15, 45 and 75 min after exposure (30-min interval). There was no significant effect of any of the decontamination regimens on the 6-h survival rate of the animals. However, all animals that had been decontaminated 15 min after exposure, showed a survival rate of more than 90%, compared to 50-60% in animals that were not decontaminated or decontaminated at 90 min after exposure. In the second phase of the study, hairless guinea pigs were exposed to 1 mg/kg VX on the shoulder, followed either by decontamination with RSDL (10 min interval), conventional treatment on indication of clinical signs or a combination thereof. It appeared that a thorough, repeated decontamination alone could not save the majority of the animals. A 100% survival rate was observed in the group that received a combination of decontamination and treatment. In conclusion, the effects of VX exposure could be influenced by various RSDL decontamination regimens. The results in freely moving animals showed that skin decontamination, although not fully effective in removing all VX from the skin and skin depot is crucial to support pharmacological intervention. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Adjuvant Radiation Therapy Treatment Time Impacts Overall Survival in Gastric Cancer

    International Nuclear Information System (INIS)

    McMillan, Matthew T.; Ojerholm, Eric; Roses, Robert E.; Plastaras, John P.; Metz, James M.; Mamtani, Ronac; Karakousis, Giorgos C.; Fraker, Douglas L.; Drebin, Jeffrey A.; Stripp, Diana; Ben-Josef, Edgar; Datta, Jashodeep

    2015-01-01

    Purpose: Prolonged radiation therapy treatment time (RTT) is associated with worse survival in several tumor types. This study investigated whether delays during adjuvant radiation therapy impact overall survival (OS) in gastric cancer. Methods and Materials: The National Cancer Data Base was queried for patients with resected gastric cancer who received adjuvant radiation therapy with National Comprehensive Cancer Network–recommended doses (45 or 50.4 Gy) between 1998 and 2006. RTT was classified as standard (45 Gy: 33-36 days, 50.4 Gy: 38-41 days) or prolonged (45 Gy: >36 days, 50.4 Gy: >41 days). Cox proportional hazards models evaluated the association between the following factors and OS: RTT, interval from surgery to radiation therapy initiation, interval from surgery to radiation therapy completion, radiation therapy dose, demographic/pathologic and operative factors, and other elements of adjuvant multimodality therapy. Results: Of 1591 patients, RTT was delayed in 732 (46%). Factors associated with prolonged RTT were non-private health insurance (OR 1.3, P=.005) and treatment at non-academic facilities (OR 1.2, P=.045). Median OS and 5-year actuarial survival were significantly worse in patients with prolonged RTT compared with standard RTT (36 vs 51 months, P=.001; 39 vs 47%, P=.005); OS worsened with each cumulative week of delay (P<.0004). On multivariable analysis, prolonged RTT was associated with inferior OS (hazard ratio 1.2, P=.002); the intervals from surgery to radiation therapy initiation or completion were not. Prolonged RTT was particularly detrimental in patients with node positivity, inadequate nodal staging (<15 nodes examined), and those undergoing a cycle of chemotherapy before chemoradiation therapy. Conclusions: Delays during adjuvant radiation therapy appear to negatively impact survival in gastric cancer. Efforts to minimize cumulative interruptions to <7 days should be considered

  17. Adjuvant Radiation Therapy Treatment Time Impacts Overall Survival in Gastric Cancer

    Energy Technology Data Exchange (ETDEWEB)

    McMillan, Matthew T. [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Ojerholm, Eric [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Roses, Robert E., E-mail: Robert.Roses@uphs.upenn.edu [Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Plastaras, John P.; Metz, James M. [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Mamtani, Ronac [Department of Hematology/Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Karakousis, Giorgos C.; Fraker, Douglas L.; Drebin, Jeffrey A. [Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Stripp, Diana; Ben-Josef, Edgar [Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States); Datta, Jashodeep [Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (United States)

    2015-10-01

    Purpose: Prolonged radiation therapy treatment time (RTT) is associated with worse survival in several tumor types. This study investigated whether delays during adjuvant radiation therapy impact overall survival (OS) in gastric cancer. Methods and Materials: The National Cancer Data Base was queried for patients with resected gastric cancer who received adjuvant radiation therapy with National Comprehensive Cancer Network–recommended doses (45 or 50.4 Gy) between 1998 and 2006. RTT was classified as standard (45 Gy: 33-36 days, 50.4 Gy: 38-41 days) or prolonged (45 Gy: >36 days, 50.4 Gy: >41 days). Cox proportional hazards models evaluated the association between the following factors and OS: RTT, interval from surgery to radiation therapy initiation, interval from surgery to radiation therapy completion, radiation therapy dose, demographic/pathologic and operative factors, and other elements of adjuvant multimodality therapy. Results: Of 1591 patients, RTT was delayed in 732 (46%). Factors associated with prolonged RTT were non-private health insurance (OR 1.3, P=.005) and treatment at non-academic facilities (OR 1.2, P=.045). Median OS and 5-year actuarial survival were significantly worse in patients with prolonged RTT compared with standard RTT (36 vs 51 mon