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Sample records for twelve months postoperatively

  1. EFFORTS Technical annex for the twelve month progress report

    DEFF Research Database (Denmark)

    Andreasen, Jan Lasson; Eriksen, Morten; Thomas christensen, Thomas Vennick;

    The present report is documentation for the work carried out at DTU during the second year of project activity. The report describes the work completed by DTU in general as well as on the active sub-tasks within materials properties, friction modelling and physical modelling, over the last twelve...

  2. 17 CFR 210.3-06 - Financial statements covering a period of nine to twelve months.

    Science.gov (United States)

    2010-04-01

    ... ACT OF 1933, SECURITIES EXCHANGE ACT OF 1934, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935, INVESTMENT COMPANY ACT OF 1940, INVESTMENT ADVISERS ACT OF 1940, AND ENERGY POLICY AND CONSERVATION ACT OF 1975... to twelve months. Except with respect to registered investment companies, the filing of...

  3. Premarital sex in the last twelve months and its predictors among ...

    African Journals Online (AJOL)

    Premarital sex in the last twelve months and its predictors among students of ... Statistical significance was determined through a 95% confidence level. ... having comprehensive knowledge of HIV [AOR(95% CI)=1.5(1.01-2.10)], alcohol use ...

  4. Premarital Sex in the Last Twelve Months and Its Predictors among Students of Wollega University, Ethiopia.

    Science.gov (United States)

    Regassa, Tesfaye; Chala, Dereje; Adeba, Emiru

    2016-07-01

    Premarital sex increases the risk of unintended pregnancy and sexually transmitted infections including HIV if unprotected and contraception is not used. Thus, the objective of this study was to assess premarital sex in the last twelve months and its predictors among regular undergraduate students of Wollega University. A cross-sectional survey using pretested, structured questionnaire was conducted on a total of 704 regular undergraduate students of Wollega University from February to March, 2014. We used multistage sampling technique to recruit study participants. Binary and multivariable logistic regressions were performed using SPSS version 20 to assess predictors of premarital sex. Statistical significance was determined through a 95% confidence level. Wollega University youths who had premarital sex in the last twelve months were 28.4%; 55.5% of them did not use condom during last sex while 31.3% engaged in multiple sex. Being male [Adjusted Odds Ratio (AOR)(95% Confidence Interval(CI))=2.7(1.58-4.75)], age 20-24 years [AOR(95%CI)=2.8(1.13-7.20)], training on how to use condom [AOR(95%CI)=1.7(1.17-2.46)], being tested for HIV [AOR(95%CI)=2.3(1.48-3.53)], using social media frequently [AOR(95%CI)=1.8(1.14-2.88)], having comprehensive knowledge of HIV [AOR(95% CI)=1.5(1.01-2.10)], alcohol use [AOR (95%CI)=2.2(1.31-3.56)] were associated with increased odds of premarital sex in the last twelve months. Nearly one-third of regular undergraduate students of the university were engaged in premarital sex in the last twelve months. Being male, using social media frequently and alcohol use were associated with increased odds of premarital sex in the stated period. Thus, higher institutions have to deliver abstinence messages alongside information about self-protection.

  5. Work environment perceptions following relocation to open-plan offices: A twelve-month longitudinal study.

    Science.gov (United States)

    Bergström, Jessica; Miller, Michael; Horneij, Eva

    2015-01-01

    A workplace's design can have various positive or negative effects on the employees and since the 1970s the advantages and disadvantages of open-plan offices have been discussed. The aim of this study was to investigate perceived health, work environment and self-estimated productivity one month before and at three, six and twelve months after relocation from individual offices to an open-plan office environment. Employees from three departments within the same company group and who worked with relatively similar tasks and who were planned to be relocated from private offices to open-plan offices were invited to participate. Questionnaires comprising items from The Salutogenic Health Indicator Scale, The Work Experience Measurement Scale, the questionnaire by Brennan et al. about perceived performance and one question from the Work Ability Index were sent to participants one month before relocation (baseline) to open-plan offices and then at three, six and twelve months after relocation. At baseline, 82 questionnaires were sent out. The response rate was 85%. At the follow-ups 77-79 questionnaires were sent out and the response-rate was 70%-81%. At follow-ups, perceived health, job satisfaction and performance had generally deteriorated. The results of the study indicate that employees' perception of health, work environment and performance decreased during a 12 month period following relocation from individual offices to open-plan offices.

  6. Proteomic characterization of human milk whey proteins during a twelve-month lactation period.

    Science.gov (United States)

    Liao, Yalin; Alvarado, Rudy; Phinney, Brett; Lönnerdal, Bo

    2011-04-01

    Human milk is a rich source of bioactive proteins that support the early growth and development of the newborn. Although the major components of the protein fraction in human milk have been studied, the expression and relative abundance of minor components have received limited attention. We examined the expression of low-abundance proteins in the whey fraction of human milk and their dynamic changes over a twelve-month lactation period. The low-abundance proteins were enriched by ProteoMiner beads, and protein identification was performed by liquid chromatography tandem mass spectrometry. One hundred and fifteen proteins were identified, thirty-eight of which have not been previously reported in human colostrum or milk. We also for the first time described differences in protein patterns among the low-abundance proteins during lactation. These results enhance our knowledge about the complexity of the human milk proteome, which constitutes part of the advantages to the breast-fed infant.

  7. INCIDENCE AND SURVIVAL OF LIPOLYTIC ORGANISMS MONITORED FOR TWELVE MONTHS IN DOMESTIC WASTEWATER AND RECEIVING STREAM

    Directory of Open Access Journals (Sweden)

    Adebowale Odeyemi

    2013-10-01

    Full Text Available The incidence and survival of lipolytic organisms in domestic wastewater and receiving stream were monitored over 12 months. The average total bacterial count in the wastewater samples reduced in April and November by 24.2% and 41.6% respectively. There was also a reduction of 42.3% and 60.1% in the load in the receiving stream in August and July. Subsequently, at 5m downstream from the entry of the wastewater the microbial load reduced in March (19.2% and June (19.2%. However, the occurrence of coliforms was more affected in the months of May (53% to July (87.2%. At 5m and 10m downstream the coliform population reduced by 27.9% and 30.1% respectively. Of the twelve (12 bacterial isolates obtained at the exit of the wastewater into the receiving stream, only four (4 were found to possess lipolytic activity. These include the species of Enterococcus, Klebsiella, Pseudomonas and Staphylococcus. There was no significant difference in the amount of nutrients found in the domestic wastewater and receiving stream during the months. This paper also discusses the implication of disposing large amounts of wastewater effluents into the receiving water and the need to remedy and minimize the overall impact of such pollution on the environment.

  8. Patients' perceptions of their postoperative recovery for one month.

    Science.gov (United States)

    Forsberg, Angelica; Vikman, Irene; Wälivaara, Britt-Marie; Engström, Åsa

    2015-07-01

    To explore orthopaedic and general surgery patients' perceptions of their postoperative recovery for one month. In general, nursing research in the postoperative context has been directed towards a single symptom or area, which is valuable. However, there is a lack of studies of orthopaedic and general surgery patients' perceptions of postoperative recovery from a short-term perspective. A quantitative approach with a longitudinal design was used. A total of 180 patients participated in the study. Data were collected using a standardised questionnaire, the Postoperative Recovery Profile, for self-assessment of recovery. Descriptive statistics reported as proportions were used for the categorical variables. Analytic statistics were used to identify statistically significant differences. Mean values and t-tests were used for quantity variables, and Mann-Whitney U-tests and Chi-squared tests were used for nonparametric variables. Overall, the orthopaedic patients were substantially less recovered than the general surgery patients. Two-thirds of the orthopaedic patients and half of the general surgery patients perceived severe or moderate pain in the acute recovery phase. Within the general surgery group, there were significant differences in the recovery between the Gastric Bypass patients and colon/ileum surgery patients. The gastric bypass patients were overall more recovered than the other groups of patients. The Gastric Bypass patients reported that they had improved after one month compared to their own status prior to surgery. Nursing support for orthopaedic patients must be improved, especially after they are discharged from the hospital. To structure and monitor individual recovery, a top-five priority profile of the most important problems should be used during follow-up calls after the patient is discharged from the hospital. Postoperative pain continues to represent a clinical problem that requires attention. Heterogeneity in the perceptions of recovery

  9. Relative peripheral refraction in children: twelve-month changes in eyes with different ametropias.

    Science.gov (United States)

    Lee, Tsui-Tsui; Cho, Pauline

    2013-05-01

    To determine the peripheral refraction of children with different types of ametropias and to evaluate the relationship between central refractive changes, baseline relative peripheral refraction (RPR) and changes in RPR over a 12-month monitoring period. Cycloplegic central and peripheral refraction were performed biannually on the right eyes of children aged 6-9 for 12 months, using an open-view autorefractor. Peripheral refraction were measured along 10°, 20° and 30° from central fixation in both nasal and temporal fields. Refractive data were transposed into M, J0 and J45 vectors for analyses. RPR was determined by subtracting the central measurement from each peripheral measurement. Hyperopic eyes showed relative peripheral myopia while myopic eyes had relative hyperopia across the central 60° horizontal field at baseline. Emmetropic eyes had relative myopia within but showed relative hyperopia beyond the central 30° field. However, there was no significant correlation between central refractive changes and baseline RPR or between changes in central refraction and RPR over twelve months in any refractive groups. Correlations between changes in PR and central myopic shift were found mainly in the nasal field in different groups. In the subgroup analysis on the initially emmetropic and the initially myopic groups, the subgroups with faster myopic progression did not have significantly different RPR from the subgroups with slower progression. The RPR pattern of the initially emmetropic and the initially myopic groups became more asymmetric at the end of the study period with a larger increase in relative hyperopia in the temporal field. RPR patterns were different among hyperopic, emmetropic and myopic eyes. However, baseline RPR and changes in RPR cannot predict changes in central refraction over time. Our results did not provide evidence to support the hypothesis of RPR as a causative factor for myopic central refractive changes in children. Ophthalmic

  10. Ocular hypotensive effect, preservation of visual fields, and safety of adding dorzolamide to prostaglandin therapy for twelve months

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    Kenji Inoue

    2011-03-01

    Full Text Available Kenji Inoue1,3, Mieko Masumoto1,3, Masato Wakakura1, Goji Tomita2, On behalf of the Ochanomizu Ophthalmology Study Group31Inouye Eye Hospital, Tokyo, Japan; 2Department of Ophthalmology, Toho University School of Medicine, Tokyo, Japan; 3Ochanomizu Ophthalmology, Tokyo, JapanPurpose: To prospectively evaluate the safety, hypotensive effect, and preservation of visual fields of dorzolamide when added to latanoprost.Subjects and methods: This study included 46 patients (46 eyes with primary open-angle glaucoma who had been treated with latanoprost. Dorzolamide (1% was added to latanoprost, and the intraocular pressure (IOP was monitored before and after 3, 6, and 12 months. The mean deviation shown by Humphrey perimetry was compared before and after twelve months of treatment. Adverse reactions were monitored over the 12-month study period.Results: The mean baseline IOP was 17.2 ± 3.0 mmHg while those after 3, 6 and 12 months of treatment were 14.9 ± 3.0 mmHg, 14.5 ± 3.2 mmHg, and 14.6 ± 2.6 mmHg respectively (P < 0.0001, 1-ß(power = 0.9999571. The absolute reduction of IOP and the percent reduction were similar after 3, 6, and 12 months of treatment. The mean deviation on Humphrey perimetry was similar before and after twelve months of treatment. Three patients discontinued dorzolamide therapy due to elevation of IOP and one patient discontinued it because of adverse reactions.Conclusion: Dorzolamide is safe and effective when used for twelve months as add-on therapy to latanoprost for open-angle glaucoma.Keywords: dorzolamide, primary open-angle glaucoma, latanoprost 

  11. EXERCISE LIMITATIONS IN A COMPETITIVE CYCLIST TWELVE MONTHS POST HEART TRANSPLANTATION

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    Nicolas G. Walton

    2009-12-01

    Full Text Available It has been well documented that for heart transplant recipients (HTrecipient post transplantation exercise capacity does not exceed 60% of healthy age-matched controls. Few studies have been undertaken to determine the cause of exercise limitations following heart transplantation (HT for an elite athlete. Participant was a 39 year old elite male cyclist who suffered an acute myocardial infarction after a cycling race and received a heart transplant (HT four months later. Six weeks prior to his AMI fitness testing was completed and a predicted VO2max of 58 mL·kg-1·min-1 and HRmax of 171 bpm was achieved. The participant underwent maximal exercise testing 6 and 12 months post transplant to determine exercise limitations. His results 6 and 12 months post transplant were a VO2max of 33.8 and 44.2 mL·kg-1·min-1 respectively, and a HR max that was 97% and 96% of HRmax measured. The participant showed an increase in both HRmax and VO2max 12 months post HT compared to previous testing. Results suggest that the limiting factors to exercise following HT are likely due to peripheral function, which became diminished as a result accumulated from 4 months of congestive heart failure, the strain of HT, and immunosuppressive therapy leading up to the exercise testing. Lifestyle before HT and a more aggressive approach to HT recovery should be considered necessary in the improvement of peripheral functioning following HT

  12. Intravitreal bevacizumab as primary treatment for retinal angiomatous proliferation: twelve-month results.

    Science.gov (United States)

    Gharbiya, Magda; Allievi, Francesca; Recupero, Vincenzo; Martini, Delia; Mazzeo, Luigi; Gabrieli, Corrado Balacco

    2009-06-01

    To evaluate the short-term efficacy and safety of intravitreal bevacizumab for the treatment of retinal angiomatous proliferation. Seventeen eyes from 16 patients with newly diagnosed retinal angiomatous proliferation underwent intravitreal injections of bevacizumab, 1.25 mg. The patients were scheduled for three monthly bevacizumab injections. Early Treatment of Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity, central macular thickness on optical coherence tomography, and fluorescein angiographic findings were examined before and after treatment. Patients were followed-up for 12 months. The mean best-corrected visual acuity (+/- standard deviation [SD]) at baseline was 39.53 (+/-10.40) letters (Snellen equivalent: 20/42). At 12 months after treatment the mean best-corrected visual acuity (+/-SD) improved significantly (P = 0.0000001) to 47.88 (+/-11.78) letters (Snellen equivalent: 20/28). Best-corrected visual acuity improved 3 ETDRS lines or more in 3 (17.65%) of 17 treated eyes, 14 (82.35%) eyes were stable, and 15 (88.23%) eyes gained 1 or more ETDRS lines. The mean central macular thickness (+/-SD) at baseline was 297 (+/-60.72) microm. At 12 months after treatment, the mean central macular thickness (+/-SD) reduced significantly (P = 0.00001) to 237 (+/-28.80) microm. At the 12-month follow-up, absence of fluorescein leakage was demonstrated in 14 (82%) of 17 treated eyes. No ocular or systemic adverse effects from treatment were encountered. The 12-month results of intravitreal bevacizumab for retinal angiomatous proliferation are very promising with no apparent short-term safety concerns. Treated eyes had a significant functional and anatomical improvement. Further studies will be needed to better determine long-term efficacy and safety.

  13. Emetic and Electric Shock Alcohol Aversion Therapy: Six- and Twelve-Month Follow-Up.

    Science.gov (United States)

    Cannon, Dale S.; Baker, Timothy B.

    1981-01-01

    Follow-up data are presented for 6- and 12-months on male alcoholics (N=20) who received either a multifaceted inpatient alcoholism treatment program alone (controls) or emetic or shock aversion therapy in addition to that program. Both emetic and control subjects compiled more days of abstinence than shock subjects. (Author)

  14. Selective Visual Attention at Twelve Months: Signs of Autism in Early Social Interactions

    Science.gov (United States)

    Hutman, Ted; Chela, Mandeep K.; Gillespie-Lynch, Kristen; Sigman, Marian

    2012-01-01

    We examined social attention and attention shifting during (a) a play interaction between 12-month olds and an examiner and (b) after the examiner pretended to hurt herself. We coded the target and duration of infants' visual fixations and frequency of attention shifts. Siblings of children with autism and controls with no family history of autism…

  15. Twelve-Month Follow-Up of Postmature and Respiratory Distress Syndrome Infants.

    Science.gov (United States)

    Field, Tiffany

    A 12-month followup study of 151 infants (46 preterm respiratory disease syndrome--RDS--Ss, 46 postterm postmaturity syndrome Ss, and 59 normal term Ss) was conducted to ascertain any early intervention needs and early predictors on 1-year performance, and to formulate a cumulative risk index which would identify those infants who were continuing…

  16. Do supervised weekly exercise programs maintain functional exercise capacity and quality of life, twelve months after pulmonary rehabilitation in COPD?

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    Alison Jennifer A

    2007-05-01

    Full Text Available Abstract Background Pulmonary rehabilitation programs have been shown to increase functional exercise capacity and quality of life in COPD patients. However, following the completion of pulmonary rehabilitation the benefits begin to decline unless the program is of longer duration or ongoing maintenance exercise is followed. Therefore, the aim of this study is to determine if supervised, weekly, hospital-based exercise compared to home exercise will maintain the benefits gained from an eight-week pulmonary rehabilitation program in COPD subjects to twelve months. Methods Following completion of an eight-week pulmonary rehabilitation program, COPD subjects will be recruited and randomised (using concealed allocation in numbered envelopes into either the maintenance exercise group (supervised, weekly, hospital-based exercise or the control group (unsupervised home exercise and followed for twelve months. Measurements will be taken at baseline (post an eight-week pulmonary rehabilitation program, three, six and twelve months. The exercise measurements will include two six-minute walk tests, two incremental shuttle walk tests, and two endurance shuttle walk tests. Oxygen saturation, heart rate and dyspnoea will be monitored during all these tests. Quality of life will be measured using the St George's Respiratory Questionnaire and the Hospital Anxiety and Depression Scale. Participants will be excluded if they require supplemental oxygen or have neurological or musculoskeletal co-morbidities that will prevent them from exercising independently. Discussion Pulmonary rehabilitation plays an important part in the management of COPD and the results from this study will help determine if supervised, weekly, hospital-based exercise can successfully maintain functional exercise capacity and quality of life following an eight-week pulmonary rehabilitation program in COPD subjects in Australia.

  17. Exercise limitations in a competitive cyclist twelve months post heart transplantation.

    Science.gov (United States)

    Patterson, Jeremy A; Walton, Nicolas G

    2009-01-01

    It has been well documented that for heart transplant recipients (HTrecipient) post transplantation exercise capacity does not exceed 60% of healthy age-matched controls. Few studies have been undertaken to determine the cause of exercise limitations following heart transplantation (HT) for an elite athlete. Participant was a 39 year old elite male cyclist who suffered an acute myocardial infarction after a cycling race and received a heart transplant (HT) four months later. Six weeks prior to his AMI fitness testing was completed and a predicted VO2max of 58 mL·kg(-1)·min(-1) and HRmax of 171 bpm was achieved. The participant underwent maximal exercise testing 6 and 12 months post transplant to determine exercise limitations. His results 6 and 12 months post transplant were a VO2max of 33.8 and 44.2 mL·kg(-1)·min(-1) respectively, and a HR max that was 97% and 96% of HRmax measured. The participant showed an increase in both HRmax and VO2max 12 months post HT compared to previous testing. Results suggest that the limiting factors to exercise following HT are likely due to peripheral function, which became diminished as a result accumulated from 4 months of congestive heart failure, the strain of HT, and immunosuppressive therapy leading up to the exercise testing. Lifestyle before HT and a more aggressive approach to HT recovery should be considered necessary in the improvement of peripheral functioning following HT. Key pointsPhysical work capacity following heart transplantation is not limited by cardiac denervation.Heart transplant rehabilitation should focus efforts on endothelial and muscular limitations.

  18. Twelve-month follow-up of left atrial appendage occlusion with Amplatzer Amulet.

    Science.gov (United States)

    Kleinecke, Caroline; Park, Jai-Wun; Gödde, Martin; Zintl, Konstantin; Schnupp, Steffen; Brachmann, Johannes

    2017-01-01

    The Amplatzer Amulet (St. Jude Medical, Minneapolis, MN, USA) is a second gen-eration Amplatzer device for left atrial appendage (LAA) occlusion (LAAO) for stroke prophylaxis in patients with atrial fibrillation. This research sought to assess the clinical performance of the Amplatzer Amulet device and in follow up for 12 months. In this single-center registry patients with atrial fibrillation and contraindication to oral anticoagulation underwent LAAO with the Amplatzer Amulet device. Follow-up was performed before discharge, by transesophageal echocardiography (TEE) after 6 weeks and telephone interview after 3, 6 and 12 months. Between October 2014 and August 2015 50 patients (76.1 ± 8.3 years; 30 male) were en-rolled. Procedural success was achieved in 49 (98%) patients. Major periprocedural adverse events were observed in 4 (8%) of patients: 1 device embolization, 2 pericardial effusions requiring pericardiocente-sis and 1 prolonged hospital stay due to retropharyngeal hematoma from the TEE probe. Follow-up TEE was available in 38 of 50 patients showing complete LAA sealing in all. 2 device-related thrombi were also documented. At 12-month follow-up 7 patients had died unrelated to the device. Ischemic stroke occurred in 3 patients. According to neurological examination two were classified as microangiopathic and not cardio-embolic. The other one could not be classified. Bleeding complications (5 minor, 3 major) were documented in 8 patients. Although minimizing procedure-related complications remains challenging, LAAO with the Amplatzer Amulet device showed high procedural success and excellent LAA sealing. (Cardiol J 2017; 24, 2: 131-138).

  19. INCIDENCE AND SURVIVAL OF LIPOLYTIC ORGANISMS MONITORED FOR TWELVE MONTHS IN DOMESTIC WASTEWATER AND RECEIVING STREAM

    OpenAIRE

    Adebowale Odeyemi; Babatunde Aderiye

    2013-01-01

    The incidence and survival of lipolytic organisms in domestic wastewater and receiving stream were monitored over 12 months. The average total bacterial count in the wastewater samples reduced in April and November by 24.2% and 41.6% respectively. There was also a reduction of 42.3% and 60.1% in the load in the receiving stream in August and July. Subsequently, at 5m downstream from the entry of the wastewater the microbial load reduced in March (19.2%) and June (19.2%). However, the occurren...

  20. Twelve months of voluntary heavy alcohol consumption in male rhesus macaques suppresses intracortical bone remodeling.

    Science.gov (United States)

    Gaddini, Gino W; Grant, Kathleen A; Woodall, Andrew; Stull, Cara; Maddalozzo, Gianni F; Zhang, Bo; Turner, Russell T; Iwaniec, Urszula T

    2015-02-01

    Chronic heavy alcohol consumption is a risk factor for cortical bone fractures in males. The increase in fracture risk may be due, in part, to reduced bone quality. Intracortical (osteonal) bone remodeling is the principle mechanism for maintaining cortical bone quality. However, it is not clear how alcohol abuse impacts intracortical bone remodeling. This study investigated the effects of long-duration heavy alcohol consumption on intracortical bone remodeling in a non-human primate model. Following a 4-month induction period, male rhesus macaques (Macaca mulatta, n=21) were allowed to voluntarily self-administer water or alcohol (4% ethanol w/v) for 22h/d, 7 d/wk for 12months. Control monkeys (n=13) received water and an isocaloric maltose-dextrin solution. Tetracycline hydrochloride was administered orally 17 and 3days prior to sacrifice for determination of active mineralization sites. Animals in the alcohol group consumed 2.7±0.2g alcohol/kg/d (mean±SE) during the 12months of self-administration, resulting in a mean daily blood alcohol concentration of 77±9mg/dl from samples taken at 7h after the start of a daily session. However, blood alcohol concentration varied widely from day to day, with peak levels exceeding 250mg/dl, modeling a binge-drinking pattern of alcohol consumption. The skeletal response to alcohol was determined by densitometry, microcomputed tomography and histomorphometry. Significant differences in tibial bone mineral content, bone mineral density, and cortical bone architecture (cross-sectional volume, cortical volume, marrow volume, cortical thickness, and polar moment of inertia) in the tibial diaphysis were not detected with treatment. However, cortical porosity was lower (1.8±0.5 % versus 0.6±0.1 %, p=0.021) and labeled osteon density was lower (0.41±0.2/mm(2)versus 0.04±0.01/mm(2), premodeling. In concordance, plasma CTx was lower (2.5±0.3ng/ml versus 1.7±0.1ng/ml, p=0.028) in the alcohol group. These results suggest that

  1. Twelve months follow-up after retrograde recanalization of superficial femoral artery chronic total occlusion

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    Joanna Wojtasik-Bakalarz

    2017-03-01

    Full Text Available Introduction : Fifty percent of cases of peripheral artery disease are caused by chronic total occlusion (CTO of the superficial femoral artery (SFA. Ten–fifteen percent of percutaneous SFA recanalization procedures are unsuccessful. In those cases the retrograde technique can increase the success rate of the procedure, but the long-term follow-up of such procedures is still unknown. Aim : To assess the efficacy and clinical outcomes during long-term follow-up after retrograde recanalization of the SFA. Material and methods: We included patients after at least one unsuccessful percutaneous antegrade recanalization of the SFA. Patients were evaluated for the procedural and clinical follow-up of mean time 13.9 months. Results: The study included 17 patients (7 females, 10 males who underwent percutaneous retrograde recanalization of the SFA from June 2011 to June 2015. The mean age of patients was 63 ±7 years. Retrograde puncture of the distal SFA was successful in all cases. A retrograde procedure was performed immediately after antegrade failure in 4 (23.5% patients and after a previously failed attempt in 13 (76.5% patients. The procedure was successful in 15 (88.2% patients, and unsuccessful in 2 (11.8% patients. Periprocedural complications included 1 peripheral distal embolization (successfully treated with aspiration thrombectomy, 1 bleeding event from the puncture site and 7 puncture site hematomas. During follow-up the all-cause mortality rate was 5.8% (1 patient, non-cardiac death. The primary patency rate at 12 months was 88.2% and secondary patency 100%. Conclusions : The retrograde SFA puncture seems to be a safe and successful technique for CTO recanalization and is associated with a low rate of perioperative and long-term follow-up complications.

  2. Twelve-Month and Lifetime Prevalence of Mental Disorders in Cancer Patients.

    Science.gov (United States)

    Kuhnt, Susanne; Brähler, Elmar; Faller, Hermann; Härter, Martin; Keller, Monika; Schulz, Holger; Wegscheider, Karl; Weis, Joachim; Boehncke, Anna; Hund, Bianca; Reuter, Katrin; Richard, Matthias; Sehner, Susanne; Wittchen, Hans-Ulrich; Koch, Uwe; Mehnert, Anja

    2016-01-01

    Psychological problems are common in cancer patients. For the purpose of planning psycho-oncological interventions and services tailored to the specific needs of different cancer patient populations, it is necessary to know to what extent psychological problems meet the criteria of mental disorders. The purpose of this study was to estimate the 12-month and lifetime prevalence rates of mental disorders in cancer patients. A representative sample of patients with different tumour entities and tumour stages (n = 2,141) in outpatient, inpatient and rehabilitation settings underwent the standardized computer-assisted Composite International Diagnostic Interview for mental disorders adapted for cancer patients (CIDI-O). The overall 12-month prevalence for any mental disorder was 39.4% (95% CI: 37.3-41.5), that for anxiety disorders was 15.8% (95% CI: 14.4-17.4), 12.5% (95% CI: 11.3-14.0) for mood disorders, 9.5% (95% CI: 8.3-10.9) for somatoform disorders, 7.3% (95% CI: 6.2-8.5) for nicotine dependence, 3.7% (95% CI: 3.0-4.6) for disorders due to general medical condition, and 1.1% (95% CI: 0.7-1.6) for alcohol abuse or dependence. Lifetime prevalence for any mental disorder was 56.3% (95% CI 54.1-58.6), that for anxiety disorders was 24.1% (95% CI: 22.3-25.9), 20.5% (95% CI: 18.9-22.3) for mood disorders, 19.9% (95% CI: 18.3-21.7) for somatoform disorders, 18.2% (95% CI: 16.6-20.0) for nicotine dependence, 6.4% (95% CI: 5.4-7.6) for alcohol abuse or dependence, 4.6% (95% CI: 3.8-5.6) for disorders due to general medical condition, and 0.2% (95% CI: 0.1-0.6) for eating disorders. Mental disorders are highly prevalent in cancer patients, indicating the need for provision of continuous psycho-oncological support from inpatient to outpatient care, leading to an appropriate allocation of direct personnel and other resources. © 2016 S. Karger AG, Basel.

  3. Retention and Effectiveness of Dental Sealant After Twelve Months in Iranian Children

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    Rafatjou

    2013-12-01

    Full Text Available Background Pit-and-fissure sealants are safe and effective ways to prevent dental caries and are considered as a part of an overall caries-preventive strategy. Dental caries are a public health problem and the most common intraoral disease affecting mankind. It is an infectious transmissible disease, with the child patient being at the highest risk. Objectives The purpose of this study was to evaluate the retention rates and effectiveness of occlusal sealants in children in Hamadan, Iran. Materials and Methods A total of 118 sealed first permanent molar teeth in 52 students (mean age, 8 years;male, 48% were evaluated for fissure sealant retention and occlusal caries status. All teeth were examined 12 months after application of sealants. Data were collected and evaluated by survival analyses methods for age at placement, patient sex, decayed/missing/filled teeth (DMFT index, fluoride history, toothbrush, tooth position in arch, and refer to dentistry. Results The overall success rate with pit-and-fissure sealant was 68.6%; in addition, 38.9% of the seals were completely retained, 38.9% partially lost, and 10.2% completely lost. There were no signs of carious lesions in 69.6% of the teeth. The factors associated with an increased risk of failure included female sex (P = 0.001 and no history of fluoride use (P < 0.01. There were no significant association between the results and patient age, tooth position in the arch, DMFT index, toothbrush, and refer to dentistry. Conclusions Although pit-and-fissure sealants are effective methods for preventing tooth caries, the low success rate of fissure sealants in current study indicated that dental sealant need to be implemented more carefully and follow-up programs are advisable.

  4. Changes in lipids over twelve months after initiating protease inhibitor therapy among persons treated for HIV/AIDS

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    Hogg Robert S

    2005-02-01

    Full Text Available Abstract Background Protease inhibitors are known to alter the lipid profiles in subjects treated for HIV/AIDS. However, the magnitude of this effect on plasma lipoproteins and lipids has not been adequately quantified. Objective To estimate the changes in plasma lipoproteins and triglycerides occurring within 12 months of initiating PI-based antiretroviral therapy among HIV/AIDS afflicted subjects. Methods We included all antiretroviral naïve HIV-infected persons treated at St-Paul's Hospital, British Columbia, Canada, who initiated therapy with protease inhibitor antiretroviral (ARV drugs between August 1996 and January 2002 and who had at least one plasma lipid measurement. Longitudinal associations between medication use and plasma lipids were estimated using mixed effects models that accounted for repeated measures on the same subjects and were adjusted for age, sex, time dependent CD4+ T-cell count, and time dependent cumulative use of non-nucleoside reverse transcriptase inhibitors and adherence. The cumulative number of prescriptions filled for PIs was considered time dependent. We estimated the changes in the 12 months following any initiation of a PI based regimen. Results A total of 679 eligible subjects were dispensed nucleoside analogues and PI at the initiation of therapy. Over a median 47 months of follow-up (interquartile range (IQR: 29–62, subjects had a median of 3 (IQR: 1–6 blood lipid measurements. Twelve months after treatment initiation of PI use, there was an estimated 20% (95% confidence interval: 17% – 24% increase in total cholesterol and 22% (12% – 33% increase in triglycerides. Conclusions Twelve months after treatment initiation with PIs, statistically significant increases in total cholesterol and triglycerides levels were observed in HIV-infected patients under conditions of standard treatment. Our results contribute to the growing body of evidence implicating PIs in the development of blood lipid

  5. Twelve-month safety and efficacy of inhaled fluticasone propionate in children aged 1 to 3 years with recurrent wheezing

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Allen, David; Milanowski, Janusz;

    2004-01-01

    : There was no significant difference in mean adjusted growth rates between the 2 groups: 84.0 mm/year in the FP group versus 86.4 mm/year in the SCG group (difference FP-SCG: -2.4 mm/year; 95% confidence interval: -6.6 to 1.8). Growth comparisons were independent of age, gender, previous use of steroid, or whether measured......, exacerbations, and requirements for oral steroid treatment and more symptom-free days and days without use of rescue treatment. CONCLUSIONS: Twelve months of treatment with inhaled FP (100 microg twice daily) in preschool children aged 1 to 3 years with recurrent wheeze has no effect on growth and no other......OBJECTIVE: Our aim was to compare the 12-month safety and efficacy of fluticasone propionate (FP) and sodium cromoglycate (SCG) in children aged 1 to 3 years with mild to moderate recurrent wheeze. METHODS: The study was a randomized, parallel-group, open-label multicenter study of 625 children...

  6. Analysis of the equine ovarian structure during the first twelve months of life by three-dimensional internal structure microscopy.

    Science.gov (United States)

    Ono, Mamiko; Akuzawa, Hiroki; Nambo, Yasuo; Hirano, Yuuko; Kimura, Junpei; Takemoto, Satoko; Nakamura, Sakiko; Yokota, Hideo; Himeno, Ryutaro; Higuchi, Tohru; Ohtaki, Tadatoshi; Tsumagari, Shigehisa

    2016-01-01

    A three-dimensional internal structure microscopy (3D-ISM) can clarify the anatomical arrangement of internal structures of equine ovaries. In this study, morphological changes of the equine ovary over the first 12 months of life were investigated by 3D-ISM in 59 fillies and by histological analysis in 2 fillies. The weight and volume of the paired ovaries initially decreased from 0 to 1 months to 2 to 3 months of age and then significantly increased at 8 to 12 months of age. The ovulation fossa was first observed around the 3rd month and became evident after the 6th month. The number of follicles with a diameter of ≥10 mm and the diameter of the largest follicle increased gradually after 6 months of age. On a volume basis, the medulla accounted for nearly 90% of the whole ovary at 0 to 1 months of age, but significantly decreased from 2 to 3 months of age. The volume of the cortex increased progressively after birth and reached approximately 60% of the total volume at 8 to 12 months of age. This significant development of the cortex coincided with the increased number and size of large follicles observed from 6 months of age. These results suggest that the development of the cortex plays a role in the maturation of the follicles and the equine ovary undergoes substantial morphological changes postnatally until puberty.

  7. Twelve-month outcomes in patients with retinal vein occlusion treated with low-frequency intravitreal ranibizumab

    Directory of Open Access Journals (Sweden)

    Sakanishi Y

    2016-06-01

    Full Text Available Yoshihito Sakanishi, Ami Lee, Ayumi Usui-Ouchi, Rei Ito, Nobuyuki Ebihara Department of Ophthalmology, Juntendo University Urayasu Hospital, Urayasu City, Chiba, Japan Purpose: The purpose of this study was to determine the clinical efficacy of low-frequency intravitreal ranibizumab to treat macular edema due to retinal vein occlusion (RVO.Patients and methods: This was a retrospective examination of cases that received intravitreal ranibizumab for untreated RVO over a period of 12 months. Instead of the conventional three monthly injections, injections were given once during the introductory period. If the recurrence of macular edema was diagnosed during the monthly visit, additional injections were given as needed. There were 21 eyes of 21 patients with branch RVO (BRVO and ten eyes of ten patients with central RVO (CRVO. The parameters examined included the number of injections over the 12-month period, improvements in best-corrected visual acuity (BCVA, and the central macular thickness (CMT. For BRVO, preinjection parameters that had an effect on the prognosis of BCVA after the 12-month period were also examined.Results: The total mean number of injections over the 12-month period was 3.4 for CRVO and 2.1 for BRVO. For CRVO, the BCVA in log minimum angular resolution changed from a preinjection value of 0.80 to 0.55 at 12 months. For BRVO, the change was from 0.51 to 0.30. For all diseases, BCVA improved after 12 months compared with the preinjection values (P<0.05. There was improvement in the CMT, and the CRVO changed from 765.0 µm at preinjection to 253.5 µm 12 months later. BRVO changed from 524.1 to 250.1 µm, and preinjection BCVA was associated with a prognosis of visual acuity after 12 months of the initial injection (P=0.0485.Conclusion: Even with a low number of injections during the introductory period, there were still improvements in both visual acuity and CMT in RVO patients after 12 months, indicating that it was

  8. Macular epiretinal brachytherapy in treated age-related macular degeneration: MERITAGE study: twelve-month safety and efficacy results.

    Science.gov (United States)

    Dugel, Pravin U; Petrarca, Robert; Bennett, Michael; Barak, Adiel; Weinberger, Dov; Nau, Jeffrey; Jackson, Timothy L

    2012-07-01

    To evaluate the safety and efficacy of epimacular brachytherapy (EMB) for the treatment of chronic, active, neovascular age-related macular degeneration (AMD). Prospective, multicenter, interventional, noncontrolled clinical trial. Fifty-three eyes of 53 participants with neovascular AMD requiring frequent anti-vascular endothelial growth factor (VEGF) retreatment. Participants underwent pars plana vitrectomy with a single 24-Gy dose of EMB delivered using an intraocular, handheld cannula containing a strontium 90/yttrium 90 source positioned over the active lesion. Participants were retreated with ranibizumab administered monthly as needed, using predefined retreatment criteria. Optical coherence tomography (OCT) was undertaken monthly, with images assessed by an independent reading center. Coprimary outcomes at 12 months were proportion of participants with stable vision (losing brachytherapy produces stable visual acuity in most participants with previously treated, active disease. Epimacular brachytherapy may reduce the need for frequent anti-VEGF retreatment. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  9. Twelve-Month Effects of the COPE Healthy Lifestyles TEEN Program on Overweight and Depressive Symptoms in High School Adolescents

    Science.gov (United States)

    Melnyk, Bernadette M.; Jacobson, Diana; Kelly, Stephanie A.; Belyea, Michael J.; Shaibi, Gabriel Q.; Small, Leigh; O'Haver, Judith A.; Marsiglia, Flavio F.

    2015-01-01

    Background: We evaluated the 12-month effects of the COPE (Creating Opportunities for Personal Empowerment) Healthy Lifestyles TEEN (Thinking, Emotions, Exercise, Nutrition) program versus an attention control program (Healthy Teens) on overweight/obesity and depressive symptoms in high school adolescents. Methods: A cluster randomized controlled…

  10. Buen Comienzo, Buen Futuro: El Bebe de Doce Meses (Healthy Start, Grow Smart: Your Twelve-Month-Old).

    Science.gov (United States)

    Landry, Susan H.; Ramey, Craig T.

    Distributed by the U.S. Departments of Agriculture, Education, and Health and Human Services, this Spanish-language pamphlet provides parents with information and advice about their infants in the twelfth month of life. Following a brief description of developmental characteristics at this age, the pamphlet offers advice on a variety of topics,…

  11. Twelve-Month Prevalence of and Risk Factors for Suicide Attempts in the World Health Organization World Mental Health Surveys

    NARCIS (Netherlands)

    Borges, Guilherme; Nock, Matthew K.; Haro Abad, Josep M.; Hwang, Irving; Sampson, Nancy A.; Alonso, Jordi; Andrade, Laura Helena; Angermeyer, Matthias C.; Beautrais, Annette; Bromet, Evelyn; Bruffaerts, Ronny; de Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Hu, Chiyi; Karam, Elie G.; Kovess-Masfety, Viviane; Lee, Sing; Levinson, Daphna; Elena Medina-Mora, Maria; Ormel, Johan; Posada-Villa, Jose; Sagar, Rajesh; Tomov, Toma; Uda, Hidenori; Williams, David R.; Kessler, Ronald C.

    2010-01-01

    Objective: Although suicide is a leading cause of death worldwide, clinicians and researchers lack a data-driven method to assess the risk of suicide attempts. This study reports the results of an analysis of a large cross-national epidemiologic survey database that estimates the 12-month prevalence

  12. Twelve-Month Follow-Up of Dexamethasone Implants for Macular Edema from Various Diseases in Vitrectomized and Nonvitrectomized Eyes

    Science.gov (United States)

    Filho, Paulo Augusto de Arruda Mello; Dias, João Rafael de Oliveira; de Andrade, Gabriel C.; Louzada, Ricardo N.; Ávila, Marcos; Berrocal, Maria; Farah, Michel

    2016-01-01

    Purpose. To evaluate the best-corrected visual acuity (BCVA), central retinal thickness (CRT), and the number of dexamethasone implants needed to treat cystoid macular edema (CME) from various etiologies over 12 months in vitrectomized and nonvitrectomized eyes. Methods. This multicenter retrospective cohort study included 112 patients with CME secondary to retinal diseases treated pro re nata (PRN) with a 0.7 mg intravitreal dexamethasone implant for 12 months. The BCVA, CRT, adverse events, safety data, and number of implants were recorded. Results. Vitrectomized and nonvitrectomized eyes received means of three implants and one implant, respectively, over 12 months (P < 0.001). The mean BCVA of all patients improved from 0.13 at baseline to 0.33 (P < 0.001) 12 months after one (P = 0.001), two (P = 0.041), and three (P < 0.001) implants but not four implants (P = 0.068). The mean baseline CRT decreased significantly (P < 0.001) from 463 to 254 microns after 12 months with one (P < 0.001), two (P = 0.002), and three (P = 0.001) implants but not with four implants (P = 0.114). The anatomic and functional outcomes were not significantly different between vitrectomized and nonvitrectomized eyes. Increased IOP was the most common adverse event (23.2%). Conclusions. Dexamethasone implant administered PRN improved VA and decreased CRT in CME, with possible long-term clinically relevant benefits for treating CME from various etiologies. Vitrectomized eyes needed more implants compared with nonvitrectomized eyes. PMID:27721989

  13. Twelve-Month Follow-Up of Dexamethasone Implants for Macular Edema from Various Diseases in Vitrectomized and Nonvitrectomized Eyes

    Directory of Open Access Journals (Sweden)

    Eduardo A. Novais

    2016-01-01

    Full Text Available Purpose. To evaluate the best-corrected visual acuity (BCVA, central retinal thickness (CRT, and the number of dexamethasone implants needed to treat cystoid macular edema (CME from various etiologies over 12 months in vitrectomized and nonvitrectomized eyes. Methods. This multicenter retrospective cohort study included 112 patients with CME secondary to retinal diseases treated pro re nata (PRN with a 0.7 mg intravitreal dexamethasone implant for 12 months. The BCVA, CRT, adverse events, safety data, and number of implants were recorded. Results. Vitrectomized and nonvitrectomized eyes received means of three implants and one implant, respectively, over 12 months (P<0.001. The mean BCVA of all patients improved from 0.13 at baseline to 0.33 (P<0.001 12 months after one (P=0.001, two (P=0.041, and three (P<0.001 implants but not four implants (P=0.068. The mean baseline CRT decreased significantly (P<0.001 from 463 to 254 microns after 12 months with one (P<0.001, two (P=0.002, and three (P=0.001 implants but not with four implants (P=0.114. The anatomic and functional outcomes were not significantly different between vitrectomized and nonvitrectomized eyes. Increased IOP was the most common adverse event (23.2%. Conclusions. Dexamethasone implant administered PRN improved VA and decreased CRT in CME, with possible long-term clinically relevant benefits for treating CME from various etiologies. Vitrectomized eyes needed more implants compared with nonvitrectomized eyes.

  14. Twelve-month experience with the GORE® TIGRIS® Vascular Stent in the superficial femoral and popliteal arteries.

    Science.gov (United States)

    Piorkowski, M; Freitas, B; Steiner, S; Botsios, S; Bausback, Y; Scheinert, D; Schmidt, A

    2015-02-01

    The aim of this paper was to report the continued mid-term follow-up of the first patients world-wide treated with the GORE(®) TIGRIS(®) Vascular Stent, a dual component stent consisting of a nitinol wire frame combined with a fluoropolymer-interconnecting structure. From December 2011 until November 2012, 32 consecutive patients (20 men, mean age 72.8 years) with 40 atherosclerotic femoropopliteal lesions (5% occlusions) underwent angioplasty and implantation of a GORE(®) TIGRIS(®) Vascular Stent. The patients were scheduled for follow-up at 3, 6 and 12 months after stent implantation for duplex ultrasound and assessment of Rutherford-Becker class (RBC) and Ankle-Brachial Index (ABI). Here we report the completed 6-month follow-up and, for the first time, a 12-month follow-up. The median follow-up was 418 days. During the 12-month follow-up 4 patients died. Restenosis or reocclusion of the stent in this time period was observed in 5 lesions (12.5%), resulting in a cumulative primary patency rate of 85.5±6.0%. The ABI increased pre-interventionally from 0.65±0.18 to 0.91±0.18 (PGORE(®) TIGRIS(®) Vascular Stent showed promising results with high 12-month primary patency rates after femoropopliteal endovascular interventions. These first clinical data are very promising compared to other stent concepts in the superficial femoral and popliteal artery.

  15. Improving Physical Health in Patients With Chronic Mental Disorders: Twelve-Month Results From a Randomized Controlled Collaborative Care Trial.

    Science.gov (United States)

    Kilbourne, Amy M; Barbaresso, Michelle M; Lai, Zongshan; Nord, Kristina M; Bramlet, Margretta; Goodrich, David E; Post, Edward P; Almirall, Daniel; Bauer, Mark S

    2017-01-01

    Persons with chronic mental disorders are disproportionately burdened with physical health conditions. We determined whether Life Goals Collaborative Care compared to usual care improves physical health in patients with mental disorders within 12 months. This single-blind randomized controlled effectiveness study of a collaborative care model was conducted at a midwestern Veterans Affairs urban outpatient mental health clinic. Patients (N = 293 out of 474 eligible approached) with an ICD-9-CM diagnosis of schizophrenia, bipolar disorder, or major depressive disorder and at least 1 cardiovascular disease risk factor provided informed consent and were randomized (February 24, 2010, to April 29, 2015) to Life Goals (n = 146) or usual care (n = 147). A total of 287 completed baseline assessments, and 245 completed 12-month follow-up assessments. Life Goals included 5 weekly sessions that provided semistructured guidance on managing physical and mental health symptoms through healthy behavior changes, augmented by ongoing care coordination. The primary outcome was change in physical health-related quality of life score (Veterans RAND 12-item Short Form Health Survey [VR-12] physical health component score). Secondary outcomes included control of cardiovascular risk factors from baseline to 12 months (blood pressure, lipids, weight), mental health-related quality of life, and mental health symptoms. Among patients completing baseline and 12-month outcomes assessments (N = 245), the mean age was 55.3 years (SD = 10.8; range, 25-78 years), and 15.4% were female. Intent-to-treat analysis revealed that compared to those in usual care, patients randomized to Life Goals had slightly increased VR-12 physical health scores (coefficient = 3.21; P = .01). Patients with chronic mental disorders and cardiovascular disease risk who received Life Goals had improved physical health-related quality of life. ClinicalTrials.gov identifiers: NCT01487668 and NCT01244854.

  16. Twelve-month contraceptive continuation and repeat pregnancy among young mothers choosing postdelivery contraceptive implants or postplacental intrauterine devices.

    Science.gov (United States)

    Cohen, Rebecca; Sheeder, Jeanelle; Arango, Natalia; Teal, Stephanie B; Tocce, Kristina

    2016-02-01

    To compare discontinuation rates and incidence of repeat pregnancy within 1 year among young mothers choosing postplacental intrauterine devices (IUDs) versus postpartum contraceptive implants. We enrolled a prospective cohort of postpartum adolescents and young women who chose either postplacental IUDs or postpartum contraceptive implants prior to hospital discharge. We used chart review and phone interviews to assess device discontinuation (by request or expulsion) and pregnancy within 12 months. Of the 244 13-22 year-old participants, 82 chose IUDs (74 levonorgestrel IUDs and 8 copper IUDs), and 162 chose implants. Both groups had participant-requested discontinuation rates of 14% (9/67 IUD; 19/135 implant) within 1 year. Participants choosing IUDs had a 25% (17/67) expulsion rate. Median time to expulsion was 4.1 weeks (range: 0.4-29.3 weeks, 16/17 within 12 weeks), and participants recognized 15/17 expulsions. IUD initiators had significantly higher pregnancy rates by 12 months (7.6% vs. 1.5%, p=0.04). Most pregnancies occurred when women discontinued their initial device and did not start alternative contraception. Participant-requested discontinuation was similar in both groups. Differences in overall device discontinuation rates were due to IUD expulsions. Pregnancy rates by 12 months postpartum were lower than previously reported in this age group in both implant initiators and IUD initiators. Young mothers who choose postplacental IUDs or postpartum contraceptive implants are unlikely to request removal within the first year. Clinicians should counsel postplacental IUD users that early expulsion is common (25%) and may be unrecognized (11% of expulsions). Patients should have a plan for contraceptive management should expulsion occur. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. A national evaluation of community-based youth cessation programs: end of program and twelve-month outcomes.

    Science.gov (United States)

    Curry, Susan J; Mermelstein, Robin J; Emery, Sherry L; Sporer, Amy K; Berbaum, Michael L; Campbell, Richard T; Flay, Brian; Warnecke, Richard B

    2013-03-01

    Most youth cessation treatment research consists of efficacy studies in which treatments are evaluated under optimal conditions of delivery. Less is known about the effectiveness of youth cessation treatments delivered in real-world, community based settings. A national sample of 41 community-based youth cessation programs participated in a longitudinal evaluation to identify site, program, and participant characteristics associated with successful cessation. Validated quit rates were comparable to those in randomized controlled trials; 7-day abstinence at the end of program averaged 14% and 30-day abstinence at 12 months averaged 12%. Multivariate GEE models explored predictors of smoking cessation at the end of the programs and at 12 months. Results showed correlates of both short- and long-term cessation. Findings point to the importance of both individual and community-level variables, including motivation, opportunities for and encouragement to engage in activities outside of academics, having youth participate in treatment before they become highly dependent smokers, and community norms and ordinances that discourage youth purchase, use and possession of tobacco. Providing evidence-based treatment to youth in community-based settings results in successful cessation.

  18. Randomized controlled trial of interventions for young people at ultra-high risk of psychosis: twelve-month outcome.

    Science.gov (United States)

    McGorry, Patrick D; Nelson, Barnaby; Phillips, Lisa J; Yuen, Hok Pan; Francey, Shona M; Thampi, Annette; Berger, Gregor E; Amminger, G Paul; Simmons, Magenta B; Kelly, Daniel; Dip, Grad; Thompson, Andrew D; Yung, Alison R

    2013-04-01

    The ultra-high risk clinical phenotype is associated with substantial distress and functional impairment and confers a greatly enhanced risk for transition to full-threshold psychosis. A range of interventions aimed at relieving current symptoms and functional impairment and reducing the risk of transition to psychosis has shown promising results, but the optimal type and sequence of intervention remain to be established. The aim of this study was to determine which intervention was most effective at preventing transition to psychosis: cognitive therapy plus low-dose risperidone, cognitive therapy plus placebo, or supportive therapy plus placebo. A double-blind, randomized, placebo-controlled 12-month trial of low-dose risperidone, cognitive therapy, or supportive therapy was conducted in a cohort of 115 clients of the Personal Assessment and Crisis Evaluation Clinic, a specialized service for young people at ultra-high risk of psychosis located in Melbourne, Australia. Recruitment commenced in August 2000 and ended in May 2006. The primary outcome measure was transition to full-threshold psychosis, defined a priori as frank psychotic symptoms occurring at least daily for 1 week or more and assessed using the Comprehensive Assessment of At-Risk Mental States. Secondary outcome measures were psychiatric symptoms, psychosocial functioning, and quality of life. The estimated 12-month transition rates were as follows: cognitive therapy + risperidone, 10.7%; cognitive therapy + placebo, 9.6%; and supportive therapy + placebo, 21.8%. While there were no statistically significant differences between the 3 groups in transition rates (log-rank test P = .60), all 3 groups improved substantially during the trial, particularly in terms of negative symptoms and overall functioning. The lower than expected, essentially equivalent transition rates in all 3 groups fail to provide support for the first-line use of antipsychotic medications in patients at ultra-high risk of

  19. Twelve-month-old infants anticipatorily plan their actions according to expected object weight in a novel motor context

    Directory of Open Access Journals (Sweden)

    Michaela Boone Upshaw

    2015-02-01

    Full Text Available Planning actions in anticipation of object weight is fundamental to skilled action production. The present study investigated whether infants can apply weight information gained from direct actions on objects in order to plan their actions according to object weight in a novel and indirect motor context. In the present study, two groups of 12-month-old infants were provided with experience acting directly on two blocks of different weights and colors (70 g versus 470 g; red versus yellow. Subsequently, infants were administered a novel task in which the same blocks (standard condition; n = 60, or blocks of the reversed color-weight pairings (switch condition; n = 60, were placed out-of-reach, on top of a cloth, and infants were encouraged to retrieve the block by acting on the cloth. Infants in the switch condition produced more failed cloth pulls when retrieving the 470 g block, due to inadequate generation of anticipatory force, relative to infants in the standard condition. This demonstrates that infants’ force on the cloth was prospectively generated based on their mental representation of the supported block’s weight, which was formed through their previous direct actions on the object. Thus, infants use information about the weight of an object in order to anticipate how to obtain that object in a novel and indirect problem-solving context.

  20. Twelve-Month-Old Infants Anticipatorily Plan Their Actions According to Expected Object Weight in a Novel Motor Context

    Science.gov (United States)

    Upshaw, Michaela Boone; Sommerville, Jessica A.

    2015-01-01

    Planning actions in anticipation of object weight is fundamental to skilled action production. The present study investigated whether infants can apply weight information gained from direct actions on objects in order to plan their actions according to object weight in a novel and indirect motor context. In the present study, two groups of 12-month-old infants were provided with experience acting directly on two blocks of different weights and colors (70 versus 470 g; red versus yellow). Subsequently, infants were administered a novel task in which the same blocks (standard condition; n = 60), or blocks of the reversed color–weight pairings (switch condition; n = 60), were placed out-of-reach, on top of a cloth, and infants were encouraged to retrieve the block by acting on the cloth. Infants in the switch condition produced more failed cloth pulls when retrieving the 470 g block, due to inadequate generation of anticipatory force, relative to infants in the standard condition. This demonstrates that infants’ force on the cloth was prospectively generated based on their mental representation of the supported block’s weight, which was formed through their previous direct actions on the object. Thus, infants use information about the weight of an object in order to anticipate how to obtain that object in a novel and indirect problem-solving context. PMID:25756040

  1. Twelve months of implementation of health care performance-based financing in Burkina Faso: A qualitative multiple case study.

    Science.gov (United States)

    Ridde, Valéry; Yaogo, Maurice; Zongo, Sylvie; Somé, Paul-André; Turcotte-Tremblay, Anne-Marie

    2017-07-03

    To improve health services' quantity and quality, African countries are increasingly engaging in performance-based financing (PBF) interventions. Studies to understand their implementation in francophone West Africa are rare. This study analysed PBF implementation in Burkina Faso 12 months post-launch in late 2014. The design was a multiple and contrasted case study involving 18 cases (health centres). Empirical data were collected from observations, informal (n = 224) and formal (n = 459) interviews, and documents. Outside the circle of persons trained in PBF, few in the community had knowledge of it. In some health centres, the fact that staff were receiving bonuses was intentionally not announced to populations and community leaders. Most local actors thought PBF was just another project, but the majority appreciated it. There were significant delays in setting up agencies for performance monitoring, auditing, and contracting, as well as in the payment. The first audits led rapidly to coping strategies among health workers and occasionally to some staging beforehand. No community-based audits had yet been done. Distribution of bonuses varied from one centre to another. This study shows the importance of understanding the implementation of public health interventions in Africa and of uncovering coping strategies. © 2017 The Authors. The International Journal of Health Planning and Management Published by John Wiley & Sons Ltd.

  2. Twelve-month-old infants anticipatorily plan their actions according to expected object weight in a novel motor context.

    Science.gov (United States)

    Upshaw, Michaela Boone; Sommerville, Jessica A

    2015-01-01

    Planning actions in anticipation of object weight is fundamental to skilled action production. The present study investigated whether infants can apply weight information gained from direct actions on objects in order to plan their actions according to object weight in a novel and indirect motor context. In the present study, two groups of 12-month-old infants were provided with experience acting directly on two blocks of different weights and colors (70 versus 470 g; red versus yellow). Subsequently, infants were administered a novel task in which the same blocks (standard condition; n = 60), or blocks of the reversed color-weight pairings (switch condition; n = 60), were placed out-of-reach, on top of a cloth, and infants were encouraged to retrieve the block by acting on the cloth. Infants in the switch condition produced more failed cloth pulls when retrieving the 470 g block, due to inadequate generation of anticipatory force, relative to infants in the standard condition. This demonstrates that infants' force on the cloth was prospectively generated based on their mental representation of the supported block's weight, which was formed through their previous direct actions on the object. Thus, infants use information about the weight of an object in order to anticipate how to obtain that object in a novel and indirect problem-solving context.

  3. Twelve-month, 12 km resolution North American WRF-Chem v3.4 air quality simulation: performance evaluation

    Directory of Open Access Journals (Sweden)

    C. W. Tessum

    2015-04-01

    Full Text Available We present results from and evaluate the performance of a 12-month, 12 km horizontal resolution year 2005 air pollution simulation for the contiguous United States using the WRF-Chem (Weather Research and Forecasting with Chemistry meteorology and chemical transport model (CTM. We employ the 2005 US National Emissions Inventory, the Regional Atmospheric Chemistry Mechanism (RACM, and the Modal Aerosol Dynamics Model for Europe (MADE with a volatility basis set (VBS secondary aerosol module. Overall, model performance is comparable to contemporary modeling efforts used for regulatory and health-effects analysis, with an annual average daytime ozone (O3 mean fractional bias (MFB of 12% and an annual average fine particulate matter (PM2.5 MFB of −1%. WRF-Chem, as configured here, tends to overpredict total PM2.5 at some high concentration locations and generally overpredicts average 24 h O3 concentrations. Performance is better at predicting daytime-average and daily peak O3 concentrations, which are more relevant for regulatory and health effects analyses relative to annual average values. Predictive performance for PM2.5 subspecies is mixed: the model overpredicts particulate sulfate (MFB = 36%, underpredicts particulate nitrate (MFB = −110% and organic carbon (MFB = −29%, and relatively accurately predicts particulate ammonium (MFB = 3% and elemental carbon (MFB = 3%, so that the accuracy in total PM2.5 predictions is to some extent a function of offsetting over- and underpredictions of PM2.5 subspecies. Model predictive performance for PM2.5 and its subspecies is in general worse in winter and in the western US than in other seasons and regions, suggesting spatial and temporal opportunities for future WRF-Chem model development and evaluation.

  4. The BREASTrial Stage II: ADM Breast Reconstruction Outcomes from Definitive Reconstruction to 3 Months Postoperative.

    Science.gov (United States)

    Mendenhall, Shaun D; Anderson, Layla A; Ying, Jian; Boucher, Kenneth M; Neumayer, Leigh A; Agarwal, Jayant P

    2017-01-01

    The Breast Reconstruction Evaluation of Acellular Dermal Matrix as a Sling Trial is a prospective randomized trial comparing outcomes of tissue expander breast reconstruction using either AlloDerm or DermaMatrix. The trial was divided into 3 outcome stages; this study reports stage II outcomes, which are those from the time of definitive reconstruction to 3 months postoperative. A randomized trial was conducted to compare complication rates between AlloDerm and DermaMatrix groups. The impact of matrix type, age, obesity, radiation therapy, chemotherapy, and reconstruction type on complications was analyzed with regression models. Of the 128 patients (199 breasts) who were randomly assigned into the trial, 111 patients (173 breasts) were available for analysis in stage II. There was no difference in overall rates of complications (15.4% vs 18.3%, P = 0.8) or implant loss (2.2% vs 3.7%, P = 0.5) between the AlloDerm and DermaMatrix groups, respectively. Obesity was the only significant predictor of complications on regression analysis (odds ratio, 4.31, P = 0.007). Matrix type, age, radiation therapy, chemotherapy, or reconstruction type had no impact on the incidence/severity of complications. Acellular dermal matrix (ADM) will likely continue to have a role in breast reconstructive surgery; however, caution should be taken when using ADM because of relatively high complication rates, especially in obese patients. The particular ADM product should be selected based on individual surgeon preference, experience, and success rates. These data and forthcoming long-term outcomes from the Breast Reconstruction Evaluation of Acellular Dermal Matrix as a Sling Trial will enable surgeons to carefully weigh the risks and benefits of ADM use in breast reconstruction.

  5. The BREASTrial Stage II: ADM Breast Reconstruction Outcomes from Definitive Reconstruction to 3 Months Postoperative

    Science.gov (United States)

    Mendenhall, Shaun D.; Anderson, Layla A.; Ying, Jian; Boucher, Kenneth M.; Neumayer, Leigh A.

    2017-01-01

    Background: The Breast Reconstruction Evaluation of Acellular Dermal Matrix as a Sling Trial is a prospective randomized trial comparing outcomes of tissue expander breast reconstruction using either AlloDerm or DermaMatrix. The trial was divided into 3 outcome stages; this study reports stage II outcomes, which are those from the time of definitive reconstruction to 3 months postoperative. Methods: A randomized trial was conducted to compare complication rates between AlloDerm and DermaMatrix groups. The impact of matrix type, age, obesity, radiation therapy, chemotherapy, and reconstruction type on complications was analyzed with regression models. Results: Of the 128 patients (199 breasts) who were randomly assigned into the trial, 111 patients (173 breasts) were available for analysis in stage II. There was no difference in overall rates of complications (15.4% vs 18.3%, P = 0.8) or implant loss (2.2% vs 3.7%, P = 0.5) between the AlloDerm and DermaMatrix groups, respectively. Obesity was the only significant predictor of complications on regression analysis (odds ratio, 4.31, P = 0.007). Matrix type, age, radiation therapy, chemotherapy, or reconstruction type had no impact on the incidence/severity of complications. Conclusions: Acellular dermal matrix (ADM) will likely continue to have a role in breast reconstructive surgery; however, caution should be taken when using ADM because of relatively high complication rates, especially in obese patients. The particular ADM product should be selected based on individual surgeon preference, experience, and success rates. These data and forthcoming long-term outcomes from the Breast Reconstruction Evaluation of Acellular Dermal Matrix as a Sling Trial will enable surgeons to carefully weigh the risks and benefits of ADM use in breast reconstruction. PMID:28203509

  6. Carotid endarterectomy for ameliorating the symptoms of transient ischemic attack: A six-month postoperative follow-up

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND:Carotid endarterectomy has certain risks,but it has obvious effects on preventing the occurrence of stroke.OBJECTIVE:To identify the effects of carotid endarterectomy on ameliorating the clinical symptoms and physical signs of patients with cerebral ischemia.DESIGN:A follow-up study.SETTING:Union Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology.PARTICIPANTS:Sixteen patients with carotid atherosclerotic stenosis accompanied by ischemic symptoms were selected from the Department of Vascular Surgery,Union Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology from March 2005 to May 2007.There were 11 males and 5 females,aged from 40 to 81 years old with a mean age of 60 years old,and they were all clearly diagnosed by carotid color Doppler ultrasound.Informed consent was obtained from all the patients.The study was approved by the hospital ethical committee.METHODS:① All the 16 patients were performed with unilateral stripping of arteriosclerotic plaque and Carotid endarterectomy,and 6 of them with bilateral stenosis was operated on the side with more serious stenosis.② The clinical symptoms,physical signs before and after operation,and the operative complications were observed.③ The patients were followed up for 6 months postoperatively.The smoothness of carotid arteries was detected with color Doppler ultrasound.The degrees of satisfaction to the quality of living were evaluated.MAIN OUTCOME MEASURES:①Amelioration of clinical symptoms postoperatively;② Smoothness of carotid arteries postoperatively;③ Degrees of satisfaction to the quality of living;④ Postoperative complications.RESULTS:All the 16 patients were involved in the final analysis of results.① Amelioration of clinical symptoms and physical signs:The postoperative muscle strengths of 3 patients with stroke history were significantly ameliorated;For the 8 patients with TIA symptoms,and the symptoms

  7. Preoperative and Postoperative (1st and 3rd Month Metabolic Data of Patients Who Underwent Bariatric Surgery

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    Nilüfer Özdemir Kutbay

    2015-03-01

    Full Text Available Purpose: The growing prevalence of obesity has become a major concern. The efficacy of medical treatment, diet and behavior therapy in morbidly obese patients is limited. Obesity surgery is a treatment option for selected morbidly obese patients. Material and Method: Data of 47 patients (n=39 women, 8 men who underwent bariatric surgery were investigated. Results: Out of 47 patients, 20 underwent Roux-en-Y gastric bypass (RYGB (43% and 27 had sleeve gastrectomy (SG (57%. The mean age of the patients was 37±9.5 (19-59 years. 17% of patients were men and 83% were women. In the analysis of data on weight that could be found for 31 out of 47 patients, we detected preoperative and postoperative (1st and 3rd month mean weight values as 125.4±15.9 kg, 112.7±13.2 kg (p<0.001 and 100.9±17.5 kg (p<0.001, respectively. In addition, the analysis of the data on mean fasting plasma glucose (FPG levels which could be found for 23 out of 47 patients, showed us that preoperative and postoperative (1st and 3rd month FPG levels were 100.9±17.5 mg/dL, 91.6±10.9 mg/dL (p=0.03 and 87.3±2.0 mg/dL, respectively. Only 1 patient had diabetes before the surgery. In the RYGB group, the mean change in weight was 12.4±5.5 kg in the 1st month and 22.2±8.6 kg in the 3rd month (compared to the weights in the preoperative period. Moreover, in the SG group, the mean change in weight was 13.7±4.5 kg in the 1st month and 23.4±5.8 kg in the 3rd month. No statistically significant difference was found between the weight changes in the 1st and the 3rd month as for surgery types. Discussion: After bariatric surgery, significant loss in weight and reduction in FPG occurred in short-term.

  8. The utility of erythrocyte sedimentation rate values and white blood cell counts after spinal deformity surgery in the early (≤3 months) post-operative period.

    Science.gov (United States)

    Kuhn, Margaret G; Lenke, Lawrence G; Bridwell, Keith H; O'Donnell, June C; Luhmann, Scott J

    2012-03-01

    The erythrocyte sedimentation rate (ESR) and white blood cell (WBC) count are frequently obtained in the work-up of post-operative fever. However, their diagnostic utility depends upon comparison with normative peri-operative trends which have not yet been described. The purpose of this study is to define a range of erythrocyte sedimentation rates and white blood cell counts following spinal instrumentation and fusion in non-infected patients. Seventy-five patients underwent spinal instrumentation and fusion. The erythrocyte sedimentation rate and white blood cell count were recorded pre-operatively, at 3 and 7 days post-operatively, and at 1 and 3 months post-operatively. Both erythrocyte sedimentation rate and white blood cell count trends demonstrated an early peak, followed by a gradual return to normal. Peak erythrocyte sedimentation rates occurred within the first week post-operatively in 98% of patients. Peak white blood cell counts occurred with the first week in 85% of patients. In the absence of infection, the erythrocyte sedimentation rate was abnormally elevated in 78% of patients at 1 month and in 53% of patients at 3 months post-operatively. The white blood cell count was abnormally elevated in only 6% of patients at 1 month post-operatively. Longer surgical time was associated with elevated white cell count at 1 week post-operatively. The fusion of more vertebral levels had a negative relationship with elevated erythrocyte sedimentation rate at 1 week post-operatively. The anterior surgical approach was associated with significantly lower erythrocyte sedimentation rate at 1 month post-operatively and with lower white cell count at 1 week post-operatively. In non-infected spinal fusion surgeries, erythrocyte sedimentation rates are in the abnormal range in 78% of patients at 1 month and in 53% of patients at 3 months post-operatively, suggesting that the erythrocyte sedimentation rate is of limited diagnostic value in the early post-operative

  9. Articular Cartilage Repair Using Marrow Stimulation Augmented with a Viable Chondral Allograft: 9-Month Postoperative Histological Evaluation

    Directory of Open Access Journals (Sweden)

    James K. Hoffman

    2015-01-01

    Full Text Available Marrow stimulation is frequently employed to treat focal chondral defects of the knee. However, marrow stimulation typically results in fibrocartilage repair tissue rather than healthy hyaline cartilage, which, over time, predisposes the repair to failure. Recently, a cryopreserved viable chondral allograft was developed to augment marrow stimulation. The chondral allograft is comprised of native viable chondrocytes, chondrogenic growth factors, and extracellular matrix proteins within the superficial, transitional, and radial zones of hyaline cartilage. Therefore, host mesenchymal stem cells that infiltrate the graft from the underlying bone marrow following marrow stimulation are provided with the optimal microenvironment to undergo chondrogenesis. The present report describes treatment of a trochlear defect with marrow stimulation augmented with this novel chondral allograft, along with nine month postoperative histological results. At nine months, the patient demonstrated complete resolution of pain and improvement in function, and the repair tissue consisted of 85% hyaline cartilage. For comparison, a biopsy obtained from a patient 8.2 months after treatment with marrow stimulation alone contained only 5% hyaline cartilage. These outcomes suggest that augmenting marrow stimulation with the viable chondral allograft can eliminate pain and improve outcomes, compared with marrow stimulation alone.

  10. Prevalence and predictors of undernutrition among infants aged six and twelve months in Butajira, Ethiopia: The P-MaMiE Birth Cohort

    Directory of Open Access Journals (Sweden)

    Tesfaye Fikru

    2010-01-01

    Full Text Available Abstract Background Child undernutrition is a major public health problem in low income countries. Prospective studies of predictors of infant growth in rural low-income country settings are relatively scarce but vital to guide intervention efforts. Methods A population-based sample of 1065 women in the third trimester of pregnancy was recruited from the demographic surveillance site (DSS in Butajira, south-central Ethiopia, and followed up until the infants were one year of age. After standardising infant weight and length using the 2006 WHO child growth standard, a cut-off of two standard deviations below the mean defined the prevalence of stunting (length-for-age Results The prevalence of infant undernutrition was high at 6 months (21.7% underweight, 26.7% stunted and 16.7% wasted and at 12 months of age (21.2% underweight, 48.1% stunted, and 8.4% wasted. Significant and consistent predictors of infant undernutrition in both logistic and linear multiple regression models were male gender, low birth weight, poor maternal nutritional status, poor household sanitary facilities and living in a rural residence. Compared to girls, boys had twice the odds of being underweight (OR = 2.00; 95%CI: 1.39, 2.86 at 6 months, and being stunted at 6 months (OR = 2.38, 95%CI: 1.69, 3.33 and at 12 months of age (OR = 2.08, 95%CI: 1.59, 2.89. Infant undernutrition at 6 and 12 months of age was not associated with infant feeding practices in the first two months of life. Conclusion There was a high prevalence of undernutrition in the first year of infancy in this rural Ethiopia population, with significant gender imbalance. Our prospective study highlighted the importance of prenatal maternal nutritional status and household sanitary facilities as potential targets for intervention.

  11. Twelve-Month Prostate-Specific Antigen Values and Perineural Invasion as Strong Independent Prognostic Variables of Long-Term Biochemical Outcome After Prostate Seed Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ding, William, E-mail: billyding888@gmail.com [Department of Radiation Oncology, California Pacific Medical Center, San Francisco, California (United States); Lee, John [Department of Radiation Oncology, California Pacific Medical Center, San Francisco, California (United States); Chamberlain, David [Department of Radiation Oncology, St. Mary' s Regional Medical Center, Reno, Nevada (United States); Cunningham, James [Carson Urology, Carson City, Nevada (United States); Yang Lixi [Department of Radiation Oncology, California Pacific Medical Center, San Francisco, California (United States); Tay, Jonathan [Department of Radiation Oncology, St. Mary' s Regional Medical Center, Reno, Nevada (United States)

    2012-11-15

    Purpose: To determine whether post-treatment prostate-specific antigen (ptPSA) values at 12 months and other clinical parameters predict long-term PSA relapse-free survival (PRFS) following prostate seed brachytherapy. Methods and Materials: Records of 204 hormone-naieve patients with localized adenocarcinoma of the prostate treated at St. Mary's Regional Medical Center in Reno, NV, and at Carson Tahoe Regional Medical Center in Carson City, NV, between 1998 and 2003, using I-125 or Pd-103 seed brachytherapy, were retrospectively analyzed. Treatment planning was done using a preplanned, modified peripheral loading technique. A total of 185 of 204 patients had PSA records at 12 months after implant. Variables included were age, initial pretreatment PSA, Gleason score, T stage, National Comprehensive Cancer Network (NCCN) risk group (RG), perineural invasion (PNI), external beam boost, dose, and ptPSA levels at 12 months with cutpoints at {<=}1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml. Results: Median follow-up was 80 months, and median age was 69 years. The numbers of patients stratified by NCCN low, intermediate, and high RG were 110:65:10, respectively. Monotherapy and boost prescription doses were 145 Gy and 110 Gy for I-125, and 125 Gy and 100 Gy for Pd-103 seeds, respectively. The median dose (D90) was 95.4% of the prescribed dose. The 5-year PRFS at the 12-months ptPSA levels of {<=}1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml were 98.5%, 85.7%, 61.5%, and 22.2%, respectively. The 10-year PRFS at the 12-months ptPSA levels of {<=}1 and 1.01 to 2.00 ng/ml were 90.5% and 85.7%, respectively. In multivariate analysis, both ptPSA and PNI were significant independent predictors of PRFS. Hazard ratios (HR) for ptPSA levels at {<=}1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml at 12 months were 1, 4.96, 27.57, and 65.10, respectively. PNI had an HR of 6.1 (p = 0.009). Conclusions: Presence of PNI and ptPSA values at 12 months are strong prognostic

  12. The twelve-month outcomes of a biolimus eluting stent with a biodegradable polymer compared with a sirolimus eluting stent with a durable polymer

    NARCIS (Netherlands)

    S.A. Garg (Scot); G. Sarno (Giovanna); P.W.J.C. Serruys (Patrick); T. de Vries (Ton); P. Buszman (Pawel); A. Linke (Axel); T. Ischinger (Thomas); V. Klauss (Volker); F.R. Eberli (Franz Robert); R. Corti (Roberto); W. Wijns (William); M-C. Morice (Marie-Claude); C. di Mario (Carlo); R.J.M. van Geuns (Robert Jan); P. Eerdmans (Pedro); G.A. van Es (Gerrit Anne); B. Meier (Bernard); P. Jùni (Peter); S. Windecker (Stephan)

    2010-01-01

    textabstractAims: This study reports the 12-month clinical outcomes of the LEADERS clinical trial which compared a biolimus eluting stent with a biodegradable polymer (BES) to a sirolimus eluting stent with a durable polymer (SES). Methods and results: The multicentre LEADERS trial employed an all-c

  13. Use of Pentamidine As Secondary Prophylaxis to Prevent Visceral Leishmaniasis Relapse in HIV Infected Patients, the First Twelve Months of a Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Ermias Diro

    Full Text Available Visceral leishmaniasis (VL has become an important opportunistic infection in persons with HIV-infection in VL-endemic areas. The co-infection leads to profound immunosuppression and high rate of annual VL recurrence. This study assessed the effectiveness, safety and feasibility of monthly pentamidine infusions to prevent recurrence of VL in HIV co-infected patients.A single-arm, open-label trial was conducted at two leishmaniasis treatment centers in northwest Ethiopia. HIV-infected patients with a VL episode were included after parasitological cure. Monthly infusions of 4 mg/kg pentamidine-isethionate diluted in normal-saline were started for 12 months. All received antiretroviral therapy (ART. Time-to-relapse or death was the primary end point.Seventy-four patients were included. The probability of relapse-free survival at 6 months and at 12 months was 79% and 71% respectively. Renal failure, a possible drug-related serious adverse event, occurred in two patients with severe pneumonia. Forty-one patients completed the regimen taking at least 11 of the 12 doses. Main reasons to discontinue were: 15 relapsed, five died and seven became lost to follow-up. More patients failed among those with a CD4+cell count ≤ 50 cells/μl, 5/7 (71.4% than those with counts above 200 cells/μl, 2/12 (16.7%, (p = 0.005.Pentamidine secondary prophylaxis led to a 29% failure rate within one year, much lower than reported in historical controls (50%-100%. Patients with low CD4+cell counts are at increased risk of relapse despite effective initial VL treatment, ART and secondary prophylaxis. VL should be detected and treated early enough in patients with HIV infection before profound immune deficiency installs.

  14. Effect of Bone Marrow-Derived Mononuclear Cell Treatment, Early or Late After Acute Myocardial Infarction: Twelve Months CMR and Long-Term Clinical Results.

    Science.gov (United States)

    Sürder, Daniel; Manka, Robert; Moccetti, Tiziano; Lo Cicero, Viviana; Emmert, Maximilian Y; Klersy, Catherine; Soncin, Sabrina; Turchetto, Lucia; Radrizzani, Marina; Zuber, Michel; Windecker, Stephan; Moschovitis, Aris; Bühler, Ines; Kozerke, Sebastian; Erne, Paul; Lüscher, Thomas F; Corti, Roberto

    2016-07-22

    Intracoronary delivery of autologous bone marrow-derived mononuclear cells (BM-MNC) may improve remodeling of the left ventricle (LV) after acute myocardial infarction (AMI). To demonstrate long-term efficacy of BM-MNC treatment after AMI. In a multicenter study, we randomized 200 patients with large AMI in a 1:1:1 pattern into an open-labeled control and 2 BM-MNC treatment groups. In the BM-MNC groups, cells were either administered 5 to 7 days (early) or 3 to 4 weeks (late) after AMI. Cardiac magnetic resonance imaging was performed at baseline and after 12 months. The current analysis investigates the change from baseline to 12 months in global LV ejection fraction, LV volumes, scar size, and N-terminal pro-brain natriuretic peptide values comparing the 2 treatment groups with control in a linear regression model. Besides the complete case analysis, multiple imputation analysis was performed to address for missing data. Furthermore, the long-term clinical event rate was computed. The absolute change in LV ejection fraction from baseline to 12 months was -1.9±9.8% for control (mean±SD), -0.9±10.5% for the early treatment group, and -0.7±10.1% for the late treatment group. The difference between the groups was not significant, both for complete case analysis and multiple imputation analysis. A combined clinical end point occurred equally in all the groups. Overall, 1-year mortality was low (2.25%). Among patients with AMI and LV dysfunction, treatment with BM-MNC either 5 to 7 days or 3 to 4 weeks after AMI did not improve LV function at 12 months, compared with control. The results are limited by an important drop out rate. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00355186. © 2016 American Heart Association, Inc.

  15. Effectiveness of long-term (twelve months nonsurgical weight loss interventions for obese women with polycystic ovary syndrome: a systematic review

    Directory of Open Access Journals (Sweden)

    Fiona Nicholson

    2010-11-01

    Full Text Available Fiona Nicholson1, Catherine Rolland1, John Broom1, John Love21Centre for Obesity Research and Epidemiology, Robert Gordon University, Aberdeen, Scotland; 2School of Applied Social Studies, Faculty of Health and Social Care, The Robert Gordon University, Aberdeen, ScotlandAbstract: Polycystic ovary syndrome (PCOS affects 2%–26% of women of reproductive age and is often accompanied by obesity. Modest weight loss reduces health risks and ameliorates effects of the syndrome. Weight loss interventions are mainly of short duration and have limited success. A systematic review of the literature was carried out to assess the efficacy of long-term (12 months, nonsurgical weight loss interventions for women with PCOS. Fifteen databases were searched, resulting in eight papers that met the search criteria. Comparison of results and meta-analysis was difficult due to heterogeneity of studies. Behavioral components of interventions were poorly described, and compliance was difficult to ascertain. The results suggested that the inclusion of a lifestyle component improves outcomes, but protocols must be clearly described to maintain study validity and to identify successful behavioral strategies.Keywords: obesity, polycystic ovary syndrome, weight loss 

  16. Twelve Months of Air Quality Monitoring at Ash Meadows National Wildlife Refuge, Southwestern Rural Nevada, U.S.A (EMSI April 2007)

    Energy Technology Data Exchange (ETDEWEB)

    Engelbrecht, Johann P; Shafer, David S; Campbell, Dave; Campbell, Scott; McCurdy, Greg; Kohl, Steven D; Nikolich, George; Sheetz, Larry

    2011-08-01

    The one year of air quality monitoring data collected at the Ash Meadows National Wildlife Refuge (NWR) was the final part of the air quality "Scoping Studies" for the Environmental Monitoring Systems Initiative (EMSI) in southern and central Nevada. The objective of monitoring at Ash Meadows was to examine aerosol and meteorological data, seasonal trends in aerosol and meteorological parameters as well as to examine evidence for long distance transport of some constituents. The 9,307 hectare refuge supports more than 50 springs and 24 endemic species, including the only population of the federally listed endangered Devil’s Hole pupfish (Cyprinodon diabolis) (U.S. Fish and Wildlife Service, 1990). Ash Meadows NWR is located in a Class II air quality area, and the aerosol measurements collected with this study are compared to those of Interagency Monitoring of Protected Visual Environments (IMPROVE) sites. Measurements taken at Ash Meadows NWR over a period of 12 months provide new baseline air quality and meteorological information for rural southwestern Nevada, specifically Nye County and the Amargosa Valley.

  17. Transanal rectopexy - twelve case studies

    Directory of Open Access Journals (Sweden)

    Rubens Henrique Oleques Fernandes

    2012-06-01

    Full Text Available OBJECTIVES: This study analyzed the results of transanal rectopexy and showed the benefits of this surgical technique. METHOD: Twelve patients were submitted to rectopexy between 1997 and 2011. The surgical technique used was transanal rectopexy, where the mesorectum was fixed to the sacrum with nonabsorbable suture. Three patients had been submitted to previous surgery, two by the Delorme technique and one by the Thiersch technique. RESULTS: Postoperative hospital stay ranged from 1 to 4 days. One patient (8.3% had intraoperative hematoma, which was treated with local compression and antibiotics. One patient (8.3% had residual mucosal prolapse, which was resected. Prolapse recurrence was seen in one case (8.3%. Improved incontinence occurred in 75% of patients and one patient reported obstructed evacuation in the first month after surgery. No death occurred. CONCLUSION: Transanal rectopexy is a simple, low cost technique, which has shown good efficacy in rectal prolapse control.OBJETIVO: O presente estudo analisou os resultados da retopexia pela via transanal e expôs os benefícios desta técnica cirúrgica. MÉTODO: Doze pacientes com prolapso foram operados no período de 1997 a 2011. A técnica cirúrgica usada foi a retopexia transanal, onde o mesorreto foi fixado ao sacro com fio inabsorvível. Três pacientes tinham cirurgia prévia, dois pela técnica de Delorme e um pela técnica de Thiersch. RESULTADOS: A permanência hospitalar pós-operatória variou de 1- 4 dias. Uma paciente (8,3% apresentou hematoma transoperatório que foi tratado com compressão local e antibioticoterapia. Um paciente apresentou prolapso mucoso residual (8,3%, que foi ressecado. Houve recidiva da procidência em um caso (8,3%. A melhora da incontinência ocorreu em 75% dos pacientes e uma paciente apresentou bloqueio evacuatório no primeiro mês após a cirurgia. Não houve mortalidade entre os pacientes operados. CONCLUSÃO: A retopexia transanal é uma t

  18. GENDER DIFFERENCES IN SPORT INJURY RISK AND TYPES OF INJU-RIES: A RETROSPECTIVE TWELVE-MONTH STUDY ON CROSS-COUNTRY SKIERS, SWIMMERS, LONG-DISTANCE RUNNERS AND SOCCER PLAYERS

    Directory of Open Access Journals (Sweden)

    Leena Ristolainen

    2009-09-01

    Full Text Available This twelve months survey compared injury risk and injury types by genders (312 females, 262 males in 15- to 35-year-old cross-country skiers, swimmers, long- distance runners and soccer players. More male than female athletes reported at least one acute injury (44% vs. 35%, p < 0.05, and more male than female runners reported at least one overuse injury (69% vs. 51%, p < 0.05. When the incidence of acute and overuse injuries both separately and combined was calculated per 1000 training hours, per 1000 competition hours and all exposure hours combined we found no gender differences in either of these comparisons. After adjustment for sport event males were at increased risk for posterior thigh overuse injuries compared to females (relative risk (RR 5.8, 95% confidence interval (CI 1.3 to 26.4, p < 0.05 while females were at increased risk for overuse injuries in the ankle compared to males (RR 3.1, 95% CI 1.0 to 9.3, p < 0.05. After adjustment for exposure time (injuries/1000 exposure hours significance of the difference between the sexes in overuse injury to the ankle persisted (female 0.11 vs. male 0.02 injuries/1000 exposure hours, p < 0.05. Six athletes had an anterior cruciate ligament (ACL injury, of whom four were female soccer players. After combining all reported acute and overuse ankle and knee injuries, the proportion of athletes with such injury was higher in the female compared to male soccer players (75% and 54% respectively; p < 0.05, but no difference was found in such injuries when calculated per 1000 exposure hours. In conclusion, we found some gender differences in sport-related injuries, but most of these differences seemed to be explained at least in part by differences in the amount of training

  19. Differences in gait characteristics between total hip, knee, and ankle arthroplasty patients: a six-month postoperative comparison

    Science.gov (United States)

    2013-01-01

    Background The recovery of gait ability is one of the primary goals for patients following total arthroplasty of lower-limb joints. The aim of this study was to objectively compare gait differences of patients after unilateral total hip arthroplasty (THA), total knee arthroplasty (TKA) and total ankle arthroplasty (TAA) with a group of healthy controls. Methods A total of 26 TAA, 26 TKA and 26 THA patients with a mean (± SD) age of 64 (± 9) years were evaluated six months after surgery and compared with 26 matched healthy controls. Subjects were asked to walk at self-selected normal and fast speeds on a validated pressure mat. The following spatiotemporal gait parameters were measured: walking velocity, cadence, single-limb support (SLS) time, double-limb support (DLS) time, stance time, step length and step width. Results TAA and TKA patients walked slower than controls at normal (pTKA>THA). THA patients demonstrated no gait differences compared with controls. In contrast, TAA and TKA patients still demonstrated gait differences compared to controls, with slower walking velocity and reduced SLS in the involved limb. In addition, TAA patients presented marked side-to-side asymmetries in gait characteristics. PMID:23731906

  20. The results of ab interno laser thermal sclerostomy combined with cataract surgery versus trabeculectomy combined with cataract surgery 6 to 12 months postoperatively.

    Science.gov (United States)

    Kendrick, R; Kollarits, C R; Khan, N

    1996-07-01

    When cataract surgery and glaucoma surgery are combined, the theoretical advantages of pressure control, removal of the visual impairment, and protection against an increase in intraocular pressure (IOP) in the immediate postoperative period are gained. The authors' objective was to determine whether ab interno laser thermal sclerostomy (LTS) combined with cataract surgery would be as effective as trabeculectomy combined with cataract surgery. Ab interno LTS was compared with trabeculectomy, retrospectively, for patients who had undergone combined cataract and glaucoma surgery. There was no significant difference in the numbers of patients using no medications or fewer medications at 6 and 12 months. There was a greater reduction in IOP in the LTS group. LTS may be better than trabeculectomy in combined cataract and glaucoma surgery because it reduces the IOP more. Compared with trabeculectomy, LTS is simpler to perform and adds less operating time to cataract surgery. Continued follow-up is recommended.

  1. Predicting one and three month postoperative Somatic Concerns, Psychological Distress, and Maladaptive Eating Behaviors in bariatric surgery candidates with the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF).

    Science.gov (United States)

    Marek, Ryan J; Ben-Porath, Yossef S; Merrell, Julie; Ashton, Kathleen; Heinberg, Leslie J

    2014-04-01

    Presurgical psychological screening of bariatric surgery candidates includes some form of standardized psychological assessment. However, associations between presurgical psychological screening and postoperative outcome have not been extensively studied. Here, we explore associations between presurgical Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) scores and early postoperative Somatic Concerns, Psychological Distress, and Maladaptive Eating Behaviors. The sample consisted of male (n = 238) and female (n = 621) patients who were administered the MMPI-2-RF at their presurgical psychological evaluation and received bariatric surgery. Patients were evaluated at their 1- and 3-month postoperative appointments. Confirmatory factor analysis indicated that three latent constructs-somatic concerns, psychological distress, and maladaptive eating behaviors-were represented by responses to a postoperative assessment and that these constructs could be measured consistently over time. Presurgical scores on MMPI-2-RF scales measuring internalizing dysfunction were associated with more psychological distress at postoperative follow-ups, scores on scales measuring somatization were associated with more postoperative somatic concerns, and scores on scales assessing emotional/internalizing, behavioral/externalizing, cognitive complaints, and thought dysfunction prior to surgery were associated with maladaptive eating behaviors after surgery. In conjunction with a presurgical psychological interview, the MMPI-2-RF provides information that can assist in anticipating postoperative outcomes and inform efforts to prevent them.

  2. Hepatic Angiosarcoma: a Review of Twelve Cases

    Institute of Scientific and Technical Information of China (English)

    Qiang Li; Xishan Hao

    2005-01-01

    OBJECTIVE Hepatic angiosarcoma (HAS), a lethal disease, is the most common sarcoma arising in the liver. Little information about the epidemiology, etiology, diagnosis and management of HAS has been reported. Increased familiarity with this disease will facilitate correct diagnosis and help to improve management of this condition in the future.The objective of this study was to describe cases of hepatic angiosarcoma and to discuss the etiologic, diagnostic, therapeutic features and prognosis of this tumor. This report not only serves to give more evidence of the relationship between hepatic angiosarcoma and carcinogenic exposure, but also demonstrates the key points in different methods of diagnosis and the optimal treatment of hepatic angiosarcoma.METHODS Twelve cases of hepatic angiosareoma were analyzed retrospectively, representing the different character in clinical presentations and laboratory computed tomographical scans; pathological data and treatment are described. Clinical and biologic follow-up was carried out for two years after surgical treatment.RESULTS There were nine men and three women varying in ages from 57 to 71 years with an average of 64.3 years. Ten patientshad a history of exposure to vinyl chloride or thorotrast. Mild or moderate abdominal pain and bloating, abdominal mass and fever were the common clinical presentations. Tumors were visualized by ultrasonography and CT scans in all patients. Biochemical profiles yielded variable results and proved to be of little value in detection or diagnosis. Surgical resection was feasible for each patient who was treated as follows: two wedge resections, six segementectomies and four bisegmentectomies. Five patients received Neoadjuvant chemotherapy postoperatively. The survival rate of those cases was poor. The maximum survival time was fourteen months. The mean survival time for this chemotherapeutic group was 11 months. The difference between the survival time of those treated with an operation

  3. Comparative analysis of the patency of the internal thoracic artery in the CABG of left anterior descending artery: 6-month postoperative coronary CT angiography evaluation.

    Science.gov (United States)

    Deininger, Maurilio Onofre; Moreira, Luiz Felipe Pinho; Dallan, Luiz Alberto Oliveira; Oliveira, Orlando Gomes de; Magalhães, Daniel Marcelo Silva; Coelho, José Reinaldo de Moura; Deininger, Eugênia di Giuseppe; Lopes, Norland de Souza; Queiroga, Ricardo Wanderley; Belmont, Elizabeth Ferreira

    2014-01-01

    To assess the patency of the pedicled right internal thoracic artery with an anteroaortic course and compare it to the patency of the left internal thoracic artery , in anastomosis to the left anterior descending artery in coronary artery bypass grafting by using coronary CT angiography at 6 months postoperatively. Between December 2008 and December 2011, 100 patients were selected to undergo a prospective coronary artery bypass grafting procedure without cardiopulmonary bypass. The patients were randomly divided by a computer-generated list into Group-1 (G-1) and Group-2 (G-2), comprising 50 patients each, the technique used was known at the beginning of the surgery. In G-1, coronary artery bypass grafting was performed using the left internal thoracic artery for the left anterior descending and the free right internal thoracic artery for the circumflex, and in G-2, coronary artery bypass grafting was performed using the right internal thoracic artery pedicled to the left anterior descending and the left internal thoracic artery pedicled to the circumflex territory. The groups were similar with regard to the preoperative clinical data. A male predominance of 75.6% and 88% was observed in G-1 and G-2, respectively. Five patients migrated from G-1 to G-2 because of atheromatous disease in the ascending aorta. The average number of distal anastomoses was 3.48 (SD=0.72) in G-1 and 3.20 (SD=0.76) in G-2. Coronary CT angiography in 96 re-evaluated patients showed that all ITAs, right or left, used in situ for the left anterior descending were patent. There were no deaths in either group. Coronary artery bypass grafting surgery involving anastomosis of the anteroaortic right internal thoracic artery to the left anterior descending artery has an outcome similar to that obtained using the left internal thoracic artery for the same coronary site.

  4. Twelve-Month Efficacy and Safety Data for the "Stress Incontinence Control, Efficacy and Safety Study": A Phase III, Multicenter, Prospective, Randomized, Controlled Study Treating Female Stress Urinary Incontinence Using the Vesair Intravesical Balloon.

    Science.gov (United States)

    Winkler, Harvey; Jacoby, Karny; Kalota, Susan; Snyder, Jeffrey; Cline, Kevin; Robertson, Kaiser; Kahan, Randall; Green, Lonny; McCammon, Kurt; Rovner, Eric; Rardin, Charles

    2017-09-26

    The "Stress Incontinence Control, Efficacy and Safety Study" (SUCCESS) is a phase III study of the Vesair Balloon in women with stress urinary incontinence who had failed conservative therapy, and either failed surgery, were not candidates for surgery, or chose not to have surgery. The safety and efficacy of the balloon at 12 months is reported for those participants in the treatment arm who elected to continue with the SUCCESS trial beyond the primary end point at 3 months. The SUCCESS trial is a multicenter, prospective, single-blinded, randomized, sham-controlled study. Participants were randomized on a 2.33:1 basis to either Vesair Balloon placement or placebo. The primary efficacy end point was a composite of both a greater than 50% reduction from baseline on 1-hour provocative pad weight test and an at least 10-point improvement in symptoms on the Incontinence Quality of Life questionnaire assessed at the 3-month study visit. Patients in the treatment arm who opted to continue in the trial were followed up prospectively up to 12 months. A total of 221 participants were randomized, including 157 in the treatment arm and 64 in the control arm. Sixty-seven participants in the treatment arm (42.7% of participants enrolled) were evaluated at 12 months, with 56.3% achieving the composite end point and 78.7% having greater than 50% reduction in pad weight from baseline in a per-protocol analysis. In an intent-to-treat analysis treating all participants who did not continue with the balloon as failures, 24% of the participants achieved the composite end point and 33.6% had a greater than 50% reduction in pad weight from baseline. Treatment-related adverse events in this group included dysuria (40.1%), gross hematuria (36.9%), and urinary tract infection (26.1%). In this phase III trial, symptom relief was maintained for those participants who continued therapy for 12 months. The balloon was found to be safe with no device- or procedure-related serious adverse events

  5. The Twelve Hotel, Barna : Video

    OpenAIRE

    Irish Food Channel

    2014-01-01

    Fergus O'Halloran, Managing Director of The Twelve Hotel in Barna in County Galway, talks about his philosophy in running this unique boutique hotel. Reproduced with kind permission from John & Sally McKenna. 3.35 mins

  6. Postoperative spine; Postoperative Wirbelsaeule

    Energy Technology Data Exchange (ETDEWEB)

    Schlaeger, R. [Universitaetsspital Basel, Neurologische Klinik und Poliklinik, Basel (Switzerland); Lieb, J.M. [Universitaetsspital Basel, Klinik fuer Radiologie und Nuklearmedizin, Basel (Switzerland); Shariat, K. [Neurochirurgie Koeln-Merheim, Koeln (Germany); Ahlhelm, F.J. [Kantonsspital Baden AG, Abteilung Neuroradiologie, Institut fuer Radiologie, Baden (Switzerland)

    2014-11-15

    Approximately 15-30 % of surgical procedures involving the lumbar spine are associated with complications that require further diagnostic work-up. The choice of imaging modality for postoperative complications depends on the extent, pattern and temporal evolution of the postoperative neurological signs and symptoms as well as on the preoperative clinical status, the surgical procedure itself and the underlying pathology. The interpretation of imaging findings, in particular the distinction between postoperative complications and normally expected nonspecific postoperative imaging alterations can be challenging and requires the integration of clinical neurological information and the results of laboratory tests. The combination of different imaging techniques might help in cases of equivocal imaging results. (orig.) [German] Etwa 15-30 % der operativen Eingriffe im Bereich der lumbalen Wirbelsaeule verlaufen nicht komplikationsfrei und erfordern weiterfuehrende Abklaerungen. Die Auswahl des bildgebenden Verfahrens im Rahmen postoperativer Komplikationen haengt dabei wesentlich von der zeitlichen Entwicklung, dem Ausmass und Verteilungsmuster der neuaufgetretenen klinisch-neurologischen bzw. orthopaedischen Symptome sowie von den Ausfaellen vor dem Eingriff, der zugrundeliegenden Pathologie und der Lokalisation und Art des Eingriffs ab. Die Interpretation der bildgebenden Befunde, insbesondere die Abgrenzung postoperativer Komplikationen von natuerlicherweise zu erwartenden postoperativen Veraenderungen kann dabei eine Herausforderung darstellen. Bei unklaren Befunden kann ergaenzend zur eingehend klinisch-neurologischen und laborchemischen Bestandsaufnahme auch der kombinierte Einsatz mehrerer bildgebender Modalitaeten diagnostisch weiterhelfen. (orig.)

  7. Postoperative spinal column; Postoperative Wirbelsaeule

    Energy Technology Data Exchange (ETDEWEB)

    Kaefer, W. [Westpfalzklinikum GmbH, Standort II, Abteilung fuer Wirbelsaeulenchirurgie, Kusel (Germany); Heumueller, I. [Westpfalzklinikum GmbH, Standort II, Institut fuer Radiologie II, Kusel (Germany); Harsch, N.; Kraus, C.; Reith, W. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

    2016-08-15

    As a rule, postoperative imaging is carried out after spinal interventions to document the exact position of the implant material. Imaging is absolutely necessary when new clinical symptoms occur postoperatively. In this case a rebleeding or an incorrect implant position abutting a root or the spinal cord must be proven. In addition to these immediately occurring postoperative clinical symptoms, there are a number of complications that can occur several days, weeks or even months later. These include the failed back surgery syndrome, implant loosening or breakage of the material and relapse of a disc herniation and spondylodiscitis. In addition to knowledge of the original clinical symptoms, it is also important to know the operation details, such as the access route and the material used. In almost all postoperative cases, imaging with contrast medium administration and corresponding correction of artefacts by the implant material, such as the dual energy technique, correction algorithms and the use of special magnetic resonance (MR) sequences are necessary. In order to correctly assess the postoperative imaging, knowledge of the surgical procedure and the previous clinical symptoms are mandatory besides special computed tomography (CT) techniques and MR sequences. (orig.) [German] In der Regel erfolgt bei spinalen Eingriffen eine postoperative Bildgebung, um die exakte Lage des Implantatmaterials zu dokumentieren. Unbedingt notwendig ist die Bildgebung, wenn postoperativ neue klinische Symptome aufgetreten sind. Hier muessen eine Nachblutung bzw. inkorrekte, eine Wurzel oder das Myelon tangierende Implantatlage nachgewiesen werden. Neben diesen direkt postoperativ auftretenden klinischen Symptomen gibt es eine Reihe von Komplikationen, die erst nach mehreren Tagen, Wochen oder sogar nach Monaten auftreten koennen. Hierzu zaehlen das Failed-back-surgery-Syndrom, die Implantatlockerung oder -bruch, aber auch ein Rezidivvorfall und die Spondylodiszitis. Neben der

  8. Twelve-month prevalence, comorbidity and correlates of mental disorders in Germany: the Mental Health Module of the German Health Interview and Examination Survey for Adults (DEGS1-MH).

    Science.gov (United States)

    Jacobi, Frank; Höfler, Michael; Siegert, Jens; Mack, Simon; Gerschler, Anja; Scholl, Lucie; Busch, Markus A; Hapke, Ulfert; Maske, Ulrike; Seiffert, Ingeburg; Gaebel, Wolfgang; Maier, Wolfgang; Wagner, Michael; Zielasek, Jürgen; Wittchen, Hans-Ulrich

    2014-09-01

    This paper provides up to date prevalence estimates of mental disorders in Germany derived from a national survey (German Health Interview and Examination Survey for Adults, Mental Health Module [DEGS1-MH]). A nationally representative sample (N = 5318) of the adult (18-79) population was examined by clinically trained interviewers with a modified version of the Composite International Diagnostic Interview (DEGS-CIDI) to assess symptoms, syndromes and diagnoses according to DSM-IV-TR (25 diagnoses covered). Of the participants 27.7% met criteria for at least one mental disorder during the past 12 months, among them 44% with more than one disorder and 22% with three or more diagnoses. Most frequent were anxiety (15.3%), mood (9.3%) and substance use disorders (5.7%). Overall rates for mental disorders were substantially higher in women (33% versus 22% in men), younger age group (18-34: 37% versus 20% in age group 65-79), when living without a partner (37% versus 26% with partnership) or with low (38%) versus high socio-economic status (22%). High degree of urbanization (> 500,000 inhabitants versus < 20,000) was associated with elevated rates of psychotic (5.2% versus 2.5%) and mood disorders (13.9% versus 7.8%). The findings confirm that almost one third of the general population is affected by mental disorders and inform about subsets in the population who are particularly affected. Copyright © 2014 John Wiley & Sons, Ltd.

  9. Postoperative pain

    DEFF Research Database (Denmark)

    Kehlet, H; Dahl, J B

    1993-01-01

    also modify various aspects of the surgical stress response, and nociceptive blockade by regional anesthetic techniques has been demonstrated to improve various parameters of postoperative outcome. It is therefore stressed that effective control of postoperative pain, combined with a high degree......Treatment of postoperative pain has not received sufficient attention by the surgical profession. Recent developments concerned with acute pain physiology and improved techniques for postoperative pain relief should result in more satisfactory treatment of postoperative pain. Such pain relief may...

  10. Lack of improvement in health-related quality of life (HRQOL) scores 6 months after surgery for adult spinal deformity (ASD) predicts high revision rate in the second postoperative year.

    Science.gov (United States)

    Bourghli, Anouar; Boissiere, Louis; Larrieu, Daniel; Vital, Jean-Marc; Yilgor, Caglar; Pellisé, Ferran; Alanay, Ahmet; Acaroglu, Emre; Perez-Grueso, Francisco-Javier; Kleinstück, Franck; Obeid, Ibrahim

    2017-08-01

    ASD is assessed radiologically with the spinopelvic parameters and clinically with HRQOL scores. The revision rate after ASD surgery is high and usually occurs during the first or second postoperative year. The aim of this study is to find clinical or radiological factors that could predict revision surgery in the second postoperative year. Inclusion criterion: ASD patients operated on by instrumented posterior fusion with more than 2 years follow-up were enrolled prospectively. Additional criterion was no revision surgery during the first postoperative year. From a multicenter database of 560 operated ASD patients, 164 patients met these criteria. The patients were divided into two groups depending on the need of revision surgery during the second postoperative year. Preoperative, 6-month, 1-year and 2-year data were collected and compared for both groups. A total of 22 patients needed revision surgery and 142 did not. All revisions were for mechanical complications (non-fusion and implant related). Preoperatively, there was a significant difference between the groups (no revision vs. revision) for age (48 vs. 60 years), ODI (37 vs. 53), and SVA (29 vs. 76 mm), respectively. At 6 months, a significant difference in sagittal alignment was found, though HRQOL scores were similar. At 1 year, the no revision group scores improved, whereas the revision group scores remained stable or worsened. At 2 years, the no revision group scores remained stable. Comparing 6- and 12-month data, patients with improved, stable and worsened HRQOL scores had 8, 15 and 28% revision rates, respectively. The revision rate at the second-year post-surgery (13.4%) remains high and demonstrated that a 2-year follow-up is mandatory. In addition to usual risk factors for mechanical complications in ASD surgery, stabilization or worsening of the HRQOL scores between the 6th and 12th month postop was highly predictive of revision rate. This observation is beneficial for ASD patient follow

  11. Postoperative changes in in vivo measured friction in total hip joint prosthesis during walking.

    Directory of Open Access Journals (Sweden)

    Philipp Damm

    Full Text Available Loosening of the artificial cup and inlay is the most common reasons for total hip replacement failures. Polyethylene wear and aseptic loosening are frequent reasons. Furthermore, over the past few decades, the population of patients receiving total hip replacements has become younger and more active. Hence, a higher level of activity may include an increased risk of implant loosening as a result of friction-induced wear. In this study, an instrumented hip implant was used to measure the contact forces and friction moments in vivo during walking. Subsequently, the three-dimensional coefficient of friction in vivo was calculated over the whole gait cycle. Measurements were collected from ten subjects at several time points between three and twelve months postoperative. No significant change in the average resultant contact force was observed between three and twelve months postoperative. In contrast, a significant decrease of up to 47% was observed in the friction moment. The coefficient of friction also decreased over postoperative time on average. These changes may be caused by 'running-in' effects of the gliding components or by the improved lubricating properties of the synovia. Because the walking velocity and contact forces were found to be nearly constant during the observed period, the decrease in friction moment suggests an increase in fluid viscosity. The peak values of the contact force individually varied by 32%-44%. The friction moment individually differed much more, by 110%-129% at three and up to 451% at twelve months postoperative. The maximum coefficient of friction showed the highest individual variability, about 100% at three and up to 914% at twelve months after surgery. These individual variations in the friction parameters were most likely due to different 'running-in' effects that were influenced by the individual activity levels and synovia properties.

  12. EFFORTS Technical annex for the twelve month progress report

    DEFF Research Database (Denmark)

    Bay, Niels; Andreasen, Jan Lasson; Eriksen, Morten;

    1998-01-01

    The present report is documentation for the work carried out at DTU during the previous first year of project activity. The report describes the work completed by DTU in general as well as on the active sub-tasks within materials properties, friction modelling and physical modelling, over the last...

  13. Postoperative handover

    DEFF Research Database (Denmark)

    Møller, Thea P; Madsen, Marlene D; Fuhrmann, Lone

    2013-01-01

    Current research has identified numerous safety risks related to patient handovers including postoperative handovers. During the postoperative handover and the recovery period, the patient is at risk of potential complications of surgery or anaesthesia. Furthermore, patients are subject to a down......Current research has identified numerous safety risks related to patient handovers including postoperative handovers. During the postoperative handover and the recovery period, the patient is at risk of potential complications of surgery or anaesthesia. Furthermore, patients are subject...

  14. Comparative Study of Skeletal Stability between Postoperative Skeletal Intermaxillary Fixation and No Skeletal Fixation after Bilateral Sagittal Split Ramus Osteotomy: an 18 Months Retrospective Study

    Directory of Open Access Journals (Sweden)

    Jens Hartlev

    2014-04-01

    Full Text Available Objectives: The purpose of the present study was to evaluate skeletal stability after mandibular advancement with bilateral sagittal split osteotomy. Material and Methods: Twenty-six patients underwent single-jaw bilateral sagittal split osteotomy (BSSO to correct skeletal Class II malocclusion. One group (n = 13 were treated postoperatively with skeletal elastic intermaxillary fixation (IMF while the other group (n = 13 where threated without skeletal elastic IMF. Results: The mean advancement at B-point and Pog in the skeletal elastic IMF group was 6.44 mm and 7.22 mm, respectively. Relapse at follow-up at B-point was -0.74 mm and -0.29 mm at Pog. The mean advancement at B-point and Pog in the no skeletal elastic IMF group was 6.30 mm and 6.45 mm, respectively. Relapse at follow-up at B-point was -0.97 mm and -0.86 mm at Pog. There was no statistical significant (P > 0.05 difference between the skeletal IMF group and the no skeletal group regarding advancement nor relapse at B-point or Pog. Conclusions: Bilateral sagittal split osteotomy is characterized as a stable treatment to correct Class II malocclusion. This study demonstrated no difference of relapse between the skeletal intermaxillary fixation group and the no skeletal intermaxillary fixation group. Because of selection-bias and the reduced number of patients it still remains inconclusive whether to recommend skeletal intermaxillary fixation or not in the prevention of relapse after mandibular advancement.

  15. [Postoperative hypothyroidism].

    Science.gov (United States)

    Olifirova, O S; Trynov, N N

    2015-01-01

    There is a number of factors such as the thyroidectomy and limiting subtotal thyroid resection against the background of euthyroidism and initial hypothyroidism (in any extent of operation) which leads to the prediction of early postoperative hypothyroidism origin during 10 days of the postoperative peri- od. The early postoperative hypothyroidism is accompanied by activation processes of lipid peroxide oxidation and at the same time by reduction of antioxidant protection.

  16. Postoperative Delirium

    Science.gov (United States)

    Marcantonio, Edward R.

    2013-01-01

    Delirium (acute confusion) complicates 15% to 50% of major operations in older adults and is associated with other major postoperative complications, prolonged length of stay, poor functional recovery, institutionalization, dementia, and death. Importantly, delirium may be predictable and preventable through proactive intervention. Yet clinicians fail to recognize and address postoperative delirium in up to 80% of cases. Using the case of Ms R, a 76-year-old woman who developed delirium first after colectomy with complications and again after routine surgery, the diagnosis, prevention, and treatment of delirium in the postoperative setting is reviewed. The risk of postoperative delirium can be quantified by the sum of predisposing and precipitating factors. Successful strategies for prevention and treatment of delirium include proactive multifactorial intervention targeted to reversible risk factors, limiting use of sedating medications (especially benzodiazepines), effective management of postoperative pain, and, perhaps, judicious use of antipsychotics. PMID:22669559

  17. Postoperative care in trichiasis surgery

    Directory of Open Access Journals (Sweden)

    Esmael Ali

    2016-10-01

    Full Text Available Postoperative care is an important aspect of trachomatous trichiasis (TT surgical services. Follow-up visits should ideally take place on the first postoperative day (to remove the eye patch, after 8–14 days (to remove sutures; optional if absorbable sutures are used, at 3 months (to re-examine the operated lid for intermediate surgical outcomes, and then at or after six months.

  18. Postoperative astigmatism.

    Science.gov (United States)

    Swinger, C A

    1987-01-01

    With the numerous significant advances in surgical methodology--e.g., microinstrumentation, the operating microscope, the surgical keratometer, and intraocular lenses--that have been developed over the past two decades, both surgeons and patients have become increasingly aware of the final optic result of any surgical intervention. This is especially so since the development of refractive surgery, where good uncorrected vision is frequently the final arbiter of success. We have progressed to the stage where the optic manipulation of the cornea, whether intentional or otherwise, can be understood in terms of a number of variables. These include the preparation and closure of the surgical wound, the choice of suture material, and both intraoperative and postoperative manipulations. Where these have failed and postoperative astigmatism still occurs, a number of surgical procedures are available to reduce the astigmatic error to an acceptable level.

  19. Postoperative radiotherapy in salivary ductal carcinoma: a single institution experience

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Hyung; Kim, Mi Sun; Choi, Seo Hee; Suh, Yang Gun; Koh, Yoon Woo; Kim, Se Hun; Choi, Eun Chang; Keum, Ki Chang [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-09-15

    We reviewed treatment outcomes and prognostic factors for patients with salivary ductal carcinoma (SDC) treated with surgery and postoperative radiotherapy from 2005 to 2012. A total of 16 patients were identified and 15 eligible patients were included in analysis. Median age was 61 years (range, 40 to 71 years) and 12 patients (80%) were men. Twelve patients (80%) had a tumor in the parotid gland, 9 (60%) had T3 or T4 disease, and 9 (60%) had positive nodal disease. All patients underwent surgery and postoperative radiotherapy. Postoperative radiotherapy was delivered using 3-dimensional conformal radiotherapy or intensity-modulated radiotherapy. Locoregional failure-free survival (LRFFS), distant failure-free survival (DFFS), progression-free survival (PFS), and overall survival (OS) were calculated using the Kaplan-Meier method. Differences in survival based on risk factors were tested using a log-rank test. Median total radiotherapy dose was 60 Gy (range, 52.5 to 63.6 Gy). Four patients received concurrent weekly chemotherapy with cisplatin. Among 10 patients who underwent surgery with neck dissection, 7 received modified radical neck dissection. With a median follow-up time of 38 months (range, 24 to 105 months), 4-year rates were 86% for LRFFS, 51% for DFFS, 46% for PFS, and 93% for OS. Local failure was observed in 2 patients (13%), and distant failure was observed in 7 (47%). The lung was the most common involved site of distant metastasis. Surgery and postoperative radiotherapy in SDC patients resulted in good local control, but high distant metastasis remained a major challenge.

  20. Postoperative seizure control in patients with tumor-associated epilepsy.

    Science.gov (United States)

    Neal, Andrew; Morokoff, Andrew; O'Brien, Terence John; Kwan, Patrick

    2016-11-01

    The patterns of postoperative seizure control and response to antiepileptic drugs (AEDs) in tumor-associated epilepsy (TAE) are poorly understood. We aim to document these characteristics in patients with supratentorial gliomas. This was a retrospective analysis of 186 patients with supratentorial gliomas. Seizure patterns were classified into four groups: A, no postoperative seizure; B, early postoperative seizure control within 6 months; C, fluctuating seizure control; and D, never seizure-free. Rates and duration of seizure freedom, subsequent seizure relapse, and response to AED were analyzed. Among patients included, 49 (26.3%) had grade II, 28 (15.1%) had grade III, and 109 (58.6%) had grade IV glioma. Outcome pattern A was observed in 95 (51.1%), B in 22 (11.8%), C in 45 (24.2%), and D in 24 (12.9%). One hundred nineteen patients had at least one seizure and were classified as having TAE. Compared to pattern A, pattern B was predicted by histologic progression; pattern C by tumor grade, preoperative seizure, and histologic progression, and pattern D by preoperative seizure and gross total resection. Among patients with TAE, 57.5% of grade II, 68.2% of grade III, and 26.3% of grade IV experienced a period of 12-month seizure freedom. After first 12-month seizure remission, 39.1%, 60.0%, and 13.3% of grade II, III, and IV gliomas, respectively, experienced subsequent seizure; 22.6% of those with TAE reached terminal seizure freedom of at least 12 months on their first postoperative AED regimen, 6.5% on their second regimen, and 5.4% on subsequent regimens. Distinct patterns of postoperative seizure control exist in gliomas; they have specific risk factor profiles, and we hypothesize these correspond to unique pathogenic mechanisms. Twelve-month seizure freedom with subsequent relapse is frequent in grade II-III gliomas. Response to AEDs is markedly poorer than with non-TAE, highlighting the complex epileptogenicity of gliomas. Wiley Periodicals, Inc. © 2016

  1. Postoperative incentive spirometry use.

    Science.gov (United States)

    Hassanzadeh, Hamid; Jain, Amit; Tan, Eric W; Stein, Benjamin E; Van Hoy, Megan L; Stewart, Nadine N; Lemma, Mesfin A

    2012-06-01

    The authors hypothesized that the use of incentive spirometry by orthopedic patients is less than the recommended level and is affected by patient-related factors and type of surgery. To determine its postoperative use, the authors prospectively surveyed all patients in their institution's general orthopedic ward who had undergone elective spine surgery or total knee or hip arthroplasty during a consecutive 3-month period in 2010, excluding patients with postoperative delirium or requiring a monitored bed. All 182 patients (74 men, 108 women; average age, 64.5 years; range, 32-88 years; spine group, n=55; arthroplasty group, n=127), per protocol, received preoperative spirometry education by a licensed respiratory therapist (recommended use, 10 times hourly) and reinforcement education by nurses. Patients were asked twice daily (morning and evening) regarding their spirometry use during the previous 1-hour period by a registered nurse on postoperative days 1 through 3. All data were collected by the same 2 nurses using the same standardized questionnaire. Spirometry use was correlated with surgery type, postoperative day/time, and patient's age and sex. Student's t test, Spearman test, and one-way analysis of variance were used to compare differences (PSpirometry use averaged 4.1 times per hour (range, 0-10 times). No statistical correlations were found between spirometry use and age. Sex did not influence spirometry use. The arthroplasty group reported significantly higher use than did the spine group: 4.3 and 3.5 times per hour, respectively. Mean use increased significantly between postoperative days 1, 2, and 3.

  2. Mythematics Solving the Twelve Labors of Hercules

    CERN Document Server

    Huber, Michael

    2009-01-01

    How might Hercules, the most famous of the Greek heroes, have used mathematics to complete his astonishing Twelve Labors? From conquering the Nemean Lion and cleaning out the Augean Stables, to capturing the Erymanthean Boar and entering the Underworld to defeat the three-headed dog Cerberus, Hercules and his legend are the inspiration for this book of fun and original math puzzles. While Hercules relied on superhuman strength to accomplish the Twelve Labors, Mythematics shows how math could have helped during his quest. How does Hercules defeat the Lernean Hydra and stop its heads from multip

  3. Postoperative hyperkalemia.

    Science.gov (United States)

    Ayach, Taha; Nappo, Robert W; Paugh-Miller, Jennifer L; Ross, Edward A

    2015-03-01

    Hyperkalemia occurs frequently in hospitalized patients and is of particular concern for those who have undergone surgery, with postoperative care provided by clinicians of many disciplines. This review describes the normal physiology and how multiple perioperative factors can disrupt potassium homeostasis and lead to severe elevations in plasma potassium concentration. The pathophysiologic basis of diverse causes of hyperkalemia was used to broadly classify etiologies into those with altered potassium distribution (e.g. increased potassium release from cells or other transcellular shifts), reduced urinary excretion (e.g. reduced sodium delivery, volume depletion, and hypoaldosteronism), or an exogenous potassium load (e.g. blood transfusions). Surgical conditions of particular concern involve: rhabdomyolysis from malpositioning, trauma or medications; bariatric surgery; vascular procedures with tissue ischemia; acidosis; hypovolemia; and volume or blood product resuscitation. Certain acute conditions and chronic co-morbidities present particular risk. These include chronic kidney disease, diabetes mellitus, many outpatient preoperative medications (e.g. beta blockers, salt substitutes), and inpatient agents (e.g. succinylcholine, hyperosmolar volume expanders). Clinicians need to be aware of these pathophysiologic mechanisms for developing perioperative hyperkalemia as many of the risks can be minimized or avoided.

  4. Postoperative magnetic resonance imaging characterization of slings for female stress urinary incontinence.

    LENUS (Irish Health Repository)

    Giri, Subhasis K

    2012-01-31

    PURPOSE: The aim was to characterize different types of slings such as autologous rectus fascia (ARF), porcine dermis (PD) and tension-free vaginal tape (TVT) in the early postoperative period with regard to its visibility and location by using magnetic resonance imaging (MRI). MATERIALS AND METHODS: Between October 2003 and June 2007, total of 60 patients underwent MRI after a sling procedure. Thirty-six patients had ARF slings. Twelve patients had a PD sling and 12 had a TVT. All patients had pelvic MRI 6-8 hr postoperatively. Six patients in the ARF sling group had both preoperative and postoperative images at 6 hr and 3 months. MRI images were analyzed with regard to visibility and location. All data were collected prospectively. RESULTS: ARF slings were clearly visible in both T1W and T2W images. ARF appeared as low signal intensity area with surrounding high signal intensity due to fat attached to the rectus fascia in the MRI images obtained 6 hr after the procedure. Although the fatty component of the sling was diminished but was still visible on MRI scan 3 months postoperatively. On the other hand PD and TVT sling materials were not visible by MRI. Most of the ARF slings were located just below the bladder neck. CONCLUSIONS: The ARF sling is easily identifiable on MRI in the early postoperative period primarily because of the fat attached to the autologous rectus fascia. However, depiction of the PD and TVT slings in the early postoperative period is very poor.

  5. Comparative analysis of twelve Dothideomycete plant pathogens

    Energy Technology Data Exchange (ETDEWEB)

    Ohm, Robin; Aerts, Andrea; Salamov, Asaf; Goodwin, Stephen B.; Grigoriev, Igor

    2011-03-11

    The Dothideomycetes are one of the largest and most diverse groups of fungi. Many are plant pathogens and pose a serious threat to agricultural crops grown for biofuel, food or feed. Most Dothideomycetes have only a single host and related Dothideomycete species can have very diverse host plants. Twelve Dothideomycete genomes have currently been sequenced by the Joint Genome Institute and other sequencing centers. They can be accessed via Mycocosm which has tools for comparative analysis

  6. Twelve tips for peer observation of teaching.

    Science.gov (United States)

    Siddiqui, Zarrin Seema; Jonas-Dwyer, Diana; Carr, Sandra E

    2007-05-01

    This paper outlines twelve tips for undertaking peer observation of teaching in medical education, using the peer review model and the experiences of the authors. An accurate understanding of teaching effectiveness is required by individuals, medical schools, and universities to evaluate the learning environment and to substantiate academic and institutional performance. Peer Observation of Teaching is one tool that provides rich, qualitative evidence for teachers, quite different from closed-ended student evaluations. When Peer Observation of Teaching is incorporated into university practice and culture, and is conducted in a mutually respectful and supportive way, it has the potential to facilitate reflective change and growth for teachers.

  7. Delirium is associated with early postoperative cognitive dysfunction

    DEFF Research Database (Denmark)

    Rudolph, J.L.; Marcantonio, E.R.; Culley, D.J.

    2008-01-01

    The purpose of this analysis was to determine if postoperative delirium was associated with early postoperative cognitive dysfunction (at 7 days) and long-term postoperative cognitive dysfunction (at 3 months). The International Study of Postoperative Cognitive Dysfunction recruited 1218 subjects......). Postoperative cognitive dysfunction was defined as a composite Z-score > 2 across tests or at least two individual test Z-scores > 2. Subjects with delirium were significantly less likely to participate in postoperative testing. Delirium was associated with an increased incidence of early postoperative...... cognitive dysfunction (adjusted risk ratio 1.6, 95% CI 1.1-2.1), but not long-term postoperative cognitive dysfunction (adjusted risk ratio 1.3, 95% CI 0.6-2.4). Delirium was associated with early postoperative cognitive dysfunction, but the relationship of delirium to long-term postoperative cognitive...

  8. Evaluation of the Effect of a Single Intra-articular Injection of Allogeneic Neonatal Mesenchymal Stromal Cells Compared to Oral Non-Steroidal Anti-inflammatory Treatment on the Postoperative Musculoskeletal Status and Gait of Dogs over a 6-Month Period after Tibial Plateau Leveling Osteotomy: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Mathieu Taroni

    2017-06-01

    Full Text Available ObjectiveCompare the clinical and pressure walkway gait evolution of dogs after a tibial plateau leveling osteotomy (TPLO for a cranial cruciate ligament rupture (CrCLR and treatment with either a 1-month course of non-steroidal anti-inflammatory drugs (NSAIDs or a single postoperative intra-articular (IA injection of allogeneic neonatal mesenchymal stromal cells (MSCs.Study designProspective, double-blinded, randomized, controlled, monocentric clinical study.AnimalsSixteen client-owned dogs.Materials and methodsDogs with unilateral CrCLR confirmed by arthroscopy were included. Allogeneic neonatal canine MSCs were obtained from fetal adnexa retrieved after C-section performed on healthy pregnant bitches. The dogs were randomly allocated to either the “MSCs group,” receiving an IA injection of MSCs after TPLO, followed by placebo for 1 month, or the “NSAIDs group,” receiving IA equivalent volume of MSCs vehicle after TPLO, followed by oral NSAID for 1 month. One of the three blinded evaluators assessed the dogs in each group before and after surgery (1, 3, and 6 months. Clinical score and gait and bone healing process were assessed. The data were statistically compared between the two groups for pre- and postoperative evaluations.ResultsFourteen dogs (nine in the MSCs group, five in the NSAIDs group completed the present study. No significant difference was observed between the groups preoperatively. No local or systemic adverse effect was observed after MSCs injection at any time point considered. At 1 month after surgery, bone healing scores were significantly higher in the MSCs group. At 1, 3, and 6 months after surgery, no significant difference was observed between the two groups for clinical scores and gait evaluation.ConclusionA single IA injection of allogeneic neonatal MSCs could be a safe and valuable postoperative alternative to NSAIDs for dogs requiring TPLO surgery, particularly for dogs intolerant to this class of

  9. Combining ability of twelve maize populations

    Directory of Open Access Journals (Sweden)

    Vacaro Elton

    2002-01-01

    Full Text Available Genetic progress depends on germplasm quality and breeding methods. Twelve maize populations and their crosses were evaluated to estimate combining ability and potential to be included as source populations in breeding programs. Plant height, point of insertion of the first ear, number of ears per plant, number of grains per ear, root and stalk lodging and grain yield were studied in two locations in Brazil, during the 1997/98 season. Genotype sum of squares was divided into general (GCA and specific (SCA combining ability. Results indicated the existence of genetic divergence for all traits analyzed, where additive effects were predominant. The high heterosis levels observed, mainly in Xanxerê, suggested the environmental influence on the manifestation of this genetic phenomenon. Populations revealed potential to be used in breeding programs; however, those more intensively submitted to selection could provide larger genetic progress, showing the importance of population improvement for the increment of the heterosis in maize.

  10. Prevention of postoperative ileus

    DEFF Research Database (Denmark)

    Holte, Kathrine; Kehlet, H

    2002-01-01

    Postoperative ileus (PI) is a major contributor to postoperative morbidity and prolonged convalescence after major surgical procedures. The pathophysiology of PI is multifactorial, including activation of the stress response to surgery, with inhibitory sympathetic visceral reflexes and inflammato...

  11. Ganho de peso e componentes do peso vivo em borregos Ile de France inteiros ou castrados e Hampshire Down castrados abatidos aos doze meses de idade Weight gain and live weight components of intact or castrated Ile de France and castrated Hampshire Down lambs slaughtered at twelve months of age

    Directory of Open Access Journals (Sweden)

    Edson Luis De Azambuja Ribeiro

    2000-04-01

    Full Text Available O principal objetivo deste trabalho foi o de avaliar o ganho de peso e os componentes do peso vivo em ovinos inteiros ou castrados abatidos aos 12 meses de idade. Foram usados 16 borregos Ile de France, sendo metade inteiros e metade castrados, e oito Hampshire Down castrados. Os borregos foram mantidos em pastagem de grama Coast-Cross e foram pesados dos três aos 12 meses de idade, quando abatidos. Não houve diferenças entre as raças para peso, ganhos de peso e para os componentes do peso vivo. Porém, os machos inteiros da raça Ile de France ganharam mais peso dos três aos 12 meses do que os castrados, com médias, respectivamente, de 0,078 e 0,063kg por dia; o ganho de peso médio diário para os borregos Hampshire Down foi de 0,064kg. As médias para os pesos vivos no abate e para os rendimentos de carcaça quente (entre parenteses foram: 38,54 (47,51%; 36,08 (47,82% e 36,44 (46,38%kg, respectivamente, para os borregos Ile de France inteiros, Ile de France castrados e Hampshire Down castrados. Os resultados indicam que, quando o abate for realizado aos 12 meses de idade, o uso de machos inteiros é recomendado devido ao seu maior ganho de peso.The main objective of this work was to evaluate the weight gain and live weight components of intact or castrated lambs slaughtered at 12 months of age. Sixteen Ile de France lambs, half intact and half castrated, and eight castrated Hampshire Down lambs were used in this experiment. The animals were kept on a Coast-Cross pasture from three to 12 months of age, and then slaughtered. There were no differences between breeds for weight, weight gain and live weight components. However, intact Ile de France lambs had a greater daily weight gain than castrated Ile de France lambs, with averages of 0.078 and 0.063kg, respectively; the average daily weight gain for the castrated Hampshire Down was 0.064kg. The averages for live weight before slaughtering and hot dressing percentage were: 38.54, 36

  12. 昆山地区12月龄幼儿气质及相关因素的研究%Research on temperament and the related influencing factors of temperament of twelve-month-old children in Kunshan region

    Institute of Scientific and Technical Information of China (English)

    孙惟; 吕冠明; 周春琴; 罗晓明; 严菊花; 杨国强

    2011-01-01

    [Objective] To research the distribution features and related influencing factors of 12 months old children 's temperament types in Kunshan region, provide evidence for early behavior intervention. [Method] Investigated 738 children aged 12 months by the Chinese Toddler Temperament Scale(CTTS) from routine health examination in Maternal and Child Health Bureau of Kunshan, and self-made questionnaire for the related factors of temperament was applied to survey the related factors. [Results] The constituent ratio of children's temperament types were Easy(5.69%), Intermediate-low(56.10%), Slow-to-warm-up(1.90%), intermediate-difficult(31.44%), difficult(4.88%). There was not significant difference in sex of temperament types. There was significant difference in activity level of temperament dimensions between boys and girls. There was significant difference in activity level, rhythmicity, taxis, adaptability, emotion essence,persistence, attention span and response threshold of temperament dimensions between the study and national norm. Mother's bearing age, education level, the time of watching TV during pregnancy, guardian, guardian's attitude, education level and character etc. factors influence children's temperament dimensions. The higher proportion of Easy were guardian with high degree, family with relative low month-earning. The higher proportion of Intermediate-low were father with high degree, without smoke or alcohol addiction and guardian with strictly attitude. The higher proportion of intermediate-difficult were low mother's bearing age, higher gestational age, cadres mother and artificial feeding. The higher proportion of difficult were higher mother's bearing age, mother often fear, low sleep and complications during pregnancy. The higher proportion of Slow-to-warm-up was father with smoke and alcohol addiction. [Conclusions] Most children in Kunshan temperament types are Easy and Intermediate-low. There is difference in active level between

  13. Twelve tips for getting your manuscript published.

    Science.gov (United States)

    Cook, David A

    2016-01-01

    The author shares twelve practical tips on how to navigate the process of getting a manuscript published. These tips, which apply to all fields of academic writing, advise that during the initial preparation phase authors should: (1) plan early to get it out the door; (2) address authorship and writing group expectations up front; (3) maintain control of the writing; (4) ensure complete reporting; (5) use electronic reference management software; (6) polish carefully before they submit; (7) select the right journal; and (8) follow journal instructions precisely. Rejection after the first submission is likely, and when this occurs authors should (9) get it back out the door quickly, but first (10) take seriously all reviewer and editor suggestions. Finally, when the invitation comes to revise and resubmit, authors should (11) respond carefully to every reviewer suggestion, even if they disagree, and (12) get input from others as they revise. The author also shares detailed suggestions on the creation of effective tables and figures, and on how to respond to reviewer critiques.

  14. Antifouling activity of twelve demosponges from Brazil

    Directory of Open Access Journals (Sweden)

    SM. Ribeiro

    Full Text Available Benthic marine organisms are constantly exposed to fouling, which is harmful to most host species. Thus, the production of secondary metabolites containing antifouling properties is an important ecological advantage for sessile organisms and may also provide leading compounds for the development of antifouling paints. High antifouling potential of sponges has been demonstrated in the Indian and Pacific oceans and in the Caribbean and Mediterranean seas. Brazilian sponges remain understudied concerning antifouling activities. Only two scientific articles reported this activity in sponges of Brazil. The objective of this study was to test crude extracts of twelve species of sponges from Brazil against the attachment of the mussel Perna perna through laboratorial assays, and highlight promising species for future studies. The species Petromica citrina, Amphimedon viridis, Desmapsamma anchorata, Chondrosia sp., Polymastia janeirensis, Tedania ignis, Aplysina fulva, Mycale angulosa, Hymeniacidon heliophila, Dysidea etheria, Tethya rubra, and Tethya maza were frozen and freeze-dried before extraction with acetone or dichloromethane. The crude extract of four species significantly inhibited the attachment of byssus: Tethya rubra (p = 0.0009, Tethya maza (p = 0.0039, Petromica citrina (p = 0.0277, and Hymeniacidon heliophila (p = 0.00003. These species, specially, should be the target of future studies to detail the substances involved in the ability antifouling well as to define its amplitude of action.

  15. Twelve Elastic Constants of Betula platyphylla Suk.

    Institute of Scientific and Technical Information of China (English)

    Wang Liyu; Lu Zhenyou

    2004-01-01

    Wood elastic constants are needed to describe the elastic behaviors of wood and be taken as an important design parameter for wood-based composite materials and structural materials. This paper clarified the relationships between compliance coefficients and engineering elastic constants combined with orthotropic properties of wood, and twelve elastic constants of Betula platyphylla Suk. were measured by electrical strain gauges. Spreading the adhesive quantity cannot be excessive or too little when the strain flakes were glued. If excessive, the glue layer was too thick which would influence the strain flakes' performance, and if too little, glues plastered were not firm, which could not accurately transmit the strain. Wood as an orthotropic material, its modulus of elasticity and poisson's ratios are related by two formulas:μij /Ei =μji /Ej and μij 0.95) between the reciprocal of elastic modulus MOE-1 and the square of the ratio of depth to length (h/l)2, which indicate that shear modulus values measured were reliable by three point bending experiment.

  16. Postoperative Complications of Beger Procedure

    Directory of Open Access Journals (Sweden)

    Nayana Samejima Peternelli

    2015-01-01

    Full Text Available Introduction. Chronic pancreatitis (CP is considered an inflammatory disease that may cause varying degrees of pancreatic dysfunction. Conservative and surgical treatment options are available depending on dysfunction severity. Presentation of Case. A 36-year-old male with history of heavy alcohol consumption and diagnosed CP underwent a duodenal-preserving pancreatic head resection (DPPHR or Beger procedure after conservative treatment failure. Refractory pain was reported on follow-up three months after surgery and postoperative imaging uncovered stones within the main pancreatic duct and intestinal dilation. The patient was subsequently subjected to another surgical procedure and intraoperative findings included protein plugs within the main pancreatic duct and pancreaticojejunal anastomosis stricture. A V-shaped enlargement and main pancreatic duct dilation in addition to the reconstruction of the previous pancreaticojejunal anastomosis were performed. The patient recovered with no further postoperative complications in the follow-up at an outpatient clinic. Discussion. Main duct and pancreaticojejunal strictures are an unusual complication of the Beger procedure but were identified intraoperatively as the cause of patient’s refractory pain and explained intraductal protein plugs accumulation. Conclusion. Patients that undergo Beger procedures should receive close outpatient clinical follow-up in order to guarantee postoperative conservative treatment success and therefore guarantee an early detection of postoperative complications.

  17. Postoperative radiotherapy for endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Eun Cheol; Kim, Jin Hee; Kim, Ok Bae; Byun, Sang Jun; Park, Seung Gyu; Kwon, Sang Hoon [Dongsan Medical Center, Keimyung University School of Medicine, Daegu (Korea, Republic of)

    2012-09-15

    To investigate the prognostic factors and effectiveness of postoperative radiotherapy alone for endometrial carcinoma. Sixty four patients with stage I?III endometrial cancer (EC) treated with postoperative radiotherapy alone between January 1989 and December 2008 at the Keimyung University Dongsan Medical Center were chosen for the present study. Typically, total hysterectomy, salpingo-oophorectomy and lymphadenectomy were performed on the patient's pelvis. Total dose from 50.4 Gy to 63 Gy was irradiated at pelvis or extended fi eld. Thirteen patients were treated with Co-60 or Ir-192 intracavitary radiotherapy. Follow-up periods were from 7 to 270 months, with a median of 56 months. Five year overall survival (OS) rate was 58.7%, respectively. Five year disease-free survival (DFS) rate was 59.2%, respectively. In univariate analysis for OS and DFS, stage, menopausal age, type of operation, serosal invasion, and lymph node involvement were found to be statistically significant. Histologic type was marginally significant. In multivariate analysis for OS and DFS, stage, types of operation, histologic type were also found to be statistically significant. Treatment failure occurred in 14 patients. The main pattern of failure was found to be distant metastasis. Time to distant metastasis was from 3 to 86 months (median, 12 months). There were no grade 3 or 4 complications. Stage, types of operation, and histologic type could be the predictive prognostic factors in patients. We contemplated postoperative radiation as effective and safe treatment method for EC. Additional treatment would be needed to reduce distant metastasis.

  18. The Relationship between Twelve-Month Home Stimulation and School Achievement.

    Science.gov (United States)

    van Doorninck, William J.; And Others

    1981-01-01

    Scores on the Home Observation for Measurement of Environment (HOME), designed to reflect parental support of early cognitive and social development, were correlated with elementary school achievement five to nine years later. Results supported the predictive value of the instrument for school achievement among low-income families. (Author/DB)

  19. Twelve-Month Evaluation of UPS Diesel Hybrid Electric Delivery Vans

    Energy Technology Data Exchange (ETDEWEB)

    Lammert, M.

    2009-12-01

    Results of an NREL study of a parallel hybrid electric-diesel propulsion system in United Parcel Service-operated delivery vans show that the hybrids had higher fuel economy than standard diesel vans.

  20. Twelve-Month-Olds Learn Novel Word-Object Pairings Differing Only in Stress Pattern

    Science.gov (United States)

    Curtin, Suzanne

    2009-01-01

    Infants at 1;2 demonstrate difficulty in accessing subtle phonetic information about newly learned word-object pairings (Stager & Werker, 1997). In this study, we examined whether or not infants can access subtle prosodic information such as lexical stress in a word learning task. We tested infants younger than 1;2 to see if they could learn two…

  1. Geothermal elastomeric materials. Twelve-months progress report, October 1, 1976--September 30, 1977

    Energy Technology Data Exchange (ETDEWEB)

    Hirasuna, A.R.; Bilyeu, G.D.; Davis, D.L.; Stephens, C.A.; Veal, G.R.

    1977-12-01

    Progress is reported on efforts to develop elastomers for packer seal element applications which will survive downhole geothermal well chemistry at 260/sup 0/C (500/sup 0/F) for 24 hours. To achieve this development, a three level elastomer testing and evaluation program was established. The first level Screening Tests is a broad screening of potential candidates and with the end objective to filter out the more promising candidates for more expensive subsequent testing. The battery of tests include standard ASTM tests and a special test developed to test extrusion resistance using specimens all made from sheet stock. The second level or Simulation Tests provide a laboratory equivalent of downhole conditions using synthetic geothermal fluid. Full scale packer seals are tested under simulated operational conditions by a test fixture. The third level or In-Situ Tests which are currently in the planning, provide for testing the most favored materials in-situ in the geothermal well. A test module provides for testing of the specimen without interfacing with the well casing. A test module freely hanging on a wireline has much lower probability of causing a problem, such as becoming lodged in the well, as compared to an operational casing packer. This maximizes the number of wells (hence geothermal environments) where access can be gained and In-Situ Testing performed. During this period commercially available polymers were investigated. Most of the work centered around formulating peroxide cured Vitons and some on EPDMs, butyls, and resin cured Vitons. Of the formulations tested to date the EPDMs appear most promising and the peroxide cured Vitons next most promising. However, data is too sparse to make any firm conclusions at this time. Minor tasks were performed evaluating current commercially available elastomers used in oil tools and conceptualization of casing packer for the geothermal application.

  2. Chronic Postoperative Roseomonas Endophthalmitis▿

    OpenAIRE

    Chen, Kuan-Jen; Lai, Chi-Chun; Kuo, Ya-Hui; WU, WEI-CHI; CHEN, TUN-LU

    2008-01-01

    We report one case with chronic postoperative endophthalmitis caused by Roseomonas species. Roseomonas spp. induced chronic endophthalmitis, which might result in misdiagnosis and delayed treatment and causes ocular damage and severe visual loss. This report is the first one related to a case with postoperative endophthalmitis secondary to Roseomonas infection.

  3. Chronic postoperative Roseomonas endophthalmitis.

    Science.gov (United States)

    Chen, Kuan-Jen; Lai, Chi-Chun; Kuo, Ya-Hui; Wu, Wei-Chi; Chen, Tun-Lu

    2009-01-01

    We report one case with chronic postoperative endophthalmitis caused by Roseomonas species. Roseomonas spp. induced chronic endophthalmitis, which might result in misdiagnosis and delayed treatment and causes ocular damage and severe visual loss. This report is the first one related to a case with postoperative endophthalmitis secondary to Roseomonas infection.

  4. Monthly errors

    Data.gov (United States)

    U.S. Environmental Protection Agency — The 2006 monthly average statistical metrics for 2m Q (g kg-1) domain-wide for the base and MODIS WRF simulations against MADIS observations. This dataset is...

  5. Mechanisms of postoperative pain

    Institute of Scientific and Technical Information of China (English)

    YUE Yun

    2007-01-01

    @@ The practice of modern anaesthesiology has extended into perioperative medicine. Due to their expertise in analgesic drug pharmacology and peripheral nerve blocking, anaesthesiologists have pioneered in the management of acute postoperative pain. Effective postoperative analgesia reduces the incidence of postoperative chronic pain, improves the functioning of organs following surgery and shortens the hospital stay.1,2 Although a variety of analgesic techniques and preventative approaches are at the disposal of modem aneasthesiologists, including patient controlled epidural analgesia (PCEA), patient controlled intravenous analgesia, multimodal analgesia and pre-empty analgesia.Despite this array of strategies, these predominantly opioid based techniques are still limited by side-effects such as vomiting, nausea, itching and urinary retention.To optimize further the management of acute postoperative pain, basic mechanisms of postoperative pain must be explored and new treatments must continue to be developed.

  6. [Characteristics of postoperative peritonitis].

    Science.gov (United States)

    Lock, J F; Eckmann, C; Germer, C-T

    2016-01-01

    Postoperative peritonitis is still a life-threatening complication after abdominal surgery and approximately 10,000 patients annually develop postoperative peritonitis in Germany. Early recognition and diagnosis before the onset of sepsis has remained a clinical challenge as no single specific screening test is available. The aim of therapy is a rapid and effective control of the source of infection and antimicrobial therapy. After diagnosis of diffuse postoperative peritonitis surgical revision is usually inevitable after intestinal interventions. Peritonitis after liver, biliary or pancreatic surgery is managed as a rule by means of differentiated therapy approaches depending on the severity.

  7. [Postoperative biliary peritonitis].

    Science.gov (United States)

    Kurbonov, K M; Daminova, N M; Mukhiddinov, N D

    2008-01-01

    An analysis of results of surgical treatment of 91 patients with postoperative biliary peritonitis has shown that frequency of postoperative biliary peritonitis depended on the volume and character of operative interventions, as well as on technical errors made at the preoperative period and during operation. The presence of latent hepatic insufficiency made for the development of polyorganic insufficiency, had negative influence on the course of the disease and might be one of the causes of high postoperative lethality (up to 23.1%) in this category of patients.

  8. Evaluation of the postoperative breast.

    Science.gov (United States)

    Mendelson, E B

    1992-01-01

    With widespread use of mammography for breast cancer screening, the number of surgical procedures has also increased. Overlapping with radiographic signs of malignancy, including masses, areas of asymmetric density and architectural distortion, microcalcifications, and skin thickening, postsurgical changes may make mammographic evaluation difficult. After tumor excision and irradiation where breast alterations are more profound and prolonged, the task of distinguishing recurrent tumor from scarring or fat necrosis is even more challenging. Mammograms after breast conservation therapy for carcinoma or after cosmetic surgery require correlation with physical findings and the surgical procedures that were performed. Responses of tissue to lumpectomy and radiation, such as breast edema and skin thickening, are most pronounced 6 to 12 months after treatment, gradually resolving within 1 to 3 years. Carefully tailored mammographic studies will promote the dual goal of early detection of local tumor recurrence and avoidance of misinterpreting postoperative and irradiation changes as malignancy. Sequential examinations should begin with a postoperative preradiation mammogram for residual carcinoma, particularly when microcalcifications have been present, followed by the baseline postradiation examination at 6 months with the next study 6 months later (1 year after initial treatment). Mammograms of the treated breast may be performed at intervals of 6 months until radiographic stability has been recognized. Annual studies thereafter are suggested. The contralateral, unaffected breast should be evaluated mammographically according to screening guidelines or clinical concerns. Mammograms performed after cosmetic and reconstructive procedures should be correlated with the surgical techniques and clinical history. Modified views for silicone implants can maximize visualization of breast parenchyma. Ultrasonography is a useful complement to mammography in demonstrating the

  9. Postoperative peritoneale adhaerencer

    DEFF Research Database (Denmark)

    Jendresen, Marianne Bille; Qvist, Niels

    2008-01-01

    Postoperative adhesions occur after most surgical intraabdominal procedures, and small bowel obstruction is a common complication. Research has focused on the pathophysiology of adhesion formation and on the development of prophylactic barriers and drugs. The present paper provides a resume...

  10. Predicting postoperative exercise capacity after major lung resection.

    Science.gov (United States)

    Nagamatsu, Yoshinori; Sueyoshi, Susumu; Tsubuku, Tatsuji; Kawasaki, Masayuki; Akagi, Yoshito

    2015-12-01

    This study investigates whether postoperative exercise capacity can be predicted from preoperative lung perfusion scintigraphy and the number of subsegments resected. We studied 315 patients, with 158 being assigned odd numbers and 157 being assigned even numbers. In the 158 patients assigned odd numbers, the predicted postoperative VO2 max/m2 (ppo VO2 max/m2) was obtained from the results of lung perfusion scintigraphy and the number of subsegments scheduled for resection. We then examined correlations with the actual values, 2 weeks and 1 month postoperatively, to obtain a regression equation (Series 1). In the 157 patients assigned even numbers, the ppo VO2 max/m2 corrected by the regression equation derived from Series 1 (corrected-ppo VO2 max/m2) was compared with the actual values, 2 weeks and 1 month postoperatively, to establish whether the postoperative VO2 max/m2 could be predicted. The regression equation between the ppo VO2 max/m2 and its actual value was y = 0.83x + 103, 2 weeks postoperatively, and y = 0.923x + 82, 1 month postoperatively. The difference between the corrected-ppo VO2 max/m2 and the actual postoperative value was small. Calculating the residual [Formula: see text]o2 max/m2 preoperatively from the results of lung perfusion scintigraphy and the number of segments scheduled for resection is useful for predicting postoperative exercise capacity.

  11. The postoperative stomach

    Energy Technology Data Exchange (ETDEWEB)

    Woodfield, Courtney A. [Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 (United States); Levine, Marc S. [Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 (United States)]. E-mail: marc.levine@uphs.upenn.edu

    2005-03-01

    Gastric surgery may be performed for the treatment of a variety of benign and malignant diseases of the upper gastrointestinal tract, including peptic ulcers and gastric carcinoma. Radiographic studies with water-soluble contrast agents often are obtained to rule out leaks, obstruction, or other acute complications during the early postoperative period. Barium studies may also be obtained to evaluate for anastomotic strictures or ulcers, bile reflux gastritis, recurrent tumor, or other chronic complications during the late postoperative period. Cross-sectional imaging studies such as CT are also helpful for detecting abscesses or other postoperative collections, recurrent or metastatic tumor, or less common complications such as afferent loop syndrome or gastrojejunal intussusception. It is important for radiologists to be familiar not only with the radiographic findings associated with these various abnormalities but also with the normal appearances of the postoperative stomach on radiographic examinations, so that such appearances are not mistaken for pseudoleaks or other postoperative complications. The purpose of this article is to describe the normal postsurgical anatomy after the most commonly performed operations (including partial gastrectomy, esophagogastrectomy and gastric pull-through, and total gastrectomy and esophagojejunostomy) and to review the acute and chronic complications, normal postoperative findings, and major abnormalities detected on radiographic examinations in these patients.

  12. [One case of postoperative facial paralysis after first branchial fistula].

    Science.gov (United States)

    Wang, Xia; Xu, Yaosheng

    2015-12-01

    Pus overflow from patent's fistula belew the left face near mandibular angle 2 years agowith a little pain. Symptoms relieved after oral antibiotics. This symptom frequently occurred in the past six months. Postoperative facial paralysis occurred after surgery, and recovered after treatment. It was diagnosed as the postoperative facial paralysis after first branchial fistula surgery.

  13. Postoperative Spine Infections

    Science.gov (United States)

    Evangelisti, Gisberto; Andreani, Lorenzo; Girardi, Federico; Darren, Lebl; Sama, Andrew; Lisanti, Michele

    2015-01-01

    Postoperative spinal wound infection is a potentially devastating complication after operative spinal procedures. Despite the utilization of perioperative prophylactic antibiotics in recent years and improvements in surgical technique and postoperative care, wound infection continues to compromise patients’ outcome after spinal surgery. In the modern era of pending health care reform with increasing financial constraints, the financial burden of post-operative spinal infections also deserves consideration. The aim of our work is to give to the reader an updated review of the latest achievements in prevention, risk factors, diagnosis, microbiology and treatment of postoperative spinal wound infections. A review of the scientific literature was carried out using electronic medical databases Pubmed, Google Scholar, Web of Science and Scopus for the years 1973-2012 to obtain access to all publications involving the incidence, risk factors, prevention, diagnosis, treatment of postoperative spinal wound infections. We initially identified 119 studies; of these 60 were selected. Despite all the measures intended to reduce the incidence of surgical site infections in spine surgery, these remain a common and potentially dangerous complication. PMID:26605028

  14. Evaluation for postoperative recurrence of Crohn disease.

    Science.gov (United States)

    Swoger, Jason M; Regueiro, Miguel

    2012-06-01

    Disease recurrence following resective surgery for Crohn disease remains a challenging clinical problem, and more studies are needed to better define risk stratification and treatment recommendations in the postoperative setting. Endoscopy remains the gold standard for the assessment of postoperative disease recurrence, and all Crohn disease patients who undergo surgery should undergo ileocolonoscopy within 6 to 12 months of surgery. The degree of endoscopic recurrence in the neoterminal ileum during this procedure provides prognostic information regarding the severity of the future disease course. WCE, MRE, and SICUS are all promising noninvasive modalities to assess for postoperative Crohn disease activity. However, further studies are needed to better define scoring systems, operating characteristics and variability, and prognostic data for each of these modalities. In patients at risk for early disease recurrence, more aggressive prophylactic therapy should be considered, in hopes of delivering true “top-down” therapy that may offer maximum impact in altering the natural history of Crohn disease.

  15. The twelve dimensional super (2+2)-brane

    CERN Document Server

    Hewson, S F

    1996-01-01

    We discuss supersymmetry in twelve dimensions and present a covariant supersymmetric action for a brane with worldsheet signature (2,2), called a super (2+2)-brane, propagating in the osp(64,12) superspace. This superspace is explicitly constructed, and is trivial in the sense that the spinorial part is a trivial bundle over spacetime, unlike the twisted superspace of usual Poincare supersymmetry. For consistency, it is necessary to take a projection of the superspace. This is the same as the projection required for worldvolume supersymmetry. Upon compactification of this superspace, a torsion is naturally introduced and we produce the membrane and type IIB string actions in 11 and 10 dimensional Minkowski spacetimes. In addition, the compactification of the twelve dimensional supersymmetry algebra produces the correct algebras for these theories, including central charges. These considerations thus give the type IIB string and M-theory a single twelve dimensional origin.

  16. Postoperative upper airway problems

    African Journals Online (AJOL)

    QuickSilver

    2003-06-09

    Jun 9, 2003 ... REVIEW ARTICLE. Southern African Journal of Anaesthesia & Analgesia - May 2003. 12. Postoperative upper airway problems way. A number of factors, some avoidable, influence the incidence ... debilitating pain, inability to swallow and temporary voice changes, and are a ..... decrease airway resistance.

  17. Alcoholics anonymous and other twelve-step programs in recovery.

    Science.gov (United States)

    Detar, D Todd

    2011-03-01

    Recovery is a new way of life for many patients; a life without substances to alter their moods but with a major change improving the physical, psychological, and emotional stability with improved overall health outcomes. The Twelve Steps of the Alcoholics Anonymous (AA) are the foundation of the AA, describing both the necessary actions and the spiritual basis for the recovery program of the AA. The Twelve Steps of the AA provide a structure for which a patient with alcoholism may turn for an answer to their problem of alcohol use, abuse, or dependence. Copyright © 2011 Elsevier Inc. All rights reserved.

  18. The strong coupling regime of twelve flavors QCD

    NARCIS (Netherlands)

    Silva, Tiago Nunes da; Pallante, Elisabetta

    2012-01-01

    We summarize the results recently reported in Ref.[1] [A. Deuzeman, M.P. Lombardo, T. Nunes da Silva and E. Pallante,"The bulk transition of QCD with twelve flavors and the role of improvement"] for the SU(3) gauge theory with Nf=12 fundamental flavors, and we add some numerical evidence and theoret

  19. Human Evolution in Science Textbooks from Twelve Different Countries

    Science.gov (United States)

    Quessada, Marie-Pierre; Clement, Pierre; Oerke, Britta; Valente, Adriana

    2008-01-01

    What kinds of images of human beings illustrate human evolution in school textbooks? A comparison between the textbooks of eighteen different countries (twelve European countries and six non-European countries) was attempted. In six countries (Algeria, Malta, Morocco, Mozambique, Portugal, and Tunisia), we did not find any chapter on the topic of…

  20. Bibliography of Spanish Materials for Students, Grades Seven through Twelve.

    Science.gov (United States)

    California State Dept. of Education, Sacramento.

    This annotated bibliography of Spanish materials for students in grades seven through twelve is divided into the following categories: (1) Art, Drama, Music, and Poetry; (2) Books in Series; (3) Culture; (4) Dictionaries and Encyclopedias; (5) Literature; (6) Mathematics; (7) Physical Education, Health, and Recreation; (8) Reading and Language…

  1. Prevention of postoperative ileus

    DEFF Research Database (Denmark)

    Holte, Kathrine; Kehlet, H

    2002-01-01

    Postoperative ileus (PI) is a major contributor to postoperative morbidity and prolonged convalescence after major surgical procedures. The pathophysiology of PI is multifactorial, including activation of the stress response to surgery, with inhibitory sympathetic visceral reflexes and inflammatory...... mediators. We update evidence on the advances in the prevention and treatment on PI. As single interventions, continuous thoracic epidural analgesia with local anesthetics and minimally invasive surgery are the most efficient interventions in the reduction of PI. The effects of pharmacological agents have...... generally been disappointing with the exception of cisapride and the introduction of the new selective peripherally acting m-opioid antagonists. Presently, introduction of a multi-modal rehabilitation programme (including continuous epidural analgesia with local anesthetics, early oral feeding and enforced...

  2. [Postoperative medical icterus].

    Science.gov (United States)

    Cerf, M

    1978-06-01

    The onset of jaundice following a surgical operation sometimes raises difficult problems. It is rarely due to hemolysis, infective hepatitis or decomposated cirrhosis of the liver. One should seek as a routine hepatitis due to halotane. However the most frequent cause is "benign postoperative cholestasis". This variety of jaundice presents in the form of an icterus due to conjugated bilirubine with often a large increase in alkaline phosphatase levels. The ocurse is variable. Almost always due to severe surgical or septic trauma, accompanied by shock and/or anoxia, it raises difficult diagnostic problems. The clinical and physiopathological aspects of benign postoperative cholestasis are recalled. One should remember, above all, that this is not an autonomous clinical entity but the sign of local or general complications which should be sought carefully.

  3. Pediatric cardiac postoperative care

    Directory of Open Access Journals (Sweden)

    Auler Jr. José Otávio Costa

    2002-01-01

    Full Text Available The Heart Institute of the University of São Paulo, Medical School is a referral center for the treatment of congenital heart diseases of neonates and infants. In the recent years, the excellent surgical results obtained in our institution may be in part due to modern anesthetic care and to postoperative care based on well-structured protocols. The purpose of this article is to review unique aspects of neonate cardiovascular physiology, the impact of extracorporeal circulation on postoperative evolution, and the prescription for pharmacological support of acute cardiac dysfunction based on our cardiac unit protocols. The main causes of low cardiac output after surgical correction of heart congenital disease are reviewed, and methods of treatment and support are proposed as derived from the relevant literature and our protocols.

  4. Keratophakia--postoperative astigmatism.

    Science.gov (United States)

    Swinger, C A; Troutman, R C; Forman, J S

    1987-01-01

    Forty-nine cases of primary keratophakia and 13 cases of secondary keratophakia were analyzed for postoperative astigmatism. For primary cases, the surgically induced astigmatism was 1.55 D, whereas for secondary cases it was 0.19 D (insignificant). There was a tendency for both procedures to induce against-the-rule astigmatism, and both procedures were found capable of producing irregular astigmatism.

  5. The role of postoperative adjuvant radiotherapy in resected esophageal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chang Geol; Kim, Choong Bae; Chung, Kyung Young; Lee, Doo Yun; Seong Jin Sil; Kim, Gwi Eon; Suh, Chang Ok [Yonsei University College of Medicine, Yonsei Cancer Center, Seoul (Korea, Republic of)

    2002-12-15

    A retrospective study was performed to evaluate whether postoperative adjuvant radiotherapy can improve survival and decrease recurrence as compared with surgery alone in resected esophageal cancer. From Jan. 1985 to Dec. 1993, among 94 esophageal cancer patients treated with surgery, fifty-one patients were included in this study. Transthoracic esophagectomy was performed in 35 patients and transhiatal esophagectomy in 16. Postoperative adjuvant radiotherapy was performed 4 weeks after surgery in 26 among 38 patients in stage II and III. A total dose of 30 {approx} 60 Gy in 1.8 Gy daily fraction, median 54 Gy over 6 weeks, was delivered in the mediastinum + both supraclavicular lymph nodes or celiac lymph nodes according to the tumor location. Forty-seven patients (92%) had squamous histology. The median follow-up period was 38 months. The overall 2-year and 5-year survival and median survival were 56.4%, 36.8% and 45 months. Two-year and 5-year survival and median survival by stage were 92%, 60.3% for stage I, 63%, 42% and 51 months for stage II and 34%, 23% and 19 months for stage III ({rho} = 0.04). For stage II and III patients, 5-year survival and median survival were 22.8%. 45 months for the surgery alone group and 37.8%, 22 months for the postoperative RT group ({rho} = 0.89). For stage III patients, 2-year survival and median survival were 0%, 11 months for the surgery alone group and 36.5%, 20 months for the postoperative RT group ({rho} = 0.14). Local and distant failure rates for stage II and III were 50%, 16% for the surgery alone and 39%, 31% for the postoperative RT group. For N1 patients, local failure rate was 71% for the surgery alone group and 37% for the postoperative RT group ({rho} = 0.19). Among 10 local failures in the postoperative RT group, in-field failures were 2, marginal failures 1, out-field 5 and anastomotic site failures 2. There were no statistically significant differences in either the overall survival or the patterns of failure

  6. Effect of preoperative abstinence on poor postoperative outcome in alcohol misusers: randomised controlled trial

    DEFF Research Database (Denmark)

    Tonnesen, H; Rosenberg, J; Nielsen, Hans Jørgen;

    1999-01-01

    liver disease admitted for elective colorectal surgery. INTERVENTIONS: Withdrawal from alcohol consumption for 1 month before operation (disulfiram controlled) compared with continuous drinking. MAIN OUTCOME MEASURES: Postoperative complications requiring treatment within the first month after surgery...

  7. Twelve Theses on Reactive Rules for the Web

    OpenAIRE

    Bry, François; Eckert, Michael

    2007-01-01

    Reactivity, the ability to detect and react to events, is an essential functionality in many information systems. In particular, Web systems such as online marketplaces, adaptive (e.g., recommender) sys- tems, and Web services, react to events such as Web page updates or data posted to a server. This article investigates issues of relevance in designing high-level programming languages dedicated to reactivity on the Web. It presents twelve theses on features desira...

  8. Postoperative conversion disorder.

    Science.gov (United States)

    Afolabi, Kola; Ali, Sameer; Gahtan, Vivian; Gorji, Reza; Li, Fenghua; Nussmeier, Nancy A

    2016-05-01

    Conversion disorder is a psychiatric disorder in which psychological stress causes neurologic deficits. A 28-year-old female surgical patient had uneventful general anesthesia and emergence but developed conversion disorder 1 hour postoperatively. She reported difficulty speaking, right-hand numbness and weakness, and right-leg paralysis. Neurologic examination and imaging revealed no neuronal damage, herniation, hemorrhage, or stroke. The patient mentioned failing examinations the day before surgery and discontinuing her prescribed antidepressant medication, leading us to diagnose conversion disorder, with eventual confirmation by neuroimaging and follow-up examinations. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Postoperative extradural hematomas.

    Science.gov (United States)

    Pichierri, Angelo; Ruggeri, Andrea; Donnarumma, Pasquale; Delfini, Roberto

    2013-01-01

    Postoperative extradural hematoma (POEH) is a possible complication after head surgery, often neglected in the literature. In a single surgeon experience we found 13 cases of POEH (0.8%). We distinguished two subtypes: (1) larger hematomas (>40 cc) with typical features and overt clinical picture that always needed evacuation, and (2) smaller hematomas (<40 cc) with insidious clinical onset and different radiological features compared with traumatic and spontaneous extradural hematomas. On the basis of our experience, we propose that clinical picture and radiologic appearance lead the decision between conservative or interventional treatment of type II hematomas.

  10. Ureteroneocystostomy in primary vesicoureteral reflux: critical retrospective analysis of factors affecting the postoperative urinary tract infection rates

    Directory of Open Access Journals (Sweden)

    Hasan Serkan Dogan

    2014-08-01

    Full Text Available Introduction To determine the parameters affecting the outcome of ureteroneocystostomy (UNC procedure for vesicoureteral reflux (VUR. Materials and Methods Data of 398 patients who underwent UNC procedure from 2001 to 2012 were analyzed retrospectively. Different UNC techniques were used according to laterality of reflux and ureteral orifice configuration. Effects of several parameters on outcome were examined. Disappearance of reflux on control VCUG or absence of any kind of UTI/symptoms in patients without control VCUG was considered as clinical improvement. Results Mean age at operation was 59.2 ± 39.8 months and follow-up was 25.6 ± 23.3 months. Grade of VUR was 1-2, 3 and 4-5 in 17, 79, 302 patients, respectively. Male to female ratio was 163/235. UNC was performed bilaterally in 235 patients and intravesical approach was used in 373 patients. The frequency of voiding dysfunction, scar on preoperative DMSA, breakthrough infection and previous surgery was 28.4%, 70.7%, 49.3% and 22.4%, respectively. Twelve patients (8.9% with postoperative contralateral reflux were excluded from the analysis. Overall clinical improvement rate for UNC was 92%. Gender, age at diagnosis and operation, laterality and grade of reflux, mode of presentation, breakthrough infections (BTI under antibiotic prophylaxis, presence of voiding dysfunction and renal scar, and operation technique did not affect the surgical outcome. However, the clinical improvement rate was lower in patients with a history of previous endoscopic intervention (83.9% vs. 94%. Postoperative UTI rate was 27.2% and factors affecting the occurrence of postoperative UTI were previous failed endoscopic injection on univariate analysis and gender, preoperative BTI, postoperative VUR state, voiding dysfunction on multivariate analysis. Surgery related complication rate was 2% (8/398. These were all low grade complications (blood transfusion in 1, hematoma under incision in 3 and prolonged

  11. A Practical Approach to Preventing Postoperative Recurrence in Crohn's Disease.

    Science.gov (United States)

    Hashash, Jana G; Regueiro, Miguel

    2016-05-01

    Postoperative Crohn's disease recurrence remains common, and preventing additional surgery remains a challenge. A critical step to postoperative management of Crohn's disease is being able to identify patients who should receive immediate postoperative therapy from the patients who can wait for recurrence prior to starting medications. All patients, regardless of their risk for recurrence, are advised to undergo a colonoscopy at 6 to 12 months after surgery to evaluate for endoscopic evidence of Crohn's disease. Further management of patients depends on symptoms and the presence or absence of endoscopic recurrence.

  12. Fast track surgery accelerates the recovery of postoperative insulin sensitivity

    Institute of Scientific and Technical Information of China (English)

    YANG Dong-jie; ZHANG Chang-hua; HE Yu-long; ZHANG Sheng; HE Wei-ling; CHEN Hua-yun; CAI Shi-rong; CHEN Chuang-qi; SONG Xin-ming; CUI Ji; MA Jin-ping

    2012-01-01

    Background Few clinical studies or randomized clinical trial results have reported the impact of fast track surgery on postoperative insulin sensitivity.This study aimed to investigate the effects of fast track surgery on postoperative insulin sensitivity in patients undergoing elective open colorectal resection.Methods Controlled,randomized clinical trial was conducted from November 2008 to January 2009 with one-month post-discharge follow-up.Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into two groups:a fast track group (35 cases) and a conventional care group (35 cases).All included patients received elective open colorectal resection with combined tracheal intubation and general anesthesia.Clinical parameters (complication rates,return of gastrointestinal function and postoperative length of stay),stress index and insulin sensitivity were evaluated in both groups perioperatively.Reaults Sixty-two patients finally completed the study,32 cases in the fast-track group and 30 cases in the conventional care group.Our findings revealed a significantly faster recovery of postoperative insulin sensitivity on postoperative day 7 in the fast-track group than that in the conventional care group.We also found a significantly shorter length of postoperative stay and a significantly faster return of gastrointestinal function in patients undergoing fast-track rehabilitation.Conclusion Fast track surgery accelerates the recovery of postoperative insulin sensitivity in elective surgery for colorectal carcinoma with a shorter length of postoperative hospital stay.

  13. Fast track surgery accelerates the recovery of postoperative insulin sensitivity.

    Science.gov (United States)

    Yang, Dong-jie; Zhang, Sheng; He, Wei-ling; Chen, Hua-yun; Cai, Shi-rong; Chen, Chuang-qi; Song, Xin-ming; Cui, Ji; Ma, Jin-Ping; Zhang, Chang-Hua; He, Yu-Long

    2012-09-01

    Few clinical studies or randomized clinical trial results have reported the impact of fast track surgery on postoperative insulin sensitivity. This study aimed to investigate the effects of fast track surgery on postoperative insulin sensitivity in patients undergoing elective open colorectal resection. Controlled, randomized clinical trial was conducted from November 2008 to January 2009 with one-month post-discharge follow-up. Seventy patients with colorectal carcinoma requiring colorectal resection were randomized into two groups: a fast track group (35 cases) and a conventional care group (35 cases). All included patients received elective open colorectal resection with combined tracheal intubation and general anesthesia. Clinical parameters (complication rates, return of gastrointestinal function and postoperative length of stay), stress index and insulin sensitivity were evaluated in both groups perioperatively. Sixty-two patients finally completed the study, 32 cases in the fast-track group and 30 cases in the conventional care group. Our findings revealed a significantly faster recovery of postoperative insulin sensitivity on postoperative day 7 in the fast-track group than that in the conventional care group. We also found a significantly shorter length of postoperative stay and a significantly faster return of gastrointestinal function in patients undergoing fast-track rehabilitation. Fast track surgery accelerates the recovery of postoperative insulin sensitivity in elective surgery for colorectal carcinoma with a shorter length of postoperative hospital stay.

  14. Efficacy of Surgical Excision in Combination with Mitomycin C and Postoperative Topical 0.002% Mitomycin C Administration for Treatment of Conjunctival Intraepithelial Neoplasia

    Directory of Open Access Journals (Sweden)

    Özlen Rodop Özgür

    2011-08-01

    Full Text Available Purpose: To evaluate the efficacy of surgical excision in combination with mitomycin C (mit-C and postoperative topical mit-C 0.002% administration for the treatment of conjunctival intraepithelial neoplasia (CIN. Material and Method: Twelve eyes of twelve patients who were histopathologically diagnosed as CIN between March 2004 and July 2008 were evaluated retrospectively for their treatment modalities and results. All lesions were excised with wide margins in combination with mit-C 0.02% application for 2 minutes. Five of 12 eyes were treated with topical mit-C 0.002% eye drops four times a day for 14 days after histopathological confirmation. Large conjunctival defects in 5 eyes were reconstructed with amniotic membrane (3 eyes and autologous conjunctiva (2 eyes. Results: Seven patients were women and 5 were men, with a mean age of 68.37 (range: 30-94 years. The right eye was involved in 6 patients and the left one - in 6 patients. The conjunctival lesion was located on the nasal conjunctiva in 5 eyes and on the temporal one - in 7 eyes. Histopathological diagnosis was CIN in all cases. After a mean follow-up period of 41.75 months (between 10 and 62 months, one recurrence (8.3% was noted. This case with recurrent lesion has been previously treated with surgical excision in combination with mit-C 0.02% application and the large conjunctival defect has been reconstructed with amniotic membrane. Discussion: Surgical excision in combination with mit-C and use of additional postoperative topical mit-C 0.002% in selected cases for conjunctival intraepithelial treatment provides a safe and effective cure. (Turk J Ophthalmol 2011; 41: 138-42

  15. Postoperative circadian disturbances

    DEFF Research Database (Denmark)

    Gögenur, Ismail

    2010-01-01

    An increasing number of studies have shown that circadian variation in the excretion of hormones, the sleep wake circle, the core body temperature rhythm, the tone of the autonomic nervous system and the activity rhythm are important both in health and in disease processes. An increasing attention...... has also been directed towards the circadian variation in endogenous rhythms in relation to surgery. The attention has been directed to the question whether the circadian variation in endogenous rhythms can affect postoperative recovery, morbidity and mortality. Based on the lack of studies where...... night after minimally invasive surgery. The core body temperature rhythm was disturbed after both major and minor surgery. There was a change in the sleep wake cycle with a significantly increased duration of REM-sleep in the day and evening time after major surgery compared with preoperatively...

  16. Postoperative circadian disturbances

    DEFF Research Database (Denmark)

    Gögenur, Ismail

    2010-01-01

    in patients with lower than median pain levels for a three days period after laparoscopic cholecystectomy. In the series of studies included in this thesis we have systematically shown that circadian disturbances are found in the secretion of hormones, the sleep-wake cycle, core body temperature rhythm......An increasing number of studies have shown that circadian variation in the excretion of hormones, the sleep wake circle, the core body temperature rhythm, the tone of the autonomic nervous system and the activity rhythm are important both in health and in disease processes. An increasing attention...... has also been directed towards the circadian variation in endogenous rhythms in relation to surgery. The attention has been directed to the question whether the circadian variation in endogenous rhythms can affect postoperative recovery, morbidity and mortality. Based on the lack of studies where...

  17. The twelve theses: a call to a new reformation

    Directory of Open Access Journals (Sweden)

    John Shelby Spong

    2015-03-01

    Full Text Available With every discovery emerging from the world of science over the last 500 years concerning the origins of the universe and of life itself, the traditional explanations offered by the Christian Church appeared to be more and more dated and irrelevant.  Christian leaders, unable to embrace the knowledge revolution seemed to believe  that the only way to save Christianity was not to disturb the old patterns either by listening to, much less by entertaining the new knowledge. I tried to articulate this challenge in a book entitled: Why Christianity Must Change or Die, published in 1998.  In that book I examined in detail the issues that I was convinced Christianity must address. Shortly after that book was published I reduced its content to twelve theses, which I attached in Luther-like fashion to the great doors on the Chapel of Mansfield College at Oxford University in the United Kingdom. I then mailed copies of those Twelve Theses to every acknowledged Christian leader of the world. It was an attempt to call them into a debate on the real issues that I was certain the Christian Church now faced.  I framed my twelve theses in the boldest, most provocative language possible, designed primarily to elicit response and debate. I welcome responses from Christians everywhere.  I claim no expertise or certainty in developing answers, but I am quite confident that I do understand the problems we are facing as Christians who are seeking to relate to the 21st century.

  18. Postoperative Rehabilitation After Rotator Cuff Repair

    Science.gov (United States)

    Mollison, Scott; Shin, Jason J.; Glogau, Alexander; Beavis, R. Cole

    2017-01-01

    Background: Postoperative rehabilitation after arthroscopic rotator cuff repair (ARCR) remains controversial and suffers from limited high-quality evidence. Therefore, appropriate use criteria must partially depend on expert opinion. Hypothesis/Purpose: The purpose of the study was to determine and report on the standard and modified rehabilitation protocols after ARCR used by member orthopaedic surgeons of the American Orthopaedic Society for Sports Medicine (AOSSM) and the Arthroscopy Association of North America (AANA). We hypothesized that there will exist a high degree of variability among rehabilitation protocols. We also predict that surgeons will be prescribing accelerated rehabilitation. Study Design: Cross-sectional study; Level of evidence, 4. Methods: A 29-question survey in English language was sent to all 3106 associate and active members of the AOSSM and the AANA. The questionnaire consisted of 4 categories: standard postoperative protocol, modification to postoperative rehabilitation, operative technique, and surgeon demographic data. Via email, the survey was sent on September 4, 2013. Results: The average response rate per question was 22.7%, representing an average of 704 total responses per question. The most common immobilization device was an abduction pillow sling with the arm in neutral or slight internal rotation (70%). Surgeons tended toward later unrestricted passive shoulder range of motion at 6 to 7 weeks (35%). Strengthening exercises were most commonly prescribed between 6 weeks and 3 months (56%). Unrestricted return to activities was most commonly allowed at 5 to 6 months. The majority of the respondents agreed that they would change their protocol based on differences expressed in this survey. Conclusion: There is tremendous variability in postoperative rehabilitation protocols after ARCR. Five of 10 questions regarding standard rehabilitation reached a consensus statement. Contrary to our hypothesis, there was a trend toward later

  19. Computerized monitoring of physical activity and sleep in postoperative abdominal surgery patients

    DEFF Research Database (Denmark)

    Bisgaard, T; Kjaersgaard, M; Bernhard, A;

    1999-01-01

    OBJECTIVE: Assessment of early postoperative activity is important in the documentation of improvements of peri-operative care. This study was designed to validate computerized activity-based monitoring of physical activity and sleep (actigraphy) in patients after abdominal surgery. METHODS...... physical activity and sleep-wake cycles after major abdominal surgery.......: The study included twelve hospitalized patients after major abdominal surgery studied on day 2 to 4 after operation and twelve unhospitalized healthy volunteers. Measurements were performed for 24 consecutive hours. The actigraphy measurements were compared with self-reported activity- and sleep...

  20. Oxygen therapy reduces postoperative tachycardia

    DEFF Research Database (Denmark)

    Stausholm, K; Kehlet, H; Rosenberg, J

    1995-01-01

    Concomitant hypoxaemia and tachycardia in the postoperative period is unfavourable for the myocardium. Since hypoxaemia per se may be involved in the pathogenesis of postoperative tachycardia, we have studied the effect of oxygen therapy on tachycardia in 12 patients randomly allocated to blinded...

  1. Preoperative alcoholism and postoperative morbidity

    DEFF Research Database (Denmark)

    Tonnesen, H; Kehlet, H

    1999-01-01

    BACKGROUND: Preoperative risk assessment has become part of daily clinical practice, but preoperative alcohol abuse has not received much attention. METHODS: A Medline search was carried out to identify original papers published from 1967 to 1998. Relevant articles on postoperative morbidity...... in alcohol abusers were used to evaluate the evidence. RESULTS: Prospective and retrospective studies demonstrate a twofold to threefold increase in postoperative morbidity in alcohol abusers, the most frequent complications being infections, bleeding and cardiopulmonary insufficiency. Wound complications...... to postoperative morbidity. CONCLUSION: Alcohol consumption should be included in the preoperative assessment of likely postoperative outcome. Reduction of postoperative morbidity in alcohol abusers may include preoperative alcohol abstinence to improve organ function, or perioperative alcohol administration...

  2. [Management of postoperative chylothorax].

    Science.gov (United States)

    Smati, B; Sadok Boudaya, M; Marghli, A; Mestiri, T; Baccari, S; Hantous, T; Djilani, H; Kilani, T

    2006-04-01

    A chylothorax can occur following any intrathoracic procedure. It is generally straightforward to make the diagnosis but optimal management can be problematic. Between 1995 and 2002, three women and one man aged from 13 to 58 years were treated for chylothorax after thoracic surgery. Their initial illnesses were a right pulmonary hydatid cyst associated with hepatic disease, a tumour of the posterior mediastinum, an oesophageal carcinoma and metastases in the left lung. These patients had: a pulmonary and hepatic cystectomies, a resection of the mediastinal tumor, an Akyama oesophagectomy and a resection of four left pulmonary metastases. Chylothorax became apparent post operatively between the 1st and the 4th day. All patients were treated with a medium-chain triglyceride diet. Two patients were re-explored with ligation of lymphatic vessels. One woman who did not have further surgery was treated with etilefrine. In the patient who had had an oesophagectomy, chylothorax persisted after re-operation. He was successfully treated by talc pleurodesis via a chest drain, which prevented further recurrence. In the management of postoperative chylothorax, medical treatment must be started early but surgery should not be delayed as operative risk is increased by the development of malnutrition and immune deficiency.

  3. Eight month post program completion; change in risk factors for chronic disease amongst participants in a four-month pedometer-based workplace health program

    DEFF Research Database (Denmark)

    Freak-Poli, Rosanne; Wolfe, Rory; Brand, Margaret

    2013-01-01

    measured waist circumference at twelve-months indicated that the significant improvements observed immediately after the health program could not be sustained. Approximately half of those not meeting guidelines for physical activity, waist circumference and blood pressure at baseline, were meeting......OBJECTIVE: To evaluate whether participation in a four-month, pedometer-based, physical activity, workplace health program is associated with long-term sustained improvements in risk factors for type 2 diabetes and cardiovascular disease, eight-months after the completion of the program. DESIGN...... guidelines at twelve-months. CONCLUSIONS: Participation in this four-month, pedometer-based, physical activity, workplace health program was associated with sustained improvements chronic disease risk factors at twelve-months. These results indicate that such programs can have a long-term benefit and thus...

  4. Bilateral postoperative maxillary cysts after orthognathic surgery: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung Hye; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul [Dept. of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2014-12-15

    Postoperative maxillary cysts are locally aggressive lesions, usually developing as delayed complications many years after radical antral surgery. This report describes a case of bilateral postoperative maxillary cysts following orthognathic surgery performed approximately 21 years previously. The patient complained of stinging pain on her right cheek. Radiographic examination revealed low-attenuation lesions on both maxillary sinuses with discontinuously corticated margins without distinct expansion or bone destruction. The cysts were enucleated with the removal of metal plates and screws for pain relief. Histopathological examination confirmed the diagnosis of postoperative maxillary cysts lined by ciliated, pseudostratified columnar cells. The patient has remained asymptomatic thus far, and there was no evidence of local recurrence at 21 months of postoperative follow-up.

  5. Twelve tips for teaching medical students with dyslexia.

    Science.gov (United States)

    Shaw, Sebastian Charles Keith; Anderson, John Leeds

    2017-07-01

    Dyslexia is a common learning difficulty. As a result of SS' own experiences as a medical student with dyslexia, we have been researching and teaching on this topic for the past two years. Here, we present twelve tips for teaching medical students with dyslexia. These are gathered from our personal experiences and research, discussions with other educators, and wider literature on the topic. This article aims to shed some light on dyslexia, and also to make practical suggestions. Teaching students with dyslexia should not be a daunting experience. Small changes to existing methods, at minor effort, can make a difference - for example, adding pastel colors to slide backgrounds or avoiding Serif fonts. These tips can help educators gain more insight into dyslexia and incorporate small, beneficial adaptations into their teaching.

  6. Antibacterial activities of extracts from twelve Centaurea species from Turkey

    Directory of Open Access Journals (Sweden)

    Tekeli Yener

    2011-01-01

    Full Text Available Members of the genus Centaurea (Asteraceae have been used in traditional plant-based medicine. The methanol extracts of twelve Centaurea species, of which five are endemic to Turkey flora, were screened for antibacterial activity against four bacteria (Escherichia coli, Bacillus cereus, Salmonella enteritidis, Staphylococcus aureus. The antibacterial activity was evaluated by the microdilution method and the minimum inhibition concentrations (MIC of the extracts were determined. C. cariensis subsp. microlepis exhibited an antimicrobial effect on all tested microorganisms. The extracts from eight Centaurea species (C. balsamita, C. calolepis, C. cariensis subsp. maculiceps, C. cariensis subsp. microlepis, C. kotschyi var. kotschyi, C. solstitialis subsp. solstitialis, C. urvillei subsp. urvillei and C. virgata possessed antibacterial activity against several of the tested microorganisms.

  7. Twelve tips on how to compile a medical educator's portfolio.

    Science.gov (United States)

    Dalton, Claudia Lucy; Wilson, Anthony; Agius, Steven

    2017-09-17

    Medical education is an expanding area of specialist interest for medical professionals. Whilst most doctors will be familiar with the compilation of clinical portfolios for scrutiny of their clinical practice and provision of public accountability, teaching portfolios used specifically to gather and demonstrate medical education activity remain uncommon in many non-academic settings. For aspiring and early career medical educators in particular, their value should not be underestimated. Such a medical educator's portfolio (MEP) is a unique compendium of evidence that is invaluable for appraisal, revalidation, and promotion. It can stimulate and provide direction for professional development, and is a rich source for personal reflection and learning. We recommend that all new and aspiring medical educators prepare an MEP, and suggest twelve tips on how to skillfully compile one.

  8. Spectroscopy of twelve Type Ia supernovae at intermediate redshift

    CERN Document Server

    Balland, C; Pain, R; Walton, N A; Amanullah, R; Astier, Pierre; Ellis, Richard S; Fabbro, S; Goobar, A; Hardin, D; Hook, I M; Irwin, M J; McMahon, R M; Mendez, J M; Ruiz-Lapuente, P; Sainton, G; Schahmaneche, K; Stanishev, V

    2005-01-01

    We present spectra of twelve Type Ia supernovae obtained in 1999 at the William Herschel Telescope and the Nordic Optical Telescope during a search for Type Ia supernovae (SN Ia) at intermediate redshift. The spectra range from z=0.178 to z=0.493, including five high signal-to-noise ratio SN Ia spectra in the still largely unexplored range 0.15 < z < 0.3. Most of the spectra were obtained before or around restframe B-band maximum light. None of them shows the peculiar spectral features found in low-redshift over- or under-luminous SN Ia. Expansion velocities of characteristic spectral absorption features such as SiII at 6355 angs., SII at 5640 angs. and CaII at 3945 angs. are found consistent with their low-z SN Ia counterparts.

  9. Postoperative chemoradiotherapy for gallbladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, K. [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of). Dept. of Radiation Oncology; Chie, E.K.; Ha, S.W. [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of). Dept. of Radiation Oncology; Seoul National Univ. (Korea, Republic of). Inst. of Radiation Medicine; Jang, J.Y.; Kim, S.W. [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of). Dept. of Surgery; Han, S.W.; Oh, D.Y.; Im, S.A.; Kim, T.Y.; Bang, Y.J. [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of). Dept. of Internal Medicine

    2012-05-15

    The goal of this work was to analyze the outcome of adjuvant chemoradiotherapy for patients with gallbladder cancer who underwent surgical resection and to identify the prognostic factors for these patients. Between August 1989 and November 2006, 47 patients with gallbladder cancer underwent surgical resection followed by adjuvant radiotherapy. There were 21 males and 26 females, and median age was 60 years (range 44-75 years). Postoperative radiotherapy was delivered to the tumor bed and regional lymph nodes up to 40-50 Gy at 2 Gy/fraction; 41 patients also received intravenous 5-fluorouracil as a radiosensitizer. Median follow-up duration was 48 months for survivors. There were 2 isolated locoregional recurrences, 14 isolated distant metastases, and 7 combined locoregional and distant relapses. The 5-year overall survival rate was 43.7%. According to the extent of resection, the 5-year overall survival rates were 52.8%, 20.0%, and 0% in R0-, R1-, and R2-resected patients, respectively (p = 0.0038). On multivariate analysis incorporating extent of resection, T stage, N stage, performance of lymph node dissection, and histologic differentiation, extent of resection was the only prognostic factor associated with overall survival (p = 0.0075). Among the 37 patients with R0 resection, there was no difference of 5-year overall survival rates in patients with N0, N1, and Nx diseases (46.2%, 60.0%, and 44.4%, respectively, p = 0.6246). As for significant treatment-related morbidity, there was only 1 patient with grade 4 gastric ulcer. Adjuvant chemoradiotherapy after R0 resection can achieve a good long-term survival rate in gallbladder cancer patients, even in those with lymph node metastases, and may play a role for patients who underwent R0 resection of primary tumor without lymph node dissection. (orig.)

  10. Postoperative Ileus in the Elderly

    Directory of Open Access Journals (Sweden)

    Chih-Peng Tu

    2014-03-01

    Full Text Available Postoperative ileus is among the most common complications after surgery. Aging is associated with an increased colonic transit time, and anesthetic disturbance to colonic motility is often aggravated in the elderly. Postoperative ileus increases morbidity, prolongs the length of hospital stay, and constitutes a significant economic burden on the healthcare system. Multimodal enhanced recovery protocols, or fast-track surgeries, have been developed to improve postoperative recovery. Patient education, avoidance of perioperative fluid overload, selective use of nasogastric decompression, early ambulation, adopting a minimally invasive approach, early initiation of clear fluids, and gum chewing are all possible measures to reduce postoperative ileus. Thoracic epidural anesthesia is a well-established technique to hasten recovery, whereas insufficient data are available to ascertain the safety and efficacy of opioid-sparing analgesia in the elderly. The evidence is clear that traditional prokinetic medications are not helpful in the treatment or prevention of postoperative ileus. Early results suggest that alvimopan is a promising agent to reverse opioid-induced ileus. Since postoperative ileus is a multifactorial condition, a concerted effort is therefore necessary to prevent or decrease the duration of postoperative ileus using multimodal strategies.

  11. Twelve Month Weekly Monitoring of Stable Isotopes of Water Associated to the Flooding of the Meirama Open Pit (NW Spain)

    Science.gov (United States)

    Delgado, J.; Juncosa, R.; Vázquez, A.

    2009-04-01

    In December, 2007, after 30 years of extraction, the mine of Meirama stopped the production of brown lignite. Since April 2008, a controlled flooding process is taking place by which a large mining lake with nearly 150 cubic hectometers and a maximum depth of 180 meters will join the geography of Galicia in a few years. A weekly-based monitoring survey has been taking place in the lake since the beginning of the flooding process. Nearly 50 components and physico-chemical parameters of a series of sampling points located in the surface of the lake as well as in related tributaries, ground and rain waters are being recorded. Among the parameters analyzed, the stable isotopes of water (18-O and 2-H) are worth noting. The data collected so far help us to better understand the hydrological processes occurring in the first year of flooding and combined with different types of chemical constituents (conservative and non-conservative) put important constrains on the hydrochemical processes observed in the lake up to date.

  12. Postoperative adjuvant chemoradiotherapy in rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Sei Kyung; Kim, Jong Woo; Oh, Do Yeun; Chong, So Young; Shin, Hyun Soo [Bundang CHA General Hospital, Pochon CHA University, Seongnam (Korea, Republic of)

    2006-09-15

    To evaluate the role of postoperative adjuvant chemoradiotherapy in rectal cancer, we retrospectively analyzed the treatment outcome of patients with rectal cancer taken curative surgical resection and postoperative adjuvant chemoradiotherapy. A total 46 patients with AJCC stage II and III carcinoma of rectum were treated with curative surgical resection and postoperative adjuvant chemoradiotherapy. T3 and T4 stage were 38 and 8 patients, respectively. N0, N1, and N2 stage were 12, 16, 18 patients, respectively. Forty patients received bolus infusions of 5-fluorouracil (500 mg/m{sup 2}/day) with leucovorin (20 mg/m{sup 2}/day), every 4 weeks interval for 6 cycles. Oral Uracil/Tegafur on a daily basis for 6 {approx} 12 months was given in 6 patients. Radiotherapy with 45 Gy was delivered to the surgical bed and regional pelvic lymph node area, followed by 5.4 {approx} 9 Gy boost to the surgical bed. The follow up period ranged from 8 to 75 months with a median 35 months. Treatment failure occurred in 17 patients (37%). Locoregional failure occurred in 4 patients (8.7%) and distant failure in 16 patients (34.8%). There was no local failure only. Five year actuarial overall survival (OS) was 51.5% and relapse free survival (RFS) was 58.7%. The OS and RFS were 100%, 100% in stage N0 patients, 53.7%, 47.6% in N1 patients, and 0%, 41.2% in N2 patients ({rho} = 0.012, {rho} = 0.009). The RFS was 55%, 78.5%, and 31.2% in upper, middle, and lower rectal cancer patients, respectively ({rho} = 0.006). Multivariate analysis showed that N stage ({rho} = 0.012) was significant prognostic factor for OS and that N stage ({rho} = 0.001) and location of tumor ({rho} = 0.006) were for RFS. Bowel complications requiring surgery occurred in 3 patients. Postoperative adjuvant chemoradiotherapy was an effective modality for locoregional control of rectal cancer. But further investigations for reducing the distant failure rate are necessary because distant failure rate is still high.

  13. Single night postoperative prone posturing in idiopathic macular hole surgery.

    LENUS (Irish Health Repository)

    2012-02-01

    Purpose. To evaluate the role of postoperative prone posturing for a single night in the outcome of trans pars plana vitrectomy (TPPV) with internal limiting membrane (ILM) peel and 20% perfluoroethane (C2F6) internal tamponade for idiopathic macular hole. Methods. This prospective trial enrolled 14 eyes in 14 consecutive patients with idiopathic macular hole. All eyes underwent TPPV with vision blue assisted ILM peeling with and without phacoemulsification and intraocular lens (IOL) for macular hole. Intraocular gas tamponade (20% C2F6) was used in all cases with postoperative face-down posturing overnight and without specific posturing afterwards. LogMAR visual acuity, appearance by slit-lamp biomicroscopy, and ocular coherence tomography (OCT) scans were compared preoperatively and postoperatively to assess outcome. Results. Among 14 eyes recruited, all eyes were phakic; 50% of patients underwent concurrent phacoemulsification with IOL. The macular holes were categorized preoperatively by OCT appearance, 4 (28.57%) were stage 2, 7 (50%) were stage 3, and 3 (21.43%) were stage 4. Mean macular hole size was 0.35 disk diameters. Symptoms of macular hole had been present for an average of 6.5 months. All holes (100%) were closed 3 and 6 months postoperatively. Mean visual acuity (logMAR) was improved to 0.61 at 3 months and was stable at 6 months after the surgery. None of the eyes had worse vision postoperatively. Conclusions. Vitrectomy with ILM peeling and 20% C2F6 gas with a brief postoperative 1 night prone posturing regimen is a reasonable approach to achieve anatomic closure in idiopathic macular hole. Concurrent cataract extraction did not alter outcomes and was not associated with any additional complications.

  14. Postoperative radiotherapy for endometrial cancer

    National Research Council Canada - National Science Library

    Choi, Eun Cheol; Kim, Jin Hee; Kim, Ok Bae; Byun, Sang Jun; Park, Seung Gyu; Kwon, Sang Hoon

    2012-01-01

    .... Sixty four patients with stage I-III endometrial cancer (EC) treated with postoperative radiotherapy alone between January 1989 and December 2008 at the Keimyung University Dongsan Medical Center were chosen for the present study...

  15. Alcohol abuse and postoperative morbidity

    DEFF Research Database (Denmark)

    Tønnesen, Hanne

    2003-01-01

    precise identification of alcohol abuse. However, the inability of the questionnaires to detect short-term changes in intake and abuse without dependence, the inconsistent predictive values of the biological markers, and the lack of evidence of an association to postoperative morbidity reduces......Patients who drink too much have more complications after surgery. The aim of this thesis was to evaluate the evidence, possible mechanisms, and prevention of the increased postoperative morbidity in alcohol abusers, defined by a consumption of at least five drinks per day. The literature could...... be criticised for several methodological flaws. Nevertheless, the results are in agreement showing moderate to strong evidence of increased postoperative morbidity after surgical procedures on alcohol abusers. There is weak to moderate evidence of increased postoperative mortality, hospital stay, and re...

  16. Radiological Features and Postoperative Histopathologic Diagnosis ...

    African Journals Online (AJOL)

    Radiological Features and Postoperative Histopathologic Diagnosis of Intracranial Masses at Tikur Anbessa ... East and Central African Journal of Surgery ... features and postoperative histopathology diagnosis of intracranial mass lesions.

  17. Twelve novel Atm mutations identified in Chinese ataxia telangiectasia patients.

    Science.gov (United States)

    Huang, Yu; Yang, Lu; Wang, Jianchun; Yang, Fan; Xiao, Ying; Xia, Rongjun; Yuan, Xianhou; Yan, Mingshan

    2013-09-01

    Ataxia telangiectasia (A-T) is an autosomal recessive disease characterized mainly by progressive cerebellar ataxia, oculocutaneous telangiectasia, and immunodeficiency. This disease is caused by mutations of the ataxia telangiectasia mutated (Atm) gene. More than 500 Atm mutations that are responsible for A-T have been identified so far. However, there have been very few A-T cases reported in China, and only two Chinese A-T patients have undergone Atm gene analysis. In order to systemically investigate A-T in China and map their Atm mutation spectrum, we recruited eight Chinese A-T patients from six unrelated families nationwide. Using direct sequencing of genomic DNA and the multiplex ligation-dependent probe amplification, we identified twelve pathogenic Atm mutations, including one missense, four nonsense, five frameshift, one splicing, and one large genomic deletion. All the Atm mutations we identified were novel, and no homozygous mutation and founder-effect mutation were found. These results suggest that Atm mutations in Chinese populations are diverse and distinct largely from those in other ethnic areas.

  18. Oral papillary squamous cell carcinoma in twelve dogs.

    Science.gov (United States)

    Nemec, A; Murphy, B G; Jordan, R C; Kass, P H; Verstraete, F J M

    2014-01-01

    Papillary squamous cell carcinoma (PSCC) is a distinct histological subtype of oral squamous cell carcinoma (SCC), described in both dogs and man. In dogs, PSCC has long been considered a malignant oral tumour of very young animals, but it has recently been reported to occur in adult dogs as well. The aim of this study was to describe the major clinicopathological characteristics of canine oral PSCC (COPSCC). Twelve dogs diagnosed with COPSCC were included in this retrospective study (1990-2012). The majority (75%) of the dogs were >6 years of age (median age 9 years). All tumours were derived from the gingiva of dentate jaws, with 66.7% affecting the rostral aspects of the jaws. The gross appearance of the lesions varied, with one having an intraosseous component only. The majority (91.7%) of the tumours were advanced lesions (T2 and T3), but no local or distant metastases were noted. Microscopically, two patterns were seen: (1) invasion of bone forming a cup-shaped indentation in the bone or a deeply cavitating cyst within the bone (cavitating pattern), (2) histologically malignant growth, but lack of apparent bone invasion (non-cavitating pattern). The microscopical appearance corresponded to imaging findings in a majority of cases, with cavitating forms presenting with a cyst-like pattern of bone loss or an expansile mass on imaging and non-cavitating forms showing an infiltrative pattern of bone destruction on imaging. These features suggest two distinct biological behaviours of COPSCC.

  19. Sensitivity and growth of twelve Elatior begonia cultivars to ozone

    Energy Technology Data Exchange (ETDEWEB)

    Reinert, R.A.; Nelson, P.V.

    1979-12-01

    Twelve cultivars of Elatior begonia (Begonia X hiemalis Fotsch.) were exposed to O/sub 3/ at 25 and 50 pphM. The 'Schwabenland' group, 'Whisper 'O' Pink', and 'Improved Krefeld Orange' were the most sensitive, whereas 'Ballerina', 'Mikkell Limelight', and 'Turo' were the least sensitive. 'Rennaisance', 'Heirloom' 'Nixe', and 'Fantasy' were intermediate in sensitivity. The dry weight of foliage (stems plus leaves) of 9 cultivars exposed to O/sub 3/ was significantly less than that of control plants. Ozone at 25 and 50 pphM inhibited flower growth (including peduncles) and development in 4 and 8 of the 12 cultivars, respectively. Differences in flower weight ranged from 43 to 105% of the control at 25 pphM and from 25 to 98% of the control at 50 pphM, depending on cultivar. 1 table.

  20. Twelve tips for designing and running longitudinal integrated clerkships.

    Science.gov (United States)

    Ellaway, Rachel; Graves, Lisa; Berry, Sue; Myhre, Doug; Cummings, Beth-Ann; Konkin, Jill

    2013-12-01

    Longitudinal integrated clerkships (LICs) involve learners spending an extended time in a clinical setting (or a variety of interlinked clinical settings) where their clinical learning opportunities are interwoven through continuities of patient contact and care, continuities of assessment and supervision, and continuities of clinical and cultural learning. Our twelve tips are grounded in the lived experiences of designing, implementing, maintaining, and evaluating LICs, and in the extant literature on LICs. We consider: general issues (anticipated benefits and challenges associated with starting and running an LIC); logistical issues (how long each longitudinal experience should last, where it will take place, the number of learners who can be accommodated); and integration issues (how the LIC interfaces with the rest of the program, and the need for evaluation that aligns with the dynamics of the LIC model). Although this paper is primarily aimed at those who are considering setting up an LIC in their own institutions or who are already running an LIC we also offer our recommendations as a reflection on the broader dynamics of medical education and on the priorities and issues we all face in designing and running educational programs.

  1. Commercializing Government-sponsored Innovations: Twelve Successful Buildings Case Studies

    Science.gov (United States)

    Brown, M. A.; Berry, L. G.; Goel, R. K.

    1989-01-01

    This report examines the commercialization and use of R and D results funded by DOE's Office of Buildings and Community Systems (OBCS), an office that is dedicated to improving the energy efficiency of the nation's buildings. Three goals guided the research described in this report: to improve understanding of the factors that hinder or facilitate the transfer of OBCS R and D results, to determine which technology transfer strategies are most effective and under what circumstances each is appropriate, and to document the market penetration and energy savings achieved by successfully-commercialized innovations that have received OBCS support. Twelve successfully-commercialized innovations are discussed here. The methodology employed involved a review of the literature, interviews with innovation program managers and industry personnel, and data collection from secondary sources. Six generic technology transfer strategies are also described. Of these, contracting R and D to industrial partners is found to be the most commonly used strategy in our case studies. The market penetration achieved to date by the innovations studied ranges from less than 1% to 100%. For the three innovations with the highest predicted levels of energy savings (i.e., the flame retention head oil burner, low-E windows, and solid-state ballasts), combined cumulative savings by the year 2000 are likely to approach 2 quads. To date the energy savings for these three innovations have been about 0.2 quads. Our case studies illustrate the important role federal agencies can play in commercializing new technologies.

  2. The strong coupling regime of twelve flavors QCD

    CERN Document Server

    da Silva, Tiago Nunes

    2012-01-01

    We summarize the results recently reported in Ref.[1] [A. Deuzeman, M.P. Lombardo, T. Nunes da Silva and E. Pallante,"The bulk transition of QCD with twelve flavors and the role of improvement"] for the SU(3) gauge theory with Nf=12 fundamental flavors, and we add some numerical evidence and theoretical discussion. In particular, we study the nature of the bulk transition that separates a chirally broken phase at strong coupling from a chirally restored phase at weak coupling. When a non-improved action is used, a rapid crossover is observed at small bare quark masses. Our results confirm a first order nature for this transition, in agreement with previous results we obtained using an improved action. As shown in Ref.[1], when improvement of the action is used, the transition is preceded by a second rapid crossover at weaker coupling and an exotic phase emerges, where chiral symmetry is not yet broken. This can be explained [1] by the non hermiticity of the improved lattice Transfer matrix, arising from the c...

  3. Monthly Meteorological Reports

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Monthly forms that do not fit into any regular submission. Tabulation sheets and generic monthly forms designed to capture miscellaneous monthly observations.

  4. Epidural morphine for postoperative pain relief in children

    DEFF Research Database (Denmark)

    Henneberg, S W; Hole, P; Haas, Inge Madsen De

    1993-01-01

    Epidural morphine for postoperative pain relief is in general use, and has proved to be very efficient in adults. The epidural technique and the use of epidural morphine are much less frequent in children. For 2 years we have prospectively followed 76 children who had epidural morphine for postop......Epidural morphine for postoperative pain relief is in general use, and has proved to be very efficient in adults. The epidural technique and the use of epidural morphine are much less frequent in children. For 2 years we have prospectively followed 76 children who had epidural morphine...... for postoperative pain relief after major abdominal surgery. The age distribution was from newborn to 13 years, with a median age of 12 months. It was estimated that 94% of the patients had good analgesia for the first 24 postoperative hours and no other opioids were given. The side effects were few, but one case...... the investigation. We observed a change in the sleeping pattern with an increased number of sleep-induced myoclonia during the administration of epidural morphine. In conclusion, the use of epidural morphine in children for postoperative pain relief is very efficient. The minimal effective dose has not been...

  5. Coréia aguda na gravidez Acute chorea in pregnancy: comments on twelve consecutive cases

    Directory of Open Access Journals (Sweden)

    Walter C. Pereira

    1967-12-01

    Full Text Available São apresentados doze casos de coréia aguda observados entre 150.000 gestantes (1/12.500. A maioria dos surtos ocorreu no segundo trimestre da primeira gravidez. A duração média dos sintomas foi de três meses, não tendo sido registrado caso algum de óbito materno. Todos os partos foram espontâneos e normais. Houve apenas um óbito fetal conseqüente a choque hemorrágico. São tecidas considerações a propósito dos aspectos clínico, laboratorial e prognóstico da coréia gravídica, sendo focalizado mais pormenorizadamente o problema fisiopatogênico dessa afecção.Twelve consecutive cases of acute chorea occurring among 150.000 pregnant women (1/12.500 are reported. Most of the cases occurred from the fourth do the sixth month of the first pregnancy. The average duration of the symptoms was of three months and no one case of maternal death was verified in the group. The deliveries were spontaneous and normal in all the patients. Only one case of fetal death occurred in consequence of a hemorragic shock. Comments are made on the clinical, laboratorial and prognostic features of chorea gravidarum, being particulary focused the physiopathogenic problem of this condtion.

  6. Thalidomide induces mucosal healing in postoperative Crohn disease endoscopic recurrence

    Science.gov (United States)

    Hu, Huiqin; Wang, Xinying; Liu, Side

    2016-01-01

    Abstract Background: Thalidomide has been successful use in patients with refractory Crohn disease (CD) in recent years. Methods: We collected the data of a postoperative CD patient who was prescribed thalidomide to induce remission and reviewed the relevant literatures. Results: A 51-year-old female was diagnosed as CD after an urgent terminal intestinal resection and presented endoscopic recurrence despite the prophylactic treatment with azathioprine (AZA). Fortunately, she achieved mucosal healing (MH) at a low dose of thalidomide for 15 months. Conclusion: Thalidomide is effective to induce MH in the postoperative CD endoscopic recurrence. PMID:27603389

  7. Intraoperative gastrojejunoscopy-assisted fistulojejunostomy for postoperative pancreatic fistula.

    Science.gov (United States)

    Toihata, Tasuku; Hashimoto, Daisuke; Hayashi, Hiromitsu; Chikamoto, Akira; Beppu, Toru; Baba, Hideo

    2014-11-01

    Postoperative pancreatic fistula is a known complication after pancreaticojejunostomy. When an anastomosis collapses completely, two-stage reconstruction is necessary. Herein, we describe the case of a 70-year-old woman who underwent subtotal stomach-preserving pancreaticoduodenectomy with pancreaticojejunostomy after she had developed a severe postoperative pancreatic fistula. The pancreaticojejunostomy was divided, and an external pancreatic drainage tube was placed. Four months later, fistulojejunostomy between the pancreas and the stump of the jejunum was performed successfully using intraoperative gastrojejunoscopy. © 2014 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

  8. The Synthesis and Antitumor Activity of Twelve Galloyl Glucosides

    Directory of Open Access Journals (Sweden)

    Chang-Wei Li

    2015-01-01

    Full Text Available Twelve galloyl glucosides 1–12, showing diverse substitution patterns with two or three galloyl groups, were synthesized using commercially available, low-cost D-glucose and gallic acid as starting materials. Among them, three compounds, methyl 3,6-di-O-galloyl-α-D-glucopyranoside (9, ethyl 2,3-di-O-galloyl-α-D-glucopyranoside (11 and ethyl 2,3-di-O-galloyl-β-D-glucopyranoside (12, are new compounds and other six, 1,6-di-O-galloyl-β-D-glucopyranose (1, 1,4,6-tri-O-galloyl-β-D-glucopyranose (2, 1,2-di-O-galloyl-β-D-glucopyranose (3, 1,3-di-O-galloyl-β-D-glucopyranose (4, 1,2,3-tri-O-galloyl-α-D-glucopyranose (6 and methyl 3,4,6-tri-O-galloyl-α-D-glucopyranoside (10, were synthesized for the first time in the present study. In in vitro MTT assay, 1–12 inhibited human cancer K562, HL-60 and HeLa cells with inhibition rates ranging from 64.2% to 92.9% at 100 μg/mL, and their IC50 values were determined to be varied in 17.2–124.7 μM on the tested three human cancer cell lines. In addition, compounds 1–12 inhibited murine sarcoma S180 cells with inhibition rates ranging from 38.7% to 52.8% at 100 μg/mL in the in vitro MTT assay, and in vivo antitumor activity of 1 and 2 was also detected in murine sarcoma S180 tumor-bearing Kunming mice using taxol as positive control.

  9. [Twelve years of working of Brazzaville cancer registry].

    Science.gov (United States)

    Nsondé Malanda, Judith; Nkoua Mbon, Jean Bernard; Bambara, Augustin Tozoula; Ibara, Gérard; Minga, Benoît; Nkoua Epala, Brice; Gombé Mbalawa, Charles

    2013-02-01

    The Brazzaville cancer registry was created in 1996 with the support of the International Agency Research against Cancer (IARC) which is located in Lyon, France. The Brazzaville cancer registry is a registry which is based on population which records new cancer cases occurring in Brazzaville by using Canreg 4.0 Software. Its aim is to supply useful information to fight against cancer to physicians and to decision makers. We conducted this study whose target was to determine the incidence of cancer in Brazzaville during twelve years, from January 1st, 1998 to December 31, 2009. During that period 6,048 new cancer cases were recorded: 3,377 women (55.8%), 2,384 men (39.4%), and 287 children (4.8%) from 0 to 14 years old with an annual average of 504 cases. Middle age to the patient's diagnosis was 49.5 years in female sex and 505.5 years old for male sex. The incidence rate of cancers in Brazzaville was 39.8 or 100.000 inhabitants per year and by sex we observed 49 to female sex and 35.2 for male sex. The first cancers localizations observed to women were in order of frequency: breast, cervix uterine, liver ovaries, hematopoietic system, to men : liver, prostate, hematopoietic system, colon and stomach; to children : retina, kidney, hematopoietic system, liver and bones. These rates are the basis to know the burden of cancer among all pathologies of Brazzaville and the achievement of a national cancer control program.

  10. Hyperinsulinism and hyperammonemia syndrome: report of twelve unrelated patients.

    Science.gov (United States)

    De Lonlay, P; Benelli, C; Fouque, F; Ganguly, A; Aral, B; Dionisi-Vici, C; Touati, G; Heinrichs, C; Rabier, D; Kamoun, P; Robert, J J; Stanley, C; Saudubray, J M

    2001-09-01

    Hyperinsulinism and hyperammonemia syndrome has been reported as a cause of moderately severe hyperinsulinism with diffuse involvement of the pancreas. The disorder is caused by gain of function mutations in the GLUD1 gene, resulting in a decreased inhibitory effect of guanosine triphosphate on the glutamate dehydrogenase (GDH) enzyme. Twelve unrelated patients (six males, six females) with hyperinsulinism and hyperammonemia syndrome have been investigated. The phenotypes were clinically heterogeneous, with neonatal and infancy-onset hypoglycemia and variable responsiveness to medical (diazoxide) and dietary (leucine-restricted diet) treatment. Hyperammonemia (90-200 micromol/L, normal carbamylglutamate administration. The patients had mean basal GDH activity (18.3 +/- 0.9 nmol/min/mg protein) not different from controls (17.9 +/- 1.8 nmol/min/mg protein) in cultured lymphoblasts. The sensitivity of GDH activity to inhibition by guanosine triphosphate was reduced in all patient lymphoblast cultures (IC(50), or concentrations required for 50% inhibition of GDH activity, ranging from 140 to 580 nM, compared with control IC(50) value of 83 +/- 1.0 nmol/L). The allosteric effect of ADP was within the normal range. The activating effect of leucine on GDH activity varied among the patients, with a significant decrease of sensitivity that was correlated with the negative clinical response to a leucine-restricted diet in plasma glucose levels in four patients. Molecular studies were performed in 11 patients. Heterozygous mutations were localized in the antenna region (four patients in exon 11, two patients in exon 12) as well as in the guanosine triphosphate binding site (two patients in exon 6, two patients in exon 7) of the GLUD1 gene. No mutation has been found in one patient after sequencing the exons 5-13 of the gene.

  11. Commercializing government-sponsored innovations: Twelve successful buildings case studies

    Energy Technology Data Exchange (ETDEWEB)

    Brown, M.A.; Berry, L.G.; Goel, R.K.

    1989-01-01

    This report examines the commercialization and use of R and D results funded by DOE's Office of Buildings and Community Systems (OBCS), an office that is dedicated to improving the energy efficiency of the nation's buildings. Three goals guided the research described in this report: to improve understanding of the factors that hinder or facilitate the transfer of OBCS R and D results, to determine which technology transfer strategies are most effective and under what circumstances each is appropriate, and to document the market penetration and energy savings achieved by successfully-commercialized innovations that have received OBCS support. Twelve successfully-commercialized innovations are discussed here. The methodology employed involved a review of the literature, interviews with innovation program managers and industry personnel, and data collection from secondary sources. Six generic technology transfer strategies are also described. Of these, contracting R and D to industrial partners is found to be the most commonly used strategy in our case studies. The market penetration achieved to date by the innovations studied ranges from less than 1% to 100%. For the three innovations with the highest predicted levels of energy savings (i.e., the flame retention head oil burner, low-E windows, and solid-state ballasts), combined cumulative savings by the year 2000 are likely to approach 2 quads. To date the energy savings for these three innovations have been about 0.2 quads. Our case studies illustrate the important role federal agencies can play in commercializing new technologies. 27 refs., 21 figs., 4 tabs.

  12. Maternal cortisol slope at 6 months predicts infant cortisol slope and EEG power at 12 months.

    Science.gov (United States)

    St John, Ashley M; Kao, Katie; Liederman, Jacqueline; Grieve, Philip G; Tarullo, Amanda R

    2017-09-01

    Physiological stress systems and the brain rapidly develop through infancy. While the roles of caregiving and environmental factors have been studied, implications of maternal physiological stress are unclear. We assessed maternal and infant diurnal cortisol when infants were 6 and 12 months. We measured 12-month infant electroencephalography (EEG) 6-9 Hz power during a social interaction. Steeper 6-month maternal slope predicted steeper 12-month infant slope controlling for 6-month infant slope and breastfeeding. Steeper 6-month maternal slope predicted lower 6-9 Hz power. Six-month maternal area under the cuve (AUCg) was unrelated to 12-month infant AUCg and 6-9 Hz power. Psychosocial, caregiving, and breastfeeding variables did not explain results. At 6 months, maternal and infant slopes correlated, as did maternal and infant AUCg. Twelve-month maternal and infant cortisol were unrelated. Results indicate maternal slope is an informative predictor of infant physiology and suggest the importance of maternal physiological stress in this developmental period. © 2017 Wiley Periodicals, Inc.

  13. Alcohol abuse and postoperative morbidity

    DEFF Research Database (Denmark)

    Tønnesen, Hanne

    2003-01-01

    Patients who drink too much have more complications after surgery. The aim of this thesis was to evaluate the evidence, possible mechanisms, and prevention of the increased postoperative morbidity in alcohol abusers, defined by a consumption of at least five drinks per day. The literature could...... be criticised for several methodological flaws. Nevertheless, the results are in agreement showing moderate to strong evidence of increased postoperative morbidity after surgical procedures on alcohol abusers. There is weak to moderate evidence of increased postoperative mortality, hospital stay, and re......-operation. The personal and economic consequences are tremendous. The incidence of alcohol abusers undergoing surgery was 7% to 49%, according to gender and diagnosis. They have been identified by a self-reported alcohol intake, which implies the possibility of underestimation. Alcohol markers could be used for a more...

  14. Post-operative urinary retention.

    Science.gov (United States)

    Steggall, Martin; Treacy, Colm; Jones, Mark

    Urinary retention is a common complication of surgery and anaesthesia. The risk of post-operative urinary retention is increased following certain surgical procedures and anaesthetic modalities, and with patients' advancing age. Patients at increased risk of post-operative urinary retention should be identified before surgery or the condition should be identified and treated in a timely manner following surgery. If conservative measures do not help the patient to pass urine, the bladder will need to be drained using either an intermittent catheter or an indwelling urethral catheter, which can result in catheter-associated urinary tract infections. This article provides an overview of normal bladder function, risk factors for developing post-operative urinary retention, and treatment options. Guidance drawn from the literature aims to assist nurses in identifying at-risk patients and inform patient care.

  15. Significance of postoperative crossed cerebellar hypoperfusion in patients with cerebral hyperperfusion following carotid endarterectomy: SPECT study

    Energy Technology Data Exchange (ETDEWEB)

    Ogasawara, Kuniaki; Kobayashi, Masakazu; Suga, Yasunori; Chida, Kohei; Saito, Hideo; Komoribayashi, Nobukazu; Otawara, Yasunari; Ogawa, Akira [Iwate Medical University, Department of Neurosurgery, Morioka (Japan); Iwate Medical University, Cyclotron Research Center, Morioka (Japan)

    2008-01-15

    Cerebral hyperperfusion after carotid endarterectomy (CEA) results in cerebral hyperperfusion syndrome and cognitive impairment. The goal of the present study was to clarify the clinical significance of postoperative crossed cerebellar hypoperfusion (CCH) in patients with cerebral hyperperfusion after CEA by assessing brain perfusion with single-photon emission computed tomography (SPECT). Brain perfusion was quantitatively measured using SPECT and the [{sup 123}I]N-isopropyl-p-iodoamphetamine-autoradiography method before and immediately after CEA and on the third postoperative day in 80 patients with ipsilateral internal carotid artery stenosis ({>=}70%). Postoperative CCH was determined by differences between asymmetry of perfusion in bilateral cerebellar hemispheres before and after CEA. Neuropsychological testing was also performed preoperatively and at the first postoperative month. Eleven patients developed cerebral hyperperfusion (cerebral blood flow increase of {>=}100% compared with preoperative values) on SPECT imaging performed immediately after CEA. In seven of these patients, CCH was observed on the third postoperative day. All three patients with hyperperfusion syndrome exhibited cerebral hyperperfusion and CCH on the third postoperative day and developed postoperative cognitive impairment. Of the eight patients with asymptomatic hyperperfusion, four exhibited CCH despite resolution of cerebral hyperperfusion on the third postoperative day, and three of these patients experienced postoperative cognitive impairment. In contrast, four patients without postoperative CCH did not experience postoperative cognitive impairment. The presence of postoperative CCH with concomitant cerebral hyperperfusion reflects the development of hyperperfusion syndrome. Further, the presence of postoperative CCH in patients with cerebral hyperperfusion following CEA suggests development of postoperative cognitive impairment, even when asymptomatic. (orig.)

  16. Postoperative Complications After Prophylactic Thyroidectomy for Very Young Patients With Multiple Endocrine Neoplasia Type 2: Retrospective Cohort Analysis.

    Science.gov (United States)

    Kluijfhout, Wouter P; van Beek, Dirk-Jan; Verrijn Stuart, Annemarie A; Lodewijk, Lutske; Valk, Gerlof D; van der Zee, David C; Vriens, Menno R; Borel Rinkes, Inne H M

    2015-07-01

    The aim of this study was to investigate whether younger age at surgery is associated with the increased incidence of postoperative complications after prophylactic thyroidectomy in pediatric patients with multiple endocrine neoplasia (MEN) 2. The shift toward earlier thyroidectomy has resulted in significantly less medullary thyroid carcinoma (MTC)-related morbidity and mortality. However, very young pediatric patients might have a higher morbidity rate compared with older patients. Hardly any literature exists on complications in the very young. A retrospective single-center analysis was performed on the outcomes of MEN2 patients undergoing a prophylactic total thyroidectomy at the age of 17 or younger. Forty-one MEN2A and 3 MEN2B patients with thyroidectomy after January 1993 and at least 6 months of follow-up were included, subdivided in 9 patients younger than 3 years, 15 patients 3 to 6 years, and 20 patients older than 6 years. Postoperative hypocalcemia and other complications were registered. Twelve (27%) patients developed transient hypocalcemia and 9 (20%) patients suffered from permanent hypocalcemia, with a nonsignificant trend toward higher incidence with decreasing age. Three (7%) patients had other complications, of whom 2 were younger than 3 years. For patients younger than 3 years, the average length of stay (LOS) was 6.7 days, versus 1.7 and 3.5 days, respectively, for the older patient groups (P surgery, MTC did not recur in any patient. In planning optimal timing of surgery, clinicians should take the risk of complications into account. We advise not to perform total thyroidectomy before the age of 3 for patients defined high risk by the American Thyroid Association guideline.

  17. Management of recurrent postoperative fungal endophthalmitis

    Directory of Open Access Journals (Sweden)

    Anand Vinekar

    2014-01-01

    Full Text Available Aim: To report the management of recurrent postoperative fungal endophthalmitis (POFE after failed pars plana vitrectomy (PPV and antifungal therapy. Settings and Design: Tertiary Care Referral Centre in North India. Retrospective, single institution, interventional case-series. Materials and Methods: Six patients with microbiologically proven recurrent post-operative fungal endophthalmitis refractory to conventional management were included. The final recurrence was managed with intraocular lens (IOL explantation and re-PPV. Main outcome measures included preserved globe anatomy, visual acuity and retinal status. ′Anatomical success′ was defined as preserved anatomy of the globe, and absence of signs of inflammation. ′Functional success′ was defined as an attached retina and a best corrected visual acuity of better than 20/400. Results: Of the six cases of POFE, five were culture positive [Aspergillus flavus (1, Aspergillus fumigatus (2, Candida albicans (1 and Candida glabrata (1] and one was smear positive for yeast. All recurred (mean recurrences, 4 despite a mean of 2.17 PPVs and intravitreal amphotericin B. No recurrences were observed after IOL explantation with re - PPV (median follow-up, 37 months. Pre-study defined criteria for successful ′anatomical′ and ′functional′ outcomes were achieved in 83.3% and 50% respectively. Conclusion: This report highlights the effective role of combined IOL explantation with PPV in managing recurrent POFE.

  18. Multimodal approach to postoperative recovery

    DEFF Research Database (Denmark)

    Kehlet, Henrik

    2009-01-01

    PURPOSE OF REVIEW: To provide updated information on recent developments within individual components of multimodal interventions to improve postoperative outcome (fast-track methodology). RECENT FINDINGS: The value of the fast-track methodology to improve recovery and decrease hospital stay...

  19. Postoperative ileus: a preventable event

    DEFF Research Database (Denmark)

    Holte, Kathrine; Kehlet, H

    2000-01-01

    BACKGROUND: Postoperative ileus has traditionally been accepted as a normal response to tissue injury. No data support any beneficial effect of ileus and indeed it may contribute to delayed recovery and prolonged hospital stay. Efforts should, therefore, be made to reduce such ileus. METHODS: Mat...

  20. Serial MRI in the early postoperative period after lumbar discectomy

    Energy Technology Data Exchange (ETDEWEB)

    Annertz, M. [Dept. of Radiology, University Hospital, Lund (Sweden); Joensson, B. [Dept. of Orthopaedics, University Hospital, Lund (Sweden); Stroemqvist, B. [Dept. of Orthopaedics, University Hospital, Lund (Sweden); Holtaas, S. [Dept. of Radiology, University Hospital, Lund (Sweden)

    1995-04-01

    The aim of this study was to determine MRI findings in patients successfully operated upon for lumbar disc herniation. We investigated 20 patients with a successful outcome after L4-5 or L5-S1 disc operations clinically and with MRI preoperatively, and at 5 days, 6 weeks, and 4 months after surgery. Postoperatively, T1- and T2-weighted images were obtained. At 4 months gadolinium-enhanced images were added. Pronounced intraspinal MRI changes were seen during follow-up. Deformation of the dural sac was seen in 13 patients preoperatively, in 19 at 5 days after operation, in 15 at 6 weeks, and in 12 at 4 months. Nerve root involvement was seen in all cases both preoperatively and at 5 days after operation, in 17 at 6 weeks, and in 15 at 4 months. No correlation between symptoms or the straight leg raising test and the size or nature of the abnormal tissue in the spinal canal postoperatively could be demonstrated. It was concluded that early postoperative MRI after lumbar discectomy must be interpreted carefully, and that oedema and scar formation are probable reasons for difficulties in interpretation. (orig.)

  1. Monthly Weather Review

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Supplements to the Monthly Weather Review publication. The Weather Bureau published the Monthly weather review Supplement irregularly from 1914 to 1949. The...

  2. Proposing Chinese Pharmacists Month

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    @@ Dear Pharmacists: Today I would like to share with you about the American Pharmacists Month which is celebrated in October every year.This month-long observance is promoted by American Pharmacist Association.

  3. Positive response to binge eating intervention enhances postoperative weight loss.

    Science.gov (United States)

    Ashton, Kathleen; Heinberg, Leslie; Windover, Amy; Merrell, Julie

    2011-01-01

    Binge eating disorder has been suggested as a predictor of negative outcomes, including weight regain and poorer weight loss, particularly if the symptoms (e.g., loss of control eating) remain after surgery. Binge eating disorder has been viewed by some as a contraindication for weight loss surgery, and preoperative treatment has been recommended to help reduce binge eating behaviors. The objective of the present study was to evaluate whether the response to a preoperative binge eating intervention related to differential postoperative weight loss at an academic medical center. A total of 128 bariatric surgery candidates completed a brief cognitive behavioral group treatment for binge eating behaviors. The patients were categorized as positive responders or nonresponders according to the postintervention outcomes, including binge eating symptoms and episodes. The percentage of excess body weight loss (%EBWL) was measured at 6 and 12 months after surgery. Across all bariatric procedures, the positive responders to the brief binge eating intervention had lost significantly more weight at 6 months (46% EBWL versus 38% EBWL) and 12 months (59% EBWL versus 50% EBWL) postoperatively. The results for a subsample of Roux-en-Y gastric bypass patients (n = 89) were also significant, with 53% EBWL for the responders and 42% EBWL for the nonresponders at 6 months and 68% EBWL versus 54% EBWL at 12 months postoperatively, respectively. The response to binge eating treatment could be an important predictor of postoperative weight loss. The results from the present study provide support for patients who respond to preoperative binge eating treatment having enhanced surgical outcomes. Copyright © 2011 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  4. Access to oral health services in children under twelve years of age in Peru, 2014

    Directory of Open Access Journals (Sweden)

    Akram Hernández-Vásquez

    2016-10-01

    Full Text Available The aim of the study was to explore the patterns of dental health services access in children under twelve years of age in Peru. Data from 25,285 children under 12 years who participated in the Demographic and Family Health Survey of 2014 were reviewed. An exploratory spatial analysis was performed to project the proportions of children with access to dental health services, according to national regions, type of health service and urban or rural place of residence. The results show that of the total sample, 26.7% had access to dental health services in the last six months, 39.6% belonged to the age group 0-4 years, 40.6% lived in the Andean region and 58.3% lived in urban areas. The regions of Huancavelica, Apurimac, Ayacucho, Lima and Pasco had the highest percentages of access nationwide. In conclusion, there is low access to dental health services in the population under 12 years of age in Peru. The spatial distribution of access to dental health services allows regions to be identified and grouped according to similar access patterns, in order to better focus public health actions.

  5. An Experiment in Humanistic Management within Community College District Twelve, Centralia/Olympia, Washington.

    Science.gov (United States)

    Miller, Dale A.; Hurley, John A.

    Community College District Twelve, a multi-college district serving a two-county area in southwestern Washington, has attempted to incorporate at administrative levels many of the humanistic, process-oriented principles of management discussed by Maslow and Maccoby. A concept of the ideal leadership style for District Twelve guides the selection…

  6. Postoperative management of pulmonary endarterectomy and outcome

    Directory of Open Access Journals (Sweden)

    Narayana Iyengar Ramakrishna

    2010-01-01

    Full Text Available Pulmonary artery thromboendarterectomy (PTE has been regarded as a promising, potentially curative surgical procedure. However, PTE is associated with specific postoperative complications, such as reperfusion pulmonary edema and right heart failure leading to a considerable mortality of 7-24%. Despite its limitations PTE is a better surgical alternative to lung transplantation which carries high morbidity and mortality. The aim of the study is to analyze the efficacy, safety, morbidity and survival associated in the postoperative period and quality of life after six months of PTE in Indian patients. Forty-one patients with surgically correctable chronic thromboembolic pulmonary hypertension underwent pulmonary endarterectomy. All patients were in New York Heart Association (NYHA Class II, III or IV. Preoperative mean pulmonary artery pressure was 40.98 ± 9.29 mmHg and mean pulmonary vascular resistance was 418.39 ± 95.88 dynes/sec/cm -5 . All patients were followed up to six months and a telephonic survey was conducted using a standard questionnaire. They were assessed and classified as per NYHA grading. There was a significant reduction in the mean pulmonary artery pressure (from 40.98 ± 9.29 mmHg to 24.13 ± 7.36 mmHg, P < 0.001 and pulmonary vascular resistance (from 418.39 ± 95.88 dynes/sec/cm -5 to 142.45 ± 36.27 dynes/sec/cm -5 , P < 0.001 with a concomitant increase in the cardiac index (from 1.99 ± 0.20 L/min/m 2 to 3.28 ± 0.56 L/min/m 2 , P < 0.001 during the postoperative period. The mortality rate in our study was 12.19% (five patients. Ninety per cent of the patients reported a significant improvement in the quality of life and exercise tolerance after surgery compared to the preoperative state. Pulmonary endarterectomy is an effective and potentially curative surgical treatment for patients with severe chronic thromboembolic pulmonary hypertension. The current techniques of operation make the procedure relatively safe and

  7. Postoperative chemoradiotherapy in high risk locally advanced gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Song, Sang Hyuk; Chie, Eui Kyu; Kim, Kyu Bo; Lee, Hyuk Joon; Yang, Han Kwang; Han, Sae Won; Oh, Do Youn; Im, Seok Ah; Bang, Yung Jue; Ha, Sung W. [Seoul National University College of Medicine, Seoul(Korea, Republic of)

    2012-12-15

    To evaluate treatment outcome of patients with high risk locally advanced gastric cancer after postoperative chemoradiotherapy. Between May 2003 and May 2012, thirteen patients who underwent postoperative chemoradiotherapy for gastric cancer with resection margin involvement or adjacent structure invasion were retrospectively analyzed. Concurrent chemotherapy was administered in 10 patients. Median dose of radiation was 50.4 Gy (range, 45 to 55.8 Gy). The median follow-up duration for surviving patients was 48 months (range, 5 to 108 months). The 5-year overall survival rate was 42% and the 5-year disease-free survival rate was 28%. Major pattern of failure was peritoneal seeding with 46%. Loco-regional recurrence was reported in only one patient. Grade 2 or higher gastrointestinal toxicity occurred in 54% of the patients. However, there was only one patient with higher than grade 3 toxicity. Despite reported suggested role of adjuvant radiotherapy with combination chemotherapy in gastric cancer, only very small portion of the patients underwent the treatment. Results from this study show that postoperative chemoradiotherapy provided excellent locoregional control with acceptable and manageable treatment related toxicity in patients with high risk locally advanced gastric cancer. Thus, postoperative chemoradiotherapy may improve treatment result in terms of locoregional control in these high risk patients. However, as these findings are based on small series, validation with larger cohort is suggested.

  8. Postoperative imaging of paranasal sinuses; Postoperative Bildgebung der Nasennebenhoehlen

    Energy Technology Data Exchange (ETDEWEB)

    Nemec, S.; Czerny, C. [Abt. fuer Osteologie, Klinik fuer Radiodiagnostik, AKH/Medizinische Univ. Wien (Austria); Formanek, M. [Klinik fuer Hals-, Nasen- und Ohrenheilkunde, AKH/Medizinische Univ. Wien (Austria)

    2007-07-15

    The radiological interpretation of postoperative changes of the paranasal sinuses requires knowledge of why and how the surgical intervention was performed and what the basic clinical findings were. It is important to know whether there was an inflammation, a reconstructive procedure, or a tumorous process. Multidetector computed tomography (MDCT) evaluated in a high-resolution bone window level setting represents the method of choice for imaging after nonfunctional and functional procedures after inflammatory changes as well as for imaging after reconstructive surgery because of facial trauma or before dental implantation. In the postoperative follow-up of tumor patients contrast-enhanced MDCT evaluated in a soft tissue window and bone window and especially magnetic resonance imaging (MRI) represent the standard. In many cases it is possible to differentiate tumor recurrence from inflammation with the help of contrast-enhanced multiplanar MRI and to detect bone marrow changes prior to CT. (orig.)

  9. When is a postoperative seizure equivalent to "epilepsy recurrence" after epilepsy surgery?

    Science.gov (United States)

    Jehi, Lara; Sarkis, Rani; Bingaman, William; Kotagal, Prakash; Najm, Imad

    2010-06-01

    Up to one-half of epilepsy surgery patients will have at least one seizure after surgery. We aim to characterize the prognosis following a first postoperative seizure, and provide criteria allowing early identification of recurrent refractory epilepsy. Analyzing 915 epilepsy surgery patients operated on between 1990 and 2007, we studied 276 who had >or=1 seizure beyond the immediate postoperative period. The probability of subsequent seizures was calculated using survival analysis. Patients were divided into seizure-free (no seizures for >or=1 year) and refractory (persistent seizures) and analyzed using multivariate regression analysis. After a first seizure, 50% had a recurrence within 1 month and 77% within a year before the risk slowed down to additional 2-3% increments every two subsequent years. After a second seizure, 50% had a recurrence within 2 weeks, 78% within 2 months, and 83% within 6 months. Having both the first and second seizures within six postoperative months [odds ratio (OR) 4.04; 95% confidence interval (CI) 2.05-8.40; p = 0.0001], an unprovoked initial recurrence (OR 3.92; 95% CI 2.13-7.30; p epilepsy and recurrent seizures developed refractoriness. Seizures will recur in most patients who present with their first postoperative event, with one-third eventually regaining seizure-freedom. Etiology and early and unprovoked postoperative seizures with epileptiform activity on EEG at six postoperative months may predict recurrent medical refractoriness.

  10. Is postoperative cognitive dysfunction a risk factor for dementia?

    DEFF Research Database (Denmark)

    Steinmetz, J; Siersma, Volkert Dirk; Kessing, L V

    2013-01-01

    BACKGROUND: /st>Postoperative cognitive dysfunction (POCD) is a common complication in elderly patients after major surgery. An association between POCD and the development of dementia has been suspected. In this study, we assessed if POCD was a risk factor for the occurrence of dementia. METHODS......: /st>Danish patients enrolled between November 1994 and October 2000 in the two International Studies of Postoperative Cognitive Dysfunction (ISPOCD 1 and 2) were followed until July 1, 2011. Cognitive performance was assessed at three time points: before operation, at 1 week, and 3 months after...... developed dementia during follow-up. The hazard ratio (95% CI) for any dementia diagnoses in patients with POCD at 1 week (n=118) and POCD at 3 months (n=57) after surgery compared with those without POCD was 1.16 (0.48-2.78), P=0.74, and 1.50 (0.51-4.44); P=0.47, respectively. CONCLUSIONS: /st...

  11. [Postoperative recurrence of Crohn's disease, and its prevention].

    Science.gov (United States)

    Lakatos, László; Lakatos, Péter László

    2010-05-23

    Crohn's disease is a chronic, progressive disabling condition ultimately leading to stricturing and/or penetrating complications. The need for surgery may be as high as 70% in patients with severe active disease or complications. However, relapse may develop in a significant proportion of the patients after surgery leading to frequent re-operations. Despite emerging data, postoperative prevention is still controversial. After careful evaluation of the individual risk a tailored therapy should be considered. In patients with small risk for relapse mesalazine or in selected cases no-treatment may be an option. In patients with a moderate-to-high risk azathioprine should be considered together with metronidazole in the three months. Follow-up ileocolonoscopy 6-12 months after the surgery is helpful in the determination of endoscopic severity and may assist in the optimization of the therapy. In most severe cases anti-TNF agents may be appropriate for postoperative prevention and therapy.

  12. Persistent postoperative hiccups: a review

    DEFF Research Database (Denmark)

    Hansen, B J; Rosenberg, J

    1993-01-01

    The pathogenesis of persistent postoperative hiccups is not known. Hiccups can present as a symptom of a subphrenic abscess of gastric distention, and metabolic alterations may also cause hiccups. The hiccups may develop because of increased activity in neural reflex pathways not yet fully defined....... Numerous treatment modalities have been tried but with questionable success. Valproate has proven effective in two trials investigating persistent non-surgical hiccups. The simple application of a nasogastric tube may successfully treat the hiccups, possibly because of an alteration of the activity...... in the reflex neural pathways involved. The available literature on the treatment of persistent hiccups is reviewed, and a treatment protocol for persistent postoperative hiccups is provided....

  13. Predictors of postoperative bleeding in children undergoing cardiopulmonary bypass: A preliminary Italian study.

    Science.gov (United States)

    Spiezia, Luca; Di Gregorio, Guido; Campello, Elena; Maggiolo, Sara; Bortolussi, Giacomo; Stellin, Giovanni; Simioni, Paolo; Vida, Vladimiro

    2017-05-01

    Several characteristics such as demographics, pre-existing conditions, surgical procedure, perioperative coagulopathy may predispose children undergoing cardiopulmonary bypass (CPB) to bleeding complications. As yet, studies on risk factors for postoperative bleeding have brought mixed results. The purpose of our study was therefore to retrospectively evaluate the parameters able to predict postoperative bleeding in a group of consecutive children undergoing cardiac surgery involving CPB. We collected demographic and perioperative laboratory data, as well as intraoperative transfusion requirements and blood loss during the first 24h after surgery in a group of consecutive children (aged ≥1month) scheduled for cardiac surgery with CPB at Padua University Hospital between June 2014 and April 2015. Cases were patients who experienced a 24-h postoperative blood loss ≥80th percentile. Univariate and multivariate logistic regression analyses were performed to determine the independent parameters associated with a high 24-h postoperative chest tube drainage volume. Eighty-three children (M:F 38:45; age range 1-168months) were enrolled. Age<7.7months (p 0.015), postoperative platelets <109×10(9)/L (p 0.003) and postoperative D-dimer ≥2350μg/L (p 0.007) were the variables most significantly and independently associated with excessive 24-h postoperative blood loss. Although preliminary, our study identified younger age, lower postoperative platelet count and higher D-dimer plasma levels as possible risk factors for postoperative bleeding. As for coagulation parameters, our results suggested consumptive coagulopathy might cause a strong predisposition to postoperative bleeding in children. Large-scale prospective studies would provide insight into the early diagnosis and treatment of CPB-related coagulopathies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Postoperative hand therapy in Dupuytren's disease

    NARCIS (Netherlands)

    Herweijer, H.; Dijkstra, P.U.; Nicolai, J.P.A.; van der Sluis, C.K.

    2007-01-01

    Background. Postoperative hand therapy in patients after surgery for Dupuytren's contracture is common medical practice to improve outcomes. Until now, patients are referred for postoperative hand rehabilitation on an empirical basis. Purpose. To evaluate whether referral criteria after surgery

  15. Postoperative hand therapy in Dupuytren's disease

    NARCIS (Netherlands)

    Herweijer, H.; Dijkstra, P.U.; Nicolai, J.P.A.; van der Sluis, C.K.

    2007-01-01

    Background. Postoperative hand therapy in patients after surgery for Dupuytren's contracture is common medical practice to improve outcomes. Until now, patients are referred for postoperative hand rehabilitation on an empirical basis. Purpose. To evaluate whether referral criteria after surgery beca

  16. Prevention of postoperative recurrence of Crohn's disease

    NARCIS (Netherlands)

    van Loo, E. S.; Dijkstra, G.; Ploeg, R. J.; Nieuwenhuijs, V. B.

    2012-01-01

    Background: Up to 75% of patients with Crohn's disease (CD) will have intestinal resection during their life. Most patients will, however, develop postoperative recurrence (endoscopic, clinical or surgical). Several medical and surgical strategies have been attempted to prevent postoperative recurre

  17. Safety of over twelve hundred infant male circumcisions using the Mogen clamp in Kenya.

    Directory of Open Access Journals (Sweden)

    Marisa R Young

    Full Text Available BACKGROUND: Several sub-Saharan African countries plan to scale-up infant male circumcision (IMC for cost-efficient HIV prevention. Little data exist about the safety of IMC in East and southern Africa. We calculated adverse event (AE rate and risks for AEs associated with introduction of IMC services at five government health facilities in western Kenya. METHODS: AE data were analyzed for IMC procedures performed between September, 2009 and November, 2011. Healthy infants aged ≤ 2 months and weighing ≥ 2.5 kg were eligible for IMC. Following parental consent, trained clinicians provided IMC services free of charge under local anesthesia using the Mogen clamp. Odds ratios and 95% confidence intervals were used to explore AE risk factors. FINDINGS: A total of 1,239 IMC procedures were performed. Median age of infants was 4 days (IQR=1, 16. The overall AE rate among infants reviewed post-operatively was 2.7% (18/678; 95%CI: 1.4, 3.9. There was one severe AE involving excision of a small piece of the lateral aspect of the glans penis. Other AEs were mild or moderate and were treated conservatively. Babies one month of age or older were more likely to have an AE (OR 3.20; 95%CI: 1.23, 8.36. AE rate did not differ by nurse versus clinical officer or number of previous procedures performed. CONCLUSION: IMC services provided in Kenyan Government hospitals in the context of routine IMC programming have AE rates comparable to those in developed countries. The optimal time for IMC is within the first month of life.

  18. Early and late postoperative seizure outcome in 97 patients with supratentorial meningioma and preoperative seizures: a retrospective study.

    Science.gov (United States)

    Zheng, Zhe; Chen, Peng; Fu, Weiming; Zhu, Junming; Zhang, Hong; Shi, Jian; Zhang, Jianmin

    2013-08-01

    We identified factors associated with early and late postoperative seizure control in patients with supratentorial meningioma plus preoperative seizures. In this retrospective study, univariate analysis and multivariate logistic regression analysis compared 24 clinical variables according to the occurrence of early (≤1 week) or late (>1 week) postoperative seizures. Sixty-two of 97 patients (63.9 %) were seizure free for the entire postoperative follow-up period (29.5 ± 11.8 months), while 13 patients (13.4 %) still had frequent seizures at the end of follow-up. Fourteen of 97 patients (14.4 %) experienced early postoperative seizures, and emergence of new postoperative neurological deficits was the only significant risk factor (odds ratio = 7.377). Thirty-three patients (34.0 %) experienced late postoperative seizures at some time during follow-up, including 12 of 14 patients with early postoperative seizures. Associated risk factors for late postoperative seizures included tumor progression (odds ratio = 7.012) and new permanent postoperative neurological deficits (odds ratio = 4.327). Occurrence of postoperative seizures in patients with supratentorial meningioma and preoperative seizure was associated with new postoperative neurological deficits. Reduced cerebral or vascular injury during surgery may lead to fewer postoperative neurological deficits and better seizure outcome.

  19. Postoperative activity restrictions: any evidence?

    Science.gov (United States)

    Weir, Larissa F; Nygaard, Ingrid E; Wilken, Jason; Brandt, Debra; Janz, Kathleen F

    2006-02-01

    Because of a widespread but untested belief that increased intra-abdominal pressure contributes to pelvic floor disorders, physicians commonly restrict various activities postoperatively. Our aim was to describe intra-abdominal pressures during common physical activities. Thirty women of wide age and weight ranges who were not undergoing treatment for pelvic floor disorders performed 3 repetitions of various activities while intra-abdominal pressures (baseline and maximal) were approximated via microtip rectal catheters. We calculated median peak and net pressures (centimeters of H(2)O). We assessed correlations between abdominal pressures and body mass index, abdominal circumference, and grip strength (a proxy for overall strength). P climbing stairs, walking briskly, or doing abdominal crunches. Body mass index and abdominal circumference each correlated positively with peak, but not net, pressures. Age and grip strength were not associated with abdominal pressure. Some activities commonly restricted postoperatively have no greater effect on intra-abdominal pressures than unavoidable activities like rising from a chair. How lifting is done impacts intra-abdominal pressure. Many current postoperative guidelines are needlessly restrictive. Further research is needed to determine whether increased intra-abdominal pressure truly promotes pelvic floor disorders. III.

  20. CLINICAL STUDY OF POSTOPERATIVE WOUND INFECTION

    OpenAIRE

    Sudheer Darbha; Giddaluru Srihari

    2016-01-01

    BACKGROUND The aim of the study is to study the most common organisms encountered and their sensitivity and resistance to antibiotics in postoperative wound infection and to study relation of emergency and elective surgery to postoperative wound infection and to study efficacy of different modes of preoperative preparation on postoperative wound infection and to study distribution of postoperative wound infection among different surgeries based on bacterial contamination such a...

  1. Surgery and postoperative recurrence in children with Crohn disease.

    Science.gov (United States)

    Hansen, Lars F; Jakobsen, Christian; Paerregaard, Anders; Qvist, Niels; Wewer, Vibeke

    2015-03-01

    The aim of this study was to describe surgery rates, complications, and risk of disease recurrence after surgery in paediatric Crohn disease (CD). Children Disease extension according to the Montreal classification at the time of operation was available in 106/115 patients: B1, 39/106 (37%); B2, 59/106 (56%); and B3, 8/106 (7%). Before/after surgery 89%/36% of the patients received corticosteroids, 26%/61% azathioprine, and 15%/34% infliximab. Ileocoecal resection was performed in 54 (47%); 17 (15%) underwent ileal resection, 21 (18%) colectomy, 13 (11%) hemicolectomy, and 10 (9%) a combined colonic and ileal resection. Median time from diagnosis to surgery was 23 months (range 0-147). The median follow-up time after surgery was 121 months (16-226), and median time to disease recurrence was 12 months (3-160). The cumulative clinical recurrence rates at 1, 5, and 10 years were 50%, 73%, and 77%, respectively. More than 1 bowel resection was needed in 39%. Postoperative azathioprine treatment did not affect rate of recurrence after surgery. In this large cohort of children with CD studied for >10 years postoperatively, we found a high postoperative recurrence rate of disease and a frequent need for >1 intestinal resection.

  2. Postoperative MR findings of the anterior cervical fusion

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Uk; Choi, Woo Suk; Oh, Joo Hyeong; Kim, Eui Jong; Yoon, Yup [Kyunghee Univ. , Seoul (Korea, Republic of)

    1996-02-01

    This study was conducted to describe the postoperative MRI findings with contrast enhancement following anterior cervical fusion(ACF). Thirteen patients after anterior cervical fusions for disc herniation or traumatic injury were studied with MRI 1 month to 10 month to 10 months after operation. MRI findings were analysed with attention to the remained vertebral body, disc material, retropharyngeal soft tissue, grafted bone fragment, and biological orthopedic prosthesis(BOP). In 8/13 cases(62%), enhancement of the retropharyngeal soft tissue was seen with good demarcation between soft tissue and surrounding vertebra or disc. In 9/13 cases (69%), grafted bone or BOP was well defined by intersurface with low signal intensity. In 4 cases of ACF with bone graft, 2 cases(50%) showed heterogeneous or homogeneous enhancement of grafted bone fragments. Remained vertebral bodies and discs showed enhancements in 8/13 cases(62%). Postoperative MR findings after ACF included good margination of enhanced retropharyngeal soft tissue, grafted bone, and remained vertebral bodies/discs. The MRI could be a useful study to differentiate findings after ACF from postoperative inflammations such as spondylitis or discitis, and be a good imaging modality for follow up of grafted bony fragment or BOP.

  3. Predictors of postoperative myasthenic crisis in patients with myasthenia gravis after thymectomy

    Institute of Scientific and Technical Information of China (English)

    CHU Xiang-yang; XUE Zhi-qiang; WANG Ru-wen; TAN Qun-you

    2011-01-01

    Background Thymectomy is considered the most effective treatment in patients with myasthenia gravis. This study aimed to explore the predictors of postoperative myasthenic crisis in patients with myasthenia gravis after thymectomy.Methods Clinical records of 243 patients with myasthenia gravis who underwent thymectomy were reviewed retrospectively. The following factors were analyzed in relation to the occurrence of myasthenic crisis after thymectomy:gender, age, duration of symptoms, Osserman stage, history of myasthenic crisis, concomitant diseases, preoperative pyridostigmine dose, preoperative steroid therapy, operation approach, operation time, presence of thymoma, major postoperative complications.Results Forty-four patients experienced postoperative myasthenic crisis during the first month after thymectomy.Univariate analysis revealed that Osserman stage (RR=0.0976, P=0.000), history of myasthenic crisis (RR=0.2309,P=0.012), preoperative pyridostigmine dose (RR=0.4349, P=0.016), thymoma (RR=0.0606, P=0.000), and major postoperative complications (RR=0.1094, P=0.000) were significantly related to postoperative myasthenic crisis.Multivariate Logistic regression analysis showed that Osserman stage (Ⅱb+Ⅲ+Ⅳ) (RR=0.0953, P=0.000), thymoma (RR=0.0294, P=0.000), and major postoperative complications (RR=0.0424, P=0.000) independently predict postoperative myasthenic crisis.Conclusion Osserman stage (Ⅱb+Ⅲb+Ⅳ), thymoma and major postoperative complications are independent predictors of postoperative myasthenic crisis in patients with myasthenia gravis who underwent thymectomy.

  4. Postoperative pleural effusion following upper abdominal surgery

    DEFF Research Database (Denmark)

    Nielsen, P H; Jepsen, S B; Olsen, A D

    1989-01-01

    Of 128 patients who underwent upper abdominal surgery, examined by standard preoperative and postoperative chest roentgenograms for the formation of postoperative pleural effusions, 89 had postoperative pleural effusions. Their presence was not related to the type of operation, infection, serum a...

  5. Postoperative pleural effusion following upper abdominal surgery

    DEFF Research Database (Denmark)

    Nielsen, P H; Jepsen, S B; Olsen, A D

    1989-01-01

    Of 128 patients who underwent upper abdominal surgery, examined by standard preoperative and postoperative chest roentgenograms for the formation of postoperative pleural effusions, 89 had postoperative pleural effusions. Their presence was not related to the type of operation, infection, serum a...

  6. Sling for correcting uterine prolapse: twelve years experience.

    Science.gov (United States)

    Khanam, R A; Rubaiyat, A; Azam, M S

    2014-01-01

    Pelvic organ prolapse is a common morbidity among Bangladeshi women. Both patient and surgeon prefer vaginal hysterectomy for the treatment of this condition and occasionally they choose Fothergill's operation. Uterine suspension is suitable for the young women to preserve the uterus. This observational study was carried out in three teaching hospitals and two other non government hospitals for the period of 12 years among 280 patients with 1st, 2nd and 3rd degree uterine prolapse. Follow up done at 6th week , 6th month, 1st year, 5th year, 10th year and 12th year for recurrence of prolapse, dragging pain and dyspareunia. Among 280 patients >60% patients were of 26-30 years age group. In last follow up at 12th year 2(0.71%) women complained feeling of some descend of uterus, 1(0.36%) complained dragging pain in abdomen and I (0.36%) complained dyspareunia. All patients expressed satisfaction which indicates psychological well being. Uterine sling is an effective procedure to save uterus in young women to improve their quality of life.

  7. The impact of alcoholics anonymous on other substance abuse-related twelve-step programs.

    Science.gov (United States)

    Laudet, Alexandre B

    2008-01-01

    This chapter explores the influence of the AA model on self-help fellowships addressing problems of drug dependence. Fellowships that have adapted the twelve-step recovery model to other substances of abuse are reviewed; next similarities and differences between AA and drug-recovery twelve-step organizations are examined; finally, we present empirical findings on patterns of attendance and perceptions of AA and Narcotics Anonymous (NA) among polydrug-dependent populations, many of whom are cross-addicted to alcohol. Future directions in twelve-step research are noted in closing.

  8. The Stabilization of Postoperative Exo-drift in Intermittent Exotropia after Surgical Treatment.

    Science.gov (United States)

    Park, Hoon; Kim, Won Jae; Kim, Myung Mi

    2016-02-01

    To investigate the long-term clinical course of intermittent exotropia after surgical treatment to determine whether and when postoperative exo-drift stabilizes, and the required postsurgery follow-up duration in cases of intermittent exotropia. We retrospectively reviewed the medical records of patients diagnosed with intermittent exotropia who underwent surgical treatment between January 1992 and January 2006 at Yeungnam University Hospital and postoperatively performed regular follow-up examinations for up to 7 years. We also analyzed the difference in exo-drift stabilization, according to surgical procedure. A total of 101 patients were enrolled in the study. Thirty-one patients underwent lateral rectus recession and medial rectus resection (R&R) and 70 patients underwent bilateral lateral rectus recession (BLR). The postoperative angles of deviation increased significantly during the initial 36 months, but no subsequent significant changes were observed for up to 84 months. Follow-ups for 7 years revealed that more than 50% of the total amount of exo-drift was observed within the first postoperative year. In addition, the angles of deviation at 1 year correlated with those at 7 years postoperatively (Pearson correlation coefficient r = 0.517, p exo-drift was observed after 36 months in patients who underwent BLR, whereas after 18 months in patients who underwent R&R. The minimum postoperative follow-up required after surgical treatment to ensure stable results is 36 months. In particular, careful follow-up is necessary during the first postoperative year to detect rapid exo-drift. Patients who underwent BLR required a longer follow-up than those who underwent R&R to ensure stable postoperative alignment.

  9. Differences in postoperative outcomes, function, and cosmesis: open versus robotic thyroidectomy.

    Science.gov (United States)

    Lee, Jandee; Nah, Kuk Young; Kim, Ra Mi; Ahn, Yeun Hee; Soh, Euy-Young; Chung, Woong Youn

    2010-12-01

    Robotic thyroidectomy using a gasless transaxillary approach, first described in 2008, has become popular. This study compared outcomes, including postoperative distress and patient satisfaction, for patients undergoing robotic thyroidectomy with those for patients treated by conventional open thyroidectomy. Of 84 prospectively enrolled patients, 41 underwent robotic thyroidectomy (the robot group), and 43 received conventional open thyroidectomy (the open group). All the patients were followed up for at least 3 months after surgery. Videolaryngostroboscopic examinations were performed preoperatively and after 1 week and after 3 months postoperatively. Postoperative pain and discomfort were evaluated using a symptom scale. Subjective voice and swallowing changes were assessed by questionnaires; and satisfaction with cosmetic outcome was measured by verbal response at 3 months. The two groups were similar in age, gender, type of operation, and final pathologic diagnosis. Although the mean operating time was significantly longer with the robotic technique than with open surgery, there were no between-group differences in postoperative pain or duration of hospital stay. No patient in either group experienced any major postoperative complication. Postoperative discomfort in the neck and swallowing disturbances were significantly more frequent in the open group than in the robot group, both at 1 week and at 3 months after surgery. However, there was no significant between-group difference in subjective voice parameters. At 3 months, the mean cosmetic satisfaction score was significantly higher in the robotic than in the open group. Although postoperative pain levels and complications were comparable in the two groups, conventional open thyroidectomy requires a shorter operative time. The robotic technique, however, offers several distinct advantages including very good to excellent cosmetic results, reduced postoperative neck discomfort, and fewer adverse swallowing

  10. A Novel Stress-Diathesis Model to Predict Risk of Post-operative Delirium: Implications for Intra-operative Management

    Directory of Open Access Journals (Sweden)

    Renée El-Gabalawy

    2017-08-01

    Full Text Available Introduction: Risk assessment for post-operative delirium (POD is poorly developed. Improved metrics could greatly facilitate peri-operative care as costs associated with POD are staggering. In this preliminary study, we develop a novel stress-diathesis model based on comprehensive pre-operative psychiatric and neuropsychological testing, a blood oxygenation level-dependent (BOLD magnetic resonance imaging (MRI carbon dioxide (CO2 stress test, and high fidelity measures of intra-operative parameters that may interact facilitating POD.Methods: The study was approved by the ethics board at the University of Manitoba and registered at clinicaltrials.gov as NCT02126215. Twelve patients were studied. Pre-operative psychiatric symptom measures and neuropsychological testing preceded MRI featuring a BOLD MRI CO2 stress test whereby BOLD scans were conducted while exposing participants to a rigorously controlled CO2 stimulus. During surgery the patient had hemodynamics and end-tidal gases downloaded at 0.5 hz. Post-operatively, the presence of POD and POD severity was comprehensively assessed using the Confusion Assessment Measure –Severity (CAM-S scoring instrument on days 0 (surgery through post-operative day 5, and patients were followed up at least 1 month post-operatively.Results: Six of 12 patients had no evidence of POD (non-POD. Three patients had POD and 3 had clinically significant confusional states (referred as subthreshold POD; ST-POD (score ≥ 5/19 on the CAM-S. Average severity for delirium was 1.3 in the non-POD group, 3.2 in ST-POD, and 6.1 in POD (F-statistic = 15.4, p < 0.001. Depressive symptoms, and cognitive measures of semantic fluency and executive functioning/processing speed were significantly associated with POD. Second level analysis revealed an increased inverse BOLD responsiveness to CO2 pre-operatively in ST-POD and marked increase in the POD groups when compared to the non-POD group. An association was also noted for

  11. Hispanic Heritage Month

    Science.gov (United States)

    York, Sherry

    2004-01-01

    Hispanic heritage month is from September 15 to October 15. One problem that arises when grouping people into categories such as Hispanic or Latino is stereotyping, stereotypes can be promoted or used in this Hispanic month to promote a greater understanding of Latino cultures.

  12. Progress report, 24 months

    DEFF Research Database (Denmark)

    Juhl, Thomas Winther; Nielsen, Jakob Skov

    The work performed during the past 12 months (months 13 – 24) of the project has included the conclusion of Task 1 – Fundamental Studies and Task 2 – Multimirror Cutting Head Design. Work on Task 3 – Compact Cutting Head Design, and Task 4 – Interface Design has been carried out and the tests...... of the multimirror cutting head have been started....

  13. Progress report, 36 months

    DEFF Research Database (Denmark)

    Juhl, Thomas Winther; Nielsen, Jakob Skov

    The work performed during the past 12 months (months 13 – 24) of the project has included the conclusion of Task 1 – Fundamental Studies and Task 2 – Multimirror Cutting Head Design. Work on Task 3 – Compact Cutting Head Design, and Task 4 – Interface Design has been carried out and the tests...... of the multimirror cutting head have been started....

  14. Progress report, 36 months

    DEFF Research Database (Denmark)

    Juhl, Thomas Winther; Nielsen, Jakob Skov

    The work performed during the past 12 months (months 13 – 24) of the project has included the conclusion of Task 1 – Fundamental Studies and Task 2 – Multimirror Cutting Head Design. Work on Task 3 – Compact Cutting Head Design, and Task 4 – Interface Design has been carried out and the tests of ...

  15. Progress report, 24 months

    DEFF Research Database (Denmark)

    Juhl, Thomas Winther; Nielsen, Jakob Skov

    The work performed during the past 12 months (months 13 – 24) of the project has included the conclusion of Task 1 – Fundamental Studies and Task 2 – Multimirror Cutting Head Design. Work on Task 3 – Compact Cutting Head Design, and Task 4 – Interface Design has been carried out and the tests of ...

  16. Prediction of postoperative pain after percutaneous nephrolithotomy

    DEFF Research Database (Denmark)

    Pedersen, Katja Venborg; Olesen, Anne Estrup; Osther, Palle Jørn Sloth;

    2013-01-01

    Postoperative pain remains a significant problem and the individual variance in postoperative pain is not fully understood. In recent years, there has been focus on identifying risk factors predicting patients with high postoperative pain intensity or consumption of analgesics, which may facilitate...... thresholds were measured using electrical (single and 5 repeated) and pressure pain stimulation over the flank bilaterally (stone-side = operation side and control-side = non-operation side). Postoperative pain scores were recorded on a numerical rating scale and analgesic consumption was registered...... patients at high risk of postoperative pain....

  17. Effects of posture on postoperative pulmonary function

    DEFF Research Database (Denmark)

    Nielsen, K G; Holte, Kathrine; Kehlet, H

    2003-01-01

    effect on postoperative pulmonary function in the sitting or standing position compared with the supine. Thus, avoidance of the supine position may improve postoperative pulmonary function. Three of six studies showed a positive effect on postoperative pulmonary function of the lateral side compared......BACKGROUND: Pulmonary morbidity is still a relevant complication to major surgery despite improvements in surgical technique and anaesthetic methods. Postoperative posture may be a pathogenic factor, but the effects of changes in postoperative posture on pulmonary function have not been reviewed...... with the supine. Thus, the lateral position has limited effects on pulmonary function. CONCLUSION: Changes of postoperative position from supine to sitting or standing are of major importance in the interpretation of postoperative pulmonary outcome studies and in future strategies to improve pulmonary outcome....

  18. CLINICAL APPLICATION OF “TWELVE WELL-POINTS” IN EMERGENCY TREATMENT

    Institute of Scientific and Technical Information of China (English)

    段功保

    2000-01-01

    In many years' clinical practice, I used blood-letting method of “Twelve Well-points” to treat emergencies as coma, syncope, acute infantile convulsion, wind-stroke syndrome, hysteria, epilepsy, etc. and have achieved immediate results.

  19. The Relationship Between Intraoperative Tear Dimensions and Postoperative Pain in 1624 Consecutive Arthroscopic Rotator Cuff Repairs.

    Science.gov (United States)

    Yeo, Daniel Y T; Walton, Judie R; Lam, Patrick; Murrell, George A C

    2017-03-01

    Rotator cuff repair often results in significant pain postoperatively, the cause of which is undetermined. Purpose/Hypothesis: The aim of this study was to evaluate the relationship between rotator cuff tear area and postoperative pain in patients who had undergone arthroscopic rotator cuff repair. We hypothesized that larger tears would be more painful because of elevated repair tension at 1 week postoperatively but that smaller tears would be more painful because of a greater healing response, especially from 6 weeks postoperatively. Cohort study; Level of evidence, 3. A total of 1624 patients who underwent arthroscopic rotator cuff repair were included in this study. Exclusion criteria were moderate to severe osteoarthritis, isolated subscapularis repair, calcific tendinitis, synthetic patch repair, revision surgery, and retears on ultrasound at 6 months after surgery. Rotator cuff tears were subdivided into groups based on the tear size and retear rate found for each group. A modified L'Insalata questionnaire was given before surgery and at 1 week, 6 weeks, 3 months, and 6 months after surgery. Pearson and Spearman correlation coefficient tests were performed between rotator cuff tear areas and pain scores. Intraoperative rotator cuff tear areas did not correlate with pain scores preoperatively or at 1 week after surgery. A smaller tear area was associated with more frequent and severe pain with overhead activities, at rest, and during sleep as well as a poorer perceived overall shoulder condition at 6 weeks, 3 months, and 6 months after repair ( r = 0.11-0.23, P 8 cm(2). There were fewer retears with smaller tears, but they were more painful than large tears postoperatively from 6 weeks to 6 months after surgery. Smaller tears may heal more vigorously, causing more pain. Patients with smaller tears experienced more pain after rotator cuff repair compared with patients with larger tears. These findings are contrary to previous ideas about tear size and

  20. Correlation between magnetoencephalography-based "clusterectomy" and postoperative seizure freedom.

    Science.gov (United States)

    Vadera, Sumeet; Jehi, Lara; Burgess, Richard C; Shea, Katherine; Alexopoulos, Andreas V; Mosher, John; Gonzalez-Martinez, Jorge; Bingaman, William

    2013-06-01

    During the presurgical evaluation of patients with medically intractable focal epilepsy, a variety of noninvasive studies are performed to localize the hypothetical epileptogenic zone and guide the resection. Magnetoencephalography (MEG) is becoming increasingly used in the clinical realm for this purpose. No investigators have previously reported on coregisteration of MEG clusters with postoperative resection cavities to evaluate whether complete "clusterectomy" (resection of the area associated with MEG clusters) was performed or to compare these findings with postoperative seizure-free outcomes. The authors retrospectively reviewed the charts and imaging studies of 65 patients undergoing MEG followed by resective epilepsy surgery from 2009 until 2012 at the Cleveland Clinic. Preoperative MEG studies were fused with postoperative MRI studies to evaluate whether clusters were within the resected area. These data were then correlated with postoperative seizure freedom. Sixty-five patients were included in this study. The average duration of follow-up was 13.9 months, the mean age at surgery was 23.1 years, and the mean duration of epilepsy was 13.7 years. In 30 patients, the main cluster was located completely within the resection cavity, in 28 it was completely outside the resection cavity, and in 7 it was partially within the resection cavity. Seventy-four percent of patients were seizure free at 12 months after surgery, and this rate decreased to 60% at 24 months. Improved likelihood of seizure freedom was seen with complete clusterectomy in patients with localization outside the temporal lobe (extra-temporal lobe epilepsy) (p = 0.04). In patients with preoperative MEG studies that show clusters in surgically accessible areas outside the temporal lobe, we suggest aggressive resection to improve the chances for seizure freedom. When the cluster is found within the temporal lobe, further diagnostic testing may be required to better localize the epileptogenic zone.

  1. Time course of postoperative hypoxaemia

    DEFF Research Database (Denmark)

    Rosenberg, J; Ullstad, T; Rasmussen, J;

    1994-01-01

    OBJECTIVE: To study the time course of nocturnal episodic and constant hypoxaemia during the first five nights after a major abdominal operation in patients not given supplementary oxygen. DESIGN: Open study. SUBJECTS: 17 patients undergoing major elective operations and with no recognised risk...... factors. MAIN OUTCOME MEASURES: Arterial oxygen saturation measured by pulse oximetry. RESULTS: The level of constant hypoxaemia was lowest during night 2 (p time spent below 90% saturation (p ... during night 3 (p constant hypoxaemia on postoperative nights 1, 3, 4, and 5...

  2. Choice reaction time in patients with post-operative cognitive dysfunction

    DEFF Research Database (Denmark)

    Steinmetz, J.; Rasmussen, L.S.

    2008-01-01

    in nine countries. CRT was measured 52 times using the four boxes test. Patients performed the test before surgery (n=1083), at 1 week (n=926) and at 3 months (n=852) post-operatively. CRT for the individual patient was determined as the median time of correct responses. The usefulness of the CRT......BACKGROUND: Post-operative cognitive dysfunction (POCD) is detected by administration of a neuropsychological test battery. Reaction time testing is at present not included as a standard test. Choice reaction time (CRT) data from the first International Study of Post-operative Cognitive Dysfunction...... had a significantly longer CRT. ROC curves revealed that a reaction time of 813 ms was the most appropriate cut-off at 1 week and 762 ms at 3 months but the positive predictive value for POCD was low: 34.4% and 14.7%, respectively. CONCLUSIONS: Post-operative cognitive dysfunction is associated...

  3. The surgery and early postoperative radicular pain in cases with multifocal lumbar disc herniation

    Science.gov (United States)

    Ulutaş, Murat; Çınar, Kadir; Seçer, Mehmet

    2017-01-01

    Abstract Persistence of postoperative radicular pain after surgery for multifocal disc herniation (MFDH) is a clinical problem. This study aims to evaluate the effects of a combined treatment approach compared with unilateral stabilization on early postoperative radicular pain in patients with MFDH. Age, sex, level of operation, clinical findings, and radicular pain visual analogue scale (VAS) scores before surgery in the early postoperative period and at 3 months after surgery were retrospectively reviewed for 20 cases of multifocal lumbar disc herniation. The combined approach (translaminar and far lateral) was used for 13 cases. Seven cases underwent transforaminal lumbar interbody fusion (TLIF) and unilateral transpedicular stabilization following total facetectomy. The mean age of the sample was 49.4 ± 10.1 years and the female-to-male ratio was 8:12. The mean VAS scores for radicular pain in cases treated with the combined approach were 8.2, 4.07, and 2.3 in the preoperative and early postoperative periods and 3 months after surgery, respectively. The mean score for radicular pain improved by 50.4% in the early postoperative period and by 72% in the late postoperative period. The mean VAS scores for radicular pain in cases who underwent TLIF and unilateral stabilization after facetectomy were 8.4, 2.1, and 1.4 in the preoperative and early postoperative periods and 3 months after surgery, respectively. The mean VAS score for radicular pain improved by 75% in the early postoperative period and by 83.3% in the late postoperative period. The combined approach is an effective alternative in cases with MFDH. TLIF and unilateral segmental stabilization provide substantial decompression and eliminate mechanical compression by conserving the height of the intervertebral foramen in the event that sufficient decompression is unable to obtain. We suggest that elimination of chemical mediators, particularly those causing pain in the dorsal ganglion, contributes to

  4. Post-operative benefits of Tisseel®/Tissucol® for mesh fixation in patients undergoing Lichtenstein inguinal hernia repair: secondary results from the TIMELI trial

    DEFF Research Database (Denmark)

    Campanelli, G; Pascual, M H; Hoeferlin, A

    2014-01-01

    scale (VAS) score 12 months post-operatively. Variables tested were: fixation method, age, employment status, physical activity, nerve handling, PND VAS score at pre-operative visit and 1 week post-operatively. The effect of fixation technique on separate PND outcomes 12 months post-surgery was also...

  5. Laparoscopic ventral hernia repair: postoperative antibiotics decrease incidence of seroma-related cellulitis.

    Science.gov (United States)

    Edwards, C; Angstadt, J; Whipple, O; Grau, R

    2005-11-01

    Seroma formation has been documented as a common complication in laparoscopic ventral herniorraphy. However, there are no recent studies documenting the incidence of or protective strategies against seroma-related cellulitis. The purpose of this study was to evaluate 65 laparoscopic ventral herniorraphies and to determine if seroma-related cellulitis can be prevented by the routine use of postoperative prophylactic antibiotics. A retrospective case review of 65 laparoscopic ventral herniorraphies was done at our institution from February 2002 to January 2004. All were performed using either Gore-Tex DualMesh or Bard Composix mesh and performed under the direct supervision of a single surgeon. Twenty patients received only preoperative third-generation cephalosporins or fluoroquinolones. All other patients received either 7 days of postoperative oral cephalosporins or fluoroquinolones in addition to preoperative antibiotics. Sixty-five patients underwent laparoscopic ventral hernia repair. There were 45 patients in the postoperative antibiotic group and 20 patients in the preoperative-only antibiotic group. Twenty-one patients developed seromas. Twelve of these developed cellulitis. The rates of seroma formation were similar in the two groups with 30 per cent in the preoperative only group and 33 per cent in the postoperative antibiotic group. However, 100 per cent of the seromas in the preoperative antibiotic group developed seroma-related cellulitis. Only 40 per cent of seromas in the postoperative antibiotic group developed cellulitis. In addition, two seromas in the preoperative antibiotics-only group progressed to frank mesh infection necessitating operative removal. There were no complications related to antibiotic administration. Laparoscopic ventral hernia repair is a safe and effective procedure. Our seroma rate is 30 per cent and compares equally with prior reported studies. Seroma-related cellulitis is a common problem that can lead to mesh infection

  6. TARP Monthly Housing Scorecard

    Data.gov (United States)

    Department of the Treasury — Treasury and the U.S. Department of Housing and Urban Development (HUD) jointly produce a Monthly Housing Scorecard on the health of the nation’s housing market. The...

  7. Lightship Monthly Observations

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Daily Weather Observations (Monthly Form 1001) from lightship stations in the United States. Please see the 'Surface Weather Observations (1001)' library for more...

  8. Oceanographic Monthly Summary

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Oceanographic Monthly Summary contains sea surface temperature (SST) analyses on both regional and ocean basin scales for the Atlantic, Pacific, and Indian Oceans....

  9. Infarto cerebral isquémico en el postoperatorio inmediato de una transposición de grandes vasos en una niña de 5 meses y medio Ischemic stroke in the early postoperative period of a transposition of great arteries in a 5 and a half months female infant

    Directory of Open Access Journals (Sweden)

    A. Rico

    2009-07-01

    Full Text Available La Transposición de los Grandes Vasos con septum íntegro (TGV con SI es una cardiopatía congénita caracterizada por la existencia de una discordancia aislada ventrículo-arterial con concordancia aurículo-ventricular. Al no existir mezcla entre las circulaciones sistémica y pulmonar a través de una comunicación interventricular se trata de una cardiopatía cianosante severa, ya que no es posible la oxigenación a nivel sistémico. Presentamos el caso de una niña diagnosticada de TGV con SI a los 5 meses y 15 días de edad. Se intervino mediante atriseptostomía de urgencia y posterior cirugía de "recuperación" (banding de la arteria pulmonar y shunt subclavia-pulmonar previa a la corrección anatómica mediante switch arterial. Falleció a los 8 días del ingreso como consecuencia de un infarto cerebral isquémico.Transposition of the Great Arteries (TGA with intact ventricular septum is a congenital heart disease characterized by ventricle-arterial discordance and atria-ventricle concordance. Cyanosis is common in patients with TGA because there is no mixing between systemic and pulmonary circulations through a ventricular septal defect and systemic oxygenation is not possible. We report the case of a 5 months and 15 days old female infant who was diagnosed with TGA with intact septum. Balloon atrial septostomy and "retraining" of left ventricle by pulmonary artery banding and subclavian-pulmonary artery shunt were necessary to be performed before anatomical correction by arterial switch. Nevertheless, she died 8 days after admission due to an ischemic stroke.

  10. Ocular coherence tomographic examination of postoperative foveal architecture after scleral buckling vs vitrectomy for macular off retinal detachment.

    LENUS (Irish Health Repository)

    Gibran, S K

    2012-02-03

    AIMS: This pilot study uses Optical Coherence Tomography (OCT) imaging to compare the difference in foveal architecture after successful retinal detachment (RD) surgery by scleral buckling or pars plana vitrectomy (PPV). METHODS: Prospective recruitment of patients with macular off RDs. Detachment surgery was undertaken by scleral buckling, external drainage, and air injection (group 1) or by PPV (group 2). Postoperatively patients had clinical examinations and OCT at 1, 3, 6, and 12 months. If abnormalities persisted, a further OCT was obtained at 18 months. RESULTS: Retinal reattachment, including clinical macular reattachment, was achieved in all cases within 24 h postoperatively. In group 1 (n=22), postoperative OCT showed persistent foveal detachment in 63% of cases (n=14) at 1 and 3 months. At 6 and 12 months, 36% (n=8) and 9% (n=2) had a persistent foveal detachment, respectively, and at 18 months, foveal detachment eventually. In group 2 (n=21), postoperative OCT showed an attached fovea in all cases; however, foveal thickening suggesting intraretinal oedema was present in all cases. The oedematous appearance of retina on OCT settled in 1-3 months. No foveal abnormality was seen at 6 and 12 months postoperatively. CONCLUSIONS: A high proportion of patients with successful retinal reattachment surgery by scleral buckling had foveal detachments postoperatively. No cases who had PPV had foveal detachments; however, transient retinal oedema was evident in all cases. The aetiology of these changes is unknown and warrants further investigation, as there is the potential of a long-term effect on vision.

  11. Risk of postoperative recurrence and postoperative management of Crohn's disease

    Institute of Scientific and Technical Information of China (English)

    Antonino Spinelli; Matteo Sacchi; Gionata Fiorino; Silvio Danese; Marco Montorsi

    2011-01-01

    Crohn's disease (CD) is a chronic inflammatory disease of the digestive tract with systemic manifestations. Etiology is unknown, even if immunological, genetic and environmental factors are involved. The majority of CD patients require surgery during their lifetime due to progressive bowel damage, but, even when all macroscopic lesions have been removed by surgery, the disease recurs in most cases. Postoperative management represents therefore a crucial mean for preventing recurrence. Several drugs and approaches have been proposed to achieve this aim. Endoscopic inspection of the ileocolic anastomosis within 1 year from surgery is widely encouraged, given that endoscopic recurrence is one of the greatest predictors for clinical recurrence. A strategy should be planned only after stratifying patients according to their individual risk of recurrence, avoiding unnecessary therapies when possible benefits are reduced, and selecting high-risk patients for more aggressive intervention.

  12. Chronic postoperative pain: recent findings in understanding and management [version 1; referees: 3 approved

    Directory of Open Access Journals (Sweden)

    Darin Correll

    2017-07-01

    Full Text Available Chronic postoperative pain is a poorly recognized potential outcome from surgery. It affects millions of patients every year, with pain lasting for months to years, resulting in patient suffering and ensuing economic consequences. The operations with the highest incidence of chronic postoperative pain are amputations, thoracotomies, cardiac surgery, and breast surgery. Other risk factors include preoperative pain, psychological factors, demographics, and the intensity of acute postoperative pain. Attempts to prevent chronic postoperative pain have often led to debatable results. This article presents data from recently published studies examining the incidence, risk factors, mechanisms, treatment options, and preventive strategies for chronic postoperative pain in adults. In summary, many of the previously identified risk factors for chronic postoperative pain have been confirmed and some novel ones discovered, such as the importance of the trajectory of acute pain and the fact that catastrophizing may not always be predictive. The incidence of chronic postoperative pain hasn’t changed over time, and there is limited new information regarding an effective preventive therapy. For example, pregabalin may actually cause more harm in certain surgeries. Further research is needed to demonstrate whether multimodal analgesic techniques have the best chance of significantly reducing the incidence of chronic postoperative pain and to determine which combination of agents is best for given surgical types and different patient populations.

  13. Postoperative systemic dissemination of injected elemental mercury.

    Science.gov (United States)

    Kang, Suk-Hyung; Park, Seung Won; Moon, Kyung-Yoon

    2011-04-01

    There were only a few reports of mercury on pulmonary artery. However, there is no data on surgery related mercury dissemination. The objective of the present article is to describe one case of postoperative injected mercury dissemination. A 19-year-old man presented severe neck pain including meningeal irritation sign and abdominal pain after injection of mercury for the purpose of suicide. Radiologic study showed injected mercury in the neck involving high cervical epidural space and subcutaneous layer of abdomen. Partial hemilaminectomy and open mercury evacuation of spinal canal was performed. For the removal of abdominal subcutaneous mercury, C-arm guided needle aspiration was done. After surgery, radiologic study showed disseminated mercury in the lung, heart, skull base and low spinal canal. Neck pain and abdominal pain were improved after surgery. During 1 month after surgery, there was no symptom of mercury intoxication except increased mercury concentration of urine, blood and hair. We assumed the bone work during surgery might have caused mercury dissemination. Therefore, we recommend minimal invasive surgical technique for removal of injected mercury. If open exposures are needed, cautious surgical technique to prohibit mercury dissemination is necessary and normal barrier should be protected to prevent the migration of mercury.

  14. Effect of preoperative abstinence on poor postoperative outcome in alcohol misusers: randomised controlled trial

    DEFF Research Database (Denmark)

    Tonnesen, H; Rosenberg, J; Nielsen, Hans Jørgen;

    1999-01-01

    often in the intervention group. Surgical stress responses were lower in the intervention group (P LT / =0.05). CONCLUSIONS: One month of preoperative abstinence reduces postoperative morbidity in alcohol abusers. The mechanism is probably reduced preclinical organ dysfunction and reduction......OBJECTIVE: To evaluate the influence of preoperative abstinence on postoperative outcome in alcohol misusers with no symptoms who were drinking the equivalent of at least 60 g ethanol/day. DESIGN: Randomised controlled trial. Setting: Copenhagen, Denmark. SUBJECTS: 42 alcoholic patients without...... liver disease admitted for elective colorectal surgery. INTERVENTIONS: Withdrawal from alcohol consumption for 1 month before operation (disulfiram controlled) compared with continuous drinking. MAIN OUTCOME MEASURES: Postoperative complications requiring treatment within the first month after surgery...

  15. Patients with chronic pain after abdominal surgery show less preoperative endogenous pain inhibition and more postoperative hyperalgesia: a pilot study.

    Science.gov (United States)

    Wilder-Smith, Oliver Hamilton; Schreyer, Tobias; Scheffer, Gert Jan; Arendt-Nielsen, Lars

    2010-06-01

    Chronic pain is common and undesirable after surgery. Progression from acute to chronic pain involves altered pain processing. The authors studied relationships between presence of chronic pain versus preoperative descending pain control (diffuse noxious inhibitory controls; DNICs) and postoperative persistence and spread of skin and deep tissue hyperalgesia (change in electric/pressure pain tolerance thresholds; ePTT/pPTT) up to 6 months postoperatively. In 20 patients undergoing elective major abdominal surgery under standardized anesthesia, we determined ePTT/pPTT (close to [abdomen] and distant from [leg] incision), eDNIC/pDNIC (change in ePTT/pPTT with cold pressor pain task; only preoperatively), and a 100 mm long pain visual analogue scale (VAS) (0 mm = no pain, 100 mm = worst pain imaginable), both at rest and on movement preoperatively, and 1 day and 1, 3, and 6 months postoperatively. Patients reporting chronic pain 6 months postoperatively had more abdominal and leg skin hyperalgesia over the postoperative period. More inhibitory preoperative eDNIC was associated with less late postoperative pain, without affecting skin hyperalgesia. More inhibitory pDNIC was linked to less postoperative leg deep tissue hyperalgesia, without affecting pain VAS. This pilot study for the first time links chronic pain after surgery, poorer preoperative inhibitory pain modulation (DNIC), and greater postoperative degree, persistence, and spread of hyperalgesia. If confirmed, these results support the potential clinical utility of perioperative pain processing testing.

  16. Trauma and postoperative follow-up; Traumata und postoperative Folgezustaende

    Energy Technology Data Exchange (ETDEWEB)

    Voth, E. [Univ. Koeln (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    1997-10-01

    Indications for the use of nuclear medicine techniques, mostly bone scintigraphy, occur in case of diagnostic problems, especially if there are discrepancies between the clinical symptoms and X-ray findings. This may happen in case of stress fractures, fractures in bones difficult to judge by X-ray imaging, and in the differentation of recent versus old fracture. A further indication for bone scanning is to assess the extent of skeletal lesions in polytrauma and in the battered child syndrome. In postoperative patients bone scanning is most frequently performed in order to assess loosening or infection of endoprosthesis. Due to bone remodelling uptake of Tc-diphosphonates varies between cemented and cementfree implants. This fact should be taken into consideration when interpreting bone scans in areas with endoprostheses. In both trauma and postoperative patients, indications for nuclear medicine imaging exist if healing is complicated. Bone scanning can be used to assess pseudoartrosis or non-union, infection, viability of grafts and bone fragments and reflex sympathetic dystrophy. In suspicious infection with positive bone scan, white blood cell or microcollid scintigraphy can be used for further differentiation. (orig./MG) [Deutsch] Indikationen zum Einsatz nuklearmedizinischer Verfahren, in der Regel der Skelettszintigraphie, ergeben sich bei diagnostischen Problemen, speziell bei Diskrepanzen zwischen der klinischen Symptomatik und dem roentgenologischen Befund. In der Traumatologie kann dies Stressfrakturen, Frakturen in roentgenologisch schwer beurteilbaren Skelettabschnitten, das Ausmass der knoechernen Verletzungen bei Polytraumata oder Kindermisshandlungen sowie die Differenzierung alte versus frische Fraktur betreffen. In der postoperativen Verlaufs- bzw. Therapiekontrolle ist die haeufigste Indikation zur Skelettszintigraphie die Frage nach Lockerung einer Endoprothese. Wegen des aus pathophysiologischen Gruenden unterschiedlichen Anreicherungsmusters

  17. Monthly energy review

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-01

    This document presents an overview of the Energy Information Administration`s (EIA) recent monthly energy statistics. The statistics cover the major activities of U.S. production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. Also included are international energy and thermal and metric conversion factors.

  18. Photos of the month

    CERN Multimedia

    Claudia Marcelloni de Oliveira

    Congratulations to Adele Rimoldi, ATLAS physicist from Pavia, who ran her first marathon in New York last month. Adele completed the 42.2 km in a time of 4:49:19. She sure makes it look easy!!! The ATLAS pixel service quarter panel in SR1

  19. Monthly Energy Review

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-05-28

    This publication presents an overview of the Energy information Administration`s recent monthly energy statistics. The statistics cover the major activities of US production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. Also included are international energy and thermal and metric conversion factors. Two brief ``energy plugs`` (reviews of EIA publications) are included, as well.

  20. Chapter Twelve

    African Journals Online (AJOL)

    User

    dissemination in Nigeria· Some local jingles from Radio Nigeria Purity F.M. .... Indigenous Language in Advertisement: Problems and Prospects – Thecla ... the rural newspapers from performing their role of rural development· The ..... Sharma Raman, M· and, S (2004), Technical Communication Principle and Practice· India:.

  1. Pre- and postoperative MR imaging of craniopharyngiomas

    Energy Technology Data Exchange (ETDEWEB)

    Hald, J.K. [Rijkshospitalet, Oslo (Norway). Dept. of Radiology; Eldevik, O.P. [Rijkshospitalet, Oslo (Norway). Dept. of Neurosurgery; Quint, D.J. [Rijkshospitalet, Oslo (Norway). Dept. of Neurosurgery; Chandler, W.F. [Univ. of Michigan Hospital, Ann Arbor, MI (United States). Dept. of Radiology; Kollevold, T. [Univ. of Michigan Hospital, Ann Arbor, MI (United States). Dept. of Neurosurgery

    1996-09-01

    Purpose: To compare the pre- and postoperative MR appearance of craniopharyngiomas with respect to lesion size, tumour morphology and identification of surrounding normal structures. Material and Methods: MR images obtained prior to and following craniopharyngioma resection were evaluated retrospectively in 10 patients. Tumour signal charcteristics, size and extension with particular reference to the optic chiasm, the pituitary gland, the pituitary stalk and the third ventricle were evaluated. Results: Following surgery, tumour volume was reduced in all patients. In 6 patients there was further tumour volume reduction between the first and second postoperative images. Two of these patients received radiation therapy between the 2 postoperative studies, while 4 had no adjuvant treatment to the surgical intervention. There was improved visualization of the optic chiasm, in 3, the pituitary stalk in one, and the third ventricle in 9 of the 10 patients. The pituitary gland was identified preoperatively only in one patient, postoperatively only in another, pre- and postoperatively in 5, and neither pre- nor postoperatively in 3 patients. In 3 patients MR imaging 0-7 days postoperatively identified tumour remnants not seen at the end of the surgical procedure. The signal intensities of solid and cystic tumour components were stable from pre- to the first postoperative MR images. Optic tract increased signal prior to surgery was gone 28 days postoperatively in one patient, but persisted on the left side for 197 days after surgery in another. Conclusion: Postoperative MR imaging of craniopharyngiomas demonstrated tumour volume reduction and tumour remnants not seen at surgery. Early postoperative MR imaging of craniopharyngiomas may overestimate the size of residual tumour. Improved visualization of peritumoral structures may be achieved. (orig.).

  2. Your Child's Development: 9 Months

    Science.gov (United States)

    ... For Parents MORE ON THIS TOPIC Your Baby's Growth: 9 Months Your Baby's Hearing, Vision, and Other Senses: 9 Months Your Child's Checkup: 9 Months Medical Care and Your 8- to 12-Month-Old Feeding Your 8- to 12-Month-Old Sleep and Your 8- to 12-Month-Old Contact ...

  3. Risk factors for chronic noncontiguous diseases: Twelve-week prospective study

    Directory of Open Access Journals (Sweden)

    Lapčević Mirjana

    2004-01-01

    Full Text Available Risk factors (RF of chronic noncontiguous diseases (CND are mutual and cannot be observed individually since there is an inter-reaction (interaction of RF in various combinations, what makes so-called personality risk profile for development of particular disease. Almost all CND belong to the group of preventable diseases, because their course may be influenced and changed through RF modification and reduction. Bad habits also contribute to CND incidence. CND prevention is the first priority of primary health care physicians. The main objective of our study was to detect RF in patients during everyday activities of general practitioner, to estimate the risk of CND within the existing RF combination, to show the results of 12-week active monitoring of population with RF of CND, and with already present CND; while the secondary goal was to assess how much population is interested in active collaboration as well as to evaluate the qualification of general medicine teams for work based on defined methodology. The study was multicentric, prospective and interventional. The study included 2086 subjects, aged from 25-64 years, and it was carried out in 17 health centers throughout Serbia in the period January-April 2002. The subjects were selected by method of open clinical experiment. Thereafter, 12-week medical intervention was initiated involving non-pharmacological and pharmacological treatment. The first control was scheduled after 8, and the second after 12 months of intervention. Congruence χ2 test, ANOVA for repeated measurements and Logistic regression were used for statistical data processing. Out of a total of 2086 subjects, the following proportion of them reported specific diagnosis in their medical histories: 77% of them reported arterial hypertension (HTA, 68% - increased body mass (BMI>27Kg/m2, 66% - hyperlipoproteinemia (HLP, 34% - diabetes mellitus (DM, 56% - inadequate physical activity (PA, and 23% - cigarette smoking (CS. On the

  4. [Risk factors for chronic noncontiguous diseases: twelve-week prospective study].

    Science.gov (United States)

    Lapcević, Mirjana; Vuković, Mira

    2004-01-01

    Risk factors (RF) of chronic noncontiguous diseases (CND) are mutual and cannot be observed individually since there is an inter-reaction (interaction of RF in various combinations), what makes so-called personality risk profile for development of particular disease. Almost all CND belong to the group of preventable diseases, because their course may be influenced and changed through RF modification and reduction. Bad habits also contribute to CND incidence. CND prevention is the first priority of primary health care physicians. The main objective of our study was to detect RF in patients during everyday activities of general practitioner, to estimate the risk of CND within the existing RF combination, to show the results of 12-week active monitoring of population with RF of CND, and with already present CND; while the secondary goal was to assess how much population is interested in active collaboration as well as to evaluate the qualification of general medicine teams for work based on defined methodology. The study was multicentric, prospective and interventional. The study included 2086 subjects, aged from 25-64 years, and it was carried out in 17 health centers throughout Serbia in the period January-April 2002. The subjects were selected by method of open clinical experiment. Thereafter, 12-week medical intervention was initiated involving non-pharmacological and pharmacological treatment. The first control was scheduled after 8, and the second after 12 months of intervention. Congruence chi2 test, ANOVA for repeated measurements and Logistic regression were used for statistical data processing. Out of a total of 2086 subjects, the following proportion of them reported specific diagnosis in their medical histories: 77% of them reported arterial hypertension (HTA), 68%--increased body mass (BMI > or = 27Kg/m2), 66%--hyperlipoproteinemia (HLP), 34%--diabetes mellitus (DM), 56%--inadequate physical activity (PA), and 23%--cigarette smoking (CS). On the basis of

  5. Petroleum marketing monthly

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-07-01

    Petroleum Marketing Monthly (PPM) provides information and statistical data on a variety of crude oils and refined petroleum products. The publication presents statistics on crude oil costs and refined petroleum products sales for use by industry, government, private sector analysts, educational institutions, and consumers. Data on crude oil include the domestic first purchase price, the f.o. b. and landed cost of imported crude oil, and the refiners` acquisition cost of crude oil. Refined petroleum product sales data include motor gasoline, distillates, residuals, aviation fuels, kerosene, and propane. The Petroleum Marketing Division, Office of Oil and Gas, Energy Information Administration ensures the accuracy, quality, and confidentiality of the published data in the Petroleum Marketing Monthly.

  6. Petroleum marketing monthly

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-02-01

    The Petroleum Marketing Monthly (PMM) provides information and statistical data on a variety of crude oils and refined petroleum products. The publication presents statistics on crude oil costs and refined petroleum products sales for use by industry, government, private sector analysts, educational institutions, and consumers. Data on crude oil include the domestic first purchase price, the f.o.b. and landed cost of imported crude oil, and the refiners acquisition cost of crude oil. Refined petroleum product sales data include motor gasoline, distillates, residuals, aviation fuels, kerosene, and propane. The Petroleum Marketing Division, Office of Oil and Gas, Energy Information Administration ensures the accuracy, quality, and confidentiality of the published data in the Petroleum Marketing Monthly.

  7. Electric power monthly

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    The Energy Information Administration (EIA) prepares the Electric Power Monthly (EPM) for a wide audience including Congress, Federal and State agencies, the electric utility industry, and the general public. This publication provides monthly statistics for net generation, fossil fuel consumption and stocks, quantity and quality of fossil fuels, cost of fossil fuels, electricity sales, revenue, and average revenue per kilowatthour of electricity sold. Data on net generation, fuel consumption, fuel stocks, quantity and cost of fossil fuels are also displayed for the North American Electric Reliability Council (NERC) regions. The EIA publishes statistics in the EPM on net generation by energy source, consumption, stocks, quantity, quality, and cost of fossil fuels; and capability of new generating units by company and plant. The purpose of this publication is to provide energy decisionmakers with accurate and timely information that may be used in forming various perspectives on electric issues that lie ahead.

  8. Electric power monthly

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Sandra R.; Johnson, Melvin; McClevey, Kenneth; Calopedis, Stephen; Bolden, Deborah

    1992-05-01

    The Electric Power Monthly is prepared by the Survey Management Division; Office of Coal, Nuclear, Electric and Alternate Fuels, Energy Information Administration (EIA), Department of Energy. This publication provides monthly statistics at the national, Census division, and State levels for net generation, fuel consumption, fuel stocks, quantity and quality of fuel, cost of fuel, electricity sales, revenue, and average revenue per kilowatthour of electricity sold. Data on net generation, fuel consumption, fuel stocks, quantity and cost of fuel are also displayed for the North American Electric Reliability Council (NERC) regions. Additionally, statistics by company and plant are published in the EPM on capability of new plants, new generation, fuel consumption, fuel stocks, quantity and quality of fuel, and cost of fuel.

  9. Preoperative Smoking Status and Postoperative Complications

    DEFF Research Database (Denmark)

    Grønkjær, Marie; Eliasen, Marie; Skov-Ettrup, Lise Skrubbeltrang;

    2014-01-01

    To systematically review and summarize the evidence of an association between preoperative smoking status and postoperative complications elaborated on complication type.......To systematically review and summarize the evidence of an association between preoperative smoking status and postoperative complications elaborated on complication type....

  10. Automated postoperative blood pressure control

    Institute of Scientific and Technical Information of China (English)

    Hang ZHENG; Kuanyi ZHU

    2005-01-01

    It is very important to maintain the level of mean arterial pressure (MAP).The MAP control is applied in many clinical situations,including limiting bleeding during cardiac surgery and promoting healing for patient's post-surgery.This paper presents a fuzzy controller-based multiple-model adaptive control system for postoperative blood pressure management.Multiple-model adaptive control (MMAC) algorithm is used to identify the patient model,and it is a feasible system identification method even in the presence of large noise.Fuzzy control (FC) method is used to design controller bank.Each fuzzy controller in the controller bank is in fact a nonlinear proportional-integral (PI) controller,whose proportional gain and integral gain are adjusted continuously according to error and rate of change of error of the plant output,resulting in better dynamic and stable control performance than the regular PI controller,especially when a nonlinear process is involved.For demonstration,a nonlinear,pulsatile-flow patient model is used for simulation,and the results show that the adaptive control system can effectively handle the changes in patient's dynamics and provide satisfactory performance in regulation of blood pressure of hypertension patients.

  11. Postoperative radicular neuroma. Case report.

    Science.gov (United States)

    Erman, T; Tuna, M; Göçer, A I; Idan, F; Akgül, E; Zorludemir, S

    2001-11-15

    Lumbar discectomy is the most common surgical procedure performed in neurosurgery clinics. Such a large number of procedures underscore not only the prevalence of conditions such as intervertebral disc herniation, but also the strong belief of surgeons that the operation does provide benefits to patients suffering from sciatica. In spite of this belief, sciatic pain may continue after the surgery. The recurrence of sciatic and/or back pain after primary discectomy is called the "failed back surgery syndrome." The rate of the complications involved in standard lumbar discectomy ranges from 5.4 to 14%. One of the complications of the lumbar disc surgery is nerve root injury. The complication rate of this injury ranges from 0.7 to 2.2%. Postoperative radicular neuroma must be considered in differential diagnosis for the patient who has failed back surgery syndrome. In this study the authors evaluate a patient who had undergone surgery for lumbar disc herniation and suffered intractable pain. A traumatic radicular neuroma is demonstrated and the pertinent literature is presented.

  12. Cytochrome P450 polymorphism and postoperative cognitive dysfunction

    DEFF Research Database (Denmark)

    Steinmetz, J; Jespersgaard, Cathrine; Dalhoff, Kim Peder;

    2012-01-01

    BACKGROUND:The etiology of postoperative cognitive dysfunction (POCD) remains unclear but toxicity of anesthetic drugs and their metabolites could be important. We aimed to assess the possible association between POCD after propofol anesthesia and various phenotypes owing to polymorphisms...... neuropsychological testing at one week had POCD, and 24 out of 307 (7.8%) had POCD at three months. None of the examined CYP2C19, 2D6 alleles, or various phenotypes were significantly associated with POCD. CONCLUSION: Polymorphisms in CYP2C19, or 2D6 genes do not seem to be related to the occurrence of cognitive...

  13. Are Hyoid Bone and Tongue the Risk Factors Contributing to Postoperative Relapse for Mandibular Prognathism?

    Directory of Open Access Journals (Sweden)

    Yu-Chuan Tseng

    2016-01-01

    Full Text Available Objective. The purpose of this study was to investigate postoperative stability and the correlation between hyoid, tongue, and mandible position following surgery for mandibular prognathism. Materials and Methods. Thirty-seven patients, treated for mandibular prognathism using intraoral vertical ramus osteotomy (IVRO, were evaluated cephalometrically. A set of four standardized lateral cephalograms were obtained from each subject preoperatively (T1, immediately postoperatively (T2, six weeks to three months postoperatively (T3, and more than one year postoperatively (T4. The Student t-tests, the Pearson correlation coefficient, and the multiple linear regression were used for statistical analysis. Results. Immediately after surgery, menton (Me setback was 12.8 mm, hyoid (H setback was 4.9 mm, and vallecula epiglottica (V setback was 5.8 mm. The postoperative stability significantly correlated (r=-0.512, p<0.01 with the amount of setback. The hyoid bone and tongue did not have significant effects on postoperative stability. Multiple linear regression model (R2=0.2658, p<0.05 showed predictability: Horizontal Relapse Me (T4-T2 = −6.406 − 0.488Me (T2-T1 + 0.069H (T2-T1 − 0.0619V (T2-T1. Conclusion. Mandibular setback surgery may push the hyoid and tongue significantly backward, but this did not correlate with mandibular relapse. Postoperative stability significantly correlated with the amount of mandibular setback.

  14. Recovery from post-operative anaemia.

    Science.gov (United States)

    Wallis, J P; Wells, A W; Whitehead, S; Brewster, N

    2005-10-01

    Acceptance of lower transfusion thresholds and shorter post-operative stays results in patients leaving hospital after surgery with lower haemoglobin (Hb) than previously. We undertook a prospective observational study to assess the haematological response to post-operative anaemia and to determine the utility of quality of life (QoL) measures in assessing the impact of anaemia on such patients. Thirty patients undergoing unilateral hip arthroplasty had blood samples taken and QoL questionnaires administered pre-operatively and at 7, 28 and 56 days post-operatively. Increased erythropoiesis was evident at day 7 post-operatively. Approximately two-thirds of the post-operative Hb deficit was corrected by day 28. There was evidence of functional iron deficiency in more than one-quarter of patients at day 56. QoL scores used did not show any relationship with Hb in the post-operative period. Red cell 2,3-diphosphoglycerate (2,3DPG) levels increased in proportion to the degree of post-operative anaemia. We concluded that substantial recovery of Hb occurs between day 7 and day 28 post-operatively. Complete recovery of Hb may be delayed beyond day 56 due to development of iron deficiency. Patients are at significant risk of developing post-operative iron deficiency depending on operative blood loss and pre-operative iron stores. Increased red cell 2,3DPG may offset the effect of anaemia on oxygen delivery. We found no evidence that anaemia produces a measurable effect on chosen QoL scores in the post-operative period.

  15. Renal allograft loss in the first post-operative month: causes and consequences.

    LENUS (Irish Health Repository)

    Phelan, Paul J

    2013-01-15

    Early transplant failure is a devastating outcome after kidney transplantation. We report the causes and consequences of deceased donor renal transplant failure in the first 30 d at our center between January 1990 and December 2009. Controls were adult deceased donor transplant patients in the same period with an allograft that functioned >30 d. The incidence of early graft failure in our series of 2381 consecutive deceased donor transplants was 4.6% (n = 109). The causes of failure were allograft thrombosis (n = 48; 44%), acute rejection (n = 19; 17.4%), death with a functioning allograft (n = 17; 15.6%), primary non-function (n = 14;12.8%), and other causes (n = 11; 10.1%). Mean time to allograft failure was 7.3 d. There has been a decreased incidence of all-cause early failure from 7% in 1990 to <1% in 2009. Patients who developed early failure had longer cold ischemia times when compared with patients with allografts lasting >30 d (p < 0.001). Early allograft failure was strongly associated with reduced patient survival (p < 0.001). In conclusion, early renal allograft failure is associated with a survival disadvantage, but has thankfully become less common in recent years.

  16. The Twelve Promises of Alcoholics Anonymous: psychometric measure validation and mediational testing as a 12-step specific mechanism of behavior change.

    Science.gov (United States)

    Kelly, John F; Greene, M Claire

    2013-12-01

    Empirical support for the recovery utility of 12-step mutual-help organizations (MHOs) has led to increased investigation of how such organizations confer benefit. The Twelve Promises of Alcoholics Anonymous (AA) feature prominently in 12-step philosophy and culture and are one of the few documented explications of the cognitive, affective, and behavioral benefits that members might accrue. This study investigated the psychometric properties of a measure of AA's Twelve Promises and examined whether it mediated the effect of 12-step participation on abstinence. Young adults (N=302, M age 20.4 [1.6], range 18-25; 27% female; 95% White) enrolled in an addiction treatment effectiveness study completed assessments at intake and 3-, 6-, and 12-months post treatment including a 26-item, Twelve Promises Scale (TPS). Factor analyses examined the TPS' psychometrics and lagged mediational analyses tested the TPS as a mechanism of behavior change. Robust principal axis factoring extraction with Varimax rotation revealed a 2-factor solution explaining 45-58% of the variance across three administrations ("Psychological Wellbeing"=26-39%; "Freedom from Craving=17-21%); internal consistency was high (alpha=.83-.93). Both factors were found to increase in relation to greater 12-step participation, but significant mediation was found only for the Freedom from Craving factor explaining 21-34% of the effect of 12-step participation in increasing abstinence. The TPS shows potential as a conceptually relevant, and psychometrically sound measure and may be useful in helping elucidate the extent to which the Twelve Promises emerge as an independent benefit of 12-step participation and/or explain SUD remission and recovery. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. Hereditary vulnerabilities to post-operative cognitive dysfunction and dementia.

    Science.gov (United States)

    Hogan, Kirk J

    2013-12-01

    In view of multiple prospective investigations reporting an incidence of 10% or greater in elderly patients after cardiac and non-cardiac procedures, it is surprising that no families, twins or even individual cases have been reported with persistent post-operative cognitive dysfunction (POCD) or post-operative dementia (POD) that is otherwise unexplained. As POCD and POD research has shifted in recent years from surgical and anesthetic variables to predictors of intrinsic, patient-specific susceptibility, a number of markers based on DNA sequence variation have been investigated. Nevertheless, no heritable, genomic indices of persistent POCD or post-operative dementia lasting 3 months or longer after surgery have been identified to date. The present manuscript surveys challenges confronting the search for markers of heritable vulnerability to POCD and POD, and proposes steps forward to be taken now, including the addition of surgical and anesthetic descriptors to ongoing longitudinal dementia protocols and randomized clinical trials (RCTs) comprising serial psychometric testing, and a fresh focus on phenotypes and genotypes shared between outliers with "extreme" POCD and POD traits.

  18. Petroleum marketing monthly

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-11-01

    The Petroleum Marketing Monthly (PMM) provides information and statistical data on a variety of crude oils and refined petroleum products. The publication presents statistics on crude oil costs and refined petroleum products sales for use by industry, government, private sector analysts, educational institutions, and consumers. Data on crude oil include the domestic first purchase price, the f.o.b. and landed cost of imported crude oil, and the refiners` acquisition cost of crude oil. Refined petroleum product sales data include motor gasoline, distillates, residuals, aviation fuels, kerosene, and propane. The Petroleum Marketing Division, Office of Oil and Gas, Energy Information Administration ensures the accuracy, quality, and confidentiality of the published data.

  19. Isolation and characterization of twelve microsatellite loci for the Japanese Devilray (Mobula japanica)

    NARCIS (Netherlands)

    Poortvliet, Marloes; Galvan-Magana, Felipe; Bernardi, Giacomo; Croll, Donald A.; Olsen, Jeanine L.

    2011-01-01

    Twelve polymorphic microsatellites loci were characterized for Mobula japanica (Japanese Devilray) using an enrichment protocol. All but two loci were in Hardy-Weinberg equilibrium with no evidence of linkage disequilibrium or null-alleles for a sample of 40 individuals from two populations. The num

  20. Twelve new species of Triplocania Roesler (Psocodea: 'Psocoptera': Ptiloneuridae), from South America.

    Science.gov (United States)

    Silva Neto, Alberto Moreira Da; Aldrete, Alfonso N García; Rafael, José Albertino

    2016-05-09

    Twelve species of Triplocania, seven based on male and female specimens and five based on male specimens, are here described and illustrated; nine species are Brazilian, three are Ecuadorian, and one of the latter is shared with Peru. Comments on sexes known and distribution of the species are included.

  1. Portrayal of Life Form in Selected Biographies for Children Eight to Twelve Years of Age.

    Science.gov (United States)

    Koch, Shirley Lois

    This study describes and analyzes, in a critical literary manner, selected biographies for children eight to twelve years of age. Biographies of Jane Addams, Cesar Chavez, Mohandas Gandhi, Toyohiko Kagawa, Martin Luther King, Jr., and Albert Schweitzer are viewed from the perspective of a literary criterion based on the principles of design to…

  2. Portrayal of Life Form in Selected Biographies for Children Eight to Twelve Years of Age.

    Science.gov (United States)

    Koch, Shirley Lois

    This study describes and analyzes, in a critical literary manner, selected biographies for children eight to twelve years of age. Biographies of Jane Addams, Cesar Chavez, Mohandas Gandhi, Toyohiko Kagawa, Martin Luther King, Jr., and Albert Schweitzer are viewed from the perspective of a literary criterion based on the principles of design to…

  3. A novel double quad-inverter configuration for multilevel twelve-phase open-winding converter

    DEFF Research Database (Denmark)

    Padmanaban, Sanjeevi Kumar; Blaabjerg, Frede; Wheeler, Patrick William

    2016-01-01

    This paper describes a novel proposal of double quad-inverter configuration for multilevel twelve-phase open-winding ac converter. Modular power units are developed from reconfigured eight classical three-phase voltage source inverters (VSIs). Each VSI has one additional bi-directional switching ...

  4. Deep brain stimulation: postoperative issues.

    Science.gov (United States)

    Deuschl, Günther; Herzog, Jan; Kleiner-Fisman, Galit; Kubu, Cynthia; Lozano, Andres M; Lyons, Kelly E; Rodriguez-Oroz, Maria C; Tamma, Filippo; Tröster, Alexander I; Vitek, Jerrold L; Volkmann, Jens; Voon, Valerie

    2006-06-01

    Numerous factors need to be taken into account when managing a patient with Parkinson's disease (PD) after deep brain stimulation (DBS). Questions such as when to begin programming, how to conduct a programming screen, how to assess the effects of programming, and how to titrate stimulation and medication for each of the targeted sites need to be addressed. Follow-up care should be determined, including patient adjustments of stimulation, timing of follow-up visits and telephone contact with the patient, and stimulation and medication conditions during the follow-up assessments. A management plan for problems that can arise after DBS such as weight gain, dyskinesia, axial symptoms, speech dysfunction, muscle contractions, paresthesia, eyelid, ocular and visual disturbances, and behavioral and cognitive problems should be developed. Long-term complications such as infection or erosion, loss of effect, intermittent stimulation, tolerance, and pain or discomfort can develop and need to be managed. Other factors that need consideration are social and job-related factors, development of dementia, general medical issues, and lifestyle changes. This report from the Consensus on Deep Brain Stimulation for Parkinson's Disease, a project commissioned by the Congress of Neurological Surgeons and the Movement Disorder Society, outlines answers to a series of questions developed to address all aspects of DBS postoperative management and decision-making with a systematic overview of the literature (until mid-2004) and by the expert opinion of the authors. The report has been endorsed by the Scientific Issues Committee of the Movement Disorder Society and the American Society of Stereotactic and Functional Neurosurgery.

  5. Indications and postoperative treatment for Ex-PRESS® insertion in Japanese patients with glaucoma: comparison with standard trabeculectomy

    Directory of Open Access Journals (Sweden)

    Kato N

    2015-08-01

    Full Text Available Noriko Kato,1,2 Genichiro Takahashi,1,2 Koichi Kumegawa,1,2 Yoshiaki Kabata,1,2 Hiroshi Tsuneoka1 1Department of Ophthalmology, Jikei University, School of Medicine, 2Katsushika Medical Center, Tokyo, Japan Background: We investigated indications and early postoperative treatment for Ex-PRESS® insertion for glaucoma by comparing postoperative outcomes with those for standard trabeculectomy. Methods: Ex-PRESS insertion was performed in 21 eyes and standard trabeculectomy (TLE in 22 eyes. Mean intraocular pressure (IOP in the 6 months after surgery, success rate for postoperative IOP decline, postoperative complications, postoperative treatment, filtering blebs, and indications were then retrospectively investigated. Results: Mean postoperative IOP did not differ significantly between the groups at any observation time for 6 months after surgery. Further, it did not differ between either the groups of patients with primary open-angle glaucoma (POAG and neovascular glaucoma (NTG, or the patients with primary open-angle glaucoma and NTG in the Ex-PRESS group. Comparison of success rates in reduction of postoperative IOP between the groups under the following four survival conditions showed no significant differences: postoperative IOP <30% of the preoperative IOP, complete success (no additional ophthalmic solution, and qualified success (ophthalmic solution required; 5 mmHg ≤ postoperative IOP ≤21 mmHg, complete success (no additional ophthalmic solution, and qualified success (ophthalmic solution required. With regard to postoperative complications and postoperative treatment, the incidence of hyphema was significantly lower in the Ex-PRESS group, but no other significant intergroup differences were seen. The height of the filtering bleb was lower in the Ex-PRESS group. Conclusion: Postoperative outcomes in the Ex-PRESS and TLE groups were comparable. The incidence of hyphema was significantly lower in the Ex-PRESS group. Ex-PRESS insertion

  6. Role of buprenorphine in acute postoperative pain

    Directory of Open Access Journals (Sweden)

    J. Alcázar-Castro

    2016-07-01

    Full Text Available Nowadays acute postoperative pain persists as a high prevalence symptom. The incidence, intensity and duration of postoperative pain vary considerably from one patient to another, from one surgery to another, from one hospital to another, and even from one country to another. It is important to learn about recent developments in central sensitisation, as it plays an important role in postoperative pain. Postoperative pain is mainly nociceptive somatic, in response to surgical damage. The surgical trauma and pain cause an endocrine response that increases the secretion of cortisol, catecholamines, and other stress hormones. Tachycardia, hypertension, decreased regional blood flow, impaired immune response, hyperglycaemia, lipolysis, and negative nitrogen balance also occur. All this plays an important role in morbidity and mortality in the postoperative period. Buprenorphine is a semi-synthetic opioid derived from thebaine. It has a binding affinity for the mu, kappa and delta receptors, and has a slow dissociation from these receptors. Because of its action on the mu and kappa receptors it can be used as an analgesic, as well as for maintenance therapy in patients with a history of drug abuse. This article will describe the characteristics of acute postoperative pain, the pharmacology of buprenorphine, and its interference in the management of postoperative pain.

  7. Action Production Influences 12-Month-Old Infants' Attention to Others' Actions

    Science.gov (United States)

    Cannon, Erin N.; Woodward, Amanda L.; Gredeback, Gustaf; von Hofsten, Claes; Turek, Colleen

    2012-01-01

    Recent work implicates a link between action control systems and action understanding. In this study, we investigated the role of the motor system in the development of visual anticipation of others' actions. Twelve-month-olds engaged in behavioral and observation tasks. "Containment activity", infants' spontaneous engagement in producing…

  8. The influence of awake craniotomy on postoperative neuropsychology

    Directory of Open Access Journals (Sweden)

    YANG Ming-yuan

    2012-12-01

    Full Text Available Objective To assess the neuropsychological function and quality of life of the patients after awake craniotomy (AC. Methods A case-control study was conducted among 81 patients who underwent awake craniotomy, and a 1-to-1 control group (matched by age, gender, degree of education, tumor location and characteristic undergoing general anesthesia (GA in glioma resections was assembled. The incidence of postoperative neurological deficits, psychological disorders and recurrence were investigated during telephone follow-ups, and Medical Outcomes Study Short Form 36 (SF-36 was adopted to evaluate the life quality of patients. Results Almost 73 pairs of patients fulfilled the survey of AC and GA group respectively. There were 21 patients and 28 patients with postoperative neurological deficits, and 12 patients and 8 patients with psychological disorders in AC and GA group respectively. Thirty patients of AC group had the recollection of being awake during the surgery. There were 9 patients in CA group having long-term ( > 6 months neurological deficits, which was less than the number of GA group (18 patients, P = 0.038. According to the assessment in short-term, medium-term and long-term postoperative neurological deficits, there was no significant difference in the quality-of-life scores between the two groups (P > 0.05, for all. Conclusion Awake craniotomy can be the main method for removing the lesions located in or close to functional areas with lower incidence of long?term postoperative neurological deficits, and it has no significant impact on the psychological status and the quality of life postoperatively.

  9. Effect of macular hole volume on postoperative central macular thickness

    Directory of Open Access Journals (Sweden)

    Taylan Ozturk

    2016-06-01

    Full Text Available ABSTRACT Purpose: To evaluate the association between macular hole volume (MHV and postoperative central macular thickness (CMT using spectral-domain optical coherence tomography (SD-OCT. Methods: Thirty-three eyes of 30 patients with a large full-thickness idiopathic macular hole with or without vitreomacular traction who underwent surgical intervention were included in this cross-sectional study. Complete ophthalmological examination, including SD-OCT, was performed for all participants during the pre- and postoperative visits. MHV was preoperatively measured using SD-OCT, which captured the widest cross-sectional image of the hole. For normal distribution analysis of the data, the Kolmogorov-Smirnov test was performed, and for statistical analyses, chi-square, Student's t-test, Mann-Whitney U test, and Pearson's correlation coefficient test were performed. Results: Mean preoperative best-corrected visual acuity (BCVA and MHV were found to be 0.99 ± 0.36 (range, 0.3-2.0 logMAR and 0.139 ± 0.076 (range, 0.004-0.318 mm3, respectively. Mean follow-up was 16.3 ± 14.3 (range, 3-50 months. No statistical correlations were found between MHV and postoperative BCVA (p=0.588 and between MHV and disease recurrence (p=0.544. A weak negative correlation existed between MHV and final CMT scores (p=0.04, r=-0.383. Conclusions: Greater MHV was found to be weakly associated with lower postoperative CMT scores.

  10. Clinical factors associated with postoperative hydronephrosis after ureteroscopic lithotripsy

    Science.gov (United States)

    Kim, Sun Woo; Ahn, Ji Hoon; Yim, Sang Un; Cho, Yang Hyun; Shin, Bo Sung; Chung, Ho Seok; Yu, Ho Song; Oh, Kyung Jin; Kim, Sun-Ouck; Jung, Seung Il; Kang, Taek Won; Kwon, Dong Deuk; Park, Kwangsung

    2016-01-01

    Purpose This study aimed to determine the predictors of ipsilateral hydronephrosis after ureteroscopic lithotripsy for ureteral calculi. Materials and Methods From January 2010 to December 2014, a total of 204 patients with ureteral calculi who underwent ureteroscopic lithotripsy were reviewed. Patients with lack of clinical data, presence of ureteral rupture, and who underwent simultaneous percutaneous nephrolithotomy (PNL) were excluded. Postoperative hydronephrosis was determined via computed tomographic scan or renal ultrasonography, at 6 months after ureteroscopic lithotripsy. Multivariable analysis was performed to determine clinical factors associated with ipsilateral hydronephrosis. Results A total of 137 patients were enrolled in this study. The mean age of the patients was 58.8±14.2 years and the mean stone size was 10.0±4.6 mm. The stone-free rate was 85.4%. Overall, 44 of the 137 patients (32.1%) had postoperative hydronephrosis. Significant differences between the hydronephrosis and nonhydronephrosis groups were noted in terms of stone location, preoperative hydronephrosis, impacted stone, operation time, and ureteral stent duration (all, p<0.05). On multivariable analysis, increasing preoperative diameter of the hydronephrotic kidney (adjusted odds ratio [OR], 1.21; 95% confidence interval [CI], 1.12–1.31; p=0.001) and impacted stone (adjusted OR, 3.01; 95% CI, 1.15–7.61; p=0.031) independently predicted the occurrence of postoperative hydronpehrosis. Conclusions Large preoperative diameter of the hydronephrotic kidney and presence of impacted stones were associated with hydronephrosis after ureteroscopic stone removal. Therefore, patients with these predictive factors undergo more intensive imaging follow-up in order to prevent renal deterioration due to postoperative hydronephrosis. PMID:27617316

  11. Pterygium excision with or without postoperative irradiation, a double-blind study

    Energy Technology Data Exchange (ETDEWEB)

    de Keizer, R.J.W. (Amsterdam Univ. (Netherlands). Academisch Ziekenhuis)

    1982-01-29

    A double-blind study (covering 40 months) of 40 eyes with a pterygium which had not previously been operated on, was carried out to study the effect of post-operative irradiation. Nineteen eyes were treated by the 'bare sclera' operation technique only and in 13 cases (68%) a recurrence occurred within 4 months. In 18 eyes from the group of patients treated with Sr 90 irradiation on the 1st, 7th and 14th postoperative day (maximum 3 x 1000 rad) no recurrences were seen. Patients with a recurrent pterygium and diplopia, symblepharon, visual disturbances (growth over the pupil or severe astigmatism) or many previous operations, were treated by lamellar keratoplasty (Dake, 1980). The recurrences without these complications were treated with success by the 'bare sclera' technique and postoperative irradiation. Complications did not occur in any of the series.

  12. Effects of posture on postoperative pulmonary function

    DEFF Research Database (Denmark)

    Nielsen, K G; Holte, Kathrine; Kehlet, H

    2003-01-01

    BACKGROUND: Pulmonary morbidity is still a relevant complication to major surgery despite improvements in surgical technique and anaesthetic methods. Postoperative posture may be a pathogenic factor, but the effects of changes in postoperative posture on pulmonary function have not been reviewed....... METHODS: Review of controlled, clinical trials evaluating postoperative pulmonary function in patients positioned in the supine vs. the sitting or standing position and patients positioned in the supine vs. the lateral position. Data were obtained from a search in the Medline and Cochrane databases (1966...

  13. Imaging of the postoperative middle ear

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Marc T. [Department of Medical Imaging, Fondation Ophtalmologique Adolphe de Rothschild, 25 rue Manin, 75940, Paris (France); Ayache, Denis [Department of Otorhinolaryngology, Fondation Ophtalmologique Adolphe de Rothschild, Paris (France)

    2004-03-01

    The aim of this article is twofold: (a) to present the principles and the indications of surgical treatment of middle ear pathologies; and (b) to review the imaging findings after middle ear surgery, including the normal postoperative aspects and imaging findings in patients presenting with unsatisfactory surgical results or with suspicion of postoperative complications. This review is intentionally restricted to the most common diseases involving the middle ear: chronic otitis media and otosclerosis. In these specific fields of interest, CT and MR imaging play a very important role in the postoperative follow-up and in the work-up of surgical failures and complications. (orig.)

  14. Commissioners' Monthly Case Activity Report

    Data.gov (United States)

    Occupational Safety and Health Review Commission — Total cases pending at the beginning of the month, total cases added to the docket during the month, total cases disposed of during the month, and total cases...

  15. Postoperative Follow-up After Bariatric Surgery: Effect on Weight Loss.

    Science.gov (United States)

    Spaniolas, Konstantinos; Kasten, Kevin R; Celio, Adam; Burruss, Matthew B; Pories, Walter J

    2016-04-01

    While adherence to long-term follow-up after bariatric surgery is a mandate for center of excellence certification, the effect of attrition on weight loss is not well understood. The aim of this study was to assess the effect of postoperative follow-up on 12-month weight loss using the Bariatric Outcomes Longitudinal Database (BOLD) dataset. Patients with complete follow-up (3, 6, and 12 months) were compared to patients who had one or more prior missed visits. There were 51,081 patients with 12-month follow-up data available. After controlling for baseline characteristics, complete follow-up was independently associated with excess weight loss ≥50%, and total weight loss ≥30%. Adherence to postoperative follow-up is independently associated with improved 12-month weight loss after bariatric surgery. Bariatric programs should strive to achieve complete follow-up for all patients.

  16. Benchmarking monthly homogenization algorithms

    Directory of Open Access Journals (Sweden)

    V. K. C. Venema

    2011-08-01

    Full Text Available The COST (European Cooperation in Science and Technology Action ES0601: Advances in homogenization methods of climate series: an integrated approach (HOME has executed a blind intercomparison and validation study for monthly homogenization algorithms. Time series of monthly temperature and precipitation were evaluated because of their importance for climate studies and because they represent two important types of statistics (additive and multiplicative. The algorithms were validated against a realistic benchmark dataset. The benchmark contains real inhomogeneous data as well as simulated data with inserted inhomogeneities. Random break-type inhomogeneities were added to the simulated datasets modeled as a Poisson process with normally distributed breakpoint sizes. To approximate real world conditions, breaks were introduced that occur simultaneously in multiple station series within a simulated network of station data. The simulated time series also contained outliers, missing data periods and local station trends. Further, a stochastic nonlinear global (network-wide trend was added.

    Participants provided 25 separate homogenized contributions as part of the blind study as well as 22 additional solutions submitted after the details of the imposed inhomogeneities were revealed. These homogenized datasets were assessed by a number of performance metrics including (i the centered root mean square error relative to the true homogeneous value at various averaging scales, (ii the error in linear trend estimates and (iii traditional contingency skill scores. The metrics were computed both using the individual station series as well as the network average regional series. The performance of the contributions depends significantly on the error metric considered. Contingency scores by themselves are not very informative. Although relative homogenization algorithms typically improve the homogeneity of temperature data, only the best ones improve

  17. [Hip fracture, antiplatelet drugs treatment and postoperative complications].

    Science.gov (United States)

    Reguant, F; Martínez, E; Gil, B; Prieto, J C; del Milagro Jiménez, L; Arnau, A; Bosch, J

    2013-11-01

    To assess the incidence of postoperative complications, blood transfusions and survival at one month, in the old patients operated for hip fracture undergoing chronic treatment with antiplatelet drugs. Two hundred twenty three patients operated for hip fracture were studied retrospectively, separated into 3 groups: patients who received acetylsalicylic acid (group I), patients who were given 100mg/day of acetylsalicylic acid or 300mg/day of triflusal (group II) and patients receiving>100mg/day of acetylsalicylic acid, or>300mg/day of triflusal or thienopyridines (group III). Surgery was delayed for 4 days in patients in group III. Demographic, biological, clinical and treatment characteristics, postoperative complications and survival at one month were recorded. Patients in group III were older and sustain worse general health status. Patients with a higher transfusion requirement were those of group II (73.8%) (P=0.192), who also showed a higher percentage of anaemia on admission. Severe cardiovascular complications were experienced by 5.4% of group III patients, 4.8% of group II patients and 2.1% of group I patients. Patients from group III presented a significant amount of respiratory complications (P=0.007). Our results suggest that delaying surgery for 4 days in patients treated with clopidogrel can be associated to an increase in postoperative respiratory complications and severe adverse cardiovascular events, without increasing the tranfusional index, hospital stay, mortality, and without complications related to neuraxial anaesthesia. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  18. Postoperative adjuvant radiotherapy and 5-fluorouracil chemotherapy for rectal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Chao, M.W.T.; Lim-Joon, M.; Wada, M. [Peter MacCallum Cancer Institute, Melbourne, VIC (Australia). Division of Radiation Oncology; Byram, D.; Vaughan, S.; McLennan, R.; Joseph, D. [Geelong Hospital, Geelong, VIC (Australia). Department of Radiation and Medical Oncology; Bell, R.; Bond, R. [St John of God Hospital, Ballarat, VIC (Australia). Department of Medical Oncology

    1998-02-01

    Postoperative combined modality therapy with radiotherapy and 5-fluorouracil (5FU) chemotherapy is an effective adjuvant approach that reduces locoregional and distant metastatic disease in patients with high-risk rectal carcinoma. However, this approach results in a treatment regimen of at least 6 months` duration. The present prospective study investigates the integration of radiotherapy and 5FU chemotherapy in a protocol designed to minimize toxicity and reduce the overall treatment time. A total of 40 patients with TNM stage 11 or 111 disease receives postoperative radiotherapy at four fractions per week with weekly 5FU bolus injections delivered on the fifth non radiotherapy day. Patients also received systemic chemotherapy with leucovorin both before and after pelvic irradiation, with the total treatment duration extending for only 18 weeks. Patients were able to complete radiotherapy in 90% of cases, while the delivery of full-dose chemotherapy was achievable in the vast majority. The incidence of haematologic and gastrointestinal toxicities requiring the cessation of treatment was acceptable. With a median follow-up of 20.9 months among surviving patients, the estimated progression-free and overall survival at 2 years were 71% and 79%, respectively. Copyright (1998) Blackwell Science Pty Ltd 15 refs., 7 tabs., 4 figs

  19. EVALUATION OF POST-OPERATIVE SENSITIVITY AND ...

    African Journals Online (AJOL)

    Prof

    composites in wear resistance and achievement of good proximal contour ... change in result was recorded for post-operative sensitivity at the end of the evaluation period. 100% was recorded ..... Overcoming challenges with resin in class II ...

  20. [Postoperative inconveniences after breast cancer surgery

    DEFF Research Database (Denmark)

    Gartner, R.; Callesen, T.; Kroman, N.

    2008-01-01

    The most common postoperative inconveniences after breast cancer surgery are pain, nausea and vomiting, which contribute to reduced patient satisfaction, prolonged hospital stays and delayed courses of rehabilitation. This article summarizes the literature regarding available procedure...

  1. Prevention of postoperative infections in ophthalmic surgery

    Directory of Open Access Journals (Sweden)

    Ram Jagat

    2001-01-01

    Full Text Available Postoperative endophthalmitis is a serious, vision-threatening complication of intraocular surgery. Better instrumentation, surgical techniques, prophylactic antibiotics and better understanding of asepsis have significantly reduced the incidence of this complication. Postoperative endophthalmitis may occur as an isolated event or as a cluster infection. Topical antibiotics, preoperative periocular preparation with povidone-iodine combined with a sterile operating room protocol significantly reduce the incidence of isolated postoperative endophthalmitis. The role of antibiotics in the irrigating fluid and subconjunctival antibiotics remains controversial. Cluster infections on the other hand are more likely to occur due to the use of contaminated fluids/viscoelastics or a breach in operating room asepsis. Prevention of postoperative endophthalmitis requires strict adherence to operating room norms, with all involved personnel discharging their assigned roles faithfully.

  2. Recovery room nurses' knowledge regarding postoperative airway ...

    African Journals Online (AJOL)

    Adele

    patients. Aim: To determine the knowledge of recovery room nurses regarding postoperative airway emergencies in adult patients in private hospitals ..... sia nursing care, as well as current research findings and new technologies in this field.

  3. Abdominal CT findings of delayed postoperative complications

    Energy Technology Data Exchange (ETDEWEB)

    Zissin, R.; Osadchy, A. [Sapir Medical Center, Dept. of Diagnostic Imaging, Kfar Saba (Israel)]. E-mail: zisinrivka@clalit.org.il; Gayer, G. [Assaf Harofe Medical Center, Dept. of Diagnostic Imaging, Zrifin (Israel)

    2007-10-15

    Despite progress in surgical techniques and modern medical treatment, postoperative complications occur not infrequently and vary according to type of surgery, clinical setting, and time elapsed since surgery. In general, they can be divided into early and delayed complications. Delayed postoperative complications can be classified as specific and nonspecific. The common nonspecific delayed complications are incisional hernia and postoperative bowel obstruction. Bowel obstruction can be further categorized as obstruction related to benign or neoplastic etiology, the latter occurring in oncology patients in whom the primary surgery was related to an underlying abdominal neoplasm. Gossypiboma is another, fortunately rare, postoperative complication. Specific complications appear after specific operations and include the following: Splenosis - following splenectomy. Retained gallstones and spilled gallstones - following cholecystectomy, mainly laparoscopic. Dropped appendicolith and stump appendicitis - following appendectomy, mainly laparoscopic. Obturation obstruction by a bezoar - following gastric surgery. Afferent loop syndrome (ALS) - following Bilroth II gastrectomy. (author)

  4. Methodological issues of postoperative cognitive dysfunction research

    DEFF Research Database (Denmark)

    Funder, Kamilia S; Steinmetz, Jacob; Rasmussen, Lars S

    2010-01-01

    to reveal postoperative cognitive decline, and questionnaires are not useful for this purpose. There is a profound lack of consensus regarding the research methodology for detection of cognitive deterioration, especially the diagnostic criteria. Issues, such as baseline performance, learning effects...

  5. Postoperative Pain Management: Clinicians' Knowledge and ...

    African Journals Online (AJOL)

    Postoperative Pain Management: Clinicians' Knowledge and Practices on Assessment and ... It, therefore, commands a central position in health seeking behavior. ... it causes, but also because of its negative effects on the process of recovery.

  6. Multimodality imaging of the postoperative shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Woertler, Klaus [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany)

    2007-12-15

    Multimodality imaging of the postoperative shoulder includes radiography, magnetic resonance (MR) imaging, MR arthrography, computed tomography (CT), CT arthrography, and ultrasound. Target-oriented evaluation of the postoperative shoulder necessitates familiarity with surgical techniques, their typical complications and sources of failure, knowledge of normal and abnormal postoperative findings, awareness of the advantages and weaknesses with the different radiologic techniques, and clinical information on current symptoms and function. This article reviews the most commonly used surgical procedures for treatment of anterior glenohumeral instability, lesions of the labral-bicipital complex, subacromial impingement, and rotator cuff lesions and highlights the significance of imaging findings with a view to detection of recurrent lesions and postoperative complications in a multimodality approach. (orig.)

  7. A Prospective Study of Comparing Multi-Gene Biomarker Chip and Serum Carcinoembryonic Antigen in the Postoperative Surveillance for Patients with Stage I-III Colorectal Cancer.

    Science.gov (United States)

    Chang, Yu-Tang; Huang, Ming-Yii; Yeh, Yung-Sung; Huang, Ching-Wen; Tsai, Hsiang-Lin; Cheng, Tian-Lu; Wang, Jaw-Yuan

    2016-01-01

    Circulating biomarkers can predict clinical outcomes in colorectal cancer patients. The aim of the study was to evaluate the feasibility of our multigene biomarker chip for detecting circulating tumor cells for postoperative surveillance of stage I-III colorectal cancer patients. In total, 298 stage I-III colorectal cancer patients were analyzed after curative resection between June 2010 and October 2014. During each follow-up, a postoperative surveillance strategy, including ESMO Guidelines Working Group recommendations and the biochip, was used. After a 28.4-month median follow-up, 48 (16.1%) patients had postoperative relapse. Univariate analysis revealed that the postoperative relapse risk factors were rectal tumor, perineural invasion, elevated preoperative and postoperative serum carcinoembryonic antigen levels, and positive biochip results (all P postoperative relapse correlated significantly with elevated postoperative serum carcinoembryonic antigen levels (odds ratio = 4.136, P = 0.008) and positive biochip results (odds ratio = 66.878, P sensitivity (P = 0.003), specificity (P = 0.003), positive (P = 0.002) and negative (P = 0.006) predictive values, and accuracy (P postoperative relapse were significantly higher than those of elevated postoperative serum carcinoembryonic antigen levels. Moreover, the median lead time between positive biochip result and postoperative relapse detection was significantly earlier than that between elevated postoperative serum carcinoembryonic antigen level and postoperative relapse detection (10.7 vs. 2.8 months, P postoperative relapse during stage I-III colorectal cancer patient surveillance. In clinical practice, this biochip may facilitate early postoperative relapse diagnosis in colorectal cancer patients.

  8. [Postoperative fever in orthopedic and urologic surgery].

    Science.gov (United States)

    Saavedra, Federico; Myburg, Cristina; Lanfranconi, Marisa B; Urtasun, Martin; De Oca, Luis Montes; Silberman, Andres; Lambierto, Alberto; Gnocchi, Cesar A

    2008-01-01

    Post-operative fever incidence varies widely. In clean and clean-contaminated surgery the non-infectious fever is more frequent than the infectious fever. We performed a prospective study including 303 patients who underwent orthopedic and urologic elective surgery. The aims of our study were to investigate the incidence of post-operative fever, its etiology, the relationship between time of onset and the etiology, and the usefulness of extensive fever work-up to determine post-operative infection. The incidence of post-operative fever was 14% (42/303) of which 81% (34/42) was noninfectious and 19% (8/42) was infectious. The etiology of the fever in the first 48 hours after surgery was always non-infectious (p fever work-up was performed in patients who presented fever only after the initial 48 hours of surgery with normal physical examination (n = 19) consisting of chest x-ray, blood (2) and urine cultures. The chest x-ray was normal in all the patients, the urine cultures were positive in four cases (21%, IC 95%: 6-45) and the blood cultures in only one case (5%, IC 95%: 0.1-26). Seven patients had post-operative infections without fever as a clinical sign. The most frequently observed etiology of post-operative fever was non-infectious, related to the normal inflammatory host response to surgery. Based on the present results, the extensive fever work-up performed to investigate post-operative infection does not seem to be a useful tool. The diagnosis of post-operative infection was based on clinical follow up and the correct interpretation of the patient's symptoms and signs.

  9. Postoperative pyrexia after arthroplasty - when to panic ?

    OpenAIRE

    Agarwala Sanjay; Jain Deepak; Bhagwat Abhijit

    2005-01-01

    Background: Success of arthroplasty is contingent on a clear understanding of the potential complications. Today with improved methods of sepsis control, incidence of joint sepsis has dropped to less than 2%. Despite this fever is still common in the early post-operative period. Methods: We reviewed 184 consecutive hip and knee replacement surgeries for incidence and clinical significance of post-operative fever. The cases were followed up for a period of over 3 to 5 years. Temperat...

  10. Need for improved treatment of postoperative pain

    DEFF Research Database (Denmark)

    Mathiesen, Ole; Thomsen, Berit Ahlmann; Kitter, Birgitte;

    2012-01-01

    A cross-sectional study was performed at Rigshospitalet, Copenhagen, a Danish tertiary university hospital, to describe current postoperative pain and nausea treatment with a view to identifying areas with improvement potential.......A cross-sectional study was performed at Rigshospitalet, Copenhagen, a Danish tertiary university hospital, to describe current postoperative pain and nausea treatment with a view to identifying areas with improvement potential....

  11. Methodological issues of postoperative cognitive dysfunction research

    DEFF Research Database (Denmark)

    Funder, Kamilia S; Steinmetz, Jacob; Rasmussen, Lars S

    2010-01-01

    Postoperative cognitive dysfunction (POCD) is a subtle impairment of memory, concentration, and speed of information processing. It is a frequent complication following surgery and can have a debilitating effect on patients' recovery and future prognosis. Neuropsychological testing is needed...... to reveal postoperative cognitive decline, and questionnaires are not useful for this purpose. There is a profound lack of consensus regarding the research methodology for detection of cognitive deterioration, especially the diagnostic criteria. Issues, such as baseline performance, learning effects...

  12. Benzodiazepines and postoperative cognitive dysfunction in the elderly

    DEFF Research Database (Denmark)

    Rasmussen, L.S.; Steentoft, Anni; Rasmussen, H.

    1999-01-01

    hypnotics benzodiazepine,diazepam,age factor,anaesthesia,geriatric,psychological responses,postoperative......hypnotics benzodiazepine,diazepam,age factor,anaesthesia,geriatric,psychological responses,postoperative...

  13. Managing diabetes during the Muslim fasting month of Ramadan.

    Science.gov (United States)

    Velayudhan, M

    2012-06-01

    Target blood sugar levels in diabetes are achieved through manipulation of diet, exercise and medication. A change in any one of these three things can skew blood sugar levels and create complications associated with hyperglycemia or hypoglycemia. Fasting during the month of Ramadan is a religious activity that devout Muslims practice whether they are diabetic or not. Since such fasting involves abstinence from food and water for twelve hours or more during the day from dawn to dusk, it is evident that advice regarding exercise and medication will have to be modified during this period.

  14. Petroleum supply monthly

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-10-01

    The Petroleum Supply Monthly (PSM) is one of a family of four publications produced by the Petroleum Supply Division within the Energy Information Administration (EIA) reflecting different levels of data timeliness and completeness. The other publications are the Weekly Petroleum Status Report (WPSR), the Winter Fuels Report, and the Petroleum Supply Annual (PSA). Data presented in the PSM describe the supply and disposition of petroleum products in the United States and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the United States (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blends, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the United States.

  15. Petroleum Supply Monthly

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-02-01

    The Petroleum Supply Monthly (PSM) is one of a family of four publications produced by the Petroleum Supply Division within the Energy Information Administration (EIA) reflecting different levels of data timeliness and completeness. The other publications are the Weekly Petroleum Status Report (WPSR), the Winter Fuels Report, and the Petroleum Supply Annual (PSA). Data presented in the PSM describe the supply and disposition of petroleum products in the United States and major U.S. geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the United States (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the United States. Data presented in the PSM are divided into two sections: Summary Statistics and Detailed Statistics.

  16. COSMIC monthly progress report

    Science.gov (United States)

    1994-01-01

    Activities of the Computer Software Management and Information Center (COSMIC) are summarized for the month of May 1994. Tables showing the current inventory of programs available from COSMIC are presented and program processing and evaluation activities are summarized. Nine articles were prepared for publication in the NASA Tech Brief Journal. These articles (included in this report) describe the following software items: (1) WFI - Windowing System for Test and Simulation; (2) HZETRN - A Free Space Radiation Transport and Shielding Program; (3) COMGEN-BEM - Composite Model Generation-Boundary Element Method; (4) IDDS - Interactive Data Display System; (5) CET93/PC - Chemical Equilibrium with Transport Properties, 1993; (6) SDVIC - Sub-pixel Digital Video Image Correlation; (7) TRASYS - Thermal Radiation Analyzer System (HP9000 Series 700/800 Version without NASADIG); (8) NASADIG - NASA Device Independent Graphics Library, Version 6.0 (VAX VMS Version); and (9) NASADIG - NASA Device Independent Graphics Library, Version 6.0 (UNIX Version). Activities in the areas of marketing, customer service, benefits identification, maintenance and support, and dissemination are also described along with a budget summary.

  17. Anatomical studies on twelve clones of Camellia species with reference to their taxonomic significance

    Directory of Open Access Journals (Sweden)

    Rajanna L

    2010-10-01

    Full Text Available Anatomical studies of leaf and stem of twelve clones of Camellia were investigated. Cross sections of the stem of all the clones exhibited a typical pattern of arrangement of tissues characteristics of woody plants. Two types of idioblastic sclereids were found in the medullary parenchyma of the taxa studied. While astrosclereids werepresent in 10 of the twelve clones, the vesciculose sclereids were found only in the four clones belonging to C. sinensis. Leaves of the clones show variations in the number of palisade layers. Astro sclereids, brachy sclereids, and dendritic forms were observed in the leaves, their distribution varying in the different clones. A few other micromorphological features are also recorded. Our study forms a basis for answering uncertainties in taxonomic revision in the genus Camellia.

  18. Effect of unrestricted bottle-feeding on early postoperative course after cleft palate repair.

    Science.gov (United States)

    Kim, Eun Key; Lee, Taik Jong; Chae, Soo Wook

    2009-09-01

    Although bottle-feeding after cheiloplasty is widely accepted, postoperative feeding regimen after palatoplasty is still controversial. The aim of this prospective randomized study was to evaluate the effect of bottle-feeding on early postoperative course after palatoplasty in a relatively homogeneous group of patients. Eighty-two consecutive patients with nonsyndromic cleft palate undergoing 2-flap palatoplasty by a single surgeon were randomized to feeding from a bottle with the usual nipple (G1, N = 42) or to feeding with a spoon, cup, or syringe (G2, N = 40). Complication rates, postoperative sedative use, oral intake for the first 6 days, and relative weight gain at 1 and 2 months were compared. There were no significant complications such as bleeding or respiratory problem. The overall complication rate including wound dehiscence and oronasal fistula was similar in G1 and G2 (11.9% versus 12.5%, P = 1.000) as was postoperative sedative use and mean daily oral intake for the first 5 days. Mean intake on the sixth day was significantly higher in G1. There were no significant between-group differences in relative weight gain after 1 and 2 months. In conclusion, bottle-feeding had no adverse effect on the early postoperative course after palatoplasty including complication rate, oral intake, and weight gain. These findings suggest that an unrestricted feeding regimen is appropriate immediately after palatoplasty.

  19. Systemic HMGB1 neutralization prevents postoperative neurocognitive dysfunction in aged rats

    Directory of Open Access Journals (Sweden)

    Niccolo Terrando

    2016-10-01

    Full Text Available Postoperative neurocognitive disorders are common complications in elderly patients following surgery or critical illness. High mobility group box 1 protein (HMGB1 is rapidly released after tissue trauma and critically involved in response to sterile injury. Herein we assessed the role of HMGB1 after liver surgery in aged rats and explored the therapeutic potential of a neutralizing anti-HMGB1 monoclonal antibody in a clinically relevant model of postoperative neurocognitive disorders. 19-22 months Sprague Dawley rats were randomly assigned as: (1 control with saline; (2 surgery, a partial hepatolobectomy under sevoflurane anesthesia and analgesia, + immunoglobulin G as control antibody; (3 surgery + anti-HMGB1. A separate cohort of animals was used to detect His-tagged HMGB1 in the brain. Systemic anti-HMGB1 antibody treatment exerted neuroprotective effects preventing postoperative memory deficits and anxiety in aged rats by preventing surgery-induced reduction of phosphorylated cyclic AMP response element-binding protein in the hippocampus. Although no evident changes in the intracellular distribution of HMGB1 in hippocampal cells were noted after surgery, HMGB1 levels were elevated on day 3 in rat plasma samples. Experiments with tagged HMGB1 further revealed a critical role of systemic HMGB1 to enable an access to the brain and causing microglial activation. Overall, these data demonstrate a pivotal role for systemic HMGB1 in mediating postoperative neuroinflammation. This may have direct implications for common postoperative complications like delirium and postoperative cognitive dysfunction.

  20. Predictive images of postoperative levator resection outcome using image processing software

    Directory of Open Access Journals (Sweden)

    Mawatari Y

    2016-09-01

    Full Text Available Yuki Mawatari,1 Mikiko Fukushima2 1Igo Ophthalmic Clinic, Kagoshima, 2Department of Ophthalmology, Faculty of Life Science, Kumamoto University, Chuo-ku, Kumamoto, Japan Purpose: This study aims to evaluate the efficacy of processed images to predict postoperative appearance following levator resection.Methods: Analysis involved 109 eyes from 65 patients with blepharoptosis who underwent advancement of levator aponeurosis and Müller’s muscle complex (levator resection. Predictive images were prepared from preoperative photographs using the image processing software (Adobe Photoshop®. Images of selected eyes were digitally enlarged in an appropriate manner and shown to patients prior to surgery.Results: Approximately 1 month postoperatively, we surveyed our patients using questionnaires. Fifty-six patients (89.2% were satisfied with their postoperative appearances, and 55 patients (84.8% positively responded to the usefulness of processed images to predict postoperative appearance.Conclusion: Showing processed images that predict postoperative appearance to patients prior to blepharoptosis surgery can be useful for those patients concerned with their postoperative appearance. This approach may serve as a useful tool to simulate blepharoptosis surgery. Keywords: levator resection, blepharoptosis, image processing, Adobe Photoshop® 

  1. Caudal analgesia and cardiothoracic surgery: a look at postoperative pain scores in a pediatric population.

    Science.gov (United States)

    Nguyen, Khoa N; Byrd, Heather S; Tan, Jonathan M

    2016-11-01

    Caudal epidural anesthesia has been shown to reduce stress response and shorten the time to extubation in children after cardiac surgery. Combined with general anesthesia, regional anesthesia has been proven to be safe and efficacious in the pediatric population. It is not known, however, whether the use of caudal anesthesia actually reduces postoperative pain scores and decreases postoperative opioid use. We retrospectively analyzed the charts of 199 children who underwent repair for atrial septal defect (ASD), ventricular septal defect (VSD), and Tetralogy of Fallot (TOF) at a major academic children's hospital between 2010 and 2013. Eighty-six patients underwent preoperative placement of caudal anesthesia (bupivacaine 0.25% 1 ml·kg(-1) up to 20 ml + clonidine 2mcg·kg(-1) + Duramorph 40 mcg·kg(-1) up to 2.5 mg) and 113 patients did not have a caudal block. Postoperative cardiac intensive care pain scores were analyzed according to standard nurse-recorded patient-appropriate pain scales ranging from 0 to 10 (CRIES for neonates and FLACC for 2 months-7 years). There was no statistical difference between caudal and noncaudal groups with respect to postoperative pain scores or with postoperative opioid requirements. There was a statistical significance with regard to intraoperative opioid use as noncaudal patients invariably received more opioid during the procedure. Although regional anesthesia reduced intraoperative opioid usage, there was no difference in postoperative opioid usage or pain scores. © 2016 John Wiley & Sons Ltd.

  2. Descriptions of twelve new species of ochyroceratids (Araneae, Ochyroceratidae) from mainland Ecuador.

    Science.gov (United States)

    Dupérré, Nadine

    2015-05-12

    Twelve new species in three different genera from the spider family Ochyroceratidae are described from mainland Ecuador: Speocera bioforestae sp. n., Speocera violacea sp. n., Speocera musgo sp. n., Ochyrocera rinocerotos sp. n., Ochyrocera callaina sp. n., Ochyrocera italoi sp. n., Ochyrocera minotaure sp. n., Ochyrocera losrios sp. n., Ochyrocera zabaleta sp. n., Ochyrocera otonga sp. n., Ochyrocera cashcatotoras sp. n. and Psiloochyrocera tortilis sp. n. Speocera machadoi Gertsch 1977 is transferred to Ochyrocera.

  3. A Hidden Twelve-Dimensional SuperPoincare Symmetry In Eleven Dimensions

    Energy Technology Data Exchange (ETDEWEB)

    Bars, Itzhak; Deliduman, Cemsinan; Pasqua, Andrea; Zumino, Bruno

    2003-12-13

    First, we review a result in our previous paper, of how a ten-dimensional superparticle, taken off-shell, has a hidden eleven-dimensional superPoincare symmetry. Then, we show that the physical sector is defined by three first-class constraints which preserve the full eleven-dimensional symmetry. Applying the same concepts to the eleven dimensional superparticle, taken off-shell, we discover a hidden twelve dimensional superPoincare symmetry that governs the theory.

  4. Hidden twelve-dimensional super Poincaré symmetry in eleven dimensions

    CERN Document Server

    Bars, Itzhak; Pasqua, A; Zumino, B; Bars, Itzhak; Deliduman, Cemsinan; Pasqua, Andrea; Zumino, Bruno

    2004-01-01

    First, we review a result in our previous paper, of how a ten-dimensional superparticle, taken off-shell, has a hidden eleven-dimensional superPoincare symmetry. Then, we show that the physical sector is defined by three first-class constraints which preserve the full eleven-dimensional symmetry. Applying the same concepts to the eleven dimensional superparticle, taken off-shell, we discover a hidden twelve dimensional superPoincare symmetry that governs the theory.

  5. Left atrial volume index as a predictor for persistent left ventricular dysfunction after aortic valve surgery in patients with chronic aortic regurgitation: the role of early postoperative echocardiography.

    Science.gov (United States)

    Cho, In-Jeong; Chang, Hyuk-Jae; Hong, Geu-Ru; Heo, Ran; Sung, Ji Min; Lee, Sang-Eun; Chang, Byung-Chul; Shim, Chi Young; Ha, Jong-Won; Chung, Namsik

    2015-06-01

    This study aimed to explore whether echocardiographic measurements during the early postoperative period can predict persistent left ventricular systolic dysfunction (LVSD) after aortic valve surgery in patients with chronic aortic regurgitation (AR). We prospectively recruited 54 patients (59 ± 12 years) with isolated chronic severe AR who subsequently underwent aortic valve surgery. Standard transthoracic echocardiography was performed before the operation, during the early postoperative period (≤2 weeks), and then 1 year after the surgery. Twelve patients with preoperative LVSD demonstrated LVSD at early after the surgery. Of the 42 patients without LVSD at preoperative echocardiography, 15 patients (36%) developed early postoperative LVSD after surgical correction. All 27 patients without LVSD at early postoperative echocardiography maintained LV function at 1 year after surgery. In the other 27 patients with postoperative LVSD, 17 patients recovered from LVSD and 10 patients did not at 1 year after surgery. Multiple logistic analysis demonstrated that postoperative left atrial volume index (LAVI) was the only independent predictor for persistent LVSD at 1 year after surgery in patients with postoperative LVSD (OR 1.180, 95% CI, 1.003-1.390, P = 0.046). The optimal LAVI cutoff value (>34.9 mL/m(2) ) had a sensitivity of 80% and a specificity of 88% for the prediction of persistent LVSD. Prevalence of early postoperative LVSD was relatively high, even in the patients without LVSD at preoperative echocardiography. Postoperative LAVI could be useful to predict persistent LVSD after aortic valve surgery in patients with early postoperative LVSD. © 2014, Wiley Periodicals, Inc.

  6. 试述十二律结合四气理论防治五脏疾病%Prevention and Treatment of Five Zang-organs Diseases with Twelve Temperaments Combining with Siqi Theory

    Institute of Scientific and Technical Information of China (English)

    贺海辉; 雷磊; 吴子明

    2013-01-01

    The study and treatment of the music therapy is very popular in Europe and America. While the Chi-nese traditional music therapy is still in the stage of excavation, both the theory and clinical practice are waiting for exploration and development. Through the formation of twelve temperaments and twelve temperaments system, this article discussed the twelve temperaments which reflect the yin and yang of twelve months, and the five in-ternal organs reflect the yin and yang of the four season . The author thinks that the twelve temperaments can pre-vent and treat diseases of five zang-organs, and puts forward the train of thought of prevention and treatment of five zang-organs diseases with twelve temperaments combining with Siqi theory.%目前音乐疗法在欧美的研究和治疗应用非常普遍,而我国中医音乐疗法还处于挖掘整理阶段,无论是基础理论还是临床实践都有待进一步的探索和发展。本文通过论述十二律的形成和十二律吕制度表明十二律反映十二月阴阳,以及五脏通应自然界四时阴阳,认为十二律能够防治五脏疾病,并提出十二律结合四气防治疾病的思路。

  7. The development of a small bowel volvulus in the early postoperative period following a distal gastrectomy: report of a case.

    Science.gov (United States)

    Sakamoto, T; Miyata, M; Nakamuro, M; Izukura, M; Kamiike, W; Matsuda, H

    1994-01-01

    A 51-year-old Japanese man who underwent a standard distal gastrectomy for cancer of the stomach developed abdominal pain when oral intake was commenced on the 6th postoperative day after an uneventful postoperative course. Complete obstruction of the jejunum led to a sudden deterioration in his general condition and a laparotomy was performed, revealing counterclockwise rotation of the mesenterium. The necrotic portion of the small intestine was removed, while 10 cm of the upper jejunum and 100 cm of the terminal ileum were preserved. His second postoperative course was uneventful apart from the development of "intestinal hurry," which is now under medical control 9 months after his second laparotomy.

  8. Intraocular lens explantation or exchange: indications, postoperative interventions, and outcomes

    Directory of Open Access Journals (Sweden)

    Refik Oltulu

    2015-06-01

    Full Text Available ABSTRACT Purpose: To analyze the indications for explantation or exchange of intraocular lenses (IOLs, which were originally implanted for the correction of aphakia during cataract extraction. Methods: All cases that involved intraocular lens explantation or exchange in one institution between January 2008 and December 2014 were analyzed retrospectively. Results: In total, 93 eyes of 93 patients were analyzed. The median time interval between implantation and explantation of the anterior chamber intraocular lenses (AC IOL and posterior chamber intraocular lenses (PC IOL was 83.40 ± 83.14 months (range: 1-276 months and 55.14 ± 39.25 months (range: 1-168 months, respectively. Pseudophakic bullous keratopathy (17 eyes, 38.6% and persistent iritis (12 eyes, 27.8% in the AC IOL group and dislocation or decentration (30 eyes, 61.2% and incorrect IOL power (nine eyes, 18.4% in the PC IOL group were the most common indications for explantation of IOLs. The mean logMAR best corrected visual acuity (BCVA improved significantly from 1.30 preoperatively to 0.62 postoperatively in the PC IOL group (p<0.001 but did not improve significantly in the AC IOL group (p=0.186. Conclusions: The primary indication for IOL explantation or exchange was pseudophakic bullous keratopathy in the AC IOL group and was dislocation or decentration in the PC IOL group. PC IOL explantation or exchange is safe and improves visual acuity.

  9. Carbon fiber intramedullary nails reduce artifact in postoperative advanced imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zimel, Melissa N. [Memorial Sloan Kettering Cancer Center, Orthopaedic Surgery Service, Department of Surgery, New York, NY (United States); Hwang, Sinchun [Memorial Sloan Kettering Cancer Center, Department of Radiology, New York, NY (United States); Riedel, Elyn R. [Memorial Sloan Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States); Healey, John H. [Memorial Sloan Kettering Cancer Center, Orthopaedic Surgery Service, Department of Surgery, New York, NY (United States); Weill Medical College of Cornell University, Department of Orthopaedic Surgery, New York, NY (United States)

    2015-09-15

    This study assessed whether radiolucent carbon fiber reinforced-polyetheretherketone (CFR-PEEK) intramedullary nails decreased hardware artifact on magnetic resonance imaging (MRI) and computed tomography (CT) in vitro and in an oncologic patient population. In vitro and clinical evaluations were done. A qualitative assessment of metal artifact was performed using CFR-PEEK and titanium nail MRI phantoms. Eight patients with a femoral or tibial prophylactic CFR-PEEK nail were retrospectively identified. All patients had postoperative surveillance imaging by MRI, CT, and were followed for a median 20 months (range, 12-28 months). CFR-PEEK images were compared to images from a comparative group of patients with titanium femoral intramedullary nails who had a postoperative MRI or CT. A musculoskeletal-trained radiologist graded visualization of the cortex, corticomedullary junction, and bone-muscle interface, on T1-weighted (T1W), STIR, and contrast-enhanced T1-weighted fat-saturated (T1W FS) sequences of both groups with a five-point scale, performing independent reviews 4 months apart. Statistical analysis used the Wilcoxon rank-sum test and a weighted kappa. Substantially less MRI signal loss occurred in the CFR-PEEK phantom than in the titanium phantom simulation, particularly as the angle increased with respect to direction of the static magnetic field. CFR-PEEK nails had less MRI artifact than titanium nails on scored T1W, STIR, and contrast-enhanced T1W FS MRI sequences (p ≤ 0.03). The mean weighted kappa was 0.64, showing excellent intraobserver reliability between readings. CFR-PEEK intramedullary nail fixation is a superior alternative to minimize implant artifact on MRI or CT imaging for patients requiring long bone fixation. (orig.)

  10. Postoperative pyrexia after arthroplasty - when to panic ?

    Directory of Open Access Journals (Sweden)

    Agarwala Sanjay

    2005-01-01

    Full Text Available Background: Success of arthroplasty is contingent on a clear understanding of the potential complications. Today with improved methods of sepsis control, incidence of joint sepsis has dropped to less than 2%. Despite this fever is still common in the early post-operative period. Methods: We reviewed 184 consecutive hip and knee replacement surgeries for incidence and clinical significance of post-operative fever. The cases were followed up for a period of over 3 to 5 years. Temperature charts up to 6 th postoperative day and all investigations were reviewed to determine the cause of fever. Results: Post operative fever was recorded after 82 procedures (44.6%. The average maximum temperature occurred on post-operative day 1 (98.9 o F. Only 2 TKR got infected. Incidence of fever was higher in TKR as compared to THR. Conclusion: Post-operative fever is common and probably inflammatory. It is not an important predictive factor of joint infection. Work up for joint infection is not indicated unless other corroborative features are present. Aspiration of painful joint is a highly accurate for identifying an infection.

  11. Management of postoperative recurrence of Crohn's disease.

    Science.gov (United States)

    van Lent, Anja U; D'Haens, Geert R

    2013-01-01

    The course of Crohn's disease (CD) is unpredictable and potentially destructive. The percentage of patients requiring surgery at some stage in their disease accumulates to over 70%. After resection of the affected intestine, reappearance of CD occurs in the majority of patients. Prophylactic medical therapy to reduce the rate of postoperative recurrence has been proven to be effective, yet the incidence of recurrence remains high. Patient profiling (risk stratification) is important in this postoperative setting. High-risk patients (associated with e.g. smoking, the need of repetitive surgery and penetrating disease) require strong immunosuppressive treatment, which should be commenced immediately after surgery, when recurrent disease activity begins. Additionally, early screening endoscopy should be performed to monitor treatment effect. The efficacy of thiopurines is shown to be higher than mesalazine or imidazole antibiotics alone for preventing and ameliorating endoscopic recurrence of CD postoperatively; however, anti-tumor necrosis factors (anti-TNFs) are increasingly considered the most potent agents. In patients with a risk factor for early postoperative recurrence, the first line of treatment is 6-mercaptopurine, in combination with imidazole antibiotics if tolerated, followed by anti-TNFs. When lesions are found at colonoscopy, therapy should be upscaled. We propose a treatment algorithm to direct therapeutic management of CD postoperatively. © 2013 S. Karger AG, Basel.

  12. Postoperative findings following the Whipple procedure: determination of prevalence and morphologic abdominal CT features

    Energy Technology Data Exchange (ETDEWEB)

    Mortele, K.J.; Lemmerling, M.; Bock, G. de; Kunnen, M. [Department of Radiology, University Hospital Gent (Belgium); Hemptinne, B. de [Department of Digestive Surgery, University Hospital Gent (Belgium); Vos, M. de [Department of Gastroenterology, University Hospital Gent (Belgium)

    2000-01-01

    This study was conducted to determine characteristic CT findings following the Whipple procedure and to evaluate the usefulness of CT in predicting tumor recurrence. Eighty-four postoperative abdominal CT scans and medical records of 43 patients were retrospectively reviewed. Perioperative histopathologic examinations revealed malignancy in 32 patients (74.4 %). Time interval between surgery and CT varied from 13 days to 6 years and 7 months. Common postoperative findings were unopacified anastomotic bowel loops in the porta hepatis (n = 69 scans), perivascular cuffing (n = 42 scans), pneumobilia (n = 40 scans), dilated intrahepatic bile ducts (n = 22 scans), reactive lymphadenopathy (n = 21 scans), and transient fluid collections (n = 20 scans). Postoperative complications were detected on 17 CT scans (20.2 %): generalized ascites (n = 8 patients), deep abscesses (n = 3 patients), wound abscess (n = 1 patient), pancreatitis (n = 1 patient), and pseudomembranous colitis (n = 1 patient). Tumor recurrence appeared in 15 patients (46.8 %) after a mean postoperative period of 11 months (1 month to 3 years): local (9 of 15), regional lymph nodes (9 of 15), and liver metastasis (8 of 15). Detection of generalized ascites more than 30 days after surgery was associated with tumor recurrence in 6 of 6 patients (100 %). Diffuse ascites (> 30 days after surgery) behaved as an early predictive sign of tumor recurrence. In our series CT accuracy for detecting recurrent tumor with CT was 93.5 %. No predilection site for disease recurrence could be determined. (orig.)

  13. Postoperative delirium and postoperative cognitive dysfunction in the elderly - what are the differences?

    DEFF Research Database (Denmark)

    Krenk, L; Rasmussen, L S

    2011-01-01

    Postoperative cognitive impairment is an increasingly common problem as more elderly patients undergo major surgery. Cognitive deficits in the postoperative period cause severe problems and are associated with a marked increase in morbidity and mortality. There are two main entities of postoperat...

  14. Twelve month follow-up report of the conference to promote international sales of US geothermal equipment (CORECT Project): Final report

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, D.N.

    1988-12-01

    The reverse trade mission ''Conference to Promote International Sales of US Geothermal Equipment'' was organized and managed by the Geothermal Resources Council (GRC) in collaboration with the California Energy Commission (CEC). The mission was held in late September/October of 1987 and was well received by the 23 participants from 18 different countries. Approximately $275,000 in immediate sales can be attributed directly to the program and the estimate of potential future sales runs as high as $4,765,000. It was felt by the attendees that the program was well organized and executed and that the caliber of persons invited to attend was optimum. All of the attendees stated that the function was very informative and beneficial and that they would recommend to others that they attend similar functions. In order to be really effective in exporting a company, a country must be highly visible to potential purchasers. Although this function lasted only two weeks it was considered as a prime first step in the development of a strong US geothermal technology export base program. As a part of the effort to maintain this presence the GRC recommends that this function be followed by other similar functions, courses, seminars, and specific field trips. In addition every effort should be made for US government and industry representatives to visit various countries as often as possible. The GRC is working toward developing an international information-dissemination program, which would include the development of courses for geothermal units in foreign countries.

  15. Twelve-months prevalence of mental disorders in the German Health Interview and Examination Survey for Adults - Mental Health Module (DEGS1-MH): a methodological addendum and correction.

    Science.gov (United States)

    Jacobi, Frank; Höfler, Michael; Strehle, Jens; Mack, Simon; Gerschler, Anja; Scholl, Lucie; Busch, Markus A; Hapke, Ulfert; Maske, Ulrike; Seiffert, Ingeburg; Gaebel, Wolfgang; Maier, Wolfgang; Wagner, Michael; Zielasek, Jürgen; Wittchen, Hans-Ulrich

    2015-12-01

    We recently published findings in this journal on the prevalence of mental disorders from the German Health Interview and Examination Survey for Adults Mental Health Module (DEGS1-MH). The DEGS1-MH paper was also meant to be the major reference publication for this large-scale German study program, allowing future users of the data set to understand how the study was conducted and analyzed. Thus, towards this goal highest standards regarding transparency, consistency and reproducibility should be applied. After publication, unfortunately, the need for an addendum and corrigendum became apparent due to changes in the eligible reference sample, and corresponding corrections of the imputed data. As a consequence the sample description, sample size and some prevalence data needed amendments. Additionally we identified a coding error in the algorithm for major depression that had a significant effect on the prevalence estimates of depression and associated conditions. This addendum and corrigendum highlights all changes and presents the corrected prevalence tables. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  16. “And twelve months later, we are still waiting…”: Insights into teaching and use of ICT in rural and remote Australian schools

    Directory of Open Access Journals (Sweden)

    Lyn Courtney

    2007-11-01

    Full Text Available This paper presents an analysis of the combined data sets from a large ARC (Australian Research Council funded study on the declining enrolments of female students in high school information technology subjects, and a SiMERR (Science, ICT and Mathematics Education for Rural and Regional Australia study of 9 rural or remote schools in the state of Queensland. The aim of examining the combined data set was to investigate any apparent differences between girls’ perceptions of studying higher level ICT subjects in rural areas compared to metropolitan areas. The findings of the study highlighted some problems experienced by female students studying outside of metropolitan areas. They perceived the subject offerings to be ‘more boring’ than their city counterparts and reported a lower level of home ownership. The paper offers possible explanations for the findings and strongly recommends that strategies need to be implemented to overcome these problems.

  17. Prevalent vitamin B-12 deficiency in twelve-month-old Guatemalan infants is predicted by maternal B-12 deficiency and infant diet.

    Science.gov (United States)

    Jones, Katharine M; Ramirez-Zea, Manuel; Zuleta, Clara; Allen, Lindsay H

    2007-05-01

    Approximately one-third of low-income women and children studied in Guatemala are reported to have deficient (deficiency can adversely affect infant development and cognitive function, the present study examined predictors of deficient plasma vitamin B-12 concentrations at the age of 12 mo. Analyses were performed on baseline data from a randomized clinical trial in 304 Guatemalan infants, 80% of whom were partially breast-fed, and their mothers. Exclusion criteria for infants included twins, severe stunting or moderate wasting, reported major health problems, severe developmental delay, hemoglobin 3 mo. Data collected included socio-economic status, infant anthropometry, vitamin B-12 intake from complementary foods, and breast-feeding frequency reported by mothers. A complete blood count and plasma vitamin B-12, folate, ferritin, and C-reactive protein were measured. Deficient or marginal plasma vitamin B-12 concentrations were found in 49% of infants and 68% of mothers. The mean intake of maternal vitamin B-12 was 3.1 microg/d, and infants consumed 2.2 microg/d from complementary foods. In linear regression analysis, infant plasma B-12 concentration was strongly and positively associated with maternal plasma vitamin B-12 and B-12 intake from complementary foods (predominantly powdered cow's milk), and inversely associated with frequency of breast-feeding and larger household size (P < 0.0001). Vitamin B-12 supplementation of lactating women, food fortification, and education to improve infant's vitamin B-12 status are potential interventions that can improve the vitamin B-12 status of mothers and infants in this population.

  18. Does behavioral intervention in pregnancy reduce postpartum weight retention? Twelve-month outcomes of the Fit for Delivery randomized trial123

    OpenAIRE

    Phelan, Suzanne; PHIPPS, MAUREEN G.; Abrams, Barbara; Darroch, Francine; Grantham, Kelsey; Schaffner, Andrew; Wing, Rena R.

    2013-01-01

    Background: Excessive weight gain during pregnancy is a risk factor for postpartum weight retention and future weight gain and obesity. Whether a behavioral intervention in pregnancy can reduce long-term weight retention is unknown.

  19. The effect of prenatal exposure on total IgE at birth and sensitization at twelve months and four years of age : The PIAMA study

    NARCIS (Netherlands)

    Kerkhof, M; Wijga, A; Smit, HA; de Jongste, JC; Aalberse, RC; Brunekreef, B; Gerritsen, J; Postma, DS

    2005-01-01

    There is increasing evidence that the development of the fetal immune system can be influenced by environmental exposure in utero. We investigated whether prenatal exposure is associated with a high neonatal total IgE level and sensitization at the age of 1 and 4 yr. Data from 1027 infants were coll

  20. Early postoperative fluoroquinolone use is associated with an increased revision rate after arthroscopic rotator cuff repair.

    Science.gov (United States)

    Cancienne, Jourdan M; Brockmeier, Stephen F; Rodeo, Scott A; Young, Chris; Werner, Brian C

    2017-07-01

    To evaluate the association of postoperative fluoroquinolone use following arthroscopic primary rotator cuff repair with failure requiring revision rotator cuff repair. An insurance database was queried for patients undergoing rotator cuff repair from 2007 to 2015. These patients were divided into three groups: (1) patients prescribed fluoroquinolones within 6 months postoperatively (divided into 0-2, 2-4, and 4-6 months), (2) a matched negative control cohort of patients not prescribed fluoroquinolones, and (3) a matched positive control cohort of patients prescribed fluoroquinolones between 6 and 18 months following rotator cuff repair. Rates of failure requiring revision rotator cuff repair were compared within 2 years. A total of 1292 patients were prescribed fluoroquinolones within 6 months after rotator cuff repair, including 442 within 2 months, 433 within 2 to 4 months, and 417 within 4 to 6 months, and were compared to 5225 matched negative controls and 1597 matched positive controls. The rate of revision rotator cuff repair was significantly higher in patients prescribed fluoroquinolones within 2 months (6.1 %) compared to matched negative (2.2 %, P = 0.0009) and positive controls (2.4 %, P = 0.0026). There were no significant differences in the rate of revision rotator cuff repair when fluoroquinolones were prescribed >2 months after rotator cuff repair. Early use of fluoroquinolones following rotator cuff repair was independently associated with significantly increased rates of failure requiring revision rotator cuff repair. This is the first clinical study examining the association of postoperative fluoroquinolone use with failure following arthroscopic rotator cuff repair. III.

  1. Electronic Services Monthly MI Report

    Data.gov (United States)

    Social Security Administration — This electronic services monthly MI report contains monthly MI data for most public facing online online applications such as iClaim, electronic access, Mobile wage...

  2. Peripherally applied opioids for postoperative pain

    DEFF Research Database (Denmark)

    Nielsen, B N; Henneberg, S W; Schmiegelow, K;

    2015-01-01

    BACKGROUND: Opioids applied peripherally at the site of surgery may produce postoperative analgesia with few side effects. We performed this systematic review to evaluate the analgesic effect of peripherally applied opioids for acute postoperative pain. METHODS: We searched PubMed (1966 to June...... 2013), Embase (1980 to June 2013), and the Cochrane Central Register of Controlled Trials (The Cochrane Library 2013, Issue 6). Randomized controlled trials investigating the postoperative analgesic effect of peripherally applied opioids vs. systemic opioids or placebo, measured by pain intensity...... difference -5 mm, 95% CI: -7 to -3) for peripherally applied opioids vs. placebo and statistically significant increased time to first analgesic (mean difference 153 min, 95% CI: 41-265). When preoperative inflammation was reported (five studies), peripherally applied opioids significantly improved...

  3. Biomarkers of postoperative delirium and cognitive dysfunction

    Directory of Open Access Journals (Sweden)

    Ganna eAndrosova

    2015-06-01

    Full Text Available Elderly surgical patients frequently experience postoperative delirium (POD and the subsequent development of postoperative cognitive dysfunction (POCD. Clinical features include deterioration in cognition, disturbance in attention and reduced awareness of the environment and result in higher morbidity, mortality and greater utilization of social financial assistance. The aging Western societies can expect an increase in the incidence of POD and POCD. The underlying pathophysiological mechanisms have been studied on the molecular level albeit with unsatisfying small research efforts given their societal burden. Here, we review the known physiological and immunological changes and genetic risk factors, identify candidates for further studies and integrate the information into a draft network for exploration on a systems level. The pathogenesis of these postoperative cognitive impairments is multifactorial; application of integrated systems biology has the potential to reconstruct the underlying network of molecular mechanisms and help in the identification of prognostic and diagnostic biomarkers.

  4. Postoperative course of chronic subdural hematoma

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Toshiaki; Tsubone, Kyoji; Kyuma, Yoshikazu; Kuwabara, Takeo (Yokohama City Univ. (Japan). Faculty of Medicine)

    1983-10-01

    1) Fourty cases of chronic subdural hematoma were operated on by trephination, irrigation and external drainage. Postoperative neurological recovery and decrease of hematoma cavity on CT scan were followed. 2) Operations were effective for recovery of neurological grade in 28 cases, moderately effective in 7 cases and not effective in 5 cases. 3) Within the tenth postoperative day, more than half residual hematoma cavity existed in 53% of examined cases. After that, more than half residual cavity existed in only 17%. 4) Preoperative feature of neurologically unimproved cases were no definite history of head trauma and water like low density of hematoma cavity. Postoperative feature was persistence of more than three fourth of residual hematoma cavity on CT scan. 5) A group of unimproved cases described above are thought to have a feature of subdural hygroma rather than subdural hematoma. When possibility of subdural hygroma is high in preoperative differential diagnosis, indication of operation should be different from chronic subdural hematoma.

  5. [Postoperative respiratory insufficiency and its treatment].

    Science.gov (United States)

    Kösek, V; Wiebe, K

    2015-05-01

    The development of a postoperative respiratory insufficiency is typically caused by several factors and include patient-related risks, the extent of the procedure and postoperative complications. Morbidity and mortality rates in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are high. It is important to have consistent strategies for prevention and preoperative conditioning is essential primarily for high-risk patients. Treatment of established postoperative lung failure requires early tracheotomy, protective ventilation (tidal volume 6 ml/kg body weight), elevated positive end expiratory pressure (PEEP, 10-20 mmH2O), recurrent bronchoscopy and early patient mobilization. In critical cases an extracorporeal lung assist is considered to be beneficial as a bridge to recovery and for realizing a protective ventilation protocol. Different systems with separate indications are available. The temporary application of a lung assist allows thoracic surgery to be performed safely in patients presenting with insufficient respiratory function.

  6. Incidence of Postoperative Acid-Base Disturbances in Abdominal Surgery

    Directory of Open Access Journals (Sweden)

    Taghavi Gilani M

    2014-04-01

    Full Text Available Introduction: Respiratory and blood pressure changes as well as fluid administration alter the acid-base balance during the perioperative period which may cause consciousness disturbance and additional hemodynamic disorders. The aim of this study was to identify frequent postoperative acid-base disturbances in order to control postoperative complications. Materials and Methods:This prospective, observational study design was used on patients who underwent abdominal surgery during a six-month period. Gasometry was performed immediately after the patients’ admittion to ICU and six and 12 hours postoperatively. SPSS v13 software was used, and PResults: 213 patients (123 male and 90 female aged 14-85 years (51.7± 22.4 were evaluated. During admission, PH and PaCO2 were (7.29±0.13 and (38.3±11.9, respectively; however, although PH increased gradually (P=0.001, PaCO2 was reduced (P=0.03. Bicarbonate and base excess had opposite effects; bicarbonate initially decreased but increased after 12 hours (P=0.001, whereas base excess initially increased (-6.3±11.6 and then decreased gradually (P=0.003. The arterial oxygen pressure was reduced for 22.5% of the patients throughout the admission period, and this did not significantly change (P=0.57. Conclusion: According to the results, in admission, 65.7% had metabolic acidosis, but metabolic alkalosis was the least. Gradually, metabolic acidosis was modified, but metabolic alkalosis increased. Intraoperative hypotension and fluid infusion may be the main factors of early metabolic acidosis and control of hypotension, or correction of acidosis may increase metabolic alkalosis.

  7. Efficacy and toxicity of postoperative temozolomide radiochemotherapy in malignant glioma

    Energy Technology Data Exchange (ETDEWEB)

    Kocher, M.; Kunze, S.; Eich, H.T.; Semrau, R.; Mueller, R.P. [Dept. of Radiation Oncology, Univ. of Cologne (Germany)

    2005-03-01

    Purpose: to evaluate the feasibility, safety and efficacy of daily temozolomide concurrent with postoperative radiotherapy in malignant glioma. Patients and methods: from 11/1999 to 03/2003, n = 81 patients aged 15-72 years (median 52 years, karnofsky score 80-100% in 83%) suffering from primary glioblastoma (n = 47), anaplastic astrocytoma (n = 6), anaplastic oligodendroglioma (n = 16), and recurrent glioma (n = 12) were treated. Patients with primary gliomas received a combination of postoperative radiotherapy (60 Gy/1.8- to 2.0-Gy fractions) and daily oral temozolomide (75 mg/m{sup 2}) at all irradiation days (30-33 doses), while recurrent tumors were treated with 45-60 Gy and temozolomide. Initially, 6/81 patients had daily temozolomide doses of 50 mg/m{sup 2}. Results: in total, 70/81 patients (86%) completed both radio- and chemotherapy. Grade 1 nausea/vomiting was seen in 28%, grade 2 in 11%, grade 3 in 1%. Antiemetics were applied in 41%. Hematologic toxicities were observed as follows: leukopenia grade 3/4 1%, lymphopenia grade 3/4 46%, thrombopenia grade 3/4 1%. Two patients under dexamethasone suffered herpes encephalitis after one and 16 doses of temozolomide (75 mg/m{sup 2}). Median survival was 15 months for glioblastoma. In oligodendroglioma patients, a 4-year survival rate of 78% was observed. Conclusion: postoperative radiochemotherapy with 30-33 daily doses of temozolomide (75 mg/m{sup 2}) is safe in patients with malignant glioma. The combined schedule is effective in oligodendroglioma patients and may prolong survival in glioblastoma. Effort should be taken to minimize corticosteroid doses, since both steroids and temozolomide lead to immunosuppression. (orig.)

  8. Management of late postoperative complications of bariatric surgery.

    Science.gov (United States)

    Hamdan, K; Somers, S; Chand, M

    2011-10-01

    The prevalence of obesity is increasing worldwide and the past decade has witnessed an exponential rise in the number of bariatric operations performed. As a consequence, an increasing number of patients are presenting to non-specialist units with complications following bariatric procedures. This article outlines the management of the most common late postoperative complications that are likely to present to the general surgeon. A search was conducted for late postoperative complications after bariatric surgery using PubMed, Embase, OVID and Google search engines, and combinations of the terms bariatric surgery, gastric bypass, gastric banding or sleeve gastrectomy, and late or delayed complications. Only studies with follow-up longer than 6 months were included. The most common long-term complications after gastric banding include band slippage and erosion. Deflation or removal of the band is often required. Internal hernia, adhesions and anastomotic stenosis are common causes of intestinal obstruction after gastric bypass surgery. Hepatobiliary complications pose a particular challenge because of the altered anatomy. Functional disorders such as reflux and dumping, and nutritional deficiencies are common and should be differentiated from conditions that require urgent investigations and timely surgical intervention. The immediate management of bariatric patients presenting with complications outside the immediate postoperative period requires adherence to basic surgical principles. Accurate diagnosis often relies on high-quality contrast and cross-sectional imaging, and effective surgical intervention necessitates a broad understanding of the altered anatomy, advanced surgical skills and liaison with specialists in the field when necessary. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

  9. Postoperative wound infections after a proctectomy—Patient experiences

    Directory of Open Access Journals (Sweden)

    Karin Hassel

    2016-02-01

    Full Text Available Poor perineal wound healing and infections after proctectomy surgery cause a significant proportion of physical and psychological morbidities, such as pain, leakage, and abscesses. In the long run, some of these symptoms will lead to extended periods of hospitalization. These kinds of postoperative complications are also associated with delays in possible chemotherapy treatment. The aim of this study was to describe patient experiences of perineal wound infections following proctectomy due to rectal cancer, and the importance of the communication with and the self-care support from the nurse for these patients. Five women and five men (61–87 years, median age 71 years were included and interviewed. A qualitative content analysis of the interviews was carried out and the following main categories emerged: “Managing postoperative complications,” “Being independent,” “Feeling safe,” and “Accepting the situation.” A perineal wound infection after a proctectomy is devastating for the individual patient. The limitations and changes to the patients’ lives turn into new daily routines, which force them to find new ways to live and to accept the situation. For many of them, the infections remained for several months and, sometimes, for years. The ability to lead an independent life is drastically reduced, but through continuity in care it is possible to create a feeling of safety. Information, communication, and self-care support are all important and valuable factors for recovery. Specialized care containing an action plan is therefore needed in clinical practice to reduce the number of perineal wound infections postoperatively and should be initiated when the patient is discharged from the ward and continue until recovery.

  10. Your Baby's Growth: 3 Months

    Science.gov (United States)

    ... to Be Smart About Social Media Your Baby's Growth: 3 Months KidsHealth > For Parents > Your Baby's Growth: 3 Months Print A A A What's in ... months of life are a period of rapid growth. Your baby will gain about 1 to 1½ ...

  11. Monthly energy review, August 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-08-01

    The Monthly Energy Review for the month of August 1997, presents an overview of the Energy Information Administration`s recent monthly energy statistics. The statistics cover the major activities of U.S. production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. Also included are international energy and thermal and metric conversion factors.

  12. Post-operative delirium in elderly patients

    Directory of Open Access Journals (Sweden)

    B Vijayakumar

    2014-01-01

    Full Text Available Delirium is a common, but an often underdiagnosed complication in the elderly following major surgery. Recognising delirium in early stages and diagnosing the condition based on established criteria can improve the outcome and management. Managing delirium with environmental, supportive and pharmacological interventions will possibly reduce the incidence and side-effects associated with post-operative delirium. The purpose of this article is to provide an over view of the current knowledge about the disease, diagnosis, pathogenesis, preventive strategies, and treatment of post-operative delirium.

  13. Outsourced cataract surgery and postoperative endophthalmitis

    DEFF Research Database (Denmark)

    Solborg Bjerrum, Søren; Kiilgaard, Jens F; Mikkelsen, Kim Lyngby;

    2013-01-01

    To compare the risk of postoperative endophthalmitis (PE) after cataract surgery at eye departments in public hospitals and private hospitals/eye clinics and to evaluate if the Danish National Patient Registry (NPR) is a reliable database to monitor the PE risk.......To compare the risk of postoperative endophthalmitis (PE) after cataract surgery at eye departments in public hospitals and private hospitals/eye clinics and to evaluate if the Danish National Patient Registry (NPR) is a reliable database to monitor the PE risk....

  14. Imaging of postoperative knee extensor mechanism

    Energy Technology Data Exchange (ETDEWEB)

    Motamedi, Kambiz [David Geffen School of Medicine at UCLA, Musculoskeletal Imaging-Department of Radiology, 200 Medical Plaza, Suite 165-59, Los Angeles, CA 90095 (United States); Seeger, Leanne L. [David Geffen School of Medicine at UCLA, Musculoskeletal Imaging-Department of Radiology, 200 Medical Plaza, Suite 165-57, Los Angeles, CA 90095 (United States); Hame, Sharon L. [David Geffen School of Medicine at UCLA, Department of Orthopedic Surgery, Box 956902, 76-143 CHS, Los Angeles, CA 90095 (United States)

    2005-05-01

    Disorders of the anterior knee are common and include patellofemoral syndrome, patella instability, patella fracture, and patellar and quadriceps tendon ruptures. Depending on the operative procedure performed, the post-operative imaging appearance of these knees may be confusing. It is crucial for the radiologist to be familiar with the procedures performed in order to recognize the postoperative findings. Radiologists must be able to interpret hardware (anchors, screw and wires) and disruptions in soft tissue planes that may persist with these types of procedures.

  15. Specificity of intraabdominal endoprosthesis of umbilical and postoperative ventral hernias

    Directory of Open Access Journals (Sweden)

    Grigoriev S.G.

    2012-03-01

    Full Text Available The research work objective was to examine the results of intraperitoneal plastics in the hernias of anterior abdominal wall. The experience of treatment of 89 patients with uncomplicated umbilical and postoperative ventral hernias was analized. The surgical treatment included an open intraperitoneal prosthetic hernioplasty. The hernial sac was not removed during the operation. The original techniques of treatment of hernia sac were used. Anatomical and morphological features in the structure of middle ventral hernias and their pathophysiological assessment were revealed. Practical recommendations for technology of intraperitoneal prosthesis were given. The early postoperative complications occurred: seroma (n=2, the outflow of serous fluid drainage for 5 days (n=1, infiltration of the umbilical area (n=3, suppuration of wounds (n=1. Vacuum drainage was performed in 24 patients after removal of large hernial defects. During the period from 6 months to 4 years recurrences were not revealed. The intraperitoneal surgery using a complex of musculo-aponeurotic tissues provided hernial implant fixation. Operation without the removal of the hernial sac reduced the trauma intervention. Method of suturing the surgical wound reduced the time of drainage and reduced the number of wound complications

  16. Definition of a Twelve-Point Polygonal SAA Boundaryfor the GLAST Mission

    Energy Technology Data Exchange (ETDEWEB)

    Djomehri, Sabra I.; /UC, Santa Cruz /SLAC

    2007-08-29

    The Gamma-Ray Large Area Space Telescope (GLAST), set to launch in early 2008, detects gamma rays within a huge energy range of 100 MeV - 300 GeV. Background cosmic radiation interferes with such detection resulting in confusion over distinguishing cosmic from gamma rays encountered. This quandary is resolved by encasing GLAST's Large Area Telescope (LAT) with an Anti-Coincidence Detector (ACD), a device which identifies and vetoes charged particles. The ACD accomplishes this through plastic scintillator tiles; when cosmic rays strike, photons produced induce currents in Photomultiplier Tubes (PMTs) attached to these tiles. However, as GLAST orbits Earth at altitudes {approx}550km and latitudes between -26 degree and 26 degree, it will confront the South Atlantic Anomaly (SAA), a region of high particle flux caused by trapped radiation in the geomagnetic field. Since the SAA flux would degrade the sensitivity of the ACD's PMTs over time, a determined boundary enclosing this region need be attained, signaling when to lower the voltage on the PMTs as a protective measure. The operational constraints on such a boundary require a convex SAA polygon with twelve edges, whose area is minimal ensuring GLAST has maximum observation time. The AP8 and PSB97 models describing the behavior of trapped radiation were used in analyzing the SAA and defining a convex SAA boundary of twelve sides. The smallest possible boundary was found to cover 14.58% of GLAST's observation time. Further analysis of defining a boundary safety margin to account for inaccuracies in the models reveals if the total SAA hull area is increased by {approx}20%, the loss of total observational area is < 5%. These twelve coordinates defining the SAA flux region are ready for implementation by the GLAST satellite.

  17. Intraoperative quantification using finger force for involutional blepharoptosis without postoperative lagophthalmos.

    Science.gov (United States)

    Kakizaki, Hirohiko; Zako, Masahiro; Mito, Hidenori; Iwaki, Masayoshi

    2006-01-01

    To report intraoperative quantification using finger force for involutional blepharoptosis, which helps in the prevention of postoperative lagophthalmos. We carried out levator resection on 20 involutional blepharoptic eyelids. Fissure height was examined intraoperatively to evaluate the extent of resection. If a patient presented more than 3 mm of lagophthalmos in voluntary eyelid closure but could fully open the eye, we forcibly closed the eyelid, using a finger, after voluntary eyelid closure. If more than 3 mm of lagophthalmos was still observed after forced eyelid closure, we corrected eyelid tension until lagophthalmos became less than 2 mm. Six of the ten patients (20 eyelids) presented with full eyelid opening but more than 3 mm of lagophthalmos in voluntary eyelid closure. After the upper eyelids were forcibly lowered, all six eyelids showed less than 2 mm of lagophthalmos. There were no cases of lagophthalmos 1 month postoperatively. Additional finger force makes precise quantification of blepharoptosis surgery possible and prevents postoperative lagophthalmos.

  18. The correlation between reading and mathematics ability at age twelve has a substantial genetic component.

    Science.gov (United States)

    Davis, Oliver S P; Band, Gavin; Pirinen, Matti; Haworth, Claire M A; Meaburn, Emma L; Kovas, Yulia; Harlaar, Nicole; Docherty, Sophia J; Hanscombe, Ken B; Trzaskowski, Maciej; Curtis, Charles J C; Strange, Amy; Freeman, Colin; Bellenguez, Céline; Su, Zhan; Pearson, Richard; Vukcevic, Damjan; Langford, Cordelia; Deloukas, Panos; Hunt, Sarah; Gray, Emma; Dronov, Serge; Potter, Simon C; Tashakkori-Ghanbaria, Avazeh; Edkins, Sarah; Bumpstead, Suzannah J; Blackwell, Jenefer M; Bramon, Elvira; Brown, Matthew A; Casas, Juan P; Corvin, Aiden; Duncanson, Audrey; Jankowski, Janusz A Z; Markus, Hugh S; Mathew, Christopher G; Palmer, Colin N A; Rautanen, Anna; Sawcer, Stephen J; Trembath, Richard C; Viswanathan, Ananth C; Wood, Nicholas W; Barroso, Ines; Peltonen, Leena; Dale, Philip S; Petrill, Stephen A; Schalkwyk, Leonard S; Craig, Ian W; Lewis, Cathryn M; Price, Thomas S; Donnelly, Peter; Plomin, Robert; Spencer, Chris C A

    2014-07-08

    Dissecting how genetic and environmental influences impact on learning is helpful for maximizing numeracy and literacy. Here we show, using twin and genome-wide analysis, that there is a substantial genetic component to children's ability in reading and mathematics, and estimate that around one half of the observed correlation in these traits is due to shared genetic effects (so-called Generalist Genes). Thus, our results highlight the potential role of the learning environment in contributing to differences in a child's cognitive abilities at age twelve.

  19. New Eyes on the Universe Twelve Cosmic Mysteries and the Tools We Need to Solve Them

    CERN Document Server

    Webb, Stephen

    2012-01-01

    "New Eyes on the Universe -- Twelve Cosmic Mysteries and the Tools We Need to Solve Them" gives an up-to-date broad overview of some of the key issues in modern astronomy and cosmology. It describes the vast amount of observational data that the new generation of observatories and telescopes are currently producing, and how that data might solve some of the outstanding puzzles inherent in our emerging world view. Included are questions such as: What is causing the Universe to blow itself apart? What could be powering the luminous gamma-ray bursters? Where is all the matter in the Uni

  20. DETECTION OF CHROMOSOME ABERRATIONS IN TWELVE PRIMARY GASTRIC CANCERS BY DIRECT CHROMOSOME ANALYSIS AND FISH

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    Direct chromosome analysis and FISH were performed on twelve primary gastric carcinomas. Two of them had simple chromosome changes: 48,XX, +8, +20, and 49, XY, +2, +8, +9, and the others had complicated chromosome changes, which includes much more numerical and structural chromosome aberrations. Frequent structural changes in the complicated types involved chromosome 7, 3, 1, 5 and 12 etc. The del 7q was noted in eight cases. The del (3p) and del (1p) were noted in six and five cases, respectively. The results provide some important clues for isolation of the genes related to gastric cancer.

  1. Developing a learning culture: twelve tips for individuals, teams and organizations.

    Science.gov (United States)

    Stinson, Lynn; Pearson, David; Lucas, Beverley

    2006-06-01

    A culture of learning in providing health services and education for health professionals is a constant challenge for individuals, team and organizations. The importance of such a culture was highlighted by the findings of the Bristol Royal Infirmary Inquiry (2001). This was discussed in the context of the literature on the Learning Organization (Senge, 1990) at the 2004 Association of Medical Education in Europe (AMEE) conference, and reviewed a year later at the 2005 AMEE conference. This paper outlines twelve tips for educational and health service organizations in facilitating a culture of learning for their members and also offers specific advice to individual students and professionals.

  2. Pre- and post-operative gait analysis for evaluation of neck pain in chronic whiplash

    Directory of Open Access Journals (Sweden)

    Ginsburg Glen M

    2009-07-01

    Full Text Available Abstract Introduction Chronic neck pain after whiplash is notoriously refractory to conservative treatment, and positive radiological findings to explain the symptoms are scarce. The apparent disproportionality between subjective complaints and objective findings is significant for the planning of treatment, impairment ratings, and judicial questions on causation. However, failure to identify a symptom's focal origin with routine imaging studies does not invalidate the symptom per se. It is therefore of a general interest both to develop effective therapeutic strategies in chronic whiplash, and to establish techniques for objectively evaluation of treatment outcomes. Methods Twelve patients with chronic neck pain after whiplash underwent pre- and postoperative computerized 3D gait analysis. Results Significant improvement was found in all gait parameters, cervical range-of-motion, and self reported pain (VAS. Conclusion Chronic neck pain is associated with abnormal cervical spine motion and gait patterns. 3D gait analysis is a useful instrument to assess the outcome of treatment for neck pain.

  3. Postoperative delirium and postoperative cognitive dysfunction in the elderly - what are the differences?

    DEFF Research Database (Denmark)

    Krenk, L; Rasmussen, L S

    2011-01-01

    Postoperative cognitive impairment is an increasingly common problem as more elderly patients undergo major surgery. Cognitive deficits in the postoperative period cause severe problems and are associated with a marked increase in morbidity and mortality. There are two main entities of postoperat......Postoperative cognitive impairment is an increasingly common problem as more elderly patients undergo major surgery. Cognitive deficits in the postoperative period cause severe problems and are associated with a marked increase in morbidity and mortality. There are two main entities...... of postoperative cognitive decline, delirium and postoperative cognitive dysfunction, which are often reported as being part of the same continuum. Although there are similarities in the predisposing factors, it seems unlikely that they share the same pathophysiology. Both have multifactorial pathogenesis...... but differ in numerous other ways, with delirium being well-defined and acute in onset and postoperative cognitive dysfunction (POCD) being subtler and with longer duration. This review aims to provide an overview of the differences in the diagnosis of the two entities and to illustrate the methodological...

  4. Significance of postoperative serum thyroglobulin levels in patients with papillary and follicular thyroid carcinomas.

    Science.gov (United States)

    Lin, Jen-Der; Huang, Miau-Ju; Hsu, Brend Ray-Sea; Chao, Tzu-Chieh; Hsueh, Chuen; Liu, Feng-Hsuan; Liou, Miaw-Jene; Weng, Hsiao-Fen

    2002-05-01

    Although there are many factors that affect postoperative serum levels of thyroglobulin (Tg), such levels have been previously used to detect recurrence of papillary and follicular thyroid carcinomas. This study was conducted to elucidate the significance of postoperative levels of Tg in patients with clinical presentations of papillary thyroid carcinoma, follicular thyroid carcinomas, or both. To collect data pertaining to patients with thyroid cancer who were treated in Chang Gung Medical Center in Linkou, Taiwan, records relating to a total of 847 patients with pathologically verified papillary or follicular thyroid cancer, all of whom received total thyroidectomy and thyroid remnant ablation with radioactive iodide ((131)I), were studied. To evaluate the clinical significance of postoperative levels of Tg, the patients were categorized into three groups based on postoperative Tg level. Group A was classified as those demonstrating a 1-month postoperative Tg levels less than 1 ng/ml. Group B patients were classified as those displaying a 1-month postoperative Tg levels greater than or equal to 1 ng/ml, but less than 10 ng/ml. Group C patients were classified as those exhibiting a 1-month postoperative Tg levels great than or equal to 10 ng/ml. Of the patients in group A, none presented with distant metastases at the time of diagnosis or during the follow-up period. In group B, 15 patients (3.5%) died of thyroid cancer. In this group, tumor size was an important factor in cancer-related mortality, diagnostic clinical class, and follow-up status. Of the 491 patients in group C, 49 (10.0%) patients died of thyroid cancer. Among the patients in group C, age, histopathologic type, stage of diagnosis, and follow-up Tg values were important factors. Among groups A, B, and C, there were 161 (95.8%), 253 (76.4%), and 129 (37.1%) patients, respectively, with disease-free status at the end of 1998. Postoperative serum Tg levels can be used as a prognostic indicator in

  5. Use of postoperative irradiation for the prevention of heterotopic bone formation after total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

    Sylvester, J.E.; Greenberg, P.; Selch, M.T.; Thomas, B.J.; Amstutz, H.

    1988-03-01

    Formation of heterotopic bone (HTB) following total hip replacement may partially or completely ankylose the joint space, causing pain and/or limiting the range of motion. Patients at high risk for formation of HTB postoperatively include those with previous HTB formation, heterotopic osteoarthritis, and active rheumatoid spondylitis. Patients in these high risk groups have a 63-69% incidence of post-operative HTB formation, usually seen radiographically by 2 months post-operation. From 1980-1986 twenty-nine hips in 28 consecutively treated patients were irradiated post-operatively at the UCLA Center for the Health Sciences. The indication for irradiation was documented HTB formation previously in 26 of the 27 hips presented below. From 1980-1982 patients received 20 Gray (Gy) in 2 Gy fractions; from 1982-1986 the dose was reduced to 10 Gy in 2 Gy fractions. Twenty-seven hips in 26 patients completed therapy and were available for evaluation, with a minimum of 2 month follow-up, and a median follow-up of 12 months. Three of 27 hips developed significant HTB (Brooker grade III or IV) post-operatively, whereas 5 of 27 hips developed minor, nonsymptomatic HTB (Brooker grade I). When irradiation was begun by postoperative day 4, 0 of 17 hips formed significant HTB. If irradiation began after post-operative day 4, 3 of 10 hips formed significant HTB (Brooker grade III or IV). These 3 hips received doses of 10 Gy in one hip and 20 Gy in the other 2 hips. There were no differences in the incidence or severity of side effects in the 10 Gy vs. the 20 Gy treatment groups. Eighteen hips received 10 Gy, 8 hips 20 Gy and, 1 hip 12 Gy. In conclusion, 10 Gy in 5 fractions appears as effective as 20 Gy in 10 fractions at preventing post-operative formation of HTB. For optimal results, treatment should begin as early as possible prior to post-operative day 4.

  6. Bariatric surgery: A review of normal postoperative anatomy and complications

    Energy Technology Data Exchange (ETDEWEB)

    Quigley, S., E-mail: shaun.quigley@bartsandthelondon.nhs.uk [Radiology Department, Homerton University Hospital NHS Foundation Trust, London (United Kingdom); Colledge, J. [Radiology Department, Homerton University Hospital NHS Foundation Trust, London (United Kingdom); Mukherjee, S. [Bariatric Surgery Unit, Homerton University Hospital NHS Foundation Trust, London (United Kingdom); Patel, K. [Radiology Department, Homerton University Hospital NHS Foundation Trust, London (United Kingdom)

    2011-10-15

    The number of bariatric surgery procedures performed is increasing every year. Patients may be referred for radiological investigations to exclude complications not only in the early postoperative period but many months later. Radiologists who do not work in bariatric centres are therefore required to have an understanding of the complex normal anatomy and complications associated with bariatric surgery to interpret imaging studies correctly. The purpose of this article is to describe the surgical techniques and normal anatomy of the four bariatric operations performed today, review the most common problems encountered in this patient group, and to describe the imaging findings that allow the accurate diagnosis of complications. In particular, we focus on identification of the internal hernia, a grave complication of bariatric surgery often missed by radiologists.

  7. Unexplained postoperative retinal hemorrhage after 23-gauge sutureless vitrectomy

    Directory of Open Access Journals (Sweden)

    Ohno H

    2011-07-01

    Full Text Available Hisato Ohno, Kenji InoueInouye Eye Hospital, Tokyo, JapanAbstract: We report five cases of unexplained retinal hemorrhage after 23-gauge sutureless vitrectomy. A 23-gauge sutureless vitrectomy was performed for four cases of macular holes (MH and one case of macular hole retinal detachment (MHRD. Retinal hemorrhages were observed on the first day after surgery and disappeared within several months without leaving any recognizable damage. We speculate that the retinal hemorrhages might have resulted from repeated collapse of the globe through a cannula under air perfusion, but other causes such as retinal vein congestion by face-down positioning are also possible.Keywords: retinal hemorrhage, vitrectomy, postoperative, macular hole, sutureless surgery

  8. Preoperative exercise training to improve postoperative outcomes

    NARCIS (Netherlands)

    Valkenet, K.

    2017-01-01

    It is common knowledge that better preoperative physical fitness is associated with better postoperative outcomes. However, as a result of aging of the population and improved surgical and anaesthesia techniques, the proportion of frail patients with decreased physical fitness levels undergoing majo

  9. Postoperative pain treatment for ambulatory surgery.

    Science.gov (United States)

    Rawal, Narinder

    2007-03-01

    One of the most significant changes in surgical practice during the last two decades has been the growth of ambulatory surgery. Adequate postoperative analgesia is a prerequisite for successful ambulatory surgery. Recent studies have shown that large numbers of patients suffer from moderate to severe pain during the first 24-48 hr. The success of fast-tracking depends to a considerable extent on effective postoperative pain management routines and the cost saving of outpatient surgery may be negated by unanticipated hospital admission for poorly treated pain. Depending on the intensity of postoperative pain current management includes the use of analgesics such as paracetamol, NSAIDs including coxibs and tramadol as single drugs or in combination as part of balanced (multimodal) analgesia. However, in the ambulatory setting many patients suffer from pain at home in spite of multimodal analgesic regimens. Sending patients home with perineural, incisional, and intra-articular catheters is a new and evolving area of postoperative pain management. Current evidence suggests that these techniques are effective, feasible and safe in the home environment if appropriate patient selection routines and organization for follow-up are in place.

  10. Ranitidine improves postoperative monocyte and neutrophil function

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Nielsen, H; Jensen, S;

    1994-01-01

    BACKGROUND: The histamine H2-receptor antagonist ranitidine hydrochloride has been shown to improve trauma-, blood transfusion-, and sepsis-induced immunosuppression. OBJECTIVE: To evaluate the effect of ranitidine on postoperative impairment in monocyte and neutrophil function. METHODS: Twenty...... difference (P detected. There were no infectious complications in ranitidine-treated patients. CONCLUSION: These results support previous studies...

  11. Characterizing postoperative cognitive dysfunction in the elderly

    NARCIS (Netherlands)

    Hovens, Iris Bertha

    2015-01-01

    In the Netherlands, yearly more than 400.000 elderly patients undergo surgery. An estimated ten percent of these patients develops long-lasting postoperative cognitive dysfunction (POCD), associated with a reduced quality of life, increased dependency and worse prognosis. Currently, there is no

  12. Prevention of postoperative pain by balanced analgesia

    DEFF Research Database (Denmark)

    Dahl, J B; Rosenberg, J; Dirkes, W E;

    1990-01-01

    Fourteen patients undergoing colorectal surgery received an intraoperative afferent neural block with combined intrathecal and extradural local anaesthetics plus a balanced postoperative low-dose regimen of extradural bupivacaine 10 mg h-1-morphine 0.2 mg h-1 and systemic piroxicam 20 mg/24 h...

  13. Neuraxial block and postoperative epidural analgesia

    DEFF Research Database (Denmark)

    Leslie, K; McIlroy, D; Kasza, J

    2016-01-01

    BACKGROUND: We assessed associations between intraoperative neuraxial block and postoperative epidural analgesia, and a composite primary outcome of death or non-fatal myocardial infarction, at 30 days post-randomization in POISE-2 Trial subjects. METHODS: 10 010 high-risk noncardiac surgical pat...

  14. Imaging the post-operative meniscus

    Energy Technology Data Exchange (ETDEWEB)

    Toms, Andoni P. [Department of Radiology, Norfolk and Norwich University Hospital, Colney Lane, Norwich, Norfolk NR4 7UY (United Kingdom)]. E-mail: andoni.toms@nnuh.nhs.uk; White, Lawrence M. [Department of Medical Imaging, University of Toronto, Mount Sinai Hospital and the University Health Network, 600 University Avenue, Toronto, Ont., M5G 1X5 (Canada); Marshall, Thomas J. [Department of Radiology, Norfolk and Norwich University Hospital, Colney Lane, Norwich, Norfolk NR4 7UY (United Kingdom); Donell, Simon T. [Institute of Health, University of East Anglia, Norwich, Norfolk NR4 7TJ (United Kingdom)

    2005-05-01

    Considerable developments have occurred in meniscal surgery, and consequently in the imaging of post-operative menisci, over the last 15 years. A drive to preserve meniscal physiologic function for as long as possible, in order to delay osteoarthrosis, has resulted in limited partial meniscectomies, meniscal repairs and meniscal transplants. Each of these techniques affects the imaging appearance of the meniscus, reducing the accuracy of conventional MRI in predicting recurrent tears. The specificity of conventional MRI can be improved by employing at least two T2-weighted sequences, but this still leaves a shortfall in sensitivity. In an attempt to increase the diagnostic accuracy of cross-sectional imaging, MR arthrography (MRA) and CT arthrography (CTA), have been applied to the post-operative meniscus. Sensitivities and specificities for these two techniques approach 90% in predicting recurrent meniscal tears. In the setting of clinical symptoms and gross meniscal deficiency, meniscal allografts are being transplanted with increasing frequency. In these transplants meniscal degeneration, fragmentation and separation are common findings, but the role of imaging in the management of these patients has not yet been well defined. This review explores the imaging techniques available for the evaluation of the post-operative meniscus, their strengths and weaknesses, and the reasons that they may find a place in a rational strategy for imaging of the symptomatic post-operative knee.

  15. Postoperative opioid analgesia: time for a reconsideration?

    DEFF Research Database (Denmark)

    Kehlet, H; Rung, G W; Callesen, T

    1996-01-01

    limit their future use in some situations. Thus, the recent emphasis on ambulatory surgery and accelerated surgical stay programs, both with a focus on early recovery of organ function and provision of functional analgesia [i.e., pain relief that allows normal function (Kehlet H: Postoperative pain...

  16. Management of pain in the postoperative neonate.

    Science.gov (United States)

    Truog, R; Anand, K J

    1989-03-01

    Only recently has the use of anesthesia and analgesia become widely accepted in the newborn infant. This is largely a result of the overwhelming evidence that neonates have the neurologic substrate for the perception of pain and display characteristic behavioral, physiologic, metabolic, and hormonal responses to noxious stimuli. The management of postoperative pain in the surgical neonate begins in the operating room, where techniques can be chosen that will ease the transition into the postoperative period. For postoperative analgesia, the most widely used and effective agents are the narcotics morphine and fentanyl. They may be administered either intermittently or continuously, and with proper precautions may be given to both intubated and nonintubated newborns. Other medications for analgesia and sedation are not as well studied in the newborn, but chloral hydrate and the benzodiazepines are useful for sedation, and acetaminophen may be used for analgesia alone or for potentiating the effect of narcotics. In addition, a number of creative nonpharmacologic techniques are being developed and promise to further decrease the discomfort experienced by postoperative neonates.

  17. Postoperative omental infarction following colonic resection

    Energy Technology Data Exchange (ETDEWEB)

    Kerr, S.F., E-mail: skerr44@doctors.org.uk [Department of Radiology, Leeds General Infirmary, Leeds (United Kingdom); Hyland, R.; Rowbotham, E.; Chalmers, A.G. [Department of Radiology, Leeds General Infirmary, Leeds (United Kingdom)

    2012-02-15

    Aim: To illustrate the computed tomography (CT) appearances and natural history of postoperative omental infarction following colonic resection and to highlight the important clinical implications of this radiological diagnosis. Materials and methods: Over a 3 year period, 15 patients with a history of colonic resection were identified as having a CT diagnosis of postoperative omental infarction. Relevant clinical and pathological data were retrospectively collected from the institution's electronic patient records system and all relevant imaging was reviewed, including serial CT images in 10 patients. Results: A diagnosis of postoperative omental infarction was made in symptomatic and asymptomatic patients who had undergone open or laparoscopic colonic resection for benign or malignant disease. CT appearances ranged from diffuse omental stranding to discrete masses, which typically appeared within weeks of surgery and could persist for years. In four (36%) of the patients with colorectal cancer, the CT appearances raised concern for recurrent malignancy, but percutaneous biopsy and/or serial CT allowed a confident diagnosis of omental infarction to be made. Although most cases were self-limiting, three (20%) cases were complicated by secondary infection and required radiological or surgical intervention. Conclusion: Postoperative omental infarction is an under-recognized complication of colonic resection. It has the potential to mimic recurrent malignancy and may require radiological or surgical intervention for secondary infection.

  18. Predicting postoperative delirium after vascular surgical procedures

    NARCIS (Netherlands)

    Visser, Linda; Prent, Anna; van der Laan, Maarten J.; van Leeuwen, Barbara L.; Izaks, Gerbrand J.; Zeebregts, Clark J.; Pol, Robert A.

    Objective: The objective of this study was to determine the incidence of and specific preoperative and intraoperative risk factors for postoperative delirium (POD) in electively treated vascular surgery patients. Methods: Between March 2010 and November 2013, all vascular surgery patients were

  19. Postoperative pain treatment' practice guideline revised

    NARCIS (Netherlands)

    Houweling, P.L.; Molag, M.L.; Boekel, R.L.M. van; Verbrugge, S.J.; Haelst, I.M. van; Hollmann, M.W.

    2013-01-01

    - On the initiative of the Dutch Association of Anaesthesiologists, a multidisciplinary workgroup has revised the 2003 practice guideline on 'Postoperative pain treatment' for adults and children.- The main reason for revision was the availability of new drugs and new methods of administration. The

  20. Body position and late postoperative nocturnal hypoxaemia

    DEFF Research Database (Denmark)

    Rosenberg-Adamsen, S; Stausholm, K; Edvardsen, L

    1997-01-01

    Thirteen patients were monitored for nocturnal body position (supine vs. side) and arterial oxygen saturation pre-operatively and on the second postoperative night after major abdominal surgery. The number of positional changes were significantly decreased after operation (p ... position than on the side (p reason for decreased nocturnal movements....

  1. Ranitidine improves postoperative monocyte and neutrophil function

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Nielsen, H; Jensen, S

    1994-01-01

    BACKGROUND: The histamine H2-receptor antagonist ranitidine hydrochloride has been shown to improve trauma-, blood transfusion-, and sepsis-induced immunosuppression. OBJECTIVE: To evaluate the effect of ranitidine on postoperative impairment in monocyte and neutrophil function. METHODS: Twenty...... difference (P detected. There were no infectious complications in ranitidine-treated patients. CONCLUSION: These results support previous studies...

  2. Anaesthesia, surgery, and challenges in postoperative recovery

    DEFF Research Database (Denmark)

    Kehlet, Henrik; Dahl, Jørgen B

    2003-01-01

    Surgical injury can be followed by pain, nausea, vomiting and ileus, stress-induced catabolism, impaired pulmonary function, increased cardiac demands, and risk of thromboembolism. These problems can lead to complications, need for treatment in hospital, postoperative fatigue, and delayed......, and by collaborating with surgeons, surgical nurses, and physiotherapists to reduce risk and pain....

  3. Postoperative External Beam Radiotherapy for Retroperitoneal Soft Tissue Sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Na Yong; Kim, Il Han; Choi, Jin Hwa; Park, Charn Il [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2008-09-15

    To evaluate the clinical outcomes and prognostic factors in retroperitoneal soft tissue sarcomas treated by postoperative radiotherapy. The records of 23 patients with retroperitoneal soft tissue sarcomas, who underwent postoperative radiotherapy between 1985 and 2003, were analyzed. The median follow-up period was 77 months (range, 8-240 months). A total of 21 patients presented with primary disease, and two patients presented with recurrent disease. Liposarcomas and leiomyosarcomas represented 78% of the diagnosed tumor cases. Moreover, 17 cases were of high grade (grade 2 or 3). The median tumor size was 13 cm (range, 3-50 cm). Complete excision was achieved in 65% of patients. The median radiation dose was 50.4 Gy (range, 45.0 to 59.4 Gy), with conventional fractionation. The 5-year overall, local recurrence-free, and distant metastasis-free survival rates were 68%, 58%, and 71%, respectively. Eleven patients experienced local recurrence, while 9 patients experienced distant metastasis. The most common site for distant metastasis was the liver. A univariate analysis revealed that adjacent organ invasion and age (>60 years) as the significant risk factors contributing to the prediction of poor overall survival. Moreover, multivariate analyses indicated that adjacent organ invasion remained significantly associated with a higher risk of death. In addition, patient age (>60 years) was the other identified risk factor for local recurrence by univariate and multivariate analyses. Except for one case of grade 3 diarrhea, no patient suffered grade 3 or higher complications. Our results were comparable to previous reports in that adjacent organ invasion and patient age (>60 years) were significant predictors of poor survival and tumor recurrence, respectively.

  4. Postoperative intussusception in pediatric abdominal malignancies: early diagnosis and management

    Institute of Scientific and Technical Information of China (English)

    Maged M. Elshafiey; Gehad T. Meselhy; Amal Refaat; Alaa A. Younes

    2012-01-01

    Objective: The aim of this study was to review the incidence of postoperative intussusception (POI) in our patients with pediatric abdominal malignancies and the end result of management of these cases. Methods: From November2007 till the end of December 2011, a total of 538 patients with different abdominal malignancies were operated upon by laparotomies in our hospital. Reoperations were required in 12 patients for post operative intestinal obstruction developed in the 1st postoperative month. Review of the identified cases focused on patient's characteristics, the primary tumor type, the primary surgical procedure, clinical and imaging features of the intussusceptions, timing and findings at the 2nd laparotomy and the end result of subsequent interventions. Results: Early post operative intestinal obstruction (within 1 month) developed in 12 patients of whom 8 patients had POI. Five patients had adhesive intestinal obstruction (one patient developed POI then adhesive obstruction). The median duration between the primary surgery and the onset of intestinal obstruction symptoms was 5 days (range 4-12 days) in the POI group and 24 days (range 10-30 days) in the adhesion group. Abdominal CT was done in all cases and it could properly diagnose POI and detect its site in the POI group while in the adhesion group it showed evidence of complete obstruction. Plain radiograph failed to detect signs of intestinal obstruction in 3 cases (two in the POI group and one in the adhesion group). In POI group simple reduction was done in 7 cases while resection anastmosis was done in 1 case due to gangrene of the ileocecal region. Adhesiolysis was done in the 5 cases of intestinal adhesion group.Conclusion: Early POI in pediatric abdominal cancer is a rare complication; however it should be kept in mind with high index of suspicion. Early diagnosis and intervention is essential for successful management. Abdominal CT is very helpful as it can detect the level and possible cause of

  5. Patient satisfaction and penile morphology changes with postoperative penile rehabilitation 2 years after Coloplast Titan prosthesis

    Science.gov (United States)

    Pryor, Michael B; Carrion, Rafael; Wang, Run; Henry, Gerard

    2016-01-01

    A common complaint after inflatable penile prosthesis surgery is reduced penile length. We previously reported how using the Coloplast Titan inflatable penile prosthesis with aggressive new length measurement technique (NLMT) coupled with postoperative IPP rehabilitation of the implant for 1-year helped to improve patient satisfaction and erectile penile measurements. This is a 2 years follow-up of a prospective, three-center, study of 40 patients who underwent Titan prosthesis placement, with new length measurement technique for erectile dysfunction. Patient instructions were to inflate daily for 6 months and then inflate maximally for 1–2 h daily for 6–24 months. Fifteen penile measurements were taken before and immediately after surgery and at follow-up visits. Measurement changes were improved at 24 months as compared to immediately postoperative and at 12 months. 67.8% of subjects were satisfied with their length at 2 years, and 77% had perceived penile length that was longer (30.8%) or the same (46.2%) as prior to the surgery. 64.3% and 17.9% of subjects had increased and unchanged satisfaction, respectively, with penile length as compared to prior to penile implant surgery. All but one subject (96.5%) was satisfied with the overall function of his implant. This study suggests using the Coloplast Titan with aggressive cylinder sizing, and a postoperative penile rehabilitation inflation protocol can optimize patient satisfaction and erectile penile measurements at 2 years postimplant. PMID:26459782

  6. Patient satisfaction and penile morphology changes with postoperative penile rehabilitation 2 years after Coloplast Titan prosthesis

    Directory of Open Access Journals (Sweden)

    Michael B Pryor

    2016-01-01

    Full Text Available A common complaint after inflatable penile prosthesis surgery is reduced penile length. We previously reported how using the Coloplast Titan inflatable penile prosthesis with aggressive new length measurement technique (NLMT coupled with postoperative IPP rehabilitation of the implant for 1-year helped to improve patient satisfaction and erectile penile measurements. This is a 2 years follow-up of a prospective, three-center, study of 40 patients who underwent Titan prosthesis placement, with new length measurement technique for erectile dysfunction. Patient instructions were to inflate daily for 6 months and then inflate maximally for 1-2 h daily for 6-24 months. Fifteen penile measurements were taken before and immediately after surgery and at follow-up visits. Measurement changes were improved at 24 months as compared to immediately postoperative and at 12 months. 67.8% of subjects were satisfied with their length at 2 years, and 77% had perceived penile length that was longer (30.8% or the same (46.2% as prior to the surgery. 64.3% and 17.9% of subjects had increased and unchanged satisfaction, respectively, with penile length as compared to prior to penile implant surgery. All but one subject (96.5% was satisfied with the overall function of his implant. This study suggests using the Coloplast Titan with aggressive cylinder sizing, and a postoperative penile rehabilitation inflation protocol can optimize patient satisfaction and erectile penile measurements at 2 years postimplant.

  7. Patient satisfaction and penile morphology changes with postoperative penile rehabilitation 2 years after Coloplast Titan prosthesis.

    Science.gov (United States)

    Pryor, Michael B; Carrion, Rafael; Wang, Run; Henry, Gerard

    2016-01-01

    A common complaint after inflatable penile prosthesis surgery is reduced penile length. We previously reported how using the Coloplast Titan inflatable penile prosthesis with aggressive new length measurement technique (NLMT) coupled with postoperative IPP rehabilitation of the implant for 1-year helped to improve patient satisfaction and erectile penile measurements. This is a 2 years follow-up of a prospective, three-center, study of 40 patients who underwent Titan prosthesis placement, with new length measurement technique for erectile dysfunction. Patient instructions were to inflate daily for 6 months and then inflate maximally for 1-2 h daily for 6-24 months. Fifteen penile measurements were taken before and immediately after surgery and at follow-up visits. Measurement changes were improved at 24 months as compared to immediately postoperative and at 12 months. 67.8% of subjects were satisfied with their length at 2 years, and 77% had perceived penile length that was longer (30.8%) or the same (46.2%) as prior to the surgery. 64.3% and 17.9% of subjects had increased and unchanged satisfaction, respectively, with penile length as compared to prior to penile implant surgery. All but one subject (96.5%) was satisfied with the overall function of his implant. This study suggests using the Coloplast Titan with aggressive cylinder sizing, and a postoperative penile rehabilitation inflation protocol can optimize patient satisfaction and erectile penile measurements at 2 years postimplant.

  8. Adult tonsillectomy: postoperative pain depends on indications

    Directory of Open Access Journals (Sweden)

    Olaf Zagólski

    Full Text Available ABSTRACT INTRODUCTION: Intense pain is one of the most important postoperative complaints after tonsillectomy. It is often described by patients as comparable to the pain that accompanies an acute tonsillitis. Although recurrent tonsillitis is the most frequent indication for surgery, many tonsillectomies are performed due to other indications and these patients may be unfamiliar with such pain. OBJECTIVE: To verify whether individuals with recurrent tonsillitis experience different post-tonsillectomy pain intensity than those with other indications for surgery, with no history of episodes of acute tonsillitis. METHODS: A total of 61 tonsillectomies were performed under general anesthesia, using a potassium titanyl phosphate (KTP laser (to eliminate the potential influence on the study results of forceful dissection of fibrotic tonsils in patients with history of recurrent tonsillitis and multiple ligations of blood vessels within the tonsillar beds. The patients received 37.5 mg Tramadoli hydrochloridum + 325 mg Paracetamol tablets for 10 days. Postoperative variables included the duration of hospital stay, postoperative hemorrhage and readmission rate. The patients reported pain intensity on consecutive days, pain duration, weight loss on postoperative day 10, character, intensity and duration of swallowing difficulties, and the need for additional doses of painkillers. Healing was also assessed. Capsular nerve fibers were histologically examined in the resected tonsils by immunostainings for general and sensory markers. RESULTS: Indications for the surgery were: recurrent acute tonsillitis (34 patients, no history of recurrent tonsillitis: focus tonsil (20 and intense malodour (7. Pain intensity on postoperative days 3-4 and incidence of readmissions due to dehydration were significantly higher in the group with no history of recurrent tonsillitis. No significant differences in relative densities of protein gene product (PGP 9.5- and

  9. Preoperative prediction of severe postoperative pain.

    Science.gov (United States)

    Kalkman, C J; Visser, K; Moen, J; Bonsel, G J; Grobbee, D E; Moons, K G M

    2003-10-01

    We developed and validated a prediction rule for the occurrence of early postoperative severe pain in surgical inpatients, using predictors that can be easily documented in a preoperative setting. A cohort of surgical inpatients (n=1416) undergoing various procedures except cardiac surgery and intracranial neurosurgery in a University Hospital were studied. Preoperatively the following predictors were collected: age, gender, type of scheduled surgery, expected incision size, blood pressure, heart rate, Quetelet index, the presence and severity of preoperative pain, health-related quality of life the (SF-36), Spielberger's State-Trait Anxiety Inventory (STAI) and the Amsterdam Preoperative Anxiety and Information Scale (APAIS). The outcome was the presence of severe postoperative pain (defined as Numeric Rating Scale > or =8) within the first hour postoperatively. Multivariate logistic regression in combination with bootstrapping techniques (as a method for internal validation) was used to derive a stable prediction model. Independent predictors of severe postoperative pain were younger age, female gender, level of preoperative pain, incision size and type of surgery. The area under the receiver operator characteristic (ROC) curve was 0.71 (95% CI: 0.68-0.74). Adding APAIS scores (measures of preoperative anxiety and need for information), but not STAI, provided a slightly better model (ROC area 0.73). The reliability of this extended model was good (Hosmer and Lemeshow test p-value 0.78). We have demonstrated that severe postoperative pain early after awakening from general anesthesia can be predicted with a scoring rule, using a small set of variables that can be easily obtained from all patients at the preoperative visit. Before this internally validated preoperative prediction rule can be applied in clinical practice to support anticipatory pain management, external validation in other clinical settings is necessary.

  10. Approximate analytic method for high-apogee twelve-hour orbits of artificial Earth's satellites

    Science.gov (United States)

    Vashkovyaka, M. A.; Zaslavskii, G. S.

    2016-09-01

    We propose an approach to the study of the evolution of high-apogee twelve-hour orbits of artificial Earth's satellites. We describe parameters of the motion model used for the artificial Earth's satellite such that the principal gravitational perturbations of the Moon and Sun, nonsphericity of the Earth, and perturbations from the light pressure force are approximately taken into account. To solve the system of averaged equations describing the evolution of the orbit parameters of an artificial satellite, we use both numeric and analytic methods. To select initial parameters of the twelve-hour orbit, we assume that the path of the satellite along the surface of the Earth is stable. Results obtained by the analytic method and by the numerical integration of the evolving system are compared. For intervals of several years, we obtain estimates of oscillation periods and amplitudes for orbital elements. To verify the results and estimate the precision of the method, we use the numerical integration of rigorous (not averaged) equations of motion of the artificial satellite: they take into account forces acting on the satellite substantially more completely and precisely. The described method can be applied not only to the investigation of orbit evolutions of artificial satellites of the Earth; it can be applied to the investigation of the orbit evolution for other planets of the Solar system provided that the corresponding research problem will arise in the future and the considered special class of resonance orbits of satellites will be used for that purpose.

  11. Global surface temperature change analysis based on MODIS data in recent twelve years

    Science.gov (United States)

    Mao, K. B.; Ma, Y.; Tan, X. L.; Shen, X. Y.; Liu, G.; Li, Z. L.; Chen, J. M.; Xia, L.

    2017-01-01

    Global surface temperature change is one of the most important aspects in global climate change research. In this study, in order to overcome shortcomings of traditional observation methods in meteorology, a new method is proposed to calculate global mean surface temperature based on remote sensing data. We found that (1) the global mean surface temperature was close to 14.35 °C from 2001 to 2012, and the warmest and coldest surface temperatures of the global in the recent twelve years occurred in 2005 and 2008, respectively; (2) the warmest and coldest surface temperatures on the global land surface occurred in 2005 and 2001, respectively, and on the global ocean surface in 2010 and 2008, respectively; and (3) in recent twelve years, although most regions (especially the Southern Hemisphere) are warming, global warming is yet controversial because it is cooling in the central and eastern regions of Pacific Ocean, northern regions of the Atlantic Ocean, northern regions of China, Mongolia, southern regions of Russia, western regions of Canada and America, the eastern and northern regions of Australia, and the southern tip of Africa. The analysis of daily and seasonal temperature change indicates that the temperature change is mainly caused by the variation of orbit of celestial body. A big data model based on orbit position and gravitational-magmatic change of celestial body with the solar or the galactic system should be built and taken into account for climate and ecosystems change at a large spatial-temporal scale.

  12. Lymphatic territories (lymphosomes in a canine: an animal model for investigation of postoperative lymphatic alterations.

    Directory of Open Access Journals (Sweden)

    Hiroo Suami

    Full Text Available BACKGROUND: Lymph node dissection is often performed as a part of surgical treatment for breast cancer and malignant melanoma to prevent malignant cells from traveling via the lymphatic system. Currently little is known about postoperative lymphatic drainage pattern alterations. This knowledge may be useful for management of recurrent cancer and prevention of breast cancer related lymphedema. We mapped the complete superficial lymphatic system of a dog and used this canine model to perform preliminary studies of lymphatic architectural changes in postoperative condition. METHODS: Lymphatic territories (lymphosomes were mapped with 4 female mongrel carcasses using an indocyanine green (ICG fluorescent lymphography and a radiographic microinjection technique. Two live dogs were then subjected to unilateral lymph node dissection of lymph basins of the forelimb, and ICG lymphography and lymphangiogram were performed 6 months after the surgery to investigate lymphatic changes. Lymphatic patterns in the carcass were then compared with postoperative lymphatic patterns in the live dogs. RESULTS: Ten lymphosomes were identified, corresponding with ten lymphatic basins. Postoperative fluorescent lymphographic images and lymphangiograms in the live dogs revealed small caliber lymphatic network fulfilling gaps in the surgical area and collateral lymphatic vessels arising from the network connecting to lymph nodes in the contralateral and ipsilateral neck in one dog and the ipsilateral subclavicular vein in another dog. CONCLUSION: Our canine lymphosome map allowed us to observe lymphatic collateral formations after lymph node dissection in live dogs. This canine model may help clarify our understanding of postoperative lymphatic changes in humans in future studies.

  13. Postoperative delirium and factors related in a cardiac surgery unit care

    Directory of Open Access Journals (Sweden)

    Julia de las Pozas Abril

    2011-07-01

    Full Text Available Objective: Describe the incidence of postoperative delirium and related risk factors associated with this complication in patients undergoing cardiac surgery. Method: Cohort study conducted for 3 months in a sample of 105 patients undergoing cardiac surgery in a hospital in Madrid. The emergence of delirium with scale ICDSC (Intensive Care Delirium Screening Checklist was measured during the first five days of postoperative and collected data on preoperative, intra-operative and post-operative factors to relate to the emergence of delirium. Results: 95 Patients studied, 15 of them developed delirium, which means an incidence of 15.7%. We found that there was a significant relationship between delirium appearance and age of the patients, the presence of atrial fibrillation, intubation orotraqueal time and the administration of adrenaline during the immediate post-operative management. The multivariable model showed the duration of orotraqueal intubation to be independently associated with delirium. Conclusions: The incidence of delirium found in this study as well as the identification of the time of orotraqueal intubation as independent risk factor supposes a new contribution to the knowledge of this postoperative complication and allow us to begin to evaluate its importance in the unit of cardiac surgery.

  14. Post-operative cognitive dysfunction in the elderly: A prospective clinical study

    Directory of Open Access Journals (Sweden)

    Nalini Kotekar

    2014-01-01

    Full Text Available Background and Aims: Aging population is a major demographic trend worldwide. Globally, 50% of all the elderly individuals are estimated to undergo atleast one surgical procedure and post-operative cognitive dysfunction (POCD is one of the most common and often poorly understood post-operative complications in this section of the population. This randomised prospective study was conducted to assess the post-operative cognitive status in the elderly undergoing non-cardiac surgery, evaluate the cognitive parameters affected, evaluate the potential risk factors and thereby analyse the potential for implementation of preventive strategies. Methods: This study was conducted on 200 patients aged 60 years or older scheduled for elective non-cardiac surgeries. The baseline cognitive status of the patients was assessed 2 days prior to the date of the surgery. The post-operative cognitive status was assessed on the 3 rd day, 7 th day and after 1 month. Statistical analysis was performed using SAS and SPSS. Results: The incidence of POCD showed a gradual decline from postoperative day 3 to 30. Females were found to be at significant risk in developing POCD. Advancing age and level of education emerged as dominant factors, while type of anaesthesia, duration of surgery, and presence of coexisting comorbidities had no influence on the incidence of cognitive dysfunction. Conclusion: POCD is a definite complication after surgery and anaesthesia in the elderly population. Gender emerged as a significant risk factor with increasing age as a dominating factor contributing to POCD.

  15. Comparative assay of fluorescent antibody test results among twelve European National Reference Laboratories using various anti-rabies conjugates

    DEFF Research Database (Denmark)

    Robardet, E.; Andrieu, S.; Rasmussen, Thomas Bruun

    2013-01-01

    Twelve National Reference Laboratories (NRLs) for rabies have undertaken a comparative assay to assess the comparison of fluorescent antibody test (FAT) results using five coded commercial anti-rabies conjugates (Biorad, Bioveta, Fujirebio, Millipore, and SIFIN conjugates). Homogenized positive...

  16. A 12-month randomized crossover study on the effects of Lanreotide Autogel and Octreotide long-acting repeatable on GH and IGF-l in patients with acromegaly

    DEFF Research Database (Denmark)

    Andries, Magdalene; Glintborg, Dorte; Kvistborg, Annette

    2007-01-01

    of acromegaly in a randomized study design. Material and methods Twelve acromegalic patients were included and 10 patients completed treatment with LAN or OCT for 6 months and were then switched to the opposite treatment modality for 6 months without a washout period in a randomized crossover design. GH and IGF...

  17. Postoperative meralgia paresthetica after posterior spine surgery: incidence, risk factors, and clinical outcomes.

    Science.gov (United States)

    Yang, Shu-Hua; Wu, Chang-Chin; Chen, Po-Quang

    2005-09-15

    A prospective study on postoperative meralgia paresthetica after posterior thoracolumbar spine surgery on the Relton-Hall frame. To assess the incidence of postoperative lateral femoral cutaneous nerve (LFCN) neuralgia and to investigate its risk factors and clinical outcomes. Postoperative meralgia paresthetica is a common complication of posterior thoracolumbar spine surgery. The injury mechanism is external compression to the LFCN near the anterior superior iliac spine in the prone position. A total of 252 patients were examined for signs of meralgia paresthetica before and after surgery. Patients with a LFCN injury were followed regularly until sensory impairment resolved. Several possible contributing factors were assessed to evaluate the correlations. Postoperative meralgia paresthetica was experienced by 60 patients (23.8%). Patients with an LFCN injury had a significantly greater body mass index (23.6 vs. 22.4 kg/m2) and a longer surgical time (3.7 vs. 3.2 hours). Overweight/obese patients had a significantly greater incidence (odds ratio, 1.83; 95% confidence interval, 1.02-3.29). Patients operated for degenerative spinal disorders also had a significantly higher incidence of LFCN injury (odds ratio, 2.81; 95% confidence interval, 1.53-5.13). Recovery took 10.5 days on average (range, 2 days to 2 months). Thirty-two patients (53%) recovered completely within the first week and every patient recovered within 2 months. Postoperative meralgia paresthetica is a common but benign complication of posterior thoracolumbar spine surgery. Degenerative spinal disorders, overweight/obesity, and longer surgical time are factors related to a higher incidence of LFCN injury. The clinical outcome is always excellent, and complete recovery can be expected within 2 months.

  18. Analysis of postoperative monitoring of patients undergoing shoulder arthroscopy for anterior instability.

    Science.gov (United States)

    Almeida, Alexandre; Menegotto, Samuel Millán; Almeida, Nayvaldo Couto de; Agostini, Ana Paula; Almeida, Letícia Agostini de

    2017-01-01

    Analyze the postoperative follow-up of patients undergoing shoulder arthroscopy for treatment of anterior instability and correlate with the prevalence of recurrence. A six-question survey was applied by phone and mail to 65 patients, seeking information on the current result of the surgical procedure. All patients were treated arthroscopically for anterior shoulder instability, with at least 12 months of postoperative time. Patients with associated posterior labial lesions and revision surgeries were not included. At the time of the survey the patients had a median of 56 (IQR: 34.5-110.5) postoperative months. The mean sample age was 24.6 years (maximum = 47, minimum = 12; SD = 7.3). Complaint of pain in the shoulder was observed in 20 patients (30.7%). Dislocation recurrence was observed in 10 patients (15.3%). Forty-four patients (67.6%) considered their shoulder normal, which was more frequent in non-recurrence patients (p < 0.001). Forty-three patients (66.1%) returned to their previous level of sport and there was no difference between recurrence and non-recurrence patients (p = 0.456). It was found that the prevalence of recurrence was 5.6 (95% CI: 1.30-24.46) times higher in individuals who abandoned monitoring before six months postoperatively (p = 0.012). The abandonment of postoperative monitoring in the early stages, when the patients receive orientation for muscle strengthening, proprioceptive education, and dangerous movements to avoid, can increase the rates of recurrent shoulder dislocation in patients treated for anterior instability by arthroscopy.

  19. Adjuvant postoperative radiation therapy for carcinoma of the uterine cervix

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Ja; Moon, Hye Seong; Kim, Seung Cheol; Kim, Chong Il; Ahn, Jung Ja [College of Medicine, Ewha Womans Univ., Seoul (Korea, Republic of)

    2003-09-01

    This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study, The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, Iymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer following simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was 45 - 50 Gy. Vagina cuff irradiation was performed, after completion of the external beam irradiation, al a low-dose rate of CS-137, with the total dose of 4488-4932 chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months (15-108 months), The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were 98%, 95% and 94%, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients (9%) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Our results indicate that postoperative radiation therapy can

  20. Multiple 18F-FDG, PET-CT for Postoperative Monitoring of Breast Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kurata, A.; Murata, Y.; Kubota, K.; Shibuya, H. (Dept. of Radioloy, Tokyo Medical and Dental Univ. Hospital, Tokyo (Japan)); Osanai, T. (Dept. of Breast Surgery, Tokyo Medical and Dental Univ. Hospital, Tokyo (Japan))

    2009-11-15

    Background: Positron emission tomography (PET)-computed tomography (CT) may be useful in the post-treatment follow-up of breast cancer patients. Purpose: To assess the usefulness of 18F-fluorodeoxyglucose (FDG) PET-CT (PET-CT) for postoperative monitoring of breast cancer patients. Material and Methods: One hundred twenty-nine PET-CT studies performed on 55 female postoperative breast cancer patients (median age 56 years, range 36-86 years) were analyzed. The median interval between the PET-CT studies was 6 months (range 1-15 months). In order to determine the usefulness of serial PET-CT examinations in the postoperative follow-up of breast cancer patients, the PET-CT findings were compared with the physical findings, findings obtained by other imaging modalities, and the 18F-FDG-PET (PET) findings. Results: The PET findings were negative in 4 metastatic bone lesions with a positive bone scan. The PET findings were also negative in 6 of 9 osteogenic bone metastases and one of 64 osteolytic bone lesions. There were 5 cases with false-positive of PET, which were determined to be areas of soft-tissue hyperactivity. All false-positive/-negative findings were corrected by the addition of CT. Conclusion: The results of this study lend support to the clinical role of PET-CT in the postoperative follow-up/monitoring of breast cancer patients

  1. Preoperative and postoperative evaluation of somatosensorial evoked potentials of upper extremities in cervical intervertebral disc herniation.

    Science.gov (United States)

    Umur, Ahmet Sukru; Selcuki, Mehmet; Selcuki, Deniz; Temiz, Cuneyt; Akbasak, Aytac

    2013-01-01

    This study aims to determine the dysfunction caused by existing pathological condition in structures involved in the transfer of sensory functions of the neural system in cervical disc herniation, and to establish whether or not the level and degree of this anatomical damage can be anticipated by SEP (Somatosensorial Evoked Potentials). We compared the obtained SEP values for statistical significance using the Friedman Variation Analysis. In parameters with statistical significance, the Wilcoxon Signed Rank test was used to identify when significant improvements occurred. The study found that the statistical data of the latency of the N14 wave originating from the dorsal column nuclei of the medulla spinalis and dorsal column gray matter improved (p < 0.05) in the postoperative period compared with the preoperative values. Using the Wilcoxon Signed Rank test, we studied postoperative months separately in regard to the difference in the latency of the N14 wave, and found the statistically significant improvement to be marked particularly in months 3 and 6 postoperatively (p < 0.05). In conclusion, we suggest that SEP is a useful tool to check the functional condition of the dorsal spinal column. The benefit of the SEP utilization is the ability to determine the severity of the pathological condition preoperatively and follow the patient's functional postoperative improvement.

  2. High incidence and spontaneous resolution of mastoid effusion after craniotomy on early postoperative magnetic resonance images

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, T.; Saito, N.; Takahashi, A.; Fujimaki, H.; Tosaka, M.; Sasaki, T. [Department of Neurosurgery, Gunma University School of Medicine, 3-39-22 Showa-machi, 371-8511, Maebashi, Gunma (Japan); Sato, N. [Department of Diagnostic Radiology, Gunma University School of Medicine, Maebashi, Gunma (Japan)

    2003-07-01

    Mastoid effusion is a poorly understood complication after craniotomy. The incidence and severity of postoperative mastoid effusion were retrospectively examined on postoperative magnetic resonance (MR) images to assess any association with craniotomy procedures, time course, and neuro-otological complications. We evaluated the early postoperative MR images (within 4 days of craniotomy) and medical records of 74 patients who underwent 77 operations for the treatment of various intracranial diseases from January 2000 to December 2001. Mastoid effusion was classified into four grades: none, partial, moderate, and severe diffuse effusion in the mastoid air cells. Thirty-three follow-up MR images from 26 patients were also reviewed. Postoperative mastoid effusion occurred ipsilateral to the craniotomy site in 62 cases and contralateral in 56 cases. Mastoid effusion was significantly more severe ipsilateral than contralateral to craniotomy with exposure of the mastoid air cells (P<0.0001). There was no significant difference in severity between the contralateral and ipsilateral sides after craniotomy without mastoid air cell opening (P=0.437). Mastoid effusion following craniotomy without exposure of mastoid air cells resolved within 3 months. However, otitis media with effusion developed in six patients with severe mastoid effusion ipsilateral to craniotomy with exposure of the mastoid air cells. Mastoid effusion frequently developed on both sides. Any grade of mastoid effusion on the ipsilateral side to craniotomy without exposure of mastoid air cells, or on the contralateral side, was asymptomatic or had a benign course, and disappeared within 3 months. (orig.)

  3. Treatment outcome of ductal carcinoma in situ patients treated with postoperative radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Yu Jin; Kim, Kyu Bo; Choi, Eui Kyu; Han, Won Shik; Noh, Dong Young; Ha, Sung W. [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2013-12-15

    To evaluate the outcome of ductal carcinoma in situ (DCIS) patients who underwent surgery followed by radiation therapy (RT). We retrospectively reviewed 106 DCIS patients who underwent surgery followed by postoperative RT between 1994 and 2006. Ninety-four patients underwent breast-conserving surgery, and mastectomy was performed in 12 patients due to extensive DCIS. Postoperative RT was delivered to whole breast with 50.4 Gy/28 fx. Tumor bed boost was offered to 7 patients (6.6%). Patients with hormonal receptor-positive tumors were treated with hormonal therapy. The median follow-up duration was 83.4 months (range, 33.4 to 191.5 months) and the median age was 47.8 years. Ten patients (9.4%) had resection margin <1 mm and high-grade and estrogen receptor-negative tumors were observed in 39 (36.8%) and 20 (18.9%) patients, respectively. The 7-year ipsilateral breast tumor recurrence (IBTR)-free survival rate was 95.3%. Resection margin (<1 or ≥1 mm) was the significant prognostic factor for IBTR in univariate and multivariate analyses (p < 0.001 and p = 0.016, respectively). Postoperative RT for DCIS can achieve favorable treatment outcome. Resection margin was the important prognostic factor for IBTR in the DCIS patients who underwent postoperative RT.

  4. Natural Gas Monthly, October 1993

    Energy Technology Data Exchange (ETDEWEB)

    1993-11-10

    The (NGM) Natural Gas Monthly highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information. This month`s feature articles are: US Production of Natural Gas from Tight Reservoirs: and Expanding Rule of Underground Storage.

  5. Natural gas monthly, May 1994

    Energy Technology Data Exchange (ETDEWEB)

    1994-05-25

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information. The featured articles for this month are: Opportunities with fuel cells, and revisions to monthly natural gas data.

  6. Monthly energy review, January 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-01-01

    This report presents an overview of recent monthly energy statistics. Major activities covered include production, consumption, trade, stocks, and prices for fossil fuels, electricity, and nuclear energy.

  7. Natural gas monthly, July 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-07-01

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information. The feature article this month is entitled ``Intricate puzzle of oil and gas reserves growth.`` A special report is included on revisions to monthly natural gas data. 6 figs., 24 tabs.

  8. Monthly Program Cost Report (MPCR)

    Data.gov (United States)

    Department of Veterans Affairs — The Monthly Program Cost Report (MPCR) replaces the Cost Distribution Report (CDR). The MPCR provides summary information about Veterans Affairs operational costs,...

  9. Effect of postoperative experiences on willingness to pay to avoid postoperative pain, nausea, and vomiting

    NARCIS (Netherlands)

    J.E. van den Bosch; G.J. Bonsel; K.G. Moons; C.J. Kalkman

    2006-01-01

    Background: The authors assessed the willingness to pay (WTP) for "perfect" prophylactic antiemetics and analgesics in patients who were scheduled to undergo surgery during general anesthesia. Furthermore, they determined whether postoperative experiences of pain and nausea and vomiting (PONV) chang

  10. Comparative Assessment of Preoperative versus Postoperative Dexamethasone on Postoperative Complications following Lower Third Molar Surgical Extraction

    Directory of Open Access Journals (Sweden)

    Hashem M. Al-Shamiri

    2017-01-01

    Full Text Available Aim. To evaluate the effect of preoperative versus postoperative administration of oral Dexamethasone on postoperative complications including pain, edema, and trismus following lower third molar surgery. Methods. 24 patients were divided into two equal groups receiving 8 mg Dexamethasone orally, one group one hour preoperatively and the other group immediately after surgery. Pain was measured using VAS, edema was measured using a graduated tape between 4 fixed points in the face, and the mouth opening was measured using a graduated sliding caliper. Results. In this study pain and trismus records were similar and statistically nonsignificant in both groups. The results had proven that preoperative administration was superior when compared to postoperative administration regarding edema (0.002. Conclusions. Preoperative oral administration of 8 mg Dexamethasone was superior to the postoperative administration of the same dose concerning edema after lower third molar surgery.

  11. The effect of sutureless wound closure on postoperative pain and swelling after impacted mandibular third molar surgery.

    Science.gov (United States)

    Hashemi, Hamid Mahmood; Beshkar, Majid; Aghajani, Reihaneh

    2012-04-01

    Our aim was to assess the influence of sutureless and multiple-suture closure of wounds on postoperative complications after extraction of bilateral, impacted, mandibular third molars in 30 patients in a split mouth study. After the teeth had been removed, on one side the flap was replaced but with no suture to hold it in place (study side), and on the other side the wound was closed primarily with three sutures (control side). Recorded complications included pain, swelling, bleeding, and formation of periodontal pockets. The results showed that patients had significantly less postoperative pain and swelling when no sutures were used (p=0.005). There were no signs of excessive bleeding or oozing postoperatively on either side. Six months postoperatively there was no significant difference in the depth of the periodontal pocket around the second molar.

  12. Monthly energy review, November 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-11-01

    The Monthly Energy Review (MER) presents an overview of the Energy Information Administration`s recent monthly energy statistics. The statistics cover the major activities of US production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. Also included are international energy and thermal and metric conversion factors. 37 figs., 61 tabs.

  13. Natural gas monthly, February 1999

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-02-01

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. 6 figs., 28 tabs.

  14. Monthly energy review: April 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-04-01

    This monthly report presents an overview of energy statistics. The statistics cover the major activities of US production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. A section is also included on international energy. The feature paper which is included each month is entitled ``Energy equipment choices: Fuel costs and other determinants.`` 37 figs., 59 tabs.

  15. ULTRAPLATE 30 month management report

    DEFF Research Database (Denmark)

    Jensen, Jens Dahl

    2003-01-01

    In the period from month 24 to month 30 focus has been on the work-package 3 activities concerning optimisation of the newly developed ULTRAPLATE technology towards specific industrial applications. Three main application areas have been pursued: 1) High- speed plating of lead free solder contact...

  16. Your Baby's Growth: 5 Months

    Science.gov (United States)

    ... to Be Smart About Social Media Your Baby's Growth: 5 Months KidsHealth > For Parents > Your Baby's Growth: 5 Months Print A A A What's in ... your child's birth, the doctor has been recording growth in weight, length, and head size (circumference) during ...

  17. Monthly energy review, November 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-11-01

    The Monthly Energy Review (MER) presents an overview of the Energy Information Administration`s recent monthly energy statistics. The statistics cover the major activities of US production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. Also included are international energy and thermal and metric conversion factors. 37 figs., 91 tabs.

  18. Natural gas monthly, November 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-11-01

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. 6 figs., 27 tabs.

  19. Natural gas monthly, January 1999

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-02-01

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. 6 figs., 28 tabs.

  20. Monthly energy review, October 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-10-01

    The Monthly Energy Review (MER) presents an overview of the Energy Information Administration`s recent monthly energy statistics. The statistics cover the major activities of US production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. Also included are international energy and thermal and metric conversion factors. 37 figs., 61 tabs.

  1. Monthly energy review, June 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-06-01

    The Monthly Energy Review (MER) presents an overview of the Energy Information Administration`s recent monthly energy statistics. The statistics cover the major activities of US production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. Also included are international energy and thermal and metric conversion factors. 36 figs., 61 tabs.

  2. Monthly energy review, May 1999

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-05-01

    The Monthly Energy Review (MER) presents an overview of the Energy Information Administration`s recent monthly energy statistics. The statistics cover the major activities of US production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. Also included are international energy and thermal and metric conversion factors. 37 figs., 61 tabs.

  3. Monthly energy review, January 1999

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-01-01

    The Monthly Energy Review (MER) presents an overview of the Energy Information Administration`s recent monthly energy statistics. The statistics cover the major activities of US production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. Also included are international energy and thermal and metric conversion factors. 37 figs., 61 tabs.

  4. Monthly energy review, February 1999

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-02-01

    The Monthly Energy Review (MER) presents an overview of the Energy Information Administration`s recent monthly energy statistics. The statistics cover the major activities of US production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. Also included are international energy and thermal and metric conversion factors. 37 figs., 73 tabs.

  5. Monthly energy review, March 1999

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-03-01

    The Monthly Energy Review (MER) presents an overview of the Energy Information Administration`s recent monthly energy statistics. The statistics cover the major activities of US production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. Also included are international energy and thermal and metric conversion factors. 37 figs., 74 tabs.

  6. Natural gas monthly, December 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-01

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. 6 figs., 28 tabs.

  7. Left behind by Birth Month

    Science.gov (United States)

    Solli, Ingeborg Foldøy

    2017-01-01

    Utilizing comprehensive administrative data from Norway I investigate long-term birth month effects. I demonstrate that the oldest children in class have a substantially higher GPA than their younger peers. The birth month differences are larger for low-SES children. Furthermore, I find that the youngest children in class are lagging significantly…

  8. Monthly Energy Review, February 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-02-26

    This monthly publication presents an overview of EIA`s recent monthly energy statistics, covering the major activities of U.S. production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. Also included are international energy and thermal and metric conversion factors. Two brief descriptions (`energy plugs`) on two EIA publications are presented at the start.

  9. Haida Months of the Year.

    Science.gov (United States)

    Cogo, Robert

    Students are introduced to Haida vocabulary in this booklet which briefly describes the seasons and traditional seasonal activities of Southeastern Alaska Natives. The first section lists the months in English and Haida; e.g., January is "Taan Kungaay," or "Bear Hunting Month." The second section contains seasonal names in…

  10. Monthly energy review, November 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-11-01

    The Monthly Energy Review (MER) presents an overview of the Energy Information Administration`s recent monthly energy statistics. The statistics cover the major activities of US production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. Also included are international energy and thermal and metric conversion factors. 75 tabs.

  11. Monthly energy review, July 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-07-01

    The Monthly Energy Review (MER) presents an overview of the Energy Information Administration`s recent monthly energy statistics. The statistics cover the major activities of US production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. Also included are international energy and thermal and metric conversion factors. 37 figs. 73 tabs.

  12. Randomization to nutritional intervention at home did not improve postoperative function, fatigue or well-being

    DEFF Research Database (Denmark)

    Jensen, Martin Bach; Hessov, Ib

    1997-01-01

    BACKGROUND: Postoperative fatigue and deterioration in functional capacity have been correlated to postoperative weight loss. This suggested that nutritional support to enhance the regain of weight might improve upon the convalescence. METHODS: Patients were allocated randomly at discharge......, gain in body-weight and lean body mass, especially in the legs as shown by dual-energy X-ray absorptiometry. Changes in work capacity, hand grip and pinching strength, fatigue and quality of life were similar in patients in control and intervention groups and had returned to preoperative values 1......-2 months after operation, although fatigue was increased at 2-3 months. CONCLUSIONS: This study did not support the hypothesis that changes in weight were important for the changes in function and fatigue in patients with small to moderate weight loss....

  13. Postoperative pelvic pain: An imaging approach.

    Science.gov (United States)

    Farah, H; Laurent, N; Phalippou, J; Bazot, M; Giraudet, G; Serb, T; Poncelet, E

    2015-10-01

    Postoperative pelvic pain after gynecological surgery is a readily detected but unspecific sign of complication. Imaging as a complement to physical examination helps establish the etiological diagnosis. In the context of emergency surgery, vascular, urinary and digestive injuries constitute the most frequent intraoperative complications. During the follow-up of patients who had undergone pelvic surgery, imaging should be performed to detect recurrent disease, postoperative fibrosis, adhesions and more specific complications related to prosthetic material. Current guidelines recommend using pelvic ultrasonography as the first line imaging modality whereas the use of pelvic computed tomography and/or magnetic resonance imaging should be restricted to specific situations, depending on local availability of equipment and suspected disease.

  14. Postoperative ileus - an update on preventive techniques

    DEFF Research Database (Denmark)

    Kehlet, H.

    2008-01-01

    institution of oral feeding and laparoscopic surgery might also be effective, but there is less clear evidence available to support their use. When some of these techniques are combined as part of the concept of multimodal postoperative rehabilitation (fast-track surgery), the duration of POI after open......This article reviews techniques currently used to prevent or reduce the duration of postoperative ileus (POI), which is considered an undesirable stress response to major abdominal surgery that leads to discomfort, morbidity and prolonged hospital stay. In several randomized studies, a number...... of techniques have been demonstrated to reduce the occurrence and/or duration of POI: thoracic epidural analgesia with local anesthetics, peripheral opioid antagonists, laxatives, chewing gum, intravenous and incisional local anesthetics, and avoidance of routine nasogastric intubation and fluid excess. Early...

  15. [Pneumothorax revealed by postoperative computed tomography].

    Science.gov (United States)

    Ikeda, Shizuka; Katori, Kiyoshi; Fujimoto, Minoru; Nitahara, Keiichi; Higa, Kazuo

    2005-11-01

    We report a case of pneumothorax revealed by postoperative computed tomography. A 39-year-old obese woman (height 153 cm, weight 70 kg) with fractures of the radius, ulna, clavicle, and femur in a traffic accident, was scheduled for osteosynthesis. Anesthesia was induced with thiopental and maintained with 50% nitrous oxide in oxygen and sevoflurane. The Spo2 decreased from 99% to 94% during the surgery. Bilateral chest sounds were symmetrical. The Spo2 increased to 100% after discontinuation of nitrous oxide. Pneumothorax was not evident on a postoperative chest X-ray, but computed tomography of the chest demonstrated right-sided pneumothorax. An ECG electrode had overlapped the fractured rib on the preoperative chest X-ray.

  16. Postoperative refraction in the second eye having cataract surgery.

    Science.gov (United States)

    Leffler, Christopher T; Wilkes, Martin; Reeves, Juliana; Mahmood, Muneera A

    2011-01-01

    Introduction. Previous cataract surgery studies assumed that first-eye predicted and observed postoperative refractions are equally important for predicting second-eye postoperative refraction. Methods. In a retrospective analysis of 173 patients having bilateral sequential phacoemulsification, multivariable linear regression was used to predict the second-eye postoperative refraction based on refractions predicted by the SRK-T formula for both eyes, the first-eye postoperative refraction, and the difference in IOL selected between eyes. Results. The first-eye observed postoperative refraction was an independent predictor of the second eye postoperative refraction (P refraction. Compared with the SRK-T formula, this model reduced the root-mean-squared (RMS) error of the predicted refraction by 11.3%. Conclusions. The first-eye postoperative refraction is an independent predictor of the second-eye postoperative refraction. The first-eye predicted refraction is less important. These findings may be due to interocular symmetry.

  17. Effect of postoperative epidural analgesia on surgical outcome

    DEFF Research Database (Denmark)

    Holte, K; Holte, Kathrine

    2002-01-01

    Pain relief allowing sufficient mobilization after major surgical procedures can only be achieved by continuous epidural analgesia with local anesthetics, which also reduces the stress response to surgery. However, the role of postoperative epidural analgesia on postoperative morbidity is controv......Pain relief allowing sufficient mobilization after major surgical procedures can only be achieved by continuous epidural analgesia with local anesthetics, which also reduces the stress response to surgery. However, the role of postoperative epidural analgesia on postoperative morbidity...... is controversial. We therefore update the effects of postoperative analgesia on surgical outcome. After major abdominal surgery, postoperative epidural analgesia with local anesthetics significantly reduces postoperative ileus and pulmonary complications while effects on cardiac morbidity are debatable. Continuous...... regimen does not contain a sufficient amount of local anesthetics. Future evaluation of the effects of epidural analgesia on postoperative outcome also requires integration of epidural analgesia within a multimodal rehabilitation programme....

  18. Effect of postoperative epidural analgesia on surgical outcome

    DEFF Research Database (Denmark)

    Holte, K; Holte, Kathrine

    2002-01-01

    Pain relief allowing sufficient mobilization after major surgical procedures can only be achieved by continuous epidural analgesia with local anesthetics, which also reduces the stress response to surgery. However, the role of postoperative epidural analgesia on postoperative morbidity is controv...

  19. Predicting and preventing postoperative decline in older cardiac surgery patients

    NARCIS (Netherlands)

    Ettema, R.G.A.

    2014-01-01

    Introduction: Delirium, depression, pressure ulcers and infection are frequently occurring postoperative complications in older cardiac surgery patients. Prevention of postoperative complications in cardiac surgery is mainly focused on the period of the hospital admission itself. There is however a

  20. Exploring Content Schemata Influence on L2 Reading: The Hunted Fox and Twelve and Not Stupid

    Directory of Open Access Journals (Sweden)

    Amizura Hanadi Mohd Radzi

    2014-10-01

    Full Text Available This paper will discuss the aspects of content schemata in second language reading among diploma level students who were taking a reading course in Universiti Teknologi MARA Perlis. In this qualitative case study, the researcher had selected two short stories that are categorized as content-familiar texts, i.e. The Hunted Fox and Twelve and Not Stupid. Six participants were asked to write a 150-word entry response on the short story and a grading criteria was used to assess the participants’ level of comprehension. An in-depth interview was also conducted on each participant. The entry responses and the interview patterns were analyzed to determine whether content schemata had contributed to the learners’ understanding of the text. This study discovered that content schemata had contributed to the learners’ understanding of the text because the learners’ comprehension was facilitated by their background knowledge on the content-familiar texts.

  1. Development and characterization of twelve microsatellite markers for Porphyra linearis Greville.

    Science.gov (United States)

    Varela-Álvarez, Elena; Paulino, Cristina; Serrão, Ester A

    2017-02-01

    The genus Porphyra (and its sister genus Pyropia) contains important red algal species that are cultivated and/or harvested for human consumption, sustaining a billion-dollar aquaculture industry. A vast amount of research has been focused on species of this genus, including studies on genetics and genomics among other areas. Twelve novel microsatellite markers were developed here for Porphyra linearis. Markers were characterized using 32 individuals collected from four natural populations of P. linearis with total heterozygosity varying from 0.098 to 0.916. The number of alleles per locus ranged from 2 to 18. All markers showed cross amplification with Porphyra umbilicalis and/or Porphyra dioica. These polymorphic microsatellite markers are useful for investigating population genetic diversity and differentiation in P. linearis and may become useful for other genetic research on the reproductive biology of this important species.

  2. Fate of the conformal fixed point with twelve massless fermions and SU(3) gauge group

    CERN Document Server

    Fodor, Zoltan; Kuti, Julius; Mondal, Santanu; Nogradi, Daniel; Wong, Chik Him

    2016-01-01

    We report new results on the conformal properties of an important strongly coupled gauge theory, a building block of composite Higgs models beyond the Standard Model. With twelve massless fermions in the fundamental representation of the SU(3) color gauge group, an infrared fixed point of the $\\beta$-function was recently reported in the theory (Cheng:2014jba) with uncertainty in the location of the critical gauge coupling inside the narrow $[ 6.0

  3. Twelve Years of Education and Public Outreach with the Fermi Gamma-ray Space Telescope

    CERN Document Server

    Cominsky, Lynn; Simonnet, Aurore; Education, the Fermi

    2013-01-01

    During the past twelve years, NASA's Fermi Gamma-ray Space Telescope has supported a wide range of Education and Public Outreach (E/PO) activities, targeting K-14 students and the general public. The purpose of the Fermi E/PO program is to increase student and public understanding of the science of the high-energy Universe, through inspiring, engaging and educational activities linked to the mission's science objectives. The E/PO program has additional more general goals, including increasing the diversity of students in the Science, Technology, Engineering and Mathematics (STEM) pipeline, and increasing public awareness and understanding of Fermi science and technology. Fermi's multi-faceted E/PO program includes elements in each major outcome category: Higher Education; Elementary and Secondary Education; Informal Education and Public Outreach.

  4. Twelve tips for developing and delivering a massive open online course in medical education.

    Science.gov (United States)

    Pickering, James D; Henningsohn, Lars; DeRuiter, Marco C; de Jong, Peter G M; Reinders, Marlies E J

    2017-07-01

    Massive open online courses (MOOCs) are a novel mode of online learning. They are typically based on higher education courses and can attract a high number of learners, often in the thousands. They are distinct from on-campus education and deliver the learning objectives through a series of short videos, recommended readings and discussion fora, alongside automated assessments. Within medical education the role of MOOCs remains unclear, with recent proposals including continuing professional development, interprofessional education or integration into campus-based blended learning curricula. In this twelve tips article, we aim to provide a framework for readers to use when developing, delivering and evaluating a MOOC within medical education based on the literature and our own experience. Practical advice is provided on how to design the appropriate curriculum, engage with learners on the platform, select suitable assessments, and comprehensively evaluate the impact of your course.

  5. Hepatoprotective activity of twelve novel 7'-hydroxy lignan glucosides from Arctii Fructus.

    Science.gov (United States)

    Yang, Ya-Nan; Huang, Xiao-Ying; Feng, Zi-Ming; Jiang, Jian-Shuang; Zhang, Pei-Cheng

    2014-09-17

    Twelve novel 7'-hydroxy lignan glucosides (1-12), including two benzofuran-type neolignans, two 8-O-4' neolignans, two dibenzylbutyrolactone lignans, and six tetrahydrofuranoid lignans, together with six known lignan glucosides (13-18), were isolated from the fruit of Arctium lappa L. (Asteraceae), commonly known as Arctii Fructus. Their structures were elucidated using spectroscopy (1D and 2D NMR, MS, IR, ORD, and UV) and on the basis of chemical evidence. The absolute configurations of compounds 1-12 were confirmed using rotating frame nuclear overhauser effect spectroscopy (ROESY), the circular dichroic (CD) exciton chirality method, and Rh2(OCOCF3)4-induced CD spectrum analysis. All of the isolated compounds were tested for hepatoprotective effects against D-galactosamine-induced cytotoxicity in HL-7702 hepatic cells. Compounds 1, 2, 7-12, and 17 showed significantly stronger hepatoprotective activity than the positive control bicyclol at a concentration of 1 × 10(-5) M.

  6. Twelve Tips for teaching medical professionalism at all levels of medical education.

    Science.gov (United States)

    Al-Eraky, Mohamed Mostafa

    2015-01-01

    Review of studies published in medical education journals over the last decade reveals that teaching medical professionalism is essential, yet challenging. According to a recent Best Evidence in Medical Education (BEME) guide, there is no consensus on a theoretical or practical model to integrate the teaching of professionalism into medical education. The aim of this article is to outline a practical manual for teaching professionalism at all levels of medical education. Drawing from research literature and author's experience, Twelve Tips are listed and organised in four clusters with relevance to (1) the context, (2) the teachers, (3) the curriculum, and (4) the networking. With a better understanding of the guiding educational principles for teaching medical professionalism, medical educators will be able to teach one of the most challenging constructs in medical education.

  7. Optimized imaging of the postoperative spine.

    Science.gov (United States)

    McLellan, Anne Marie; Daniel, Simon; Corcuera-Solano, Idoia; Joshi, Vivek; Tanenbaum, Lawrence N

    2014-05-01

    Few tasks in imaging are more challenging than that of optimizing evaluations of the instrumented spine. The authors describe how applying fundamental and more advanced principles to postoperative spine computed tomography and magnetic resonance examinations mitigates the challenges associated with metal implants and significantly improves image quality and consistency. Newer and soon-to-be-available enhancements should provide improved visualization of tissues and hardware as multispectral imaging sequences continue to develop.

  8. Postoperative infection in the foot and ankle.

    LENUS (Irish Health Repository)

    Chan, Victoria O

    2012-07-01

    Our discussion highlights the commonly performed surgical procedures in the foot and ankle and reviews the various imaging modalities available for the detection of infection with graphic examples to better enable radiologists to approach the radiological evaluation of postoperative infection in the foot and ankle. Discrimination between infectious and noninfectious inflammation remains a diagnostic challenge usually needing a combination of clinical assessment, laboratory investigations, and imaging studies to increase diagnostic accuracy.

  9. The Postoperative Pain Assessment Skills Pilot Trial

    Directory of Open Access Journals (Sweden)

    Michael McGillion

    2011-01-01

    Full Text Available BACKGROUND/OBJECTIVES: Pain-related misbeliefs among health care professionals (HCPs are common and contribute to ineffective postoperative pain assessment. While standardized patients (SPs have been effectively used to improve HCPs’ assessment skills, not all centres have SP programs. The present equivalence randomized controlled pilot trial examined the efficacy of an alternative simulation method – deteriorating patient-based simulation (DPS – versus SPs for improving HCPs’ pain knowledge and assessment skills.

  10. Postoperative delirium: diagnostic evaluation and treatment

    Directory of Open Access Journals (Sweden)

    C. Mussi

    2013-05-01

    Full Text Available BACKGROUND Postoperative delirium (POD is an acute, transient and fluctuating disturbance of consciousness that occurs shortly after surgery. Its clinical importance is high, since it increases mortality, length of stay, institutionalization, and it is related to poor prognosis. AIM OF THE REVIEW The aim of this short review is to describe the epidemiology of POD, to assess risk factors of POD, to define the diagnosis and to focus on the possible pharmacologic and non pharmacologic therapies.

  11. Post-operative delirium in elderly patients

    OpenAIRE

    Vijayakumar, B.; Elango, P; Ganessan, R

    2014-01-01

    Delirium is a common, but an often underdiagnosed complication in the elderly following major surgery. Recognising delirium in early stages and diagnosing the condition based on established criteria can improve the outcome and management. Managing delirium with environmental, supportive and pharmacological interventions will possibly reduce the incidence and side-effects associated with post-operative delirium. The purpose of this article is to provide an over view of the current knowledge ab...

  12. Controlling postoperative ileus by vagal activation

    Institute of Scientific and Technical Information of China (English)

    Tim; Lubbers; Wim; Buurman; Misha; Luyer

    2010-01-01

    Postoperative ileus is a frequently occurring surgical complication, leading to increased morbidity and hospital stay. Abdominal surgical interventions are known to result in a protracted cessation of bowel movement. Activation of inhibitory neural pathways by nociceptive stimuli leads to an inhibition of propulsive activity, which resolves shortly after closure of the abdomen. The subsequent formation of an inflammatory infiltrate in the muscular layers of the intestine results in a more prolonged phase of...

  13. Preoperative Alcohol Consumption and Postoperative Complications

    DEFF Research Database (Denmark)

    Eliasen, Marie; Grønkjær, Marie; Skov-Ettrup, Lise Skrubbeltrang

    2013-01-01

    .30-2.49), prolonged stay at the hospital (RR = 1.24; 95% CI: 1.18-1.31), and admission to intensive care unit (RR = 1.29; 95% CI: 1.03-1.61). Clearly defined high alcohol consumption was associated with increased risk of postoperative mortality (RR = 2.68; 95% CI: 1.50-4.78). Low to moderate preoperative alcohol...... complications, prolonged stay at the hospital, and admission to intensive care unit....

  14. Leiomyoma cellulare in postoperative material: clinical cases

    OpenAIRE

    2013-01-01

    Introduction: Leiomyoma in one of the most common benign endometrial cancers. Location of the myoma in the cervix and the area of the broad ligament of the uterus is rare. Leiomyoma cellulare (LC) occurs in about 5.0% of leiomyoma cases. Aim of the research: To determine the occurrence of LC among 294 cases of myomas as well as myomas and uterine endometriosis, found in postoperative examinations. Material and methods: Patients were qualified for the surgery based on a gynaecolog...

  15. Postoperative pain: specific-procedure approach

    OpenAIRE

    Martínez-Vísbal Alfonso Luis; Rodríguez-Betancourt Nancy Tatiana

    2012-01-01

    Pain is an unpleasant sensorial and emotional experience associated to real or potentialtissue response, in special if the trigger factor is known, as it occurs in a surgicalprocedure. In spite of the advance in analgesic techniques and medication, moderateto severe postoperative pain is presented in 70% of the operated patients. Multimodalanalgesia has been proposed due to it involves preventive analgesia and advanceanalgesia. Equally an specific analgesic management for each surgical proced...

  16. Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ja Young; Kim, Sung Hwan; Kim, Ki Won; Park, Dong Choon; Yoon, Joo Hee; Yoon, Sei Chul [St. Vincent' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of); Yu, Mina [St. Mary' s Hospital, The Catholic University of Korea School of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

  17. Needle aponeurotomy for Dupuytren contracture: Effectiveness of postoperative night extension splinting.

    Science.gov (United States)

    Tam, Louisa; Chung, Yin-Yin

    2016-01-01

    Night extension splinting has been used to treat patients with Dupuytren contracture to improve active range of motion (AROM) of the hand. A published case study demonstrated the benefit of splinting following needle aponeurotomy; however, no larger studies have evaluated the impact of postoperative splinting. To compare the impact of night extension splinting on AROM, specifically extension, following needle aponeurotomy for Dupuytren contracture. A retrospective chart review was conducted in which the charts of 53 patients who underwent needle aponeurotomy for Dupuytren contracture between 2009 and 2013 were reviewed. The control group consisted of patients who underwent needle aponeurotomy only, whereas the treatment group was also referred for fabrication of custom night extension splints after surgery. Comparisons in pre- and postoperative AROM measurements for the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints were made between both groups of patients. The degrees of change in AROM for each joint were categorized in terms of levels of change: mild (0° to 29°); moderate (30° to 60°); and significant (≥61°). All patients exhibited increased AROM after surgery for both MCP and PIP joints. Both groups had a greater increase in AROM in the MCP joint. Twelve joints from the control group had moderate changes and two from the treatment group had significant changes. When both groups were compared, the levels of change of AROM between both groups did not vary significantly. Night extension splinting following needle aponeurotomy may not improve AROM of the MCP or PIP joints.

  18. Comparative analysis and supragenome modeling of twelve Moraxella catarrhalis clinical isolates

    Directory of Open Access Journals (Sweden)

    Hermans Peter WM

    2011-01-01

    Full Text Available Abstract Background M. catarrhalis is a gram-negative, gamma-proteobacterium and an opportunistic human pathogen associated with otitis media (OM and exacerbations of chronic obstructive pulmonary disease (COPD. With direct and indirect costs for treating these conditions annually exceeding $33 billion in the United States alone, and nearly ubiquitous resistance to beta-lactam antibiotics among M. catarrhalis clinical isolates, a greater understanding of this pathogen's genome and its variability among isolates is needed. Results The genomic sequences of ten geographically and phenotypically diverse clinical isolates of M. catarrhalis were determined and analyzed together with two publicly available genomes. These twelve genomes were subjected to detailed comparative and predictive analyses aimed at characterizing the supragenome and understanding the metabolic and pathogenic potential of this species. A total of 2383 gene clusters were identified, of which 1755 are core with the remaining 628 clusters unevenly distributed among the twelve isolates. These findings are consistent with the distributed genome hypothesis (DGH, which posits that the species genome possesses a far greater number of genes than any single isolate. Multiple and pair-wise whole genome alignments highlight limited chromosomal re-arrangement. Conclusions M. catarrhalis gene content and chromosomal organization data, although supportive of the DGH, show modest overall genic diversity. These findings are in stark contrast with the reported heterogeneity of the species as a whole, as wells as to other bacterial pathogens mediating OM and COPD, providing important insight into M. catarrhalis pathogenesis that will aid in the development of novel therapeutic regimens.

  19. Radical cystectomy: Analysis of postoperative course

    Directory of Open Access Journals (Sweden)

    Jeremić Dimitrije

    2010-01-01

    Full Text Available Background/Aim. Radical cystectomy is a method of choice in the therapy of infiltrative bladder cancer. The aim of this research was to analyze postoperative course after radical cystectomy (length of hospitalization, most frequent complications and utilization of antibiotics and transfusions. Methods. We analyzed the records of 82 patients operated on in the Department of Urology, Clinical Center of Vojvodina, in a three-year period. In order to aquire data World Health Organization (WHO has developed Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD methodology. Defined daily dose (DDD is the assumed average maintenance dose per day for a drug use for its main indication. Results. Continent urinary derivation was preformed in 23.15% cases. Postoperative complications occurred in 18.29% of patients. Average blood utilization was 2.19 units. Blood utilization for continent derivations (n = 48 was 4.6 units, and incontinent ones 3.36 units. Totally 159.33 DDD/100 bed days were used. Conclusion. When preforming continent derivation there is a significant increase in blood utilization. Frequency of postoperative complications correlates to those reported in the literature.

  20. Pathophysiology and prevention of postoperative peritoneal adhesions

    Institute of Scientific and Technical Information of China (English)

    Willy Arung1; Michel Meurisse; Olivier Detry

    2011-01-01

    Peritoneal adhesions represent an important clinical challenge in gastrointestinal surgery. Peritoneal adhesions are a consequence of peritoneal irritation by infection or surgical trauma, and may be considered as the pathological part of healing following any peritoneal injury, particularly due to abdominal surgery. The balance between fibrin deposition and degradation is critical in determining normal peritoneal healing or adhesion formation. Postoperative peritoneal adhesions are a major cause of morbidity resulting in multiple complications, many of which may manifest several years after the initial surgical procedure. In addition to acute small bowel obstruction, peritoneal adhesions may cause pelvic or abdominal pain, and infertility. In this paper, the authors reviewed the epidemiology, pathogenesis and various prevention strategies of adhesion formation, using Medline and PubMed search. Several preventive agents against postoperative peritoneal adhesions have been investigated. Their role aims in activating fibrinolysis, hampering coagulation, diminishing the inflammatory response, inhibiting collagen synthesis or creating a barrier between adjacent wound surfaces. Their results are encouraging but most of them are contradictory and achieved mostly in animal model. Until additional findings from future clinical researches, only a meticulous surgery can be recommended to reduce unnecessary morbidity and mortality rates from these untoward effects of surgery. In the current state of knowledge, pre-clinical or clinical studies are still necessary to evaluate the effectiveness of the several proposed prevention strategies of postoperative peritoneal adhesions.

  1. Postoperative Autologous Reinfusion in Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    A. Crescibene

    2015-01-01

    Full Text Available Surgeries for total knee replacement (TKR are increasing and in this context there is a need to develop new protocols for management and use of blood transfusion therapy. Autologous blood reduces the need for allogeneic blood transfusion and the aim of the present study was to verify the safety and the clinical efficacy. An observational retrospective study has been conducted on 124 patients, undergoing cemented total knee prosthesis replacement. Observed population was stratified into two groups: the first group received reinfusion of autologous blood collected in the postoperative surgery and the second group did not receive autologous blood reinfusion. Analysis of data shows that patients undergoing autologous blood reinfusion received less homologous blood bags (10.6% versus 30%; p=0.08 and reduced days of hospitalization (7.88 ± 0.7 days versus 8.96 ± 2.47 days for the control group; p=0.03. Microbiological tests were negative in all postoperatively salvaged and reinfused units. Our results emphasize the effectiveness of this procedure and have the characteristics of simplicity, low cost (€97.53 versus €103.79; p<0.01, and easy reproducibility. Use of autologous drainage system postoperatively is a procedure that allows reducing transfusion of homologous blood bags in patients undergoing TKR.

  2. Intravitreal Daptomycin for Recalcitrant Postoperative Endophthalmitis

    Directory of Open Access Journals (Sweden)

    Jennifer M. Sim

    2016-02-01

    Full Text Available Purpose: To report the first case to our knowledge of intravitreal daptomycin used to successfully treat culture-negative vancomycin resistant to exogenous endophthalmitis. Methods: Case report with preoperative, intraoperative, and postoperative findings. Results: A 63-year-old Caucasian male underwent routine pars plana vitrectomy with epiretinal membrane peeling. He developed acute postoperative endophthalmitis, and underwent vitreous tap and injection of intravitreal vancomycin/ceftazidime/dexamethasone. Gram stain showed Gram-positive cocci, but cultures were negative. His infection subsequently proved very recalcitrant and his treatment course involved pars plana vitrectomy with anterior chamber washout and repeat injection of antibiotics, followed by repeat intravitreal vancomycin and ceftazidime. Ultimately, a second vitrectomy with intravitreal daptomycin controlled his intraocular infection. On each occasion, cultures were negative. Conclusion: This case suggests that vancomycin resistance should be considered in culture-negative postoperative endophthalmitis, and intravitreal daptomycin should be considered as an important treatment alternative. Although vancomycin resistance is fairly rare in endophthalmitis, acknowledgment of its increasing occurrence rate is critical for optimal management.

  3. Postoperative MRI findings after cholesteatoma surgery

    Energy Technology Data Exchange (ETDEWEB)

    Segawa, Yuko; Tono, Tetsuya; Kano, Kiyo; Morimitsu, Tamotsu [Miyazaki Medical Coll., Kiyotake (Japan)

    1995-07-01

    This study was designed to show MRI findings of postoperative middle ear pathologies and to discuss the usefulness of Gadolinium-enhanced MRI in evaluating the postoperative state of cholesteatoma. Thirty-eight ears which underwent intact canal wall tympanoplasty for cholesteatoma were examined. Recurrent cholesteatoma was detected as an iso-intensity area on T1-weighted images with negative enhancement. Notably, residual cholesteatoma were generally depicted as a round iso-intensity area with negative enhancement. Residual cholesteatoma less than 5 mm in diameter were, however, not generally detectable with our MRI scanner. Granulation tissue can be separated from cholesteatoma as an area with positive enhancement. Cholesterol granuloma shows a characteristic high signal pattern on both T1 and T2-weighted images. Hypovascular fibrous tissue and fluid collection may be depicted as a pattern similar to that of cholesteatoma. However, the signal is usually more homogeneous than that of cholesteatoma. We conclude that Gadolinium-enhanced MRI is useful for detecting postoperative cholesteatoma and avoiding unnecessary second-look operations after cholesteatoma surgery, by the canal-up procedure. (author).

  4. Takotsubo Cardiomyopathy Occurring in the Postoperative Period.

    Science.gov (United States)

    Deniz, Süleyman; Bakal, Ömer; İnangil, Gökhan; Şen, Hüseyin; Özkan, Sezai

    2015-02-01

    Takotsubo cardiomyopathy simulates acute myocardial infarction, and it is characterised by reversible left ventricular failure. A case of Takotsubo cardiomyopathy diagnosed after emergency angiography performed in a patient with evidence of acute myocardial infarction in the postoperative period will be described in this report. Transurethral resection of a bladder tumour (TUR-BT) was performed in a 92-year-old male patient by the urology clinic. The patient was transferred to the post-anaesthesia care unit after the operation. An echocardiography was performed because of the sudden onset of dyspnoea, tachycardia (140-150 beats per minute, rhythm-atrial fibrillation) and ST-segment elevation on electrocardiography (ECG) at the first postoperative hour, and midapical dyskinesia was detected at the patient. An immediate angiography was performed due to suspicion of acute coronary syndrome. Patent coronary arteries and temporary aneurysmatic dilatation of the apex of the heart were revealed by angiography. As a result of these findings, the patient was diagnosed with Takotsubo cardiomyopathy by the cardiology service. The patient was discharged uneventfully following 10 days in the intensive care unit. Aneurysm of the apex of the left ventricle and normal anatomy of the coronary arteries in the angiography have diagnostic value for Takotsubo cardiomyopathy. Diuretics (furosemide) and beta-blockers (metoprolol) are commonly used for the treatment of Takotsubo cardiomyopathy. Even though Takotsubo cardiomyopathy is a rare and benign disease, it should be kept in mind in patients suspected for acute myocardial infarction in the postoperative period.

  5. Nutritional and developmental status among 6- to 8-month-old children in southwestern Uganda: a cross-sectional study

    OpenAIRE

    Grace K. M. Muhoozi; Atukunda, Prudence; Mwadime, Robert; Iversen, Per Ole; Westerberg, Ane C.

    2016-01-01

    Background: Undernutrition continues to pose challenges to Uganda’s children, but there is limited knowledge on its association with physical and intellectual development.Objective: In this cross-sectional study, we assessed the nutritional status and milestone development of 6- to 8-month-old children and associated factors in two districts of southwestern Uganda.Design: Five hundred and twelve households with mother–infant (6–8 months) pairs were randomly sampled. Data about background vari...

  6. Evaluation of Buprenorphine in a Postoperative Pain Model in Rats

    OpenAIRE

    Curtin, Leslie I; Grakowsky, Julie A.; Suarez, Mauricio; Thompson, Alexis C; DiPirro, Jean M.; Martin, Lisa BE; Kristal, Mark B.

    2009-01-01

    We evaluated the commonly prescribed analgesic buprenorphine in a postoperative pain model in rats, assessing acute postoperative pain relief, rebound hyperalgesia, and the long-term effects of postoperative opioid treatment on subsequent opioid exposure. Rats received surgery (paw incision under isoflurane anesthesia), sham surgery (anesthesia only), or neither and were treated postoperatively with 1 of several doses of subcutaneous buprenorphine. Pain sensitivity to noxious and nonnoxious m...

  7. Arthroscopic Synovectomy and Postoperative Assisted Radiotherapy for Treating Diffuse Pigmented Villonodular Synovitis of the Knee: An observational retrospective study.

    Science.gov (United States)

    Li, Wei; Sun, Xiaofei; Lin, Jianning; Ji, Wei; Ruan, Dike

    2015-01-01

    This retrospective observational study aims to explore the treatment procedure and outcomes of arthroscopically assisted radiotherapy for diffuse pigmented villonodular synovitis (PVNS) of the knee joint. From September 2006 to August 2011, 28 diffuse PVNS patients were diagnosed and treated under arthroscopy. Twenty six underwent post-operative radiotherapy. All patients were followed up, and the average follow-up period was 54 months (range: 24 to 72 months). All 26 patients who received external radiotherapy showed no recurrence at post-operative follow-up; The Lysholm knee joint function score increased from 54.3±9.0 at pre-operation to 71.2±6.7 at post-operation (paired t-test, t = -13.35, PPVNS of the knee. Adjuvant post-operative external radiotherapy prevents the recurrence of diffuse PVNS.

  8. Biliopancreatic diversion with duodenal switch modifies plasma chemerin in early and late post-operative periods.

    Science.gov (United States)

    Parlee, Sebastian D; Wang, Yan; Poirier, Paul; Lapointe, Marc; Martin, Julie; Bastien, Marjorie; Cianflone, Katherine; Goralski, Kerry B

    2015-06-01

    Bariatric surgery remains the most effective treatment for obesity and metabolic syndrome. Surgical benefit arises from early-phase resolution of hyperglycemia and late-phase weight loss. The adipokine chemerin is of interest given its roles in immunity, adipogenesis, and metabolism. The study objective was to examine the effects of biliopancreatic diversion with duodenal switch (BPD-DS) on plasma chemerin in the early and late post-operative stages. 83 adults with obesity undergoing BPD-DS, 45 obese non-surgical controls, and 9 lean surgical controls were enrolled. Plasma parameters and anthropometric measures were obtained at baseline and at, early (24 h, 5 D) and late (6 months and 12 months) post-operative stages. Plasma chemerin dropped from 176±49 ng/mL at baseline to 132±52 ng/mL 24 h after BPD-DS, rebounded to 200±66 ng/mL after 5 D, and declined to 124±51 and 110±34 ng/mL after 6 and 12 months. Plasma chemerin correlated negatively with measures of inflammation and hepatic injury and positively with measures of obesity, metabolic syndrome, and inflammation in the early and late post-operative periods, respectively. Chemerin has a novel role in surgical injury but not hyperglycemia resolution early after BPD-DS. Over the long term, plasma chemerin declines to a new set point that is partially determined by body fat reductions. © 2015 The Obesity Society.

  9. Pre- and Postoperative Vomiting in Children Undergoing Video-Assisted Gastrostomy Tube Placement

    Directory of Open Access Journals (Sweden)

    Torbjörn Backman

    2014-01-01

    Full Text Available Background. The aim of this study was to determine the incidence of pre- and postoperative vomiting in children undergoing a Video-Assisted Gastrostomy (VAG operation. Patients and Methods. 180 children underwent a VAG operation and were subdivided into groups based on their underlying diagnosis. An anamnesis with respect to vomiting was taken from each of the children’s parents before the operation. After the VAG operation, all patients were followed prospectively at one and six months after surgery. All complications including vomiting were documented according to a standardized protocol. Results. Vomiting occurred preoperatively in 51 children (28%. One month after surgery the incidence was 43 (24% in the same group of children and six months after it was found in 40 (22%. There was a difference in vomiting frequency both pre- and postoperatively between the children in the groups with different diagnoses included in the study. No difference was noted in pre- and postoperative vomiting frequency within each specific diagnosis group. Conclusion. The preoperative vomiting symptoms persisted after the VAG operation. Neurologically impaired children had a higher incidence of vomiting than patients with other diagnoses, a well-known fact, probably due to their underlying diagnosis and not the VAG operation. This information is useful in preoperative counselling.

  10. [The value of postoperative C-reactive protein in predictive diagnosis of postoperative intra-abdominal septic complications for patients with Crohn disease].

    Science.gov (United States)

    Li, Y; Zhu, W M; Gong, J F; Guo, Z; Cao, L

    2016-08-01

    To analyze the value of postoperative C-reactive protein (CRP) in predictive diagnosis of postoperative intra-abdominal septic complications (IASC) for patients with Crohn disease (CD). Clinical data of patients with CD received intestinal resection and anastomosis surgery at Research Institute of General Surgery, Jinling Hospital from January 2011 to January 2015 were analyzed. Patients were divided into two groups by whether suffer from IASC 1 month after surgery, including IASC group and no-IASC group. Propensity score matching method was used to match the general clinical data. A total of 54 patients were analyzed, including IASC 17 cases, no-IASC 37 cases. Postoperative CRP at 1-day and 3-day were compared between the two groups using t test. Receiver operator characteristic (ROC) cure was used to analyze the value of postoperative CRP in predictive diagnosis of IASC. IASC group had higher levels of CRP at 1-day ((78±13) mg/L vs. (54±19) mg/L, t=4.633, P=0.000) and 3-day ((103±19) mg/L vs. (69±21) mg/L, t=5.859, P=0.000) after surgery than no-IASC group. ROC analysis showed that the CRP 3-day after surgery cut-off point value of 81.45 mg/L, as used for the predictive diagnosis of IASC, provided a sensitivity of 94.1%, a specificity of 82.9%, an area under the curve of 0.90, better than CRP 1-day after surgery. Postoperative CRP can be used as a predictive diagnosis of IASC for CD patients received intestinal resection and anastomosis surgery.

  11. Influence of the femoral head size on early postoperative gait restoration after total hip arthroplasty

    Institute of Scientific and Technical Information of China (English)

    ZHOU Yi-xin; GUO Sheng-jie; LIU Qing; TANG Jing; LI Yu-jun

    2009-01-01

    Background We investigated the effects of using large-diameter femoral heads in total hip prostheses on eady postoperative gait restoration in patients undergoing total hip arthroplasty (THA). Methods We collected data for 19 primary THAs using 28-mm metal-on-polyethylene heads (conventional group) and for 12 THAs (BHR group) using metal-on-metal femoral heads with an average size of 45 mm (range, 40-49 mm). All patients had unilateral femoral head avascular necrosis. All patients underwent Harris Hip Scores evaluation and gait analysis with the IDEEA device at the same 3 time points which were before surgery and then at 1 month and again at 3 months after surgery, and the parameters measured were walking speed, stride length (SL), single limb support (SLS), cycle duration (CD), and swing power (SP). Harris Hip Scores and gait analysis parameters for both groups were compared.Results Intraclass comparison indicated that Harris Hip Scores, speed scores, and gait parameter measures in both groups improved significantly with the passage of time; Interclass comparison showed no significance between Harris1m postop - Harrispreop and Harris3m postop- Harrispreop in both groups. The speed in the BHR group at 1 month and at 3 months after surgery was significantly higher than that of conventional group. At 1 month after surgery, each mean for SLnormal-SLaffected, (SLSnormal - SLSaffected)/CD, and SPnormal - SPaffocted in the BHR group was significantly lower than that for the conventional group. At 3 months after surgery, the differences between means for both groups for SLnormal - SLaffected.(SLSnormal- SLSaffected)/CD, and SPnormal - SPaffected were not significant, but the mean of SPnormal - SPaffected in the BHR group was significantly lower than that in the conventional group.Conclusions Our data suggest that large-diameter femoral heads in THA provide better early gait restoration than conventional-size femoral heads.

  12. Natural gas monthly, May 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-05-01

    The Natural Gas Monthly highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information. The feature article this month is ``Restructuring energy industries: Lessons from natural gas.`` 6 figs., 26 tabs.

  13. Natural gas monthly, June 1994

    Energy Technology Data Exchange (ETDEWEB)

    1994-06-01

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information. The feature article this month is the executive summary from Natural Gas 1994: Issues and Trends. 6 figs., 31 tabs.

  14. Natural gas monthly, January 1994

    Energy Technology Data Exchange (ETDEWEB)

    1994-02-01

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information. The featured article for this month is on US coalbed methane production.

  15. Natural gas monthly, December 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-01

    The Natural Gas Monthly highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information. The article this month is entitled ``Recent Trends in Natural Gas Spot Prices.`` 6 figs., 27 tabs.

  16. Postoperative sensitivity associated with low shrinkage versus conventional composites

    OpenAIRE

    Ivanović Vladimir; Savić-Stanković Tatjana; Karadžić Branislav; Ilić Jugoslav; Santini Ario; Beljić-Ivanović Katarina

    2013-01-01

    Introduction. Postoperative sensitivity in restorative dentistry can be related to preparation trauma, dentin adhesives’ ability to seal open dentinal tubules, deformation of restorations under occlusal stresses and microleakage. Objective. The study assessed possible reduction in postoperative sensitivity with low shrinkage compared to conventional composites using different bonding agents and the influence of the operator skill on the incidence of postoperative sensitivity. Methods. N...

  17. Circadian aspects of post-operative morbidity and mortality

    DEFF Research Database (Denmark)

    Kvaslerud, T.; Hansen, M.V.; Rosenberg, J.;

    2010-01-01

    concerning post-operative circadian disturbances. We also present the literature concerning circadian variation in post-operative morbidity and mortality. PubMed and the Cochrane database were searched for papers using a combination of 'circadian,' 'surgery,' 'post-operative,' 'mortality' and 'morbidity...

  18. Postoperative craniospinal radiotherapy of medulloblastoma in children and young adults

    Directory of Open Access Journals (Sweden)

    Golubičić Ivana V.

    2003-01-01

    Full Text Available PURPOSE The aim of this study was: 1. to evaluate treatment results of combined therapy (surgery, postoperative craniospinal radiotherapy with or without chemotherapy and 2. to assess factors affecting prognosis (extend of tumor removal, involvement of the brain stem, extent of disease postoperative meningitis, shunt placement, age, sex and time interval from surgery to start of postoperative radiotherapy. PATIENTS AND METHODS During the period 1986-1996, 78 patients with medulloblastoma, aged 1-22 years (median 8.6 years, were treated with combined modality therapy and 72 of them were evaluable for the study end-points. Entry criteria were histologically proven diagnosis, age under 22 years, and no history of previous malignant disease. The main characteristics of the group are shown in Table 1. Twenty-nine patients (37.2% have total, 8 (10.3% near total and 41 (52.5% partial removal. Seventy-two of 78 patients were treated with curative intent and received postoperative craniospinal irradiation. Radiotherapy started 13-285 days after surgery (median 36 days. Only 13 patients started radiotherapy after 60 days following surgery. Adjuvant chemotherapy was applied in 63 (80.7% patients. The majority of them (46 73% received chemotherapy with CCNU and Vincristine. The survival rates were calculated with the Kaplan-Meier method and the differences in survival were analyzed using the Wilcoxon test and log-rank test. RESULTS The follow-up period ranged from 1-12 years (median 3 years. Five-year overall survival (OS was 51% and disease-free survival (DFS 47% (Graph 1. During follow-up 32 relapses occurred. Patients having no brain stem infiltration had significantly better survival (p=0.0023 (Graph 2. Patients with positive myelographic findings had significantly poorer survival compared to dose with negative myelographic findings (p=0.0116. Significantly poorer survival was found in patients with meningitis developing in the postoperative period

  19. Long-Term Results Following Postoperative Radiotherapy for Soft Tissue Sarcomas of the Extremity

    Energy Technology Data Exchange (ETDEWEB)

    McGee, Lisa [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States); Indelicato, Daniel J., E-mail: dindelicato@floridaproton.org [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States); University of Florida Proton Therapy Institute, Jacksonville, Florida (United States); Dagan, Roi; Morris, Christopher G. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States); Knapik, Jacquelyn A.; Reith, John D. [Department of Pathology, University of Florida College of Medicine, Gainesville, Florida (United States); Scarborough, Mark T.; Gibbs, C. Parker [Department of Orthopedics, University of Florida College of Medicine, Gainesville, Florida (United States); Marcus, Robert B. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States); University of Florida Proton Therapy Institute, Jacksonville, Florida (United States); Zlotecki, Robert A. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, Florida (United States)

    2012-11-15

    Purpose: To review long-term outcomes following postoperative radiotherapy (RT) for extremity soft tissue sarcoma (STS) and identify variables affecting the therapeutic ratio. Methods and Materials: Between 1970 and 2008, 173 patients with localized extremity STS were treated with postoperative radiation. No patients received prior irradiation. Sixteen percent of tumors had recurred after initial surgery alone; 89% of tumors were high grade. The median patient age was 57 years (range, 18-86 years). Sixty-one percent underwent >1 surgery before RT in an attempt to achieve wide negative margins. Final margin status was negative in 70% and marginal or microscopically positive in 30%. The median time between final surgery and start of RT was 40 days. The median RT dose was 65 Gy (range, 49-74 Gy). The median follow-up for all patients was 10.4 years and 13.2 years among survivors. Results: At 10 years, local control (LC), cause-specific survival (CSS), and overall survival (OS) rates were 87%, 80%, and 70%, respectively, with 89% of local failures occurring within 3 years after treatment. On multivariate analysis, age >55 years (82% vs 93%, P<.05) and recurrent presentation (67% vs 91%, P<.05) were associated with inferior 10-year LC. The LC according to final margin status was 90% for wide negative margins vs 79% for marginal/microscopically positive margins (P=.08). Age >55 years and local recurrence were associated with inferior CSS and OS on multivariate analysis. Twelve percent of patients experienced grade 3+ toxicity; 12 of these occurred in patients with tumors of the proximal lower extremity, with the most common toxicity of pathologic fracture occurring in 6.3%. Conclusions: This large single-institution series confirms that postoperative RT for STS of the extremities provides good long-term disease control with acceptable toxicity. Our experience supports recurrent presentation and older age as adverse prognostic factors for LC.

  20. US Monthly Pilot Balloon Observations

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Monthly winds aloft summary forms summarizing Pilot Balloon observational data for the United States. Generally labeled as Form 1114, and then transitioning to Form...

  1. Monthly energy review, August 1993

    Energy Technology Data Exchange (ETDEWEB)

    1993-08-26

    This publication presents information for the month of August, 1993 on the following: Energy overview; energy consumption; petroleum; natural gas; oil and gas resource development; coal; electricity; nuclear energy; energy prices, and international energy.

  2. Monthly Energy Review, July 1992

    Energy Technology Data Exchange (ETDEWEB)

    None

    1992-07-27

    The Monthly Energy Review is prepared by the Energy Information Administration. Topics discussed include: Energy Overview, Energy Consumption, Petroleum, Natural Gas, Oil and Gas Resource Development, Coal, Electricity, Nuclear Energy, Energy Prices, International Energy. (VC)

  3. Monthly energy review, July 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-07-01

    This document presents an overview of recent monthly energy statistics. Activities covered include: U.S. production, consumption, trade, stock, and prices for petroleum, coal, natural gas, electricity, and nuclear energy.

  4. Monthly energy review, August 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-08-01

    This report presents an overview of recent monthly energy statistics. The statistics cover the major activities of U.S. production, consumption, trade, stocks, and prices for petroleum, coal, natural gas, electricity, and nuclear energy.

  5. Monthly energy review, August 1993

    Energy Technology Data Exchange (ETDEWEB)

    1993-08-26

    This publication presents information for the month of August, 1993 on the following: Energy overview; energy consumption; petroleum; natural gas; oil and gas resource development; coal; electricity; nuclear energy; energy prices, and international energy.

  6. Your Child's Development: 15 Months

    Science.gov (United States)

    ... Child Too Busy? Helping Your Child Adjust to Preschool School Lunches Kids and Food: 10 Tips for Parents Healthy Habits for TV, Video Games, and the Internet Your Child's Development: 15 Months KidsHealth > For Parents > Your Child's Development: ...

  7. Your Child's Development: 6 Months

    Science.gov (United States)

    ... Child Too Busy? Helping Your Child Adjust to Preschool School Lunches Kids and Food: 10 Tips for Parents Healthy Habits for TV, Video Games, and the Internet Your Child's Development: 6 Months KidsHealth > For Parents > Your Child's Development: ...

  8. Your Child's Development: 2 Months

    Science.gov (United States)

    ... Child Too Busy? Helping Your Child Adjust to Preschool School Lunches Kids and Food: 10 Tips for Parents Healthy Habits for TV, Video Games, and the Internet Your Child's Development: 2 Months KidsHealth > For Parents > Your Child's Development: ...

  9. Anterior chamber depth and refractive change in late postoperative capsular bag distension syndrome: a retrospective analysis.

    Directory of Open Access Journals (Sweden)

    Min Kyu Yang

    Full Text Available To assess the characteristic findings and effects of laser capsulotomy in patients with late postoperative capsular bag distension syndrome (CBDS.Twenty patients diagnosed with late postoperative CBDS between July 2010 and August 2013 were retrospectively reviewed. Before and 1 week after capsulotomy, changes in the anterior chamber depth (ACD were assessed using ultrasound biomicroscopy. Changes in the refractive status and uncorrected visual acuity (UCVA were also measured 1 week and 1 month after capsulotomy. For patients who received bilateral cataract surgery, preoperative ACD and axial length measured by IOLMaster were compared between the two eyes.Twenty-two eyes from 20 patients who had undergone laser capsulotomy showed a mean UCVA improvement of 0.27 ± 0.24 logMAR (range, 0.00-0.90. ACD was increased by an average of +0.04 mm (95% confidence interval, +0.01 to +0.06 mm, p = 0.034, equivalent to predicted refractive change of +0.10 D. The discrepancy between actual (+1.33 D and predicted refractive change after capsulotomy suggests that refractive change may not be generated from IOL displacement in late postoperative CBDS. Preoperative ACD was deeper in the eye with late postoperative CBDS in all bilaterally pseudophakic patients (mean, 3.68 mm vs. 3.44 mm in the fellow eye, p = 0.068.Late postoperative CBDS showed refractive changes that were resolved successfully after laser capsulotomy. The convex lens effects of opalescent material in the distended capsular bag may play a major role in myopic shift. A larger preoperative ACD is possibly associated with the development of late postoperative CBDS.

  10. Postoperative delirium and myocardial infarction in elderly patients with hip fractures: the role of postoperative anemia

    Directory of Open Access Journals (Sweden)

    V. V. Kuz’Min

    2015-01-01

    Full Text Available Objective. To assess the impact of anemia on the incidence of myocardial infarction and delirium in the early postoperative period in patients with hip fractures who underwent total hip replacement. Materials and methods. A retrospective study of 303 patients with hip fractures who underwent total hip replacement was performed. Patients were divided into two groups according to the level of hemoglobin (Hb on the 2nd postoperative day: Group 1 (n = 116 with Hb levels above 100 g/L and Group 2 (n = 187 with Hb levels below 100 g/L. Results and conclusion. Transfusion in Group 1 was performed more often intraoperatively or in the early postoperative hours (67 vs. 35 patients; p <0.001. Hb levels on the 2nd day were significantly higher in Group 1 (108 [104; 117] vs. 87 [80; 92] g/L; p <0.001. Moderate and severe anemia in the early postoperative period was noted in 53.5% and 4.3% of the patients of Group 2, respectively. The incidence of myocardial infarction and delirium was higher in Group 2 than in Group 1 (6.4% vs. 0%; p = 0,013 and 7.5% vs 0.8%; p = 0.021, respectively. The study has shown that moderate and severe anemia in the early postoperative period is associated with an increase in the incidence of myocardial infarction and delirium.

  11. Monthly energy review, August 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-08-01

    The Monthly Energy Review (MER) presents an overview of the Energy Information Administration`s recent monthly energy statistics. The statistics cover the major activities of US production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. Also included are international energy and thermal and metric conversion factors. The MER is intended for use by Members of Congress, Federal and State agencies, energy analysts, and the general public. 37 figs., 73 tabs.

  12. Natural gas monthly, July 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-07-01

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information. 6 figs., 25 tabs.

  13. Natural gas monthly, June 1999

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-06-01

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information. 6 figs., 25 tabs.

  14. Natural gas monthly, August 1994

    Energy Technology Data Exchange (ETDEWEB)

    1994-08-24

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information.

  15. Natural gas monthly, June 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-06-01

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information. 6 figs., 27 tabs.

  16. Natural gas monthly, April 1994

    Energy Technology Data Exchange (ETDEWEB)

    1994-04-26

    The National Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information.

  17. Natural gas monthly, September 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-09-01

    The National Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information. 6 figs., 27 tabs.

  18. Natural gas monthly, June 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-06-01

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information. 6 figs., 24 tabs.

  19. Natural gas monthly, October 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-10-01

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information. 6 figs., 27 tabs.

  20. Monthly energy review, April 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-04-01

    This report presents an overview of the Energy Information Administration`s recent monthly energy statistics. The statistics cover the major activities of U.S. production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. Also included are international energy data. A brief summary of the monthly and historical comparison data is provided in Section 1 of the report. A highlight section of the report provides an assessment of summer 1997 motor gasoline price increases.

  1. Monthly energy review, April 1999

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-04-01

    The Monthly Energy Review (MER) presents an overview of the Energy Information Administration`s recent monthly energy statistics. The statistics cover the major activities of US production, consumption, trade, stocks, and prices for petroleum, natural gas, coal, electricity, and nuclear energy. Also included are international energy and thermal and metric conversion factors. The MER is intended for use by Members of Congress, Federal and State agencies, energy analysts, and the general public.

  2. Natural gas monthly, May 1999

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-05-01

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time the NGM features articles designed to assist readers in using and interpreting natural gas information. 6 figs., 27 tabs.

  3. Natural gas monthly: December 1993

    Energy Technology Data Exchange (ETDEWEB)

    1993-12-01

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. Articles are included which are designed to assist readers in using and interpreting natural gas information.

  4. Natural gas monthly, July 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-07-01

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information. 6 figs., 25 tabs.

  5. Natural Gas Monthly, March 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-03-25

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information.

  6. Natural gas monthly, July 1994

    Energy Technology Data Exchange (ETDEWEB)

    1994-07-20

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information.

  7. Natural gas monthly, November 1993

    Energy Technology Data Exchange (ETDEWEB)

    1993-11-29

    The Natural Gas Monthly (NGM) highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground state data are also reported. From time to time, the NGM features articles designed to assist readers in using and interpreting natural gas information.

  8. Natural gas monthly, October 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-10-23

    The Natural Gas Monthly highlights activities, events, and analyses of interest to public and private sector organizations associated with the natural gas industry. Volume and price data are presented each month for natural gas production, distribution, consumption, and interstate pipeline activities. Producer-related activities and underground storage data are also reported. A glossary of the terms used in this report is provided to assist readers in understanding the data presented in this publication. 6 figs., 30 tabs.

  9. Pain, psychological distress and health-related quality of life at baseline and 3 months after radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Johansson Fannie

    2006-11-01

    Full Text Available Abstract Background Inadequate management of postoperative pain is common, and postoperative pain is a risk factor for prolonged pain. In addition to medical and technical factors, psychological factors may also influence the experience of postoperative pain. Methods Pain was measured postoperatively at 24, 48, and 72 hr in hospital and after 3 months at home in 140 patients undergoing radical prostatectomy (RP. Patients answered questionnaires about anxiety and depression (HAD scale and health-related quality of life (SF-36 at baseline and 3 months after surgery. Results In the first 3 postoperative days, mild pain was reported by 45 patients (32%, moderate pain by 64 (45%, and severe pain by 31 (22% on one or more days. High postoperative pain scores were correlated with length of hospital stay and with high pain scores at home. Forty patients (29% reported moderate (n = 35 or severe (n = 5 pain after discharge from hospital. Patients who experienced anxiety and depression preoperatively had higher postoperative pain scores and remained anxious and depressed 3 months after surgery. The scores for the physical domains in the SF-36 were decreased, while the mental health scores were increased at 3 months. Anxiety and depression were negatively correlated with all domains of the SF-36. Conclusion There is a need for nurses to be aware of the psychological status of RP patients and its impact upon patients' experience of postoperative pain and recovery. The ability to identify patients with psychological distress and to target interventions is an important goal for future research.

  10. Ten-year postoperative results of penetrating keratoplasty.

    Science.gov (United States)

    Ing, J J; Ing, H H; Nelson, L R; Hodge, D O; Bourne, W M

    1998-10-01

    To investigate the changes in central corneal endothelial cells and corneal thickness in transplanted corneas from 5 to 10 years after grafting. This study also aimed to investigate the development of glaucoma, graft rejection, and graft failure during the first 10 postoperative years. Longitudinal cohort study of 500 consecutive penetrating keratoplasties by 1 surgeon. Patients were asked to return for follow-up examinations at 2 months and at 1, 3, 5, and 10 years after grafting. The authors excluded eyes regrafted during the study and the fellow eyes of bilateral cases, leaving 394 grafts in 394 patients for analysis. Penetrating keratoplasty was performed. Using specular microscopy, the authors measured endothelial cell density, coefficient of variation of cell area, percentage of hexagonal cells, and corneal thickness. The authors performed clinical examinations to determine graft rejection or failure and the development of glaucoma. By 10 years postkeratoplasty, 80 of the 394 patients had died and 68 grafts had failed. Of the remaining 246 patients, 119 (48%) returned for their 10-year examinations. For the 72 patients who returned for all of the scheduled postoperative visits and had no rejection episodes, reoperations, or failure, endothelial cell loss from preoperative donor levels at 10 years was 67 +/- 18% (mean +/- standard deviation), endothelial cell density was 958 +/- 471 cells/mm2, coefficient of variation was 0.32 +/- 0.11, hexagonal cells were 56 +/- 12%, and corneal thickness was 0.58 +/- 0.05 mm. The 5- to 10-year changes for all these values were significant (P risk of glaucoma, rejection, or failure was 21%, 21%, and 22%, respectively. Late endothelial failure became the major cause for graft failure, accounting for 9 of the 11 failures after 5 postoperative years. From 5 to 10 years after penetrating keratoplasty, the annual rate of endothelial cell loss was seven times the normal rate. The endothelial cell loss, pleomorphism, polymegethism

  11. Postoperative spindle cell nodules of genitourinary tract resembling sarcomas. A report of eight cases.

    Science.gov (United States)

    Proppe, K H; Scully, R E; Rosai, J

    1984-02-01

    Eight cases of proliferative spindle cell nodules that developed 5 weeks to 3 months after operations on the lower genital tract of four women, and the lower urinary tract of four men, are described. The lesions ranged up to 4 cm in diameter, resembled spindle cell sarcomas on microscopical examination, and were initially interpreted as such in most of the cases. Six of the lesions were treated by local excision alone, and two by a radical surgical procedure, followed by radiation therapy in one case. The six patients whose lesions were treated inadequately on the assumption that they were sarcomas were free of disease 9-60 months (average, 28 months) postoperatively, and the two men who were treated by radical procedures were well 18 and 60 months later. The microscopic features, the unusual clinical setting, and the favorable prognosis of these lesions suggest that they were examples of a hitherto undescribed form of benign reactive lesion resembling a sarcoma.

  12. Twelve-year cyclic surging episode at Donjek Glacier in Yukon, Canada

    Science.gov (United States)

    Furuya, M.; Abe, T.; Sakakibara, D.

    2015-12-01

    Surge-type glaciers exhibit several-fold to orders-of-magnitude speed-up during the short active phase, resulting in km-scale terminus advance. Although there are many surge-type glaciers near the border of Alaska and the Yukon, the generation mechanisms remain uncertain because of limited and few continuous observations. To better understand the surge dynamics and predict the next event, it is essential to examine the entire surge cycles. Here we use Landsat optical imageries to reveal the long-term evolutions, and report three surging episodes at Donjek Glacier in Yukon, Canada. Using the Landsat images, we found three surging events in 1989, 2001, and 2013. In the 2001 event, the surface speed significantly increased by up to 4.5 m/d; during the quiescent phases it was ~0.5 m/d at the terminus. While the duration of active phase is about 4~5 and 2~3 year in the 2001 and 2013 events, the period in the 1989 event is unclear because of the lack of high temporal resolution data. Remarkably, the surging area is limited to the ~20-km section from the terminus instead of the entire glacier. Moreover, we examined the terminus area changes from 1975 to 2014. Although the area has been secularly decreasing probably due to the tread of global warming, it has also revealed four significant fluctuations during the nearly forty years. Comparing the speed and the area changes, the three speed-up events correspond to the terminus area fluctuations with a few time lags. It turns out that the surge event has been quite regularly repeating every twelve years. Although the behavior is rather similar to that in Svalbard glaciers in terms of maximum speed and unclear initiation season, the recurrence interval is much shorter than other nearby surges. Considering that the surge events seem to have initiated around significantly narrower area than upstream, the strong valley constriction may control the regularity as well as the twelve-year recurrence time.

  13. Secondary intraocular lens implantation following infantile cataract surgery: intraoperative indications, postoperative outcomes.

    Science.gov (United States)

    Wood, K S; Tadros, D; Trivedi, R H; Wilson, M E

    2016-09-01

    PurposeThe purpose of this study was to determine the long-term complications and outcomes of secondary intraocular lens (IOL) implantation in patients with congenital cataracts.Patients and MethodsThe medical records of children operated for secondary IOL implantation surgery between 2000 and 2014 were retrospectively reviewed. Those who had undergone their initial congenital cataract surgery before 7 months of age were included and were analyzed for intra- and postoperative factors and postoperative refractive outcomes. We focused on three complications: visual axis opacification (VAO), glaucoma, and IOL exchange after at least 1 year of follow-up.ResultsA total of 49 eyes of 49 patients were analyzed for intraoperative indications. Of those, 37 eyes of 37 patients had at least 1 year of follow-up and were analyzed for postoperative outcomes. The mean age at secondary implantation was 55.2±21.6 months. At secondary implantation, 69.4% of eyes were implanted in the capsular bag, 28.6% in the sulcus, and 2.0% that were angle-supported. There was no significant correlation between the site of secondary IOL implantation and age at implantation (P=0.216). The mean follow-up after implantation was 57.6±33.6 months. The rate of VAO was 5.4%, the rate of glaucoma occurring after secondary implantation was 16.2%, and the rate of IOL exchange was 2.7%. The median visual acuity at final follow-up was 20/40. For patients with unilateral cataracts it was 20/60 and for bilateral patients it was 20/30.ConclusionsThe secondary IOL implantation in children is a relatively safe procedure associated with low rates of postoperative complications. Visual outcomes are acceptable and are better for bilateral patients than for unilateral patients.

  14. Bladder exstrophy: current management and postoperative imaging

    Energy Technology Data Exchange (ETDEWEB)

    Pierre, Ketsia [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Borer, Joseph [Boston Children' s Hospital, Department of Urology, Boston, MA (United States); Phelps, Andrew [University of California, San Francisco, Department of Pediatric Radiology, San Francisco, CA (United States); Chow, Jeanne S. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Boston Children' s Hospital, Department of Urology, Boston, MA (United States)

    2014-07-15

    Bladder exstrophy is a rare malformation characterized by an infra-umbilical abdominal wall defect, incomplete closure of the bladder with mucosa continuous with the abdominal wall, epispadias, and alterations in the pelvic bones and muscles. It is part of the exstrophy-epispadias complex, with cloacal exstrophy on the severe and epispadias on the mild ends of the spectrum. Bladder exstrophy is the most common of these entities and is more common in boys. The goal of this paper is to describe common methods of repair and to provide an imaging review of the postoperative appearances. (orig.)

  15. Visuel analog skala til postoperative smerter

    DEFF Research Database (Denmark)

    Rauh, Katja Halladin; Andersen, Rikke Søby; Rosenberg, Jacob

    2013-01-01

    All patients with pain who are admitted to hospitals in Denmark must be assessed for levels of pain. However, it is not certain how pain should be measured. One way to measure pain is to use a visual analogue scale (VAS). This article focuses on how the VAS should be used in clinical practice...... in the assessment of post-operative pain. Furthermore, other suitable methods are compared with VAS. VAS is particularly useful for clinical research, but for daily clinical practice it may be easier to use a numeric rating scale....

  16. [Endoscopic management of postoperative biliary fistulas].

    Science.gov (United States)

    Farca, A; Moreno, M; Mundo, F; Rodríguez, G

    1991-01-01

    Biliary fistulas have been managed by surgical correction with no good results. From 1986 to 1990, endoscopic therapy was attempted in 24 patients with postoperative persistent biliary-cutaneous fistulas. Endoscopic retrograde cholangiography demonstrated residual biliary stones in 19 patients (79%). The mean fistula drainage was 540 ml/day, and in 75% the site of the fistula was near the cistic duct stump. Sphincterotomy with or without biliary stent placement resulted in rapid resolution of the fistula in 23 patients (95.8%). In those patients treated with biliary stents the fistula healed spectacularly in 24-72 hrs.

  17. Visuel analog skala til postoperative smerter

    DEFF Research Database (Denmark)

    Rauh, Katja Halladin; Andersen, Rikke Søby; Rosenberg, Jacob

    2013-01-01

    All patients with pain who are admitted to hospitals in Denmark must be assessed for levels of pain. However, it is not certain how pain should be measured. One way to measure pain is to use a visual analogue scale (VAS). This article focuses on how the VAS should be used in clinical practice...... in the assessment of post-operative pain. Furthermore, other suitable methods are compared with VAS. VAS is particularly useful for clinical research, but for daily clinical practice it may be easier to use a numeric rating scale....

  18. The effect of lower limb rehabilitation gymnastics on postoperative rehabilitation in elderly patients with femoral shaft fracture

    Science.gov (United States)

    Yang, Si-Dong; Ning, Sheng-Hua; Zhang, Li-Hong; Zhang, Ying-Ze; Ding, Wen-Yuan; Yang, Da-Long

    2016-01-01

    Abstract The purpose of this study was to explore the effect of lower limb rehabilitation gymnastics on postoperative rehabilitation in elderly patients with femoral shaft fracture after undergoing intramedullary nail fixation surgery. We collected medical records of elderly patients aged ≥ 60 years with femoral shaft fracture between 03/2010 and 03/2015 in Longyao County Hospital. Totally, 160 patients were identified and divided into the intervention group (n = 80) and the control group (n = 80). During the postoperative period, the intervention group received lower limb rehabilitation gymnastics treatment for 3 months, but the control group did not. All patients were routinely asked to return hospital for a check in the 1st postoperative week, as well as the 2nd week, the 1st month, and the 3rd month, after surgery. The clinical rehabilitation effect was evaluated by checking lower limb action ability, detecting the lower limb deep venous thrombosis (DVT), scoring muscle strength of quadriceps and visual analog scale (VAS) score, and performing satisfaction survey. At the 1st week and 2nd week after surgery, the clinical rehabilitation effect in the intervention group was better regarding lower limb action ability, lower limb DVT, muscle strength of quadriceps, VAS score, and patient satisfaction, as compared with the control group. However, there was no significant difference at the 1st month and the 3rd month after surgery when comparing the intervention group to the control group. In the early postoperative stage, lower limb rehabilitation gymnastics can effectively improve the recovery of lower limb function, beneficial to reducing postoperative complications such as lower limb DVT and muscle atrophy, and increasing patient satisfaction rate. PMID:27537579

  19. Postoperative antibiotic use and the incidence of intra-abdominal abscess in the setting of suppurative appendicitis: a retrospective analysis.

    Science.gov (United States)

    Bae, Esther; Dehal, Ahmed; Franz, Vanessa; Joannides, Michael; Sakis, Nicholas; Scurlock, Joshua; Nguyen, Patrick; Hussain, Farabi

    2016-12-01

    Although guidelines exist for postoperative antibiotic use in acute appendicitis that is perforated, gangrenous, or simple/uncomplicated, there are less data about its use in suppurative appendicitis. Here, we targeted this subgroup of patients to determine whether postoperative antibiotic administration affects incidence of intra-abdominal abscess formation. We retrospectively examined 1,192 patients who underwent laparoscopic appendectomy for acute appendicitis at Kaiser Permanente Fontana Hospital between August 2010 and August 2013. Suppurative appendicitis was described for 143 (12%) patients. Fifty-two patients received postoperative antibiotics for at least 1 week on discharge home, 91 did not. Of 143 patients with suppurative appendicitis, 1 (1.9%) who received postoperative antibiotics came back with an intra-abdominal abscess within 1 month. Of the 91 patients in the no antibiotic group, 1 (1.1%) came back with an intra-abdominal abscess. The administration of postoperative antibiotic in the setting of suppurative appendicitis has no effect on the rate of intra-abdominal abscess formation. Routine postoperative antibiotics may not be necessary in this patient population, and more evidence is needed to justify its use. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Surgical treatment of partial atrioventricular septal defect: functional analysis of the mitral valve in the postoperative period

    Directory of Open Access Journals (Sweden)

    Josué Viana Castro Neto

    2002-11-01

    Full Text Available OBJECTIVE: To study mitral valve function in the postoperative period after correction of the partial form of atrioventricular septal defect. METHODS: Fifty patients underwent surgical correction of the partial form of atrioventricular septal defect. Their mean age was 11.8 years and 62% of the patients were males. Preoperative echocardiography showed moderate and severe mitral insufficiency in 44% of the patients. The mitral valve cleft was sutured in 45 (90% patients (group II - GII. Echocardiographies were performed in the early postoperative period, and 6 and 12 months after hospital discharge. RESULTS: The patients who had some type of arrhythmia in the postoperative period had ostium primum atrial septal defect of a larger size (2.74 x 2.08 cm. All 5 patients in group I (GI, who did not undergo closure of the cleft, had a competent mitral valve or mild mitral insufficiency in the preoperative period. One of these patients began to have moderate mitral insufficiency in the postoperative period. On the other hand, in GII, 88.8% and 82.2% of the patients had competent mitral valve or mild mitral insufficiency in the early and late postoperative periods, respectively. CONCLUSION: The mitral valve cleft was repaired in 90% of cases. Echocardiography revealed competent mitral valve or mild mitral insufficiency in 88.8% and 82.2% of GII patients in the early and late postoperative periods, respectively.